S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1690
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 12, 2017
                                ___________
 
 Introduced  by  M.  of  A.  ZEBROWSKI  --  read once and referred to the
   Committee 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 34 to read as follows:
   (34)  EVERY  POLICY  WHICH  PROVIDES MEDICAL, MAJOR-MEDICAL OR SIMILAR
 COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT A PATIENT TO ASSIGN HIS OR  HER
 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 (t) to read as follows:
   (T) 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 HIS OR HER 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 (k) to read as follows:
   (K)  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.
              

                                                            LBD04396-01-7

 A. 1690                             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 HIS
 OR HER 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.