| Date of Action |
Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|---|---|
| May 02, 2012 |
referred to insurance |
Senate Bill S7336
2011-2012 Legislative Session
Sponsored By
(R, C, IP, RFM) Senate District
Archive: Last Bill Status - In Senate Committee Insurance Committee
Actions
2011-S7336 (ACTIVE) - Details
- See Assembly Version of this Bill:
- A5226
- Current Committee:
- Senate Insurance
- Law Section:
- Insurance Law
- Laws Affected:
- Amd §3217-b, Ins L; amd §4406-c, Pub Health L
- Versions Introduced in 2013-2014 Legislative Session:
-
S4476, A67
2011-S7336 (ACTIVE) - Summary
No insurer or health care plan shall by contract, written policy or written procedure require the maintenance of hospital privileges by any non-hospital employee health care provider as a condition of entering into or maintaining a contract, agreement of membership or acceptance into a health care plan or health maintenance organization's provider network; provides that no insurer or health care plan can prohibit or restrict any health care provider from referring an insured to another physician based solely upon the referred physician's lack of affiliation and/or lack of hospital privileges.
2011-S7336 (ACTIVE) - Sponsor Memo
BILL NUMBER:S7336
TITLE OF BILL:
An act to amend the insurance law and the public health law, in
relation to restricting limitations on non-affiliated physicians from
becoming a network provider of any health care plan or health
maintenance organization
PURPOSE:
To allow non-affiliated physicians the opportunity to be part of a
health insurer's provider network in order to coordinate patient care
and help control the spiraling cost of medical care.
SUMMARY OF PROVISIONS:
Amends section 3217-b of the insurance law and section 4406-c of the
public health law to prohibit a health insurer from requiring a
physician to be affiliated with and/or maintain hospital privileges as
a condition of entering into or remaining in the provider network.
Also prohibits a health insurer from restricting a physician's ability
to refer a patient to another physician based solely on the referred
physician's lack of affiliation with a hospital.
JUSTIFICATION:
The contractual agreements that exist between insurance companies and
hospitals creates an environment that restricts community based
physicians from entering into network provider agreements unless they
2011-S7336 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
7336
I N S E N A T E
May 2, 2012
___________
Introduced by Sen. SEWARD -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law and the public health law, in relation
to restricting limitations on non-affiliated physicians from becoming
a network provider of any health care plan or health maintenance
organization
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 3217-b of the insurance law is amended by adding a
new subsection (j) to read as follows:
(J) (1) NO INSURER SUBJECT TO THIS ARTICLE SHALL BY CONTRACT, WRITTEN
POLICY OR WRITTEN PROCEDURE REQUIRE THE AFFILIATION AND/OR REQUIRE THE
MAINTENANCE OF HOSPITAL PRIVILEGES BY ANY NON-HOSPITAL EMPLOYEE HEALTH
CARE PROVIDER AS A CONDITION OF ENTERING INTO AND/OR MAINTAINING A
CONTRACT, AGREEMENT OF MEMBERSHIP OR ACCEPTANCE INTO A HEALTH CARE PLAN
OR HEALTH MAINTENANCE ORGANIZATION'S PROVIDER NETWORK.
(2) NO INSURER SUBJECT TO THIS ARTICLE SHALL BY CONTRACT, WRITTEN
POLICY OR WRITTEN PROCEDURE PROHIBIT OR RESTRICT ANY HEALTH CARE PROVID-
ER FROM REFERRING AN INSURED TO ANOTHER PHYSICIAN BASED SOLELY UPON THE
REFERRED PHYSICIAN'S LACK OF AFFILIATION AND/OR LACK OF HOSPITAL PRIVI-
LEGES; PROVIDED THAT THE REFERRED PHYSICIAN IS LICENSED TO PRACTICE
UNDER APPLICABLE STATE LAW.
S 2. Subdivision 7 of section 4406-c of the public health law, as
renumbered by section 487 of the laws of 2010, is renumbered subdivision
9 and a new subdivision 8 is added to read as follows:
8. (A) NO HEALTH CARE PLAN SHALL BY CONTRACT, WRITTEN POLICY OR WRIT-
TEN PROCEDURE REQUIRE THE AFFILIATION AND/OR REQUIRE THE MAINTENANCE OF
HOSPITAL PRIVILEGES BY ANY NON-HOSPITAL EMPLOYEE HEALTH CARE PROVIDER AS
A CONDITION OF ENTERING INTO AND/OR MAINTAINING A CONTRACT, AGREEMENT OF
MEMBERSHIP OR ACCEPTANCE INTO A HEALTH CARE PLAN OR HEALTH MAINTENANCE
ORGANIZATION'S PROVIDER NETWORK.
(B) NO HEALTH CARE PLAN SHALL BY CONTRACT, WRITTEN POLICY OR WRITTEN
PROCEDURE PROHIBIT OR RESTRICT ANY HEALTH CARE PROVIDER FROM REFERRING
AN INSURED TO ANOTHER PHYSICIAN BASED SOLELY UPON THE REFERRED PHYSI-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
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