Bill Text: NY A08713 | 2021-2022 | General Assembly | Introduced

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Bill Title: Relates to the satisfaction of requirements for an explanation of benefits for certain pharmaceutical claims.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2022-03-15 - substituted by s7692 [A08713 Detail]

Download: New_York-2021-A08713-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          8713

                   IN ASSEMBLY

                                    January 11, 2022
                                       ___________

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

        AN  ACT  to  amend the insurance law, in relation to the satisfaction of
          requirements for an explanation of benefits for certain pharmaceutical
          claims; and to amend a chapter of the laws of 2021 amending the insur-
          ance law  relating  to  requiring  insurers  to  provide  insureds  or
          subscribers with an explanation of pharmaceutical benefits relating to
          claims  under  certain  accident  and  health  insurance  policies, as
          proposed in legislative bills numbers S. 7075 and A. 3516, in relation
          to the effectiveness thereof

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

     1    Section 1. Section 3244 of the insurance law, as renumbered by a chap-
     2  ter of the laws of 2021 amending the insurance law relating to requiring
     3  insurers to provide insureds or subscribers with an explanation of phar-
     4  maceutical benefits relating to claims under certain accident and health
     5  insurance  policies,  as  proposed in legislative bills numbers S.  7075
     6  and A. 3516, is amended by adding  a  new  subsection  (e)  to  read  as
     7  follows:
     8    (e)  The  provisions of this section requiring an explanation of bene-
     9  fits form for pharmaceutical claims shall be satisfied by either a quar-
    10  terly written summary of the information prescribed by subsection (b) of
    11  this section or by making such information available  electronically  on
    12  the  member  portal of the insurer's, health maintenance organization's,
    13  or article forty-three organization's website, provided that the  member
    14  consents to receiving the information electronically.
    15    § 2. Section 2 of a chapter of the laws of 2021 amending the insurance
    16  law  relating  to  requiring insurers to provide insureds or subscribers
    17  with an explanation of pharmaceutical benefits relating to claims  under
    18  certain  accident and health insurance policies, as proposed in legisla-
    19  tive bills numbers S. 7075 and A. 3516, is amended to read as follows:
    20    § 2. This act shall take effect [on the sixtieth day  after  it  shall
    21  have  become  a law] January 1, 2022 and shall apply to all claims filed
    22  on and after such effective date. Effective  immediately  the  addition,

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01845-02-2
        A. 8713                             2

     1  amendment  and/or  repeal  of  any  rule or regulation necessary for the
     2  implementation of this act on its effective date are  authorized  to  be
     3  made and completed on or before such date.
     4    §  3.  This act shall take effect immediately; provided, however, that
     5  section one of this act shall take effect on the same date  and  in  the
     6  same  manner as a chapter of the laws of 2021 amending the insurance law
     7  relating to requiring insurers to provide insureds or  subscribers  with
     8  an  explanation  of  pharmaceutical  benefits  relating  to claims under
     9  certain accident and health insurance policies, as proposed in  legisla-
    10  tive bills numbers S. 7075 and A. 3516, takes effect.