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
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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