New York A 6803: Enacts the health care consumer and provider protection act relating to collective negotiations by health care providers with certain health care plans

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A06803 Summary:

BILL NOA06803 

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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 49 Title III §§4920 - 4920-i, Pub Health L

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Enacts provisions relating to collective negotiations by health care providers with certain health care plans in certain counties; applies to health benefit plans that provide benefits for medical or surgical expenses incurred as a result of a health condition, accident or sickness, including an individual, group, blanket or franchise insurance policy or insurance agreement offered by certain enumerated entities.

Go to top A06803 Actions:

BILL NOA06803 

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03/14/2025referred to health

01/07/2026referred to health

Go to topA06803 Committee&nbspVotes:

Go to topA06803 Floor&nbspVotes:

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

Go to topA06803 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 6803

 2025-2026 Regular Sessions

 IN ASSEMBLY

 March 14, 2025
 ___________

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

 AN ACT to amend the public health law, in relation to requirements for
 collective negotiations by health care providers with certain health
 benefit plans in certain counties, and providing for the repeal of
 such provisions upon expiration thereof

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

 1 Section 1. Statement of legislative intent. The legislature finds that
 2 collective negotiation by competing health care providers for the terms
 3 and conditions of contracts with health plans can result in beneficial
 4 results for health care consumers. The legislature further finds
 5 instances where health plans dominate the market to such a degree that
 6 fair and adequate negotiations between health care providers and the
 7 plans are adversely affected, so that it is necessary and appropriate to
 8 provide for a demonstration to examine the risks and benefits associated
 9 with a system of collective action on behalf of health care providers.
 10 Consequently, the legislature finds it appropriate and necessary in the
 11 demonstration service area to displace competition with regulation of
 12 health plan-provider agreements and authorize collective negotiations on
 13 the terms and conditions of the relationship between health care plans
 14 and health care providers so the imbalances between the two will not
 15 result in adverse conditions of health care. This act is not intended to
 16 apply to or affect in any respect collective bargaining relationships
 17 involving health care providers as defined in section 4920 of the public
 18 health law or rights relating to collective bargaining arising under
 19 applicable federal or state collective bargaining statutes.
 20 § 2. Short title. This act shall be known and may be cited as the
 21 "health care consumer and provider protection act".
 22 § 3. Article 49 of the public health law is amended by adding a new
 23 title III to read as follows:

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD05865-01-5

 A. 6803 2

 1 TITLE III
 2 COLLECTIVE NEGOTIATIONS BY HEALTH CARE
 3 PROVIDERS WITH HEALTH CARE PLANS
 4 Section 4920. Definitions.
 5 4920-a. Non-fee related collective negotiation authorized.
 6 4920-b. Fee related collective negotiation.
 7 4920-c. Collective negotiation requirements.
 8 4920-d. Requirements for health care providers' representative.
 9 4920-e. Certain collective action prohibited.
 10 4920-f. Fees.
 11 4920-g. Monitoring of agreements.
 12 4920-h. Confidentiality.
 13 4920-i. Severability and construction.
 14 § 4920. Definitions. For purposes of this title:
 15 1. "Health care plan" means an entity (other than a health care
 16 provider) that approves, provides, arranges for, or pays for health care
 17 services in the demonstration service area, including but not limited
 18 to:
 19 (a) a health maintenance organization licensed pursuant to article
 20 forty-three of the insurance law or certified pursuant to article
 21 forty-four of this chapter;
 22 (b) any other organization certified pursuant to article forty-four of
 23 this chapter; or
 24 (c) an