What's happening
This bill allows Medicaid claims delayed by the implementation of new or upgraded electronic medical record systems to be filed and paid.
Why it matters
Reduces financial risk for healthcare providers. By allowing late Medicaid claims due to electronic medical record (EMR) system changes, providers are less likely to lose reimbursement for technical or administrative delays outside their control.
Encourages modernization of healthcare records. Providers may be more willing to adopt or upgrade EMR systems, knowing that necessary transitions won’t threaten their ability to get paid for services delivered during the switch.
Improves continuity of patient care. Facilitating smoother EMR upgrades can reduce disruptions in patient records and billing, which can help maintain uninterrupted care for Medicaid recipients.
Requires prompt regulatory action. The law mandates the health commissioner to create and implement these delay codes quickly, signaling a direct administrative response to technological challenges in healthcare billing.
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Who cares
Headline styles
Extend Medicaid Claims Deadline
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Recommit, enacting clause stricken
- Referred to health
- Reported and committed to finance
- Referred to health
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1818
2019-2020 Regular Sessions
IN SENATE
January 16, 2019
Introduced by Sen. RIVERA -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the social services law, in relation to timely filing of Medicaid claims
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 8 of section 367-b of the social services law is amended by adding a new paragraph (d) to read as follows:
(d) The commissioner shall provide by regulation for a delay reason code to allow the filing and paying of otherwise-valid medical assistance claims that are not submitted in accordance with the department's timely filing requirements due to the implementation of a new or upgraded electronic medical record system.
§ 2. This act shall take effect on the ninetieth day after it shall become a law. The commissioner of health shall make regulations and take other actions reasonably necessary to implement this act on its effective date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03864-01-9
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the social services law, in relation to timely filing of Medicaid claims
Purpose
To provide a mechanism to file and pay Medicaid claims when submission is delayed due to implementing a new or upgraded medical record system.
Summary of provisions
Amend SSL § 367-b to require the department to establish a delay reason code for claims that are not submitted within the State's timely filing requirements due to complications caused by a new or upgraded medical record system.
Justification
Medicaid providers are under increasing pressure to install electronic medical records (EMRs) in order to comply with paver requirements. At first, most EMR systems were home-brewed innovations building on comput- ers already used by a clinic. Newer systems are not only more functional but also interoperable with third party payers and other clinicians. The transition from older systems to new can require up to a year and still not anticipate all the issues that arise when a system finally goes live.
In order to be paid, Medicaid regulations require that all claims be initially submitted within 90 days of the date of service, unless the claim is delayed due to circumstances outside the control of the provid- er. If a claim is submitted after 90 days, Medicaid requires a delay reason code or the claim will be denied. Currently, there is no delay reason code covering the problems in transitioning EMR systems. This bill will provide a means by which providers can move forward with both improving EMRs and providing patient care.
Legislative history
New bill.
Fiscal implications
None
Effective date
90 days after enactment provided that the Commissioner may make regu- lations beforehand that would become effective at the same time as the law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.