Bill Text: NY S05319 | 2025-2026 | General Assembly | Introduced
Bill Title: Includes permissible payment methods, advance consent for direct payments, and annually providing the updated rate schedule as required terms for certain insurance contracts.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2025-02-20 - REFERRED TO INSURANCE [S05319 Detail]
Download: New_York-2025-S05319-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 5319 2025-2026 Regular Sessions IN SENATE February 20, 2025 ___________ Introduced by Sen. BAILEY -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law and the public health law, in relation to required terms for certain insurance contracts The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph 3 of subsection (e) of section 3217-b of the 2 insurance law, as added by chapter 586 of the laws of 1998, is amended 3 and three new paragraphs 3-a, 3-b and 3-c are added to read as follows: 4 (3) a description of the records or information relied upon to calcu- 5 late any such payments and adjustments, including the date of service, 6 patient identification number, an identification of the service for 7 which the payment is made, the reimbursement paid by the insurer for the 8 service, and a description of how the provider can access a summary of 9 such calculations and adjustments; 10 (3-a) the permissible payment methods as check, direct deposit, debit 11 or credit card or online payment system, provided the health care 12 provider can access the payment in full, without encumbrances, costs, 13 charges, or fees, including a fee for replacement of a lost or stolen 14 check, under at least one payment method offered by the insurer; 15 (3-b) the advance written consent of a provider to the insurer for the 16 method of payment and to directly pay or deposit payments in a bank or 17 other financial institution of the provider's choosing; 18 (3-c) the insurer's annual obligation, beginning on the effective date 19 of this paragraph and continuing every first of January thereafter, to 20 provide the health care provider with an updated payment rate schedule; 21 § 2. Paragraph 3 of subsection (e) of section 4325 of the insurance 22 law, as added by chapter 586 of the laws of 1998, is amended and three 23 new paragraphs 3-a, 3-b and 3-c are added to read as follows: 24 (3) a description of the records or information relied upon to calcu- 25 late any such payments and adjustments, including the date of service, EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD07324-01-5S. 5319 2 1 patient identification number, an identification of the service for 2 which the payment is made, the reimbursement paid by the corporation for 3 the service, and a description of how the provider can access a summary 4 of such calculations and adjustments; 5 (3-a) the permissible payment methods as check, direct deposit, debit 6 or credit card or online payment system, provided the health care 7 provider can access the payment in full, without encumbrances, costs, 8 charges, or fees, including a fee for replacement of a lost or stolen 9 check, under at least one payment method offered by the corporation; 10 (3-b) the advance written consent of a provider to the corporation for 11 the method of payment and to directly pay or deposit payments in a bank 12 or other financial institution of the provider's choosing; 13 (3-c) the corporation's annual obligation, beginning on the effective 14 date of this paragraph and continuing every first of January thereafter, 15 to provide the health care provider with an updated payment rate sched- 16 ule, including a description of any services bundled within a single 17 rate; 18 § 3. Paragraph (c) of subdivision 5-a of section 4406-c of the public 19 health law, as added by chapter 586 of the laws of 1998, is amended and 20 three new paragraphs (c-1), (c-2) and (c-3) are added to read as 21 follows: 22 (c) a description of the records or information relied upon to calcu- 23 late any such payments and adjustments, including the date of service, 24 patient identification number, an identification of the service for 25 which the payment is made, the reimbursement paid by the health care 26 plan for the service, and a description of how the provider can access a 27 summary of such calculations and adjustments; 28 (c-1) the permissible payment methods as check, direct deposit, debit 29 or credit card or online payment system, provided the health care 30 provider can access the payment in full, without encumbrances, costs 31 charges, or fees, including a fee for replacement of a lost or stolen 32 check, under at least one payment method offered by the health care 33 plan; 34 (c-2) the advance written consent of a provider to the health care 35 plan for the method of payment and to directly pay or deposit payments 36 in a bank or other financial institution of the provider's choosing; 37 (c-3) the health care plan's annual obligation, beginning on the 38 effective date of this paragraph and continuing every first of January 39 thereafter, to provide the health care provider with an updated payment 40 rate schedule, including a description of any services bundled within a 41 single rate; 42 § 4. This act shall take effect on the thirtieth day after it shall 43 have become a law and shall apply to all contracts entered into, 44 renewed, modified or amended on or after such effective date.
