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.
STATE OF NEW YORK
________________________________________________________________________
363--B
2017-2018 Regular Sessions
IN SENATE(Prefiled)
January 4, 2017
___________
Introduced by Sens. LITTLE, AKSHAR, BROOKS, CARLUCCI, FUNKE, GALLIVAN,
HELMING, MURPHY -- read twice and ordered printed, and when printed to
be committed to the Committee on Local Government -- reported favora-
bly from said committee and committed to the Committee on Finance --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee -- recommitted to the Committee on Local
Government in accordance with Senate Rule 6, sec. 8 -- 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-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00334-04-8
S. 363--B 2
1 ant to this subdivision, the fees and charges collected shall be
2 disbursed in accordance with a written contract entered into between the
3 authority having control of a fire department or fire company and the
4 fire department or fire company itself. The acceptance by any fireman
5 of any personal remuneration or gratuity, directly or indirectly, from a
6 person served shall be a ground for his expulsion or suspension as a
7 member of the fire department or fire company.
8 (b) Notwithstanding the provisions of paragraph (a) of this subdivi-
9 sion, a basic life support service which establishes a schedule of fees
10 for service shall enter into a contract with a provider or providers of
11 advanced life support services to provide such advanced life support
12 services. Such contract shall at a minimum establish the fees for
13 advanced life support services and the means by which said provider will
14 be reimbursed when the ambulance service bills for emergency medical
15 service.
16 § 2. Paragraph (e) of subdivision 1 of section 122-b of the general
17 municipal law, as amended by chapter 303 of the laws of 1980, is amended
18 to read as follows:
19 (e) [No] A contract [shall] may be entered into pursuant to the
20 provisions of this section for the services of an emergency rescue and
21 first aid squad of a fire department or fire company which is subject to
22 the provisions of section two hundred nine-b of [the general municipal
23 law] this chapter;
24 § 3. Subdivision 1 of section 184 of the town law, as amended by chap-
25 ter 599 of the laws of 1994, is amended to read as follows:
26 1. Whenever the town board shall have established or extended a fire
27 protection district pursuant to the provisions of this article, the town
28 board shall provide for the furnishing of fire protection within the
29 district and for that purpose may (a) contract with any city, village,
30 fire district or incorporated fire company maintaining adequate and
31 suitable apparatus and appliances for the furnishing of fire protection
32 in such district or (b) may acquire by gift or purchase such apparatus
33 and appliances for use in such district and may contract with any city,
34 village, fire district or incorporated fire company for operation, main-
35 tenance, and repair of the same and for the furnishing of fire
36 protection in such district, or both. The contract may also provide for
37 the furnishing of (1) emergency service in case of accidents, calamities
38 or other emergencies in connection with which the services of firefight-
39 ers would be required and (2) general ambulance service subject, howev-
40 er, to the provisions of section two hundred nine-b of the general
41 municipal law. In the event that the fire department or fire company
42 furnishing fire protection within the district pursuant to contract does
43 not maintain and operate an ambulance then a separate contract may be
44 made for the furnishing within the district of emergency ambulance
45 service or general ambulance service, or both, with any city, village or
46 fire district the fire department of which, or with an incorporated fire
47 company having its headquarters outside the district which, maintains
48 and operates an ambulance subject, however, in the case of general ambu-
49 lance service, to the provisions of section two hundred nine-b of the
50 general municipal law, or with an ambulance service, certified or regis-
51 tered pursuant to article thirty of the public health law[, which is not
52 organized under the provisions of section two hundred nine-b of the
53 general municipal law]. Any such contract with any such ambulance
54 service permitted herein shall be subject to the provisions of this
55 section.
S. 363--B 3
1 § 4. Section 3224-a of the insurance law is amended by adding a new
2 subsection (k) to read as follows:
3 (k) Payments to nonparticipating or nonpreferred providers of ambu-
4 lance services licensed under article thirty of the public health law.
