senate Bill S1674

Amended

Provides a premium reduction for physicians and licensed midwives who complete a risk management strategies course

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 09 / Jan / 2013
    • REFERRED TO HEALTH
  • 21 / Feb / 2013
    • AMEND AND RECOMMIT TO HEALTH
  • 21 / Feb / 2013
    • PRINT NUMBER 1674A
  • 07 / May / 2013
    • REPORTED AND COMMITTED TO FINANCE
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 06 / May / 2014
    • REPORTED AND COMMITTED TO FINANCE

Summary

Provides for a premium reduction for physicians and licensed midwives who complete a risk management strategies course in obstetrics or midwifery.

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Bill Details

See Assembly Version of this Bill:
A414
Versions:
S1674
S1674A
Legislative Cycle:
2013-2014
Current Committee:
Senate Finance
Law Section:
Public Health Law
Laws Affected:
Add §2506-a, Pub Health L; amd §2343, Ins L
Versions Introduced in Previous Legislative Cycles:
2011-2012: S5153B, A344B
2009-2010: A759, A759
2007-2008: A8125B, A8125B

Sponsor Memo

BILL NUMBER:S1674

TITLE OF BILL:
An act
to amend the public health law and the
insurance law, in relation to premium reduction for
obstetric practitioners who complete a risk management
strategies course

PURPOSE: To improve birth outcomes and to promote
informed
consultation by Patients with their physicians and licensed midwives

SUMMARY OF SPECIFIC PROVISIONS: Section one amends
the public health
law by adding a new section 2506-a that provides that the
commissioner of health shall approve professional education courses
for eligible physicians and licensed midwives that cover risk
management strategies in obstetrics, including information on
potential risks and strategies to fully inform patients of risks
associated with their decisions. Such courses shall be subject to
standards as the commissioner shall prescribe by regulation.
Physicians and licensed midwives who successfully complete a risk
reduction course may receive continuing medical education credit and
a certificate of completion. Topics to be included in such course are
provided. Attendance at any course approved by the commissioner may
be in person or through distance learning methods. The commissioner
is authorized to prescribe any rules and regulations necessary and
shall consult with the Superintendent of Financial Services.

Section two amends section 2343 of the insurance law by amending
subsection (e) that provides that the superintendent shall approve an
actuarially appropriate premium reduction for an insured physician or
licensed midwife who successfully completes a risk management course
or a risk management course in obstetrics and midwifery.

Section three provides the effective date.

JUSTIFICATION: In order for a woman to determine the
most appropriate
mode of delivery in light of her individual circumstances, it is
critical that she be fully informed about the risks of each birth
option as well as considerations regarding options for labor. For
example, cesarean delivery has been show to
imply a higher risk of maternal death, a longer recovery time and
operative complications as well as a higher risk of unexplained
stillbirths in subsequent pregnancies and respiratory problems of the
newborn. Elective cesarean deliveries (cesareans performed in the
absence of medical indication) are considered by many to account for
the significant rise in cesarean births.

To promote informed consultation with patients during pregnancy by
their physicians and licensed midwives, physicians and licensed
midwives should be knowledgeable of current, evidence-based
information regarding options for labor and delivery, including
factors to be considered potential risks. This 12) bill will provide
eligible physicians and licensed midwives with the opportunity,
through approved professional risk management strategies in
obstetrics and midwifery education courses, to stay well-versed in
the considerations and concerns that should be taken into account
regarding available options while providing a possible insurance
premium reduction.

Obstetrics and gynecology is considered among the specialties at
highest risk for malpractice claims and most severely affected by
rising insurance premiums. The increases in medical malpractice
premiums discourage licensed midwives from practicing in New York
State and have caused many ob-gyns to retire early, drop high-risk
obstetric patients; or to drop obstetric services altogether.

