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120.968           Waiver of Primary Care Referral Requirements for Skilled Nursing Facilities and Sub-Acute Rehabilitation Facilities: MSSNY will pursue legislation and/or regulation to simplify and make transparent the health coverage of Skilled Nursing Facilities/Sub-Acute Rehabilitation Facility residents, by waiving the primary care referral requirement so that patients receive timely and appropriate treatment and appropriate reimbursement is provided

120.967           Hearing Aids: MSSNY will work with the American Medical Association to encourage all insurers, including Medicare, to provide coverage for hearing aids for individuals determined by professionals to be hearing impaired.  (HOD 2008-263; Reaffirmed HOD 2018)

120.966           Coverage by Carriers for Annual Physical Examination in Healthy NY Program: MSSNY will encourage the Healthy NY Program to negotiate a benefit package that allows for an annual health maintenance visit.  (HOD 2008-264; Reaffirmed HOD 2018)

120.965             Medically Necessary Procedures and Pre-certification and Pre-authorization Protocols: MSSNY will: Seek the enactment of legislation, regulation or other appropriate means to eliminate the need to obtain pre-authorization for certain procedures and tests that are clearly indicated, including for urgent and emergency care, based upon a patient’s particular health

120.964               Universal Bill: MSSNY will seek legislation or other appropriate means to assure that all durable medical equipment (DME) vendors have a universal bill that is consumer-friendly and clearly states what was paid by the health plan, secondary insurer and what is owed by the patient and that

120.963                 Retail Clinics: MSSNY will pursue legislation, regulation, or other appropriate means to (a) assure that a retail clinic that receives insurer reimbursement be required to comply with existing standards for the operation of medical practices; and (b) prohibit health plans from incentivizing the utilization of health

120.962                 United States Health Care and Gratuitous Privatization: MSSNY supports those health care policies that favor insurance products to achieve the health care goals of quality, cost containment and interoperability, only when the evidence in support of the superiority of such insurance products is composed of unbiased,

120.961          Impediments to Obtaining Pre-authorizations for Medically Indicated Diagnostic Tests: MSSNY will take appropriate steps including, if necessary, seeking the enactment of legislation and regulation, to eliminate unnecessary impediments imposed by health insurance companies to obtaining pre-authorization, including reducing the need and time for obtaining pre-authorization. (Council 3/3/08; Reaffirmed HOD 2014-58;

120.960           Assuring Seamless Coverage for Patients Changed from HMOroducts into PPO Products:  SUNSET HOD 2019  

120.959            Revision of the Federal Tort Claims Act: MSSNY will endorse the proposal that all patients whose care is funded in all or in part by federal funds, and/or whose care is delivered in facilities funded in all or in part by federal funds, such as those patients covered by