S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  3230

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                            January 23, 2009
                               ___________

Introduced by M. of A. BRADLEY, GOTTFRIED, J. RIVERA, MAYERSOHN, COLTON,
  GALEF, MILLMAN, SCARBOROUGH, LATIMER -- Multi-Sponsored by -- M. of A.
  ALESSI,  CAHILL, CHRISTENSEN, CLARK, ESPAILLAT, FARRELL, GREENE, HOOP-
  ER, JOHN, PHEFFER, REILLY, SWEENEY -- read once and  referred  to  the
  Committee on Insurance

AN ACT to amend the insurance law, in relation to hospital care

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 3216 of the insurance law is amended  by  adding  a
new subsection (m) to read as follows:
  (M) EVERY POLICY THAT PROVIDES HOSPITAL, MEDICAL, OR SURGICAL COVERAGE
MAY NOT CHARGE AN INSURED AN OUT-OF-NETWORK RATE FOR A HOSPITAL VISIT IF
THE  HOSPITAL  PARTICIPATES  IN  THE  IN-NETWORK BENEFITS PORTION OF THE
INSURER'S NETWORK FOR THE MANAGED CARE PRODUCT, EVEN THOUGH  THE  DOCTOR
WHO  PERFORMED THE SERVICES AT SUCH HOSPITAL DOES NOT PARTICIPATE IN THE
IN-NETWORK BENEFITS PORTION OF SUCH INSURER'S NETWORK.
  S 2. Section 3221 of the insurance law is  amended  by  adding  a  new
subsection (r) to read as follows:
  (R) EVERY POLICY THAT PROVIDES HOSPITAL, MEDICAL, OR SURGICAL COVERAGE
MAY NOT CHARGE AN INSURED AN OUT-OF-NETWORK RATE FOR A HOSPITAL VISIT IF
THE  HOSPITAL  PARTICIPATES  IN  THE  IN-NETWORK BENEFITS PORTION OF THE
INSURER'S NETWORK FOR THE MANAGED CARE PRODUCT, EVEN THOUGH  THE  DOCTOR
WHO  PERFORMED THE SERVICES AT SUCH HOSPITAL DOES NOT PARTICIPATE IN THE
IN-NETWORK BENEFITS PORTION OF SUCH INSURER'S NETWORK.
  S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (ff) to read as follows:
  (FF)  EVERY POLICY THAT PROVIDES HOSPITAL, MEDICAL, OR SURGICAL COVER-
AGE MAY NOT CHARGE AN INSURED AN  OUT-OF-NETWORK  RATE  FOR  A  HOSPITAL
VISIT IF THE HOSPITAL PARTICIPATES IN THE IN-NETWORK BENEFITS PORTION OF
THE  INSURER'S  NETWORK  FOR  THE  MANAGED CARE PRODUCT, EVEN THOUGH THE
DOCTOR WHO PERFORMED THE SERVICES AT SUCH HOSPITAL DOES NOT  PARTICIPATE
IN THE IN-NETWORK BENEFITS PORTION OF SUCH INSURER'S NETWORK.
  S 4. This act shall take effect immediately.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                      [ ] is old law to be omitted.
                                                           LBD03288-01-9