S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8576
 
                           I N  A S S E M B L Y
 
                             January 12, 2024
                                ___________
 
 Introduced by M. of A. McDONALD -- read once and referred to the Commit-
   tee on Insurance
 
 AN  ACT to amend the insurance law, in relation to prohibiting the impo-
   sition of a charge or deduction from a payment due to  a  health  care
   provider  because  such  payment  is  made through electronic or paper
   means
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The closing paragraph of subsection (b) of section 3224-a
 of the insurance law, as amended by chapter 694 of the laws of 2021,  is
 amended to read as follows:
   Upon  receipt  of the information requested in paragraph three of this
 subsection or an appeal of a claim or  bill  for  health  care  services
 denied pursuant to this subsection, an insurer or organization or corpo-
 ration  licensed  or certified pursuant to article forty-three or forty-
 seven of this chapter or article forty-four of  the  public  health  law
 shall  comply with subsection (a) of this section; provided, that if the
 insurer or organization or corporation licensed or certified pursuant to
 article forty-three or forty-seven of this chapter or article forty-four
 of the public health law determines that payment or  additional  payment
 is  due  on the claim, such payment shall be made to the policyholder or
 covered person or health care provider within fifteen days of the deter-
 mination. Any denial or partial approval of claim  or  payment  and  the
 specific  reasons  for  such denial or partial approval pursuant to this
 subsection shall be prominently displayed on a written  notice  with  at
 least  twelve-point  type.  A partial approval of claim or payment shall
 state at the top of such written notice  with  at  least  fourteen-point
 type bold: "NOTICE OF PARTIAL APPROVAL OF MEDICAL COVERAGE". A denial of
 claim  or  payment shall state at the top of such written notice with at
 least fourteen-point type bold: "NOTICE OF DENIAL OF MEDICAL  COVERAGE".
 Any  additional  terms  or conditions included on such notice of partial
 approval or such notice of denial, such  as  but  not  limited  to  time
 restraints  to  file  an appeal, shall be included with at least twelve-
 point type.  NO INSURER, ORGANIZATION OR CORPORATION LICENSED OR  CERTI-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD13142-01-3
 A. 8576                             2
 
 FIED  PURSUANT  TO  ARTICLE  FORTY-THREE  OR FORTY-SEVEN OF THIS CHAPTER
 OR ARTICLE FORTY-FOUR OF THE  PUBLIC HEALTH LAW SHALL IMPOSE A CHARGE OR
 MAKE A DEDUCTION FROM A PAYMENT DUE TO A HEALTH  CARE  PROVIDER  BECAUSE
 SUCH PAYMENT IS MADE THROUGH ELECTRONIC OR PAPER MEANS.
   §  2.  This  act shall take effect on the ninetieth day after it shall
 have become  a  law  and  shall apply to payments made on and after such
 effective date.