N.Y. Public Health Law § 2805-b: Admission of patients and emergency treatment of nonadmitted patients

* § 2805-b. Admission of patients and emergency treatment of

nonadmitted patients. 1. For purposes of this section, the following

terms shall have the following meanings:

(a) "Emergency medical condition" shall mean:

(i) a medical condition manifesting itself by acute symptoms of

sufficient severity (including severe pain) such that the absence of

immediate medical attention could reasonably be expected to result in:

(1) placing the health of the individual in serious jeopardy;

(2) serious impairment to bodily functions, including risks to future

fertility;

(3) serious dysfunction of any bodily organ or part; or

(ii) with respect to a pregnant person who is in active labor:

(1) that there is inadequate time to effect a safe transfer to another

hospital before delivery; or

(2) that transfer poses a threat to the health or safety of the

pregnant person or the pregnancy.

(b) "Stabilize" shall mean, with respect to an emergency medical

condition described in subparagraph (i) of paragraph (a) of this

subdivision, to provide such medical treatment of the condition as may

be necessary to assure, within reasonable medical probability, that no

material deterioration of the condition is likely to result from or

occur during the transfer of the individual from a facility, or, with

respect to an emergency medical condition described in subparagraph (ii)

of paragraph (a) of this subdivision, to deliver, including the

placenta. "Stabilizing treatment" includes abortion pursuant to section

twenty-five hundred ninety-nine-bb of this article when failure to

provide an abortion will, within reasonable probability, result in

material deterioration of the patient's condition upon or during

transfer of the patient from the facility.

(c) "Transfer" shall mean the movement (including the discharge) of an

individual outside of a general hospital's facilities at the direction

of any person employed by, or affiliated or associated, directly or

indirectly, with, the general hospital, but does not include such a

movement of an individual who (i) has been declared dead, or (ii) leaves

the facility without the permission of any such person.

(d) "Appropriate transfer" shall mean a transfer to a medical

facility:

(i) in which the transferring general hospital provides the medical

treatment within its capacity which minimizes the risks to the

individual's health;

(ii) in which the receiving facility:

(1) has available space and qualified personnel for the treatment of

the individual; and

(2) has agreed to accept transfer of the individual and to provide

appropriate medical treatment;

(iii) in which the transferring general hospital sends to the

receiving facility all medical records related to the emergency

condition for which the individual has presented available at the time

of the transfer, including records related to the individual's emergency

medical condition, observations of signs or symptoms, preliminary

diagnosis, treatment provided, results of any tests and the informed

written consent or certification or copy thereof provided under

paragraph (d) of subdivision three of this section, unless the patient

objects; and

(iv) in which the transfer is effected through qualified personnel and

transportation equipment, as required, including the use of necessary

and medically appropriate life support measures during the transfer.

2. Every general hospital as defined in this article shall admit any

person who is in need of immediate hospitalization with all convenient

speed and shall not before admission question the patient or any member

of the patient's family concerning insurance, credit or payment of

charges, provided, however, that the patient or a member of the

patient's family shall agree to supply such information promptly after

the patient's admission. However, no general hospital shall require any

patient or member of the patient's family to write or to sign during

those times when the religious tenets of such person temporarily

prohibit such person from performing such acts. No general hospital

shall transfer any patient to another hospital or health care facility

on the grounds that the patient is unable to pay or guarantee payment

for services rendered. Every general hospital which maintains facilities

for providing out-patient emergency medical care must provide such care

to any person who, in the opinion of a health care practitioner

licensed, certified, or authorized under title eight of the education

law, acting within their lawful scope of practice, requires such care.

3. (a) Medical screening required. Every general hospital must provide

appropriate medical screening examination within the capability of the

general hospital's emergency department, including ancillary services

routinely available to the emergency department when a request is made

by an individual or on the individual's behalf for examination or

treatment for a medical condition to determine whether an emergency

medical condition exists. With respect to a pregnant person, such

medical screening examination must include a determination by a health

care practitioner licensed, certified, or authorized under title eight

of the education law, acting within their lawful scope of practice as to

whether the individual is in active labor. A general hospital may not

delay provision of an appropriate medical screening examination or

further medical examination, and treatment required under paragraph (b)

of this subdivision in order to inquire about the individual's method of

payment or insurance status.

