The New York State Senate

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

                                 7717--A

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                              May 11, 2017
                               ___________

Introduced by M. of A. JONES, McDONALD, LUPINACCI, McDONOUGH, RA -- read
  once  and  referred to the Committee on Local Governments -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN ACT to amend the general municipal law and the town law, in  relation
  to authorizing fees and charges for emergency medical services; and to
  amend  the insurance law, in relation to payments to prehospital emer-
  gency medical services providers

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

  Section  1.    Subdivision 4 of section 209-b of the general municipal
law, as amended by chapter 718 of the laws of 1958, is amended  to  read
as follows:
  4. Fees and charges [prohibited] AUTHORIZED.  (A) emergency and gener-
al  ambulance service, INCLUDING EMERGENCY MEDICAL SERVICE AS DEFINED IN
SECTION THREE THOUSAND ONE OF THE PUBLIC HEALTH LAW, authorized pursuant
to this section [shall] MAY be furnished  without  cost  to  the  person
served; PROVIDED, HOWEVER, THAT THE AUTHORITIES HAVING CONTROL OF A FIRE
DEPARTMENT  OR FIRE COMPANY THAT HAVE AUTHORIZED SUCH FIRE DEPARTMENT OR
FIRE COMPANY TO PROVIDE SUCH SERVICE OR SERVICES MAY FIX A  SCHEDULE  OF
FEES  OR  CHARGES  TO  BE  PAID  BY  PERSONS  REQUESTING SUCH SERVICE OR
SERVICES. THE AUTHORITIES HAVING CONTROL OF A FIRE  DEPARTMENT  OR  FIRE
COMPANY MAY PROVIDE FOR THE COLLECTION OF FEES AND CHARGES OR MAY FORMU-
LATE  RULES  AND  REGULATIONS  FOR  THE  COLLECTION  THEREOF BY THE FIRE
DEPARTMENT OR FIRE COMPANY. WHEN FEES AND CHARGES ARE AUTHORIZED  PURSU-
ANT  TO  THIS  SUBDIVISION,  THE  FEES  AND  CHARGES  COLLECTED SHALL BE
DISBURSED IN ACCORDANCE WITH A WRITTEN CONTRACT ENTERED INTO BETWEEN THE
AUTHORITY HAVING CONTROL OF A FIRE DEPARTMENT OR FIRE  COMPANY  AND  THE
FIRE  DEPARTMENT  OR FIRE COMPANY ITSELF.  The acceptance by any fireman
of any personal remuneration or gratuity, directly or indirectly, from a

