NY A07055

Requires health insurance coverage under the New York state health insurance program to reimburse out-of-network health care services at a minimum of eighty percent of the usual and customary cost.

Defines "usual and customary cost" as the eightieth percentile of all charges for a particular health care service performed by a provider in the same or similar specialty and geographical area, as reported in a benchmarking database maintained by a nonprofit organization specified by the superintendent of financial services.

Clarifies that the superintendent of financial services maintains authority over benchmarking databases used to determine out-of-network reimbursement rates for the state health insurance program.

Prohibits the president of the civil service from extending health benefits to non-covered employees in a manner that diminishes current existing benefits.

Takes effect immediately upon enactment.