120.929 Improving Medical Insurance Customer Service The Medical Society of the State of New York (MSSNY) will seek regulation or legislation which ensures that all coverage information be made available to health insurance customer service agents to review with patients during phone conversations. MSSNY will seek regulation or legislation which ensures
120.928 Transfer of Insureds to Other Carriers without Proper Notification The Medical Society of the State of New York (MSSNY) will work with the appropriate state agencies to enact regulation banning the transfer of insureds or contract term changes without appropriate and easy to understand written notice of at least 90
120.927 Deleting State or Federally-Mandated Coverage The Medical Society of the State of New York will seek federal regulation or legislation that prohibits self-insured health insurance companies from deleting coverage mandated by government. (HOD 2016-259)
120.926 Private Insurers and Managed Care Organizations Pre–Authorization/Pre–Certification Protocols The Medical Society of the State of New York (MSSNY) will seek legislation or regulation applying to all insurers which will: Require insurance companies to provide clear instructions in a timely manner about the procedure for obtaining a prior authorization; Require
120.925 Peer-to-Peer Reviews by Insurers The Medical Society of the State of New York will seek legislation to change peer to peer review by insurers to include evidence-based criteria publicly available and to be conducted by a physician of the same specialty and responded to the physician practice on a timely basis via fax or
120.924 New York State Insurance Fund Unfair Rule Changes The Medical Society of the State of New York will work with all relevant agencies, including the Workers Compensation Board, to force the New York State Insurance Fund to return to the policy of providing physician offices with both the status
120.923 Prompt Response to Physician’s Request for Patient Care Services Authorization MSSNY will seek legislation and/or regulation requiring all insurance plans to respond in one business day to requests for services for the patient and if such response is not in the affirmative, then the response must include an option for
120.922 Insurers Withhold Key Financial Information from Out-of-Network Physicians MSSNY will seek legislation or regulation which would require important information contained in a Claim Remittance or Explanation of Medical Benefits be sent to all treating physicians. MSSNY will seek legislation or regulation which would prohibit insurers from using the term
120.921 Sale of Health Insurance Across State Lines The Medical Society of the State of New York opposes federal and state legislative proposals that permit the sale of health insurance products in a state that does not comply with that state’s law and regulations. This resolution will be introduced
120.920 Out of Network Insurance Benefit Availability in Individual Market and Self-Funded Plans MSSNY will seek, through legislation and/or regulation, the availability of out-of-network benefits including plans utilizing usual, customary and reasonable (UCR) payment methodology for out-of-network benefits in all tiers, including the individual market and New York State of Health.
