NY State Senate Bill 2017-S2527A

Senate Bill S2527A

2017-2018 Legislative Session

Authorizes payments to nonparticipating or nonpreferred providers of ambulance services licensed under article 30 of the public health law

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance 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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 05, 2018	print number 2527a
Feb 05, 2018	amend and recommit to insurance
Jan 03, 2018	referred to insurance
Jan 13, 2017	referred to insurance

Bill Amendments

Original

A (Active)

co-Sponsors

View additional co-sponsors

2017-S2527 - Details

See Assembly Version of this Bill:: A343
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3224-a, 3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S4462, A10735
2011-2012: S2714, A1341, A4093
2013-2014: S3542, A7534
2015-2016: S1764, A6195, A8581
2019-2020: S3526, A6211
2021-2022: S3556, A1309
2023-2024: S1466, A250

2017-S2527 - Summary

Authorizes payments to nonparticipating or nonpreferred providers of ambulance services licensed under article 30 of the public health law.

2017-S2527 - Sponsor Memo

                                 BILL NUMBER:  S2527

 TITLE OF BILL :

An act to amend the insurance law, in relation to payments to
prehospital emergency medical services providers

 PURPOSE :

To ensure that responding ambulance service companies receive direct
payment for all ambulance service transports upon submission of an
invoice to the insurance company without the need for the responding
ambulance company to be a preferred provider.

 SUMMARY OF PROVISIONS :

Section 1 amends section 3224-a of the insurance law to provide that
payments made to nonparticipating or non-preferred providers of
ambulance services made by health insurers shall be done so directly
to the provider or jointly to both the provider and the insured.

Section 2 amends subparagraphs (c) and (d) of paragraph 24 of
subsection (i) of section 3216 of the insurance law stating that the
insurers shall send such payments directly to the provider of such
ambulance services if the ambulance service includes an executed
assignment of benefits form with the claim and the provisions of this

paragraph shall apply to transfers of patients between hospitals or
health care facilities.

Section 3 amends subparagraphs (c) and (d) of paragraph 15 of
subsection (1) of section 3221 of the insurance law stating that the
insurers shall send such payments directly to the provider of such
ambulance services if the ambulance service includes an executed
assignment of benefits form with the claim and the provisions of this
paragraph shall apply to transfers of patients between hospitals or
health care facilities.

Section 4 amends paragraphs 3 and 4 of subsection (aa) of section 4303
of the insurance law stating that the insurers shall send such
payments directly to the provider of such ambulance services if the
ambulance service includes an executed assignment of benefits form
with the claim and the provisions of this paragraph shall apply to
transfers of patients between hospitals or health care facilities.

Section 5. Effective Date.

 JUSTIFICATION :

The constant and quick availability of ambulance response is something
that all of our citizens have grown accustomed to and it is essential
to the survivability of all New Yorkers when there is a medical
crisis. Fair and direct reimbursement for those services is paramount
to the financial stability and continued availability of ambulances to
respond.

Current law permits insurance companies to pay for ambulance service
charges direct to the patient until and unless the ambulance company
becomes a preferred provider of that specific insurance company. It is
not practical to expect a preferred provider relationship with every
insurance company. But then it is the responsibility of the ambulance
company to try to recoup payment for service from that patient.

All types of EMS providers routinely are not paid by the patient for
ambulance services even though the patient receives payment from the
insurance company. Especially as the financial crisis we are currently
facing deepens, more and more patients are pocketing these funds.
Further, the insurance company is not obligated to advise the
ambulance company that they in fact paid the ambulance transport bill
direct to the patient. This disconnect of information leads to
confusion and furthers the lack of proper payment issue.

In New York State, ambulance companies are mandated responders. As
such, most ambulance providers have no knowledge of the patient's
ability to pay or if or by whom they are insured by when a medical
emergency or accidental event occurs. Ambulance service is one of the
few medical services where payment is not expected at the time of
service.

This legislation will assure that responding ambulance service will
receive direct payment for all ambulance service transports upon
submission of an invoice to the insurance company without the need for
the responding ambulance company to be a preferred provider.

 LEGISLATIVE HISTORY :

S.1764 of 2015-16;
S.3542 of 2013-14;
S.2714-B of 2011-12;
S.4462 of 2010.

 FISCAL IMPLICATIONS :

None.


