Prohibits approved organizations providing coverage under the child health insurance plan from discriminating against health care providers which do not participate in the organization's health care network.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A9541
SPONSOR: Pretlow
 
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:
11/03/21 tabled
11/03/21 vetoed memo.51
2019-20 A3654 passed assembly
03/19/18 referred to health
01/30/13 referred to health
01/08/14 referred to health
04/07/14 reported
04/24/14 advanced to third reading cal.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
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
This act shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
9541
IN ASSEMBLY
March 20, 2024
___________
Introduced by M. of A. PRETLOW -- read once and referred to the Commit-
tee on Health
AN ACT to amend the public health law, in relation to prohibiting
approved organizations in the child health insurance plan from limit-
ing the participation of certain health care providers
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 7 of section 2511 of the public health law is
2 amended by adding a new paragraph (d) to read as follows:
3 (d) No approved organization shall prohibit or in any way limit the
4 provision of covered health care services by a health care provider on
5 the grounds that such provider chooses not to participate in a health
6 care network maintained by such approved organization to serve commer-
7 cial insureds, enrollees or subscribers.
8 § 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09371-01-3