Assembly Health Committee Update — February 2017

The Assembly Committee on Health favorably reported 30 bills at its meetings in February.

The Committee reported the “New York Health Act” (A.4738) a state bill for “improved Medicare for all” (single-payer), which would establish universal, complete health coverage for every New Yorker. It would save tens of billions currently spent on insurance administration and waste and remove the costly barriers to care. Deductibles, copays, out-of-network charges and other out-of-pocket costs are why one in three families with insurance to put off necessary medical care for reasons of cost. The New York Health Act would end the regressive "tax" we pay in insurance premiums, deductibles, co-pays, and out-of-network charges that have no relation to ability to pay, and instead be funded by a broad-based progressive tax based on ability to pay. The Assembly has passed the bill the past two years.

The Committee also reported bills to bring down drug costs for Medicaid and commercial health plans (A.4233) and regulates pharmacy benefit managers (PBMs) (A.2661).

For more information on a particular bill, please contact the sponsor listed after the description. For the text of a bill, supporting memorandum, and information on its status, go to:

February 7

Prohibiting Smoking Near Libraries – Prohibits smoking within 100 feet of the entrance or exit of a library. (A330, Dinowitz)

Home Care Claims Standards –Sets forth standards for “clean claims” for payment for home health care and consumer directed personal care. (A564, Abinanti)

Brooklyn Asthma Study – Directs the Department of Health to conduct a study on the high incidence of asthma in the borough of Brooklyn. (A947, Simon)

Regulating Retail Clinics – Retail clinics currently exist throughout NY, providing episodic care as an alternative to emergency rooms. However, there is no statutory or regulatory system in place to govern their practice. This bill ensures that all retail clinics be limited to drop-in episodic care and be subject to standards to ensure they provide safe, high quality, integrated health care. With the regulations in place, the bill would allow the retail company to own the clinic under Public Health Law Article 28, as an alternative to leasing space for it. (A958, Paulin)

Burn Unit Feasibility Study - Requires the Department to study the feasibility of creating a burn unit at Kings County Medical Center in collaboration with the trauma center at SUNY Downstate Medical Center's University Hospital of Brooklyn. (A1024, Richardson)

Managed Long Term Care Plan Ownership - Prohibits for-profit health maintenance organizations from owning managed long term care plans. (A2358, Gottfried)

Health Plans Switching Drugs - Bans health plans from changing a patient's prescription without the prescriber's consent, and bars contracts that limit a physician from referring a patient to an out-of-network provider. (A2370, Gottfried)

Streamlining Health Plan Credentialing - Requires health plans to use standardized forms (developed by the Health Commissioner) for health care providers applying to be included in a plan's network and for referrals. (A2389, Gottfried)

Review of Health Plan Coverage Denials - Provides that a health plan’s internal review of a denial of coverage for a service must be done by a physician in the specialty involved; this is currently the rule for external appeals. (A2539, Gottfried)

Pharmacy Benefit Manager (PBM) Transparency - "Pharmacy benefit managers" administer drug coverage for health plans, including negotiating discounts with drug manufacturers. There have been serious cases of PBM misconduct at the expense of health plans, imposing additional costs on beneficiaries and employers. This bill would require financial transparency and require PBMs to operate in the interest of their health plan clients. (A2661, Gottfried)

Adult Home Death and Felony Reporting – Improves reporting by adult care facilities of resident deaths and attempted suicides and any felony in the facility. (A2702, Gottfried)

Impaired Physician Programs – The NY Medical Society’s Committee for Physician Health provides treatment and counseling to physicians thought to be suffering from alcoholism, substance abuse, or mental illness. Physicians who provide services in the program have liability protection. However, a recent lower court decision has left doubt as to whether the protections apply to the Medical Society itself. This legislation clarifies that the liability protection applies to the Medical Society. (A2703, Gottfried)

Food Allergy Awareness - Requires the Department of Health to establish educational materials and programs about food allergens for public eating establishments, and to create regulations on disclosure and posting. (A3190, Ortiz)

