An act to amend the public health law and the insurance law, in relation
to improper practices relating to staff membership or professional priv-
ileges of a physician and board certification
Relates to addressing the increasing burdens associated with maintaining
board certification for licensed healthcare professionals and ensuring
fair access to healthcare facilities and networks irrespective of
certification status.
Section 1 amends section 2801-b of the public health law prohibits
improper practices by a hospital's governing body regarding applica-
tions, staff memberships, and professional privileges that result in the
exclusion or termination of a licensed professional for reasons unre-
lated to patient care, patient welfare, the institution's objectives, or
the applicant's character and competencies, but only for physicians who
have not maintained their board-certification.
Section 2 amends section 4406-d of the public health law as it relates
to minimum qualification standards for healthcare practitioners wanting
to participate in a healthcare plan network. This provision emphasizes
that a health care plan cannot deny approval for membership in its
network simply because a physician who was once board-certified but no
longer maintains current certification is not board-certified.
Section 3 of the bill amends section 4803 of the insurance law, address-
ing qualification requirements for healthcare professionals seeking
participation in an insurance plan's network. This stipulation assures
that insurers cannot prohibit network membership to physicians who
previously were board-certified but no longer maintain current certif-
ication or are lacking current board certification.
Section 4 provides an effective date.
In today's healthcare landscape, the costs and time commitments associ-
ated with board certification are escalating the burden of obtaining and
maintaining them. Certification is becoming increasingly prohibitive,
particularly for physicians already grappling with rising overhead
expenses and reductions in insurer reimbursements.
Licensed professionals undergo rigorous training and examination proc-
esses to obtain their state medical licenses, demonstrating their compe-
tence to practice medicine. Physicians are generally issued state
medical licenses shortly after successfully passing medical school and
internship examinations. Beyond that, many physicians desire this
credential and pursue it because it is a recognized marker of expertise
and proficiency in a specific medical specialty, providing physicians
with enhanced credibility and opportunities for professional advance-
ment. However, the demands of maintaining ongoing board certification,
including costly recertification exams mandated by certain organiza-
tions, have placed undue strain on practitioners.
While initial board certification is an important milestone in a physi-
cian's development, frequent recertification on a periodic basis is not
only unnecessary, but there is no evidence that such recertification
actually improves the delivery of healthcare. Physicians generally
remain current in their knowledge base by attending seminars, reading
journals, discussions with other physicians, and various other endeavors
that are designed to continually improve a physician's delivery of
medical care. Furthermore, the expenditures are becoming more prohib-
itively high. For older physicians, the cost may force them out of
practice completely. This legislation aims to alleviate these burdens
and ensure that licensed professionals are not unfairly barred from
providing essential healthcare services based solely on their certif-
ication status. By prohibiting hospitals and health insurance companies
from imposing arbitrary board certification requirements as conditions
for participation, we safeguard against discrimination and promote equi-
table access to healthcare facilities.
Instead of creating excessive bureaucratic hurdles, there should be an
emphasis on qualifications that are directly relevant to patient care.
By removing barriers to participation for licensed professionals who may
not maintain board certification, this legislation fosters a more inclu-
sive healthcare environment. It recognizes that physicians remain
current in their specialties through continuous education and profes-
sional development, independent of formal recertification processes, and
upholds the principles of fairness and equality within our healthcare
system, ensuring that patients receive care from a diverse array of
qualified practitioners.
2019-2020: S5280/A5140 Schimminger
2021-2022: S2116
None to the state
This act shall take effect immediately.

Statutes affected:
S1727: 2801-b public health law, 2801-b(1) public health law, 4803 insurance law, 4803(a) insurance law
S1727A: 2801-b public health law, 2801-b(1) public health law, 4803 insurance law, 4803(a) insurance law