The legislature has reached a final agreed upon budget of $212 billion (largest budget to date). The budget sharply increases spending, directing much of the new money to schools, health care, renters and small landlords, as well as to undocumented immigrant workers affected by the pandemic. Democratic lawmakers said the budget is meant to help boost the state's nascent recovery and aid those who were severely impacted by the crisis. Republicans blasted the plan for its tax increases, and argued it should have done more to aid small businesses and veterans. The new taxes include a corporate franchise tax increase and personal income tax increases for high income earners, which are estimated to raise $4.3B in additional State revenue. This will place New York above California as the highest taxing state in the country.
State Budget Finalized
This week the Legislature was completing passage of a $212 billion Budget package that produced several “victories” for organized medicine following months of extensive advocacy by MSSNY working together with county and specialty medical societies.
These issues include:
Excess Malpractice Insurance Program Extended
The final State Budget provides full funding for an additional year for the Excess Medical Malpractice Insurance program, which provides 17,000 physicians with a bonus $1 million/$3 million layer of liability insurance above the primary layer purchased by a physician. The State Budget restores the proposed $51 million cut in program funding and deleted an Executive Budget proposal strongly opposed by medicine to impose a 50% physician cost share requirement, which would have resulted in the imposition of thousands to tens of thousands of dollars of new costs on these 17,000 enrolled physicians.
Physician Due Process Protected
The final State Budget deleted several provisions proposed in the Executive Budget to substantially curtail physician due process rights when a complaint has been filed against them with the OPMC. The adverse provisions that were deleted included permitting the Commissioner to publicly disclose information regarding a complaint filed against a physician and creating a nebulous standard for imposing a summary suspension prior to the conclusion of disciplinary proceedings.
Pharmacy Scope Changes Rejected
The final State Budget deleted several provisions opposed by MSSNY that would have expanded the scope of pharmacists, including proposals to greatly expand the physician-pharmacy Collaborative Drug Therapy program, permitted pharmacist self-ordering of lab tests, and significantly expanded the number of the immunizations that can be performed by pharmacists.
Essential Plan Enhancements
The final Budget contains provisions supported by MSSNY to eliminate the premium requirements for the over 800,000 New Yorkers enrolled in the State’s Essential Plan, as well as providing bonus pool funding for physicians and other care providers participating with these plans.
Protect Ability to Apply for E-Prescribing Waivers
The final State Budget deletes the Executive Budget proposal opposed by MSSNY to eliminate the ability for physicians and other prescribers to apply for a year-to-year waiver of e-prescribing requirements (availed by over 2,000 prescribers across the State of New York).
Protect Medicaid “Prescriber Prevails”
The final Budget deletes the Executive Budget proposal opposed by MSSNY to remove the statutory protection for the prescriber’s determination (not State Medicaid’s) to prevail for a medication prescribed to a patient covered by Medicaid.
No-Fault De-credentialing Rejected
The final Budget deletes the Executive Budget proposal MSSNY had raised concerns with to expand the power of the Superintendent of Financial Services to prohibit certain physicians from submitting claims for No-Fault services.
The final State Budget includes an expansion of site locations where telehealth services can both provided and received. Importantly, it deletes a provision opposed by MSSNY advocacy that would have established an “interstate compact” of out of state health professionals to provide health care services to New York patients. Unfortunately, the final Budget also did not include “parity” for the payment of telehealth services.
Ensure Collaborative Practice by Nurse Practitioners with Physicians
The final Budget includes a provision to extend for an additional year – until June 30, 2022 – the existing law permitting certain nurse practitioners to practice without a written collaborative agreement with a physician provided they have proof of “collaborative arrangements” with physicians in the same specialty practiced by the NP. MSSNY has advocated for much stronger collaboration requirements for nurse practitioners in order to protect patients, however, with the sunset of the existing law coming up in two months, legislation (A.1535/S.3056) has also been introduced and strongly opposed by MSSNY that would repeal the requirements to even maintain proof of these collaborative arrangements. (DIVISION OF GOVERNMENTAL AFFAIRS)