S T A T E O F N E W Y O R K
________________________________________________________________________
2495
2025-2026 Regular Sessions
I N A S S E M B L Y
January 17, 2025
___________
Introduced by M. of A. McDONALD, WEPRIN -- read once and referred to the
Committee 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
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03380-01-5
A. 2495 2
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-
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.