NY State Assembly Bill 2009-A11134

Assembly Bill A11134

2009-2010 Legislative Session

Provides out-patient care for patients of academic medical centers regardless of source of payment or insurance type; provides improved notification to patients

download bill text pdf

Archive: Last Bill Status - In Assembly Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

Please enter your contact information

First Name

Last Name

Email Address

A valid email address is required.

Home address is used to determine the senate district in which you reside. Your support or opposition to this bill is then shared immediately with the senator who represents you.

Optional services from the NY State Senate:

Create an account. An account allows you to officially support or oppose key legislation, sign petitions with a single click, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Include a custom message for your Senator? (Optional)

Enter a message to your senator. Many New Yorkers use this to share the reasoning behind their support or opposition to the bill. Others might share a personal anecdote about how the bill would affect them or people they care about.

Actions

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 19, 2010	referred to health

co-Sponsors

2009-A11134 (ACTIVE) - Details

See Senate Version of this Bill:: S7807
Current Committee:: Assembly Health
Law Section:: Public Health Law
Laws Affected:: Add §2805-u, amd §2807-k, Pub Health L; amd §364-j, Soc Serv L

2009-A11134 (ACTIVE) - Summary

Provides quality out-patient care for patients of academic medical centers regardless of source of payment or insurance type; provides improved notification to patients regarding their rights to financial assistance at hospitals; improves access to specialty care for medical assistance recipients.

2009-A11134 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:A11134

TITLE  OF  BILL:   An act to amend the public health law, in relation to
providing quality out-patient care  for  patients  of  academic  medical
centers regardless of source of payment or insurance type and to provid-
ing  improved  notification to patients regarding their rights to finan-
cial assistance at hospitals; and to amend the social services  law,  in
relation  to  improving  access to specialty care for medical assistance
recipients

PURPOSE OR GENERAL IDEA OF BILL: The purpose of the bill  is  to  ensure
that all patients receive quality medical care, regardless of the source
of  payment or insurance type in New York City's private teaching hospi-
tals, a measure that will discontinue the practice of  'steering'  which
contributes  to  the  widespread racial and ethnic disparities in health
outcomes observed in New York.

SUMMARY OF SPECIFIC PROVISIONS: Section 1 creates a new  sub-section  in
the  public  health  law  which requires that the outpatient services of
general hospitals in New York City be provided in the outpatient  clinic
that is owned and operated by the general hospital. This section prohib-
its  general  hospitals  from referring, steering or otherwise directing
patients to private physicians' practices,  including  faculty  practice
corporations  that  are not licensed by the Department of Health, unless
the general hospital does  not  accept  the  patient's  insurance.  This
section  will not apply to the New York City Health and Hospitals Corpo-

ration.

Section 2 requires that patients be informed about the  availability  of
hospital  financial  assistance through a notification on the hospital's
website and through its physician referral line.

Section 3 requires general hospitals to make best efforts  to  negotiate
with  Medicaid  managed  care  plans in their social service district to
ensure that all medical service providers employed by the general hospi-
tal are credentialed by the available plans.  Section  3  also  requires
hospitals to submit a strategic plan describe their goals and efforts to
meet the requirements of this section.

Section  4  provides  for an effective date 270 days after enactment and
gives the department the power to promulgate regulations.

JUSTIFICATION: In 2002, the Institute of Medicine  (ION)  published  its
Unequal  Treatment report, which cast a strong national spotlight on the
complex causes of racial and ethnic disparities in  health  care.    The
report  described  "how  the financial and institutional arrangements of
health systems have disparate and negative effects on minorities' abili-
ty to attain quality care.

In New York City, private teaching hospitals operate a two tiered system
of outpatient specialty care. Patients with private insurance are treat-
ed in the hospitals' faculty practices. Patients who  have  Medicaid  or

are  uninsured  are  treated in the hospital-based specialty clinics. In
the private teaching  hospitals,  faculty  practices  have  more  highly
trained  providers,  greater  communication  between  providers, 24-hour
phone access, continuity of care, and accountability to both the patient
and  the referring primary care provider. Patients at specialty clinics,
on the other hand, are far more likely to receive  care  from  residents
who  are rotating in and out of clinics and are less able to provide the
continuity of care that is critical to patients with chronic or  serious
conditions.  Since  insurance status is so closely linked to race in New
York City, the sorting of patients into two separate and unequal systems
of care contributes to the pervasive racial and  ethnic  disparities  in
health outcomes that have been documented by the IOM and others.

