Bill Text: NY S06565 | 2011-2012 | General Assembly | Introduced

---

Bill Title: Regulates the payment of reimbursement where the insured has assigned his or her rights to an out-of-plan health care provider.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Introduced - Dead) 2012-02-28 - REFERRED TO INSURANCE [S06565 Detail]

Download: New_York-2011-S06565-Introduced.html

---

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         6565
                                   I N  S E N A T E
                                   February 28, 2012
                                      ___________
       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 assignment  of  rights
         by the insured
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
    2  amended by adding a new paragraph 29 to read as follows:
    3    (29)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
    4  COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN POLICY  OR
    5  WRITTEN  PROCEDURE  AN  INSURED  TO ASSIGN HIS RIGHTS UNDER HIS CONTRACT
    6  WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN AN INSURED
    7  ASSIGNS HIS RIGHT  TO  RECEIVE  REIMBURSEMENT  FOR  MEDICALLY  NECESSARY
    8  HEALTH  CARE SERVICES TO A HEALTH CARE PROVIDER, THE INSURER SHALL REMIT
    9  PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE HEALTH CARE PROVIDER. WHEN
   10  AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT SENT TO THE INSURED RATHER THAN
   11  TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY THE PLAN'S  OBLIGATION  OR
   12  REQUIREMENTS  UNDER  SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
   13  THIS ARTICLE AND IS SUBJECT TO INTEREST CHARGE PURSUANT TO SECTION THREE
   14  THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THIS ARTICLE.
   15    S 2. Section 3221 of the insurance law is  amended  by  adding  a  new
   16  subsection (s) to read as follows:
   17    (S)  EVERY  POLICY  WHICH  PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
   18  COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN POLICY  OR
   19  WRITTEN  PROCEDURE  AN  INSURED  TO ASSIGN HIS RIGHTS UNDER HIS CONTRACT
   20  WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN AN INSURED
   21  ASSIGNS HIS RIGHT  TO  RECEIVE  REIMBURSEMENT  FOR  MEDICALLY  NECESSARY
   22  HEALTH  CARE SERVICES TO A HEALTH CARE PROVIDER, THE INSURER SHALL REMIT
   23  PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE HEALTH CARE PROVIDER. WHEN
   24  AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT SENT TO THE INSURED RATHER THAN
   25  TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY THE PLAN'S  OBLIGATION  OR
   26  REQUIREMENTS  UNDER  SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
   27  THIS ARTICLE AND IS SUBJECT TO INTEREST CHARGE PURSUANT TO SECTION THREE
   28  THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THIS ARTICLE.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD08565-02-2
       S. 6565                             2
    1    S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
    2  subsection (a-1) to read as follows:
    3    (A-1) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION
    4  OR  HEALTH  SERVICE CORPORATION WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR
    5  SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT  BY  CONTRACT,  WRITTEN
    6  POLICY  OR  WRITTEN  PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS
    7  CONTRACT WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE  PROVIDER.  WHEN
    8  AN  INSURED  ASSIGNS  HIS  RIGHT  TO RECEIVE REIMBURSEMENT FOR MEDICALLY
    9  NECESSARY HEALTH CARE SERVICES TO AN OUT-OF-PLAN HEALTH  CARE  PROVIDER,
   10  THE  INSURER  SHALL  REMIT PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE
   11  HEALTH CARE PROVIDER. WHEN AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT MADE
   12  TO THE INSURED RATHER THAN TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY
   13  THE PLAN'S OBLIGATION OR REQUIREMENTS UNDER SECTION THREE  THOUSAND  TWO
   14  HUNDRED  TWENTY-FOUR-A  OF  THIS  CHAPTER  AND IS SUBJECT TO AN INTEREST
   15  CHARGE PURSUANT TO SECTION THREE THOUSAND TWO HUNDRED  TWENTY-FOUR-A  OF
   16  THIS CHAPTER.
   17    S  4. This act shall take effect on the first of January next succeed-
   18  ing the date on which it shall have become a law, and shall apply to all
   19  policies and contracts issued, renewed, modified, altered or amended  on
   20  or after such effective date.