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NY S08856
Bill
Status
7/29/2020
Primary Sponsor
Leroy Comrie
Click for details
AI Summary
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Allows Medicaid managed care providers to approve coverage for out-of-network health care professionals when a patient has an established long-term relationship with that provider.
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Defines "long term relationship" as a treatment relationship of at least 90 days during which the health care professional provided medical assistance to the patient at least 10 times.
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Requires out-of-network health care professionals to be paid the managed care provider's in-network rates when approved under this provision.
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Excludes coverage under this provision if the health care professional has any reported allegations of fraud, abuse, or malpractice of which the managed care provider is aware.
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Takes effect on the 90th day after becoming law, with deductibles and co-insurance to be set by the Commissioner of Health consistent with other Medicaid benefits.
Legislative Description
Requires Medicare and Medicaid managed care providers to provide coverage for certain out-of-network health care when the patient has a long term relationship with a medical professional who is not a recurring provider under the managed care provider's network.
Last Action
REFERRED TO RULES
7/29/2020