(b) Necessary stabilizing treatment for emergency medical conditions

and labor. If any individual comes to a general hospital and the general

hospital determines that the individual has an emergency medical

condition, the general hospital must provide either:

(i) within the staff and facilities available at the general hospital,

for such further medical examination and such treatment as may be

required to stabilize the medical condition; or

(ii) for transfer of the individual to another medical facility in

accordance with paragraph (e) of this subdivision.

(c) Obligation to provide treatment in accordance with applicable

standard of care. Admission of an individual experiencing an emergency

medical condition does not relieve a general hospital of the obligation

to provide treatment that is within the hospital's abilities and

consistent with the applicable standard of care.

(d) Refusal to consent to treatment. A general hospital is deemed to

meet the requirements of paragraph (b) of this subdivision with respect

to an individual if the general hospital offers the individual the

further medical examination and treatment described in such paragraph

and informs the individual, or a person legally authorized to make

health care decisions on behalf of the individual, of the risks and

benefits to the individual of such examination and treatment, but the

individual, or a person legally authorized to make health care decisions

on behalf of the individual, refuses to consent to the examination and

treatment. The general hospital shall take all reasonable steps to

secure the individual's written informed consent, or that of an

individual legally authorized to make health care decisions on behalf of

the individual, to refuse such examination and treatment.

(e) Restricting transfers until individual stabilized. (i) If an

individual at a general hospital has an emergency medical condition

which has not been stabilized, the general hospital may not transfer the

individual unless:

(1) the individual, or a person legally authorized to make health care

decisions on behalf of the individual, after being informed of the

general hospital's obligations under this section and of the risk of

transfer, in writing requests transfer to another medical facility; and

(2) a health care practitioner licensed, certified, or authorized

under title eight of the education law, acting within their lawful scope

of practice has signed a certification that:

(A) based upon the information available at the time of transfer, the

medical benefits reasonably expected from the provision of appropriate

medical treatment at another medical facility outweigh the increased

risks to the individual; and

(B) the transfer is an appropriate transfer to that facility;

(ii) A certification described in clauses one and two of subparagraph

(i) of this paragraph shall include a summary of the risks and benefits

upon which the certification is based.

(f) Acceptance of transfer. A general hospital shall not refuse to

accept an appropriate transfer of an individual who requires such

specialized capabilities or facilities if the general hospital has the

capacity to treat the individual.

(g) No delay in examination or treatment. A general hospital may not

delay provision of an appropriate medical screening examination required

under paragraph (a) of this subdivision or further medical examination

and treatment required under paragraph (b) of this subdivision in order

to inquire about the individual's method of payment or insurance status.

(h) Retaliation prohibited. A general hospital may not penalize,

retaliate, discriminate or otherwise take an adverse action against a

health care practitioner, because the practitioner refuses to authorize

the transfer of an individual with an emergency medical condition that

has not been stabilized or because the practitioner provides treatment

necessary to stabilize a patient who is, in the practitioner's

reasonable medical judgment, experiencing an emergency medical

condition. A general hospital may not penalize, retaliate, discriminate

or otherwise take an adverse action against any individual because the

individual reports a violation of a requirement of this subdivision.

(i) Nothing herein shall be interpreted as requiring the provision of

care in violation of state or federal law.

4. General hospitals shall adopt, implement, and periodically update

standard protocols for the management of emergency medical conditions,

including diagnosis, stabilization, treatment, or transfer to another

medical unit or facility.

