STATE OF NEW YORK ________________________________________________________________________ 7745 2019-2020 Regular Sessions IN ASSEMBLY May 17, 2019 ___________ Introduced by M. of A. GOTTFRIED, PAULIN -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to retail clinics The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The public health law is amended by adding a new section 2 230-e to read as follows: 3 § 230-e. Retail clinics. 1. As used in this section, "retail clinic" 4 means a facility or portion of a facility that is operated by any entity 5 that is authorized under the laws of this state to provide professional 6 services to the public and that provides health care services or treat- 7 ment provided by a health care practitioner licensed, certified, regis- 8 tered or authorized to practice under title eight of the education law, 9 acting within his or her lawful scope of practice, that: (a) operates 10 within the space of a retail business operation, such as a pharmacy or a 11 store open to the general public; (b) is labeled, branded, advertised or 12 marketed with the name or symbol of a retail business entity; or (c) is 13 labeled, branded, advertised or marketed with the name or symbol of a 14 business entity, other than a business entity that provides health care 15 services or treatment provided at the facility. However, a facility or 16 portion of a facility shall not be deemed to be a retail clinic if it 17 ordinarily is used only for providing health care services to employees 18 of the retail business operation. A facility shall not be deemed to be 19 a retail clinic if the health care service under title eight of the 20 education law it provides is limited to pharmacy or ophthalmic dispens- 21 ing and ophthalmologic or optometric services provided in connection 22 with ophthalmic dispensing. 23 2. The treatments and services that may be provided by a retail clinic 24 shall be limited to the provision of treatment and services to patients 25 for acute episodic illness or condition; episodic preventive treatment 26 and services such as immunizations; ophthalmic dispensing and ophthalmo- EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD11379-01-9

A. 7745 2 1 logic or optometric services provided in connection with ophthalmic 2 dispensing; or treatment and services for minor injuries that are not 3 reasonably likely to be life-threatening or potentially disabling or 4 have complications if ambulatory care within the capacity of the retail 5 clinic is provided; but the treatments and services provided by a retail 6 clinic shall not include monitoring or treatment and services over 7 multiple visits over prolonged periods. 8 3. A retail clinic shall be deemed to be a "health care provider" for 9 the purposes of title two-D of this article. A prescriber practicing in 10 a retail clinic shall not be deemed to be in the employ of a pharmacy or 11 practicing in a hospital for purposes of subdivision two of section 12 sixty-eight hundred seven of the education law. 13 4. (a) The commissioner shall make regulations setting forth opera- 14 tional and physical plant standards for retail clinics, which may be 15 different from the regulations otherwise applicable to diagnostic and 16 treatment centers, including, but not limited to: 17 (i) requiring that retail clinics attain and maintain accreditation by 18 an appropriate accrediting entity approved by the commissioner and 19 requiring timely reporting to the department if a retail clinic loses 20 its accreditation; 21 (ii) designating or limiting the treatments and services that may be 22 provided, including limiting the scope of services to the following, 23 provided that such services shall not include monitoring or treatment 24 and services over multiple visits or prolonged periods: 25 (A) the provision of treatment and services to patients for minor 26 acute episodic illnesses or conditions; 27 (B) episodic prevention and wellness treatments and services such as 28 immunizations; 29 (C) ophthalmic dispensing and ophthalmologic or optometric services 30 provided in connection with ophthalmic dispensing; 31 (D) treatment and services for minor injuries that are not reasonably 32 likely to be life threatening or potentially disabling or have compli- 33 cations if ambulatory care within the capacity of the retail clinic is 34 provided; 35 (E) prohibiting the provision of services to patients twenty-four 36 months of age or younger; 37 (iii) requiring retail clinics to accept walk-ins and offer extended 38 business hours; 39 (iv) setting forth guidelines for advertising and signage, which shall 40 include signage indicating that prescriptions and over-the-counter 41 supplies may be purchased by a patient from any business and do not need 42 to be purchased on-site; 43 (v) setting forth guidelines for informed consent, record keeping, 44 referral for treatment and continuity of care, case reporting to the 45 patient's primary care or other health care providers, design, 46 construction, fixtures, and equipment. 47 (b) Such regulations also shall promote and strengthen primary care by 48 requiring retail clinics to: 49 (i) inquire of each patient whether he or she has a primary care 50 provider; 51 (ii) maintain and regularly update a list of local primary care 52 providers and provide such list to each patient who indicates that he or 53 she does not have a primary care provider. Such roster (A) shall be 54 drawn from a list of primary care providers maintained and periodically 55 updated by the department on its website (in searchable form) including 56 the information required in clauses (B) and (C) of this subparagraph,

