N.Y. Insurance Law § 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.