Bill Text: NY S04476 | 2013-2014 | General Assembly | Introduced
Bill Title: Provides that no insurer or health care plan shall by contract, written policy or written procedure require the maintenance of hospital privileges by any non-hospital employee health care provider as a condition of entering into or maintaining a contract, agreement of membership or acceptance into a health care plan or health maintenance organization's provider network; provides that no insurer or health care plan can prohibit or restrict any health care provider from referring an insured to another physician based solely upon the referred physician's lack of affiliation and/or lack of hospital privileges.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2013-04-15 - RECOMMIT, ENACTING CLAUSE STRICKEN [S04476 Detail]
Download: New_York-2013-S04476-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
4476
2013-2014 Regular Sessions
I N S E N A T E
April 3, 2013
___________
Introduced by Sen. SEWARD -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law and the public health law, in relation
to restricting limitations on non-affiliated physicians from becoming
a network provider of any health care plan or health maintenance
organization
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Section 3217-b of the insurance law is amended by adding a
2 new subsection (k) to read as follows:
3 (K) (1) NO INSURER SUBJECT TO THIS ARTICLE SHALL BY CONTRACT, WRITTEN
4 POLICY OR WRITTEN PROCEDURE REQUIRE THE AFFILIATION AND/OR REQUIRE THE
5 MAINTENANCE OF HOSPITAL PRIVILEGES BY ANY NON-HOSPITAL EMPLOYEE HEALTH
6 CARE PROVIDER AS A CONDITION OF ENTERING INTO AND/OR MAINTAINING A
7 CONTRACT, AGREEMENT OF MEMBERSHIP OR ACCEPTANCE INTO A HEALTH CARE PLAN
8 OR HEALTH MAINTENANCE ORGANIZATION'S PROVIDER NETWORK.
9 (2) NO INSURER SUBJECT TO THIS ARTICLE SHALL BY CONTRACT, WRITTEN
10 POLICY OR WRITTEN PROCEDURE PROHIBIT OR RESTRICT ANY HEALTH CARE PROVID-
11 ER FROM REFERRING AN INSURED TO ANOTHER PHYSICIAN BASED SOLELY UPON THE
12 REFERRED PHYSICIAN'S LACK OF AFFILIATION AND/OR LACK OF HOSPITAL PRIVI-
13 LEGES; PROVIDED THAT THE REFERRED PHYSICIAN IS LICENSED TO PRACTICE
14 UNDER APPLICABLE STATE LAW.
15 S 2. Subdivision 7 of section 4406-c of the public health law, as
16 renumbered by section 487 of the laws of 2010, is renumbered subdivision
17 10 and a new subdivision 9 is added to read as follows:
18 9. (A) NO HEALTH CARE PLAN SHALL BY CONTRACT, WRITTEN POLICY OR WRIT-
19 TEN PROCEDURE REQUIRE THE AFFILIATION AND/OR REQUIRE THE MAINTENANCE OF
20 HOSPITAL PRIVILEGES BY ANY NON-HOSPITAL EMPLOYEE HEALTH CARE PROVIDER AS
21 A CONDITION OF ENTERING INTO AND/OR MAINTAINING A CONTRACT, AGREEMENT OF
22 MEMBERSHIP OR ACCEPTANCE INTO A HEALTH CARE PLAN OR HEALTH MAINTENANCE
23 ORGANIZATION'S PROVIDER NETWORK.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02214-01-3
S. 4476 2
1 (B) NO HEALTH CARE PLAN SHALL BY CONTRACT, WRITTEN POLICY OR WRITTEN
2 PROCEDURE PROHIBIT OR RESTRICT ANY HEALTH CARE PROVIDER FROM REFERRING
3 AN INSURED TO ANOTHER PHYSICIAN BASED SOLELY UPON THE REFERRED PHYSI-
4 CIAN'S LACK OF AFFILIATION AND/OR LACK OF HOSPITAL PRIVILEGES; PROVIDED
5 THAT THE REFERRED PHYSICIAN IS LICENSED TO PRACTICE UNDER APPLICABLE
6 STATE LAW.
7 S 3. This act shall take effect on the one hundred eightieth day after
8 it shall have become a law.
