165.986 Gag Rule in Managed Care Contracts
165.986 Gag Rule in Managed Care Contracts :SUNSET HOD 2014
165.985 “Hold Harmless” Clauses in Physicians’ Contracts with Health Care Delivery Entities
165.985 “Hold Harmless” Clauses in Physicians’ Contracts with Health Care Delivery Entities: SUNSET HOD 2014
165.984 Prior Authorization for Procedures Under Managed Care: Limits on Time Requirements
165.984 Prior Authorization for Procedures Under Managed Care: Limits on Time Requirements: MSSNY supports the requirement that managed care organizations implement and comply with written procedures to assure that entities that conduct utilization review: (1) provide adequate access to its review staff by a toll-free or collect call
165.983 Redefining the Roles, Obligations and Responsibilities of Insurance Companies which Utilize Capitation as a Means of Physician Reimbursement
165.983 Redefining the Roles, Obligations and Responsibilities of Insurance Companies which Utilize Capitation as a Means of Physician Reimbursement: MSSNY will seek legislation requiring managed care organizations to assume appropriate risk while at the same time: (a) providing an adequate proportion of premium dollars dedicated to medical care; (b)
165.982 Changes in the Bundling of Medical Services by Managed Care Plans
165.982 Changes in the Bundling of Medical Services by Managed Care Plans: It is MSSNY’s position that when a patient sees a physician for evaluation and management of an illness, whether primary care or consultation, and the physician also performs a procedure which helps in the diagnosis or treatment
165.981 Toll-Free Telephone Numbers to be Required for all Health Insurance Carriers to Provide Access for Participating Physicians
165.981 Toll-Free Telephone Numbers to be Required for all Health Insurance Carriers to Provide Access for Participating Physicians: The Medical Society of the State of New York will seek legislation or regulatory action to require PPOs and self-insured plans, as well as insurers not engaged in utilization review procedures, to provide adequate personnel to respond
165.980 Dismissals for Cause in Managed Care Contracts
165.980 Dismissals for Cause in Managed Care Contracts: The Medical Society of the State of New York shall seek legislation that no terminations or non-renewals of physician contracts with managed care plans shall be valid without cause, and will seek the introduction of legislation which would require managed care
165.979 Elimination of the Managed Care Requirement to Obtain a Referral from a Primary Care Physician Prior to Utilizing the Services of a Specialist
165.979 Elimination of the Managed Care Requirement to Obtain a Referral from a Primary Care Physician Prior to Utilizing the Services of a Specialist: SUNSET HOD 2013
165.978 Referrals To Allied Health Providers
165.978 Referrals To Allied Health Providers: It is the position of MSSNY that managed care organizations in the State of New York should be required to designate only MDs and DOs as primary care providers for any individual or group of patients. MSSNY will continue its public opposition to
165.977 Financial Incentives Based Upon The Non Provision Of Services
165.977 Financial Incentives Based Upon The Non Provision Of Services: MSSNY will seek legislation which would prohibit the use of any financial incentives which inhibit the provision of medically necessary care. (HOD 1997-68; Reaffirmed HOD 2014; Reaffirmed HOD 2024)
