What's happening
This bill requires standardized billing codes and electronic payments for mental health and substance abuse Medicaid claims in New York.
Why it matters
Streamlines administrative processes. for mental health and substance abuse providers by mandating standardized billing codes, potentially reducing errors and confusion in claim submissions.
Improves payment speed and transparency. by requiring all Medicaid claims for these services to be paid electronically, which may reduce delays and lost payments compared to paper-based systems.
Promotes consistency across insurers. , including Medicaid managed care plans, making it easier for providers to navigate billing regardless of which plan is involved.
May enhance oversight and data collection. , as standardized electronic billing enables better tracking of services, potentially informing policy decisions and resource allocation.
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Who cares
Headline styles
Streamline Mental Health Payments
Plain English, a few words. Used as the page title.
Sponsors
Senator · Senate District 40
No co-sponsors yet.
History
- Referred to health
- Returned to senate
- Died in assembly
- Referred to health
- Delivered to assembly
- Passed senateVote 62–0
- Advanced to third reading
- 2nd report cal.
- 1st report cal.642
- 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.
Standardize Mental Health Billing
In Assembly Committee · Health · Sponsor Aileen Gunther
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
283
2017-2018 Regular Sessions
IN SENATE (Prefiled)
January 4, 2017
Introduced by Sen. MURPHY -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the public health law, in relation to universal standards for the coding and electronic payment of medical assistance claims for mental health or substance abuse disorder services
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The public health law is amended by adding two new sections 4403-h and 4403-i to read as follows:
§ 4403-h. Universal standards for coding of payment for medical assistance claims for mental health or substance abuse disorder services. Claims for payment contracts or agreements with insurers under the medical assistance program for mental health or substance abuse disorder services provided under this article, by facilities operating pursuant to articles thirty-one and thirty-two of the mental hygiene law shall have standard billing codes. Such insurers shall include, but not be limited to, Medicaid managed care plans and insurers certified pursuant to this article. Such payments shall be based on universal billing codes approved by the department or a nationally accredited organization as approved by the department.
§ 4403-i. Electronic payment of claims. The payment of claims submitted under contracts or agreements with insurers under the medical assistance program for mental health or substance abuse disorder services provided under this article, and by facilities operating pursuant to articles thirty-one and thirty-two of the mental hygiene law shall be paid via electronic funds transfer. Such insurers shall include, but not be limited to, Medicaid managed care plans and insurers certified pursuant to this article.
§ 2. This act shall take effect on the first of January next succeeding the date on which it shall have become a law; provided, however,
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02343-01-7
S. 283 2
that effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized and directed to be made and completed on or before such effective date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to universal standards for the coding and electronic payment of medical assistance claims for mental health or substance abuse disorder services
Purpose
This bill would establish standardized billing codes for mental health and substance abuse disorder service providers to be utilized by Medicaid managed care organizations and other insurers. The bill further requires Medicaid managed care plans and other insurers to accept electronic payment of claims from such providers.
Summary of provisions
Section one of the bill adds new section 4403-h to the public health law to add the requirement for universal standard billing codes for mental health and substance abuse disorder services, to be used by insurers including but not limited to Medicaid managed care plans and insurers certified under article 44 of the public health law.
Further, a new section 4403-i to the public health law to authorize Medicaid managed care plans and other insurers certified under article 44 of the public health law to pay for substance abuse disorder or mental health services via electronic funds transfer.
Section two establishes the effective date.
Justification
The behavioral health industry is in the process of transitioning to Medicaid managed care. There are multiple challenges to ensuring that this transition happens smoothly for both providers and the patients who depend on their care. This bill would help mitigate some of these challenges by streamlining two administrative hurdles faced by providers.
Billing for Medicaid services has always been complex. Even under the current system, agencies can spend months submitting and resubmitting claims in a seemingly trial and error manner. Despite training from state agencies, both providers and managed care companies continue to be confused by billing requirements. As the state moves toward Medicaid managed care, providers are beginning to deal with multiple insurance plans all of which have their own system for processing claims and payments. These processing issues could be easily mitigated by streamlining codes and utilizing electronic billing, allowing providers to deal with similar processes with each insurer. These administrative hurdles are just one piece of multiple challenges to the transition to managed care, but getting out in front of this is important.
Legislative history
2015-2016: S.5983 - Passed Senate
Fiscal implications
None.
Effective date
This act shall take effect on the first of January next succeeding the date on which it shall have become a law; provided, however, that effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized and directed to be made and completed on or before such effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.