New York State Assembly

 
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A00378 Summary:

A00378 Actions:

A00378 Committee Votes:

Committee:HEALTH   Chair:Gottfried      
DATE:01/17/2017AYE/NAY:26/0  Action: Favorable refer to committee Codes        
Gottfried
Aye
Raia
Aye
Schimminger
Aye
McDonough
Aye
Galef
Aye
Ra
Aye
Dinowitz
Aye
Walter
Aye
Cahill
Aye
Garbarino
Aye
Paulin
Aye
Byrne
Aye
Cymbrowitz
Aye
Norris
Aye
Gunther
Aye
Rosenthal
Aye
Hevesi
Aye
Lavine
Aye
Titone
Aye
Mayer
Aye
Jaffee
Aye
Steck
Aye
Abinanti
Aye
Braunstein
Aye
Kim
Aye
Solages
Aye

Committee:RULES   Chair:Heastie      
DATE:01/17/2017AYE/NAY:29/0  Action: Favorable         
Heastie
Aye
Kolb
Aye
Gottfried
Aye
Oaks
Aye
Lentol
Aye
Butler
Aye
Farrell
Aye
Crouch
Aye
Gantt
Aye
Finch
Aye
Nolan
Aye
Barclay
Aye
Weinstein
Aye
Raia
Aye
Hooper
Aye
Hawley
Aye
Ortiz
Aye
Pretlow
Aye
Cook
Aye
Glick
Aye
Morelle
Aye
Aubry
Aye
Englebright
Aye
Dinowitz
Aye
Colton
Excused
Magnarelli
Aye
Perry
Excused
Galef
Aye
Paulin
Aye
Titus
Aye
Peoples-Stokes
Aye

Committee:CODES   Chair:Lentol      
DATE:01/17/2017AYE/NAY:21/0  Action: Favorable refer to committee Rules        
Lentol
Aye
Graf
Aye
Schimminger
Aye
Giglio
Aye
Weinstein
Aye
McKevitt
Aye
Pretlow
Aye
Montesano
Aye
Cook
Aye
Ra
Aye
Cymbrowitz
Aye
Morinello
Aye
Titus
Aye
O'Donnell
Aye
Lavine
Aye
Perry
Excused
Zebrowski
Aye
Abinanti
Aye
Weprin
Aye
Mosley
Aye
Hevesi
Aye
Fahy
Aye

A00378 Floor Votes:

A00378 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
 submitted in accordance with Assembly Rule III, Sec 1(f)



 
BILL NUMBER: A378
 
SPONSOR: Abinanti

 
TITLE OF BILL:  An act to amend the public health law, in relation to
the state medical indemnity fund; to amend a chapter of the laws of
2016, amending the public health law relating to payments from the New
York state medical indemnity fund, in relation to the effectiveness
thereof; and to repeal subdivisions 2-a and 7-a of section 2999-j and
section 2999-k of the public health law, relating to requests for
denials of claims and denials of requests for prior authorizations and
consumer and stakeholder workgroups
 
 
PURPOSE OR GENERAL IDEA OF BILL:

The purpose of this bill to make modifications to the Medical Indemnity
Fund (MIF).
 
 
SUMMARY OF SPECIFIC PROVISIONS:
 
Section 1 repeals subdivisions 2-a and 7-a of section 2999-j of the
public health law.
 
Section 2 amends paragraph (c) of subdivision 2 of section 2999-j of the
public health law to clarify that the Department of Health is prohibited
from promulgating regulations disqualifying certain health care costs.
 
Section 3 amends subdivision 3 of section 2999-h of the public health
law to delete from the definition of "qualifying health care costs" the
phrase "including other therapeutic benefit."
 
Section 4 repeals section 2999-k of the public health law.
 
Section 5 directs the Superintendent of Financial Services to issue a
report to the Governor and the Legislature on the financial state of the
Medical Indemnity Fund by April 1, 2017.
 
Section 6 modifies the effective date of chapter 517 of the laws of 2016
as it pertains to increased reimbursement rates. The rates will take
effect on June 30, 2017, and shall expire and be deemed repealed on
December 31, 2019.
 
Section 7 is the effective date.
 
 
JUSTIFICATION:
 
The Medical Indemnity Fund (MIF) was designed to ensure that children
with birth-related neurological injuries are able to have their medical
needs met, and access services that they need to improve their quality
of life. In furtherance of that goal, the bill that created chapter 517
of the laws of 2016 as well this bill make changes to the MIF to allow
children to better access such services.
 
This bill clarifies that where a benefit has been determined to be
medically necessary for the injured individual, no regulation may permit
the denial of payment because someone else in the household may also
benefit. The new language makes it clear that the determining factor is
whether the individual benefits, and if so, it may not be prohibited
where, incidentally, someone else benefits.
 
Additionally, the phrase "including other therapeutic benefits" was
deleted from the definition of "qualifying health care cost," as that is
duplicative of other services delineated in such definition, such as
rehabilitation and habilitation. Rehabilitation traditionally provides
for various types of therapies to facilitate the recovery process, while
habilitation provides for a broad range of therapies to build on such
recovery and further improve activities of daily life. These therapies
help individuals recover and improve physically, socially, cognitively,
communicatively, and intellectually in order to maximize independence
and enhance the overall quality of life.
 
