Add §2803-bb, 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 health care facility a list of its policy-based exclusions and publish such information on the department's website.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A733A
SPONSOR: Rozic
 
TITLE OF BILL:
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
 
PURPOSE:
The purpose of this legislation is to ensure that individuals have
access to information about whether the hospital, or hospitals, in their
area provides the care they seek prior to admission and to identify
health care deserts in regions of the state.
 
SUMMARY OF PROVISIONS:
Section 1 of the legislation includes legislative findings explaining
the problem this legislation seeks to address and making clear that some
healthcare denials violate existing state and federal law.
Section 2 of the legislation requires the Department of Health to
collect a list of policy-based exclusions from each healthcare facility;
to publish a list of the healthcare facilities that have policy-based
exclusions, and the specific policy-based exclusions for each, on its
website; to update the website annually; and to ensure that the website
is readily understandable to patients, prospective patients, and members
of the public. In addition, this section requires the Department of
Health to provide to the Senate and Assembly, and publish on its
website, every four years a report regarding policy-based exclusions in
the state and the impact of such policy-based exclusions on patients'
ability to access quality, comprehensive, affordable care near their
residences and whether and how access to care varies by community, as
well as by race, ethnicity, sexual orientation, gender identity and
socioeconomic status, across the state. Finally, this section defines
policy-based exclusions.
Section 3 of the legislation requires that the statement regarding
patients' rights and responsibilities that healthcare facilities are
already required to provide to each patient include information about
policy-based exclusions, as well as a link to the Department's website.
This section also requires healthcare facilities websites to include a
link to the Department's website.
Sections 4 and 5 of the legislation require that the disclosure each
insurer provides to each prospective insured prior to enrollment
includes information about policy-based exclusions, as well as a link to
the Department's website.
Section 6 of the legislation makes clear that nothing in the bill shall
be construed to permit or authorize denials of care or discrimination in
the provision of health care or health insurance and that compliance
with the bill does not reduce or limit any liability for healthcare
facilities in connection with policy-based exclusions, including
violations of state or federal law.
Section 7 of the legislation is a severability clause. Section 8 sets
forth the effective date.
 
JUSTIFICATION:
Since 2003, more than 40 community hospitals in New York have closed.
As a result, large health care systems now control more than 70 percent
of acute hospital beds, and hospital mergers in New York continue apace.
Unfortunately, these large hospital systems sometimes remove categories
of care from local hospitals, leaving patients in regions of the state
without access to particular types of care, including some types of
emergency care. Too often, patients do not have the ability to determine
whether the Hospitals or healthcare facilities in their area provides
the care they seek, because information about how healthcare facilities'
restrictions impact options for care is too difficult to obtain. Worse
still, denials of care can lead to serious adverse health impacts that
jeopardize individuals' lives and wellbeing. And, some denials of care
violate state and federal law. It is incumbent on New York to identify
whether and where there are health care deserts in the state where
particular types of care are unavailable and to understand the impacts
of such gaps on communities and individuals statewide. It is equally
imperative to give prospective patients the tools they need to determine
whether the hospital, or healthcare facilities, in their area provides
the care they seek prior to admission. Access to this information is
lifesaving it permits patients to make informed decisions about where to
seek the health care they need.
 
LEGISLATIVE YITSTORY:
2022: A6334 (Rozic) - Health
2021: A6334 (Rozic) - Health
 
FISCAL IMPACT ON STATE:
To be determined.
 
