NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A9522
SPONSOR: Peoples-Stokes TITLE OF BILL:
An act to amend the public health law and the executive law, in relation
to HIV post-exposure prophylaxis and other health care services for
sexual assault victims; and to amend a chapter of the laws of 2019,
amending the public health law and the executive law relating to HIV
post-exposure prophylaxis and other health care services for sexual
assault victims, as proposed in legislative bills numbers S. 2279-A and
A. 1204-A in relation to the effectiveness thereof
PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is provide increased medical services to
victims of sexual assault that are more at risk of being unable to
obtain the necessary services on their own and to increase reimburse for
health care providers of such services.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 would require hospitals to inform victims of sexual assault of
the rape crisis and local victim assistance organizations in the
geographic area served by the hospital. The section would also require
hospitals to provide a full regimen of lily post exposure prophylaxis
for those under the age of 18. This section would make technical amend-
ments necessary to effectuate the changes outlined in this bill.
Section 2 would require the Department of Health to produce an annual
report on the cost of reimbursement for medical examinations and treat-
ment by the State on an annual basis.
Section 3 would establish new reimbursement methodologies for health
care providers rendering services to victims of a sexual assault and
makes other technical changes necessary to accomplish this. This section
would also make sexual assault survivors aware that reimbursement for
services under this program does not make them automatically eligible
for other compensation benefits, which they would need to apply for.
Section 4 clarifies that the provisions of this bill and Chapter 681 of
the Laws of 2019 apply to claims made after enactment.
Section 5 would establish the effective date.
JUSTIFICATION:
Chapter 681 of the Laws of 2019 authorized the reimbursement for health
care providers treating victims of sexual assault to be increased beyond
the statutory $800 cap by the Office of Victim Services. This bill
replaces that provision with a more detail tiered system for reimburse-
ment of providers depending on the level of care provided. Additionally,
it focuses efforts for treatment of victims to provide a full course of
HIV post exposure prophylaxis to minors as they are the most likely to
be unable to obtain access to these services while protecting their
privacy. This legislation will help to ensure victims of sexual assault
receive the proper medical care needed.
PRIOR LEGISLATIVE HISTORY:
New Legislation.
FISCAL IMPLICATIONS:
None noted.
EFFECTIVE DATE:
This act shall take effect immediately, provided, however, that sections
one, two and three of this act take effect on the same date and in the
same manner as a chapter of the laws of 2019, amending the public health
law and the executive law relating to HIV post exposure prophylaxis and
other health care services for sexual assault victims, as proposed in
legislative bills numbers S. 2279-A and A. 1204-A, takes effect
STATE OF NEW YORK
________________________________________________________________________
9522
IN ASSEMBLY
January 23, 2020
___________
Introduced by M. of A. PEOPLES-STOKES -- read once and referred to the
Committee on Health
AN ACT to amend the public health law and the executive law, in relation
to HIV post-exposure prophylaxis and other health care services for
sexual assault victims; and to amend a chapter of the laws of 2019,
amending the public health law and the executive law relating to HIV
post-exposure prophylaxis and other health care services for sexual
assault victims, as proposed in legislative bills numbers S. 2279-A
and A. 1204-A in relation to the effectiveness thereof
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 1 of section 2805-i of the public health law,
2 as amended by section 1 of part HH of chapter 57 of the laws of 2018,
3 paragraph (c) as amended by a chapter of the laws of 2019, amending the
4 public health law and the executive law relating to HIV post-exposure
5 prophylaxis and other health care services for sexual assault victims,
6 as proposed in legislative bills numbers S. 2279-A and A. 1204-A, is
7 amended to read as follows:
8 1. Every hospital providing treatment to alleged victims of a sexual
9 offense shall be responsible for:
10 (a) maintaining sexual offense evidence and the chain of custody as
11 provided in subdivision two of this section;
