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.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7214
SPONSOR: McDonald TITLE OF BILL:
An act to amend the public health law, in relation to submission of
information to the department of health for physician profiles
PURPOSE OR GENERAL IDEA OF BILL:
Makes updates to the physician profile to include provider plan network
information and to help ensure greater compliance:
SUMMARY OF SPECIFIC PROVISIONS:
Section one amends Public Health Law (PHL) § 2995-a(1) (a) to provide
that health care plan information shall be included and updated by the
Department of Health utilizing provider network participation informa-
tion, 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 profile.
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.
Section five provides the effective date.
JUSTIFICATION:
The physician profile is a highly utilized online database that is
available to the public and contains information about New York State
licensed physicians. Several years ago, the Senate one-house budget
included language to update the physician profile and include informa-
tion regarding the health plan networks the physician participates in.
After considerable push back from the NYS Department of Health (DOH),
the final adopted budget that year required the DOH to study the feasi-
bility 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, since 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, this can be accomplished without addi-
tional reporting burdens on the individual physician.
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 makes the recommended
changes 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 desig-
nee or employee to submit the information and to align Education Law and
Public Health Law requirements. Such changes have been incorporated into
this legislation with the goal of increasing physician reporting and
providing consumers with accurate up-to-date information.
PRIOR LEGISLATIVE HISTORY:
2021-2022: A.8467 (Gottfried)/S.5487 (Rivera)
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become a law.
STATE OF NEW YORK
________________________________________________________________________
7214
2023-2024 Regular Sessions
IN ASSEMBLY
May 15, 2023
___________
Introduced by M. of A. McDONALD -- read once and referred to the Commit-
tee on Health
AN ACT to amend the public health law, in relation to submission of
information to the department of health for physician profiles
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph (q) of subdivision 1 of section 2995-a of the
2 public health law, as added by chapter 542 of the laws of 2000, is
3 amended to read as follows:
4 (q) health care plans with which the licensee has contracts, employ-
5 ment, or other affiliation; provided that the reporting of such informa-
6 tion shall not be the responsibility of the physician, but shall be
7 included and updated by the department utilizing provider network
8 participation information, or other reliable sources of information
9 submitted by health care plans.
10 § 2. Subdivision 4 of section 2995-a of the public health law, as
11 amended by section 3 of part A of chapter 57 of the laws of 2015, is
12 amended to read as follows:
13 4. Each physician shall periodically report to the department on forms
14 and in the time and manner required by the commissioner any other infor-
15 mation as is required by the department for the development of profiles
16 under this section which is not otherwise reasonably obtainable. In
17 addition to such periodic reports and providing the same information,
18 each physician shall update his or her profile information within the
19 six months prior to the [expiration date of such physician's registra-
20 tion period] submission of the re-registration application, as a condi-
21 tion of registration renewal under article one hundred thirty-one of the
22 education law. Except for optional information provided, physicians
23 shall notify the department of any change in the profile information
24 within thirty days of such change.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06144-01-3
A. 7214 2
1 § 3. Subdivision 6 of section 2995-a of the public health law, as
2 added by chapter 542 of the laws of 2000, is amended to read as follows:
3 6. A physician may elect to have his or her profile omit certain
4 information provided pursuant to paragraphs (l), (m)[,] and (n) [and
5 (q)] of subdivision one of this section. In collecting information for
6 such profiles and disseminating the same, the department shall inform
7 physicians that they may choose not to provide such information required
8 pursuant to paragraphs (l), (m)[,] and (n) [and (q)] of subdivision one
9 of this section.
10 § 4. Section 2995-a of the public health law is amended by adding a
11 new subdivision 7-a to read as follows:
12 7-a. For purposes of this section, a physician may authorize a desig-
13 nee to register, transmit, enter or update information on his or her
14 behalf, provided that:
15 (a) the designee so authorized is employed by the physician or the
16 same professional practice or is under contract with such practice;
17 (b) the physician takes reasonable steps to ensure that such designee
18 is sufficiently competent in the profile requirements; and
19 (c) the physician remains responsible for ensuring the accuracy of the
20 information provided and for any failure to provide accurate informa-
21 tion.
22 The commissioner shall establish in regulation reasonable parameters
23 with regard to a physician's ability to authorize designees pursuant to
24 this section, which shall include processes necessary to allow the
25 department to: (i) grant access to the profile in a reasonably prompt
26 manner to designees authorized by physicians; (ii) require that physi-
27 cians notify the department upon terminating the authorization of any
28 designee; and (iii) establish a mechanism to prevent such terminated
29 designees from accessing the profile in a reasonably prompt manner
30 following such notification.
31 § 5. This act shall take effect on the ninetieth day after it shall
32 have become a law.
