October 28, 2024

The NYS Council continues to seek definitive written guidance from the O agencies regarding the applicability of the new Patient Protections Laws that were included in the enacted 24-25 state budget.  Until we have this, the NYS Council is reluctant to tell our members that they are exempt from these new provisions although it appears that way.  There is mention of mental health agencies being exempt in the letter from DoH to Hospital CEOs (shared with all members last week) we strongly prefer and are trying to obtain unambiguous guidance from OMH and OASAS stating that OMH and/or OASAS licensed, certified or otherwise registered agencies (not duly licensed) are exempt.  We will continue to chase the state agencies on the need for clarity in this regard.  
At this point here’s what we can say with a fair degree of confidence:   

• DOH interprets the law to apply to hospital facilities and duly licensed (28/31 and 28/32) providers due to their Article 28 license. 
• At the present time new provision 18-c (summarized directly below) is ‘paused’ by the Department pending further communication to the field.  This is in response to advocacy from across the healthcare industry (including the NYS Council) expressing concern that requiring the patient’s consent to pay for healthcare services after treatment is unworkable. 

Separate Consent for Payment and Services (Public Health Law Section 18-C):

As outlined in the newly introduced Section 18-c of the Public Health Law, patient consent to treatment and patient consent to pay for medical services must be obtained separately. This new requirement may significantly affect providers who have been using a single, all-encompassing consent form to cover both treatment and payment as part of their patient intake process.

In addition, patient consent to pay for services cannot be obtained prior to the patient receiving services and discussing treatment costs with the provider. It remains unclear whether patients will need to provide a separate consent for each service or whether a single consent can cover multiple services or treatments. The New York Department of Health is expected to issue further guidance and clarification on how to comply with this new law.  Non-compliance with these consent requirements may result in significant penalties, including fines of $2,000 per violation.  (Source: Rivkin Radler)

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Summary of Guidance from DoH to Hospital CEOs:

Hospital Financial Assistance Requirements

• Increasing patient eligibility for financial assistance to individuals earning up to 400% of the federal poverty level (FPL);
• Preventing hospitals from denying admission or treatment/services to patients because of an unpaid medical bill;
• Requiring the use of a Uniform Financial Assistance Application for all hospitals (regardless of participation in the Indigent Care Pool);
• Decreasing the maximum monthly payment a hospital may require under a payment plan to 5% of the patient’s monthly income, and the interest rate to 2%;
• Banning the sale of patient debt to a third party, unless the third party will relieve the debt; and
• Prohibiting hospitals from bringing lawsuits against patients earning up to 400% FPL to collect on unpaid medical bills.

 
These changes impact all medical services offered by the hospital and provided by employed physicians, including inpatient, emergency room, and outpatient services.
 
New Consumer Protections
The following new protections apply to all patients regardless of income level, eligibility for financial assistance, or the type of provider from which they are receiving services:

• Prohibiting hospitals and health care providers from completing any part of an application for a medical financial product (medical credit card or third-party medical installment loan) on behalf of a patient;
• Prohibiting hospitals and health care providers from requiring credit card pre-authorization or requiring the patient to have a credit card on file prior to rendering emergency or medically necessary services;
• Requiring hospitals to notify patients regarding the risk of paying for medical services with a credit card, including that they are forgoing state and federal protections regarding medical debt.

Separate Patient Consent for Payment and Treatment
The Budget provision requiring hospitals and health care providers to obtain a separate patient consent for treatment and payment “is on hold until further guidance is released” following outreach and questions from stakeholders regarding its intent. All other changes are effective October 20, 2024.

This information is subject to change with the subsequent release of additional guidance from DoH, OMH, OASAS, or other state regulators.  

As always, if we can be of assistance please contact Lauri at 518 461-8200 or lauri@nyscouncil.org