120.950 Regulation and Transparency of Imaging Benefit Managers’ Contracts The Medical Society of State of New York will seek legislation that any health plan, or its business partner, conducting prior authorization for non-urgent and non-emergent services or procedures 1) respond to these requests within two business days; 2) utilize recognized standards of care and comply
120.949 Health Insurance Policies for Small Groups In view of health insurance companies moving to eliminate many or all of the health insurance plans being offered to small groups (2-50 employees), while also dramatically reducing the financial incentives for brokers to market their plans, and continuing to raise premiums on
120.948 Third Party Payer Coverage of Follow Up Exams for Patients with Dense Breast Tissue MSSNY will seek legislation to require insurance companies and other third party payers to pay for follow up exams for women who receive a report of dense breast tissue. (HOD 2013-154; reaffirmed HOD 2023)
120.947 Collapse Individual and Small Group Insurance Markets MSSNY will seek legislation and/or regulation to eliminate the (newly obsolete) health insurance premium pricing differential that exists between the individual and small group pools. (HOD 2013-264; Reaffirmed HOD 2023)
120.946 Cost-saving Public Coverage for Renal Transplant Patients MSSNY will ask the AMA to support private and public mechanisms that would extend insurance coverage for the full spectrum of renal transplant care for the life of the transplanted organ; and ask the AMA to offer technical assistance to individual
120.945 Access to Timely Care The Medical Society of the State of New York will advocate for legislation or regulation to assure the right of a patient to have insurance coverage which permits them to be treated by an out of network physician of the patient’s choice if
120.944 Changes in Pre-certification for Medications to Reduce Delays The Medical Society of the State of New York will continue to advocate to reduce the circumstances when pre-authorization for needed patient medications are required, including eliminating the requirement for annual re-authorization once a prior authorization for a prescription medication has been approved. The Medical Society
120.943 Physicians and Health Care Institutions as Providers of Health Insurance In the case where a provider or health care institution provides such insurance it should be held to the highest standards and oversight to prevent conflicts of interest that impair quality care; and any institution in the business
120.942 Thoroughly Informing Patients and Physicians About Out-Of-Network Benefit Reduction and Cancellation The Medical Society of the State of New York (MSSNY) will take all possible appropriate steps, utilizing all possible methods including public relations, to fully and thoroughly educate patients and the public about the emerging realities of out-of-network
120.941 Affordable Care The Medical Society of the State of New York will advocate for regulation and legislation which provides that insurers give reasonable credit for out of network expenses based on Fair Health toward a participant’s annual deductibles and out of pocket maximums. MSSNY will submit a resolution
