NY State Senate Bill 2009-S2886

Senate Bill S2886

2009-2010 Legislative Session

Enacts provisions relating to collective negotiations by health care providers with certain health care plans

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Archive: Last Bill Status - In Senate Committee Health Committee

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 06, 2010	referred to health
Mar 05, 2009	referred to health

2009-S2886 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add Art 49 Title III §§4920 - 4928, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2011-2012: S3186
2013-2014: S3690
2015-2016: S1157
2017-2018: S3663
2019-2020: S3462
2021-2022: S1575
2023-2024: S4785

2009-S2886 (ACTIVE) - Summary

Enacts provisions relating to collective negotiations by health care providers with certain health care plans; applies to health benefit plans that provide benefits for medical or surgical expenses incurred as a result of a health condition, accident or sickness, including an individual, group, blanket or franchise insurance policy or insurance agreement offered by certain enumerated entities.

2009-S2886 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S2886

 TITLE OF BILL :
An act to amend the public health law, in relation to requirements for
collective negotiations by health care providers with certain health
benefit plans


 PURPOSE OR GENERAL IDEA OF BILL :
This bill is designed to restore fairness in the contracting process
between physicians and large managed care plans by allowing doctors to
join together to negotiate contract provisions. This legislation would
not authorize strikes of health benefit plans by physicians.

 SUMMARY OF SPECIFIC PROVISIONS :
Section 1 is a statement of legislative intent that states that the
legislature finds it appropriate and necessary to authorize collective
negotiations on patient care issues and on fee-related and other
issues where it determines that health plans have an undue advantage
negotiating the terms of contracts with health care providers. The
legislative intent clarifies that the act is not intended to apply or
affect collective bargaining relationships involving health care
providers who are employees of health care providers or rights
relating to collective bargaining arising under applicable
federal/state collective bargaining statutes.

Section 2 cites the bill as the New York State Managed Care Freedom of
Choice Act.

Section 3 amends article 49 to the public health law by adding a new
title III titled Collective Negotiations by Health Care Providers with
Health Care Plans.

This legislation adds a new Article 49-A to the public health law to
authorize collective bargaining for independent contractor health care
providers including physicians. This bill would create a system under
which the state would closely monitor those negotiations and any
negotiations involving fee-related matters would only be permitted
when an individual managed care plan controls a substantial share of
the managed care market. This legislation would not authorize strikes
or concerted action by physicians in response to negotiations with
health care plans.

Section 4. This act shall take effect 90 days after it shall have
become a law, provided that the department of health may promulgate
and establish any regulations pursuant hereto prior to the effective
date.

 EFFECTS OF PRESENT LAW WHICH THIS BILL WOULD ALTER :
Existing law does not provide a statutory right for independent
contractor physicians to collectively negotiate with health care
plans.

 JUSTIFICATION :
Currently, federal antitrust laws prohibit individual physicians from
collectively negotiating any provisions of contracts they sign with
managed care entities. This bill would allow physicians in New York
State to conduct some collective negotiations by creating a system
under which the state would closely monitor those negotiations.
Negotiations involving fee-related matters would be prohibited unless
an individual managed care plan controls a substantial share of the
managed care market.  Giving physicians greater ability to advocate
for patients in contract negotiations is critical since large health
maintenance organizations are gobbling up huge shares of the health
insurance market. The proposed merger of Aetna/U.S. Healthcare/NYLCare
with Prudential Healthcare would produce a company with an
overwhelming share of the managed care market in New York State. Much
publicity has surrounded the experiences of physicians across the
state in dealing with the large insurance companies' bullying tactics.
Due to the current imbalance of negotiating power in favor of the
HMOs, physicians throughout the country are being offered
take-it-or-leave-it contracts that significantly hamper their ability
to provide quality patient care. Typical provider-contract abuses used
by large HMOs and insurers include clauses in which the HMO withholds
a portion of a physician's monthly per-patient payment, releasing the
differential at the end of the year only to physicians whose patients
use less than the average amount of medical services.  This conflict
between the economic interests of physicians and the welfare of their
patients creates an unfair ethical burden that can lead to
less-than-optimal care for patients. Another typical physician
contract abuse holds physicians solely responsible for the quality of
health care services provided while at the same time requiring
physicians to fully comply with the HMO's utilization review program,
which limits the amount and nature of medical services that can be
provided to a patient. This responsibility-without-authority provision
is designed to insulate the managed c are company from liability for
patients who are harmed by its utilization review decisions. This
bill, by allowing independent contractor physicians to conduct some
collective negotiations while being closely monitored by the state,
would give physicians greater ability to advocate for patients in
contract negotiations. This bill would create a system under which the
state would closely monitor those negotiations and any negotiations
involving fee-related matters would only be permitted when an
individual managed care plan controls a substantial share of the
managed care market. This legislation would not authorize strikes or
boycotts of health benefit plans by physicians.

