Assemblyman Cusick, Senator Lanza Announce Governor Cuomo Has Signed Their Legislation Requiring Insurers & Health Care Plans to Provide Expedited Review of Health Care Professionals Joining Group Practices

On Tuesday, Assemblyman Michael Cusick (D – Mid-Island) and Senator Andrew Lanza (R – Staten Island) announced that Governor Cuomo has signed their legislation (A.501-E/S.2545-D) requiring Insurers & Health Care Plans to expedite their review of health care professionals seeking to join an insurer’s provider network. The law shortens the time for the review of applications from 90 days to 60 days, and, in the event an application has been delayed past 60 days due to missing information, provides “provisional credentialing” for a physician joining a practice of physicians already participating in that insurer’s network.

“Ensuring high-quality and efficient patient care is the paramount goal of all physicians, and as such, I am pleased to help solve an issue which has hampered physician groups who have sought to better meet patient care needs by recruiting new physicians.” said Assemblyman Cusick. “Group practices add physicians because of increased demand for their services, and we should make every effort possible to eliminate potential roadblocks to the physician joining the practice.”

The legislation is necessary because some practices have difficulty in bringing on a new provider who may be new to New York. They are delayed from seeing patients for months while waiting for the insurer to complete its credentialing review to participate in the network. When a busy practice seeks to add a new physician to meet patient demand, these delays hurt the ability to provide care as the physician is essentially unable to treat patients until completion of the approved application.

Senator Lanza said: "Currently there are no requirements or incentives for insurance companies to facilitate the timely processing of enrollment applications from participating groups and providers, causing months of delays, lost revenue and productivity and untenable working schedules for physicians. I thank Governor Cuomo and Assemblyman Cusick for their efforts on this important bill which will help deliver quality health care to the residents of New York."

“Delays by health insurers in approving physicians to participate in their networks can cause unnecessary delays for our patients who are waiting to be seen and treated, particularly when a busy physician practice seeks to add a new physician to their group to respond to patient demand” stated Dr. Sal Volpe, President-elect of the Richmond County Medical Society “This bill will help to reduce these delays by expediting the time frame for health insurers to complete their review of a physician’s application to be a participating provider. We thank Assemblyman Cusick and Senator Lanza for advancing this legislation, and Governor Cuomo for signing this legislation into law.”

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