NY State Senate Bill 2019-S4811

Senate Bill S4811

2019-2020 Legislative Session

Establishes an office of the state medical fund ombudsman and a medical indemnity fund advisory panel

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2020	referred to health
Apr 09, 2019	reported and committed to finance
Mar 26, 2019	referred to health

Votes

- Apr 9, 2019 - Health Committee Vote
  S4811
  
  13
  
  Aye
  
  0
  
  Nay
  
  1
  
  Aye with Reservations
  
  0
  
  Absent
  
  1
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: Apr 9, 2019
      
      aye (13)
      
      Antonacci
      
      Benjamin
      
      Biaggi
      
      Carlucci
      
      Hoylman-Sigal
      
      Jacobs
      
      Kaminsky
      
      Metzger
      
      Montgomery
      
      Ritchie
      
      Rivera
      
      Salazar
      
      Stavisky
      
      aye wr (1)
      
      Little
      
      excused (1)
      
      Gallivan

co-Sponsors

2019-S4811 (ACTIVE) - Details

See Assembly Version of this Bill:: A2347
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add §§2999-k & 2999-l, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2017-2018: S6948, A9018
2021-2022: S2527, A4985
2023-2024: S5958, A9994

2019-S4811 (ACTIVE) - Summary

Establishes an office of the state medical indemnity fund ombudsman and a medical indemnity fund advisory panel to advocate for, assist and represent the interests of qualified plaintiffs.

2019-S4811 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S4811

SPONSOR: RIVERA
 
PURPOSE OR GENERAL IDEA OF BILL:

This bill would establish a Medical Indemnity Fund Ombudsman and Advi-
sory Panel.

 
SUMMARY OF PROVISIONS:

Section one of the bill adds Public Health Law § 2999-k establishing a
Medical Indemnity Fund Ombudsman for the purpose of receiving and
resolving complaints, and informing qualified plaintiffs and their
representatives of the services, supplies and modifications they are
entitled. This section also adds a Public Health Law § 2999-1 to create
the Medical Indemnity Fund Advisory Panel for the purpose of bringing
together stakeholders to make recommendations on way to improve the
functioning of the Medical Indemnity Fund.

Section 2 is the effective date.

JUSTIFICATION:

The Medical Indemnity Fund (MIF) was created in 2011 to provide a fund-
ing source for future health care costs associated with birth-related
neurological injuries and to reduce medical malpractice insurance premi-
ums. MIF enrollees have either settled or won a judgment in a malprac-
tice action. Rather than receiving damages for future health care costs,
the law requires these children be enrolled in the MIF to cover said
costs. A few years after implementation, issues began to arise regarding
reimbursement rates, access to care, coverage and appeals within the
fund. Accordingly, the Legislature enacted Ch.  517 of 2016 to address
these concerns. Amendments to this Chapter were negotiated (Ch. 4 of
2017) at the behest of the Executive. The final result was legislation
that: clarified qualifying health care costs could not be denied on the
grounds they may incidentally benefit others in the household; increased
reimbursement rates until December 21, 2019; and required a report to be
issued by the Executive to the Legislature on or before April 1, 2017
detailing the financial condition of the MIF.  The purpose of this
report was to educate the Legislature on how to proceed with any future
amendments to the MIF. On June 12, 2017, two days prior the Senate
roundtable on the MIF, said report was released.

At the June 14, 2017 Senate roundtable parents, attorneys and providers
recounted their experiences and challenges with the MIF. One parent, who
is a lawyer by trade, testified to the need for a patient advocate to
educate and assist parents trying to navigate the MIF.  Additionally,
many concerns were raised regarding the potential disruption that may be
caused by the transition to a new administrator scheduled to occur a few
months later. While all were assured by the Departments of Health and
Financial Services that there was a plan in the works to ensure a smooth
transition, months later complaints began coming in. The new administra-
tor was not reimbursing claims, families were unable to obtain supplies,
claims were being paid cents on the dollar, families were forced to
obtain new providers, and the new administrator was seemingly applying
new policy guidelines that were unknown to providers, enrollees and
their families. The families with children enrolled in the MIF struggle
with enough challenges to obtain quality care for their child, they
should not have to deal with administrative hurdles and changing poli-
cies in order to obtain services and supplies needed to keep their child
alive. This legislation establishes an ombudsman to serve as a much
needed advocate for the MIF families to ensure they are educated and
able to access the services, supplies and modifications they are enti-
tled.