 LEGISLATIVE HISTORY :
2007-2008: A.2177 Reported to Ways & Means
2005-2006: A.6458 Reported to Ways & Means
2003-2004: A1317-A Reported to Ways & means
2001-2002: A5466/S.3569 Reported to Third Reading Calendar
2000: A9484-A/S.7541-A Referred to Health/Senate Finance

 FISCAL IMPLICATIONS :
None to the State. The bill would provide the legal basis for an
appropriation of funds to implement the provisions of the bill.

 EFFECTIVE DATE :
120 days after it shall have become a law, provided that the
department of health may promulgate and establish any regulations
pursuant hereto prior to the effective date.

2009-S2886 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2886

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                              March 5, 2009
                               ___________

Introduced  by  Sen. BONACIC -- 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  requirements  for
  collective  negotiations  by health care providers with certain health
  benefit plans

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Statement of legislative intent. The legislature finds that
collective  negotiation by competing health care providers for the terms
and conditions of contracts with health plans can result  in  beneficial
results  for  health  care  consumers.  The  legislature  further  finds
instances where health plans dominate the market to such a  degree  that
fair  and  adequate  negotiations  between health care providers and the
plans are adversely affected, so that it is necessary and appropriate to
provide for a system of collective  action  on  behalf  of  health  care
providers. Consequently, the legislature finds it appropriate and neces-
sary to authorize collective negotiations on the terms and conditions of
the  relationship between health care plans and health care providers so
the imbalances between the two will not result in adverse conditions  of
health  care.  This  act  is  not  intended to apply to or affect in any
respect  collective  bargaining  relationships  involving  health   care
providers  as defined in section 4920 of the public health law or rights
relating to collective bargaining arising under  applicable  federal  or
state collective bargaining statutes.
  S  2.  This  act  shall  be known and may be cited as the "health care
providers collective negotiations act".
  S 3. Article 49 of the public health law is amended by  adding  a  new
title III to read as follows:
                                TITLE III
                 COLLECTIVE NEGOTIATIONS BY HEALTH CARE
                    PROVIDERS WITH HEALTH CARE PLANS

