120.866 Prohibit Arbitrary Time Limits on Preauthorizations The Medical Society of the State of New York advocate for changes in New York legislation and Division of Financial Services policy to prohibit health insurers in NYS including Medicaid plans from establishing time limits on duration of preauthorization for care of less than one year. The Medical
120.867 Universal Out of Network Benefits MSSNY will advocate for a state law that requires all private insurers that operate in New York State to only offer health insurance plans with out-of-network benefits, and MSSNY will ask the AMA to advocate for a federal law that requires all private insurers that operate in the United
120.868 Ensuring Fair Reimbursement Rates for Physicians in New York The Medical Society of the State of New York (MSSNY) advocate for legislation and regulatory measures that prohibit commercial insurance companies from reimbursing physicians at rates lower than those established by the 80th percentile of Fair Health. MSSNY supports initiatives aimed at monitoring and enforcing
120.869 Prohibiting Insurers from Denying Payment for Procedures Based on Site of Service The Medical Society of the State of New York (MSSNY) advocates for legislation or regulation that prohibit insurers in NY State from denying payment for a procedure based on the site of service in which it was performed, provided that the procedure is
120.870 Mandating Health Insurers to Provide a Real-Time Online Tool for Coverage and Payment Policies, Integrated into Electronic Health Records (EHRs) The Medical Society of the State of New York (MSSNY) shall advocate for legislation or regulations requiring all health insurers in New York State to provide a real-time online tool for physicians and patients
120.871 Mandate for Insurance Companies to Assist in the Transition of Patients to Alternative Participating Physicians Upon Contract Termination The Medical Society of the State of New York (MSSNY) advocate through legislation or regulations that private and public health insurers be mandated on the event of a treating physician terminating participation with that insurer to provide
120.872 Support for Protections Against Health Insurance Industry Limitations on Anesthesia Delivery The Medical Society of the State of New York (MSSNY) seek legislation or regulation to the New York State Office of Insurance prevent anesthesia services coverage from being based on time limitations. (HOD 2025-252)
120.873 Ensuring Direct Payment to Providers for Out-of-Network Services The Medical Society of the State of New York advocate for legislative and regulatory changes requiring insurance carriers to issue payments for out-of-network services directly to the healthcare provider physician or practice with the patients consent, in the event that the patient has already paid the
120.874 Definition of Medical Necessity in Terms of Patient Autonomy The Medical Society of the State of New York will advocate for laws that ensure that, if a physician determines a treatment is medically necessary, and an insured patient desires to proceed with the physician’s recommended treatment, then under the doctrine of patient autonomy under
120.875 CMS violations of HIPAA and the Administrative Procedure Act The Medical Society of the State of New York continue to work with the American Medical Association and other allied groups to urge federal and state regulatory authorities to take all necessary steps to prohibit health insurers and other third party payors from forcing physicians
