assembly Bill A8169A

Signed By Governor
2021-2022 Legislative Session

Relates to prohibiting certain provisions in insurance contracts

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Sponsored By

Archive: Last Bill Status Via S7199 - Signed by Governor


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

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Actions

view actions (16)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Dec 09, 2022 approval memo.36
signed chap.665
Dec 02, 2022 delivered to governor
Jun 03, 2022 returned to senate
passed assembly
Jun 01, 2022 ordered to third reading rules cal.544
substituted for a8169a
Jun 01, 2022 substituted by s7199a
rules report cal.544
reported
May 31, 2022 reported referred to rules
May 27, 2022 reference changed to ways and means
May 26, 2022 print number 8169a
May 26, 2022 amend (t) and recommit to insurance
Jan 05, 2022 referred to insurance
Jul 07, 2021 referred to insurance

Votes

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Jun 1, 2022 - Rules committee Vote

S7199A
21
0
committee
21
Aye
0
Nay
0
Aye with Reservations
0
Absent
0
Excused
0
Abstained
show committee vote details

May 31, 2022 - Rules committee Vote

S7199A
15
2
committee
15
Aye
2
Nay
3
Aye with Reservations
1
Absent
0
Excused
0
Abstained
show committee vote details

Co-Sponsors

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A8169 - Details

See Senate Version of this Bill:
S7199
Law Section:
Insurance Law
Laws Affected:
Amd §3217-b, Ins L

A8169 - Summary

Prohibits certain provisions in health plan contracts including most-favored-nation provisions and restrictions on disclosure of actual claim costs, prices or quality in certain situations.

A8169 - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8169
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               July 7, 2021
                                ___________
 
 Introduced  by  M. of A. CRUZ -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the insurance law and the public health law, in relation
   to certain prohibited contract provisions
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section  1. Section 3217-b of the insurance law is amended by adding a
 new subsection (m) to read as follows:
   (M) (1) NO INSURER THAT OFFERS A MANAGED CARE PRODUCT OR A  COMPREHEN-
 SIVE  POLICY  THAT  UTILIZES  A  NETWORK OF PROVIDERS SHALL ENTER INTO A
 CONTRACT, WRITTEN POLICY, WRITTEN PROCEDURE  OR  AGREEMENT  (HEREINAFTER
 AND SOLELY FOR PURPOSES OF THIS SUBSECTION COLLECTIVELY REFERRED TO AS A
 "CONTRACT") WITH ANY HEALTH CARE PROVIDER THAT:
   (A)  REQUIRES  THE INSURER TO INCLUDE WITHIN THE SCOPE OF THE CONTRACT
 ALL COVERED GROUPS OF THE INSURER, INCLUDING  GROUPS  OR  BENEFIT  FUNDS
 THAT  CONTRACT  WITH  THE  INSURER,  OR AN AFFILIATE OF THE INSURER, FOR
 ACCESS TO THE INSURER'S NETWORK OF PARTICIPATING PROVIDERS;
   (B) REQUIRES AN INSURER TO INCLUDE ALL MEMBERS OF A  PROVIDER  SYSTEM,
 INCLUDING  MEDICAL  PRACTICE  GROUPS  AND  AFFILIATED FACILITIES, IN ITS
 NETWORK OF PARTICIPATING PROVIDERS;
   (C) REQUIRES AN INSURER, OR AN AFFILIATE OF AN INSURER, TO INCLUDE ALL
 MEMBERS OF A PROVIDER SYSTEM,  INCLUDING  MEDICAL  PRACTICE  GROUPS  AND
 AFFILIATED  FACILITIES,  IN  ALL  PRODUCTS  OFFERED BY THE INSURER OR AN
 AFFILIATE OF THE INSURER;
   (D) RESTRICTS THE ABILITY OF AN INSURER TO CREATE OR MODIFY  A  TIERED
 NETWORK  BENEFIT  PLAN  OR REQUIRES AN INSURER TO PLACE ALL MEMBERS OF A
 PROVIDER SYSTEM, INCLUDING MEDICAL PRACTICE GROUPS AND AFFILIATED FACIL-
 ITIES, IN THE SAME NETWORK TIER OR OTHERWISE  LIMITS  THE  RIGHT  OF  AN
 INSURER TO PLACE A PROVIDER IN A PARTICULAR TIER;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11774-01-1

