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A02922 Summary:

BILL NOA02922
 
SAME ASNo Same As
 
SPONSORPeoples-Stokes
 
COSPNSRBarron, Robinson, Joyner
 
MLTSPNSRSimon
 
Amd SS210 & 4323, Ins L; amd S206, add Art 2 Title 3-A SS245 - 249, Pub Health L
 
Establishes a health care disparities data collection system.
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A02922 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2922
 
                               2015-2016 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 20, 2015
                                       ___________
 
        Introduced  by  M. of A. PEOPLES-STOKES -- read once and referred to the
          Committee on Mental Health
 
        AN ACT to amend the insurance law and the public health law, in relation
          to establishing a health care disparities data collection system
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Subsections  (d)  and (e) of section 210 of the insurance
     2  law, as added by chapter 579 of the laws of 1998, are amended to read as
     3  follows:
     4    (d) Beginning no later than September first of the year following  the
     5  effective date of the rules and regulations establishing the health care
     6  disparities data collection system, pursuant to title three-A of article
     7  two  of  the  public health law, and on September first of the preceding
     8  year  if  practicable,  in  addition  to  the  information  required  in
     9  subsections  (a),  (b) and (c) of this section, the superintendent shall
    10  include in such guide and selection  of  the  data  applicable  to  each
    11  insurer  or  entity  from  the  health  care disparities data collection
    12  system. Such data shall include data collected or compiled in regard  to
    13  health care quality and health outcomes pursuant to section two thousand
    14  nine  hundred  ninety-five-c of the public health law or other data that
    15  is generally recognized as authoritative and reliable.
    16    (e) Health insurers and entities certified pursuant to article  forty-
    17  four  of the public health law shall provide annually to the superinten-
    18  dent and the commissioner of health,  and  the  commissioner  of  health
    19  shall  provide  to  the superintendent, all of the information necessary
    20  for the superintendent to produce the annual  consumer  guide,  provided
    21  that  this  requirement  shall  not apply to information provided for in
    22  subsection (d) of this section if the superintendent  already  possesses
    23  such  information  as part of the data collection system provided for in
    24  title three-A of article two of the public health law. In compiling  the
    25  guide,  the  superintendent  shall  make every effort to ensure that the
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01341-01-5

        A. 2922                             2
 
     1  information is presented in a clear, understandable fashion which facil-
     2  itates comparisons among individual insurers  and  entities,  and  in  a
     3  format which lends itself to the widest possible distribution to consum-
     4  ers.  The  superintendent  shall either include the information from the
     5  annual consumer  guide  in  the  consumer  shopping  guide  required  by
     6  subsection  (a)  of  section four thousand three hundred twenty-three of
     7  this chapter or combine the two guides as long as consumers in the indi-
     8  vidual market are provided with the information required  by  subsection
     9  (a) of section four thousand three hundred twenty-three of this chapter.
    10    [(e)]  (f) The superintendent shall contract with a national organiza-
    11  tion for the purposes of drafting and designing the guide, including the
    12  preparation of relevant explanatory material.  Such  organization  shall
    13  have  actual  experience  in  preparing a similar guide for at least one
    14  other state. The superintendent, in consultation with  the  commissioner
    15  of  health, may also contract with one or more national organizations to
    16  assist such commissioner in the collection of data and the analysis  and
    17  auditing  of  the  clinical  measurers. Such organizations shall consult
    18  periodically with associations representing health insurers  and  health
    19  maintenance  organizations  as  well as with consumer representatives in
    20  New York in preparing the consumer guide. In regard to information added
    21  to the consumer guide or guides  pursuant  to  subsection  (d)  of  this
    22  section,  the data selected as well as the format shall be determined by
    23  the superintendent in consultation with the commissioner of health, with
    24  consideration given to the views expressed by stakeholders in the review
    25  and comment process held pursuant to subdivision eleven of  section  two
    26  hundred forty-seven of the public health law.
    27    §  2.  Subsection (a) of section 4323 of the insurance law, as amended
    28  by chapter 1 of the laws of 1999, is amended to read as follows:
    29    (a) All health  maintenance  organizations  issued  a  certificate  of
    30  authority  under article forty-four of the public health law or licensed
    31  under this article shall prepare, in conjunction  with  the  superinten-
    32  dent, and shall participate in and share the cost of the publication and
    33  dissemination of a consumer's shopping guide for standardized individual
    34  health  plans  issued  pursuant  to sections four thousand three hundred
    35  twenty-one and four thousand three hundred twenty-two  of  this  article
    36  and a separate consumer shopping guide for standardized qualifying indi-
    37  vidual  health  insurance  contracts  and  standardized qualifying group
    38  health insurance contracts issued  pursuant  to  section  four  thousand
    39  three hundred twenty-six of this article. The consumer's shopping guides
    40  shall  be  published annually and shall include the names, addresses and
    41  telephone numbers of all health maintenance organizations offering  such
    42  coverage  as  well  as  a description of the plan design and premiums in
    43  such a manner that facilitates consumer comparison. Such consumer guides
    44  shall also contain, in a manner that facilitates consumer comparison,  a
    45  selection  of the data applicable to each such health maintenance organ-
    46  ization from the health care disparities data collection  system  estab-
    47  lished  under title three-A of article two of the public health law. The
    48  data selected as well as the format shall be determined  by  the  super-
    49  intendent  in consultation with the commissioner of health, with consid-
    50  eration given to the views expressed by stakeholders in the  review  and
    51  comment  process  held  pursuant  to  subdivision  eleven of section two
    52  hundred forty-seven of the public health law.
    53    § 3. Subdivision 1 of section 206 of the public health law is  amended
    54  by adding a new subdivision (v) to read as follows:
    55    (v) establish, administer and enforce the health care disparities data
    56  collection system established under title three-A of this article.

