Provides for a premium reduction for physicians and licensed midwives who complete a risk management strategies course in obstetrics or midwifery.
TITLE OF BILL: An act to amend the public health law and the insurance law, in relation to premium reduction for obstetric practitioners who complete a risk management strategies course
PURPOSE: To improve birth outcomes and to promote informed consultation by Patients with their physicians and licensed midwives
SUMMARY OF SPECIFIC PROVISIONS: Section one amends the public health law by adding a new section 2506-a that provides that the commissioner of health shall approve professional education courses for eligible physicians and licensed midwives that cover risk management strategies in obstetrics, including information on potential risks and strategies to fully inform patients of risks associated with their decisions. Such courses shall be subject to standards as the commissioner shall prescribe by regulation. Physicians and licensed midwives who successfully complete a risk reduction course may receive continuing medical education credit and a certificate of completion. Topics to be included in such course are provided. Attendance at any course approved by the commissioner may be in person or through distance learning methods. The commissioner is authorized to prescribe any rules and regulations necessary and shall consult with the Superintendent of Financial Services.
Section two amends section 2343 of the insurance law by amending subsection (e) that provides that the superintendent shall approve an actuarially appropriate premium reduction for an insured physician or licensed midwife who successfully completes a risk management course or a risk management course in obstetrics and midwifery.
Section three provides the effective date.
JUSTIFICATION: In order for a woman to determine the most appropriate mode of delivery in light of her individual circumstances, it is critical that she be fully informed about the risks of each birth option as well as considerations regarding options for labor. For example, cesarean delivery has been show to imply a higher risk of maternal death, a longer recovery time and operative complications as well as a higher risk of unexplained stillbirths in subsequent pregnancies and respiratory problems of the newborn. Elective cesarean deliveries (cesareans performed in the absence of medical indication) are considered by many to account for the significant rise in cesarean births.
To promote informed consultation with patients during pregnancy by their physicians and licensed midwives, physicians and licensed midwives should be knowledgeable of current, evidence-based information regarding options for labor and delivery, including factors to be considered potential risks. This 12) bill will provide eligible physicians and licensed midwives with the opportunity, through approved professional risk management strategies in obstetrics and midwifery education courses, to stay well-versed in the considerations and concerns that should be taken into account regarding available options while providing a possible insurance premium reduction.
Obstetrics and gynecology is considered among the specialties at highest risk for malpractice claims and most severely affected by rising insurance premiums. The increases in medical malpractice premiums discourage licensed midwives from practicing in New York State and have caused many ob-gyns to retire early, drop high-risk obstetric patients; or to drop obstetric services altogether.
Physicians and licensed midwives will thereby be better able to educate their patients so that they can make informed decisions regarding their labor and delivery. In facilitating greater education of physicians and licensed midwives and their patients, resulting in more informed decision-making by patients, we will enhance our ability to improve birth as well as maternal and neonatal outcomes.
PRIOR LEGISLATIVE HISTORY: A.759, 2009 and 2010 referred to health. A.8125-B, 2007 and 2008 advanced to third reading. S. 5153B of 2011-2012 Committed to the Senate Finance Committee.
FISCAL IMPLICATIONS:; None to the state.
EFFECTIVE DATE: This act shall take effect one year after it shall have become a law and shall apply to all insurance policies and contracts issued, renewed, modified or altered on and after such, effective date.
