BILL NUMBER: S586
SPONSOR: PERSAUD
 
TITLE OF BILL:
An act to amend the insurance law, in relation to establishing a
mandated window of five business days for both Medicaid and private
insurers to respond to pre-authorization claims for testing and/or
treatments made by physicians on behalf of oncology patients
 
PURPOSE OR GENERAL IDEA OF BILL:
This bill provides for swifter action from Medicaid and private insurers
to respond to a physician's pre-authorization for needed oncology test-
ing and/or treatment so that a patient receives the care needed to save
their lives.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 of the bill adds a new paragraph 7 to section 1 subsection
(a) of section 3238 of the insurance law that would mandates a waiting
period of five business days be established in which an insurer must
respond to oncology testing and/or treatment preauthorization.
Section 2 sets the effective date.
 
JUSTIFICATION:
Due to the immensely long wait time that patients face for preauthori-
zation claims from insurance companies, this legislation would enact a
five-day window for preauthorization claims which if a patient had not
received a response from their insurer, a physician would be granted the
ability to sign off on potentially lifesaving oncology testing or treat-
ment.
As it currently stands, patients in dire need of oncology testing and
treatment is forced to wait long and indefinite periods of time waiting
for preauthorization. This legislation would make a big impact.on cancer
patients in their pursuit of lifesaving care.
 
PRIOR LEGISLATIVE HISTORY:
2024: Referred to Rules
 
FISCAL IMPLICATIONS:
None noted.
 
EFFECTIVE DATE:
This act shall take effect immediately.

Statutes affected:
S586: 3238 insurance law, 3238(a) insurance law