Bill > A01532

This bill amends the Public Health Law to prevent health maintenance organizations (HMOs) from substantially reducing inpatient referrals to a hospital they have referred patients to for at least three years, without the approval of the Commissioner of Health. A substantial reduction is defined as one that would result in a decrease of more than 5% in the hospital's total discharges compared to the prior year. HMOs must submit a written plan to the Department of Health and the appropriate Health Systems Agency, outlining the projected reduction in referrals, plans to ensure quality and continuity of service for HMO enrollees, and steps to minimize the adverse impact on the hospital. The Commissioner must approve the plan if it adequately protects quality and accessibility of services, reflects reasonable efforts to minimize the impact on the hospital, and does not unduly risk the quality or accessibility of hospital services in the community.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2021/A1532