assembly Bill A3802

2011-2012 Legislative Session

Relates to the reimbursement of out-of-network providers of clinical laboratory services

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Assembly Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

view actions (3)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 04, 2012 referred to insurance
Mar 25, 2011 reference changed to insurance
Jan 27, 2011 referred to health

Co-Sponsors

A3802 (ACTIVE) - Details

See Senate Version of this Bill:
S2817
Current Committee:
Assembly Insurance
Law Section:
Public Health Law
Laws Affected:
Amd §4406, Pub Health L; amd §4804, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A11385
2013-2014: A636, S1083
2015-2016: A3527, S5374
2017-2018: A5409, S948
2019-2020: A3928, S1323
2021-2022: A8909

A3802 (ACTIVE) - Summary

Relates to the reimbursement of out-of-network providers of clinical laboratory services by organizations providing or offering comprehensive health services plans.

A3802 (ACTIVE) - Bill Text download pdf

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

                                  3802

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            January 27, 2011
                               ___________

Introduced by M. of A. WEPRIN -- read once and referred to the Committee
  on Health

AN ACT to amend the public health law and the insurance law, in relation
  to the reimbursement of out-of-network providers of clinical laborato-
  ry  services  by  organizations  providing  or  offering comprehensive
  health services plans

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

  Section  1. Section 4406 of the public health law is amended by adding
a new subdivision 6 to read as follows:
  6. NOTWITHSTANDING ANY OTHER PROVISION  OF  LAW,  IF  AN  ENROLLEE  IS
REFERRED  BY  AN  IN-PLAN  PROVIDER TO A PROVIDER OF CLINICAL LABORATORY
SERVICES NOT PARTICIPATING IN THE PLAN (A "NON-PARTICIPATING  PROVIDER")
FOR  ANY  SERVICE  COVERED UNDER THE TERMS OF THE PLAN, THE ORGANIZATION
SHALL BE RESPONSIBLE  FOR  PAYMENT  DIRECTLY  TO  THE  NON-PARTICIPATING
PROVIDER  FOR  THOSE SERVICES IN ACCORDANCE WITH THE TIME FRAME FOR SUCH
PAYMENTS SET FORTH IN SECTION THREE THOUSAND TWO  HUNDRED  TWENTY-FOUR-A
OF  THE  INSURANCE  LAW;  PROVIDED,  HOWEVER, THAT THE ENROLLEE SHALL BE
RESPONSIBLE FOR ANY APPLICABLE COPAY, COINSURANCE OR DEDUCTIBLE FOR SUCH
SERVICES. CLINICAL LABORATORIES SEEKING REIMBURSEMENT PURSUANT  TO  THIS
SECTION FOR SERVICES RENDERED SHALL DIRECTLY BILL THE ORGANIZATION WHOSE
ENROLLEE  RECEIVED  THE  SERVICES.  ANY  PAYMENT MADE BY AN ORGANIZATION
DIRECTLY TO THE ENROLLEE RATHER THAN TO THE CLINICAL LABORATORY  SEEKING
REIMBURSEMENT SHALL NOT SATISFY THE ORGANIZATION'S PAYMENT OBLIGATION TO
THE CLINICAL LABORATORY.
  S  2.  Section  4804  of  the insurance law is amended by adding a new
subsection (g) to read as follows:
  (G) NOTWITHSTANDING ANY OTHER PROVISION OF  LAW,  IF  AN  ENROLLEE  IS
REFERRED  BY  AN  IN-PLAN  PROVIDER TO A PROVIDER OF CLINICAL LABORATORY
SERVICES NOT PARTICIPATING IN THE PLAN (A "NON-PARTICIPATING  PROVIDER")
FOR  ANY  SERVICE  COVERED UNDER THE TERMS OF THE PLAN, THE ORGANIZATION

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01186-02-1