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A7862Assembly2017-2018 SessionSame asS5340

Limit Penalties for Insurers

Official title

“Relates to penalties to managed care organizations”

Sponsor Richard GottfriedAD-75Affects Health
Status
In Senate Committee
Health
Impact
4/10
Low
Passage
0%

Bill progress

Step 5 of 7

In Senate · Health

What's happening

This bill clarifies that managed care organizations can't face duplicate penalties for encounter data errors, except in cases of fraud or abuse.

Why it matters

  1. Reduces administrative burden on managed care organizations (MCOs). by ensuring they are not penalized multiple times for the same late, incomplete, or inaccurate encounter data, which could otherwise lead to unnecessary costs and inefficiencies.

  2. Distinguishes between unintentional errors and intentional wrongdoing. , making it clear that while honest mistakes with encounter data won't result in stacked penalties, cases involving fraud or abuse remain fully subject to additional legal penalties.

  3. Increases clarity and predictability for MCOs. regarding their compliance obligations and potential penalties, helping them better manage risk and focus resources on improving data quality and patient care rather than on defending against overlapping sanctions.

  4. Supports program integrity without over-penalizing. by maintaining the state’s authority to pursue fraud or abuse, thus protecting public funds while avoiding undue punishment for administrative errors.

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Who cares

Headline styles

Limit Penalties for Insurers

Plain English, a few words. Used as the page title.

Sponsors

Primary sponsor
Richard Gottfried

Assembly Member · Assembly District 75

No co-sponsors yet.

History

  1. Referred to health
  2. Delivered to senate
  3. Passed assembly
  4. Ordered to third reading cal.556
  5. Returned to assembly
  6. Died in senate
  7. Referred to rules
  8. Delivered to senate
  9. Passed assembly
  10. Ordered to third reading rules cal.653
  11. Rules report cal.653
  12. Reported
Show 6 earlier actions
  1. Reported referred to rules
  2. Reported referred to ways and means
  3. Print number 7862a
  4. Amend and recommit to codes
  5. Reported referred to codes
  6. Referred to health

Companion bill

The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.

S5340Senate

Limit Penalties for Insurers

In Senate Committee · Health · Sponsor Kemp Hannon

Impact 4 · Low0% to pass

Full text

1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗

STATE OF NEW YORK

7862--A

2017-2018 Regular Sessions

IN ASSEMBLY

May 17, 2017

Introduced by M. of A. GOTTFRIED -- read once and referred to the Committee on Health -- reported and referred to the Committee on Codes -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee

AN ACT to amend the social services law, in relation to penalties to managed care organizations

The People of the State of New York, represented in Senate and Assembly, do enact as follows:

Section 1. Paragraph (d) of subdivision 32 of section 364-j of the social services law, as added by section 15 of part B of chapter 59 of the laws of 2016, is amended to read as follows:

(d) (i) Penalties under this subdivision may be applied to any and all circumstances described in paragraph (b) of this subdivision until the managed care organization complies with the requirements for submission of encounter data.

(ii) No penalties for late, incomplete or inaccurate encounter data shall be assessed against managed care organizations in addition to those provided for in this subdivision, provided, however, that nothing in this paragraph shall prohibit the imposition of penalties, in cases of fraud or abuse, otherwise authorized by law.

§ 2. This act shall take effect on the ninetieth day after it shall have become a law, provided that the amendments to section 364-j of the social services law, made by section one of this act, shall not affect the repeal of such section, and shall be deemed repealed therewith.

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD10145-02-7

Reflowed for reading: line numbers and page breaks removed. Cite the official text.

Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.