What's happening
This bill updates the definition and qualifications for "clinical peer reviewers" in New York's public health and insurance laws.
Why it matters
Narrows and clarifies who can serve as a clinical peer reviewer. by specifying more detailed licensing, certification, and specialty requirements—potentially raising the bar for who is qualified to make decisions that can affect patients' access to care.
Adds explicit requirements for peer reviewers involved in behavioral health, mental health, and substance use disorder cases. , mandating relevant specialty training and experience—this could improve the quality and appropriateness of reviews for these sensitive and complex cases.
Eliminates some previous flexibility for non-physician reviewers. by more strictly tying their qualifications to state licensure and national credentialing, which might reduce variability in reviewer qualifications but could also limit the pool of available reviewers.
Maintains statutory scope-of-practice protections. for health professionals, ensuring that this update to reviewer qualifications does not inadvertently expand or restrict what licensed providers are legally allowed to do in New York.
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Who cares
Headline styles
Clarify Clinical Reviewer Rules
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to rules
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.
Clarify Peer Reviewer Rules
In Senate Committee · Rules · Sponsor Richard Gottfried
Full text
5 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8844
IN SENATE
July 29, 2020
Introduced by Sen. BENJAMIN -- read twice and ordered printed, and when printed to be committed to the Committee on Rules
AN ACT to amend the public health law and the insurance law, in relation to the definition of clinical peer reviewer
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 2 of section 4900 of the public health law, as amended by chapter 586 of the laws of 1998, item (B) of subparagraph (ii) of paragraph (a) as amended by chapter 41 of the laws of 2014 and subparagraph (iii) as amended and subparagraph (iv) of paragraph (a) as added by section 42 of subpart A of part BB of chapter 57 of the laws of 2019, is amended to read as follows:
2. "Clinical peer reviewer" means:
(a) [for purposes of title one of this article:
(i) a physician who possesses a current and valid non-restricted license to practice medicine; or
(ii) a health care professional other than a licensed physician who:
(A) where applicable, possesses a current and valid non-restricted license, certificate or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession; and
(B) is in the same profession and same or similar specialty as the health care provider who typically manages the medical condition or disease or provides the health care service or treatment under review; or
(iii) for purposes of a determination involving substance use disorder treatment:
(A) a physician who possesses a current and valid non-restricted license to practice medicine and who specializes in behavioral health and has experience in the delivery of substance use disorder courses of treatment; or
(B) a health care professional other than a licensed physician who specializes in behavioral health and has experience in the delivery of substance use disorder courses of treatment and, where applicable,
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03373-04-0
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possesses a current and valid non-restricted license, certificate or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession; or
(iv) for purposes of a determination involving treatment for a mental health condition:
(A) a physician who possesses a current and valid non-restricted license to practice medicine and who specializes in behavioral health and has experience in the delivery of mental health courses of treatment; or
(B) a health care professional other than a licensed physician who specializes in behavioral health and has experience in the delivery of a mental health courses of treatment and, where applicable, possesses a current and valid non-restricted license, certificate, or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession; and
(b) for purposes of title two of this article:
(i)] a physician who:
[(A)] (i) possesses a current and valid non-restricted license to practice medicine under article one hundred thirty-one of the education law;
[(B)] (ii) where applicable, is board certified or board eligible in the same or similar specialty as the health care provider who typically manages the medical condition or disease or provides the health care service or treatment under review or appeal;
[(C)] (iii) has been practicing in such area of specialty for a period of at least five years; [and]
(iv) for purposes of a determination involving substance use disorder treatment, possesses a current and valid non-restricted license to practice medicine and specializes in behavioral health and has experience in the delivery of substance use disorder courses of treatment;
(v) for purposes of a determination involving treatment for a mental health condition, possesses a current and valid non-restricted license to practice medicine and who specializes in behavioral health and has experience in the delivery of mental health courses of treatment; and
[(D)] (vi) is knowledgeable about the health care service or treatment under review or appeal; or
[(ii)] (b) a health care professional other than a licensed physician who possesses a current and valid non-restricted license or certification under title eight of the education law:
[(A)] (i) where applicable, possesses a current and valid non-restricted license, certificate or registration;
[(B)] (ii) where applicable, is credentialed by the national accrediting body appropriate to the profession in the same profession and same or similar specialty as the health care provider who typically manages the medical condition or disease or provides the health care service or treatment under review or appeal;
[(C)] (iii) has been practicing in such area of specialty for a period of at least five years;
[(D)] (iv) is knowledgeable about the health care service or treatment under review or appeal; [and]
(v) for purposes of a determination involving substance use disorder, specializes in behavioral health and has experience in the delivery of substance use disorder courses of treatment and, where applicable, possesses a current and valid non-restricted license, certificate or
S. 8844 3
registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession;
(vi) for purposes of a determination involving treatment for a mental health condition, specializes in behavioral health and has experience in the delivery of mental health courses of treatment and, where applicable, possesses a current and valid non-restricted license, certificate, or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession; and
[(E)] (vii) where applicable to such health care professional's scope of practice, is clinically supported by a physician who possesses a current and valid non-restricted license to practice medicine.
