senate Bill S6585

2013-2014 Legislative Session

Relates to referrals of patients for health related items or services

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Committee


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

do you support this bill?

Actions

view actions (1)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Feb 10, 2014 referred to health

S6585 - Bill Details

See Assembly Version of this Bill:
A5357
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Amd §238-a, Pub Health L
Versions Introduced in Previous Legislative Sessions:
2011-2012: A3551A, S4660
2009-2010: A9933, S6955

S6585 - Bill Texts

view summary

Relates to referrals of patients for health related items or services that are prohibited under law.

view sponsor memo
BILL NUMBER:S6585

TITLE OF BILL: An act to amend the public health law, in relation to
referrals of patients for health or health related items or services

PURPOSE OR GENERAL IDEA OF BILL: To promote conformity between the
federal Stark Law and New York's Health Care Practitioner Referrals
Statute.

SUMMARY OF PROVISIONS: Amends Public Health Law § 238-a (2) (c) to
provide that a referral or arrangement that would be allowed under
federal law, 42 U.S.C. 1395-nn or its regulations would similarly be
allowed under the New York law, unless the Public Health and Health
Planning Council declares a type of arrangement to pose a substantial
risk of payor or patient abuse, by regulation approved by the Health
Commissioner.

Amends the list of exemptions in Public Health Law § 238-a (6) (c) to
add any referral or arrangement allowed under federal law, unless the
state Public Health and Health Planning Council declares a type of
referral to pose a substantial risk of payor or patient abuse, by
regulation subject approval of the Health Commissioner.

JUSTIFICATION: The federal Stark law (named for its congressional
sponsor) establishes complex rules on referrals from one health care
provider to another and the financial relationships between providers.
The purpose is to avoid kickback arrangements and conflicts of
interest that cost patients and third-party payers money and can lead
to unnecessary and inappropriate services,. New York State's law is
similar but not the same. So some arrangements or referrals are
permissible under the federal Stark law but not under the New York
statute. This can create difficulties for health care providers.

For example, the New York statute does not contain exceptions for
providing electronic medical record systems, donations of items and
services to federally qualified health centers, and fair market value
arrangements. Also, the New York exception for in-office ancillary
services requires an employer/employee relationship, as compared to
the Stark exception, which permits an independent contractor
relationship.

The bill would provide that arrangements or referrals that are allowed
under the federal law are also allowed under the New York law, unless
the Public Health and Health Planning Council and the Health
Commissioner designate particular types of arrangements or referrals
that would not be allowed because they pose a substantial risk of
payor or patient abuse. The bill was drafted in conjunction with the
State Bar Association's health law section and has broad provider
support.

PRIOR LEGISLATIVE HISTORY: 2009-10: A.9933 -- passed Assembly.
2011-2012: A.3551-A - vetoed by the Governor, #153

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: Immediately.


view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  6585

                            I N  S E N A T E

                            February 10, 2014
                               ___________

Introduced  by  Sen.  RIVERA -- 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  referrals  of
  patients for health or health related items or services

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

  Section 1. Paragraph (g) of subdivision 2  of  section  238-a  of  the
public  health  law,  as  added  by  chapter 803 of the laws of 1992, is
amended to read as follows:
  (g) [in the case of any other financial relationship which the  public
health  council  determines  and  specifies  in  regulations, subject to
approval by the commissioner, does not pose a substantial risk of  payor
or  patient  abuse  in  relation  to patient benefits consistent, to the
extent practicable, with  financial  relationships  specified  in  regu-
lations  adopted  pursuant  to  federal  law applicable to reimbursement
pursuant to title XVIII of the federal social  security  act  (medicare)
for  clinical  laboratory  services  provided  to beneficiaries of title
XVIII of the federal social security  act  (medicare)]  ANY  ARRANGEMENT
THAT, UNDER THE FEDERAL STATUTORY PROHIBITION ON CERTAIN REFERRALS CODI-
FIED  AT  42 U.S.C. 1395NN AND REGULATIONS PROMULGATED THEREUNDER, WOULD
BE AN ARRANGEMENT BETWEEN A PRACTITIONER (OR  IMMEDIATE  FAMILY  MEMBER)
AND A HEALTH CARE PROVIDER THAT:
  (I) WOULD NOT BE A FINANCIAL RELATIONSHIP IF EXISTING BETWEEN A PHYSI-
CIAN  AND AN ENTITY, AS SUCH TERMS ARE DEFINED UNDER SUCH FEDERAL LAW OR
REGULATIONS; OR
  (II) WOULD SATISFY THE REQUIREMENTS OF AN EXCEPTION RELATING TO FINAN-
CIAL RELATIONSHIPS PROVIDED UNDER SUCH FEDERAL  LAW  OR  REGULATIONS  IF
EXISTING  BETWEEN  A  PHYSICIAN AND AN ENTITY, AS SUCH TERMS ARE DEFINED
UNDER SUCH FEDERAL LAW OR REGULATIONS.
  AN ARRANGEMENT SHALL NOT BE EXCEPTED UNDER THIS PARAGRAPH IF IT  IS  A
PARTICULAR  TYPE OF FINANCIAL RELATIONSHIP THAT WOULD POSE A SUBSTANTIAL
RISK OF PAYOR OR PATIENT ABUSE,  AS  DETERMINED  AND  SPECIFIED  BY  THE
PUBLIC  HEALTH  AND  HEALTH  PLANNING COUNCIL IN REGULATIONS, SUBJECT TO
APPROVAL BY THE COMMISSIONER.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01597-01-3

S. 6585                             2

  S 2. Paragraph (c) of subdivision 6 of section  238-a  of  the  public
health  law,  as added by chapter 803 of the laws of 1992, is amended to
read as follows:
  (c) provided further, however, that the following shall not constitute
a referral by a referring practitioner:
  (i) a request by a practitioner for practitioners' services consisting
solely of professional services to be furnished personally by that prac-
titioner, or under that practitioner's supervision;
  (ii)  a  request  by  a pathologist for clinical diagnostic laboratory
tests and  pathological  examination  services,  if  such  services  are
furnished  by or under the supervision of such pathologist pursuant to a
consultation requested by another practitioner; [and]
  (iii) a request by a  radiologist  for  diagnostic  x-ray  or  imaging
services,  if such services are furnished by or under the supervision of
such radiologist pursuant to a consultation requested by another practi-
tioner[.]; AND
  (IV) A REFERRAL FOR ANY SERVICES EXCEPTED UNDER 42 U.S.C. S 1395NN AND
REGULATIONS PROMULGATED THEREUNDER, UNLESS THE PUBLIC HEALTH AND  HEALTH
PLANNING  COUNCIL  DETERMINES  AND  SPECIFIES IN REGULATIONS, SUBJECT TO
APPROVAL BY THE COMMISSIONER, THAT A PARTICULAR TYPE OF  REFERRAL  WOULD
POSE A SUBSTANTIAL RISK OF PAYOR OR PATIENT ABUSE IN RELATION TO PATIENT
BENEFITS.
  S 3. This act shall take effect immediately.

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.