Also raised at the roundtable by many was the need to continue conversa-
tions, to take a deeper look into the data, and to have an ongoing proc-
ess to address concerns regarding the functioning of the MIF.  Much like
the workgroup proposed in the original Chapter from 2016, this legis-
lation establishes a MIF stakeholder advisory panel that will meet at a
minimum of twice annually to discuss ongoing issues and make recommenda-
tions.

Together these protections will help ensure the MIF is functioning as
originally intended and that families are getting the care they are
entitled and need for their children.

 
LEGISLATIVE HISTORY:

2017-18: S6948A (Hannon) passed Senate

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect 90th day after it shall have become law;
provided that 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 and directed to be made
and completed on or before such effective date.

2019-S4811 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4811
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                              March 26, 2019
                                ___________
 
 Introduced  by  Sens. RIVERA, KRUEGER -- read twice and ordered printed,
   and when printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law, in relation  to  establishing  an
   office  of  the  state  medical indemnity fund ombudsman and a medical
   indemnity fund advisory panel

   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 two new sections
 2999-k and 2999-l to read as follows:
   §  2999-K. MEDICAL INDEMNITY FUND OMBUDSMAN. 1. THERE IS HEREBY ESTAB-
 LISHED AN OFFICE OF THE STATE MEDICAL INDEMNITY FUND OMBUDSMAN  FOR  THE
 PURPOSE OF RECEIVING AND RESOLVING COMPLAINTS AFFECTING QUALIFIED PLAIN-
 TIFFS,  WHERE  APPROPRIATE, REFERRING SUCH COMPLAINTS TO THE APPROPRIATE
 AGENCIES AND ACTING IN CONCERT WITH SUCH AGENCIES. THE COMMISSIONER,  IN
 CONSULTATION  WITH  THE  SUPERINTENDENT  OF  FINANCIAL  SERVICES,  SHALL
 APPOINT A FULL-TIME MEDICAL INDEMNITY FUND OMBUDSMAN TO  ADMINISTER  AND
 SUPERVISE  THE OFFICE OF THE STATE MEDICAL INDEMNITY FUND OMBUDSMAN. THE
 MEDICAL INDEMNITY FUND OMBUDSMAN SHALL BE SELECTED FROM  AMONG  INDIVID-
 UALS WITH EXPERTISE AND EXPERIENCE IN THE FIELD OF NEUROLOGICAL INJURIES
 AND  ADVOCACY, AND WITH SUCH OTHER QUALIFICATIONS AS SHALL BE DETERMINED
 BY THE COMMISSIONER, IN CONSULTATION WITH THE SUPERINTENDENT  OF  FINAN-
 CIAL SERVICES. SUCH OMBUDSMAN MAY, WITH APPROVAL OF THE COMMISSIONER, IN
 CONSULTATION  WITH THE SUPERINTENDENT OF FINANCIAL SERVICES, APPOINT ONE
 OR MORE AUTHORIZED DEPUTIES TO ASSIST IN HIS OR HER DUTIES  PURSUANT  TO
 THIS  SECTION;  PROVIDED,  HOWEVER,  THAT  NO SUCH DEPUTY SHALL HAVE ANY
 CONFLICT OF INTEREST, OR BE EMPLOYED BY THE FUND ADMINISTRATOR OR  OTHER
 PARTY INVOLVED IN THE MANAGEMENT OF THE FUND. THE MEDICAL INDEMNITY FUND
 OMBUDSMAN SHALL, PERSONALLY OR THROUGH AUTHORIZED DEPUTIES:
   (A)  IDENTIFY,  INVESTIGATE AND RESOLVE COMPLAINTS THAT ARE MADE BY OR
 ON BEHALF OF QUALIFIED PLAINTIFFS, AND THAT RELATE TO ACTIONS, INACTIONS
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05225-01-9

