Assembly Bill A1932

2015-2016 Legislative Session

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

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Assembly 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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2015-A1932 (ACTIVE) - Details

Current Committee:
Assembly 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
2011-2012: A1808
2013-2014: A366
2017-2018: A256
2019-2020: A5033
2021-2022: A2299
2023-2024: A5129

2015-A1932 (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.

2015-A1932 (ACTIVE) - Bill Text download pdf

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

                                  1932

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 13, 2015
                               ___________

Introduced  by  M.  of  A.  DINOWITZ, GOTTFRIED, GALEF, HOOPER, CLARK --
  Multi-Sponsored by -- M.  of A. BRENNAN, COLTON, LIFTON --  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.
                                                           LBD00904-01-5
              

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