12 (b) informing sexual offense victims of the availability of rape
13 crisis and local victim assistance organizations, if any, in the
14 geographic area served by the hospital, and contacting a rape crisis or
15 local victim assistance organization[, if any, providing victim assist-
16 ance to the geographic area served by that hospital] to establish the
17 coordination of non-medical services to sexual offense victims who
18 request such coordination and services;
19 (c) offering and making available appropriate HIV post-exposure treat-
20 ment therapies; including a [full regimen] seven day starter pack of HIV
21 post-exposure prophylaxis for a person eighteen years of age or older,
22 or the full regimen of HIV post-exposure prophylaxis for a person less
23 than eighteen years of age, in cases where it has been determined, in
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD04742-08-0
A. 9522 2
1 accordance with guidelines issued by the commissioner, that a signif-
2 icant exposure to HIV has occurred, and informing the victim that
3 payment assistance for such therapies and other crime related expenses
4 may be available from the office of victim services pursuant to the
5 provisions of article twenty-two of the executive law. With the consent
6 of the victim of a sexual assault, the hospital emergency room depart-
7 ment shall provide or arrange for an appointment for medical follow-up
8 related to HIV post-exposure prophylaxis and other care as appropriate[,
9 and inform the victim that payment assistance for such care may be
10 available from the office of victim services pursuant to the provisions
11 of article twenty-two of the executive law]; and
12 (d) ensuring sexual assault survivors are not billed for sexual
13 assault forensic exams and are notified orally and in writing of the
14 option to decline to provide private health insurance information and
15 have the office of victim services reimburse the hospital for the exam
16 pursuant to subdivision thirteen of section six hundred thirty-one of
17 the executive law.
18 § 2. Subdivision 1 of section 201 of the public health law is amended
19 by adding a new paragraph (x) to read as follows:
20 (x) produce an annual report analyzing the costs related to the sexual
21 assault examination direct reimbursement program as created under subdi-
22 vision thirteen of section six hundred thirty-one of the executive law
23 and provide such report to the office of victim services on or before
24 September first of each year. Such report shall be provided to the
25 governor, temporary president of the senate and the speaker of the
26 assembly.
27 § 3. Subdivision 13 of section 631 of the executive law, as amended by
28 a chapter of the laws of 2019, amending the public health law and the
29 executive law relating to HIV post-exposure prophylaxis and other health
30 care services for sexual assault victims, as proposed in legislative
31 bills numbers S. 2279-A and A. 1204-A, is amended to read as follows:
32 13. (a) Notwithstanding any other provision of law, rule, or regu-
33 lation to the contrary, when any New York state accredited hospital,
34 accredited sexual assault examiner program, or licensed health care
35 provider furnishes services to any sexual assault survivor, including
36 but not limited to a health care forensic examination in accordance with
37 the sex offense evidence collection protocol and standards established
38 by the department of health, such hospital, sexual assault examiner
39 program, or licensed healthcare provider shall provide such services to
40 the person without charge and shall bill the office directly. The
41 office, in consultation with the department of health, shall define the
42 specific services to be covered by the sexual assault forensic exam
43 reimbursement fee, which must include at a minimum forensic examiner
44 services, hospital or healthcare facility services related to the exam,
45 and any necessary related laboratory tests [and necessary] or pharmaceu-
46 ticals; including but not limited to HIV post-exposure prophylaxis
47 provided by a hospital emergency room at the time of the forensic rape
48 examination pursuant to paragraph (c) of subdivision one of section
49 twenty-eight hundred five-i of the public health law. [Follow-up] For a
50 person eighteen years of age or older, follow-up HIV post-exposure
51 prophylaxis costs shall continue to be [billed by the health care
52 provider to the office directly and] reimbursed [by the] according to
53 established office [directly] procedure. The office, in consultation
54 with the department of health, shall also generate the necessary regu-
55 lations and forms for the direct reimbursement procedure.
