120.908 Ensure Post Discharge Follow-Up Care with Original Treating Physicians MSSNY will work with the New York State Legislature and other appropriate state agencies to ensure that patients treated by non-participating providers in the hospital promptly be authorized out of network coverage for follow up care to complete the current episode of care by the
120.892 Patient Protection from Insurance Company Contract Disputes The Medical Society of the State of New York will support legislation that permits employers the right during a policy year to seek an alternative health insurance plan for their employees when the initial contracted health insurance plan ends a participation agreement with a hospital system or
120.907 Nuisance Prior Authorizations Prior authorizations for medication must have a sound clinical justification which would be available upon request from the Pharmacy Benefit Manager and which would include, but not be limited to, promotion of adherence to guidelines, promotion of generic alternatives, and prevention of adverse reactions. MSSNY will advocate with the NYS Department
120.906 Grandfathering of Medications that have been Prescribed for Over 1 Year MSSNY will advocate that a physician be able to ensure continued insurer authorization for a particular medication that a patient has been using for over one year by noting on the e-prescription that the patient is stabilized on that medication. (HOD 2019-68)
120.905 Physician Credentialing Improvement MSSNY will advocate for regulation or legislation asserting that, until an application is accepted or rejected, a physician who has submitted a completed application for credentialing may bill for services under the general supervision of a physician who is already credentialed by that plan. This shall be applied to all insurance
120.904 Fertility Preservation Therapy Insurance Coverage for Patients MSSNY will advocate for payment for fertility preservation therapy services by all payers when iatrogenic infertility may be caused directly or indirectly by necessary medical treatments as determined by a licensed physician, and will advocate for appropriate state regulation requiring payment for fertility preservation therapy services by
120.903 Bypassing Surprise Bill Good Faith Negotiation The Medical Society of the State of New York will seek legislation and/or regulation that would prohibit insurance companies from the practice of making a small payment and filing a dispute without negotiation, which is not in the spirit of the Surprise Bill Law and MSSNY will monitor
120.902 COBRA for College Students The Medical Society of the State of New York will call for legislation similar to COBRA to allow college students to continue their healthcare coverage, at their own expense, for up to 18 months after graduation or other termination of enrollment. This resolution will be sent to AMA. (HOD 2020-253)
120.901 Health Insurance that Fairly Compensates Physicians MSSNY will advocate for insurance plans to compensate physicians enough to stay in practice independent of hospital employment. This resolution will be transmitted to the AMA for further advocacy for adequate compensation of physicians. (HOD 2020-257)
120.900 Paid in Full Insurance Check Payments The Medical Society of the State of New York will seek legislation and/or regulation to ban the insurance companies from issuing “paid in full” on checks used to pay physicians and will investigate and provide guidance for best practices for responsible management of checks issued in this manner.
