Bill > A02526

This bill establishes a comprehensive framework for collective negotiations between health care providers and health care plans in certain counties, with the goal of addressing market imbalances and protecting health care consumers. The legislation allows health care providers to collectively negotiate various non-fee and fee-related contract terms when a health care plan has a substantial market share, including aspects like utilization review procedures, coverage provisions, medical necessity definitions, administrative procedures, and reimbursement methods. The bill requires health care providers to work through a designated representative who must obtain approval from the commissioner of health before engaging in negotiations, and mandates rigorous reporting and transparency requirements. Key provisions include establishing a mediation and fact-finding process to resolve negotiation impasses, prohibiting certain anti-competitive actions, and ensuring that negotiations do not limit provider participation or service scope. The bill aims to create a regulated environment for contract negotiations that balances the interests of health care providers and health care plans, with the ultimate goal of improving conditions for health care consumers. The legislation will take effect 120 days after becoming law, with the health commissioner authorized to prepare implementation guidelines in advance.

Health and Social Services, Housing and Urban Affairs

https://www.nysenate.gov/legislation/bills/2025/A2526