Assembly Health Committee Update

February 26, 2020

The Assembly Health Committee favorably reported 31 bills at its January and February meetings. The Committee reported bills to extend Medicaid coverage for new mothers; reform the distribution of indigent care pool funds for hospitals serving low-income patients; create an emerging contaminants monitoring list in order to ensure that all water systems in New York are tested for potentially dangerous chemicals, lower lead levels in school water, and provide insurance coverage for medical marijuana.

Several of the bills are "chapter amendments," which are typically technical changes requested by the Governor as conditions of signing a bill.

For more information on a bill, please contact the sponsor listed after the description. For the text of a bill, supporting memorandum, and information on its status, go to: http://public.leginfo.state.ny.us/menuf.cgi

January 22

Medical Marijuana Providers Expansion - Currently, physicians, nurse practitioners and physician assistants can certify a patient for use of medical marijuana. However, other providers are authorized to prescribe powerful and potentially addictive controlled substances in their scope of practice (e.g., a dentist or podiatrist treating mouth or foot pain). This bill allows any practitioner authorized to prescribe controlled substances to certify patients for medical marijuana, when acting within his or her scope of practice and with the same requirements as current practitioners (training, registration, and use of the prescription monitoring program). (A1149, Gottfried)

Medical Marijuana Medicaid and Insurance Coverage - Cost is a major barrier to access for medical marijuana patients. Because neither private health insurance nor Medicaid covers it, patients are forced to pay out of pocket. Workers' compensation has chosen to cover it in some, but not all, cases. This bill adds medical marijuana coverage to Medicaid; clarifies that commercial payers may (though are not required to) cover it; adds it as a covered benefit in workers' compensation; and adds it to the list of drugs covered by Elderly Pharmaceutical Insurance Coverage (EPIC), a State program which supplements out-of-pocket drug costs for seniors. (A2824, Gottfried)

Indigent Care Pool Reform - The Indigent Care Pool (ICP) is a fund meant to supplement payments to hospitals who serve high proportions of low-income uninsured and Medicaid patients. ICP money is currently distributed according to an old formula that gives disproportionate funding to hospitals that do little actual indigent care, including some of the highest-profit hospitals in the state. This bill, drafted in consultation with advocates and representatives of high-need hospitals, rebalances the ICP to better target the facilities that actually provide the bulk of care to low-income patients, including, among others, public hospitals and rural community hospitals. (A6677, Gottfried)

Home Health Agency Rate Benchmark - Certified home health agencies (CHHAs) provide acute and post-acute home health services. Unlike some other Medicaid service providers, CHHAs have not received a rate increase in over a decade despite increased labor and operating costs, including state mandated costs. Insufficient availability of CHHA services means hospitals struggle to discharge patients safely back into the community. This bill directs the Commissioner of Health to establish benchmark rates for CHHAs in Medicaid in order to ensure sustainability of CHHA services. (A7798-A, Gottfried)

SUDEP Patient Information - Sudden unexpected death in epilepsy (SUDEP) causes death in 1.2 people per 1,000 diagnosed with epilepsy. Despite this prevalence, SUDEP is not widely discussed by doctors with their patients, even at specialty epilepsy clinics. This bill requires the Health Department to provide written information on SUDEP to health care practitioners and for practitioners to provide this information to any patients they are treating for epilepsy. (A7807-A, Epstein)

Birth Certificates for Individuals Under Community Supervision - New Yorkers need state-issued identification to access critical social and other services. A 2010 law allows New Yorkers in state prisons and local jails to get free copies of their birth certificates in anticipation of their release, to improve their reintegration into society. However, this law did not clearly cover individuals who have already been released and are on parole. This bill expands the 2010 law to cover them as well. (A8386, Weprin)

Protecting Access to Complex Rehabilitation Equipment - This bill would have DOH establish qualifications for equipment suppliers to ensure adequate supply, configuration, delivery, and repair of complex rehabilitation equipment as well as to establish minimum reimbursement rates; and have Medicaid apply any new Medicare billing codes for such equipment. (A9003, Steck)

