Bill Text: NY A10332 | 2021-2022 | General Assembly | Introduced

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Bill Title: Requires that insurers providing no-fault coverage reimburse other insurers for the payment of claims to providers which should have been covered by a no-fault insurer.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2022-05-13 - referred to insurance [A10332 Detail]

Download: New_York-2021-A10332-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          10332

                   IN ASSEMBLY

                                      May 13, 2022
                                       ___________

        Introduced  by COMMITTEE ON RULES -- (at request of M. of A. Septimo) --
          read once and referred to the Committee on Insurance

        AN ACT to amend the insurance law, in relation to  the  coordination  of
          no-fault benefits for persons injured in motor vehicle accidents

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The insurance law is amended by adding a new  section  5110
     2  to read as follows:
     3    §  5110.  Payment for services provided for motor vehicle injuries. 1.
     4  Any provider of treatment to any covered person,  who  renders  care  or
     5  supplies  a  product within seventy-two hours of the motor vehicle acci-
     6  dent, in the absence of fraud or deception by the claimant,  is  conclu-
     7  sively  presumed  to have accepted, and to have consented to, an assign-
     8  ment of no-fault benefits under this article in the form  prescribed  by
     9  the  superintendent.   The provisions of this subdivision shall apply if
    10  the provider knows, or is on notice of  facts  that  indicate  that  the
    11  injuries  or  conditions treated are the result of a motor vehicle acci-
    12  dent which occurred in the preceding seventy-two hours.
    13    2. Any provider of treatment to a covered  person  who  mistakenly  or
    14  otherwise  bills  an  insurer other than the no-fault insurer for claims
    15  eligible for first-party benefits under this article must, upon  presen-
    16  tation  with  proof  of  applicable coverage under article six, eight or
    17  forty-four-B of the vehicle and traffic law, return such fees  and  seek
    18  payment for services from the no-fault insurer instead. A provider shall
    19  be permitted to maintain insurance information in the event it is estab-
    20  lished  that  there  are no first-party benefits available for emergency
    21  treatment under this article.
    22    3. The time limit for presentation of invoices to an insurer shall  be
    23  measured  from the first date on which the provider or the patient first
    24  presented the invoice to any insurer.
    25    4.  Any  compensation  provider  that,   notwithstanding   the   other
    26  provisions  of  this  law, pays for the emergency treatment of a covered
    27  person, has a right of direct action  against  the  insurer  liable  for
    28  coverage  under  this article for reimbursement, but in no case will the

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10765-02-1
        A. 10332                            2

     1  reimbursement exceed the amount of lawful benefits according  to  state-
     2  promulgated fee schedules.
     3    5.  No  insurer  providing  coverage  under this article shall exclude
     4  reimbursement for first-party benefits which have been paid to a  health
     5  care  provider  or medical equipment supplier by a compensation provider
     6  not under this article.
     7    § 2. This act shall take effect immediately.