STATE OF NEW YORK ________________________________________________________________________ 1674 2013-2014 Regular Sessions IN SENATE (PREFILED) January 9, 2013 ___________Introduced by Sen. GRISANTI -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law and the insurance law, in relation to premium reduction for obstetric practitioners who complete a risk management strategies course THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The public health law is amended by adding a new section 2506-a to read as follows: S 2506-A. RISK MANAGEMENT STRATEGIES IN OBSTETRICS AND MIDWIFERY COURSES. 1. IN ORDER TO IMPROVE PATIENT SAFETY, BIRTH OUTCOMES AND TO PROMOTE INFORMED CONSULTATION BY PATIENTS WITH THEIR PHYSICIANS AND LICENSED MIDWIVES DURING THE PRENATAL THROUGH INTRAPARTUM AND POSTPARTUM PERIODS, THE COMMISSIONER SHALL APPROVE PROFESSIONAL EDUCATION COURSES FOR ELIGIBLE PHYSICIANS AND LICENSED MIDWIVES AS PROVIDED IN SUBDIVISION FOUR OF THIS SECTION THAT COVERS RISK MANAGEMENT STRATEGIES IN OBSTET- RICS AND MIDWIFERY AS DESCRIBED IN SUBDIVISION TWO OF THIS SECTION. SUCH RISK MANAGEMENT STRATEGIES COURSES SHALL BE SUBJECT TO SUCH STANDARDS AS THE COMMISSIONER MAY PRESCRIBE BY REGULATION. IN PRESCRIBING SUCH REGU- LATIONS, THE COMMISSIONER MAY CONSULT WITH THE AMERICAN CONGRESS OF OBSTETRICIANS AND GYNECOLOGISTS, NEW YORK STATE ASSOCIATION OF LICENSED MIDWIVES AND OTHER HEALTH CARE ORGANIZATIONS. AN ELIGIBLE PHYSICIAN OR LICENSED MIDWIFE WHO SUCCESSFULLY COMPLETES SUCH RISK MANAGEMENT STRATE- GIES COURSE PURSUANT TO THIS SECTION SHALL RECEIVE CONTINUING MEDICAL EDUCATION CREDIT AND A CERTIFICATE OF COMPLETION. 2. COURSES ON RISK MANAGEMENT STRATEGIES DURING THE PRENATAL THROUGH INTRAPARTUM AND POSTPARTUM PERIODS SHALL PROMOTE EVIDENCE-BASED CLINICAL GUIDELINES AND PATIENT SAFETY PROTOCOLS FROM BOTH THE MIDWIFERY AND OBSTETRICAL PERSPECTIVES. OPTIONS FOR COURSES SHOULD BE APPROPRIATE FOR THE RESPECTIVE PROFESSION AND MAY INCLUDE INFORMATION AND EDUCATIONEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04691-01-3 S. 1674 2
ADDRESSING RISKS ASSOCIATED WITH THE PRACTICE OF OBSTETRICS AND MIDWIF- ERY. COURSE OPTIONS MAY INCLUDE ISSUES SUCH AS: METHODS TO ELIMINATE NON-MEDICALLY INDICATED (ELECTIVE) DELIVERIES PRIOR TO THIRTY-NINE WEEKS GESTATION INCLUDING THE NEONATAL IMPACT OF LATE PRETERM BIRTHS; VAGINAL BIRTHS AFTER CESAREAN BIRTHS AND THE APPLICABILITY TO A TRIAL OF LABOR; REDUCTIONS IN CESAREAN BIRTHS; MONITORING OF FETAL WELL-BEING; MANAGE- MENT OF PAIN IN LABOR; MANAGEMENT OF MATERNAL HEMORRHAGE, HYPERTENSIVE CRISIS, VAGINAL BREECH AND PREVENTION OF SHOULDER DYSTOCIA; AND OTHER EVIDENCE-BASED GUIDELINE DETERMINED ISSUES THAT IMPROVE THE CARE AND OUTCOMES OF WOMEN. 3. ATTENDANCE AT ANY COURSE APPROVED BY THE COMMISSIONER PURSUANT TO THIS SECTION MAY BE IN PERSON OR THROUGH DISTANCE LEARNING METHODS WHICH EVINCE THAT ALL PARTICIPANTS ARE IN ATTENDANCE FOR THE DURATION OF THE COURSE AND ABLE TO ASK QUESTIONS OF THE INSTRUCTOR. 4. PHYSICIANS WHO ARE BOARD CERTIFIED OR ARE ACTIVE CANDIDATES FOR BOARD CERTIFICATION IN OBSTETRICS AND PHYSICIANS WHO ARE BOARD CERTIFIED OR ARE ELIGIBLE FOR BOARD CERTIFICATION IN FAMILY PRACTICE AND PROVIDE OBSTETRIC SERVICES AND MIDWIVES WHO ARE LICENSED IN THE STATE ARE ELIGI- BLE FOR A RISK MANAGEMENT STRATEGIES COURSE. 5. THE COMMISSIONER IS AUTHORIZED TO PRESCRIBE ANY RULES AND REGU- LATIONS NECESSARY TO IMPLEMENT THIS SECTION. IN PRESCRIBING SUCH RULES AND REGULATIONS, THE COMMISSIONER SHALL CONSIDER THE RULES AND REGU- LATIONS PROMULGATED BY THE SUPERINTENDENT OF FINANCIAL SERVICES PURSUANT TO SUBSECTION (E) OF SECTION TWO THOUSAND THREE HUNDRED FORTY-THREE OF THE INSURANCE LAW AND MAY CONSULT WITH THE SUPERINTENDENT OF FINANCIAL SERVICES. S 2. Subsection (e) of section 2343 of the insurance law, as added by chapter 642 of the laws of 1990, is amended to read as follows: (e) The superintendent may approve an ACTUARIALLY appropriate premium reduction for an insured physician who successfully completes a risk management course
[, which must be approved by the superintendent subject to such standards as the superintendent may prescribe by regulation. In prescribing such regulation the superintendent may consult with the commissioner of health]OR A COURSE AUTHORIZED BY THE COMMISSIONER OF HEALTH UNDER SECTION TWO THOUSAND FIVE HUNDRED SIX-A OF THE PUBLIC HEALTH LAW. S 3. This act shall take effect one year after it shall have become a law and shall apply to all insurance policies and contracts issued, renewed, modified or altered on and after such effective date. The commissioner of health and the superintendent of financial services are authorized and directed to adopt, amend, suspend or repeal regulations and take other actions necessary for the implementation of this act prior to such effective date; provided, however, that such adoption, amendment, suspension or repeal of regulations shall not have legal effect until this act takes effect.