Memorandum in Support

For Immediate Release:   May 24, 2021

Re:   A.7659/S.6801 (Buttenschon/Rivera) – An act to amend chapter 451 of the laws of 2007 amending the public health law, the social services law and the insurance law, relating to providing enhanced consumer and provider protections, in relation to the effectiveness thereof

The New York Health Plan Association (HPA) supports A.7659, which extends important consumer protections in instances where hospitals and health insurers are in the middle of contract negotiations.

The original legislation, enacted in 2007, established a “cooling off” period of two months after a contract between a plan and a hospital is not renewed or is terminated by either party.  Simultaneously, it advanced the date that plans are required to notify enrollees of the change in the network, allowing both sides an opportunity continue to negotiate in an environment conducive for reaching agreement.  The legislation specifies that if both parties can agree, they can forego the “cooling off” period.

This reform eliminated a hospital negotiating tactic of terminating a contract during ongoing discussion, thereby triggering plan notice to patients and physicians that they will need to find an alternative hospital for care.  The turmoil caused for patients and physicians is eliminated by the “cooling off” provision as almost all plan and hospital contracts disputes are resolved.

The existing law represents a compromise that balances the needs of all parties, showing that when health plans and providers work collaboratively, they can make the process work better for New York consumers. The current system works and should be extended and HPA strongly supports its passage.