Bill Text: NY S08591 | 2021-2022 | General Assembly | Amended

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Bill Title: Relates to qualifying health care costs and case management services under the New York state medical indemnity fund; makes permanent certain provisions relating to payments from the New York state medical indemnity fund.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2022-12-28 - APPROVAL MEMO.90 [S08591 Detail]

Download: New_York-2021-S08591-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         8591--A

                    IN SENATE

                                     March 18, 2022
                                       ___________

        Introduced  by  Sen. KRUEGER -- read twice and ordered printed, and when
          printed to be committed  to  the  Committee  on  Health  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee

        AN  ACT to amend the public health law, in relation to qualifying health
          care costs under the New York state medical  indemnity  fund;  and  to
          amend  chapter 517 of the laws of 2016, amending the public health law
          relating to payments from the New York state medical  indemnity  fund,
          in relation to the effectiveness thereof

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Section 2999-h of  the  public  health  law,  as  added  by
     2  section 52 of part H of chapter 59 of the laws of 2011, subdivision 1 as
     3  amended  by chapter 517 of the laws of 2016, subdivision 3 as amended by
     4  chapter 4 of the laws of 2017 and subdivision 4 as amended by section  1
     5  of  part  K  of  chapter  57  of the laws of 2019, is amended to read as
     6  follows:
     7    § 2999-h. Definitions. As used in this title, unless  the  context  or
     8  subject matter requires otherwise:
     9    1.  "Activities  of daily living" means basic personal everyday activ-
    10  ities, including, but not limited to, tasks such as  eating,  toileting,
    11  grooming, dressing, bathing, and transferring.
    12    2. "Birth-related neurological injury" means an injury to the brain or
    13  spinal  cord  of  a  live  infant caused by the deprivation of oxygen or
    14  mechanical injury occurring in the course of labor, delivery or resusci-
    15  tation, or by other medical services provided  or  not  provided  during
    16  delivery  admission,  that  rendered  the  infant  with  a permanent and
    17  substantial motor impairment or with a developmental disability as  that
    18  term is defined by section 1.03 of the mental hygiene law, or both. This
    19  definition shall apply to live births only.
    20    [2.] 3. "Fund" means the New York state medical indemnity fund.
    21    [3.]  4.  "Instrumental  activities  of daily living" means activities
    22  related to living independently in  the  community,  including  but  not
    23  limited  to,  meal planning and preparation, managing finances, shopping

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14632-05-2
        S. 8591--A                          2

     1  for food, clothing  and  other  essential  items,  performing  essential
     2  household  chores,  communicating by phone or other media, and traveling
     3  around and participating in the community.
     4    5.  "Qualifying health care costs" means the future costs for medical,
     5  hospital, surgical, nursing, dental,  rehabilitation  services,  habili-
     6  tation  services,  [respite,  custodial, durable medical equipment, home
     7  modifications, assistive technology, vehicle modifications,] therapeutic
     8  services, and custodial care; behavioral and mental health care; respite
     9  care;  durable  medical  equipment;  environmental  home   modifications
    10  (emods),  assistive  technology, and vehicle modifications; prescription
    11  and over the counter medications; transportation for purposes of  health
    12  care  related  appointments[,  prescription and non-prescription medica-
    13  tions,] and other health  care  costs  actually  incurred  for  services
    14  rendered  to  and  supplies  utilized by qualified plaintiffs, which are
    15  necessary to meet their health  care  needs[,  as  determined  by  their
    16  treating  physicians,  physician assistants, or nurse practitioners] and
    17  as otherwise defined by the commissioner in regulation;  copayments  and
    18  deductibles  for  services,  items,  equipment or medication paid for by
    19  commercial insurance; and any other health care costs actually  incurred
    20  for  services rendered to and supplies utilized by a qualified plaintiff
    21  that their health care provider has stated in writing  is  necessary  to
    22  meet  the  qualified  plaintiff's  health  care  needs. The statement of
    23  necessity may be based on the  assessment  of  a  health  care  provider
    24  licensed  or  certified  under  title  eight of the education law and as
    25  otherwise defined in regulation.  Health care providers as used in  this
    26  section  shall  mean  health  care providers licensed or certified under
    27  title eight of the education law and as  otherwise  may  be  defined  in
    28  regulation.  Qualifying health care costs shall be covered regardless of
    29  the setting where these services are provided.
    30    [4.]  6.  "Qualified  plaintiff" means every plaintiff or claimant who
    31  (i) has been found by a jury or court to have sustained a  birth-related
    32  neurological  injury  as  the result of medical malpractice, or (ii) has
    33  sustained a birth-related neurological injury as the result  of  alleged
    34  medical  malpractice, and has settled his or her lawsuit or claim there-
    35  for; and (iii) has been ordered to be enrolled in the fund by a court in
    36  New York state.
    37    § 2. The public health law is amended by adding a new  section  2999-k
    38  to read as follows:
    39    § 2999-k. Explanation  of benefits forms relating to claims for quali-
    40  fying health care costs under the fund.  The  fund  administrator  shall
    41  provide  qualified plaintiffs with an explanation of benefits form which
    42  shall include an identification of the service for which the  claim  was
    43  made, an explanation of any denial or reduction in reimbursement for the
    44  amount  claimed,  and  information  on the process to appeal a denial of
    45  benefits.
    46    § 3. Section 5 of chapter 517 of the laws of 2016, amending the public
    47  health law relating to payments from the New York state  medical  indem-
    48  nity  fund,  as amended by section 8 of part S of chapter 57 of the laws
    49  of 2021, is amended to read as follows:
    50    § 5. This act shall take effect on the forty-fifth day after it  shall
    51  have  become  a  law,  provided  that the amendments to subdivision 4 of
    52  section 2999-j of the public health law made by section two of this  act
    53  shall  take  effect  on  June  30,  2017 [and shall expire and be deemed
    54  repealed December 31, 2022].
    55    § 4. This act shall take effect  immediately,  provided  however  that
    56  sections  one and two of this act shall take effect on the thirtieth day
        S. 8591--A                          3

     1  after it shall have become a law. Effective immediately,  the  addition,
     2  amendment  and/or  repeal  of  any  rule or regulation necessary for the
     3  implementation of this act on its effective date are  authorized  to  be
     4  made and completed on or before such effective date.