Senate Bill S3675

2011-2012 Legislative Session

Prohibits health care plans and health insurers from requiring health care providers to accept products offered by such plan or insurer

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 04, 2012	referred to health
Mar 02, 2011	referred to health

co-Sponsors

2011-S3675 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §4406-c, Pub Heath L; amd §3217-b & 4325, Ins L

2011-S3675 (ACTIVE) - Summary

Prohibits health care plans and health insurers from requiring any health care provider to accept any or all products offered by such plan or insurer; further prohibits the reduction of the rate of reimbursement to any health care provider refusing the products of such plan or insurer.

2011-S3675 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S3675

TITLE OF BILL:
An act
to amend the public health law and the insurance law, in relation to
provisions requiring health care providers to accept the products of a
health care plan or insurer

PURPOSE:
To prohibit the use of "all products" clauses which mandate
the acceptance of all types of insurance products, even those which
the physician believes are inferior and may not serve to protect the
patient's health.

SUMMARY OF PROVISIONS:
Section 1 would amend section 4406-c of the
Public Health Law to prohibit the use of" all products" clauses which
mandate the acceptance of all types of Insurance products, even those
which the physician believes are inferior and may not serve to
protect the patient's health.

Sections 2 and 3 make the same changes to sections 32l7-b and 4325
of the Insurance Law.

EXISTING LAW:
There are currently no provisions of law which would accommodate the

stated purpose of this bill.

JUSTIFICATION:
"All-products" clauses may be used by the HMO industry
to gain leverage over physicians and their patients in the
contracting arena. Just as Virginia, Maryland and Kentucky have done,
this bill would ban the inappropriate use of "all-products" clauses.
Some HMOs and other insurers now require physicians to sign
"all-products" clauses in their contracts for participation. This
means that if a physician agrees to see patients in one of the plan's
products lines, she or he must agree to accept patients from all of
the plan's products lines, regardless of his or her belief that one
or some products are not adequate. This practice is similar to
contracts of adhesion and can lead to the movement of patients into
lower quality health care settings. Once an insurance plan has
secured enough "all-products" signatories, it may then begin to drive
patients, through marketing, pricing and enrollment strategies, to
those plans that have fewer benefits for the patients and lower
rates of reimbursement to the heal care providers. These contract
provisions also can allow plans to quickly establish new product
lines, despite concerns regarding their adequacy because they do not
have to go into the market and induce physicians
and other health care providers to sign on to the new product.
Questions and decisions of what, if
any, products lines a physician may accept should be determined by
negotiation between the physician and the plan - not by a provision
in a different, unrelated contact.

LEGISLATIVE HISTORY:


S.4934 of 2007-2008; S.4613 of 2005-2006; S.2919 of 2003-2004;
S.6330 of 2001-2002

FISCAL IMPLICATIONS:
To be determined.

EFFECTIVE DATE:
Immediately and shall apply to any contract issued, renewed,
modified or amended on or after such date, with provisions.

2011-S3675 (ACTIVE) - Bill Text download pdf

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

                                  3675

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                              March 2, 2011
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law and the insurance law, in relation
  to provisions requiring health care providers to accept  the  products
  of a health care plan or insurer

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

  Section 1. Section 4406-c of the  public  health  law  is  amended  by
adding a new subdivision 5-e to read as follows:
  5-E.  NO CONTRACT OR AGREEMENT BETWEEN A HEALTH CARE PLAN AND A HEALTH
CARE PROVIDER SHALL  CONTAIN  ANY  CLAUSE  REQUIRING  SUCH  HEALTH  CARE
PROVIDER TO ACCEPT ANY OR ALL PRODUCTS OFFERED BY SUCH HEALTH CARE PLAN.
NOR  SHALL  ANY SUCH CONTRACT OR AGREEMENT CREATE OR INCLUDE A DIFFEREN-
TIATED REIMBURSEMENT SCHEDULE,  PLAN  OR  POLICY  CONTINGENT  UPON  SUCH
HEALTH  CARE  PROVIDER'S  CONDITION  OF  ACCEPTING  OR NOT ACCEPTING ALL
PRODUCTS OFFERED BY THE HEALTH CARE PLAN.
  S 2. Subsections (h) and (i) of section 3217-b of the  insurance  law,
as  relettered  by  chapter  237  of  the  laws  of 2009, are relettered
subsections (i) and (j) and a new subsection (h) is  added  to  read  as
follows:
  (H)  NO  CONTRACT  OR  AGREEMENT  BETWEEN AN INSURER AND A HEALTH CARE
PROVIDER SHALL CONTAIN ANY CLAUSE REQUIRING SUCH HEALTH CARE PROVIDER TO
ACCEPT ANY OR ALL PRODUCTS OFFERED BY SUCH INSURER. NOR SHALL  ANY  SUCH
CONTRACT  OR  AGREEMENT CREATE OR INCLUDE A DIFFERENTIATED REIMBURSEMENT
SCHEDULE, PLAN OR POLICY CONTINGENT UPON  SUCH  HEALTH  CARE  PROVIDER'S
CONDITION  OF  ACCEPTING  OR  NOT  ACCEPTING ALL PRODUCTS OFFERED BY THE
INSURER.
  S 3. Subsections (i) and (j) of section 4325 of the insurance law,  as
relettered   by  chapter  487  of  the  laws  of  2010,  are  relettered
subsections (j) and (k) and a new subsection (i) is  added  to  read  as
follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09774-01-1

S. 3675                             2

  (I)  NO  CONTRACT  OR  AGREEMENT BETWEEN A CORPORATION ORGANIZED UNDER
THIS ARTICLE AND A HEALTH CARE PROVIDER SHALL CONTAIN ANY CLAUSE REQUIR-
ING SUCH HEALTH CARE PROVIDER TO ACCEPT ANY OR ALL PRODUCTS  OFFERED  BY
SUCH  CORPORATION.  NOR  SHALL  ANY SUCH CONTRACT OR AGREEMENT CREATE OR
INCLUDE  A DIFFERENTIATED REIMBURSEMENT SCHEDULE, PLAN OR POLICY CONTIN-
GENT UPON SUCH HEALTH CARE PROVIDER'S  CONDITION  OF  ACCEPTING  OR  NOT
ACCEPTING ALL PRODUCTS OFFERED BY THE CORPORATION.
  S  4.  This  act  shall take effect immediately and shall apply to any
contract issued, renewed, modified or amended on  or  after  such  date;
provided,  however,  that  the  relettering of subsection (i) of section
3217-b of the insurance law and subsection (j) of section  4325  of  the
insurance  law made by sections two and three of this act, respectively,
shall not affect the repeal of such subsections and shall be  deemed  to
be repealed therewith.

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Senate Bill S3675

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Archive: Last Bill Status - In Senate Committee Health Committee

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co-Sponsors

2011-S3675 (ACTIVE) - Details

2011-S3675 (ACTIVE) - Summary

2011-S3675 (ACTIVE) - Sponsor Memo

2011-S3675 (ACTIVE) - Bill Text download pdf

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Sponsored By

Kemp Hannon

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

co-Sponsors

Suzi Oppenheimer

Michael H. Ranzenhofer

2011-S3675 (ACTIVE) - Details

2011-S3675 (ACTIVE) - Summary

2011-S3675 (ACTIVE) - Sponsor Memo

2011-S3675 (ACTIVE) - Bill Text download pdf

Comments