NY S03526

Requires insurers and health plans to pay nonparticipating or nonpreferred ambulance service providers directly at usual and customary charges (not excessive or unreasonable) when providers have an executed assignment of benefits on file.

Mandates insurers send benefit payments directly to ambulance service providers with valid assignments and provide written notice of payment to the insured person.

Allows reimbursement rates to be negotiated between insurers and ambulance providers, with usual and customary charges applied when no agreed rates exist.

Permits insurers to maintain different benefit levels and coinsurance percentages between participating/preferred and nonparticipating/nonpreferred ambulance providers.

Takes effect January 1, 2021 and applies to health care claims submitted for payment on or after that date.