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00334-03-7

A. 7717--A                          2

person served shall be a ground for his expulsion  or  suspension  as  a
member of the fire department or fire company.
  (B)  NOTWITHSTANDING  THE PROVISIONS OF PARAGRAPH (A) OF THIS SUBDIVI-
SION, A BASIC LIFE SUPPORT SERVICE WHICH ESTABLISHES A SCHEDULE OF  FEES
FOR  SERVICE SHALL ENTER INTO A CONTRACT WITH A PROVIDER OR PROVIDERS OF
ADVANCED LIFE SUPPORT SERVICES TO PROVIDE  SUCH  ADVANCED  LIFE  SUPPORT
SERVICES.  SUCH  CONTRACT  SHALL  AT  A  MINIMUM  ESTABLISH THE FEES FOR
ADVANCED LIFE SUPPORT SERVICES AND THE MEANS BY WHICH SAID PROVIDER WILL
BE REIMBURSED WHEN THE AMBULANCE SERVICE  BILLS  FOR  EMERGENCY  MEDICAL
SERVICE.
  §  2.  Paragraph  (e) of subdivision 1 of section 122-b of the general
municipal law, as amended by chapter 303 of the laws of 1980, is amended
to read as follows:
  (e) [No] A contract [shall]  MAY  be  entered  into  pursuant  to  the
provisions  of  this section for the services of an emergency rescue and
first aid squad of a fire department or fire company which is subject to
the provisions of section two hundred nine-b of [the  general  municipal
law] THIS CHAPTER;
  § 3. Subdivision 1 of section 184 of the town law, as amended by chap-
ter 599 of the laws of 1994, is amended to read as follows:
  1.  Whenever  the town board shall have established or extended a fire
protection district pursuant to the provisions of this article, the town
board shall provide for the furnishing of  fire  protection  within  the
district  and  for that purpose may (a) contract with any city, village,
fire district or incorporated  fire  company  maintaining  adequate  and
suitable  apparatus and appliances for the furnishing of fire protection
in such district or (b) may acquire by gift or purchase  such  apparatus
and  appliances for use in such district and may contract with any city,
village, fire district or incorporated fire company for operation, main-
tenance, and  repair  of  the  same  and  for  the  furnishing  of  fire
protection  in such district, or both. The contract may also provide for
the furnishing of (1) emergency service in case of accidents, calamities
or other emergencies in connection with which the services of firefight-
ers would be required and (2) general ambulance service subject,  howev-
er,  to  the  provisions  of  section  two hundred nine-b of the general
municipal law. In the event that the fire  department  or  fire  company
furnishing fire protection within the district pursuant to contract does
not  maintain  and  operate an ambulance then a separate contract may be
made for the furnishing  within  the  district  of  emergency  ambulance
service or general ambulance service, or both, with any city, village or
fire district the fire department of which, or with an incorporated fire
company  having  its  headquarters outside the district which, maintains
and operates an ambulance subject, however, in the case of general ambu-
lance service, to the provisions of section two hundred  nine-b  of  the
general municipal law, or with an ambulance service, certified or regis-
tered pursuant to article thirty of the public health law[, which is not
organized  under  the  provisions  of  section two hundred nine-b of the
general municipal law].  Any  such  contract  with  any  such  ambulance
service  permitted  herein  shall  be  subject to the provisions of this
section.
  § 4. Section 3224-a of the insurance law is amended by  adding  a  new
subsection (k) to read as follows:
  (K)  PAYMENTS  TO  NONPARTICIPATING OR NONPREFERRED PROVIDERS OF AMBU-
LANCE SERVICES LICENSED UNDER ARTICLE THIRTY OF THE PUBLIC  HEALTH  LAW.
(1)  WHENEVER  AN INSURER OR AN ORGANIZATION, OR CORPORATION LICENSED OR
CERTIFIED PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER

