NY State Senate Bill 2023-S1465

Current Bill Status - In Senate Committee Insurance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to insurance
Jan 12, 2023	referred to insurance

co-Sponsors

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2023-S1465 (ACTIVE) - Details

See Assembly Version of this Bill:: A3496
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2011-2012: S6982, A10091
2013-2014: S3541, A3707
2015-2016: S1763, A931
2017-2018: S2524, A908
2019-2020: S3525, A3721
2021-2022: S3550, A1842

2023-S1465 (ACTIVE) - Summary

Relates to reimbursement for ambulance services; requires insurers to submit payments directly to ambulance providers who are in-network or, for out-of-network ambulance providers, requires the issuance of a joint check to the insured specifying both the insured and the ambulance provider as payees.

2023-S1465 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S1465

SPONSOR: BRESLIN
 
TITLE OF BILL:

An act to amend the insurance law, in relation to reimbursement for
ambulance services

 
PURPOSE:

To require insurers to submit payments directly to ambulance providers
who are in-,network or, for out-of-network ambulance providers, to
require the issuance of a joint check to the insured specifying both the
insured and the ambulance provider as payees.

 
SUMMARY OF PROVISIONS:

Amends sections 3216(1)(24), 3221(1)(15) and 4303(aa) to require insur-
ers to submit payments directly to in-network ambulance providers at the
negotiated rates. For out-of-network ambulance providers where there is
no negotiated rate, the insurer is required to issue a joint check to
the insured specifying both the insured and ambulance provider as

payees, at the usual and customary charge.

Further, the legislation requires the insurer to issue reimbursement
directly to the ambulance provider if the insured has filed an assign-
ment of benefits for such ambulance services. The legislation also
requires the insurer to notify the ambulance provider electronically
upon the issuance of a joint check to the insured. The notification must
include the name of the patient, date of service, date of payment,
amount of payment and address to which the payment was sent.

 
JUSTIFICATION:

This bill would amend the insurance law to require insurers to issue
joint signature checks to both the patient and ambulance service provid-
er when the patient utilizes an ambulance service provider that is a
non-participating provider of their network.

Currently, when a patient uses an out-of-network ambulance provider,
their insurance company will send the ambulance reimbursement payment
directly to the patient. The patient is then expected to forward that
reimbursement payment to the ambulance service that provided the
service. In many cases with a single signature check, the patients never
send the insurance reimbursement to the service provider.  Rather, they
keep the money for themselves, diverting millions of dollars from our
healthcare system in the process.

This bill would ensure that healthcare dollars stay in the healthcare
system and that healthcare providers are paid for the work that they do.
In order to cash the check, both parties would need to endorse the
check. Insurers would send the joint signature check to the patient, the
patient would sign it and send it to the ambulance provider. The ambu-
lance provider could then endorse the check and be paid for their
service. The insurer will also notify the ambulance provider when a
joint signature check has been sent to the patient.

Ambulance providers are mandated responders who must provide service
when an emergency call comes in. They answer these calls without know-
ledge of a patient's ability to pay and without concern of being paid at
the time of service. In order to keep the ambulance system strong and
viable they must collect payment for service. This bill would assist in
collecting payments.

 
LEGISLATIVE HISTORY:

S.3550 of 2021-2022;

S.3525 of 2019-20;

S.2524 of 2017-18;

S.1763 of 2015-16;

S.3541 of 2013-14;

S.6982 of 2012

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
Immediately.

2023-S1465 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1465
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 12, 2023
                                ___________
 
 Introduced by Sens. BRESLIN, ADDABBO, GALLIVAN, HELMING, PERSAUD, SKOUF-
   IS -- read twice and ordered printed, and when printed to be committed
   to the Committee on Insurance
 
