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A04863 Summary:

BILL NOA04863
 
SAME ASSAME AS S02168
 
SPONSORBarrett
 
COSPNSRCahill
 
MLTSPNSR
 
Amd 213, Ins L
 
Requires the New York state health care quality and cost containment commission to issue a report considering the impact on health insurance costs and quality of legislation requiring coverage of long term and chronic Lyme disease and other tick-borne diseases.
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A04863 Actions:

BILL NOA04863
 
02/03/2017referred to insurance
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A04863 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A4863
 
SPONSOR: Barrett
  TITLE OF BILL: An act to amend the insurance law, in relation to meetings and reports of the New York state health care quality and cost containment commis- sion   PURPOSE: The purpose of this bill is to require the New York State Health Care Quality and Cost Containment Commission to meet each year and to submit a report on the impact of healthcare costs and legislation requiring insurance coverage for Lyme and other tick-borne related diseases.   SUMMARY OF PROVISIONS: The bill amends section 213 of the insurance law, as added by section 1 of part L of chapter 57 of the laws of 2007 to require the commission to submit a report to the governor and legislature regarding the impact on health insurance costs and quality of legislation requiring coverage of Lyme and other tick-borne diseases by May 1, 2018. The bill also requires the commission to meet on the first Monday after the first of January of each year to consider any outstanding requests or duties.   JUSTIFICATION: Currently health insurance companies are not required to cover long term treatment for those who suffer from chronic Lyme or other tick-borne diseases, and for many New Yorkers this is devastating. Those suffering from chronic Lyme and other tick-borne diseases can experience extreme and long term fatigue, nausea, depression, joint pain and many other severe symptoms. Rhode Island and Connecticut have recognized the toll these diseases take on victims by passing legislation that requires insurance coverage.   LEGISLATIVE HISTORY: 2016: A10677 Referred to Insurance   FISCAL IMPLICATIONS: None   EFFECTIVE DATE: Immediately
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A04863 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          4863
 
                               2017-2018 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 3, 2017
                                       ___________
 
        Introduced  by M. of A. BARRETT, CAHILL -- read once and referred to the
          Committee on Insurance
 
        AN ACT to amend the insurance law, in relation to meetings  and  reports
          of the New York state health care quality and cost containment commis-
          sion
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Section 213 of the insurance law, as added by section 1  of
     2  part L of chapter 57 of the laws of 2007, is amended to read as follows:
     3    § 213. New York state health care quality and cost containment commis-
     4  sion.  (a)  There  is hereby established within the department a commis-
     5  sion, to be known as the "New York state health care  quality  and  cost
     6  containment  commission".  The  commission  shall  consist  of  thirteen
     7  members appointed by the governor, one of whom shall be the  superinten-
     8  dent,  one  of whom shall be the commissioner of health, and six of whom
     9  shall be appointed on the recommendation of the legislative leaders, two
    10  on the recommendation of the temporary president of the senate,  two  on
    11  the  recommendation of the speaker of the assembly, one on the recommen-
    12  dation of the minority leader of the senate, and one on the  recommenda-
    13  tion  of the minority leader of the assembly. All members shall serve at
    14  the pleasure of the governor, and vacancies shall be  appointed  in  the
    15  same  manner  as  original appointments. Members of the commission shall
    16  serve without compensation, but shall be reimbursed for reasonable trav-
    17  el expenses. In making appointments  to  the  commission,  the  governor
    18  shall  ensure  that  the interests of health care consumers, small busi-
    19  nesses, the medical community and health plans are  represented  on  the
    20  commission.    The  commission  shall  be  required to meet on the first
    21  Monday after the first of January of  each  calendar  year  to  consider
    22  outstanding requests or duties.  Any vacancies shall be deemed waived by
    23  the  appointing authority for the purposes of the first meeting. Nothing
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04853-01-7

        A. 4863                             2
 
     1  in this section shall forfeit the right for an appointment authority  to
     2  fill vacancies within their statutorily allowed members.
     3    (b)(1) The purpose of the commission shall be to analyze the impact on
     4  health  insurance  costs and quality of proposed legislation which would
     5  mandate that health benefits be offered or made available in  individual
     6  and  group health insurance policies, contracts and comprehensive health
     7  service plans, including legislation that affects the delivery of health
     8  benefits or services or the reimbursement of health care providers.
     9    (2) [The] Notwithstanding any other provision of  law,  the  governor,
    10  the  chair of the senate insurance committee and the chair of the assem-
    11  bly insurance committee may request in writing that the commission eval-
    12  uate a proposed mandated benefit. Upon receiving  such  a  request,  the
    13  commission  may,  by a majority vote of its members, undertake an evalu-
    14  ation of such proposed mandated benefit.
    15    (3) In evaluating a proposed mandated benefit, the commission shall:
    16    (A) investigate the current practices of health plans with  regard  to
    17  the  proposed mandated benefit, and, to the extent possible, self-funded
    18  health benefit plans;
    19    (B) investigate the potential premium impact of the proposed  mandated
    20  benefits  on all segments of the insurance market, as well as the poten-
    21  tial for avoided costs through early detection and treatment  of  condi-
    22  tions, or more cost-effective delivery of medical services; and
    23    (C) analyze the most current medical literature regarding the proposed
    24  mandated benefit to determine its impact on health care quality.
    25    (4) In evaluating a proposed mandated benefit, the commission may hold
    26  one  or more public hearings, and shall strive to obtain independent and
    27  verifiable information from diverse sources within the healthcare indus-
    28  try, medical community and among health care consumers  with  regard  to
    29  the proposed mandated benefit.
    30    (c)  To assist the commission in its duties, and upon the direction of
    31  the commission, the superintendent is authorized to enter  into  one  or
    32  more  contracts  with independent entities and organizations with demon-
    33  strable expertise in health care quality, finance, utilization and actu-
    34  arial services. For the purposes of  this  section,  the  superintendent
    35  shall  not enter into contracts with health plans, entities or organiza-
    36  tions owned or controlled by health plans, or with significant  business
    37  relationships with health plans.
    38    (d)  Upon  completion of its evaluation of a proposed mandated benefit
    39  pursuant to this section, the commission shall deliver a written  report
    40  of its findings to the chair of the assembly insurance committee and the
    41  chair of the senate insurance committee.
    42    (e)  The commission shall issue a report to the governor, the majority
    43  leader of the senate, the speaker of the assembly,  the  chairs  of  the
    44  senate  and  assembly  insurance committees, and the chair of the senate
    45  task force on Lyme and tick-borne diseases, considering  the  impact  on
    46  health  insurance costs and quality of legislation requiring coverage of
    47  long-term and chronic Lyme disease and other  tick-borne  diseases.  The
    48  commission  shall  be  required  to  consider  issues including, but not
    49  limited to, the specific medical impacts to particular geographic  areas
    50  in the state including the Hudson Valley and Long Island, best practices
    51  developed  for  coverage for long-term and chronic Lyme disease in other
    52  states, and the associated costs of mandated  coverage  in  addition  to
    53  projected  costs  of untreated symptoms.  The commission shall deliver a
    54  written report of its findings by May first, two thousand eighteen.
    55    § 2. This act shall take effect immediately.
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