Senate Bill S3389A

2011-2012 Legislative Session

Provides that persons with clotting protein deficiencies who are otherwise eligible for certain health insurance programs shall have access to reimbursement for certain health services

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Archive: Last Bill Status - In Senate Committee Rules 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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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 12, 2012	committee discharged and committed to rules
Feb 27, 2012	notice of committee consideration - requested
Jan 13, 2012	print number 3389a
Jan 13, 2012	amend and recommit to health
Jan 04, 2012	referred to health
Feb 17, 2011	referred to health

Bill Amendments

2011-S3389 - Details

Current Committee:: Senate Rules
Law Section:: Public Health Law
Laws Affected:: Amd §2510, Pub Health L; amd §369-ee, Soc Serv L; amd §4326, Ins L

2011-S3389 - Summary

Provides that persons with hemophilia and other clotting protein deficiencies who are otherwise eligible for the Child Health Plus, Family Health Plus, and Healthy New York programs shall have access to reimbursement for outpatient blood clotting factor concentrates and other necessary treatments and services.

2011-S3389 - Sponsor Memo

                                BILL NUMBER:S3389

TITLE OF BILL:
An act
to amend the public health law, the social services law and the
insurance law, in relation to providing that persons with hemophilia and
other clotting protein deficiencies who are otherwise eligible for the
Child Health Plus, Family Health Plus, and Healthy New York programs
shall have access to reimbursement for outpatient blood clotting factor
concentrates and other necessary treatments and services

PURPOSE:
This bill amends the public health, social services and insurance laws
to provide outpatient coverage under the Child Health Plus, Family
Health Plus, and Healthy New York programs for blood clotting factor
concentrates as well as other treatments and services necessary for
individuals with hemophilia and other clotting protein deficiencies.

SUMMARY OF PROVISIONS:
Sections 2510 (7) and (7)(a) of the public health law are amended to
include outpatient blood clotting factor products and other
treatments and services furnished in connection with the care of
hemophilia and other blood dotting protein deficiencies in the
definition of Covered Health Care Services and Primary and
Preventative health care services. A new paragraph is added (xvii)
to include blood dotting factor products and other treatments and

services furnished in connection with the care of hemophilia and
other blood clotting protein deficiencies as defined by the
commissioner of health in consultation with the superintendent.
Paragraph 1.3 of section 4326 of the insurance law is amended to
include outpatient services for hemophilia and other blood clotting
protein deficiencies

JUSTIFICATION:
Hemophilia is a rare hereditary bleeding disorder affecting roughly
2,000 New Yorkers, resulting from a deficiency in blood proteins
known as clotting factors. Without an adequate supply of dotting
factors, individuals can experience prolonged bleeding following
routine medical and dental procedures, trauma, and a range of
physical activities. Additionally, individuals with hemophilia often
experience spontaneous internal bleeding that can cause severe joint
damage, chronic pain, and even death.

Prior to the 1970's, individuals with hemophilia seldom lived beyond
30. Early treatment consisted of whole blood and plasma transfusions
at hospitals. These treatments were difficult, time consuming and
only minimally effective. The advent of commercially prepared blood
dotting factors in the 1980s represented a major advance in
treatment, both in terms of efficacy and convenience. Most
importantly, these advances allowed for home infusion.

In addition to hemophilia, there are several other disorders
resulting from blood protein deficiencies. These include Von
Willebrand Disease (VWD), the most common bleeding disorder,
affecting approximately two million Americans. Individuals with the


severest form of VWD rely on clotting factor treatments similar to
those used by individuals with hemophilia.

Clotting factor products produced today (derived from plasma or
recombinant technology) are very safe and highly effective
medications. Access to therapies has vastly improved both the health
outcomes and quality of life for the majority of patients and their
families. Many patients today are on a prophylactic regimen to
prevent bleeding episodes. This regimen has significantly reduced
visits to emergency rooms, hospitalizations and joint damage.
Further, the ability to manage hemophilia and other bleeding
disorders outside of the hospital setting has improved attendance for
school-aged children, decreased absenteeism from work for adult
patients and caregivers, vastly improved the ability of affected
persons to join the work force, and minimized life disruptions for
the entire family.

