GNYHA has identified securing HMO reforms as its top priority for the 2000 session of the State Legislature, and is working with a variety of partners to make HMO reform a reality this year. In recent weeks, GNYHA has continued its collaboration with the Healthcare Association of New York State (HANYS) to identify a core set of HMO reforms that, if enacted, would be of great use to hospitals, other health care providers, and the public in the ongoing effort to curb the abusive payment practices of HMOs and other third-party payers. The reforms included in the GNYHA/HANYS legislative package include creation of a dispute resolution system for payment denials, creation of a periodic interim payment system for payers that routinely flout the State's prompt payment and electronic claim acceptance statutes, creation of a guaranty fund to provide security for consumers and providers in case of an HMO or health insurer insolvency, and other important amendments to the State's prompt pay and utilization review laws. GNYHA and HANYS have shared these proposals with the leaders of the State Legislature as well as the Chairmen of the Assembly and Senate Health and Insurance Committees. The package of reforms can be found on GNYHA's Web site at
www.gnyha.org. In addition, HMO reforms have been identified as the top legislative priority of the Healthcare Education Project, GNYHA's ongoing collaborative effort with 1199/SEIU. In the coming weeks, the Project will be launching a highly visible campaign to help educate the public about needed reforms. The package of reforms supported by the Healthcare Education Project include the reforms mentioned above as well as a number of reforms identified as important to consumer advocates, including holding payers accountable for medical decisions, guaranteeing continuity of care when a provider becomes disassociated from a health plan, and other important reforms. The Healthcare Education Project's reform package is being shared with State leaders and members of the State Legislature, and will soon be viewable on the Web at
www.healtheducationproject.com. GNYHA is also discussing HMO reforms with the Medical Society of the State of New York to ensure that the concerns of physicians are well represented in GNYHA's reform agenda.