Source: https://www.nysenate.gov/legislation/bills/2017/s4633/amendment/original
Timestamp: 2019-05-22 19:29:48
Document Index: 122368082

Matched Legal Cases: ['§ 2995', '§ 2995', '§ 6524', '§ 2995', '§ 2995', '§ 2', '§ 3', '§ 4']

Provides that health care plan participation by physicians shall be reported, for purposes of physician profiles, by the health care plans
Apr 25, 2017 referred to health
Mar 07, 2017 1st report cal.389
Feb 23, 2017 referred to health
S4633 (ACTIVE) - Details
S4633 (ACTIVE) - Summary
Provides that health care plan participation by physicians shall be reported, for purposes of physician profiles, by the health care plans; requires physicians to periodically submit information for his or her physician profile within 6 months of his or her triennial re-registration to practice; authorizes physicians to designate a designee to submit his or her information for the physician profile.
S4633 (ACTIVE) - Sponsor Memo
BILL NUMBER:  S4633
to submission of information to the department of health for physician
Makes updates to the physician profile to include provider plan
network information and to help ensure greater compliance.
Section one amends Public Health Law (PHL) § 2995-a(1)(q) to provide
that health care plan information shall be included and updated by the
Department of Health utilizing provider network participation
information, or other reliable sources of information the Department
receives from health plans.
Section two amends PHL § 2995-a(4) to conform to Education Law § 6524.
Section three amends PHL § 2995-a(6) to make the inclusion of provider
health plan network participation a mandatory component of the
Section four adds a new PHL § 2995-a(7-a) to permit physicians to
authorize a designee to register, transmit, enter and update
information on his or her behalf.
The physician profile is a highly utilized, online database, available
to the public, containing information about New York State licensed
physicians. Several years ago, the Senate one house budget included
language to update the physician profile and include information
regarding the health plan networks the physician participates in.
After considerable push back from the Department of Health (DOH), the
final adopted budget required the DOH to study the feasibility of
incorporating network participation on the physician's profile without
creating additional reporting burdens on the physicians.
On November 15, 2016, DOH released a report which found that despite
the overwhelming consumer support for listing this information on the
profile, only 51% of physicians do so. The report highlights recent
measures such as the Surprise Bill Law, which went into effect on
March 31, 2015, making the inclusion of such information easier. This
law requires providers to offer patients or prospective patients their
network participation and requires insurers to provide a list of all
participating providers, which must be updated within 15 days of an
addition, termination or change in hospital affiliation, on their
website. As the Senate urged in 2015, this relatively new law, in
addition to the fact that the DOH already collects this information
directly from health plans for the purposes of the Provider Network
Data System (PNDS), including this information and ensuring its
accuracy is feasible. Further, such can be accomplished without
additional reporting burdens on the individual physician.  Thus, DOH
determined in the report that health plan network affiliation could be
included in an accurate and up-to-date manner, and that there was
stakeholder support to do so. This legislation make the changes
recommended to the Public Health Law, in order to implement this
change and provide for greater consumer access to this information.
In addition to the inclusion of provider network information, the
report also recommended a statutory change in order to improve
physician compliance with the profile reporting requirements by
allowing a designee or employee to submit the information and to align
Education Law and Public Health Law requirements. Such changes have
also been incorporated into this legislation with the goal of
increasing physician reporting and providing consumers with accurate
S4633 (ACTIVE) - Bill Text download pdf
AN ACT to amend the public health law,  in  relation  to  submission  of
information to the department of health for physician profiles
Section 1. Paragraph (q) of subdivision 1 of  section  2995-a  of  the
public  health  law,  as  added  by  chapter 542 of the laws of 2000, is
(q) health care plans with which the licensee has  contracts,  employ-
ment, or other affiliation; PROVIDED THAT THE REPORTING OF SUCH INFORMA-
TION  SHALL  NOT  BE  THE  RESPONSIBILITY OF THE PHYSICIAN, BUT SHALL BE
INCLUDED AND  UPDATED  BY  THE  DEPARTMENT  UTILIZING  PROVIDER  NETWORK
PARTICIPATION  INFORMATION,  OR  OTHER  RELIABLE  SOURCES OF INFORMATION
SUBMITTED BY HEALTH CARE PLANS.
§ 2. Subdivision 4 of section 2995-a of  the  public  health  law,  as
amended  by  section  3  of part A of chapter 57 of the laws of 2015, is
4. Each physician shall periodically report to the department on forms
and in the time and manner required by the commissioner any other infor-
mation as is required by the department for the development of  profiles
under  this  section  which  is  not otherwise reasonably obtainable. In
addition to such periodic reports and providing  the  same  information,
each  physician  shall  update his or her profile information within the
six months prior to the [expiration date of such  physician's  registra-
tion  period] SUBMISSION OF THE RE-REGISTRATION APPLICATION, as a condi-
tion of registration renewal under article one hundred thirty-one of the
education law. Except  for  optional  information  provided,  physicians
shall  notify  the  department  of any change in the profile information
within thirty days of such change.
LBD10197-01-7
§ 3. Subdivision 6 of section 2995-a of  the  public  health  law,  as
6.  A  physician  may  elect  to  have his or her profile omit certain
information provided pursuant to paragraphs (l),  (m)[,]  AND  (n)  [and
(q)]  of  subdivision one of this section. In collecting information for
such profiles and disseminating the same, the  department  shall  inform
physicians that they may choose not to provide such information required
pursuant  to paragraphs (l), (m)[,] AND (n) [and (q)] of subdivision one
§ 4. Section 2995-a of the public health law is amended  by  adding  a
new subdivision 7-a  to read as follows:
7-A.  FOR PURPOSES OF THIS SECTION, A PHYSICIAN MAY AUTHORIZE A DESIG-
NEE TO REGISTER, TRANSMIT, ENTER OR UPDATE INFORMATION  ON  HIS  OR  HER
BEHALF, PROVIDED THAT:
(A)  THE  DESIGNEE  SO  AUTHORIZED IS EMPLOYED BY THE PHYSICIAN OR THE
SAME PROFESSIONAL PRACTICE OR IS UNDER CONTRACT WITH SUCH PRACTICE;
(B) THE PHYSICIAN TAKES REASONABLE STEPS TO ENSURE THAT SUCH  DESIGNEE
IS SUFFICIENTLY COMPETENT IN THE PROFILE REQUIREMENTS; AND
(C) THE PHYSICIAN REMAINS RESPONSIBLE FOR ENSURING THE ACCURACY OF THE
INFORMATION  PROVIDED  AND  FOR ANY FAILURE TO PROVIDE ACCURATE INFORMA-
THE COMMISSIONER SHALL ESTABLISH IN REGULATION  REASONABLE  PARAMETERS
WITH  REGARD TO A PHYSICIAN'S ABILITY TO AUTHORIZE DESIGNEES PURSUANT TO
THIS SECTION, WHICH SHALL  INCLUDE  PROCESSES  NECESSARY  TO  ALLOW  THE
DEPARTMENT  TO:  (I)  GRANT ACCESS TO THE PROFILE IN A REASONABLY PROMPT
MANNER TO DESIGNEES AUTHORIZED BY PHYSICIANS; (II) REQUIRE  THAT  PHYSI-
CIANS  NOTIFY  THE  DEPARTMENT UPON TERMINATING THE AUTHORIZATION OF ANY
DESIGNEE; AND (III) ESTABLISH A MECHANISM  TO  PREVENT  SUCH  TERMINATED
DESIGNEES  FROM  ACCESSING  THE  PROFILE  IN  A REASONABLY PROMPT MANNER
FOLLOWING SUCH NOTIFICATION.