Bill Text: NY A02413 | 2019-2020 | General Assembly | Introduced

New York Assembly Bill 2413 (Prior Session Legislation)

Introduced

Bill Title: Relates to referrals of patients for health related items or services that are prohibited under law.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced - Dead) 2020-01-08 - referred to health [A02413 Detail]

Download: New_York-2019-A02413-Introduced.html

                STATE OF NEW YORK
        ________________________________________________________________________
                                          2413
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                    January 22, 2019
                                       ___________
        Introduced by M. of A. PICHARDO -- read once and referred to the Commit-
          tee on Health
        AN  ACT  to  amend  the  public  health law, in relation to referrals of
          patients for health or health related items or services
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Paragraph  (g)  of  subdivision 2 of section 238-a of the
     2  public health law, as added by chapter 803  of  the  laws  of  1992,  is
     3  amended to read as follows:
     4    (g)  [in the case of any other financial relationship which the public
     5  health council determines  and  specifies  in  regulations,  subject  to
     6  approval  by the commissioner, does not pose a substantial risk of payor
     7  or patient abuse in relation to  patient  benefits  consistent,  to  the
     8  extent  practicable,  with  financial  relationships  specified in regu-
     9  lations adopted pursuant to  federal  law  applicable  to  reimbursement
    10  pursuant  to  title  XVIII of the federal social security act (medicare)
    11  for clinical laboratory services  provided  to  beneficiaries  of  title
    12  XVIII  of  the  federal  social security act (medicare)] any arrangement
    13  that, under the federal statutory prohibition on certain referrals codi-
    14  fied at 42 U.S.C. 1395nn and regulations promulgated  thereunder,  would
    15  be  an  arrangement  between a practitioner (or immediate family member)
    16  and a health care provider that:
    17    (i) would not be a financial relationship if existing between a physi-
    18  cian and an entity, as such terms are defined under such federal law  or
    19  regulations; or
    20    (ii) would satisfy the requirements of an exception relating to finan-
    21  cial  relationships  provided  under  such federal law or regulations if
    22  existing between a physician and an entity, as such  terms  are  defined
    23  under such federal law or regulations.
    24    An  arrangement  shall not be excepted under this paragraph if it is a
    25  particular type of financial relationship that would pose a  substantial
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05451-01-9

        A. 2413                             2
     1  risk  of  payor  or  patient  abuse,  as determined and specified by the
     2  public health and health planning council  in  regulations,  subject  to
     3  approval by the commissioner.
     4    §  2.  Paragraph  (c)  of subdivision 6 of section 238-a of the public
     5  health law, as added by chapter 803 of the laws of 1992, is  amended  to
     6  read as follows:
     7    (c) provided further, however, that the following shall not constitute
     8  a referral by a referring practitioner:
     9    (i) a request by a practitioner for practitioners' services consisting
    10  solely of professional services to be furnished personally by that prac-
    11  titioner, or under that practitioner's supervision;
    12    (ii)  a  request  by  a pathologist for clinical diagnostic laboratory
    13  tests and  pathological  examination  services,  if  such  services  are
    14  furnished  by or under the supervision of such pathologist pursuant to a
    15  consultation requested by another practitioner; [and]
    16    (iii) a request by a  radiologist  for  diagnostic  x-ray  or  imaging
    17  services,  if such services are furnished by or under the supervision of
    18  such radiologist pursuant to a consultation requested by another practi-
    19  tioner[.]; and
    20    (iv) a referral for any services excepted under 42 U.S.C. § 1395nn and
    21  regulations promulgated thereunder, unless the public health and  health
    22  planning  council  determines  and  specifies in regulations, subject to
    23  approval by the commissioner, that a particular type of  referral  would
    24  pose a substantial risk of payor or patient abuse in relation to patient
    25  benefits.
    26    § 3. This act shall take effect immediately.