 EFFECTIVE DATE :
This act shall take effect January 1, 2019 and shall apply to health
care claims submitted for payment after such date.

2017-S2527 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2527
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2017
                                ___________
 
 Introduced  by  Sens.  SEWARD,  ADDABBO,  AVELLA, BOYLE, BRESLIN, FUNKE,
   GALLIVAN, MARCHIONE -- read twice and ordered printed, and when print-
   ed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law, in relation to payments to  prehospi-
   tal emergency medical services providers

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 3224-a of the insurance law is amended by adding  a
 new subsection (k) to read as follows:
   (K)  PAYMENTS  TO  NONPARTICIPATING OR NONPREFERRED PROVIDERS OF AMBU-
 LANCE SERVICES LICENSED UNDER ARTICLE THIRTY OF THE PUBLIC  HEALTH  LAW.
 (1)  WHENEVER  AN INSURER OR AN ORGANIZATION, OR CORPORATION LICENSED OR
 CERTIFIED PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER
 OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW PROVIDES THAT ANY  HEALTH
 CARE  CLAIMS  SUBMITTED  UNDER CONTRACTS OR AGREEMENTS ISSUED OR ENTERED
 INTO PURSUANT TO THIS  ARTICLE  OR  ARTICLE  FORTY-TWO,  FORTY-THREE  OR
 FORTY-SEVEN  OF THIS CHAPTER AND ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH
 LAW ARE PAYABLE TO A PARTICIPATING OR PREFERRED  PROVIDER  OF  AMBULANCE
 SERVICES  FOR  SERVICES  RENDERED,  THE INSURER, ORGANIZATION, OR CORPO-
 RATION LICENSED OR CERTIFIED PURSUANT TO ARTICLE FORTY-THREE  OR  FORTY-
 SEVEN  OF  THIS  CHAPTER  OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW
 SHALL BE REQUIRED TO PAY SUCH BENEFITS EITHER DIRECTLY TO ANY  SIMILARLY
 LICENSED  NONPARTICIPATING  OR  NONPREFERRED  PROVIDER  AT THE USUAL AND
 CUSTOMARY CHARGE, WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE, WHEN THE
 PROVIDER HAS RENDERED SUCH SERVICES, HAS A WRITTEN ASSIGNMENT  OF  BENE-
 FITS,  AND  HAS  CAUSED WRITTEN NOTICE OF SUCH ASSIGNMENT TO BE GIVEN TO
 THE INSURER, ORGANIZATION, OR CORPORATION LICENSED OR CERTIFIED PURSUANT
 TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTICLE  FORTY-
 FOUR  OF  THE  PUBLIC  HEALTH LAW OR JOINTLY TO SUCH NONPARTICIPATING OR
 NONPREFERRED PROVIDER AND TO THE INSURED, SUBSCRIBER, OR  OTHER  COVERED
 PERSON;  PROVIDED,  HOWEVER,  THAT IN EITHER CASE THE INSURER, ORGANIZA-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD00551-01-7

