What's happening
This bill establishes an ombudsman office and advisory panel to oversee and assist with New York's medical indemnity fund for qualified plaintiffs.
Why it matters
Creates an independent ombudsman office. specifically to help "qualified plaintiffs" (primarily people with neurological injuries covered by the fund) resolve complaints, navigate complex regulations, and understand their rights—potentially increasing transparency and accountability for a vulnerable population.
Mandates confidentiality. for the ombudsman and deputies, protecting sensitive medical and personal information of plaintiffs, which can help foster trust and encourage people to seek help without fear of exposure.
Requires annual public reporting. by the ombudsman on the office’s activities, the types of complaints received, and recommendations for legal or regulatory changes—offering lawmakers and the public valuable insight into how the fund is working and where it may need improvement.
Establishes a diverse advisory panel. including state officials, fund beneficiaries, medical professionals, and other stakeholders, ensuring that multiple perspectives are considered in shaping fund policies and improving its administration.
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Who cares
Headline styles
Create Medical Fund Watchdog Office
Plain English, a few words. Used as the page title.
Sponsors
3 Co-sponsors
History
- Referred to ways and means
- Delivered to assembly
- Passed senateVote 60–0
- Ordered to third reading cal.2053
- Committee discharged and committed to rules
- Print number 6948a
- Amend and recommit to finance
- Reported and committed to finance
- Referred to health
- Referred to rules
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Create Medical Fund Watchdog
In Assembly Committee · Ways And Means · Sponsor Thomas Abinanti
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
6948--A
2017-2018 Regular Sessions
IN SENATE
November 17, 2017
Introduced by Sens. HANNON, SEWARD, LARKIN, RITCHIE -- read twice and ordered printed, and when printed to be committed to the Committee on Rules -- recommitted to the Committee on Health in accordance with Senate Rule 6, sec. 8 -- reported favorably from said committee and committed to the Committee on Finance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT to amend the public health law, in relation to establishing an office of the state medical indemnity fund ombudsman and a medical indemnity fund advisory panel
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Title 4 of article 29-D of the public health law is amended by adding two new sections 2999-k and 2999-l to read as follows:
§ 2999-k. Medical indemnity fund ombudsman. 1. There is hereby established an office of the state medical indemnity fund ombudsman for the purpose of receiving and resolving complaints affecting qualified plaintiffs, where appropriate, referring such complaints to the appropriate agencies and acting in concert with such agencies. The commissioner, in consultation with the superintendent of financial services, shall appoint a full-time medical indemnity fund ombudsman to administer and supervise the office of the state medical indemnity fund ombudsman. The medical indemnity fund ombudsman shall be selected from among individuals with expertise and experience in the field of neurological injuries and advocacy, and with such other qualifications as shall be determined by the commissioner, in consultation with the superintendent of financial services. Such ombudsman may, with approval of the commissioner, in consultation with the superintendent of financial services, appoint one or more authorized deputies to assist in his or her duties pursuant to this section; provided, however, that no such deputy shall have any conflict of interest, or be employed by the fund administrator or other
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD13790-03-8
S. 6948--A 2
party involved in the management of the fund. The medical indemnity fund ombudsman shall, personally or through authorized deputies:
(a) identify, investigate and resolve complaints that are made by or on behalf of qualified plaintiffs, and that relate to actions, inactions or decisions that may adversely affect the health, safety, welfare or rights of qualified plaintiffs;
(b) provide services to assist qualified plaintiffs, or their representatives, in navigating the fund and understanding the fund's regulations, guidelines and procedures;
(c) inform qualified plaintiffs, or their representatives, of their rights and means of obtaining the services, supplies and modifications to which they are entitled;
(d) analyze and monitor implementation of the laws and regulations relating to the fund; and
(e) carry out other such activities as the commissioner, in consultation with the superintendent of financial services, shall determine appropriate.
2. Neither the medical indemnity fund ombudsman, nor any of his or her deputies shall disclose to any person outside the office of the state medical indemnity fund ombudsman any information obtained from a qualified plaintiff's records without the consent of the qualified plaintiff or his or her representative.
3. Within one year of the effective date of this section, and annually thereafter, the medical indemnity fund ombudsman shall submit to the commissioner, the superintendent of financial services, the speaker of the assembly and the temporary president of the senate, a report which shall include, but not be limited to, a detailed summary of the activities of the office of the state medical indemnity fund ombudsman, data regarding the complaints and issues within the fund, the process used in resolving issues, and recommendations for legislative or regulatory amendments to improve the fund.
