STATE OF NEW YORK
________________________________________________________________________
6442--C
2021-2022 Regular Sessions
IN ASSEMBLY
March 17, 2021
___________
Introduced by M. of A. ABINANTI -- read once and referred to the Commit-
tee on Health -- committee discharged, bill amended, ordered reprinted
as amended and recommitted to said committee -- recommitted to the
Committee on Health in accordance with Assembly Rule 3, sec. 2 --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee -- again reported from said committee
with amendments, ordered reprinted as amended and recommitted to said
committee
AN ACT to amend the public health law, in relation to qualifying health
care costs under the New York state medical indemnity fund; and to
amend chapter 517 of the laws of 2016, amending the public health law
relating to payments from the New York state medical indemnity fund,
in relation to the effectiveness thereof
The People of the State of New York, represented in Senate and Assem-
bly, do enact as follows:
1 Section 1. Section 2999-h of the public health law, as added by
2 section 52 of part H of chapter 59 of the laws of 2011, subdivision 1 as
3 amended by chapter 517 of the laws of 2016, subdivision 3 as amended by
4 chapter 4 of the laws of 2017 and subdivision 4 as amended by section 1
5 of part K of chapter 57 of the laws of 2019, is amended to read as
6 follows:
7 § 2999-h. Definitions. As used in this title, unless the context or
8 subject matter requires otherwise:
9 1. "Activities of daily living" means basic personal everyday activ-
10 ities, including, but not limited to, tasks such as eating, toileting,
11 grooming, dressing, bathing, and transferring.
12 2. "Birth-related neurological injury" means an injury to the brain or
13 spinal cord of a live infant caused by the deprivation of oxygen or
14 mechanical injury occurring in the course of labor, delivery or resusci-
15 tation, or by other medical services provided or not provided during
16 delivery admission, that rendered the infant with a permanent and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10436-05-2
A. 6442--C 2
1 substantial motor impairment or with a developmental disability as that
2 term is defined by section 1.03 of the mental hygiene law, or both. This
3 definition shall apply to live births only.
4 [2.] 3. "Fund" means the New York state medical indemnity fund.
5 [3.] 4. "Instrumental activities of daily living" means activities
6 related to living independently in the community, including but not
7 limited to, meal planning and preparation, managing finances, shopping
8 for food, clothing and other essential items, performing essential
9 household chores, communicating by phone or other media, and traveling
10 around and participating in the community.
11 5. "Qualifying health care costs" means the future costs for medical,
12 hospital, surgical, nursing, dental, rehabilitation services, habili-
13 tation services, [respite, custodial, durable medical equipment, home
14 modifications, assistive technology, vehicle modifications,] therapeutic
15 services, and custodial care; behavioral and mental health care; respite
16 care; durable medical equipment; environmental home modifications
17 (emods), assistive technology, and vehicle modifications; prescription
18 and over the counter medications; transportation for purposes of health
19 care related appointments[, prescription and non-prescription medica-
20 tions,] and other health care costs actually incurred for services
21 rendered to and supplies utilized by qualified plaintiffs, which are
22 necessary to meet their health care needs[, as determined by their
23 treating physicians, physician assistants, or nurse practitioners] and
24 as otherwise defined by the commissioner in regulation; copayments and
25 deductibles for services, items, equipment or medication paid for by
26 commercial insurance; and any other health care costs actually incurred
27 for services rendered to and supplies utilized by a qualified plaintiff
28 that their health care provider has stated in writing is necessary to
29 meet the qualified plaintiff's health care needs. The statement of
30 necessity may be based on the assessment of a health care provider
31 licensed or certified under title eight of the education law and as
32 otherwise defined in regulation. Health care providers as used in this
33 section shall mean health care providers licensed or certified under
34 title eight of the education law and as otherwise may be defined in
35 regulation. Qualifying health care costs shall be covered regardless of
36 the setting where these services are provided.
37 [4.] 6. "Qualified plaintiff" means every plaintiff or claimant who
38 (i) has been found by a jury or court to have sustained a birth-related
39 neurological injury as the result of medical malpractice, or (ii) has
40 sustained a birth-related neurological injury as the result of alleged
41 medical malpractice, and has settled his or her lawsuit or claim there-
42 for; and (iii) has been ordered to be enrolled in the fund by a court in
43 New York state.
44 § 2. The public health law is amended by adding a new section 2999-k
45 to read as follows:
46 § 2999-k. Explanation of benefits forms relating to claims for quali-
47 fying health care costs under the fund. The fund administrator shall
48 provide qualified plaintiffs with an explanation of benefits form which
49 shall include an identification of the service for which the claim was
50 made, an explanation of any denial or reduction in reimbursement for the
51 amount claimed, and information on the process to appeal a denial of
52 benefits.
53 § 3. Section 5 of chapter 517 of the laws of 2016, amending the public
54 health law relating to payments from the New York state medical indem-
55 nity fund, as amended by section 8 of part S of chapter 57 of the laws
56 of 2021, is amended to read as follows:
A. 6442--C 3
1 § 5. This act shall take effect on the forty-fifth day after it shall
2 have become a law, provided that the amendments to subdivision 4 of
3 section 2999-j of the public health law made by section two of this act
4 shall take effect on June 30, 2017 [and shall expire and be deemed
5 repealed December 31, 2022].
6 § 4. This act shall take effect immediately, provided however that
7 sections one and two of this act shall take effect on the thirtieth day
8 after it shall have become a law. Effective immediately, the addition,
9 amendment and/or repeal of any rule or regulation necessary for the
10 implementation of this act on its effective date are authorized to be
11 made and completed on or before such effective date.