S T A T E O F N E W Y O R K
________________________________________________________________________
9019--A
I N A S S E M B L Y
February 5, 2024
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Introduced by M. of A. WOERNER, THIELE, GLICK, McDONALD, BICHOTTE HERME-
LYN -- read once and referred to the Committee on Insurance -- commit-
tee discharged, bill amended, ordered reprinted as amended and recom-
mitted to said committee
AN ACT to amend the insurance law and the public health law, in relation
to required terms for certain insurance contracts
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph 3 of subsection (e) of section 3217-b of the
insurance law, as added by chapter 586 of the laws of 1998, is amended
and three new paragraphs 3-a, 3-b and 3-c are added to read as follows:
(3) a description of the records or information relied upon to calcu-
late any such payments and adjustments, INCLUDING THE DATE OF SERVICE,
PATIENT IDENTIFICATION NUMBER, AN IDENTIFICATION OF THE SERVICE FOR
WHICH THE PAYMENT IS MADE, THE REIMBURSEMENT PAID BY THE INSURER FOR THE
SERVICE, and a description of how the provider can access a summary of
such calculations and adjustments;
(3-A) THE PERMISSIBLE PAYMENT METHODS AS CHECK, DIRECT DEPOSIT, DEBIT
OR CREDIT CARD OR ONLINE PAYMENT SYSTEM, PROVIDED THE HEALTH CARE
PROVIDER CAN ACCESS THE PAYMENT IN FULL, WITHOUT ENCUMBRANCES, COSTS,
CHARGES, OR FEES, INCLUDING A FEE FOR REPLACEMENT OF A LOST OR STOLEN
CHECK, UNDER AT LEAST ONE PAYMENT METHOD OFFERED BY THE INSURER;
(3-B) THE ADVANCE WRITTEN CONSENT OF A PROVIDER TO THE INSURER FOR THE
METHOD OF PAYMENT AND TO DIRECTLY PAY OR DEPOSIT PAYMENTS IN A BANK OR
OTHER FINANCIAL INSTITUTION OF THE PROVIDER'S CHOOSING;
(3-C) THE INSURER'S ANNUAL OBLIGATION, BEGINNING ON THE EFFECTIVE DATE
OF THIS PARAGRAPH AND CONTINUING EVERY FIRST OF JANUARY THEREAFTER, TO
PROVIDE THE HEALTH CARE PROVIDER WITH AN UPDATED PAYMENT RATE SCHEDULE;
§ 2. Paragraph 3 of subsection (e) of section 4325 of the insurance
law, as added by chapter 586 of the laws of 1998, is amended and three
new paragraphs 3-a, 3-b and 3-c are added to read as follows:
(3) a description of the records or information relied upon to calcu-
late any such payments and adjustments, INCLUDING THE DATE OF SERVICE,
PATIENT IDENTIFICATION NUMBER, AN IDENTIFICATION OF THE SERVICE FOR
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD14217-02-4
A. 9019--A 2
WHICH THE PAYMENT IS MADE, THE REIMBURSEMENT PAID BY THE CORPORATION FOR
THE SERVICE, and a description of how the provider can access a summary
of such calculations and adjustments;
(3-A) THE PERMISSIBLE PAYMENT METHODS AS CHECK, DIRECT DEPOSIT, DEBIT
OR CREDIT CARD OR ONLINE PAYMENT SYSTEM, PROVIDED THE HEALTH CARE
PROVIDER CAN ACCESS THE PAYMENT IN FULL, WITHOUT ENCUMBRANCES, COSTS,
CHARGES, OR FEES, INCLUDING A FEE FOR REPLACEMENT OF A LOST OR STOLEN
CHECK, UNDER AT LEAST ONE PAYMENT METHOD OFFERED BY THE CORPORATION;
(3-B) THE ADVANCE WRITTEN CONSENT OF A PROVIDER TO THE CORPORATION FOR
THE METHOD OF PAYMENT AND TO DIRECTLY PAY OR DEPOSIT PAYMENTS IN A BANK
OR OTHER FINANCIAL INSTITUTION OF THE PROVIDER'S CHOOSING;
(3-C) THE CORPORATION'S ANNUAL OBLIGATION, BEGINNING ON THE EFFECTIVE
DATE OF THIS PARAGRAPH AND CONTINUING EVERY FIRST OF JANUARY THEREAFTER,
TO PROVIDE THE HEALTH CARE PROVIDER WITH AN UPDATED PAYMENT RATE SCHED-
ULE, INCLUDING A DESCRIPTION OF ANY SERVICES BUNDLED WITHIN A SINGLE
RATE;
§ 3. Paragraph (c) of subdivision 5-a of section 4406-c of the public
health law, as added by chapter 586 of the laws of 1998, is amended and
three new paragraphs (c-1), (c-2) and (c-3) are added to read as
follows:
(c) a description of the records or information relied upon to calcu-
late any such payments and adjustments, INCLUDING THE DATE OF SERVICE,
PATIENT IDENTIFICATION NUMBER, AN IDENTIFICATION OF THE SERVICE FOR
WHICH THE PAYMENT IS MADE, THE REIMBURSEMENT PAID BY THE HEALTH CARE
PLAN FOR THE SERVICE, and a description of how the provider can access a
summary of such calculations and adjustments;
(C-1) THE PERMISSIBLE PAYMENT METHODS AS CHECK, DIRECT DEPOSIT, DEBIT
OR CREDIT CARD OR ONLINE PAYMENT SYSTEM, PROVIDED THE HEALTH CARE
PROVIDER CAN ACCESS THE PAYMENT IN FULL, WITHOUT ENCUMBRANCES, COSTS
CHARGES, OR FEES, INCLUDING A FEE FOR REPLACEMENT OF A LOST OR STOLEN
CHECK, UNDER AT LEAST ONE PAYMENT METHOD OFFERED BY THE HEALTH CARE
PLAN;
(C-2) THE ADVANCE WRITTEN CONSENT OF A PROVIDER TO THE HEALTH CARE
PLAN FOR THE METHOD OF PAYMENT AND TO DIRECTLY PAY OR DEPOSIT PAYMENTS
IN A BANK OR OTHER FINANCIAL INSTITUTION OF THE PROVIDER'S CHOOSING;
(C-3) THE HEALTH CARE PLAN'S ANNUAL OBLIGATION, BEGINNING ON THE
EFFECTIVE DATE OF THIS PARAGRAPH AND CONTINUING EVERY FIRST OF JANUARY
THEREAFTER, TO PROVIDE THE HEALTH CARE PROVIDER WITH AN UPDATED PAYMENT
RATE SCHEDULE, INCLUDING A DESCRIPTION OF ANY SERVICES BUNDLED WITHIN A
SINGLE RATE;
§ 4. This act shall take effect on the thirtieth day after it shall
have become a law and shall apply to all contracts entered into,
renewed, modified or amended on or after such effective date.