A. 7717--A                          3

OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW PROVIDES THAT ANY  HEALTH
CARE  CLAIMS  SUBMITTED  UNDER CONTRACTS OR AGREEMENTS ISSUED OR ENTERED
INTO PURSUANT TO THIS  ARTICLE  OR  ARTICLE  FORTY-TWO,  FORTY-THREE  OR
FORTY-SEVEN  OF THIS CHAPTER AND ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH
LAW ARE PAYABLE TO A PARTICIPATING OR PREFERRED  PROVIDER  OF  AMBULANCE
SERVICES  FOR  SERVICES  RENDERED,  THE INSURER, ORGANIZATION, OR CORPO-
RATION LICENSED OR CERTIFIED PURSUANT TO ARTICLE FORTY-THREE  OR  FORTY-
SEVEN  OF  THIS  CHAPTER  OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW
SHALL BE REQUIRED TO PAY SUCH BENEFITS EITHER DIRECTLY TO ANY  SIMILARLY
LICENSED  NONPARTICIPATING  OR  NONPREFERRED  PROVIDER  AT THE USUAL AND
CUSTOMARY CHARGE, WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE, WHEN THE
PROVIDER HAS RENDERED SUCH SERVICES, HAS A WRITTEN ASSIGNMENT  OF  BENE-
FITS,  AND  HAS  CAUSED WRITTEN NOTICE OF SUCH ASSIGNMENT TO BE GIVEN TO
THE INSURER, ORGANIZATION, OR CORPORATION LICENSED OR CERTIFIED PURSUANT
TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTICLE  FORTY-
FOUR  OF  THE  PUBLIC  HEALTH LAW OR JOINTLY TO SUCH NONPARTICIPATING OR
NONPREFERRED PROVIDER AND TO THE INSURED, SUBSCRIBER, OR  OTHER  COVERED
PERSON;  PROVIDED,  HOWEVER,  THAT IN EITHER CASE THE INSURER, ORGANIZA-
TION, OR CORPORATION LICENSED OR CERTIFIED PURSUANT  TO  ARTICLE  FORTY-
THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTICLE FORTY-FOUR OF THE PUBLIC
HEALTH  LAW  SHALL BE REQUIRED TO SEND SUCH BENEFIT PAYMENTS DIRECTLY TO
THE PROVIDER WHO HAS  THE  WRITTEN  ASSIGNMENT.  WHEN  PAYMENT  IS  MADE
DIRECTLY  TO  A  PROVIDER  OF  AMBULANCE  SERVICES AS AUTHORIZED BY THIS
SECTION, THE INSURER, ORGANIZATION, OR CORPORATION LICENSED OR CERTIFIED
PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR  ARTI-
CLE  FORTY-FOUR  OF  THE  PUBLIC HEALTH LAW SHALL GIVE WRITTEN NOTICE OF
SUCH PAYMENT TO THE INSURED, SUBSCRIBER, OR OTHER COVERED PERSON.
  (2)  AN  INSURER  SHALL  PROVIDE  REIMBURSEMENT  FOR  THOSE   SERVICES
PRESCRIBED  BY  THIS SECTION AT RATES NEGOTIATED BETWEEN THE INSURER AND
THE PROVIDER OF SUCH SERVICES. IN THE ABSENCE OF AGREED UPON  RATES,  AN
INSURER  SHALL  PAY FOR SUCH SERVICES AT THE USUAL AND CUSTOMARY CHARGE,
WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE.
  (3) NOTHING CONTAINED IN THIS SECTION SHALL BE DEEMED TO PROHIBIT  THE
PAYMENT  OF  DIFFERENT  LEVELS OF BENEFITS OR FROM HAVING DIFFERENCES IN
COINSURANCE  PERCENTAGES  APPLICABLE  TO  BENEFIT  LEVELS  FOR  SERVICES
PROVIDED BY PARTICIPATING OR PREFERRED PROVIDERS AND NONPARTICIPATING OR
NONPREFERRED PROVIDERS.
  THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO POLICIES THAT DO NOT
INCLUDE COVERAGE FOR AMBULANCE SERVICES.
  §  5.  Subparagraphs  (C) and (D) of paragraph 24 of subsection (i) of
section 3216 of the insurance law, as added by chapter 506 of  the  laws
of 2001, are amended to read as follows:
  (C)   An  insurer  shall  provide  reimbursement  for  those  services
prescribed by this section at rates negotiated between the  insurer  and
the  provider  of such services. In the absence of agreed upon rates, an
insurer shall pay for such services at the usual and  customary  charge,
which  shall  not  be excessive or unreasonable.  THE INSURER SHALL SEND
SUCH PAYMENTS DIRECTLY TO THE PROVIDER OF SUCH  AMBULANCE  SERVICES,  IF
THE  AMBULANCE  SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF BENEFITS FORM
WITH THE CLAIM.
  (D) The provisions of this paragraph  shall  have  no  application  to
transfers  of patients between hospitals or health care facilities by an
ambulance service as described in subparagraph  (A)  of  this  paragraph
UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.

