Summary of State Legislative Efforts Aimed at Health Care Transformation Reforms
New York toughens certificate of need rules to promote equity
Average annual healthcare cost in all 50 states
AdventHealth-MultiPlan suit spotlights out-of-network pay fight
MultiPlan’s contracts are ‘like a mafia enforcer for insurers,’ AdventHealth alleges in antitrust lawsuit
A 7153
Creates the health insurance guaranty fund. To protect consumers and providers from the failure of a health insurer to perform its contractual obligations due to financial impairment or insolvency.
A 7268 (see companion bill S 3400)
Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.
S 3400 (see companion bill A 7268)
Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.
A 7346 (see companion bill S 926)
Provides that the New York state health care quality and cost containment commission shall: evaluate each mandated benefit; investigate current practices of health plans with regard to the mandated benefit; investigate the potential premium impact of repealing and/or modifying the mandated benefits on all segments of the insurance market; hold at least two public hearings; and submit a report to the legislature; makes related provisions.
S 926 (see companion bill A 7346)
Provides that the New York state health care quality and cost containment commission shall: evaluate each mandated benefit; investigate current practices of health plans with regard to the mandated benefit; investigate the potential premium impact of repealing and/or modifying the mandated benefits on all segments of the insurance market; hold at least two public hearings; and submit a report to the legislature; makes related provisions.