BILL NUMBER: S6255
SPONSOR: SKOUFIS
 
TITLE OF BILL:
An act to amend the insurance law, in relation to reimbursement for
ambulance services
 
PURPOSE:
To require insurers to submit payments directly to ambulance providers
who are in-network or, for out-of-network ambulance providers, to
require the issuance of a joint check to the insured specifying both the
insured and the ambulance provider as payees.
 
SUMMARY OF PROVISIONS:
Section 1: Amends paragraph 24 of subsection (i) of section 3216 of the
insurance law by adding new subparagraph (F) to require insurers to
submit payments directly to in-network ambulance providers at the nego-
tiated rates. For out-of-network ambulance providers where there is no
negotiated rate, the insurer is required to issue a joint check to the
insured specifying both the insured and ambulance provider as payees, at
the usual and customary charge.
Section 2: Amends paragraph 15 of subsection (1) of section 3221 of the
insurance law by adding a new subparagraph (F)which requires the insurer
to notify the ambulance provider electronically upon the issuance of a
joint check to the insured. The notification must include the name of
the patient, date of service, date of payment, amount of payment and
address to which the payment was sent
Section 3: Amends subsection (aa) of section 4303 of the insurance law
by adding a new paragraph 6 which the legislation requires the insurer
to issue reimbursement directly to the ambulance provider if the insured
has filed an assignment of benefits for such ambulance services.
Section 4: Sets effective date.
 
JUSTIFICATION:
This bill would amend the insurance law to require insurers to issue
joint signature checks to both the patient and ambulance service provid-
er when the patient utilizes an ambulance service provider that is a
nonparticipating provider of their network.
Currently, when a patient uses an out-of-network ambulance provider,
their insurance company will send the ambulance reimbursement payment
directly to the patient. The patient is then expected to forward that
reimbursement payment to the ambulance service that provided the
service. In many cases with a single signature check, the patients never
send the insurance reimbursement to the service provider. Rather, they
keep the money for themselves, diverting millions of dollars from our
healthcare system in the process.
This bill would ensure that healthcare dollars stay in the healthcare
system and that healthcare providers are paid for the work that they do.
In order to cash the check, both parties would need to endorse the
check. Insurers would send the joint signature check to the patient, the
patient would sign it and send it to the ambulance provider. The ambu-
lance provider could then endorse the check and be paid for their
service. The insurer will also notify the ambulance provider when a
joint signature check has been sent to the patient.
Ambulance providers are mandated responders who must provide service
when an emergency call comes in. They answer these calls without know-
ledge of a patient's ability to pay and without concern of being paid at
the time of service. In order to keep the ambulance system strong and
viable they must collect payment for service. This bill would assist in
collecting payments.
 
LEGISLATIVE HISTORY:
Senate
2011: N/A
2012: S6982, Referred to insurance
2013: S3541, Referred to insurance
2014: S3541, Referred to insurance
2015: S1763, Referred to insurance
2016: S1763, Referred to insurance
2017: S2524, Referred to insurance
2018: S2524, Referred to insurance
2019: S3525, Referred to insurance
2020: S3525, Referred to insurance
2021: S3550, Referred to insurance
2022: S3550, Referred to insurance
2023: S1465, Referred to insurance
2024: S1465, Referred to insurance
Assembly
2011: N/A
2012: A10091, Referred to insurance
2013: A3703, Referred to insurance
2014: A3703, Referred to insurance
2015: A931,Referredto insurance
2016: A931, Referred to insurance
2017: A908, Referred to insurance
2018: A908, Referred to insurance
2019: A3721, Referred to insurance
2020: A3721, Referred to insurance
2021: A1842, Referred to insurance
2022: A1842, Referred to insurance
2023: A3496, Referred to insurance
2024: A3496, Referred to insurance
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
Immediately.

Statutes affected:
S6255: 3216 insurance law, 3216(i) insurance law, 3221 insurance law, 3221(1) insurance law, 4303 insurance law, 4303(aa) insurance law