Bill Text: NY S07692 | 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: (Passed) 2022-03-18 - SIGNED CHAP.143 [S07692 Detail]

Download: New_York-2021-S07692-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          7692

                    IN SENATE

                                     January 7, 2022
                                       ___________

        Introduced  by  Sen. BRESLIN -- read twice and ordered printed, and when
          printed to be committed to the Committee on Rules

        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
        S. 7692                             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.