Bill

Bill > A00832


NY A00832

NY A00832
Relates to certain prohibitions in contracts or agreements by health maintenance organizations; prohibits clauses which entitle reimbursement at the lowest price or rate; prohibits contracts which restrict referral of patients based solely upon a health care provider's status with a managed care product; prohibits contracts which allow for the substitution of a pharmaceutical drug or agent by any person other than the prescribing health care professional.


summary

Introduced
01/06/2021
In Committee
03/30/2022
Crossed Over
03/30/2022
Passed
Dead
12/31/2022

Introduced Session

2021-2022 General Assembly

Bill Summary

Relates to certain prohibitions in contracts or agreements by health maintenance organizations; prohibits clauses which entitle reimbursement at the lowest price or rate; prohibits contracts which restrict referral of patients based solely upon a health care provider's status with a managed care product; prohibits disclosure of an enrollee's diagnosis on a prescription as a condition for authorizing coverage for payment or dispensing of a prescription; and prohibits contracts which allow for the substitution of a pharmaceutical drug or agent by any person other than the prescribing health care professional.

AI Summary

This bill prohibits certain practices by health maintenance organizations (HMOs) and insurers. It prohibits HMOs and insurers from including clauses in contracts that allow them to reimburse health care providers at the lowest price or rate they have charged other entities. It also prohibits HMOs and insurers from prohibiting health care providers from referring patients to other providers based solely on the provider's status with the HMO or insurer's managed care product. Additionally, the bill prohibits HMOs and insurers from allowing the substitution of pharmaceutical drugs or agents by anyone other than the prescribing health care professional or a pharmacist.

Committee Categories

Health and Social Services

Sponsors (17)

Last Action

REFERRED TO HEALTH (on 03/30/2022)

bill text


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