Bill > A08052

This bill clarifies and strengthens protections for health care professionals in their contracts with health care plans and insurers by establishing more robust review processes for contract terminations and non-renewals. The legislation requires health care plans and insurers to provide written explanations for proposed contract terminations and offer health care professionals the right to a hearing before a panel of three licensed professionals in the same field, with one member appointed by the plan/insurer, one by the professional being reviewed, and a third chosen by those two members. The bill ensures that any termination or non-renewal cannot be based on a professional advocating for patients, filing complaints, appealing decisions, or requesting hearings. Additionally, the legislation mandates that health care plans and insurers regularly provide professionals with performance data and profiling information, allowing them to discuss unique aspects of their patient populations that might impact their performance metrics. The bill also specifies that any contract provisions that conflict with these protections are void and unenforceable, and defines health care professionals as those licensed, registered, or certified under New York State's education law. These changes aim to create a more transparent and fair process for health care professionals when their contracts are at risk of termination or non-renewal.

Health and Social Services, Housing and Urban Affairs

https://www.nysenate.gov/legislation/bills/2025/A8052