Assembly Bill A9281

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9281
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             November 21, 2025
                                ___________
 
 Introduced  by M. of A. SOLAGES -- read once and referred to the Commit-
   tee on Insurance
 
 AN ACT to amend the insurance law,  in  relation  to  requiring  medical
   insurers to permit patients to assign their payment
 
   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)  EVERY  POLICY  WHICH  PROVIDES MEDICAL, MAJOR-MEDICAL OR SIMILAR
 COMPREHENSIVE-TYPE COVERAGE  SHALL  PERMIT  A  PATIENT  TO  ASSIGN  SUCH
 PATIENT'S  PAYMENT TO THE PROVIDER OF SUCH HOSPITAL, SURGICAL OR MEDICAL
 SERVICES, REGARDLESS OF WHETHER THE PROVIDER IS IN THE NETWORK OF HEALTH
 CARE PROVIDERS OFFERED BY THE INSURER ISSUING THE POLICY, PROVIDED  THAT
 THE  SERVICES  RENDERED  TO  THE  PATIENT  BY THE PROVIDER ARE OTHERWISE
 COVERED UNDER THE POLICY.
   § 2. Section 3221 of the insurance law is  amended  by  adding  a  new
 subsection (v) to read as follows:
   (V)  EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
 THIS STATE WHICH PROVIDES HOSPITAL, SURGICAL OR MEDICAL  COVERAGE  SHALL
 PERMIT  A  PATIENT  TO  ASSIGN SUCH PATIENT'S PAYMENT TO THE PROVIDER OF
 SUCH HOSPITAL, SURGICAL OR MEDICAL SERVICES, REGARDLESS OF  WHETHER  THE
 PROVIDER  IS  IN  THE  NETWORK  OF  HEALTH CARE PROVIDERS OFFERED BY THE
 INSURER ISSUING THE POLICY, PROVIDED THAT THE SERVICES RENDERED  TO  THE
 PATIENT BY THE PROVIDER ARE OTHERWISE COVERED UNDER THE POLICY.
   §  3.  Section  3224-a of the insurance law is amended by adding a new
 subsection (m) to read as follows:
   (M) WHERE PAYMENT FOR ANY PORTION OF A CLAIM IS  MADE  DIRECTLY  TO  A
 HEALTH  CARE PROVIDER, SUCH INSURER OR ORGANIZATION OR CORPORATION SHALL
 PROVIDE AT THE TIME PAYMENT IS MADE WRITTEN NOTIFICATION OF SUCH PAYMENT
 TO THE POLICYHOLDER WHO RENDERED THE SERVICE FOR  WHICH  THE  CLAIM  WAS
 PAID. SUCH NOTIFICATION SHALL INCLUDE, BUT NOT BE LIMITED TO, THE AMOUNT
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD14080-01-5
              

 A. 9281                             2
 
 PAID  TO  THE  HEALTH  CARE  PROVIDER, THE PERCENTAGE OF THE TOTAL CLAIM
 REPRESENTED BY THE PAYMENT, THE SERVICES FOR WHICH PAYMENT WAS MADE, THE
 HEALTH CARE PROVIDER PROVIDING THOSE SERVICES AND THE  CALCULATIONS  FOR
 PAYMENT,   BY  SERVICE  PROVIDED,  INCLUDING  CO-PAYMENTS,  DEDUCTIBLES,
 SURCHARGES AND FEE SCHEDULES.
   § 4. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (a-1) to read as follows:
   (A-1) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION
 OR  HEALTH  SERVICE CORPORATION WHICH PROVIDES MEDICAL, MAJOR-MEDICAL OR
 SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT  A  PATIENT  TO  ASSIGN
 SUCH  PATIENT'S  BENEFITS  TO THE PROVIDER OF SUCH HOSPITAL, SURGICAL OR
 MEDICAL SERVICES, REGARDLESS OF WHETHER THE PROVIDER IS IN  THE  NETWORK
 OF  HEALTH  CARE  PROVIDERS  OFFERED  BY THE INSURER ISSUING THE POLICY,
 PROVIDED THAT THE SERVICES RENDERED TO THE PATIENT BY THE  PROVIDER  ARE
 OTHERWISE COVERED UNDER THE POLICY.
   §  5.  This  act shall take effect on the ninetieth day after it shall
 have become a law and shall apply  to  policies  and  contracts  issued,
 renewed, modified, altered or amended on or after such date.