S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9522
 
                           I N  A S S E M B L Y
 
                             January 23, 2020
                                ___________
 
 Introduced  by  M. of A. PEOPLES-STOKES -- read once and referred to the
   Committee on Health
 
 AN ACT to amend the public health law and the executive law, in relation
   to HIV post-exposure prophylaxis and other health  care  services  for
   sexual  assault  victims;  and to amend a chapter of the laws of 2019,
   amending the public health law and the executive law relating  to  HIV
   post-exposure  prophylaxis  and  other health care services for sexual
   assault victims, as proposed in legislative bills  numbers  S.  2279-A
   and A. 1204-A in relation to the effectiveness thereof
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivision 1 of section 2805-i of the public  health  law,
 as  amended  by  section 1 of part HH of chapter 57 of the laws of 2018,
 paragraph (c) as amended by a chapter of the laws of 2019, amending  the
 public  health  law  and the executive law relating to HIV post-exposure
 prophylaxis and other health care services for sexual  assault  victims,
 as  proposed  in  legislative  bills numbers S. 2279-A and A. 1204-A, is
 amended to read as follows:
   1. Every hospital providing treatment to alleged victims of  a  sexual
 offense shall be responsible for:
   (a)  maintaining  sexual  offense evidence and the chain of custody as
 provided in subdivision two of this section;
   (b) INFORMING SEXUAL OFFENSE  VICTIMS  OF  THE  AVAILABILITY  OF  RAPE
 CRISIS  AND  LOCAL  VICTIM  ASSISTANCE  ORGANIZATIONS,  IF  ANY,  IN THE
 GEOGRAPHIC AREA SERVED BY THE HOSPITAL, AND contacting a rape crisis  or
 LOCAL  victim assistance organization[, if any, providing victim assist-
 ance to the geographic area served by that hospital]  to  establish  the
 coordination  of  non-medical  services  to  sexual  offense victims who
 request such coordination and services;
   (c) offering and making available appropriate HIV post-exposure treat-
 ment therapies; including a [full regimen] SEVEN DAY STARTER PACK of HIV
 post-exposure prophylaxis FOR A PERSON EIGHTEEN YEARS OF AGE  OR  OLDER,
 OR  THE  FULL REGIMEN OF HIV POST-EXPOSURE PROPHYLAXIS FOR A PERSON LESS
 THAN EIGHTEEN YEARS OF AGE, in cases where it has  been  determined,  in
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD04742-08-0

