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A09541 Summary:

BILL NOA09541
 
SAME ASSAME AS S04922
 
SPONSORPretlow
 
COSPNSR
 
MLTSPNSR
 
Amd 2511, Pub Health L
 
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.
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A09541 Memo:

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.
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A09541 Text:



 
                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
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