S T A T E O F N E W Y O R K
________________________________________________________________________
3820--B
2025-2026 Regular Sessions
I N S E N A T E
January 30, 2025
___________
Introduced by Sens. RIVERA, GIANARIS, BRISPORT, FERNANDEZ, HINCHEY,
HOYLMAN-SIGAL, KRUEGER, MAYER, PERSAUD, RAMOS, STAVISKY, WEBB -- read
twice and ordered printed, and when printed to be committed to the
Committee on Insurance -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee -- 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.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD08023-04-5
S. 3820--B 2
(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.
§ 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-
S. 3820--B 3
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
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.