Assembly Bill A3218

2019-2020 Legislative Session

Relates to providing that health maintenance organizations shall provide market access to diagnostic laboratories

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Assembly 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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2019-A3218 (ACTIVE) - Details

Current Committee:
Assembly Health
Law Section:
Public Health Law
Laws Affected:
Amd §§4406 & 4406-c, Pub Health L; amd §4804, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A8836
2011-2012: A1691
2013-2014: A5910
2015-2016: A8513
2017-2018: A3711

2019-A3218 (ACTIVE) - Summary

Provides that health maintenance organizations shall provide market access to diagnostic laboratories.

2019-A3218 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3218
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 29, 2019
                                ___________
 
 Introduced by M. of A. ORTIZ -- Multi-Sponsored by -- M. of A. CRESPO --
   read once and referred to the Committee on Health
 
 AN ACT to amend the public health law and the insurance law, in relation
   to  providing  access to diagnostic laboratories by patients in health
   maintenance organizations

   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"),
 ANY SERVICE PROVIDED BY A NON-PARTICIPATING PROVIDER THAT  WOULD  OTHER-
 WISE  BE PAID FOR BY THE PLAN TO OTHER NON-PARTICIPATING PROVIDERS SHALL
 BE PAID FOR BY THE PLAN, AND THE PLAN SHALL BE RESPONSIBLE  FOR  PAYMENT
 DIRECTLY  TO  THE NON-PARTICIPATING PROVIDER FOR THAT SERVICE IN ACCORD-
 ANCE 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 LABORATO-
 RIES  SEEKING  REIMBURSEMENT  PURSUANT  TO  THIS  ARTICLE  FOR  SERVICES
 RENDERED  SHALL  DIRECTLY  BILL  THE  PLAN  WHOSE  ENROLLEE RECEIVED THE
 SERVICES. ANY PAYMENT MADE BY A PLAN DIRECTLY  TO  THE  ENROLLEE  RATHER
 THAN  TO THE CLINICAL LABORATORY SEEKING REIMBURSEMENT SHALL NOT SATISFY
 THE PLAN'S PAYMENT OBLIGATION TO THE CLINICAL LABORATORY.
   § 2. Section 4406-c of the public health law is amended by adding  two
 new subdivisions 4-a and 4-b to read as follows:
   4-A.  NO HEALTH CARE PLAN, NOT-FOR-PROFIT OR FOR-PROFIT HEALTH MAINTE-
 NANCE ORGANIZATION, PREFERRED PROVIDER ORGANIZATION,  POINT  OF  SERVICE
 PLAN,  GOVERNMENT  SUBSIDIZED  HEALTH  CARE  PLAN  OR  SELF INSURED PLAN
 (COLLECTIVELY, "PLAN")  SHALL  EXCLUDE  FROM  PARTICIPATING  WITHIN  ITS
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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