Relates to transparency in health insurance claims data for public employers participating in the New York state health insurance program.
TITLE OF BILL: An act to amend the civil service law, in relation to transparency in health insurance claims data for public employers participating in the New York state health insurance program
PURPOSE: To provide public employers participating in NYSHIP information relating to benefits, claims and premium payments on quarterly basis.
SUMMARY OF PROVISIONS:
Section 1: Requires the Department of Financial Services to disclose to all employers participating in NYSHIP information on a quarterly basis relating to that employers utilization of benefits, claims, premium payments. Including, but not limited to claims paid by the month, broken out by medical and pharmacy, and a separate listing of claims over $50,000 in compliance with the health insurance portability and accountability act of 1996.
Section 2: Establishes the effective date.
JUSTIFICATION: Local governments and school districts participating in the New York State Health Insurance Program (NYSHIP) are often not provided timely, meaningful claims information about their own claims and experience, even if they request it. This makes it difficult for them to calculate current and future health care costs. This legislation requires the Department of Financial Services to provide NYSHIP participants with information relating to benefits, claims and premium payments on a quarterly basis. The overall goal is to make NYSHIP more transparent for local governments and school districts participating in the program.
LEGISLATIVE HISTORY: 2012: S.7499-A - Rules
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: Immediately.
STATE OF NEW YORK ________________________________________________________________________ 3788 2013-2014 Regular Sessions IN SENATE February 15, 2013 ___________Introduced by Sen. FLANAGAN -- read twice and ordered printed, and when printed to be committed to the Committee on Civil Service and Pensions AN ACT to amend the civil service law, in relation to transparency in health insurance claims data for public employers participating in the New York state health insurance program THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 162 of the civil service law is amended by adding a new subdivision 9 to read as follows: 9. THE DEPARTMENT SHALL BE REQUIRED TO DISCLOSE TO ALL EMPLOYERS PARTICIPATING IN THE NEW YORK STATE HEALTH INSURANCE PROGRAM, ON A QUAR- TERLY BASIS AND IN A MANNER TO BE DIRECTED BY THE SUPERINTENDENT OF FINANCIAL SERVICES, ALL INFORMATION RELATING TO THAT EMPLOYER'S UTILIZA- TION OF PROVIDED BENEFITS, CLAIMS AND PREMIUM PAYMENTS, AND SHALL INCLUDE, BUT NOT BE LIMITED TO, CLAIMS PAID BY MONTH, BROKEN OUT BY MEDICAL AND PHARMACY, AND A SEPARATE LISTING OF CLAIMS OVER FIFTY THOU- SAND DOLLARS IN COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996. S 2. This act shall take effect immediately.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD01514-01-3