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A06334 Summary:

BILL NOA06334
 
SAME ASSAME AS S05400
 
SPONSORRozic
 
COSPNSRReyes, Stirpe, Carroll, Simon, Gonzalez-Rojas, Fahy, Niou, Hevesi, Dinowitz, McDonald, Englebright, Seawright, Jacobson, Aubry, Wallace, Kelles, Steck, Glick, Rosenthal L, Barrett, Otis
 
MLTSPNSR
 
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 general hospital a list of its policy-based exclusions and publish such information on the department's website.
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A06334 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          6334
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                     March 16, 2021
                                       ___________
 
        Introduced  by M. of A. ROZIC -- read once and referred to the Committee
          on Health
 
        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 the hospital, or hospitals, in their area provides the
    11  care they seek, because information about  how  hospitals'  restrictions
    12  impact options for care is too difficult to obtain.
    13    The  legislature  also  finds that denials of care can lead to serious
    14  adverse health impacts that jeopardize individuals' lives and  wellbeing
    15  and  that New York needs to understand health care gaps and their impact
    16  statewide.
    17    Finally, the legislature finds that some denials of care violate state
    18  and federal law.
    19    § 2. Section 2803 of the public health law is amended by adding a  new
    20  subdivision 13 to read as follows:
    21    13.  (a)  The  commissioner  or his or her designee shall collect from
    22  each general hospital a list of its policy-based exclusions on an annual
    23  basis.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09581-01-1

        A. 6334                             2
 
     1    (b) The commissioner or his or  her  designee  shall  publish  on  the
     2  department's website a current list of all of the general hospitals with
     3  policy-based exclusions and the policy-based exclusions for each general
     4  hospital  not  later  than  six  months after the effective date of this
     5  subdivision.  The  commissioner or his or her designee shall update this
     6  list on an annual basis. The commissioner, in consultation with  experts
     7  in  health  care access, patient advocacy, types of health care that are
     8  frequently inaccessible, and hospital  administration  shall  promulgate
     9  rules  and  regulations  creating standardized language for this list to
    10  ensure that  it  is  readily  understandable  to  patients,  prospective
    11  patients, and members of the public.
    12    (c)  Within  one  year  of  the effective date of this subdivision and
    13  every four years thereafter, the commissioner shall submit a  report  to
    14  the  temporary  president  of the senate and the speaker of the assembly
    15  regarding policy-based exclusions in the state and the  impact  of  such
    16  policy-based  exclusions on patients' ability to access quality, compre-
    17  hensive, affordable care near  their  residences  and  whether  and  how
    18  access  to  care varies by community, as well as by race, ethnicity, and
    19  socioeconomic status, across the state. The report shall be made public-
    20  ly available on the department's website.
    21    (d) The commissioner or his or her designee shall evaluate and  ensure
    22  community  awareness of policy-based exclusions and the website required
    23  pursuant to paragraph (b) of this subdivision.
    24    (e) For the purposes of this  subdivision,  "policy-based  exclusions"
    25  shall mean non-clinical criteria, rules, or policies, whether written or
    26  unwritten, that restrict medical personnel at that general hospital from
    27  providing  types  of  care  that  the  medical personnel are licensed to
    28  provide and that the general hospital is licensed  to  provide  or  that
    29  restrict the provision of care to categories of patients on the basis of
    30  any characteristic protected under section two hundred ninety-six of the
    31  executive  law that the general hospital is licensed to provide.  "Poli-
    32  cy-based exclusions" shall include, but not be  limited  to,  objections
    33  under  section  twenty-nine hundred ninety-four-n or twenty-nine hundred
    34  eighty-four of this chapter and 10 NYCCRR § 405.9(b)(10).  "Policy-based
    35  exclusions" shall not include restrictions based on lack  of  equipment,
    36  available bed space in the facility, or insurance denial.
    37    (f)  The  commissioner may promulgate additional rules and regulations
    38  as may be necessary and proper to carry out effectively  the  provisions
    39  of this subdivision.
    40    § 3. Subdivision 1 of section 2803 of the public health law is amended
    41  by adding a new paragraph (m) to read as follows:
    42    (m)  The  statement  regarding  patient  rights  and responsibilities,
    43  required pursuant to paragraph (g) of this subdivision, shall include  a
    44  link  to  the  section of the department's website required in paragraph
    45  (b) of subdivision twelve  of  this  section.  Each  general  hospital's
    46  website  shall  prominently link to the department's website required in
    47  paragraph (b) of subdivision twelve of this  section.  The  commissioner
    48  may  promulgate  rules and regulations as may be necessary and proper to
    49  carry out effectively the provisions of this paragraph.
    50    § 4. Subsection (a) of section 3217-a of the insurance law is  amended
    51  by adding a new paragraph 22 to read as follows:
    52    (22)(A)  an  explanation  of policy-based exclusions and the fact that
    53  some general hospitals may have policy-based exclusions,  along  with  a
    54  link  to  the website required pursuant to subdivision twelve of section
    55  twenty-eight hundred three of the public health law.

