A.2460 Amend the Public Health Law

Morris Auster, Esq.                           Division of Governmental Affairs             Senior Vice President /
Chief Legislative Counsel        

                                                                     MEMORANDUM  IN  SUPPORT 

ON ASSEMBLY HEALTH COMMITTEE              A.2460 (GOTTFRIED)
AGENDA

ON SENATE FLOOR (Cal. #717)                               S.3661 (HANNON)
 
AN ACT to amend the public health law and the education law, in relation to quality assurance and peer review activities 

This measure would extend the confidentiality provisions relating to discovery of testimony to apply to statements made by any person in attendance at peer-review committee that is a party to an action the subject matter of which was reviewed at such meeting. The Medical Society of the State of New York supports enactment of this measure.

The objective of the existing discovery exclusions under section 2805-m of the Public Health Law and section 6527 of the Education Law is to enhance the objectivity of the review process and to assure that medical peer review committees may frankly and objectively analyze the quality of health services rendered. This exclusion from discoverability, however, contains a narrow and yet potent exception that permits disclosure of statements given at an otherwise privileged peer-review meeting by a party (medical provider) to a lawsuit which involves the same underlying conduct that is the topic of discussion at the meeting.  As a result of this narrow exception, any statements or information volunteered as part of the peer-review process could be discovered and used against them in such proceedings.  It is believed that incidents involving medical errors can go undetected and are under-reported because physicians and other health care providers understand that they would potentially be exposed to future civil actions even though the particular event did not involve negligence.  Moreover, it should be noted that New York is one of only a small number of states that actually permits statements in peer-review proceedings to be disclosed.  Most other states do not permit such disclosure.

This legislation would improve the peer-review process and the clear benefits to be derived therefrom through the increased willingness of providers to submit information without fear of misuse in subsequent legal proceedings.

For the above stated reasons, the Medical Society supports enactment of this legislation.

Respectfully submitted,
MSSNY DIVISION OF GOVERNMENTAL AFFAIRS

5/12/17
MMA – support

A.2460 – Amend the Public Health Law

Morris Auster, Esq.                             Division of Governmental Affairs           

Senior Vice President /                    MEMORANDUM  IN  SUPPORT
Chief Legislative Counsel

ON ASSEMBLY HEALTH COMMITTEE           A.2460 (GOTTFRIED)
AGENDA

ON SENATE FLOOR (Cal. #717)                               S.3661 (HANNON)

AN ACT to amend the public health law and the education law, in relation to quality assurance and peer review activities

This measure would extend the confidentiality provisions relating to discovery of testimony to apply to statements made by any person in attendance at peer-review committee that is a party to an action the subject matter of which was reviewed at such meeting. The Medical Society of the State of New York supports enactment of this measure.

The objective of the existing discovery exclusions under section 2805-m of the Public Health Law and section 6527 of the Education Law is to enhance the objectivity of the review process and to assure that medical peer review committees may frankly and objectively analyze the quality of health services rendered. This exclusion from discoverability, however, contains a narrow and yet potent exception that permits disclosure of statements given at an otherwise privileged peer-review meeting by a party (medical provider) to a lawsuit which involves the same underlying conduct that is the topic of discussion at the meeting.  As a result of this narrow exception, any statements or information volunteered as part of the peer-review process could be discovered and used against them in such proceedings.  It is believed that incidents involving medical errors can go undetected and are under-reported because physicians and other health care providers understand that they would potentially be exposed to future civil actions even though the particular event did not involve negligence.  Moreover, it should be noted that New York is one of only a small number of states that actually permits statements in peer-review proceedings to be disclosed.  Most other states do not permit such disclosure.

This legislation would improve the peer-review process and the clear benefits to be derived therefrom through the increased willingness of providers to submit information without fear of misuse in subsequent legal proceedings.

For the above stated reasons, the Medical Society supports enactment of this legislation.

