NY State Senate Bill 2021-S7199A

Archive: Last Bill Status - Passed Senate & Assembly

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	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

- Jun 1, 2022 - Floor Vote
  S7199A
  
  50
  
  Aye
  
  13
  
  Nay
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Floor Vote: Jun 1, 2022
      
      aye (50)
      
      Addabbo Jr.
      
      Akshar
      
      Bailey
      
      Biaggi
      
      Boyle
      
      Breslin
      
      Brisport
      
      Brooks
      
      Brouk
      
      Cleare
      
      Comrie
      
      Cooney
      
      Felder
      
      Gaughran
      
      Gianaris
      
      Gounardes
      
      Harckham
      
      Hinchey
      
      Hoylman-Sigal
      
      Jackson
      
      Jordan
      
      Kaminsky
      
      Kaplan
      
      Kavanagh
      
      Kennedy
      
      Krueger
      
      Lanza
      
      Liu
      
      Mannion
      
      May
      
      Mayer
      
      Myrie
      
      Palumbo
      
      Parker
      
      Persaud
      
      Ramos
      
      Reichlin-Melnick
      
      Ritchie
      
      Rivera
      
      Ryan
      
      Salazar
      
      Sanders Jr.
      
      Savino
      
      Sepúlveda
      
      Serrano
      
      Skoufis
      
      Stavisky
      
      Stec
      
      Stewart-Cousins
      
      Thomas
      
      nay (13)
      
      Borrello
      
      Gallivan
      
      Griffo
      
      Helming
      
      Martucci
      
      Mattera
      
      O'Mara
      
      Oberacker
      
      Ortt
      
      Rath III
      
      Serino
      
      Tedisco
      
      Weik
  Jun 1, 2022 - Rules Committee Vote
  S7199A
  
  21
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Rules Committee Vote: Jun 1, 2022
      
      aye (21)
      
      Addabbo Jr.
      
      Bailey
      
      Biaggi
      
      Boyle
      
      Breslin
      
      Comrie
      
      Gallivan
      
      Gianaris
      
      Griffo
      
      Kennedy
      
      Krueger
      
      Lanza
      
      Liu
      
      Mayer
      
      O'Mara
      
      Ortt
      
      Parker
      
      Ritchie
      
      Savino
      
      Sepúlveda
      
      Stewart-Cousins
  May 31, 2022 - Rules Committee Vote
  S7199A
  
  15
  
  Aye
  
  2
  
  Nay
  
  3
  
  Aye with Reservations
  
  1
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Rules Committee Vote: May 31, 2022
      
      aye (15)
      
      Addabbo Jr.
      
      Bailey
      
      Biaggi
      
      Breslin
      
      Comrie
      
      Gallivan
      
      Gianaris
      
      Kennedy
      
      Krueger
      
      Liu
      
      Mayer
      
      Parker
      
      Savino
      
      Sepúlveda
      
      Stewart-Cousins
      
      nay (2)
      
      Boyle
      
      Ortt
      
      aye wr (3)
      
      Griffo
      
      Lanza
      
      Ritchie
      
      absent (1)
      
      O'Mara

Bill Amendments

Original

A (Active)

co-Sponsors

View additional co-sponsors

2021-S7199 - Details

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

2021-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.

2021-S7199 - Sponsor Memo

                                 
BILL NUMBER: S7199

SPONSOR: GOUNARDES
 
TITLE OF BILL:

An act to amend the insurance law and the public health law, in relation
to certain prohibited contract provisions

 
PURPOSE OR GENERAL IDEA OF BILL:

This bill, known as the Hospital Equity and Affordability Legislation
(HEAL Act), aims to improve market access and increase transparency of
health insurance contracts by banning certain anti-competitive
provisions

 
SUMMARY OF PROVISIONS:

Section one of the bill amends section 3217-b of the Insurance Law to
prohibit insurers from entering into contracts with certain anti-compet-
itive practices including:

* Requiring 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;

* Requiring an insurer to include all members of a provider system,
including medical practice groups and affiliated facilities, in its
network of participating providers;

* Restricting 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; and

* Prohibiting insurers from using benefit designs, including wellness
programs and other benefits, to encourage members to seek services from
value-based health care providers.

The bill would also prohibit the use of most-favored-nation provisions
and allow insurers to disclose price and quality information regarding
negotiated rates and other discounts with health care providers.

Section two of the bill amends section 4406 of the Public Health Law to
make the same provisions for health maintenance organizations.

Section three sets the effective date.

