03/17/2017

Cuomo Signs Health Insurer Changes

Governor Cuomo has signed into law two bills designed to reduce some of the administrative burdens on practitioners in their dealings with health insurers.

• The first bill (A.501-E/S.2545-D) reduces from 90 to 60 days the time within which a health insurer must complete its review of an application to participate in the network of a health insurer, as well as reducing from 90 to 60 days the time within which a practitioner can become “provisionally credentialed” if the plan does not complete its review.   The bill also eliminates some ambiguous statutory language that currently gives discretion to a health insurer to delay a decision on an application after these deadlines have passed. The new law applies to credentialing applications received by health insurers on or after April 1, 2017.
• The second bill (A.6983-A/S.4721-A) would direct the Commissioner of Health and Department of Financial Services to create standards to provide greater uniformity among health insurers regarding the processes to be followed when requests are made to insurers to cover a patient’s needed prescription medications. The law takes effect immediately.