What's happening
This bill updates insurance law to require fair reimbursement rates for health service providers treating no-fault claimants in New York.
Why it matters
Shifts authority for setting reimbursement rates. from the Workers' Compensation Board to the Superintendent of Insurance, potentially allowing for more specialized oversight and responsiveness to no-fault insurance claims.
Requires that reimbursement schedules reflect the actual treatment needs of no-fault insurance claimants. , aiming to ensure that providers are fairly compensated for the specific types of care often required after auto accidents.
Mandates the establishment of sufficient rates for specialty providers. , which could improve access to care for patients with complex injuries by encouraging more providers to accept no-fault insurance cases.
May lead to more consistent and transparent payment standards statewide. , reducing disputes between providers and insurers and potentially speeding up the process for claimants to receive necessary medical treatment.
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Who cares
Headline styles
Limit Health Service Charges
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
265
2019-2020 Regular Sessions
IN ASSEMBLY (Prefiled)
January 9, 2019
Introduced by M. of A. CAHILL -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to limits on charges by providers of health services
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subsections (a) and (b) of section 5108 of the insurance law are amended to read as follows:
(a) The charges for services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article and any further health service charges which are incurred as a result of the injury and which are in excess of basic economic loss, shall not exceed the charges permissible under the [schedules] schedule prepared and established by the [chairman of the workers' compensation board for industrial accidents] superintendent pursuant to subsection (b) of this section, except where the insurer or arbitrator determines that unusual procedures or unique circumstances justify the excess charge.
(b) The superintendent[, after consulting with the chairman of the workers' compensation board and the commissioner of health,] shall promulgate rules and regulations [implementing and coordinating the provisions of this article and the workers' compensation law] with respect to charges for the professional health services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article, including the establishment of schedules for all such services [for which schedules have not been prepared and established by the chairman of the workers' compensation board]. In establishing such schedules the superintendent shall ensure that provider reimbursement rates accurately reflect the treatment needs of no-fault claimants including the establishment of rates sufficient to reimburse specialty providers who treat no-fault claimants.
§ 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00055-01-9
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.