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02535-01-9

S. 2886                             2

SECTION 4920. DEFINITIONS.
        4921. COLLECTIVE NEGOTIATION AUTHORIZED.
        4922. LIMITATIONS ON COLLECTIVE NEGOTIATION.
        4923. COLLECTIVE NEGOTIATION REQUIREMENTS.
        4924. REQUIREMENTS FOR HEALTH CARE PROVIDERS' REPRESENTATIVE.
        4925. CERTAIN COLLECTIVE ACTION PROHIBITED.
        4926. FEES.
        4927. CONFIDENTIALITY.
        4928. SEVERABILITY AND CONSTRUCTION.
  S 4920. DEFINITIONS. FOR PURPOSES OF THIS TITLE:
  1.  "HEALTH  CARE  PLAN"  MEANS  AN  ENTITY  (OTHER THAN A HEALTH CARE
PROVIDER) THAT APPROVES, PROVIDES, ARRANGES FOR, OR PAYS FOR HEALTH CARE
SERVICES, INCLUDING BUT NOT LIMITED TO:
  (A) A HEALTH MAINTENANCE ORGANIZATION  LICENSED  PURSUANT  TO  ARTICLE
FORTY-THREE  OF  THE  INSURANCE  LAW  OR  CERTIFIED  PURSUANT TO ARTICLE
FORTY-FOUR OF THIS CHAPTER;
  (B) ANY OTHER ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR OF
THIS CHAPTER; OR
  (C) AN INSURER OR CORPORATION SUBJECT TO THE INSURANCE LAW.
  2. "PERSON" MEANS AN  INDIVIDUAL,  ASSOCIATION,  CORPORATION,  OR  ANY
OTHER LEGAL ENTITY.
  3.  "HEALTH CARE PROVIDERS' REPRESENTATIVE" MEANS A THIRD PARTY WHO IS
AUTHORIZED BY HEALTH CARE PROVIDERS TO NEGOTIATE ON  THEIR  BEHALF  WITH
HEALTH  CARE PLANS OVER CONTRACTUAL TERMS AND CONDITIONS AFFECTING THOSE
HEALTH CARE PROVIDERS.
  4. "STRIKE" MEANS A WORK STOPPAGE IN PART OR IN WHOLE, DIRECT OR INDI-
RECT, BY A BODY OF WORKERS TO GAIN COMPLIANCE WITH DEMANDS  MADE  ON  AN
EMPLOYER.
  5.  "SUBSTANTIAL  MARKET  POWER IN A BUSINESS LINE" EXISTS IF A HEALTH
CARE PLAN'S MARKET SHARE OF A BUSINESS LINE WITHIN  A  SERVICE  AREA  AS
APPROVED  BY  THE  COMMISSIONER, ALONE OR IN COMBINATION WITH THE MARKET
SHARES OF AFFILIATES, EXCEEDS EITHER TEN PERCENT OF THE TOTAL NUMBER  OF
COVERED LIVES IN THAT SERVICE AREA FOR SUCH BUSINESS LINE OR TWENTY-FIVE
THOUSAND  LIVES,  OR  IF THE COMMISSIONER DETERMINES THE MARKET POWER OF
THE INSURER IN THE RELEVANT INSURANCE PRODUCT AND GEOGRAPHIC MARKETS FOR
THE SERVICES OF THE PROVIDERS SEEKING TO COLLECTIVELY NEGOTIATE  SIGNIF-
ICANTLY  EXCEEDS THE COUNTERVAILING MARKET POWER OF THE PROVIDERS ACTING
INDIVIDUALLY.
  6. "HEALTH CARE PROVIDER" MEANS A PERSON WHO IS  LICENSED,  CERTIFIED,
OR REGISTERED PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW AND WHO PRAC-
TICES  AS A HEALTH CARE PROVIDER AS AN INDEPENDENT CONTRACTOR AND/OR WHO
IS AN OWNER, OFFICER,  SHAREHOLDER,  OR  PROPRIETOR  OF  A  HEALTH  CARE
PROVIDER.  A HEALTH CARE PROVIDER UNDER TITLE EIGHT OF THE EDUCATION LAW
WHO PRACTICES AS AN EMPLOYEE OF A HEALTH  CARE  PROVIDER  SHALL  NOT  BE
DEEMED A HEALTH CARE PROVIDER FOR PURPOSES OF THIS TITLE.
  S  4921.  COLLECTIVE  NEGOTIATION AUTHORIZED. 1. HEALTH CARE PROVIDERS
PRACTICING WITHIN THE SERVICE AREA OF A HEALTH CARE PLAN  MAY  MEET  AND
COMMUNICATE  FOR  THE  PURPOSE OF COLLECTIVELY NEGOTIATING THE FOLLOWING
TERMS AND CONDITIONS OF PROVIDER CONTRACTS WITH THE HEALTH CARE PLAN:
  (A) THE DETAILS OF THE UTILIZATION REVIEW PLAN AS DEFINED PURSUANT  TO
SUBDIVISION TEN OF SECTION FORTY-NINE HUNDRED OF THIS ARTICLE;
  (B)  COVERAGE  PROVISIONS;  HEALTH  CARE  BENEFITS;  BENEFIT MAXIMUMS,
INCLUDING BENEFIT LIMITATIONS; AND EXCLUSIONS OF COVERAGE;
  (C) THE DEFINITION OF MEDICAL NECESSITY;
  (D) THE CLINICAL PRACTICE GUIDELINES USED TO  MAKE  MEDICAL  NECESSITY
AND UTILIZATION REVIEW DETERMINATIONS;

