RETRIEVE BILL
 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                           395
 
                               2003-2004 Regular Sessions
 
                    IN SENATE
 
                                       (Prefiled)
 
                                     January 8, 2003
                                       ___________
 
        Introduced  by  Sens.  VELELLA,  BALBONI,  DeFRANCISCO, LAVALLE, MENDEZ,
          PADAVAN, SALAND -- read twice and ordered printed, and when printed to
          be committed to the Committee on Judiciary
 
        AN ACT to amend the general obligations law, the civil practice law  and
          rules  and  the  public health law, in relation to holding health care
          organizations accountable for the consequences of their decisions
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Legislative  findings.  The legislature finds that a wide
     2  variety of entities are integrating the functions of paying  for  health
     3  care,  determining what health care is paid for, and providing the care.
     4  This integration of functions is breaking down traditional distinctions.
     5  Increasingly,  payor  determinations  are  governing  health  care   and
     6  controlling  decisions  that  in  the  past were the exclusive domain of
     7  health care professionals and patients. The  legislature  further  finds
     8  that  this integration of functions makes it imperative that health care
     9  organizations be held fully responsible for the  consequences  of  their
    10  decisions,  much as health care professionals have been held accountable
    11  for the consequences of their decisions.
    12    § 2. The general obligations law is amended by adding two new sections
    13  11-108 and 11-109 to read as follows:
    14    § 11-108. Accountability of  health  care  organizations.  1.    Defi-
    15  nitions.  For purposes of this section and section 11-109 of this title,
    16  unless the context clearly requires otherwise:
    17    (a) "Health care organization" means an entity (other  than  a  health
    18  care provider) that approves, provides, arranges for, or pays for health
    19  care services, including but not limited to:
    20    (i)  a  health  maintenance  organization licensed pursuant to article
    21  forty-three of the  insurance  law  or  certified  pursuant  to  article
    22  forty-four of the public health law,
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01677-02-3

        S. 395                              2
 
     1    (ii)  any  other organization certified pursuant to article forty-four
     2  of the public health law, or
     3    (iii) an insurer or corporation subject to the insurance law.
     4    No  entity  or person shall be deemed to be a health care organization
     5  because the entity or  person  procures  or  pays  for  health  coverage
     6  through  an  entity acting under the insurance law or article forty-four
     7  of the public health law.
     8    (b) "Health care provider" means an entity licensed or certified under
     9  article twenty-eight or thirty-six of the public health law, a preferred
    10  provider organization, a participating entity  through  which  a  health
    11  maintenance organization offers health services under article forty-four
    12  of  the public health law, an entity licensed or certified under article
    13  sixteen, thirty-one or thirty-two of the mental hygiene  law,  a  health
    14  care practitioner licensed, registered or certified under title eight of
    15  the  education law, or a provider of pharmaceutical products or services
    16  or durable medical equipment.
    17    (c) "Health care service"  means  health  care  services,  treatments,
    18  products or equipment provided by a health care provider.
    19    2. (a) Whenever a health care organization delays, fails or refuses to
    20  approve,  provide,  arrange  for,  or  pay  for, in a timely manner, any
    21  health care service to a person to the extent  it  is  contractually  or
    22  legally  obligated to do so, it shall be liable for any personal injury,
    23  death or damages caused by the delay, failure or refusal.
    24    (b) A health care organization shall be  liable  under  this  section,
    25  under otherwise applicable rules of tort and contract liability, includ-
    26  ing  but  not  limited to rules relating to agency, vicarious liability,
    27  and joint and several liability, for any act by  an  agent,  contractor,
    28  participating entity, or health care provider, for which the health care
    29  organization  would  be  liable  if it were committed by the health care
    30  organization.
    31    3. The failure of the person (or of any other  person  acting  on  the
    32  person's  behalf)  to  seek an alternative provider of or to pay for the
    33  health care service shall not diminish the  health  care  organization's
    34  liability  or  constitute  culpable  conduct for the purposes of section
    35  fourteen hundred eleven of the civil practice law and rules.
    36    4. Nothing in this section shall limit  any  other  right,  remedy  or
    37  cause of action that any person may otherwise have.
    38    5.  No  contract or agreement between a health care organization and a
    39  health care provider shall:
    40    (a) directly or indirectly require a health care provider to indemnify
    41  or hold harmless the health care organization for any liability  result-
    42  ing from the health care organization's acts or omissions; or
    43    (b)  waive, limit, or delegate the liability of the health care organ-
    44  ization under this section to any health care provider.
    45    6. No contract or agreement between a health care organization and any
    46  person shall waive or limit any liability of the health  care  organiza-
    47  tion under this section to the person.
    48    7. If the time in which a plaintiff could have commenced an action for
    49  professional  malpractice  for  the act, error or omission complained of
    50  has expired prior to the commencement of an action brought  pursuant  to
    51  this  section  against a health care organization, the defendant in said
    52  action shall be barred from commencing a third-party  action  against  a
    53  person  not a party who is or may be liable to that defendant for all or
    54  part of the plaintiff's claim against the defendant and against whom the
    55  plaintiff cannot commence an action for professional  malpractice due to