 S. 2527                             2
 
 TION, OR CORPORATION LICENSED OR CERTIFIED PURSUANT  TO  ARTICLE  FORTY-
 THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTICLE FORTY-FOUR OF THE PUBLIC
 HEALTH  LAW  SHALL BE REQUIRED TO SEND SUCH BENEFIT PAYMENTS DIRECTLY TO
 THE  PROVIDER  WHO  HAS  THE  WRITTEN  ASSIGNMENT.  WHEN PAYMENT IS MADE
 DIRECTLY TO A PROVIDER OF  AMBULANCE  SERVICES  AS  AUTHORIZED  BY  THIS
 SECTION, THE INSURER, ORGANIZATION, OR CORPORATION LICENSED OR CERTIFIED
 PURSUANT  TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTI-
 CLE FORTY-FOUR OF THE PUBLIC HEALTH LAW SHALL  GIVE  WRITTEN  NOTICE  OF
 SUCH PAYMENT TO THE INSURED, SUBSCRIBER, OR OTHER COVERED PERSON.
   (2)   AN  INSURER  SHALL  PROVIDE  REIMBURSEMENT  FOR  THOSE  SERVICES
 PRESCRIBED BY THIS SECTION AT RATES NEGOTIATED BETWEEN THE  INSURER  AND
 THE  PROVIDER  OF SUCH SERVICES. IN THE ABSENCE OF AGREED UPON RATES, AN
 INSURER SHALL PAY FOR SUCH SERVICES AT THE USUAL AND  CUSTOMARY  CHARGE,
 WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE.
   (3)  NOTHING CONTAINED IN THIS SECTION SHALL BE DEEMED TO PROHIBIT THE
 PAYMENT OF DIFFERENT LEVELS OF BENEFITS OR FROM  HAVING  DIFFERENCES  IN
 COINSURANCE  PERCENTAGES  APPLICABLE  TO  BENEFIT  LEVELS  FOR  SERVICES
 PROVIDED BY PARTICIPATING OR PREFERRED PROVIDERS AND NONPARTICIPATING OR
 NONPREFERRED PROVIDERS.
   THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO POLICIES THAT DO NOT
 INCLUDE COVERAGE FOR AMBULANCE SERVICES.
   § 2. Subparagraphs (C) and (D) of paragraph 24 of  subsection  (i)  of
 section  3216  of the insurance law, as added by chapter 506 of the laws
 of 2001, are amended to read as follows:
   (C)  An  insurer  shall  provide  reimbursement  for  those   services
 prescribed  by  this section at rates negotiated between the insurer and
 the provider of such services. In the absence of agreed upon  rates,  an
 insurer  shall  pay for such services at the usual and customary charge,
 which shall not be excessive or unreasonable.   THE INSURER  SHALL  SEND
 SUCH  PAYMENTS  DIRECTLY  TO THE PROVIDER OF SUCH AMBULANCE SERVICES, IF
 THE AMBULANCE SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF  BENEFITS  FORM
 WITH THE CLAIM.
   (D)  The  provisions  of  this  paragraph shall have no application to
 transfers of patients between hospitals or health care facilities by  an
 ambulance  service  as  described  in subparagraph (A) of this paragraph
 UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
   § 3. Subparagraphs (C) and (D) of paragraph 15 of  subsection  (l)  of
 section  3221  of the insurance law, as added by chapter 506 of the laws
 of 2001, are amended to read as follows:
   (C)  An  insurer  shall  provide  reimbursement  for  those   services
 prescribed  by  this section at rates negotiated between the insurer and
 the provider of such services. In the absence of agreed upon  rates,  an
 insurer  shall  pay for such services at the usual and customary charge,
 which shall not be excessive or unreasonable.   THE INSURER  SHALL  SEND
 SUCH  PAYMENTS  DIRECTLY  TO THE PROVIDER OF SUCH AMBULANCE SERVICES, IF
 THE AMBULANCE SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF  BENEFITS  FORM
 WITH THE CLAIM.
   (D)  The  provisions  of  this  paragraph shall have no application to
 transfers of patients between hospitals or health care facilities by  an
 ambulance  service  as  described  in subparagraph (A) of this paragraph
 UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
   § 4. Paragraphs 3 and 4 of subsection (aa)  of  section  4303  of  the
 insurance  law, as added by chapter 506 of the laws of 2001, are amended
 to read as follows:
   (3)  An  insurer  shall  provide  reimbursement  for  those   services
 prescribed  by  this section at rates negotiated between the insurer and

 S. 2527                             3
 
 the provider of such services. In the absence of agreed upon  rates,  an
 insurer  shall  pay for such services at the usual and customary charge,
 which shall not be excessive or unreasonable.   THE INSURER  SHALL  SEND
 SUCH  PAYMENTS  DIRECTLY  TO THE PROVIDER OF SUCH AMBULANCE SERVICES, IF
 THE AMBULANCE SERVICE INCLUDES AN EXECUTED ASSIGNMENT OF  BENEFITS  FORM
 WITH THE CLAIM.
   (4)  The  provisions  of  this subsection shall have no application to
 transfers of patients between hospitals or health care facilities by  an
 ambulance  service  as  described  in  paragraph  one of this subsection
 UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
   § 5. This act shall take effect January 1, 2019  and  shall  apply  to
 health care claims submitted for payment after such date.

co-Sponsors

View additional co-sponsors

2017-S2527A (ACTIVE) - Details

See Assembly Version of this Bill:: A343
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3224-a, 3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S4462, A10735
2011-2012: S2714, A1341, A4093
2013-2014: S3542, A7534
2015-2016: S1764, A6195, A8581
2019-2020: S3526, A6211
2021-2022: S3556, A1309
2023-2024: S1466, A250

2017-S2527A (ACTIVE) - Summary

Authorizes payments to nonparticipating or nonpreferred providers of ambulance services licensed under article 30 of the public health law.

