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