assembly Bill A8909

2021-2022 Legislative Session

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

download bill text pdf

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Current Bill Status - In Assembly Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 19, 2022 referred to insurance

A8909 (ACTIVE) - Details

Current Committee:
Assembly Insurance
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: A3802
2013-2014: A636
2015-2016: A3527
2017-2018: A5409
2019-2020: A3928

A8909 (ACTIVE) - Summary

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

A8909 (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8909
 
                           I N  A S S E M B L Y
 
                             January 19, 2022
                                ___________
 
 Introduced by M. of A. WEPRIN -- read once and referred to the Committee
   on Insurance
 
 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
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.