|SAME AS||SAME AS S06544-B|
|COSPNSR||D'Urso, Thiele, Sepulveda, Skoufis, Cusick, Joyner, Gottfried, McDonald, Cook, Lavine, Simon, Taylor, Seawright, Pellegrino, Ortiz, Arroyo, Barron, Englebright|
|Add §32.06, Ment Hyg L|
|Prohibits certain practices concerning or consideration for referrals by providers of substance abuse disorder services.|
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NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7689A SPONSOR: Rosenthal L
TITLE OF BILL: An act to amend the mental hygiene law, in relation to prohibited practices by providers of substance use disorder services   PURPOSE OR GENERAL IDEA OF BILL: This bill would prohibit the practice of substance use disorder patient brokering in New York.   SUMMARY OF PROVISIONS: Section 1 would create a new Mental Hygiene L. § 32.06 to prohibit any individual, addiction professional, credentialed professional, health care provider, health care facility or substance abuse program from giving or receiving a commission, bonus, rebate, or kickback, directly or indirectly, to induce the referral of a potential service recipient in connection with the performance of substance abuse services. This section establishes any violation of this section will constitute a misdemeanor. Sections 2 would make this bill effective immediately.   JUSTIFICATION: The heroin and opioid epidemic has devastated families across New York State. Overdose deaths from heroin, fentanyl, car-fentanyl, and other synthetic iterations have skyrocketed and families are desperate to get care for their loved ones. However, there has also been a corresponding rise in individuals who aggressively pursue people in need of substance use disorder treatment services and, for a sometimes extravagant fee, promise admission to treatment programs. For individuals engaging in this predatory behavior, the most desirable patients are those with robust insurance coverage, and out of network benefit packages. Patient brokers refer these clients to programs offering the highest rate of "return" to the patient broker, with little or no regard for the patient's specific needs. This predatory practice should be prohibited because it capitalizes on, and exploits, families' fears while putting patients at risk of inappro- priate treatment. This bill would make it a crime to offer to or accept any kickback from an individual or entity that provides substance abuse services in exchange for patient referral and admission.   PRIOR LEGISLATIVE HISTORY: This is a new bill.   FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None.   EFFECTIVE DATE: The bill would take effect 60 days after it shall become law.
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STATE OF NEW YORK ________________________________________________________________________ 7689--A 2017-2018 Regular Sessions IN ASSEMBLY May 9, 2017 ___________ Introduced by M. of A. L. ROSENTHAL, D'URSO, THIELE, SKOUFIS, CUSICK -- read once and referred to the Committee on Alcoholism and Drug Abuse -- reported and referred to the Committee on Codes -- recommitted to the Committee on Codes in accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the mental hygiene law, in relation to prohibited prac- tices by providers of substance use disorder services The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The mental hygiene law is amended by adding a new section 2 32.06 to read as follows: 3 § 32.06 Prohibited practices by providers of substance use disorder 4 services. 5 1. For purposes of this section, unless the context clearly requires 6 otherwise, "provider" shall mean any person, firm, partnership, group, 7 practice association, fiduciary, employer, representative thereof or any 8 other entity who is providing or purporting to provide substance use 9 disorder services. Provided, however, that "provider" shall not include 10 a person receiving substance use disorder services from the provider. 11 2. No provider shall intentionally solicit, receive, accept or agree 12 to receive or accept any payment, benefit or other consideration in any 13 form to the extent such payment, benefit or other consideration is given 14 for the referral of a person as a potential patient for substance use 15 disorder services. 16 3. No provider providing or purporting to provide substance use disor- 17 der services pursuant to this chapter, shall intentionally make, offer, 18 give, or agree to make, offer, or give any payment, benefit or other 19 consideration in any form to the extent such payment, benefit or other 20 consideration is given for the referral of a person as a potential 21 patient for substance use disorder services. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. A LBD10119-04-8A. 7689--A 2 1 4. This section shall not apply to any: 2 (a) lawful payments by a health maintenance organization or health 3 insurer, operating in accordance with article thirty-two or forty-three 4 of the insurance law or article forty-four of the public health law on 5 behalf of their enrollees for such substance use disorder services or 6 other benefits required to be provided; 7 (b) lawful payments to or by a provider to a health maintenance organ- 8 ization or health insurer operating in accordance with article thirty- 9 two or forty-three of the insurance law or article forty-four of the 10 public health law, as payment for services provided, a refund for an 11 overpayment, a participating provider fee, or any similar remuneration; 12 (c) provider for an activity that, at the time of such activity, would 13 have been lawful as specifically exempt, or otherwise not prohibited, 14 under any federal statute or regulations, including but not limited to 15 42 U.S.C. § 1320a-7b (b) or the regulations promulgated thereunder, if 16 conducted by a person, firm, partnership, group, practice, association, 17 fiduciary, employer representative thereof or any other entity providing 18 substance use disorder services; 19 (d) any employee or representative of a provider who is conducting 20 marketing activities, where the employee or representative identifies 21 the provider represented or for whom or which the employee or represen- 22 tative works, identifies that the employee or representative is a mark- 23 eter and not a clinician or other individual who can provide diagnostic, 24 counseling or assessment services, and such marketing activities are 25 limited to educating the potential patient about the program with no 26 effort to steer or lead the potential patient to select or consider 27 selection of the substance use disorder services provider represented or 28 for whom or which the employee or representative works; or 29 (e) commissions, fees or other remuneration lawfully paid to insurance 30 agents as provided under the insurance law. 31 5. Any provider who intentionally violates the provisions of subdivi- 32 sion two or three of this section shall be guilty of a misdemeanor as 33 defined in the penal law. 34 6. If the commissioner has reason to believe a provider has violated 35 subdivision two or three of this section, the commissioner may proceed 36 to investigate and institute enforcement actions, as may be authorized 37 pursuant to the applicable provisions of this article. 38 7. The provisions of this section are in addition to any other civil, 39 administrative or criminal enforcement actions provided by law. Penal- 40 ties authorized under this section may be imposed against corporate 41 providers and individual providers. 42 8. The commissioner shall adopt and may amend rules and regulations to 43 effectuate the provisions of this section. 44 § 2. This act shall take effect on the sixtieth day after it shall 45 have become a law.