January 28

Managed Care Payment Pass-through - The 2018-19 budget included $700 million to support minimum wage increases for Medicaid-funded home care providers. But since Medicaid is run almost entirely through managed care plans, these funds would have to flow through the premiums the State pays the plans rather than being paid directly to home care agencies. Providers frequently complain that plans fail to update their payment rates to reflect the new funding. This bill ensures that all funds appropriated to support minimum wage are distributed in a timely manner from plans to providers. (A2788-A, Gottfried)

Emerging Contaminants List - New York's 2017 emerging contaminant monitoring law requires monitoring of certain chemicals in small water systems (under 10,000 people) which are exempt from testing requirements under the federal Unregulated Contaminant Monitoring Rule (UCMR.) The state law included a short list of just three emerging contaminants to start while directing the Commissioner to create a longer list. Since then the Commissioner has failed to produce such a list, so this bill adds a longer list of chemicals largely reflecting the federal UCMR-3. It was drafted in consultation with Environmental Advocates, the New York Public Interest Research Group, and other environmental groups. (A7839, Gottfried)

Medication Synchronization - Medication synchronization enables partial prescription fills so that refill times are coordinated among multiple prescriptions. This bill allows partial fills for synchronized dispensing when the patient, prescriber, and pharmacist agree. It was vetoed by Governor Cuomo in 2019 on the claim that it would require additional Medicaid expenditures, which it would not. (A9012, Gottfried)

Prison and Jail Health Oversight - In 2009, a law was enacted giving the Commissioner of Health authority and responsibility to "review any policy or practice" in correctional facilities relating to HIV/AIDS and hepatitis C. Advocates have universally praised the law for improving care in these areas. However, DOH oversight is limited to these two conditions. This bill expands the law to provide for DOH oversight for additional populations and conditions, such as women and transgender inmates, older inmates, and those with chronic conditions. It also requires a staffing adequacy study in response to evidence of severe health care staffing shortages. This bill was vetoed in 2019 on fiscal grounds. (A9044, Gottfried)

Rare Disease Advisory Council - There are nearly 7,000 rare diseases, defined as conditions affecting fewer than 200,000 Americans, which often lack recommended treatment plans or best practices. A bill signed in 2019 established a Rare Disease Advisory Council. This bill is a chapter amendment making minor technical changes. (A9132, Paulin)

Information on Complications from Pregnancy - Current law requires hospitals to provide informational material to maternity patients. A bill signed in 2019 required that material to include information on possible complications from pregnancy. This bill is a chapter amendment making minor technical changes. (A9133, Richardson)

Hospital Identification and Assistance for Domestic Violence Victims - A bill signed in 2019 established procedures for hospitals and emergency rooms to properly identify and assist suspected or confirmed cases of domestic violence. This bill is a chapter amendment making minor technical changes. (A9134, Lavine)

Central Venous Line Patient Information - A bill signed in 2019 requires hospitals to determine if family or other caregivers are able and willing to do the tasks involved in maintaining a central venous line for a patient about to be sent home from the hospital. This bill is a chapter amendment making minor technical changes. (A9135, Galef)

February 4

Medical Marijuana Patient Drug Test Protections - Provides that a certified medical marijuana patient testing positive for marijuana on a drug test shall not be determinative of whether the patient is impaired in performing his or her employment duties. (A2865, Abinanti)

Public Health Emergency Notifications - Requires county health commissioners to notify all local heads of municipalities and county legislators covering the affected area in the event of an imminent risk to public health and safety. (A2885, Abinanti)

Physician Names on Birth Certificates - Patients who were abused or harassed by physicians should not have to relive the trauma when they look at their child's birth certificate. In response to patients who have raised this issue, this bill allows patients who have endured such abuse to receive certified copies of birth certificates with the perpetrator's name removed. (A7514, Simotas)

Good Samaritan Law - To promote the use of naloxone and other drugs to prevent opioid overdose deaths, the law authorizes a broad category of lay people in different settings to possess and administer those drugs, including "good Samaritan" protection from civil liability. This bill expands the definition of "covered public accommodation" to include additional settings. (A7812A, Rosenthal)