 AN  ACT  to  amend  the  insurance law, in relation to reimbursement for
   ambulance services
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  24  of  subsection  (i) of section 3216 of the
 insurance law is amended by adding a new subparagraph  (F)  to  read  as
 follows:
   (F)  AN  INSURER  WHO  ISSUES REIMBURSEMENT UNDER THIS PARAGRAPH SHALL
 SUBMIT SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES  NEGO-
 TIATED  BETWEEN  THE  PROVIDER  AND THE INSURER, OR IF NO  RATE HAS BEEN
 NEGOTIATED BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN  THE
 FORM  OF  A  JOINT  CHECK  SPECIFYING AS PAYEES BOTH THE INSURED AND THE
 PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
 SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
 ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
 FITS FOR SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING  ANY  POLICY
 LANGUAGE  TO  THE  CONTRARY,  THE ISSUER SHALL ACCEPT SUCH ASSIGNMENT OF
 BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
 ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
 THE PROVIDER VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE  OF  SUCH
 PAYMENT.  THE  NOTIFICATION  SHALL  INCLUDE THE NAME OF THE PATIENT, THE
 DATE OF SERVICE, THE DATE OF PAYMENT, THE  AMOUNT  OF  PAYMENT  AND  THE
 ADDRESS TO WHICH THE PAYMENT WAS SENT.
   §  2.  Paragraph 15 of subsection (1) of section 3221 of the insurance
 law is amended by adding a new subparagraph (F) to read as follows:
   (F) AN INSURER WHO ISSUES REIMBURSEMENT  UNDER  THIS  PARAGRAPH  SHALL
 SUBMIT  SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES NEGO-
 TIATED BETWEEN THE PROVIDER AND THE INSURER, OR  IF  NO  RATE  HAS  BEEN
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05290-01-3

 S. 1465                             2
 
 NEGOTIATED  BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN THE
 FORM OF A JOINT CHECK SPECIFYING AS PAYEES  BOTH  THE  INSURED  AND  THE
 PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
 SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
 ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
 FITS  FOR  SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING ANY POLICY
 LANGUAGE TO THE CONTRARY, THE INSURER SHALL ACCEPT  SUCH  ASSIGNMENT  OF
 BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
 ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
 THE  PROVIDER  VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE OF SUCH
 PAYMENT. THE NOTIFICATION SHALL INCLUDE THE NAME  OF  THE  PATIENT,  THE
 DATE  OF  SERVICE,  THE  DATE  OF PAYMENT, THE AMOUNT OF PAYMENT AND THE
 ADDRESS TO WHICH THE PAYMENT WAS SENT.
   § 3. Subsection (aa) of section 4303 of the insurance law  is  amended
 by adding a new paragraph 6 to read as follows:
   (6)  AN  INSURER  WHO ISSUES REIMBURSEMENT UNDER THIS SUBSECTION SHALL
 SUBMIT SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES  NEGO-
 TIATED  BETWEEN  THE  PROVIDER  AND  THE INSURER, OR IF NO RATE HAS BEEN
 NEGOTIATED BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN  THE
 FORM  OF  A  JOINT  CHECK  SPECIFYING AS PAYEES BOTH THE INSURED AND THE
 PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
 SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
 ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
 FITS FOR SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING  ANY  POLICY
 LANGUAGE  TO  THE  CONTRARY, THE INSURER SHALL ACCEPT SUCH ASSIGNMENT OF
 BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
 ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
 THE PROVIDER VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE  OF  SUCH
 PAYMENT.  THE  NOTIFICATION  SHALL  INCLUDE THE NAME OF THE PATIENT, THE
 DATE OF SERVICE, THE DATE OF PAYMENT, THE  AMOUNT  OF  PAYMENT  AND  THE
 ADDRESS TO WHICH THE PAYMENT WAS SENT.
   § 4. This act shall take effect immediately.

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Senate Bill S1465

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee

co-Sponsors

2023-S1465 (ACTIVE) - Details

2023-S1465 (ACTIVE) - Summary

2023-S1465 (ACTIVE) - Sponsor Memo

2023-S1465 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S1465

Share this bill

Sponsored By

Neil D. Breslin

Current Bill Status - In Senate Committee Insurance Committee

co-Sponsors

Joseph P. Addabbo Jr.

Jeremy A. Cooney

Patrick M. Gallivan

Pamela Helming

2023-S1465 (ACTIVE) - Details

2023-S1465 (ACTIVE) - Summary

2023-S1465 (ACTIVE) - Sponsor Memo

2023-S1465 (ACTIVE) - Bill Text download pdf

Comments