5 (1) Whenever an insurer or an organization, or corporation licensed or
6 certified pursuant to article forty-three or forty-seven of this chapter
7 or article forty-four of the public health law provides that any health
8 care claims submitted under contracts or agreements issued or entered
9 into pursuant to this article or article forty-two, forty-three or
10 forty-seven of this chapter and article forty-four of the public health
11 law are payable to a participating or preferred provider of ambulance
12 services for services rendered, the insurer, organization, or corpo-
13 ration licensed or certified pursuant to article forty-three or forty-
14 seven of this chapter or article forty-four of the public health law
15 shall be required to pay such benefits either directly to any similarly
16 licensed nonparticipating or nonpreferred provider at the usual and
17 customary charge, which shall not be excessive or unreasonable, when the
18 provider has rendered such services, has a written assignment of bene-
19 fits, and has caused written notice of such assignment to be given to
20 the insurer, organization, or corporation licensed or certified pursuant
21 to article forty-three or forty-seven of this chapter or article forty-
22 four of the public health law or jointly to such nonparticipating or
23 nonpreferred provider and to the insured, subscriber, or other covered
24 person; provided, however, that in either case the insurer, organiza-
25 tion, or corporation licensed or certified pursuant to article forty-
26 three or forty-seven of this chapter or article forty-four of the public
27 health law shall be required to send such benefit payments directly to
28 the provider who has the written assignment. When payment is made
29 directly to a provider of ambulance services as authorized by this
30 section, the insurer, organization, or corporation licensed or certified
31 pursuant to article forty-three or forty-seven of this chapter or arti-
32 cle forty-four of the public health law shall give written notice of
33 such payment to the insured, subscriber, or other covered person.
34 (2) An insurer shall provide reimbursement for those services
35 prescribed by this section at rates negotiated between the insurer and
36 the provider of such services. In the absence of agreed upon rates, an
37 insurer shall pay for such services at the usual and customary charge,
38 which shall not be excessive or unreasonable.
39 (3) Nothing contained in this section shall be deemed to prohibit the
40 payment of different levels of benefits or from having differences in
41 coinsurance percentages applicable to benefit levels for services
42 provided by participating or preferred providers and nonparticipating or
43 nonpreferred providers.
44 The provisions of this section shall not apply to policies that do not
45 include coverage for ambulance services.
46 § 5. Subparagraphs (C) and (D) of paragraph 24 of subsection (i) of
47 section 3216 of the insurance law, as added by chapter 506 of the laws
48 of 2001, are amended to read as follows:
49 (C) An insurer shall provide reimbursement for those services
50 prescribed by this section at rates negotiated between the insurer and
51 the provider of such services. In the absence of agreed upon rates, an
52 insurer shall pay for such services at the usual and customary charge,
53 which shall not be excessive or unreasonable. The insurer shall send
54 such payments directly to the provider of such ambulance services, if
55 the ambulance service includes an executed assignment of benefits form
56 with the claim.
S. 363--B 4
1 (D) The provisions of this paragraph shall have no application to
2 transfers of patients between hospitals or health care facilities by an
3 ambulance service as described in subparagraph (A) of this paragraph
4 unless such services are covered under the policy.
5 § 6. Subparagraphs (C) and (D) of paragraph 15 of subsection (l) of
6 section 3221 of the insurance law, as added by chapter 506 of the laws
7 of 2001, are amended to read as follows:
8 (C) An insurer shall provide reimbursement for those services
9 prescribed by this section at rates negotiated between the insurer and
10 the provider of such services. In the absence of agreed upon rates, an
11 insurer shall pay for such services at the usual and customary charge,
12 which shall not be excessive or unreasonable. The insurer shall send
13 such payments directly to the provider of such ambulance services, if
14 the ambulance service includes an executed assignment of benefits form
15 with the claim.
16 (D) The provisions of this paragraph shall have no application to
17 transfers of patients between hospitals or health care facilities by an
18 ambulance service as described in subparagraph (A) of this paragraph
19 unless such services are covered under the policy.
20 § 7. Paragraphs 3 and 4 of subsection (aa) of section 4303 of the
21 insurance law, as added by chapter 506 of the laws of 2001, are amended
22 to read as follows:
23 (3) An insurer shall provide reimbursement for those services
24 prescribed by this section at rates negotiated between the insurer and
25 the provider of such services. In the absence of agreed upon rates, an
26 insurer shall pay for such services at the usual and customary charge,
27 which shall not be excessive or unreasonable. The insurer shall send
28 such payments directly to the provider of such ambulance services, if
29 the ambulance service includes an executed assignment of benefits form
30 with the claim.
31 (4) The provisions of this subsection shall have no application to
32 transfers of patients between hospitals or health care facilities by an
33 ambulance service as described in paragraph one of this subsection
34 unless such services are covered under the policy.
35 § 8. This act shall take effect on the ninetieth day after it shall
36 have become a law, except that sections four, five, six and seven of
37 this act shall take effect January 1, 2020, and shall apply to health
38 care claims submitted on or after such date.
