S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5319
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             February 20, 2025
                                ___________
 
 Introduced  by  Sen.  BAILEY -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law and the public health law, in relation
   to required terms for certain insurance contracts
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  3  of  subsection (e) of section 3217-b of the
 insurance law, as added by chapter 586 of the laws of 1998,  is  amended
 and three new paragraphs 3-a, 3-b and 3-c are added to read as follows:
   (3)  a description of the records or information relied upon to calcu-
 late any such payments and adjustments, INCLUDING THE DATE  OF  SERVICE,
 PATIENT  IDENTIFICATION  NUMBER,  AN  IDENTIFICATION  OF THE SERVICE FOR
 WHICH THE PAYMENT IS MADE, THE REIMBURSEMENT PAID BY THE INSURER FOR THE
 SERVICE, and a description of how the provider can access a  summary  of
 such calculations and adjustments;
   (3-A)  THE PERMISSIBLE PAYMENT METHODS AS CHECK, DIRECT DEPOSIT, DEBIT
 OR CREDIT CARD OR  ONLINE  PAYMENT  SYSTEM,  PROVIDED  THE  HEALTH  CARE
 PROVIDER  CAN  ACCESS  THE PAYMENT IN FULL, WITHOUT ENCUMBRANCES, COSTS,
 CHARGES, OR FEES, INCLUDING A FEE FOR REPLACEMENT OF A  LOST  OR  STOLEN
 CHECK, UNDER AT LEAST ONE PAYMENT METHOD OFFERED BY THE INSURER;
   (3-B) THE ADVANCE WRITTEN CONSENT OF A PROVIDER TO THE INSURER FOR THE
 METHOD  OF  PAYMENT AND TO DIRECTLY PAY OR DEPOSIT PAYMENTS IN A BANK OR
 OTHER FINANCIAL INSTITUTION OF THE PROVIDER'S CHOOSING;
   (3-C) THE INSURER'S ANNUAL OBLIGATION, BEGINNING ON THE EFFECTIVE DATE
 OF THIS PARAGRAPH AND CONTINUING EVERY FIRST OF JANUARY  THEREAFTER,  TO
 PROVIDE THE HEALTH CARE PROVIDER WITH AN UPDATED PAYMENT RATE SCHEDULE;
   §  2.  Paragraph  3 of subsection (e) of section 4325 of the insurance
 law, as added by chapter 586 of the laws of 1998, is amended  and  three
 new paragraphs 3-a, 3-b and 3-c are added to read as follows:
   (3)  a description of the records or information relied upon to calcu-
 late any such payments and adjustments, INCLUDING THE DATE  OF  SERVICE,
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07324-01-5
              

 S. 5319                             2
 
 PATIENT  IDENTIFICATION  NUMBER,  AN  IDENTIFICATION  OF THE SERVICE FOR
 WHICH THE PAYMENT IS MADE, THE REIMBURSEMENT PAID BY THE CORPORATION FOR
 THE SERVICE, and a description of how the provider can access a  summary
 of such calculations and adjustments;
   (3-A)  THE PERMISSIBLE PAYMENT METHODS AS CHECK, DIRECT DEPOSIT, DEBIT
 OR CREDIT CARD OR  ONLINE  PAYMENT  SYSTEM,  PROVIDED  THE  HEALTH  CARE
 PROVIDER  CAN  ACCESS  THE PAYMENT IN FULL, WITHOUT ENCUMBRANCES, COSTS,
 CHARGES, OR FEES, INCLUDING A FEE FOR REPLACEMENT OF A  LOST  OR  STOLEN
 CHECK, UNDER AT LEAST ONE PAYMENT METHOD OFFERED BY THE CORPORATION;
   (3-B) THE ADVANCE WRITTEN CONSENT OF A PROVIDER TO THE CORPORATION FOR
 THE  METHOD OF PAYMENT AND TO DIRECTLY PAY OR DEPOSIT PAYMENTS IN A BANK
 OR OTHER FINANCIAL INSTITUTION OF THE PROVIDER'S CHOOSING;
   (3-C) THE CORPORATION'S ANNUAL OBLIGATION, BEGINNING ON THE  EFFECTIVE
 DATE OF THIS PARAGRAPH AND CONTINUING EVERY FIRST OF JANUARY THEREAFTER,
 TO  PROVIDE THE HEALTH CARE PROVIDER WITH AN UPDATED PAYMENT RATE SCHED-
 ULE, INCLUDING A DESCRIPTION OF ANY SERVICES  BUNDLED  WITHIN  A  SINGLE
 RATE;
   §  3. Paragraph (c) of subdivision 5-a of section 4406-c of the public
 health law, as added by chapter 586 of the laws of 1998, is amended  and
 three  new  paragraphs  (c-1),  (c-2)  and  (c-3)  are  added to read as
 follows:
   (c) a description of the records or information relied upon to  calcu-
 late  any  such payments and adjustments, INCLUDING THE DATE OF SERVICE,
 PATIENT IDENTIFICATION NUMBER, AN  IDENTIFICATION  OF  THE  SERVICE  FOR
 WHICH  THE  PAYMENT  IS  MADE, THE REIMBURSEMENT PAID BY THE HEALTH CARE
 PLAN FOR THE SERVICE, and a description of how the provider can access a
 summary of such calculations and adjustments;
   (C-1) THE PERMISSIBLE PAYMENT METHODS AS CHECK, DIRECT DEPOSIT,  DEBIT
 OR  CREDIT  CARD  OR  ONLINE  PAYMENT  SYSTEM,  PROVIDED THE HEALTH CARE
 PROVIDER CAN ACCESS THE PAYMENT IN  FULL,  WITHOUT  ENCUMBRANCES,  COSTS
 CHARGES,  OR  FEES,  INCLUDING A FEE FOR REPLACEMENT OF A LOST OR STOLEN
 CHECK, UNDER AT LEAST ONE PAYMENT METHOD  OFFERED  BY  THE  HEALTH  CARE
 PLAN;
   (C-2)  THE  ADVANCE  WRITTEN  CONSENT OF A PROVIDER TO THE HEALTH CARE
 PLAN FOR THE METHOD OF PAYMENT AND TO DIRECTLY PAY OR  DEPOSIT  PAYMENTS
 IN A BANK OR OTHER FINANCIAL INSTITUTION OF THE PROVIDER'S CHOOSING;
   (C-3)  THE  HEALTH  CARE  PLAN'S  ANNUAL  OBLIGATION, BEGINNING ON THE
 EFFECTIVE DATE OF THIS PARAGRAPH AND CONTINUING EVERY FIRST  OF  JANUARY
 THEREAFTER,  TO PROVIDE THE HEALTH CARE PROVIDER WITH AN UPDATED PAYMENT
 RATE SCHEDULE, INCLUDING A DESCRIPTION OF ANY SERVICES BUNDLED WITHIN  A
 SINGLE RATE;
   §  4.  This  act shall take effect on the thirtieth day after it shall
 have become a law  and  shall  apply  to  all  contracts  entered  into,
 renewed, modified or amended on or after such effective date.