Add §2803-bb, amd §2803, Pub Health L; amd §§3217-a & 4324, Ins L
Relates to providing information to patients and the public on policy-based exclusions; requires the commissioner of health to collect from each health care facility a list of its policy-based exclusions and publish such information on the department's website.
STATE OF NEW YORK
________________________________________________________________________
1003--A
2023-2024 Regular Sessions
IN SENATE
January 9, 2023
___________
Introduced by Sens. HINCHEY, BRESLIN, HARCKHAM, HOYLMAN-SIGAL, MAY,
MYRIE, RIVERA, SALAZAR, SEPULVEDA, WEBB -- read twice and ordered
printed, and when printed to be committed to the Committee on Health
-- reported favorably from said committee and committed to the Commit-
tee on Rules -- committee discharged, bill amended, ordered reprinted
as amended and recommitted to said committee
AN ACT to amend the public health law and the insurance law, in relation
to providing information to patients and the public on policy-based
exclusions
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Legislative findings. The legislature finds that since 2003
2 more than 40 community hospitals in New York state have closed.
3 The legislature additionally finds that as a result of hospital
4 consolidation, large health care systems now control more than 70
5 percent of acute hospital beds in the state and that these systems some-
6 times remove categories of care from local hospitals, leaving patients
7 in regions of the state without access to particular types of care,
8 including some types of emergency care.
9 The legislature further finds that patients do not have the ability to
10 determine whether health care facilities in their area provide the care
11 they seek, because information about how facility restrictions impact
12 options for care is too difficult to obtain.
13 The legislature also finds that denials and poor access to care can
14 lead to serious adverse health impacts that jeopardize individuals'
15 lives and wellbeing and that New York needs to understand health care
16 gaps and their impact statewide.
17 Finally, the legislature finds that some denials of care violate state
18 and federal law.
19 § 2. The public health law is amended by adding a new section 2803-bb
20 to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02598-04-3
S. 1003--A 2
1 § 2803-bb. Policy-based exclusions. 1. Definitions. As used in this
2 section: (a) "Health care facility" means a general hospital as defined
3 in subdivision ten of section twenty-eight hundred one of this article.
4 (b) "Policy-based exclusions" means any criteria, rules, or policies,
5 whether written or unwritten, formally adopted or drafted, endorsed by
6 the health care facility or followed from an external source, that
7 restrict medical personnel at that health care facility from providing
8 types of care that the medical personnel is licensed to provide and that
9 the health care facility is licensed to provide or that restrict the
10 provision of care to categories of patients on the basis of any charac-
11 teristic protected under section two hundred ninety-six of the executive
12 law that the health care facility is licensed to provide. "Policy-based
13 exclusions" shall include, but not be limited to, objections under
14 section twenty-nine hundred eighty-four or twenty-nine hundred ninety-
15 four-n of this chapter. "Policy-based exclusions" shall not include
16 restrictions based on lack of equipment, available bed space in the
17 facility, or insurance denial.
18 2. (a) The commissioner shall collect from each health care facility a
19 list of its policy-based exclusions on an annual basis.
20 (b) The commissioner shall publish on the department's website a
21 current list of all of the health care facilities with policy-based
22 exclusions and the policy-based exclusions for each health care facility
23 not later than six months after the effective date of this section. The
24 commissioner shall update this list on an annual basis. The commission-
25 er, in consultation with experts in health care access, patient advoca-
26 cy, types of health care that are frequently inaccessible, and hospital
27 administration shall promulgate rules and regulations creating standard-
28 ized language for this list to ensure that it is readily understandable
29 to patients, prospective patients, and members of the public.
30 (c) Within one year of the effective date of this section and every
31 five years thereafter, the commissioner shall submit a report to the
32 temporary president of the senate and the speaker of the assembly
33 regarding policy-based exclusions in the state and the impact of such
34 policy-based exclusions on patients' ability to access quality, compre-
35 hensive, affordable care near their residences and whether and how
36 access to care varies by community, as well as by race, gender, ethnici-
37 ty, sexual orientation, gender identity or gender expression, and
38 socioeconomic status, across the state. The report shall be made public-
39 ly available on the department's website.
40 (d) The commissioner shall evaluate and ensure community awareness of
41 policy-based exclusions and the website required pursuant to paragraph
42 (b) of this subdivision.
43 (e) The commissioner may promulgate additional rules and regulations
44 as may be necessary and proper to carry out effectively the provisions
45 of this section.
46 § 3. Subdivision 1 of section 2803 of the public health law is amended
47 by adding a new paragraph (m) to read as follows:
48 (m) The statement regarding patient rights and responsibilities,
49 required pursuant to paragraph (g) of this subdivision, shall include a
50 link to the section of the department's website required in paragraph
51 (b) of subdivision two of section twenty-eight hundred three-bb of this
52 article. Each health care facility's website shall prominently link to
53 the department's website required in paragraph (b) of subdivision two of
54 section twenty-eight hundred three-bb of this article. The commissioner
55 may promulgate rules and regulations as may be necessary and proper to
56 carry out effectively the provisions of this paragraph.
S. 1003--A 3
1 § 4. Subsection (a) of section 3217-a of the insurance law is amended
2 by adding a new paragraph 22 to read as follows:
3 (22)(A) an explanation of policy-based exclusions and the fact that
4 some health care facilities may have policy-based exclusions, along with
5 a link to the website required pursuant to subdivision two of section
6 twenty-eight hundred three-bb of the public health law.
7 (B) for the purposes of this paragraph, "policy-based exclusions"
8 shall have the same meaning as in section twenty-eight hundred three-bb
9 of the public health law.
10 § 5. Subsection (a) of section 4324 of the insurance law is amended by
11 adding a new paragraph 23 to read as follows:
12 (23)(A) an explanation of policy-based exclusions and the fact that
13 some health care facilities may have policy-based exclusions, along with
14 a link to the website required pursuant to subdivision two of section
15 twenty-eight hundred three-bb of the public health law.
16 (B) for the purposes of this paragraph, "policy-based exclusions"
17 shall have the same meaning as in section twenty-eight hundred three-bb
18 of the public health law.
19 § 6. Nothing in this act shall be construed to permit or authorize
20 denials of care or discrimination in the provision of health care or
21 health insurance. Compliance with this act does not reduce or limit any
22 liability for health care facilities in connection with policy-based
23 exclusions, including violations of state or federal law.
24 § 7. Severability clause. If any provision of this act, or any appli-
25 cation of any provision of this act, is held to be invalid, or ruled to
26 violate or be inconsistent with any applicable federal law or regu-
27 lation, that shall not affect the validity or effectiveness of any other
28 provision of this act, or of any other application of any provision of
29 this act. It is hereby declared to be the intent of the legislature
30 that this act would have been enacted even if such invalid provisions
31 had not been included herein.
32 § 8. This act shall take effect one year after it shall have become a
33 law. Effective immediately, the addition, amendment and/or repeal of any
34 rule or regulation necessary for the implementation of this act on its
35 effective date are authorized to be made and completed on or before such
36 effective date.
