Bill Text: NY A06442 | 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 2-0)

Status: (Introduced - Dead) 2022-05-31 - substituted by s8591a [A06442 Detail]

Download: New_York-2021-A06442-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         6442--C

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                     March 17, 2021
                                       ___________

        Introduced by M. of A. ABINANTI -- read once and referred to the Commit-
          tee on Health -- committee discharged, bill amended, ordered reprinted
          as  amended  and  recommitted  to said committee -- recommitted to the
          Committee on Health in accordance with Assembly  Rule  3,  sec.  2  --
          committee  discharged,  bill amended, ordered reprinted as amended and
          recommitted to said committee -- again reported  from  said  committee
          with  amendments, 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

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10436-05-2
        A. 6442--C                          2

     1  substantial  motor impairment or with a developmental disability as that
     2  term is defined by section 1.03 of the mental hygiene law, or both. This
     3  definition shall apply to live births only.
     4    [2.] 3. "Fund" means the New York state medical indemnity fund.
     5    [3.]  4.  "Instrumental  activities  of daily living" means activities
     6  related to living independently in  the  community,  including  but  not
     7  limited  to,  meal planning and preparation, managing finances, shopping
     8  for food, clothing  and  other  essential  items,  performing  essential
     9  household  chores,  communicating by phone or other media, and traveling
    10  around and participating in the community.
    11    5. "Qualifying health care costs" means the future costs for  medical,
    12  hospital,  surgical,  nursing,  dental, rehabilitation services, habili-
    13  tation services, [respite, custodial, durable  medical  equipment,  home
    14  modifications, assistive technology, vehicle modifications,] therapeutic
    15  services, and custodial care; behavioral and mental health care; respite
    16  care;   durable  medical  equipment;  environmental  home  modifications
    17  (emods), assistive technology, and vehicle  modifications;  prescription
    18  and  over the counter medications; transportation for purposes of health
    19  care related appointments[, prescription  and  non-prescription  medica-
    20  tions,]  and  other  health  care  costs  actually incurred for services
    21  rendered to and supplies utilized by  qualified  plaintiffs,  which  are
    22  necessary  to  meet  their  health  care  needs[, as determined by their
    23  treating physicians, physician assistants, or nurse  practitioners]  and
    24  as  otherwise  defined by the commissioner in regulation; copayments and
    25  deductibles for services, items, equipment or  medication  paid  for  by
    26  commercial  insurance; and any other health care costs actually incurred
    27  for services rendered to and supplies utilized by a qualified  plaintiff
    28  that  their  health  care provider has stated in writing is necessary to
    29  meet the qualified plaintiff's  health  care  needs.  The  statement  of
    30  necessity  may  be  based  on  the  assessment of a health care provider
    31  licensed or certified under title eight of  the  education  law  and  as
    32  otherwise  defined in regulation.  Health care providers as used in this
    33  section shall mean health care providers  licensed  or  certified  under
    34  title  eight  of  the  education  law and as otherwise may be defined in
    35  regulation.  Qualifying health care costs shall be covered regardless of
    36  the setting where these services are provided.
    37    [4.] 6. "Qualified plaintiff" means every plaintiff  or  claimant  who
    38  (i)  has been found by a jury or court to have sustained a birth-related
    39  neurological injury as the result of medical malpractice,  or  (ii)  has
    40  sustained  a  birth-related neurological injury as the result of alleged
    41  medical malpractice, and has settled his or her lawsuit or claim  there-
    42  for; and (iii) has been ordered to be enrolled in the fund by a court in
    43  New York state.
    44    §  2.  The public health law is amended by adding a new section 2999-k
    45  to read as follows:
    46    § 2999-k. Explanation of benefits forms relating to claims for  quali-
    47  fying  health  care  costs  under the fund. The fund administrator shall
    48  provide qualified plaintiffs with an explanation of benefits form  which
    49  shall  include  an identification of the service for which the claim was
    50  made, an explanation of any denial or reduction in reimbursement for the
    51  amount claimed, and information on the process to  appeal  a  denial  of
    52  benefits.
    53    § 3. Section 5 of chapter 517 of the laws of 2016, amending the public
    54  health  law  relating to payments from the New York state medical indem-
    55  nity fund, as amended by section 8 of part S of chapter 57 of  the  laws
    56  of 2021, is amended to read as follows:
        A. 6442--C                          3

     1    §  5. This act shall take effect on the forty-fifth day after it shall
     2  have become a law, provided that the  amendments  to  subdivision  4  of
     3  section  2999-j of the public health law made by section two of this act
     4  shall take effect on June 30, 2017  [and  shall  expire  and  be  deemed
     5  repealed December 31, 2022].
     6    §  4.  This  act  shall take effect immediately, provided however that
     7  sections one and two of this act shall take effect on the thirtieth  day
     8  after  it  shall have become a law. Effective immediately, the addition,
     9  amendment and/or repeal of any rule  or  regulation  necessary  for  the
    10  implementation  of  this  act on its effective date are authorized to be
    11  made and completed on or before such effective date.