 A. 9522                             2
 
 accordance  with  guidelines  issued by the commissioner, that a signif-
 icant exposure to HIV  has  occurred,  AND  INFORMING  THE  VICTIM  THAT
 PAYMENT  ASSISTANCE  FOR SUCH THERAPIES AND OTHER CRIME RELATED EXPENSES
 MAY  BE  AVAILABLE  FROM  THE  OFFICE OF VICTIM SERVICES PURSUANT TO THE
 PROVISIONS OF ARTICLE TWENTY-TWO OF THE EXECUTIVE LAW. With the  consent
 of  the  victim of a sexual assault, the hospital emergency room depart-
 ment shall provide or arrange for an appointment for  medical  follow-up
 related to HIV post-exposure prophylaxis and other care as appropriate[,
 and  inform  the  victim  that  payment  assistance for such care may be
 available from the office of victim services pursuant to the  provisions
 of article twenty-two of the executive law]; and
   (d)  ensuring  sexual  assault  survivors  are  not  billed for sexual
 assault forensic exams and are notified orally and  in  writing  of  the
 option  to  decline  to provide private health insurance information and
 have the office of victim services reimburse the hospital for  the  exam
 pursuant  to  subdivision  thirteen of section six hundred thirty-one of
 the executive law.
   § 2. Subdivision 1 of section 201 of the public health law is  amended
 by adding a new paragraph (x) to read as follows:
   (X) PRODUCE AN ANNUAL REPORT ANALYZING THE COSTS RELATED TO THE SEXUAL
 ASSAULT EXAMINATION DIRECT REIMBURSEMENT PROGRAM AS CREATED UNDER SUBDI-
 VISION  THIRTEEN  OF SECTION SIX HUNDRED THIRTY-ONE OF THE EXECUTIVE LAW
 AND PROVIDE SUCH REPORT TO THE OFFICE OF VICTIM SERVICES  ON  OR  BEFORE
 SEPTEMBER  FIRST  OF  EACH  YEAR.  SUCH  REPORT SHALL BE PROVIDED TO THE
 GOVERNOR, TEMPORARY PRESIDENT OF THE  SENATE  AND  THE  SPEAKER  OF  THE
 ASSEMBLY.
   § 3. Subdivision 13 of section 631 of the executive law, as amended by
 a  chapter  of  the laws of 2019, amending the public health law and the
 executive law relating to HIV post-exposure prophylaxis and other health
 care services for sexual assault victims,  as  proposed  in  legislative
 bills numbers S.  2279-A and A. 1204-A, is amended to read as follows:
   13.  (A)  Notwithstanding  any  other provision of law, rule, or regu-
 lation to the contrary, when any New  York  state  accredited  hospital,
 accredited  sexual  assault  examiner  program,  or licensed health care
 provider furnishes services to any sexual  assault  survivor,  including
 but not limited to a health care forensic examination in accordance with
 the  sex  offense evidence collection protocol and standards established
 by the department of health,  such  hospital,  sexual  assault  examiner
 program,  or licensed healthcare provider shall provide such services to
 the person without charge  and  shall  bill  the  office  directly.  The
 office,  in consultation with the department of health, shall define the
 specific services to be covered by  the  sexual  assault  forensic  exam
 reimbursement  fee,  which  must  include at a minimum forensic examiner
 services, hospital or healthcare facility services related to the  exam,
 and ANY NECESSARY related laboratory tests [and necessary] OR pharmaceu-
 ticals;  including  but  not  limited  to  HIV post-exposure prophylaxis
 provided by a hospital emergency room at the time of the  forensic  rape
 examination  pursuant  to  paragraph  (c)  of subdivision one of section
 twenty-eight hundred five-i of the public health law. [Follow-up] FOR  A
 PERSON  EIGHTEEN  YEARS  OF  AGE  OR  OLDER, FOLLOW-UP HIV post-exposure
 prophylaxis costs shall CONTINUE  TO  be  [billed  by  the  health  care
 provider  to  the  office directly and] reimbursed [by the] ACCORDING TO
 ESTABLISHED office [directly] PROCEDURE.  The  office,  in  consultation
 with  the  department of health, shall also generate the necessary regu-
 lations and forms for the direct reimbursement procedure.

