Bill Text: NY S06982 | 2011-2012 | General Assembly | Introduced

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Bill Title: Relates to reimbursement for ambulance services.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2012-04-19 - REFERRED TO INSURANCE [S06982 Detail]

Download: New_York-2011-S06982-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         6982
                                   I N  S E N A T E
                                    April 19, 2012
                                      ___________
       Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
         printed to be committed to the Committee on Insurance
       AN ACT to amend the insurance law,  in  relation  to  reimbursement  for
         ambulance services
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Paragraph 24 of subsection  (i)  of  section  3216  of  the
    2  insurance  law  is  amended  by adding a new subparagraph (F) to read as
    3  follows:
    4    (F) AN INSURER WHO ISSUES REIMBURSEMENT  UNDER  THIS  PARAGRAPH  SHALL
    5  SUBMIT  SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES NEGO-
    6  TIATED BETWEEN THE PROVIDER AND THE INSURER, OR IF NO    RATE  HAS  BEEN
    7  NEGOTIATED  BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN THE
    8  FORM OF A JOINT CHECK SPECIFYING AS PAYEES  BOTH  THE  INSURED  AND  THE
    9  PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
   10  SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
   11  ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
   12  FITS  FOR  SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING ANY POLICY
   13  LANGUAGE TO THE CONTRARY, THE ISSUER SHALL  ACCEPT  SUCH  ASSIGNMENT  OF
   14  BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
   15  ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
   16  THE  PROVIDER  VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE OF SUCH
   17  PAYMENT. THE NOTIFICATION SHALL INCLUDE THE NAME  OF  THE  PATIENT,  THE
   18  DATE  OF  SERVICE,  THE  DATE  OF PAYMENT, THE AMOUNT OF PAYMENT AND THE
   19  ADDRESS TO WHICH THE PAYMENT WAS SENT.
   20    S 2.  Paragraph 15 of subsection (1) of section 3221 of the  insurance
   21  law is amended by adding a new subparagraph (F) to read as follows:
   22    (F)  AN  INSURER  WHO  ISSUES REIMBURSEMENT UNDER THIS PARAGRAPH SHALL
   23  SUBMIT SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES  NEGO-
   24  TIATED  BETWEEN  THE  PROVIDER  AND  THE INSURER, OR IF NO RATE HAS BEEN
   25  NEGOTIATED BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN  THE
   26  FORM  OF  A  JOINT  CHECK  SPECIFYING AS PAYEES BOTH THE INSURED AND THE
   27  PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
   28  SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD15189-01-2
       S. 6982                             2
    1  ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
    2  FITS FOR SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING  ANY  POLICY
    3  LANGUAGE  TO  THE  CONTRARY, THE INSURER SHALL ACCEPT SUCH ASSIGNMENT OF
    4  BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
    5  ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
    6  THE  PROVIDER  VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE OF SUCH
    7  PAYMENT. THE NOTIFICATION SHALL INCLUDE THE NAME  OF  THE  PATIENT,  THE
    8  DATE  OF  SERVICE,  THE  DATE  OF PAYMENT, THE AMOUNT OF PAYMENT AND THE
    9  ADDRESS TO WHICH THE PAYMENT WAS SENT.
   10    S 3. Subsection (aa) of section 4303 of the insurance law  is  amended
   11  by adding a new paragraph 6 to read as follows:
   12    (6)  AN  INSURER  WHO  ISSUES REIMBURSEMENT UNDER THIS PARAGRAPH SHALL
   13  SUBMIT SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES  NEGO-
   14  TIATED  BETWEEN  THE  PROVIDER  AND  THE INSURER, OR IF NO RATE HAS BEEN
   15  NEGOTIATED BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN  THE
   16  FORM  OF  A  JOINT  CHECK  SPECIFYING AS PAYEES BOTH THE INSURED AND THE
   17  PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
   18  SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
   19  ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
   20  FITS FOR SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING  ANY  POLICY
   21  LANGUAGE  TO  THE  CONTRARY, THE INSURER SHALL ACCEPT SUCH ASSIGNMENT OF
   22  BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
   23  ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
   24  THE PROVIDER VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE  OF  SUCH
   25  PAYMENT.  THE  NOTIFICATION  SHALL  INCLUDE THE NAME OF THE PATIENT, THE
   26  DATE OF SERVICE, THE DATE OF PAYMENT, THE  AMOUNT  OF  PAYMENT  AND  THE
   27  ADDRESS TO WHICH THE PAYMENT WAS SENT.
   28    S 4. This act shall take effect immediately.