December 17, 2024

Having recently received information that NYS commercial health insurance plans impacted by the new Part AA commercial rate mandate are meeting with NYS leaders this week to request a delay of the January 1, 2025 start date, we have turned up the volume on our already intense advocacy, pressing state leaders to hold the line and implement the law as written as of January 1 and beyond (depending on when the insurer and the purchaser execute the 2025 policy agreement).

Anticipating a potential problem, NYS Council representatives have been meeting with state leaders for many months, urging them to hold the line on the implementation date and sharing detailed information regarding how commercial billing works.  We have met with leaders from the Governor’s Office, the Department of Financial Services, and the O agencies with one clear message – the plans have had 7 months to prepare and the time is now to increase access to care for New Yorkers with commercial insurance.

Despite significant waiting lists around the state, providers who are calling commercial insurers seeking ‘in network’ status with the plan, these requests for consideration have often been met with resistance as plan reps tell them ‘the network is closed’ or that the plan is not going to consider new applications for in network status for many months.  This is entirely unacceptable given the Attorney General’s recent report that found an abundance of inaccurate provider directory information and massive ghost networks across both Medicaid and commercial insurer directories.  We have reminded government leaders that the response that the network is full despite proof to the contrary is in violation of the intent of the law (to increase access to care for New Yorkers with eligible commercial insurance benefits).  Insurers have also failed to uniformly work with their in network providers to ensure claims will be processed and reimbursed as required by the law.

There are no more excuses.

Today we placed an Open Letter to Governor Hochul in the Empire Report – a daily news and information sheet read by hundreds of thousands of NYS government leaders and political types around the state.  Please see the attached documents for the Letter and the priority placement of the link to the letter in today’s Empire Report.  Later this week a banner ad that the reader can click on for more information will appear on the front page of the Report.