New York State is the only state in the U.S. that currently prevents
individuals qualifying for the State Children's Health Insurance
Program (i.e., Child Health Plus) access to outpatient clotting
factor products. Moreover, all three programs, Child Health Plus,
Family Health Plus and Healthy New York, were created to improve
access to health care for low-income individuals. Having a public
health policy in place that prevents otherwise eligible individuals
with hemophilia and other bleeding disorders from accessing
lifesaving medications not only violates the spirit of the policy, it
fundamentally undermines the programs' goal of ensuring that
low-income children and families have access to the quality health
care.

LEGISLATIVE HISTORY:
New bill 2011.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
This shall take effect on the first of April next succeeding the date
upon which it shall have become law.

2011-S3389 - Bill Text download pdf

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

                                  3389

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            February 17, 2011
                               ___________

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

AN ACT to amend the public health law, the social services law  and  the
  insurance  law,  in relation to providing that persons with hemophilia
  and other clotting protein deficiencies who are otherwise eligible for
  the Child Health Plus,  Family  Health  Plus,  and  Healthy  New  York
  programs shall have access to reimbursement for outpatient blood clot-
  ting factor concentrates and other necessary treatments and services

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

  Section 1. Subdivision 7 of section 2510 of the public health law,  as
amended  by  section 21 of part B of chapter 109 of the laws of 2010, is
amended to read as follows:
  7. "Covered health care services" means: the services  of  physicians,
optometrists,  nurses,  nurse  practitioners, midwives and other related
professional personnel  which  are  provided  on  an  outpatient  basis,
including  routine well-child visits; diagnosis and treatment of illness
and injury; inpatient health care services; laboratory tests; diagnostic
x-rays; prescription and  non-prescription  drugs  and  durable  medical
equipment;  radiation  therapy;  chemotherapy;  hemodialysis; OUTPATIENT
BLOOD  CLOTTING  FACTOR  PRODUCTS  AND  OTHER  TREATMENTS  AND  SERVICES
FURNISHED  IN  CONNECTION  WITH  THE  CARE OF HEMOPHILIA AND OTHER BLOOD
CLOTTING  PROTEIN  DEFICIENCIES;  emergency   room   services;   hospice
services;  emergency,  preventive  and  routine  dental  care, including
medically necessary orthodontia but excluding cosmetic surgery; emergen-
cy, preventive and routine vision care, including eyeglasses; speech and
hearing services; and, inpatient and outpatient mental  health,  alcohol
and substance abuse services as defined by the commissioner in consulta-
tion  with  the superintendent. "Covered health care services" shall not
include drugs, procedures and supplies for  the  treatment  of  erectile
dysfunction  when provided to, or prescribed for use by, a person who is

