Establishes the New York state health insurance authority; the purpose of the authority is to develop a new mechanism to effectively and efficiently deliver high quality, portable health insurance to the citizens of the state.
STATE OF NEW YORK
________________________________________________________________________
3535
2009-2010 Regular Sessions
IN ASSEMBLY
January 27, 2009
___________
Introduced by M. of A. BRADLEY -- read once and referred to the Commit-
tee on Insurance
AN ACT to amend the public authorities law, in relation to establishing
the New York state health insurance authority
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Article 8 of the public authorities law is amended by
2 adding a new title 20 to read as follows:
3 TITLE 20
4 NEW YORK STATE HEALTH INSURANCE AUTHORITY
5 Section 2489-a. Short title.
6 2489-b. Statement of legislative findings.
7 2489-c. New York state health insurance authority.
8 2489-d. General purposes and powers of the authority.
9 2489-e. Report and recommendations of the New York state health
10 insurance authority.
11 § 2489-a. Short title. This title shall be known and may be cited as
12 the "New York state health insurance authority act".
13 § 2489-b. Statement of legislative findings. The legislature hereby
14 finds and determines that health insurance is a necessity that should be
15 maintained by every citizen of the state. That due to the ever escalat-
16 ing cost of health insurance, it has become ever more difficult for
17 employers to offer such coverage as a benefit, and still remain compet-
18 itive in the global market place. As a result, the legislature hereby
19 further finds and determines that it has now become necessary to develop
20 a new mechanism to effectively and efficiently deliver high quality,
21 portable health insurance to every citizen in New York state.
22 The legislature additionally finds and determines that the present
23 matrix system for health insurance and medicaid has become both ineffi-
24 cient and ineffective, leading to unnecessarily high costs, the failure
25 to provide sufficient coverage to a significant number of people, and a
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03523-01-9
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1 reduced quality of health insurance benefits and health care, it has
2 essentially led to a system where health insurance is not sufficiently
3 affordable, available or portable for the citizens of the state of New
4 York.
5 In order to meet the needs of the state's modern society, and in order
6 to remove the heavy burdens that the current matrix system of providing
7 health insurance and medicaid now imposes upon the state's businesses,
8 citizens and taxpayers, and thereby improve both the state's business
9 and economic climate, as well as improve the health care of all the
10 state's citizens, the legislature finds and determines that a new health
11 insurance and medicaid system needs to be developed by the state of New
12 York, to assure high quality, low cost, portable health insurance cover-
13 age for every citizen of the state.
14 The legislature also finds and determines that the best and most
15 appropriate mechanism to accomplish the delivery of high quality, low
16 cost, portable health insurance to all the citizens of New York state is
17 a public authority, incorporated by the legislature, for the purpose of
18 providing this public benefit. Such public authority shall be known as
19 the New York state health insurance authority.
20 The legislature further finds and determines that in order to accom-
21 plish this state policy of providing high quality, low cost, portable
22 health insurance to every citizen of New York, that the New York state
23 health insurance authority shall use economies of scale to purchase
24 health insurance from the private market. In so doing, it will combine
25 the benefits of capitalism with the purchasing power of the state
26 government, to promote competition for the provision of high quality,
27 low cost, portable health insurance coverage for every citizen of New
28 York.
29 The legislature also finds and determines, that in order to provide
30 for the economies of scale to take advantage of the competition in the
31 private marketplace, the New York state health insurance authority shall
32 develop and design a standardized, high quality, uniform, portable
33 health insurance policy. Such policy shall be delivered to every citizen
34 of New York without direct charge to the citizen. Such policy shall
35 contain all the coverage requirements for large group health insurance
36 policies set forth within the insurance law, together with long term
37 care coverage for nursing home care.
38 The legislature additionally finds and determines that the financing
39 of the provision of such health insurance and long term care policy
40 benefits to all the citizens of the state of New York shall be done
41 through a combination of state directed federal medicaid funds and a
42 dedicated state tax, with the revenues derived from such being appropri-
43 ated to the New York state health insurance authority. The dedicated
44 state tax shall be a portion of the state and local sales and use tax,
45 and if necessary, a payroll tax based upon employee wages. It is the
46 further intent of this legislature, that through the provision of such
47 health insurance and long term care policy benefits to all the citizens
48 of the state of New York, that this new matrix developed by the New York
49 state health insurance authority, shall replace the current employer
50 funded health insurance and state medicaid matrix systems.
