senate Bill S4970B

2013-2014 Legislative Session

Requires health care plans and insurers to provide expedited review of applications of health care professionals who are joining a group practice

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

do you support this legislation?

You must fill out the form below in order to support or oppose this bill. X

You must login or fill out the fields below for the senator to have an accurate account of the support or opposition to this bill.

Your valid home address is used to determine which NY State Senator Represents you.
Create an account. An account allows you to officially support or oppose key legislation, sign petitions with a single click, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.
Use this box to enter a message to your senator.

Actions

view actions (6)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
May 06, 2014 print number 4970b
amend and recommit to health
Feb 21, 2014 print number 4970a
amend and recommit to health
Jan 08, 2014 referred to health
May 02, 2013 referred to health

S4970 - Details

See Assembly Version of this Bill:
A6426B
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Amd §4406-d, Pub Health L; amd §4803, Ins L

S4970 - Summary

Requires health care plans and insurers to provide expedited review of applications of health care professionals who are joining a group practice and grant provisional credentials to such professionals; provides that health care professionals who have received credentials and change the address of or add locations to the practice need only notify the health care plan or insurer of such change or addition.

S4970 - Sponsor Memo

S4970 - Bill Text download pdf

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

                                  4970

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               May 2, 2013
                               ___________

Introduced  by  Sen.  LANZA  -- 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 requiring health care  plans  and  insurers  to  provide  expedited
  review  of applications of health care professionals who are joining a
  group practice and grant provisional credentials to such professionals

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

  Section  1.  Subdivision 1 of section 4406-d of the public health law,
as amended by chapter 237 of the laws of 2009, is  amended  to  read  as
follows:
  1.  (a)  A  health  care  plan shall, upon request, make available and
disclose to health care professionals written application procedures and
minimum qualification requirements which a health care professional must
meet in order to be considered by the health care plan. The  plan  shall
consult with appropriately qualified health care professionals in devel-
oping  its qualification requirements. A health care plan shall complete
review of the health care professional's application to  participate  in
the  in-network  portion  of  the  health care plan's network and shall,
within ninety days of receiving a health care  professional's  completed
application to participate in the health care plan's network, notify the
health  care  professional as to: (i) whether he or she is credentialed;
or (ii) whether additional time is necessary to make a determination  in
spite  of the health care plan's best efforts or because of a failure of
a third party to provide  necessary  documentation,  or  non-routine  or
unusual  circumstances  require  additional  time  for  review.  In such
instances where additional time is necessary because of a lack of neces-
sary documentation, a health plan shall make every effort to obtain such
information as soon as possible. PROVIDED, HOWEVER, THAT IF  THE  APPLI-
CANT  IS  A  HEALTH CARE PROFESSIONAL WHO IS JOINING A GROUP PRACTICE OF
HEALTH CARE PROFESSIONALS, AT LEAST ONE  OF  WHOM  PARTICIPATES  IN  THE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09628-01-3

S4970A - Details

See Assembly Version of this Bill:
A6426B
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Amd §4406-d, Pub Health L; amd §4803, Ins L

S4970A - Summary

Requires health care plans and insurers to provide expedited review of applications of health care professionals who are joining a group practice and grant provisional credentials to such professionals; provides that health care professionals who have received credentials and change the address of or add locations to the practice need only notify the health care plan or insurer of such change or addition.

S4970A - Sponsor Memo

S4970A - Bill Text download pdf

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

                                 4970--A

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               May 2, 2013
                               ___________

Introduced  by  Sen.  LANZA  -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health --  recommitted  to
  the  Committee  on  Health in accordance with Senate Rule 6, sec. 8 --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted to said committee

AN ACT to amend the public health law and the insurance law, in relation
  to  requiring  health  care  plans  and  insurers to provide expedited
  review of applications of health care professionals who are joining  a
  group practice and grant provisional credentials to such professionals

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

  Section 1.  Subdivision 1 of section 4406-d of the public health  law,
as  amended  by  chapter  237 of the laws of 2009, is amended to read as
follows:
  1. (a) A health care plan shall,  upon  request,  make  available  and
disclose to health care professionals written application procedures and
minimum qualification requirements which a health care professional must
meet  in  order to be considered by the health care plan. The plan shall
consult with appropriately qualified health care professionals in devel-
oping its qualification requirements. A health care plan shall  complete
review  of  the health care professional's application to participate in
the in-network portion of the health  care  plan's  network  and  shall,
within  ninety  days of receiving a health care professional's completed
application to participate in the health care plan's network, notify the
health care professional as to: (i) whether he or she  is  credentialed;
or  (ii) whether additional time is necessary to make a determination in
spite of the health care plan's best efforts or because of a failure  of
a  third  party  to  provide  necessary documentation, or non-routine or
unusual circumstances  require  additional  time  for  review.  In  such
instances where additional time is necessary because of a lack of neces-
sary documentation, a health plan shall make every effort to obtain such

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09628-03-4

S4970B (ACTIVE) - Details

See Assembly Version of this Bill:
A6426B
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Amd §4406-d, Pub Health L; amd §4803, Ins L

S4970B (ACTIVE) - Summary

Requires health care plans and insurers to provide expedited review of applications of health care professionals who are joining a group practice and grant provisional credentials to such professionals; provides that health care professionals who have received credentials and change the address of or add locations to the practice need only notify the health care plan or insurer of such change or addition.

S4970B (ACTIVE) - Sponsor Memo

S4970B (ACTIVE) - Bill Text download pdf

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

                                 4970--B

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               May 2, 2013
                               ___________

Introduced  by  Sen.  LANZA  -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health --  recommitted  to
  the  Committee  on  Health in accordance with Senate Rule 6, sec. 8 --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted  to  said committee -- committee discharged, bill amended,
  ordered reprinted as amended and recommitted to said committee

AN ACT to amend the public health law and the insurance law, in relation
  to requiring health care  plans  and  insurers  to  provide  expedited
  review  of applications of health care professionals who are joining a
  group practice and grant provisional credentials to such professionals

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

  Section  1.  Subdivision 1 of section 4406-d of the public health law,
as amended by chapter 237 of the laws of 2009, is  amended  to  read  as
follows:
  1.  (a)  A  health  care  plan shall, upon request, make available and
disclose to health care professionals written application procedures and
minimum qualification requirements which a health care professional must
meet in order to be considered by the health care plan. The  plan  shall
consult with appropriately qualified health care professionals in devel-
oping  its qualification requirements. A health care plan shall complete
review of the health care professional's application to  participate  in
the  in-network  portion  of  the  health care plan's network and shall,
within ninety days of receiving a health care  professional's  completed
application to participate in the health care plan's network, notify the
health  care  professional as to: (i) whether he or she is credentialed;
or (ii) whether additional time is necessary to make a determination  in
spite  of the health care plan's best efforts or because of a failure of
a third party to provide  necessary  documentation,  or  non-routine  or
unusual  circumstances  require  additional  time  for  review.  In such
instances where additional time is necessary because of a lack of neces-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09628-05-4

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.