New York A 5438: Relates to authorizing the care and treatment of injured employees by duly licensed or certified acupuncturists under the workers' compensation program

Bill Text

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A05438 Summary:

BILL NOA05438 

&nbsp

SAME ASNo Same As

&nbsp

SPONSORWeprin

&nbsp

COSPNSRReyes, Meeks, Hevesi, Shimsky

&nbsp

MLTSPNSR

&nbsp

Add §3246, Ins L

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Establishes reporting requirements for out of state entities provide reimbursement of health care costs and penalties for failing to comply with such reporting requirements.

Go to top A05438 Actions:

BILL NOA05438 

&nbsp

02/14/2025referred to insurance

01/07/2026referred to insurance

Go to topA05438 Committee&nbspVotes:

Go to topA05438 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA05438 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 5438

 2025-2026 Regular Sessions

 IN ASSEMBLY

 February 14, 2025
 ___________

 Introduced by M. of A. WEPRIN -- read once and referred to the Committee
 on Insurance

 AN ACT to amend the insurance law, in relation to establishing reporting
 requirements for out of state entities not authorized to facilitate
 payment or reimbursement of health care costs

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. The insurance law is amended by adding a new section 3246
 2 to read as follows:
 3 § 3246. Health care share plan or arrangement reporting requirements.
 4 1. Any entity not authorized by the superintendent to offer insurance
 5 in the state of New York, who offers or intends to offer a plan or
 6 arrangement to facilitate payment or reimbursement of health care costs
 7 for residents of New York, regardless of domicile, shall submit the
 8 following information to the superintendent by October first, two thou-
 9 sand twenty-five, and annually thereafter by March first:
 10 (a) participant information, including:
 11 (i) the total number of individual and household participants in the
 12 state of New York for the previous calendar year;
 13 (ii) the total number of employer groups participating, with specific
 14 participant numbers for each employer group; and
 15 (iii) the total number of national participants, if offered outside
 16 the state of New York.
 17 (b) provider contracts which shall include a list of contacts with New
 18 York-based providers delivering health care services to participants.
 19 (c) financial and operational information, including:
 20 (i) the total fees, dues, or other payments collected from New York
 21 participants in the previous year, specifying the percentage retained
 22 for administrative costs;
 23 (ii) the dollar amounts of health care reimbursement requests submit-
 24 ted and paid within New York for the prior calendar year;

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD07830-01-5

 A. 5438 2

 1 (iii) the number of reimbursement requests denied, including percent-
 2 ages and appeals denied; and
 3 (iv) the amount the health care sharing ministry spent on medical care
 4 versus administration over the past five years of the ministry's opera-
 5 tion.
 6 (d) disclosure of coverage and exclusions, including:
 7 (i) a comprehensive list of all benefits covered by the ministry and a
 8 detailed list of any excluded health procedures, drugs, and devices;
 9 (ii) a list of all health care providers, hospitals, health centers,
 10 dentists, laboratories, and pharmacies that participate in the health
 11 care sharing ministry;
 12 (iii) a list of any excluded health conditions, including pre-existing
 13 conditions or higher fees that may be levied due to an enrollee's exist-
 14 ing health condition or status;
 15 (iv) a description of any waiting periods for eligibility for health
 16 care sharing ministry payment; and
 17 (v) a description of any enrollment eligibility rules or conditions,
 18 such as age limits or requirements to be married.
 19 (e) operational and marketing information, including:
 20 (i) a list of counties in New York where plans were offered in the
 21 previous year and are planned for the following year; and
 22 (ii) details of any third-party entities involved in marketing or
 23 enrolling participants in New York, including commissions or fees paid.
 24 (f) organizational information, including:
 25 (i) names, addresses, and contact information for key organi