S00926 Summary:

BILL NOS00926
 
SAME ASSAME AS A07346
 
SPONSORGALLIVAN
 
COSPNSRBORRELLO
 
MLTSPNSR
 
Amd §213, Ins L
 
Provides that the New York state health care quality and cost containment commission shall: evaluate each mandated benefit; investigate current practices of health plans with regard to the mandated benefit; investigate the potential premium impact of repealing and/or modifying the mandated benefits on all segments of the insurance market; hold at least two public hearings; and submit a report to the legislature; makes related provisions.
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S00926 Actions:

BILL NOS00926
 
01/09/2023REFERRED TO INSURANCE
01/03/2024REFERRED TO INSURANCE
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S00926 Committee Votes:

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S00926 Floor Votes:

There are no votes for this bill in this legislative session.
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S00926 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                           926
 
                               2023-2024 Regular Sessions
 
                    IN SENATE
 
                                     January 9, 2023
                                       ___________
 
        Introduced  by Sen. GALLIVAN -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance
 
        AN ACT to amend the insurance law, in relation to  the  New  York  state
          health care quality and cost containment commission
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Section 213 of the insurance law, as added by section 1  of
     2  part L of chapter 57 of the laws of 2007, is amended to read as follows:
     3    § 213. New York state health care quality and cost containment commis-
     4  sion.  (a)  There  is hereby established within the department a commis-
     5  sion, to be known as the "New York state health care  quality  and  cost
     6  containment  commission".  The  commission  shall  consist  of  thirteen
     7  members appointed by the governor, one of whom shall be the  superinten-
     8  dent,  one  of whom shall be the commissioner of health, and six of whom
     9  shall be appointed on the recommendation of the legislative leaders, two
    10  on the recommendation of the temporary president of the senate,  two  on
    11  the  recommendation of the speaker of the assembly, one on the recommen-
    12  dation of the minority leader of the senate, and one on the  recommenda-
    13  tion  of the minority leader of the assembly. All members shall serve at
    14  the pleasure of the governor, and vacancies shall be  appointed  in  the
    15  same  manner  as  original appointments. Members of the commission shall
    16  serve without compensation, but shall be reimbursed for reasonable trav-
    17  el expenses. In making appointments  to  the  commission,  the  governor
    18  shall  ensure  that  the interests of health care consumers, small busi-
    19  nesses, the medical community and health plans are  represented  on  the
    20  commission,  and  that  the commission include at least one actuary, one
    21  expert on health benefits, having no less than fifteen years  of  direct
    22  experience  with  health benefits, and one physician. All members of the
    23  commission shall be seated no later than ninety days after the effective
    24  date of the chapter of the  laws  of  two  thousand  twenty-three  which
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00189-01-3

