120.958 Eligibility for Enrollment in Family Health Plus
120.958 Eligibility for Enrollment in Family Health Plus: SUNSET HOD 2019
120.913 Qualified Physicians on Preauthorization Phone Lines
120.913 Qualified Physicians on Preauthorization Phone Lines The Medical Society of the State of New York will seek legislation or regulation requiring that prescribers be able to reach a qualified medical person promptly (within 10 minutes) on all telephone calls to third-party carriers for precertification, appeals, etc. and that the personnel qualified to adjudicate these
120.936 Requiring Insurance Companies to Cover ADD/ADHD Medications
120.936 Requiring Insurance Companies to Cover ADD/ADHD Medications For children who have already previously been successfully stabilized on a specific ADD/ADHD medication, the Medical Society of the State of New York (MSSNY) will pursue legislation and/or regulation that requires an insurer to continue to cover, at lowest tier cost, or
120.957 Outsourcing of Claims
120.957 Outsourcing of Claims: MSSNY will take all appropriate steps including, if necessary, the passage of legislation to assure that health insurance companies which subcontract with third party vendor(s) located in a foreign country for claims processing, utilization review or for any other service adhere to all appropriate federal and state legal requirements for the
120.956 Out-of-Network Care by Health Plan Providers
120.956 Out-of-Network Care by Health Plan Providers: MSSNY will petition health plans as well as the New York State Insurance Department to allow the health plan’s physician to charge a subscriber as an out-of-network provider when the subscriber is not an enrolled member of the physician’s specifically contracted health plan product. (HOD 2009-262; Reaffirmed HOD
120.955 Truth in Out-of-Network Healthcare Benefits Act
120.955 Truth in Out-of-Network Healthcare Benefits Act: MSSNY will continue to seek enforcement of the law requiring insurance companies to provide to potential purchasers the true expected out-of-pocket costs if patients to out of network. (HOD 2010-58; Amended and reaffirmed HOD 2020)
120.954 Child Health Plus Program Funding
120.954 Child Health Plus Program Funding: MSSNY will continue to work with New York’s Congressional Delegation and the AMA to assure that federal funding for care provided to beneficiaries of the Child Health Plus and Medicaid programs in New York is not diminished in the future. (HOD 2010-91; Reaffirmed HOD 2020)
120.953 Transparency in Insurance Contracts:
120.953 Transparency in Insurance Contracts: MSSNY will seek legislation and/or regulation that would enforce health insurance plans to clearly and transparently declare what exactly is covered and not covered in each of their plans in a plain, simple and concise summary, with carefully documented exclusions to coverage, in a standardized format to be approved by
120.952 Insurance Companies Dis-enrollment of Participating Physicians
120.952 Insurance Companies Dis-enrollment of Participating Physicians: SUNSET HOD 2022
120.951 Clear Statement of Coverage on Health Insurance ID Cards
120.951 Clear Statement of Coverage on Health Insurance ID Cards The Medical Society of the State of New York (MSSNY) will work with insurers to develop standardized information to be required on all health insurance ID cards which clearly states services, co-pays, and other vital coverage data purchased by the