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09165-02-1

S. 3389                             2

required to register as a sex offender pursuant to article six-C of  the
correction  law,  provided  that  any  denial of coverage of such drugs,
procedures or supplies shall provide  the  patient  with  the  means  of
obtaining  additional  information  concerning  both  the denial and the
means of challenging such denial.
  S 2. Subdivision 7 of section 2510 of the public health law, as  added
by chapter 922 of the laws of 1990, is amended to read as follows:
  7.  a.  "Primary  and  preventive  health  care  services"  means: the
services  of  physicians,  optometrists,  nurses,  nurse  practitioners,
midwives  and other related professional personnel which are provided on
an outpatient basis, including routine well-child visits; diagnosis  and
treatment  of  illness  and injury; laboratory tests; diagnostic x-rays;
prescription  drugs;  radiation  therapy;  chemotherapy;   hemodialysis;
OUTPATIENT  BLOOD  CLOTTING  FACTOR  PRODUCTS  AND  OTHER TREATMENTS AND
SERVICES FURNISHED IN CONNECTION WITH THE CARE OF HEMOPHILIA  AND  OTHER
BLOOD  CLOTTING  PROTEIN  DEFICIENCIES; emergency room services; hospice
services; and,  outpatient  alcohol  and  substance  abuse  services  as
defined by the commissioner in consultation with the superintendent.
  b.  "Optional  primary  and  preventive  health  care services" means:
dental, vision, speech and hearing services as defined  by  the  commis-
sioner in consultation with the superintendent.
  S 3. Subparagraphs (xv) and (xvi) of paragraph (e) of subdivision 1 of
section  369-ee of the social services law, subparagraph (xv) as amended
and subparagraph (xvi) as added by chapter 526 of the laws of 2002,  are
amended and a new paragraph (xvii) is added to read as follows:
  (xv) services provided to meet the requirements of 42 U.S.C. 1396d(r);
[and]
  (xvi) hospice services; AND
  (XVII)  OUTPATIENT BLOOD CLOTTING FACTOR PRODUCTS AND OTHER TREATMENTS
AND SERVICES FURNISHED IN CONNECTION WITH THE  CARE  OF  HEMOPHILIA  AND
OTHER BLOOD CLOTTING PROTEIN DEFICIENCIES AS DEFINED BY THE COMMISSIONER
OF HEALTH IN CONSULTATION WITH THE SUPERINTENDENT.
  S  4.  Paragraph 13 of subsection (d) of section 4326 of the insurance
law, as added by chapter 1 of the laws of 1999, is amended  to  read  as
follows:
  (13)  blood and blood products furnished in connection with surgery or
inpatient hospital services OR OUTPATIENT SERVICES  FOR  HEMOPHILIA  AND
OTHER BLOOD CLOTTING PROTEIN DEFICIENCIES; and
  S  5. This act shall take effect on the first of April next succeeding
the date upon which it shall have become a law.

2011-S3389A (ACTIVE) - Details

Current Committee:: Senate Rules
Law Section:: Public Health Law
Laws Affected:: Amd §2510, Pub Health L; amd §369-ee, Soc Serv L; amd §4326, Ins L

2011-S3389A (ACTIVE) - Summary

2011-S3389A (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S3389A

TITLE OF BILL:
An act
to amend the public health law, the social services law and the
insurance law, in relation to providing that persons with hemophilia and
other clotting protein deficiencies who are otherwise eligible for the
Child Health Plus, Family Health Plus, and Healthy New York programs
shall have access to reimbursement for outpatient blood clotting factor
concentrates and other necessary treatments and services

PURPOSE:
This bill amends the public health, social services and insurance laws
to provide outpatient coverage under the Child Health Plus, Family
Health Plus, and Healthy New York programs for blood clotting factor
concentrates as well as other treatments and services necessary for
individuals with hemophilia and other clotting protein deficiencies.

SUMMARY OF PROVISIONS:
Sections 2510 (7) and (7) (a) of the public health law are amended to
include outpatient blood clotting factor products and other
treatments and services furnished in connection with the care of
hemophilia and other blood dotting protein deficiencies in the
definition of Covered Health Care Services and primary and
Preventative health care services.
A new paragraph is added (xvii) to include blood dotting factor

products and other treatments and services furnished in connection
with the care of hemophilia and other blood clotting protein
deficiencies as defined by the commissioner of health in consultation
with the superintendent.
Paragraph 1.3 of section 4326 of the insurance law is amended to
include outpatient services for hemophilia and other blood clotting
protein deficiencies

JUSTIFICATION:
Hemophilia is a rare hereditary bleeding disorder affecting roughly
2,000 New Yorkers, resulting from a deficiency in blood proteins
known as clotting factors. Without an adequate supply of dotting
factors, individuals can experience prolonged bleeding following
routine medical and dental procedures, trauma, and a range of
physical activities. Additionally! individuals with hemophilia often
experience spontaneous internal bleeding that can cause severe joint
damage, chronic pain, and even death.

Prior to the 1970's, individuals with hemophilia seldom lived beyond 30.
Early treatment consisted of whole blood and plasma transfusions at
hospitals. These treatments were difficult, time consuming and only
minimally effective. The advent of commercially prepared blood dotting
factors in the 1980s represented a major advance in treatment, both
in terms of efficacy and convenience. Most importantly, these
advances allowed for home infusion.

