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A01733 Summary:

BILL NOA01733
 
SAME ASSAME AS S04305
 
SPONSORGottfried
 
COSPNSR
 
MLTSPNSR
 
Add §211, Ins L
 
Relates to the designation of an independent consumer assistance program to assist consumers with the filing of complaints and appeals, track problems, educate consumers, assist uninsured, insured, or underinsured consumers in accessing appropriate health care services, assist with enrollment and provide other health insurance assistance.
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A01733 Actions:

BILL NOA01733
 
01/11/2021referred to insurance
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A01733 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A1733
 
SPONSOR: Gottfried
  TITLE OF BILL: An act to amend the insurance law, in relation to the designation of an independent consumer assistance program   PURPOSE OR GENERAL IDEA OF BILL: To designate an independent consumer assistance program, define its duties and require New York state regulated health plans to provide contact information for the independent consumer assistance program to consumers.   SUMMARY OF SPECIFIC PROVISIONS: Section one amends the insurance law by adding a new section 211 requir- ing the superintendent of financial services, in consultation with the commissioner of health, to designate an independent consumer assistance program and sets out the duties of the program. Section one also requires New York State regulated health plans to provide the contact information of the independent consumer assistance program on documents the plans send to consumers. Section two of the bill establishes the effective date.   JUSTIFICATION: Navigating the health care system is difficult. This is especially true for people who are uninsured, underinsured, denied coverage for services they thought their health plan covers, forced to obtain prior authori- zations for the tests ordered by their health care providers, receiving "surprise" bills from "out-of-network" providers thought to be "in network" or even being unfairly dropped from their health insurance plan altogether. Recognizing these challenges, independent consumer assistance programs were established and initially funded as part of the Affordable Care Act. New York has continued the program with funding supported by the Legislature and the Governor. New York contracts with Community Health Advocates, CHA, to operate the program. CHA has handled over 337,000 cases since 2010, including over 28,000 in 2018. CHA has saved New Yorkers approximately $35 million since 2010, $5.9 million in 2018. CHA advocates also assist small busi- ness owners to understand how they can offer health insurance to their employees and receive health insurance tax credits. This bill seeks to codify the independent consumer assistance program to ensure the valu- able services it provides continue into the future.   PRIOR LEGISLATIVE HISTORY: 2019-2020: A.7754 - referred to Insurance Committee   FISCAL IMPLICATIONS: Funding for the program is included in the budget annually.   EFFECTIVE DATE: This act shall take effect immediately.
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A01733 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          1733
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 11, 2021
                                       ___________
 
        Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
          Committee on Insurance
 
        AN ACT to amend the insurance law, in relation to the designation of  an
          independent consumer assistance program
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The insurance law is amended by adding a new section 211 to
     2  read as follows:
     3    § 211. Independent consumer assistance program. The superintendent, in
     4  consultation with the commissioner of health, shall designate  an  inde-
     5  pendent consumer assistance program that will have the following duties:
     6    (a) The independent consumer assistance program shall:
     7    (1)  assist  consumers  with  the  filing  of  complaints and appeals,
     8  including filing appeals with the internal appeal or  grievance  process
     9  of  the  group  health  plans  or  health insurance issuers involved and
    10  providing information about and assisting consumers  with  the  external
    11  appeals and administrative hearing process;
    12    (2) collect, track, and quantify problems and inquiries encountered by
    13  consumers;
    14    (3)  educate  consumers  on  their  rights  and  responsibilities with
    15  respect to group health plans and health insurance coverage;
    16    (4) assist consumers with enrollment in a group health plan or  health
    17  insurance coverage by providing information, referral, and assistance;
    18    (5)  resolve problems with obtaining premium tax credits under section
    19  36B of the Internal Revenue Code of 1986;
    20    (6) assist consumers with disputes eligible for resolution under arti-
    21  cle six of the financial services law;
    22    (7) assist uninsured, insured, or underinsured consumers in  accessing
    23  appropriate  health  care services, hospital financial assistance or the
    24  resolution of their health care bills; and
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00383-01-1

        A. 1733                             2
 
     1    (8) provide assistance to health consumers on any  additional  matters
     2  related to accessing health insurance coverage and health care services.
     3    (b)  All  New  York  state regulated health plans shall be required to
     4  list the name, phone number, address and email of the state  independent
     5  consumer assistance programs on notices to consumers of adverse determi-
     6  nations  and  explanation  of  benefits and in the subscriber agreement,
     7  member handbook and any additional consumer facing materials  as  deter-
     8  mined by the superintendent and the commissioner of health.
     9    § 2. This act shall take effect immediately.
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