Senate Bill S1761

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1761

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            February 6, 2009
                               ___________

Introduced  by  Sen.  FARLEY -- read twice and ordered printed, and when
  printed to be committed to the Committee on Investigations and Govern-
  ment Operations

AN ACT to amend the legislative law and the insurance law,  in  relation
  to mandated health insurance benefits

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Legislative intent. The legislature finds that there  is  a
growing  crisis  in  both the availability and cost of health insurance.
Millions of New Yorkers, many of whom are employed, are uninsured.  Many
persons  who  would otherwise purchase individual coverage are precluded
from doing so because of the cost.  Numerous factors can be tied to  the
escalating  cost of health insurance such as the aging population, tech-
nological advances, the cost of malpractice insurance  and  the  unknown
cost of mandated benefits and services.
  The  legislature  further  finds  a need to explore every avenue which
might lead to lower costs and increased availability  of  health  insur-
ance.  The legislature therefore desires to examine the process by which
mandated benefits and services are incorporated into New York's statutes
and to evaluate the costs associated with  the  existing  statutory  and
regulatory   requirements   which  mandate  the  current  coverages  and
services.   Therefore, the legislature  declares  that  no  bills  which
mandate  a particular benefit or service shall be considered by a stand-
ing committee until a full assessment, by the New York  state  insurance
department,  is  made  of  the  impact of the proposed mandated benefit.
Further, the legislature directs  the  superintendent  of  insurance  to
undertake  a  study of existing health insurance mandates, concentrating
on several specific aspects and possible consequences of mandated  bene-
fits and services.
  S 2. The legislative law is amended by adding a new section 68 to read
as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04065-01-9
              

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  S  68.  BILLS MANDATING HEALTH INSURANCE BENEFITS. A BILL WHICH ENACTS
OR AMENDS ANY PROVISION OF LAW MANDATING EITHER HEALTH INSURANCE  COVER-
AGE FOR SPECIFIC HEALTH SERVICES OR FOR CERTAIN PROVIDERS OF HEALTH CARE
SERVICES  AS  PART  OF  INDIVIDUAL, GROUP OR BLANKET ACCIDENT AND HEALTH
INSURANCE  POLICIES,  OR  CONTRACTS ISSUED BY HOSPITAL OR HEALTH SERVICE
CORPORATIONS SHALL, PRIOR TO CONSIDERATION BY A STANDING  COMMITTEE,  BE
REVIEWED  PURSUANT  TO SECTION TWO HUNDRED FIFTEEN OF THE INSURANCE LAW.
FOR THE PURPOSES OF THIS SECTION, A MANDATED OPTION SHALL NOT BE CONSID-
ERED A MANDATED BENEFIT.
  S 3. The insurance law is amended by adding a new section 215 to  read
as follows:
  S  215.  MANDATED  HEALTH  INSURANCE  BENEFITS.  (A)  PURSUANT TO THIS
SECTION AND SECTION SIXTY-EIGHT OF THE LEGISLATIVE LAW, IT SHALL BE  THE
DUTY  OF  THE  SUPERINTENDENT TO ASSESS THE IMPACT OF ANY BILL MANDATING
EITHER HEALTH INSURANCE COVERAGE FOR SPECIFIC  HEALTH  SERVICES  OR  FOR
CERTAIN  PROVIDERS  OF HEALTH CARE SERVICES AS PART OF INDIVIDUAL, GROUP
OR BLANKET ACCIDENT AND HEALTH INSURANCE POLICIES, OR  CONTRACTS  ISSUED
BY HOSPITAL OR HEALTH SERVICE CORPORATIONS.
  (B)  TO  CARRY  OUT  THE  PURPOSES OF THIS SECTION, THE SUPERINTENDENT
SHALL ASSESS THE IMPACT OF  THE  PROPOSED  MANDATED  BENEFIT,  INCLUDING
COSTS  TO  EMPLOYERS  AND  INSURERS, COSTS TO THE HEALTH CARE SYSTEM AND
OTHER FACTORS WHICH THE SUPERINTENDENT DEEMS  APPROPRIATE.  AS  PART  OF
SUCH  ASSESSMENT,  THE SUPERINTENDENT SHALL CONSULT WITH PERSONS WHO ARE
LIKELY TO BE AFFECTED BY THE PROPOSED MANDATE, INCLUDING REPRESENTATIVES
OF:  COMMERCIAL HEALTH INSURANCE COMPANIES, HOSPITAL AND HEALTH  SERVICE
CORPORATIONS,  SMALL  BUSINESS,  MAJOR  INDUSTRY, THE HOSPITAL INDUSTRY,
PHYSICIANS, PROVIDERS OF  SERVICES  SPECIFIED  IN  THE  BILL  AND  OTHER
PERSONS  WHOM  THE  SUPERINTENDENT  DEEMS  APPROPRIATE.  THE INFORMATION
RECEIVED FROM SUCH SOURCES SHALL BE  INCLUDED  IN  THE  SUPERINTENDENT'S
ASSESSMENT, WHICH SHALL BE FORWARDED WITHIN THIRTY DAYS OF THE INTRODUC-
TION OF THE BILL TO THE SPONSOR OF THE BILL AND THE CHAIRMAN AND RANKING
MINORITY  MEMBER  OF  THE  STANDING  COMMITTEE  TO  WHICH  THE  BILL WAS
REFERRED.  SHOULD THE SUPERINTENDENT FAIL TO REPORT BACK HIS FINDINGS TO
THE SPONSOR WITHIN THE ALLOTTED THIRTY DAYS, THE BILL  SHALL  BE  DEEMED
ACTIVE  AND CAN BE ACTED ON BY THE STANDING COMMITTEE TO WHICH SUCH BILL
WAS REFERRED.
  S 4. (a) The superintendent of insurance shall undertake  a  study  of
existing mandated health insurance benefits. The study shall include, at
a  minimum  and to the extent that information is available, the follow-
ing:
  (1) The extent to which the treatment or  service  is  utilized  by  a
significant portion of the population;
  (2)  The  extent to which the treatment or service is available to the
population;
  (3) The extent to which the mandated insurance coverage has  increased
or  decreased  the  cost  of the treatment or service over the past five
years;
  (4) The extent to which the mandated insurance coverage  has  affected
the  number  and types of providers of the mandated treatment or service
over the past five years;
  (5) The extent to which insurance coverage of the health care  service
or  provider has increased or decreased the insurance premium and admin-
istrative expenses of policyholders;
  (6) The impact of indirect costs, which are costs other than  premiums
and  administrative  costs, on the question of the costs and benefits of
coverage;

S. 1761                             3

  (7) The impact of this coverage on the total cost of health care; and
  (8) The effects on the cost of health care to employers and employees.
  (b) The superintendent of insurance shall further consider:
  (1)  The  extent to which the need for mandated benefits outweighs the
costs associated with the mandate; and
  (2) The advisability of mandating the availability of  benefits  which
are presently mandated.
  (c)  The  superintendent  of  insurance  shall forward a report of the
study to the legislature on or before December 31, 2012.
  S 5. This act shall  take  effect  on  the  first  of  September  next
succeeding  the  date  on  which it shall have become a law, except that
section four of this act shall take effect immediately.