senate Bill S7199A

2021-2022 Legislative Session

Relates to prohibiting certain provisions in insurance contracts

download bill text pdf

Sponsored By

Current Bill Status - Passed Senate & Assembly


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

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Actions

view actions (13)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jun 03, 2022 returned to senate
passed assembly
Jun 01, 2022 ordered to third reading rules cal.544
substituted for a8169a
referred to ways and means
delivered to assembly
passed senate
May 31, 2022 ordered to third reading cal.1649
committee discharged and committed to rules
May 25, 2022 print number 7199a
May 25, 2022 amend (t) and recommit to insurance
Jan 05, 2022 referred to insurance
Jun 07, 2021 referred to rules

Votes

view votes

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 Rules 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 Rules committee vote details

Rules Committee Vote: May 31, 2022

nay (2)
aye wr (3)
absent (1)

Co-Sponsors

view additional co-sponsors

S7199 - Details

See Assembly Version of this Bill:
A8169
Law Section:
Insurance Law
Laws Affected:
Amd §3217-b, Ins L

S7199 - 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.

S7199 - Sponsor Memo

S7199 - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7199
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                               June 7, 2021
                                ___________
 
 Introduced by Sen. GOUNARDES -- read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 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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S7199A (ACTIVE) - Details

See Assembly Version of this Bill:
A8169
Law Section:
Insurance Law
Laws Affected:
Amd §3217-b, Ins L

S7199A (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.

S7199A (ACTIVE) - Sponsor Memo

S7199A (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7199--A
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                               June 7, 2021
                                ___________
 
 Introduced  by  Sens.  GOUNARDES, BAILEY, BIAGGI, BROUK, CLEARE, COMRIE,
   HINCHEY, HOYLMAN,  JACKSON,  KAVANAGH,  KRUEGER,  LIU,  MAYER,  MYRIE,
   RAMOS,  REICHLIN-MELNICK, RIVERA, SALAZAR, SAVINO, SEPULVEDA, SKOUFIS,
   STAVISKY -- read twice and ordered printed, and  when  printed  to  be
   committed to the Committee on Rules -- recommitted to the Committee on
   Insurance  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 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
 SHALL INCLUDE PROTECTED HEALTH INFORMATION OR OTHER INFORMATION  COVERED
 BY STATUTORY OR OTHER PRIVILEGE.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11774-08-2

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