Senate Bill S4241

2017-2018 Legislative Session

Relates to establishing protections from excessive hospital emergency charges

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee Rules Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Bill Amendments

2017-S4241 - Details

See Assembly Version of this Bill:
A7611
Current Committee:
Senate Rules
Law Section:
Financial Services Law
Laws Affected:
Amd §§605 & 608, Fin Serv L
Versions Introduced in Other Legislative Sessions:
2015-2016: S7868, A10470
2019-2020: S3171, A264

2017-S4241 - Summary

Relates to establishing protections from excessive hospital emergency charges; includes hospital charges.

2017-S4241 - Sponsor Memo

2017-S4241 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4241
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             February 6, 2017
                                ___________
 
 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 financial services law, in relation to  establishing
   protections from excessive hospital emergency charges
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 605 of the financial  services  law,  as  added  by
 section  26  of  part H of chapter 60 of the laws of 2014, is amended to
 read as follows:
   § 605.  Dispute  resolution  for  emergency  services.  (a)  Emergency
 services for an insured. (1) When a health care plan receives a bill for
 emergency  services  from a non-participating physician OR HOSPITAL, the
 health care plan shall pay an amount that it  determines  is  reasonable
 for  the  emergency services rendered by the non-participating physician
 OR HOSPITAL, in accordance with section three thousand two hundred twen-
 ty-four-a of the insurance law, except  for  the  insured's  co-payment,
 coinsurance  or  deductible,  if  any, and shall ensure that the insured
 shall incur no greater out-of-pocket costs for  the  emergency  services
 than  the  insured would have incurred with a participating physician OR
 HOSPITAL pursuant to  subsection  (c)  of  section  three  thousand  two
 hundred forty-one of the insurance law.
   (2)  A  non-participating  physician OR HOSPITAL or a health care plan
 may submit a dispute regarding a fee or payment for  emergency  services
 for review to an independent dispute resolution entity. IN CASES WHERE A
 HEALTH  CARE  PLAN  SUBMITS  A  DISPUTE REGARDING A FEE FOR PAYMENT OF A
 NON-PARTICIPATING HOSPITAL'S EMERGENCY ROOM SERVICES,  THE  HEALTH  CARE
 PLAN  SHALL  PAY  THE AMOUNT IT DETERMINES IS REASONABLY DIRECTLY TO THE
 NON-PARTICIPATING HOSPITAL.
   (3) The independent dispute resolution entity shall  make  a  determi-
 nation within thirty days of receipt of the dispute for review.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09770-01-7
              

co-Sponsors

2017-S4241A - Details

See Assembly Version of this Bill:
A7611
Current Committee:
Senate Rules
Law Section:
Financial Services Law
Laws Affected:
Amd §§605 & 608, Fin Serv L
Versions Introduced in Other Legislative Sessions:
2015-2016: S7868, A10470
2019-2020: S3171, A264

2017-S4241A - Summary

Relates to establishing protections from excessive hospital emergency charges; includes hospital charges.

2017-S4241A - Sponsor Memo

2017-S4241A - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4241--A
     Cal. No. 1078
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             February 6, 2017
                                ___________
 
 Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
   printed to be committed to the  Committee  on  Insurance  --  reported
   favorably  from  said  committee,  ordered to first and second report,
   ordered to a third reading, amended and ordered  reprinted,  retaining
   its place in the order of third reading

 AN  ACT to amend the financial services law, in relation to establishing
   protections from excessive hospital emergency charges
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Section  605  of  the financial services law, as added by
 section 26 of part H of chapter 60 of the laws of 2014,  is  amended  to
 read as follows:
   §  605.  Dispute  resolution  for  emergency  services.  (a) Emergency
 services for an insured. (1) When a health care plan receives a bill for
 emergency services from a non-participating physician OR  HOSPITAL,  the
 health  care  plan  shall pay an amount that it determines is reasonable
 for the emergency services rendered by the  non-participating  physician
 OR HOSPITAL, in accordance with section three thousand two hundred twen-
 ty-four-a  of  the  insurance  law, except for the insured's co-payment,
 coinsurance or deductible, if any, and shall  ensure  that  the  insured
 shall  incur  no  greater out-of-pocket costs for the emergency services
 than the insured would have incurred with a participating  physician  OR
 HOSPITAL  pursuant  to  subsection  (c)  of  section  three thousand two
 hundred forty-one of the insurance law.
   (2) A non-participating physician OR HOSPITAL or a  health  care  plan
 may  submit  a dispute regarding a fee or payment for emergency services
 for review to an independent dispute resolution entity.  IN CASES  WHERE
 A  HEALTH  CARE  PLAN SUBMITS A DISPUTE REGARDING A FEE FOR PAYMENT OF A
 NON-PARTICIPATING PHYSICIAN OR HOSPITAL'S EMERGENCY SERVICES, THE HEALTH
 CARE PLAN SHALL, AFTER THE INITIAL PAYMENT, PAY ANY  ADDITIONAL  AMOUNTS
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

co-Sponsors

2017-S4241B - Details

See Assembly Version of this Bill:
A7611
Current Committee:
Senate Rules
Law Section:
Financial Services Law
Laws Affected:
Amd §§605 & 608, Fin Serv L
Versions Introduced in Other Legislative Sessions:
2015-2016: S7868, A10470
2019-2020: S3171, A264

2017-S4241B - Summary

Relates to establishing protections from excessive hospital emergency charges; includes hospital charges.