5. A general hospital within a city with a population of one million

or more may request the emergency medical service of such city's health

and hospitals corporation or any person, firm, organization or

corporation providing ambulance service to divert ambulances to another

hospital only under the following circumstances:

A request for diversion of emergency patients with life threatening

conditions shall only be made by a hospital when acceptance of an

additional critical patient may endanger the life of that patient or the

life of another patient. A request for the diversion of other emergency

patients shall only be made when all appropriate beds are filled and

shall be withdrawn as soon as a bed is available. Notwithstanding the

foregoing, all requests for diversion must be renewed at the beginning

of each tour of duty as designated by the emergency medical service of

such city's health and hospitals corporation.

Diversion of patients with certain medical conditions which, in the

best interest of the patients, require their transport directly to

specialty referral centers shall be permitted following the designation

of such specialty referral centers. Diversion of patients with

psychiatric conditions to comprehensive psychiatric emergency programs,

as such term is defined in section 1.03 of the mental hygiene law, and

subject to the provisions of section 31.27 of such law, shall only be

permitted following the designation of the programs by the commissioners

of health and mental health to receive such patients.

6. Nothing in this section shall be construed to deny to a health care

practitioner licensed, certified, or authorized under title eight of the

education law, acting within their lawful scope of practice the right to

evaluate the medical needs of persons arriving at the hospital for

emergency treatment and to delay or deny medical treatment where, in the

opinion of the health care practitioner, no emergency medical condition

exists.

7. The staff of a general hospital shall: (a) inquire whether or not

the person admitted has served in the United States armed forces. Such

information shall be listed on the admissions form; (b) notify any

admittee who is a veteran of the possible availability of services at a

hospital operated by the United States veterans health administration,

and, upon request by the admittee, such staff shall make arrangements

for the individual's transfer to a United States veterans health

administration hospital, provided, however, that transfers shall be

authorized only after it has been determined, according to accepted

clinical and medical standards, that the patient's condition has

stabilized and transfer can be accomplished safely and without

complication; and (c) provide any admittee who has served in the United

States armed forces with a copy of the "Information for Veterans

concerning Health Care Options" fact sheet, maintained by the department

of veterans' services pursuant to subdivision twenty-nine of section

four of the veterans' services law prior to discharging or transferring

the patient. The commissioner shall promulgate rules and regulations for

notifying such admittees of possible available services and for

arranging a requested transfer.

* NB Effective until July 1, 2027

* § 2805-b. Admission of patients and emergency treatment of

nonadmitted patients. 1. For purposes of this section, the following

terms shall have the following meanings:

(a) "Emergency medical condition" shall mean:

(i) a medical condition manifesting itself by acute symptoms of

sufficient severity (including severe pain) such that the absence of

immediate medical attention could reasonably be expected to result in:

(1) placing the health of the individual in serious jeopardy;

(2) serious impairment to bodily functions, including risks to future

fertility;

(3) serious dysfunction of any bodily organ or part; or

(ii) with respect to a pregnant person who is in active labor:

(1) that there is inadequate time to effect a safe transfer to another

hospital before delivery; or

(2) that transfer poses a threat to the health or safety of the

pregnant person or the pregnancy.

(b) "Stabilize" shall mean, with respect to an emergency medical

condition described in subparagraph (i) of paragraph (a) of this

subdivision, to provide such medical treatment of the condition as may

be necessary to assure, within reasonable medical probability, that no

material deterioration of the condition is likely to result from or

occur during the transfer of the individual from a facility, or, with

respect to an emergency medical condition described in subparagraph (ii)

of paragraph (a) of this subdivision, to deliver, including the

placenta. "Stabilizing treatment" includes abortion pursuant to section

twenty-five hundred ninety-nine-bb of this article when failure to

provide an abortion will, within reasonable probability, result in

material deterioration of the patient's condition upon or during

transfer of the patient from the facility.

(c) "Transfer" shall mean the movement (including the discharge) of an

individual outside of a general hospital's facilities at the direction

of any person employed by, or affiliated or associated, directly or

indirectly, with, the general hospital, but does not include such a

movement of an individual who (i) has been declared dead, or (ii) leaves

the facility without the permission of any such person.

