165.832 Lab Test Without Medical Orders Any medical testing shall require ordering by a licensed health care professional with an exception for instances where the DOH permits direct access testing. (HOD 2025-100)
165.833 Ban Non-Competes The Medical Society of the State of New York revise its policy on noncompete agreements to advocate for legislation/regulation to eliminate noncompete agreements from all physician employment contracts. (HOD 2025-58)
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
165.835 Regulation Against Insurance Company Denials Following Insurer Peer-to-Peer Prior Authorization The Medical Society of the State of New York reaffirms MSSNY Policies 120.925 and 165.945. The Medical Society of the State of New York will continue to advocate for the imposition of stronger penalties against insurance companies for inappropriately denying and delaying authorization and
165.834 Payment for Pre-Authorized/Pre-Certified Procedures The Medical Society of the State of New York continue to advocate for legislation, regulation or other appropriate means to ensure that all health plans including those regulated by ERISA, pay for services that are pre-authorized, or pre-certified by such health plan, including services that are deemed pre-authorized or pre-certified
165.972 Requiring The Use Of Accepted Medical Guidelines By Insurers And Managed Care Entities: MSSNY will seek legislative or regulatory relief to ensure that insurers and managed care entities use medical guidelines developed by recognized medical specialty societies; such legislation should include provisions that insurers and managed care entities be required
165.837 Timely Claim Filing Limit & Insurance Company Audit Time Limit MSSNY will work to seek legislative and regulatory changes to establish a timely filing limit of 366 days from date of service. (HOD 2023-258)
165.999 Regionalized Emergency Care Exemption: SUNSET HOD 2014
165.998 Point of Service Provision in Managed Care Programs: MSSNY supports legislation to require all managed care organizations to offer enrollees the option of purchasing coverage for medical care and services provided out-of-network or out-of-plan, and that such option be affordable and provide reasonable payment in order to
165.997 Physician Participation in Managed Care Plan: MSSNY reaffirms current policy on managed care adopted by the Council on March 10, 1994 which is consistent with AMA policy and addresses the right of any physician to seek participation in any health care system. The relevant provisions of this