Crohn's and Colitis Identity Card - A law passed in 2018 authorized individuals with Crohn's disease and ulcerative colitis to use employee-only bathroom facilities in businesses already open to the public. Since businesses do not have a clear way to identify who has a permitted condition, this bill creates an identification card available for such individuals. (A8146, Paulin)

Extended Maternal Medicaid - Current law offers Medicaid coverage at a higher income eligibility level for pregnant women, extending 60 days after giving birth. New York's maternal mortality rate is alarmingly high at almost 20 deaths per 100,000 live births, and black women are three times more likely to die of pregnancy-related causes than white women (over 50 deaths per 100,000 live births.) Increasing access to health care would prevent many of these deaths and improve postpartum child and maternal health outcomes. This bill, widely endorsed by women's and children's health providers and advocates, would extend postpartum Medicaid coverage from 60 days to one year. (A9156, Gottfried)

Adult Home Resident Rights - A bill signed in 2019 codified adult home resident rights, including informed consent to proposed treatments or medications. This bill is a chapter amendment making minor technical changes. (A9521, Gottfried)

Uniform Anatomical Gift Act - A bill signed in 2019 updated New York law to conform to the nationally-used Uniform Anatomical Gift Act, including clarifying the consent and decision-making rules. This bill is a chapter amendment making minor technical changes. (A9523, Gottfried)

February 11

Patient Reporting Rights Information - Patients are often unaware of how to report sexual misconduct by health care providers. This bill requires the Office of Professional Medical Conduct (OPMC) to post information on its website regarding patient rights and reporting options in such cases, and requires doctor's practice settings to post signage directing patients to OPMC's website. (A7991A, Simotas)

Obstetric Hemorrhage Protocols - A bill signed in 2019 required hospitals to develop, implement, and periodically update obstetric hemorrhage protocols. This bill is a chapter amendment making minor technical changes. (A9520, Joyner)

HIV Post-Exposure Prophylaxis - A bill signed in 2019 required hospitals to provide full courses of post-exposure prophylaxis (PEP) for HIV to sequel assault victims. This bill is a chapter amendment making minor technical changes. (A9522, Peoples-Stokes)

Window Blind Safety Pamphlets - A bill signed in 2019 required the Department to produce pamphlets regarding strangulation risks to children posed by window blind cords. This bill is a chapter amendment making minor technical changes. (A9524, McDonald)

Public Health and Health Planning Council Membership - The Public Health and Health Planning Council (PHHPC) makes decisions and recommendations regarding health care facility establishment, transfer, construction, and services and DOH regulations. Only one of its 24 seats is designated for a consumer representative. A bill vetoed in 2019 would have expanded PHHPC with additional legislative appointees, labor, and consumer representation. The Governor in his veto message said he would appoint two additional consumers himself, even though PHHPC does not have vacant seats. This bill would add two seats, designated for additional consumer representatives. (A9530, Gottfried)

Medicaid Consumer Assistance Notices - New York State contracts with an independent consumer assistance program and an independent substance use disorder and mental health ombudsman. These programs assist consumers with understanding their benefits, including their rights to appeal processes when services are denied. However, many Medicaid enrollees are unaware these programs exist. This bill would require Medicaid managed care plans to include contact information for these programs, including phone numbers and websites, on any adverse determination, grievance, or appeal documents sent to enrollees. (A9538, Gottfried)

Lowering School Drinking Water Lead Levels - Children are particularly vulnerable to the harmful effects of lead. The American Academy of Pediatrics (AAP), Centers for Disease Control and Prevention, and World Health Organization agree that there is no safe level of lead for children. Current law requires "periodic" testing of school drinking water for lead, with an allowable threshold of 15 parts per billion. This bill would lower the allowable level to 5 parts (similar to Illinois, Vermont, and Washington, D.C. public schools); require annual rather than periodic testing; and eliminate some exemptions from testing in the current law. It comes out of discussions with the Healthy Schools Network, League of Conservation Voters, and other children's' health and environmental advocates. (A9545, Gottfried)

Lactation Counseling Services - A bill signed in 2019 expanded who could provide lactation counseling services under Medicaid. This bill is a chapter amendment making minor technical changes. (A9648, Gottfried)