In addition to hemophilia, there are several other disorders resulting
from blood protein deficiencies. These include Von Willebrand Disease
(VWD), the most common bleeding disorder, affecting approximately two
million Americans. Individuals with the severest form of VWD rely on


clotting factor treatments similar to those used by individuals with
hemophilia.

Clotting factor products produced today (derived from plasma or
recombinant technology) are very safe and highly effective
medications. Access to therapies has vastly improved both the health
outcomes and quality of life for the majority of patients and their
families. Many patients today are on a prophylactic regimen to
prevent bleeding episodes. This regimen has significantly reduced
visits to emergency rooms, hospitalizations and joint damage.
Further, the ability to manage hemophilia and other bleeding
disorders outside of the hospital setting has improved attendance for
school-aged children, decreased absenteeism from work for adult
patients and caregivers, vastly improved the ability of affected
persons to join the work force, and minimized life disruptions for
the entire family.

New York state is the only state in the U.S. that currently prevents
individuals qualifying for the State Children's Health Insurance
Program (i.e., Child Health Plus) access to outpatient clotting
factor products.
Moreover, all three programs, Child Health plus, Family Health Plus
and Healthy New York, were created to improve access to health care
for low-income individuals. Having a public health policy in place
that prevents otherwise eligible individuals with hemophilia and
other bleeding disorders from accessing lifesaving medications not
only violates the spirit of the policy, it fundamentally undermines
the programs' goal of ensuring that low-income children and families
have access to the quality health care.

LEGISLATIVE HISTORY:
New bill 2011.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
This shall take effect on the first of April next succeeding the date
upon which it shall have become law.

2011-S3389A (ACTIVE) - Bill Text download pdf

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

                                 3389--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            February 17, 2011
                               ___________

Introduced  by  Sen. KRUEGER -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health --  recommitted  to
  the  Committee  on  Health in accordance with Senate Rule 6, sec. 8 --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted to said committee

AN  ACT  to amend the public health law, the social services law and the
  insurance law, in relation to providing that persons  with  hemophilia
  and other clotting protein deficiencies who are otherwise eligible for
  the  Child  Health  Plus,  Family  Health  Plus,  and Healthy New York
  programs shall have access to reimbursement for outpatient blood clot-
  ting factor concentrates and other necessary treatments and services

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

  Section  1. Subdivision 7 of section 2510 of the public health law, as
amended by section 21 of part B of chapter 109 of the laws of  2010,  is
amended to read as follows:
  7.  "Covered  health care services" means: the services of physicians,
optometrists, nurses, nurse practitioners, midwives  and  other  related
professional  personnel  which  are  provided  on  an  outpatient basis,
including routine well-child visits; diagnosis and treatment of  illness
and injury; inpatient health care services; laboratory tests; diagnostic
x-rays;  prescription  and  non-prescription  drugs  and durable medical
equipment; radiation  therapy;  chemotherapy;  hemodialysis;  OUTPATIENT
BLOOD  CLOTTING  FACTOR  PRODUCTS  AND  OTHER  TREATMENTS  AND  SERVICES
FURNISHED IN CONNECTION WITH THE CARE  OF  HEMOPHILIA  AND  OTHER  BLOOD
CLOTTING   PROTEIN   DEFICIENCIES;   emergency  room  services;  hospice
services; emergency,  preventive  and  routine  dental  care,  including
medically necessary orthodontia but excluding cosmetic surgery; emergen-
cy, preventive and routine vision care, including eyeglasses; speech and
hearing  services;  and, inpatient and outpatient mental health, alcohol
and substance abuse services as defined by the commissioner in consulta-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09165-03-2