Effects of Artificial Night Light - Requires the Department of Health to study the health effects of night-time artificial lighting. (A3519, Rosenthal)

February 14

Technical Corrections to Law on Do-Not-Resuscitate (DNR) Orders – Repeals sections of Public Health Law related to DNRs that are now covered by the Family Health Care Decisions Act. (A851, Gunther)

Improving Indoor Air Quality - Establishes standards, training programs, and compliance investigation methods for indoor air quality in state owned, leased, or operated buildings. (A926, Lupardo)

Healthy Teens Act - Establishes Department of Health grants for age-appropriate sex education programs. (A2705, Gottfried)

Technical Corrections to Hospice Law – Updates references to palliative care in the hospice law. (A2723, Gottfried)

Protecting Day Care Air Quality - Bars day care centers from being located near environmentally hazardous sites. Requires air quality and ventilation standards for day care centers. (A2831, Englebright)

Patient Access to Medical Records – Expands patient access to their own medical records from all health care providers, and prohibits fees when patients request records necessary to claim government benefits. (A2869, Gottfried)

Window Blind Safety Pamphlets – Requires the Health Department to produce pamphlets regarding strangulation risks to children posed by window blind cords. The Department will provide these pamphlets to pediatricians for distribution at children’s six month appointments. (A5804, McDonald)

Community Food Programs - Creates the Community Food Security, Empowerment and Economic Development Program to increase the self-sufficiency of low-income communities in providing for their food needs. (A3442, Cook)

Provider Participation in Child Health Plus Plans - Prohibits insurance companies that offer Child Health Plus from requiring a participating health care provider in its Child Health Plus plan to also sign up for the insurance company's other health plans. (A3866, Pretlow)

Hospital Identification and Assistance for Domestic Violence Victims - Establishes procedures for hospitals and emergency rooms to properly identify and assist suspected or confirmed cases of domestic violence. (A4014, Lavine)

Surrogate and Hospital Dispute Resolution – The Family Health Care Decisions Act states that if a surrogate directs provision of life-sustaining treatment but the hospital does not wish to provide it, the hospital must either comply with the surrogate, transfer the patient, or seek court review. This bill clarifies that the hospital may prevail if it is carrying out the patient’s own decision. (A4019, Pretlow)

Ending the HIV/AIDS Epidemic: Sharing HIV Data with Health Care Providers – This bill enacts recommendations of the Governor’s End the Epidemic Task Force. It allows sharing of HIV data with health care providers and care coordinators in order to improve HIV patient care coordination and care monitoring. (A4053, Gottfried)

Lower Drug Prices for Medicaid and Private Insurance - The Preferred Drug Program (PDP) negotiates rebates from drug manufacturers as a condition for including their drugs on Medicaid’s “preferred drug list,” but only for the very small fee-for-service Medicaid population. The bill would help lower drug costs by having the PDP negotiate drug prices for the whole 6.5 million patient Medicaid program. Currently, each Medicaid managed care plan handles its own drug benefit. The bill would also invite commercial health plans to buy their drugs through the PDP. This would further increase the PDP’s bargaining power and make lower prices available to the commercial health plans.(A4233, Gottfried)

Health Care Provider Collective Negotiation with Health Plans - Allows doctors and other health care providers to form organizations to negotiate collectively with health plans. Negotiations could cover rates of payment, procedures for approving coverage of services, and other terms and conditions. (A4472, Gottfried)

Determining Patient Incapacity – This bill amends Public Health Law and the Surrogate’s Court Procedure Act to improve the process of determining patient incapacity to make health care decisions. (A4478, Pretlow)

New York Health Act – Single-Payer Plan - Establishes "New York Health," a universal, single-payer health care program that would cover all New Yorkers without consideration of income. New York Health would replace insurance company premiums, deductibles, and co-pays with a publicly-funded benefit package more comprehensive than commercial health plans. (A4738, Gottfried)