STATE OF NEW YORK
        ________________________________________________________________________
                                          2792
                               2017-2018 Regular Sessions
                   IN ASSEMBLY
                                    January 23, 2017
                                       ___________
        Introduced  by M. of A. DILAN -- read once and referred to the Committee
          on Insurance
        AN ACT to amend the insurance law, in relation to requiring notification
          to insured persons that an out-of-network physician  may  be  used  in
          their procedure, test or surgery
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. Section 3216 of the insurance law is amended  by  adding  a
     2  new subsection (n) to read as follows:
     3    (n)  (1)  Every  person  insured under a policy of accident and health
     4  insurance delivered or issued for delivery in this state shall be  enti-
     5  tled  to  notification  from  the billing entity prior to the procedure,
     6  test or surgery, that an out-of-network physician may be  used  in  such
     7  procedure,  test  or  surgery and such physician's services shall not be
     8  covered by their insurance policy.
     9    (2) The patient costs of out-of-network physician  services  shall  be
    10  covered  by  the  insurance policy of an insured person if he or she has
    11  not received notification  of  such  situations,  prior  to  the  health
    12  service or procedure, as prescribed in paragraph one of this subsection.
    13    §  2.  Section  3221  of  the insurance law is amended by adding a new
    14  subsection (t) to read as follows:
    15    (t) (1) Every person insured under a policy  of  accident  and  health
    16  insurance  delivered or issued for delivery in this state shall be enti-
    17  tled to notification from the billing entity  prior  to  the  procedure,
    18  test  or  surgery,  that an out-of-network physician may be used in such
    19  procedure, test or surgery and such physician's services  shall  not  be
    20  covered by their insurance policy.
    21    (2)  The  patient  costs of out-of-network physician services shall be
    22  covered by the insurance policy of an insured person if he  or  she  has
    23  not  received  notification  of  such  situations,  prior  to the health
    24  service or procedure, as prescribed in paragraph one of this subsection.
    25    § 3. This act shall take effect immediately.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04777-01-7