What's happening
This bill updates requirements for physician profile information, shifting some reporting duties away from physicians and allowing designated agents to update profiles.
Why it matters
Reduces administrative burden on physicians. by shifting the responsibility for reporting health care plan affiliations from individual doctors to the Department of Health, which will gather this information from provider networks and health plans directly.
Allows physicians to designate authorized agents. (such as staff or contracted personnel within their practice) to update and manage their profile information, increasing flexibility in how practices handle regulatory requirements.
Maintains physician accountability. by requiring that, even when a designee updates the profile, the physician remains ultimately responsible for the accuracy of the information and any errors or omissions.
Directs the Department of Health to set safeguards. for managing designee access, including prompt granting and removal of access and mechanisms to prevent former designees from accessing sensitive physician profile data after authorization is revoked, which enhances data security and privacy.
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Who cares
Headline styles
Health Plans Report Doctor Networks
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to health
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1789
2019-2020 Regular Sessions
IN SENATE
January 16, 2019
Introduced by Sen. RIVERA -- 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 submission of information to the department of health for physician profiles
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Paragraph (q) of subdivision 1 of section 2995-a of the public health law, as added by chapter 542 of the laws of 2000, is amended to read as follows:
(q) health care plans with which the licensee has contracts, employment, or other affiliation; provided that the reporting of such information shall not be the responsibility of the physician, but shall be included and updated by the department utilizing provider network participation information, or other reliable sources of information submitted by health care plans.
§ 2. Subdivision 4 of section 2995-a of the public health law, as amended by section 3 of part A of chapter 57 of the laws of 2015, is amended to read as follows:
4. Each physician shall periodically report to the department on forms and in the time and manner required by the commissioner any other information as is required by the department for the development of profiles under this section which is not otherwise reasonably obtainable. In addition to such periodic reports and providing the same information, each physician shall update his or her profile information within the six months prior to the [expiration date of such physician's registration period] submission of the re-registration application, as a condition of registration renewal under article one hundred thirty-one of the education law. Except for optional information provided, physicians shall notify the department of any change in the profile information within thirty days of such change.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07750-01-9
S. 1789 2
§ 3. Subdivision 6 of section 2995-a of the public health law, as added by chapter 542 of the laws of 2000, is amended to read as follows:
6. A physician may elect to have his or her profile omit certain information provided pursuant to paragraphs (l), (m)[,] and (n) [and (q)] of subdivision one of this section. In collecting information for such profiles and disseminating the same, the department shall inform physicians that they may choose not to provide such information required pursuant to paragraphs (l), (m)[,] and (n) [and (q)] of subdivision one of this section.
§ 4. Section 2995-a of the public health law is amended by adding a new subdivision 7-a to read as follows:
7-a. For purposes of this section, a physician may authorize a designee to register, transmit, enter or update information on his or her behalf, provided that:
(a) the designee so authorized is employed by the physician or the same professional practice or is under contract with such practice;
(b) the physician takes reasonable steps to ensure that such designee is sufficiently competent in the profile requirements; and
(c) the physician remains responsible for ensuring the accuracy of the information provided and for any failure to provide accurate information.
The commissioner shall establish in regulation reasonable parameters with regard to a physician's ability to authorize designees pursuant to this section, which shall include processes necessary to allow the department to: (i) grant access to the profile in a reasonably prompt manner to designees authorized by physicians; (ii) require that physicians notify the department upon terminating the authorization of any designee; and (iii) establish a mechanism to prevent such terminated designees from accessing the profile in a reasonably prompt manner following such notification.
§ 5. This act shall take effect on the ninetieth day after it shall have become a law.
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 submission of information to the department of health for physician profiles
Purpose
Makes updates to the physician profile to include provider plan network information and to help ensure greater compliance.
Summary of provisions
Section one amends Public Health Law (PHL) § 2995-a(1)(a) to provide that health care plan information shall be included and updated by the Department of Health utilizing provider network participation informa- tion, or other reliable sources of information the Department receives from health plans.
Section two amends PHL § 2995-a(4) to conform to Education Law § 6524.
Section three amends PHL § 2995-a(6) to make the inclusion of provider health plan network participation a mandatory component of the profile.
Section four adds a new PHL § 2995-a(7-a) to permit physicians to authorize a designee to register, transmit, enter and update information on his or her behalf.
Section five provides the effective date.
Justification
The physician profile is a highly utilized, online database, available to the public, containing information about New York State licensed physicians. Several years ago, the Senate one house budget included language to update the physician profile and include information regard- ing the health plan networks the physician participates in. After considerable push back from the Department of Health (DOH), the final adopted budget required the DOH to study the feasibility of incorporat- ing network participation on the physician's profile without creating additional reporting burdens on the physicians.
On November 15, 2016, DOH released a report which found that despite the overwhelming consumer support for listing this information on. the profile, only 51% of physicians do so. The report highlights recent measures such as the Surprise Bill Law, which went into effect on March 31, 2015, making the inclusion of such information easier. This law requires providers to offer patients or prospective patients their network participation and requires insurers to provide a list of all participating providers, which must be updated within 15 days of an addition, termination or change in hospital affiliation, on their website. As the Senate urged in 2015, this relatively new law, in addi- tion to the fact that the DOH already collects this information directly from health plans for the purposes of the Provider Network Data System (PNDS), including this information and ensuring its accuracy is feasi- ble. Further,- such can be accomplished without additional reporting burdens on the individual physician. Thus, DOH determined in the report that health plan network affiliation could be included in an accurate and up-to-date manner, and that there was stakeholder support to do so. This legislation make the changes recommended to the Public Health Law, in order to implement this change and provide for greater consumer access to this information.
In addition to the inclusion of provider network information, the report also recommended a statutory change in order to improve physician compliance with the profile reporting requirements by allowing a desig- nee or employee to submit the information and to align Education Law and Public Health Law requirements. Such changes have also been incorporated into this legislation with the goal of increasing physician reporting and providing consumers with accurate up-to-date information.
Legislative history
New bill.
Fiscal implications
None.
Effective date
90 days- after enactment.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.