S T A T E   O F   N E W   Y O R K
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                                 1064--A

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                             January 8, 2015
                               ___________

Introduced by M. of A. CAHILL -- read once and referred to the Committee
  on  Insurance  -- recommitted to the Committee on Insurance in accord-
  ance with Assembly Rule  3,  sec.  2  --  committee  discharged,  bill
  amended,  ordered reprinted as amended and recommitted to said commit-
  tee

AN ACT to amend the public health law and the insurance law, in relation
  to requiring health insurers to accept third party payments for cover-
  age

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

  Section  1.  Section  4406-c  of  the  public health law is amended by
adding a new subdivision 9 to read as follows:
  9. WITH REGARD TO A SUBSCRIBER CONTRACT OFFERED THROUGH THE INDIVIDUAL
MARKET, A HEALTH MAINTENANCE ORGANIZATION SHALL NOT BY  CONTRACT  OR  IN
ANY  OTHER  MANNER REFUSE TO ACCEPT PREMIUM OR ANY REQUIRED COST SHARING
PAYMENTS FROM THIRD PARTIES IF MADE  BY  (A)  AN  INDIAN  TRIBE,  TRIBAL
ORGANIZATION, URBAN INDIAN ORGANIZATION, OR ANY STATE OR FEDERAL GOVERN-
MENT  PROGRAM  OR  GRANTEE  (SUCH AS THE RYAN WHITE HIV/AIDS PROGRAM) ON
BEHALF OF AN ENROLLEE, OR (B) A PRIVATE, NOT-FOR-PROFIT  FOUNDATION,  ON
BEHALF  OF  AN ENROLLEE WHO SATISFIES DEFINED CRITERIA THAT ARE BASED ON
FINANCIAL STATUS AND DO NOT CONSIDER  HEALTH  STATUS,  AND  THE  PAYMENT
COVERS THE ENTIRE POLICY YEAR.
  S  2.  Section  3217-b of the insurance law is amended by adding a new
subsection (k) to read as follows:
  (K) WITH REGARD TO AN INSURANCE POLICY OFFERED THROUGH THE  INDIVIDUAL
MARKET,  AN  INSURER SHALL NOT BY CONTRACT OR IN ANY OTHER MANNER REFUSE
TO ACCEPT PREMIUM OR ANY  REQUIRED  COST  SHARING  PAYMENTS  FROM  THIRD
PARTIES IF MADE BY (1) AN INDIAN TRIBE, TRIBAL ORGANIZATION, URBAN INDI-
AN  ORGANIZATION,  OR ANY STATE OR FEDERAL GOVERNMENT PROGRAM OR GRANTEE
(SUCH AS THE RYAN WHITE HIV/AIDS PROGRAM) ON BEHALF OF  AN  INSURED,  OR
(2)  A  PRIVATE,  NOT-FOR-PROFIT FOUNDATION, ON BEHALF OF AN INSURED WHO

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06407-02-6
              

A. 1064--A                          2

SATISFIES DEFINED CRITERIA THAT ARE BASED ON FINANCIAL STATUS AND DO NOT
CONSIDER HEALTH STATUS, AND THE PAYMENT COVERS THE ENTIRE POLICY YEAR.
  S  3.  Section  4325  of  the insurance law is amended by adding a new
subsection (l) to read as follows:
  (L) WITH REGARD TO AN INSURANCE CONTRACT OFFERED THROUGH THE  INDIVID-
UAL  MARKET,  A  CORPORATION  ORGANIZED  UNDER THIS ARTICLE SHALL NOT BY
CONTRACT OR IN ANY OTHER MANNER REFUSE TO ACCEPT PREMIUM OR ANY REQUIRED
COST SHARING PAYMENTS FROM THIRD PARTIES IF MADE BY (1) AN INDIAN TRIBE,
TRIBAL ORGANIZATION, URBAN INDIAN ORGANIZATION, OR ANY STATE OR  FEDERAL
GOVERNMENT  PROGRAM OR GRANTEE (SUCH AS THE RYAN WHITE HIV/AIDS PROGRAM)
ON BEHALF OF A SUBSCRIBER, OR (2) A PRIVATE, NOT-FOR-PROFIT  FOUNDATION,
ON  BEHALF OF A SUBSCRIBER WHO SATISFIES DEFINED CRITERIA THAT ARE BASED
ON FINANCIAL STATUS AND DO  NOT  CONSIDER  HEALTH  STATUS,  AND  PAYMENT
COVERS THE ENTIRE POLICY YEAR.
  S 4. This act shall take effect January 1, 2017.