Co-Sponsors

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A8169A (ACTIVE) - Details

See Senate Version of this Bill:
S7199
Law Section:
Insurance Law
Laws Affected:
Amd §3217-b, Ins L

A8169A (ACTIVE) - Summary

Prohibits certain provisions in health plan contracts including most-favored-nation provisions and restrictions on disclosure of actual claim costs, prices or quality in certain situations.

A8169A (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8169--A
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               July 7, 2021
                                ___________
 
 Introduced by M. of A. CRUZ, ANDERSON, SOLAGES, JACKSON, SIMON, MAMDANI,
   FERNANDEZ,   HEVESI,   DINOWITZ,   SEAWRIGHT,   SAYEGH,  J. D. RIVERA,
   WILLIAMS, JOYNER, TAPIA, BURGOS, BARNWELL, COLTON, GLICK, GONZALEZ-RO-
   JAS,   FORREST,   RAMOS,   AUBRY,   J. RIVERA,    CARROLL,    BURDICK,
   BICHOTTE HERMELYN,     EPSTEIN,    GALLAGHER,    JACOBSON,    SEPTIMO,
   DE LOS SANTOS, KIM,  JEAN-PIERRE,  DICKENS,  NIOU  --  read  once  and
   referred to the Committee on Insurance -- recommitted to the Committee
   on  Insurance  in accordance with Assembly Rule 3, sec. 2 -- committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 AN ACT to amend the insurance law, in  relation  to  certain  prohibited
   contract provisions
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 3217-b of the insurance law is amended by adding  a
 new subsection (o) to read as follows:
   (O) (1) NO CONTRACT OR AGREEMENT BETWEEN A HEALTH PLAN SUBJECT TO THIS
 ARTICLE  AND  A  HEALTH CARE PROVIDER,   OTHER THAN A RESIDENTIAL HEALTH
 CARE FACILITY AS DEFINED BY SECTION TWO THOUSAND EIGHT  HUNDRED  ONE  OF
 THE PUBLIC HEALTH LAW, SHALL INCLUDE A PROVISION THAT:
   (A) CONTAINS A MOST-FAVORED-NATION PROVISION; OR
   (B)  RESTRICTS  THE ABILITY OF A HEALTH PLAN, AN ENTITY THAT CONTRACTS
 WITH A HEALTH PLAN FOR A PROVIDER NETWORK, OR A HEALTH CARE PROVIDER  TO
 DISCLOSE  (I)  ACTUAL  CLAIMS COSTS OR (II) PRICE OR QUALITY INFORMATION
 REQUIRED TO BE  DISCLOSED  UNDER  FEDERAL  LAW,  INCLUDING  THE  ALLOWED
 AMOUNT, NEGOTIATED RATES OR DISCOUNTS, OR ANY OTHER CLAIM-RELATED FINAN-
 CIAL  OBLIGATIONS,  INCLUDING,  BUT NOT LIMITED TO, PATIENT COST-SHARING
 COVERED BY THE PROVIDER CONTRACT TO ANY INSURED, GROUP OR  OTHER  ENTITY
 RECEIVING  HEALTH  CARE  SERVICES  PURSUANT  TO  THE CONTRACT, OR TO ANY
 PUBLIC COMPILATION OF REIMBURSEMENT DATA SUCH AS THE NEW YORK ALL  PAYER
 DATABASE  REQUIRED  BY  LAW  OR  REGULATION, PROVIDED THAT NO DISCLOSURE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11774-09-2