Section 213. New York state health care quality and cost containment commission  


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  • (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.