Bill Text: NY S01940 | 2019-2020 | General Assembly | Introduced
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; authorizes health insurer payments to nonparticipating or nonpreferred providers of ambulance services licensed under article 30 of the public health law.
Spectrum: Slight Partisan Bill (Republican 5-2)
Status: (Introduced - Dead) 2019-02-11 - RECOMMIT, ENACTING CLAUSE STRICKEN [S01940 Detail]
Download: New_York-2019-S01940-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 1940 2019-2020 Regular Sessions IN SENATE January 17, 2019 ___________ Introduced by Sens. LITTLE, AKSHAR, BROOKS, CARLUCCI, FUNKE, GALLIVAN, HELMING -- read twice and ordered printed, and when printed to be committed to the Committee on Local Government 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- 20 fighter of any personal remuneration or gratuity, directly or indirect- 21 ly, from a person served shall be a ground for his or her expulsion or 22 suspension as a member of the fire department or fire company. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD02799-03-9S. 1940 2 1 (b) Notwithstanding the provisions of paragraph (a) of this subdivi- 2 sion, a basic life support service which establishes a schedule of fees 3 for service shall enter into a contract with a provider or providers of 4 advanced life support services to provide such advanced life support 5 services. Such contract shall at a minimum establish the fees for 6 advanced life support services and the means by which said provider will 7 be reimbursed when the ambulance service bills for emergency medical 8 service. 9 § 2. Paragraph (e) of subdivision 1 of section 122-b of the general 10 municipal law, as amended by chapter 303 of the laws of 1980, is amended 11 to read as follows: 12 (e) [No] A contract [shall] may be entered into pursuant to the 13 provisions of this section for the services of an emergency rescue and 14 first aid squad of a fire department or fire company which is subject to 15 the provisions of section two hundred nine-b of [the general municipal16law] this chapter; 17 § 3. Subdivision 1 of section 184 of the town law, as amended by chap- 18 ter 599 of the laws of 1994, is amended to read as follows: 19 1. Whenever the town board shall have established or extended a fire 20 protection district pursuant to the provisions of this article, the town 21 board shall provide for the furnishing of fire protection within the 22 district and for that purpose may (a) contract with any city, village, 23 fire district or incorporated fire company maintaining adequate and 24 suitable apparatus and appliances for the furnishing of fire protection 25 in such district or (b) may acquire by gift or purchase such apparatus 26 and appliances for use in such district and may contract with any city, 27 village, fire district or incorporated fire company for operation, main- 28 tenance, and repair of the same and for the furnishing of fire 29 protection in such district, or both. The contract may also provide for 30 the furnishing of (1) emergency service in case of accidents, calamities 31 or other emergencies in connection with which the services of firefight- 32 ers would be required and (2) general ambulance service subject, howev- 33 er, to the provisions of section two hundred nine-b of the general 34 municipal law. In the event that the fire department or fire company 35 furnishing fire protection within the district pursuant to contract does 36 not maintain and operate an ambulance then a separate contract may be 37 made for the furnishing within the district of emergency ambulance 38 service or general ambulance service, or both, with any city, village or 39 fire district the fire department of which, or with an incorporated fire 40 company having its headquarters outside the district which, maintains 41 and operates an ambulance subject, however, in the case of general ambu- 42 lance service, to the provisions of section two hundred nine-b of the 43 general municipal law, or with an ambulance service, certified or regis- 44 tered pursuant to article thirty of the public health law[, which is not45organized under the provisions of section two hundred nine-b of the46general municipal law]. Any such contract with any such ambulance 47 service permitted herein shall be subject to the provisions of this 48 section. 49 § 4. Section 3224-a of the insurance law is amended by adding a new 50 subsection (k) to read as follows: 51 (k) Payments to nonparticipating or nonpreferred providers of ambu- 52 lance services licensed under article thirty of the public health law. 53 (1) Whenever an insurer or an organization, or corporation licensed or 54 certified pursuant to article forty-three or forty-seven of this chapter 55 or article forty-four of the public health law provides that any health 56 care claims submitted under contracts or agreements issued or enteredS. 