S T A T E O F N E W Y O R K
________________________________________________________________________
7807
I N S E N A T E
May 13, 2010
___________
Introduced by Sen. ESPADA -- read twice and ordered printed, and when
printed to be committed to the Committee 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
S. 7807 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.