Prohibits approved organizations providing coverage under the child health insurance plan from discriminating against health care providers which do not participate in the organization's health care network.
Summary
Bill S05812 seeks to amend the public health law in New York to prevent approved organizations within the child health insurance plan from limiting the participation of certain healthcare providers. Specifically, the bill prohibits these organizations from denying or restricting the provision of covered health care services based on whether a provider chooses to participate in the organization's healthcare network for commercial insureds, enrollees, or subscribers. This change aims to enhance access to healthcare services for children covered under the child health insurance plan.
Impact
If enacted, this bill would significantly alter the operational dynamics of approved organizations under the child health insurance plan by ensuring that healthcare providers cannot be excluded from providing services based solely on their network participation status. This could lead to increased provider options for families and potentially improve healthcare access for children, as more providers would be allowed to offer services without facing discrimination based on network affiliation.
Sentiment
The sentiment surrounding Bill S05812 appears to be mixed. During the Senate Health Committee vote, there was a relatively close margin with 9 in favor and 5 against. The final Senate floor vote showed a larger divide, with 41 voting in favor and 20 against, indicating some level of support but also notable opposition. The discussions leading up to the votes suggest that while there is a desire to improve access to healthcare, concerns about the implications for healthcare networks and provider relationships were raised.
Contention
Notable points of contention include concerns from some senators regarding the potential impact on healthcare networks and the quality of care. Opponents argue that allowing non-network providers to participate could disrupt existing care coordination and lead to inefficiencies. Proponents, on the other hand, emphasize the need for greater access to healthcare providers for children and argue that the bill would empower families to choose their healthcare providers without restrictions.
Same As
Prohibits approved organizations providing coverage under the child health insurance plan from discriminating against health care providers which do not participate in the organization's health care network.
Prohibits approved organizations providing coverage under the child health insurance plan from discriminating against health care providers which do not participate in the organization's health care network.
Prohibits health insurers from taking adverse payment or contracting actions against participating facilities based solely on another provider's network status (EN INCREASE EX See Note)
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.
Prohibits hospitals, health systems, and health care providers from charging facility fees that are not covered by the patient's health insurance carrier.