BILL NUMBER: S6801

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend chapter 451 of the laws of 2007 amending the public
health law, the social services law and the insurance law, relating to
providing enhanced consumer and provider protections, in relation to the
effectiveness thereof

 
PURPOSE OR GENERAL IDEA OF BILL:

To maintain existing consumer protections that makes consumers aware of
changes to network coverage under their health plan.

 
SUMMARY OF SPECIFIC PROVISIONS:

This bill would extend the sunset provisions of chapter 451 of the laws
of 2007 for an additional two years, to expire June 30, 2023.

These provisions require that if a contract between a plan and a hospi-
              

tal is not renewed or is terminated by either party, the parties contin-
ue to abide by the terms of the contract, including reimbursement terms
for a period of two months from the termination or end of the contract
period. The provisions require that notice be provided to enrollees
within 15 days of the commencement of the two-month period. However,
these requirements do not apply where both parties agree to the termi-
nation or non-renewal and the insurer provides notice to the insured at
least 30 days in advance of the date of contract termination. It also
allows the Department of Health to waive the two month extension if the
contract is being terminated for cause.

 
JUSTIFICATION:

This bill would maintain current protections for consumers when a
contract is terminated between the health care provider and their health
plan. By requiring health plans and hospitals to continue to abide by
the terms of the contract for a period of two months from the termi-
nation or end of the contract period, consumers will not be unduly
surprised or alarmed and will have time to adequately prepare for this
transition.

 
PRIOR LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
Immediately.