Bill S3139-2013

Requires health insurance companies to provide health proxy forms to the insured and to store completed proxies on behalf of the insured

Requires health insurance companies to provide health proxy forms to the insured and to store completed proxies on behalf of the insured; requires the department of social services to provide health proxy forms and instructions to persons applying for Medicaid.

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  • Jan 8, 2014: REFERRED TO INSURANCE
  • Jan 30, 2013: REFERRED TO INSURANCE

Memo

BILL NUMBER:S3139

TITLE OF BILL: An act to amend the insurance law, in relation to requiring health insurance companies to provide health care proxy forms to the insured and to store completed proxies on behalf of the insured and to amend the social services law, in relation to requiring the department of social services to provide health care proxy forms and instructions to applicants for Medicaid

PURPOSE OF GENERAL IDEA OF BILL: To require health insurance providers in New York State to issue and store health care proxy forms and written descriptions of its purpose for policyholders.

SUMMARY:

Section one adds a new subsection (f) to Section 3217-a of the insurance law to require health insurance providers to give the health proxy form to all policy holders upon request and every two years. Completion of the form by the policy holder is not mandatory.

Section two of this bill adds a new section 3240 which requires the health insurance provider to receive and store the completed proxy form with the enrollees other records. The insurance carrier shall provide the proxy form to the healthcare institutions/medical personnel who need to contact the proxy named on the form in the course of the policyholder's care.

Section 366-a of the social services law is amended to require the department to provide health care proxy forms with instructions to complete the forms to individuals applying for Medicaid. The department shall accept and store the completed proxy form from the applicant. In addition the department shall supply the form to the medical facility treating the applicant.

JUSTIFICATION: Healthcare proxies have been legal documents in New York State since 1991. A proxy allows a person to designate someone to be their surrogate decision-maker in a healthcare setting should they be unable to speak or make decisions for themselves. The State Department of Health website has forms, extensive instructions and information on healthcare proxies. Unfortunately, very few people in the State have completed this form, or even know that it exists.

Currently, hospitals are required by law to provide this form to anyone being admitted, although it may not be an ideal time for the patient to make important healthcare decisions. A person entering a hospital may be in no condition to fill out paperwork or consider who best understands or knows their wishes. Even if a hospitalization is planned, it can be a stressful time for an individual and people close to them, making them unwilling to complete the document or to make the best choice regarding the identity of their healthcare proxy.

For those who do have a healthcare proxy, there is no set system for making this form available to the healthcare institution caring for the Proxy-holder. If one fills out a proxy form at a healthcare institution, is discharged, and then some time later is admitted to a different institution, a new form would likely be needed. If one has supplied a completed form to one's primary care physician's office, there is no guarantee that it will be transferred to an admitting hospital in a timely manner. Because there is no standardized system for storing this information, there have also been situations in which a person's most updated proxy has not been available, and therefore a former proxy no longer appropriate (for example, a divorced spouse) was the legal agent.

Because it is clear that the people who are closest to a person are best suited to represent that individual and make decisions regarding their care, New York has recently passed into law the Family Healthcare Decisions Act (FHDA). While this certainly represents progress in our efforts to achieve quality patient care, it also highlights the fact that for some the person who would be their designated agent per FHDA may not be the one they would choose as their healthcare proxy. Furthermore, FHDA only applies to certain healthcare settings, while a Proxy applies to all settings. For example, if a person suffering from dementia wished to be represented by their spouse at their community clinic, this would be possible under current law only if the person had designated their spouse as their proxy.

Individuals, families, healthcare institutions, and health insurance companies are all best served by patients and their loved ones being satisfied that a person is receiving the individual care that they would choose. Having a current healthcare proxy is the ideal way to accomplish this. The only way for more people to complete this document and update it if their life circumstances change, is to increase exposure to the document.

Whenever a person is admitted to a healthcare institution, that institution always contacts their insurance provider for personal information and reimbursement purposes. In the process of such a transaction, it would be convenient for the policy provider to make available the Proxy's identity and contact information in whatever format they are providing other data needed by the health care institution (phone, fax, etc.)

FISCAL IMPLICATIONS FOR THE STATE: To be determined.

EFFECTIVE DATE: This act shall take effect on the sixtieth day after it shall become 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.


