§ 2805-B — Admission of patients and emergency treatment of nonadmitted patients

* § 2805-b. Admission of patients and emergency treatment of\nnonadmitted patients. 1. For purposes of this section, the following\nterms shall have the following meanings:\n (a) "Emergency medical condition" shall mean:\n (i) a medical condition manifesting itself by acute symptoms of\nsufficient severity (including severe pain) such that the absence of\nimmediate medical attention could reasonably be expected to result in:\n (1) placing the health of the individual in serious jeopardy;\n (2) serious impairment to bodily functions, including risks to future\nfertility;\n (3) serious dysfunction of any bodily organ or part; or\n (ii) with respect to a pregnant person who is in active labor:\n (1) that there is inadequate time to effect a safe transfer to another\nhospital before delivery; or\n (2) that transfer poses a threat to the health or safety of the\npregnant person or the pregnancy.\n (b) "Stabilize" shall mean, with respect to an emergency medical\ncondition described in subparagraph (i) of paragraph (a) of this\nsubdivision, to provide such medical treatment of the condition as may\nbe necessary to assure, within reasonable medical probability, that no\nmaterial deterioration of the condition is likely to result from or\noccur during the transfer of the individual from a facility, or, with\nrespect to an emergency medical condition described in subparagraph (ii)\nof paragraph (a) of this subdivision, to deliver, including the\nplacenta. "Stabilizing treatment" includes abortion pursuant to section\ntwenty-five hundred ninety-nine-bb of this article when failure to\nprovide an abortion will, within reasonable probability, result in\nmaterial deterioration of the patient's condition upon or during\ntransfer of the patient from the facility.\n (c) "Transfer" shall mean the movement (including the discharge) of an\nindividual outside of a general hospital's facilities at the direction\nof any person employed by, or affiliated or associated, directly or\nindirectly, with, the general hospital, but does not include such a\nmovement of an individual who (i) has been declared dead, or (ii) leaves\nthe facility without the permission of any such person.\n (d) "Appropriate transfer" shall mean a transfer to a medical\nfacility:\n (i) in which the transferring general hospital provides the medical\ntreatment within its capacity which minimizes the risks to the\nindividual's health;\n (ii) in which the receiving facility:\n (1) has available space and qualified personnel for the treatment of\nthe individual; and\n (2) has agreed to accept transfer of the individual and to provide\nappropriate medical treatment;\n (iii) in which the transferring general hospital sends to the\nreceiving facility all medical records related to the emergency\ncondition for which the individual has presented available at the time\nof the transfer, including records related to the individual's emergency\nmedical condition, observations of signs or symptoms, preliminary\ndiagnosis, treatment provided, results of any tests and the informed\nwritten consent or certification or copy thereof provided under\nparagraph (d) of subdivision three of this section, unless the patient\nobjects; and\n (iv) in which the transfer is effected through qualified personnel and\ntransportation equipment, as required, including the use of necessary\nand medically appropriate life support measures during the transfer.\n 2. Every general hospital as defined in this article shall admit any\nperson who is in need of immediate hospitalization with all convenient\nspeed and shall not before admission question the patient or any member\nof the patient's family concerning insurance, credit or payment of\ncharges, provided, however, that the patient or a member of the\npatient's family shall agree to supply such information promptly after\nthe patient's admission. However, no general hospital shall require any\npatient or member of the patient's family to write or to sign during\nthose times when the religious tenets of such person temporarily\nprohibit such person from performing such acts. No general hospital\nshall transfer any patient to another hospital or health care facility\non the grounds that the patient is unable to pay or guarantee payment\nfor services rendered. Every general hospital which maintains facilities\nfor providing out-patient emergency medical care must provide such care\nto any person who, in the opinion of a health care practitioner\nlicensed, certified, or authorized under title eight of the education\nlaw, acting within their lawful scope of practice, requires such care.\n 3. (a) Medical screening required. Every general hospital must provide\nappropriate medical screening examination within the capability of the\ngeneral hospital's emergency department, including ancillary services\nroutinely available to the emergency department when a request is made\nby an individual or on the individual's behalf for examination or\ntreatment for a medical condition to determine whether an emergency\nmedical condition exists. With respect to a pregnant person, such\nmedical screening examination must include a determination by a health\ncare practitioner licensed, certified, or authorized under title eight\nof the education law, acting within their lawful scope of practice as to\nwhether the individual is in active labor. A general hospital may not\ndelay provision of an appropriate medical screening examination or\nfurther medical examination, and treatment required under paragraph (b)\nof this subdivision in order to inquire about the individual's method of\npayment or insurance status.\n (b) Necessary stabilizing treatment for emergency medical conditions\nand labor. If any individual comes to a general hospital and the general\nhospital determines that the individual has an emergency medical\ncondition, the general hospital must provide either:\n (i) within the staff and facilities available at the general hospital,\nfor such further medical examination and such treatment as may be\nrequired to stabilize the medical condition; or\n (ii) for transfer of the individual to another medical facility in\naccordance with paragraph (e) of this subdivision.