A. 7745 3 1 located in the zip code area and adjacent zip code areas of the retail 2 clinic, and may include additional primary care providers added by the 3 retail clinic; (B) shall identify preferred providers who have achieved 4 recognition as a patient centered medical home (pcmh) or other similar 5 designation and a description of what such designation means; and (C) 6 shall include federally qualified health centers and other providers who 7 serve medicaid, low-income and uninsured patients, and people with disa- 8 bilities and shall identify cultural and linguistic capabilities when 9 available; 10 (iii) refer patients to their primary care providers or other health 11 care providers where appropriate; 12 (iv) transmit by electronic means whenever possible, records of 13 services to patients' primary care providers; 14 (v) decline to treat any patient for the same condition or illness 15 more than three times in a year; and 16 (vi) report to the department relevant data, as may be deemed neces- 17 sary by the department, related to services provided and patients 18 served, provided that such reporting shall comply with all privacy laws 19 related to patient data. 20 (c) Retail clinics already in operation at the time this section takes 21 effect must comply with accreditation requirements under this subdivi- 22 sion within one year after the effective date of this section. 23 (d) The department shall routinely review the compliance by retail 24 clinics with the provisions of this section and if a retail clinic fails 25 to comply with the provisions of this section, or regulations adopted 26 pursuant to this section, the department shall have the authority to 27 take enforcement actions under title two of article one of this chapter. 28 (e) In making regulations under this section, the commissioner may 29 consult with a workgroup including, but not limited to, representatives 30 of health care consumers and representatives of professional societies 31 of appropriate health care professionals, including those in primary 32 care and other specialties. 33 5. A retail clinic shall provide treatment without discrimination as 34 to source of payment. 35 6. The department shall provide an annual report which it shall make 36 available on its website; the report shall include locations of retail 37 clinics in the state and shall indicate which clinics are located in 38 medically underserved areas; such report shall also include an analysis 39 as to whether retail clinics have improved access to health care in 40 underserved areas, recommendations related thereto and any other infor- 41 mation the department may deem necessary. 42 7. This section does not authorize any form of ownership or organiza- 43 tion of a retail clinic or practice of any profession that would not 44 otherwise be legal, and does not expand the scope of practice of any 45 health care practitioner. Where any regulation under this section would 46 affect the scope of practice that may be provided in a retail clinic a 47 health care practitioner licensed, registered, certified or authorized 48 to practice under title eight of the education law, the regulation shall 49 be made in consultation with the commissioner of education. 50 8. The host business entity of a retail clinic shall not, directly or 51 indirectly, by contract, policy, communication, incentive or otherwise, 52 influence or seek to influence any clinical decision, policy or practice 53 of any health care practitioner providing any health care service in the 54 retail clinic, including prescribing or recommending drugs, devices or 55 supplies. This subdivision shall not preclude the host business entity 56 from establishing, consistent with this section and applicable law,

A. 7745 4 1 limitations on or requirements as to the scope of health care services 2 to be provided in the retail clinic or activities to assure maintaining 3 quality standards of health care services. As used in this section, 4 "host business entity" means any retail business organization, retail 5 business entity or business entity within whose space the retail clinic 6 is located or with whose name or symbol the retail clinic is labeled, 7 branded, advertised or marketed. 8 § 2. This act shall take effect on the one hundred eightieth day after 9 it shall have because a law. Effective immediately, the commissioner of 10 health shall make regulations and take other actions reasonably neces- 11 sary to implement this act on that date.

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