NY State Senate Bill 2009-S7807

Senate Bill S7807

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 Senate Committee Health 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

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 13, 2010	referred to health

2009-S7807 (ACTIVE) - Details

See Assembly Version of this Bill:: A11134
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add §2805-u, amd §2807-k, Pub Health L; amd §364-j, Soc Serv L

2009-S7807 (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-S7807 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S7807

 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 providing
improved notification to patients regarding their rights to financial
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 hospitals, 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 prohibits 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 Corporation.

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
hospital 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 (IOM) 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'
ability 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 treated 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-S7807 (ACTIVE) - Bill Text download pdf

                            
                    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.

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