165.000 MANAGED CARE

165.955              The Need for Patients to be Informed as to the Difference Between Physicians and Other Types of Health Care Provides so as to Allow the Patient to Make a Choice of a Physician or Other Health Care Provider Based in Informed Consent: MSSNY shall seek enactment of State

165.954               Prudent Layperson – 911 Calls: MSSNY reaffirms its support of the prudent layperson standard for emergency medical service and opposes triage by 911 dispatch which divert 911 (Emergency Dispatch) calls to non-emergency facilities, other than birthing centers or those facilities identified by the local REMAC (Regional Medical

165.953              Accountability for HMO Termination of a Physician by Mistake: MSSNY will actively seek legislation or regulation which holds an HMO or managed care plan accountable for all damages incurred by a physician as the result of termination notification which was made in error, to the physician’s patients. MSSNY

165.952               Managed Care Organizations’ Restricting Practice of Credentialed Physicians: MSSNY will seek legislation or regulation barring managed care organizations from limiting, by internal policy or refusal of payment, qualified physicians from practicing within the scope of their abilities, license and training. (HOD 1999-54; Reaffirmed HOD 2014; Reaffirmed HOD

165.951                Quarterly Financial Disclosures: MSSNY will seek the introduction of legislation and/or regulation to require HMOs and insurance companies to provide quarterly: a standard financial report, a statement of financial reserves, and a statement of outstanding debt including “disputed” and “undisputed” claims to the Medical Society of the

165.950               Require that HMO Subscribers Select a Primary Care Physician Within 30 Days or be Assigned One by the Plan, as per the Requirements of the NYS Medicaid Managed Care Guidelines Issued by the NYS Department of Health: SUNSET HOD 2024

165.949                Quarterly Publication of Supplementary Provider Lists for HMO Subscribers: SUNSET HOD 2014

165.948           Community Rating for Medical Coverage: MSSNY will work with the American Medical Association to secure passage of federal legislation to: (a) replace the current tax exclusion of employer-provided coverage with a refundable tax credit for each individual who receives coverage as a benefit of employment, or who purchases health

165.947           HMO Physician Indemnification: MSSNY will seek legislation requiring health care plans to indemnify and hold harmless a participating physician who acts in good faith and is sued by an insured patient for outcomes that result when the physician’s recommended course of action has been denied by the health care plan.  (HOD 1999-81; Reaffirmed HOD

165.946        Information Included on Health Insurance Identification Cards: MSSNY reaffirms its commitment to the positions embodied in Resolution 97-56, (Policy 165.981) and, in addition, MSSNY will work with payors to encourage the use of “smart cards” which would encode information, including but not limited to, the patient’s eligibility data, co-pay, type of