NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6032
SPONSOR: Paulin TITLE OF BILL:
An act to amend the public health law, in relation to the establishment,
incorporation, construction, or increase in capacity of for-profit
hospice
PURPOSE OR GENERAL IDEA OF BILL:
To prohibit future establishment or increased capacity of for-profit
hospice.
SUMMARY OF SPECIFIC PROVISIONS:
The bill amends Public Health Law § 4004 (3) to prohibit the Public
Health and Health Planning Council of-the Department of Health from
approving new applications for establishment, construction or increased
capacity by for-profit hospice entities. Existing for profit hospice
will remain approved but may not expand capacity.
JUSTIFICATION:
An article recently published by ProPublica and digitally released in
The New Yorker, titled "Hospice Became a For-Profit Hustle" shines a
light on multiple instances of fraud targeting the Medicare hospice
benefit. It illustrates how patient care suffers when bad actors are
able to manipulate its original intent and purpose.
An earlier article published in the Journal of the American Medical
Association* found that "for-profit compared with nonprofit hospices
provide narrower ranges of services to patients, use less skilled clin-
ical staff, care for patients with lower-skilled needs over longer
enrollment periods, have higher rates of complaint allegations and defi-
ciencies, and provide fewer community benefits, including training,
research, and charity care. For-profit hospices are more likely than
nonprofit hospices to discharge patients prior to death, to discharge
patients with dementia, and to have higher rates of hospital and emer-
gency department use."
For-profit organizations have a duty to their owners to generate as much
profit as possible and distribute net income to the owners. Their obli-
gations to the people they ostensibly serve are secondary. This is
especially troubling in the case of hospice. The mission of hospice,
providing compassionate end-of-life care, should not be subservient to
providing profit to investors. New York is uniquely situated to prevent
the deterioration of end-of-life care described above, as currently only
two of 41 hospice in New York are for-profit, compared to a national
average of two-thirds as of 2017. Now is the time to place the care and
safety of persons who are dying first and foremost over profit.
In her 2022 veto message 149, Governor Hochul says she will direct the
New York State Master Plan for the Aging "to assess the services offered
by for-profit hospices" and "to include a recommendation on their
continued need." It is important for the Master. Plan for the Aging to
consider these issues however we already know from the experience of
patients, the advocates working on their behalf and the experiences
described in the articles referenced above that New York should take the
proactive step of prohibiting new for-profit hospices. * Hospice Tax
Status and Ownership Matters for Patients and Families JAMA Internal
Medicine, August 1, 2021 By Melissa D. Aldridge.
PRIOR LEGISLATIVE HISTORY:
2022: A8472 - vetoed
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
Immediately
STATE OF NEW YORK
________________________________________________________________________
6032
2023-2024 Regular Sessions
IN ASSEMBLY
March 30, 2023
___________
Introduced by M. of A. PAULIN, SIMON, SEAWRIGHT, HEVESI, GONZALEZ-ROJAS,
KELLES, SAYEGH, OTIS -- read once and referred to the Committee on
Health
AN ACT to amend the public health law, in relation to the establishment,
incorporation, construction, or increase in capacity of for-profit
hospice
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 3 of section 4004 of the public health law is
2 amended by adding a new paragraph (a-1) to read as follows:
3 (a-1) No hospice shall be approved for establishment, incorporation or
4 construction if it is to be operated on a for-profit basis or by a for-
5 profit entity, in whole or in part. No increase in capacity shall be
6 approved for any existing hospice that is operated on a for-profit basis
7 or by a for-profit entity, in whole or in part. This paragraph applies
8 to any approval on or after the date on which it takes effect.
9 § 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09884-01-3
