Assembly Health Committee Update

The Assembly Health Committee reported 57 bills at its first three meetings of the year. Several of these were “chapter amendments,” which are new bills making minor changes agreed to as a condition of the Governor signing previous bills.

The Committee reported several bills dealing with nursing home staffing, oversight, and other areas including:

  • Safe Staffing: Two new reports by New York State Attorney General Tish James and the US Public Interest Research Group document the dangers of nursing home staff shortages during COVID-19. The “Safe Staffing” bill by Assembly Member and nurse Aileen Gunther sets minimum staffing ratios for hospitals and nursing homes based on peer-reviewed recommendations;
  • Public Health Law Penalties and Nursing Home Funding – Public Health Law violation penalties have not been increased since 2008 and too many operators see them as a “cost of doing business.” This bill by Assembly Member Gottfried increases the penalties and dedicates revenues from nursing home penalties specifically to a fund for nursing home quality improvement;
  • Nursing Home Visitation – New York State banned nursing home visitation in March 2020 in response to COVID-19. While the ban addressed a real public health concern, isolation also presents risks both to residents’ mental health and from decreased outside oversight by residents’ families. This bill by Assembly Member Bronson would permit caregiving visitors to residents in nursing homes, subject to appropriate regulations by the Commissioner for patient protection;
  • Displaying Nursing Home Ratings – The federal Center for Medicare and Medicaid Services has a “five-star” system for rating nursing homes on the basis of staffing, health inspections, and other quality measures.  This bill by Assembly Member Dinowitz requires these ratings be displayed prominently on the website of the New York State Health Department, and that ratings of individual facilities be displayed prominently both on the facility’s own websites and visibly inside the facility itself.

The Committee also reported bills expanding the medical marijuana program; creating new oversight of pharmacy benefit managers; ensuring continuation of 340B funds that benefit community health clinics; and creating an emerging contaminants monitoring list for water systems.

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: .

January 20

Emerging Contaminants List – New York’s 2017 emerging contaminant monitoring law requires monitoring of certain chemicals in small water systems (under 10,000 people) which are exempt from testing requirements under the federal Unregulated Contaminant Monitoring Rule (UCMR.) The state law included a short list of three emerging contaminants to start while directing the Commissioner to create a longer list. Since then the Commissioner has failed to produce such a list, so this bill adds a longer list of chemicals largely reflecting the UCMR-3. It was drafted in consultation with Environmental Advocates, the New York Public Interest Research Group, and other environmental groups. (A126, Gottfried)

Medical Marijuana Conditions Expansion - There is no drug other than medical marijuana for which the State restricts its use to a limited list of medical conditions. The list was added as a requirement for gaining Senate and Executive support, but takes decision-making power away from health care practitioners and their patients. This bill removes the list, instead covering any condition for which, in the practitioner’s professional opinion and review of past treatments, the patient is likely to receive therapeutic or palliative benefit. (A169, Gottfried)

Medical Marijuana Providers Expansion - Currently physicians, nurse practitioners and physician assistants can certify a patient for use of medical marijuana. However, other providers are authorized to prescribe powerful and potentially addictive controlled substances in their scope of practice (e.g., a dentist or podiatrist treating mouth or foot pain). This bill allows any practitioner authorized to prescribe controlled substances to certify patients for medical marijuana, when acting within his or her scope of practice and with the same requirements as current practitioners (training, registration, and use of the State’s prescription monitoring database). (A170, Gottfried)

Medication Synchronization – Medication synchronization enables partial prescription fills so that refill times are coordinated among multiple prescriptions. This bill allows partial fills for synchronized dispensing when the patient, prescriber, and pharmacist agree. It was vetoed by Governor Cuomo in 2019 on the claim that it would require additional Medicaid expenditures, which it would not. (A187, Gottfried)

Notifying Patients of Hospital Policies on Refusing Treatment - Hospitals are required to disclose to patients their policies that may be contrary to a patient's wishes (e.g., relating to withdrawal of life-sustaining treatment). This bill requires notice prior to admission, except in an emergency. (A210, Rosenthal)