 
JUSTIFICATION:

In recent years, hospital consolidation has resulted in dominant systems
exercising anti-competitive market power. There have been a number of
hospital mergers and acquisitions, with big hospitals acquiring smaller
ones, along with physician practices. These hospital systems reduce
competition and have the market power to dictate price. While these
systems assert that the mergers will improve quality and reduce costs,
the data does not support that.  Instead they leverage their market
power to increase prices when they negotiate rates and contracts with
payers. And often these contracts include clauses that prohibit the
disclosure of prices.

However, the landscape is changing. In California, a group of payers
sued Sutter Health in a case that was joined by the State Attorney
General. They argued that Sutter engaged in anticompetitive practices
that drove up healthcare prices in Northern California. In March 2021, a
Superior Court of California judge granted preliminary approval for a
$575 million settlement, which also includes an agreement by Sutter
Health to end "all or nothing" contract provisions requiring payers to
contract with all Sutter hospitals if they wanted access to any Sutter
facility.

In New York, there are similar highly concentrated hospital markets.
The recent public disputes between payers and the large systems have
highlighted the need for increased transparency and visibility to the
terms and conditions of such multi-year agreements and how such agree-
ments are contributing to rising health care costs.

Large hospital systems that maintain robust provider networks are lever-
aging that market share during negotiations to restrict health insurance
networks designs and access. The result of these anti-competitive nego-
tiation tactics is increased costs charged to insurance companies and
self-insured entities, which ultimately are passed on to consumers,
through premiums and cost sharing.

Importantly, these agreements affect the networks for commercial lines
of business including HMO, PPO, individual, small group, large group,
self-insured benefit funds, the State of New York, the City of New York,
other municipalities, Medicaid, and Medicare Advantage.

Several states have enacted legislation to prevent such behavior or
pursued antitrust enforcement actions. The contract clauses that have
raised the most concern include:

* Most Favored Nation Clause: a guarantee that a buyer of goods or
services (i.e. a payer) receives terms from a seller (i.e. a hospital or
provider) that are at least as favorable as those provided to any other
buyer.

* All-or-nothing Clause: a requirement that a payer contract with all
facilities in a health system if they want to include any facilities in
the plan. Provider organizations typically use all-or-nothing provisions
to leverage the desirability of their must-have facilities to force
inclusion of lower performing facilities.

* Anti-tiering/Anti-steering Clause: a contractual requirement that a
payer place all physicians, hospitals, and other facilities associated
with a hospital system in the most favorable tier of providers (i.e.
anti-tiering) or at the lowest cost-sharing rate to avoid steering
patients away from that network (i.e. anti-steering).

* Anti-Disclosure: a contractual provision that prevents disclosure of
certain contract terms.

* Exclusive Contracting Clause: a contractual agreement in which a
provider prevents the payer from contracting with other competitive

providers. Under the umbrella of exclusive contracting are exclusive
dealing provisions and tying arrangements.

This legislation would increase transparency and prohibit certain anti-
competitive contracting behaviors that drive up the cost of healthcare
services.

 
PRIOR LEGISLATIVE HISTORY:

None

 
FISCAL IMPLICATIONS:

TBD

 
EFFECTIVE DATE:
This act shall take effect on January 1st, 2022.