\n (c) Obligation to provide treatment in accordance with applicable\nstandard of care. Admission of an individual experiencing an emergency\nmedical condition does not relieve a general hospital of the obligation\nto provide treatment that is within the hospital's abilities and\nconsistent with the applicable standard of care.\n (d) Refusal to consent to treatment. A general hospital is deemed to\nmeet the requirements of paragraph (b) of this subdivision with respect\nto an individual if the general hospital offers the individual the\nfurther medical examination and treatment described in such paragraph\nand informs the individual, or a person legally authorized to make\nhealth care decisions on behalf of the individual, of the risks and\nbenefits to the individual of such examination and treatment, but the\nindividual, or a person legally authorized to make health care decisions\non behalf of the individual, refuses to consent to the examination and\ntreatment. The general hospital shall take all reasonable steps to\nsecure the individual's written informed consent, or that of an\nindividual legally authorized to make health care decisions on behalf of\nthe individual, to refuse such examination and treatment.\n (e) Restricting transfers until individual stabilized. (i) If an\nindividual at a general hospital has an emergency medical condition\nwhich has not been stabilized, the general hospital may not transfer the\nindividual unless:\n (1) the individual, or a person legally authorized to make health care\ndecisions on behalf of the individual, after being informed of the\ngeneral hospital's obligations under this section and of the risk of\ntransfer, in writing requests transfer to another medical facility; and\n (2) a health care practitioner licensed, certified, or authorized\nunder title eight of the education law, acting within their lawful scope\nof practice has signed a certification that:\n (A) based upon the information available at the time of transfer, the\nmedical benefits reasonably expected from the provision of appropriate\nmedical treatment at another medical facility outweigh the increased\nrisks to the individual; and\n (B) the transfer is an appropriate transfer to that facility;\n (ii) A certification described in clauses one and two of subparagraph\n(i) of this paragraph shall include a summary of the risks and benefits\nupon which the certification is based.\n (f) Acceptance of transfer. A general hospital shall not refuse to\naccept an appropriate transfer of an individual who requires such\nspecialized capabilities or facilities if the general hospital has the\ncapacity to treat the individual.\n (g) No delay in examination or treatment. A general hospital may not\ndelay provision of an appropriate medical screening examination required\nunder paragraph (a) of this subdivision or further medical examination\nand treatment required under paragraph (b) of this subdivision in order\nto inquire about the individual's method of payment or insurance status.\n (h) Retaliation prohibited. A general hospital may not penalize,\nretaliate, discriminate or otherwise take an adverse action against a\nhealth care practitioner, because the practitioner refuses to authorize\nthe transfer of an individual with an emergency medical condition that\nhas not been stabilized or because the practitioner provides treatment\nnecessary to stabilize a patient who is, in the practitioner's\nreasonable medical judgment, experiencing an emergency medical\ncondition. A general hospital may not penalize, retaliate, discriminate\nor otherwise take an adverse action against any individual because the\nindividual reports a violation of a requirement of this subdivision.\n (i) Nothing herein shall be interpreted as requiring the provision of\ncare in violation of state or federal law.\n 4. General hospitals shall adopt, implement, and periodically update\nstandard protocols for the management of emergency medical conditions,\nincluding diagnosis, stabilization, treatment, or transfer to another\nmedical unit or facility.\n 5. A general hospital within a city with a population of one million\nor more may request the emergency medical service of such city's health\nand hospitals corporation or any person, firm, organization or\ncorporation providing ambulance service to divert ambulances to another\nhospital only under the following circumstances:\n A request for diversion of emergency patients with life threatening\nconditions shall only be made by a hospital when acceptance of an\nadditional critical patient may endanger the life of that patient or the\nlife of another patient. A request for the diversion of other emergency\npatients shall only be made when all appropriate beds are filled and\nshall be withdrawn as soon as a bed is available. Notwithstanding the\nforegoing, all requests for diversion must be renewed at the beginning\nof each tour of duty as designated by the emergency medical service of\nsuch city's health and hospitals corporation.\n Diversion of patients with certain medical conditions which, in the\nbest interest of the patients, require their transport directly to\nspecialty referral centers shall be permitted following the designation\nof such specialty referral centers. Diversion of patients with\npsychiatric conditions to comprehensive psychiatric emergency programs,\nas such term is defined in section 1.03 of the mental hygiene law, and\nsubject to the provisions of section 31.27 of such law, shall only be\npermitted following the designation of the programs by the commissioners\nof health and mental health to receive such patients.