Assemblymember Kevin A. Cahill: Legislation Gives New Yorkers Power to Stand Up to Health Insurance Companies

June 28, 2004

Assemblymember Kevin A. Cahill (D-Ulster and Dutchess Counties) announced Assembly passage of legislation he supported that would set penalties for violations of the Managed Care Bill of Rights and speed up health care claims. A third measure awaiting Assembly approval would establish a managed care assistance program.

"Accessing quality health care can be confusing and time-consuming," Assemblymember Cahill said. "But there are ways to make it work better. This legislation holds health care companies to a higher standard and gives people help in understanding their coverage."

The Managed Care Bill of Rights provides consumers protection from unfair practices by HMOs, but currently there are no monetary penalties for violations. The Assembly’s legislation would establish fines of between $500 and $5,000, depending on the severity of the violation, for defying the Managed Care Bill of Rights (A.8604).

"As the law stands now, there is little to deter managed care providers from taking advantage of people," Mr. Cahill said. "This legislation would put teeth in this vital law that protects people who have managed health care coverage."

Another bill the Assembly passed would:

  • promote prompt and fair resolutions of health care claims;
  • establish a system for the resolution of claim disputes; and
  • create a fund for the payment of claims in case a health plan lacks the money to pay them (A.6844-a).

"Many times people wait months and months for the results of their health care claims, only to find out they will not receive as much money as they expected or deserved," Assemblymember Cahill said. "This is unacceptable. By speeding up the claims process and ensuring that a fair amount will be paid, this legislation makes sure consumers are not paying for health insurance company shortcomings."

Assemblymember Cahill sponsored legislation that creates the Managed Care Consumer Assistance Program (A.4454-a). The MCCAP would provide comprehensive information about managed care choices, rights and responsibilities. It would also help consumers quickly resolve questions and complaints about their care.

"The number of New Yorkers enrolled in managed care organizations continues to rise sharply," Mr. Cahill said. "The Managed Care Consumer Assistance Program would help people navigate the sometimes confusing world of managed care and ensure they are receiving a high quality of service," he concluded.