Assembly Bill A1204

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1204--A
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2019
                                ___________
 
 Introduced by M. of A. PEOPLES-STOKES, GOTTFRIED, MOSLEY, JAFFEE, GALEF,
   JEAN-PIERRE,  DE LA ROSA,  SIMOTAS,  WEPRIN,  BRONSON,  EPSTEIN, CRUZ,
   RODRIGUEZ, HEVESI -- Multi-Sponsored by -- M. of A. BRAUNSTEIN -- read
   once and referred to the Committee on Health -- reported and  referred
   to the Committee on Codes -- reported and referred to the Committee on
   Ways   and  Means  --  committee  discharged,  bill  amended,  ordered
   reprinted as amended and recommitted to said committee
 
 AN ACT to amend the public health law and the executive law, in relation
   to HIV post-exposure prophylaxis and other health  care  services  for
   sexual assault victims
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (c) of subdivision 1 of  section  2805-i  of  the
 public health law, as amended by  section 1 of  part HH of chapter 57 of
 the laws of 2018, is amended to read as follows:
   (c) offering and making available appropriate HIV post-exposure treat-
 ment therapies; including a [seven day starter pack] FULL REGIMEN of HIV
 post-exposure  prophylaxis,  in  cases  where it has been determined, in
 accordance with guidelines issued by the commissioner,  that  a  signif-
 icant  exposure  to  HIV  has  occurred[,  and informing the victim that
 payment assistance for such therapies may be available from  the  office
 of  victim  services pursuant to the provisions of article twenty-two of
 the executive law]. With the consent of the victim of a sexual  assault,
 the  hospital  emergency room department shall provide or arrange for an
 appointment for medical follow-up related to HIV  post-exposure  prophy-
 laxis  and other care as appropriate, AND INFORM THE VICTIM THAT PAYMENT
 ASSISTANCE FOR SUCH CARE MAY BE AVAILABLE  FROM  THE  OFFICE  OF  VICTIM
 SERVICES  PURSUANT TO THE PROVISIONS OF ARTICLE TWENTY-TWO OF THE EXECU-
 TIVE LAW; and

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04742-06-9

              

 A. 1204--A                          2
 
   § 2. Subdivision 13 of section 631 of the executive law, as amended by
 section 3 of part HH of chapter 57 of the laws of 2018,  is  amended  to
 read as follows:
   13. Notwithstanding any other provision of law, rule, or regulation to
 the  contrary,  when  any New York state accredited hospital, accredited
 sexual assault  examiner  program,  or  licensed  health  care  provider
 furnishes  services  to  any  sexual assault survivor, including but not
 limited to a health care forensic examination in accordance with the sex
 offense evidence collection protocol and standards  established  by  the
 department of health, such hospital, sexual assault examiner program, or
 licensed  healthcare  provider shall provide such services to the person
 without charge and shall  bill  the  office  directly.  The  office,  in
 consultation  with  the  department of health, shall define the specific
 services to be covered by the sexual assault forensic exam reimbursement
 fee, which must include at a minimum forensic examiner services,  hospi-
 tal  or  healthcare  facility  services related to the exam, and related
 laboratory tests and necessary pharmaceuticals; including but not limit-
 ed to HIV post-exposure prophylaxis provided  by  a  hospital  emergency
 room  at the time of the forensic rape examination pursuant to paragraph
 (c) of subdivision one of section twenty-eight  hundred  five-i  of  the
 public  health  law. Follow-up HIV post-exposure prophylaxis costs shall
 [continue to] be BILLED BY  THE  HEALTH  CARE  PROVIDER  TO  THE  OFFICE
 DIRECTLY  AND  reimbursed [according to established office procedure] BY
 THE OFFICE DIRECTLY. The office, in consultation with the department  of
 health,  shall also generate the necessary regulations and forms for the
 direct reimbursement procedure. The rate for reimbursement shall be  the
 amount  of  itemized charges not exceeding eight hundred dollars, [to be
 reviewed and adjusted annually by the  office]  PROVIDED,  HOWEVER,  THE
 OFFICE  SHALL,  in  consultation with the department of health, ANNUALLY
 REVIEW AND DETERMINE IF A HIGHER RATE  FOR  REIMBURSEMENT  FOR  ITEMIZED
 CHARGES  EXCEEDING  EIGHT  HUNDRED  DOLLARS  IS FEASIBLE AND APPROPRIATE
 BASED ON THE ACTUAL COST OF REIMBURSABLE EXPENSES, AND ADJUST SUCH  RATE
 FOR  REIMBURSEMENT  ACCORDINGLY.   The hospital, sexual assault examiner
 program, or licensed health  care  provider  must  accept  this  fee  as
 payment  in  full for these specified services. No additional billing of
 the survivor for said services is permissible. A sexual assault survivor
 may voluntarily assign any private insurance benefits to which she or he
 is entitled for the healthcare forensic examination, in which  case  the
 hospital  or  healthcare  provider  may not charge the office; provided,
 however, in the event the sexual assault survivor  assigns  any  private
 health  insurance  benefit, such coverage shall not be subject to annual
 deductibles or coinsurance or balance billing by  the  hospital,  sexual
 assault  examiner  program or licensed health care provider. A hospital,
 sexual assault examiner program or licensed health care provider  shall,
 at  the  time  of  the  initial visit, request assignment of any private
 health insurance benefits to which the sexual assault survivor is  enti-
 tled  on a form prescribed by the office; provided, however, such sexual
 assault survivor shall be advised orally and in writing that he  or  she
 may  decline to provide such information regarding private health insur-
 ance benefits if he or she believes that the provision of such  informa-
 tion  would  substantially interfere with his or her personal privacy or
 safety and in such event, the sexual assault forensic exam fee shall  be
 paid  by  the office. Such sexual assault survivor shall also be advised
 that providing such information may provide additional resources to  pay
 for  services  to other sexual assault victims. If he or she declines to
 provide such health insurance information, he or she shall indicate such

 A. 1204--A                          3
 
 decision on the form provided by the hospital, sexual  assault  examiner
 program or licensed health care provider, which form shall be prescribed
 by the office.
   § 3. This act shall take effect on the one hundred eightieth day after
 it  shall  have  become  a law; provided that effective immediately, the
 commissioner of health and the director of the office of victim services
 shall make regulations and take other action necessary to implement this
 act on such date.