A4456A-2011 Actions

• Jun 12, 2012: reported referred to codes
• Jun 6, 2012: print number 4456a
• Jun 6, 2012: amend and recommit to insurance
• Jan 4, 2012: referred to insurance
• Feb 3, 2011: referred to insurance

A4456A-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 4456--A
 2011-2012 Regular Sessions
 I N  ASSEMBLY
 February 3, 2011
 
 Introduced  by  M.  of  A. CASTRO, HOOPER, BARRON, STEVENSON, P. RIVERA,
 RAMOS, LINARES, WEPRIN, ROBERTS, ORTIZ -- Multi-Sponsored by -- M.  of
 A.  BOYLAND, COOK -- read once and referred to the Committee on Insur
 ance -- recommitted to the Committee on Insurance in  accordance  with
 Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
 reprinted as amended and recommitted to said committee
 

AN ACT to amend the insurance law and the public health law, in relation
 to prohibiting the disruption of health services by any third party
 

THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM
 BLY, DO ENACT AS FOLLOWS:

 

Section 1.

Section 3217-e of the insurance law, as  added  by  chapter
 219 of the laws of 2011, is amended to read as follows:

 

S  3217-e.  Choice of health care provider. An insurer that is subject
 to this article and requires or provides for designation by  an  insured
 of  a  participating  primary  care provider shall permit the insured to
 designate any participating primary care provider who  is  available  to
 accept  such  individual,  and  in the case of a child, shall permit the
 insured  to  designate  a  physician  (allopathic  or  osteopathic)  who
 specializes  in  pediatrics as the child's primary care provider if such
 provider participates in the network of the insurer. NO INSURER  SUBJECT
 TO  THIS  ARTICLE  SHALL  CAUSE  A DISRUPTION IN HEALTH CARE SERVICES BY
 REQUIRING THAT AN INSURED RECEIVE SERVICES FROM A SPECIFIC PRIMARY  CARE
 PROVIDER;  PROVIDED  HOWEVER,  NOTHING  HEREIN SHALL RESTRICT AN INSURER
 FROM REQUIRING AN INSURED TO SELECT A PRIMARY CARE PROVIDER FROM  WITHIN
 THE  INSURER'S  NETWORK  OF  PARTICIPATING  PROVIDERS.  IT  SHALL NOT BE
 CONSIDERED TO BE A DISRUPTION OF HEALTH CARE SERVICES  WHEN  AN  INSURER
 SUBJECT  TO  THIS  ARTICLE  IS AUTHORIZED BY LAW, RULE, OR REGULATION TO
 SELECT A PRIMARY CARE PROVIDER  ON  BEHALF  OF  THE  INSURED  WHEN  SUCH
 INSURED HAS NOT MADE SUCH SELECTION IN A TIMELY MANNER.
 

S  2. 

Section 4306-d of the insurance law, as added by chapter 219 of
 the laws of 2011, is amended to read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD03001-03-2
 
       A. 4456--A                          2
 

S 4306-d. Choice of  health  care  provider.  A  corporation  that  is
 subject  to  the provisions of this article and requires or provides for
 designation by a subscriber of a  participating  primary  care  provider
 shall  permit the subscriber to designate any participating primary care
 provider  who is available to accept such individual, and in the case of
 a child, shall permit the subscriber to designate a physician (allopath
 ic or osteopathic) who specializes in pediatrics as the child's  primary
 care provider if such provider participates in the network of the corpo
 ration.  NO  INSURER SUBJECT TO THIS ARTICLE SHALL CAUSE A DISRUPTION IN
 HEALTH CARE SERVICES BY REQUIRING THAT AN INSURED RECEIVE SERVICES  FROM
 A SPECIFIC PRIMARY CARE PROVIDER; PROVIDED HOWEVER, NOTHING HEREIN SHALL
 RESTRICT  AN  INSURER FROM REQUIRING AN INSURED TO SELECT A PRIMARY CARE
 PROVIDER FROM WITHIN THE INSURER'S NETWORK OF  PARTICIPATING  PROVIDERS.
 IT  SHALL  NOT  BE CONSIDERED TO BE A DISRUPTION OF HEALTH CARE SERVICES
 WHEN AN INSURER SUBJECT TO THIS ARTICLE IS AUTHORIZED BY LAW,  RULE,  OR
 REGULATION  TO  SELECT  A PRIMARY CARE PROVIDER ON BEHALF OF THE INSURED
 WHEN SUCH INSURED HAS NOT MADE SUCH SELECTION IN A TIMELY MANNER.
 

S 3. Subdivision 7 of section 4403 of the public health law, as  added
 by chapter 219 of the laws of 2011, is amended to read as follows:

 7.  A  health  maintenance  organization that requires or provides for
 designation by an enrollee of  a  participating  primary  care  provider
 shall  permit  the  enrollee to designate any participating primary care
 provider who is available to accept such individual, and in the case  of
 a  child, shall permit the enrollee to designate a physician (allopathic
 or osteopathic) who specializes in pediatrics  as  the  child's  primary
 care provider if such provider participates in the network of the health
 maintenance  organization. NO HEALTH MAINTENANCE ORGANIZATION SUBJECT TO
 THIS ARTICLE SHALL CAUSE A DISRUPTION IN HEALTH CARE SERVICES BY REQUIR
 ING THAT AN INSURED  RECEIVE  SERVICES  FROM  A  SPECIFIC  PRIMARY  CARE
 PROVIDER; PROVIDED HOWEVER, NOTHING HEREIN SHALL RESTRICT A HEALTH MAIN
 TENANCE  ORGANIZATION FROM REQUIRING AN INSURED TO SELECT A PRIMARY CARE
 PROVIDER FROM WITHIN THE HEALTH MAINTENANCE  ORGANIZATION'S  NETWORK  OF
 PARTICIPATING  PROVIDERS.  IT SHALL NOT BE CONSIDERED TO BE A DISRUPTION
 OF HEALTH CARE SERVICES WHEN A HEALTH MAINTENANCE  ORGANIZATION  SUBJECT
 TO  THIS  ARTICLE  IS AUTHORIZED BY LAW, RULE, OR REGULATION TO SELECT A
 PRIMARY CARE PROVIDER ON BEHALF OF THE INSURED WHEN SUCH INSURED HAS NOT
 MADE SUCH SELECTION IN A TIMELY MANNER.
 

S 4. This act shall take effect on the first of January next  succeed
 ing the date upon which it shall have become a law.

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