S00363 Summary:

BILL NOS00363B
 
SAME ASSAME AS A07717-B
 
SPONSORLITTLE
 
COSPNSRPHILLIPS, AKSHAR, BOYLE, BROOKS, CARLUCCI, FUNKE, GALLIVAN, HELMING, KAMINSKY, MURPHY
 
MLTSPNSR
 
Amd 209-b & 122-b, Gen Muni L; amd 184, Town L; amd 3224-a, 3216, 3221 & 4303, Ins L
 
Provides that authorities having control of a fire department or fire company which provides emergency medical services may establish fees and charges for services; authorizes health insurer payments to nonparticipating or nonpreferred providers of ambulance services licensed under article 30 of the public health law.
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S00363 Actions:

BILL NOS00363B
 
01/04/2017REFERRED TO LOCAL GOVERNMENT
03/07/2017REPORTED AND COMMITTED TO FINANCE
05/15/2017AMEND (T) AND RECOMMIT TO FINANCE
05/15/2017PRINT NUMBER 363A
01/03/2018REFERRED TO LOCAL GOVERNMENT
01/24/2018AMEND AND RECOMMIT TO LOCAL GOVERNMENT
01/24/2018PRINT NUMBER 363B
05/15/2018REPORTED AND COMMITTED TO FINANCE
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S00363 Memo:

Memo not available
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S00363 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         363--B
 
                               2017-2018 Regular Sessions
 
                    IN SENATE
 
                                       (Prefiled)
 
                                     January 4, 2017
                                       ___________
 
        Introduced  by  Sens. LITTLE, AKSHAR, BROOKS, CARLUCCI, FUNKE, GALLIVAN,
          HELMING, MURPHY -- read twice and ordered printed, and when printed to
          be committed to the Committee on Local Government -- reported  favora-
          bly  from  said committee and committed to the Committee on Finance --
          committee discharged, bill amended, ordered reprinted as  amended  and
          recommitted to said committee -- recommitted to the Committee on Local
          Government  in  accordance  with  Senate  Rule  6, sec. 8 -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee
 
        AN ACT to amend the general municipal law and the town law, in  relation
          to authorizing fees and charges for emergency medical services; and to
          amend  the insurance law, in relation to payments to prehospital emer-
          gency medical services providers
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.    Subdivision 4 of section 209-b of the general municipal
     2  law, as amended by chapter 718 of the laws of 1958, is amended  to  read
     3  as follows:
     4    4. Fees and charges [prohibited] authorized.  (a) emergency and gener-
     5  al  ambulance service, including emergency medical service as defined in
     6  section three thousand one of the public health law, authorized pursuant
     7  to this section [shall] may be furnished  without  cost  to  the  person
     8  served; provided, however, that the authorities having control of a fire
     9  department  or fire company that have authorized such fire department or
    10  fire company to provide such service or services may fix a  schedule  of
    11  fees  or  charges  to  be  paid  by  persons  requesting such service or
    12  services. The authorities having control of a fire  department  or  fire
    13  company may provide for the collection of fees and charges or may formu-
    14  late  rules  and  regulations  for  the  collection  thereof by the fire
    15  department or fire company. When fees and charges are authorized  pursu-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00334-04-8

