S T A T E O F N E W Y O R K
________________________________________________________________________
5146
2013-2014 Regular Sessions
I N A S S E M B L Y
February 20, 2013
___________
Introduced by M. of A. GOTTFRIED, PAULIN -- Multi-Sponsored by -- M. of
A. KELLNER, MILLMAN, WEISENBERG -- read once and referred to the
Committee on Insurance
AN ACT to amend the insurance law, in relation to assignment of rights
by the insured
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Subsection (i) of section 3216 of the insurance law is
2 amended by adding a new paragraph 30 to read as follows:
3 (30) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
4 COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN POLICY OR
5 WRITTEN PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS CONTRACT
6 WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN AN INSURED
7 ASSIGNS HIS RIGHT TO RECEIVE REIMBURSEMENT FOR MEDICALLY NECESSARY
8 HEALTH CARE SERVICES TO A HEALTH CARE PROVIDER, THE INSURER SHALL REMIT
9 PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE HEALTH CARE PROVIDER. WHEN
10 AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT SENT TO THE INSURED RATHER THAN
11 TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY THE PLAN'S OBLIGATION OR
12 REQUIREMENTS UNDER SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
13 THIS ARTICLE AND IS SUBJECT TO INTEREST CHARGE PURSUANT TO SECTION THREE
14 THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THIS ARTICLE.
15 S 2. Section 3221 of the insurance law is amended by adding a new
16 subsection (s) to read as follows:
17 (S) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
18 COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN POLICY OR
19 WRITTEN PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS CONTRACT
20 WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN AN INSURED
21 ASSIGNS HIS RIGHT TO RECEIVE REIMBURSEMENT FOR MEDICALLY NECESSARY
22 HEALTH CARE SERVICES TO A HEALTH CARE PROVIDER, THE INSURER SHALL REMIT
23 PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE HEALTH CARE PROVIDER. WHEN
24 AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT SENT TO THE INSURED RATHER THAN
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01207-01-3
A. 5146 2
1 TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY THE PLAN'S OBLIGATION OR
2 REQUIREMENTS UNDER SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
3 THIS ARTICLE AND IS SUBJECT TO INTEREST CHARGE PURSUANT TO SECTION THREE
4 THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THIS ARTICLE.
5 S 3. Section 4303 of the insurance law is amended by adding a new
6 subsection (a-1) to read as follows:
7 (A-1) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION
8 OR HEALTH SERVICE CORPORATION WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR
9 SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN
10 POLICY OR WRITTEN PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS
11 CONTRACT WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN
12 AN INSURED ASSIGNS HIS RIGHT TO RECEIVE REIMBURSEMENT FOR MEDICALLY
13 NECESSARY HEALTH CARE SERVICES TO AN OUT-OF-PLAN HEALTH CARE PROVIDER,
14 THE INSURER SHALL REMIT PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE
15 HEALTH CARE PROVIDER. WHEN AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT MADE
16 TO THE INSURED RATHER THAN TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY
17 THE PLAN'S OBLIGATION OR REQUIREMENTS UNDER SECTION THREE THOUSAND TWO
18 HUNDRED TWENTY-FOUR-A OF THIS CHAPTER AND IS SUBJECT TO AN INTEREST
19 CHARGE PURSUANT TO SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
20 THIS CHAPTER.
21 S 4. This act shall take effect on the first of January next succeed-
22 ing the date on which it shall have become a law, and shall apply to all
23 policies and contracts issued, renewed, modified, altered or amended on
24 or after such effective date.