What's happening
This bill requires health insurers in New York to allow patients to assign insurance payments directly to their medical providers, regardless of network status.
Why it matters
Empowers patients. by allowing them to direct insurance payments to any provider, including out-of-network doctors or hospitals, which could make it easier to access care from specialists or facilities not in their insurance’s network.
Improves provider reimbursement. by ensuring that payment for covered services can go directly to healthcare providers, potentially reducing administrative burdens and delays for both patients and providers.
Increases transparency. by requiring insurers to notify patients in writing about payments made to providers, including details such as payment amounts, services covered, and calculations involving co-pays and deductibles.
May impact out-of-network billing dynamics. by shifting how payments are routed and possibly influencing negotiations between providers and insurers, which could affect billing practices and patient financial responsibility.
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Who cares
Headline styles
Let Patients Assign Payments
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Referred to insurance
- Referred to insurance
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2867
2019-2020 Regular Sessions
IN ASSEMBLY
January 28, 2019
Introduced by M. of A. ZEBROWSKI -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring medical insurers to permit patients to assign their payment
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 35 to read as follows:
(35) Every policy which provides medical, major-medical or similar comprehensive-type coverage shall permit a patient to assign his or her payment to the provider of such hospital, surgical or medical services, regardless of whether the provider is in the network of health care providers offered by the insurer issuing the policy, provided that the services rendered to the patient by the provider are otherwise covered under the policy.
§ 2. Section 3221 of the insurance law is amended by adding a new subsection (t) to read as follows:
(t) Every group or blanket policy delivered or issued for delivery in this state which provides hospital, surgical or medical coverage shall permit a patient to assign his or her payment to the provider of such hospital, surgical or medical services, regardless of whether the provider is in the network of health care providers offered by the insurer issuing the policy, provided that the services rendered to the patient by the provider are otherwise covered under the policy.
§ 3. Section 3224-a of the insurance law is amended by adding a new subsection (k) to read as follows:
(k) Where payment for any portion of a claim is made directly to a health care provider, such insurer or organization or corporation shall provide at the time payment is made written notification of such payment to the policyholder who rendered the service for which the claim was paid. Such notification shall include, but not be limited to, the amount
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02142-01-9
A. 2867 2
paid to the health care provider, the percentage of the total claim represented by the payment, the services for which payment was made, the health care provider providing those services and the calculations for payment, by service provided, including co-payments, deductibles, surcharges and fee schedules.
§ 4. Section 4303 of the insurance law is amended by adding a new subsection (a-1) to read as follows:
(a-1) Every contract issued by a medical expense indemnity corporation or health service corporation which provides medical, major medical or similar comprehensive-type coverage shall permit a patient to assign his or her benefits to the provider of such hospital, surgical or medical services, regardless of whether the provider is in the network of health care providers offered by the insurer issuing the policy, provided that the services rendered to the patient by the provider are otherwise covered under the policy.
§ 5. This act shall take effect on the ninetieth day after it shall have become a law and shall apply to policies and contracts issued, renewed, modified, altered or amended on or after such date.
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.