MANAGED CARE REFORM LEGISLATION ADVANCES IN ASSEMBLY

The Assembly advanced a series of MSSNY-supported bills to provide comprehensive reform to the many hassles experienced by patients and physicians in their dealings with health insurance companies. Very significantly these bills included legislation (A.4301, Canestrari, Gottfried et al.) which was unanimously approved by the Assembly Health Committee and which fundamentally changes the nature of health plan-physician interactions by granting physicians and other health care providers the legal ability to collectively negotiate critically important patient care and reimbursement contract terms with health plans. The bill now advances to the Assembly Ways and Means Committee.

Additionally a number of bills that passed the Assembly last session, but not the Senate, have been advanced for consideration again by the full Assembly, including the following legislation:

• A.723 (Gottfried) – Would require a coverage denial decision made by a health plan to be made by a physician board-certified in the same or similar specialty as the physician who typically provides the recommended treatment.
• A.726 (Gottfried) – Would prohibit health plans from including certain offensive provisions in contracts with health care providers, such as limiting referrals to out of network providers, and “most favored nation” clauses
• A.729 (Gottfried) – Would better assure the ability of a patient to be successful in an external appeal of a health plan denial by facilitating evidence-based appeals founded on medical and scientific literature, the patient’s medical record, and other pertinent information.
• A.764 (Gottfried) – Would mandate the use by health plans of universal credentialing and re-credentialing forms

All physicians are asked to communicate their support for these bills to their elected member of the Assembly. All Assembly members can be reached by calling (518) 455-4100.

This entry was posted on Wednesday, January 20th, 2010 at 12:46 pm and is filed under NEWS FROM THE NYS LEGISLATURE. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.