By contrast, New York City's public hospital system does not operate two
separate systems of specialty care within its facilities.

This  legislation will bring the private teaching hospitals operating in
New York City in line with the integrated specialty care  already  being
offered  by  the public system by requiring private hospitals to provide
care in the same place at the same time to all regardless  of  insurance
status.  Specifically,  this bill requires the expansion and improvement
of the clinic-based system by requiring private hospitals to  treat  all
patients,  publicly  insured,  privately  insured  and uninsured, in the
clinic setting. It would also prohibit private hospitals  from  steering
patients into one care setting or another based on the type of insurance
they  have.  This bill, by calling for the creation of a single locus of
specialty care in the clinic setting, would ensure that all New  Yorkers
have  access to the highest quality of care our health care institutions
have to offer.

PRIOR LEGISLATIVE HISTORY: None.

FISCAL IMPLICATIONS: None to the state.

EFFECTIVE DATE: This bill shall take  effect  on  the  two  hundred  and
seventieth day after it shall have become a law.

2009-A11134 (ACTIVE) - Bill Text download pdf

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

                                  11134

                          I N  A S S E M B L Y

                              May 19, 2010
                               ___________

Introduced by M. of A. BENJAMIN -- read once and referred to the Commit-
  tee on Health

AN  ACT to amend the public health law, in relation to providing quality
  out-patient care for patients of academic medical  centers  regardless
  of  source  of  payment  or  insurance  type and to providing improved
  notification to patients regarding their rights to  financial  assist-
  ance  at  hospitals; and to amend the social services law, in relation
  to improving access to specialty care for medical  assistance  recipi-
  ents

  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
2805-u to read as follows:
  S  2805-U.  PROHIBITION  AGAINST  PATIENT  STEERING BASED ON SOURCE OF
PAYMENT AND INTEGRATION OF OUT-PATIENT CARE. 1. EVERY  GENERAL  HOSPITAL
LOCATED  IN A CITY WITH A POPULATION OF ONE MILLION OR MORE SHALL ENSURE
THAT EVERY PATIENT SEEKING OUT-PATIENT HOSPITAL SERVICES, REGARDLESS  OF
SOURCE  OF  PAYMENT,  SHALL RECEIVE CARE IN THE OUT-PATIENT CLINIC OWNED
AND OPERATED BY SUCH GENERAL HOSPITAL PURSUANT TO THE PROVISIONS OF THIS
ARTICLE.
  2. NO GENERAL HOSPITAL LOCATED IN A CITY  WITH  A  POPULATION  OF  ONE
MILLION  OR  MORE  SHALL  REFER,  STEER, OR OTHERWISE DIRECT ANY PATIENT
SEEKING OUT-PATIENT HOSPITAL SERVICES  TO  PRIVATE  PHYSICIAN  PRACTICES
THAT  ARE  NOT  LICENSED  PURSUANT  TO  THE  PROVISIONS OF THIS ARTICLE,
INCLUDING BUT NOT LIMITED TO, UNIVERSITY FACULTY  PRACTICE  CORPORATIONS
AS   DEFINED  IN  SECTION  ONE  THOUSAND  FOUR  HUNDRED  TWELVE  OF  THE
NOT-FOR-PROFIT CORPORATION LAW, IF THE PATIENT'S INSURANCE  IS  ACCEPTED
BY  THE  GENERAL  HOSPITAL AND APPROPRIATELY CREDENTIALED PHYSICIANS ARE
AVAILABLE TO TREAT THE PATIENT IN  THE  APPROPRIATE  OUT-PATIENT  CLINIC
OWNED  AND  OPERATED  BY  THE  GENERAL  HOSPITAL. THE PROVISIONS OF THIS
SECTION SHALL APPLY REGARDLESS  OF  WHETHER  THE  PATIENT  CONTACTS  THE
GENERAL  HOSPITAL  VIA  A  TELEPHONE-BASED  OR  INTERNET-BASED PHYSICIAN
REFERRAL SERVICE, AS A WALK-IN, OR THROUGH THE  PATIENT'S  PRIMARY  CARE
PHYSICIAN.
  3. THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO THE NEW YORK CITY
HEALTH  AND  HOSPITALS  CORPORATION,  ESTABLISHED  BY  THE NEW YORK CITY