[(c)] Nothing [herein] in this subdivision shall be construed to change any statutorily-defined scope of practice.
§ 2. Subsection (b) of section 4900 of the insurance law, as amended by chapter 586 of the laws of 1998, item (ii) of subparagraph (B) of paragraph 1 as amended by chapter 41 of the laws of 2014, subparagraph (C) as amended and subparagraph (D) of paragraph 1 as added by section 36 of subpart A of part BB of chapter 57 of the laws of 2019, is amended to read as follows:
(b) "Clinical peer reviewer" means:
(1) [for purposes of title one of this article:
(A) a physician who possesses a current and valid non-restricted license to practice medicine; or
(B) a health care professional other than a licensed physician who:
(i) where applicable, possesses a current and valid non-restricted license, certificate or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession; and
(ii) is in the same profession and same or similar specialty as the health care provider who typically manages the medical condition or disease or provides the health care service or treatment under review; or
(C) for purposes of a determination involving substance use disorder treatment:
(i) a physician who possesses a current and valid non-restricted license to practice medicine and who specializes in behavioral health and has experience in the delivery of substance use disorder courses of treatment; or
(ii) a health care professional other than a licensed physician who specializes in behavioral health and has experience in the delivery of substance use disorder courses of treatment and, where applicable, possesses a current and valid non-restricted license, certificate or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession; or
(D) for purposes of a determination involving treatment for a mental health condition:
(i) a physician who possesses a current and valid non-restricted license to practice medicine and who specializes in behavioral health and has experience in the delivery of mental health courses of treatment; or
(ii) a health care professional other than a licensed physician who specializes in behavioral health and has experience in the delivery of mental health courses of treatment and, where applicable, possesses a
S. 8844 4
current and valid non-restricted license, certificate, or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession; and
(2) for purposes of title two of this article:
(A)] a physician who:
[(i)] (A) possesses a current and valid non-restricted license to practice medicine under article one hundred thirty-one of the education law;
[(ii)] (B) where applicable, is board certified or board eligible in the same or similar specialty as the health care provider who typically manages the medical condition or disease or provides the health care service or treatment under review or appeal;
[(iii)] (C) has been practicing in such area of specialty for a period of at least five years; [and]
(D) for purposes of a determination involving substance use disorder treatment, possesses a current and valid non-restricted license to practice medicine and who specializes in behavioral health and has experience in the delivery of substance use disorder courses of treatment;
(E) for purposes of a determination involving treatment for a mental health condition, possesses a current and valid non-restricted license to practice medicine and who specializes in behavioral health and has experience in the delivery of mental health courses of treatment; and
[(iv)] (F) is knowledgeable about the health care service or treatment under review or appeal; or
[(B)] (2) a health care professional other than a licensed physician who possesses a current and valid non-restricted license or certification under title eight of the education law:
[(i)] (A) where applicable, possesses a current and valid non-restricted license, certificate or registration;
[(ii)] (B) where applicable, is credentialed by the national accrediting body appropriate to the profession in the same profession and same or similar specialty as the health care provider who typically manages the medical condition or disease or provides the health care service or treatment under review or appeal;
[(iii)] (C) has been practicing in such area of specialty for a period of at least five years;
[(iv)] (D) for purposes of a determination involving substance use disorder treatment, specializes in behavioral health and has experience in the delivery of substance use disorder courses of treatment and, where applicable, possesses a current and valid non-restricted license, certificate or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession;
(E) for purposes of a determination involving treatment for a mental health condition, specializes in behavioral health and has experience in the delivery of mental health courses of treatment and, where applicable, possesses a current and valid non-restricted license, certificate, or registration or, where no provision for a license, certificate or registration exists, is credentialed by the national accrediting body appropriate to the profession;
(F) is knowledgeable about the health care service or treatment under review or appeal; and
[(v)] (G) where applicable to such health care professional's scope of practice, is clinically supported by a physician who possesses a current and valid non-restricted license to practice medicine.
