With time running out in the calendar year, local state lawmarkers are making a renewed push to get approval for legislation that will limit the role of insurance companies in out-of-network medical cases.
Talking at a roundtable Monday held at the Mount Kisco Public Library, state Sen. Greg Ball (R-Patterson) and Assemblyman Robert Castelli (R-Goldens Bridge) talked strategy.
The bill has already been passed by the state senate but awaits passage in the assembly.
Speculating about priorities to come for the legislature, Ball suggested that there could be a special session and that an insurance bill could move through as part of a package for it. Noting this scenario, Ball called on the leadership in Albany, including Gov. Andrew Cuomo, to make insurance reform a priority.
“This has to be an ask," he said.
Ball held two press conferences on the issue earlier this year at Northern Westchester Hospital, and highlighted the plight of the Kenney family from Bedford Hills, who got a large bill because husband Philip was treated at Westchester Medical Center, whose trauma center was out of network. The lawmaker's proposed legislation includes requiring insurance companies to disclose their reimbursement formulas for non-network healthcare and limiting insurance plans that do not provide non-network coverage.
Folks at the roundtable discussed mobilizing an area medical society, along with patients adversely affected by the current system, to help in pushing for the bill. They also discussed ways in which to persuade other assembly members to back the legislation, although getting it past the leadership was cited as a challenge.
Examples of getting grassroots support active, it was explained, include asking lawmakers abotu the issue at public events such as debates
Even with the bill, attendees complained that insurance companie will still have an advantage because they are exempt from federal antitrust law.
“They’re allowed to have a monopoly," said Castelli. "Well, that’s just great, who is the genius that came up with that one?” he added sarcastically.
Dr. Michael Brisman, a Long Island neurosurgery specialist, argued that if antitrust oversight is limited, then perhaps there should be a greater state government role in regulation. He also felt that the current system limits choice and hurt patients.
“This is what happens when you have monopolies and when you no checks,” he said. Additionally, Brisman suggested that the bill could contain a provision allowing for a neutral arbitration role in the event that a patient and insurance company have a dispute over coverage.