Text

STATE OF NEW YORK ________________________________________________________________________ 3139 2013-2014 Regular Sessions IN SENATE January 30, 2013 ___________
Introduced by Sen. KRUEGER -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring health insurance companies to provide health care proxy forms to the insured and to store completed proxies on behalf of the insured and to amend the social services law, in relation to requiring the department of social services to provide health care proxy forms and instructions to applicants for Medicaid THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 3217-a of the insurance law is amended by adding a new subsection (f) to read as follows: (F) EACH INSURER SUBJECT TO THIS ARTICLE SHALL SUPPLY TO EACH INSURED BIENNIALLY, OR UPON REQUEST, TO EACH PROSPECTIVE INSURED PRIOR TO ENROLLMENT, A WRITTEN HEALTH CARE PROXY FORM AND A WRITTEN DESCRIPTION OF THE PURPOSE OF THE HEALTH CARE PROXY FORM AND THE PROCEDURE BY WHICH TO COMPLETE SUCH FORM. S 2. The insurance law is amended by adding a new section 3240 to read as follows: S 3240. HEALTH CARE PROXY. (A) AN INSURER SUBJECT TO THIS ARTICLE SHALL ACCEPT RECEIPT FROM AN INSURED OF HIS OR HER COMPLETED HEALTH CARE PROXY AND STORE SUCH COMPLETED PROXY WITH THE INSURED'S PERMANENT RECORDS. THE INSURED MAY SUBMIT SUCH PROXY TO THE INSURER AT THE TIME OF REGISTRATION OR ENROLLMENT OF HIS OR HER HEALTH INSURANCE POLICY OR AT ANY TIME THE INSURED HOLDS A POLICY WITH THE INSURER. THE INSURED MAY FILE AN UPDATED COMPLETED PROXY WITH HIS OR HER INSURER AT ANY TIME THE INSURED HOLDS A POLICY WITH THE INSURER. (B) AN INSURER SHALL PROVIDE A COPY OF AN INSURED'S MOST RECENTLY EXECUTED HEALTH CARE PROXY STORED WITH THE INSURED'S PERMANENT RECORDS BY THE INSURER TO ANY HEALTH CARE PROVIDER OR INSTITUTION TREATING THE
INSURED WITHIN TWENTY-FOUR HOURS AFTER RECEIVING INITIAL NOTIFICATION OF THE INSURED'S TREATMENT. S 3. Subdivision 1-a of section 366-a of the social services law, as added by chapter 512 of the laws of 2011, is amended to read as follows: 1-a. Every person making application for medical assistance, and every person on whose behalf an application is made, shall[, if interested,] be given the New York state department of health model health care proxy form, A WRITTEN DESCRIPTION OF THE PURPOSE OF THE HEALTH CARE PROXY FORM AND THE PROCEDURE BY WHICH TO COMPLETE SUCH FORM by the person taking the application, except where doing so would impede the immediate provision of health care services. THE DEPARTMENT SHALL SUPPLY TO EACH PERSON INSURED BIENNIALLY, OR UPON REQUEST, A WRITTEN HEALTH CARE PROXY FORM, A WRITTEN DESCRIPTION OF THE PURPOSE OF THE HEALTH CARE PROXY FORM AND THE PROCEDURE BY WHICH TO COMPLETE SUCH FORM. THE DEPARTMENT SHALL ACCEPT RECEIPT FROM THE APPLICANT OF HIS OR HER COMPLETED HEALTH CARE PROXY AND STORE SUCH COMPLETED PROXY WITH THE APPLICANT'S PERMANENT RECORDS. THE APPLICANT MAY SUBMIT HIS OR HER COMPLETED PROXY TO THE DEPARTMENT AT THE TIME OF APPLICATION OR ENROLLMENT FOR BENEFITS PURSU- ANT TO THE PROVISIONS OF THIS TITLE OR AT ANY TIME THE APPLICANT IS RECEIVING BENEFITS PURSUANT TO THE PROVISIONS OF THIS TITLE. THE DEPART- MENT SHALL PROVIDE A COPY OF THE APPLICANT'S MOST RECENTLY EXECUTED HEALTH CARE PROXY STORED WITH THE APPLICANT'S PERMANENT RECORDS BY THE DEPARTMENT TO ANY HEALTH CARE PROVIDER OR INSTITUTION TREATING THE APPLICANT WITHIN TWENTY-FOUR HOURS AFTER RECEIVING INITIAL NOTIFICATION OF THE APPLICANT'S TREATMENT. S 4. This act shall take effect on the sixtieth 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.

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