Bill > A06775

This bill establishes the NYS Health Care Consumer and Provider Protection and Equity Act, which allows physicians and dentists to collectively negotiate with health benefit plans under specific conditions. The legislation aims to address the power imbalance between health insurance carriers and healthcare providers by enabling physicians and dentists to jointly negotiate contract terms such as reimbursement rates, administrative procedures, quality assurance programs, and dispute resolution methods. To ensure fair practices, an independent review panel consisting of the Attorney General, State Health Commissioner, and State Labor Commissioner will oversee and approve these negotiations. The bill sets strict guidelines to prevent anti-competitive behavior, including limiting the percentage of physicians an authorized third party can represent and prohibiting collective service cessation. Importantly, the negotiations must focus on improving market competitiveness, protecting patient care access, promoting healthcare infrastructure, and enhancing communication between providers and insurers. The bill includes provisions to protect against potential antitrust violations and does not interfere with existing collective bargaining rights. Negotiations can cover topics like clinical guidelines, payment procedures, referral processes, and provider selection criteria, but cannot exclude non-physician providers or dictate their service settings. The law will take effect 180 days after becoming law.

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https://www.nysenate.gov/legislation/bills/2025/A6775