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 obstetrics course
PURPOSE OR GENERAL IDEA OF BILL: 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 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 ________________________________________________________________________ 5153--A 2011-2012 Regular Sessions IN SENATE May 3, 2011 ___________Introduced by Sen. GRISANTI -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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 TOEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00315-03-1 S. 5153--A 2
FULLY INFORM PATIENTS OF THE BENEFITS AND RISKS ASSOCIATED WITH THEIR DECISIONS. 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 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.