What's happening
This bill requires insurance reimbursements for ambulance services to be paid directly to providers or via joint checks, improving payment transparency and process.
Why it matters
Direct payment to ambulance providers ensures they are promptly and properly compensated. , reducing delays and complications that can arise when payments go to patients or intermediaries instead.
Mandating joint checks when no direct rate is negotiated increases transparency and accountability. , making it harder for funds to be misdirected or for providers to be underpaid for services already rendered.
Requiring insurers to honor assignments of benefits (even if policy language says otherwise) empowers patients and providers. , supporting the provider’s ability to collect payment and minimizing disputes or administrative burdens for patients.
Notification requirements for joint checks improve communication and reduce billing confusion. , helping ambulance services track payments and follow up effectively, which can help keep these vital services financially sustainable.
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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 Pay for Ambulance Services
In Senate Committee · Insurance · Sponsor Neil D. Breslin
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
3721
2019-2020 Regular Sessions
IN ASSEMBLY
January 30, 2019
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.
LBD04523-01-9
A. 3721 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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