NY State Senate Bill 2019-S1789

Senate Bill S1789

2019-2020 Legislative Session

Provides that health care plan participation by physicians shall be reported, for purposes of physician profiles, by the health care plans

download bill text pdf

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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2020	referred to health
Jan 16, 2019	referred to health

2019-S1789 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §2995-a, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2017-2018: S4633
2021-2022: S5487
2023-2024: S3472

2019-S1789 (ACTIVE) - Summary

Provides that health care plan participation by physicians shall be reported, for purposes of physician profiles, by the health care plans; requires physicians to periodically submit information for his or her physician profile within 6 months of his or her triennial re-registration to practice; authorizes physicians to designate a designee to submit his or her information for the physician profile.

2019-S1789 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S1789

SPONSOR: RIVERA
 
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.

2019-S1789 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1789
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                             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 ASSEM-
 BLY, 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,  employ-
 ment, or other affiliation; PROVIDED THAT THE REPORTING OF SUCH INFORMA-
 TION  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 infor-
 mation 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  registra-
 tion  period] SUBMISSION OF THE RE-REGISTRATION APPLICATION, as a condi-
 tion 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 DESIG-
 NEE 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 INFORMA-
 TION.
   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  PHYSI-
 CIANS  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.

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