Physicians and licensed midwives will thereby be better able to
educate their patients so that they can make informed decisions
regarding their labor and delivery. In facilitating greater education
of physicians and licensed midwives and their patients, resulting in
more informed decision-making by patients, we will enhance our
ability to improve birth as well as maternal and neonatal outcomes.

PRIOR LEGISLATIVE HISTORY: A.759, 2009 and 2010
referred to health.
A.8125-B, 2007 and 2008 advanced to third reading.
S. 5153B of 2011-2012 Committed to the Senate Finance Committee.

FISCAL IMPLICATIONS:; None to the state.

EFFECTIVE DATE: This act shall take effect one year
after it shall
have become a law and shall apply to all insurance policies and
contracts issued, renewed, modified or altered on and after such,
effective date.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1674

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced  by Sen. GRISANTI -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law and the insurance law, in relation
  to premium reduction for obstetric practitioners who complete  a  risk
  management strategies course

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The public health law is amended by adding  a  new  section
2506-a to read as follows:
  S  2506-A.  RISK  MANAGEMENT  STRATEGIES  IN  OBSTETRICS AND MIDWIFERY
COURSES. 1. IN ORDER TO IMPROVE PATIENT SAFETY, BIRTH  OUTCOMES  AND  TO
PROMOTE  INFORMED  CONSULTATION  BY  PATIENTS  WITH THEIR PHYSICIANS AND
LICENSED MIDWIVES DURING THE PRENATAL THROUGH INTRAPARTUM AND POSTPARTUM
PERIODS, THE COMMISSIONER SHALL APPROVE PROFESSIONAL  EDUCATION  COURSES
FOR ELIGIBLE PHYSICIANS AND LICENSED MIDWIVES AS PROVIDED IN SUBDIVISION
FOUR  OF  THIS SECTION THAT COVERS RISK MANAGEMENT STRATEGIES IN OBSTET-
RICS AND MIDWIFERY AS DESCRIBED IN SUBDIVISION TWO OF THIS SECTION. SUCH
RISK MANAGEMENT STRATEGIES COURSES SHALL BE SUBJECT TO SUCH STANDARDS AS
THE COMMISSIONER MAY PRESCRIBE BY REGULATION. IN PRESCRIBING SUCH  REGU-
LATIONS,  THE  COMMISSIONER  MAY  CONSULT  WITH THE AMERICAN CONGRESS OF
OBSTETRICIANS AND GYNECOLOGISTS, NEW YORK STATE ASSOCIATION OF  LICENSED
MIDWIVES  AND  OTHER HEALTH CARE ORGANIZATIONS. AN ELIGIBLE PHYSICIAN OR
LICENSED MIDWIFE WHO SUCCESSFULLY COMPLETES SUCH RISK MANAGEMENT STRATE-
GIES COURSE PURSUANT TO THIS SECTION SHALL  RECEIVE  CONTINUING  MEDICAL
EDUCATION CREDIT AND A CERTIFICATE OF COMPLETION.
  2.   COURSES ON RISK MANAGEMENT STRATEGIES DURING THE PRENATAL THROUGH
INTRAPARTUM AND POSTPARTUM PERIODS SHALL PROMOTE EVIDENCE-BASED CLINICAL
GUIDELINES AND PATIENT SAFETY PROTOCOLS  FROM  BOTH  THE  MIDWIFERY  AND
OBSTETRICAL  PERSPECTIVES. OPTIONS FOR COURSES SHOULD BE APPROPRIATE FOR
THE RESPECTIVE PROFESSION AND  MAY  INCLUDE  INFORMATION  AND  EDUCATION

