Relates to reimbursement of non-emergency ambulette transportation services.
TITLE OF BILL: An act to amend the insurance law, in relation to non-emergency ambulette transportation services provided to covered persons
PURPOSE: The purpose of this bill is to allow reputable ambulette services that are certified by Medicaid, to receive reimbursement from insurance for non-emerg(mcy transportation services provided to no fault patients.
SUMMARY: Amends section 5110 of the Insurance law to require reimbursement to Medicaid-certified ambulette companies for transportation services of no fault patients to and from health care appointments that are related to treatment of injuries sustained as a result of a motor vehicle accident. Section B indicates that ambulette companies paid by insurers shall not seek compensation or have recourse against a covered person for services provided. Section C authorizes ambulette companies to accept letters of reassignment of benefits from covered persons. Section D provides that reimbursement rates shall be at a rate negotiated between the insurer and the provider of services. In the absence of such an agreement the insurer shall pay the usual and customary charge for such services so long as they are not excessive or exorbitant.
JUSTIFICATION: This is an important piece of legislation that will ensure that patients covered under the no fault insurance law will receive medically necessary, quality, non-emergency transportation services to and from health care appointments to treat injuries sustained in motor vehicle accidents. No fault patients that are suffering from neck, back or other serious injuries require transportation to doctor visits, physical therapy etc must be transported by professionals who are trained to transport such patients in a manner that does not risk aggravation of injuries or added pain and discomfort that can be caused by improper transportation procedures.
PRIOR LEGISLATIVE HISTORY: S.1695 of 2011 01/11/11 REFERRED TO INSURANCE 01/04/12 REFERRED TO INSURANCE
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: Immediately.
STATE OF NEW YORK ________________________________________________________________________ 246 2013-2014 Regular Sessions IN SENATE (PREFILED) January 9, 2013 ___________Introduced by Sen. SAMPSON -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to non-emergency ambu- lette transportation services provided to covered persons THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The insurance law is amended by adding a new section 5110 to read as follows: S 5110. AMBULETTE TRANSPORTATION SERVICES. (A) EVERY OWNER'S POLICY OF LIABILITY INSURANCE ISSUED ON A MOTOR VEHICLE IN SATISFACTION OF THE REQUIREMENTS OF ARTICLE SIX OR EIGHT OF THE VEHICLE AND TRAFFIC LAW SHALL INCLUDE REIMBURSEMENT OF NON-EMERGENCY AMBULETTE TRANSPORTATION SERVICES THAT ARE MEDICAID-CERTIFIED FOR THE TRANSPORT OF COVERED PERSONS TO AND FROM APPOINTMENTS WITH HEALTH CARE PROVIDERS THAT ARE DIRECTLY RELATED TO TREATMENT OF AN INJURY OR INJURIES SUSTAINED AS A RESULT OF A MOTOR VEHICLE ACCIDENT. (B) PAYMENT BY AN INSURER PURSUANT TO THIS SECTION SHALL BE PAYMENT IN FULL FOR THE SERVICES PROVIDED. AN AMBULETTE SERVICE REIMBURSED PURSUANT TO THIS SECTION SHALL NOT CHARGE OR SEEK ANY REIMBURSEMENT FROM, OR HAVE ANY RECOURSE AGAINST A COVERED PERSON FOR THE SERVICES PROVIDED PURSUANT TO THIS SECTION. (C) AMBULETTE COMPANIES SHALL BE AUTHORIZED TO ACCEPT LETTERS OF REAS- SIGNMENT OF BENEFITS FROM COVERED PERSONS. (D) AN INSURER SHALL PROVIDE REIMBURSEMENT FOR THOSE SERVICES PRESCRIBED BY THIS SECTION AT RATES NEGOTIATED BETWEEN THE INSURER AND THE PROVIDER OF SUCH SERVICES. IN THE ABSENCE OF AGREED UPON RATES, AN INSURER SHALL PAY FOR SUCH SERVICES AT THE USUAL AND CUSTOMARY CHARGE, WHICH SHALL NOT BE EXCESSIVE OR UNREASONABLE. S 2. This act shall take effect immediately.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD02186-01-3