Bill Text: NY A01778 | 2019-2020 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Provides that authorities having control of a fire department or fire company which provides emergency medical services may establish fees and charges for services.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2020-01-08 - referred to local governments [A01778 Detail]

Download: New_York-2019-A01778-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          1778
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                    January 17, 2019
                                       ___________
        Introduced  by  M.  of A. JONES, McDONOUGH, RA, LAVINE, D'URSO, WOERNER,
          BLAKE, DiPIETRO, BYRNE, STECK, COOK, BUCHWALD, JEAN-PIERRE, MORINELLO,
          NORRIS, GALEF, FAHY, BRONSON,  LUPARDO,  ABINANTI,  BARRETT,  SOLAGES,
          RAIA, GOODELL, HUNTER, PHEFFER AMATO, COLTON, B. MILLER -- Multi-Spon-
          sored  by  --  M.  of A. M. L. MILLER -- read once and referred to the
          Committee on Local Governments
        AN ACT to amend the general municipal law and the town law, in  relation
          to authorizing fees and charges for emergency medical services; and to
          amend  the insurance law, in relation to payments to prehospital emer-
          gency medical services providers
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.    Subdivision 4 of section 209-b of the general municipal
     2  law, as amended by chapter 476 of the laws of 2018, is amended  to  read
     3  as follows:
     4    4. Fees and charges [prohibited] authorized.  (a) Emergency and gener-
     5  al  ambulance service, including emergency medical service as defined in
     6  section three thousand one of the public health law, authorized pursuant
     7  to this section [shall] may be furnished  without  cost  to  the  person
     8  served; provided, however, that the authorities having control of a fire
     9  department  or fire company that have authorized such fire department or
    10  fire company to provide such service or services may fix a  schedule  of
    11  fees  or  charges  to  be  paid  by  persons  requesting such service or
    12  services. The authorities having control of a fire  department  or  fire
    13  company may provide for the collection of fees and charges or may formu-
    14  late  rules  and  regulations  for  the  collection  thereof by the fire
    15  department or fire company. When fees and charges are authorized  pursu-
    16  ant  to  this  subdivision,  the  fees  and  charges  collected shall be
    17  disbursed in accordance with a written contract entered into between the
    18  authority having control of a fire department of fire  company  and  the
    19  fire  department  or  fire company itself.   The acceptance by any fire-
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02799-03-9
        A. 1778                             2
     1  fighter of any personal remuneration or gratuity, directly or  indirect-
     2  ly,  from  a person served shall be a ground for his or her expulsion or
     3  suspension as a member of the fire department or fire company.
     4    (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
     5  sion, a basic life support service which establishes a schedule of  fees
     6  for  service shall enter into a contract with a provider or providers of
     7  advanced life support services to provide  such  advanced  life  support
     8  services.  Such  contract  shall  at  a  minimum  establish the fees for
     9  advanced life support services and the means by which said provider will
    10  be reimbursed when the ambulance service  bills  for  emergency  medical
    11  service.