51 The legislature also finds and determines that in order to maximize
52 the cost effectiveness of the delivery of these developed, high quality,
53 uniform, portable standardized health insurance policies to all citizens
54 of the state of New York, the New York state health insurance authority
55 shall develop and design a standardized schedule of reimbursement prac-
56 tices and forms to be used by all health care and nursing home providers
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1 in the state. Such procedures shall seek to reduce paperwork, adminis-
2 tration and processing time, and to increase efficiency and speed of
3 processing by both the insurers and the health care providers.
4 In order to deliver and provide the designated high quality, uniform,
5 portable health insurance coverage to every citizen of the state of New
6 York, the legislature hereby further finds and determines that the New
7 York state health insurance authority shall solicit open bids from
8 private insurance companies, for the purchase of such standardized poli-
9 cies, and that such private companies, subject to the design of the
10 standardized policy, shall be the underwriters and providers of such
11 health insurance coverage to the citizens of the state of New York. The
12 New York state health insurance authority may accept multiple bids from
13 multiple insurers in multiple regions, purchasing policies for the citi-
14 zens of those regions, so long as the insurers provide the coverage
15 pursuant to the designed requirements of the standardized policy.
16 § 2489-c. New York state health insurance authority. 1. The New York
17 state health insurance authority. The New York state health insurance
18 authority is hereby created. Such authority shall be a body corporate
19 and politic constituting a public benefit corporation. The governing
20 body of the authority shall be a board. The authority shall consist of
21 seventeen members who are residents of the state of New York, appointed
22 by the governor as follows:
23 (a) The superintendent of insurance;
24 (b) The commissioner of labor;
25 (c) The commissioner of health;
26 (d) The director of the governor's office of regulatory reform;
27 (e) The director of the governor's office of employee relations;
28 (f) Two members upon recommendation of the temporary president of the
29 senate;
30 (g) Two members upon recommendation of the speaker of the assembly;
31 (h) One member upon recommendation of the senate minority leader;
32 (i) One member upon recommendation of the assembly minority leader;
33 (j) Two members with experience in the insurance industry;
34 (k) Two members who are a practicing physician, nurse, chiropractor or
35 other health care specialist;
36 (l) One member who is affiliated with organized labor; and
37 (m) One member who is affiliated with small business organization.
38 2. Board members. All members shall serve for a term of five years,
39 with each term commencing from the first day of January next succeeding
40 their appointment. Each member, unless removed for good cause by a two-
41 thirds vote of the senate, shall hold office until a successor has been
42 appointed and qualified.
43 3. Chair and vice chair of the board. A member of the board shall be
44 designated as chair by the governor, upon advice and consent of the
45 senate, and shall be chair of such board until his or her term as member
46 expires. The superintendent of insurance, the commissioner of labor,
47 the commissioner of health, the director of the governor's office of
48 regulatory reform, and the director of the governor's office of employee
49 relations shall be ineligible to serve as chair of the board. The gover-
50 nor shall also designate, upon advice and consent of the senate, a
51 member of the board, who is eligible to serve as chair, to serve as
52 vice-chair of the board until his or her term as member expires.
53 4. Executive director. The chair of the board shall be the chief exec-
54 utive officer of the authority and shall be primarily responsible for
55 the discharge of its administrative functions. The chair may appoint an
56 executive director of the authority, upon advice and consent of the
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1 board, to which such administrative functions may be delegated. The
2 executive director shall be deemed an employee of the authority, and as
3 such be an exempt, management confidential employee, who is a public
4 officer and entitled to an annual salary and benefits as established by
5 the authority board.
6 5. Power of the authority. The power of such corporation shall be
7 vested in and exercised by the board. Such board may delegate to one or
8 more of its members or its officers, agents and employees such powers
9 and duties as it may deem proper. Such board and its corporate existence
10 shall continue until its existence shall be terminated by law. Upon the
11 termination of the existence of the authority, all its rights and prop-
12 erties shall pass to and be vested in the state of New York. Nine
13 members of the board shall constitute a quorum for the transaction of
14 business. A majority of the members of the board present at any meeting
15 at which a quorum shall be present, shall be sufficient to pass any
16 resolution, except as otherwise specified in this title.
