Requires an insurance company which owns a health care provider to pay any health care provider which it does not own an amount that is no less than the amount that it pays a health care provider which it does own for a comparable service; prohibits an insurance company which is owned by a health care provider from paying any health care provider which does not own such insurance company an amount that is less than the amount that it pays a health care provider which does own such company for a comparable service.
Summary
A09099 would amend New York’s insurance law to create payment-parity rules for transactions between insurers and health care providers when there is common ownership. If an insurance company owns a health care provider, it would have to pay non-owned providers at least as much as it pays its owned providers for comparable services. The bill also applies the same rule in reverse: if a health care provider owns an insurance company, that insurer could not pay non-owner providers less than it pays provider-owners for comparable services.
The measure is aimed at preventing affiliated entities from using ownership relationships to steer payments or create unequal reimbursement rates for similar care. It would take effect 60 days after becoming law and would add a new subsection to Insurance Law section 3224-a, which governs prompt payment and related insurer obligations.
Impact
The bill would add a new anti-discrimination reimbursement requirement to New York Insurance Law section 3224-a, directly regulating how insurers with ownership ties to providers set payment amounts. It would affect health insurers, physician groups, hospitals, and other health care providers involved in affiliated or vertically integrated arrangements by requiring comparable payment treatment between owned and non-owned providers for comparable services. The practical effect would be to limit preferential reimbursement structures within insurer-provider corporate families and could influence contracting, network design, and payment negotiations across the health care market.
Sentiment
Based on the bill text and the absence of recorded committee debate or votes, the available record suggests a policy-driven, reform-oriented proposal with no documented opposition in the provided materials. The bill’s framing indicates support for payment fairness and transparency in insurer-provider relationships, and its sponsors appear to be targeting perceived inequities in reimbursement tied to ownership structures. Because no transcripts or vote history are available, there is no evidence in the record provided of formal support or resistance beyond the bill’s stated purpose.
Contention
The main point of contention likely concerns whether the bill appropriately addresses anti-competitive or unfair reimbursement practices without unduly restricting business arrangements between insurers and provider systems. Potential critics could argue that mandated parity may reduce flexibility in contracting, interfere with integrated care models, or affect cost management, while supporters would likely view it as necessary to prevent self-dealing and discriminatory payment practices. No specific objections or named opponents appear in the supplied legislative history.
Same As
Requires an insurance company which owns a health care provider to pay any health care provider which it does not own an amount that is no less than the amount that it pays a health care provider which it does own for a comparable service; prohibits an insurance company which is owned by a health care provider from paying any health care provider which does not own such insurance company an amount that is less than the amount that it pays a health care provider which does own such company for a comparable service.