Relates to referrals of patients for health related items or services

BILL NUMBER:A9933

Title of bill

An act to amend the public health law, in relation to referrals of patients for health or health related items or services

Purpose or general idea of bill

To promote conformity between the federal Stark Law and New York's Health Care Practitioner Referrals Statute.

Summary of provisions

Amends Public Health Law §238-a (2) (c) to provide that a referral that would be allowed under federal law, 42 U.S.C. 1395nn or its regulations would similarly be allowed under the New York law, unless the Public Health Council declares a type of arrangement to pose a substantial risk of payer or patient abuse, by regulation approved by the Health Commissioner.

Amends the list of exemptions in Public Health Law § 238-a (6) (c) to add any referral allowed under federal law, unless the state Public Health Counsel declares a type of referral to pose a substantial risk of payer or patient abuse, by regulation subject approval of the Health Commissioner.

Justification

In the absence of conformity between the federal and State statutes, some arrangements or referrals involving health care provider that are permissible under the federal Stark law may not be permitted by the New York statute. For example, the New York statute does not contain exceptions for providing electronic medical record systems, donations of items and services to federally qualified health centers, and fair market value arrangements. Also, the New York excep- tion for in-office ancillary services requires an employer/employee relationship, as compared to the Stark exception, which permits an inde- pendent contractor relationship.

The New York State Department of Health has at times refrained from enforcing the State law as written, but with the increased focus on compliance and enforcement, it is important that health care providers know that compliance with federal law will, in most cases, also consti- tute compliance with State law. The bill would accomplish this objec- tive, thereby enhancing compliance and enabling providers and attorneys to know the appropriate way to structure certain arrangements.

While the examples cited above appear are, in general, arrangements that are in the public interest, there certainly could be types of arrange- ments or referrals allowed under federal law that should not be allowed in New York. Therefore, the bill would empower the Public Health Council and the Health Commissioner to designate particular types of arrange- ments or referrals that would not be allowed because they pose a substantial risk of payer or patient abuse.

Prior legislative history

New bill.

Fiscal implications

None.

Effective date

Immediately.