BILL NUMBER: S3437

SPONSOR: KRUEGER
 
TITLE OF BILL:

An act to amend the public health law, in relation to the establishment,
incorporation, construction, or increase in capacity of for-profit
hospice

 
PURPOSE OR GENERAL IDEA OF BILL:

To prohibit future establishment or increased capacity of for-profit
hospice.

 
SUMMARY OF SPECIFIC PROVISIONS:

The bill amends Public Health Law § 4004 (3) to prohibit the Public
Health and Health Planning Council of the Department of Health from
approving new applications for establishment, construction or increased
capacity by for-profit hospice entities. Existing for profit hospice
will remain approved but may not expand capacity.

              

 
JUSTIFICATION:

An article recently published by propublics and digitally released in
the New Yorker titled "Hospice Became a For-Profit Hustle" shines a
light on multiple instances of fraud targeting the Medicare hospice
benefit. It illustrates how patient care suffers when bad actors are
able to manipulate its original intent and purpose.

An earlier article published in the Journal of the American Medical
Association* found that "for-profit compared with nonprofit hospices
provide narrower ranges of services to patients, use less skilled clin-
ical staff, care for patients with lower-skilled needs over longer
enrollment periods, have higher rates of complaint allegations and defi-
ciencies, and provide fewer community benefits, including training,
research, and charity care. For-profit hospices are more likely than
nonprofit hospices to discharge patients prior to death, to discharge
patients with dementia, and to have higher rates of hospital and emer-
gency department use."

For-profit organizations have a duty to their owners to generate as much
profit as possible and distribute net income to the owners.  Their obli-
gations to the people they ostensibly serve are secondary.  This is
especially troubling in the case of hospice. The mission of hospice,
providing compassionate end-of-life care, should not be subservient to
providing profit to investors.

New York is uniquely situated to prevent the deterioration of end-of-
life care described above, as currently only two of 41 hospice in New
York are for-profit, compared to a national average of two-thirds as of
2017. Now is the time to place the care and safety of persons who are
dying first and foremost over profit.

In her 2022 veto message  149, Governor Hochul says she will direct the
New York State Master Plan for the Aging "to assess the services offered
by for-profit hospices" and "to include a recommendation on their
continued need." It is important for the Master Plan for the Aging to
consider these issues however we already know from the experience of
patients, the advocates working on their behalf and the experiences
described in the articles referenced above that New York should take the
proactive step of prohibiting new for-profit hospices.

* Hospice Tax Status and Ownership Matters for Patients and Families
JAMA Internal Medicine, August 1, 2021 By Melissa D. Aldridge.

 
PRIOR LEGISLATIVE HISTORY:

2023-24: S.6460/A.6032 Passed Senate

2022: S.9387/A8472 - vetoed

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
Immediately