Bill Text: NY A06495 | 2023-2024 | General Assembly | Introduced

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Bill Title: Requires out-of-network treatment disclosure within twenty-four hours of approval of certain surgical procedures.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-01-03 - referred to health [A06495 Detail]

Download: New_York-2023-A06495-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          6495

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                     April 12, 2023
                                       ___________

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

        AN ACT to amend the public health law,  in  relation  to  out-of-network
          treatment disclosure for certain surgical procedures

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

     1    Section 1. Subdivision 5 of section 230-d of the public health law, as
     2  added by chapter 365 of the laws of 2007, is amended to read as follows:
     3    5. Every licensee performing inpatient and/or outpatient surgical care
     4  and that requires pre-approval of surgical procedures by  the  patient's
     5  insurance  provider  shall  provide  notice  to  the patient if all or a
     6  portion of treatment approved is authorized to be rendered by a provider
     7  that is not an in-network provider. Such notification shall be  provided
     8  to  the  patient by telephone call, email or text message at the time of
     9  approval by the licensee and shall be confirmed by mail  not  more  than
    10  twenty-four  hours  after  approval  of  the  surgical procedure. If the
    11  licensee fails to provide such notice to the  patient  at  least  forty-
    12  eight hours prior to the procedure, the licensee shall cover the cost of
    13  the  procedure  as  though  the  services were rendered by an in-network
    14  provider. The provisions of this subdivision  shall  not  apply  to  any
    15  surgical  procedure performed within twenty-four hours after the insured
    16  sustains the injury necessitating the surgical procedure.
    17    6. the commissioner shall make, adopt,  promulgate  and  enforce  such
    18  rules  and regulations, as he or she may deem appropriate, to effectuate
    19  the purposes of this section. Where any rule or  regulation  under  this
    20  section would affect the scope of practice of a health care practitioner
    21  licensed, registered or certified under title eight of the education law
    22  other  than  those licensed under articles one hundred thirty-one or one
    23  hundred thirty-one-B of the education law, the rule or regulation  shall
    24  be made with the concurrence of the commissioner of education.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02615-01-3
        A. 6495                             2

     1    §  2.  The public health law is amended by adding a new section 2807-g
     2  to read as follows:
     3    §  2807-g. Notice of out-of-network treatment. Every hospital or other
     4  licensed entity providing inpatient and/or outpatient surgical care that
     5  requires pre-approval of surgical procedures by the patient's  insurance
     6  provider  shall  provide  notice  to  the patient if all or a portion of
     7  treatment approved is authorized to be rendered by a  provider  that  is
     8  not  an  in-network provider. Such notification shall be provided to the
     9  patient by telephone call, email or text message at the time of approval
    10  by such hospital or other licensed entity and shall be confirmed by mail
    11  not more than twenty-four hours after approval of  the  surgical  proce-
    12  dure.  If  such  hospital or other licensed entity fails to provide such
    13  notice to the patient at least forty-eight hours prior to the procedure,
    14  such hospital or other licensed entity  shall  cover  the  cost  of  the
    15  procedure  as though the services were rendered by an in-network provid-
    16  er. The provisions of this subdivision shall not apply to  any  surgical
    17  procedure  performed within twenty-four hours after the insured sustains
    18  the injury necessitating the surgical procedure.
    19    § 3. This act shall take effect on the ninetieth day  after  it  shall
    20  have become a law.