A. 7717--A                          4

  §  6.  Subparagraphs  (C) and (D) of paragraph 15 of subsection (l) of
section 3221 of the insurance law, as added by chapter 506 of  the  laws
of 2001, are amended to read as follows:
  (C)   An  insurer  shall  provide  reimbursement  for  those  services
prescribed by this section at rates negotiated between the  insurer  and
the  provider  of such services. In the absence of agreed upon rates, an
insurer shall pay for such services at the usual and  customary  charge,
which  shall  not  be excessive or unreasonable.  THE INSURER SHALL SEND
SUCH PAYMENTS DIRECTLY TO THE PROVIDER OF SUCH  AMBULANCE  SERVICES,  IF
THE  AMBULANCE  SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF BENEFITS FORM
WITH THE CLAIM.
  (D) The provisions of this paragraph  shall  have  no  application  to
transfers  of patients between hospitals or health care facilities by an
ambulance service as described in subparagraph  (A)  of  this  paragraph
UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
  §  7.  Paragraphs  3  and  4 of subsection (aa) of section 4303 of the
insurance law, as added by chapter 506 of the laws of 2001, are  amended
to read as follows:
  (3)   An  insurer  shall  provide  reimbursement  for  those  services
prescribed by this section at rates negotiated between the  insurer  and
the  provider  of such services. In the absence of agreed upon rates, an
insurer shall pay for such services at the usual and  customary  charge,
which  shall  not  be excessive or unreasonable.  THE INSURER SHALL SEND
SUCH PAYMENTS DIRECTLY TO THE PROVIDER OF SUCH  AMBULANCE  SERVICES,  IF
THE  AMBULANCE  SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF BENEFITS FORM
WITH THE CLAIM.
  (4) The provisions of this subsection shall  have  no  application  to
transfers  of patients between hospitals or health care facilities by an
ambulance service as described  in  paragraph  one  of  this  subsection
UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
  §  8.  This  act shall take effect on the ninetieth day after it shall
have become a law, except that sections four, five,  six  and  seven  of
this  act  shall  take effect January 1, 2019, and shall apply to health
care claims submitted on or after such date.

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

                                 7717--B

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                              May 11, 2017
                               ___________

Introduced  by  M. of A. JONES, McDONALD, McDONOUGH, RA, HARRIS, LAVINE,
  D'URSO, WOERNER, BLAKE, DiPIETRO, BYRNE, STECK, COOK, BUCHWALD, ERRIGO
  -- read once and referred to the Committee  on  Local  Governments  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee -- recommitted to the Committee on Local
  Governments in accordance with Assembly Rule 3, sec.  2  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN  ACT to amend the general municipal law and the town law, in relation
  to authorizing fees and charges for emergency medical services; and to
  amend the insurance law, in relation to payments to prehospital  emer-
  gency medical services providers

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

  Section 1.  Subdivision 4 of section 209-b of  the  general  municipal
law,  as  amended by chapter 718 of the laws of 1958, is amended to read
as follows:
  4. Fees and charges [prohibited] AUTHORIZED.  (A) emergency and gener-
al ambulance service, INCLUDING EMERGENCY MEDICAL SERVICE AS DEFINED  IN
SECTION THREE THOUSAND ONE OF THE PUBLIC HEALTH LAW, authorized pursuant
to  this  section  [shall]  MAY  be furnished without cost to the person
served; PROVIDED, HOWEVER, THAT THE AUTHORITIES HAVING CONTROL OF A FIRE
DEPARTMENT OR FIRE COMPANY THAT HAVE AUTHORIZED SUCH FIRE DEPARTMENT  OR
FIRE  COMPANY  TO PROVIDE SUCH SERVICE OR SERVICES MAY FIX A SCHEDULE OF
FEES OR CHARGES TO  BE  PAID  BY  PERSONS  REQUESTING  SUCH  SERVICE  OR
SERVICES.  THE  AUTHORITIES  HAVING CONTROL OF A FIRE DEPARTMENT OR FIRE
COMPANY MAY PROVIDE FOR THE COLLECTION OF FEES AND CHARGES OR MAY FORMU-
LATE RULES AND REGULATIONS  FOR  THE  COLLECTION  THEREOF  BY  THE  FIRE
DEPARTMENT  OR FIRE COMPANY. WHEN FEES AND CHARGES ARE AUTHORIZED PURSU-
ANT TO THIS  SUBDIVISION,  THE  FEES  AND  CHARGES  COLLECTED  SHALL  BE
DISBURSED IN ACCORDANCE WITH A WRITTEN CONTRACT ENTERED INTO BETWEEN THE