 A. 9522                             3
 
   (B) The rate  for  reimbursement  shall  be  the  amount  of  itemized
 charges,  TO  BE REIMBURSED AT THE MEDICAID RATE AND WHICH SHALL CUMULA-
 TIVELY not [exceeding] EXCEED  (1)  eight  hundred  dollars[,  provided,
 however,  the  office  shall,  in  consultation] FOR AN EXAM OF A SEXUAL
 ASSAULT  SURVIVOR  WHERE  NO  SEXUAL  OFFENSE EVIDENCE COLLECTION KIT IS
 USED; (2) ONE THOUSAND TWO HUNDRED DOLLARS  FOR  AN  EXAM  OF  A  SEXUAL
 ASSAULT SURVIVOR WHERE A SEXUAL OFFENSE EVIDENCE COLLECTION KIT IS USED;
 (3)  ONE  THOUSAND  FIVE HUNDRED DOLLARS FOR AN EXAM OF A SEXUAL ASSAULT
 SURVIVOR WHO IS EIGHTEEN YEARS OF AGE OR OLDER, WITH OR WITHOUT THE  USE
 OF A SEXUAL OFFENSE EVIDENCE COLLECTION KIT, AND WITH THE PROVISION OF A
 NECESSARY  HIV POST-EXPOSURE PROPHYLAXIS SEVEN DAY STARTER PACK; AND (4)
 TWO THOUSAND FIVE HUNDRED DOLLARS FOR AN EXAM OF A SEXUAL ASSAULT SURVI-
 VOR WHO IS LESS THAN EIGHTEEN YEARS OF AGE, WITH OR WITHOUT THE USE OF A
 SEXUAL OFFENSE EVIDENCE COLLECTION KIT, AND WITH THE  PROVISION  OF  THE
 FULL  REGIMEN  OF  NECESSARY  HIV  POST-EXPOSURE  PROPHYLAXIS  [with the
 department of health, annually review and determine if a higher rate for
 reimbursement for itemized charges exceeding eight  hundred  dollars  is
 feasible  and  appropriate  based  on  the  actual  cost of reimbursable
 expenses, and adjust such rate  for  reimbursement  accordingly].    The
 hospital,  sexual  assault  examiner  program,  or  licensed health care
 provider must accept this fee as payment in  full  for  these  specified
 services.  No  additional  billing  of the survivor for said services is
 permissible. A  sexual  assault  survivor  may  voluntarily  assign  any
 private  insurance  benefits  to  which  she  or  he is entitled for the
 healthcare forensic examination, in which case the hospital  or  health-
 care provider may not charge the office; provided, however, in the event
 the  sexual  assault survivor assigns any private health insurance bene-
 fit, such coverage shall not be subject to annual deductibles or coinsu-
 rance or balance  billing  by  the  hospital,  sexual  assault  examiner
 program  or  licensed  health  care provider. A hospital, sexual assault
 examiner program or licensed health care provider shall, at the time  of
 the  initial  visit,  request assignment of any private health insurance
 benefits to which the sexual assault survivor  is  entitled  on  a  form
 prescribed  by the office; provided, however, such sexual assault survi-
 vor shall be advised orally and in writing that he or she may decline to
 provide such information regarding private health insurance benefits  if
 he or she believes that the provision of such information would substan-
 tially  interfere with his or her personal privacy or safety and in such
 event, the sexual assault forensic exam fee shall be paid by the office.
 Such sexual assault survivor shall also be advised that  providing  such
 information  may  provide  additional  resources  to pay for services to
 other sexual assault victims.  SUCH SEXUAL ASSAULT SURVIVOR  SHALL  ALSO
 BE  ADVISED  THAT  THE  DIRECT REIMBURSEMENT PROGRAM ESTABLISHED BY THIS
 SUBDIVISION DOES NOT AUTOMATICALLY MAKE  THEM  ELIGIBLE  FOR  ANY  OTHER
 COMPENSATION  BENEFITS  AVAILABLE  FROM  THE  OFFICE  INCLUDING, BUT NOT
 LIMITED TO, REIMBURSEMENT FOR MENTAL HEALTH COUNSELING  EXPENSES,  RELO-
 CATION  EXPENSES, AND LOSS OF EARNINGS, AND THAT SUCH COMPENSATION BENE-
 FITS MAY ONLY BE MADE AVAILABLE TO THEM SHOULD THE SEXUAL ASSAULT SURVI-
 VOR OR OTHER PERSON ELIGIBLE TO FILE PURSUANT  TO  SECTION  SIX  HUNDRED
 TWENTY-FOUR  OF  THIS  ARTICLE, FILE A COMPENSATION APPLICATION WITH THE
 OFFICE. If he or she declines to provide such health insurance  informa-
 tion, he or she shall indicate such decision on the form provided by the
 hospital,  sexual  assault  examiner  program  or  licensed  health care
 provider, which form shall be prescribed by the office.
   § 4. Section 3 of a chapter of the laws of 2019, amending  the  public
 health  law  and the executive law relating to HIV post-exposure prophy-

 A. 9522                             4
 
 laxis and other health care services  for  sexual  assault  victims,  as
 proposed  in  legislative  bills  numbers  S.  2279-A  and A. 1204-A, is
 amended to read as follows:
   § 3. This act shall take effect on the one hundred eightieth day after
 it  shall  have  become  a law AND APPLY TO ALL CLAIMS FILED ON OR AFTER
 SUCH DATE; provided that  effective  immediately,  the  commissioner  of
 health  and  the  director  of  the office of victim services shall make
 regulations and take other action necessary to  implement  this  act  on
 such date.
   §  5.  This act shall take effect immediately, provided, however, that
 sections one, two and three of this act take effect on the same date and
 in the same manner as a chapter of the laws of 2019, amending the public
 health law and the executive law relating to HIV  post-exposure  prophy-
 laxis  and  other  health  care  services for sexual assault victims, as
 proposed in legislative bills numbers S. 2279-A  and  A.  1204-A,  takes
 effect.