        A. 2922                             3
 
     1    §  4.  Article  2  of the public health law is amended by adding a new
     2  title 3-A to read as follows:
     3                                 TITLE III-A
     4               HEALTH CARE DISPARITIES DATA COLLECTION SYSTEM
     5  Section 245. Legislative intent.
     6          246. Definitions.
     7          247. Establishment  of  health  care disparities data collection
     8                 system.
     9          248. Dissemination  of  health  care  disparities  data  to  the
    10                 public.
    11          249. Enforcement.
    12    §  245.  Legislative  intent.  The legislature finds and declares that
    13  substantial disparities exist as to health care outcomes based on  race,
    14  ethnicity,  sex,  primary language, disability status, and sexual orien-
    15  tation in this state and in the nation. The intent of this title  is  to
    16  establish  a uniform data health care disparities data collection system
    17  in this state which will  enable  health  care  consumers  to  be  fully
    18  informed  as  to the record of health plans and health care institutions
    19  in addressing disparities based  on  these  factors  in  order  to  make
    20  informed  health  care  choices  and  for  state policymakers to address
    21  disparities. The data collection system  established  under  this  title
    22  shall  incorporate  the  disparities  data  collected  under the patient
    23  protection and affordable care act, existing state and federal laws  and
    24  regulations,  and  the  additional  requirements  established under this
    25  title. It is further the intent of this title that the department assem-
    26  ble health disparities data from all state  and  federal  agencies  that
    27  presently  collect  such  data or that will be required to collect it in
    28  the future and compile this data in a format that is  easily  accessible
    29  and available to the public at no charge.
    30    §  246.  Definitions. The following words and phrases, as used in this
    31  title, shall have  the  following  meanings:  1.  "Article  twenty-eight
    32  facility"  means any entity regulated under article twenty-eight of this
    33  chapter, including a hospital, nursing home, or residential health  care
    34  facility.
    35    2.  "Data  provider"  means  an  article twenty-eight facility defined
    36  pursuant to subdivision one of this section or a health insurer  defined
    37  pursuant to subdivision four of this section.
    38    3.   "Health   care  disparities  data  collection  system"  or  "data
    39  collection system" means the  collection  of  information  in  the  form
    40  established in this title.
    41    4.  "Health  insurer" means a health maintenance organization issued a
    42  certificate of authority under article forty-four of  this  chapter,  an
    43  entity licensed under article forty-three or forty-four of the insurance
    44  law,  or  a person, firm or corporation providing health insurance poli-
    45  cies under article thirty-two of the  insurance  law.  Such  term  shall
    46  include a public insurance program.
    47    5.  "Patient  protection  and affordable care act" or "affordable care
    48  act" means public law 111-148 and public law 111-152, as such  laws  may
    49  from time to time be amended.
    50    6. "Public insurance program" includes an approved organization pursu-
    51  ant  to  title one-A of article twenty-five of this chapter, an approved
    52  organization pursuant to section  three  hundred  sixty-nine-ee  of  the
    53  social services law, and a participant in the program created by section
    54  four  thousand  three hundred twenty-six of the insurance law. Such term
    55  shall also include medical assistance  for  needy  persons  pursuant  to
    56  title eleven of article five of the social services law.

