BIAGGI, BRESLIN, HARCKHAM, HOYLMAN, MAY, MYRIE, REICHLIN-MELNICK, RIVERA, SALAZAR, SEPULVEDA
MLTSPNSR
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 general hospital a list of its policy-based exclusions and publish such information on the department's website.
STATE OF NEW YORK
________________________________________________________________________
5400
2021-2022 Regular Sessions
IN SENATE
March 3, 2021
___________
Introduced by Sen. HINCHEY -- read twice and ordered printed, and when
printed to be committed to the Committee on Health
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 the hospital, or hospitals, in their area provides the
11 care they seek, because information about how hospitals' restrictions
12 impact options for care is too difficult to obtain.
13 The legislature also finds that denials of care can lead to serious
14 adverse health impacts that jeopardize individuals' lives and wellbeing
15 and that New York needs to understand health care gaps and their impact
16 statewide.
17 Finally, the legislature finds that some denials of care violate state
18 and federal law.
19 § 2. Section 2803 of the public health law is amended by adding a new
20 subdivision 13 to read as follows:
21 13. (a) The commissioner or his or her designee shall collect from
22 each general hospital a list of its policy-based exclusions on an annual
23 basis.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09581-01-1
S. 5400 2
1 (b) The commissioner or his or her designee shall publish on the
2 department's website a current list of all of the general hospitals with
3 policy-based exclusions and the policy-based exclusions for each general
4 hospital not later than six months after the effective date of this
5 subdivision. The commissioner or his or her designee shall update this
6 list on an annual basis. The commissioner, in consultation with experts
7 in health care access, patient advocacy, types of health care that are
8 frequently inaccessible, and hospital administration shall promulgate
9 rules and regulations creating standardized language for this list to
10 ensure that it is readily understandable to patients, prospective
11 patients, and members of the public.
12 (c) Within one year of the effective date of this subdivision and
13 every four years thereafter, the commissioner shall submit a report to
14 the temporary president of the senate and the speaker of the assembly
15 regarding policy-based exclusions in the state and the impact of such
16 policy-based exclusions on patients' ability to access quality, compre-
17 hensive, affordable care near their residences and whether and how
18 access to care varies by community, as well as by race, ethnicity, and
19 socioeconomic status, across the state. The report shall be made public-
20 ly available on the department's website.
21 (d) The commissioner or his or her designee shall evaluate and ensure
22 community awareness of policy-based exclusions and the website required
23 pursuant to paragraph (b) of this subdivision.
24 (e) For the purposes of this subdivision, "policy-based exclusions"
25 shall mean non-clinical criteria, rules, or policies, whether written or
26 unwritten, that restrict medical personnel at that general hospital from
27 providing types of care that the medical personnel are licensed to
28 provide and that the general hospital is licensed to provide or that
29 restrict the provision of care to categories of patients on the basis of
30 any characteristic protected under section two hundred ninety-six of the
31 executive law that the general hospital is licensed to provide. "Poli-
32 cy-based exclusions" shall include, but not be limited to, objections
33 under section twenty-nine hundred ninety-four-n or twenty-nine hundred
34 eighty-four of this chapter and 10 NYCCRR § 405.9(b)(10). "Policy-based
35 exclusions" shall not include restrictions based on lack of equipment,
36 available bed space in the facility, or insurance denial.
37 (f) The commissioner may promulgate additional rules and regulations
38 as may be necessary and proper to carry out effectively the provisions
39 of this subdivision.
40 § 3. Subdivision 1 of section 2803 of the public health law is amended
41 by adding a new paragraph (m) to read as follows:
42 (m) The statement regarding patient rights and responsibilities,
43 required pursuant to paragraph (g) of this subdivision, shall include a
44 link to the section of the department's website required in paragraph
45 (b) of subdivision twelve of this section. Each general hospital's
46 website shall prominently link to the department's website required in
47 paragraph (b) of subdivision twelve of this section. The commissioner
48 may promulgate rules and regulations as may be necessary and proper to
49 carry out effectively the provisions of this paragraph.
50 § 4. Subsection (a) of section 3217-a of the insurance law is amended
51 by adding a new paragraph 22 to read as follows:
52 (22)(A) an explanation of policy-based exclusions and the fact that
53 some general hospitals may have policy-based exclusions, along with a
54 link to the website required pursuant to subdivision twelve of section
55 twenty-eight hundred three of the public health law.
S. 5400 3
1 (B) for the purposes of this paragraph, "policy-based exclusions"
2 shall mean non-clinical criteria, rules, or policies, whether written or
3 unwritten, that restrict medical personnel at that general hospital from
4 providing types of care that the medical personnel are licensed to
5 provide and that the general hospital is licensed to provide or that
6 restrict the provision of care to categories of patients on the basis of
7 any characteristic protected under section two hundred ninety-six of the
8 executive law that the general hospital is licensed to provide. "Poli-
9 cy-based exclusions" shall include, but not be limited to, objections
10 under section twenty-nine hundred ninety-four-n or twenty-nine hundred
11 eighty-four of the public health law and 10 NYCCRR § 405.9(b)(10).
12 "Policy-based exclusions" shall not include restrictions based on lack
13 of equipment, available bed space in the facility, or insurance denial.
14 § 5. Subsection (a) of section 4324 of the insurance law is amended by
15 adding a new paragraph 23 to read as follows:
16 (23)(A) an explanation of policy-based exclusions and the fact that
17 some general hospitals may have policy-based exclusions, along with a
18 link to the website required pursuant to subdivision twelve of section
19 twenty-eight hundred three of the public health law.
20 (B) for the purposes of this paragraph, "policy-based exclusions"
21 shall mean non-clinical criteria, rules, or policies, whether written or
22 unwritten, that restrict medical personnel at that general hospital from
23 providing types of care that the medical personnel are licensed to
24 provide and that the general hospital is licensed to provide or that
25 restrict the provision of care to categories of patients on the basis of
26 any characteristic protected under section two hundred ninety-six of the
27 executive law that the general hospital is licensed to provide. "Poli-
28 cy-based exclusions" shall include, but not be limited to, objections
29 under section twenty-nine hundred ninety-four-n or twenty-nine hundred
30 eighty-four of the public health law and 10 NYCCRR § 405.9(b)(10).
31 "Policy-based exclusions" shall not include restrictions based on lack
32 of equipment, available bed space in the facility, or insurance denial.
33 § 6. Nothing in this act shall be construed to permit or authorize
34 denials of care or discrimination in the provision of health care or
35 health insurance. Compliance with this act does not reduce or limit any
36 liability for general hospitals in connection with policy-based exclu-
37 sions, including violations of state or federal law.
38 § 7. Severability clause. If any clause, sentence, paragraph, subdivi-
39 sion, section or part of this act shall be adjudged by any court of
40 competent jurisdiction to be invalid, such judgment shall not affect,
41 impair, or invalidate the remainder thereof, but shall be confined in
42 its operation to the clause, sentence, paragraph, subdivision, section
43 or part thereof directly involved in the controversy in which such judg-
44 ment shall have been rendered. It is hereby declared to be the intent of
45 the legislature that this act would have been enacted even if such
46 invalid provisions had not been included herein.
47 § 8. This act shall take effect six months after it shall have become
48 a law. Effective immediately, the addition, amendment and/or repeal of
49 any rule or regulation necessary for the implementation of this act on
50 its effective date are authorized to be made and completed on or before
51 such effective date.
