BILL NUMBER: S6760

SPONSOR: SEPULVEDA
 
TITLE OF BILL:  An act to amend the public health law, in relation to
prohibiting approved organizations in the child health insurance plan
from limiting the participation of certain health care providers

 
PURPOSE OR GENERAL IDEA:

This bill would prohibit insurance companies that administer the Child
Health Plus program from requiring that participating health care
providers also sign up for the commercial health care network operated
by the insurer.

 
SUMMARY OF SPECIFIC PROVISIONS:

This bill would add a new paragraph (d) to subdivision 7 of section 2511
of the Public Health Law to prohibit an approved organization adminis-
tering the Child Health Plus program from denying or limiting the
provision of health care services by a provider on the grounds that the
provider refuses to participate in a commercial health care network
              

maintained by the organization.

 
JUSTIFICATION:

Child Health Plus is a publicly funded insurance assistance program
intended to meet the health needs of children who have limited or no
health insurance. The program is administered by insurance companies
which may also include commercial health maintenance organization (HMO)
programs.

Some insurance companies that administer Child Health Plus are using the
state-funded Child Health Plus program as bait for their commercial,
profit-making activities. These companies are forcing health care
providers who want to serve uninsured children through the Child Health
Plus program to participate in the insurer's commercial HMO.

Doctors who refuse to join the commercial HMO are denied the opportunity
to provide state-funded health care to uninsured children. This bill
would prohibit the discriminatory practice by health insurance compa-
nies. Under the bill, doctors who want to serve uninsured children
through the Child Health Plus program would be able to do so without
being forced to participate in a commercial HMO. As a result, families
of uninsured children would have better access to health care through a
greater choice of pediatricians and other health care providers.

 
LEGISLATIVE HISTORY:

01/30/13 referred to health
01/08/14 referred to health
04/07/14 reported
04/24/14 advanced to third reading cal.560
04/28/14 passed assembly
04/28/14 delivered to senate 04/28/14 REFERRED TO HEALTH
01/20/15 A2918 referred to health
04/22/15 A2918 reported
04/23/15 A2918 advanced to third reading cal.188
01/06/16 A2918 referred to health
02/02/16 A2918 reported
02/04/16 A2918 advanced to third reading cal.365
03/19/18 referred to health
05/08/2019 A3654 passed assembly
05/08/2019 A3654 delivered to senate
05/08/2019 A3654 referred to health

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.