S01940 Summary:

BILL NOS01940
 
SAME ASSAME AS A01778
 
SPONSORLITTLE
 
COSPNSRAKSHAR, BROOKS, CARLUCCI, FUNKE, GALLIVAN, HELMING
 
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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S01940 Actions:

BILL NOS01940
 
01/17/2019REFERRED TO LOCAL GOVERNMENT
02/11/2019RECOMMIT, ENACTING CLAUSE STRICKEN
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S01940 Memo:

Memo not available
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S01940 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          1940
 
                               2019-2020 Regular Sessions
 
                    IN SENATE
 
                                    January 17, 2019
                                       ___________
 
        Introduced  by  Sens. LITTLE, AKSHAR, BROOKS, CARLUCCI, FUNKE, GALLIVAN,
          HELMING -- read twice and ordered printed,  and  when  printed  to  be
          committed to the Committee on Local Government
 
        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-
    21  ly, from a person served shall be a ground for his or her  expulsion  or
    22  suspension as a member of the fire department or fire company.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02799-03-9

        S. 1940                             2
 
     1    (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
     2  sion, a basic life support service which establishes a schedule of  fees
     3  for  service shall enter into a contract with a provider or providers of
     4  advanced life support services to provide  such  advanced  life  support
     5  services.  Such  contract  shall  at  a  minimum  establish the fees for
     6  advanced life support services and the means by which said provider will
     7  be reimbursed when the ambulance service  bills  for  emergency  medical
     8  service.
     9    §  2.  Paragraph  (e) of subdivision 1 of section 122-b of the general
    10  municipal law, as amended by chapter 303 of the laws of 1980, is amended
    11  to read as follows:
    12    (e) [No] A contract [shall]  may  be  entered  into  pursuant  to  the
    13  provisions  of  this section for the services of an emergency rescue and
    14  first aid squad of a fire department or fire company which is subject to
    15  the provisions of section two hundred nine-b of [the  general  municipal
    16  law] this chapter;
    17    § 3. Subdivision 1 of section 184 of the town law, as amended by chap-
    18  ter 599 of the laws of 1994, is amended to read as follows:
    19    1.  Whenever  the town board shall have established or extended a fire
    20  protection district pursuant to the provisions of this article, the town
    21  board shall provide for the furnishing of  fire  protection  within  the
    22  district  and  for that purpose may (a) contract with any city, village,
    23  fire district or incorporated  fire  company  maintaining  adequate  and
    24  suitable  apparatus and appliances for the furnishing of fire protection
    25  in such district or (b) may acquire by gift or purchase  such  apparatus
    26  and  appliances for use in such district and may contract with any city,
    27  village, fire district or incorporated fire company for operation, main-
    28  tenance, and  repair  of  the  same  and  for  the  furnishing  of  fire
    29  protection  in such district, or both. The contract may also provide for
    30  the furnishing of (1) emergency service in case of accidents, calamities
    31  or other emergencies in connection with which the services of firefight-
    32  ers would be required and (2) general ambulance service subject,  howev-
    33  er,  to  the  provisions  of  section  two hundred nine-b of the general
    34  municipal law. In the event that the fire  department  or  fire  company
    35  furnishing fire protection within the district pursuant to contract does
    36  not  maintain  and  operate an ambulance then a separate contract may be
    37  made for the furnishing  within  the  district  of  emergency  ambulance
    38  service or general ambulance service, or both, with any city, village or
    39  fire district the fire department of which, or with an incorporated fire
    40  company  having  its  headquarters outside the district which, maintains
    41  and operates an ambulance subject, however, in the case of general ambu-
    42  lance service, to the provisions of section two hundred  nine-b  of  the
    43  general municipal law, or with an ambulance service, certified or regis-
    44  tered pursuant to article thirty of the public health law[, which is not
    45  organized  under  the  provisions  of  section two hundred nine-b of the
    46  general municipal law].  Any  such  contract  with  any  such  ambulance
    47  service  permitted  herein  shall  be  subject to the provisions of this
    48  section.
    49    § 4. Section 3224-a of the insurance law is amended by  adding  a  new
    50  subsection (k) to read as follows:
    51    (k)  Payments  to  nonparticipating or nonpreferred providers of ambu-
    52  lance services licensed under article thirty of the public  health  law.
    53  (1)  Whenever  an insurer or an organization, or corporation licensed or
    54  certified pursuant to article forty-three or forty-seven of this chapter
    55  or article forty-four of the public health law provides that any  health
    56  care  claims  submitted  under contracts or agreements issued or entered

