New York A 6775: Relates to creating the N.Y. State Health Care Consumer and Provider Protection and Equity Act

Bill Text

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A06775 Summary:

BILL NOA06775 

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SAME ASNo Same As

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SPONSORPretlow

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COSPNSR

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MLTSPNSR

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Add Art 57 §§5701 - 5709, Ins L

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Establishes the NYS Health Care Consumer and Provider Protection and Equity Act to allow physicians and dentists to negotiate collectively with employers.

Go to top A06775 Actions:

BILL NOA06775 

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03/14/2025referred to insurance

01/07/2026referred to insurance

Go to topA06775 Committee&nbspVotes:

Go to topA06775 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA06775 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 6775

 2025-2026 Regular Sessions

 IN ASSEMBLY

 March 14, 2025
 ___________

 Introduced by M. of A. PRETLOW -- read once and referred to the Commit-
 tee on Insurance

 AN ACT to amend the insurance law, in relation to the health care
 consumer and provider protection and equity act

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. The insurance law is amended by adding a new article 57 to
 2 read as follows:
 3 ARTICLE 57
 4 HEALTH CARE CONSUMER AND PROVIDER PROTECTION
 5 AND EQUITY ACT
 6 Section 5701. Legislative findings.
 7 5702. Collective action by competing physicians.
 8 5703. Application for hearing.
 9 5704. Fee for registration of authorized third parties.
 10 5705. Regulations.
 11 5706. Good faith negotiations.
 12 5707. Prohibition of collective cessation of services.
 13 5708. No interference with other statutory rights.
 14 5709. Definitions.
 15 § 5701. Legislative findings. The legislature finds and declares that:
 16 (a) Under the McCarran-Ferguson act of 1945, 15 U.S.C. § 1011, et
 17 seq., insurance companies are exempt from federal anti-trust laws that
 18 otherwise apply to most other businesses;
 19 (b) Active, robust and fully competitive markets for health care and
 20 dental services provide the best opportunity for the residents of this
 21 state to receive high-quality health care and dental services at an
 22 appropriate cost;
 23 (c) A substantial amount of health care and dental services in this
 24 state is purchased for the benefit of patients by health and dental
 25 insurance carriers engaged in the financing of health care and dental

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD05881-01-5

 A. 6775 2

 1 services or is otherwise delivered subject to the terms of agreements
 2 between carriers and physicians and dentists;
 3 (d) Carriers are able to control the flow of patients to physicians
 4 and dentists through compelling financial incentives for patients in
 5 their health and dental benefits plans to utilize only the services of
 6 physicians and dentists with whom the carriers have contracted;
 7 (e) Carriers also control the health care and dental services rendered
 8 to patients through utilization management and other managed care tools
 9 and associated coverage and payment policies;
 10 (f) Carriers are often able to virtually dictate the terms of the
 11 contracts that they offer physicians and dentists and commonly offer
 12 these contracts on a take-it-or-leave-it basis;
 13 (g) The power of carriers to unilaterally impose provider contract
 14 terms jeopardizes the ability of physicians and dentists to deliver the
 15 superior quality health care and dental services traditionally available
 16 in this state;
 17 (h) Physicians and dentists do not have sufficient market power to
 18 reject unfair provider contract terms offered by carriers that impede
 19 their ability to deliver medically appropriate care without undue delay
 20 or difficulties;
 21 (i) Inadequate reimbursement and other unfair payment terms offered by
 22 carriers adversely affect the quality of patient care and access to care
 23 by reducing the resources that physicians and dentists can devote to
 24 patient care and decreasing the time that physicians and dentists are
 25 able to spend with their patients;
 26 (j) Inequitable reimbursement and other unfair payment terms also
 27 endanger the health care infrastructure and medical progress by divert-
 28 ing capital needed for reinvestment in the health care delivery system,
 2