Assembly Bill A7562A

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7562--A
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               April 1, 2025
                                ___________
 
 Introduced  by M. of A. REYES -- read once and referred to the Committee
   on Insurance -- committee discharged, bill amended, ordered  reprinted
   as amended and recommitted to said committee
 
 AN  ACT  to  amend  the  insurance  law, in relation to requiring health
   insurance policies include coverage for anesthesia for the duration of
   a medical procedure
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 41 to read as follows:
   (41) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL OR
 MEDICAL CARE SHALL PROVIDE THE COVERAGE FOR ANESTHESIA,  AS  DEFINED  BY
 THE AMERICAN MEDICAL ASSOCIATION'S CURRENT PROCEDURAL TERMINOLOGY CODES,
 FOR  THE ENTIRE DURATION OF ANESTHESIA TIME AND SHALL NOT IMPOSE A LIMIT
 ON THE TIME OF ANESTHESIA. FOR THE PURPOSES OF THIS PARAGRAPH ANESTHESIA
 TIME SHALL MEAN THE PERIOD DURING WHICH AN ANESTHESIA PROVIDER IS  PRES-
 ENT WITH THE PATIENT. ANESTHESIA TIME STARTS WHEN THE ANESTHESIA PROVID-
 ER  BEGINS TO PREPARE THE PATIENT FOR ANESTHESIA SERVICES IN THE OPERAT-
 ING ROOM OR AN EQUIVALENT AREA AND ENDS WHEN THE ANESTHESIA PROVIDER  IS
 NO  LONGER  FURNISHING ANESTHESIA SERVICES TO THE PATIENT, THAT IS, WHEN
 THE PATIENT MAY BE PLACED SAFELY UNDER POSTOPERATIVE OR  POST-ANESTHESIA
 CARE.    IN  COUNTING  ANESTHESIA TIME FOR SERVICES FURNISHED, THE ANES-
 THESIA PROVIDER MAY INCLUDE BLOCKS OF TIME  AROUND  AN  INTERRUPTION  IN
 ANESTHESIA  TIME  PROVIDED THE ANESTHESIA PROVIDER IS FURNISHING CONTIN-
 UOUS ANESTHESIA CARE WITHIN THE TIME PERIODS  AROUND  THE  INTERRUPTION.
 FOR PURPOSES OF THIS SUBSECTION, ANESTHESIA PROVIDER MEANS THOSE AUTHOR-
 IZED UNDER STATE LAW AND REGULATION TO PROVIDE ANESTHESIA SERVICES.
   (B)  NO  INSURER  SHALL  ESTABLISH,  IMPLEMENT, OR ENFORCE ANY POLICY,
 PRACTICE, OR PROCEDURE THAT IMPOSES A TIME  LIMIT  FOR  THE  PAYMENT  OF
 ANESTHESIA SERVICES PROVIDED DURING A MEDICAL OR SURGICAL PROCEDURE.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08023-05-5
 A. 7562--A                          2
              

