Assembly Bill A1808

2011-2012 Legislative Session

Provides for a right of health maintenance organization enrollees to continue to receive services from a provider who disaffiliates

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Sponsored By

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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2011-A1808 (ACTIVE) - Details

Current Committee:
Senate Health
Law Section:
Insurance Law
Laws Affected:
Amd §§4803 & 4804, Ins L; amd §§4403 & 4406-d, Pub Health L
Versions Introduced in Other Legislative Sessions:
2009-2010: A633
2013-2014: A366
2015-2016: A1932
2017-2018: A256
2019-2020: A5033
2021-2022: A2299
2023-2024: A5129

2011-A1808 (ACTIVE) - Summary

Extends period during which health maintenance organization enrollees may continue to receive services from a health care provider who disaffiliates from 60 or 90 days to 1 year, or in case of terminal illness, until the time of such insured's death; bars incentives which induce a provider to provide health care to an enrollee in a manner inconsistent with law.

2011-A1808 (ACTIVE) - Bill Text download pdf

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

                                  1808

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            January 12, 2011
                               ___________

Introduced  by  M.  of A. DINOWITZ, PHEFFER, GALEF, HOOPER, GOTTFRIED --
  Multi-Sponsored by -- M. of A. BOYLAND, BRENNAN, COLTON, LIFTON, SWEE-
  NEY -- read once and referred to the Committee on Health

AN ACT to amend the insurance law and the public health law, in relation
  to access to health care providers in managed care plans

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

  Section  1.  Subsection  (e)  of section 4803 of the insurance law, as
added by chapter 705 of the laws of 1996, is amended to read as follows:
  (e) No insurer shall terminate or  refuse  to  renew  a  contract  for
participation in the in-network benefits portion of an insurer's network
for  a  managed care product solely because the health care professional
has: (1) advocated on behalf of an insured; (2) [has] filed a  complaint
against  the  insurer; (3) [has] appealed a decision of the insurer; (4)
provided information or filed a report pursuant  to  section  forty-four
hundred  six-c of the public health law; [or] (5) requested a hearing or
review pursuant to this section; OR (6) RENDERED  AN  OPINION  REGARDING
WHETHER  AN INSURED'S ILLNESS IS TERMINAL PURSUANT TO SECTION FOUR THOU-
SAND EIGHT HUNDRED FOUR OF THIS ARTICLE.
  S 2. Subsections (e) and (f) of section 4804 of the insurance law,  as
added  by  chapter  705  of  the  laws  of  1996, are amended to read as
follows:
  (e) (1) If an insured's health  care  provider  leaves  the  insurer's
in-network  benefits  portion  of its network of providers for a managed
care product for reasons other than those for which the  provider  would
not  be  eligible  to  receive  a  hearing  pursuant to paragraph one of
subsection (b) of section  [forty-eight]  FOUR  THOUSAND  EIGHT  hundred
three of this [chapter] ARTICLE, the insurer shall permit the insured to
continue  [an  ongoing  course of treatment with] TO RECEIVE HEALTH CARE
PROCEDURES, TREATMENTS, AND SERVICES FROM the insured's  current  health
care  provider  during  a transitional period of (i) up to [ninety days]

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04377-01-1
              

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