NEW YORK - Acting on concerns about possible “physician profiling,” state lawmakers said Monday they would pass a law to force health insurers that rank doctors to put patient care first instead of using cost as the sole measure.
Legislative leaders joined state Attorney General Andrew Cuomo to announce the proposed law, which is based on a so-called model code for doctor ranking that Cuomo has persuaded top insurers to adopt.
Doctor ranking programs are a rapidly growing practice within the health care industry.
Cuomo said major insurers nationwide either operate or are in the process of developing these programs.
Leaders of doctors' groups and consumer groups endorsed Cuomo's effort.
“Attorney General Cuomo is to be credited for persuading many of the nation's largest health insurers to acknowledge the risks of physician profiling,” said Dr. Nancy Nielsen, president-elect of the American Medical Association.
Six health insurance companies have signed agreements with Cuomo to adopt the doctor ranking protocols, and four of them have agreed to apply the principles nationwide.
Cuomo said Schenectady-based MVP Health Care and its Rochester affiliate, Preferred Care, with approximately 660,000 customers combined in New York, Vermont and New Hampshire, was the latest insurer to adopt the code.
Cigna Healthcare, Aetna, Empire Blue Cross Blue Shield, UnitedHealthcare and its affiliated Oxford Health Plans, and Group Health Incorporated and Health Insurance Plan of Greater New York, already agreed to adopt the code.
Cuomo began investigating the health insurance industry's ranking practices because he was concerned insurers might rate a doctor's quality based disproportionately on the insurance company's economic interests.
“It is imperative that New Yorkers aren't steered to certain preferred physicians based solely on cost, but instead have access to clear and meaningful measurements of quality of care to help them make well-informed decisions,” he said Monday.
Under the code, insurers that rank doctors must tell doctors and consumers what their criteria are.
They must base their rankings on established national standards, and they must retain a monitor to oversee compliance with the agreement.
The leaders of the Democratic-controlled Assembly and the Republican-controlled Senate said they had agreed to pass legislation based on the code.
State Assemblyman Richard Gottfried, chairman of the Assembly's Health Committee, said, “I don't want my health plan telling my doctor that if he dares to order tests or procedures that they don't want to pay for ... that they're going to retaliate by telling him he's a bad doctor.”
On the Net
www.oag.state.ny.us
Doctor ranking programs are a rapidly growing practice within the health care industry.
Cuomo said major insurers nationwide either operate or are in the process of developing these programs.
Leaders of doctors' groups and consumer groups endorsed Cuomo's effort.
“Attorney General Cuomo is to be credited for persuading many of the nation's largest health insurers to acknowledge the risks of physician profiling,” said Dr. Nancy Nielsen, president-elect of the American Medical Association.
Six health insurance companies have signed agreements with Cuomo to adopt the doctor ranking protocols, and four of them have agreed to apply the principles nationwide.
Cuomo said Schenectady-based MVP Health Care and its Rochester affiliate, Preferred Care, with approximately 660,000 customers combined in New York, Vermont and New Hampshire, was the latest insurer to adopt the code.
Cigna Healthcare, Aetna, Empire Blue Cross Blue Shield, UnitedHealthcare and its affiliated Oxford Health Plans, and Group Health Incorporated and Health Insurance Plan of Greater New York, already agreed to adopt the code.
Cuomo began investigating the health insurance industry's ranking practices because he was concerned insurers might rate a doctor's quality based disproportionately on the insurance company's economic interests.
“It is imperative that New Yorkers aren't steered to certain preferred physicians based solely on cost, but instead have access to clear and meaningful measurements of quality of care to help them make well-informed decisions,” he said Monday.
Under the code, insurers that rank doctors must tell doctors and consumers what their criteria are.
They must base their rankings on established national standards, and they must retain a monitor to oversee compliance with the agreement.
The leaders of the Democratic-controlled Assembly and the Republican-controlled Senate said they had agreed to pass legislation based on the code.
State Assemblyman Richard Gottfried, chairman of the Assembly's Health Committee, said, “I don't want my health plan telling my doctor that if he dares to order tests or procedures that they don't want to pay for ... that they're going to retaliate by telling him he's a bad doctor.”
On the Net
www.oag.state.ny.us
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