    12    §  2.  Paragraph  (e) of subdivision 1 of section 122-b of the general
    13  municipal law, as amended by chapter 303 of the laws of 1980, is amended
    14  to read as follows:
    15    (e) [No] A contract [shall]  may  be  entered  into  pursuant  to  the
    16  provisions  of  this section for the services of an emergency rescue and
    17  first aid squad of a fire department or fire company which is subject to
    18  the provisions of section two hundred nine-b of [the  general  municipal
    19  law] this chapter;
    20    § 3. Subdivision 1 of section 184 of the town law, as amended by chap-
    21  ter 599 of the laws of 1994, is amended to read as follows:
    22    1.  Whenever  the town board shall have established or extended a fire
    23  protection district pursuant to the provisions of this article, the town
    24  board shall provide for the furnishing of  fire  protection  within  the
    25  district  and  for that purpose may (a) contract with any city, village,
    26  fire district or incorporated  fire  company  maintaining  adequate  and
    27  suitable  apparatus and appliances for the furnishing of fire protection
    28  in such district or (b) may acquire by gift or purchase  such  apparatus
    29  and  appliances for use in such district and may contract with any city,
    30  village, fire district or incorporated fire company for operation, main-
    31  tenance, and  repair  of  the  same  and  for  the  furnishing  of  fire
    32  protection  in such district, or both. The contract may also provide for
    33  the furnishing of (1) emergency service in case of accidents, calamities
    34  or other emergencies in connection with which the services of firefight-
    35  ers would be required and (2) general ambulance service subject,  howev-
    36  er,  to  the  provisions  of  section  two hundred nine-b of the general
    37  municipal law. In the event that the fire  department  or  fire  company
    38  furnishing fire protection within the district pursuant to contract does
    39  not  maintain  and  operate an ambulance then a separate contract may be
    40  made for the furnishing  within  the  district  of  emergency  ambulance
    41  service or general ambulance service, or both, with any city, village or
    42  fire district the fire department of which, or with an incorporated fire
    43  company  having  its  headquarters outside the district which, maintains
    44  and operates an ambulance subject, however, in the case of general ambu-
    45  lance service, to the provisions of section two hundred  nine-b  of  the
    46  general municipal law, or with an ambulance service, certified or regis-
    47  tered pursuant to article thirty of the public health law[, which is not
    48  organized  under  the  provisions  of  section two hundred nine-b of the
    49  general municipal law].  Any  such  contract  with  any  such  ambulance
    50  service  permitted  herein  shall  be  subject to the provisions of this
    51  section.
    52    § 4. Section 3224-a of the insurance law is amended by  adding  a  new
    53  subsection (k) to read as follows:
    54    (k)  Payments  to  nonparticipating or nonpreferred providers of ambu-
    55  lance services licensed under article thirty of the public  health  law.
    56  (1)  Whenever  an insurer or an organization, or corporation licensed or
        A. 1778                             3
     1  certified pursuant to article forty-three or forty-seven of this chapter
     2  or article forty-four of the public health law provides that any  health
     3  care  claims  submitted  under contracts or agreements issued or entered
     4  into  pursuant  to  this  article  or  article forty-two, forty-three or
     5  forty-seven of this chapter and article forty-four of the public  health
     6  law  are  payable  to a participating or preferred provider of ambulance
     7  services for services rendered, the  insurer,  organization,  or  corpo-
     8  ration  licensed  or certified pursuant to article forty-three or forty-
     9  seven of this chapter or article forty-four of  the  public  health  law
    10  shall  be required to pay such benefits either directly to any similarly
    11  licensed nonparticipating or nonpreferred  provider  at  the  usual  and
    12  customary charge, which shall not be excessive or unreasonable, when the
    13  provider  has  rendered such services, has a written assignment of bene-
    14  fits, and has caused written notice of such assignment to  be  given  to
    15  the insurer, organization, or corporation licensed or certified pursuant
    16  to  article forty-three or forty-seven of this chapter or article forty-
    17  four of the public health law or jointly  to  such  nonparticipating  or
    18  nonpreferred  provider  and to the insured, subscriber, or other covered
    19  person; provided, however, that in either case  the  insurer,  organiza-
    20  tion,  or  corporation  licensed or certified pursuant to article forty-
    21  three or forty-seven of this chapter or article forty-four of the public
    22  health law shall be required to send such benefit payments  directly  to
    23  the  provider  who  has  the  written  assignment.  When payment is made
    24  directly to a provider of  ambulance  services  as  authorized  by  this
    25  section, the insurer, organization, or corporation licensed or certified
    26  pursuant  to article forty-three or forty-seven of this chapter or arti-
    27  cle forty-four of the public health law shall  give  written  notice  of
    28  such payment to the insured, subscriber, or other covered person.
