Senate Bill S3820B

                             
                     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.