State legislative activity update
Gov. Andrew Cuomo has approved 636 bills since the end of the 2019 legislative session, including the following chaptered bills of interest to HANYS and our members:
- Prior authorization exception expansion. This HANYS-authored bill prohibits an insurer from denying payment for claims due to a lack of pre-authorization in instances where the healthcare provider determines during the course of treatment that an additional or related service or procedure is necessary and it is not medically advisable to interrupt the provision of care to obtain prior authorization for such service or procedure. The bill also applies in instances where the Current Procedural Terminology code for the additional or related service or procedure is different from the CPT code for the initial procedure or treatment for which prior authorization was obtained. This bill closes an existing loophole that allows unnecessary administrative denials and would help to ensure coverage and the timely provision of medically needed services. This new law (Chapter 640) takes effect March 11, 2020.
Obstetric hemorrhage protocols. Directs the commissioner of health, in conjunction with clinical experts, to provide guidance and develop or identify management protocols and strategies related to obstetric hemorrhages to be used by hospitals. It requires hospitals to adopt, implement and regularly update their obstetric hemorrhage protocols, including a response plan for emergency transfers to facilities that can provide a higher level of care. Additionally, the bill directs DOH to submit a biannual report to the legislature on such protocols and the strategies developed and implemented. This new law (Chapter 662) takes effect June 16, 2020.
Note: The governor noted in his approval message that, as drafted, the bill is duplicative of existing efforts. The Executive has secured an agreement with the Legislature to make certain amendments necessary to address these concerns.
Full regimen of HIV post-exposure prophylaxis. Requires hospitals to provide the full regimen of HIV post-exposure prophylaxis in cases where it has been determined a significant exposure to HIV has occurred. Existing law requires a “seven-day starter pack.” The bill also requires healthcare providers to bill the Office of Victim Services directly for any follow-up HIV PEP costs and require OVS to annually review and determine if a reimbursement rate higher than the existing statutory maximum rate of $800 is feasible and appropriate and to adjust accordingly. This new law (Chapter 681) takes effect June 15, 2020.
Note: The governor noted in his approval message that the Executive has secured an agreement with the Legislature to amend the bill. Such amendments will include ensuring that minors can immediately access the full regimen of PEP.
- Plant-based food options in hospitals. Requires hospitals to offer patients a plant-based food option as an alternative to every meal or snack offered in food service. The provisions of the bill would not apply to patient nutritional support products, such as infant formula. This new law (Chapter 588) takes effect Dec. 6, 2020.
- Discharging patients with central venous lines. Requires hospitals to consult with the caregiver of a patient with a central venous line within 24 hours of discharge regarding his or her capability of providing appropriate care for such patient. The bill also authorizes the hospital to order appropriate care, including home care services, when the caregiver cannot confidently provide proper care of the central venous line. This new law (Chapter 617) takes effect immediately.
- Health care decisions for adult patients without surrogates. Provides that decisions about routine care for patients without a surrogate decision maker do not require prior review by an Ethics Review Committee and are governed by the provisions in the Family Health Care Decisions Act. This new law (Chapter 622) takes effect immediately.
- Child custody medical decisions. Includes non-parents with lawful orders of custody as persons who may make medical decisions for minors in their care and clarifies that such persons’ consent is not required for emergency care. This new law (Chapter 623) takes effect immediately.
- Mental hygiene legal services. Authorizes MHLS to provide legal assistance to patients or residents of residential healthcare facilities who have been admitted directly from a psychiatric facility or a psychiatric ward of a hospital and who have a serious mental illness for which they are receiving services related to such illness. This new law (Chapter 658) takes effect immediately.
- Abuse in nursing homes. Expands the types of reportable offenses in nursing homes to include non-physical abuse and misappropriation of property. Additionally, the bill requires DOH to develop forms that could be used for reporting any potentially criminal activity to appropriate law enforcement entities and authorizes DOH to appoint independent quality monitors in certain situations. This new law (Chapter 677) takes effect April 14, 2020.
Gov. Cuomo vetoed the following bills of interest over the last several weeks:
- Doula certification. Would establish the title of certified doula and establish the requirements for professional certification.
- Outpatient mental health services. Would expand the types of mental health services for which commercial insurers must provide coverage to include outpatient care provided by a mental health counselor, marriage and family therapist, creative arts therapist or a psychoanalyst.
- Rural suicide prevention council. Would establish a Rural Suicide Prevention Council to examine the causes and conditions related to rural suicides and make recommendations that may result in the reduction of rural suicide.
Currently, 18 bills that have passed both houses are awaiting delivery to the governor for consideration and action before the end of the year.
Should you have questions on the information provided or any other legislative activity or issues, please contact our state governmental affairs team: Amy Nickson, vice president, governmental affairs; Katie Gordon, director, research and legislation; and Scott Janke, director, state governmental affairs.