Bill Text: NY S06491 | 2015-2016 | General Assembly | Introduced

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Bill Title: Directs health insurers to provide enrollees the option to assign the payment of emergency services benefits directly to an out of network health care provider.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2016-01-20 - REFERRED TO INSURANCE [S06491 Detail]

Download: New_York-2015-S06491-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          6491
                    IN SENATE
                                    January 20, 2016
                                       ___________
        Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance
        AN ACT to amend the insurance  law,  in  relation  to  requiring  health
          insurers  to provide insureds and covered persons the option to assign
          the payment of emergency services  benefits  directly  to  an  out  of
          network health care provider
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. Subsection (c) of section 3241 of  the  insurance  law,  as
     2  added  by  section  6  of  part  H of chapter 60 of the laws of 2014, is
     3  amended to read as follows:
     4    (c) (1) When an insured or enrollee under a contract  or  policy  that
     5  provides  coverage  for  emergency services receives the services from a
     6  health care provider that does not participate in the  provider  network
     7  of  an  insurer, a corporation organized pursuant to article forty-three
     8  of this chapter, a municipal cooperative health benefit  plan  certified
     9  pursuant  to  article  forty-seven of this chapter, a health maintenance
    10  organization certified pursuant to  article  forty-four  of  the  public
    11  health  law, or a student health plan established or maintained pursuant
    12  to section one thousand one hundred twenty-four of this chapter ("health
    13  care plan"), the health care plan  shall  ensure  that  the  insured  or
    14  enrollee shall (A) incur no greater out-of-pocket costs for the emergen-
    15  cy  services  than  the  insured  or enrollee would have incurred with a
    16  health care provider that participates in the health care plan's provid-
    17  er network and (B) provide the insured or enrollee the option of assign-
    18  ing the payment of any  benefits  due  under  such  contract  or  policy
    19  directly  to the health care provider. Whenever, in any health insurance
    20  claim form, an insured or enrollee specifically authorizes  the  payment
    21  of  benefits  directly  to  a health care provider, the health care plan
    22  shall make such payment to the  health  care  provider.    (2)  For  the
    23  purpose of this section, "emergency services" shall have the meaning set
    24  forth in subparagraph (D) of paragraph nine of subsection (i) of section
    25  three  thousand two hundred sixteen of this article, subparagraph (D) of
    26  paragraph four of subsection (k) of section three thousand  two  hundred
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13383-02-6