Bill Text: NY S05875 | 2019-2020 | General Assembly | Introduced


Bill Title: Authorizes healthcare facilities and professionals to pay for the fair market value of practice management, billing or health information technology services.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2020-01-08 - REFERRED TO HEALTH [S05875 Detail]

Download: New_York-2019-S05875-Introduced.html



                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.
                                                                   LBD00407-01-9

        S. 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.
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