Requires health insurance companies to provide health proxy forms to the insured and to store completed proxies on behalf of the insured

Summary

Section one adds a new subsection (f) to Section 3217-a of the insurance law to require health insurance providers to give the health proxy form to all policy holders upon request and every two years. Completion of the form by the policy holder is not mandatory.

Section two of this bill adds a new section 3240 which requires the health insurance provider to receive and store the completed proxy form with the enrollees other records. The insurance carrier shall provide the proxy form to the healthcare institutions/medical personnel who need to contact the proxy named on the form in the course of the policyholder's care.

Section 366-a of the social services law is amended to require the department to provide health care proxy forms with instructions to complete the forms to individuals applying for Medicaid. The department shall accept and store the completed proxy form from the applicant. In addition the department shall supply the form to the medical facility treating the applicant.

Justification

Healthcare proxies have been legal documents in New York State since 1991. A proxy allows a person to designate someone to be their surrogate decision-maker in a healthcare setting should they be unable to speak or make decisions for themselves. The State Department of Health website has forms, extensive instructions and information on healthcare proxies. Unfortunately, very few people in the State have completed this form, or even know that it exists.

Currently, hospitals are required by law to provide this form to anyone being admitted, although it may not be an ideal time for the patient to make important healthcare decisions. A person entering a hospital may be in no condition to fill out paperwork or consider who best understands or knows their wishes. Even if a hospitalization is planned, it can be a stressful time for an individual and people close to them, making them unwilling to complete the document or to make the best choice regarding the identity of their healthcare proxy.

For those who do have a healthcare proxy, there is no set system for making this form available to the healthcare institution caring for the Proxy-holder. If one fills out a proxy form at a healthcare institution, is discharged, and then some time later is admitted to a different institution, a new form would likely be needed. If one has supplied a completed form to one's primary care physician's office, there is no guarantee that it will be transferred to an admitting hospital in a timely manner. Because there is no standardized system for storing this information, there have also been situations in which a person's most updated proxy has not been available, and therefore a former proxy no longer appropriate (for example, a divorced spouse) was the legal agent.

Because it is clear that the people who are closest to a person are best suited to represent that individual and make decisions regarding their care, New York has recently passed into law the Family Healthcare Deci- sions Act (FHDA). While this certainly represents progress in our efforts to achieve quality patient care, it also highlights the fact that for some the person who would be their designated agent per FHDA may not be the one they would choose as their healthcare proxy. Further- more, FHDA only applies to certain healthcare settings, while a Proxy applies to all settings. For example, if a person suffering from demen- tia wished to be represented by their spouse at their community clinic, this would be possible under current law only if the person had desig- nated their spouse as their proxy.

Individuals, families, healthcare institutions, and health insurance companies are all best served by patients and their loved ones being satisfied that a person is receiving the individual care that they would choose. Having a current healthcare proxy is the ideal way to accomplish this. The only way for more people to complete this document and update it if their life circumstances change, is to increase exposure to the document.

Whenever a person is admitted to a healthcare institution, that institu- tion always contacts their insurance provider for personal information and reimbursement purposes. In the process of such a transaction, it would be convenient for the policy provider to make available the Proxy's identity and contact information in whatever format they are providing other data needed by the health care institution (phone, fax, etc.)

Fiscal implications for the state

To be determined.

Effective date

This act shall take effect on the sixtieth day after it shall become law; provided, however, that effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized and directed to be made and completed on or before such effective date.