Provides that it is unlawful for any person to directly or indirectly own, operate, or control the whole or any part of a health insurance company and a health care provider; requires divestment within three years.
Impact
Once enacted, A09225 would significantly affect how health insurance companies and healthcare providers operate in New York. All individuals or entities currently holding dual ownership would be required to divest from one entity within three years. Violators of this law would face civil penalties, including fines of up to ten thousand dollars per day. This legislative move is viewed as a step towards increased regulatory compliance and accountability within the health sector, potentially leading to improved patient care and lower healthcare costs by dismantling monopolistic practices.
Summary
A09225 is a legislative proposal that aims to amend New York's general obligations law by introducing a prohibition on overlapping ownership between health insurance companies and healthcare providers. Specifically, the bill states that it will be unlawful for any person to directly or indirectly own, operate, or control both a health insurance company and a healthcare provider. This provision is designed to eliminate potential conflicts of interest that could arise from such dual control, ensuring more transparent operations within the healthcare industry.
Contention
The introduction of A09225, however, is not without controversy. Supporters argue that the bill protects consumers by preventing conflicts of interest and ensuring that patient care is not compromised by ownership controls. Conversely, opponents, typically from the health industry, argue that this bill could lead to disruptions in existing operational frameworks. There are concerns that divesting could undermine the financial viability of certain healthcare providers, especially smaller, community-based entities that rely on the support from integrated health systems to remain operational.
Same As
Provides that it is unlawful for any person to directly or indirectly own, operate, or control the whole or any part of a health insurance company and a health care provider; requires divestment within three years.
Provides that it is unlawful for any person to directly or indirectly own, operate, or control the whole or any part of a health insurance company and a health care provider; requires divestment within three years.
Requires an insurance company which owns a health care provider to pay any health care provider which it does not own an amount that is no less than the amount that it pays a health care provider which it does own for a comparable service; prohibits an insurance company which is owned by a health care provider from paying any health care provider which does not own such insurance company an amount that is less than the amount that it pays a health care provider which does own such company for a comparable service.
Requires an insurance company which owns a health care provider to pay any health care provider which it does not own an amount that is no less than the amount that it pays a health care provider which it does own for a comparable service; prohibits an insurance company which is owned by a health care provider from paying any health care provider which does not own such insurance company an amount that is less than the amount that it pays a health care provider which does own such company for a comparable service.
Enacts the "health insurance preauthorization disclosure act"; requires health insurance companies to provide participating health care providers with a list of health care treatments and services that require preauthorization from the health insurance company.
Prohibits a person offering loot boxes to consumers within the state to repurchase the contents of any such loot box whether directly themselves or indirectly through a third-party provider.
Provides limitations on overlapping control between insurance companies and pharmacy benefits managers and pharmacies; requires divestment of the interest in one or more insurance companies and pharmacy benefits managers.
Provides limitations on overlapping control between insurance companies and pharmacy benefits managers and pharmacies; requires divestment of the interest in one or more insurance companies and pharmacy benefits managers.
Requires insurance companies to establish and maintain API to facilitate patient and provider access to health information; includes patient access, provider directory and payer to payer exchange.