Cesarean Section Information – Caesarian deliveries are sometimes performed when not medically called for. For low-risk pregnancies, Cesarean delivery increases the risk of maternal and infant mortality and morbidity. This bill establishes procedures for maternal health providers to provide written information to women for whom Cesarean sections are recommended, requested but not medically necessary, or performed when not planned. The information would include the benefits and risks of C-sections and implications for future pregnancies. (A217, Paulin)

Medical Marijuana Medicaid and Insurance Coverage – Cost is a major barrier to access for medical marijuana patients. Because neither private health insurance nor Medicaid covers it, patients are forced to pay out of pocket. Workers’ compensation has chosen to cover it in some, but not all, cases. This bill adds medical marijuana coverage to Medicaid; clarifies that commercial payers may (though are not required to) cover it; adds it as a covered benefit in workers’ compensation; and adds it to the list of drugs covered by Elderly Pharmaceutical Insurance Coverage (EPIC), a State program which supplements out-of-pocket drug costs for seniors. (A242, Gottfried)

Schenectady Birth and Death Certificate Fees – Authorizes the Schenectady City Council to set the fee charged for birth and death records issued by the City Clerk. Several counties and cities have been given this authority. (A274, Steck)

Home Health Agency Rate Benchmark – Certified home health agencies (CHHAs) provide acute and post-acute home health services. Unlike some other Medicaid service providers, CHHAs have not received a rate increase in over a decade despite increased labor and operating costs, including state mandated costs. Insufficient availability of CHHA services means hospitals struggle to discharge patients safely back into the community. This bill directs the Commissioner of Health to establish benchmark rates for CHHAs in Medicaid in order to ensure sustainability of CHHA services. (A293, Gottfried)

Protecting Patient Health Information – Requires a medical facility to obtain express written prior consent before broadcasting visual images of a patient’s medical treatment (A520, Braunstein)

Pesticide Prevention at Children’s Camps – Limits the use of pesticides at children’s overnight or summer day camps to designated safe categories, modeled on the standards for schools. (A528, Paulin)

Free COVID Testing for the Uninsured – This bill would permit any uninsured individual to receive free COVID-19 testing, consistent with confidentiality protections for patient and medical data. (A737, Gottfried)

Child Health Plus Coverage of Ostomy Supplies – Children suffering from birth defects or disorders such as Crohn’s disease may require ostomy supplies and equipment. These supplies can easily exceed hundreds of dollars a month. This bill adds coverage of ostomy supplies to the Child Health Plus program. (A783, Cahill)

Home Care Lookback Clarification – The 2020 budget applied a two and a half year “lookback” period on asset transfers by people applying for Medicaid home care services. New York did not previously apply a lookback period to home care, and the lack of any phase-in period will disrupt financial planning for New Yorkers acting in good faith under the old rules. This bill makes corrections to ensure that adults and people with disabilities will not be locked out of appropriate services and put at risk of unnecessary institutionalization. (A833, Gottfried)

Chapter Amendment – COVID Correctional Health Oversight – A bill signed last year expanded the Health Department’s oversight over health policies and practices in Department of Corrections and local jail custody. This bill clarifies that the scope of this oversight would be in relation to COVID-19. (A984, Gottfried)

Chapter Amendment – Public Health and Health Planning Council (PHHPC) Membership – A bill signed last year added consumer advocate representation to PHHPC. This bill clarifies the total number of PHHPC members. (A986, Gottfried)

Chapter Amendment – Disparities in Breastfeeding Study – A bill signed last year required the Health Department to conduct a study and create a report on the effects of racial and ethnic disparities on breastfeeding rates within one year. This bill changes the study to a review of existing data and requires the Department to solicit recommendations from people specializing in relevant fields before preparing a report within 18 months. (A987, Solages)

