Senate Bill S4788

2011-2012 Legislative Session

Establishes health care organization accountability for delay, failure or refusal to approve, provide, arrange or timely pay for certain health care services

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee Judiciary Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

Do you support this bill?

Please enter your contact information

Home address is used to determine the senate district in which you reside. Your support or opposition to this bill is then shared immediately with the senator who represents you.

Optional services from the NY State Senate:

Create an account. An account allows you to officially support or oppose key legislation, sign petitions with a single click, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Include a custom message for your Senator? (Optional)

Enter a message to your senator. Many New Yorkers use this to share the reasoning behind their support or opposition to the bill. Others might share a personal anecdote about how the bill would affect them or people they care about.
Actions
Votes

co-Sponsors

2011-S4788 (ACTIVE) - Details

See Assembly Version of this Bill:
A1540
Current Committee:
Senate Judiciary
Law Section:
General Obligations Law
Laws Affected:
Add §§11-108 & 11-109, Gen Ob L; amd §1602, CPLR; amd §4410, Pub Health L
Versions Introduced in Other Legislative Sessions:
2009-2010: A767
2013-2014: S2788, A5143

2011-S4788 (ACTIVE) - Summary

Provides for accountability of "health care organizations" (i.e., entities, other than a health care provider, that approve, provide, arrange for or pay for health care services, including a health plan's preferred provider organization): provides that whenever health care organizations delay, fail or refuse to approve, provide, arrange for, or pay for in a timely manner any health care service that it is contractually obligated to provide or cover for a person, it shall be liable for any personal injury, death or damages caused by delay, failure or refusal; provides that an organization shall be liable for acts by an agent, contractor, etc., for which the organization would be liable if the act were committed by the organization; imposes upon all health plans (including workers compensation and casualty insurers) the duty to exercise reasonable care when making decisions that affect the health care service of an enrollee, and in selecting and exerting influence over its employees, agents, etc., who act on its behalf regarding decisions that affect the quality of an enrollee's diagnosis, care or treatment; prohibits organizations from requiring a health care provider to indemnify or hold it harmless for its liability

2011-S4788 (ACTIVE) - Sponsor Memo

2011-S4788 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4788

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 25, 2011
                               ___________

Introduced  by  Sen. LAVALLE -- 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:

  Section  1.  Legislative  findings.  The legislature finds that a wide
variety of entities are integrating the functions of paying  for  health
care,  determining what health care is paid for, and providing the care.
This integration of functions is breaking down traditional distinctions.
Increasingly,  payor  determinations  are  governing  health  care   and
controlling  decisions  that  in  the  past were the exclusive domain of
health care professionals and patients. The  legislature  further  finds
that  this integration of functions makes it imperative that health care
organizations be held fully responsible for the  consequences  of  their
decisions,  much as health care professionals have been held accountable
for the consequences of their decisions.
  S 2. The general obligations law is amended by adding two new sections
11-108 and 11-109 to read as follows:
  S 11-108. ACCOUNTABILITY OF  HEALTH  CARE  ORGANIZATIONS.  1.    DEFI-
NITIONS.  FOR PURPOSES OF THIS SECTION AND SECTION 11-109 OF THIS TITLE,
UNLESS THE CONTEXT CLEARLY REQUIRES OTHERWISE:
  (A) "HEALTH CARE ORGANIZATION" MEANS AN ENTITY (OTHER  THAN  A  HEALTH
CARE PROVIDER) THAT APPROVES, PROVIDES, ARRANGES FOR, OR PAYS FOR HEALTH
CARE SERVICES, INCLUDING BUT NOT LIMITED TO:
  (I)  A  HEALTH  MAINTENANCE  ORGANIZATION LICENSED PURSUANT TO ARTICLE
FORTY-THREE OF THE  INSURANCE  LAW  OR  CERTIFIED  PURSUANT  TO  ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW,
  (II)  ANY  OTHER ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR
OF THE PUBLIC HEALTH LAW, OR

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05342-01-1
              

Comments

Open Legislation is a forum for New York State legislation. All comments are subject to review and community moderation is encouraged.

Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity, hate or toxic speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Attempts to intimidate and silence contributors or deliberately deceive the public, including excessive or extraneous posting/posts, or coordinated activity, are prohibited and may result in the temporary or permanent banning of the user. Comment moderation is generally performed Monday through Friday. By contributing or voting you agree to the Terms of Participation and verify you are over 13.

Create an account. An account allows you to sign petitions with a single click, officially support or oppose key legislation, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.