S. 3389--A                          2

tion with the superintendent. "Covered health care services"  shall  not
include  drugs,  procedures  and  supplies for the treatment of erectile
dysfunction when provided to, or prescribed for use by, a person who  is
required  to register as a sex offender pursuant to article six-C of the
correction law, provided that any denial  of  coverage  of  such  drugs,
procedures  or  supplies  shall  provide  the  patient with the means of
obtaining additional information concerning  both  the  denial  and  the
means of challenging such denial.
  S  2. Subdivision 7 of section 2510 of the public health law, as added
by chapter 922 of the laws of 1990, is amended to read as follows:
  7. a.  "Primary  and  preventive  health  care  services"  means:  the
services  of  physicians,  optometrists,  nurses,  nurse  practitioners,
midwives and other related professional personnel which are provided  on
an  outpatient basis, including routine well-child visits; diagnosis and
treatment of illness and injury; laboratory  tests;  diagnostic  x-rays;
prescription   drugs;  radiation  therapy;  chemotherapy;  hemodialysis;
OUTPATIENT BLOOD CLOTTING  FACTOR  PRODUCTS  AND  OTHER  TREATMENTS  AND
SERVICES  FURNISHED  IN CONNECTION WITH THE CARE OF HEMOPHILIA AND OTHER
BLOOD CLOTTING PROTEIN DEFICIENCIES; emergency  room  services;  hospice
services;  and,  outpatient  alcohol  and  substance  abuse  services as
defined by the commissioner in consultation with the superintendent.
  b. "Optional primary  and  preventive  health  care  services"  means:
dental,  vision,  speech  and hearing services as defined by the commis-
sioner in consultation with the superintendent.
  S 3. Subparagraphs (xv) and (xvi) of paragraph (e) of subdivision 1 of
section 369-ee of the social services law, subparagraph (xv) as  amended
and  subparagraph (xvi) as added by chapter 526 of the laws of 2002, are
amended and a new paragraph (xvii) is added to read as follows:
  (xv) services provided to meet the requirements of 42 U.S.C. 1396d(r);
[and]
  (xvi) hospice services; AND
  (XVII) OUTPATIENT BLOOD CLOTTING FACTOR PRODUCTS AND OTHER  TREATMENTS
AND  SERVICES  FURNISHED  IN  CONNECTION WITH THE CARE OF HEMOPHILIA AND
OTHER BLOOD CLOTTING PROTEIN DEFICIENCIES AS DEFINED BY THE COMMISSIONER
OF HEALTH IN CONSULTATION WITH THE SUPERINTENDENT.
  S 4. Paragraph 13 of subsection (d) of section 4326 of  the  insurance
law,  as  amended by chapter 219 of the laws of 2011, is amended to read
as follows:
  (13) blood and blood products furnished in connection with surgery  or
inpatient  hospital  services  OR OUTPATIENT SERVICES FOR HEMOPHILIA AND
OTHER BLOOD CLOTTING PROTEIN DEFICIENCIES;
  S 5. This act shall take effect on the first of April next  succeeding
the  date upon which it shall have become a law; provided, however, that
the amendments to subdivision 7 of section 2510 of the public health law
made by section one of this act shall be subject to the  expiration  and
reversion of such subdivision pursuant to section 47 of chapter 2 of the
laws  of 1998, as amended, when upon such date the provisions of section
two of this act shall take effect.

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Senate Bill S3389A

Sponsored By

Archive: Last Bill Status - In Senate Committee Rules Committee

Actions

Bill Amendments

2011-S3389 - Details

2011-S3389 - Summary

2011-S3389 - Sponsor Memo

2011-S3389 - Bill Text download pdf

2011-S3389A (ACTIVE) - Details

2011-S3389A (ACTIVE) - Summary

2011-S3389A (ACTIVE) - Sponsor Memo

2011-S3389A (ACTIVE) - Bill Text download pdf

Comments

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Sponsored By

Liz Krueger

Archive: Last Bill Status - In Senate Committee Rules Committee

Actions

Bill Amendments

2011-S3389 - Details

2011-S3389 - Summary

2011-S3389 - Sponsor Memo

2011-S3389 - Bill Text download pdf

2011-S3389A (ACTIVE) - Details

2011-S3389A (ACTIVE) - Summary

2011-S3389A (ACTIVE) - Sponsor Memo

2011-S3389A (ACTIVE) - Bill Text download pdf

Comments