S T A T E O F N E W Y O R K
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10188
I N A S S E M B L Y
September 24, 2014
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Introduced by COMMITTEE ON RULES -- (at request of M. of A. Abbate) --
read once and referred to the Committee on Insurance
AN ACT to amend the public health law, in relation to prohibiting estab-
lishing quality ratings for dentists based solely on cost of services
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 206 of the public health law is amended by adding a
new subdivision 29 to read as follows:
29. THE COMMISSIONER SHALL PROMULGATE REGULATIONS, IN CONSULTATION
WITH THE NEW YORK STATE OFFICE OF THE ATTORNEY GENERAL, TO PROHIBIT
HEALTH INSURANCE ENTITIES FROM ESTABLISHING RATING SYSTEMS FOR DENTISTS
BASED SOLELY ON COST OF SERVICES. A HEALTH INSURANCE ENTITY IS ANY
ENTITY THAT IS SUBJECT TO ARTICLES FORTY-TWO, FORTY-THREE AND
FORTY-EIGHT OF THE INSURANCE LAW OR ARTICLE FORTY-FOUR OF THIS CHAPTER.
ANY QUALITY RATING SYSTEM SHALL ONLY BE BASED ON DATA THAT IS VERIFIED
FOR ACCURACY AND MADE TRANSPARENT, FAIR, AND ACCESSIBLE TO DENTISTS,
CONSUMERS, AND DISCLOSED TO THE PUBLIC. FAIR DATA SHALL MEAN DATA THAT
IS DERIVED FROM NATIONALLY RECOGNIZED EVIDENCE-BASED AND/OR
CONSENSUS-BASED CLINICAL RECOMMENDATIONS OR GUIDELINES; INCLUDES CHARAC-
TERISTICS OF THE DENTIST'S PATIENT POPULATIONS INCLUDING, BUT NOT LIMIT-
ED, CASE MIX, SEVERITY OF THE PATIENT'S CONDITION, CO-MORBIDITIES, AND
THE EXTENT TO WHICH PATIENT COMPLIANCE IS A FACTOR IN ACHIEVING A QUALI-
TY OUTCOME; AND IS SUPPORTED BY SUFFICIENT DENTAL RECORD BASED VERIFICA-
TIONS TO ASSURE DATA ACCURACY.
S 2. This act shall take effect immediately.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15785-01-4