Collective Bargaining Alert

Memorandum in Support
A.2474, Canestrari/ S.3186, Hannon
Health Care Providers Collective Negotiations Act

The New York State Academy of Family Physicians strongly supports this legislation to allow for collective negotiations by health care providers related to the terms and conditions of contracts with health plans.

Physicians are one of the few professions where they are prohibited from joining together to negotiate contract provisions and payments with managed care plans.  This bill corrects this inequity which will both restore fairness to physician negotiations and enable physicians to better advocate on behalf of the patients that they serve. 

Large managed care plans in New York dominate the market to such a degree that fair and adequate negotiations are nearly impossible.  Further in today’s system, health plan administrators, not physicians, dictate the establishment of clinical standards and control the manner in which they are applied.  This is seen in many areas ranging from the establishment of clinical review criteria used to justify utilization review determinations to the mechanisms that plans use to rate physician performance.

What’s more, each plan dictates the policies and procedures that they use to enroll physicians in their networks including varying and ever-changing credentialing requirements and other burdensome procedures which take up physician and staff time that could otherwise be spent seeing and assisting patients.

Physicians currently face non-negotiable, take-it-or-leave-it contracts that allow health plans to retroactively change contract terms, with little or no notice, and to set payment rates well below the costs to physicians associated with providing the services to patients.  Where a single plan controls a substantial share of the managed care market share, this legislation would allow physicians to also negotiate fees in addition to the terms and conditions of their contracts with health plans.

The New York State Academy of Family Physicians, representing 4,300 physicians across the state strongly urges the Legislature’s support and timely passage of this legislation this session.  This bill is critical to restore fairness to the contracting process between physicians and managed care plans as well as to allow physicians to advocate on behalf of their patients for the services and treatments that will best serve their health care needs.