155.989 Supporting Independent Practice- Payment Parity The Medical Society of the State of New York will advocate for payment parity for physicians providing the same services (adjusted for local costs), allowing small independent practices to survive, thus helping to stem the loss of physicians to locum tenens, concierge practice and non-clinical careers, and helping to
40.987 Removing Board Certification as a Requirement for Billing for Home Sleep Studies The Medical Society of the State of New York lobby the appropriate bodies in New York State government to remove Sleep Board Certification and facility accreditation as a requirement for the approval of and payment for home sleep studies, simply allowing this
180.975 United Healthcare Group Abuse of Physicians The Medical Society of the State of New York (MSSNY) will use all means available, regulatory, legislative, or legal, to force United to cease its demands for excessive records. United Healthcare should also be obligated to allow electronic uploading of medical records. (HOD 2024 – 254)
165.836 Making Care Primary–A Capitated Payment Model The Medical Society of the State of New York will remove from its website webinars or other materials advocating participation in MCP, or at a minimum, add a statement informing NYS physicians and patients of the conflicts of interest and the potential risks of participating in a capitated
120.877 Full Transparency – Explanation of Benefits MSSNY will advocate legislation and regulations that mandate that explanation of benefits, whether sent to the patient or the physician practice, include the actual CPT codes billed, DRG-codes, CPT descriptions, and optional consumer-friendly descriptions; and EOB must list the actual allowed amount, patient responsibilities (copay, deductible, coinsurance), non-covered
120.878 Transparency – Non-Payment for Services to Patients with ACA Exchange Plans with Unpaid Premiums MSSNY will advocate for legislation to require that health plans inform healthcare providers whether the plan premium has been paid and whether the account is late on payment as part of benefit verification, whether by phone, fax, or electronic transaction,
120.879 Mandated Economic Escalators in Insurance Contracts The Medical Society of the State of New York (MSSNY) will advocate through legislation or regulation for the mandatory insertion of an economic escalator provision in all commercial insurance contracts to account for economic inflation or a decline in Medicare Physician Fee Schedule (PFS). MSSNY shall bring a
120.880 AI In Insurance Claims MSSNY supports:(1) transparency standards which allow for the state agency auditing of AI algorithms used by New York State health insurers to approve and deny claims (2) the modification of New York statute to explicitly preempt the utilization of race and race-based proxies in the algorithmic claims processing of health
120.881 Do Not Penalize Primary Care Incentives if Patients Refuses Screening Tests MSSNY and the AMA will lobby to propose legislation to the Department of Financial Services and Department of Labor (DOL) to cover fully and self-insured plans in order to revise the punitive practice that health insurances hold Physicians responsible for the sole actions
235.979 Mandating Private Payer Coverage for Delegated Credentialing by Certified Verification Organizations and Extending Delegated Credentialing to Medicaid, Including Managed Medicaid Plans The Medical Society of the State of New York (MSSNY) will advocate for the establishment of regulations mandating insurance private payers to provide coverage for the cost of performing delegated credentialing by certified
