Senate Bill S1003A

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1003--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                              January 9, 2023
                                ___________
 
 Introduced  by  Sens.  HINCHEY,  BRESLIN,  HARCKHAM, HOYLMAN-SIGAL, MAY,
   MYRIE, RIVERA, SALAZAR, SEPULVEDA, WEBB  --  read  twice  and  ordered
   printed,  and  when printed to be committed to the Committee on Health
   -- reported favorably from said committee and committed to the Commit-
   tee on Rules -- committee discharged, bill amended, ordered  reprinted
   as amended and recommitted to said committee
 
 AN ACT to amend the public health law and the insurance law, in relation
   to  providing  information  to patients and the public on policy-based
   exclusions
 
   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 since 2003
 more than 40 community hospitals in New York state have closed.
   The  legislature  additionally  finds  that  as  a  result of hospital
 consolidation, large health  care  systems  now  control  more  than  70
 percent of acute hospital beds in the state and that these systems some-
 times  remove  categories of care from local hospitals, leaving patients
 in regions of the state without access  to  particular  types  of  care,
 including some types of emergency care.
   The legislature further finds that patients do not have the ability to
 determine  whether health care facilities in their area provide the care
 they seek, because information about how  facility  restrictions  impact
 options for care is too difficult to obtain.
   The  legislature  also  finds that denials and poor access to care can
 lead to serious adverse  health  impacts  that  jeopardize  individuals'
 lives  and  wellbeing  and that New York needs to understand health care
 gaps and their impact statewide.
   Finally, the legislature finds that some denials of care violate state
 and federal law.
   § 2. The public health law is amended by adding a new section  2803-bb
 to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02598-04-3
              

 S. 1003--A                          2
 
   §  2803-BB.  POLICY-BASED EXCLUSIONS.  1. DEFINITIONS. AS USED IN THIS
 SECTION:  (A) "HEALTH CARE FACILITY" MEANS A GENERAL HOSPITAL AS DEFINED
 IN SUBDIVISION TEN OF SECTION TWENTY-EIGHT HUNDRED ONE OF THIS ARTICLE.
   (B)  "POLICY-BASED EXCLUSIONS" MEANS ANY CRITERIA, RULES, OR POLICIES,
 WHETHER WRITTEN OR UNWRITTEN, FORMALLY ADOPTED OR DRAFTED,  ENDORSED  BY
 THE  HEALTH  CARE  FACILITY  OR  FOLLOWED  FROM AN EXTERNAL SOURCE, THAT
 RESTRICT MEDICAL PERSONNEL AT THAT HEALTH CARE FACILITY  FROM  PROVIDING
 TYPES OF CARE THAT THE MEDICAL PERSONNEL IS LICENSED TO PROVIDE AND THAT
 THE  HEALTH  CARE  FACILITY  IS LICENSED TO PROVIDE OR THAT RESTRICT THE
 PROVISION OF CARE TO CATEGORIES OF PATIENTS ON THE BASIS OF ANY  CHARAC-
 TERISTIC PROTECTED UNDER SECTION TWO HUNDRED NINETY-SIX OF THE EXECUTIVE
 LAW THAT THE HEALTH CARE FACILITY IS LICENSED TO PROVIDE.  "POLICY-BASED
 EXCLUSIONS"  SHALL  INCLUDE,  BUT  NOT  BE  LIMITED TO, OBJECTIONS UNDER
 SECTION TWENTY-NINE HUNDRED EIGHTY-FOUR OR TWENTY-NINE  HUNDRED  NINETY-
 FOUR-N  OF  THIS  CHAPTER.   "POLICY-BASED EXCLUSIONS" SHALL NOT INCLUDE
 RESTRICTIONS BASED ON LACK OF EQUIPMENT,  AVAILABLE  BED  SPACE  IN  THE
 FACILITY, OR INSURANCE DENIAL.
   2. (A) THE COMMISSIONER SHALL COLLECT FROM EACH HEALTH CARE FACILITY A
 LIST OF ITS POLICY-BASED EXCLUSIONS ON AN ANNUAL BASIS.
   (B)  THE  COMMISSIONER  SHALL  PUBLISH  ON  THE DEPARTMENT'S WEBSITE A
 CURRENT LIST OF ALL OF THE  HEALTH  CARE  FACILITIES  WITH  POLICY-BASED
 EXCLUSIONS AND THE POLICY-BASED EXCLUSIONS FOR EACH HEALTH CARE FACILITY
 NOT  LATER THAN SIX MONTHS AFTER THE EFFECTIVE DATE OF THIS SECTION. THE
 COMMISSIONER SHALL UPDATE THIS LIST ON AN ANNUAL BASIS. THE  COMMISSION-
 ER,  IN CONSULTATION WITH EXPERTS IN HEALTH CARE ACCESS, PATIENT ADVOCA-
 CY, TYPES OF HEALTH CARE THAT ARE FREQUENTLY INACCESSIBLE, AND  HOSPITAL
 ADMINISTRATION SHALL PROMULGATE RULES AND REGULATIONS CREATING STANDARD-
 IZED  LANGUAGE FOR THIS LIST TO ENSURE THAT IT IS READILY UNDERSTANDABLE
 TO PATIENTS, PROSPECTIVE PATIENTS, AND MEMBERS OF THE PUBLIC.
   (C) WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS  SECTION  AND  EVERY
 FIVE  YEARS  THEREAFTER,  THE  COMMISSIONER SHALL SUBMIT A REPORT TO THE
 TEMPORARY PRESIDENT OF THE  SENATE  AND  THE  SPEAKER  OF  THE  ASSEMBLY
 REGARDING  POLICY-BASED  EXCLUSIONS  IN THE STATE AND THE IMPACT OF SUCH
 POLICY-BASED EXCLUSIONS ON PATIENTS' ABILITY TO ACCESS QUALITY,  COMPRE-
 HENSIVE,  AFFORDABLE  CARE  NEAR  THEIR  RESIDENCES  AND WHETHER AND HOW
 ACCESS TO CARE VARIES BY COMMUNITY, AS WELL AS BY RACE, GENDER, ETHNICI-
 TY, SEXUAL  ORIENTATION,  GENDER  IDENTITY  OR  GENDER  EXPRESSION,  AND
 SOCIOECONOMIC STATUS, ACROSS THE STATE. THE REPORT SHALL BE MADE PUBLIC-
 LY AVAILABLE ON THE DEPARTMENT'S WEBSITE.
   (D)  THE COMMISSIONER SHALL EVALUATE AND ENSURE COMMUNITY AWARENESS OF
 POLICY-BASED EXCLUSIONS AND THE WEBSITE REQUIRED PURSUANT  TO  PARAGRAPH
 (B) OF THIS SUBDIVISION.
   (E)  THE  COMMISSIONER MAY PROMULGATE ADDITIONAL RULES AND REGULATIONS
 AS MAY BE NECESSARY AND PROPER TO CARRY OUT EFFECTIVELY  THE  PROVISIONS
 OF THIS SECTION.
   § 3. Subdivision 1 of section 2803 of the public health law is amended
 by adding a new paragraph (m) to read as follows:
   (M)  THE  STATEMENT  REGARDING  PATIENT  RIGHTS  AND RESPONSIBILITIES,
 REQUIRED PURSUANT TO PARAGRAPH (G) OF THIS SUBDIVISION, SHALL INCLUDE  A
 LINK  TO  THE  SECTION OF THE DEPARTMENT'S WEBSITE REQUIRED IN PARAGRAPH
 (B) OF SUBDIVISION TWO OF SECTION TWENTY-EIGHT HUNDRED THREE-BB OF  THIS
 ARTICLE.   EACH HEALTH CARE FACILITY'S WEBSITE SHALL PROMINENTLY LINK TO
 THE DEPARTMENT'S WEBSITE REQUIRED IN PARAGRAPH (B) OF SUBDIVISION TWO OF
 SECTION TWENTY-EIGHT HUNDRED THREE-BB OF THIS ARTICLE.  THE COMMISSIONER
 MAY PROMULGATE RULES AND REGULATIONS AS MAY BE NECESSARY AND  PROPER  TO
 CARRY OUT EFFECTIVELY THE PROVISIONS OF THIS PARAGRAPH.
 S. 1003--A                          3
 