        S. 395                              3
 
     1  the expiration of the statute of limitations prior to  the  commencement
     2  of the action against the defendant.
     3    8.  A  health  care  organization shall exercise reasonable care:  (a)
     4  when making decisions which affect the health care service of an  enrol-
     5  lee;  and  (b) in selecting and exercising influence or control over its
     6  employees, agents, ostensible agents, or representatives who are  acting
     7  on  its behalf, respecting decisions which may affect the quality of the
     8  health care service provided to its enrollees.
     9    9. This section shall not be construed to diminish any contractual  or
    10  legal obligation of the health care organization, nor to create an obli-
    11  gation on the part of the health care organization to provide any health
    12  care service to an enrollee that is not a covered benefit.
    13    §  11-109.  Protection  of  health  care  providers. 1. No health care
    14  organization or health care  provider  shall,  by  contract,  policy  or
    15  procedure:
    16    (a)  prohibit  or  restrict  any  health  care  provider from filing a
    17  complaint;
    18    (b) prohibit or restrict any health care provider from making a report
    19  or commenting to the appropriate government agency regarding  the  poli-
    20  cies  or  practices  of the organization which may negatively affect the
    21  quality of or access to health care services; or
    22    (c) prohibit or restrict any health care provider from  disclosing  or
    23  commenting  on policies or practices of the organization which may nega-
    24  tively affect the quality of or access to health care  services  to  the
    25  public.
    26    This  subdivision  shall  not  be  construed  to  permit a health care
    27  provider to disclose any information regarding  a  patient  which  would
    28  otherwise  be  deemed confidential or privileged, or which should not be
    29  disclosed or discussed according to law or reasonable professional stan-
    30  dards.
    31    2. No health care organization or health care provider shall terminate
    32  a contract or employment of a health care provider, or refuse  to  renew
    33  such  a  contract, or penalize a health care provider or reduce or limit
    34  the compensation of a health care provider solely because a health  care
    35  provider has:
    36    (a)  advocated  for,  recommended or provided a particular health care
    37  service to a patient, to which the patient was entitled  by contract  or
    38  law;
    39    (b) taken any action under subdivision one of this section;
    40    (c)  appealed  or  assisted in appealing a decision of the health care
    41  organization; or
    42    (d) requested a hearing or review to which the provider was entitled.
    43    3. No health care organization or health care provider shall apply any
    44  incentive, whether monetary or otherwise,  to  a  health  care  provider
    45  intended  or  having  the effect of inducing the health care provider to
    46  delay, fail or refuse to provide any health  care  service  to  which  a
    47  patient is entitled by contract or law.
    48    §  3.  Section  1602 of the civil practice law and rules is amended by
    49  adding a new subdivision 13 to read as follows:
    50    13. not apply to an action against a health care organization  brought
    51  pursuant to section 11-108 of the general obligations law.
    52    §  4. Subdivision 1 of section 4410 of the public health law, as added
    53  by chapter 938 of the laws of 1976, is amended to read as follows:
    54    1.  The provision of comprehensive health services directly  or  indi-
    55  rectly,  by  a health maintenance organization through its comprehensive
    56  health services plan shall not be considered the practice of the profes-

        S. 395                              4
 
     1  sion of medicine by such organization or plan.  [However,  each]  Except
     2  that:
     3    (a) This subdivision shall not be construed to limit any liability the
     4  health  maintenance  organization  or  its comprehensive health services
     5  plan would otherwise have relating to any professional services rendered
     6  by, on behalf of, or in connection with the organization or plan.
     7    (b) Each member, employee or agent of such organization or plan  shall
     8  be  fully  and  personally  liable  and accountable for any negligent or
     9  wrongful act or misconduct committed by him or her or any  person  under
    10  his  or  her direct supervision and control while rendering professional
    11  services on behalf of [such] the organization or plan.
    12    (c) No contract or agreement between a health maintenance organization
    13  or its comprehensive health services plan and any health  care  provider
    14  shall  delegate  the liability of the health maintenance organization to
    15  any health care provider or shall require the health  care  provider  to
    16  indemnify  or  hold  harmless the organization or plan for any liability
    17  the organization or plan may incur.
    18    § 5. If any provision of this act or the application thereof shall  be
    19  held to be invalid, such invalidity shall not affect other provisions or
    20  other  applications  of  any  provision  of  this act which can be given
    21  effect without the invalid provision or application, and  to  that  end,
    22  the provisions and application of this act are severable.
    23    § 6. This act shall take effect immediately.