Bill Text: NY A03166 | 2009-2010 | General Assembly | Introduced
Bill Title: An act to amend the public health law, in relation to hospital and physician clinical integration
Spectrum: Partisan Bill (Democrat 16-0)
Status: (Introduced - Dead) 2009-01-23 - referred to health [A03166 Detail]
Download: New_York-2009-A03166-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
3166
2009-2010 Regular Sessions
I N A S S E M B L Y
January 23, 2009
___________
Introduced by M. of A. BRADLEY, BENEDETTO, BENJAMIN, SCHIMEL, ZEBROWSKI,
GUNTHER, BROOK-KRASNY, JAFFEE -- Multi-Sponsored by -- M. of A. COOK,
DelMONTE, GALEF, JOHN, KOON, MAYERSOHN, REILLY, TOWNS -- read once and
referred to the Committee on Health
AN ACT to amend the public health law, in relation to hospital and
physician clinical integration
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Legislative findings and determinations. The legislature
2 finds and determines that in order to promote the quality and continuity
3 of care provided to residents of the state, it shall be the policy of
4 this state to encourage cooperative, collaborative and integrative
5 arrangements among general hospitals, among physicians, and among gener-
6 al hospitals and physicians involving clinical integration. The know-
7 ledge provided through multiple providers working together is key to
8 improving clinical care and outcomes.
9 The legislature further finds and determines that in order to improve
10 patient care and increase the efficiency of delivering the highest qual-
11 ity of care at the lowest costs possible, clinical, economic and policy
12 experts across the nation are recommending increased integration of the
13 management of patient care. Within this context, integration is the
14 sharing of best practices through group interaction and planning,
15 including the documentation and measurement of patient outcomes based on
16 documented standards of care, comparing future performance to baseline
17 measures that are currently available pursuant to publicly reported
18 state and federal quality measures.
19 The legislature additionally finds and determines that despite the
20 anticipated and documented benefits, there currently exist only a few
21 such venues for such sharing of information and advancement of medicine.
22 Such collaboration and integration represents an important shift in the
23 practice of medicine away from the current culture of blame and informa-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03355-01-9
A. 3166 2
1 tion suppression to a culture of informed, interconnected health
2 systems. As a result, collaborations acknowledge that everyone is striv-
3 ing toward the same high quality care, everyone experiences successes
4 and shortcomings in their practices, and everyone can learn from others'
5 experiences.
6 S 2. The public health law is amended by adding a new section 2821 to
7 read as follows:
8 S 2821. HOSPITAL AND PHYSICIAN CLINICAL INTEGRATION. 1. FOR THE
9 PURPOSES OF THIS SECTION, THE TERM "CLINICAL INTEGRATION" SHALL MEAN:
10 (A) THE ESTABLISHMENT OF GOALS RELATING TO QUALITY AND APPROPRIATE
11 UTILIZATION OF SERVICES BY THE PROVIDERS PARTICIPATING IN THE JOINT
12 VENTURE;
13 (B) THE DEVELOPMENT AND APPLICATION OF PRACTICE STANDARDS AND PROTO-
14 COLS TO GOVERN TREATMENT AND UTILIZATION OF SERVICES;
15 (C) THE REVIEW OF THE CARE RENDERED BY THE PROVIDERS IN THE JOINT
16 VENTURE IN LIGHT OF THESE STANDARDS AND PROTOCOLS WITH REMEDIAL ACTION
17 FOR POOR PERFORMANCE;
18 (D) THE MONITORING OF PATIENT SATISFACTION;