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[(3)] Nothing [herein] in this subdivision shall be construed to change any statutorily-defined scope of practice.
§ 3. This act shall take effect on the same date and in the same manner as subpart A of part BB of chapter 57 of the laws of 2019, or on the ninetieth day after it shall have become a law, whichever is later.
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 and the insurance law, in relation to the definition of clinical peer reviewer
Purpose or general idea of bill
To ensure that a health plan may only deny payment for an otherwise covered benefit upon the review of a physician or other health care professional licensed in NYS and, when appropriate, board certified in the same or similar specialty as the treatment under review.
Summary of specific provisions
Section 1 of the bill would amend section 4900 of the Public Health Law to re-define the qualifications of a "clinical peer reviewer" who a, health plan or insurer may use to deny payment for an otherwise covered benefit on the basis that the treatment is not medically necessary. Under current law, only when a claim dispute arises to the level of an external appeal, does any qualification for such a "clinical peer reviewer" apply.
This legislation would:
* require that when the clinical peer reviewer is a physician, he or she would be board-certified or board eligible in the same or similar specialty as the physician who typically recommends the treatment or manages the condition under review;
* require all clinical peer reviewers, whether physicians or other health care professionals, be licensed or certified in New York State;
* apply the same qualifications for clinical peer reviewers to the initial internal health plan utilization review process.
Section 2 of the bill would amend section 4900 of the Insurance Law to make the identical changes described above.
Section 3. of the bill is the effective date.
Justification
Under current law, the only qualification required for a utilization review agent, a person who, on behalf of a health care plan or insurer, may deny payment for an otherwise covered benefit on the basis that it is not medically necessary, is that such reviewer be a physician or health care professional licensed somewhere and trained in utilization review practice. There is no requirement that the reviewing agent be trained in the same specialty as the health care professional who would typically recommend the treatment that is under review.
Therefore, a patient's treatment recommendation may be reviewed by a provider working for the health plan who is not qualified to review the treatment that has been recommended. This can result in medically neces- sary care being inappropriately denied or unnecessarily delayed. The similar specialty qualification had been required by the 1996 Managed Care Bill of Rights. However, in 1998, in enacting the External Appeals Law, the requirement was not continued for utilization review. This legislation would restore this requirement, and in addition, ensure that all reviewers at both levels of appeal be licensed or certified in New York State, and when appropriate, such reviewing physicians be either board certified or board eligible in that specialty.
Prior legislative history
2002: A.11479 - passed Assembly
2004: A.3441 - passed Assembly
2005-2006: A.2206-B - passed Assembly
2007-2008: S.3450 Third reading in Senate / A.4609 - passed Assembly
2009-2010: A.723 - passed Assembly
2011-2012: A.662 passed Assembly
2013-2014: A.2693 - advanced to third reading calendar
2015-2016: S.4783-A Insurance Committee / A.445-A - advanced to third reading calendar
2017-2018: A.2539 - advanced to third reading calendar
2019-2020: Passed assembly
Fiscal implications
None
Effective date
Ninety days after enactment.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.