Respectfully submitted,

MSSNY DIVISION OF GOVERNMENTAL AFFAIRS

5/12/17
MMA – support

 

A.1404 Patient privacy protection act

Morris M. Auster, Esq.                   Division of Governmental Affairs
Senior Vice President/                  MEMORANDUM  IN  OPPOSITION
Chief Legislative Counsel

ON ASSEMBLY FLOOR                                        A.1404 (WEINSTEIN) 

IN SENATE JUDICIARY COMMITTEE       S.243 (DEFANCISCO)

AN ACT to amend the civil practice law and rules, in relation to enacting the “patient privacy protection act”

This bill would amend the civil practice law and rules to prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician.   The Medical Society of the State of New York opposes this legislation and urges that it be defeated. 

This legislation would overturn a very important New York State Court Appeals decision that was issued in 2007 that affirmed a long-standing principle in our legal system that no party has a proprietary interest in a particular witness in a civil liability action.  Were this decision to be overturned through legislation, it would present significant problems for a physician defendant in seeking to defend himself or herself in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.     

New York’s dysfunctional liability adjudication system is in need of systemic reforms to reduce our huge liability insurance premiums, instead of provisions such as this proposed legislation which would undoubtedly increase them.  New York’s health care delivery system already faces severe financial strains due to a myriad of factors.  Therefore, it is imperative that the State Legislature take action to assure that physicians and hospitals remain available to deliver the care New Yorkers are expecting to receive, including acting to reduce the choking costs of medical liability insurance.

Given the extraordinary costs of medical liability insurance that many physicians must pay, combined with the enormous changes in health care delivery and payment that is placing huge new financial pressures on physician practices and hospitals, it is irresponsible to consider legislation at this time that might actually increase these costs.  Many New York physicians already pay liability premiums that far exceed $100,000 and some even exceed $300,000!

The timing of this legislation and other bills to expand tort liability could not be worse.  We now have multiple malpractice insurance companies operating in New York State that appear to be facing serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action.  Moreover, with the US House’s recent passage of the AHCA, there is enormous uncertainty in our health care system because of proposals in the AHCA that could profoundly restructure New York’s Medicaid system.

For many physicians currently struggling to keep their practices afloat due to the enormous changes taking place in health care delivery, this legislation could be the “final straw” to drive them out of practice and into other states. Many New York physicians pay liability premiums that far exceed $100,000 and some even exceed $300,000!  The cost of medical liability coverage for the 2015-16 year is:

  • $338,252 for a neurosurgeon in Nassau and Suffolk counties;
  • $186,630 for an obstetrician in Bronx and Richmond counties;
  • $141,534 for an orthopedic surgeon in Nassau and Suffolk Counties;
  • $132,704 for a general surgeon in Kings and Queens counties, and
  • $134,902 for a vascular surgeon or cardiac surgeon in Bronx and Richmond counties.

Furthermore, malpractice payouts in New York State continue to be far out of proportion to the rest of country.  For example, a recently released report by Diederich Healthcare showed that once again New York State had by far and away the highest number cumulative medical liability payouts ($711,718,250), nearly two times greater than the state with the next highest amounts, Pennsylvania ($374,018,550), and far exceeding states such as California ($263,874,600) and Florida ($248,911,150).    At the same time, New York had by far and away the highest per-capita medical liability payments in the country, far exceeding the second highest state Massachusetts by nearly 20%, the third highest state Pennsylvania by 23%, and the fourth highest state New Jersey by 26%.   Remarkably, it was more than 500% more than California!

It is little wonder that a recent analysis from the website WalletHub listed New York as the worst state in the country in which to practice medicine, in large part due to its overwhelming liability exposure as compared to other states in the country.  Legislation such as this will only make this embarrassment even worse!

At the same time physicians face these exorbitant costs, health plans continue to reduce payments to physicians by inappropriately denying, delaying and reducing payment for needed care.   Exacerbating these problems are the increasingly large patient balances that are accruing as a result of a significant increase in the use of high deductible health insurance plans.   At the same time, physicians face substantial new costs as a significant component of their revenue base will be conditioned on participation in often unwieldy value-based payment schemes both in Medicare and in Medicaid, including the need to invest tens of thousands of dollars to implement electronic medical record systems.    When factoring all these problems together, it is no surprise that regions all across New York State are beginning to see shortages in several specialties, according to reports issued by the Center for Health Workforce Studies.

