Bill Text: NY A02205 | 2023-2024 | General Assembly | Introduced
Bill Title: Provides that no insurance contract or agreement between a health insurance plan and a health care provider, other than a residential health care facility, shall include a provision that: contains a most-favored-nation provision; or restricts the ability of a corporation, an entity that contracts with a corporation for a provider network, or a health care provider to disclose certain costs, prices or information; extends the effective date from January 1, 2023 until July 1, 2023.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2023-02-01 - substituted by s1330 [A02205 Detail]
Download: New_York-2023-A02205-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 2205 2023-2024 Regular Sessions IN ASSEMBLY January 24, 2023 ___________ Introduced by M. of A. CRUZ -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law and the public health law, in relation to certain health care contracts or agreements; and to amend a chapter of the laws of 2022 amending the insurance law relating to certain prohibited contract provisions, as proposed in legislative bills numbers S. 7199-A and A. 8169-A, in relation to the effectiveness thereof The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 4235 of the insurance law is amended by adding a 2 new subsection (o) to read as follows: 3 (o) (1) No contract or agreement between a health plan subject to this 4 article and a health care provider, other than a residential health care 5 facility as defined by section twenty-eight hundred one of the public 6 health law, shall include a provision that: 7 (A) contains a most-favored-nation provision; or 8 (B) restricts the ability of a corporation, an entity that contracts 9 with a corporation for a provider network, or a health care provider to 10 disclose: (i) actual claims costs; or (ii) price or quality information 11 required to be disclosed under federal law, including the allowed 12 amount, negotiated rates or discounts, or any other claim-related finan- 13 cial obligations, including, but not limited to, patient cost-sharing 14 covered by the provider contract to any subscriber, enrollee, group, or 15 other entity receiving health care services pursuant to the contract, or 16 to any public compilation of reimbursement data such as the New York all 17 payer database required by law or regulation, provided that no disclo- 18 sure shall include protected health information or other information 19 covered by statutory or other privilege. 20 (2) For purposes of this subsection, the term "health plan" shall 21 include: (A) an insurer licensed pursuant to this chapter or a health EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04298-01-3A. 2205 2 1 maintenance organization certified pursuant to article forty-four of the 2 public health law; and 3 (B) a third-party administrator, affiliated with an insurer or health 4 maintenance organization, who administers a health benefit plan. 5 § 2. Section 4406-c of the public health law is amended by adding a 6 new subdivision 13 to read as follows: 7 13. (a) No contract or agreement between a health plan subject to this 8 article and a health care provider, other than a residential health care 9 facility as defined by section twenty-eight hundred one of this chapter, 10 shall include a provision that: 11 (i) contains a most-favored-nation provision; or 12 (ii) restricts the ability of a health plan, an entity that contracts 13 with a health care plan for a provider network, or a health care provid- 14 er to disclose: (A) actual claims costs; or (B) price or quality infor- 15 mation required to be disclosed under federal law, including the allowed 16 amount, negotiated rates or discounts, or any other claim-related finan- 17 cial obligations, including, but not limited to, patient cost-sharing 18 covered by the provider contract to any subscriber, enrollee, group, or 19 other entity receiving health care services pursuant to the contract, or 20 to any public compilation of reimbursement data such as the New York all 21 payer database required by law or regulation, provided that no disclo- 22 sure shall include protected health information or other information 23 covered by statutory or other privilege. 24 (b) For purposes of this subdivision, the term "health plan" shall 25 include: 26 (i) an insurer licensed pursuant to the insurance law or a health 27 maintenance organization certified pursuant to this article; and 28 (ii) a third-party administrator, affiliated with an insurer or health 29 maintenance organization, who administers a health benefit plan. 30 § 3. Section 2 of a chapter of the laws of 2022 amending the insurance 31 law relating to certain prohibited contract provisions, as proposed in 32 legislative bills numbers S. 7199-A and A. 8169-A, is amended to read as 33 follows: 34 § 2. This act shall take effect [January] July 1, 2023. 35 § 4. This act shall take effect immediately, provided, however, that 36 sections one and two of this act shall take effect on the same date and 37 in the same manner as a chapter of the laws of 2022 amending the insur- 38 ance law relating to certain prohibited contract provisions, as proposed 39 in legislative bills numbers S. 7199-A and A. 8169-A, takes effect.