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

                                                           LBD00334-05-8

A. 7717--B                          2

AUTHORITY  HAVING  CONTROL  OF A FIRE DEPARTMENT OR FIRE COMPANY AND THE
FIRE DEPARTMENT OR FIRE COMPANY ITSELF.  The acceptance by  any  fireman
of any personal remuneration or gratuity, directly or indirectly, from a
person  served  shall  be  a ground for his expulsion or suspension as a
member of the fire department or fire company.
  (B) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (A) OF  THIS  SUBDIVI-
SION,  A BASIC LIFE SUPPORT SERVICE WHICH ESTABLISHES A SCHEDULE OF FEES
FOR SERVICE SHALL ENTER INTO A CONTRACT WITH A PROVIDER OR PROVIDERS  OF
ADVANCED  LIFE  SUPPORT  SERVICES  TO PROVIDE SUCH ADVANCED LIFE SUPPORT
SERVICES. SUCH CONTRACT SHALL  AT  A  MINIMUM  ESTABLISH  THE  FEES  FOR
ADVANCED LIFE SUPPORT SERVICES AND THE MEANS BY WHICH SAID PROVIDER WILL
BE  REIMBURSED  WHEN  THE  AMBULANCE SERVICE BILLS FOR EMERGENCY MEDICAL
SERVICE.
  § 2. Paragraph (e) of subdivision 1 of section 122-b  of  the  general
municipal law, as amended by chapter 303 of the laws of 1980, is amended
to read as follows:
  (e)  [No]  A  contract  [shall]  MAY  be  entered into pursuant to the
provisions of this section for the services of an emergency  rescue  and
first aid squad of a fire department or fire company which is subject to
the  provisions  of section two hundred nine-b of [the general municipal
law] THIS CHAPTER;
  § 3. Subdivision 1 of section 184 of the town law, as amended by chap-
ter 599 of the laws of 1994, is amended to read as follows:
  1. Whenever the town board shall have established or extended  a  fire
protection district pursuant to the provisions of this article, the town
board  shall  provide  for  the furnishing of fire protection within the
district and for that purpose may (a) contract with any  city,  village,
fire  district  or  incorporated  fire  company maintaining adequate and
suitable apparatus and appliances for the furnishing of fire  protection
in  such  district or (b) may acquire by gift or purchase such apparatus
and appliances for use in such district and may contract with any  city,
village, fire district or incorporated fire company for operation, main-
tenance,  and  repair  of  the  same  and  for  the  furnishing  of fire
protection in such district, or both. The contract may also provide  for
the furnishing of (1) emergency service in case of accidents, calamities
or other emergencies in connection with which the services of firefight-
ers  would be required and (2) general ambulance service subject, howev-
er, to the provisions of section  two  hundred  nine-b  of  the  general
municipal  law.  In  the  event that the fire department or fire company
furnishing fire protection within the district pursuant to contract does
not maintain and operate an ambulance then a separate  contract  may  be
made  for  the  furnishing  within  the  district of emergency ambulance
service or general ambulance service, or both, with any city, village or
fire district the fire department of which, or with an incorporated fire
company having its headquarters outside the  district  which,  maintains
and operates an ambulance subject, however, in the case of general ambu-
lance  service,  to  the provisions of section two hundred nine-b of the
general municipal law, or with an ambulance service, certified or regis-
tered pursuant to article thirty of the public health law[, which is not
organized under the provisions of section  two  hundred  nine-b  of  the
general  municipal  law].  Any  such  contract  with  any such ambulance
service permitted herein shall be subject  to  the  provisions  of  this
section.
  §  4.  Section  3224-a of the insurance law is amended by adding a new
subsection (k) to read as follows:

