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.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7717B
SPONSOR: Jones TITLE OF BILL: 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 emergency medical services providers
PURPOSE:
The bill would allow fire departments to charge for emergency medical
services provided. They are prohibited from doing so at this time.
SUMMARY OF PROVISIONS:
Section 1 This bill amends section 209-b (4) of the General Municipal
Law to remove the prohibition of fire department emergency medical bill-
ing.
This bill also amends Section 2 Section 122-b (1)(e) of the General
Municipal Law
Section 3 Section 184(1) of the town law in order to authorize contract-
ing with fire department emergency medical service units.
Section 4 Contains the effective date
JUSTIFICATION:
Paragraph 4 of section 209-b of the General Municipal Law prohibits any
ambulance service, which is run as part of a fire department, from
charging a fee for such service. Every other emergency medical provider
in the state is allowed to charge for such service. If enacted, this
bill would simply allow fire departments to recover costs for services
rendered. The ever increasing costs of state mandates, coupled with
increases in equipment and personnel costs have led many municipality
and volunteer ambulance providers to charge for this very costly
service. If the ambulance is provided through a police department, ambu-
lance department, volunteer ambulance corps, or even contracted with a
proprietary/for-profit service, a fee can be charged. However, if the
service is rendered by a fire department, no fee may be charge. This
legislation would not require any fee to be established, but would offer
municipalities and volunteer fire companies the opportunity to recover
these ever increasing, mandated costs.
LEGISLATIVE HISTORY:
2015-16 A.3721/S.1914
2013-14 A.4113/S.3262
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
Ninety days after it shall have become law.
STATE OF NEW YORK
________________________________________________________________________
7717--B
2017-2018 Regular Sessions
IN ASSEMBLY
May 11, 2017
___________
Introduced by M. of A. JONES, McDONALD, McDONOUGH, RA, HARRIS, LAVINE,
D'URSO, WOERNER, BLAKE, DiPIETRO, BYRNE, STECK, COOK, BUCHWALD, ERRIGO
-- read once and referred to the Committee on Local Governments --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee -- recommitted to the Committee on Local
Governments in accordance with Assembly Rule 3, sec. 2 -- 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 718 of the laws of 1958, 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
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00334-05-8
A. 7717--B 2
1 authority having control of a fire department or fire company and the
2 fire department or fire company itself. The acceptance by any fireman
3 of any personal remuneration or gratuity, directly or indirectly, from a
4 person served shall be a ground for his expulsion or suspension as a
5 member of the fire department or fire company.
6 (b) Notwithstanding the provisions of paragraph (a) of this subdivi-
7 sion, a basic life support service which establishes a schedule of fees
8 for service shall enter into a contract with a provider or providers of
9 advanced life support services to provide such advanced life support
10 services. Such contract shall at a minimum establish the fees for
11 advanced life support services and the means by which said provider will
12 be reimbursed when the ambulance service bills for emergency medical
13 service.
14 § 2. Paragraph (e) of subdivision 1 of section 122-b of the general
15 municipal law, as amended by chapter 303 of the laws of 1980, is amended
16 to read as follows:
17 (e) [No] A contract [shall] may be entered into pursuant to the
18 provisions of this section for the services of an emergency rescue and
19 first aid squad of a fire department or fire company which is subject to
20 the provisions of section two hundred nine-b of [the general municipal
21 law] this chapter;
22 § 3. Subdivision 1 of section 184 of the town law, as amended by chap-
23 ter 599 of the laws of 1994, is amended to read as follows:
24 1. Whenever the town board shall have established or extended a fire
25 protection district pursuant to the provisions of this article, the town
26 board shall provide for the furnishing of fire protection within the
27 district and for that purpose may (a) contract with any city, village,
28 fire district or incorporated fire company maintaining adequate and
29 suitable apparatus and appliances for the furnishing of fire protection
30 in such district or (b) may acquire by gift or purchase such apparatus
31 and appliances for use in such district and may contract with any city,
32 village, fire district or incorporated fire company for operation, main-
33 tenance, and repair of the same and for the furnishing of fire
34 protection in such district, or both. The contract may also provide for
35 the furnishing of (1) emergency service in case of accidents, calamities
36 or other emergencies in connection with which the services of firefight-
37 ers would be required and (2) general ambulance service subject, howev-
38 er, to the provisions of section two hundred nine-b of the general
39 municipal law. In the event that the fire department or fire company
40 furnishing fire protection within the district pursuant to contract does
41 not maintain and operate an ambulance then a separate contract may be
42 made for the furnishing within the district of emergency ambulance
43 service or general ambulance service, or both, with any city, village or
44 fire district the fire department of which, or with an incorporated fire
45 company having its headquarters outside the district which, maintains
46 and operates an ambulance subject, however, in the case of general ambu-
47 lance service, to the provisions of section two hundred nine-b of the
48 general municipal law, or with an ambulance service, certified or regis-
49 tered pursuant to article thirty of the public health law[, which is not
50 organized under the provisions of section two hundred nine-b of the
51 general municipal law]. Any such contract with any such ambulance
52 service permitted herein shall be subject to the provisions of this
53 section.