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD17302-02-0

A. 11134                            2

HEALTH AND HOSPITALS CORPORATION ACT PURSUANT TO  CHAPTER  ONE  THOUSAND
SIXTEEN OF THE LAWS OF NINETEEN HUNDRED SIXTY-NINE.
  S  2. Paragraph (c) of subdivision 9-a of section 2807-k of the public
health law, as added by section 39-a of part A of chapter 57 of the laws
of 2006, is amended to read as follows:
  (c) Such policies and procedures shall be  clear,  understandable,  in
writing and publicly available in summary form and each general hospital
participating  in the pool shall ensure that every patient is made aware
of the existence of such policies and procedures and is provided,  in  a
timely  manner,  with  a  summary  of  such policies and procedures upon
request. Any summary provided to patients shall, at a  minimum,  include
specific  information  as to income levels used to determine eligibility
for assistance, a description of the primary service area of the  hospi-
tal and the means of applying for assistance. For general hospitals with
twenty-four  hour  emergency  departments,  such policies and procedures
shall require the notification of patients during the intake and  regis-
tration process, through the conspicuous posting of language-appropriate
information  in  the  general  hospital,  NOTIFICATION  ON  WEBSITES AND
THROUGH THE GENERAL HOSPITAL'S PATIENT REFERRAL LINE, and information on
bills and statements sent to patients, that financial aid may be  avail-
able  to  qualified  patients and how to obtain further information. For
specialty hospitals without twenty-four hour emergency departments, such
notification shall take place  through  written  materials  provided  to
patients  during  the  intake  and  registration  process  prior  to the
provision of any health care services  or  procedures,  NOTIFICATION  ON
WEBSITES AND THROUGH THE SPECIALTY HOSPITAL'S PATIENT REFERRAL LINE, and
through  information  on  bills  and  statements  sent to patients, that
financial aid may be available to qualified patients and how  to  obtain
further  information.  Application  materials  shall include a notice to
patients that upon submission of a completed application, including  any
information or documentation needed to determine the patient's eligibil-
ity  pursuant to the hospital's financial assistance policy, the patient
may disregard any bills until the hospital has rendered  a  decision  on
the application in accordance with this paragraph.
  S  3.  Paragraph  (a)  of subdivision 4 of section 364-j of the social
services law is amended by adding a new subparagraph  (iv)  to  read  as
follows:
  (IV)  EVERY  GENERAL  HOSPITAL,  AS  DEFINED  BY  SECTION TWENTY-EIGHT
HUNDRED ONE OF THE PUBLIC HEALTH LAW, LOCATED IN A  CITY  WITH  A  POPU-
LATION  OF ONE MILLION OR MORE SHALL USE THEIR BEST EFFORTS TO NEGOTIATE
WITH MANAGED CARE PROVIDERS LICENSED TO OPERATE IN THE  SOCIAL  SERVICES
DISTRICT  IN  WHICH  SUCH  GENERAL HOSPITAL IS LOCATED TO CREDENTIAL ALL
MEDICAL SERVICES PROVIDERS EMPLOYED  BY  SUCH  GENERAL  HOSPITAL.  EVERY
GENERAL  HOSPITAL  SUBJECT TO THIS SECTION SHALL SUBMIT AN ANNUAL REPORT
TO THE DEPARTMENT OF HEALTH PURSUANT  TO  SECTION  TWENTY-EIGHT  HUNDRED
THREE-B OF THE PUBLIC HEALTH LAW DESCRIBING THE GENERAL HOSPITAL'S STRA-
TEGIC PLAN TO MEET THE REQUIREMENTS OF THIS SECTION AND THE EFFORTS MADE
TO FULFILL THE STRATEGIC PLAN.
  S  4.  This  act  shall  take effect on the two hundred seventieth day
after it shall have become a  law;  provided,  that  the  amendments  to
section  364-j  of the social services law made by section three of this
act shall not affect the repeal of such section and shall be  deemed  to
be  repealed  therewith;  and  provided  further, that the department of
health may promulgate any rules necessary for implementing and  carrying
out the provisions of this act prior to its effective date.

Comments

Open Legislation is a forum for New York State legislation. All comments are subject to review and community moderation is encouraged.

Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity, hate or toxic speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Attempts to intimidate and silence contributors or deliberately deceive the public, including excessive or extraneous posting/posts, or coordinated activity, are prohibited and may result in the temporary or permanent banning of the user. Comment moderation is generally performed Monday through Friday. By contributing or voting you agree to the Terms of Participation and verify you are over 13.

Create an account. An account allows you to sign petitions with a single click, officially support or oppose key legislation, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Assembly Bill A11134

Share this bill

Sponsored By

BENJAMIN