NY S01466

Requires insurers and health plans (except in cities with population over 1 million) to pay nonparticipating or nonpreferred ambulance service providers directly at usual and customary charges when a provider has an executed assignment of benefits on file.

Insureds must receive no greater out-of-pocket costs for services from nonparticipating or nonpreferred ambulance providers than they would incur with participating or preferred providers.

Payment rates shall be negotiated between insurers and ambulance providers, or if no agreement exists, paid at usual and customary charges that are not excessive or unreasonable.

Insurers must provide written notice to insureds when benefit payments are made directly to ambulance service providers.

Effective January 1, 2025 for health care claims submitted after that date; does not apply to policies without ambulance service coverage.