        A. 2922                             4
 
     1    7.  "Race  and  ethnicity" means all racial categories compiled by the
     2  United States census, provided that the "Asian" racial category shall be
     3  broken down further into the subcategories  designated  by  the  census,
     4  including  "Asian  Indian," "Chinese," "Filipino," "Japanese," "Korean,"
     5  "Vietnamese," and "other Asian."
     6    8. "Retention rate" means the percentage of those enrolled in a public
     7  insurance  program  that are asked to renew or recertify and do renew or
     8  recertify as of two months after the expiration of their previous health
     9  insurance coverage.
    10    9. "Take up rate" means the percentage of those eligible for a  public
    11  insurance program that enroll in the program.
    12    §  247.  Establishment  of  health  care  disparities  data collection
    13  system.  1. The department shall establish by rulemaking a  health  care
    14  disparities  data collection system. Once established, the data included
    15  in such system shall be made available to the  public  under  the  terms
    16  established in this title.
    17    2.  All  data providers shall be required to furnish the data mandated
    18  to be submitted under subdivision three of this section  and  any  other
    19  data  which the department shall prescribe, and otherwise participate in
    20  the health care disparities collection  system  established  under  this
    21  title.
    22    3.  The  data  collection  system shall include at least the following
    23  data sets disaggregated by race and ethnicity,  sex,  primary  language,
    24  disability status, and sexual orientation:
    25    a.  in the case of health insurers, the number of subscribers, covered
    26  persons (including spouses and children in the case of family coverage),
    27  and applicants;
    28    b. in the case of  article  twenty-eight  facilities,  the  number  of
    29  patients  and  data  concerning  health care quality and health outcomes
    30  collected and/or disseminated pursuant  to  section  two  thousand  nine
    31  hundred  ninety-five-b  of this chapter, and/or any other data in regard
    32  to health care quality and health outcomes selected  by  the  department
    33  that is generally recognized as authoritative and reliable;
    34    c.  in  the  case  of  public  insurance  programs,  take up rates and
    35  retention rates;
    36    d. data collected or compiled pursuant to section  two  thousand  nine
    37  hundred ninety-five-c of this chapter;
    38    e. any data in addition to the data referred to in paragraphs b, c and
    39  d  of  this  subdivision  in  regard to health care quality and outcomes
    40  which is required to be disclosed or furnished to any  state  agency  by
    41  any  provision  of  law,  that  is  already disaggregated by race and/or
    42  ethnicity, sex,  primary  language,  disability  status,  and/or  sexual
    43  orientation, or for which it is practicable to disaggregate such data by
    44  such factors;
    45    f.  any  data that is required to be reported in regard to applicants,
    46  recipients or participants under title one of the patient protection and
    47  affordable care act (42 U.S.C. 300k) and its  implementing  regulations,
    48  as such regulations may from time to time be amended; and
    49    g.  any  other data or data methodology that the department determines
    50  would meet the goals of this title, including data produced or collected
    51  by the federal government.
    52    4. Unless the context clearly indicates otherwise, for the purposes of
    53  paragraph f of subdivision three of this section, the terms "applicant,"
    54  "recipient" or "participant" shall have the same meaning as  such  terms
    55  are  given  in the affordable care act and its implementing regulations,
    56  as such act and regulations shall from time to time be amended.