§ 2999-l. Medical indemnity fund advisory panel. There is hereby established an advisory panel to be comprised of the commissioner, the superintendent of financial services, qualified plaintiffs or representatives of qualified plaintiffs, physicians, medical suppliers, advocates and other interested parties. The advisory panel shall be co-chaired by the commissioner and the superintendent of financial services, and shall be composed of not less than nine additional members appointed by the governor, of which two shall be appointed upon recommendation of the temporary president of the senate and two shall be appointed upon the recommendation of the speaker of the assembly. The advisory panel shall meet biannually, with the first meeting occurring within one hundred eighty days of the effective date of this section, to discuss the functioning of the fund and any relevant issues. The commissioner and the superintendent of financial services shall consider the input and comments of the advisory panel in drafting and amending regulations, guidelines or policies pertaining to the fund administration.
§ 2. This act shall take effect on the ninetieth day after it shall have become a 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.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to establishing an office of the state medical indemnity fund ombudsman and a medical indemnity fund advisory panel
Purpose
To establish a Medical Indemnity Fund Ombudsman and Advisory Panel.
Summary of provisions
Section one adds Public Health Law § 2999-k establishing a Medical Indemnity Fund Ombudsman for the purpose of receiving and resolving complaints, and informing qualified plaintiffs and their representatives of the services, supplies and modifications they are entitled. This section also adds a Public Health Law § 2999-1 to create the Medical Indemnity Fund Advisory Panel for the purpose of bringing together stakeholders to make recommendations on ways to improve the functioning of the Medical Indemnity Fund.
Read the full memo (729 words)
Section two provides that the act take effect 90 days after enactment; provided effective immediately the Commissioner may amend, establish or repeal any regulation necessary to implement.
Justification
The Medical Indemnity Fund (MIF) was created in 2011 to provide a fund- ing source for future health care costs associated with birth-related neurological injuries and to reduce medical malpractice insurance premi- ums. MIF enrollees have either settled or won a judgment in a malprac- tice action. Rather than receiving damages for future health care costs, the law requires these children be enrolled in the MIF for said costs. Once implemented for a few years, issues began to arise regarding reimbursement rates, access to care, coverage and appeals within the fund. Accordingly, the Legislature enacted Ch. 517 of 2016 to address these concerns. Amendments to this Chapter were negotiated (Ch. 4 of 2017) at the behest of the Executive. The final result was legislation that: clarified qualifying health care costs could not be denied on the grounds they may incidentally benefit others in the household; increased reimbursement rates until December 21, 2019; and required a report to be issued by the Executive to the Legislature on or before April 1, 2017 detailing the financial condition of the MIF. The purpose of this report was to educate the Legislature on how to proceed with any future amend- ments to the MIF. On June 12, 2017, two days prior the Senate roundtable on the MIF, said report was released.
At the June 14, 2017 Senate roundtable parents, attorneys and providers recounted their experiences and challenges with the MIF. One parent, who is a lawyer by trade, testified to the need for a patient advocate to educate and assist parents trying to navigate the MIF. Additionally, many concerns were raised regarding the potential disruption that may be caused by the transition to a new administrator scheduled to occur a few months later. While all were assured by the Departments of Health and Financial Services that there was plan in the works to ensure a smooth transition, months later complaints began rolling in. The new adminis- trator was not reimbursing claims, families were unable to obtain supplies, claims were being paid cents on the dollar, families were forced to obtain new providers, and the new administrator was seemingly applying new policy guidelines that were unknown to providers, enrollees and their families. The families with children enrolled in the MIF struggle with enough challenges to obtain quality care for their child, they should not have to deal with administrative hurdles and changing policies in order to obtain services and supplies needed to keep their child alive. This legislation establishes an ombuds man to serve as a much needed advocate for the MIF families to ensure they are educated and able to access the services, supplies and modifications they are entitled.
Also raised at the roundtable by many was the need to continue conversa- tions, to take a deeper look into the data, and to have an ongoing proc- ess to address concerns regarding the functioning of the MIF. Much like the workgroup proposed in the original Chapter from 2016, this legis- lation establishes a MIF stakeholder advisory panel that will meet at a minimum of twice annually to discuss ongoing issues and to make recom- mendations.
Together these protections will help ensure the MIF is functioning as originally intended and that families are getting the care they are entitled.
Legislative history
New bill.
Fiscal implications
To be determined.
Effective date
90 days after enactment; provided effective immediately the Commissioner may amend, establish or repeal any regulation necessary to implement.
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