Assembly Bill A5064

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5064
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 2, 2023
                                ___________
 
 Introduced  by M. of A. GUNTHER -- read once and referred to the Commit-
   tee on Health
 
 AN ACT to amend the public health law,  in  relation  to  requiring  the
   commissioner  of health to promulgate rules and regulations related to
   the timeframe for increases to patients' bills

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 206 of the public health law is amended by adding a
 new subdivision 32 to read as follows:
   32. (A) THE COMMISSIONER SHALL, IN CONJUNCTION WITH THE SUPERINTENDENT
 OF  FINANCIAL  SERVICES, PROMULGATE RULES AND REGULATIONS PROVIDING THAT
 NO PATIENT SHALL BE HELD RESPONSIBLE FOR ANY AMOUNTS FOR WHICH A PATIENT
 WOULD OTHERWISE BE LIABLE AS A RESULT OF AN INCREASE IN ANY BILL FROM  A
 HEALTH  INSURANCE  COMPANY,  HOSPITAL  OR  HEALTH  SYSTEM OR HEALTH CARE
 PROVIDER AFTER THE DATE ON WHICH ALL AMOUNTS DUE UNDER THE ORIGINAL BILL
 WERE PAID IN FULL UNLESS  THE  HEALTH  INSURANCE  COMPANY,  HOSPITAL  OR
 HEALTH  SYSTEM  OR  HEALTH  CARE  PROVIDER, AS APPLICABLE, CAN SHOW GOOD
 CAUSE FOR SUCH INCREASE AND SENDS NOTICE OF SUCH INCREASE TO THE PATIENT
 NO LATER THAN NINETY DAYS AFTER THE AMOUNT DUE BY  THE  PATIENT  IN  THE
 ORIGINAL  BILL  WAS PAID IN FULL.  NO HEALTH INSURANCE COMPANY, HOSPITAL
 OR HEALTH SYSTEM OR HEALTH CARE PROVIDER MAY SEND NOTICE TO A PATIENT OF
 ANY INCREASE IN A BILL UNLESS SUCH HEALTH INSURANCE COMPANY, HOSPITAL OR
 HEALTH SYSTEM OR HEALTH CARE PROVIDER SENDS SUCH  NOTICE  PRIOR  TO  THE
 EXPIRATION  OF SUCH NINETY DAY PERIOD AND CAN SHOW THE GOOD CAUSE REASON
 FOR SUCH INCREASE. THE FOREGOING RESTRICTIONS IN THIS SUBDIVISION  SHALL
 NOT  APPLY  TO  AN  INCREASE  WHICH  IS  THE RESULT OF AN ACTION BY SUCH
 PATIENT WARRANTING SUCH INCREASE.
   (B) FOR PURPOSES OF THIS SUBDIVISION:
   (I) "PATIENT" SHALL MEAN THE INDIVIDUAL RECEIVING MEDICAL SERVICES  OR
 THE INDIVIDUAL RESPONSIBLE FOR PAYING THE BILL ON BEHALF OF THE INDIVID-
 UAL RECEIVING MEDICAL SERVICES; AND
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD06983-01-3
              

 A. 5064                             2
 
   (II)  "GOOD  CAUSE"  SHALL MEAN A CLERICAL ERROR, TYPOGRAPHICAL ERROR,
 SCRIVENER'S ERROR OR COMPUTER ERROR, UNLESS A  PATTERN  OF  SUCH  ERRORS
 EXISTS,  FRAUDULENT  BILLING  IS  ALLEGED, OR SUCH ERROR IS DUE TO GROSS
 NEGLIGENCE, RECKLESSNESS, WILLFUL  MALFEASANCE  OR  OTHER  ACTION  TAKEN
 WHICH IS NOT IN GOOD FAITH.
   (C)  THIS SUBDIVISION SHALL NOT APPLY TO HEALTH CARE SERVICES, INCLUD-
 ING EMERGENCY SERVICES, WHERE PHYSICIAN FEES ARE SUBJECT TO SCHEDULES OR
 OTHER MONETARY LIMITATIONS UNDER ANY OTHER LAW, INCLUDING  THE  WORKERS'
 COMPENSATION  LAW  AND ARTICLE FIFTY-ONE OF THE INSURANCE LAW, AND SHALL
 NOT PREEMPT ANY SUCH LAW.
   (D) THE RULES AND  REGULATIONS  REQUIRED  BY  THIS  SUBDIVISION  SHALL
 INCLUDE, AT A MINIMUM:
   (I)  A REQUIREMENT THAT AN EXPLANATION FOR ANY INCREASE IN A PATIENT'S
 BILL SHALL BE PROVIDED IN PLAIN LANGUAGE IN  CONSPICUOUS    TWELVE-POINT
 BOLD FACE TYPE AND SHALL BE AVAILABLE IN THE TOP SIX LANGUAGES SPOKEN IN
 THE HOSPITAL'S SERVICE AREA; AND
   (II)  A  PROCESS  TO  DETERMINE RESPONSIBILITY FOR AMOUNTS FOR WHICH A
 PATIENT IS NOT RESPONSIBLE BY REASON OF THIS SUBDIVISION.
   § 2. This act shall take effect immediately.