NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6171
SPONSOR: Pichardo TITLE OF BILL: An act to amend the public health law, in relation to
referrals of patients for health or health related items or services
PURPOSE OR GENERAL IDEA OF BILL:
To promote conformity between the federal Stark Law and New York's
Health Care Practitioner Referrals Statute.
SUMMARY OF PROVISIONS:
Amends Public Health Law § 238-a (2) (c) to provide that a referral or
arrangement that would be allowed under federal law, 42 U.S.C. 1395-nn
or its regulations would similarly be allowed under the New York law,
unless the Public Health and Health Planning Council declares a type of
arrangement to pose a substantial risk of pay or patient abuse, by regu-
lation approved by the Health Commissioner.
Amends the list of exemptions in Public Health Law § 238-a (6) (c) to
add any referral or arrangement allowed under federal law, unless the
state Public Health and Health Planning Council declares a type of
referral to pose a substantial risk of payor or patient abuse, by regu-
lation subject approval of the Health Commissioner.
JUSTIFICATION:
The federal Stark law (named for its congressional sponsor) establishes
complex rules on referrals from one health care provider to another and
the financial relationships between providers. The purpose is to avoid
kickback arrangements and conflicts of interest that cost patients and
third-party payers money and can lead to unnecessary and inappropriate
services. New York State's law is similar but not the same. So some
arrangements or referrals are permissible under the federal Stark law
but not under the New York statute. This can create difficulties for
health care providers.
For example, the New York statute does not contain exceptions for
providing electronic medical record systems, donations of items and
services to federally qualified health centers, and fair market value
arrangements. Also, the New York exception for in-office ancillary
services requires an employer/employee relationship, as compared to the
Stark exception, which permits an independent contractor relationship.
The bill would provide that arrangements or referrals that are allowed
under the federal law are also allowed under the New York law, unless
the Public Health and Health Planning Council and the Health Commission-
er designate particular types of arrangements or referrals that would
not be allowed because they pose a substantial risk of payor or patient
abuse. The bill was drafted in conjunction with the State Bar Associ-
ation's health law section and has broad provider support.
PRIOR LEGISLATIVE HISTORY:
2009-10: A.9933 - passed Assembly.
2011-2012: A.3551 -A - vetoed by the Governor, 153tc,
01/06/16 DIED IN SENATE
01/06/16 RETURNED TO ASSEMBLY
01/06/16 ordered to third reading cal.283
03/28/16 passed assembly
03/28/16 delivered to senate
03/28/16 REFERRED TO HEALTH
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
Immediately.
