S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    733
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             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 -- read
   once and referred 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:
 
   Section 1. Legislative findings. The legislature finds that since 2003
 more than 40 community hospitals in New York state have closed.
   The legislature additionally  finds  that  as  a  result  of  hospital
 consolidation,  large  health  care  systems  now  control  more than 70
 percent of acute hospital beds in the state and that these systems some-
 times 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.
   The legislature further finds that patients do not have the ability to
 determine whether the hospital, or hospitals, in their area provides the
 care they seek, because information about  how  hospitals'  restrictions
 impact options for care is too difficult to obtain.
   The  legislature  also  finds that denials of care can lead to serious
 adverse health impacts that jeopardize individuals' lives and  wellbeing
 and  that New York needs to understand health care gaps and their impact
 statewide.
   Finally, the legislature finds that some denials of care violate state
 and federal law.
   § 2. Section 2803 of the public health law is amended by adding a  new
 subdivision 14 to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02598-01-3
 A. 733                              2
 
              

   14.  (A)  THE  COMMISSIONER  OR HIS OR HER DESIGNEE SHALL COLLECT FROM
 EACH GENERAL HOSPITAL A LIST OF ITS POLICY-BASED EXCLUSIONS ON AN ANNUAL
 BASIS.
   (B)  THE  COMMISSIONER  OR  HIS  OR  HER DESIGNEE SHALL PUBLISH ON THE
 DEPARTMENT'S WEBSITE A CURRENT LIST OF ALL OF THE GENERAL HOSPITALS WITH
 POLICY-BASED EXCLUSIONS AND THE POLICY-BASED EXCLUSIONS FOR EACH GENERAL
 HOSPITAL NOT LATER THAN SIX MONTHS AFTER  THE  EFFECTIVE  DATE  OF  THIS
 SUBDIVISION.  THE  COMMISSIONER OR HIS OR HER DESIGNEE SHALL UPDATE THIS
 LIST ON AN ANNUAL BASIS. THE COMMISSIONER, IN CONSULTATION WITH  EXPERTS
 IN  HEALTH  CARE ACCESS, PATIENT ADVOCACY, TYPES OF HEALTH CARE THAT ARE
 FREQUENTLY INACCESSIBLE, AND HOSPITAL  ADMINISTRATION  SHALL  PROMULGATE
 RULES  AND  REGULATIONS  CREATING STANDARDIZED LANGUAGE FOR THIS LIST TO
 ENSURE THAT  IT  IS  READILY  UNDERSTANDABLE  TO  PATIENTS,  PROSPECTIVE
 PATIENTS, AND MEMBERS OF THE PUBLIC.
   (C)  WITHIN  ONE  YEAR  OF  THE EFFECTIVE DATE OF THIS SUBDIVISION AND
 EVERY FOUR YEARS THEREAFTER, THE COMMISSIONER SHALL SUBMIT A  REPORT  TO
 THE  TEMPORARY  PRESIDENT  OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY
 REGARDING POLICY-BASED EXCLUSIONS IN THE STATE AND THE  IMPACT  OF  SUCH
 POLICY-BASED  EXCLUSIONS ON PATIENTS' ABILITY TO ACCESS QUALITY, COMPRE-
 HENSIVE, AFFORDABLE CARE NEAR  THEIR  RESIDENCES  AND  WHETHER  AND  HOW
 ACCESS  TO  CARE VARIES BY COMMUNITY, AS WELL AS BY RACE, ETHNICITY, AND
 SOCIOECONOMIC STATUS, ACROSS THE STATE. THE REPORT SHALL BE MADE PUBLIC-
 LY AVAILABLE ON THE DEPARTMENT'S WEBSITE.
   (D) THE COMMISSIONER OR HIS OR HER DESIGNEE SHALL EVALUATE AND  ENSURE
 COMMUNITY  AWARENESS OF POLICY-BASED EXCLUSIONS AND THE WEBSITE REQUIRED
 PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION.
