WPCNR ALBANY Correspondent. From Assemblyman Adam Bradley's Office. June 23, 2006: Assemblyman Adam Bradley (D-White Plains) announced today that the Assembly and Senate have both passed bipartisan legislation he authored to bring sweeping reforms to the health care system (A.11996). Bradley’s measure will establish fair, uniform and consistent procedures for the processing of health claims, the processing of overpayment recovery claims and the credentialing of physicians by health plans.
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“Inconsistent and cumbersome procedures cause physicians to waste valuable resources dealing with the administrative burdens of health care plans, rather than treating patients,” said Bradley. “To address these issues, my legislation would enact much needed reforms by attempting to assure fairness, uniformity and consistency for physicians and health plans.”
Specific provisions of the legislation include:
· requiring Health Plans to accept the American Medical Association's Current Procedural Terminology (CPT) codes when processing all health care claims
· limiting the time period for health plans to demand refunds from 6 years to 24 months, with limited exceptions; and
· requiring health plans to complete physician credentialing to participate in the insurer’s network within 90 days.
Bradley noted that his bipartisan legislation responds to common health care concerns such as dealing with confusing health plan rules used to adjudicate claims submitted by physicians and hospitals, excessive demands for refunds of claims paid several years in the past, and unjustifiable delays by health plans in credentialing physicians to participate in the health plans network.
“I will continue working in a bipartisan fashion to ensure that our healthcare system works for the New Yorkers it was designed to serve – not the bureaucrats that have been lining their pockets with hefty profits,” Bradley said. “By making our health insurance regulations more efficient, we can reach the goal of putting patients before profits. I urge the governor to quickly sign this measure into law.”