2017-S2527A (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S2527A

SPONSOR: SEWARD
 
TITLE OF BILL:  An act to amend the insurance law, in relation to
payments to prehospital emergency medical services providers

 
PURPOSE:

To ensure that responding ambulance service companies receive direct
payment for all ambulance service transports upon submission of an
invoice to the insurance company without the need for the responding
ambulance company to be a preferred provider.

 
SUMMARY OF PROVISIONS:

Section 1 amends section 3224-a of the insurance law to provide that
payments made to nonparticipating or non-preferred providers of ambu-
lance services made by health insurers shall be done so directly to the
provider or jointly to both the provider and the insured.

Section 2 amends subparagraphs (c) and (d) of paragraph 24 of subsection

(i) of section 3216 of the insurance law stating that the insurers shall
send such payments directly to the provider of such ambulance services
if the ambulance service includes an executed assignment of benefits
form with the claim and the provisions of this paragraph shall apply to
transfers of patients between hospitals or health care facilities.

Section 3 amends subparagraphs (c) and (d) of paragraph 15 of subsection
(1) of section 3221 of the insurance law stating that the insurers shall
send such payments directly to the provider of such ambulance services
if the ambulance service includes an executed assignment of benefits
form with the claim and the provisions of this paragraph shall apply to
transfers of patients between hospitals or health care facilities.

Section 4 amends paragraphs 3 and 4 of subsection (aa) of section 4303
of the insurance law stating that the insurers shall send such payments
directly to the provider of such ambulance services if the ambulance
service includes an executed assignment of benefits form with the claim
and the provisions of this paragraph shall apply to transfers of
patients between hospitals or health care facilities.

Section 5. Effective Date.

 
JUSTIFICATION:

The constant and quick availability of ambulance response is something
that all of our citizens have grown accustomed to and it is essential to
the survivability of all New Yorkers when there is a medical crisis.
Fair and direct reimbursement for those services is paramount to the
financial stability and continued availability of ambulances to respond.

Current law permits insurance companies to pay for ambulance service
charges direct to the patient until and unless the ambulance company
becomes a preferred provider of that specific insurance company. It is
not practical to expect a preferred provider relationship with every
insurance company. But then it is the responsibility of the ambulance
company to try to recoup payment for service from that patient.


All types of EMS providers routinely are not paid by the patient for
ambulance services even though the patient receives payment from the
insurance company. Especially as the financial crisis we are currently
facing deepens, more and more patients are pocketing these funds.
Further, the insurance company is not obligated to advise the ambulance
company that they in fact paid the ambulance transport bill direct to
the patient. This disconnect of information leads to confusion and
furthers the lack of proper payment issue.

In New York State, ambulance companies are mandated responders. As such,
most ambulance providers have no knowledge of the patient's ability to
pay or if or by whom they are insured by when a medical emergency or
accidental event occurs. Ambulance service is one of the few medical
services where payment is not expected at the time of service.

This legislation will assure that responding ambulance service will
receive direct payment for all ambulance service transports upon
submission of an invoice to the insurance company without the need for
the responding ambulance company to be a preferred provider.

 
LEGISLATIVE HISTORY:

S.1764 of 2015-16;
S.3542 of 2013-14;
S.2714-8 of 2011-12;
S.4462 of 2010.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect January 1, 2020 and shall apply to health
care claims submitted for payment after such date.

