BILL NUMBER: S2212

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 ca1.560

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

01/08/2020 S. 6760 referred to health

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.