        S. 363--B                           2
 
     1  ant  to  this  subdivision,  the  fees  and  charges  collected shall be
     2  disbursed in accordance with a written contract entered into between the
     3  authority having control of a fire department or fire  company  and  the
     4  fire  department  or fire company itself.  The acceptance by any fireman
     5  of any personal remuneration or gratuity, directly or indirectly, from a
     6  person served shall be a ground for his expulsion  or  suspension  as  a
     7  member of the fire department or fire company.
     8    (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
     9  sion, a basic life support service which establishes a schedule of  fees
    10  for  service shall enter into a contract with a provider or providers of
    11  advanced life support services to provide  such  advanced  life  support
    12  services.  Such  contract  shall  at  a  minimum  establish the fees for
    13  advanced life support services and the means by which said provider will
    14  be reimbursed when the ambulance service  bills  for  emergency  medical
    15  service.
    16    §  2.  Paragraph  (e) of subdivision 1 of section 122-b of the general
    17  municipal law, as amended by chapter 303 of the laws of 1980, is amended
    18  to read as follows:
    19    (e) [No] A contract [shall]  may  be  entered  into  pursuant  to  the
    20  provisions  of  this section for the services of an emergency rescue and
    21  first aid squad of a fire department or fire company which is subject to
    22  the provisions of section two hundred nine-b of [the  general  municipal
    23  law] this chapter;
    24    § 3. Subdivision 1 of section 184 of the town law, as amended by chap-
    25  ter 599 of the laws of 1994, is amended to read as follows:
    26    1.  Whenever  the town board shall have established or extended a fire
    27  protection district pursuant to the provisions of this article, the town
    28  board shall provide for the furnishing of  fire  protection  within  the
    29  district  and  for that purpose may (a) contract with any city, village,
    30  fire district or incorporated  fire  company  maintaining  adequate  and
    31  suitable  apparatus and appliances for the furnishing of fire protection
    32  in such district or (b) may acquire by gift or purchase  such  apparatus
    33  and  appliances for use in such district and may contract with any city,
    34  village, fire district or incorporated fire company for operation, main-
    35  tenance, and  repair  of  the  same  and  for  the  furnishing  of  fire
    36  protection  in such district, or both. The contract may also provide for
    37  the furnishing of (1) emergency service in case of accidents, calamities
    38  or other emergencies in connection with which the services of firefight-
    39  ers would be required and (2) general ambulance service subject,  howev-
    40  er,  to  the  provisions  of  section  two hundred nine-b of the general
    41  municipal law. In the event that the fire  department  or  fire  company
    42  furnishing fire protection within the district pursuant to contract does
    43  not  maintain  and  operate an ambulance then a separate contract may be
    44  made for the furnishing  within  the  district  of  emergency  ambulance
    45  service or general ambulance service, or both, with any city, village or
    46  fire district the fire department of which, or with an incorporated fire
    47  company  having  its  headquarters outside the district which, maintains
    48  and operates an ambulance subject, however, in the case of general ambu-
    49  lance service, to the provisions of section two hundred  nine-b  of  the
    50  general municipal law, or with an ambulance service, certified or regis-
    51  tered pursuant to article thirty of the public health law[, which is not
    52  organized  under  the  provisions  of  section two hundred nine-b of the
    53  general municipal law].  Any  such  contract  with  any  such  ambulance
    54  service  permitted  herein  shall  be  subject to the provisions of this
    55  section.

        S. 363--B                           3
 
     1    § 4. Section 3224-a of the insurance law is amended by  adding  a  new
     2  subsection (k) to read as follows:
     3    (k)  Payments  to  nonparticipating or nonpreferred providers of ambu-
     4  lance services licensed under article thirty of the public  health  law.
     5  (1)  Whenever  an insurer or an organization, or corporation licensed or
     6  certified pursuant to article forty-three or forty-seven of this chapter
     7  or article forty-four of the public health law provides that any  health
     8  care  claims  submitted  under contracts or agreements issued or entered
     9  into pursuant to this  article  or  article  forty-two,  forty-three  or
    10  forty-seven  of this chapter and article forty-four of the public health
    11  law are payable to a participating or preferred  provider  of  ambulance
    12  services  for  services  rendered,  the insurer, organization, or corpo-
    13  ration licensed or certified pursuant to article forty-three  or  forty-
    14  seven  of  this  chapter  or article forty-four of the public health law
    15  shall be required to pay such benefits either directly to any  similarly
    16  licensed  nonparticipating  or  nonpreferred  provider  at the usual and
    17  customary charge, which shall not be excessive or unreasonable, when the
    18  provider has rendered such services, has a written assignment  of  bene-
    19  fits,  and  has  caused written notice of such assignment to be given to
    20  the insurer, organization, or corporation licensed or certified pursuant
    21  to article forty-three or forty-seven of this chapter or article  forty-
    22  four  of  the  public  health law or jointly to such nonparticipating or
    23  nonpreferred provider and to the insured, subscriber, or  other  covered
    24  person;  provided,  however,  that in either case the insurer, organiza-
    25  tion, or corporation licensed or certified pursuant  to  article  forty-
    26  three or forty-seven of this chapter or article forty-four of the public
    27  health  law  shall be required to send such benefit payments directly to
    28  the provider who has  the  written  assignment.  When  payment  is  made
    29  directly  to  a  provider  of  ambulance  services as authorized by this
    30  section, the insurer, organization, or corporation licensed or certified
    31  pursuant to article forty-three or forty-seven of this chapter or  arti-
    32  cle  forty-four  of  the  public health law shall give written notice of
    33  such payment to the insured, subscriber, or other covered person.
    34    (2)  An  insurer  shall  provide  reimbursement  for  those   services
    35  prescribed  by  this section at rates negotiated between the insurer and
    36  the provider of such services. In the absence of agreed upon  rates,  an
    37  insurer  shall  pay for such services at the usual and customary charge,
    38  which shall not be excessive or unreasonable.
    39    (3) Nothing contained in this section shall be deemed to prohibit  the
    40  payment  of  different  levels of benefits or from having differences in
    41  coinsurance  percentages  applicable  to  benefit  levels  for  services
    42  provided by participating or preferred providers and nonparticipating or
    43  nonpreferred providers.
    44    The provisions of this section shall not apply to policies that do not
    45  include coverage for ambulance services.
    46    §  5.  Subparagraphs  (C) and (D) of paragraph 24 of subsection (i) of
    47  section 3216 of the insurance law, as added by chapter 506 of  the  laws
    48  of 2001, are amended to read as follows:
    49    (C)   An  insurer  shall  provide  reimbursement  for  those  services
    50  prescribed by this section at rates negotiated between the  insurer  and
    51  the  provider  of such services. In the absence of agreed upon rates, an
    52  insurer shall pay for such services at the usual and  customary  charge,
    53  which  shall  not  be excessive or unreasonable.  The insurer shall send
    54  such payments directly to the provider of such  ambulance  services,  if
    55  the  ambulance  service includes an executed assignment of benefits form
    56  with the claim.