        A. 2922                             5
 
     1    5. The department shall require data  providers  to  update  at  least
     2  annually  any  data  that  is  furnished under subdivision three of this
     3  section. Notwithstanding the preceding sentence, for any data  collected
     4  pursuant  to  any  other  provision  of law which requires updating more
     5  frequently  than  annually, the frequency provided for in such provision
     6  shall apply.
     7    6.  Any  state  agency,  including  any  health  benefit  exchange  or
     8  exchanges  created  in  the  state  under  the affordable care act which
     9  obtains or possesses data which  is  subject  to  this  title  shall  be
    10  required  to  furnish  such  data to the department upon request, in the
    11  format and manner requested by the department.  Such  agency  or  entity
    12  shall  also  be  required to cooperate with the department in the estab-
    13  lishment and maintenance of the data collection system.
    14    7. a. The department is authorized to enter into  any  agreement  with
    15  the  federal department of health and human services or any other entity
    16  that is necessary to obtain the data obtained by the federal  department
    17  of  health  and human services from any federally conducted or supported
    18  health care or public health program, activity  or  survey  pursuant  to
    19  title  XXXI  of  the affordable care act (42 U.S.C. 300k) and its imple-
    20  menting regulations for inclusion in the data collection system.
    21    b. The commissioner is authorized to contract with one or  more  enti-
    22  ties  to operate any part of the health care disparities data collection
    23  system, and to accept grants and enter into contracts as may  be  neces-
    24  sary to provide funding for such data collection system.
    25    8.  The  department  shall  prescribe  forms or questionnaires for the
    26  collection of data from data providers that are necessary for  the  data
    27  collection  system,  along  with  appropriate  instructions  for persons
    28  completing the form  or  questionnaire.  Notwithstanding  the  preceding
    29  sentence,  the  department  shall  be authorized to use means other than
    30  such form or questionnaire if data needed for the data collection system
    31  is otherwise reasonably obtainable by other means,  including  from  the
    32  department  of health and human services pursuant to the affordable care
    33  act. In order to reduce the costs  or  administrative  burdens  on  data
    34  providers,  patients,  applicants,  or other persons, the department may
    35  alternatively include questions eliciting  the  data  mandated  by  this
    36  title on a questionnaire or form developed for purposes other than spec-
    37  ified in this title.
    38    9.  Unless  required by any other provision of law, it shall be volun-
    39  tary for any patient, applicant or any other person receiving or seeking
    40  services from a data provider to provide information in regard to  their
    41  race,  ethnicity,  sex,  primary  language, disability status, or sexual
    42  orientation, and no patient, applicant or any other such person shall be
    43  denied services or in any way discriminated against in  the  receipt  of
    44  services  for  failure to answer any such question. The department shall
    45  include a statement explaining that the information requested is  volun-
    46  tary in all questionnaires or forms provided for in subdivision eight of
    47  this section.
    48    10.  In  administering  this title, the department shall seek to avoid
    49  duplicative requirements on data providers, state  agencies,  and  state
    50  entities,  so  long  as the methodology selected meets the goals of this
    51  title.
    52    11. Stakeholders selected by the commissioner, including  health  care
    53  consumer  organizations,  organizations that represent racial and ethnic
    54  minorities, women, those whose first language  is  not  English,  people
    55  with  disabilities,  and  gay and lesbian data providers, as well as the
    56  superintendent of financial services, shall be provided with the  oppor-

