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Ensuring Adequate Out of Network Coverage

March 20, 2018 9:52 AM | Anonymous

New York's Health Insurance Exchange is a model for the nation, facilitating necessary health coverage for over 2 million New Yorkers.

S5675 (Hannon) / A7671 (Rosenthal) ensures consumer choice by amending the public health law and the insurance law requiring health care insurers to offer coverage for health care provided by out-of-network providers (inside and outside of statewide health benefit exchange).  

The Exchange is experiencing a lack of network adequacy due to physicians being unfairly excluded from Exchange networks despite their interest to participate in the plans. In several areas of the State (HV, NYC and LI), there are NO policies available in the individual Exchange market. In addition, there are pervasive reports and frustrations over the inaccuracies on health insurers websites listing "participating" physicians who actually do not participate, are not taking new patients, or list wrong contact information.

Our Ask: Support efforts to advance S5675 (Hannon) / A7671 (Rosenthal)

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