   (E) FOR THE PURPOSES OF THIS  SUBDIVISION,  "POLICY-BASED  EXCLUSIONS"
 SHALL MEAN NON-CLINICAL CRITERIA, RULES, OR POLICIES, WHETHER WRITTEN OR
 UNWRITTEN, THAT RESTRICT MEDICAL PERSONNEL AT THAT GENERAL HOSPITAL FROM
 PROVIDING  TYPES  OF  CARE  THAT  THE  MEDICAL PERSONNEL ARE LICENSED TO
 PROVIDE AND THAT THE GENERAL HOSPITAL IS LICENSED  TO  PROVIDE  OR  THAT
 RESTRICT THE PROVISION OF CARE TO CATEGORIES OF PATIENTS ON THE BASIS OF
 ANY CHARACTERISTIC PROTECTED UNDER SECTION TWO HUNDRED NINETY-SIX OF THE
 EXECUTIVE  LAW THAT THE GENERAL HOSPITAL IS LICENSED TO PROVIDE.  "POLI-
 CY-BASED EXCLUSIONS" SHALL INCLUDE, BUT NOT BE  LIMITED  TO,  OBJECTIONS
 UNDER  SECTION  TWENTY-NINE HUNDRED NINETY-FOUR-N OR TWENTY-NINE HUNDRED
 EIGHTY-FOUR OF THIS CHAPTER AND 10 NYCCRR § 405.9(B)(10).  "POLICY-BASED
 EXCLUSIONS" SHALL NOT INCLUDE RESTRICTIONS BASED ON LACK  OF  EQUIPMENT,
 AVAILABLE BED SPACE IN THE FACILITY, OR INSURANCE DENIAL.
   (F)  THE  COMMISSIONER MAY PROMULGATE ADDITIONAL RULES AND REGULATIONS
 AS MAY BE NECESSARY AND PROPER TO CARRY OUT EFFECTIVELY  THE  PROVISIONS
 OF THIS SUBDIVISION.
   § 3. Subdivision 1 of section 2803 of the public health law is amended
 by adding a new paragraph (m) to read as follows:
   (M)  THE  STATEMENT  REGARDING  PATIENT  RIGHTS  AND RESPONSIBILITIES,
 REQUIRED PURSUANT TO PARAGRAPH (G) OF THIS SUBDIVISION, SHALL INCLUDE  A
 LINK  TO  THE  SECTION OF THE DEPARTMENT'S WEBSITE REQUIRED IN PARAGRAPH
 (B) OF SUBDIVISION FOURTEEN OF THIS  SECTION.  EACH  GENERAL  HOSPITAL'S
 WEBSITE  SHALL  PROMINENTLY LINK TO THE DEPARTMENT'S WEBSITE REQUIRED IN
 PARAGRAPH (B) OF SUBDIVISION FOURTEEN OF THIS SECTION. THE  COMMISSIONER
 MAY  PROMULGATE  RULES AND REGULATIONS AS MAY BE NECESSARY AND PROPER TO
 CARRY OUT EFFECTIVELY THE PROVISIONS OF THIS PARAGRAPH.
   § 4. Subsection (a) of section 3217-a of the insurance law is  amended
 by adding a new paragraph 22 to read as follows:
   (22)(A)  AN  EXPLANATION  OF POLICY-BASED EXCLUSIONS AND THE FACT THAT
 SOME GENERAL HOSPITALS MAY HAVE POLICY-BASED EXCLUSIONS,  ALONG  WITH  A
 A. 733                              3
 
 LINK TO THE WEBSITE REQUIRED PURSUANT TO SUBDIVISION FOURTEEN OF SECTION
 TWENTY-EIGHT HUNDRED THREE OF THE PUBLIC HEALTH LAW.