A. 7717--B                          3

  (K) PAYMENTS TO NONPARTICIPATING OR NONPREFERRED  PROVIDERS  OF  AMBU-
LANCE  SERVICES  LICENSED UNDER ARTICLE THIRTY OF THE PUBLIC HEALTH LAW.
(1) WHENEVER AN INSURER OR AN ORGANIZATION, OR CORPORATION  LICENSED  OR
CERTIFIED PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER
OR  ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW PROVIDES THAT ANY HEALTH
CARE CLAIMS SUBMITTED UNDER CONTRACTS OR AGREEMENTS  ISSUED  OR  ENTERED
INTO  PURSUANT  TO  THIS  ARTICLE  OR  ARTICLE FORTY-TWO, FORTY-THREE OR
FORTY-SEVEN OF THIS CHAPTER AND ARTICLE FORTY-FOUR OF THE PUBLIC  HEALTH
LAW  ARE  PAYABLE  TO A PARTICIPATING OR PREFERRED PROVIDER OF AMBULANCE
SERVICES FOR SERVICES RENDERED, THE  INSURER,  ORGANIZATION,  OR  CORPO-
RATION  LICENSED  OR CERTIFIED PURSUANT TO ARTICLE FORTY-THREE OR FORTY-
SEVEN OF THIS CHAPTER OR ARTICLE FORTY-FOUR OF  THE  PUBLIC  HEALTH  LAW
SHALL  BE REQUIRED TO PAY SUCH BENEFITS EITHER DIRECTLY TO ANY SIMILARLY
LICENSED NONPARTICIPATING OR NONPREFERRED  PROVIDER  AT  THE  USUAL  AND
CUSTOMARY CHARGE, WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE, WHEN THE
PROVIDER  HAS  RENDERED SUCH SERVICES, HAS A WRITTEN ASSIGNMENT OF BENE-
FITS, AND HAS CAUSED WRITTEN NOTICE OF SUCH ASSIGNMENT TO  BE  GIVEN  TO
THE INSURER, ORGANIZATION, OR CORPORATION LICENSED OR CERTIFIED PURSUANT
TO  ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTICLE FORTY-
FOUR OF THE PUBLIC HEALTH LAW OR JOINTLY  TO  SUCH  NONPARTICIPATING  OR
NONPREFERRED  PROVIDER  AND TO THE INSURED, SUBSCRIBER, OR OTHER COVERED
PERSON; PROVIDED, HOWEVER, THAT IN EITHER CASE  THE  INSURER,  ORGANIZA-
TION,  OR  CORPORATION  LICENSED OR CERTIFIED PURSUANT TO ARTICLE FORTY-
THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTICLE FORTY-FOUR OF THE PUBLIC
HEALTH LAW SHALL BE REQUIRED TO SEND SUCH BENEFIT PAYMENTS  DIRECTLY  TO
THE  PROVIDER  WHO  HAS  THE  WRITTEN  ASSIGNMENT.  WHEN PAYMENT IS MADE
DIRECTLY TO A PROVIDER OF  AMBULANCE  SERVICES  AS  AUTHORIZED  BY  THIS
SECTION, THE INSURER, ORGANIZATION, OR CORPORATION LICENSED OR CERTIFIED
PURSUANT  TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTI-
CLE FORTY-FOUR OF THE PUBLIC HEALTH LAW SHALL  GIVE  WRITTEN  NOTICE  OF
SUCH PAYMENT TO THE INSURED, SUBSCRIBER, OR OTHER COVERED PERSON.
  (2)   AN  INSURER  SHALL  PROVIDE  REIMBURSEMENT  FOR  THOSE  SERVICES
PRESCRIBED BY THIS SECTION AT RATES NEGOTIATED BETWEEN THE  INSURER  AND
THE  PROVIDER  OF SUCH SERVICES. IN THE ABSENCE OF AGREED UPON RATES, AN
INSURER SHALL PAY FOR SUCH SERVICES AT THE USUAL AND  CUSTOMARY  CHARGE,
WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE.
  (3)  NOTHING CONTAINED IN THIS SECTION SHALL BE DEEMED TO PROHIBIT THE
PAYMENT OF DIFFERENT LEVELS OF BENEFITS OR FROM  HAVING  DIFFERENCES  IN
COINSURANCE  PERCENTAGES  APPLICABLE  TO  BENEFIT  LEVELS  FOR  SERVICES
PROVIDED BY PARTICIPATING OR PREFERRED PROVIDERS AND NONPARTICIPATING OR
NONPREFERRED PROVIDERS.
  THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO POLICIES THAT DO NOT
INCLUDE COVERAGE FOR AMBULANCE SERVICES.
  § 5. Subparagraphs (C) and (D) of paragraph 24 of  subsection  (i)  of
section  3216  of the insurance law, as added by chapter 506 of the laws
of 2001, are amended to read as follows:
  (C)  An  insurer  shall  provide  reimbursement  for  those   services
prescribed  by  this section at rates negotiated between the insurer and
the provider of such services. In the absence of agreed upon  rates,  an
insurer  shall  pay for such services at the usual and customary charge,
which shall not be excessive or unreasonable.   THE INSURER  SHALL  SEND
SUCH  PAYMENTS  DIRECTLY  TO THE PROVIDER OF SUCH AMBULANCE SERVICES, IF
THE AMBULANCE SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF  BENEFITS  FORM
WITH THE CLAIM.
  (D)  The  provisions  of  this  paragraph shall have no application to
transfers of patients between hospitals or health care facilities by  an

