S T A T E O F N E W Y O R K
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10332
I N A S S E M B L Y
May 13, 2022
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Introduced by COMMITTEE ON RULES -- (at request of M. of A. Septimo) --
read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to the coordination of
no-fault benefits for persons injured in motor vehicle accidents
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The insurance law is amended by adding a new section 5110
to read as follows:
§ 5110. PAYMENT FOR SERVICES PROVIDED FOR MOTOR VEHICLE INJURIES. 1.
ANY PROVIDER OF TREATMENT TO ANY COVERED PERSON, WHO RENDERS CARE OR
SUPPLIES A PRODUCT WITHIN SEVENTY-TWO HOURS OF THE MOTOR VEHICLE ACCI-
DENT, IN THE ABSENCE OF FRAUD OR DECEPTION BY THE CLAIMANT, IS CONCLU-
SIVELY PRESUMED TO HAVE ACCEPTED, AND TO HAVE CONSENTED TO, AN ASSIGN-
MENT OF NO-FAULT BENEFITS UNDER THIS ARTICLE IN THE FORM PRESCRIBED BY
THE SUPERINTENDENT. THE PROVISIONS OF THIS SUBDIVISION SHALL APPLY IF
THE PROVIDER KNOWS, OR IS ON NOTICE OF FACTS THAT INDICATE THAT THE
INJURIES OR CONDITIONS TREATED ARE THE RESULT OF A MOTOR VEHICLE ACCI-
DENT WHICH OCCURRED IN THE PRECEDING SEVENTY-TWO HOURS.
2. ANY PROVIDER OF TREATMENT TO A COVERED PERSON WHO MISTAKENLY OR
OTHERWISE BILLS AN INSURER OTHER THAN THE NO-FAULT INSURER FOR CLAIMS
ELIGIBLE FOR FIRST-PARTY BENEFITS UNDER THIS ARTICLE MUST, UPON PRESEN-
TATION WITH PROOF OF APPLICABLE COVERAGE UNDER ARTICLE SIX, EIGHT OR
FORTY-FOUR-B OF THE VEHICLE AND TRAFFIC LAW, RETURN SUCH FEES AND SEEK
PAYMENT FOR SERVICES FROM THE NO-FAULT INSURER INSTEAD. A PROVIDER SHALL
BE PERMITTED TO MAINTAIN INSURANCE INFORMATION IN THE EVENT IT IS ESTAB-
LISHED THAT THERE ARE NO FIRST-PARTY BENEFITS AVAILABLE FOR EMERGENCY
TREATMENT UNDER THIS ARTICLE.
3. THE TIME LIMIT FOR PRESENTATION OF INVOICES TO AN INSURER SHALL BE
MEASURED FROM THE FIRST DATE ON WHICH THE PROVIDER OR THE PATIENT FIRST
PRESENTED THE INVOICE TO ANY INSURER.
4. ANY COMPENSATION PROVIDER THAT, NOTWITHSTANDING THE OTHER
PROVISIONS OF THIS LAW, PAYS FOR THE EMERGENCY TREATMENT OF A COVERED
PERSON, HAS A RIGHT OF DIRECT ACTION AGAINST THE INSURER LIABLE FOR
COVERAGE UNDER THIS ARTICLE FOR REIMBURSEMENT, BUT IN NO CASE WILL THE
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10765-02-1
A. 10332 2
REIMBURSEMENT EXCEED THE AMOUNT OF LAWFUL BENEFITS ACCORDING TO STATE-
PROMULGATED FEE SCHEDULES.
5. NO INSURER PROVIDING COVERAGE UNDER THIS ARTICLE SHALL EXCLUDE
REIMBURSEMENT FOR FIRST-PARTY BENEFITS WHICH HAVE BEEN PAID TO A HEALTH
CARE PROVIDER OR MEDICAL EQUIPMENT SUPPLIER BY A COMPENSATION PROVIDER
NOT UNDER THIS ARTICLE.
§ 2. This act shall take effect immediately.