S T A T E   O F   N E W   Y O R K
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                                  3354

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                            January 27, 2009
                               ___________

Introduced  by  M.  of  A.  BRADLEY, ESPAILLAT, JOHN, GOTTFRIED, COLTON,
  CAHILL, BENEDETTO, JAFFEE, EDDINGTON, PHEFFER, WRIGHT, GREENE,  CLARK,
  ORTIZ,  GALEF, FIELDS, LATIMER -- Multi-Sponsored by -- M. of A. BREN-
  NAN, DelMONTE, GABRYSZAK,  GLICK,  GUNTHER,  JACOBS,  KOON,  V. LOPEZ,
  MARKEY,  MAYERSOHN,  McENENY,  PEOPLES, REILLY, SWEENEY, WEISENBERG --
  read once and referred to the Committee on Insurance

AN ACT to amend the insurance law,  in  relation  to  rates  charged  by
  insurance companies

  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 PHYSICIAN'S
SERVICES IF  THE  PHYSICIAN  PARTICIPATES  IN  THE  IN-NETWORK  BENEFITS
PORTION  OF  THE  INSURER'S  NETWORK  FOR THE MANAGED CARE PRODUCT, EVEN
THOUGH THE HOSPITAL AT WHICH THE SERVICES WERE PROVIDED DOES NOT PARTIC-
IPATE 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 PHYSICIAN'S
SERVICES IF  THE  PHYSICIAN  PARTICIPATES  IN  THE  IN-NETWORK  BENEFITS
PORTION  OF  THE  INSURER'S  NETWORK  FOR THE MANAGED CARE PRODUCT, EVEN
THOUGH THE HOSPITAL AT WHICH THE SERVICES WERE PROVIDED DOES NOT PARTIC-
IPATE 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  PHYSICIAN'S
SERVICES  IF  THE  PHYSICIAN  PARTICIPATES  IN  THE  IN-NETWORK BENEFITS

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03343-01-9
              

A. 3354                             2

PORTION OF THE INSURER'S NETWORK FOR  THE  MANAGED  CARE  PRODUCT,  EVEN
THOUGH THE HOSPITAL AT WHICH THE SERVICES WERE PROVIDED DOES NOT PARTIC-
IPATE IN THE IN-NETWORK BENEFITS PORTION OF SUCH INSURER'S NETWORK.
  S 4. This act shall take effect immediately.