S. 2886                             3

  (E) PREVENTIVE CARE AND OTHER MEDICAL MANAGEMENT PRACTICES;
  (F)  DRUG  FORMULARIES  AND  STANDARDS  AND PROCEDURES FOR PRESCRIBING
OFF-FORMULARY DRUGS;
  (G) RESPECTIVE PHYSICIAN LIABILITY FOR THE TREATMENT OR LACK OF TREAT-
MENT OF COVERED PERSONS;
  (H) THE DETAILS OF HEALTH CARE PLAN RISK  TRANSFER  ARRANGEMENTS  WITH
PROVIDERS;
  (I)  PLAN  ADMINISTRATIVE  PROCEDURES, INCLUDING METHODS AND TIMING OF
HEALTH CARE PROVIDER PAYMENT FOR SERVICES PURSUANT TO SECTION FORTY-FOUR
HUNDRED SIX-C OF THIS CHAPTER;
  (J) PROCEDURES TO BE UTILIZED TO RESOLVE DISPUTES BETWEEN  THE  HEALTH
CARE PLAN AND HEALTH CARE PROVIDERS;
  (K)  PATIENT  REFERRAL PROCEDURES INCLUDING, BUT NOT LIMITED TO, THOSE
APPLICABLE TO OUT-OF-POCKET NETWORK REFERRALS;
  (L) THE FORMULATION AND APPLICATION OF HEALTH CARE PROVIDER REIMBURSE-
MENT PROCEDURES;
  (M) QUALITY ASSURANCE PROGRAMS;
  (N)  THE  PROCESS  FOR  RENDERING  UTILIZATION  REVIEW  DETERMINATIONS
INCLUDING:  ESTABLISHMENT  OF A PROCESS FOR RENDERING UTILIZATION REVIEW
DETERMINATIONS WHICH SHALL, AT A MINIMUM, INCLUDE: WRITTEN PROCEDURES TO
ASSURE THAT UTILIZATION REVIEWS AND DETERMINATIONS ARE CONDUCTED  WITHIN
THE  TIMEFRAMES  ESTABLISHED  IN  THIS  ARTICLE; PROCEDURES TO NOTIFY AN
ENROLLEE, AN  ENROLLEE'S  DESIGNEE  AND/OR  AN  ENROLLEE'S  HEALTH  CARE
PROVIDER OF ADVERSE DETERMINATIONS; AND PROCEDURES FOR APPEAL OF ADVERSE
DETERMINATIONS,  INCLUDING  THE  ESTABLISHMENT  OF  AN EXPEDITED APPEALS
PROCESS FOR DENIALS OF CONTINUED INPATIENT CARE OR WHERE THERE IS  IMMI-
NENT OR SERIOUS THREAT TO THE HEALTH OF THE ENROLLEE; AND
  (O)  HEALTH  CARE  PROVIDER SELECTION AND TERMINATION CRITERIA USED BY
THE HEALTH CARE PLAN.
  2. NOTHING IN THIS SECTION SHALL BE CONSTRUED TO ALLOW OR AUTHORIZE AN
ALTERATION OF THE TERMS OF THE INTERNAL AND EXTERNAL  REVIEW  PROCEDURES
SET FORTH IN LAW.
  3.  NOTHING  IN THIS SECTION SHALL BE CONSTRUED TO ALLOW A STRIKE OF A
HEALTH CARE PLAN BY HEALTH CARE PROVIDERS  OR  PLANS  AS  OTHERWISE  SET
FORTH IN THE LAWS OF THIS STATE.
  4.  NOTHING  IN  THIS SECTION SHALL BE CONSTRUED TO ALLOW OR AUTHORIZE
TERMS OR CONDITIONS WHICH WOULD IMPEDE THE ABILITY OF A HEALTH CARE PLAN
TO OBTAIN OR RETAIN ACCREDITATION BY THE NATIONAL COMMITTEE FOR  QUALITY
ASSURANCE OR A SIMILAR BODY.
  S  4922.  LIMITATIONS ON COLLECTIVE NEGOTIATION. 1. IF THE HEALTH CARE
PLAN HAS SUBSTANTIAL MARKET POWER IN A  BUSINESS  LINE  IN  ANY  SERVICE
AREA,  HEALTH  CARE  PROVIDERS  PRACTICING  WITHIN THAT SERVICE AREA MAY
COLLECTIVELY NEGOTIATE THE FOLLOWING TERMS AND  CONDITIONS  RELATING  TO
THAT BUSINESS LINE WITH THE HEALTH CARE PLAN:
  (A)  THE FEES ASSESSED BY THE HEALTH CARE PLAN FOR SERVICES, INCLUDING
FEES ESTABLISHED THROUGH THE APPLICATION OF REIMBURSEMENT PROCEDURES;
  (B) THE  CONVERSION  FACTORS  USED  BY  THE  HEALTH  CARE  PLAN  IN  A
RESOURCE-BASED  RELATIVE  VALUE SCALE REIMBURSEMENT METHODOLOGY OR OTHER
SIMILAR METHODOLOGY; PROVIDED THE SAME ARE NOT OTHERWISE ESTABLISHED  BY
STATE OR FEDERAL LAW OR REGULATION;
  (C)  THE AMOUNT OF ANY DISCOUNT GRANTED BY THE HEALTH CARE PLAN ON THE
FEE OF HEALTH CARE SERVICES TO BE RENDERED BY HEALTH CARE PROVIDERS;
  (D) THE DOLLAR AMOUNT  OF  CAPITATION  OR  FIXED  PAYMENT  FOR  HEALTH
SERVICES  RENDERED  BY  HEALTH CARE PROVIDERS TO HEALTH CARE PLAN ENROL-
LEES;

