Assembly Bill A10470

2015-2016 Legislative Session

Relates to establishing protections from excessive hospital emergency charges; repealer

download bill text pdf

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Archive: Last Bill Status - In Senate Committee Rules Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2015-A10470 (ACTIVE) - Details

See Senate Version of this Bill:
S7868
Current Committee:
Senate Rules
Law Section:
Financial Services Law
Laws Affected:
Amd ยงยง605 & 608, Fin Serv L
Versions Introduced in Other Legislative Sessions:
2017-2018: A7611, S4241
2019-2020: A264, S3171

2015-A10470 (ACTIVE) - Summary

Relates to establishing protections from excessive hospital emergency charges; includes hospital charges; extends coverage for members in certain counties.

2015-A10470 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  10470

                          I N  A S S E M B L Y

                              May 27, 2016
                               ___________

Introduced by M. of A. CAHILL -- read once and referred to the Committee
  on Insurance

AN  ACT to amend the financial services law, in relation to establishing
  protections from excessive hospital emergency charges;  and  providing
  for the repeal of certain provisions upon expiration thereof

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 605 of the financial  services  law,  as  added  by
section  26  of  part H of chapter 60 of the laws of 2014, is amended to
read as follows:
  S 605.  Dispute  resolution  for  emergency  services.  (a)  Emergency
services for an insured. (1) When a health care plan receives a bill for
emergency  services  from a non-participating physician OR HOSPITAL, the
health care plan shall pay an amount that it  determines  is  reasonable
for  the  emergency services rendered by the non-participating physician
OR HOSPITAL, in accordance with section three thousand two hundred twen-
ty-four-a of the insurance law, except  for  the  insured's  co-payment,
coinsurance  or  deductible,  if  any, and shall ensure that the insured
shall incur no greater out-of-pocket costs for  the  emergency  services
than  the  insured would have incurred with a participating physician OR
HOSPITAL pursuant to  subsection  (c)  of  section  three  thousand  two
hundred forty-one of the insurance law.
  (2)  A  non-participating  physician OR HOSPITAL or a health care plan
may submit a dispute regarding a fee or payment for  emergency  services
for review to an independent dispute resolution entity. IN CASES WHERE A
HEALTH  CARE  PLAN  SUBMITS  A  DISPUTE REGARDING A FEE FOR PAYMENT OF A
NON-PARTICIPATING HOSPITAL'S EMERGENCY ROOM SERVICES,  THE  HEALTH  CARE
PLAN  SHALL  PAY  THE AMOUNT IT DETERMINES IS REASONABLE DIRECTLY TO THE
NON-PARTICIPATING HOSPITAL.
  (3) The independent dispute resolution entity shall  make  a  determi-
nation within thirty days of receipt of the dispute for review.
  (4)  In  determining  a  reasonable  fee for the services rendered, an
independent dispute resolution entity shall  select  either  the  health
care  plan's  payment or the non-participating physician's OR HOSPITAL'S

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
              

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