With all these enormous changes occurring in patient care delivery, physicians need comprehensive reform of our flawed civil justice system and reduction in our medical liability costs, not legislation that increases costs and exacerbates existing problems.

This bill would do nothing to address the problems facing our health care system, and would instead make these problems worse.  Physicians need liability cost decreases, not increases!

For all of the reasons stated above, we urge that this measure be defeated. 

                                                                        Respectfully submitted,

MSSNY DIVISION OF GOVERNMENTAL AFFAIRS

5/22/17
MMA – oppose                                              

A.352 Oppose School Information

Morris Auster, Esq.                               Division of Governmental Affairs

Senior Vice President /                    MEMORANDUM  IN OPPOSITION
Chief Legislative Counsel

ON ASSEMBLY FLOOR                     A.352 (Perry) (Ca1. #3) 

IN SENATE HEALTH COMMITTEE                    S.2113 (Felder)

 AN ACT to amend the public health law, in relation requiring physicians and hospitals to obtain the name of the  school  attended  by school-aged  patients  and to include this information in their admission registration forms This legislation would amend the public health law to require physicians and hospitals to obtain the name of the school attended by school-aged patients and to include this information in their admission registration forms.  The Medical Society of the State of New York opposes this legislation. 

While the intent of this legislation is laudable, it would impose yet another unfunded mandate on already overstressed physician offices seeking to assure patients receive needed care amid the myriad of requirements already imposed by Medicare, Medicaid, private insurers, as well as other state mandates.  These increasing mandates take more and more time away from the ability to deliver the timely care patients expect to receive.  This trend is well documented.  Indeed, a recent 2016 study reported in the Annals of Internal Medicine concluded, remarkably, that for every one hour of patient care delivered by a physician, two more must be spent on paperwork.   Moreover, these overwhelming paperwork demands is one of the major factors that is causing physicians to feel compelled to leave private practice to become employed in a large health system, which can threaten the continuity of existing physician-patient relationships.  At a time when we are seeking to assure that the hundreds of thousands of patients who have newly received health insurance coverage through New York’s Exchange are truly able to receive needed care, imposing new paperwork requirements will only create further delays and roadblocks to patients receiving care.

Based on the foregoing, the Medical Society of the State of New York opposes this legislation and urges that it be defeated. 

Respectfully submitted,
MSSNY DIVISION OF GOVERNMENTAL AFFAIRS

6/13/17MMA – oppose      

 

A.2317 Higher-Cost Drugs

Morris Auster, Esq.                              Division of Governmental Affairs           Senior Vice President /                     MEMORANDUM  IN  SUPPORT
Chief Legislative Counsel

ON ASSEMBLY FLOOR                           A.2317 (PEOPLES-STOKES)

IN SENATE INSURANCE COMMITTEE                  S.5022 (SERINO)
 
AN ACT to amend the insurance law, in relation to prescription drug formulary changes during a contract year/ 

This bill would amend the Insurance Law to protect health insurance consumers by prohibiting healthcare plans from moving a drug to a higher-cost tier and not allow for the removal of a prescription drug from a formulary during the enrollment year. The Medical Society of the State of New York supports enactment of this measure.

Critical to assuring a patient’s recovery from illness or stabilizing a patient’s condition is through continuation of a medication regimen recommended by their physician.    As a result, a consumer’s choice of which insurance plan to enroll is often driven by which health insurance plan will cover their needed medication with the lowest possible out of pocket cost.  Under this bill, consumers would be assured that coverage for prescription drugs in the plan’s formulary will not change during the enrollment year.  Unexpected prescription drug changes in the formulary could result in higher out-of-pocket costs, which could seriously interfere with the continued medication therapy for patients with serious medical conditions such as epilepsy, cancer, asthma, and HIV/AIDS,  This legislation would help to protect consumers from unforeseen higher deductibles, copayments and coinsurance that would result from health care plans moving prescription drugs to a tier with higher patient cost sharing.

For the above stated reasons, the Medical Society supports enactment of this legislation.

Respectfully submitted,

5/17/17

MMA – support
MSSNY DIVISION OF GOVERNMENTAL AFFAIRS

Bill Memos

Bill Memos 2017

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