2019 New York Laws
ISC - Insurance
Article 2 - Organization of the Department of Financial Services
213 - New York State Health Care Quality and Cost Containment Commission.

§  213.  New  York  state  health  care  quality  and cost containment
commission. (a) There is hereby  established  within  the  department  a
commission,  to  be known as the "New York state health care quality and
cost containment commission". The commission shall consist  of  thirteen
members   appointed   by   the  governor,  one  of  whom  shall  be  the
superintendent, one of whom shall be the commissioner of health, and six
of whom shall be appointed on  the  recommendation  of  the  legislative
leaders,  two  on  the  recommendation of the temporary president of the
senate, two on the recommendation of the speaker of the assembly, one on
the recommendation of the minority leader of the senate, and one on  the
recommendation of the minority leader of the assembly. All members shall
serve  at the pleasure of the governor, and vacancies shall be appointed
in the same manner as original appointments. Members of  the  commission
shall serve without compensation, but shall be reimbursed for reasonable
travel  expenses. In making appointments to the commission, the governor
shall  ensure  that  the  interests  of  health  care  consumers,  small
businesses,  the  medical  community and health plans are represented on
the commission.
  (b)(1) The purpose of the commission shall be to analyze the impact on
health insurance costs and quality of proposed legislation  which  would
mandate  that health benefits be offered or made available in individual
and group health insurance policies, contracts and comprehensive  health
service plans, including legislation that affects the delivery of health
benefits or services or the reimbursement of health care providers.
  (2)  The governor, the chair of the senate insurance committee and the
chair of the assembly insurance committee may request  in  writing  that
the commission evaluate a proposed mandated benefit. Upon receiving such
a  request,  the  commission  may,  by  a  majority vote of its members,
undertake an evaluation of such proposed mandated benefit.
  (3) In evaluating a proposed mandated benefit, the commission shall:
  (A) investigate the current practices of health plans with  regard  to
the  proposed mandated benefit, and, to the extent possible, self-funded
health benefit plans;
  (B) investigate the potential premium impact of the proposed  mandated
benefits  on  all  segments  of  the  insurance  market,  as well as the
potential for avoided costs through early  detection  and  treatment  of
conditions, or more cost-effective delivery of medical services; and
  (C) analyze the most current medical literature regarding the proposed
mandated benefit to determine its impact on health care quality.
  (4) In evaluating a proposed mandated benefit, the commission may hold
one  or more public hearings, and shall strive to obtain independent and
verifiable  information  from  diverse  sources  within  the  healthcare
industry,  medical community and among health care consumers with regard
to the proposed mandated benefit.
  (c) To assist the commission in its duties, and upon the direction  of
the  commission,  the  superintendent is authorized to enter into one or
more  contracts  with  independent  entities  and   organizations   with
demonstrable  expertise in health care quality, finance, utilization and
actuarial services. For the purposes of this section, the superintendent
shall  not  enter  into  contracts  with  health  plans,   entities   or
organizations  owned  or controlled by health plans, or with significant
business relationships with health plans.
  (d) Upon completion of its evaluation of a proposed  mandated  benefit
pursuant  to this section, the commission shall deliver a written report
of its findings to the chair of the assembly insurance committee and the
chair of the senate insurance committee.