S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    27
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 4, 2017
                                ___________
 
 Introduced by M. of A. CAHILL -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the public health law and the insurance law, in relation
   to requiring health insurers to accept third party payments for cover-
   age

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 4406-c of the  public  health  law  is  amended  by
 adding a new subdivision 9 to read as follows:
   9. WITH REGARD TO A SUBSCRIBER CONTRACT OFFERED THROUGH THE INDIVIDUAL
 MARKET,  A  HEALTH  MAINTENANCE ORGANIZATION SHALL NOT BY CONTRACT OR IN
 ANY OTHER MANNER REFUSE TO ACCEPT PREMIUM OR ANY REQUIRED  COST  SHARING
 PAYMENTS  FROM  THIRD  PARTIES  IF  MADE  BY (A) AN INDIAN TRIBE, TRIBAL
 ORGANIZATION, URBAN INDIAN ORGANIZATION, OR ANY STATE OR FEDERAL GOVERN-
 MENT PROGRAM OR GRANTEE (SUCH AS THE RYAN  WHITE  HIV/AIDS  PROGRAM)  ON
 BEHALF  OF  AN ENROLLEE, OR (B) A PRIVATE, NOT-FOR-PROFIT FOUNDATION, ON
 BEHALF OF AN ENROLLEE WHO SATISFIES DEFINED CRITERIA THAT ARE  BASED  ON
 FINANCIAL  STATUS  AND  DO  NOT  CONSIDER HEALTH STATUS, AND THE PAYMENT
 COVERS THE ENTIRE POLICY YEAR.
   § 2. Section 3217-b of the insurance law is amended by  adding  a  new
 subsection (k) to read as follows:
   (K)  WITH REGARD TO AN INSURANCE POLICY OFFERED THROUGH THE INDIVIDUAL
 MARKET, AN INSURER SHALL NOT BY CONTRACT OR IN ANY OTHER  MANNER  REFUSE
 TO  ACCEPT  PREMIUM  OR  ANY  REQUIRED  COST SHARING PAYMENTS FROM THIRD
 PARTIES IF MADE BY (1) AN INDIAN TRIBE, TRIBAL ORGANIZATION, URBAN INDI-
 AN ORGANIZATION, OR ANY STATE OR FEDERAL GOVERNMENT PROGRAM  OR  GRANTEE
 (SUCH  AS  THE  RYAN WHITE HIV/AIDS PROGRAM) ON BEHALF OF AN INSURED, OR
 (2) A PRIVATE, NOT-FOR-PROFIT FOUNDATION, ON BEHALF OF  AN  INSURED  WHO
 SATISFIES DEFINED CRITERIA THAT ARE BASED ON FINANCIAL STATUS AND DO NOT
 CONSIDER HEALTH STATUS, AND THE PAYMENT COVERS THE ENTIRE POLICY YEAR.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD01313-01-7

 A. 27                               2
 
   §  3.  Section  4325  of  the insurance law is amended by adding a new
 subsection (l) to read as follows:
   (L)  WITH REGARD TO AN INSURANCE CONTRACT OFFERED THROUGH THE INDIVID-
 UAL MARKET, A CORPORATION ORGANIZED UNDER  THIS  ARTICLE  SHALL  NOT  BY
 CONTRACT OR IN ANY OTHER MANNER REFUSE TO ACCEPT PREMIUM OR ANY REQUIRED
 COST SHARING PAYMENTS FROM THIRD PARTIES IF MADE BY (1) AN INDIAN TRIBE,
 TRIBAL  ORGANIZATION, URBAN INDIAN ORGANIZATION, OR ANY STATE OR FEDERAL
 GOVERNMENT PROGRAM OR GRANTEE (SUCH AS THE RYAN WHITE HIV/AIDS  PROGRAM)
 ON  BEHALF OF A SUBSCRIBER, OR (2) A PRIVATE, NOT-FOR-PROFIT FOUNDATION,
 ON BEHALF OF A SUBSCRIBER WHO SATISFIES DEFINED CRITERIA THAT ARE  BASED
 ON  FINANCIAL  STATUS  AND  DO  NOT  CONSIDER HEALTH STATUS, AND PAYMENT
 COVERS THE ENTIRE POLICY YEAR.
   § 4. This act shall take effect January 1, 2018.