Relates to the establishment of a registry system for medical orders for life-sustaining treatment (MOLST)

Title of bill

An act to amend the public health law, in relation to the establishment of a registry system for medical orders for life-sustaining treatment (MOLST)

Purpose

To support the long-term sustainability of the Medical Orders for Life-Sustaining Treatment (MOLST) program by expressly referencing the MOLST program in statute, creating an e-MOLST registry, and provide for mandatory submission to the registry in order to accelerate the digital transformation of the MOLST program.

Summary of provisions

Section 1 amends Section 2994-dd of the Public Health Law to expressly reference and define the MOLST program in statute.

Section 2 amends the Public Health Law to direct the Department of Health, or a designee of the Department of Health, to establish and maintain an electronic system for collecting, maintaining, and transmitting MOLST forms, to be known as the "New York State e-MOLST Registry".

Section 3 amends the Public Health Law to require a health care provider that completes and signs a medical order form DOH-5003 MOLST or the electronic version of DOH-5003 MOLST ("eMOLST") to submit a copy of the completed form to the Registry within fourteen days of completion.

Section 4 prohibits the imposition of fees on practitioners or patients that use MOLST or eMOLST to fund the operation of the Registry.

Section 5 authorizes the Commissioner of Health to promulgate rules and regulations necessary to establish, operate and maintain the Registry.

Justification

The MOLST program, developed with the assistance of Excellus Blue Cross Blue Shield and in collaboration with the Department of Health, has grown into a statewide program that assists physicians and other health care providers discuss and convey a patient's wishes regarding cardiopulmonary resuscitation (CPR) and other life-sustaining treatment. The MOLST form is the only authorized form in New York for documenting both nonhospital DNR and DNI orders. The form is beneficial to patients and providers as it provides specific medical orders and is recognized all health care settings, including the community. The MOLST program has grown to include a secure web-based electronic version of the MOLST Form (eMOLST) and an electronic database centrally housing eMOLST forms to allow 24/7 access in an emergency.

New York has been a national leader in advanced care planning and providing patients with opportunities and consumer protections to ensure their preferences for treatment at the end of life are honored. Recently, other states have passed legislation and invested significant resources to further advance and sustain their MOLST programs. This Bill would enhance the public-private partnership of the program to ensure that it continues to benefit the residents of New York.

The goals of the MOLST program align with the Department's development innovative payment models and the triple aim. Health care policy is beginning to recognize the importance of advance care planning. CMS recently began reimbursing health care professionals for providing advance care planning services to Medicare and Medicaid members. New York State insurers have reimbursed health care professionals for MOLST discussions and end of life care planning. Advancement of this program will allow for more New York residents to ensure their preferences for treatment at the end of life are honored.

Legislative history

New Bill.

Fiscal implications

Minimal.

Effective date

This act shall take effect immediately.