Bill Text: NY A06781 | 2021-2022 | General Assembly | Introduced

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

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced - Dead) 2021-09-15 - enacting clause stricken [A06781 Detail]

Download: New_York-2021-A06781-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          6781

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                      April 8, 2021
                                       ___________

        Introduced  by  M.  of  A. PICHARDO, TAYLOR, DE LA ROSA -- read once and
          referred to the Committee 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.
                                                                   LBD05337-01-1
        A. 6781                             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.