17 All propositions requiring the expenditure of money or affecting
18 contract rights or property, shall be presented to the board in writing.
19 No resolution containing such a proposition shall pass unless it
20 receives approval of at least nine board members in office. The board
21 shall hold at least one regular meeting every month. The chair, or in
22 his or her absence the vice chair, or any six members, may call a
23 special meeting by notice as specified by the board. All meetings of the
24 board shall be subject to article seven of the public officers law.
25 6. Compensation of members of the board. Members of the board shall
26 be entitled to no compensation for their services, but shall be entitled
27 to reimbursement for their actual and necessary expenses incurred in the
28 performance of their official duties.
29 Notwithstanding any inconsistent provision of any general, special or
30 local law, no officer or employee of the state, or of any municipality,
31 as defined in the public officers law, the county law or the town law,
32 shall be deemed to have forfeited or shall forfeit his or her public
33 office or any benefits provided under the retirement and social security
34 law or under any public retirement system maintained by the state or any
35 of its subdivisions by reason of his or her acceptance of membership on
36 or chairmanship or vice chairmanship of the authority; provided, howev-
37 er, a member who holds such other public office shall receive no addi-
38 tional compensation for services rendered pursuant to this title, but
39 shall be entitled to reimbursement for actual and necessary expenses
40 incurred in the performance of such services.
41 Subject to the provisions of this title, members of the authority may
42 engage in private employment, or in a profession or business.
43 7. Offices of the authority. The principal office of the authority
44 shall be located in the city of Albany.
45 8. Audits of the authority. The comptroller may conduct periodic
46 financial audits of the authority and report the results of such audits
47 to the governor, the chair of the senate finance committee, and the
48 chair of the assembly ways and means committee.
49 § 2489-d. General purposes and powers of the authority. 1. The general
50 purposes of the authority shall be to:
51 (a) develop a new mechanism to effectively and efficiently deliver and
52 provide high quality, portable health insurance coverage to every citi-
53 zen in New York state. In so doing the authority shall seek to:
54 (i) replace the state's current matrix medicaid and employer and indi-
55 vidual provided health insurance system;
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1 (ii) remove the heavy burden that the current matrix medicaid and
2 employer and individual provided health insurance system now imposes
3 upon the state's businesses, citizens and taxpayers;
4 (iii) improve the state's business and economic climate;
5 (iv) improve the health care of all the state's citizens; and
6 (v) assure the efficient, low cost, effective delivery and provision
7 of high quality, portable, health insurance coverage for every citizen
8 of New York; and
9 (b) develop and design a standardized, high quality, uniform, portable
10 health insurance policy, which the authority can purchase and provide
11 for every citizen of the state of New York without direct charge to the
12 citizen. In so doing the authority shall seek to:
13 (i) assure that such standardized, designed health insurance policy,
14 to be delivered and provided to every citizen, contains all the coverage
15 requirements for large group health insurance policies set forth by the
16 insurance law, together with long term care coverage for nursing home
17 care;
18 (ii) use economies of scale to purchase such standardized, designed
19 health insurance policies from the private market for every citizen of
20 the state of New York;
21 (iii) use the benefits of capitalism to promote competition for high
22 quality, low cost and portable health insurance coverage; and
23 (iv) take advantage of the competition in the private marketplace; and
24 (c) develop and design a standardized schedule of reimbursement prac-
25 tices and forms to be used by all health care and nursing home providers
26 in the state. In so doing the authority shall seek to:
27 (i) maximize the cost effectiveness of the delivery and provision of
28 standardized health insurance policies to all citizens; and
29 (ii) reduce paperwork, administration and processing time, to increase
30 efficiency and speed of processing, by both the insurers and the health
31 care providers; and
32 (d) receive state directed federal medicaid funds and dedicated state
33 tax revenues from appropriations in order to provide the financing for
34 the purchase, delivery and provision of such health insurance and long
35 term care policy benefits to all the citizens of the state of New York;
36 and
37 (e) deliver and provide the designed, standardized, high quality,
38 uniform, portable health insurance coverage to every citizen of the
39 state of New York, by means of purchased policies from private insurance
40 companies, pursuant to the solicitation of open bids from such compa-
41 nies. Pursuant to such purchases, such companies shall be the underwrit-
42 ers and providers of such health insurance coverage to the citizens of
43 the state of New York. In making such purchases, the New York state
44 health insurance authority may accept multiple bids from multiple insur-
45 ers in multiple regions, purchasing policies for the citizens of those
46 regions, so long as the insurers so awarded the bids provide the cover-
47 age pursuant to the designed requirements of the standardized policy.