S. 2886                             4

  (E) THE PROCEDURE CODE OR OTHER DESCRIPTION OF A HEALTH  CARE  SERVICE
COVERED  BY  A  PAYMENT  AND  THE  APPROPRIATE GROUPING OF THE PROCEDURE
CODES; OR
  (F) THE AMOUNT OF ANY OTHER COMPONENT OF THE REIMBURSEMENT METHODOLOGY
FOR A HEALTH CARE SERVICE.
  2.  NOTHING  HEREIN  SHALL BE DEEMED TO AFFECT OR LIMIT THE RIGHT OF A
HEALTH CARE PROVIDER OR GROUP OF HEALTH CARE PROVIDERS  TO  COLLECTIVELY
PETITION A GOVERNMENT ENTITY FOR A CHANGE IN A LAW, RULE, OR REGULATION.
  S 4923. COLLECTIVE NEGOTIATION REQUIREMENTS. 1. COLLECTIVE NEGOTIATION
RIGHTS GRANTED BY THIS TITLE MUST CONFORM TO THE FOLLOWING REQUIREMENTS:
  (A)  HEALTH  CARE  PROVIDERS  MAY  COMMUNICATE  WITH OTHER HEALTH CARE
PROVIDERS REGARDING THE CONTRACTUAL TERMS AND CONDITIONS TO  BE  NEGOTI-
ATED WITH A HEALTH CARE PLAN;
  (B)  HEALTH CARE PROVIDERS MAY COMMUNICATE WITH HEALTH CARE PROVIDERS'
REPRESENTATIVES;
  (C) A HEALTH CARE PROVIDERS' REPRESENTATIVE IS THE ONLY PARTY  AUTHOR-
IZED  TO  NEGOTIATE  WITH HEALTH CARE PLANS ON BEHALF OF THE HEALTH CARE
PROVIDERS AS A GROUP;
  (D) A HEALTH CARE PROVIDER CAN BE BOUND BY THE  TERMS  AND  CONDITIONS
NEGOTIATED BY THE HEALTH CARE PROVIDERS' REPRESENTATIVES; AND
  (E)  IN  COMMUNICATING  OR NEGOTIATING WITH THE HEALTH CARE PROVIDERS'
REPRESENTATIVE, A HEALTH CARE PLAN IS ENTITLED TO CONTRACT WITH OR OFFER
DIFFERENT CONTRACT TERMS AND CONDITIONS TO INDIVIDUAL  COMPETING  HEALTH
CARE PROVIDERS.
  2. A HEALTH CARE PROVIDERS' REPRESENTATIVE MAY NOT REPRESENT MORE THAN
THIRTY PERCENT OF THE MARKET OF HEALTH CARE PROVIDERS OR OF A PARTICULAR
HEALTH CARE PROVIDER TYPE OR SPECIALTY PRACTICING IN THE SERVICE AREA OR
PROPOSED  SERVICE  AREA OF A HEALTH CARE PLAN THAT COVERS LESS THAN FIVE
