Governor Andrew Cuomo has signed A.264-B/S.3171-A and A.8404/S.6544-A, which subject out of-network (OON) hospital emergency charges to an independent dispute resolution (IDR) process. They are now Chapter 375 and 377 of the Laws of 2019.
GNYHA strongly opposed the bill’s first version because it would have destroyed a strong incentive for insurers to contract with hospitals and negotiate adequate payment rates. After conversations with GNYHA and other stakeholders, Senate and Assembly leaders introduced the second bill, which requires that in OON hospital emergency situations, insurers pay hospitals at least 125% of the previous in-network rate. It also specifies criteria the IDR must use to make its determination and mandates a non-binding mediation process between hospitals and insurers 60 days before a contract ends.
The agreement preserves the incentive for insurers to negotiate in good faith with providers. For more information, please see here.