| Date of Action |
Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|---|---|
| Jan 06, 2010 |
referred to insurance |
| Apr 23, 2009 |
referred to insurance |
Senate Bill S4464
2009-2010 Legislative Session
Sponsored By
(D, WF) Senate District
Archive: Last Bill Status - In Senate Committee Insurance Committee
Actions
2009-S4464 (ACTIVE) - Details
- Current Committee:
- Senate Insurance
- Law Section:
- Insurance Law
- Laws Affected:
- Add ยง3224-c, Ins L
2009-S4464 (ACTIVE) - Sponsor Memo
BILL NUMBER: S4464
TITLE OF BILL :
An act to amend the insurance law, in relation to requiring health
care insurers to pay for ambulance services performed by non-preferred
providers
PURPOSE OR GENERAL IDEA OF BILL :
This legislation provides that the responding 911 ambulance service
will be paid their usual and customary charge for the applicable
treatment regardless of whether or not they were a preferred provider
of the insurance company.
SUMMARY OF PROVISIONS :
Section 1 of the insurance law is amended by adding a new section
3224-c which requires the reimbursement amount paid by health insurers
to providers of ambulance services to be based on providers usual and
customary charge regardless of whether or not they are a preferred
provider of the health insurance company.
JUSTIFICATION :
2009-S4464 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
4464
2009-2010 Regular Sessions
I N S E N A T E
April 23, 2009
___________
Introduced by Sen. BRESLIN -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring health care
insurers to pay for ambulance services performed by non-preferred
providers
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The insurance law is amended by adding a new section 3224-c
to read as follows:
S 3224-C. HEALTH BENEFIT PLANS PROVIDING INCENTIVES TO USE SERVICES OF
PREFERRED PROVIDERS; MINIMUM REQUIREMENTS. (A) HEALTH CARE INSURERS MAY
ISSUE HEALTH BENEFIT PLANS WHICH PROVIDE FOR INCENTIVES FOR COVERED
PERSONS TO USE THE AMBULANCE SERVICES OF PREFERRED PROVIDERS. SUCH POLI-
CIES OR SUBSCRIBER CERTIFICATES SHALL CONTAIN AT LEAST THE FOLLOWING
PROVISIONS:
(1) A PROVISION THAT IF A COVERED PERSON RECEIVES EMERGENCY CARE FROM
AMBULANCE SERVICE PROVIDERS LICENSED UNDER ARTICLE THIRTY OF THE PUBLIC
HEALTH LAW, FOR SERVICES SPECIFIED IN THE PREFERRED PROVIDER ARRANGEMENT
AND CANNOT REASONABLY REACH A PREFERRED PROVIDER, THAT EMERGENCY CARE
RENDERED DURING THE COURSE OF THE EMERGENCY WILL BE PAID FOR IN ACCORD-
ANCE WITH THE TERMS OF THE AMBULANCE SERVICE PROVIDER, BASED ON THE
USUAL AND CUSTOMARY CHARGES, WHICH SHALL NOT BE EXCESSIVE OR UNREASON-
ABLE FOR THE APPLICABLE TREATMENT, IN THE AREA WHERE THE TREATMENT IS
PROVIDED; AND
(2) A PROVISION WHICH CLEARLY IDENTIFIES THE DIFFERENCES IN BENEFIT
LEVELS FOR AMBULANCE SERVICES OF PREFERRED PROVIDERS AND BENEFIT LEVELS
FOR AMBULANCE SERVICES OF NONPREFERRED PROVIDERS.
(B) FOR PURPOSES OF THIS SECTION, WHEN A REQUEST FOR EMERGENCY CARE IS
MADE THROUGH THE EMERGENCY 911 SYSTEM ON BEHALF OF A COVERED PERSON AND
THE NON-AIRBORNE TRANSPORTATION THAT WAS DISPATCHED IN RESPONSE TO THE
REQUEST IS NOT A PREFERRED PROVIDER, FOR PURPOSES OF PAYMENT UNDER PARA-
GRAPH ONE OF SUBSECTION (A) OF THIS SECTION, IT SHALL BE PRESUMED THAT
THE COVERED PERSON COULD NOT REASONABLY REACH A PREFERRED PROVIDER.
S 2. This act shall take effect immediately.
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