   (B)  FOR  THE  PURPOSES  OF  THIS PARAGRAPH, "POLICY-BASED EXCLUSIONS"
 SHALL MEAN NON-CLINICAL CRITERIA, RULES, OR POLICIES, WHETHER WRITTEN OR
 UNWRITTEN, THAT RESTRICT MEDICAL PERSONNEL AT THAT GENERAL HOSPITAL FROM
 PROVIDING TYPES OF CARE THAT  THE  MEDICAL  PERSONNEL  ARE  LICENSED  TO
 PROVIDE  AND  THAT  THE  GENERAL HOSPITAL IS LICENSED TO PROVIDE OR THAT
 RESTRICT THE PROVISION OF CARE TO CATEGORIES OF PATIENTS ON THE BASIS OF
 ANY CHARACTERISTIC PROTECTED UNDER SECTION TWO HUNDRED NINETY-SIX OF THE
 EXECUTIVE LAW THAT THE GENERAL HOSPITAL IS LICENSED TO PROVIDE.   "POLI-
 CY-BASED  EXCLUSIONS"  SHALL  INCLUDE, BUT NOT BE LIMITED TO, OBJECTIONS
 UNDER SECTION TWENTY-NINE HUNDRED NINETY-FOUR-N OR  TWENTY-NINE  HUNDRED
 EIGHTY-FOUR  OF  THE  PUBLIC  HEALTH  LAW  AND 10 NYCCRR § 405.9(B)(10).
 "POLICY-BASED EXCLUSIONS" SHALL NOT INCLUDE RESTRICTIONS BASED  ON  LACK
 OF EQUIPMENT, AVAILABLE BED SPACE IN THE FACILITY, OR INSURANCE DENIAL.
   § 5. Subsection (a) of section 4324 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23)(A)  AN  EXPLANATION  OF POLICY-BASED EXCLUSIONS AND THE FACT THAT
 SOME GENERAL HOSPITALS MAY HAVE POLICY-BASED EXCLUSIONS,  ALONG  WITH  A
 LINK TO THE WEBSITE REQUIRED PURSUANT TO SUBDIVISION FOURTEEN OF SECTION
 TWENTY-EIGHT HUNDRED THREE OF THE PUBLIC HEALTH LAW.
   (B)  FOR  THE  PURPOSES  OF  THIS PARAGRAPH, "POLICY-BASED EXCLUSIONS"
 SHALL MEAN NON-CLINICAL CRITERIA, RULES, OR POLICIES, WHETHER WRITTEN OR
 UNWRITTEN, THAT RESTRICT MEDICAL PERSONNEL AT THAT GENERAL HOSPITAL FROM
 PROVIDING TYPES OF CARE THAT  THE  MEDICAL  PERSONNEL  ARE  LICENSED  TO
 PROVIDE  AND  THAT  THE  GENERAL HOSPITAL IS LICENSED TO PROVIDE OR THAT
 RESTRICT THE PROVISION OF CARE TO CATEGORIES OF PATIENTS ON THE BASIS OF
 ANY CHARACTERISTIC PROTECTED UNDER SECTION TWO HUNDRED NINETY-SIX OF THE
 EXECUTIVE LAW THAT THE GENERAL HOSPITAL IS LICENSED TO PROVIDE.   "POLI-
 CY-BASED  EXCLUSIONS"  SHALL  INCLUDE, BUT NOT BE LIMITED TO, OBJECTIONS
 UNDER SECTION TWENTY-NINE HUNDRED NINETY-FOUR-N OR  TWENTY-NINE  HUNDRED
 EIGHTY-FOUR  OF  THE  PUBLIC  HEALTH  LAW  AND 10 NYCCRR § 405.9(B)(10).
 "POLICY-BASED EXCLUSIONS" SHALL NOT INCLUDE RESTRICTIONS BASED  ON  LACK
 OF EQUIPMENT, AVAILABLE BED SPACE IN THE FACILITY, OR INSURANCE DENIAL.
   §  6.  Nothing  in  this act shall be construed to permit or authorize
 denials of care or discrimination in the provision  of  health  care  or
 health  insurance. Compliance with this act does not reduce or limit any
 liability for general hospitals in connection with  policy-based  exclu-
 sions, including violations of state or federal law.
   § 7. Severability clause. If any clause, sentence, paragraph, subdivi-
 sion,  section  or  part  of  this act shall be adjudged by any court of
 competent jurisdiction to be invalid, such judgment  shall  not  affect,
 impair,  or  invalidate  the remainder thereof, but shall be confined in
 its operation to the clause, sentence, paragraph,  subdivision,  section
 or part thereof directly involved in the controversy in which such judg-
 ment shall have been rendered. It is hereby declared to be the intent of
 the  legislature  that  this  act  would  have been enacted even if such
 invalid provisions had not been included herein.
   § 8. This act shall take effect six months 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.