Assembly Bill A264B

Signed By Governor
2019-2020 Legislative Session

Relates to establishing protections from excessive hospital emergency charges

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Sponsored By

Archive: Last Bill Status - Signed by Governor


  • 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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Actions

Bill Amendments

co-Sponsors

multi-Sponsors

2019-A264 - Details

See Senate Version of this Bill:
S3171
Law Section:
Financial Services Law
Laws Affected:
Amd §§605, 608 & 604, Fin Serv L
Versions Introduced in Other Legislative Sessions:
2015-2016: A10470, S7868
2017-2018: A7611, S4241

2019-A264 - Summary

Establishes patient protections from excessive hospital emergency charges; includes hospital charges, including hospital charges for inpatient services which follow an emergency room visit.

2019-A264 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    264
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced  by  M.  of  A.  CAHILL, COLTON, ARROYO, JEAN-PIERRE, TAYLOR,
   McDONOUGH -- Multi-Sponsored by -- M. of A. EPSTEIN -- read  once  and
   referred 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 SERVICES, THE  HEALTH  CARE  PLAN
 SHALL,  AFTER  THE INITIAL PAYMENT, PAY ANY ADDITIONAL AMOUNTS IT DETER-
 MINES IS REASONABLE DIRECTLY TO THE NON-PARTICIPATING HOSPITAL.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

co-Sponsors

multi-Sponsors

2019-A264A - Details

See Senate Version of this Bill:
S3171
Law Section:
Financial Services Law
Laws Affected:
Amd §§605, 608 & 604, Fin Serv L
Versions Introduced in Other Legislative Sessions:
2015-2016: A10470, S7868
2017-2018: A7611, S4241

2019-A264A - Summary

Establishes patient protections from excessive hospital emergency charges; includes hospital charges, including hospital charges for inpatient services which follow an emergency room visit.

2019-A264A - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  264--A
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced  by  M.  of  A.  CAHILL, COLTON, ARROYO, JEAN-PIERRE, TAYLOR,
   McDONOUGH -- Multi-Sponsored by -- M. of A. EPSTEIN -- read  once  and
   referred  to  the Committee on Insurance -- committee discharged, bill
   amended, ordered reprinted as amended and recommitted to said  commit-
   tee

 AN  ACT  to  amend  the  financial  services law, in relation to patient
   protections from excess hospital 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,
 INCLUDING  A  BILL FOR INPATIENT SERVICES WHICH FOLLOW AN EMERGENCY ROOM
 VISIT, 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  twenty-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  thou-
 sand 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  SERVICES, THE HEALTH CARE PLAN
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

co-Sponsors

multi-Sponsors

2019-A264B (ACTIVE) - Details

See Senate Version of this Bill:
S3171
Law Section:
Financial Services Law
Laws Affected:
Amd §§605, 608 & 604, Fin Serv L
Versions Introduced in Other Legislative Sessions:
2015-2016: A10470, S7868
2017-2018: A7611, S4241

2019-A264B (ACTIVE) - Summary

Establishes patient protections from excessive hospital emergency charges; includes hospital charges, including hospital charges for inpatient services which follow an emergency room visit.

2019-A264B (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  264--B
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced  by  M.  of  A.  CAHILL, COLTON, ARROYO, JEAN-PIERRE, TAYLOR,
   McDONOUGH, JACOBSON -- Multi-Sponsored by -- M. of A. EPSTEIN --  read
   once   and  referred  to  the  Committee  on  Insurance  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee -- again reported from said  committee  with  amend-
   ments, ordered reprinted as amended and recommitted to said committee
 
 AN  ACT to amend the financial services law, in relation to establishing
   protections from excess hospital 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,
 INCLUDING  A  BILL FOR INPATIENT SERVICES WHICH FOLLOW AN EMERGENCY ROOM
 VISIT, 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  twenty-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  thou-
 sand 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

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