Legislation Concludes Session with Passage of Multiple Health Insurance Reform Bills Supported by MSSNY

Legislation Concludes Session with Passage of Multiple Health Insurance Reform Bills Supported by MSSNY

Colleagues:

As you most likely know, the NYS Legislature concluded the 2023 session late last week. The good news is that many health insurance reform bills advocated for by MSSNY this Legislative Session (together with patient advocacy group allies) passed both the Senate and Assembly.  MSSNY will be urging Governor Hochul to sign these bills into law.  These include:

• A463-A (McDonald)/S.2677-A (Breslin) requires health insurers to provide more detailed information and appeal rights to patients and their physicians when a request to override a health insurer’s step therapy protocol has been denied.
• A1673-A (Hunter)/S.1196-A (Persaud) requires health insurers to cover biomarker testing for diagnosis, treatment, or appropriate management, of a patient’s disease or condition when the test is supported by medical and scientific evidence.

These reforms supplement other important patient protection reforms supported by MSSNY included in the recently enacted State Budget.  One of these provisions will ensure that, starting in 2024, an appeal of a denied claim by a health insurer must be reviewed by a physician in the same or similar specialty as the physician recommending or providing the care.  The other provision requires the creation of a Health Insurance “Guarantee Fund” to pay claims in the event of a health insurance insolvency, such as we saw in 2015 with Health Republic.

More good news: the Legislative Session concluded without acting on numerous bills that would have endangered patient care by removing important oversight and/or collaboration provided by a physician.  These bills were opposed by MSSNY working together with numerous impacted specialty societies.  Some of these bills opposed by MSSNY and the specialty societies included:

• A.6958-A/S.769-A, which would allow Nurse Anesthetists to administer anesthesia without physician oversight.
• A.5012/S.5520 which would allow Physician Assistants (PAs) to practice independently without physician oversight after 3,600 hours of practice.
• S.66-A/A.1262-A which would grant prescribing rights to psychologists similar to psychiatrists.
• S.6800/A.6445 which would make permanent provisions that permit nurse practitioners to practice without physician collaboration after 3,600 hours and enables those 3,600 hours to be obtained by working for a NP, not a physician.
• A.2217-A/S.2254-A which would significantly expand the scope of services of a podiatrist to treat conditions of the ankle and leg.

The bad news is that the slightly revised wrongful death expansion bill (A.6698/S.6636) did pass the Legislature. Physicians will again need to contact Governor Hochul to urge the governor to veto this bill.                                                                                                        

This legislation would exponentially increase awards in wrongful death lawsuits without taking any steps to address our already staggering liability costs. The continued expansion of wrongful death awards to include the new category of non-economic damages has led multiple actuarial studies to conclude that, if passed, it would increase liability insurance costs by a staggering 40%-45%. Indeed, the New York State Division of Budget has estimated that it would add nearly $700 million in new costs to the state’s hospitals, including nearly $200 million for the state’s distressed safety net providers that care for underserved communities. The adverse impact that this increase in cost would have on patient access to our health care system was a major reason why this legislation was vetoed by the Governor in January.

Again, please contact Governor Hochul to urge her that any legislation to update New York’s wrongful death law be balanced to also address the extraordinary medical liability costs in our state.  Moreover, to assist in our advocacy, please let us know if you have a story to share regarding what the legislation could mean for patient access to care in your community.

Paul A. Pipia, MD

MSSNY President