New York S 10512: Authorizes payments to nonparticipating or nonpreferred providers of medical services

Bill Text

Bill Search and Legislative Information | New York State Assembly 

• 

• 

• 

• 

• 

• 

• 

• 

 Skip to main content 

 New York State Assembly

 Speaker Carl E. Heastie

 --> 
 --> 

 --> 

• 
 Assembly Members 

• 
 Legislative Info 

• 
 Public Hearings 

• 
 Speaker's Press 

• 
 Assembly Reports 

• 
 Committees & More 

• Bill Search Home
• Laws
• Legislative Calendar
• Public Hearing Schedule
• Assembly Calendars
• Assembly Committee Agenda 

 Javascript must be enabled to properly view this page. 

 Bill No.: 

• Summary 
• Actions 
• Committee&nbspVotes 
• Floor&nbspVotes 
• Memo 
• Text 
• LFIN 
• Chamber&nbspVideo/Transcript 
S10512 Summary:

BILL NOS10512 

&nbsp

SAME ASNo Same As

&nbsp

SPONSORRIVERA

&nbsp

COSPNSR

&nbsp

MLTSPNSR

&nbsp

Amd §3224-a, Ins L

&nbsp

Authorizes payments to nonparticipating or nonpreferred providers of medical services.

Go to top S10512 Actions:

BILL NOS10512 

&nbsp

05/15/2026REFERRED TO INSURANCE

Go to topS10512 Committee&nbspVotes:

Go to topS10512 Floor&nbspVotes:

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

Go to topS10512 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 10512

 IN SENATE

 May 15, 2026
 ___________

 Introduced by Sen. RIVERA -- 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 payments to medical
 services providers

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

 1 Section 1. Section 3224-a of the insurance law is amended by adding a
 2 new subsection (m) to read as follows:
 3 (m) Payments to nonparticipating or nonpreferred providers licensed
 4 under the public health law or the education law. (1) Whenever an insur-
 5 er or an organization, or corporation licensed or certified pursuant to
 6 article forty-three or forty-seven of this chapter or article forty-four
 7 of the public health law provides that any health care claims submitted
 8 under contracts or agreements issued or entered into pursuant to this
 9 article or article forty-two, forty-three or forty-seven of this chapter
 10 and article forty-four of the public health law are payable to a partic-
 11 ipating or preferred provider for services rendered, the insurer, organ-
 12 ization, or corporation licensed or certified pursuant to article
 13 forty-three or forty-seven of this chapter or article forty-four of the
 14 public health law shall be required to pay such benefits either directly
 15 to any similarly licensed nonparticipating or nonpreferred provider at
 16 the usual and customary charge, which shall not be excessive or unrea-
 17 sonable, when the provider has rendered such services, has on file a
 18 duly executed assignment of benefits, and has caused notice of such
 19 assignment to be given to the insurer, organization, or corporation
 20 licensed or certified pursuant to article forty-three or forty-seven of
 21 this chapter or article forty-four of the public health law or jointly
 22 to such nonparticipating or nonpreferred provider and to the insured,
 23 subscriber, or other covered person; provided, however, that in either
 24 case the insurer, organization, or corporation licensed or certified
 25 pursuant to article forty-three or forty-seven of this chapter or arti-
 26 cle forty-four of the public health law shall be required to send such
 27 benefit payments directly to the provider who has the assignment on
 28 file. When payment is made directly to a provider as authorized by this

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD13775-02-6

 S. 10512 2

 1 section, the insurer, organization, or corporation licensed or certified
 2 pursuant to article forty-three or forty-seven of this chapter or arti-
 3 cle forty-four of the public health law shall give written notice of
 4 such payment to the insured, subscriber, or other covered person.
 5 (2) An insurer shall provide reimbursement for those services
 6 prescribed by this section at rates negotiated between the insurer and
 7 the provider of such services. In the absence of agreed upon rates, an
 8 insurer shall pay for such services at the usual and customary charge,
 9 which shall not be excessive or unreasonable.
 10 (3) A nonparticipating or nonpreferred provider shall not seek advance
 11 payment, deposits, or full payment for covered services from an insured,
 12 subscriber, or other covered person unless and until the provider has
 13 first submitted a claim to the applicable insurer and the claim has been
 14 adjudicated. Nothing contained in this section shall be deemed to
 15 prohibit the payment of different levels of benefits or from having
 16 differences in coinsurance percentages applicable to benefit levels for
 17 services provided by participating or preferred providers a