| Date of Action |
Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|---|---|
| Feb 28, 2012 |
referred to insurance |
Senate Bill S6565
2011-2012 Legislative Session
Sponsored By
(R, C, IP) Senate District
Archive: Last Bill Status - In Senate Committee Insurance Committee
Actions
co-Sponsors
(R, C, IP) Senate District
2011-S6565 (ACTIVE) - Details
- See Assembly Version of this Bill:
- A5040
- Current Committee:
- Senate Insurance
- Law Section:
- Insurance Law
- Laws Affected:
- Amd §§3216, 3221 & 4303, Ins L
- Versions Introduced in Other Legislative Sessions:
-
2009-2010:
A766
2013-2014: A5146
2011-S6565 (ACTIVE) - Sponsor Memo
BILL NUMBER:S6565
TITLE OF BILL:
An act
to amend the insurance law, in relation to assignment of rights by the
insured
PURPOSE OR GENERAL IDEA OF BILL:
To improve managed care market conduct and to clarify that consumers
have the option to authorize direct reimbursement from their insurer
to their out-of-network provider.
SUMMARY OF PROVISIONS:
Section one adds a §3216(i)(29) to the Insurance Law, Section two adds
a §3221(s) to the Insurance Law and section three adds a §4303(a-1)
to the Insurance Law.
These sections require that insurers allow consumers to have the
option to authorize direct reimbursement from their insurer to their
out-of-network provider.
Section four provides that the act shall take effect on January 1st
next succeeding the date on which it shall become law.
JUSTIFICATION:
A new managed care practice is emerging where health insurers are
2011-S6565 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
6565
I N S E N A T E
February 28, 2012
___________
Introduced by Sen. HANNON -- 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 assignment of rights
by the insured
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 29 to read as follows:
(29) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN POLICY OR
WRITTEN PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS CONTRACT
WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN AN INSURED
ASSIGNS HIS RIGHT TO RECEIVE REIMBURSEMENT FOR MEDICALLY NECESSARY
HEALTH CARE SERVICES TO A HEALTH CARE PROVIDER, THE INSURER SHALL REMIT
PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE HEALTH CARE PROVIDER. WHEN
AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT SENT TO THE INSURED RATHER THAN
TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY THE PLAN'S OBLIGATION OR
REQUIREMENTS UNDER SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
THIS ARTICLE AND IS SUBJECT TO INTEREST CHARGE PURSUANT TO SECTION THREE
THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THIS ARTICLE.
S 2. Section 3221 of the insurance law is amended by adding a new
subsection (s) to read as follows:
(S) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN POLICY OR
WRITTEN PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS CONTRACT
WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN AN INSURED
ASSIGNS HIS RIGHT TO RECEIVE REIMBURSEMENT FOR MEDICALLY NECESSARY
HEALTH CARE SERVICES TO A HEALTH CARE PROVIDER, THE INSURER SHALL REMIT
PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE HEALTH CARE PROVIDER. WHEN
AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT SENT TO THE INSURED RATHER THAN
TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY THE PLAN'S OBLIGATION OR
REQUIREMENTS UNDER SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
THIS ARTICLE AND IS SUBJECT TO INTEREST CHARGE PURSUANT TO SECTION THREE
THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THIS ARTICLE.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
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