BILL NUMBER:  S2772

 TITLE OF BILL :

An act to amend the insurance law, in relation to entitlement to first
party benefits


 PURPOSE :

To make certain that health care providers are compensated for their
services regardless of the fact that the insured was injured as a
result of operating a motor vehicle in an intoxicated condition and to
allow insurers a right of recovery where the injured person is found
guilty of operating a motor vehicle while in an intoxicated condition
or while his ability to operate a motor vehicle is impaired by the use
of drugs or alcohol.

 SUMMARY OF PROVISIONS :

Section one amends subsection (b) of section 5103 of the Insurance Law
to provide that health care providers which render any of the services
otherwise covered by no-fault auto insurance medical benefits and in
accordance with their obligations under law and regulations regarding
emergency care and the screening, treatment and stabilization of
patients, are reimbursed for their services. It also permits insurers
              

to recover payments that they have made for these services from the
individual in the event he or she is found guilty of a DWI or DUI
offense.

 JUSTIFICATION :

Section 2805-b of the Public Health Law and the federal Emergency
Medical Treatment and Active Labor Act (EMTALA) require health care
providers such as hospitals, emergency room physicians, nurses and
surgeons to provide emergency medical services to persons in need of
care, and screening, stabilization and treatment of persons seeking
medical care at hospitals. At the same time, New York's No-fault auto
insurance law allows insurers to deny reimbursement when insureds are
injured while operating a motor vehicle in an intoxicated condition.
It is grossly unfair to permit health care institutions and
professionals to provide lifesaving care, and then provide no
compensation. Health care providers offer the life-saving services
that are needed when a person is in a motor vehicle accident. In
addition, there is no evidence that current No-fault standards deter
drunk driving; they simply penalize health care providers for the
irresponsible and dangerous behavior of others. This bill would
correct the gross inequity by providing for No-fault medical
reimbursement for these dedicated professionals and institutions when
they provide care pursuant to state and federal guidelines.

The current exclusion on No-fault benefits also represents a serious
barrier that prevents individuals with substance abuse problems from
getting the treatment they need. Health care providers who test
accident victims for blood alcohol levels usually in emergency rooms -
risk the loss of tens of thousands of dollars in insurance
reimbursement. Without testing, individuals with substance abuse
problems are not required to seek counseling or treatment. Instead,
they continue their self-destructive behavior and may harm or kill
others in the future.

This bill will eliminate the financial disincentives health care
providers face when considering whether to perform tests that could
force individuals with substance abuse problems into confronting their
illness. This bill will also eliminate the gross inequity of an

insurance system that penalizes health care professionals and
institutions for providing life saving care that is required by law.

Finally, this bill allows the no-fault insurer to seek recovery from
the drunk driver for the cost of hospital care and treatment. This
would create another disincentive to make the poor decision of driving
under the influence of alcohol or drugs.

 LEGISLATIVE HISTORY :

2008:  S.8294/A.10000 - Passed Both Houses; Vetoed by Governor (
170)

 FISCAL IMPLICATIONS :

To be determined.

 EFFECTIVE DATE :
This act shall take effect on the 180th day after it shall have become
law, and shall apply to all policies issued, renewed, modified, or
altered on or after such effective date.