   §  4. Subsection (a) of section 3217-a of the insurance law is amended
 by adding a new paragraph 22 to read as follows:
   (22)(A)  AN  EXPLANATION  OF POLICY-BASED EXCLUSIONS AND THE FACT THAT
 SOME HEALTH CARE FACILITIES MAY HAVE POLICY-BASED EXCLUSIONS, ALONG WITH
 A LINK TO THE WEBSITE REQUIRED PURSUANT TO SUBDIVISION  TWO  OF  SECTION
 TWENTY-EIGHT HUNDRED THREE-BB OF THE PUBLIC HEALTH LAW.
   (B)  FOR  THE  PURPOSES  OF  THIS PARAGRAPH, "POLICY-BASED EXCLUSIONS"
 SHALL HAVE THE SAME MEANING AS IN SECTION TWENTY-EIGHT HUNDRED  THREE-BB
 OF THE PUBLIC HEALTH LAW.
   § 5. Subsection (a) of section 4324 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23)(A)  AN  EXPLANATION  OF POLICY-BASED EXCLUSIONS AND THE FACT THAT
 SOME HEALTH CARE FACILITIES MAY HAVE POLICY-BASED EXCLUSIONS, ALONG WITH
 A LINK TO THE WEBSITE REQUIRED PURSUANT TO SUBDIVISION  TWO  OF  SECTION
 TWENTY-EIGHT HUNDRED THREE-BB OF THE PUBLIC HEALTH LAW.
   (B)  FOR  THE  PURPOSES  OF  THIS PARAGRAPH, "POLICY-BASED EXCLUSIONS"
 SHALL HAVE THE SAME MEANING AS IN SECTION TWENTY-EIGHT HUNDRED  THREE-BB
 OF THE PUBLIC HEALTH LAW.
   §  6.  Nothing  in  this act shall be construed to permit or authorize
 denials of care or discrimination in the provision  of  health  care  or
 health  insurance. Compliance with this act does not reduce or limit any
 liability for health care facilities  in  connection  with  policy-based
 exclusions, including violations of state or federal law.
   § 7. Severability clause.  If any provision of this act, or any appli-
 cation  of any provision of this act, is held to be invalid, or ruled to
 violate or be inconsistent with any  applicable  federal  law  or  regu-
 lation, that shall not affect the validity or effectiveness of any other
 provision  of  this act, or of any other application of any provision of
 this act.  It is hereby declared to be the  intent  of  the  legislature
 that  this  act  would have been enacted even if such invalid provisions
 had not been included herein.
   § 8. This act shall take effect one year after it shall have become  a
 law. Effective immediately, the addition, amendment and/or repeal of any
 rule  or  regulation necessary for the implementation of this act on its
 effective date are authorized to be made and completed on or before such
 effective date.