NY A05069

Requires health plans to accept and process all healthcare claims submitted by physicians using current American Medical Association CPT codes, reporting guidelines, and conventions, including evaluation and management codes.

Mandates health plans follow current CPT provisions, guidelines, and conventions for claims processing, payment, and review specifically for evaluation and management codes and their documentation.

Applies requirements to HMOs licensed under Article 43 of the Insurance Law, independent practice associations, and medical groups, prohibiting them from blocking claim acceptance and processing under current CPT standards.

Directs the Commissioner of Health and Superintendent of the Department of Financial Services to promulgate rules and regulations necessary to implement the bill's provisions.

Takes effect immediately upon enactment.