S03685 Summary:

BILL NOS03685A
 
SAME ASSAME AS A01778
 
SPONSORBROOKS
 
COSPNSRLITTLE, FUNKE, GALLIVAN, HARCKHAM, THOMAS
 
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.
Go to top    

S03685 Actions:

BILL NOS03685A
 
02/12/2019REFERRED TO LOCAL GOVERNMENT
04/10/2019AMEND AND RECOMMIT TO LOCAL GOVERNMENT
04/10/2019PRINT NUMBER 3685A
05/06/20191ST REPORT CAL.567
05/07/20192ND REPORT CAL.
05/08/2019ADVANCED TO THIRD READING
Go to top

S03685 Memo:

Memo not available
Go to top

S03685 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         3685--A
 
                               2019-2020 Regular Sessions
 
                    IN SENATE
 
                                    February 12, 2019
                                       ___________
 
        Introduced  by  Sens.  BROOKS, LITTLE -- read twice and ordered printed,
          and when printed to be committed to the Committee on Local  Government
          --  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 476 of the laws of 2018, 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-
    16  ant  to  this  subdivision,  the  fees  and  charges  collected shall be
    17  disbursed in accordance with a written contract entered into between the
    18  authority having control of a fire department of fire  company  and  the
    19  fire  department  or  fire company itself.   The acceptance by any fire-
    20  fighter of any personal remuneration or gratuity, directly or  indirect-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02799-04-9

        S. 3685--A                          2
 
     1  ly,  from  a person served shall be a ground for his or her expulsion or
     2  suspension as a member of the fire department or fire company.
     3    (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
     4  sion, a basic life support service which establishes a schedule of  fees
     5  for  service shall enter into a contract with a provider or providers of
     6  advanced life support services to provide  such  advanced  life  support
     7  services.  Such  contract  shall  at  a  minimum  establish the fees for
     8  advanced life support services and the means by which said provider will
     9  be reimbursed when the ambulance service  bills  for  emergency  medical
    10  service.
    11    §  2.  Paragraph  (e) of subdivision 1 of section 122-b of the general
    12  municipal law, as amended by chapter 303 of the laws of 1980, is amended
    13  to read as follows:
    14    (e) [No] A contract [shall]  may  be  entered  into  pursuant  to  the
    15  provisions  of  this section for the services of an emergency rescue and
    16  first aid squad of a fire department or fire company which is subject to
    17  the provisions of section two hundred nine-b of [the  general  municipal
    18  law] this chapter;
    19    § 3. Subdivision 1 of section 184 of the town law, as amended by chap-
    20  ter 599 of the laws of 1994, is amended to read as follows:
    21    1.  Whenever  the town board shall have established or extended a fire
    22  protection district pursuant to the provisions of this article, the town
    23  board shall provide for the furnishing of  fire  protection  within  the
    24  district  and  for that purpose may (a) contract with any city, village,
    25  fire district or incorporated  fire  company  maintaining  adequate  and
    26  suitable  apparatus and appliances for the furnishing of fire protection
    27  in such district or (b) may acquire by gift or purchase  such  apparatus
    28  and  appliances for use in such district and may contract with any city,
    29  village, fire district or incorporated fire company for operation, main-
    30  tenance, and  repair  of  the  same  and  for  the  furnishing  of  fire
    31  protection  in such district, or both. The contract may also provide for
    32  the furnishing of (1) emergency service in case of accidents, calamities
    33  or other emergencies in connection with which the services of firefight-
    34  ers would be required and (2) general ambulance service subject,  howev-
    35  er,  to  the  provisions  of  section  two hundred nine-b of the general
    36  municipal law. In the event that the fire  department  or  fire  company
    37  furnishing fire protection within the district pursuant to contract does
    38  not  maintain  and  operate an ambulance then a separate contract may be
    39  made for the furnishing  within  the  district  of  emergency  ambulance
    40  service or general ambulance service, or both, with any city, village or
    41  fire district the fire department of which, or with an incorporated fire
    42  company  having  its  headquarters outside the district which, maintains
    43  and operates an ambulance subject, however, in the case of general ambu-
    44  lance service, to the provisions of section two hundred  nine-b  of  the
    45  general municipal law, or with an ambulance service, certified or regis-
    46  tered pursuant to article thirty of the public health law[, which is not
    47  organized  under  the  provisions  of  section two hundred nine-b of the
    48  general municipal law].  Any  such  contract  with  any  such  ambulance
    49  service  permitted  herein  shall  be  subject to the provisions of this
    50  section.
    51    § 4. Section 3224-a of the insurance law is amended by  adding  a  new
    52  subsection (k) to read as follows:
    53    (k)  Payments  to  nonparticipating or nonpreferred providers of ambu-
    54  lance services licensed under article thirty of the public  health  law.
    55  (1)  Whenever  an insurer or an organization, or corporation licensed or
    56  certified pursuant to article forty-three or forty-seven of this chapter

