New York A 7298: Includes ambulance services to the emergency room as part of emergency services for the purposes of surprise bills

Bill Text

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A07298 Summary:

BILL NOA07298 

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SAME ASNo Same As

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SPONSORWoerner

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COSPNSR

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MLTSPNSR

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Amd §§603, 605 & 606, Fin Serv L

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Includes ambulance services to the emergency room as part of emergency services for the purposes of surprise bills.

Go to top A07298 Actions:

BILL NOA07298 

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03/25/2025referred to insurance

01/07/2026referred to insurance

Go to topA07298 Committee&nbspVotes:

Go to topA07298 Floor&nbspVotes:

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

Go to topA07298 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 7298

 2025-2026 Regular Sessions

 IN ASSEMBLY

 March 25, 2025
 ___________

 Introduced by M. of A. WOERNER -- read once and referred to the Commit-
 tee on Insurance

 AN ACT to amend the financial services law, in relation to including
 ambulance services to the emergency room as part of emergency services
 for the purposes of surprise bills

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

 1 Section 1. Subsection (b) of section 603 of the financial services
 2 law, as added by section 26 of part H of chapter 60 of the laws of 2014,
 3 is amended to read as follows:
 4 (b) "Emergency services" means, with respect to an emergency condi-
 5 tion: (1) a medical screening examination as required under section
 6 1867 of the social security act, 42 U.S.C. § 1395dd, which is within the
 7 capability of the emergency department of a hospital, including ancil-
 8 lary services routinely available to the emergency department to evalu-
 9 ate such emergency medical condition; [and] (2) within the capabilities
 10 of the staff and facilities available at the hospital, such further
 11 medical examination and treatment as are required under section 1867 of
 12 the social security act, 42 U.S.C. § 1395dd, to stabilize the patient;
 13 and (3) public or private ambulance services to the emergency room for
 14 treatment of an emergency condition.
 15 § 2. Paragraphs 1 and 2 of subsection (a) of section 605 of the finan-
 16 cial services law, as amended by section 5 of subpart A of part AA of
 17 chapter 57 of the laws of 2022, are amended to read as follows:
 18 (1) When a health care plan receives a bill for emergency services
 19 from a non-participating provider, including a bill for ambulance
 20 services or inpatient services which follow an emergency room visit, the
 21 health care plan shall pay an amount that it determines is reasonable
 22 for the emergency services, including ambulance services or inpatient
 23 services which follow an emergency room visit, rendered by the non-par-
 24 ticipating provider, in accordance with section three thousand two

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD11139-01-5

 A. 7298 2

 1 hundred twenty-four-a of the insurance law, except for the insured's
 2 co-payment, coinsurance or deductible, if any, and shall ensure that the
 3 insured shall incur no greater out-of-pocket costs for the emergency
 4 services, including ambulance services or inpatient services which
 5 follow an emergency room visit, than the insured would have incurred
 6 with a participating provider. The non-participating provider may bill
 7 the health care plan for the services rendered. Upon receipt of the
 8 bill, the health care plan shall pay the non-participating provider the
 9 amount prescribed by this section and any subsequent amount determined
 10 to be owed to the provider in relation to the emergency services
 11 provided, including ambulance services or inpatient services which
 12 follow an emergency room visit.
 13 (2) A non-participating provider or a health care plan may submit a
 14 dispute regarding a fee or payment for emergency services, including
 15 ambulance services or inpatient services which follow an emergency room
 16 visit, for review to an independent dispute resolution entity.
 17 § 2-a. Paragraphs 1 and 2 of subsection (a) of section 605 of the
 18 financial services law, as amended by section 13 of subpart A of part II
 19 of chapter 57 of the laws of 2023, are amended to read as follows:
 20 (1) When a health care plan receives a bill for emergency services