Senate Bill S4476

2013-2014 Legislative Session

Restricts limitations on non-affiliated physicians from becoming a network provider of any health care plan or health maintenance organization

download bill text pdf

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Archive: Last Bill Status - Stricken

  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2013-S4476 (ACTIVE) - Details

Law Section:
Insurance Law
Laws Affected:
Amd §3217-b, Ins L; amd §4406-c, Pub Health L
Versions Introduced in 2011-2012 Legislative Session:
S7336

2013-S4476 (ACTIVE) - Summary

Provides that no insurer or health care plan shall by contract, written policy or written procedure require the maintenance of hospital privileges by any non-hospital employee health care provider as a condition of entering into or maintaining a contract, agreement of membership or acceptance into a health care plan or health maintenance organization's provider network; provides that no insurer or health care plan can prohibit or restrict any health care provider from referring an insured to another physician based solely upon the referred physician's lack of affiliation and/or lack of hospital privileges.

2013-S4476 (ACTIVE) - Sponsor Memo

2013-S4476 (ACTIVE) - Bill Text download pdf 

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4476

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                              April 3, 2013
                               ___________

Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
  printed to be committed to the Committee on Insurance

AN ACT to amend the insurance law and the public health law, in relation
  to restricting limitations on non-affiliated physicians from  becoming
  a  network  provider  of  any  health  care plan or health maintenance
  organization

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

  Section  1. Section 3217-b of the insurance law is amended by adding a
new subsection (k) to read as follows:
  (K) (1) NO INSURER SUBJECT TO THIS ARTICLE SHALL BY CONTRACT,  WRITTEN
POLICY  OR  WRITTEN PROCEDURE REQUIRE THE AFFILIATION AND/OR REQUIRE THE
MAINTENANCE OF HOSPITAL PRIVILEGES BY ANY NON-HOSPITAL  EMPLOYEE  HEALTH
CARE  PROVIDER  AS  A  CONDITION  OF  ENTERING INTO AND/OR MAINTAINING A
CONTRACT, AGREEMENT OF MEMBERSHIP OR ACCEPTANCE INTO A HEALTH CARE  PLAN
OR HEALTH MAINTENANCE ORGANIZATION'S PROVIDER NETWORK.
  (2)  NO  INSURER  SUBJECT  TO  THIS ARTICLE SHALL BY CONTRACT, WRITTEN
POLICY OR WRITTEN PROCEDURE PROHIBIT OR RESTRICT ANY HEALTH CARE PROVID-
ER FROM REFERRING AN INSURED TO ANOTHER PHYSICIAN BASED SOLELY UPON  THE
REFERRED  PHYSICIAN'S LACK OF AFFILIATION AND/OR LACK OF HOSPITAL PRIVI-
LEGES; PROVIDED THAT THE REFERRED  PHYSICIAN  IS  LICENSED  TO  PRACTICE
UNDER APPLICABLE STATE LAW.
  S  2.  Subdivision  7  of  section 4406-c of the public health law, as
renumbered by section 487 of the laws of 2010, is renumbered subdivision
10 and a new subdivision 9 is added to read as follows:
  9. (A) NO HEALTH CARE PLAN SHALL BY CONTRACT, WRITTEN POLICY OR  WRIT-
TEN  PROCEDURE REQUIRE THE AFFILIATION AND/OR REQUIRE THE MAINTENANCE OF
HOSPITAL PRIVILEGES BY ANY NON-HOSPITAL EMPLOYEE HEALTH CARE PROVIDER AS
A CONDITION OF ENTERING INTO AND/OR MAINTAINING A CONTRACT, AGREEMENT OF
MEMBERSHIP OR ACCEPTANCE INTO A HEALTH CARE PLAN OR  HEALTH  MAINTENANCE
ORGANIZATION'S PROVIDER NETWORK.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02214-01-3

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