Senate Bill S1323

2019-2020 Legislative Session

Relates to the reimbursement of out-of-network providers of clinical laboratory services

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee Health 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

Do you support this bill?

Please enter your contact information

Home address is used to determine the senate district in which you reside. Your support or opposition to this bill is then shared immediately with the senator who represents you.

Optional services from the NY State Senate:

Create an account. An account allows you to officially support or oppose key legislation, sign petitions with a single click, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Include a custom message for your Senator? (Optional)

Enter a message to your senator. Many New Yorkers use this to share the reasoning behind their support or opposition to the bill. Others might share a personal anecdote about how the bill would affect them or people they care about.
Actions

2019-S1323 (ACTIVE) - Details

See Assembly Version of this Bill:
A3928
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Amd §4406, Pub Health L; amd §4804, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A11385
2011-2012: S2817, A3802
2013-2014: S1083, A636
2015-2016: S5374, A3527
2017-2018: S948, A5409
2021-2022: A8909
2023-2024: A2376

2019-S1323 (ACTIVE) - Summary

Relates to the reimbursement of out-of-network providers of clinical laboratory services by organizations providing or offering comprehensive health services plans.

2019-S1323 (ACTIVE) - Sponsor Memo

2019-S1323 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1323
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                             January 14, 2019
                                ___________
 
 Introduced  by  Sen.  FUNKE  -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law and the insurance law, in relation
   to the reimbursement of out-of-network providers of clinical laborato-
   ry services  by  organizations  providing  or  offering  comprehensive
   health services plans
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 4406 of the public health law is amended by  adding
 a new subdivision 6 to read as follows:
   6.  NOTWITHSTANDING  ANY  OTHER  PROVISION  OF  LAW, IF AN ENROLLEE IS
 REFERRED BY AN IN-PLAN PROVIDER TO A  PROVIDER  OF  CLINICAL  LABORATORY
 SERVICES  NOT PARTICIPATING IN THE PLAN (A "NON-PARTICIPATING PROVIDER")
 FOR ANY SERVICE COVERED UNDER THE TERMS OF THE  PLAN,  THE  ORGANIZATION
 SHALL  BE  RESPONSIBLE  FOR  PAYMENT  DIRECTLY  TO THE NON-PARTICIPATING
 PROVIDER FOR THOSE SERVICES IN ACCORDANCE WITH THE TIME FRAME  FOR  SUCH
 PAYMENTS  SET  FORTH IN SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A
 OF THE INSURANCE LAW; PROVIDED, HOWEVER,  THAT  THE  ENROLLEE  SHALL  BE
 RESPONSIBLE FOR ANY APPLICABLE COPAY, COINSURANCE OR DEDUCTIBLE FOR SUCH
 SERVICES.  CLINICAL  LABORATORIES SEEKING REIMBURSEMENT PURSUANT TO THIS
 SECTION FOR SERVICES RENDERED SHALL DIRECTLY BILL THE ORGANIZATION WHOSE
 ENROLLEE RECEIVED THE SERVICES. ANY  PAYMENT  MADE  BY  AN  ORGANIZATION
 DIRECTLY  TO THE ENROLLEE RATHER THAN TO THE CLINICAL LABORATORY SEEKING
 REIMBURSEMENT SHALL NOT SATISFY THE ORGANIZATION'S PAYMENT OBLIGATION TO
 THE CLINICAL LABORATORY.
   § 2. Section 4804 of the insurance law is  amended  by  adding  a  new
 subsection (g) to read as follows:
   (G)  NOTWITHSTANDING  ANY  OTHER  PROVISION  OF LAW, IF AN ENROLLEE IS
 REFERRED BY AN IN-PLAN PROVIDER TO A  PROVIDER  OF  CLINICAL  LABORATORY
 SERVICES  NOT PARTICIPATING IN THE PLAN (A "NON-PARTICIPATING PROVIDER")
 FOR ANY SERVICE COVERED UNDER THE TERMS OF THE  PLAN,  THE  ORGANIZATION
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

Comments

Open Legislation is a forum for New York State legislation. All comments are subject to review and community moderation is encouraged.

Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity, hate or toxic speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Attempts to intimidate and silence contributors or deliberately deceive the public, including excessive or extraneous posting/posts, or coordinated activity, are prohibited and may result in the temporary or permanent banning of the user. Comment moderation is generally performed Monday through Friday. By contributing or voting you agree to the Terms of Participation and verify you are over 13.

Create an account. An account allows you to sign petitions with a single click, officially support or oppose key legislation, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.