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NY A04772
Bill
Status
Introduced
2/23/2023
Primary Sponsor
Gary Pretlow
Click for details
AI Summary
- Amends Insurance Law by adding section 2601-a to regulate health maintenance organization (HMO) claim denials
- Requires HMOs operating in New York to inform insured individuals of covered alternative procedures or treatments when denying a claim based on lack of medical necessity
- Alternatively, HMOs must provide a statement explaining the past ineffectiveness of the requested procedure or treatment
- Takes effect on the thirtieth day after becoming law
- Introduced by M. of A. Pretlow on February 23, 2023
Legislative Description
Directs a health maintenance organization which denies a claim due to absence of medical necessity to inform the insured as to preferred alternative treatment, or provide the insured with a statement as to the past ineffectiveness of the requested procedure or treatment.
Last Action
referred to insurance
1/3/2024
Committee Referrals
Insurance2/23/2023
Full Bill Text
No bill text available