Chapter Amendment – Disparities in Infant Mortality Study – A bill signed last year required the Health Department to conduct a study and create a report on the effects of racial and ethnic disparities on infant mortality within one year. This bill slightly modifies the purpose of the study to provide more leeway for the Department and extends the timeline for the report to 18 months. (A988, Solages)

Chapter Amendment – Bone Marrow Registry – A bill signed last year required the Department to develop material regarding bone marrow donation and registries and post the information on its website for health care practitioners to use when discussing the topic with patients. This bill makes minor technical changes to it. (A989, Solages)

Adding Embryos to Tissue Bank Storage – Embryo storage is part of the in vitro fertilization process and is regulated by the Department. However, embryos are not currently included in the list of tissues that may be stored by tissue bank and storage facilities. This bill authorizes embryo storage in order by these facilities to ensure appropriate safeguards. (A1135, Paulin)

Chapter Amendment – Contact Tracing Confidentiality – A bill signed last year created confidentiality safeguards for COVID-19 contact tracing information. This bill makes a number of technical amendments to ensure appropriate implementation by State and City agencies. (A1253, Gottfried)

Chapter Amendment – Pre-Term Labor Information – A bill signed last year required hospitals to adopt and implement protocols for managing emergency treatment of pre-term labor, including distribution of information leaflets to maternity patients. This bill makes minor changes to the information distribution. (A1254, Bichotte Hermelyn)

Chapter Amendment – Crohn’s and Colitis Identification Cards – A bill signed last year required the Department to develop identification cards under the Crohn’s and Colitis Fairness Act which allows public bathroom access for those with certain eligible conditions. This bill clarifies the forms used to certify individuals. (A1260, Paulin)

January 26

Lowering School Drinking Water Lead Levels – Children are particularly vulnerable to the harmful effects of lead. The American Academy of Pediatrics, Centers for Disease Control and Prevention, and World Health Organization agree that there is no safe level for children. Current law requires “periodic” testing of school drinking water for lead, with an allowable threshold of 15 parts per billion. This bill would lower the allowable level to 5 parts (similar to Illinois, Vermont, and Washington, D.C. public schools); require annual rather than periodic testing; and eliminate some exemptions from testing. It comes out of discussions with the Healthy Schools Network, League of Conservation Voters, and other children’s’ health and environmental advocates. (A160, Gottfried)

Family Health Care Decisions Act Technical Amendments – The 2010 Family Health Care Decisions Act (FHCDA) and other laws govern health care decision-making, such as life-sustaining treatment decisions, for patients who lack decision-making capacity. This bill makes a number of minor technical changes to the FHCDA such as updating names of agencies, conforming references to physician assistants, and eliminating outdated references. (A175, Gottfried)

Changes in Hospital Ownership or Control – Hospitals are increasingly merging and forming alliances and networks. These changes often have a big impact on a community. But because of technical limits in the law, they can occur with little or no Health Department oversight. This bill would broaden the scope of the law so all changes in ownership or control of a hospital would require State DOH and the Public Health and Health Planning Council review and approval. (A190, Gottfried)

Traumatic Brain Injury (TBI) and Nursing Home Transition and Diversion (NHTD) Waiver Program – Medicaid-eligible individuals who suffer from TBI are served by a highly successful program that provides supports and services to help them live in the most integrated community setting. The Health Department planned to move this population into Medicaid Managed Care, but advocates, providers, and managed care plans raised serious concerns resulting in a series of temporary delays. This bill provides that these TBI and Nursing Home Transition and Diversion programs shall remain outside of Medicaid Managed Care. (A192, Gottfried)

Medically Tailored Meals (MTM) Medicaid Coverage – Appropriate food and nutrition are critical to managing chronic illness. Multiple studies of pilot programs across the country have shown that providing medically tailored meals reduces the frequency and duration of patients’ hospitalizations or institutionalizations, improving outcomes whiles saving more money than the cost of providing the meals. This bill adds MTM coverage to the Medicaid benefit. (A195, Gottfried)

