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Who cares
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Sponsors
1 Co-sponsor
History
- Print number 7868a
- Amend (t) and recommit to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Relates to establishing protections from excessive hospital emergency charges; repealer
In Senate Committee · Rules · Sponsor Kevin Cahill
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
Title of bill
An act to amend the financial services law, in relation to establishing protections from excessive hospital emergency charges; and providing for the repeal of certain provisions upon expiration thereof
Purpose
This bill subjects hospital charges for emergency services to the independent dispute resolution process established to protect against excessive emergency charges.
Summary of provisions
Section 1 amends section 605 of the financial services law by including hospital charges in the emergency charges that are subject to the independent dispute resolution process. It also provides that if a health insurer submits a dispute regarding the hospital's charge to dispute resolution, the health insurer shall pay a reasonable amount for the services directly to the hospital.
Section 2 amends section 608 of the financial services law by including hospitals in the payment and settlement provisions with respect to the cost of the independent dispute resolution process.
Section 3 requires parties to a contract between a commercial health insurer and a hospital or hospital system to engage in mutually agreeable third-party mediation for the purposes of settling a financial dispute.
Section 4 sets the effective date, and sets forth that section 3 of the bill shall be deemed repealed on January 1, 2017.
Justification
Section 3241 of the insurance law requires health insurers to ensure that enrollees incur no greater out-of-pocket costs than they would have incurred with a participating provider when emergency services are received from a non-participating provider. Currently, section 605 of the financial services law establishes an independent dispute resolution process for physician emergency charges.
The charges billed by hospitals for emergency services when they are out-of-network are often excessive. This is particularly true given section 3241 of the insurance law cited above, which essentially requires health insurers to pay charges to non-participating hospitals for emergency services to ensure that members are not balance billed. Hospitals are assured of receiving their billed charges, notwithstanding how excessive the charges might be.
Hospital charges for emergency services must be subject to dispute resolution to ensure that hospitals are not able to take advantage of section 3241 of the insurance law by charging exorbitant fees which ultimately drive up the cost of health insurance.
Legislative history
New bill.
Fiscal implications
None.
Effective date
Immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.