Bill Text: NY S01847 | 2015-2016 | General Assembly | Introduced
Bill Title: Allows health insurers to offer out-of-network coverage outside of the health benefit exchange.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2016-05-24 - referred to insurance [S01847 Detail]
Download: New_York-2015-S01847-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
1847
2015-2016 Regular Sessions
I N S E N A T E
January 15, 2015
___________
Introduced by Sen. HANNON -- read twice and ordered printed, and when
printed to be committed to the Committee on Health
AN ACT to amend the public health law and the insurance law, in relation
to allowing health care insurers to offer out-of-network coverage
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Section 4403 of the public health law is amended by adding
2 a new subdivision 9 to read as follows:
3 9. NOTWITHSTANDING ANY RULE OR REGULATION TO THE CONTRARY, EVERY
4 HEALTH MAINTENANCE ORGANIZATION MAY OFFER, PURSUANT TO OTHER PROVISIONS
5 OF LAW, OUT-OF-NETWORK COVERAGE OUTSIDE OF THE HEALTH BENEFIT EXCHANGE
6 REGARDLESS OF WHETHER SUCH COVERAGE IS MADE AVAILABLE WITHIN THE HEALTH
7 BENEFIT EXCHANGE.
8 S 2. Section 3217-e of the insurance law, as added by chapter 219 of
9 the laws of 2011, is amended to read as follows:
10 S 3217-e. Choice of health care provider. (A) An insurer that is
11 subject to this article and requires or provides for designation by an
12 insured of a participating primary care provider shall permit the
13 insured to designate any participating primary care provider who is
14 available to accept such individual, and in the case of a child, shall
15 permit the insured to designate a physician (allopathic or osteopathic)
16 who specializes in pediatrics as the child's primary care provider if
17 such provider participates in the network of the insurer.
18 (B) NOTWITHSTANDING ANY RULE OR REGULATION TO THE CONTRARY, EVERY
19 INSURER THAT OFFERS HEALTH INSURANCE AND IS SUBJECT TO THE PROVISIONS OF
20 THIS ARTICLE, MAY OFFER, PURSUANT TO OTHER PROVISIONS OF LAW,
21 OUT-OF-NETWORK COVERAGE OUTSIDE OF THE HEALTH BENEFIT EXCHANGE REGARD-
22 LESS OF WHETHER SUCH COVERAGE IS MADE AVAILABLE WITHIN THE HEALTH BENE-
23 FIT EXCHANGE.
24 S 3. Section 4306-d of the insurance law, as added by chapter 219 of
25 the laws of 2011, is amended to read as follows:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04031-01-5
S. 1847 2
1 S 4306-d. Choice of health care provider. (A) A corporation that is
2 subject to the provisions of this article and requires or provides for
3 designation by a subscriber of a participating primary care provider
4 shall permit the subscriber to designate any participating primary care
5 provider who is available to accept such individual, and in the case of
6 a child, shall permit the subscriber to designate a physician (allopath-
7 ic or osteopathic) who specializes in pediatrics as the child's primary
8 care provider if such provider participates in the network of the corpo-
9 ration.
10 (B) NOTWITHSTANDING ANY RULE OR REGULATION TO THE CONTRARY, EVERY
11 CORPORATION THAT IS SUBJECT TO THE PROVISIONS OF THIS ARTICLE, MAY
12 OFFER, PURSUANT TO OTHER PROVISIONS OF LAW, OUT-OF-NETWORK COVERAGE
13 OUTSIDE OF THE HEALTH BENEFIT EXCHANGE REGARDLESS OF WHETHER SUCH COVER-
14 AGE IS MADE AVAILABLE WITHIN THE HEALTH BENEFIT EXCHANGE.
15 S 4. This act shall take effect immediately, and shall apply to
16 contracts and policies issued, renewed, modified or amended on or after
17 such date.