Medical Futility Standard – For over 20 years under previous do-not-resuscitate (DNR) law, a surrogate could consent to a DNR order if the patient met any one of four clinical criteria, one of which was a finding of “medical futility” by two physicians. When DNR orders were made a part of the Family Health Care Decisions Act, however, the legislation neglected to include the “medical futility” standard. This bill restores the previous, longtime medical futility standard. (A204, Gottfried)

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. (A216, Gottfried)

Health Care Transformation Fund – The Health Care Transformation Fund is a pool of State money set up in 2018 “to support health care delivery.” This bill carves out a minimum of 25% of the funding to be used for community-based organizations (such as primary care or home care providers), in order to ensure that hospitals do not use up all the funding at the expense of CBOs. (A264, Gottfried)

Applied Behavioral Analysis Medicaid Coverage – Applied Behavioral Analysis (ABA) is a behavioral intervention used to treat individuals with autism spectrum disorders. New York has required that commercial insurance plans cover ABA since 2011. This bill adds ABA coverage to Medicaid. (A299, Gottfried)

Lymphedema Information – Lymphedema and lymphatic diseases affect nearly 10 million people in the United States. This bill requires hospitals to provide information to patients at high risk for developing lymphedema. (A333, Rosenthal)

Medical Marijuana for Dysmenorrhea – This bill makes dysmenorrhea (menstrual cramps) an eligible condition under the medical marijuana law. (A413, Rosenthal)

Apartment Building Smoking Policies - Requires owners of multiple dwelling buildings to develop smoking policies (which must be within their existing authority as owner), publicly post these policies, and share them with both tenants and prospective tenants. (A445, Paulin)

Medical Marijuana Comprehensive Reforms – There have been several changes to the 2014 Medical Marijuana law since its enactment, but numerous barriers to appropriate patient access remain. This bill consolidates a number of proposals to address geographic availability, cost, and other problems raised by restrictions on the medical practice and business model of the industry. This includes but is not limited to expanding eligible conditions to include any certified by a practitioner; removing the prohibition against smoking (a cheaper delivery form than others); authorizing “caregiver facilities” to ensure access to patients in residential settings; allowing medical marijuana companies to contract out certain services; and increasing the number of companies and dispensaries allowed. (A531, Gottfried)

Automated External Defibrillators (AEDs) in Health Clubs – Current law requires health clubs with over 500 members to have at least one AED on the premises. This bill expands the requirement to all health clubs over 50 members. (A744, Wallace)

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. (A879, Gottfried)

Medical Marijuana for Autism – This bill make autism an eligible condition under the medical marijuana law. (A1150, Abinanti)

Long Range Acoustic Devices Study - Long range acoustic devices (LRADs) are increasingly used by police forces at short ranges for crowd control. This bill requires a study to determine the health effects of exposure to LRADs. (A1196, Rosenthal)

Prohibiting behavioral health all-products clauses – Prohibits health plans from requiring behavioral health providers to participate in all their product lines, including commercial policies, which typically have significant lower payment rates, as a condition of the provider participating in the plan’s Medicaid products. (A1316, Cahill)

Pharmacy Benefit Manager Accountability – Pharmacy benefit managers (PBMs) are companies that manage prescription drug benefit programs for health plans. PBMs promote themselves as saving health plans and their covered members money, but in reality, their negotiations and discounts or rebates they get from drug companies are very secretive and they commonly pocket payments from drug manufacturers that ought to be used to lower drug prices. This bill requires PBMs to be registered and licensed by the State and establishes a duty and standards for fair dealing with health plans, pharmacists and patients. The State will establish minimum standards for PBM licensees addressing conflicts of interest, deceptive and anti-competitive practices, unfair claims practices, and consumer protections. The bill will also allow patients, prescribers and pharmacists to sue PBMs if a PBM’s fail to meet appropriate standards. (A1396, Gottfried)

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. (A1523, Pretlow)

