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NY S06929
Bill
Status
Vetoed
11/22/2024
Primary Sponsor
Nathalia Fernandez
Click for details
AI Summary
- Increases the threshold for specialist consultations, surgical operations, therapy procedures, x-ray examinations, and diagnostic laboratory tests requiring prior authorization from an unspecified amount to $1,500
- Clarifies that the board's list of pre-authorized procedures expedites treatment authorization but does not prohibit varied treatment or serve as a basis to deny treatment not contained on the list
- Requires requests for varied treatment to comply only with subdivision 5 requirements, streamlining the authorization process
- Mandates that diagnostic tests, x-ray examinations, MRI, and other radiological examinations costing more than $1,500 performed by out-of-network providers be paid at the carrier's negotiated network rate
- Takes effect immediately upon enactment
Legislative Description
Allows for treatment costing less than $1,500 to be done without prior approval, and more clearly defines the list of "pre-authorized procedures" as a floor on treatment as opposed to its current status as a ceiling; allows non-network providers of testing to be compensated at the provider network rate negotiated by the carrier.
Last Action
VETOED MEMO.62
11/22/2024
Committee Referrals
Labor6/5/2024
Labor5/15/2023
Full Bill Text
No bill text available