54 § 4. Section 3224-a of the insurance law is amended by adding a new
55 subsection (k) to read as follows:
A. 7717--B 3
1 (k) Payments to nonparticipating or nonpreferred providers of ambu-
2 lance services licensed under article thirty of the public health law.
3 (1) Whenever an insurer or an organization, or corporation licensed or
4 certified pursuant to article forty-three or forty-seven of this chapter
5 or article forty-four of the public health law provides that any health
6 care claims submitted under contracts or agreements issued or entered
7 into pursuant to this article or article forty-two, forty-three or
8 forty-seven of this chapter and article forty-four of the public health
9 law are payable to a participating or preferred provider of ambulance
10 services for services rendered, the insurer, organization, or corpo-
11 ration licensed or certified pursuant to article forty-three or forty-
12 seven of this chapter or article forty-four of the public health law
13 shall be required to pay such benefits either directly to any similarly
14 licensed nonparticipating or nonpreferred provider at the usual and
15 customary charge, which shall not be excessive or unreasonable, when the
16 provider has rendered such services, has a written assignment of bene-
17 fits, and has caused written notice of such assignment to be given to
18 the insurer, organization, or corporation licensed or certified pursuant
19 to article forty-three or forty-seven of this chapter or article forty-
20 four of the public health law or jointly to such nonparticipating or
21 nonpreferred provider and to the insured, subscriber, or other covered
22 person; provided, however, that in either case the insurer, organiza-
23 tion, or corporation licensed or certified pursuant to article forty-
24 three or forty-seven of this chapter or article forty-four of the public
25 health law shall be required to send such benefit payments directly to
26 the provider who has the written assignment. When payment is made
27 directly to a provider of ambulance services as authorized by this
28 section, the insurer, organization, or corporation licensed or certified
29 pursuant to article forty-three or forty-seven of this chapter or arti-
30 cle forty-four of the public health law shall give written notice of
31 such payment to the insured, subscriber, or other covered person.
32 (2) An insurer shall provide reimbursement for those services
33 prescribed by this section at rates negotiated between the insurer and
34 the provider of such services. In the absence of agreed upon rates, an
35 insurer shall pay for such services at the usual and customary charge,
36 which shall not be excessive or unreasonable.
37 (3) Nothing contained in this section shall be deemed to prohibit the
38 payment of different levels of benefits or from having differences in
39 coinsurance percentages applicable to benefit levels for services
40 provided by participating or preferred providers and nonparticipating or
41 nonpreferred providers.
42 The provisions of this section shall not apply to policies that do not
43 include coverage for ambulance services.
44 § 5. Subparagraphs (C) and (D) of paragraph 24 of subsection (i) of
45 section 3216 of the insurance law, as added by chapter 506 of the laws
46 of 2001, are amended to read as follows:
47 (C) An insurer shall provide reimbursement for those services
48 prescribed by this section at rates negotiated between the insurer and
49 the provider of such services. In the absence of agreed upon rates, an
50 insurer shall pay for such services at the usual and customary charge,
51 which shall not be excessive or unreasonable. The insurer shall send
52 such payments directly to the provider of such ambulance services, if
53 the ambulance service includes an executed assignment of benefits form
54 with the claim.
55 (D) The provisions of this paragraph shall have no application to
56 transfers of patients between hospitals or health care facilities by an
A. 7717--B 4
1 ambulance service as described in subparagraph (A) of this paragraph
2 unless such services are covered under the policy.
3 § 6. Subparagraphs (C) and (D) of paragraph 15 of subsection (l) of
4 section 3221 of the insurance law, as added by chapter 506 of the laws
5 of 2001, are amended to read as follows:
6 (C) An insurer shall provide reimbursement for those services
7 prescribed by this section at rates negotiated between the insurer and
8 the provider of such services. In the absence of agreed upon rates, an
9 insurer shall pay for such services at the usual and customary charge,
10 which shall not be excessive or unreasonable. The insurer shall send
11 such payments directly to the provider of such ambulance services, if
12 the ambulance service includes an executed assignment of benefits form
13 with the claim.
14 (D) The provisions of this paragraph shall have no application to
15 transfers of patients between hospitals or health care facilities by an
16 ambulance service as described in subparagraph (A) of this paragraph
17 unless such services are covered under the policy.
18 § 7. Paragraphs 3 and 4 of subsection (aa) of section 4303 of the
19 insurance law, as added by chapter 506 of the laws of 2001, are amended
20 to read as follows:
21 (3) An insurer shall provide reimbursement for those services
22 prescribed by this section at rates negotiated between the insurer and
23 the provider of such services. In the absence of agreed upon rates, an
24 insurer shall pay for such services at the usual and customary charge,
25 which shall not be excessive or unreasonable. The insurer shall send
26 such payments directly to the provider of such ambulance services, if
27 the ambulance service includes an executed assignment of benefits form
28 with the claim.
29 (4) The provisions of this subsection shall have no application to
30 transfers of patients between hospitals or health care facilities by an
31 ambulance service as described in paragraph one of this subsection
32 unless such services are covered under the policy.
33 § 8. This act shall take effect on the ninetieth day after it shall
34 have become a law, except that sections four, five, six and seven of
35 this act shall take effect January 1, 2020, and shall apply to health
36 care claims submitted on or after such date.