        S. 3685--A                          3
 
     1  or article forty-four of the public health law provides that any  health
     2  care  claims  submitted  under contracts or agreements issued or entered
     3  into pursuant to this  article  or  article  forty-two,  forty-three  or
     4  forty-seven  of this chapter and article forty-four of the public health
     5  law are payable to a participating or preferred  provider  of  ambulance
     6  services  for  services  rendered,  the insurer, organization, or corpo-
     7  ration licensed or certified pursuant to article forty-three  or  forty-
     8  seven  of  this  chapter  or article forty-four of the public health law
     9  shall be required to pay such benefits either directly to any  similarly
    10  licensed  nonparticipating  or  nonpreferred  provider  at the usual and
    11  customary charge, which shall not be excessive or unreasonable, when the
    12  provider has rendered such services, has a written assignment  of  bene-
    13  fits,  and  has  caused written notice of such assignment to be given to
    14  the insurer, organization, or corporation licensed or certified pursuant
    15  to article forty-three or forty-seven of this chapter or article  forty-
    16  four  of  the  public  health law or jointly to such nonparticipating or
    17  nonpreferred provider and to the insured, subscriber, or  other  covered
    18  person;  provided,  however,  that in either case the insurer, organiza-
    19  tion, or corporation licensed or certified pursuant  to  article  forty-
    20  three or forty-seven of this chapter or article forty-four of the public
    21  health  law  shall be required to send such benefit payments directly to
    22  the provider who has  the  written  assignment.  When  payment  is  made
    23  directly  to  a  provider  of  ambulance  services as authorized by this
    24  section, the insurer, organization, or corporation licensed or certified
    25  pursuant to article forty-three or forty-seven of this chapter or  arti-
    26  cle  forty-four  of  the  public health law shall give written notice of
    27  such payment to the insured, subscriber, or other covered person.
    28    (2)  An  insurer  shall  provide  reimbursement  for  those   services
    29  prescribed  by  this section at rates negotiated between the insurer and
    30  the provider of such services. In the absence of agreed upon  rates,  an
    31  insurer  shall  pay for such services at the usual and customary charge,
    32  which shall not be excessive or unreasonable.
    33    (3) Nothing contained in this section shall be deemed to prohibit  the
    34  payment  of  different  levels of benefits or from having differences in
    35  coinsurance  percentages  applicable  to  benefit  levels  for  services
    36  provided by participating or preferred providers and nonparticipating or
    37  nonpreferred providers.
    38    The provisions of this section shall not apply to policies that do not
    39  include coverage for ambulance services.
    40    §  5.  Subparagraphs  (C) and (D) of paragraph 24 of subsection (i) of
    41  section 3216 of the insurance law, as added by chapter 506 of  the  laws
    42  of 2001, are amended to read as follows:
    43    (C)   An  insurer  shall  provide  reimbursement  for  those  services
    44  prescribed by this section at rates negotiated between the  insurer  and
    45  the  provider  of such services. In the absence of agreed upon rates, an
    46  insurer shall pay for such services at the usual and  customary  charge,
    47  which  shall  not  be excessive or unreasonable.  The insurer shall send
    48  such payments directly to the provider of such  ambulance  services,  if
    49  the  ambulance  service includes an executed assignment of benefits form
    50  with the claim.
    51    (D) The provisions of this paragraph  shall  have  no  application  to
    52  transfers  of patients between hospitals or health care facilities by an
    53  ambulance service as described in subparagraph  (A)  of  this  paragraph
    54  unless such services are covered under the policy.

        S. 3685--A                          4
 
     1    §  6.  Subparagraphs  (C) and (D) of paragraph 15 of subsection (l) of
     2  section 3221 of the insurance law, as added by chapter 506 of  the  laws
     3  of 2001, are amended to read as follows:
     4    (C)   An  insurer  shall  provide  reimbursement  for  those  services
     5  prescribed by this section at rates negotiated between the  insurer  and
     6  the  provider  of such services. In the absence of agreed upon rates, an
     7  insurer shall pay for such services at the usual and  customary  charge,
     8  which  shall  not  be excessive or unreasonable.  The insurer shall send
     9  such payments directly to the provider of such  ambulance  services,  if
    10  the  ambulance  service includes an executed assignment of benefits form
    11  with the claim.
    12    (D) The provisions of this paragraph  shall  have  no  application  to
    13  transfers  of patients between hospitals or health care facilities by an
    14  ambulance service as described in subparagraph  (A)  of  this  paragraph
    15  unless such services are covered under the policy.
    16    §  7.  Paragraphs  3  and  4 of subsection (aa) of section 4303 of the
    17  insurance law, as added by chapter 506 of the laws of 2001, are  amended
    18  to read as follows:
    19    (3)   An  insurer  shall  provide  reimbursement  for  those  services
    20  prescribed by this section at rates negotiated between the  insurer  and
    21  the  provider  of such services. In the absence of agreed upon rates, an
    22  insurer shall pay for such services at the usual and  customary  charge,
    23  which  shall  not  be excessive or unreasonable.  The insurer shall send
    24  such payments directly to the provider of such  ambulance  services,  if
    25  the  ambulance  service includes an executed assignment of benefits form
    26  with the claim.
    27    (4) The provisions of this subsection shall  have  no  application  to
    28  transfers  of patients between hospitals or health care facilities by an
    29  ambulance service as described  in  paragraph  one  of  this  subsection
    30  unless such services are covered under the policy.
    31    §  8.  This  act shall take effect on the ninetieth day after it shall
    32  have become a law, except that sections four, five,  six  and  seven  of
    33  this  act  shall  take effect January 1, 2022, and shall apply to health
    34  care claims submitted on or after such date.
Go to top

S03685 LFIN:

 NO LFIN
Go to top