New York A 5106: Establishes the interstate insurance product regulation compact to regulate certain insurance products among member states

Bill Text

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A05106 Summary:

BILL NOA05106 

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SAME ASSAME AS S07577

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SPONSORHunter

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COSPNSR

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MLTSPNSR

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Amd §3217-b, Ins L; amd §4406, Pub Health L

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Prohibits an insurer or health maintenance organization from including certain requirements in insurance contracts.

Go to top A05106 Actions:

BILL NOA05106 

&nbsp

02/12/2025referred to insurance

01/07/2026referred to insurance

Go to topA05106 Committee&nbspVotes:

Go to topA05106 Floor&nbspVotes:

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

Go to topA05106 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 5106

 2025-2026 Regular Sessions

 IN ASSEMBLY

 February 12, 2025
 ___________

 Introduced by M. of A. HUNTER -- read once and referred to the Committee
 on Insurance

 AN ACT to amend the insurance law and the public health law, in relation
 to prohibiting certain requirements in insurance contracts

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

 1 Section 1. Section 3217-b of the insurance law is amended by adding a
 2 new subsection (p) to read as follows:
 3 (p)(1) No insurer that offers a managed care product or a comprehen-
 4 sive policy that utilizes a network of providers shall enter into a
 5 contract, written policy, written procedure or agreement with any health
 6 care provider that:
 7 (A) Requires an insurer to include all members of a provider group,
 8 including medical practice groups and facilities, in its network of
 9 participating providers;
 10 (B) Requires an insurer to place all members of a provider group,
 11 including medical practice groups and facilities, in the same network
 12 tier;
 13 (C) Requires an insurer to include all members of a provider group,
 14 including medical practice groups and facilities, in all products
 15 offered by the insurer;
 16 (D) Prohibits insurers from using benefit designs to encourage members
 17 to seek services from higher-value health care providers;
 18 (E) Contains a most-favored-nation provision; provided, however, noth-
 19 ing in this section shall be construed to prohibit a health insurer and
 20 a provider from negotiating payment rates and performance-based contract
 21 terms that would result in the insurer receiving a rate that is as
 22 favorable, or more favorable, than the rates negotiated between a health
 23 care provider and another entity; and

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD08595-01-5

 A. 5106 2

 1 (F) Limits the ability of the insurer or health care provider from
 2 disclosing fees for services or the allowed amounts to an insured or
 3 insured's health care provider.
 4 (2) After January first, two thousand twenty-six, any contract, writ-
 5 ten policy, written procedure or agreement that contains a clause
 6 contrary to the provisions set forth in this section shall be null and
 7 void; provided, however, the remaining clauses of the contract shall
 8 remain in effect for the duration of the contract term.
 9 § 2. Section 4406 of the public health law is amended by adding a new
 10 subdivision 6 to read as follows:
 11 6. (a) No health maintenance organization that offers a managed care
 12 product or a comprehensive policy that utilizes a network of providers
 13 shall enter into a contract, written policy, written procedure or agree-
 14 ment with any health care provider that:
 15 (i) Requires an insurer to include all members of a provider group,
 16 including medical practice groups and facilities, in its network of
 17 participating providers;
 18 (ii) Requires an insurer to place all members of a provider group,
 19 including medical practice groups and facilities, in the same network
 20 tier;
 21 (iii) Requires an insurer to include all members of a provider group,
 22 including medical practice groups and facilities, in all products
 23 offered by the insurer;
 24 (iv) Prohibits insurers from using benefit designs to encourage
 25 members to seek services from higher-value health care providers;
 26 (v) Contains a most-favored-nation provision; provided, however, noth-
 27 ing in this section shall be construed to prohibit a health insurer and
 28 a provider from negotiatin