MEMORANDUM IN SUPPORT
A.2474-A (Canestrari) - Referred to Assembly Health Committee | Assembly Health Committee Agenda January 31, 2012
S.3186-A (Hannon) - Referred to Senate Health Committee
AN ACT to amend the public health law, in relation to requirements for collective negotiations by health care providers with certain health benefit plans
The American Congress of Obstetricians and Gynecologists (ACOG) strongly supports this legislation, which would allow physicians to collectively negotiate contract provisions with managed care plans and other insurance entities in order to restore fairness to the contracting process in New York State.
In regions across the state, either one or a small number of managed care companies dominate the local health insurance market. In this circumstance, managed care companies can force individual and small provider groups to accept inadequate reimbursement rates and other harmful contract provisions.
Under current anti-trust laws, individual physicians are prohibited from coming together to collectively negotiate any provisions of contracts they sign with managed care entities. Anti-trust laws, coupled with the strong market share of health insurance plans in New York State, create an imbalance of negotiating power in favor of the insurance industry and puts individual physicians at a serious disadvantage when negotiating contract terms with plans.
This bill would allow physicians in New York State to conduct some collective negotiations with health care plans while being closely monitored by the state. Negotiations involving fee-related matters would be prohibited unless an individual managed care plan controls a substantial share of the managed care market. This legislation would not authorize strikes or boycotts of health benefit plans by physicians.
Accessible, high-quality medical care is essential for improving and maintaining the health of women in New York State. However, the medical liability climate is currently threatening the ability of obstetrician-gynecologists (ob-gyns) to provide care to women. The dramatic increases in medical liability premiums during the past six years coupled with the fear of litigation have caused many ob-gyns in New York State to make several changes to their practices, including early retirement, dropping high-risk obstetric patients, dropping obstetric services altogether, increasing cesarean section rates, and decreasing their number of deliveries.[1]
Giving physicians a greater ability to advocate for their patients in contract negotiations is critical under the current health insurance market. Without providing physicians the opportunity to communicate with each other and jointly negotiate with managed care companies, physicians are powerless to challenge the managed care companies’ take-it-or-leave-it contracts full of anti-patient provisions.
This legislation will create a more even playing field between managed care plans and physicians, thus increasing physicians’ ability to better advocate on behalf of their patients.
For these reasons, ACOG strongly supports A.2474-A/S.3186-A and urges its passage.
[1] 2009 ACOG Professional Liability Survey
The American Congress of Obstetricians and Gynecologists, District II (ACOG) represents the board certified obstetrician-gynecologists in the state who deliver health care to New York's women. Our Albany office offers the New York State Legislature its resources as a scientific and educational organization dedicated to quality health care for women. If you have questions on this or any other state legislative proposal, please contact our office at 518-436-3461.