senate Bill S4788

2011-2012 Legislative Session

Establishes health care organization accountability for delay, failure or refusal to approve, provide, arrange or timely pay for certain health care services

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Archive: Last Bill Status - In Committee


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

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Actions

view actions (6)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 04, 2012 referred to judiciary
Jun 24, 2011 committed to rules
Jun 14, 2011 advanced to third reading
Jun 13, 2011 2nd report cal.
Jun 07, 2011 1st report cal.1078
Apr 25, 2011 referred to judiciary

Votes

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Jun 7, 2011 - Judiciary committee Vote

S4788
18
0
committee
18
Aye
0
Nay
5
Aye with Reservations
0
Absent
0
Excused
0
Abstained
show Judiciary committee vote details

Co-Sponsors

S4788 - Details

See Assembly Version of this Bill:
A1540
Current Committee:
Law Section:
General Obligations Law
Laws Affected:
Add §§11-108 & 11-109, Gen Ob L; amd §1602, CPLR; amd §4410, Pub Health L
Versions Introduced in 2009-2010 Legislative Session:
A767

S4788 - Summary

Provides for accountability of "health care organizations" (i.e., entities, other than a health care provider, that approve, provide, arrange for or pay for health care services, including a health plan's preferred provider organization): provides that whenever health care organizations delay, fail or refuse to approve, provide, arrange for, or pay for in a timely manner any health care service that it is contractually obligated to provide or cover for a person, it shall be liable for any personal injury, death or damages caused by delay, failure or refusal; provides that an organization shall be liable for acts by an agent, contractor, etc., for which the organization would be liable if the act were committed by the organization; imposes upon all health plans (including workers compensation and casualty insurers) the duty to exercise reasonable care when making decisions that affect the health care service of an enrollee, and in selecting and exerting influence over its employees, agents, etc., who act on its behalf regarding decisions that affect the quality of an enrollee's diagnosis, care or treatment; prohibits organizations from requiring a health care provider to indemnify or hold it harmless for its liability  (view more) related provisions.

S4788 - Sponsor Memo

S4788 - Bill Text download pdf

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

                                  4788

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 25, 2011
                               ___________

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

AN ACT to amend the general obligations law, the civil practice law  and
  rules  and  the  public health law, in relation to holding health care
  organizations accountable for the consequences of their decisions

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

  Section  1.  Legislative  findings.  The legislature finds that a wide
variety of entities are integrating the functions of paying  for  health
care,  determining what health care is paid for, and providing the care.
This integration of functions is breaking down traditional distinctions.
Increasingly,  payor  determinations  are  governing  health  care   and
controlling  decisions  that  in  the  past were the exclusive domain of
health care professionals and patients. The  legislature  further  finds
that  this integration of functions makes it imperative that health care
organizations be held fully responsible for the  consequences  of  their
decisions,  much as health care professionals have been held accountable
for the consequences of their decisions.
  S 2. The general obligations law is amended by adding two new sections
11-108 and 11-109 to read as follows:
  S 11-108. ACCOUNTABILITY OF  HEALTH  CARE  ORGANIZATIONS.  1.    DEFI-
NITIONS.  FOR PURPOSES OF THIS SECTION AND SECTION 11-109 OF THIS TITLE,
UNLESS THE CONTEXT CLEARLY REQUIRES OTHERWISE:
  (A) "HEALTH CARE ORGANIZATION" MEANS AN ENTITY (OTHER  THAN  A  HEALTH
CARE PROVIDER) THAT APPROVES, PROVIDES, ARRANGES FOR, OR PAYS FOR HEALTH
CARE SERVICES, INCLUDING BUT NOT LIMITED TO:
  (I)  A  HEALTH  MAINTENANCE  ORGANIZATION LICENSED PURSUANT TO ARTICLE
FORTY-THREE OF THE  INSURANCE  LAW  OR  CERTIFIED  PURSUANT  TO  ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW,
  (II)  ANY  OTHER ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR
OF THE PUBLIC HEALTH LAW, OR

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05342-01-1

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