Legislation
SECTION 213
New York state health care quality and cost containment commission
Insurance (ISC) CHAPTER 28, ARTICLE 2
§ 213. New York state health care quality and cost containment
commission. (a) There is hereby established within the department a
commission, to be known as the "New York state health care quality and
cost containment commission". The commission shall consist of thirteen
members appointed by the governor, one of whom shall be the
superintendent, one of whom shall be the commissioner of health, and six
of whom shall be appointed on the recommendation of the legislative
leaders, two on the recommendation of the temporary president of the
senate, two on the recommendation of the speaker of the assembly, one on
the recommendation of the minority leader of the senate, and one on the
recommendation of the minority leader of the assembly. All members shall
serve at the pleasure of the governor, and vacancies shall be appointed
in the same manner as original appointments. Members of the commission
shall serve without compensation, but shall be reimbursed for reasonable
travel expenses. In making appointments to the commission, the governor
shall ensure that the interests of health care consumers, small
businesses, the medical community and health plans are represented on
the commission.
(b)(1) The purpose of the commission shall be to analyze the impact on
health insurance costs and quality of proposed legislation which would
mandate that health benefits be offered or made available in individual
and group health insurance policies, contracts and comprehensive health
service plans, including legislation that affects the delivery of health
benefits or services or the reimbursement of health care providers.
(2) The governor, the chair of the senate insurance committee and the
chair of the assembly insurance committee may request in writing that
the commission evaluate a proposed mandated benefit. Upon receiving such
a request, the commission may, by a majority vote of its members,
undertake an evaluation of such proposed mandated benefit.
(3) In evaluating a proposed mandated benefit, the commission shall:
(A) investigate the current practices of health plans with regard to
the proposed mandated benefit, and, to the extent possible, self-funded
health benefit plans;
(B) investigate the potential premium impact of the proposed mandated
benefits on all segments of the insurance market, as well as the
potential for avoided costs through early detection and treatment of
conditions, or more cost-effective delivery of medical services; and
(C) analyze the most current medical literature regarding the proposed
mandated benefit to determine its impact on health care quality.
(4) In evaluating a proposed mandated benefit, the commission may hold
one or more public hearings, and shall strive to obtain independent and
verifiable information from diverse sources within the healthcare
industry, medical community and among health care consumers with regard
to the proposed mandated benefit.
(c) To assist the commission in its duties, and upon the direction of
the commission, the superintendent is authorized to enter into one or
more contracts with independent entities and organizations with
demonstrable expertise in health care quality, finance, utilization and
actuarial services. For the purposes of this section, the superintendent
shall not enter into contracts with health plans, entities or
organizations owned or controlled by health plans, or with significant
business relationships with health plans.
(d) Upon completion of its evaluation of a proposed mandated benefit
pursuant to this section, the commission shall deliver a written report
of its findings to the chair of the assembly insurance committee and the
chair of the senate insurance committee.
commission. (a) There is hereby established within the department a
commission, to be known as the "New York state health care quality and
cost containment commission". The commission shall consist of thirteen
members appointed by the governor, one of whom shall be the
superintendent, one of whom shall be the commissioner of health, and six
of whom shall be appointed on the recommendation of the legislative
leaders, two on the recommendation of the temporary president of the
senate, two on the recommendation of the speaker of the assembly, one on
the recommendation of the minority leader of the senate, and one on the
recommendation of the minority leader of the assembly. All members shall
serve at the pleasure of the governor, and vacancies shall be appointed
in the same manner as original appointments. Members of the commission
shall serve without compensation, but shall be reimbursed for reasonable
travel expenses. In making appointments to the commission, the governor
shall ensure that the interests of health care consumers, small
businesses, the medical community and health plans are represented on
the commission.
(b)(1) The purpose of the commission shall be to analyze the impact on
health insurance costs and quality of proposed legislation which would
mandate that health benefits be offered or made available in individual
and group health insurance policies, contracts and comprehensive health
service plans, including legislation that affects the delivery of health
benefits or services or the reimbursement of health care providers.
(2) The governor, the chair of the senate insurance committee and the
chair of the assembly insurance committee may request in writing that
the commission evaluate a proposed mandated benefit. Upon receiving such
a request, the commission may, by a majority vote of its members,
undertake an evaluation of such proposed mandated benefit.
(3) In evaluating a proposed mandated benefit, the commission shall:
(A) investigate the current practices of health plans with regard to
the proposed mandated benefit, and, to the extent possible, self-funded
health benefit plans;
(B) investigate the potential premium impact of the proposed mandated
benefits on all segments of the insurance market, as well as the
potential for avoided costs through early detection and treatment of
conditions, or more cost-effective delivery of medical services; and
(C) analyze the most current medical literature regarding the proposed
mandated benefit to determine its impact on health care quality.
(4) In evaluating a proposed mandated benefit, the commission may hold
one or more public hearings, and shall strive to obtain independent and
verifiable information from diverse sources within the healthcare
industry, medical community and among health care consumers with regard
to the proposed mandated benefit.
(c) To assist the commission in its duties, and upon the direction of
the commission, the superintendent is authorized to enter into one or
more contracts with independent entities and organizations with
demonstrable expertise in health care quality, finance, utilization and
actuarial services. For the purposes of this section, the superintendent
shall not enter into contracts with health plans, entities or
organizations owned or controlled by health plans, or with significant
business relationships with health plans.
(d) Upon completion of its evaluation of a proposed mandated benefit
pursuant to this section, the commission shall deliver a written report
of its findings to the chair of the assembly insurance committee and the
chair of the senate insurance committee.