Assembly Bill A3591

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

                                  3591

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                            January 27, 2009
                               ___________

Introduced  by  M.  of  A.  BRADLEY,  LANCMAN, PAULIN, KELLNER, SWEENEY,
  FIELDS, SCHIMEL, GALEF, MAISEL,  EDDINGTON,  CAHILL,  JAFFEE,  GORDON,
  ROSENTHAL,  ESPAILLAT  --  Multi-Sponsored  by  -- M. of A. BENEDETTO,
  BOYLAND, BRENNAN, BROOK-KRASNY, CHRISTENSEN, COOK,  DelMONTE,  GABRYS-
  ZAK,   GLICK,   GOTTFRIED,   GUNTHER,  HIKIND,  HOOPER,  HYER-SPENCER,
  JEFFRIES, JOHN, PHEFFER, REILLY, SCARBOROUGH, TITONE -- read once  and
  referred to the Committee on Insurance

AN ACT to amend the insurance law, in relation to settlement of claims

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

  Section 1. Subsection (a) of section 3224-a of the insurance  law,  as
amended  by  chapter  666  of  the  laws  of 1997, is amended to read as
follows:
  (a) Except in a case where the obligation of an insurer or  an  organ-
ization  or corporation licensed or certified pursuant to article forty-
three of this chapter or article forty-four of the public health law  to
pay  a  claim  submitted  by a policyholder or person covered under such
policy or make a payment to a health care  provider  is  not  reasonably
clear,  or when there is a reasonable basis supported by specific infor-
mation available for review by the superintendent  that  such  claim  or
bill  for health care services rendered was submitted fraudulently, such
insurer or organization or corporation shall pay the claim to a  policy-
holder  or  covered  person  or make a payment to a health care provider
within [forty-five] FIFTEEN DAYS OF RECEIPT  OF  A  CLAIM  OR  BILL  FOR
SERVICES  RENDERED  WHICH IS TRANSMITTED ELECTRONICALLY OR WITHIN THIRTY
days of receipt of a claim  or  bill  for  services  rendered  WHICH  IS
SUBMITTED IN WRITING.
  S  2.  Subsection (a) of section 2406 of the insurance law, as amended
by chapter 666 of the laws of 1997, is amended to read as follows:
  (a) If the hearing was on a charge of a defined violation  the  super-
intendent  shall  make  an  order  on his report and serve a copy of the

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03533-01-9
              

A. 3591                             2

findings and order upon the person charged with the  violation  and  any
intervenor.  If  the  superintendent finds that the person complained of
has engaged in a defined violation, the order shall require  the  person
to  cease  and desist from engaging in such defined violation.  Further-
more, if the superintendent finds, after notice and  hearing,  that  the
person  complained  of has engaged in an act prohibited by section three
thousand two hundred twenty-four-a of this chapter,  the  superintendent
[is  authorized to] SHALL levy a civil penalty against such person in an
amount up to TWO THOUSAND five hundred dollars  per  day  for  each  day
beyond  the  date that a bill or claim was to be processed in accordance
with section three thousand two hundred twenty-four-a of this  chapter[,
but in no event shall such penalty exceed five thousand dollars].
  S  3.  This  act shall take effect on the ninetieth day after it shall
have become a law.