S T A T E O F N E W Y O R K
________________________________________________________________________
7777--A
Cal. No. 1288
I N S E N A T E
May 12, 2016
___________
Introduced by Sen. SERINO -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance -- reported
favorably from said committee, ordered to first and second report,
ordered to a third reading, amended and ordered reprinted, retaining
its place in the order of third reading
AN ACT to amend the insurance law, in relation to meetings and reports
of the New York state health care quality and cost containment commis-
sion
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 213 of the insurance law, as added by section 1 of
part L of chapter 57 of the laws of 2007, is amended to read as follows:
S 213. New York state health care quality and cost containment commis-
sion. (a) There is hereby established within the department a commis-
sion, to be known as the "New York state health care quality and cost
containment commission". The commission shall consist of thirteen
members appointed by the governor, one of whom shall be the superinten-
dent, one of whom shall be the commissioner of health, and six of whom
shall be appointed on the recommendation of the legislative leaders, two
on the recommendation of the temporary president of the senate, two on
the recommendation of the speaker of the assembly, one on the recommen-
dation of the minority leader of the senate, and one on the recommenda-
tion of the minority leader of the assembly. All members shall serve at
the pleasure of the governor, and vacancies shall be appointed in the
same manner as original appointments. Members of the commission shall
serve without compensation, but shall be reimbursed for reasonable trav-
el expenses. In making appointments to the commission, the governor
shall ensure that the interests of health care consumers, small busi-
nesses, the medical community and health plans are represented on the
commission. THE COMMISSION SHALL BE REQUIRED TO MEET ON THE FIRST
MONDAY AFTER THE FIRST OF JANUARY OF EACH CALENDAR YEAR TO CONSIDER
OUTSTANDING REQUESTS OR DUTIES. ANY VACANCIES SHALL BE DEEMED WAIVED BY
THE APPOINTING AUTHORITY FOR THE PURPOSES OF THE FIRST MEETING. NOTHING
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15373-02-6
S. 7777--A 2
IN THIS SECTION SHALL FORFEIT THE RIGHT FOR AN APPOINTMENT AUTHORITY TO
FILL VACANCIES WITHIN THEIR STATUTORILY ALLOWED MEMBERS.
(b)(1) The purpose of the commission shall be to analyze the impact on
health insurance costs and quality of proposed legislation which would
mandate that health benefits be offered or made available in individual
and group health insurance policies, contracts and comprehensive health
service plans, including legislation that affects the delivery of health
benefits or services or the reimbursement of health care providers.
(2) [The] NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE governor,
the chair of the senate insurance committee and the chair of the assem-
bly insurance committee may request in writing that the commission eval-
uate a proposed mandated benefit. Upon receiving such a request, the
commission may, by a majority vote of its members, undertake an evalu-
ation of such proposed mandated benefit.
(3) In evaluating a proposed mandated benefit, the commission shall:
(A) investigate the current practices of health plans with regard to
the proposed mandated benefit, and, to the extent possible, self-funded
health benefit plans;
(B) investigate the potential premium impact of the proposed mandated
benefits on all segments of the insurance market, as well as the poten-
tial for avoided costs through early detection and treatment of condi-
tions, or more cost-effective delivery of medical services; and
(C) analyze the most current medical literature regarding the proposed
mandated benefit to determine its impact on health care quality.
(4) In evaluating a proposed mandated benefit, the commission may hold
one or more public hearings, and shall strive to obtain independent and
verifiable information from diverse sources within the healthcare indus-
try, medical community and among health care consumers with regard to
the proposed mandated benefit.
(c) To assist the commission in its duties, and upon the direction of
the commission, the superintendent is authorized to enter into one or
more contracts with independent entities and organizations with demon-
strable expertise in health care quality, finance, utilization and actu-
arial services. For the purposes of this section, the superintendent
shall not enter into contracts with health plans, entities or organiza-
tions owned or controlled by health plans, or with significant business
relationships with health plans.
(d) Upon completion of its evaluation of a proposed mandated benefit
pursuant to this section, the commission shall deliver a written report
of its findings to the chair of the assembly insurance committee and the
chair of the senate insurance committee.
(E) THE COMMISSION SHALL ISSUE A REPORT TO THE GOVERNOR, THE MAJORITY
LEADER OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, THE CHAIRS OF THE
SENATE AND ASSEMBLY INSURANCE COMMITTEES, AND THE CHAIR OF THE SENATE
TASK FORCE ON LYME AND TICK-BORNE DISEASES, CONSIDERING THE IMPACT ON
HEALTH INSURANCE COSTS AND QUALITY OF LEGISLATION REQUIRING COVERAGE OF
LONG-TERM AND CHRONIC LYME DISEASE AND OTHER TICK-BORNE DISEASES. THE
COMMISSION SHALL BE REQUIRED TO CONSIDER ISSUES INCLUDING, BUT NOT
LIMITED TO, THE SPECIFIC MEDICAL IMPACTS TO PARTICULAR GEOGRAPHIC AREAS
IN THE STATE INCLUDING THE HUDSON VALLEY AND LONG ISLAND, BEST PRACTICES
DEVELOPED FOR COVERAGE FOR LONG-TERM AND CHRONIC LYME DISEASE IN OTHER
STATES, AND THE ASSOCIATED COSTS OF MANDATED COVERAGE IN ADDITION TO
PROJECTED COSTS OF UNTREATED SYMPTOMS. THE COMMISSION SHALL DELIVER A
WRITTEN REPORT OF ITS FINDINGS BY MAY FIRST, TWO THOUSAND SEVENTEEN.
S 2. This act shall take effect immediately.
