NY A02376

Requires health insurance organizations to pay out-of-network clinical laboratory providers directly when an enrollee is referred by an in-network provider for covered services.

Insurance organizations must make payments within the timeframe specified in Insurance Law Section 3224-a.

Enrollees remain responsible for applicable copays, coinsurance, and deductibles for out-of-network clinical laboratory services.

Clinical laboratories must bill the insurance organization directly; payments made to enrollees do not satisfy the organization's payment obligation to the laboratory.

Applies these requirements to both comprehensive health services plans under Public Health Law Section 4406 and insurance organizations under Insurance Law Section 4804, effective immediately upon enactment.