|Assembly Actions - Lowercase
Senate Actions - UPPERCASE
|Jan 08, 2014||referred to insurance|
|Feb 05, 2013||referred to insurance|
senate Bill S3541
Archive: Last Bill Status - In Senate Committee
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
S3541 - Details
S3541 - Sponsor Memo
BILL NUMBER:S3541 TITLE OF BILL: An act to amend the insurance law, in relation to reimbursement for ambulance services PURPOSE: To require insurers to submit payments directly to ambulance providers who are in-network or, for out-of-network ambulance providers, to require the issuance of a joint check to the insured specifying both the insured and the ambulance provider as payees. SUMMARY OF PROVISIONS: Amends sections 3216(i)(24), 3221(1)(15) and 4303(aa) to require insurers to submit payments directly to in-network ambulance providers at the negotiated rates For out-of-network ambulance providers where there is no negotiated rate, the insurer is required to issue a joint check to the insured specifying both the insured and ambu- lance provider as payees, at the usual and customary charge. Further, the legislation requires the insurer to issue reimbursement directly to the ambulance provider if the insured has filed an assign- ment of benefits for such ambulance services. The legislation also requires the insurer to notify the ambulance provider electronically upon the issuance of a joint check to the insured. The notification must include the name of the patient, date of service, date of payment, amount of payment and address to which the payment was sent.
S3541 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 3541 2013-2014 Regular Sessions I N S E N A T E February 5, 2013 ___________ Introduced by Sen. SEWARD -- 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 reimbursement for ambulance services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph 24 of subsection (i) of section 3216 of the insurance law is amended by adding a new subparagraph (F) to read as follows: (F) AN INSURER WHO ISSUES REIMBURSEMENT UNDER THIS PARAGRAPH SHALL SUBMIT SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES NEGO- TIATED BETWEEN THE PROVIDER AND THE INSURER, OR IF NO RATE HAS BEEN NEGOTIATED BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN THE FORM OF A JOINT CHECK SPECIFYING AS PAYEES BOTH THE INSURED AND THE PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID- ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE- FITS FOR SUCH SERVICES TO THE INSURER, NOTWITHSTANDING ANY POLICY LANGUAGE TO THE CONTRARY, THE ISSUER SHALL ACCEPT SUCH ASSIGNMENT OF BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID- ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY THE PROVIDER VIA ELECTRONIC COMMUNICATION OF THE ISSUANCE OF SUCH PAYMENT. THE NOTIFICATION SHALL INCLUDE THE NAME OF THE PATIENT, THE DATE OF SERVICE, THE DATE OF PAYMENT, THE AMOUNT OF PAYMENT AND THE ADDRESS TO WHICH THE PAYMENT WAS SENT. S 2. Paragraph 15 of subsection (1) of section 3221 of the insurance law is amended by adding a new subparagraph (F) to read as follows: (F) AN INSURER WHO ISSUES REIMBURSEMENT UNDER THIS PARAGRAPH SHALL SUBMIT SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES NEGO- TIATED BETWEEN THE PROVIDER AND THE INSURER, OR IF NO RATE HAS BEEN NEGOTIATED BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN THE EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD07580-01-3
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