        S. 1940                             3
 
     1  into pursuant to this  article  or  article  forty-two,  forty-three  or
     2  forty-seven  of this chapter and article forty-four of the public health
     3  law are payable to a participating or preferred  provider  of  ambulance
     4  services  for  services  rendered,  the insurer, organization, or corpo-
     5  ration licensed or certified pursuant to article forty-three  or  forty-
     6  seven  of  this  chapter  or article forty-four of the public health law
     7  shall be required to pay such benefits either directly to any  similarly
     8  licensed  nonparticipating  or  nonpreferred  provider  at the usual and
     9  customary charge, which shall not be excessive or unreasonable, when the
    10  provider has rendered such services, has a written assignment  of  bene-
    11  fits,  and  has  caused written notice of such assignment to be given to
    12  the insurer, organization, or corporation licensed or certified pursuant
    13  to article forty-three or forty-seven of this chapter or article  forty-
    14  four  of  the  public  health law or jointly to such nonparticipating or
    15  nonpreferred provider and to the insured, subscriber, or  other  covered
    16  person;  provided,  however,  that in either case the insurer, organiza-
    17  tion, or corporation licensed or certified pursuant  to  article  forty-
    18  three or forty-seven of this chapter or article forty-four of the public
    19  health  law  shall be required to send such benefit payments directly to
    20  the provider who has  the  written  assignment.  When  payment  is  made
    21  directly  to  a  provider  of  ambulance  services as authorized by this
    22  section, the insurer, organization, or corporation licensed or certified
    23  pursuant to article forty-three or forty-seven of this chapter or  arti-
    24  cle  forty-four  of  the  public health law shall give written notice of
    25  such payment to the insured, subscriber, or other covered person.
    26    (2)  An  insurer  shall  provide  reimbursement  for  those   services
    27  prescribed  by  this section at rates negotiated between the insurer and
    28  the provider of such services. In the absence of agreed upon  rates,  an
    29  insurer  shall  pay for such services at the usual and customary charge,
    30  which shall not be excessive or unreasonable.
    31    (3) Nothing contained in this section shall be deemed to prohibit  the
    32  payment  of  different  levels of benefits or from having differences in
    33  coinsurance  percentages  applicable  to  benefit  levels  for  services
    34  provided by participating or preferred providers and nonparticipating or
    35  nonpreferred providers.
    36    The provisions of this section shall not apply to policies that do not
    37  include coverage for ambulance services.
    38    §  5.  Subparagraphs  (C) and (D) of paragraph 24 of subsection (i) of
    39  section 3216 of the insurance law, as added by chapter 506 of  the  laws
    40  of 2001, are amended to read as follows:
    41    (C)   An  insurer  shall  provide  reimbursement  for  those  services
    42  prescribed by this section at rates negotiated between the  insurer  and
    43  the  provider  of such services. In the absence of agreed upon rates, an
    44  insurer shall pay for such services at the usual and  customary  charge,
    45  which  shall  not  be excessive or unreasonable.  The insurer shall send
    46  such payments directly to the provider of such  ambulance  services,  if
    47  the  ambulance  service includes an executed assignment of benefits form
    48  with the claim.
    49    (D) The provisions of this paragraph  shall  have  no  application  to
    50  transfers  of patients between hospitals or health care facilities by an
    51  ambulance service as described in subparagraph  (A)  of  this  paragraph
    52  unless such services are covered under the policy.
    53    §  6.  Subparagraphs  (C) and (D) of paragraph 15 of subsection (l) of
    54  section 3221 of the insurance law, as added by chapter 506 of  the  laws
    55  of 2001, are amended to read as follows:

        S. 1940                             4
 
     1    (C)   An  insurer  shall  provide  reimbursement  for  those  services
     2  prescribed by this section at rates negotiated between the  insurer  and
     3  the  provider  of such services. In the absence of agreed upon rates, an
     4  insurer shall pay for such services at the usual and  customary  charge,
     5  which  shall  not  be excessive or unreasonable.  The insurer shall send
     6  such payments directly to the provider of such  ambulance  services,  if
     7  the  ambulance  service includes an executed assignment of benefits form
     8  with the claim.
     9    (D) The provisions of this paragraph  shall  have  no  application  to
    10  transfers  of patients between hospitals or health care facilities by an
    11  ambulance service as described in subparagraph  (A)  of  this  paragraph
    12  unless such services are covered under the policy.
    13    §  7.  Paragraphs  3  and  4 of subsection (aa) of section 4303 of the
    14  insurance law, as added by chapter 506 of the laws of 2001, are  amended
    15  to read as follows:
    16    (3)   An  insurer  shall  provide  reimbursement  for  those  services
    17  prescribed by this section at rates negotiated between the  insurer  and
    18  the  provider  of such services. In the absence of agreed upon rates, an
    19  insurer shall pay for such services at the usual and  customary  charge,
    20  which  shall  not  be excessive or unreasonable.  The insurer shall send
    21  such payments directly to the provider of such  ambulance  services,  if
    22  the  ambulance  service includes an executed assignment of benefits form
    23  with the claim.
    24    (4) The provisions of this subsection shall  have  no  application  to
    25  transfers  of patients between hospitals or health care facilities by an
    26  ambulance service as described  in  paragraph  one  of  this  subsection
    27  unless such services are covered under the policy.
    28    §  8.  This  act shall take effect on the ninetieth day after it shall
    29  have become a law, except that sections four, five,  six  and  seven  of
    30  this  act  shall  take effect January 1, 2022, and shall apply to health
    31  care claims submitted on or after such date.
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S01940 LFIN:

 NO LFIN
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