A 3488: 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.

  
  STATE OF NEW YORK ________________________________________________________________________ 3488 2025-2026 Regular Sessions  IN ASSEMBLY January 28, 2025 ___________ Introduced by M. of A. DILAN -- read once and referred 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