Requires health insurers to offer coverage of health care provided by out-of-network providers.
Summary
Bill A01657 seeks to amend the public health law and the insurance law in New York by requiring health care insurers to offer coverage for services provided by out-of-network providers. Specifically, it mandates that every health maintenance organization and insurer must provide out-of-network coverage as an optional rider to any contract. Additionally, at least one policy option that includes out-of-network coverage must be available both within the statewide health benefit exchange and outside of it. This aims to enhance patient choice and access to a broader range of healthcare providers.
Impact
If enacted, this bill would significantly alter the current landscape of health insurance in New York by ensuring that consumers have the option to receive care from out-of-network providers without facing prohibitive costs. This change could lead to increased competition among healthcare providers and potentially improve the quality of care as patients seek services from their preferred providers. Furthermore, it would require adjustments in the policies of health maintenance organizations and insurers to comply with the new requirements.
Sentiment
The general sentiment surrounding Bill A01657 appears to be supportive among advocates for patient rights and access to healthcare. However, there may be concerns from insurers about the potential financial implications of mandating out-of-network coverage options. The lack of recorded votes or committee discussions suggests that the bill is still in the early stages of consideration, and further debate may be necessary to gauge broader legislative support.
Contention
Notable points of contention may arise from insurance companies that could argue against the financial burden of providing out-of-network coverage. These companies may express concerns regarding increased premiums or the potential for higher healthcare costs overall. On the other hand, proponents of the bill, including patient advocacy groups, are likely to emphasize the importance of consumer choice and access to necessary healthcare services.
An Act Requiring Health Insurers To Allow A Covered Person To Terminate Coverage And Procure Alternate Health Insurance Without Penalty When Such Covered Person's Health Care Providers Are Designated Out-of-network.
"Breann's Law" requires health insurers, the State Health Benefits Program and NJ FamilyCare to provide "out of network" coverage for children with catastrophic illnesses.
A bill for an act relating to insurance coverage for health care services provided pursuant to a referral by an out-of-network primary care provider.(See HF 2434.)
A bill for an act relating to insurance coverage for health care services provided pursuant to a referral by an out-of-network primary care provider. (Formerly HSB 506.) Effective date: 07/01/2026.