        S. 926                              2
 
     1  amended  this section and all vacancies shall be filled as soon as prac-
     2  ticable.
     3    (b)(1) The purpose of the commission shall be to analyze the impact on
     4  health  insurance  costs and quality of proposed legislation which would
     5  mandate that health benefits be offered or made available in  individual
     6  and  group health insurance policies, contracts and comprehensive health
     7  service plans, including legislation that affects the delivery of health
     8  benefits or services or the reimbursement of health care providers.
     9    (2) The governor, the chair of the senate insurance committee and  the
    10  chair  of  the  assembly insurance committee may request in writing that
    11  the commission evaluate a proposed mandated benefit. Upon receiving such
    12  a request, the commission [may, by a  majority  vote  of  its  members,]
    13  shall undertake an evaluation of such proposed mandated benefit.
    14    (3) In evaluating a proposed mandated benefit, the commission shall:
    15    (A)  investigate  the current practices of health plans with regard to
    16  the proposed mandated benefit, and, to the extent possible,  self-funded
    17  health benefit plans;
    18    (B)  investigate the potential premium impact of the proposed mandated
    19  benefits on all segments of the insurance market, as well as the  poten-
    20  tial  for  avoided costs through early detection and treatment of condi-
    21  tions, or more cost-effective delivery of medical services; [and]
    22    (C) analyze the most current [medical]  and  credible  evidence  based
    23  medicine literature regarding the proposed mandated benefit published in
    24  peer  reviewed  medical  literature generally recognized by the relevant
    25  medical  community  to  determine  the  effectiveness  of  the  proposed
    26  mandated benefit and its impact on health care quality[.]; and
    27    (D)  investigate  the  potential  cost  to  the  state of the proposed
    28  mandated benefits in light of the implementation of the federal afforda-
    29  ble care act.
    30    (4) In evaluating a proposed mandated benefit, the commission may hold
    31  one or more public hearings, and shall strive to obtain independent  and
    32  verifiable information from diverse sources within the healthcare indus-
    33  try,  medical  community  and among health care consumers with regard to
    34  the proposed mandated benefit.
    35    (c) To assist the commission in its duties, and upon the direction  of
    36  the  commission,  the  superintendent is authorized to enter into one or
    37  more contracts with independent entities and organizations  with  demon-
    38  strable expertise in health care quality, finance, utilization and actu-
    39  arial  services.  For  the  purposes of this section, the superintendent
    40  shall not enter into contracts with health plans, entities or  organiza-
    41  tions  owned or controlled by health plans, or with significant business
    42  relationships with health plans.
    43    (d) Upon completion of its evaluation of a proposed  mandated  benefit
    44  pursuant  to this section, the commission shall deliver a written report
    45  of its findings to the chair of the assembly insurance committee and the
    46  chair of the senate insurance committee.
    47    (e)(1) Beginning no later than nine months  after  the  commission  is
    48  seated,  and  reoccurring no less often than once every three years, the
    49  commission shall analyze the impact on health insurance costs and quali-
    50  ty of all state laws which mandate that health benefits  be  offered  or
    51  made  available  in  individual  and  group  health  insurance policies,
    52  contracts and comprehensive health  service  plans,  including  but  not
    53  limited  to laws that affect the delivery of health benefits or services
    54  or the reimbursement of health care providers.
    55    (2) In evaluating each mandated benefit, the commission shall:

        S. 926                              3
 
     1    (A) investigate the current practices of health plans with  regard  to
     2  the  mandated  benefit,  and, to the extent possible, self-funded health
     3  benefit plans including but not limited to avoided costs  through  early
     4  detection  and  treatment of conditions, or more cost-effective delivery
     5  of medical services;
     6    (B) investigate the potential premium impact of repealing and/or modi-
     7  fying the mandated benefits on all segments of the insurance market;
     8    (C)  analyze  the  most  current  and credible evidence based medicine
     9  literature regarding the mandated benefit  published  in  peer  reviewed
    10  medical literature generally recognized by the relevant medical communi-
    11  ty to determine the effectiveness of the mandated benefit and its impact
    12  on health care quality; and
    13    (D)  investigate  the  potential  cost  to  the  state of the proposed
    14  mandated benefits in light of the implementation of the federal afforda-
    15  ble care act.
    16    (3) In evaluating mandated benefits, the commission shall hold no less
    17  than two public hearings, and shall strive  to  obtain  independent  and
    18  verifiable  information  from  diverse  sources  within  the health care
    19  industry, medical community and among health care consumers with  regard
    20  to each mandated benefit.
    21    (4)(A)  On  or  before the first day of February, two thousand twenty-
    22  four, the commission shall submit to the legislature and disseminate  to
    23  the  public  recommendations for the repeal and/or modification of state
    24  laws which mandate benefits, along with a single  piece  of  legislation
    25  necessary to implement such recommendations. These recommendations shall
    26  not  be  expected  to  increase  the  average premium in the state. Upon
    27  receipt of such recommendations, the implementing  legislation  therefor
    28  shall be introduced in both houses of the legislature without any amend-
    29  ments within five days.
    30    (B)  The  legislation  introduced pursuant to subparagraph (A) of this
    31  paragraph shall be voted upon, without amendment, by both such houses of
    32  the legislature within ninety days, but not  sooner  than  thirty  days,
    33  after  the commission submits its recommendations to the legislature. If
    34  approved, the legislature shall forward such legislation to the governor
    35  within five days.
    36    § 2. This act shall take effect immediately.
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