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1 (b) The rate for reimbursement shall be the amount of itemized
2 charges, to be reimbursed at the Medicaid rate and which shall cumula-
3 tively not [exceeding] exceed (1) eight hundred dollars[, provided,
4 however, the office shall, in consultation] for an exam of a sexual
5 assault survivor where no sexual offense evidence collection kit is
6 used; (2) one thousand two hundred dollars for an exam of a sexual
7 assault survivor where a sexual offense evidence collection kit is used;
8 (3) one thousand five hundred dollars for an exam of a sexual assault
9 survivor who is eighteen years of age or older, with or without the use
10 of a sexual offense evidence collection kit, and with the provision of a
11 necessary HIV post-exposure prophylaxis seven day starter pack; and (4)
12 two thousand five hundred dollars for an exam of a sexual assault survi-
13 vor who is less than eighteen years of age, with or without the use of a
14 sexual offense evidence collection kit, and with the provision of the
15 full regimen of necessary HIV post-exposure prophylaxis [with the
16 department of health, annually review and determine if a higher rate for
17 reimbursement for itemized charges exceeding eight hundred dollars is
18 feasible and appropriate based on the actual cost of reimbursable
19 expenses, and adjust such rate for reimbursement accordingly]. The
20 hospital, sexual assault examiner program, or licensed health care
21 provider must accept this fee as payment in full for these specified
22 services. No additional billing of the survivor for said services is
23 permissible. A sexual assault survivor may voluntarily assign any
24 private insurance benefits to which she or he is entitled for the
25 healthcare forensic examination, in which case the hospital or health-
26 care provider may not charge the office; provided, however, in the event
27 the sexual assault survivor assigns any private health insurance bene-
28 fit, such coverage shall not be subject to annual deductibles or coinsu-
29 rance or balance billing by the hospital, sexual assault examiner
30 program or licensed health care provider. A hospital, sexual assault
31 examiner program or licensed health care provider shall, at the time of
32 the initial visit, request assignment of any private health insurance
33 benefits to which the sexual assault survivor is entitled on a form
34 prescribed by the office; provided, however, such sexual assault survi-
35 vor shall be advised orally and in writing that he or she may decline to
36 provide such information regarding private health insurance benefits if
37 he or she believes that the provision of such information would substan-
38 tially interfere with his or her personal privacy or safety and in such
39 event, the sexual assault forensic exam fee shall be paid by the office.
40 Such sexual assault survivor shall also be advised that providing such
41 information may provide additional resources to pay for services to
42 other sexual assault victims. Such sexual assault survivor shall also
43 be advised that the direct reimbursement program established by this
44 subdivision does not automatically make them eligible for any other
45 compensation benefits available from the office including, but not
46 limited to, reimbursement for mental health counseling expenses, relo-
47 cation expenses, and loss of earnings, and that such compensation bene-
48 fits may only be made available to them should the sexual assault survi-
49 vor or other person eligible to file pursuant to section six hundred
50 twenty-four of this article, file a compensation application with the
51 office. If he or she declines to provide such health insurance informa-
52 tion, he or she shall indicate such decision on the form provided by the
53 hospital, sexual assault examiner program or licensed health care
54 provider, which form shall be prescribed by the office.
55 § 4. Section 3 of a chapter of the laws of 2019, amending the public
56 health law and the executive law relating to HIV post-exposure prophy-
A. 9522 4
1 laxis and other health care services for sexual assault victims, as
2 proposed in legislative bills numbers S. 2279-A and A. 1204-A, is
3 amended to read as follows:
4 § 3. This act shall take effect on the one hundred eightieth day after
5 it shall have become a law and apply to all claims filed on or after
6 such date; provided that effective immediately, the commissioner of
7 health and the director of the office of victim services shall make
8 regulations and take other action necessary to implement this act on
9 such date.
10 § 5. This act shall take effect immediately, provided, however, that
11 sections one, two and three of this act take effect on the same date and
12 in the same manner as a chapter of the laws of 2019, amending the public
13 health law and the executive law relating to HIV post-exposure prophy-
14 laxis and other health care services for sexual assault victims, as
15 proposed in legislative bills numbers S. 2279-A and A. 1204-A, takes
16 effect.