        A. 2922                             6
 
     1  tunity to review and comment on the methodology used to comply with this
     2  title,  including  collection methods, analysis, formatting, and methods
     3  and means for release and dissemination. Such opportunity to review  and
     4  comment  shall  include,  but  not  be  limited  to, whether the data is
     5  formatted in a manner so as to enable consumers to make informed choices
     6  of health insurers and article twenty-eight facilities and the usability
     7  of the website under section two hundred forty-eight of this title.  The
     8  opportunity for review and comment shall include at least one meeting of
     9  such stakeholders prior to the development of the regulations promulgat-
    10  ed  pursuant to this title, and at least one meeting annually thereafter
    11  so that modifications to the data collection system may be considered by
    12  the department. The department shall report the results of  such  review
    13  and comment process to the superintendent of financial services.
    14    § 248. Dissemination of health care disparities data to the public. 1.
    15  As  early as practicable after the receipt by the department of any data
    16  which is a component of the data collection system and in no case longer
    17  than ninety days after receipt, the department shall post such data on a
    18  website maintained by the department which is easily accessible  to  the
    19  public  and downloadable using a spreadsheet program used by substantial
    20  numbers of the general public that  permits  manipulation  of  the  data
    21  after  downloading.  The  department  shall  ensure  that  the  data  is
    22  displayed in a clear format which is easily  understandable,  and  which
    23  facilitates consumer comparison in such a manner so as to enable consum-
    24  ers  to make informed choices of health insurers or article twenty-eight
    25  facilities.  The  website  shall  also  include  easily   understandable
    26  instructions  on  how  to  access  the data, and a glossary of the terms
    27  used. The data shall be made available to the public on the  website  at
    28  no charge.
    29    2. a. The department shall compile the data collected under this title
    30  and  post it on the website on a statewide basis and also in a form that
    31  is disaggregated by group factors.  In  addition,  such  data  collected
    32  shall  be  further  disaggregated  on  a  county  and an industry basis,
    33  provided that for any city with a population of one million residents or
    34  more, such data shall also be further disaggregated on a citywide basis.
    35  The department shall consider the feasibility of including other methods
    36  of presenting the data other than that as mandated in  this  title  that
    37  might promote the goals of this title of helping consumers make informed
    38  health care choices and state policymakers in addressing disparities.
    39    b. For the purposes of paragraph a of this subdivision:
    40    i. to "compile the data collected" means to calculate the total number
    41  of  patients,  subscribers,  applicants  or  other  persons receiving or
    42  applying for services, as applicable, and the percentage  of  the  total
    43  for each data element;
    44    ii.  to  disaggregate  by "group factors" means by race and ethnicity,
    45  sex, primary language, disability status, and sexual orientation; and
    46    iii. to disaggregate by "industry" means to disaggregate the data into
    47  at least the following categories: general hospitals, nursing homes  and
    48  residential  care facilities in the case of article twenty-eight facili-
    49  ties, and commercial insurers,  health  maintenance  organizations,  and
    50  public insurance programs in the case of health insurers. In the case of
    51  public  insurance  programs, the data shall also be broken down further,
    52  into the following categories: all approved  organizations  pursuant  to
    53  title  one-A of article twenty-five of this chapter, all approved organ-
    54  izations pursuant to section three hundred sixty-nine-ee of  the  social
    55  services  law,  all  participants in the program created by section four
    56  thousand three hundred twenty-six of the insurance law, and all data  in

        A. 2922                             7
 
     1  regard  to  providing  medical  assistance for needy persons pursuant to
     2  title eleven of article five of the social services law.
     3    3.  Notwithstanding  any  other provision of state or federal law, the
     4  department shall restrict dissemination of  any  data  subject  to  this
     5  title  if  such dissemination would reveal any data as to any individual
     6  consumer, including but not limited to his or her race and/or ethnicity,
     7  primary language, disability status, or sexual orientation.
     8    4. For all data compiled by the department  pursuant  to  section  two
     9  hundred  forty-seven  of  this  title  or  disseminated pursuant to this
    10  section, data in regard to the Asian racial category shall  be  compiled
    11  and  disseminated  as  to  all Asians, and also for the subcategories of
    12  Asians provided for in subdivision seven of section two  hundred  forty-
    13  six  of this title. Hispanics shall be listed both under their race, and
    14  separate data shall be compiled and disseminated for  Hispanics  of  all
    15  races.
    16    §  249.  Enforcement.  In addition to the penalties otherwise provided
    17  under this chapter, any violation of this title by an authorized  insur-
    18  er,  representative  of  the  insurer,  or  any  other  person or entity
    19  licensed, certified, registered, or authorized pursuant to the insurance
    20  law, the superintendent of financial services  shall  be  authorized  to
    21  seek  the remedies provided in section one hundred nine of the insurance
    22  law.  Nothing in this title shall in any way  contravene  or  limit  the
    23  rights  or  remedies that are otherwise available to a state agency or a
    24  consumer under any other provision of law.
    25    § 5. This act shall take effect three months after the effective  date
    26  of  regulations  implementing  Title  XXXI of the patient protection and
    27  affordable care act (42 U.S.C. 300k)  or  July  1,  2015,  whichever  is
    28  later;  provided,  however  that  effective  immediately,  the addition,
    29  amendment and/or repeal of any rule  or  regulation  necessary  for  the
    30  implementation  of  this  act  on  its effective date are authorized and
    31  directed to be made and completed on or before such effective date,  and
    32  provided  further,  that any state agency may gather information or take
    33  any other action necessary for the implementation of  this  act  on  its
    34  effective  date;  provided,  further,  however, that the commissioner of
    35  health shall notify the legislative bill drafting  commission  upon  the
    36  occurrence of the issuance of the regulations implementing Title XXXI of
    37  the patient protection and affordable care act in order that the commis-
    38  sion  may  maintain  an  accurate  and timely effective data base of the
    39  official text of the laws of the state of New  York  in  furtherance  of
    40  effectuating  the  provisions  of  section 44 of the legislative law and
    41  section 70-b of the public officers law.
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