Bill Text: NY S06341 | 2019-2020 | General Assembly | Introduced

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Bill Title: Requires health insurers to provide health care providers with the coverage a policyholder or covered person has, when liability for a health care claim is not reasonably clear.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Engrossed - Dead) 2020-01-08 - REFERRED TO INSURANCE [S06341 Detail]

Download: New_York-2019-S06341-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          6341

                               2019-2020 Regular Sessions

                    IN SENATE

                                      June 5, 2019
                                       ___________

        Introduced  by  Sen. BRESLIN -- read twice and ordered printed, and when
          printed to be committed to the Committee on Rules

        AN ACT to amend the insurance  law,  in  relation  to  requiring  health
          insurers  to  provide,  when  liability  for a claim is not reasonably
          clear, the coverage the policyholder or covered person is enrolled in

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

     1    Section  1.  Paragraph  2  of  subsection (b) of section 3224-a of the
     2  insurance law, as amended by chapter 237 of the laws of 2009, is amended
     3  and a new paragraph 3 is added to read as follows:
     4    (2) to request all additional information needed to determine  liabil-
     5  ity to pay the claim or make the health care payment[.]; and
     6    (3)  of  the  specific  type  of  plan  or product the policyholder or
     7  covered person is enrolled in; provided that  nothing  in  this  section
     8  shall authorize discrimination based on the source of payment.
     9    §  2. Subsection (d) of section 3224-a of the insurance law is amended
    10  by adding a new paragraph 3 to read as follows:
    11    (3) "plan or product" shall mean:
    12    (i) medicaid coverage certified  pursuant  to  section  three  hundred
    13  sixty-four-j of the social services law;
    14    (ii) a child health insurance plan certified pursuant to section twen-
    15  ty-five hundred eleven of the public health law;
    16    (iii)  basic  health  program  coverage  certified pursuant to section
    17  three hundred sixty-nine-gg of the social services  law,  including  the
    18  specific rating group the policyholder or covered person is enrolled in;
    19    (iv) coverage purchased on the New York insurance exchange established
    20  pursuant to article sixty-two of this chapter; and
    21    (v)  any  other product fully insured and regulated by the state under
    22  article forty-two, forty-three, or forty-seven of this chapter, or arti-
    23  cle forty-four of the public health law.
    24    § 3. This act shall take effect July 1, 2020.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13221-01-9