No Fault Insurance Coverage of Emergency Treatment
The New York Chapter of the American College of Emergency Physicians (New York ACEP) strongly supports A.3694, sponsored by Assemblyman Dinowitz. This legislation would amend the insurance law by requiring no-fault insurance coverage for emergency services provided to a patient regardless of whether the patient has been injured as a result of operating a motor vehicle while in an intoxicated state. This bill would also permit insurers to recover payments they have made for these services from the individual if he or she is found guilty of a Driving While Intoxicated (DWI) or Driving Under the Influence (DUI) offense.
There is an alcohol-related traffic fatality every 30 minutes and an alcohol-related traffic injury every 2 minutes in the United States, according to the Insurance Information Institute. Further, the National Highway Traffic Safety Administration found that in 2005, 37% of all auto crash fatalities in New York were alcohol-related. And according to the National Trauma Data Bank Report, emergency departments in New York State provided care for 6,419 intoxicated drivers injured in motor vehicle accidents in 2002.

 

Physicians are required by Federal law (EMTALA) to provide emergency department care to all patients, regardless of whether the patient is intoxicated and/or insured. However, current law does not allow health care providers to receive compensation for their services under a patient’s No-Fault automobile insurance policy if the patient was intoxicated. In many of these situations, the health care providers must absorb the cost of the treatments provided.

 

Medical treatment for individuals who have been injured in a motor vehicle accident is almost always an emergency situation. This is magnified when the victim is in an intoxicated state.  Physicians do not discriminate by withholding necessary health care services to any individual.

 

With the exorbitant cost of treating an individual for injuries from alcohol-related crashes, health care providers, including emergency physicians, can no longer bear the burden of such costs. This legislation corrects this inequity by ensuring that health care providers are not put in the untenable position of absorbing the high costs of providing treatment to these patients, but rather are properly compensated.

 

The New York Chapter of the American College of Emergency Physicians represents over 1900 physicians statewide and is one of the largest indigent care providers in the state, serving all people that require emergency treatment and services 24 hours a day, 365 days a year. New York ACEP strongly urges the passage of A.3694 this legislative session.

 

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Memorandum in Support: A. 1596 Gottfried  CONFIDENTIALITY OF PEER REVIEW PROCEEDINGS

On Assembly Committee on Health Agenda, 1/22/09

 

The New York Chapter of the American College of Emergency Physicians (New York ACEP) strongly supports legislation, A.1596, to amend the public health law and the education law, in relation to quality assurance and peer review activities.
This bill would extend the confidentiality provisions relating to discovery of testimony to apply to statements made by any person in attendance at peer review committees who is a party to an action or proceeding the subject matter of which was reviewed during such meetings.

 

The extension of confidentiality in these cases would enhance the identification and correction of medical errors by health care providers to protect the public health and reduce the incidence of avoidable medical errors.

 

Currently, incidents involving medical errors may go undetected or may be under-reported because health care providers believe that they could be exposed to future civil actions and any statements or information volunteered as part of the peer review process could be discovered and used against them in later court proceedings.

 

The confidentiality protections in this legislation would greatly enhance the peer review process and significant benefits would be derived from the extension of confidentiality provisions through the increased willingness of providers to volunteer information without fear of misuse in subsequent legal proceedings.
New York ACEP represents over 1900 physicians statewide and is one of the largest indigent care providers in the state, serving all people that require emergency treatment and services 24 hours a day, 365 days a year.

 

We strongly support the passage of A.1596 to ensure the highest quality of care for all New Yorkers.

 

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Patient Access to Emergency and Inpatient Medical Care

In order to ensure prompt patient access to emergency and inpatient medical services, the New York Chapter of the American College of Emergency Physicians (New York ACEP) respectfully requests that legislative measures are taken to reduce hospital crowding and ambulance diversion in New York State.
Crowding in Emergency Departments is an increasing problem throughout New York State and nationally. Crowding in hospitals is not caused by misusage or unnecessary visits to emergency departments (EDs). Rather, crowding has to do with sick patients who have been evaluated, treated and admitted, but who cannot be transferred to inpatient units of the hospital because rooms are not made available. Recent surveys by the New York State Department of Health and New York ACEP show that even absent the on-going threat of terrorism, New York’s hospitals currently lack the capacity to respond to emergency patient needs and emergency department volume.

 

Further, the surveys show that hospital crowding and ambulance diversion are significant problems in nearly every geographic area of the State and are not simply due to episodic or seasonal events. In some institutions the situation has reached crisis proportions. Due to capacity and resource constraints within hospitals, care is delayed for waiting patients or patients are diverted to other hospitals, requiring travel at significant distances in an emergency.

 

Continuity and quality of care are being compromised.  Ambulances are being diverted and in some cases patients are not being transported to the hospital of their choice, also denying them access to their private physicians. Additionally, patients who have been seen in emergency departments and are admitted to the hospital are being boarded, awaiting inpatient beds for inordinate amounts of time, while being cared for by emergency department staff in hallways without comforts like a bathroom, mattress, call light, privacy or confidentiality.

 

The problems associated with hospital crowding and ambulance diversion must be addressed in order to ensure timely access to the highest quality of care for all patients who seek emergency medical services.  The New York State Department of Health has issued guidelines for reducing hospital crowding and ambulance diversion. New York ACEP strongly supports this legislation to codify these guidelines into law and to create a mechanism to implement and enforce these directives, including unannounced annual inspections by the Department of Health and a requirement that hospitals report over six diversions in a month or over twenty-five in a year to the Department.

 

Emergency Departments are an essential part of the State’s health care safety net. Hospital crowding results in the reduction of timely patient access to necessary services, as well as hinders an emergency department’s ability to maintain emergency preparedness if faced with another terrorist attack or natural disaster or pandemic.

 

New York ACEP represents over 1900 emergency physicians statewide who are one of the largest indigent care providers in the state, serving all patients 24 hours a day, 365 days a year. We respectfully request your support for this legislation to reduce hospital crowding and ambulance diversion in New York State.