senate Bill S1083

2013-2014 Legislative Session

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

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Archive: Last Bill Status - In Committee


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

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 08, 2014 referred to health
Jan 09, 2013 referred to health

Co-Sponsors

S1083 - Details

See Assembly Version of this Bill:
A636
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Amd §4406, Pub Health L; amd §4804, Ins L
Versions Introduced in Previous Legislative Sessions:
2011-2012: S2817, A3802
2009-2010: A11385

S1083 - Summary

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

S1083 - Sponsor Memo

S1083 - Bill Text download pdf

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

                                  1083

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced  by  Sen. MAZIARZ -- read twice and ordered printed, and when
  printed to be committed 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")

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

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