 S. 4811                             2
 
 OR DECISIONS THAT MAY ADVERSELY AFFECT THE HEALTH,  SAFETY,  WELFARE  OR
 RIGHTS OF QUALIFIED PLAINTIFFS;
   (B)  PROVIDE  SERVICES TO ASSIST QUALIFIED PLAINTIFFS, OR THEIR REPRE-
 SENTATIVES, IN NAVIGATING THE FUND AND UNDERSTANDING  THE  FUND'S  REGU-
 LATIONS, GUIDELINES AND PROCEDURES;
   (C)  INFORM  QUALIFIED  PLAINTIFFS, OR THEIR REPRESENTATIVES, OF THEIR
 RIGHTS AND MEANS OF OBTAINING THE SERVICES, SUPPLIES  AND  MODIFICATIONS
 TO WHICH THEY ARE ENTITLED;
   (D)  ANALYZE  AND  MONITOR  IMPLEMENTATION OF THE LAWS AND REGULATIONS
 RELATING TO THE FUND; AND
   (E) CARRY OUT OTHER SUCH ACTIVITIES AS THE COMMISSIONER, IN  CONSULTA-
 TION  WITH  THE  SUPERINTENDENT  OF  FINANCIAL SERVICES, SHALL DETERMINE
 APPROPRIATE.
   2. NEITHER THE MEDICAL INDEMNITY FUND OMBUDSMAN, NOR ANY OF HIS OR HER
 DEPUTIES SHALL DISCLOSE TO ANY PERSON OUTSIDE THE OFFICE  OF  THE  STATE
 MEDICAL  INDEMNITY FUND OMBUDSMAN ANY INFORMATION OBTAINED FROM A QUALI-
 FIED PLAINTIFF'S RECORDS WITHOUT THE CONSENT OF THE QUALIFIED  PLAINTIFF
 OR HIS OR HER REPRESENTATIVE.
   3. WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS SECTION, AND ANNUALLY
 THEREAFTER,  THE  MEDICAL  INDEMNITY  FUND OMBUDSMAN SHALL SUBMIT TO THE
 COMMISSIONER, THE SUPERINTENDENT OF FINANCIAL SERVICES, THE  SPEAKER  OF
 THE  ASSEMBLY  AND THE TEMPORARY PRESIDENT OF THE SENATE, A REPORT WHICH
 SHALL INCLUDE, BUT NOT BE LIMITED TO, A DETAILED SUMMARY OF  THE  ACTIV-
 ITIES  OF THE OFFICE OF THE STATE MEDICAL INDEMNITY FUND OMBUDSMAN, DATA
 REGARDING THE COMPLAINTS AND ISSUES WITHIN THE FUND, THE PROCESS USED IN
 RESOLVING ISSUES, AND  RECOMMENDATIONS  FOR  LEGISLATIVE  OR  REGULATORY
 AMENDMENTS TO IMPROVE THE FUND.
   §  2999-L.  MEDICAL  INDEMNITY  FUND  ADVISORY  PANEL. THERE IS HEREBY
 ESTABLISHED AN ADVISORY PANEL TO BE COMPRISED OF THE  COMMISSIONER,  THE
 SUPERINTENDENT  OF FINANCIAL SERVICES, QUALIFIED PLAINTIFFS OR REPRESEN-
 TATIVES OF QUALIFIED PLAINTIFFS, PHYSICIANS,  MEDICAL  SUPPLIERS,  ADVO-
 CATES  AND  OTHER  INTERESTED  PARTIES.  THE  ADVISORY  PANEL  SHALL  BE
 CO-CHAIRED BY THE  COMMISSIONER  AND  THE  SUPERINTENDENT  OF  FINANCIAL
 SERVICES, AND SHALL BE COMPOSED OF NOT LESS THAN NINE ADDITIONAL MEMBERS
 APPOINTED  BY  THE GOVERNOR, OF WHICH TWO SHALL BE APPOINTED UPON RECOM-
 MENDATION OF THE TEMPORARY PRESIDENT OF THE  SENATE  AND  TWO  SHALL  BE
 APPOINTED  UPON  THE  RECOMMENDATION OF THE SPEAKER OF THE ASSEMBLY. THE
 ADVISORY PANEL SHALL MEET BIANNUALLY, WITH THE FIRST  MEETING  OCCURRING
 WITHIN ONE HUNDRED EIGHTY DAYS OF THE EFFECTIVE DATE OF THIS SECTION, TO
 DISCUSS THE FUNCTIONING OF THE FUND AND ANY RELEVANT ISSUES. THE COMMIS-
 SIONER  AND  THE SUPERINTENDENT OF FINANCIAL SERVICES SHALL CONSIDER THE
 INPUT AND COMMENTS OF THE ADVISORY PANEL IN DRAFTING AND AMENDING  REGU-
 LATIONS, GUIDELINES OR POLICIES PERTAINING TO THE FUND ADMINISTRATION.
   §  2.  This  act shall take effect on the ninetieth day 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.

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Senate Bill S4811

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Sponsored By

Gustavo Rivera