School Registration Notification - Requires physicians and hospitals to document the name and address of any school attended by a school-aged patient and include such information in the patient's file. This will help track and prevent exposure to infectious diseases. (A1615, Perry)

340B Provider Protection – The federal 340B prescription drug program lowers drug prices for certain government-funded health clinics and is especially used by community health centers. A 2020 policy change carving the Medicaid drug benefit out of managed care, while beneficial to the State’s ability to negotiate drug prices, threatens to disrupt providers’ access to the 340B program. This bill delays implementation for the transition in order to enable the Health Department to consider ways to minimize the impact of the carve-out on 340B providers. (A1671, Gottfried)

Generic Drug Information Access - Requires the Commissioner of Health to collect and publish data on the therapeutic effectiveness of generic drug products. (A1923, Paulin)

February 2

Safe Staffing Levels – Requires the Department of Health to set nurse staffing minimum standards for hospitals and nursing homes, to increase quality of care. (A108, Gunther)

Living Donor Support Act – New York faces a shortage of organs for transplantation. This bill would encourage living donation by providing reimbursement for certain donation-related expenses incurred by living donors who are residents of New York and whose donation recipients are also New Yorkers. (A146, Gottfried)

Clinical Trial Access & Education Fund - Promotes access to clinical trials by creating a state grant program to help pay for travel and lodging for patients and family members. (A180, Gottfried)

Public Health Law Penalties and Nursing Home Funding – Public Health Law violations are penalized at a minimum of $2,000 per violation ($5,000 for repeat violations), numbers which have not been changed since 2008. For too many facility operators, this is considered a “cost of doing business.” This bill raises the minimums to $5,000 per / $10,000 for repeat offenses, and dedicates revenues collected from actions against nursing homes specifically to a fund for nursing home quality improvement. (A232A, 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. (A832, Gottfried)

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. (A839, Gottfried)

Nursing Home Visitation – New York State banned nursing home visitation in March 2020 in response to COVID-19. While the ban addressed a real public health concern, isolation from loved ones also presents risks in terms of both residents’ mental health and a lack of outside oversight often driven by residents’ families. This bill would permit caregiving visitors to residents in nursing homes, subject to appropriate regulations by the Commissioner for patient protection. (A1052A, Bronson)

Medicaid Coverage for Medication Assisted Treatment – Medication Assisted Treatment (MAT) is an evidence-based treatment method used to treat substance use disorders. Under current law, Medicaid coverage for MAT may require prior authorization, only cover certain medications, or require other barriers to care. This bill ensures Medicaid coverage for all MAT services without prior authorization. (A2030, Rosenthal)

Displaying Nursing Home Ratings – The federal Center for Medicare and Medicaid Services has a “five-star” system for rating nursing homes on the basis of staffing, health inspections, and other quality measures. However, families are often not aware of individual facility ratings and even that such a system exists. This bill requires that these ratings be displayed prominently on the website of the New York State Health Department, and that ratings of individual facilities be displayed prominently both on the facility’s own websites and visibly inside the facility itself. (A2037, Dinowitz)

Assisted Living Facility Closure Requirements – Increases the amount of time from 90 to 120 days that operators of a for-profit assisted living residence have to submit written notices of closure to DOH to give residents more time to acquire new living accommodations. The notice must include a proposed plan for closure. (A2211, Simon)

Education and Outreach on Sudden Cardiac Arrest - Establishes an education and outreach program in the Department on sudden cardiac arrest among student athletes. (A2275, Cusick)

Medicaid Eligibility for Youths Leaving Court-Ordered Placement – Releasing youths from juvenile justice facilities without access to health care puts them at risk as they try to transition back into the community. This bill provides presumptive Medicaid eligibility for them while their eligibility applications are processed. (A2417, Barron)

Blood Alcohol Device Study – Blood alcohol measurement devices are used by law enforcement to estimate people’s blood alcohol levels during traffic stops and other settings. Concerns have been raised about their accuracy. This bill requires the Commissioner to do a study on the effectiveness and accuracy of these devices. (A2613, Sayegh)