Senate Bill S3118

2017-2018 Legislative Session

Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery

download bill text pdf

Sponsored By

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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2017-S3118 (ACTIVE) - Details

See Assembly Version of this Bill:
A2792
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216 & 3221, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: S7186, A9773, A8091
2011-2012: S1119, A495
2013-2014: S2637, A635
2015-2016: S1513, A7235
2019-2020: S4502, A2765
2021-2022: S4787, A1983
2023-2024: S5753, A2663

2017-S3118 (ACTIVE) - Summary

Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery and such physician's services shall not be covered by their insurance policy; such services must be covered if the insured person does not receive notification prior to such services or procedure.

2017-S3118 (ACTIVE) - Sponsor Memo

2017-S3118 (ACTIVE) - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3118
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             January 19, 2017
                                ___________
 
 Introduced  by  Sen.  PARKER -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law, in relation to requiring notification
   to insured persons that an out-of-network physician  may  be  used  in
   their procedure, test or surgery

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 3216 of the insurance law is amended  by  adding  a
 new subsection (n) to read as follows:
   (N)  (1)  EVERY  PERSON  INSURED UNDER A POLICY OF ACCIDENT AND HEALTH
 INSURANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE SHALL BE  ENTI-
 TLED  TO  NOTIFICATION  FROM  THE BILLING ENTITY PRIOR TO THE PROCEDURE,
 TEST OR SURGERY, THAT AN OUT-OF-NETWORK PHYSICIAN MAY BE  USED  IN  SUCH
 PROCEDURE,  TEST  OR  SURGERY AND SUCH PHYSICIAN'S SERVICES SHALL NOT BE
 COVERED BY THEIR INSURANCE POLICY.
   (2) THE PATIENT COSTS OF OUT-OF-NETWORK PHYSICIAN  SERVICES  SHALL  BE
 COVERED  BY  THE  INSURANCE POLICY OF AN INSURED PERSON IF HE OR SHE HAS
 NOT RECEIVED NOTIFICATION  OF  SUCH  SITUATIONS,  PRIOR  TO  THE  HEALTH
 SERVICE OR PROCEDURE, AS PRESCRIBED IN PARAGRAPH ONE OF THIS SUBSECTION.
   §  2.  Section  3221  of  the insurance law is amended by adding a new
 subsection (t) to read as follows:
   (T) (1) EVERY PERSON INSURED UNDER A POLICY  OF  ACCIDENT  AND  HEALTH
 INSURANCE  DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE SHALL BE ENTI-
 TLED TO NOTIFICATION FROM THE BILLING ENTITY  PRIOR  TO  THE  PROCEDURE,
 TEST  OR  SURGERY,  THAT AN OUT-OF-NETWORK PHYSICIAN MAY BE USED IN SUCH
 PROCEDURE, TEST OR SURGERY AND SUCH PHYSICIAN'S SERVICES  SHALL  NOT  BE
 COVERED BY THEIR INSURANCE POLICY.
   (2)  THE  PATIENT  COSTS OF OUT-OF-NETWORK PHYSICIAN SERVICES SHALL BE
 COVERED BY THE INSURANCE POLICY OF AN INSURED PERSON IF HE  OR  SHE  HAS
 NOT  RECEIVED  NOTIFICATION  OF  SUCH  SITUATIONS,  PRIOR  TO THE HEALTH
 SERVICE OR PROCEDURE, AS PRESCRIBED IN PARAGRAPH ONE OF THIS SUBSECTION.
   § 3. This act shall take effect immediately.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

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