S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1842
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 11, 2021
                                ___________
 
 Introduced  by M. of A. PRETLOW -- read once and referred to the Commit-
   tee on Insurance
 
 AN ACT to amend the insurance law,  in  relation  to  reimbursement  for
   ambulance services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Paragraph 24 of subsection  (i)  of  section  3216  of  the
 insurance  law  is  amended  by adding a new subparagraph (F) to read as
 follows:
   (F) AN INSURER WHO ISSUES REIMBURSEMENT  UNDER  THIS  PARAGRAPH  SHALL
 SUBMIT  SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES NEGO-
 TIATED BETWEEN THE PROVIDER AND THE INSURER, OR IF NO    RATE  HAS  BEEN
 NEGOTIATED  BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN THE
 FORM OF A JOINT CHECK SPECIFYING AS PAYEES  BOTH  THE  INSURED  AND  THE
 PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
 SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
 ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
 FITS  FOR  SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING ANY POLICY
 LANGUAGE TO THE CONTRARY, THE ISSUER SHALL  ACCEPT  SUCH  ASSIGNMENT  OF
 BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
 ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
 THE  PROVIDER  VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE OF SUCH
 PAYMENT. THE NOTIFICATION SHALL INCLUDE THE NAME  OF  THE  PATIENT,  THE
 DATE  OF  SERVICE,  THE  DATE  OF PAYMENT, THE AMOUNT OF PAYMENT AND THE
 ADDRESS TO WHICH THE PAYMENT WAS SENT.
   § 2.  Paragraph 15 of subsection (1) of section 3221 of the  insurance
 law is amended by adding a new subparagraph (F) to read as follows:
   (F)  AN  INSURER  WHO  ISSUES REIMBURSEMENT UNDER THIS PARAGRAPH SHALL
 SUBMIT SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES  NEGO-
 TIATED  BETWEEN  THE  PROVIDER  AND  THE INSURER, OR IF NO RATE HAS BEEN
 NEGOTIATED BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN  THE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD00267-01-1

 A. 1842                             2
 
 FORM  OF  A  JOINT  CHECK  SPECIFYING AS PAYEES BOTH THE INSURED AND THE
 PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
 SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
 ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
 FITS  FOR  SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING ANY POLICY
 LANGUAGE TO THE CONTRARY, THE INSURER SHALL ACCEPT  SUCH  ASSIGNMENT  OF
 BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
 ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
 THE  PROVIDER  VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE OF SUCH
 PAYMENT. THE NOTIFICATION SHALL INCLUDE THE NAME  OF  THE  PATIENT,  THE
 DATE  OF  SERVICE,  THE  DATE  OF PAYMENT, THE AMOUNT OF PAYMENT AND THE
 ADDRESS TO WHICH THE PAYMENT WAS SENT.
   § 3. Subsection (aa) of section 4303 of the insurance law  is  amended
 by adding a new paragraph 6 to read as follows:
   (6)  AN  INSURER  WHO ISSUES REIMBURSEMENT UNDER THIS SUBSECTION SHALL
 SUBMIT SUCH PAYMENTS EITHER DIRECTLY TO THE PROVIDER AT THE RATES  NEGO-
 TIATED  BETWEEN  THE  PROVIDER  AND  THE INSURER, OR IF NO RATE HAS BEEN
 NEGOTIATED BETWEEN THE PROVIDER AND INSURER, THEN TO THE INSURED IN  THE
 FORM  OF  A  JOINT  CHECK  SPECIFYING AS PAYEES BOTH THE INSURED AND THE
 PROVIDER OF AMBULANCE SERVICES, AT THE USUAL AND CUSTOMARY CHARGE, WHICH
 SHALL NOT BE EXCESSIVE OR UNREASONABLE; PROVIDED HOWEVER, IF THE PROVID-
 ER OF AMBULANCE SERVICES HAS ON FILE A DULY EXECUTED ASSIGNMENT OF BENE-
 FITS FOR SUCH  SERVICES  TO  THE  INSURER,  NOTWITHSTANDING  ANY  POLICY
 LANGUAGE  TO  THE  CONTRARY, THE INSURER SHALL ACCEPT SUCH ASSIGNMENT OF
 BENEFITS AND THE INSURER SHALL ISSUE REIMBURSEMENT SOLELY TO THE PROVID-
 ER. AN INSURER ISSUING PAYMENT IN THE FORM OF A JOINT CHECK SHALL NOTIFY
 THE PROVIDER VIA  ELECTRONIC  COMMUNICATION  OF  THE  ISSUANCE  OF  SUCH
 PAYMENT.  THE  NOTIFICATION  SHALL  INCLUDE THE NAME OF THE PATIENT, THE
 DATE OF SERVICE, THE DATE OF PAYMENT, THE  AMOUNT  OF  PAYMENT  AND  THE
 ADDRESS TO WHICH THE PAYMENT WAS SENT.
   § 4. This act shall take effect immediately.