Bill > A05106

This bill prohibits insurance companies and health maintenance organizations (HMOs) from including certain restrictive provisions in their contracts with healthcare providers. Specifically, the bill prevents insurers from being required to include all members of a provider group in their network, place all group members in the same network tier, or include all group members in all of their insurance products. The bill also bars contracts from prohibiting insurers from using benefit designs that encourage patients to seek care from higher-value providers, and from including most-favored-nation clauses that limit pricing negotiations. Additionally, the bill protects providers' and insurers' ability to disclose service fees and allowed amounts to patients or their healthcare providers. Any contracts containing these prohibited clauses will become null and void after January 1, 2026, though the remaining terms of such contracts will remain in effect. The legislation applies to both insurance companies regulated under the insurance law and health maintenance organizations governed by public health law, aiming to increase transparency and flexibility in healthcare provider contracts.

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https://www.nysenate.gov/legislation/bills/2025/A5106