S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    144
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced by M. of A. CAHILL -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the public health law and the insurance law, in relation
   to requiring health insurers to accept third party payments for cover-
   age

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 4406-c of the  public  health  law  is  amended  by
 adding a new subdivision 10 to read as follows:
   10.  WITH REGARD TO A SUBSCRIBER CONTRACT OFFERED THROUGH THE INDIVID-
 UAL MARKET, A HEALTH MAINTENANCE ORGANIZATION SHALL NOT BY  CONTRACT  OR
 IN  ANY OTHER MANNER REFUSE TO ACCEPT PREMIUM OR ANY REQUIRED COST SHAR-
 ING PAYMENTS FROM THIRD PARTIES IF MADE BY (A) AN INDIAN  TRIBE,  TRIBAL
 ORGANIZATION, URBAN INDIAN ORGANIZATION, OR ANY STATE OR FEDERAL GOVERN-
 MENT  PROGRAM  OR  GRANTEE  (SUCH AS THE RYAN WHITE HIV/AIDS PROGRAM) ON
 BEHALF OF AN ENROLLEE, OR (B) A PRIVATE, NOT-FOR-PROFIT  FOUNDATION,  ON
 BEHALF  OF  AN ENROLLEE WHO SATISFIES DEFINED CRITERIA THAT ARE BASED ON
 FINANCIAL STATUS AND DO NOT CONSIDER  HEALTH  STATUS,  AND  THE  PAYMENT
 COVERS THE ENTIRE POLICY YEAR.
   §  2.  Section  3217-b of the insurance law is amended by adding a new
 subsection (l) to read as follows:
   (L) WITH REGARD TO AN INSURANCE POLICY OFFERED THROUGH THE  INDIVIDUAL
 MARKET,  AN  INSURER SHALL NOT BY CONTRACT OR IN ANY OTHER MANNER REFUSE
 TO ACCEPT PREMIUM OR ANY  REQUIRED  COST  SHARING  PAYMENTS  FROM  THIRD
 PARTIES IF MADE BY (1) AN INDIAN TRIBE, TRIBAL ORGANIZATION, URBAN INDI-
 AN  ORGANIZATION,  OR ANY STATE OR FEDERAL GOVERNMENT PROGRAM OR GRANTEE
 (SUCH AS THE RYAN WHITE HIV/AIDS PROGRAM) ON BEHALF OF  AN  INSURED,  OR
 (2)  A  PRIVATE,  NOT-FOR-PROFIT FOUNDATION, ON BEHALF OF AN INSURED WHO
 SATISFIES DEFINED CRITERIA THAT ARE BASED ON FINANCIAL STATUS AND DO NOT
 CONSIDER HEALTH STATUS, AND THE PAYMENT COVERS THE ENTIRE POLICY YEAR.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD00077-01-9

 A. 144                              2
 
   § 3. Section 4325 of the insurance law is  amended  by  adding  a  new
 subsection (m) to read as follows:
   (M)  WITH REGARD TO AN INSURANCE CONTRACT OFFERED THROUGH THE INDIVID-
 UAL MARKET, A CORPORATION ORGANIZED UNDER  THIS  ARTICLE  SHALL  NOT  BY
 CONTRACT OR IN ANY OTHER MANNER REFUSE TO ACCEPT PREMIUM OR ANY REQUIRED
 COST SHARING PAYMENTS FROM THIRD PARTIES IF MADE BY (1) AN INDIAN TRIBE,
 TRIBAL  ORGANIZATION, URBAN INDIAN ORGANIZATION, OR ANY STATE OR FEDERAL
 GOVERNMENT PROGRAM OR GRANTEE (SUCH AS THE RYAN WHITE HIV/AIDS  PROGRAM)
 ON  BEHALF OF A SUBSCRIBER, OR (2) A PRIVATE, NOT-FOR-PROFIT FOUNDATION,
 ON BEHALF OF A SUBSCRIBER WHO SATISFIES DEFINED CRITERIA THAT ARE  BASED
 ON  FINANCIAL  STATUS  AND  DO  NOT  CONSIDER HEALTH STATUS, AND PAYMENT
 COVERS THE ENTIRE POLICY YEAR.
   § 4. This act shall take effect January 1, 2021.