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04691-01-3

S. 1674                             2

ADDRESSING  RISKS ASSOCIATED WITH THE PRACTICE OF OBSTETRICS AND MIDWIF-
ERY. COURSE OPTIONS MAY INCLUDE ISSUES SUCH  AS:  METHODS  TO  ELIMINATE
NON-MEDICALLY INDICATED (ELECTIVE) DELIVERIES PRIOR TO THIRTY-NINE WEEKS
GESTATION  INCLUDING THE NEONATAL IMPACT OF LATE PRETERM BIRTHS; VAGINAL
BIRTHS AFTER CESAREAN BIRTHS AND THE APPLICABILITY TO A TRIAL OF  LABOR;
REDUCTIONS  IN  CESAREAN BIRTHS; MONITORING OF FETAL WELL-BEING; MANAGE-
MENT OF PAIN IN LABOR; MANAGEMENT OF MATERNAL  HEMORRHAGE,  HYPERTENSIVE
CRISIS,  VAGINAL  BREECH  AND PREVENTION OF SHOULDER DYSTOCIA; AND OTHER
EVIDENCE-BASED GUIDELINE DETERMINED ISSUES THAT  IMPROVE  THE  CARE  AND
OUTCOMES OF WOMEN.
  3.  ATTENDANCE  AT ANY COURSE APPROVED BY THE COMMISSIONER PURSUANT TO
THIS SECTION MAY BE IN PERSON OR THROUGH DISTANCE LEARNING METHODS WHICH
EVINCE THAT ALL PARTICIPANTS ARE IN ATTENDANCE FOR THE DURATION  OF  THE
COURSE AND ABLE TO ASK QUESTIONS OF THE INSTRUCTOR.
  4.  PHYSICIANS  WHO  ARE  BOARD CERTIFIED OR ARE ACTIVE CANDIDATES FOR
BOARD CERTIFICATION IN OBSTETRICS AND PHYSICIANS WHO ARE BOARD CERTIFIED
OR ARE ELIGIBLE FOR BOARD CERTIFICATION IN FAMILY PRACTICE  AND  PROVIDE
OBSTETRIC SERVICES AND MIDWIVES WHO ARE LICENSED IN THE STATE ARE ELIGI-
BLE FOR A RISK MANAGEMENT STRATEGIES COURSE.
  5.  THE  COMMISSIONER  IS  AUTHORIZED TO PRESCRIBE ANY RULES AND REGU-
LATIONS NECESSARY TO IMPLEMENT THIS SECTION. IN PRESCRIBING  SUCH  RULES
AND  REGULATIONS,  THE  COMMISSIONER  SHALL CONSIDER THE RULES AND REGU-
LATIONS PROMULGATED BY THE SUPERINTENDENT OF FINANCIAL SERVICES PURSUANT
TO SUBSECTION (E) OF SECTION TWO THOUSAND THREE HUNDRED  FORTY-THREE  OF
THE  INSURANCE  LAW AND MAY CONSULT WITH THE SUPERINTENDENT OF FINANCIAL
SERVICES.
  S 2. Subsection (e) of section 2343 of the insurance law, as added  by
chapter 642 of the laws of 1990, is amended to read as follows:
  (e)  The superintendent may approve an ACTUARIALLY appropriate premium
reduction for an insured physician who  successfully  completes  a  risk
management course[, which must be approved by the superintendent subject
to  such standards as the superintendent may prescribe by regulation. In
prescribing such regulation the  superintendent  may  consult  with  the
commissioner  of  health]  OR A COURSE AUTHORIZED BY THE COMMISSIONER OF
HEALTH UNDER SECTION TWO THOUSAND  FIVE  HUNDRED  SIX-A  OF  THE  PUBLIC
HEALTH LAW.
  S  3. This act shall take effect one year after it shall have become a
law and shall apply to all  insurance  policies  and  contracts  issued,
renewed,  modified  or  altered  on  and  after such effective date. The
commissioner of health and the superintendent of financial services  are
authorized  and  directed to adopt, amend, suspend or repeal regulations
and take other actions necessary for  the  implementation  of  this  act
prior  to  such  effective  date; provided, however, that such adoption,
amendment, suspension or repeal of  regulations  shall  not  have  legal
effect until this act takes effect.

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