(d) "Appropriate transfer" shall mean a transfer to a medical

facility:

(i) in which the transferring general hospital provides the medical

treatment within its capacity which minimizes the risks to the

individual's health;

(ii) in which the receiving facility:

(1) has available space and qualified personnel for the treatment of

the individual; and

(2) has agreed to accept transfer of the individual and to provide

appropriate medical treatment;

(iii) in which the transferring general hospital sends to the

receiving facility all medical records related to the emergency

condition for which the individual has presented available at the time

of the transfer, including records related to the individual's emergency

medical condition, observations of signs or symptoms, preliminary

diagnosis, treatment provided, results of any tests and the informed

written consent or certification or copy thereof provided under

paragraph (d) of subdivision three of this section, unless the patient

objects; and

(iv) in which the transfer is effected through qualified personnel and

transportation equipment, as required, including the use of necessary

and medically appropriate life support measures during the transfer.

2. Every general hospital as defined in this article shall admit any

person who is in need of immediate hospitalization with all convenient

speed and shall not before admission question the patient or any member

of the patient's family concerning insurance, credit or payment of

charges, provided, however, that the patient or a member of the

patient's family shall agree to supply such information promptly after

the patient's admission. However, no general hospital shall require any

patient or member of the patient's family to write or to sign during

those times when the religious tenets of such person temporarily

prohibit such person from performing such acts. No general hospital

shall transfer any patient to another hospital or health care facility

on the grounds that the patient is unable to pay or guarantee payment

for services rendered. Every general hospital which maintains facilities

for providing out-patient emergency medical care must provide such care

to any person who, in the opinion of a health care practitioner

licensed, certified, or authorized under title eight of the education

law, acting within their lawful scope of practice, requires such care.

5. A general hospital within a city with a population of one million

or more may request the emergency medical service of such city's health

and hospitals corporation or any person, firm, organization or

corporation providing ambulance service to divert ambulances to another

hospital only under the following circumstances:

A request for diversion of emergency patients with life threatening

conditions shall only be made by a hospital when acceptance of an

additional critical patient may endanger the life of that patient or the

life of another patient. A request for the diversion of other emergency

patients shall only be made when all appropriate beds are filled and

shall be withdrawn as soon as a bed is available. Notwithstanding the

foregoing, all requests for diversion must be renewed at the beginning

of each tour of duty as designated by the emergency medical service of

such city's health and hospitals corporation.

Diversion of patients with certain medical conditions which, in the

best interest of the patients, require their transport directly to

specialty referral centers shall be permitted following the designation

of such specialty referral centers. Diversion of patients with

psychiatric conditions to comprehensive psychiatric emergency programs,

as such term is defined in section 1.03 of the mental hygiene law, and

subject to the provisions of section 31.27 of such law, shall only be

permitted following the designation of the programs by the commissioners

of health and mental health to receive such patients.

6. Nothing in this section shall be construed to deny to a health care

practitioner licensed, certified, or authorized under title eight of the

education law, acting within their lawful scope of practice the right to

evaluate the medical needs of persons arriving at the hospital for

emergency treatment and to delay or deny medical treatment where, in the

opinion of the health care practitioner, no emergency medical condition

exists.

7. The staff of a general hospital shall: (a) inquire whether or not

the person admitted has served in the United States armed forces. Such

information shall be listed on the admissions form; (b) notify any

admittee who is a veteran of the possible availability of services at a

hospital operated by the United States veterans health administration,

and, upon request by the admittee, such staff shall make arrangements

for the individual's transfer to a United States veterans health

administration hospital, provided, however, that transfers shall be

authorized only after it has been determined, according to accepted

clinical and medical standards, that the patient's condition has

stabilized and transfer can be accomplished safely and without

complication; and (c) provide any admittee who has served in the United

States armed forces with a copy of the "Information for Veterans

concerning Health Care Options" fact sheet, maintained by the department

of veterans' services pursuant to subdivision twenty-nine of section

four of the veterans' services law prior to discharging or transferring

the patient. The commissioner shall promulgate rules and regulations for

notifying such admittees of possible available services and for

arranging a requested transfer.

* NB Effective July 1, 2027