NY State Senate Bill 2023-S5958

Senate Bill S5958

2023-2024 Legislative Session

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

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Current Bill Status - In Senate Committee Finance 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
May 15, 2024	reported and committed to finance
Jan 03, 2024	referred to health
Apr 25, 2023	reported and committed to finance
Mar 23, 2023	referred to health

Votes

- May 15, 2024 - Health Committee Vote
  S5958
  
  11
  
  Aye
  
  0
  
  Nay
  
  4
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: May 15, 2024
      
      aye (11)
      
      Ashby
      
      Brouk
      
      Felder
      
      Hoylman-Sigal
      
      Mannion
      
      May
      
      Myrie
      
      Rivera
      
      Salazar
      
      Thomas
      
      Webb
      
      aye wr (4)
      
      Gallivan
      
      Martins
      
      Rhoads
      
      Stec
  Apr 25, 2023 - Health Committee Vote
  S5958
  
  11
  
  Aye
  
  0
  
  Nay
  
  4
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: Apr 25, 2023
      
      aye (11)
      
      Ashby
      
      Brouk
      
      Felder
      
      Hoylman-Sigal
      
      Mannion
      
      May
      
      Myrie
      
      Rivera
      
      Salazar
      
      Thomas
      
      Webb
      
      aye wr (4)
      
      Gallivan
      
      Martins
      
      Rhoads
      
      Stec

co-Sponsors

2023-S5958 (ACTIVE) - Details

See Assembly Version of this Bill:: A9994
Current Committee:: Senate Finance
Law Section:: Public Health Law
Laws Affected:: Add §§2999-l & 2999-l-1, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2017-2018: S6948, A9018
2019-2020: S4811, A2347
2021-2022: S2527, A4985

2023-S5958 (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.

2023-S5958 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S5958

SPONSOR: RIVERA
 
TITLE OF BILL:

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

 
PURPOSE:

To establish an office of the state medical fund ombudsman and a medical
indemnity fund advisory panel.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends the public health law by adding new sections 2999-1 and
2999-1-1 by establishing the medical indemnity fund ombudsman and the
medical indemnity fund advisory panel. This section provides language
that establishes the duties and responsibilities for each program. The
medical indemnity fund ombudsman will help identify, investigate, and
resolve complaints that are made by or on the behalf of qualified plain-

tiffs. The medical indemnity fund advisory panel serves to bring stake-
holders together to draft and amend regulations, guidelines, or policies
in a way that helps improve the fund.

Section 2 provides 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 amend-
ments 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 administrator 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 seem-
ingly 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 and they should not have to deal with administrative hurdles and
changing policies 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 to
which they are entitled.

Another issue raised at the roundtable by many was the need to continue
conversations, to take a deeper look into the data, and to have an ongo-
ing process to address concerns regarding the functioning of the MIF.
Much like the workgroup proposed in the original Chapter from 2016, this
legislation establishes a MIF stakeholder advisory panel that will meet
at a minimum of twice annually to discuss ongoing issues and make recom-
mendations.

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

 
LEGISLATIVE HISTORY:

2017-18: S6948A (Hannon)/A9018A Abinanti passed Senate

2019-2020: S4811 Rivera/A2347 Abinanti

2021-2022: S2527A/A4958 Abinanti

 
FISCAL IMPLICATIONS:

To be determined

 
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it becomes law.

2023-S5958 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5958
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                              March 23, 2023
                                ___________
 
 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-l and 2999-l-1 to read as follows:
   §  2999-L. 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
 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  INDI-
 VIDUALS WITH EXPERTISE AND EXPERIENCE IN THE FIELD OF NEUROLOGICAL INJU-
 RIES AND ADVOCACY, AND WITH SUCH OTHER QUALIFICATIONS AS SHALL BE DETER-
 MINED  BY  THE  COMMISSIONER.   SUCH OMBUDSMAN MAY, WITH APPROVAL OF THE
 COMMISSIONER, 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
 OR DECISIONS THAT MAY ADVERSELY AFFECT THE HEALTH,  SAFETY,  WELFARE  OR
 RIGHTS OF QUALIFIED PLAINTIFFS;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08066-01-3
 S. 5958                             2

 
   (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  SHALL  DETER-
 MINE 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 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 ACTIVITIES OF THE OFFICE OF  THE  STATE  MEDICAL
 INDEMNITY FUND OMBUDSMAN, DATA REGARDING THE COMPLAINTS AND ISSUES WITH-
 IN  THE  FUND, THE PROCESS USED IN RESOLVING ISSUES, AND RECOMMENDATIONS
 FOR LEGISLATIVE OR REGULATORY AMENDMENTS TO IMPROVE THE FUND.
   § 2999-L-1. MEDICAL INDEMNITY FUND ADVISORY  PANEL.  THERE  IS  HEREBY
 ESTABLISHED AN ADVISORY PANEL TO BE COMPRISED OF THE COMMISSIONER, QUAL-
 IFIED PLAINTIFFS OR REPRESENTATIVES OF QUALIFIED PLAINTIFFS, PHYSICIANS,
 MEDICAL  SUPPLIERS, ADVOCATES AND OTHER INTERESTED PARTIES. THE ADVISORY
 PANEL SHALL BE CHAIRED BY THE COMMISSIONER AND SHALL BE COMPOSED OF  NOT
 LESS  THAN  NINE  ADDITIONAL MEMBERS APPOINTED BY THE GOVERNOR, OF WHICH
 TWO SHALL BE APPOINTED UPON RECOMMENDATION 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 EFFEC-
 TIVE DATE OF THIS SECTION, TO DISCUSS THE FUNCTIONING OF  THE  FUND  AND
 ANY  RELEVANT  ISSUES.  THE  COMMISSIONER  SHALL  CONSIDER THE INPUT AND
 COMMENTS OF THE ADVISORY PANEL IN  DRAFTING  AND  AMENDING  REGULATIONS,
 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 S5958

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Sponsored By

Gustavo Rivera