PERCENT OF THE ACTUAL NUMBER OF COVERED LIVES OF THE HEALTH CARE PLAN IN
THE AREA, AS DETERMINED BY THE DEPARTMENT.
  3. NOTHING IN THIS SECTION SHALL BE CONSTRUED TO  PROHIBIT  COLLECTIVE
ACTION  ON  THE  PART  OF  ANY HEALTH CARE PROVIDER WHO IS A MEMBER OF A
COLLECTIVE BARGAINING UNIT RECOGNIZED PURSUANT  TO  THE  NATIONAL  LABOR
RELATIONS ACT.
  S  4924.  REQUIREMENTS  FOR  HEALTH CARE PROVIDERS' REPRESENTATIVE. 1.
BEFORE ENGAGING IN COLLECTIVE NEGOTIATIONS WITH A HEALTH  CARE  PLAN  ON
BEHALF OF HEALTH CARE PROVIDERS, A HEALTH CARE PROVIDERS' REPRESENTATIVE
SHALL  FILE  WITH  THE  COMMISSIONER,  IN  THE  MANNER PRESCRIBED BY THE
COMMISSIONER, INFORMATION IDENTIFYING THE REPRESENTATIVE, THE  REPRESEN-
TATIVE'S  PLAN  OF  OPERATION,  AND  THE  REPRESENTATIVE'S PROCEDURES TO
ENSURE COMPLIANCE WITH THIS TITLE.
  2. BEFORE ENGAGING IN THE COLLECTIVE  NEGOTIATIONS,  THE  HEALTH  CARE
PROVIDERS'  REPRESENTATIVE SHALL ALSO SUBMIT TO THE COMMISSIONER FOR THE
COMMISSIONER'S APPROVAL A REPORT IDENTIFYING THE PROPOSED SUBJECT MATTER
OF THE NEGOTIATIONS OR DISCUSSIONS WITH THE HEALTH  CARE  PLAN  AND  THE
EFFICIENCIES  OR  BENEFITS  EXPECTED  TO BE ACHIEVED THROUGH THE NEGOTI-
ATIONS. THE COMMISSIONER SHALL NOT APPROVE THE REPORT IF THE COMMISSION-
ER DETERMINES THAT THE PROPOSED NEGOTIATIONS WOULD EXCEED THE  AUTHORITY
GRANTED UNDER THIS TITLE.
  3.  THE  REPRESENTATIVE SHALL SUPPLEMENT THE INFORMATION IN THE REPORT
ON A REGULAR BASIS OR AS NEW INFORMATION BECOMES  AVAILABLE,  INDICATING
THAT  THE  SUBJECT  MATTER OF THE NEGOTIATIONS WITH THE HEALTH CARE PLAN
HAS CHANGED OR WILL CHANGE. IN NO EVENT SHALL THE REPORT  BE  LESS  THAN
EVERY THIRTY DAYS.
  4. WITH THE ADVICE OF THE SUPERINTENDENT OF INSURANCE, THE COMMISSION-
ER  SHALL  APPROVE OR DISAPPROVE THE REPORT NOT LATER THAN THE TWENTIETH

