NY A05245

Prohibits invalidation of otherwise valid medical assistance program claims based solely on failure to submit within 90 days of date of service.

Requires insurers and HMOs to compensate participating providers who render care to patients even if not listed as the patient's primary care physician.

Mandates HMOs provide electronic remittance advices to enrollees, health care providers, and necessary parties detailing payment or denial of claims.

Requires HMOs to provide health care providers monthly reports of charges, payments, and patient numbers under Family Health Plus, Child Health Plus, Medicare, and Medicaid programs.

Obligates HMOs to provide health care providers electronic rosters of current eligible enrollees and allows credentialed health care professionals to submit claims for BBA and CHIP subsidies even if claims are initially denied, provided the patient was an active participant in a state-funded health insurance program.