S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2281
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 25, 2023
                                ___________
 
 Introduced  by M. of A. SEPTIMO -- read once and referred to the Commit-
   tee on Insurance
 
 AN ACT to amend the insurance law, in relation to  the  coordination  of
   no-fault benefits for persons injured in motor vehicle accidents
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The insurance law is amended by adding a new  section  5110
 to read as follows:
   §  5110.  PAYMENT FOR SERVICES PROVIDED FOR MOTOR VEHICLE INJURIES. 1.
 ANY PROVIDER OF TREATMENT TO ANY COVERED PERSON,  WHO  RENDERS  CARE  OR
 SUPPLIES  A  PRODUCT WITHIN SEVENTY-TWO HOURS OF THE MOTOR VEHICLE ACCI-
 DENT, IN THE ABSENCE OF FRAUD OR DECEPTION BY THE CLAIMANT,  IS  CONCLU-
 SIVELY  PRESUMED  TO HAVE ACCEPTED, AND TO HAVE CONSENTED TO, AN ASSIGN-
 MENT OF NO-FAULT BENEFITS UNDER THIS ARTICLE IN THE FORM  PRESCRIBED  BY
 THE  SUPERINTENDENT.   THE PROVISIONS OF THIS SUBDIVISION SHALL APPLY IF
 THE PROVIDER KNOWS, OR IS ON NOTICE OF  FACTS  THAT  INDICATE  THAT  THE
 INJURIES  OR  CONDITIONS TREATED ARE THE RESULT OF A MOTOR VEHICLE ACCI-
 DENT WHICH OCCURRED IN THE PRECEDING SEVENTY-TWO HOURS.
   2. ANY PROVIDER OF TREATMENT TO A COVERED  PERSON  WHO  MISTAKENLY  OR
 OTHERWISE  BILLS  AN  INSURER OTHER THAN THE NO-FAULT INSURER FOR CLAIMS
 ELIGIBLE FOR FIRST-PARTY BENEFITS UNDER THIS ARTICLE MUST, UPON  PRESEN-
 TATION  WITH  PROOF  OF  APPLICABLE COVERAGE UNDER ARTICLE SIX, EIGHT OR
 FORTY-FOUR-B OF THE VEHICLE AND TRAFFIC LAW, RETURN SUCH FEES  AND  SEEK
 PAYMENT FOR SERVICES FROM THE NO-FAULT INSURER INSTEAD. A PROVIDER SHALL
 BE PERMITTED TO MAINTAIN INSURANCE INFORMATION IN THE EVENT IT IS ESTAB-
 LISHED  THAT  THERE  ARE NO FIRST-PARTY BENEFITS AVAILABLE FOR EMERGENCY
 TREATMENT UNDER THIS ARTICLE.
   3. THE TIME LIMIT FOR PRESENTATION OF INVOICES TO AN INSURER SHALL  BE
 MEASURED  FROM THE FIRST DATE ON WHICH THE PROVIDER OR THE PATIENT FIRST
 PRESENTED THE INVOICE TO ANY INSURER.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01559-01-3
 A. 2281                             2
              

 
   4.  ANY  COMPENSATION  PROVIDER  THAT,   NOTWITHSTANDING   THE   OTHER
 PROVISIONS  OF  THIS  LAW, PAYS FOR THE EMERGENCY TREATMENT OF A COVERED
 PERSON, HAS A RIGHT OF DIRECT ACTION  AGAINST  THE  INSURER  LIABLE  FOR
 COVERAGE  UNDER  THIS ARTICLE FOR REIMBURSEMENT, BUT IN NO CASE WILL THE
 REIMBURSEMENT  EXCEED  THE AMOUNT OF LAWFUL BENEFITS ACCORDING TO STATE-
 PROMULGATED FEE SCHEDULES.
   5. NO INSURER PROVIDING COVERAGE  UNDER  THIS  ARTICLE  SHALL  EXCLUDE
 REIMBURSEMENT  FOR FIRST-PARTY BENEFITS WHICH HAVE BEEN PAID TO A HEALTH
 CARE PROVIDER OR MEDICAL EQUIPMENT SUPPLIER BY A  COMPENSATION  PROVIDER
 NOT UNDER THIS ARTICLE.
   § 2. This act shall take effect immediately.