What's happening
This bill requires insurers to pay ambulance service reimbursements directly to providers or via joint checks with detailed notification procedures.
Why it matters
Ensures ambulance providers are paid directly or through a joint check. , which can help reduce delays or lost payments, improving cash flow for ambulance services and potentially speeding up care for patients.
Mandates clear notification to ambulance providers when payment is issued via joint check. , including key details such as patient name, service date, payment date, amount, and address, increasing transparency and making it easier for providers to track and confirm payments.
Overrides existing insurance policy language if a patient assigns benefits directly to the ambulance provider. , meaning insurers must honor these assignments and pay the provider directly, helping to prevent billing confusion and reducing administrative burdens for both providers and patients.
Establishes that payments must be at negotiated rates or, in the absence of such rates, at the usual and customary charge (but not excessive or unreasonable). , which could help limit surprise billing for patients and ensure fair compensation for ambulance services.
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Who cares
Headline styles
Direct Ambulance Payment Reform
Plain English, a few words. Used as the page title.
Sponsors
History
- Referred 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.
Direct Payments for Ambulance Services
In Senate Committee · Insurance · Sponsor James L. Seward
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
908
2017-2018 Regular Sessions
IN ASSEMBLY
January 9, 2017
Introduced by M. of A. PRETLOW -- read once and referred to the Committee 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 Assembly, 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 negotiated 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 provider of ambulance services has on file a duly executed assignment of benefits 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 provider. 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 negotiated 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.
LBD04476-01-7
A. 908 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 provider of ambulance services has on file a duly executed assignment of benefits 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 provider. 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 negotiated 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 provider of ambulance services has on file a duly executed assignment of benefits 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 provider. 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.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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