BILL NUMBER:S5554

TITLE OF BILL:
An act
to amend the public health law, in relation to permitting a hospice to
employ and enter into contracts with licensed healthcare providers

PURPOSE:
The bill extends the scope of hospice care to people with a life
expectancy of twelve months from the current six, and would permit a
hospice to employ or contract with licensed health care professionals
to provide health care services that the hospice is authorized to
provide to its patients.

SUMMARY OF PROVISIONS:
The bill amends section 4002 of the Public Health Law to define
"terminally ill" to mean that a patient has a medical prognosis that
the individual's life expectancy is approximately one year or less if
the illness runs its normal course. Current state law does not define
the term, but Medicare uses a definition of six months. The bill
amends section 4008 of the Public Health Law to permit hospices to
directly employ or contract with licensed health care professionals
to provide health care services that the hospice is authorized to
provide to its patients.

JUSTIFICATION:
              

Studies by Kaiser Permanente, Aetna, and others have found that
palliative care services improve patient satisfaction while reducing
health care costs.
Over time, the experience of palliative end-of-life care-giving has
lengthened, partially due to medical innovations as well as an
improved understanding of the death process. Several states have
modified their laws to enable hospice care for up to one year. The
Medicaid Redesign Team proposed a similar change for New York in MRT
proposal 209.

This definition would not change what Medicare pays for, but it would
allow a hospice to serve patients for payment other than by Medicare.

Hospices are authorized to contract with health care providers to
provide health care services to the hospice's patients, provided that
the hospice maintains full responsibility for the planning,
coordination and quality of such services and the adherence to the
plan of care established for the patients. However, there is concern
that the rules against corporate practice of licensed professions bar
a hospice from directly employing or contracting with licensed
professionals.

Certain entities, such as hospitals under PHL Art. 28, may do so. This
legislation would enable hospices to do the same. This would simplify
and improve their operation.

LEGISLATIVE HISTORY:
New bill.

FISCAL IMPLICATIONS:
Medicaid savings.

EFFECTIVE DATE:
Immediately.