S. 2886                             5

DAY AFTER THE DATE ON WHICH THE REPORT IS  FILED.  IF  DISAPPROVED,  THE
COMMISSIONER  SHALL  FURNISH  A WRITTEN EXPLANATION OF ANY DEFICIENCIES,
ALONG WITH A STATEMENT OF SPECIFIC PROPOSALS FOR  REMEDIAL  MEASURES  TO
CURE  THE  DEFICIENCIES.  IF THE COMMISSIONER DOES NOT SO ACT WITHIN THE
TWENTY DAYS, THE REPORT SHALL BE DEEMED APPROVED.
  5. A PERSON WHO ACTS AS A HEALTH CARE PROVIDERS' REPRESENTATIVE  WITH-
OUT  THE APPROVAL OF THE COMMISSIONER UNDER THIS SECTION SHALL BE DEEMED
TO BE ACTING OUTSIDE THE AUTHORITY GRANTED UNDER THIS TITLE.
  6. BEFORE REPORTING THE RESULTS OF NEGOTIATIONS  WITH  A  HEALTH  CARE
PLAN OR PROVIDING TO THE AFFECTED HEALTH CARE PROVIDERS AN EVALUATION OF
ANY  OFFER MADE BY A HEALTH CARE PLAN, THE HEALTH CARE PROVIDERS' REPRE-
SENTATIVE SHALL FURNISH FOR APPROVAL BY THE COMMISSIONER, BEFORE DISSEM-
INATION TO THE HEALTH CARE PROVIDERS, A COPY OF ALL COMMUNICATIONS TO BE
MADE TO THE HEALTH CARE PROVIDERS RELATED TO NEGOTIATIONS,  DISCUSSIONS,
AND OFFERS MADE BY THE HEALTH CARE PLAN.
  7.  A  HEALTH  CARE PROVIDERS' REPRESENTATIVE  SHALL REPORT THE END OF
NEGOTIATIONS TO THE COMMISSIONER NOT LATER THAN THE FOURTEENTH DAY AFTER
THE DATE OF A HEALTH CARE PLAN DECISION DECLINING NEGOTIATION, CANCELING
NEGOTIATIONS, OR FAILING TO RESPOND TO A REQUEST FOR NEGOTIATION.
  S 4925. CERTAIN COLLECTIVE ACTION PROHIBITED. 1.  THIS  TITLE  IS  NOT
INTENDED  TO AUTHORIZE COMPETING HEALTH CARE PROVIDERS TO ACT IN CONCERT
IN RESPONSE TO A REPORT ISSUED BY THE HEALTH CARE  PROVIDERS'  REPRESEN-
TATIVE  RELATED TO THE REPRESENTATIVE'S DISCUSSIONS OR NEGOTIATIONS WITH
HEALTH CARE PLANS.
  2. NO HEALTH CARE PROVIDERS' REPRESENTATIVE SHALL NEGOTIATE ANY AGREE-
MENT THAT EXCLUDES, LIMITS THE PARTICIPATION  OR  REIMBURSEMENT  OF,  OR
OTHERWISE LIMITS THE SCOPE OF SERVICES TO BE PROVIDED BY ANY HEALTH CARE
PROVIDER  OR GROUP OF HEALTH CARE PROVIDERS WITH RESPECT TO THE PERFORM-
ANCE OF SERVICES THAT ARE WITHIN THE HEALTH  CARE  PROVIDER'S  SCOPE  OF
PRACTICE, LICENSE, REGISTRATION, OR CERTIFICATE.
  S  4926. FEES. EACH PERSON WHO ACTS AS THE REPRESENTATIVE OR NEGOTIAT-
ING PARTIES UNDER THIS TITLE SHALL PAY TO THE DEPARTMENT A FEE TO ACT AS
A REPRESENTATIVE. THE COMMISSIONER, BY RULE, SHALL SET FEES  IN  AMOUNTS
DEEMED  REASONABLE  AND  NECESSARY  TO  COVER  THE COSTS INCURRED BY THE
DEPARTMENT IN ADMINISTERING THIS TITLE. ANY  FEE  COLLECTED  UNDER  THIS
SECTION  SHALL  BE  DEPOSITED IN THE STATE TREASURY TO THE CREDIT OF THE
GENERAL FUND/STATE OPERATIONS - 003 FOR THE NEW YORK STATE DEPARTMENT OF
HEALTH FUND.
  S 4927. CONFIDENTIALITY. ALL REPORTS AND OTHER INFORMATION REQUIRED TO
BE REPORTED TO THE DEPARTMENT UNDER THIS TITLE SHALL NOT BE  SUBJECT  TO
DISCLOSURE UNDER ARTICLE SIX OF THE PUBLIC OFFICERS LAW OR ARTICLE THIR-
TY-ONE OF THE CIVIL PRACTICE LAW AND RULES.
  S  4928.  SEVERABILITY  AND CONSTRUCTION. THE PROVISIONS OF THIS TITLE
SHALL BE SEVERABLE, AND IF ANY COURT OF COMPETENT JURISDICTION  DECLARES
ANY  PHRASE,  CLAUSE, SENTENCE OR PROVISION OF THIS TITLE TO BE INVALID,
OR ITS APPLICABILITY TO ANY GOVERNMENT, AGENCY, PERSON  OR  CIRCUMSTANCE
IS DECLARED INVALID, THE REMAINDER OF THIS TITLE AND ITS RELEVANT APPLI-
CABILITY  SHALL  NOT  BE AFFECTED. THE PROVISIONS OF THIS TITLE SHALL BE
LIBERALLY CONSTRUED TO GIVE EFFECT TO THE PURPOSES THEREOF.
  S 4. This act shall take effect on the one hundred twentieth day after
it shall have become a law; provided that the commissioner of health  is
authorized  to promulgate any and all rules and regulations and take any
other measures necessary to implement this act on its effective date  on
or before such date.

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