Bill Text: NY A03496 | 2023-2024 | General Assembly | Introduced

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Bill Title: Relates to reimbursement for ambulance services; requires insurers to submit payments directly to ambulance providers who are in-network or, for out-of-network ambulance providers, requires the issuance of a joint check to the insured specifying both the insured and the ambulance provider as payees.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-01-03 - referred to insurance [A03496 Detail]

Download: New_York-2023-A03496-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          3496

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                    February 3, 2023
                                       ___________

        Introduced  by M. of A. PRETLOW -- read once and referred to the Commit-
          tee on Insurance

        AN ACT to amend the insurance law,  in  relation  to  reimbursement  for
          ambulance services

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Paragraph 24 of subsection  (i)  of  section  3216  of  the
     2  insurance  law  is  amended  by adding a new subparagraph (F) to read as
     3  follows:
     4    (F) An insurer who issues reimbursement  under  this  paragraph  shall
     5  submit  such payments either directly to the provider at the rates nego-
     6  tiated between the provider and the insurer, or if no    rate  has  been
     7  negotiated  between the provider and insurer, then to the insured in the
     8  form of a joint check specifying as payees  both  the  insured  and  the
     9  provider of ambulance services, at the usual and customary charge, which
    10  shall not be excessive or unreasonable; provided however, if the provid-
    11  er of ambulance services has on file a duly executed assignment of bene-
    12  fits  for  such  services  to  the  insurer,  notwithstanding any policy
    13  language to the contrary, the issuer shall  accept  such  assignment  of
    14  benefits and the insurer shall issue reimbursement solely to the provid-
    15  er. An insurer issuing payment in the form of a joint check shall notify
    16  the  provider  via  electronic  communication  of  the  issuance of such
    17  payment. The notification shall include the name  of  the  patient,  the
    18  date  of  service,  the  date  of payment, the amount of payment and the
    19  address to which the payment was sent.
    20    § 2.  Paragraph 15 of subsection (1) of section 3221 of the  insurance
    21  law is amended by adding a new subparagraph (F) to read as follows:
    22    (F)  An  insurer  who  issues reimbursement under this paragraph shall
    23  submit such payments either directly to the provider at the rates  nego-
    24  tiated  between  the  provider  and  the insurer, or if no rate has been
    25  negotiated between the provider and insurer, then to the insured in  the

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05290-01-3
        A. 3496                             2

     1  form  of  a  joint  check  specifying as payees both the insured and the
     2  provider of ambulance services, at the usual and customary charge, which
     3  shall not be excessive or unreasonable; provided however, if the provid-
     4  er of ambulance services has on file a duly executed assignment of bene-
     5  fits  for  such  services  to  the  insurer,  notwithstanding any policy
     6  language to the contrary, the insurer shall accept  such  assignment  of
     7  benefits and the insurer shall issue reimbursement solely to the provid-
     8  er. An insurer issuing payment in the form of a joint check shall notify
     9  the  provider  via  electronic  communication  of  the  issuance of such
    10  payment. The notification shall include the name  of  the  patient,  the
    11  date  of  service,  the  date  of payment, the amount of payment and the
    12  address to which the payment was sent.
    13    § 3. Subsection (aa) of section 4303 of the insurance law  is  amended
    14  by adding a new paragraph 6 to read as follows:
    15    (6)  An  insurer  who issues reimbursement under this subsection shall
    16  submit such payments either directly to the provider at the rates  nego-
    17  tiated  between  the  provider  and  the insurer, or if no rate has been
    18  negotiated between the provider and insurer, then to the insured in  the
    19  form  of  a  joint  check  specifying as payees both the insured and the
    20  provider of ambulance services, at the usual and customary charge, which
    21  shall not be excessive or unreasonable; provided however, if the provid-
    22  er of ambulance services has on file a duly executed assignment of bene-
    23  fits for such  services  to  the  insurer,  notwithstanding  any  policy
    24  language  to  the  contrary, the insurer shall accept such assignment of
    25  benefits and the insurer shall issue reimbursement solely to the provid-
    26  er. An insurer issuing payment in the form of a joint check shall notify
    27  the provider via  electronic  communication  of  the  issuance  of  such
    28  payment.  The  notification  shall  include the name of the patient, the
    29  date of service, the date of payment, the  amount  of  payment  and  the
    30  address to which the payment was sent.
    31    § 4. This act shall take effect immediately.