48 2. To carry out such purposes the authority shall have the power:
49 (a) to sue and be sued;
50 (b) to acquire, hold and dispose of real and personal property for its
51 corporate purposes;
52 (c) to have a seal and alter the same at pleasure;
53 (d) to borrow money and issue bonds for any of its corporate purposes
54 or its projects, or to refund the same, and to provide for the rights of
55 the holders thereof;
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1 (e) to make by-laws for the management and regulation of its affairs
2 subject to agreements with bondholders;
3 (f) to appoint officers, agents and employees; and to describe their
4 qualifications and fix their compensation; subject, however, to the
5 provisions of the civil service law as provided in this title;
6 (g) to make contracts and leases, and to execute all instruments
7 necessary or convenient;
8 (h) to collect revenues, dues, costs, assessments, rentals, fees and
9 other charges for the use of real or personal property and/or facilities
10 of the authority subject to and in accordance with such agreements with
11 bondholders as may be provided in this title;
12 (i) to contract for the services of insurance companies, health care
13 professionals, architects, engineers, consultants, lawyers, financial
14 and other professional advisors, developers, contractors, vendors,
15 concessioners, tenants, facility and/or managers and other professional
16 consultants and service providers, and to fix their compensation;
17 (j) to develop and design a standardized, high quality, uniform, port-
18 able health insurance policy, which the authority can purchase for every
19 citizen of the state of New York, which contains all the coverage
20 requirements for large group health insurance policies contained within
21 the insurance law, together with long term care coverage for nursing
22 home care;
23 (k) to seek and request medicaid funding reimbursement from the feder-
24 al government for the purchase of standardized health insurance and long
25 term care coverage for every citizen of the state of New York;
26 (l) to develop and design a standardized schedule of reimbursement
27 practices and forms to be used by all health care and nursing home
28 providers in the state;
29 (m) to maximize the cost effectiveness of the delivery of standardized
30 health insurance policies to all citizens;
31 (n) to reduce paperwork, administration and processing time;
32 (o) to increase efficiency and speed of processing insurance claims by
33 both the insurers and the health care providers;
34 (p) to solicit open bids from private insurance companies, subject to
35 the design of the standardized policy, for the underwriting and
36 provision of health insurance coverage to all citizens of the state of
37 New York;
38 (q) to accept bids from multiple insurers in multiple regions, so long
39 as the insurers provide the required standardized health insurance and
40 long term care coverage pursuant to the designed policy requirements of
41 the authority;
42 (r) to purchase the developed and designed standardized, high quality
43 uniform, portable health insurance policy, which contains all the cover-
44 age requirements for large group health insurance policies contained
45 within the insurance law, together with long term care coverage for
46 nursing home care, for every citizen of the state of New York;
47 (s) to designate the depositories of its money;
48 (t) to establish its fiscal year;
49 (u) to appoint such officers, employees and agents as the authority
50 may require for the performance of its duties and to fix and determine
51 their qualifications, duties, and compensation subject to the provisions
52 of the civil service law and any applicable collective bargaining agree-
53 ment, and to retain or employ counsel, auditors, engineers and private
54 consultants on a contract basis or otherwise for rendering professional,
55 management or technical services and advice;
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1 (v) to receive and consider reports and recommendations from any advi-
2 sory councils or boards as may be established; and
3 (w) to do all things necessary, convenient or desirable, including
4 ancillary and incidental activities, to carry out its purposes and for
5 the exercise of the powers granted in this title.
6 § 2489-e. Report and recommendations of the New York state health
7 insurance authority. On or before March thirty-first, two thousand ten,
8 the authority board shall prepare and produce a report with recommenda-
9 tions to the governor, the temporary president of the senate, the speak-
10 er of the assembly, and the chairs of the senate and assembly standing
11 committees on corporations, authorities and commissions.