A. 7717--B                          4

ambulance  service  as  described  in subparagraph (A) of this paragraph
UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
  §  6.  Subparagraphs  (C) and (D) of paragraph 15 of subsection (l) of
section 3221 of the insurance law, as added by chapter 506 of  the  laws
of 2001, are amended to read as follows:
  (C)   An  insurer  shall  provide  reimbursement  for  those  services
prescribed by this section at rates negotiated between the  insurer  and
the  provider  of such services. In the absence of agreed upon rates, an
insurer shall pay for such services at the usual and  customary  charge,
which  shall  not  be excessive or unreasonable.  THE INSURER SHALL SEND
SUCH PAYMENTS DIRECTLY TO THE PROVIDER OF SUCH  AMBULANCE  SERVICES,  IF
THE  AMBULANCE  SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF BENEFITS FORM
WITH THE CLAIM.
  (D) The provisions of this paragraph  shall  have  no  application  to
transfers  of patients between hospitals or health care facilities by an
ambulance service as described in subparagraph  (A)  of  this  paragraph
UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
  §  7.  Paragraphs  3  and  4 of subsection (aa) of section 4303 of the
insurance law, as added by chapter 506 of the laws of 2001, are  amended
to read as follows:
  (3)   An  insurer  shall  provide  reimbursement  for  those  services
prescribed by this section at rates negotiated between the  insurer  and
the  provider  of such services. In the absence of agreed upon rates, an
insurer shall pay for such services at the usual and  customary  charge,
which  shall  not  be excessive or unreasonable.  THE INSURER SHALL SEND
SUCH PAYMENTS DIRECTLY TO THE PROVIDER OF SUCH  AMBULANCE  SERVICES,  IF
THE  AMBULANCE  SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF BENEFITS FORM
WITH THE CLAIM.
  (4) The provisions of this subsection shall  have  no  application  to
transfers  of patients between hospitals or health care facilities by an
ambulance service as described  in  paragraph  one  of  this  subsection
UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
  §  8.  This  act shall take effect on the ninetieth day after it shall
have become a law, except that sections four, five,  six  and  seven  of
this  act  shall  take effect January 1, 2020, and shall apply to health
care claims submitted on or after such date.