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NY A04772

Bill

Status

Introduced

2/23/2023

Primary Sponsor

Gary Pretlow

Click for details

Origin

Assembly

2023-2024 General Assembly

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