 
PRIOR LEGISLATIVE HISTORY:
 
This is a new bill.
 
 
FISCAL IMPLICATIONS:
 
Undetermined.
 
 
EFFECTIVE DATE:
This act shall take effect immediately; provided, however, that sections
one, two, three and four of this act shall take effect on the same date
and in the same manner as a chapter of the laws of 2016, amending the
public health law relating to payments from the New York state medical
indemnity fund, as proposed in legislative bills numbers S.7873-B and
A.9835-B, takes effect.

A00378 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                           378
 
                               2017-2018 Regular Sessions
 
                   IN ASSEMBLY
 
                                     January 5, 2017
                                       ___________
 
        Introduced by M. of A. ABINANTI -- read once and referred to the Commit-
          tee on Health
 
        AN  ACT to amend the public health law, in relation to the state medical
          indemnity fund; to amend a chapter of the laws of 2016,  amending  the
          public health law relating to payments from the New York state medical
          indemnity  fund,  in  relation  to  the  effectiveness thereof; and to
          repeal subdivisions 2-a and 7-a of section 2999-j and  section  2999-k
          of  the  public health law, relating to requests for denials of claims
          and denials of requests for  prior  authorizations  and  consumer  and
          stakeholder workgroups
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1.  Subdivisions 2-a and 7-a of section 2999-j of  the  public
     2  health  law,  as  added  by  a chapter of the laws of 2016, amending the
     3  public health law relating to payments from the New York  state  medical
     4  indemnity  fund,  as  proposed in legislative bills numbers S.7873-B and
     5  A.9835-B, are REPEALED.
     6    § 2. Paragraph (c) of subdivision 2 of section 2999-j  of  the  public
     7  health  law,  as  added  by  a chapter of the laws of 2016, amending the
     8  public health law relating to payments from the New York  state  medical
     9  indemnity  fund,  as  proposed in legislative bills numbers S.7873-B and
    10  A.9835-B, is amended to read as follows:
    11    (c) such regulations shall not prohibit qualifying health  care  costs
    12  on  the  grounds that the qualifying health care cost [is not limited to
    13  the direct need of the  patient  and]  may  incidentally  benefit  other
    14  members  of  the  household, provided that whether the qualifying health
    15  care cost primarily benefits the patient may be considered.
    16    § 3. Subdivision 3 of section 2999-h of  the  public  health  law,  as
    17  amended by a chapter of the laws of 2016, amending the public health law
    18  relating  to payments from the New York state medical indemnity fund, as
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD06718-04-7
        A. 378                              2
 
     1  proposed in legislative bills numbers S.7873-B and A.9835-B, is  amended
     2  to read as follows:
     3    3.  "Qualifying health care costs" means the future medical, hospital,
     4  surgical, nursing, dental, rehabilitation, habilitation, respite, custo-
     5  dial, durable medical equipment, home modifications, assistive technolo-
     6  gy, vehicle modifications, transportation for purposes  of  health  care
     7  related appointments, prescription and non-prescription medications, and
     8  other  health  care costs actually incurred for services rendered to and
     9  supplies utilized by qualified plaintiffs, which are necessary  to  meet
    10  their  health  care needs, [including providing therapeutic benefit,] as
    11  determined by their treating physicians, physician assistants, or  nurse
    12  practitioners  and  as  otherwise  defined  by the commissioner in regu-
    13  lation.
    14    § 4. Section 2999-k of the public health law, as added by a chapter of
    15  the laws of 2016, amending the public health law  relating  to  payments
    16  from  the New York state medical indemnity fund, as proposed in legisla-
    17  tive bills numbers S.7873-B and A.9835-B, is REPEALED.
    18    § 5. On or before April  1,  2017,  the  superintendent  of  financial
    19  services  shall  issue  a  report  to  the  governor and the legislature
    20  addressing the financial condition of the state medical indemnity  fund,
    21  the  future solvency of such fund, and any issues relating to the opera-
    22  tion  of  such  fund  that  the  superintendent,  in  his  or  her  sole
    23  discretion,  elects  to  include in the report. In preparing the report,
    24  the superintendent may  consult  with  qualified  plaintiffs,  represen-
    25  tatives  of  qualified  plaintiffs, and physicians, advocates, and other
    26  interested parties.
    27    § 6. Section 5 of a chapter of the laws of 2016, amending  the  public
    28  health  law  relating to payments from the New York state medical indem-
    29  nity fund,  as  proposed  in  legislative  bills  numbers  S.7873-B  and
    30  A.9835-B, is amended to read as follows:
    31    §  5. This act shall take effect on the forty-fifth day after it shall
    32  have become a law, provided that the  amendments  to  subdivision  4  of
    33  section  2999-j of the public health law made by section two of this act
    34  shall take effect on June 30,  2017  and  shall  expire  and  be  deemed
    35  repealed December 31, 2019.
    36    §  7.  This act shall take effect immediately; provided, however, that
    37  sections one, two, three and four of this act shall take effect  on  the
    38  same  date  and  in  the  same  manner as a chapter of the laws of 2016,
    39  amending the public health law relating to payments from  the  New  York
    40  state  medical  indemnity fund, as proposed in legislative bills numbers
    41  S.7873-B and A.9835-B, takes effect.

A00378 Chamber Video/Transcript: