ALBANY, N.Y., November 14 – Consolidation in the health insurance industry and its impact on health care services, patients, and providers will be examined at joint hearings by the New York State Assembly Committees on Insurance and Health in New York City and Syracuse, N.Y.

The New York City meeting will be Friday, December 1 at 10:00 A.M. in the Assembly Hearing Room, Room 1923, at 250 Broadway.

The Syracuse meeting will be Tuesday, November 21 at 11:00 A.M. in the Common Council Chambers at City Hall, Third Floor, 233 East Washington Street.

According to the Notice of Public Hearing, posted by the Assembly, consolidation in the health insurance industry in New York and across the nation is transforming health insurance markets and the health care system. Over 12 million New Yorkers get their health care today from plans that were involved in a merger, acquisition, or some other type of affiliation agreement in just the past three years. Consolidation has also resulted in shifts in market share.

The Assembly committees will explore the impact consolidation has had on patients access to health services, and the ability of health care providers, both institutional and non-institutional, to fairly negotiate contractual relationships with health plans.

The Assembly notice suggests that testimony given at the hearing should hit on the following points:

The New York State Insurance department (NYSID) has approved over a dozen mergers or acquisitions of health plans in the last few years without conducting a single hearing. Should the State Insurance Laws Holding Company Act be amended to require public hearings on merger applications? The recent NYSID approval of HIP/GHI affiliation includes premium increase protections of enrollees and rate protections for providers. Why werent these protections included in previous merger approvals issued by the NYSID?

To what extent has health industry consolidation resulted in a health plan or group of health plans dominating a market within New York State?

What impact do health plans with significant market share in a region have on delivery and access to health care services, control of health care decision-making (utilization review), and the ability of providers to care for their patients?

What regulatory or legislative changes should be considered to ease the turmoil that has become common in the contracting process and to ensure that health providers are able to negotiate fair agreements with health care plans that minimize disruptions for patients and providers, and preserve important community services?