S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    543
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced by M. of A. CAHILL -- read once and referred to the Committee
   on Health
 
 AN  ACT  to  amend  the  public  health law, in relation to convening an
   office-based  surgery  workgroup  to  make  recommendations  regarding
   appropriate reforms or policy changes necessary and in the best inter-
   est of the public
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The public health law is amended by adding  a  new  section
 230-e to read as follows:
   §  230-E.  OFFICE-BASED  SURGERY WORKGROUP. 1. AN OFFICE-BASED SURGERY
 WORKGROUP SHALL BE CONVENED AND SHALL CONSIST OF NINE MEMBERS  APPOINTED
 BY THE GOVERNOR. TWO MEMBERS SHALL BE APPOINTED ON THE RECOMMENDATION OF
 THE  SPEAKER  OF  THE ASSEMBLY AND TWO MEMBERS SHALL BE APPOINTED ON THE
 RECOMMENDATION OF THE  TEMPORARY  PRESIDENT  OF  THE  SENATE  AND  SHALL
 CONSIST OF TWO REPRESENTATIVES OF THE OFFICE-BASED SURGERY INDUSTRY, ONE
 REPRESENTATIVE  OF HEALTH PLANS, ONE REPRESENTATIVE OF THE ACCREDITATION
 AGENCIES, ONE REPRESENTATIVE OF A STATEWIDE SOCIETY REPRESENTING  PHYSI-
 CIANS AND TWO CONSUMERS AND SHALL BE CO-CHAIRED BY THE SUPERINTENDENT OF
 FINANCIAL  SERVICES  AND  THE  COMMISSIONER. SUCH REPRESENTATIVES OF THE
 WORKGROUP MUST REPRESENT DIFFERENT REGIONS OF  THE  STATE.  THE  MEMBERS
 SHALL  RECEIVE  NO  COMPENSATION FOR THEIR SERVICES BUT SHALL BE ALLOWED
 THEIR ACTUAL AND NECESSARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR
 DUTIES.
   2. THE WORKGROUP SHALL REVIEW  THE  HISTORY  OF  OFFICE-BASED  SURGERY
 SINCE  ENACTMENT  OF ACCREDITATION REQUIREMENTS FOR OFFICE-BASED SURGERY
 ENTITIES PURSUANT TO SECTION TWO HUNDRED THIRTY-D OF THIS TITLE AND  ANY
 IMPACTS  INCLUDING  TRENDS, UPWARDS OR DOWNWARDS, IN SIZE, SPECIALTY AND
 GEOGRAPHIC DISTRIBUTION OF OFFICE-BASED SURGERY  PRACTICES  AND  COMPAR-
 ISONS  WITH  OTHER  OUT-PATIENT  SURGICAL SETTINGS ESPECIALLY RELATED TO
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD03126-01-9

 A. 543                              2
 
 PATIENT ACCESS, SAFETY AND RATES OF REIMBURSEMENT PAID BY HEALTH  PLANS.
 BASED  ON THIS REVIEW, SUCH WORKGROUP SHALL MAKE RECOMMENDATIONS REGARD-
 ING APPROPRIATE REFORMS OR POLICY CHANGES  NECESSARY  AND  IN  THE  BEST
 INTEREST OF THE PUBLIC AND CONSIDERING THE FOLLOWING FACTORS:
   (A)  CURRENT SCIENTIFIC OR MEDICAL RESEARCH DIRECTLY EXAMINING OFFICE-
 BASED SURGERY AND PATIENT OUTCOMES;
   (B) TRENDS IN ACCESS TO OUT-PATIENT SURGICAL CARE;
   (C) TRENDS IN REIMBURSEMENT RATES FOR OUT-PATIENT SURGICAL CARE ACROSS
 ALL SETTINGS AND THE ACTUAL COSTS OF OUT-PATIENT SURGICAL CARE;
   (D) REGIONAL DIFFERENCES REGARDING ACCESS AND COSTS;
   (E) THE IMPACT RATES OF REIMBURSEMENT ACROSS SETTINGS HAVE ON  CONSUM-
 ERS WHO ACCESS OUT-PATIENT SURGERY SERVICES;
   (F)  THE  IMPACT RATES OF REIMBURSEMENT ACROSS SETTINGS HAVE ON HEALTH
 PLAN PREMIUM COSTS;
   (G) PATIENT CLAIMS DATA FROM ALL HEALTH PLANS BOTH PUBLIC AND  PRIVATE
 AS  WELL  AS CHARGE DATA FROM MEDICAL PROFESSIONALS AND HOSPITALS AVAIL-
 ABLE THROUGH THE ALL PAYER DATABASE  AND  OFFICE-BASED  SURGERY  RELATED
 DATA  REQUIRED  PURSUANT  TO SECTION TWO HUNDRED THIRTY-D OF THIS TITLE;
 AND
   (H) OTHER ISSUES DEEMED APPROPRIATE BY MEMBERS OF  THE  WORKGROUP  AND
 EITHER THE SUPERINTENDENT OF FINANCIAL SERVICES OR THE COMMISSIONER.
   3.  THE WORKGROUP SHALL REVIEW THE AVAILABILITY OF OUT-PATIENT SURGERY
 SERVICES IN TERMS OF PATIENT ACCESS AND COST BY REGION OF THE STATE  AND
 MAKE RECOMMENDATIONS TAKING INTO CONSIDERATION THE FOLLOWING FACTORS:
   (A)  THE  EXTENT  TO  WHICH  OFFICE-BASED SURGERY IS AVAILABLE IN EACH
 REGION IN THIS STATE;
   (B) THE EXTENT TO WHICH AND DIVERSITY OF SPECIALTIES  IN  OFFICE-BASED
 SURGERY  IS  AVAILABLE IN EVERY REGION IN THIS STATE, INCLUDING THE MOST
 COMMON SPECIALTIES AND SUBSPECIALTY SERVICES; AND
   (C) OTHER ISSUES DEEMED APPROPRIATE BY THE MEMBERS  OF  THE  WORKGROUP
 AND EITHER THE SUPERINTENDENT OF FINANCIAL SERVICES OR THE COMMISSIONER.
   4.  THE  WORKGROUP  SHALL REPORT ITS FINDINGS AND MAKE RECOMMENDATIONS
 FOR LEGISLATION AND REGULATIONS TO THE  GOVERNOR,  THE  SPEAKER  OF  THE
 ASSEMBLY,  THE  SENATE  MAJORITY LEADER, THE CHAIRS OF THE INSURANCE AND
 HEALTH COMMITTEES IN BOTH THE ASSEMBLY AND THE SENATE,  AND  THE  SUPER-
 INTENDENT  OF FINANCIAL SERVICES NO LATER THAN APRIL FIRST, TWO THOUSAND
 TWENTY.
   § 2. This act shall take effect immediately.