BILL NUMBER:S7031

TITLE OF BILL:
An act to amend the public health law, in relation to non-emergent
treatment in hospitals of nonadmitted patients

PURPOSE OR GENERAL IDEA OF BILL:
This bill would ensure that hospitals have the maximum flexibility
necessary to successfully implement observational levels of care in New
York State while abiding by federal requirements.

SUMMARY OF PROVISIONS:
Section 1 of the bill amends the section heading of section 2805-b of
the public health law.

Section 2 of the bill adds a new subdivision 6 of section 2805-b of the
public health law which requires the commissioner of health, when issu-
ing rules or regulations concerning "observational units," to ensure
they conform with federal Medicare rules and provided sufficient flexi-
bility to allow hospitals to successfully implement new requirements.

Section 3 of the bill provides for an effective date.

JUSTIFICATION:
The federal government requires that hospitals make a distinction
between admitting a patient and observing a patient to further evaluate
              

the patient's condition and need for an admission. The federal Centers
for Medicare and Medicaid Services (CMS) are auditing hospitals to
enforce these provisions, and the New York State Department of Health
has established regulations on Observation Unit Operating Standards
effective January 11, 2012. There has been concern expressed that the
State Regulations may impose restrictions on hospitals that go beyond
those of the federal government and could result in unnecessary costs
and disruption of care and treatment patterns of some hospitals. For
example, the regulations require that observations beds be under the
Emergency Department and a discrete unit. Depending on a hospital's
physical plan, this could require capital construction and many hospi-
tals prefer to scatter observation beds among clinical specialties to
better monitor patients - rather than have them remain under the juris-
diction of the Emergency Department. Additionally, the maximum stay in
an observation unit should be extended from 24 to 48 hours as provided
for in the federal regulations.

This bill will provide hospitals with the flexibility they need to abide
by the federal requirements when establishing and operating "observation
units" by clarifying how these regulations should be implemented.

PRIOR LEGISLATIVE HISTORY:
New bill.

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:
Immediately.