1940 3 1 into pursuant to this article or article forty-two, forty-three or 2 forty-seven of this chapter and article forty-four of the public health 3 law are payable to a participating or preferred provider of ambulance 4 services for services rendered, the insurer, organization, or corpo- 5 ration licensed or certified pursuant to article forty-three or forty- 6 seven of this chapter or article forty-four of the public health law 7 shall be required to pay such benefits either directly to any similarly 8 licensed nonparticipating or nonpreferred provider at the usual and 9 customary charge, which shall not be excessive or unreasonable, when the 10 provider has rendered such services, has a written assignment of bene- 11 fits, and has caused written notice of such assignment to be given to 12 the insurer, organization, or corporation licensed or certified pursuant 13 to article forty-three or forty-seven of this chapter or article forty- 14 four of the public health law or jointly to such nonparticipating or 15 nonpreferred provider and to the insured, subscriber, or other covered 16 person; provided, however, that in either case the insurer, organiza- 17 tion, or corporation licensed or certified pursuant to article forty- 18 three or forty-seven of this chapter or article forty-four of the public 19 health law shall be required to send such benefit payments directly to 20 the provider who has the written assignment. When payment is made 21 directly to a provider of ambulance services as authorized by this 22 section, the insurer, organization, or corporation licensed or certified 23 pursuant to article forty-three or forty-seven of this chapter or arti- 24 cle forty-four of the public health law shall give written notice of 25 such payment to the insured, subscriber, or other covered person. 26 (2) An insurer shall provide reimbursement for those services 27 prescribed by this section at rates negotiated between the insurer and 28 the provider of such services. In the absence of agreed upon rates, an 29 insurer shall pay for such services at the usual and customary charge, 30 which shall not be excessive or unreasonable. 31 (3) Nothing contained in this section shall be deemed to prohibit the 32 payment of different levels of benefits or from having differences in 33 coinsurance percentages applicable to benefit levels for services 34 provided by participating or preferred providers and nonparticipating or 35 nonpreferred providers. 36 The provisions of this section shall not apply to policies that do not 37 include coverage for ambulance services. 38 § 5. Subparagraphs (C) and (D) of paragraph 24 of subsection (i) of 39 section 3216 of the insurance law, as added by chapter 506 of the laws 40 of 2001, are amended to read as follows: 41 (C) An insurer shall provide reimbursement for those services 42 prescribed by this section at rates negotiated between the insurer and 43 the provider of such services. In the absence of agreed upon rates, an 44 insurer shall pay for such services at the usual and customary charge, 45 which shall not be excessive or unreasonable. The insurer shall send 46 such payments directly to the provider of such ambulance services, if 47 the ambulance service includes an executed assignment of benefits form 48 with the claim. 49 (D) The provisions of this paragraph shall have no application to 50 transfers of patients between hospitals or health care facilities by an 51 ambulance service as described in subparagraph (A) of this paragraph 52 unless such services are covered under the policy. 53 § 6. Subparagraphs (C) and (D) of paragraph 15 of subsection (l) of 54 section 3221 of the insurance law, as added by chapter 506 of the laws 55 of 2001, are amended to read as follows:S. 1940 4 1 (C) An insurer shall provide reimbursement for those services 2 prescribed by this section at rates negotiated between the insurer and 3 the provider of such services. In the absence of agreed upon rates, an 4 insurer shall pay for such services at the usual and customary charge, 5 which shall not be excessive or unreasonable. The insurer shall send 6 such payments directly to the provider of such ambulance services, if 7 the ambulance service includes an executed assignment of benefits form 8 with the claim. 9 (D) The provisions of this paragraph shall have no application to 10 transfers of patients between hospitals or health care facilities by an 11 ambulance service as described in subparagraph (A) of this paragraph 12 unless such services are covered under the policy. 13 § 7. Paragraphs 3 and 4 of subsection (aa) of section 4303 of the 14 insurance law, as added by chapter 506 of the laws of 2001, are amended 15 to read as follows: 16 (3) An insurer shall provide reimbursement for those services 17 prescribed by this section at rates negotiated between the insurer and 18 the provider of such services. In the absence of agreed upon rates, an 19 insurer shall pay for such services at the usual and customary charge, 20 which shall not be excessive or unreasonable. The insurer shall send 21 such payments directly to the provider of such ambulance services, if 22 the ambulance service includes an executed assignment of benefits form 23 with the claim. 24 (4) The provisions of this subsection shall have no application to 25 transfers of patients between hospitals or health care facilities by an 26 ambulance service as described in paragraph one of this subsection 27 unless such services are covered under the policy. 28 § 8. This act shall take effect on the ninetieth day after it shall 29 have become a law, except that sections four, five, six and seven of 30 this act shall take effect January 1, 2022, and shall apply to health 31 care claims submitted on or after such date.
