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S04013 Summary:

BILL NOS04013
 
SAME ASSAME AS UNI. A08318
 
SPONSORVELELLA
 
COSPNSRLACK, LAVALLE, SALAND, SPANO
 
MLTSPNSR
 
Add SS11-108 & 11-109, Gen Ob L; amd S1602, CPLR; amd S4410, Pub Health L
 
Provides for accountability of "health care organizations" (i.e., entities, other than a health care provider, that approve, provide, arrange for or pay for health care services, including a health plan's preferred provider organization): provides that whenever health care organizations delay, fail or refuse to approve, provide, arrange for, or pay for in a timely manner any health care service that it is contractually obligated to provide or cover for a person, it shall be liable for any personal injury, death or damages caused by delay, failure or refusal; provides that an organization shall be liable for acts by an agent, contractor, etc., for which the organization would be liable if the act were committed by the organization; imposes upon all health plan (including workers compensation and casualty insurers) the duty to exercise reasonable care when making decisions that affect the health care service of an enrollee, and in selecting and exerting influence over its employees, agents, etc., who act on its behalf regarding decisions that affect the quality of an enrollee's diagnosis, care or treatment; prohibits organizations from requiring a health care provider to indemnify or hold it harmless for its liability; related provisions.
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