|Assembly Actions - Lowercase
Senate Actions - UPPERCASE
|Jan 08, 2014||referred to insurance|
|Feb 05, 2013||referred to insurance|
senate Bill S3546
Archive: Last Bill Status - In Committee
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
S3546 - Details
- Current Committee:
- Law Section:
- Insurance Law
- Laws Affected:
- Amd §§5108 & 5106, Ins L
- Versions Introduced in 2011-2012 Legislative Session:
S3546 - Summary
Relates to providing for the use of treatment guidelines in the no-fault system; prohibits insurers from paying any charge which exceeds the applicable fee schedule or which is not provided for under the fee schedule or compensable under Medicare.
S3546 - Sponsor Memo
BILL NUMBER:S3546 TITLE OF BILL: An act to amend the insurance law, in relation to providing for the use of treatment guidelines under the comprehensive motor vehicle reparations act PURPOSE: To eliminate fraudulent and unnecessary medical treatment in the no-fault system. SUMMARY OF PROVISIONS: Section 1 of this bill would require the estab- lishment of treatment guidelines for medical treatment provided under the no-fault system. Section 2 of this bill would provide an expedited process for the resol- ution of disputes regarding deviations from the treatment guidelines. Section 3 of the bill is the effective date. JUSTIFICATION: On February 29, 2012, the Manhattan U.S. Attorney announced the indictment of 36 people for participating in a $279 million no-fault fraud scheme involving fraudulent medical clinics (medical mills) One of the reasons why medical mills proliferate in New York is because New York's no-fault system makes it very easy to bill insurance companies for fraudulent and unnecessary treatment. This bill would remedy this situation by establishing guidelines for the treatment of various injuries commonly sustained in automobile accidents.
S3546 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 3546 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 providing for the use of treatment guidelines under the comprehensive motor vehicle repara- tions act THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 5108 of the insurance law is amended to read as follows: S 5108. Limit on charges by providers of health services. (a) The charges for services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article and any further health service charges which are incurred as a result of the injury and which are in excess of basic economic loss, shall not exceed the charges permissible under the schedules prepared and established by the chairman of the workers' compensation board for industrial accidents, except where the insurer or arbitrator determines that unusual procedures or unique circumstances justify the excess charge, AND SHALL BE SUBJECT TO THE TREATMENT GUIDELINES ESTABLISHED PURSUANT TO SUBSECTION (D) OF THIS SECTION. AT NO TIME SHALL AN INSURER PAY ANY CHARGE THAT EXCEEDS THE CHARGES PERMISSIBLE UNDER THE SCHEDULE PREPARED AND ESTABLISHED BY THE CHAIR OF THE WORKERS' COMPENSATION BOARD. (b) The superintendent, after consulting with the chairman of the workers' compensation board and the commissioner of health, shall promulgate rules and regulations implementing and coordinating the provisions of this article and the workers' compensation law with respect to charges for the professional health services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article, including the establishment of schedules for all such services for which schedules have not been prepared and established by the chairman of the workers' compensation board, INCLUDING, BUT NOT EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08136-01-3
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