EFFECTIVE DATE:
This act shall take effect one year after it shall have become a law.
Effective immediately, the addition, amendment, and/or repeal of any
rule or regulation necessary for the implementation of this act on its
effective date are authorized to be made and completed on or before such
effective date.
STATE OF NEW YORK
________________________________________________________________________
733--A
2023-2024 Regular Sessions
IN ASSEMBLY
January 11, 2023
___________
Introduced by M. of A. ROZIC, REYES, STIRPE, CARROLL, SIMON,
GONZALEZ-ROJAS, FAHY, HEVESI, DINOWITZ, SEAWRIGHT, JACOBSON, AUBRY,
WALLACE, KELLES, STECK, GLICK, L. ROSENTHAL, BARRETT, OTIS, SOLAGES,
GALLAGHER, ARDILA, RAGA -- read once and referred to the Committee on
Health -- reported and referred to the Committee on Ways and Means --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee
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 health care facilities in their area provide the care
11 they seek, because information about how facility restrictions impact
12 options for care is too difficult to obtain.
13 The legislature also finds that denials and poor access to care can
14 lead to serious adverse health impacts that jeopardize individuals'
15 lives and wellbeing and that New York needs to understand health care
16 gaps and their impact statewide.
17 Finally, the legislature finds that some denials of care violate state
18 and federal law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02598-05-3
A. 733--A 2
1 § 2. The public health law is amended by adding a new section 2803-bb
2 to read as follows:
3 § 2803-bb. Policy-based exclusions. 1. Definitions. As used in this
4 section: (a) "Health care facility" means a general hospital as defined
5 in subdivision ten of section twenty-eight hundred one of this article.
6 (b) "Policy-based exclusions" means any criteria, rules, or policies,
7 whether written or unwritten, formally adopted or drafted, endorsed by
8 the health care facility or followed from an external source, that
9 restrict medical personnel at that health care facility from providing
10 types of care that the medical personnel is licensed to provide and that
11 the health care facility is licensed to provide or that restrict the
12 provision of care to categories of patients on the basis of any charac-
13 teristic protected under section two hundred ninety-six of the executive
14 law that the health care facility is licensed to provide. "Policy-based
15 exclusions" shall include, but not be limited to, objections under
16 section twenty-nine hundred eighty-four or twenty-nine hundred ninety-
17 four-n of this chapter. "Policy-based exclusions" shall not include
18 restrictions based on lack of equipment, available bed space in the
19 facility, or insurance denial.
20 2. (a) The commissioner shall collect from each health care facility a
21 list of its policy-based exclusions on an annual basis.
22 (b) The commissioner shall publish on the department's website a
23 current list of all of the health care facilities with policy-based
24 exclusions and the policy-based exclusions for each health care facility
25 not later than six months after the effective date of this section. The
26 commissioner shall update this list on an annual basis. The commission-
27 er, in consultation with experts in health care access, patient advoca-
28 cy, types of health care that are frequently inaccessible, and hospital
29 administration shall promulgate rules and regulations creating standard-
30 ized language for this list to ensure that it is readily understandable
31 to patients, prospective patients, and members of the public.
32 (c) Within one year of the effective date of this section and every
33 five years thereafter, the commissioner shall submit a report to the
34 temporary president of the senate and the speaker of the assembly
35 regarding policy-based exclusions in the state and the impact of such
36 policy-based exclusions on patients' ability to access quality, compre-
37 hensive, affordable care near their residences and whether and how
38 access to care varies by community, as well as by race, gender, ethnici-
39 ty, sexual orientation, gender identity or gender expression, and
40 socioeconomic status, across the state. The report shall be made public-
41 ly available on the department's website.
42 (d) The commissioner shall evaluate and ensure community awareness of
43 policy-based exclusions and the website required pursuant to paragraph
44 (b) of this subdivision.
45 (e) The commissioner may promulgate additional rules and regulations
46 as may be necessary and proper to carry out effectively the provisions
47 of this section.
48 § 3. Subdivision 1 of section 2803 of the public health law is amended
49 by adding a new paragraph (m) to read as follows:
50 (m) The statement regarding patient rights and responsibilities,
51 required pursuant to paragraph (g) of this subdivision, shall include a
52 link to the section of the department's website required in paragraph
53 (b) of subdivision two of section twenty-eight hundred three-bb of this
54 article. Each health care facility's website shall prominently link to
55 the department's website required in paragraph (b) of subdivision two of
56 section twenty-eight hundred three-bb of this article. The commissioner
A. 733--A 3
1 may promulgate rules and regulations as may be necessary and proper to
2 carry out effectively the provisions of this paragraph.
3 § 4. Subsection (a) of section 3217-a of the insurance law is amended
4 by adding a new paragraph 22 to read as follows:
5 (22)(A) an explanation of policy-based exclusions and the fact that
6 some health care facilities may have policy-based exclusions, along with
7 a link to the website required pursuant to subdivision two of section
8 twenty-eight hundred three-bb of the public health law.
9 (B) for the purposes of this paragraph, "policy-based exclusions"
10 shall have the same meaning as in section twenty-eight hundred three-bb
11 of the public health law.
12 § 5. Subsection (a) of section 4324 of the insurance law is amended by
13 adding a new paragraph 23 to read as follows:
14 (23)(A) an explanation of policy-based exclusions and the fact that
15 some health care facilities may have policy-based exclusions, along with
16 a link to the website required pursuant to subdivision two of section
17 twenty-eight hundred three-bb of the public health law.
18 (B) for the purposes of this paragraph, "policy-based exclusions"
19 shall have the same meaning as in section twenty-eight hundred three-bb
20 of the public health law.
21 § 6. Nothing in this act shall be construed to permit or authorize
22 denials of care or discrimination in the provision of health care or
23 health insurance. Compliance with this act does not reduce or limit any
24 liability for health care facilities in connection with policy-based
25 exclusions, including violations of state or federal law.
26 § 7. Severability clause. If any provision of this act, or any appli-
27 cation of any provision of this act, is held to be invalid, or ruled to
28 violate or be inconsistent with any applicable federal law or regu-
29 lation, that shall not affect the validity or effectiveness of any other
30 provision of this act, or of any other application of any provision of
31 this act. It is hereby declared to be the intent of the legislature
32 that this act would have been enacted even if such invalid provisions
33 had not been included herein.
34 § 8. This act shall take effect one year after it shall have become a
35 law. Effective immediately, the addition, amendment and/or repeal of any
36 rule or regulation necessary for the implementation of this act on its
37 effective date are authorized to be made and completed on or before such
38 effective date.