Bill Text: NY A07689 | 2017-2018 | General Assembly | Amended


Bill Title: Prohibits certain practices concerning or consideration for referrals by providers of substance abuse disorder services.

Spectrum: Partisan Bill (Democrat 20-0)

Status: (Engrossed) 2018-06-18 - RETURNED TO ASSEMBLY [A07689 Detail]

Download: New_York-2017-A07689-Amended.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                         7689--A
                               2017-2018 Regular Sessions
                   IN ASSEMBLY
                                       May 9, 2017
                                       ___________
        Introduced  by M. of A. L. ROSENTHAL, D'URSO, THIELE, SKOUFIS, CUSICK --
          (at request of the Office of Alcoholism and Substance Abuse  Services)
          --  read  once  and  referred  to the Committee on Alcoholism and Drug
          Abuse -- reported and referred to the Committee on Codes --  recommit-
          ted to the Committee on Codes in accordance with Assembly Rule 3, sec.
          2  -- committee discharged, bill amended, ordered reprinted as amended
          and recommitted to said committee
        AN ACT to amend the mental hygiene law, in relation to prohibited  prac-
          tices by providers of substance use disorder services
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. The mental hygiene law is amended by adding a  new  section
     2  32.06 to read as follows:
     3  § 32.06 Prohibited  practices  by  providers  of  substance use disorder
     4            services.
     5    1. For purposes of this section, unless the context  clearly  requires
     6  otherwise,  "provider"  shall mean any person, firm, partnership, group,
     7  practice association, fiduciary, employer, representative thereof or any
     8  other entity who is providing or purporting  to  provide  substance  use
     9  disorder  services. Provided, however, that "provider" shall not include
    10  a person receiving substance use disorder services from the provider.
    11    2. No provider shall intentionally solicit, receive, accept  or  agree
    12  to  receive or accept any payment, benefit or other consideration in any
    13  form to the extent such payment, benefit or other consideration is given
    14  for the referral of a person as a potential patient  for  substance  use
    15  disorder services.
    16    3. No provider providing or purporting to provide substance use disor-
    17  der  services pursuant to this chapter, shall intentionally make, offer,
    18  give, or agree to make, offer, or give any  payment,  benefit  or  other
    19  consideration  in  any form to the extent such payment, benefit or other
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10119-04-8

        A. 7689--A                          2
     1  consideration is given for the referral  of  a  person  as  a  potential
     2  patient for substance use disorder services.
     3    4. This section shall not apply to any:
     4    (a)  lawful  payments  by  a health maintenance organization or health
     5  insurer, operating in accordance with article thirty-two or  forty-three
     6  of  the  insurance law or article forty-four of the public health law on
     7  behalf of their enrollees for such substance use  disorder  services  or
     8  other benefits required to be provided;
     9    (b) lawful payments to or by a provider to a health maintenance organ-
    10  ization  or  health insurer operating in accordance with article thirty-
    11  two or forty-three of the insurance law or  article  forty-four  of  the
    12  public  health  law,  as  payment for services provided, a refund for an
    13  overpayment, a participating provider fee, or any similar remuneration;
    14    (c) provider for an activity that, at the time of such activity, would
    15  have been lawful as specifically exempt, or  otherwise  not  prohibited,
    16  under  any  federal statute or regulations, including but not limited to
    17  42 U.S.C. § 1320a-7b (b) or the regulations promulgated  thereunder,  if
    18  conducted  by a person, firm, partnership, group, practice, association,
    19  fiduciary, employer representative thereof or any other entity providing
    20  substance use disorder services;
    21    (d) any employee or representative of a  provider  who  is  conducting
    22  marketing  activities,  where  the employee or representative identifies
    23  the provider represented or for whom or which the employee or  represen-
    24  tative  works, identifies that the employee or representative is a mark-
    25  eter and not a clinician or other individual who can provide diagnostic,
    26  counseling or assessment services, and  such  marketing  activities  are
    27  limited  to  educating  the  potential patient about the program with no
    28  effort to steer or lead the potential  patient  to  select  or  consider
    29  selection of the substance use disorder services provider represented or
    30  for whom or which the employee or representative works; or
    31    (e) commissions, fees or other remuneration lawfully paid to insurance
    32  agents as provided under the insurance law.
    33    5.  Any provider who intentionally violates the provisions of subdivi-
    34  sion two or three of this section shall be guilty of  a  misdemeanor  as
    35  defined in the penal law.
    36    6.  If  the commissioner has reason to believe a provider has violated
    37  subdivision two or three of this section, the commissioner  may  proceed
    38  to  investigate  and institute enforcement actions, as may be authorized
    39  pursuant to the applicable provisions of this article.
    40    7. The provisions of this section are in addition to any other  civil,
    41  administrative  or  criminal enforcement actions provided by law. Penal-
    42  ties authorized under this section  may  be  imposed  against  corporate
    43  providers and individual providers.
    44    8. The commissioner shall adopt and may amend rules and regulations to
    45  effectuate the provisions of this section.
    46    §  2.  This  act  shall take effect on the sixtieth day after it shall
    47  have become a law.
feedback