BILL NUMBER: S149

SPONSOR: GIANARIS
 
TITLE OF BILL:

An act to amend the public health law, in relation to the provision of
end stage renal disease services

 
PURPOSE:

To clarify that diagnostic and treatment centers established exclusively
to provide end stage renal disease services subject to Public Health Law
§ 2801-a (15)(a) includes ambulatory surgery centers established exclu-
sively to create and maintain vascular access necessary to dialyze
patients with end stage renal disease.

 
SUMMARY OF PROVISIONS:

Section one amends paragraph (a) of subdivision 15 of section 2801-a of
the public health law to add language that diagnostic and treatment
centers established exclusively to provide end stage renal disease
services includes ambulatory surgery centers established exclusively to
              

create and maintain vascular access necessary to dialyze patients with
end stage renal disease.

Section two sets the effective date.

 
EXISTING LAW:

Click here

 
JUSTIFICATION:

Paragraph (a) of subdivision 15 of section 2801-a of the public health
law authorizes diagnostic and treatment centers established exclusively
to provide end stage renal disease services to be operated by corpo-
rations and limited liability companies whose stockholders and members
are not natural persons. Inasmuch as life-sustaining hemodialysis treat-
ment necessarily depends upon the creation and maintenance of access to
the patient's blood stream, end stage renal disease services necessarily
includes the creation and maintenance of vascular access for end stage
renal disease patients.

This bill will make clear that a diagnostic and treatment center estab-
lished exclusively to provide end stage renal disease services includes
an ambulatory surgery center established exclusively to create and main-
tain vascular access for end stage renal disease patients receiving
hemodialysis.

Clarification that dialysis corporations are authorized to establish
single-specialty ambulatory surgery centers established exclusively to
create and maintain vascular access for hemodialysis patients will
facilitate the integration of dialysis treatment and dialysis vascular
access. A vascular access integration model has been proven to (1)
decrease catheter exposure time consistent with the Centers For Medicare
and Medicaid Services (CMS) quality and cost containment goals, (2)
increase the use of arteriovenous fistulas ("AVFs") as the preferred
method of vascular access for hemodialysis consistent with CMS's Fistula
First Initiative, with a concomitant decrease in costs and vascular
complication rates, (3) decrease mortality rates, (4) decrease the
number of missed dialysis treatments due to access compromise, (5) lower
hospital admission rates and inpatient days consistent with DSRIP goals,
and (6) decrease overall costs per ESRD patient.

Moreover, this Bill is consistent with CMS' ongoing efforts to reduce
the cost, and manage the care of, ESRD patients as reflected in its
Comprehensive ESRD Care ("CEC") Model and corresponding ESRD Seamless
Care Organizations ("ESCOs") designed to coordinate all care for ESRD
beneficiaries.

 
LEGISLATIVE HISTORY:

2022: Passed Senate; Died in Health (Assembly)

2021: Passed Senate; Died in Health (Assembly)

 
FISCAL IMPLICATIONS:

None.

 
LOCAL FISCAL IMPLICATIONS:

Click here

 
EFFECTIVE DATE:
Immediately.