    29    (2)   An  insurer  shall  provide  reimbursement  for  those  services
    30  prescribed by this section at rates negotiated between the  insurer  and
    31  the  provider  of such services. In the absence of agreed upon rates, an
    32  insurer shall pay for such services at the usual and  customary  charge,
    33  which shall not be excessive or unreasonable.
    34    (3)  Nothing contained in this section shall be deemed to prohibit the
    35  payment of different levels of benefits or from  having  differences  in
    36  coinsurance  percentages  applicable  to  benefit  levels  for  services
    37  provided by participating or preferred providers and nonparticipating or
    38  nonpreferred providers.
    39    The provisions of this section shall not apply to policies that do not
    40  include coverage for ambulance services.
    41    § 5. Subparagraphs (C) and (D) of paragraph 24 of  subsection  (i)  of
    42  section  3216  of the insurance law, as added by chapter 506 of the laws
    43  of 2001, are amended to read as follows:
    44    (C)  An  insurer  shall  provide  reimbursement  for  those   services
    45  prescribed  by  this section at rates negotiated between the insurer and
    46  the provider of such services. In the absence of agreed upon  rates,  an
    47  insurer  shall  pay for such services at the usual and customary charge,
    48  which shall not be excessive or unreasonable.   The insurer  shall  send
    49  such  payments  directly  to the provider of such ambulance services, if
    50  the ambulance service includes an executed assignment of  benefits  form
    51  with the claim.
    52    (D)  The  provisions  of  this  paragraph shall have no application to
    53  transfers of patients between hospitals or health care facilities by  an
    54  ambulance  service  as  described  in subparagraph (A) of this paragraph
    55  unless such services are covered under the policy.
        A. 1778                             4
     1    § 6. Subparagraphs (C) and (D) of paragraph 15 of  subsection  (l)  of
     2  section  3221  of the insurance law, as added by chapter 506 of the laws
     3  of 2001, are amended to read as follows:
     4    (C)   An  insurer  shall  provide  reimbursement  for  those  services
     5  prescribed by this section at rates negotiated between the  insurer  and
     6  the  provider  of such services. In the absence of agreed upon rates, an
     7  insurer shall pay for such services at the usual and  customary  charge,
     8  which  shall  not  be excessive or unreasonable.  The insurer shall send
     9  such payments directly to the provider of such  ambulance  services,  if
    10  the  ambulance  service includes an executed assignment of benefits form
    11  with the claim.
    12    (D) The provisions of this paragraph  shall  have  no  application  to
    13  transfers  of patients between hospitals or health care facilities by an
    14  ambulance service as described in subparagraph  (A)  of  this  paragraph
    15  unless such services are covered under the policy.
    16    §  7.  Paragraphs  3  and  4 of subsection (aa) of section 4303 of the
    17  insurance law, as added by chapter 506 of the laws of 2001, are  amended
    18  to read as follows:
    19    (3)   An  insurer  shall  provide  reimbursement  for  those  services
    20  prescribed by this section at rates negotiated between the  insurer  and
    21  the  provider  of such services. In the absence of agreed upon rates, an
    22  insurer shall pay for such services at the usual and  customary  charge,
    23  which  shall  not  be excessive or unreasonable.  The insurer shall send
    24  such payments directly to the provider of such  ambulance  services,  if
    25  the  ambulance  service includes an executed assignment of benefits form
    26  with the claim.
    27    (4) The provisions of this subsection shall  have  no  application  to
    28  transfers  of patients between hospitals or health care facilities by an
    29  ambulance service as described  in  paragraph  one  of  this  subsection
    30  unless such services are covered under the policy.
    31    §  8.  This  act shall take effect on the ninetieth day after it shall
    32  have become a law, except that sections four, five,  six  and  seven  of
    33  this  act  shall  take effect January 1, 2022, and shall apply to health
    34  care claims submitted on or after such date.