Allows dental provider networks, certain health and hospital service corporations, and health care plans to enter into contracts with a third party to gain access to services and discounted rates of a provider under a provider network contract.
Summary
Bill A06650 amends the insurance law and public health law to allow dental provider networks, health and hospital service corporations, and health care plans to enter into contracts with third parties. These contracts enable third parties to access services and discounted rates provided by dentists under existing provider network contracts. The bill outlines specific requirements for insurers, including obtaining consent from providers, maintaining updated lists of third parties, and ensuring providers are informed of any changes to contracts.
Impact
The bill impacts state laws by establishing clear guidelines for third-party access to dental services and rates, thereby enhancing transparency and communication between insurers and providers. It prohibits insurers from terminating contracts with providers solely based on their refusal to allow third-party access, thereby protecting provider rights and ensuring that providers are adequately informed about third-party agreements.
Sentiment
The general sentiment around Bill A06650 appears to be supportive, as it aims to improve the relationship between providers and insurers by ensuring transparency and consent. However, the lack of voting history and committee discussions makes it difficult to gauge any significant opposition or concerns from stakeholders.
Contention
Notable points of contention may arise regarding the balance of power between insurers and providers, particularly concerning the consent requirements and the potential for third parties to influence reimbursement rates. Providers may advocate for stronger protections against unilateral changes by insurers, while insurers may argue for flexibility in managing third-party contracts.
Same As
Allows dental provider networks, certain health and hospital service corporations, and health care plans to enter into a third-party network contract to provide access to care services and discounted rates of a provider under a provider network contract.
Allows dental provider networks, certain health and hospital service corporations, and health care plans to enter into a third-party network contract to provide access to care services and discounted rates of a provider under a provider network contract.
Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.
Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.