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A01928 Summary:

BILL NOA01928
 
SAME ASNo Same As
 
SPONSORBichotte Hermelyn
 
COSPNSRAubry, Gibbs, Kim
 
MLTSPNSR
 
Amd §366-d, Soc Serv L
 
Prohibits medical assistance providers from refusing to furnish care, services or supplies to any person who is entitled to receive such care, services or supplies under this title if such medical assistance provider furnishes the same care, services or supplies under the Medicare program pursuant to title XVIII of the federal social security act and the person is dually eligible under that program.
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A01928 Actions:

BILL NOA01928
 
01/23/2023referred to health
05/16/2023reported referred to ways and means
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A01928 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A1928
 
SPONSOR: Bichotte Hermelyn
  TITLE OF BILL: An act to amend the social services law, in relation to prohibiting medical assistance providers from refusing to furnish care, services or supplies to any person who is entitled to receive such care, services or supplies under Medicaid because benefits payable under Medicaid are payable as secondary insurance   PURPOSE OR GENERAL IDEA OF BILL: This bill will allow for people who have specific insurance coverages such as Medicare HMO and Medicare Advantage PPO plans, to be given the same services as someone who has Medicaid alone, without being denied care due to what their primary insurance plan is.   SUMMARY OF SPECIFIC PROVISIONS: Section 1. Subdivisions 1 and 2 of section 366-d of the social services law, subdivision 1 as added by chapter 41 of the laws of 1992 and subdi- vision 2 as amended by chapter 2 of the laws of 1998, are amended to read as follows: 1. Definitions. As used in this section, "medical assistance provider" means any person, firm, partnership, group, association, fiduciary, hospital, employer or representative thereof or other entity who is furnishing care, services or supplies under this title (eleven of arti- cle five of this chapter). 2. No medical assistance, provider shall: (a) solicit, receive, accept or agree to receive or accept any payment or other consideration in any form from another person to the extent such payment or other consideration is given: (i) for the referral of services for which payment is made under this title (eleven of article five of this chapter); or (ii) to purchase, lease or order any good, facility, service or item for which payment is made under this title (eleven of article five of this chapter); or (b) offer, agree to give or give any payment or other consideration in any form to another person to the extent such payment or other consider- ation is given: (i) for the referral of services for which payment is made under this title (eleven of article five of this chapter); or (ii) to purchase, lease or order any good, facility, service. or item for which payment is made under this title (eleven of article five of this chapter); or (c) refuse to furnish care, services or supplies to any person who is entitled to receive such care, services or supplies under this title if such medical assistance provider furnishes the same care, services or supplies under the medicare program pursuant to title XVIII of the federal social security act and the person is dually eligible under that program. ((c) as) (d) As used in this section "person" shall have the meaning set forth in subdivision seven of section 10.00 of the penal law.((d) this) (e) This subdivision shall not apply to any activity specifically exempt by federal statuteĽor federal regulations promulgated thereunder. § 2. The commissioner of health shall make any amendments to the state plan for medical assistance, or apply for any waiver or approval under the federal social security act that are necessary to carry out the provisions of this act. § 3. This act shall take effect on the one hundred ninetieth day after it shall have become a law. Effective immediately the addition, amend- ment and/or repeal of any rule or regulation necessary for the implemen- tation of this act on its effective date are authorized to be made and completed on or before such date.   JUSTIFICATION: Medicare HMO plans covers regular doctor visits but does not cover urgent or emergency visits, which leaves patients who have Medicare HMO to be forced to go seek outside help and pay out of pocket costs. Same goes for Medicare Advantage PPO when it comes to having to pay addi- tional costs out of pocket. Thus, for patients who have insurance plans other than Medicaid as their primary plan, their doctor can turn them away due to them only accepting Medicaid as a primary form of insurance. For this reason; patients should be covered no matter what insurance their doctor accepts as their primary or secondary insurance coverage because secondary insurance coverages should also be payable.   PRIOR LEGISLATIVE HISTORY: 2021-22: A06982; referred to health 2019-20: A10072a; referred to health   FISCAL IMPLICATIONS: To be determined.   EFFECTIVE DATE: This act shall take effect on the one hundred ninetieth day after it shall have become a law.
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A01928 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          1928
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 23, 2023
                                       ___________
 
        Introduced  by  M.  of A. BICHOTTE HERMELYN -- read once and referred to
          the Committee on Health
 
        AN ACT to amend the social services  law,  in  relation  to  prohibiting
          medical  assistance  providers from refusing to furnish care, services
          or supplies to any person  who  is  entitled  to  receive  such  care,
          services  or  supplies  under  Medicaid because benefits payable under
          Medicaid are payable as secondary insurance
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Subdivisions  1  and  2  of  section  366-d of the social
     2  services law, subdivision 1 as added by chapter 41 of the laws  of  1992
     3  and  subdivision  2  as  amended  by  chapter 2 of the laws of 1998, are
     4  amended to read as follows:
     5    1. Definitions. As used in this section, "medical assistance provider"
     6  means any person,  firm,  partnership,  group,  association,  fiduciary,
     7  hospital,  employer  or  representative  thereof  or other entity who is
     8  furnishing care, services or supplies under this title [eleven of  arti-
     9  cle five of this chapter].
    10    2.  No medical assistance provider shall:
    11    (a)    solicit,  receive,  accept  or  agree  to receive or accept any
    12  payment or other consideration in any form from another  person  to  the
    13  extent  such payment or other consideration is given: (i) for the refer-
    14  ral of services for which payment is made under this  title  [eleven  of
    15  article  five  of this chapter]; or (ii) to purchase, lease or order any
    16  good, facility, service or item for which payment  is  made  under  this
    17  title [eleven of article five of this chapter]; or
    18    (b)    offer, agree to give or give any payment or other consideration
    19  in any form to another person  to  the  extent  such  payment  or  other
    20  consideration  is  given:  (i)  for  the  referral of services for which
    21  payment is made under this title [eleven of article five of  this  chap-
    22  ter]; or (ii) to purchase, lease or order any good, facility, service or
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD03363-01-3

        A. 1928                             2
 
     1  item  for which payment is made under this title [eleven of article five
     2  of this chapter]; or
     3    (c)  refuse to furnish care, services or supplies to any person who is
     4  entitled to receive such care, services or supplies under this title  if
     5  such  medical  assistance  provider furnishes the same care, services or
     6  supplies under the Medicare program  pursuant  to  title  XVIII  of  the
     7  federal    social  security  act and the person is dually eligible under
     8  that program.
     9    [(c) as] (d) As used in this section "person"  shall have the  meaning
    10  set forth in subdivision seven of section 10.00 of the penal law.
    11    [(d)  this]  (e)  This  subdivision  shall  not  apply to any activity
    12  specifically exempt by federal statute or federal regulations promulgat-
    13  ed thereunder.
    14    § 2. The commissioner of health shall make any amendments to the state
    15  plan for medical assistance, or apply for any waiver or  approval  under
    16  the  federal  social  security  act  that are necessary to carry out the
    17  provisions of this act.
    18    § 3. This act shall take effect on the one hundred ninetieth day after
    19  it shall have become a law. Effective immediately the  addition,  amend-
    20  ment and/or repeal of any rule or regulation necessary for the implemen-
    21  tation  of  this act on its effective date are authorized to be made and
    22  completed on or before such date.
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