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NY A05129
Bill
Status
3/2/2023
Primary Sponsor
Jeffrey Dinowitz
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AI Summary
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Extends transitional care periods from 90 days to one year when a managed care provider leaves an insurer's network, allowing patients to continue with their current provider during the extended period.
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Adds terminal illness as a new basis for extended transitional care, defined as an illness likely to cause death within three years per physician opinion, allowing continued care until the patient's death.
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Reduces initial transitional period for new enrollees with out-of-network providers from 60 days to one year, with exceptions for terminal illness (until death) and pregnancy (including post-partum care).
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Prohibits insurers and health maintenance organizations from terminating provider contracts based on the provider rendering an opinion about whether a patient's illness is terminal.
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Bans provider incentives (monetary or otherwise) designed to induce providers to deliver care in a manner inconsistent with these transitional care requirements.
Legislative Description
Extends period during which health maintenance organization enrollees may continue to receive services from a health care provider who disaffiliates from 60 or 90 days to 1 year, or in case of terminal illness, until the time of such insured's death; bars incentives which induce a provider to provide health care to an enrollee in a manner inconsistent with law.
Last Action
reported referred to rules
5/22/2024