120.940 Patient Educational Tools on Insurer Administrative Policies The Medical Society of the State of New York will develop a series of educational tools for members to give to their patients that will inform patients about policy and administrative problems caused by insurance plans making it more difficult for
120.939 Physician-Directed Medication Access The Medical Society of the State of New York will continue to advocate for: Legislation which will ensure that the physician’s judgment regarding the necessity of a particular medication for their patient prevails over an insurer’s judgment, including for all patients insured through Medicare
120.938 Out of Network Coverage Denials for Physician Prescriptions and Ordered Services MSSNY will pursue regulation or legislation to prohibit any insurer from writing individual or group policies which deny or unreasonably delay coverage of medically necessary prescription drugs or services based on network distinctions of the licensed
120.937 HCV Testing and Treatment The Medical Society of the State of New York will send a letter to the New York State Division of Financial Services seeking a requirement that commercial insurers provide coverage for the HCV test. MSSNY will seek, by legislation if needed, to ensure that
120.935 Non-Experimental Status Determined by Centers for Medicare and Medicaid Services The Medical Society of the State of New York will seek by regulation and/or legislation New York State policy/law requiring that any medical service deemed non experimental by the Centers for Medicare and Medicaid Services for government programs also be deemed non-experimental by private
120.934 Payments by Medicare Supplemental Policies The Medical Society of the State of New York will take appropriate action to educate MSSNY members through the E-news and the News of New York about their patients Medigap Plans so that physicians can, in turn, educate their patients’ about the benefits
120.933 Limitation on Outpatient Therapy Copayments As a result of increased physical therapy co-pays, which often cause patients to delay medically necessary treatment, the Medical Society of the State of New York should seek legislation or regulation which would limit a patient’s out-of-pocket co-pay for a prescribed course of
120.932 Insurance Simplification of Explanation of Benefits (EOBs) The Medical Society of the State of New York will seek regulation or legislation that would require all claims from a health care provider relating to a single encounter be reported together on the same EOB, rather than across multiple EOBs in order to
120.931 NYS Private Payer Medical Necessity Guidelines MSSNY will support legislation and/or regulation which prohibit insurance companies from using proprietary guidelines to deny pre-authorization and/or payment. (HOD 2016-251)
120.930 Centralized Insurance Registry The Medical Society of the State of New York (MSSNY) working with the New York State Department of Health — Office of Health Insurance Programs will seek establishment of a centralized system of insurance eligibility accessible to all providers. (HOD 2016-254)
