STATE OF NEW YORK ________________________________________________________________________ 5875 2019-2020 Regular Sessions IN SENATE May 16, 2019 ___________ Introduced by Sen. GALLIVAN -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health and education law, in relation to the provision of practice management, billing and health information tech- nology services for healthcare facilities and professionals The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 2811 of the public health law, as added by chapter 2 776 of the laws of 1971 and as renumbered by chapter 649 of the laws of 3 1975, is amended to read as follows: 4 § 2811. Discounts and splitting fees with medical referral services; 5 prohibited. No hospital or facility delivering health care shall grant 6 or receive a discount to or from any medical referral service or in any 7 manner split fees with a medical referral service; provided, however, 8 that nothing contained in this chapter shall prohibit such facilities or 9 licensed professionals from paying a fair market value fee to any person 10 or entity whose purpose is to perform practice management, billing or 11 health information technology services based upon a percentage of fees 12 billed or collected, a flat fee, or any other arrangement that directly 13 or indirectly divides fees, for such purposes, provided that: 14 1. the person or entity providing practice management, billing or 15 health information technology services is not responsible for the amount 16 of fees charged and collected for the services rendered by such facility 17 or licensed professional; 18 2. all charges collected are paid directly to the facility or to the 19 licensed professional or are deposited directly into an account in the 20 name of and under the sole control of the facility or licensed profes- 21 sional; and 22 3. the person or entity providing practice management, billing or 23 health information technology services does not refer patients to the 24 facility or licensed professional and that payments made are not related EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD00407-01-9S. 5875 2 1 to or compensating for the referral of patients to the facility or 2 licensed professional. 3 § 2. Section 6509-a of the education law, as amended by chapter 555 of 4 the laws of 1993, is amended to read as follows: 5 § 6509-a. Additional definition of professional misconduct; limited 6 application. Notwithstanding any inconsistent provision of this article 7 or of any other provision of law to the contrary, the license or regis- 8 tration of a person subject to the provisions of articles one hundred 9 thirty-two, one hundred thirty-three, one hundred thirty-six, one 10 hundred thirty-seven, one hundred thirty-nine, one hundred forty-one, 11 one hundred forty-three, one hundred forty-four, one hundred fifty-six, 12 one hundred fifty-nine and one hundred sixty-four of this chapter may be 13 revoked, suspended or annulled or such person may be subject to any 14 other penalty provided in section sixty-five hundred eleven of this 15 article in accordance with the provisions and procedure of this article 16 for the following: 17 That any person subject to the above enumerated articles, has directly 18 or indirectly requested, received or participated in the division, 19 transference, assignment, rebate, splitting or refunding of a fee for, 20 or has directly requested, received or profited by means of a credit or 21 other valuable consideration as a commission, discount or gratuity in 22 connection with the furnishing of professional care, or service, includ- 23 ing x-ray examination and treatment, or for or in connection with the 24 sale, rental, supplying or furnishing of clinical laboratory services or 25 supplies, x-ray laboratory services or supplies, inhalation therapy 26 service or equipment, ambulance service, hospital or medical supplies, 27 physiotherapy or other therapeutic service or equipment, artificial 28 limbs, teeth or eyes, orthopedic or surgical appliances or supplies, 29 optical appliances, supplies or equipment, devices for aid of hearing, 30 drugs, medication or medical supplies or any other goods, services or 31 supplies prescribed for medical diagnosis, care or treatment under this 32 chapter, except payment, not to exceed thirty-three and one-third per 33 centum of any fee received for x-ray examination, diagnosis or treat- 34 ment, to any hospital furnishing facilities for such examination, diag- 35 nosis or treatment. Nothing contained in this section shall prohibit 36 such persons from practicing as partners, in groups or as a professional 37 corporation or as a university faculty practice corporation nor from 38 pooling fees and moneys received, either by the partnerships, profes- 39 sional corporations, university faculty practice corporations or groups 40 by the individual members thereof, for professional services furnished 41 by any individual professional member, or employee of such partnership, 42 corporation or group, nor shall the professionals constituting the part- 43 nerships, corporations or groups be prohibited from sharing, dividing or 44 apportioning the fees and moneys received by them or by the partnership, 45 corporation or group in accordance with a partnership or other agree- 46 ment; provided that no such practice as partners, corporations or in 47 groups or pooling of fees or moneys received or shared, division or 48 apportionment of fees shall be permitted with respect to care and treat- 49 ment under the workers' compensation law except as expressly authorized 50 by the workers' compensation law. Nothing contained in this chapter 51 shall prohibit a medical or dental expense indemnity corporation pursu- 52 ant to its contract with the subscriber from prorationing a medical or 53 dental expense indemnity allowance among two or more professionals in 54 proportion to the services rendered by each such professional at the 55 request of the subscriber, provided that prior to payment thereof such 56 professionals shall submit both to the medical or dental expense indem-S. 5875 3 1 nity corporation and to the subscriber statements itemizing the services 2 rendered by each such professional and the charges therefor. Nothing 3 contained in this chapter shall prohibit such professionals from paying 4 a fair market value fee to any person or entity whose purpose is to 5 perform practice management, billing or health information technology 6 services based upon a percentage of fees billed or collected, a flat 7 fee, or any other arrangement that directly or indirectly divides fees, 8 for such purposes, provided that: 9 (1) the person or entity providing practice management, billing or 10 health information technology services is not responsible for the amount 11 of fees charged and collected for the services rendered by such profes- 12 sional; 13 (2) all charges collected are paid directly to the professional or are 14 deposited directly into an account in the name of and under the sole 15 control of the professional; and 16 (3) the person or entity providing practice management, billing or 17 health information technology services does not refer patients to the 18 professional and that payments made are not related to or compensating 19 for the referral of patients to the professional. 20 § 3. Subdivision 19 of section 6530 of the education law, as added by 21 chapter 606 of the laws of 1991, is amended to read as follows: 22 19. Permitting any person to share in the fees for professional 23 services, other than: a partner, employee, associate in a professional 24 firm or corporation, professional subcontractor or consultant authorized 25 to practice medicine, or a legally authorized trainee practicing under 26 the supervision of a licensee. This prohibition shall include any 27 arrangement or agreement whereby the amount received in payment for 28 furnishing space, facilities, equipment or personnel services used by a 29 licensee constitutes a percentage of, or is otherwise dependent upon, 30 the income or receipts of the licensee from such practice, except as 31 otherwise provided by law with respect to a facility licensed pursuant 32 to article twenty-eight of the public health law or article thirteen of 33 the mental hygiene law. Nothing contained in this chapter shall prohib- 34 it such professionals from paying a fair market value fee to any person 35 or entity whose purpose is to perform practice management, billing or 36 health information technology services based upon a percentage of fees 37 billed or collected, a flat fee, or any other arrangement that directly 38 or indirectly divides fees, for such purposes, provided that: 39 (a) the person or entity providing practice management, billing or 40 health information technology services is not responsible for the amount 41 of fees charged and collected for the services rendered by such profes- 42 sional; 43 (b) all charges collected are paid directly to the professional or are 44 deposited directly into an account in the name of and under the sole 45 control of the professional; and 46 (c) the person or entity providing practice management, billing or 47 health information technology services does not refer patients to the 48 professional and that payments made are not related to or compensating 49 for the referral of patients to the professional. 50 § 4. This act shall take effect immediately.