What's happening
This bill prohibits child health insurance plan organizations from limiting provider participation based on their involvement in commercial health care networks.
Why it matters
Expands provider access for children. by ensuring that doctors and other health providers can participate in the Child Health Insurance Plan (CHIP) even if they are not part of the insurer’s commercial (private) health network, potentially increasing the number and diversity of providers available to children.
Reduces insurer control over provider choice. , preventing insurers from using participation in their commercial plans as leverage to exclude or pressure providers, which could help protect smaller practices or specialists who focus on public health insurance populations.
Could improve continuity of care. for children with complex health needs who might see specialists not in commercial networks, by allowing those providers to join the CHIP network without broader contractual obligations.
May foster greater fairness in network contracting. , addressing concerns that large insurers can use their market power to dictate terms to providers, which could ultimately help maintain a broader safety net for vulnerable children.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Headline styles
Stop Provider Network Discrimination
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Stop Insurance Provider Discrimination
In Senate Committee · Health · Sponsor J. Gary Pretlow
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8744
IN SENATE
May 10, 2018
Introduced by Sen. SEPULVEDA -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the public health law, in relation to prohibiting approved organizations in the child health insurance plan from limiting the participation of certain health care providers
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 7 of section 2511 of the public health law is amended by adding a new paragraph (d) to read as follows:
(d) No approved organization shall prohibit or in any way limit the provision of covered health care services by a health care provider on the grounds that such provider chooses not to participate in a health care network maintained by such approved organization to serve commercial insureds, enrollees or subscribers.
§ 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD08692-01-7
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to prohibiting approved organizations in the child health insurance plan from limiting the participation of certain health care providers
Purpose or general idea
This bill would prohibit insurance companies that administer the Child Health Plus program from requiring that participating health care providers also sign up for the commercial health care network operated by the insurer.
Summary of specific provisions
This bill would add a new paragraph (d) to subdivision 7 of section 2511 of the Public Health Law to prohibit an approved organization adminis- tering the Child Health Plus program from denying or limiting the provision of health care services by a provider on the grounds that the provider refuses to participate in a commercial health care network maintained by the organization.
Justification
Child Health Plus is a publicly funded insurance assistance program intended to meet the health needs of children who have limited or no health insurance. The program is administered by insurance companies which may also include commercial health maintenance organization (HMO) programs.
Some insurance companies that administer Child Health Plus are using the state-funded Child Health Plus program as bait for their commercial, profit-making activities. These companies are forcing health care providers who want to serve uninsured children through the Child Health Plus program to participate in the insurer's commercial HMO.
Doctors who refuse to join the commercial HMO are denied the opportunity to provide state-funded health care to uninsured children. This bill would prohibit the discriminatory practice by health insurance compa- nies. Under the bill, doctors who want to serve uninsured children through the Child Health Plus program would be able to do so without being forced to participate in a commercial HMO. As a result, families of uninsured children would have better access to health care through a greater choice of pediatricians and other health care providers.
Legislative history
01/30/13 referred to health 01/08/14 referred to health 04/07/14 reported 04/24/14 advanced to third reading cal.560 04/28/14 passed assembly 04/28/14 delivered to senate 04/28/14 REFERRED TO HEALTH 01/20/15 A2918 referred to health 04/22/15 A2918 reported 04/23/15 A2918 advanced to third reading cal.188 01/06/16 A2918 referred to health 02/02/16 A2918 reported 02/04/16 A2918 advanced to third reading cal.365
Fiscal implications
None.
Effective date
This act shall take effect immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.