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

                                  7616

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                              May 20, 2015
                               ___________

Introduced by M. of A. LAVINE -- read once and referred to the Committee
  on Health

AN ACT to amend the public health law and the insurance law, in relation
  to  prohibiting  health  care plans and health insurers from requiring
  any health care provider to provide services through the state  health
  benefit  exchange,  unless  the  health  care  provider  has agreed to
  participate in the in-network portion of such plan or insurance

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

  Section  1.  Section  4406-c  of  the  public health law is amended by
adding a new subdivision 5-e to read as follows:
  5-E. NO HEALTH CARE PLAN SHALL, BY CONTRACT OR WRITTEN POLICY OR WRIT-
TEN PROCEDURE, REQUIRE A HEALTH CARE PROVIDER TO PARTICIPATE IN A  PROD-
UCT  OFFERED  AS  A  QUALIFIED  HEALTH  PLAN  IN  A STATE HEALTH BENEFIT
EXCHANGE ESTABLISHED PURSUANT TO  THE  FEDERAL  PATIENT  PROTECTION  AND
AFFORDABLE  CARE  ACT (P.L.   111-148), AS AMENDED BY THE FEDERAL HEALTH
CARE AND EDUCATION RECONCILIATION ACT OF 2010 (P.L.    111-152),  UNLESS
THE  HEALTH  CARE PROVIDER AND HEALTH CARE PLAN HAVE EXECUTED A SEPARATE
AGREEMENT WHEREBY THE HEALTH CARE PROVIDER AGREES TO BE A PARTICIPANT IN
THE IN-NETWORK PORTION OF SUCH QUALIFIED HEALTH PLAN.
  S 2. Section 3217-b of the insurance law is amended by  adding  a  new
subsection (d-1) to read as follows:
  (D-1) NO INSURER SUBJECT TO THIS ARTICLE SHALL, BY CONTRACT OR WRITTEN
POLICY  OR  WRITTEN PROCEDURE, REQUIRE A HEALTH CARE PROVIDER TO PARTIC-
IPATE IN A PRODUCT OFFERED AS A QUALIFIED HEALTH PLAN IN A STATE  HEALTH
BENEFIT  EXCHANGE ESTABLISHED PURSUANT TO THE FEDERAL PATIENT PROTECTION
AND AFFORDABLE CARE ACT (P.L. 111-148), AS AMENDED BY THE FEDERAL HEALTH
CARE AND EDUCATION RECONCILIATION ACT OF 2010 (P.L. 111-152), UNLESS THE
HEALTH CARE PROVIDER AND INSURER  HAVE  EXECUTED  A  SEPARATE  AGREEMENT
WHEREBY  THE  HEALTH  CARE  PROVIDER  AGREES  TO BE A PARTICIPANT IN THE
IN-NETWORK PORTION OF SUCH QUALIFIED HEALTH PLAN.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10490-01-5
              

A. 7616                             2

  S 3. Section 4325 of the insurance law is  amended  by  adding  a  new
subsection (d-1) to read as follows:
  (D-1)  NO  CORPORATION ORGANIZED UNDER THIS ARTICLE SHALL, BY CONTRACT
OR WRITTEN POLICY OR WRITTEN PROCEDURE, REQUIRE A HEALTH  CARE  PROVIDER
TO  PARTICIPATE  IN  A  PRODUCT  OFFERED AS A QUALIFIED HEALTH PLAN IN A
STATE HEALTH  BENEFIT  EXCHANGE  ESTABLISHED  PURSUANT  TO  THE  FEDERAL
PATIENT PROTECTION AND AFFORDABLE CARE ACT (P.L. 111-148), AS AMENDED BY
THE  FEDERAL  HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010 (P.L.
111-152), UNLESS THE HEALTH CARE PROVIDER AND CORPORATION HAVE  EXECUTED
A  SEPARATE  AGREEMENT  WHEREBY  THE HEALTH CARE PROVIDER AGREES TO BE A
PARTICIPANT IN THE IN-NETWORK PORTION OF SUCH QUALIFIED HEALTH PLAN.
  S 4. This act shall take effect immediately.