2017-S4241B - Sponsor Memo

2017-S4241B - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4241--B
     Cal. No. 728
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             February 6, 2017
                                ___________
 
 Introduced  by  Sens. SEWARD, AMEDORE, KRUEGER, LARKIN -- read twice and
   ordered printed, and when printed to be committed to the Committee  on
   Insurance  -- reported favorably from said committee, ordered to first
   and second report, ordered to a third  reading,  amended  and  ordered
   reprinted, retaining its place in the order of third reading -- recom-
   mitted to the Committee on Insurance in accordance with Senate Rule 6,
   sec. 8 -- reported favorably from said committee, ordered to first and
   second  report,  ordered  to  a  third  reading,  amended  and ordered
   reprinted, retaining its place in the order of third reading
 
 AN ACT to amend the financial services law, in relation to  establishing
   protections from excessive hospital emergency charges
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 605 of the financial  services  law,  as  added  by
 section  26  of  part H of chapter 60 of the laws of 2014, is amended to
 read as follows:
   § 605.  Dispute  resolution  for  emergency  services.  (a)  Emergency
 services for an insured. (1) When a health care plan receives a bill for
 emergency  services  from a non-participating physician OR HOSPITAL, the
 health care plan shall pay an amount that it  determines  is  reasonable
 for  the  emergency services rendered by the non-participating physician
 OR HOSPITAL, in accordance with section three thousand two hundred twen-
 ty-four-a of the insurance law, except  for  the  insured's  co-payment,
 coinsurance  or  deductible,  if  any, and shall ensure that the insured
 shall incur no greater out-of-pocket costs for  the  emergency  services
 than  the  insured would have incurred with a participating physician OR
 HOSPITAL pursuant to  subsection  (c)  of  section  three  thousand  two
 hundred forty-one of the insurance law.
   (2)  A  non-participating  physician OR HOSPITAL or a health care plan
 may submit a dispute regarding a fee or payment for  emergency  services
 for  review to an independent dispute resolution entity.  IN CASES WHERE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

co-Sponsors

2017-S4241C (ACTIVE) - Details

See Assembly Version of this Bill:
A7611
Current Committee:
Senate Rules
Law Section:
Financial Services Law
Laws Affected:
Amd §§605 & 608, Fin Serv L
Versions Introduced in Other Legislative Sessions:
2015-2016: S7868, A10470
2019-2020: S3171, A264

2017-S4241C (ACTIVE) - Summary

Relates to establishing protections from excessive hospital emergency charges; includes hospital charges.

2017-S4241C (ACTIVE) - Sponsor Memo

2017-S4241C (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4241--C
     Cal. No. 728
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             February 6, 2017
                                ___________
 
 Introduced  by  Sens. SEWARD, AMEDORE, KRUEGER, LARKIN -- read twice and
   ordered printed, and when printed to be committed to the Committee  on
   Insurance  -- reported favorably from said committee, ordered to first
   and second report, ordered to a third  reading,  amended  and  ordered
   reprinted, retaining its place in the order of third reading -- recom-
   mitted to the Committee on Insurance in accordance with Senate Rule 6,
   sec. 8 -- reported favorably from said committee, ordered to first and
   second  report,  ordered  to  a  third  reading,  amended  and ordered
   reprinted, retaining its place in the order of third reading --  again
   amended  and  ordered  reprinted,  retaining its place in the order of
   third reading
 
 AN ACT to amend the financial services law, in relation to  establishing
   protections from excessive hospital emergency charges
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 605 of the financial  services  law,  as  added  by
 section  26  of  part H of chapter 60 of the laws of 2014, is amended to
 read as follows:
   § 605.  Dispute  resolution  for  emergency  services.  (a)  Emergency
 services for an insured. (1) When a health care plan receives a bill for
 emergency  services  from a non-participating physician OR HOSPITAL, the
 health care plan shall pay an amount that it  determines  is  reasonable
 for  the  emergency services rendered by the non-participating physician
 OR HOSPITAL, in accordance with section three thousand two hundred twen-
 ty-four-a of the insurance law, except  for  the  insured's  co-payment,
 coinsurance  or  deductible,  if  any, and shall ensure that the insured
 shall incur no greater out-of-pocket costs for  the  emergency  services
 than  the  insured would have incurred with a participating physician OR
 HOSPITAL pursuant to  subsection  (c)  of  section  three  thousand  two
 hundred forty-one of the insurance law.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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