The New York American College of Emergency Physicians exists to support quality emergency medical care and to promote the interest of emergency physicians.

2010 Legislative Session Highlights

Auto insurers required to cover care provided to intoxicated drivers in the emergency department | Family Health Care Decisions Act enabling the appointment of a surrogate to make health care decisions for incapacitated individuals  legislation permitting HIV testing of patients in cases of occupational exposure | managed care reforms enacted to expedite processing of physician claims | managed care reforms enacted to limit the ability of HMOs to deny claims and reduce payment | enactment of legislation to reinstitute insurance department review and approval of health insurance premium rates | two year freeze on physician liaibility premiums | averted a $400 increase in physician registration fees | defeated HMO legislation to limit physicians' ability to refuse to participate in a plan defeated legislation to repeal contingency fee limitations, extend statue of limitations and expand damages in wrongful death actions. 
 
New York American College of Emergency Physicians (New York ACEP) 2010 legislative priorities:
  • Support No Fault Insurance Coverage of Emergency Treatment of Intoxicated  (A.11116 Dinowitz/S.7845 Breslin)
  • Support HIV Testing of Patients for Occupational Exposures 
  • Support Legislation to Address Problems Associated with Hospital Crowding (A.732 Gottfried)
  • Support Comprehensive Medical Liability Reform (A.6184 Schimminger/S.6799 Hannon)
  • Oppose Change in Statute of Limitations (S.1729 Schneiderman/A.4627A Weinstein)
  • Oppose Any Measure to Cap or Reduce Reimbursement for Emergency Services for Non-Participating Providers
New York ACEP was successful in getting legislation enacted into law to address no fault insurance coverage of emergency treatment of intoxicated drivers. No Fault Insurance Coverage of Emergency Services (Chapter 303 of the Laws of 2010): This new law requires no fault insurance carriers to cover emergency health services provided to a patient regardless of whether the patient was injured as a result of operating a motor vehicle while in an intoxicated state. Prior to the passage of this bill, health care providers could not seek compensation for their services under a patient’s no-fault automobile insurance policy if the patient was intoxicated.
 
Legislation was also signed into law to permit HIV testing of patients in cases of occupational exposure. This law contains concerning provisions that require health care providers, including emergency physicians, to offer an HIV test to individuals ages 13-64. One exception to this requirement is where the patient is being treated for a life threatening emergency. HIV Testing of Patients for Occupational Exposure (Chapter 308 of the Laws of 2010): This new law permits the anonymous testing of a source patient in cases of potential occupational exposure if the source patient is deceased, comatose or otherwise unable to consent. Specifically, the new law: 
  • permits the anonymous testing of a source patient in cases of potential occupational exposure if the source patient is deceased, comatose or otherwise unable to consent;
  • allows for oral informed consent for Rapid HIV tests with documentation in the patient’s chart;
  • requires that informed consent still contain a signature by the patient but authorizes an opt out provision for the patient; 
  • provides for written or oral informal consent to be valid until patient revokes consent;
  • simplifies pre-test and post-test counseling to be tailored to results; and
  • requires the offering of HIV testing to those between the ages of 13-64 in all practice settings except where the individual is being treated for a life threatening emergency, the individual has previously been offered a test or has been the subject of an HIV related test or the individual lacks capacity to consent to an HIV related test.
Significant progress was made with the New York State Department of Health (NYS DOH) on a plan to address hospital crowding. Hospital Crowding: New York ACEP has worked for a number of years with officials at NYS DOH to find solutions to hospital crowding. Efforts have included surveys conducted by New York ACEP, the introduction of legislation in the Senate and Assembly, member participation in a DOH Task Force and the development of a white paper.
 
Last year, the NYS DOH announced that it will be using data collected through the Health Emergency Response Data System (HERDS) to identify a sample of hospitals to complete a comprehensive survey on the issue of crowding. NYS DOH said in a letter to all hospital CEOs that "Emergency Department (ED) crowding is a hospital wide problem and demands the priority attention of hospital administration as well as the hospital's medical staff and nursing personnel.” Unfortunately, the survey which was scheduled to begin in the fall of 2009 was put on hold due to the H1N1 pandemic.
 
The Department is now resuming its’ plans for this survey. It will consist of interviews with administration and key staff, medical record reviews and observation of patient care. Information gathered will be used by the NYS DOH to develop guidelines and/or regulatory and statutory remedies to address crowding.
 
Attempts by health insurance lobbyists to cap reimbursement for emergency services for non-participating providers were defeated. Reimbursement for Emergency Services for Non-Participating Providers: For the past six years, the insurance lobby in New York State has pushed aggressively for various proposals to limit reimbursement for out-of-network emergency care. In the past, these proposals have included a bill to ban balancing billing, legislation to require non-participating emergency providers to accept a health insurance plan’s “usual and customary fee” and a draft regulation to impose penalties on out-of-network providers who charge “unconscionably” high fees.
 
These proposals were the subject of a hearing held by the New York State Senate and a joint public hearing convened by the State Insurance Department and the Department of Health. New York ACEP has successfully defeated these proposals by waging an Albany-based and statewide grassroots campaign focused on the challenges that emergency physicians face in providing care to patients, and the fact that limiting fees will reduce patient access to care by increasing the current hospital crowding and specialty care shortage crisis.
 
The Legislature and the Governor were unable to agree on a comprehensive medical liability reform measure. New York ACEP was able to work with other physician groups to defeat legislation that would change the statute of limitations to the date of discovery and allow for a one-year revival of previously dismissed cases. Medical Liability. A freeze on medical liability insurance rates that was passed by the Legislature in 2008 expired on June 30, 2010. As a result, the State Insurance Department approved an average rate increase of 5%. In approving the increase, Superintendent James Wrynn stated that “Reform is still needed and the State Insurance Department will continue work towards a long-term solution.”
 
Family Health Care Decisions Act (Chapter 8 of the Laws of 2010): Legislation was signed into law to establish procedures for making health care decisions on behalf of patients unable to decide about treatment for themselves. The bill authorizes family members or other persons close to patients who lack decision-making capacity to decide about treatment in consultation with health care professionals and in accordance with specific safeguards. The bill does not apply to patients who have a health care proxy, a guardian appointed under Article 17 A of the Surrogate’s Court Procedure Act, or if surrogate decisions could be made for the patient pursuant to section 1750-b of the Surrogate’s Court Procedure Act or pursuant to regulations by the Office of Mental Health or Office of Mental Retardation and Developmental Disabilities.