Provides for a premium reduction for physicians and licensed midwives who complete a risk management strategies course in obstetrics or midwifery.

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S5153-2011 Actions

• Jun 13, 2012: PRINT NUMBER 5153B
• Jun 13, 2012: AMEND (T) AND RECOMMIT TO FINANCE
• May 15, 2012: REPORTED AND COMMITTED TO FINANCE
• Jan 4, 2012: REFERRED TO HEALTH
• May 19, 2011: PRINT NUMBER 5153A
• May 19, 2011: AMEND AND RECOMMIT TO HEALTH
• May 3, 2011: REFERRED TO HEALTH

S5153-2011 Votes

S5153-2011 Memo

BILL NUMBER:S5153

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 obstetrics 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 benefits and risks and strategies to fully inform patients
of the benefits and 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 such course shall receive continuing medical
education credit and a certificate of completion. Topics to be
included in such course are provided. The commissioner shall
determine the maximum fee for such course which shall be set forth in
regulations. Attendance at any course approved by the commissioner
may be in person or through distance learning methods.

Section two amends section 2343 of the insurance law by adding a new
subsection (f) that provides that the superintendent shall approve an
appropriate premium reduction for an insured physician or licensed
midwife who receives a certificate of completion of a risk management
strategies in obstetrics course. The superintendent shall promulgate
rules and regulations, which may be amended from time to time,
necessary to implement the establishment of an appropriate premium
reduction and may consult with the commissioner of health.

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 and benefits of
each birth option as well as considerations regarding options for
labor. For example, cesarean delivery has been shown 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, Yet
the rate of cesarean births has increased worldwide as well as in the
United States. Nationwide, the percentage of cesarean births
increased from 7% in 1970 to 32% in 2007. In 2007, in New York City
the average rate of
cesarean births was 32%, with one hospital reporting a rate of 45%. In
Westchester County, the average rate of cesarean births for that year


was 43%, with one hospital reporting a rate of 53%. These reported
rates far exceed the rate of 15% recommended by the Centers for
Disease Control and the World Health Organization. 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 up-to-date information regarding
options for labor and delivery, including factors to be considered,
potential benefits and risks.
This bill will provide eligible physicians and licensed midwives with
the opportunity, through approved professional risk management
strategies in obstetrics 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. 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.

FISCAL IMPLICATIONS:
None to the state.

EFFECTIVE DATE:
This act shall take effect on the one hundred
twentieth day 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.

S5153-2011 Text

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

                                    5153

                         2011-2012 Regular Sessions

                              I N  SENATE

                                 May 3, 2011
                                 ___________

  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 obstetrics 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 COURSE. 1. IN ORDER
  TO  IMPROVE  PATIENT  SAFETY,  BIRTH  OUTCOMES  AND  TO PROMOTE INFORMED
  CONSULTATION BY PATIENTS WITH THEIR  PHYSICIANS  AND  LICENSED  MIDWIVES
  DURING  PREGNANCY,  THE COMMISSIONER SHALL APPROVE A PROFESSIONAL EDUCA-
  TION COURSE FOR ELIGIBLE PHYSICIANS AND LICENSED MIDWIVES AS PROVIDED IN
  SUBDIVISION FIVE OF THIS SECTION THAT COVERS RISK MANAGEMENT  STRATEGIES
  IN OBSTETRICS AS DESCRIBED IN SUBDIVISION TWO OF THIS SECTION. SUCH RISK
  MANAGEMENT  STRATEGIES  COURSE 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 COLLEGE OF
  OBSTETRICIANS AND GYNECOLOGISTS AND OTHER HEALTH CARE ORGANIZATIONS.  AN
  ELIGIBLE  PHYSICIAN  OR LICENSED MIDWIFE WHO SUCCESSFULLY COMPLETES SUCH
  RISK MANAGEMENT STRATEGIES IN OBSTETRICS COURSE PURSUANT TO THIS SECTION
  SHALL RECEIVE CONTINUING MEDICAL EDUCATION CREDIT AND A  CERTIFICATE  OF
  COMPLETION.
    2.  A  RISK  MANAGEMENT STRATEGIES IN OBSTETRICS COURSE SHALL INCLUDE,
  BUT NOT BE LIMITED TO, INFORMATION ON THE POTENTIAL BENEFITS  AND  RISKS
  ASSOCIATED  WITH  ELECTIVE OR NON-ELECTIVE INDUCTION, NEONATAL IMPACT OF
  LATE PRETERM BIRTHS, TRIAL OF LABOR AND VAGINAL  BIRTHS  AFTER  CESAREAN
  BIRTHS,  PRIMARY,  ELECTIVE OR REPEAT CESAREAN BIRTHS, AND STRATEGIES TO
  FULLY INFORM PATIENTS OF THE BENEFITS AND RISKS  ASSOCIATED  WITH  THEIR
  DECISIONS.

   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD00315-01-1

 S. 5153                             2

    3.  THE  MAXIMUM FEE TO BE CHARGED FOR A RISK MANAGEMENT STRATEGIES IN
  OBSTETRICS COURSE SHALL BE SET FORTH IN REGULATIONS PROMULGATED  BY  THE
  COMMISSIONER.
    4.  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.
    5.  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 IN OBSTETRICS COURSE.
    S  2.  Section  2343  of  the insurance law is amended by adding a new
  subsection (f) to read as follows:

    (F) THE SUPERINTENDENT SHALL APPROVE AN APPROPRIATE PREMIUM  REDUCTION
  FOR  AN  INSURED  ELIGIBLE  PHYSICIAN OR LICENSED MIDWIFE WHO RECEIVES A
  CERTIFICATE OF COMPLETION OF A RISK MANAGEMENT STRATEGIES IN  OBSTETRICS
  COURSE  AS  PROVIDED  IN SECTION TWENTY-FIVE HUNDRED SIX-A OF THE PUBLIC
  HEALTH LAW.  THE SUPERINTENDENT SHALL PROMULGATE SUCH  RULES  AND  REGU-
  LATIONS,  WHICH MAY BE AMENDED FROM TIME TO TIME, NECESSARY TO IMPLEMENT
  THE ESTABLISHMENT OF AN APPROPRIATE  PREMIUM  REDUCTION,  INCLUDING  THE
  PERIOD  DURING  WHICH  THE  PREMIUM  REDUCTION  SHALL  BE  EFFECTIVE. IN
  PRESCRIBING SUCH RULES AND REGULATIONS, THE SUPERINTENDENT  MAY  CONSULT
  WITH THE COMMISSIONER OF HEALTH.
    S 3. This act shall take effect on the one hundred twentieth day 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 effec-
  tive date. The commissioner of health and the superintendent  of  insur-
  ance  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.