 
   (C)  PAYMENT FOR ANESTHESIA SERVICE SHALL BE DEFINED BY THE PREVAILING
 MEDICAL CODING AND BILLING STANDARDS IN THE PROFESSIONAL MEDICAL BILLING
 COMMUNITY, INCLUDING BUT NOT LIMITED TO, CURRENT AMERICAN MEDICAL  ASSO-
 CIATION  CURRENT PROCEDURAL TERMINOLOGY CODES, THE MEDICARE CLAIMS PROC-
 ESSING  MANUAL,  AND THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS GUIDANCE.
 PAYMENT FOR ANESTHESIA SERVICES IS BASED ON BASE PLUS TIME UNITS TOGETH-
 ER MULTIPLIED BY AN ANESTHESIA CONVERSION  FACTOR,  AS  DEFINED  IN  THE
 INDIVIDUAL  CONTRACT  BETWEEN  THE  INSURER  AND  ANESTHESIA PROVIDER OR
 GROUP. ANESTHESIA TIME UNITS ARE RECOGNIZED WITH APPROPRIATE TIME INTER-
 VALS. EACH TIME UNIT INTERVAL MUST BE NO MORE THAN  FIFTEEN  MINUTES  IN
 LENGTH.  THE  SUM OF THE TIME UNIT INTERVALS MUST ADD UP TO THE DURATION
 OF THE ANESTHESIA TIME AS DEFINED IN SUBPARAGRAPH (A) OF THIS PARAGRAPH.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23) (A) EVERY INSURER DELIVERING A GROUP OR BLANKET POLICY OR ISSUING
 A GROUP OR BLANKET POLICY FOR  DELIVERY  IN  THIS  STATE  THAT  PROVIDES
 COVERAGE FOR HOSPITAL, SURGICAL OR MEDICAL CARE SHALL PROVIDE THE COVER-
 AGE  FOR  ANESTHESIA,  AS  DEFINED BY THE AMERICAN MEDICAL ASSOCIATION'S
 CURRENT PROCEDURAL TERMINOLOGY CODES, FOR THE ENTIRE DURATION  OF  ANES-
 THESIA  TIME AND SHALL NOT IMPOSE A LIMIT ON THE TIME OF ANESTHESIA. FOR
 THE PURPOSES OF THIS PARAGRAPH ANESTHESIA TIME  SHALL  MEAN  THE  PERIOD
 DURING  WHICH  AN ANESTHESIA PROVIDER IS PRESENT WITH THE PATIENT. ANES-
 THESIA TIME STARTS WHEN THE ANESTHESIA PROVIDER BEGINS  TO  PREPARE  THE
 PATIENT  FOR  ANESTHESIA SERVICES IN THE OPERATING ROOM OR AN EQUIVALENT
 AREA AND ENDS WHEN THE ANESTHESIA PROVIDER IS NO LONGER FURNISHING ANES-
 THESIA SERVICES TO THE PATIENT, THAT IS, WHEN THE PATIENT MAY BE  PLACED
 SAFELY  UNDER  POSTOPERATIVE  OR POST-ANESTHESIA CARE. IN COUNTING ANES-
 THESIA TIME FOR SERVICES FURNISHED, THE ANESTHESIA PROVIDER MAY  INCLUDE
 BLOCKS  OF  TIME  AROUND AN INTERRUPTION IN ANESTHESIA TIME PROVIDED THE
 ANESTHESIA PROVIDER IS FURNISHING CONTINUOUS ANESTHESIA CARE WITHIN  THE
 TIME  PERIODS  AROUND  THE INTERRUPTION. FOR PURPOSES OF THIS PARAGRAPH,
 ANESTHESIA PROVIDER MEANS THOSE AUTHORIZED UNDER  STATE  LAW  AND  REGU-
 LATION TO PROVIDE ANESTHESIA SERVICES.
   (B)  NO  INSURER  SHALL  ESTABLISH,  IMPLEMENT, OR ENFORCE ANY POLICY,
 PRACTICE, OR PROCEDURE THAT IMPOSES A TIME  LIMIT  FOR  THE  PAYMENT  OF
 ANESTHESIA SERVICES PROVIDED DURING A MEDICAL OR SURGICAL PROCEDURE.
   (C)  PAYMENT FOR ANESTHESIA SERVICE SHALL BE DEFINED BY THE PREVAILING
 MEDICAL CODING AND BILLING STANDARDS IN THE PROFESSIONAL MEDICAL BILLING
 COMMUNITY, INCLUDING BUT NOT LIMITED TO, CURRENT AMERICAN MEDICAL  ASSO-
 CIATION  CURRENT PROCEDURAL TERMINOLOGY CODES, THE MEDICARE CLAIMS PROC-
 ESSING MANUAL, AND THE AMERICAN SOCIETY OF  ANESTHESIOLOGISTS  GUIDANCE.
 PAYMENT FOR ANESTHESIA SERVICES IS BASED ON BASE PLUS TIME UNITS TOGETH-
 ER  MULTIPLIED  BY  AN  ANESTHESIA  CONVERSION FACTOR, AS DEFINED IN THE
 INDIVIDUAL CONTRACT BETWEEN  THE  INSURER  AND  ANESTHESIA  PROVIDER  OR
 GROUP. ANESTHESIA TIME UNITS ARE RECOGNIZED WITH APPROPRIATE TIME INTER-
 VALS.  EACH  TIME  UNIT INTERVAL MUST BE NO MORE THAN FIFTEEN MINUTES IN
 LENGTH. THE SUM OF THE TIME UNIT INTERVALS MUST ADD UP TO  THE  DURATION
 OF THE ANESTHESIA TIME AS DEFINED IN SUBPARAGRAPH (A) OF THIS PARAGRAPH.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (ww) to read as follows:
   (WW) A MEDICAL  EXPENSE  INDEMNITY  CORPORATION,  A  HOSPITAL  SERVICE
 CORPORATION  OR  A HEALTH SERVICE CORPORATION THAT PROVIDES COVERAGE FOR
 HOSPITAL, SURGICAL OR MEDICAL CARE SHALL PROVIDE THE COVERAGE FOR  ANES-
 THESIA,  AS DEFINED BY THE AMERICAN MEDICAL ASSOCIATION'S CURRENT PROCE-
 DURAL TERMINOLOGY CODES, FOR THE ENTIRE DURATION OF ANESTHESIA TIME  AND
 SHALL  NOT IMPOSE A LIMIT ON THE TIME OF ANESTHESIA. FOR THE PURPOSES OF
 A. 7562--A                          3
 
 THIS SUBSECTION ANESTHESIA TIME SHALL MEAN THE PERIOD  DURING  WHICH  AN
 ANESTHESIA  PROVIDER IS PRESENT WITH THE PATIENT. ANESTHESIA TIME STARTS
 WHEN THE ANESTHESIA PROVIDER BEGINS TO PREPARE  THE  PATIENT  FOR  ANES-
 THESIA  SERVICES  IN  THE  OPERATING ROOM OR AN EQUIVALENT AREA AND ENDS
 WHEN THE ANESTHESIA PROVIDER IS NO LONGER FURNISHING ANESTHESIA SERVICES
 TO THE PATIENT, THAT IS, WHEN THE PATIENT MAY  BE  PLACED  SAFELY  UNDER
 POSTOPERATIVE  OR  POST-ANESTHESIA CARE. IN COUNTING ANESTHESIA TIME FOR
 SERVICES FURNISHED, THE ANESTHESIA PROVIDER MAY INCLUDE BLOCKS  OF  TIME
 AROUND  AN  INTERRUPTION  IN  ANESTHESIA  TIME  PROVIDED  THE ANESTHESIA
 PROVIDER IS FURNISHING CONTINUOUS ANESTHESIA CARE WITHIN THE TIME  PERI-
 ODS AROUND THE INTERRUPTION. FOR PURPOSES OF THIS SUBSECTION, ANESTHESIA
 PROVIDER  MEANS  THOSE  AUTHORIZED  UNDER  STATE  LAW  AND REGULATION TO
 PROVIDE ANESTHESIA SERVICES.
   § 4. This act shall take effect immediately.