        A. 6334                             3
 
     1    (B) for the purposes  of  this  paragraph,  "policy-based  exclusions"
     2  shall mean non-clinical criteria, rules, or policies, whether written or
     3  unwritten, that restrict medical personnel at that general hospital from
     4  providing  types  of  care  that  the  medical personnel are licensed to
     5  provide  and  that  the  general hospital is licensed to provide or that
     6  restrict the provision of care to categories of patients on the basis of
     7  any characteristic protected under section two hundred ninety-six of the
     8  executive law that the general hospital is licensed to provide.   "Poli-
     9  cy-based  exclusions"  shall  include, but not be limited to, objections
    10  under section twenty-nine hundred ninety-four-n or  twenty-nine  hundred
    11  eighty-four  of  the  public  health  law  and 10 NYCCRR § 405.9(b)(10).
    12  "Policy-based exclusions" shall not include restrictions based  on  lack
    13  of equipment, available bed space in the facility, or insurance denial.
    14    § 5. Subsection (a) of section 4324 of the insurance law is amended by
    15  adding a new paragraph 23 to read as follows:
    16    (23)(A)  an  explanation  of policy-based exclusions and the fact that
    17  some general hospitals may have policy-based exclusions,  along  with  a
    18  link  to  the website required pursuant to subdivision twelve of section
    19  twenty-eight hundred three of the public health law.
    20    (B) for the purposes  of  this  paragraph,  "policy-based  exclusions"
    21  shall mean non-clinical criteria, rules, or policies, whether written or
    22  unwritten, that restrict medical personnel at that general hospital from
    23  providing  types  of  care  that  the  medical personnel are licensed to
    24  provide and that the general hospital is licensed  to  provide  or  that
    25  restrict the provision of care to categories of patients on the basis of
    26  any characteristic protected under section two hundred ninety-six of the
    27  executive  law that the general hospital is licensed to provide.  "Poli-
    28  cy-based exclusions" shall include, but not be  limited  to,  objections
    29  under  section  twenty-nine hundred ninety-four-n or twenty-nine hundred
    30  eighty-four of the public health  law  and  10  NYCCRR  §  405.9(b)(10).
    31  "Policy-based  exclusions"  shall not include restrictions based on lack
    32  of equipment, available bed space in the facility, or insurance denial.
    33    § 6. Nothing in this act shall be construed  to  permit  or  authorize
    34  denials  of  care  or  discrimination in the provision of health care or
    35  health insurance. Compliance with this act does not reduce or limit  any
    36  liability  for  general hospitals in connection with policy-based exclu-
    37  sions, including violations of state or federal law.
    38    § 7. Severability clause. If any clause, sentence, paragraph, subdivi-
    39  sion, section or part of this act shall be  adjudged  by  any  court  of
    40  competent  jurisdiction  to  be invalid, such judgment shall not affect,
    41  impair, or invalidate the remainder thereof, but shall  be  confined  in
    42  its  operation  to the clause, sentence, paragraph, subdivision, section
    43  or part thereof directly involved in the controversy in which such judg-
    44  ment shall have been rendered. It is hereby declared to be the intent of
    45  the legislature that this act would  have  been  enacted  even  if  such
    46  invalid provisions had not been included herein.
    47    §  8. This act shall take effect six months after it shall have become
    48  a law. Effective immediately, the addition, amendment and/or  repeal  of
    49  any  rule  or regulation necessary for the implementation of this act on
    50  its effective date are authorized to be made and completed on or  before
    51  such effective date.
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