New York S 7918: Relates to reimbursement for anesthesia services

Bill Text

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S07918 Summary:

BILL NOS07918A

&nbsp

SAME ASSAME AS A05375-A

&nbsp

SPONSORSKOUFIS

&nbsp

COSPNSR

&nbsp

MLTSPNSR

&nbsp

Add 3246 & 4331, Ins L; add 365-q, Soc Serv L

&nbsp

Relates to reimbursement for anesthesia services; provides that an insurer may use a time related reimbursement methodology for anesthesia services if such methodology is based upon criteria established by an independent organization.

Go to top S07918 Actions:

BILL NOS07918A

&nbsp

05/14/2025REFERRED TO INSURANCE

05/21/2025AMEND (T) AND RECOMMIT TO INSURANCE

05/21/2025PRINT NUMBER 7918A

01/07/2026REFERRED TO INSURANCE

Go to topS07918 Committee&nbspVotes:

Go to topS07918 Floor&nbspVotes:

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

Go to topS07918 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 7918--A

 2025-2026 Regular Sessions

 IN SENATE

 May 14, 2025
 ___________

 Introduced by Sen. SKOUFIS -- read twice and ordered printed, and when
 printed to be committed to the Committee on Insurance -- committee
 discharged, bill amended, ordered reprinted as amended and recommitted
 to said committee

 AN ACT to amend the insurance law and the social services law, in
 relation to reimbursement for anesthesia services

 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. Reimbursement for anesthesia services. (a) An insurer issuing
 4 a policy of hospital, medical, or surgical expense insurance pursuant to
 5 this section or any other section of law shall not impose arbitrary time
 6 caps on reimbursement for anesthesia services provided during medically
 7 necessary procedures.
 8 (b) Reimbursement for anesthesia services shall be determined based on
 9 medical necessity as determined by the insurer, taking into consider-
 10 ation the complexity of the procedure as evidenced by the submission of
 11 medical records submitted by the attending anesthesiologist or licensed
 12 anesthesia provider.
 13 (c) (1) An insurer issuing a policy of hospital, medical, or surgical
 14 expense insurance pursuant to this section or any other section of law
 15 shall be prohibited from denying payment for anesthesia services solely
 16 because the duration of care exceeded a pre-set time limit.
 17 (2) Notwithstanding paragraph one of this subsection, an insurer may
 18 use a time related reimbursement methodology for anesthesia services if
 19 such methodology is based upon criteria established by an independent
 20 organization, including the criteria used by the centers for Medicare
 21 and Medicaid services to reimburse anesthesia services under title XVIII
 22 of the United States Social Security Act (Medicare). If an insurer uses
 23 a time related reimbursement methodology, it should have an established

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD09176-03-5

 S. 7918--A 2

 1 process for the submission of additional medical records and the sharing
 2 of electronic medical records to assess whether an increase to the
 3 reimbursement is warranted.
 4 § 2. The insurance law is amended by adding a new section 4331 to read
 5 as follows:
 6 § 4331. Reimbursement for anesthesia services. (a) Every corporation
 7 subject to the provisions of this article that provide hospital,
 8 medical, or surgical expense insurance coverage shall not impose arbi-
 9 trary time caps on reimbursement for anesthesia services provided during
 10 medically necessary procedures.
 11 (b) Reimbursement for anesthesia services shall be determined based on
 12 medical necessity as determined by the corporation, taking into consid-
 13 eration the complexity of the procedure as evidenced by the submission
 14 of medical records submitted by the attending anesthesiologist or
 15 licensed anesthesia provider.
 16 (c)(1) A corporation issuing hospital, medical, or surgical expense
 17 insurance coverage shall be prohibited from denying payment for anes-
 18 thesia services solely because the duration of care exceeded a pre-set
 19 time limit.
 20 (2) Notwithstanding paragraph one of this subsection, a corporation
 21 may use a time rela