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A03551 Summary:

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A03551 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         3551--A
                                                                Cal. No. 138
 
                               2011-2012 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 25, 2011
                                       ___________
 
        Introduced by M. of A. GOTTFRIED, WEISENBERG, GALEF, PAULIN, CYMBROWITZ,
          LAVINE,  JAFFEE,  MONTESANO, MAGNARELLI -- Multi-Sponsored by -- M. of
          A.  BRENNAN,  BURLING,  CORWIN,  CROUCH,  MAGEE,  McENENY,  P. RIVERA,
          SAYWARD  --  read  once  and  referred  to  the Committee on Health --

          ordered to a third reading -- passed by Assembly and delivered to  the
          Senate,  recalled  from  the  Senate, vote reconsidered, bill amended,
          ordered reprinted, retaining its place on the order of third reading
 
        AN ACT to amend the public health  law,  in  relation  to  referrals  of
          patients for health or health related items or services
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraph (g) of subdivision 2  of  section  238-a  of  the
     2  public  health  law,  as  added  by  chapter 803 of the laws of 1992, is
     3  amended to read as follows:
     4    (g) [in the case of any other financial relationship which the  public
     5  health  council  determines  and  specifies  in  regulations, subject to

     6  approval by the commissioner, does not pose a substantial risk of  payor
     7  or  patient  abuse  in  relation  to patient benefits consistent, to the
     8  extent practicable, with  financial  relationships  specified  in  regu-
     9  lations  adopted  pursuant  to  federal  law applicable to reimbursement
    10  pursuant to title XVIII of the federal social  security  act  (medicare)
    11  for  clinical  laboratory  services  provided  to beneficiaries of title
    12  XVIII of the federal social security  act  (medicare)]  any  arrangement
    13  that, under the federal statutory prohibition on certain referrals codi-
    14  fied  at  42 U.S.C. 1395nn and regulations promulgated thereunder, would
    15  be an arrangement between a practitioner (or  immediate  family  member)

    16  and a health care provider that:
    17    (i) would not be a financial relationship if existing between a physi-
    18  cian  and an entity, as such terms are defined under such federal law or
    19  regulations; or
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02276-03-2
        A. 3551--A                          2
 
     1    (ii) would satisfy the requirements of an exception relating to finan-
     2  cial relationships provided under such federal  law  or  regulations  if
     3  existing  between  a  physician and an entity, as such terms are defined
     4  under such federal law or regulations.

     5    An  arrangement  shall not be excepted under this paragraph if it is a
     6  particular type of financial relationship that would pose a  substantial
     7  risk  of  payor  or  patient  abuse,  as determined and specified by the
     8  public health and health planning council  in  regulations,  subject  to
     9  approval by the commissioner.
    10    §  2.  Paragraph  (c)  of subdivision 6 of section 238-a of the public
    11  health law, as added by chapter 803 of the laws of 1992, is  amended  to
    12  read as follows:
    13    (c) provided further, however, that the following shall not constitute
    14  a referral by a referring practitioner:
    15    (i) a request by a practitioner for practitioners' services consisting
    16  solely of professional services to be furnished personally by that prac-
    17  titioner, or under that practitioner's supervision;

    18    (ii)  a  request  by  a pathologist for clinical diagnostic laboratory
    19  tests and  pathological  examination  services,  if  such  services  are
    20  furnished  by or under the supervision of such pathologist pursuant to a
    21  consultation requested by another practitioner; [and]
    22    (iii) a request by a  radiologist  for  diagnostic  x-ray  or  imaging
    23  services,  if such services are furnished by or under the supervision of
    24  such radiologist pursuant to a consultation requested by another practi-
    25  tioner[.]; and
    26    (iv) a referral for any services excepted under 42 U.S.C. § 1395nn and
    27  regulations promulgated thereunder, unless the public health and  health
    28  planning  council  determines  and  specifies in regulations, subject to
    29  approval by the commissioner, that a particular type of  referral  would

    30  pose a substantial risk of payor or patient abuse in relation to patient
    31  benefits.
    32    § 3. This act shall take effect immediately.