2017-S2527A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2527--A
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2017
                                ___________
 
 Introduced  by  Sens.  SEWARD,  ADDABBO, AKSHAR, AVELLA, BOYLE, BRESLIN,
   FUNKE, GALLIVAN, MARCHIONE -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance  --  recommitted
   to the Committee on Insurance in accordance with Senate Rule 6, sec. 8
   --  committee  discharged,  bill amended, ordered reprinted as amended
   and recommitted to said committee
 
 AN ACT to amend the insurance law, in relation to payments to  prehospi-
   tal emergency medical services providers
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 3224-a of the insurance law is amended by adding  a
 new subsection (k) to read as follows:
   (K)  PAYMENTS  TO  NONPARTICIPATING OR NONPREFERRED PROVIDERS OF AMBU-
 LANCE SERVICES LICENSED UNDER ARTICLE THIRTY OF THE PUBLIC  HEALTH  LAW.
 (1)  WHENEVER  AN INSURER OR AN ORGANIZATION, OR CORPORATION LICENSED OR
 CERTIFIED PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER
 OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW PROVIDES THAT ANY  HEALTH
 CARE  CLAIMS  SUBMITTED  UNDER CONTRACTS OR AGREEMENTS ISSUED OR ENTERED
 INTO PURSUANT TO THIS  ARTICLE  OR  ARTICLE  FORTY-TWO,  FORTY-THREE  OR
 FORTY-SEVEN  OF THIS CHAPTER AND ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH
 LAW ARE PAYABLE TO A PARTICIPATING OR PREFERRED  PROVIDER  OF  AMBULANCE
 SERVICES  FOR  SERVICES  RENDERED,  THE INSURER, ORGANIZATION, OR CORPO-
 RATION LICENSED OR CERTIFIED PURSUANT TO ARTICLE FORTY-THREE  OR  FORTY-
 SEVEN  OF  THIS  CHAPTER  OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW
 SHALL BE REQUIRED TO PAY SUCH BENEFITS EITHER DIRECTLY TO ANY  SIMILARLY
 LICENSED  NONPARTICIPATING  OR  NONPREFERRED  PROVIDER  AT THE USUAL AND
 CUSTOMARY CHARGE, WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE, WHEN THE
 PROVIDER HAS RENDERED SUCH SERVICES, HAS ON FILE A DULY EXECUTED ASSIGN-
 MENT OF BENEFITS, AND HAS CAUSED NOTICE OF SUCH ASSIGNMENT TO  BE  GIVEN
 TO  THE  INSURER,  ORGANIZATION,  OR  CORPORATION  LICENSED OR CERTIFIED
 PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR  ARTI-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD00551-04-8

