S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3901
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 31, 2019
                                ___________
 
 Introduced  by  M.  of  A.  DenDEKKER  --  read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance  law,  in  relation  to  health  insurance
   coverage for clinical laboratory services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
 amended by adding a new paragraph 35 to read as follows:
   (35)  NO SUCH POLICY SHALL LIMIT OR DENY REIMBURSEMENT FOR BENEFITS TO
 ANY INSURED ON THE BASIS THAT A LABORATORY PROVIDING CLINICAL LABORATORY
 SERVICES IS AN OUT-OF-NETWORK PROVIDER, IF  AN  IN-NETWORK  HEALTH  CARE
 PROVIDER  DIRECTS  SPECIMENS  RETRIEVED  BY SUCH HEALTH CARE PROVIDER TO
 SUCH OUT-OF-NETWORK LABORATORY OR SUCH HEALTH CARE PROVIDER DIRECTS  THE
 INSURED  TO  SUCH  OUT-OF-NETWORK  LABORATORY  FOR  CLINICAL  LABORATORY
 SERVICES. NO SUCH POLICY SHALL PROHIBIT  A  DULY  REGISTERED  LABORATORY
 FROM PROVIDING SERVICES, PROVIDED SUCH LABORATORY AGREES TO PROVIDE SUCH
 SERVICES  IN  ACCORDANCE  WITH  THE MINIMUM STANDARDS AND CONDITIONS FOR
 SIMILAR PROVIDERS THAT HAVE BEEN ESTABLISHED BY SUCH POLICY.
   § 2. Subsection (e) of section 3221 of the insurance law is amended by
 adding a new paragraph 9 to read as follows:
   (9) NO SUCH GROUP OR BLANKET POLICY SHALL LIMIT OR DENY  REIMBURSEMENT
 FOR  BENEFITS  TO  ANY  INSURED ON THE BASIS THAT A LABORATORY PROVIDING
 CLINICAL LABORATORY  SERVICES  IS  AN  OUT-OF-NETWORK  PROVIDER,  IF  AN
 IN-NETWORK  HEALTH  CARE  PROVIDER  DIRECTS  SPECIMENS RETRIEVED BY SUCH
 HEALTH CARE PROVIDER TO SUCH OUT-OF-NETWORK LABORATORY  OR  SUCH  HEALTH
 CARE  PROVIDER DIRECTS THE INSURED TO SUCH OUT-OF-NETWORK LABORATORY FOR
 CLINICAL LABORATORY SERVICES. NO SUCH  GROUP  OR  BLANKET  POLICY  SHALL
 PROHIBIT  A DULY REGISTERED LABORATORY FROM PROVIDING SERVICES, PROVIDED
 SUCH LABORATORY AGREES TO PROVIDE SUCH SERVICES IN ACCORDANCE  WITH  THE
 MINIMUM  STANDARDS  AND  CONDITIONS FOR SIMILAR PROVIDERS THAT HAVE BEEN
 ESTABLISHED BY SUCH GROUP OR BLANKET POLICY.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD07981-01-9

 A. 3901                             2
 
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ss) to read as follows:
   (SS)  NO  SUCH  POLICY  ISSUED  BY A THIRD PARTY BENEFIT PROGRAM SHALL
 LIMIT OR DENY REIMBURSEMENT FOR BENEFITS TO ANY  INSURED  ON  THE  BASIS
 THAT  A  LABORATORY PROVIDING CLINICAL LABORATORY SERVICES IS AN OUT-OF-
 NETWORK PROVIDER, IF AN IN-NETWORK HEALTH CARE PROVIDER  DIRECTS  SPECI-
 MENS RETRIEVED BY SUCH HEALTH CARE PROVIDER TO SUCH OUT-OF-NETWORK LABO-
 RATORY  OR  SUCH  HEALTH  CARE  PROVIDER  DIRECTS  THE  INSURED  TO SUCH
 OUT-OF-NETWORK LABORATORY FOR  CLINICAL  LABORATORY  SERVICES.  NO  SUCH
 THIRD  PARTY BENEFIT PROGRAM SHALL PROHIBIT A DULY REGISTERED LABORATORY
 FROM PROVIDING SERVICES, PROVIDED SUCH LABORATORY AGREES TO PROVIDE SUCH
 SERVICES IN ACCORDANCE WITH THE MINIMUM  STANDARDS  AND  CONDITIONS  FOR
 SIMILAR PROVIDERS THAT HAVE BEEN ESTABLISHED BY SUCH THIRD PARTY BENEFIT
 PROGRAM.
   §  4. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become a law and shall apply to  all
 policies  and contracts issued, renewed, modified, altered or amended on
 or after such effective date.