        S. 363--B                           4
 
     1    (D) The provisions of this paragraph  shall  have  no  application  to
     2  transfers  of patients between hospitals or health care facilities by an
     3  ambulance service as described in subparagraph  (A)  of  this  paragraph
     4  unless such services are covered under the policy.
     5    §  6.  Subparagraphs  (C) and (D) of paragraph 15 of subsection (l) of
     6  section 3221 of the insurance law, as added by chapter 506 of  the  laws
     7  of 2001, are amended to read as follows:
     8    (C)   An  insurer  shall  provide  reimbursement  for  those  services
     9  prescribed by this section at rates negotiated between the  insurer  and
    10  the  provider  of such services. In the absence of agreed upon rates, an
    11  insurer shall pay for such services at the usual and  customary  charge,
    12  which  shall  not  be excessive or unreasonable.  The insurer shall send
    13  such payments directly to the provider of such  ambulance  services,  if
    14  the  ambulance  service includes an executed assignment of benefits form
    15  with the claim.
    16    (D) The provisions of this paragraph  shall  have  no  application  to
    17  transfers  of patients between hospitals or health care facilities by an
    18  ambulance service as described in subparagraph  (A)  of  this  paragraph
    19  unless such services are covered under the policy.
    20    §  7.  Paragraphs  3  and  4 of subsection (aa) of section 4303 of the
    21  insurance law, as added by chapter 506 of the laws of 2001, are  amended
    22  to read as follows:
    23    (3)   An  insurer  shall  provide  reimbursement  for  those  services
    24  prescribed by this section at rates negotiated between the  insurer  and
    25  the  provider  of such services. In the absence of agreed upon rates, an
    26  insurer shall pay for such services at the usual and  customary  charge,
    27  which  shall  not  be excessive or unreasonable.  The insurer shall send
    28  such payments directly to the provider of such  ambulance  services,  if
    29  the  ambulance  service includes an executed assignment of benefits form
    30  with the claim.
    31    (4) The provisions of this subsection shall  have  no  application  to
    32  transfers  of patients between hospitals or health care facilities by an
    33  ambulance service as described  in  paragraph  one  of  this  subsection
    34  unless such services are covered under the policy.
    35    §  8.  This  act shall take effect on the ninetieth day after it shall
    36  have become a law, except that sections four, five,  six  and  seven  of
    37  this  act  shall  take effect January 1, 2020, and shall apply to health
    38  care claims submitted on or after such date.
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S00363 LFIN:

 NO LFIN
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