2021-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

 S. 7199                             2
 
   (E) PROHIBITS INSURERS FROM USING BENEFIT DESIGNS, INCLUDING  WELLNESS
 PROGRAMS  AND OTHER BENEFITS, TO ENCOURAGE MEMBERS TO SEEK SERVICES FROM
 VALUE-BASED HEALTH CARE PROVIDERS;
   (F) CONTAINS A MOST-FAVORED-NATION PROVISION; PROVIDED, HOWEVER, NOTH-
 ING  IN THIS SECTION SHALL BE CONSTRUED TO PROHIBIT A HEALTH INSURER AND
 A PROVIDER FROM NEGOTIATING PAYMENT RATES AND PERFORMANCE-BASED CONTRACT
 TERMS THAT WOULD RESULT IN THE INSURER  RECEIVING  A  RATE  THAT  IS  AS
 FAVORABLE, OR MORE FAVORABLE, THAN THE RATES NEGOTIATED BETWEEN A HEALTH
 CARE PROVIDER AND ANOTHER ENTITY; OR
   (G)  RESTRICTS THE ABILITY OF THE INSURER TO DISCLOSE PRICE OR QUALITY
 INFORMATION,  INCLUDING  THE  ALLOWED  AMOUNT,   NEGOTIATED   RATES   OR
 DISCOUNTS,  OR  ANY OTHER CLAIM-RELATED FINANCIAL OBLIGATIONS COVERED BY
 THE PROVIDER CONTRACT TO ANY ENROLLEE, GROUP OR OTHER  ENTITY  RECEIVING
 HEALTH CARE SERVICES PURSUANT TO THE CONTRACT.
   (2)  BEGINNING  JANUARY  FIRST, TWO THOUSAND TWENTY-TWO, ANY CONTRACT,
 WRITTEN POLICY, WRITTEN PROCEDURE OR AGREEMENT THAT  CONTAINS  A  CLAUSE
 CONTRARY  TO  THE PROVISIONS SET FORTH IN THIS SECTION SHALL BE NULL AND
 VOID; PROVIDED, HOWEVER, THE REMAINING CLAUSES  OF  THE  CONTRACT  SHALL
 REMAIN IN EFFECT FOR THE DURATION OF THE CONTRACT TERM.
   §  2. Section 4406 of the public health law is amended by adding a new
 subdivision 6 to read as follows:
   6. (A) NO HEALTH MAINTENANCE ORGANIZATION THAT OFFERS A  MANAGED  CARE
 PRODUCT  OR  A COMPREHENSIVE POLICY THAT UTILIZES A NETWORK OF PROVIDERS
 SHALL ENTER INTO A CONTRACT, WRITTEN POLICY, WRITTEN PROCEDURE OR AGREE-
 MENT WITH ANY HEALTH CARE PROVIDER THAT:
   (I) 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;
   (II)  REQUIRES AN INSURER TO INCLUDE ALL MEMBERS OF A PROVIDER SYSTEM,
 INCLUDING MEDICAL PRACTICE GROUPS  AND  AFFILIATED  FACILITIES,  IN  ITS
 NETWORK OF PARTICIPATING PROVIDERS;
   (III)  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;
   (IV) 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;
   (V)  PROHIBITS INSURERS FROM USING BENEFIT DESIGNS, INCLUDING WELLNESS
 PROGRAMS AND OTHER BENEFITS, TO ENCOURAGE MEMBERS TO SEEK SERVICES  FROM
 VALUE-BASED HEALTH CARE PROVIDERS;
   (VI)  CONTAINS  A  MOST-FAVORED-NATION  PROVISION;  PROVIDED, HOWEVER,
 NOTHING IN THIS SECTION SHALL BE CONSTRUED TO PROHIBIT A HEALTH  INSURER
 AND  A  PROVIDER  FROM  NEGOTIATING  PAYMENT RATES AND PERFORMANCE-BASED
 CONTRACT TERMS THAT WOULD RESULT IN THE INSURER RECEIVING A RATE THAT IS
 AS FAVORABLE, OR MORE FAVORABLE, THAN THE  RATES  NEGOTIATED  BETWEEN  A
 HEALTH CARE PROVIDER AND ANOTHER ENTITY; OR
   (VII) RESTRICTS THE ABILITY OF THE INSURER TO DISCLOSE PRICE OR QUALI-
 TY  INFORMATION,  INCLUDING  THE  ALLOWED  AMOUNT,  NEGOTIATED  RATES OR
 DISCOUNTS, OR ANY OTHER CLAIM-RELATED FINANCIAL OBLIGATIONS  COVERED  BY
 THE  PROVIDER  CONTRACT TO ANY ENROLLEE, GROUP OR OTHER ENTITY RECEIVING
 HEALTH CARE SERVICES PURSUANT TO THE CONTRACT.

 S. 7199                             3
 
   (B) AFTER JANUARY FIRST, TWO THOUSAND TWENTY-TWO, ANY CONTRACT,  WRIT-
 TEN  POLICY,  WRITTEN  PROCEDURE  OR  AGREEMENT  THAT  CONTAINS A CLAUSE
 CONTRARY TO THE PROVISIONS SET FORTH IN THIS SECTION SHALL BE  NULL  AND
 VOID;  PROVIDED,  HOWEVER,  THE  REMAINING CLAUSES OF THE CONTRACT SHALL
 REMAIN IN EFFECT FOR THE DURATION OF THE CONTRACT TERM.
   § 3. This act shall take effect January 1, 2022.

co-Sponsors

View additional co-sponsors

2021-S7199A (ACTIVE) - Details

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

2021-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.

2021-S7199A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S7199A

SPONSOR: GOUNARDES
 
TITLE OF BILL:

An act to amend the insurance law, in relation to certain prohibited
contract provisions

 
PURPOSE OR GENERAL IDEA OF BILL:

This bill, known as the Hospital Equity and Affordability Legislation
(HEAL Act), aims to improve market access and increase transparency of
health insurance contracts by banning certain anti-competitive
provisions

 
SUMMARY OF PROVISIONS:

Section one of the bill amends section 3217-b of the Insurance Law to
prohibit insurers from entering into contracts with certain anti-compet-
itive clauses such as most-favored-nation provisions. The bill would
also allow insurers to disclose price and quality information regarding
negotiated rates and other discounts with health care providers.

Section two sets the effective date.