19 (E) THE DEVELOPMENT OF INFORMATION SYSTEMS NECESSARY TO GATHER AGGRE-
20 GATE AND INDIVIDUAL PROVIDER DATA ON THE COST, QUANTITY, AND NATURE OF
21 SERVICES PROVIDED BY THE PROVIDERS;
22 (F) THE MEASUREMENT OF PERFORMANCE OF THE JOINT VENTURE AS A WHOLE AND
23 THE INDIVIDUAL PROVIDERS IN THE JOINT VENTURE AGAINST COST AND QUALITY
24 BENCHMARKS; AND
25 (G) THE PUBLICATION OF DETAILED PUBLIC REPORTS ON THE COST AND QUANTI-
26 TY OF SERVICES PROVIDED, AND ON THE JOINT VENTURE'S SUCCESS IN MEETING
27 ITS GOALS.
28 2. (A) THE DEPARTMENT SHALL HEREBY INSTITUTE A PROGRAM TO ENCOURAGE
29 COOPERATIVE, COLLABORATIVE AND INTEGRATIVE ARRANGEMENTS AMONG GENERAL
30 HOSPITALS, AMONG PHYSICIANS, AND AMONG GENERAL HOSPITALS AND PHYSICIANS
31 INVOLVING CLINICAL INTEGRATION. IT SHALL BE THE POLICY OF THE DEPARTMENT
32 IN INSTITUTING SUCH PROGRAM TO SEEK IMPROVEMENTS AND EFFICIENCIES IN
33 HEALTH CARE RESULTING FROM CLINICAL INTEGRATION. IN THE IMPLEMENTATION
34 AND EFFECTUATION OF THIS PROGRAM, THE DEPARTMENT SHALL ENCOURAGE THE
35 NEGOTIATION OF REIMBURSEMENT RATES WITH PAYERS ON BEHALF OF THEIR
36 PARTICIPANTS.
37 (B) THE DEPARTMENT'S CLINICAL INTEGRATION ENCOURAGEMENT PROGRAM SHALL
38 SUPPORT THE POLICY OF CLINICAL INTEGRATION REGARDING BEST PRACTICES
39 WITHIN AND AMONG PHYSICIAN OFFICES AND HOSPITALS. SUCH POLICY SHALL
40 FURTHER SEEK TO USE CLINICAL INTEGRATION IN A MANNER TO PROVIDE THE BEST
41 QUALITY OF CARE, IN THE MOST EFFICIENT MEANS POSSIBLE, FOR THE PEOPLE OF
42 THE STATE OF NEW YORK. SUCH POLICY SHALL ALSO SEEK TO USE CLINICAL INTE-
43 GRATION TO PRODUCE SAVINGS REALIZED THROUGH IMPROVED EFFICIENCIES OF
44 HEALTH EXPENDITURES BY REDUCED DUPLICATION OF TESTING, IMPROVED RAPIDITY
45 OF DIAGNOSIS AND TREATMENT, AND A REDUCTION IN MEDICAL ERRORS.
46 (C) THE DEPARTMENT'S CLINICAL INTEGRATION ENCOURAGEMENT PROGRAM SHALL
47 FURTHER SEEK THE RESULT, WHERE PARTICIPATING HOSPITALS AND PHYSICIANS
48 WILL HAVE MET THE FEDERAL THRESHOLD FOR CLINICAL INTEGRATION, AND HAVE
49 THE ABILITY TO ENTER GROUP NEGOTIATIONS WITH HEALTH INSURERS. SUCH
50 PROGRAM SHALL THEREBY ATTEMPT TO REBALANCE THE OBTAINMENT OF REIMBURSE-
51 MENT AT LEVELS SUFFICIENT TO OFFER EVIDENCE-BASED CLINICAL ADVANCEMENTS
52 TO THE COMMUNITIES SERVED BY SUCH PARTICIPATING HOSPITALS AND PHYSI-
53 CIANS.
54 3. THE COMMISSIONER SHALL HAVE OVERSIGHT AND MANAGEMENT OVER THE
55 DEPARTMENT'S PROGRAM TO ENCOURAGE COOPERATIVE, COLLABORATIVE AND INTE-
56 GRATIVE ARRANGEMENTS AMONG GENERAL HOSPITALS, AMONG PHYSICIANS, AND
A. 3166 3
1 AMONG GENERAL HOSPITALS AND PHYSICIANS INVOLVING CLINICAL INTEGRATION.
2 WHETHER A PROVIDER JOINT VENTURE INITIALLY MEETS, AND CONTINUES TO MEET,
3 THE CRITERIA FOR CLINICAL INTEGRATION AS DEFINED IN SUBDIVISION ONE OF
4 THIS SECTION SHALL BE DETERMINED BY THE COMMISSIONER. THE DEPARTMENT
5 SHALL HAVE THE AUTHORITY TO ISSUE REGULATIONS TO EFFECTUATE THE
6 PROVISIONS AND TERMS OF THIS SECTION.
7 4. TO THE EXTENT THE DEPARTMENT'S CLINICAL INTEGRATION ENCOURAGEMENT,
8 OR THE CLINICAL INTEGRATION MEASURES CONDUCTED THEREUNDER, ARE DEEMED
9 ANTI-COMPETITIVE WITHIN THE MEANING OR INTENT OF ANY FEDERAL OR STATE
10 ANTITRUST LAW OR REGULATION, STATE ACTION IMMUNITY UNDER SUCH ANTITRUST
11 LAWS AND REGULATIONS IS HEREBY CONFERRED WITH RESPECT TO THE PLANNING,
12 IMPLEMENTATION AND OPERATION OF SUCH CLINICAL INTEGRATION MEASURES
13 AND/OR JOINT VENTURES. SUCH MEASURES AND JOINT VENTURES SHALL ALSO BE
14 DEEMED EXEMPT FROM THE PROVISIONS OF ARTICLE TWENTY-TWO OF THE GENERAL
15 BUSINESS LAW INVOLVING CONTRACTS OR AGREEMENTS IN RESTRAINT OF TRADE.
16 S 3. This act shall take effect immediately.
