New York S 4012: Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery

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S04012 Summary:

BILL NOS04012 

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SAME ASSAME AS A03488

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SPONSORPARKER

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COSPNSR

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MLTSPNSR

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Amd §§3216 & 3221, Ins L

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Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery and such physician's services shall not be covered by their insurance policy; provides such services must be covered if the insured person does not receive notification prior to such services or procedure.

Go to top S04012 Actions:

BILL NOS04012 

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01/31/2025REFERRED TO INSURANCE

01/07/2026REFERRED TO INSURANCE

Go to topS04012 Committee&nbspVotes:

Go to topS04012 Floor&nbspVotes:

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

Go to topS04012 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 4012

 2025-2026 Regular Sessions

 IN SENATE

 January 31, 2025
 ___________

 Introduced by Sen. PARKER -- 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 requiring notification
 to insured persons that an out-of-network physician may be used in
 their procedure, test or surgery

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

 1 Section 1. Section 3216 of the insurance law is amended by adding a
 2 new subsection (n) to read as follows:
 3 (n) (1) Every person insured under a policy of accident and health
 4 insurance delivered or issued for delivery in this state shall be enti-
 5 tled to notification from the billing entity prior to the procedure,
 6 test or surgery, that an out-of-network physician may be used in such
 7 procedure, test or surgery and such physician's services shall not be
 8 covered by their insurance policy.
 9 (2) The patient costs of out-of-network physician services shall be
 10 covered by the insurance policy of an insured person if they have not
 11 received notification of such situations, prior to the health service or
 12 procedure, as prescribed in paragraph one of this subsection.
 13 § 2. Section 3221 of the insurance law is amended by adding a new
 14 subsection (v) to read as follows:
 15 (v) (1) Every person insured under a policy of accident and health
 16 insurance delivered or issued for delivery in this state shall be enti-
 17 tled to notification from the billing entity prior to the procedure,
 18 test or surgery, that an out-of-network physician may be used in such
 19 procedure, test or surgery and such physician's services shall not be
 20 covered by their insurance policy.
 21 (2) The patient costs of out-of-network physician services shall be
 22 covered by the insurance policy of an insured person if they have not
 23 received notification of such situations, prior to the health service or
 24 procedure, as prescribed in paragraph one of this subsection.
 25 § 3. This act shall take effect immediately.

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD07470-01-5

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