12 The report with recommendations shall investigate, examine and offer
13 proposed solutions, consistent with the provisions of this title, on all
14 topics that the board deems important to the successful future operation
15 of the authority in the execution of its purposes and mission as
16 described in this title, including but not limited to, the following
17 issues:
18 1. The development of a new mechanism to effectively and efficiently
19 deliver and provide high quality, portable health insurance coverage to
20 every citizen in New York state;
21 2. The replacement of the state's current matrix medicaid and employer
22 and individual provided health insurance system with the new system set
23 forth under this title;
24 3. Strategies for obtaining and expanding the receipt of federal medi-
25 caid and medicare revenues into the authority for the purpose of provid-
26 ing revenue for the purchase of the high quality, portable health insur-
27 ance coverage for every citizen in New York state that this title
28 requires the authority to perform;
29 4. Projections and detailed explanations of the costs, expenditures
30 and revenues that will be necessary to implement the purposes and
31 mission of this title, together with an examination and impact assess-
32 ment of the possible revenue sources necessary to implement the purposes
33 and mission of this title;
34 5. An examination and analysis of the effects and measures necessary
35 to remove the heavy burden that the current matrix medicaid and employer
36 and individual provided health insurance system now imposes upon the
37 state's businesses, citizens and taxpayers;
38 6. An examination and analysis on how to improve the state's business
39 and economic climate, and what impact and effects the establishment
40 would have upon such climate;
41 7. An examination and analysis on how to improve the health care of
42 all the state's citizens;
43 8. An examination and analysis on the best practices and procedures to
44 assure the efficient, low cost, effective delivery and provision of high
45 quality, portable, health insurance coverage for every citizen of New
46 York, consistent with the provisions of this title;
47 9. An examination and analysis of the development and design of a
48 standardized, high quality, uniform, portable health insurance policy,
49 which contains all the coverage requirements for large group health
50 insurance policies set forth by the insurance law, together with long
51 term care coverage for nursing home care, which the authority can
52 purchase from private insurance companies, and provide to every citizen
53 of the state of New York without direct charge to the citizen;
54 10. An examination and analysis on the best practices and procedures
55 to assure that such standardized, designed health insurance policy, will
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1 be delivered and provided to every citizen without direct charge to the
2 citizen;
3 11. An examination and analysis on the best practices and procedures
4 to use and deploy economies of scale to purchase such standardized,
5 designed health insurance policies from the private market for every
6 citizen of the state of New York;
7 12. An examination and analysis on the best practices and procedures
8 to use and deploy the benefits of capitalism so as to promote competi-
9 tion for high quality, low cost and portable health insurance coverage;
10 13. An examination and analysis on the best practices and procedures
11 to use and deploy to take advantage of the competition in the private
12 marketplace;
13 14. An examination and analysis on the best practices and procedures
14 to develop and design a standardized schedule of reimbursement practices
15 and forms to be used by all health care and nursing home providers in
16 the state;
17 15. An examination and analysis on the best practices and procedures
18 to maximize the cost effectiveness of the delivery and provision of
19 standardized health insurance policies to all citizens of the state of
20 New York;
21 16. An examination and analysis on the best practices and procedures
22 to reduce paperwork, administration and processing time, and to increase
23 efficiency and speed of processing, by both the insurers and the health
24 care providers;
25 17. An examination and analysis on the best practices and procedures
26 to receive state directed federal medicaid funds and dedicated state tax
27 revenues from appropriations in order to provide the financing for the
28 purchase, delivery and provision of such health insurance and long term
29 care policy benefits to all the citizens of the state of New York;
30 18. An examination and analysis on the best practices and procedures
31 to deliver and provide the designed, standardized, high quality,
32 uniform, portable health insurance coverage to every citizen of the
33 state of New York, by means of purchased policies from private insurance
34 companies, pursuant to the solicitation of open bids from such compa-
35 nies;
36 19. An examination and analysis on the best practices and procedures
37 to have, pursuant to such purchases, such companies be the underwriters
38 and providers of such health insurance coverage to the citizens of the
39 state of New York;
40 20. An examination and analysis on the best practices and procedures
41 to access and accept multiple bids from multiple insurers in multiple
42 regions, in purchasing policies for the citizens of those regions, so
43 long as the insurers so awarded the bids provide the coverage pursuant
44 to the designed requirements of the standardized policy;
45 21. An examination and analysis on the best practices and procedures
46 to operate the authority in order to best achieve the intent, purposes
47 and mission of this title.
48 § 2. This act shall take effect immediately.
