Bill Text: NY A03688 | 2009-2010 | General Assembly | Introduced
Bill Title: An act to amend the public health law and the insurance law, in relation to altering the terms of a health care plan
Spectrum: Moderate Partisan Bill (Democrat 35-5)
Status: (Introduced - Dead) 2009-01-28 - referred to insurance [A03688 Detail]
Download: New_York-2009-A03688-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
3688
2009-2010 Regular Sessions
I N A S S E M B L Y
January 28, 2009
___________
Introduced by M. of A. BRADLEY, JACOBS, FIELDS, GUNTHER, GALEF, BENEDET-
TO, CLARK, MAGNARELLI, TITONE, ALESSI, KOON, PHEFFER, LANCMAN --
Multi-Sponsored by -- M. of A. BING, BOYLAND, CHRISTENSEN, COLTON,
DelMONTE, GLICK, GOTTFRIED, HYER-SPENCER, JOHN, LATIMER, MAISEL,
MAYERSOHN, McENENY, PERRY, SCHIMEL, SWEENEY, WEISENBERG -- read once
and referred to the Committee on Insurance
AN ACT to amend the public health law and the insurance law, in relation
to altering the terms of a health care plan
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Section 4406-c of the public health law is amended by
2 adding a new subdivision 5-d to read as follows:
3 5-D. A PROVIDER OF A HEALTH CARE PLAN MAY NOT DURING THE TERM OF A
4 CONTRACT WITH A HEALTH CARE PROVIDER IMPLEMENT POLICIES AND PROCEDURES
5 THAT RESULT IN A MATERIAL ADVERSE CHANGE TO SUCH HEALTH CARE PROVIDER.
6 FOR THE PURPOSES OF THIS SECTION, A "MATERIAL ADVERSE CHANGE" SHALL MEAN
7 ANY CHANGE IN A HEALTH CARE PLAN'S POLICIES THAT COULD REASONABLY BE
8 EXPECTED TO HAVE A MATERIAL ADVERSE IMPACT ON:
9 (A) THE LEVEL OF REIMBURSEMENT BY A HEALTH CARE PLAN TO A CONTRACTING
10 HEALTH CARE PROVIDER; OR
11 (B) THE ADMINISTRATION OF A CONTRACTING HEALTH CARE PROVIDER'S PRAC-
12 TICE.
13 S 2. Section 3217-b of the insurance law is amended by adding a new
14 subsection (f-1) to read as follows:
15 (F-1) AN INSURER MAY NOT DURING THE TERM OF A CONTRACT WITH A HEALTH
16 CARE PROVIDER IMPLEMENT POLICIES AND PROCEDURES THAT RESULT IN A MATERI-
17 AL ADVERSE CHANGE TO SUCH HEALTH CARE PROVIDER. FOR THE PURPOSES OF THIS
18 SECTION, A "MATERIAL ADVERSE CHANGE" SHALL MEAN ANY CHANGE IN AN INSUR-
19 ER'S POLICIES THAT COULD REASONABLY BE EXPECTED TO HAVE A MATERIAL
20 ADVERSE IMPACT ON:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03360-01-9
A. 3688 2
1 (1) THE LEVEL OF REIMBURSEMENT BY AN INSURER TO A CONTRACTING HEALTH
2 CARE PROVIDER; OR
3 (2) THE ADMINISTRATION OF A CONTRACTING HEALTH CARE PROVIDER'S PRAC-
4 TICE.
5 S 3. Section 4325 of the insurance law is amended by adding a new
6 subsection (f-1) to read as follows:
7 (F-1) AN INSURER MAY NOT DURING THE TERM OF A CONTRACT WITH A HEALTH
8 CARE PROVIDER IMPLEMENT POLICIES AND PROCEDURES THAT RESULT IN A MATERI-
9 AL ADVERSE CHANGE TO SUCH HEALTH CARE PROFESSIONAL. FOR THE PURPOSES OF
10 THIS SECTION, A "MATERIAL ADVERSE CHANGE" SHALL MEAN ANY CHANGE IN AN
11 INSURER'S POLICIES THAT COULD REASONABLY BE EXPECTED TO HAVE A MATERIAL
12 ADVERSE IMPACT ON:
13 (1) THE LEVEL OF REIMBURSEMENT BY AN INSURER TO A CONTRACTING HEALTH
14 CARE PROVIDER; OR
15 (2) THE ADMINISTRATION OF A CONTRACTING HEALTH CARE PROVIDER'S PRAC-
16 TICE.
17 S 4. This act shall take effect on the ninetieth day after it shall
18 have become a law.
