Bill Text: NY A00434 | 2017-2018 | General Assembly | Introduced

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Bill Title: Requires health insurers to offer coverage of health care provided by out-of-network providers.

Spectrum: Partisan Bill (Democrat 10-0)

Status: (Introduced - Dead) 2018-01-03 - referred to insurance [A00434 Detail]

Download: New_York-2017-A00434-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                           434
                               2017-2018 Regular Sessions
                   IN ASSEMBLY
                                     January 9, 2017
                                       ___________
        Introduced  by  M.  of  A. ROSENTHAL, THIELE, GALEF, SKOUFIS, SEPULVEDA,
          STECK, ZEBROWSKI -- Multi-Sponsored by -- M. of A.  LUPINACCI,  SIMON,
          SKARTADOS -- read once and referred to the Committee on Insurance
        AN ACT to amend the insurance law and the public health law, in relation
          to  requiring  health  care insurers to offer coverage for health care
          provided by out-of-network providers
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Section  3217-e of the insurance law, as added by chapter
     2  219 of the laws of 2011, is amended to read as follows:
     3    § 3217-e. Choice of health care  provider.  (a)  An  insurer  that  is
     4  subject  to  this article and requires or provides for designation by an
     5  insured of a  participating  primary  care  provider  shall  permit  the
     6  insured  to  designate  any  participating  primary care provider who is
     7  available to accept such individual, and in the case of a  child,  shall
     8  permit  the insured to designate a physician (allopathic or osteopathic)
     9  who specializes in pediatrics as the child's primary  care  provider  if
    10  such provider participates in the network of the insurer.
    11    (b)  Every  insurer that offers health insurance and is subject to the
    12  provisions of this article, shall offer out-of-network  coverage  as  an
    13  optional  rider to any policy and shall offer at least one policy option
    14  that includes out-of-network  coverage.  These  options  shall  be  made
    15  available  both within the statewide health benefit exchange and outside
    16  of the health benefit exchange.
    17    § 2. Section 4306-d of the insurance law, as added by chapter  219  of
    18  the laws of 2011, is amended to read as follows:
    19    §  4306-d.  Choice  of health care provider. (a) A corporation that is
    20  subject to the provisions of this article and requires or  provides  for
    21  designation  by  a  subscriber  of a participating primary care provider
    22  shall permit the subscriber to designate any participating primary  care
    23  provider  who is available to accept such individual, and in the case of
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01720-01-7
        A. 434                              2
     1  a child, shall permit the subscriber to designate a physician (allopath-
     2  ic or osteopathic) who specializes in pediatrics as the child's  primary
     3  care provider if such provider participates in the network of the corpo-
     4  ration.
     5    (b)  Every corporation that is subject to the provisions of this arti-
     6  cle, shall offer out-of-network coverage as an  optional  rider  to  any
     7  contract  and  shall  offer  at  least one contract option that includes
     8  out-of-network coverage. These options  shall  be  made  available  both
     9  within  the  statewide health benefit exchange and outside of the health
    10  benefit exchange.
    11    § 3. Section 4403 of the public health law is amended by adding a  new
    12  subdivision 9 to read as follows:
    13    9.  Every  health  maintenance organization shall offer out-of-network
    14  coverage as an optional rider to any contract and shall offer  at  least
    15  one contract option that includes out-of-network coverage. These options
    16  shall  be  made  available  both  within  the  statewide  health benefit
    17  exchange and outside of the health benefit exchange.
    18    § 4. This act shall take effect on the first of January next  succeed-
    19  ing  the  date  on  which it shall have become a law, and shall apply to
    20  contracts and policies issued, renewed, modified or amended on or  after
    21  such date.