Maddy summaryBill A 8172 establishes new timeframes and processes for insurers to pay claims submitted by hospitals. It requires insurers to pay hospital claims at the contracted rate as billed, regardless of their own medical necessity or administrative policies, before any review. After payment, insurers can request a post-payment review for a limited percentage of claims by a joint committee composed of medical professionals from both the insurer and the hospital. If this committee cannot agree on the medical necessity of the services, an independent third-party review agent will make a binding determination, and hospitals must refund payments for services found not medically necessary.
Asm. Jo Anne Simon
Sponsored bills
Establishes in the city of New York a bicycle lane safety program to enforce certain restrictions on the use of bicycle lanes and/or protected bicycle lanes by means of bicycle lane photo devices.
Requires the collection and reporting of sexual offense evidence on the statewide electronic tracking system within seven days of permission to release the evidence by the alleged sexual offense victim; relates to additional rules and guidelines.
Authorizes the secretary of state to appoint a person from the utility intervention unit within the consumer protection division to serve on the state energy planning board.
Extends DEC's authority to regulate management of crabs to 12/31/2027; prohibits the taking of horseshoe crabs for commercial and biomedical purposes.
Maddy summaryThis bill (A 565) prohibits the establishment of new for-profit hospices and bans capacity increases for existing for-profit hospices. It applies to all approvals after the law takes effect, directly affecting for-profit hospice providers and their expansion plans. The law requires new hospice facilities to operate as non-profits and prevents existing for-profit hospices from growing their services. This represents a concrete change in healthcare regulation, restricting for-profit models in hospice care.
Enacts the consumer litigation funding act to promote consumer protections related to consumer litigation funding transactions; provides for contract requirements, including that the contract contain a no penalty provision for the prepayment of the funded amount prior to the settlement of their case; makes related provisions.
Relates to including outpatient care provided by creative arts therapists in certain insurance policies covering care for other mental health services.
Includes entities that provide employment or services to formerly incarcerated persons in the preferred source exemption for purposes of state purchasing.
Enacts the "Lieutenant Joseph Banish mental health act" which establishes a law enforcement peer support program to provide confidentiality for communications arising out of law enforcement peer support counseling; defines terms; provides exceptions for when a peer support communication may be disclosed.