 S. 2527--A                          2
 
 CLE  FORTY-FOUR  OF  THE PUBLIC HEALTH LAW OR JOINTLY TO SUCH NONPARTIC-
 IPATING OR NONPREFERRED PROVIDER AND  TO  THE  INSURED,  SUBSCRIBER,  OR
 OTHER  COVERED PERSON; PROVIDED, HOWEVER, THAT IN EITHER CASE THE INSUR-
 ER, ORGANIZATION, OR CORPORATION LICENSED OR CERTIFIED PURSUANT TO ARTI-
 CLE  FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR ARTICLE FORTY-FOUR OF
 THE PUBLIC HEALTH LAW SHALL BE REQUIRED TO SEND  SUCH  BENEFIT  PAYMENTS
 DIRECTLY TO THE PROVIDER WHO HAS THE ASSIGNMENT ON FILE. WHEN PAYMENT IS
 MADE  DIRECTLY TO A PROVIDER OF AMBULANCE SERVICES AS AUTHORIZED BY THIS
 SECTION, THE INSURER, ORGANIZATION, OR CORPORATION LICENSED OR CERTIFIED
 PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR  ARTI-
 CLE  FORTY-FOUR  OF  THE  PUBLIC HEALTH LAW SHALL GIVE WRITTEN NOTICE OF
 SUCH PAYMENT TO THE INSURED, SUBSCRIBER, OR OTHER COVERED PERSON.
   (2)  AN  INSURER  SHALL  PROVIDE  REIMBURSEMENT  FOR  THOSE   SERVICES
 PRESCRIBED  BY  THIS SECTION AT RATES NEGOTIATED BETWEEN THE INSURER AND
 THE PROVIDER OF SUCH SERVICES. IN THE ABSENCE OF AGREED UPON  RATES,  AN
 INSURER  SHALL  PAY FOR SUCH SERVICES AT THE USUAL AND CUSTOMARY CHARGE,
 WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE.
   (3) NOTHING CONTAINED IN THIS SECTION SHALL BE DEEMED TO PROHIBIT  THE
 PAYMENT  OF  DIFFERENT  LEVELS OF BENEFITS OR FROM HAVING DIFFERENCES IN
 COINSURANCE  PERCENTAGES  APPLICABLE  TO  BENEFIT  LEVELS  FOR  SERVICES
 PROVIDED BY PARTICIPATING OR PREFERRED PROVIDERS AND NONPARTICIPATING OR
 NONPREFERRED PROVIDERS.
   THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO POLICIES THAT DO NOT
 INCLUDE COVERAGE FOR AMBULANCE SERVICES.
   §  2.  Subparagraphs  (C) and (D) of paragraph 24 of subsection (i) of
 section 3216 of the insurance law, as added by chapter 506 of  the  laws
 of 2001, are amended to read as follows:
   (C)   An  insurer  shall  provide  reimbursement  for  those  services
 prescribed by this section at rates negotiated between the  insurer  and
 the  provider  of such services. In the absence of agreed upon rates, an
 insurer shall pay for such services at the usual and  customary  charge,
 which  shall  not  be excessive or unreasonable.  THE INSURER SHALL SEND
 SUCH PAYMENTS DIRECTLY TO THE PROVIDER OF SUCH  AMBULANCE  SERVICES,  IF
 THE  AMBULANCE  SERVICE  HAS  ON FILE AN EXECUTED ASSIGNMENT OF BENEFITS
 FORM WITH THE CLAIM.
   (D) The provisions of this paragraph  shall  have  no  application  to
 transfers  of patients between hospitals or health care facilities by an
 ambulance service as described in subparagraph  (A)  of  this  paragraph
 UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
   §  3.  Subparagraphs  (C) and (D) of paragraph 15 of subsection (l) of
 section 3221 of the insurance law, as added by chapter 506 of  the  laws
 of 2001, are amended to read as follows:
   (C)   An  insurer  shall  provide  reimbursement  for  those  services
 prescribed by this section at rates negotiated between the  insurer  and
 the  provider  of such services. In the absence of agreed upon rates, an
 insurer shall pay for such services at the usual and  customary  charge,
 which  shall  not  be excessive or unreasonable.  THE INSURER SHALL SEND
 SUCH PAYMENTS DIRECTLY TO THE PROVIDER OF SUCH  AMBULANCE  SERVICES,  IF
 THE  AMBULANCE  SERVICE  HAS  ON FILE AN EXECUTED ASSIGNMENT OF BENEFITS
 FORM WITH THE CLAIM.
   (D) The provisions of this paragraph  shall  have  no  application  to
 transfers  of patients between hospitals or health care facilities by an
 ambulance service as described in subparagraph  (A)  of  this  paragraph
 UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.

 S. 2527--A                          3
 
   §  4.  Paragraphs  3  and  4 of subsection (aa) of section 4303 of the
 insurance law, as added by chapter 506 of the laws of 2001, are  amended
 to read as follows:
   (3)   An  insurer  shall  provide  reimbursement  for  those  services
 prescribed by this section at rates negotiated between the  insurer  and
 the  provider  of such services. In the absence of agreed upon rates, an
 insurer shall pay for such services at the usual and  customary  charge,
 which  shall  not  be excessive or unreasonable.  THE INSURER SHALL SEND
 SUCH PAYMENTS DIRECTLY TO THE PROVIDER OF SUCH  AMBULANCE  SERVICES,  IF
 THE  AMBULANCE  SERVICE  HAS  ON FILE AN EXECUTED ASSIGNMENT OF BENEFITS
 FORM WITH THE CLAIM.
   (4) The provisions of this subsection shall  have  no  application  to
 transfers  of patients between hospitals or health care facilities by an
 ambulance service as described  in  paragraph  one  of  this  subsection
 UNLESS SUCH SERVICES ARE COVERED UNDER THE POLICY.
   §  5.  This  act  shall take effect January 1, 2020 and shall apply to
 health care claims submitted for payment after such date.

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Senate Bill S2527A

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Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

Bill Amendments

co-Sponsors

2017-S2527 - Details

2017-S2527 - Summary

2017-S2527 - Sponsor Memo

2017-S2527 - Bill Text download pdf

co-Sponsors

2017-S2527A (ACTIVE) - Details

2017-S2527A (ACTIVE) - Summary

2017-S2527A (ACTIVE) - Sponsor Memo

2017-S2527A (ACTIVE) - Bill Text download pdf

Comments