 
JUSTIFICATION:

In recent years, hospital consolidation has resulted in dominant systems
exercising anti-competitive market power. There have been a number of
hospital mergers and acquisitions, with big hospitals acquiring smaller
ones, along with physician practices. These hospital systems reduce
competition and have the market power to dictate price. While these
systems assert that the mergers will improve quality and reduce costs,
the data does not support that.  Instead they leverage their market
power to increase prices when they negotiate rates and contracts with
payers. And often these contracts include clauses that prohibit the
disclosure of prices.

The landscape, however, is changing. In California, a group of payers
sued Sutter Health in a case that was joined by the State Attorney
General. They argued that Sutter engaged in anticompetitive practices
that drove up healthcare prices in Northern California. In March 2021, a
Superior Court of California judge granted preliminary approval for a
$575 million settlement, which also includes an agreement by Sutter
Health to end "all or nothing" contract provisions requiring payers to
contract with all Sutter hospitals if they wanted access to any Sutter
facility.

In New York, there are similar highly concentrated hospital markets.
The recent public disputes between payers and the large systems have
highlighted the need for increased transparency and visibility to the
terms and conditions of such multi-year agreements and how such agree-
ments are contributing to rising health care costs.

Large hospital systems that maintain robust provider networks are lever-
aging that market share during negotiations to restrict health insurance
networks designs and access. The result of these anti-competitive nego-
tiation tactics is increased costs charged to insurance companies and

self-insured entities, which ultimately are passed on to consumers,
through premiums and cost sharing.

Importantly, these agreements affect the networks for commercial lines
of business including HMO, PPO, individual, small group, large group,
self-insured benefit funds, the State of New York, the City of New York,
other municipalities, Medicaid, and Medicare Advantage.

This legislation aims to increase fairness and visibility by outlawing
most favored nation clauses, which guarantee that a buyer of good or
services (i.e. a payer) receives terms from a seller (i.e. a hospital or
provider) that are at least as favorable as those provided to any other
buyer. It would also bar anti-disclosure clauses, which are contractual
provisions that prevent a party to the contract from revealing actual
claims costs, negotiated rates or discounts, or patient cost-sharing
data (protected health information would remain privileged and could not
be disclosed). This bill would apply to all health plans negotiated by
insurers, health maintenance organizations (HMOs), or third parties who
administer a health plan on behalf of another entity such as a self-in-
sured fund.

In barring these two contract practices which are widely recognized to
serve no purpose beyond the consolidation of market power and inflation
of healthcare prices, this bill will increase transparency and ensure a
fairer and more diverse healthcare marketplace for all.

 
PRIOR LEGISLATIVE HISTORY:

None

 
FISCAL IMPLICATIONS:

TBD

 
EFFECTIVE DATE:
This act shall take effect on January 1st, 2023.

2021-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

 S. 7199--A                          2
 
   (2)  FOR  PURPOSES  OF  THIS  SUBSECTION, THE TERM "HEALTH PLAN" SHALL
 INCLUDE (A) AN INSURER LICENSED PURSUANT  TO  THE  INSURANCE  LAW  OR  A
 HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR
 OF THE PUBLIC HEALTH LAW AND (B) A THIRD-PARTY ADMINISTRATOR, AFFILIATED
 WITH  AN  INSURER  OR HEALTH MAINTENANCE ORGANIZATION, WHO ADMINISTERS A
 HEALTH BENEFIT PLAN.
   § 2. This act shall take effect January 1, 2023.

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Senate Bill S7199A

Sponsored By

Archive: Last Bill Status - Passed Senate & Assembly

Jun 1, 2022 - Floor Vote

Floor Vote: Jun 1, 2022

Jun 1, 2022 - Rules Committee Vote

Rules Committee Vote: Jun 1, 2022

May 31, 2022 - Rules Committee Vote

Rules Committee Vote: May 31, 2022

Bill Amendments

co-Sponsors

2021-S7199 - Details

2021-S7199 - Summary

2021-S7199 - Sponsor Memo

2021-S7199 - Bill Text download pdf

co-Sponsors

2021-S7199A (ACTIVE) - Details

2021-S7199A (ACTIVE) - Summary

2021-S7199A (ACTIVE) - Sponsor Memo

2021-S7199A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S7199A

Share this bill

Sponsored By

Archive: Last Bill Status - Passed Senate & Assembly

Bill Amendments

co-Sponsors

2021-S7199 - Details

2021-S7199 - Summary

2021-S7199 - Sponsor Memo

2021-S7199 - Bill Text download pdf

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2021-S7199A (ACTIVE) - Details

2021-S7199A (ACTIVE) - Summary

2021-S7199A (ACTIVE) - Sponsor Memo

2021-S7199A (ACTIVE) - Bill Text download pdf

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