\n 6. Nothing in this section shall be construed to deny to a health care\npractitioner licensed, certified, or authorized under title eight of the\neducation law, acting within their lawful scope of practice the right to\nevaluate the medical needs of persons arriving at the hospital for\nemergency treatment and to delay or deny medical treatment where, in the\nopinion of the health care practitioner, no emergency medical condition\nexists.\n 7. The staff of a general hospital shall: (a) inquire whether or not\nthe person admitted has served in the United States armed forces. Such\ninformation shall be listed on the admissions form; (b) notify any\nadmittee who is a veteran of the possible availability of services at a\nhospital operated by the United States veterans health administration,\nand, upon request by the admittee, such staff shall make arrangements\nfor the individual's transfer to a United States veterans health\nadministration hospital, provided, however, that transfers shall be\nauthorized only after it has been determined, according to accepted\nclinical and medical standards, that the patient's condition has\nstabilized and transfer can be accomplished safely and without\ncomplication; and (c) provide any admittee who has served in the United\nStates armed forces with a copy of the "Information for Veterans\nconcerning Health Care Options" fact sheet, maintained by the department\nof veterans' services pursuant to subdivision twenty-nine of section\nfour of the veterans' services law prior to discharging or transferring\nthe patient. The commissioner shall promulgate rules and regulations for\nnotifying such admittees of possible available services and for\narranging a requested transfer.\n * NB Effective until July 1, 2027\n * § 2805-b. Admission of patients and emergency treatment of\nnonadmitted patients. 1. For purposes of this section, the following\nterms shall have the following meanings:\n (a) "Emergency medical condition" shall mean:\n (i) a medical condition manifesting itself by acute symptoms of\nsufficient severity (including severe pain) such that the absence of\nimmediate medical attention could reasonably be expected to result in:\n (1) placing the health of the individual in serious jeopardy;\n (2) serious impairment to bodily functions, including risks to future\nfertility;\n (3) serious dysfunction of any bodily organ or part; or\n (ii) with respect to a pregnant person who is in active labor:\n (1) that there is inadequate time to effect a safe transfer to another\nhospital before delivery; or\n (2) that transfer poses a threat to the health or safety of the\npregnant person or the pregnancy.\n (b) "Stabilize" shall mean, with respect to an emergency medical\ncondition described in subparagraph (i) of paragraph (a) of this\nsubdivision, to provide such medical treatment of the condition as may\nbe necessary to assure, within reasonable medical probability, that no\nmaterial deterioration of the condition is likely to result from or\noccur during the transfer of the individual from a facility, or, with\nrespect to an emergency medical condition described in subparagraph (ii)\nof paragraph (a) of this subdivision, to deliver, including the\nplacenta. "Stabilizing treatment" includes abortion pursuant to section\ntwenty-five hundred ninety-nine-bb of this article when failure to\nprovide an abortion will, within reasonable probability, result in\nmaterial deterioration of the patient's condition upon or during\ntransfer of the patient from the facility.\n (c) "Transfer" shall mean the movement (including the discharge) of an\nindividual outside of a general hospital's facilities at the direction\nof any person employed by, or affiliated or associated, directly or\nindirectly, with, the general hospital, but does not include such a\nmovement of an individual who (i) has been declared dead, or (ii) leaves\nthe facility without the permission of any such person.\n (d) "Appropriate transfer" shall mean a transfer to a medical\nfacility:\n (i) in which the transferring general hospital provides the medical\ntreatment within its capacity which minimizes the risks to the\nindividual's health;\n (ii) in which the receiving facility:\n (1) has available space and qualified personnel for the treatment of\nthe individual; and\n (2) has agreed to accept transfer of the individual and to provide\nappropriate medical treatment;\n (iii) in which the transferring general hospital sends to the\nreceiving facility all medical records related to the emergency\ncondition for which the individual has presented available at the time\nof the transfer, including records related to the individual's emergency\nmedical condition, observations of signs or symptoms, preliminary\ndiagnosis, treatment provided, results of any tests and the informed\nwritten consent or certification or copy thereof provided under\nparagraph (d) of subdivision three of this section, unless the patient\nobjects; and\n (iv) in which the transfer is effected through qualified personnel and\ntransportation equipment, as required, including the use of necessary\nand medically appropriate life support measures during the transfer.\n 2. Every general hospital as defined in this article shall admit any\nperson who is in need of immediate hospitalization with all convenient\nspeed and shall not before admission question the patient or any member\nof the patient's family concerning insurance, credit or payment of\ncharges, provided, however, that the patient or a member of the\npatient's family shall agree to supply such information promptly after\nthe patient's admission. However, no general hospital shall require any\npatient or member of the patient's family to write or to sign during\nthose times when the religious tenets of such person temporarily\nprohibit such person from performing such acts. No general hospital\nshall transfer any patient to another hospital or health care facility\non the grounds that the patient is unable to pay or guarantee payment\nfor services rendered. Every general hospital which maintains facilities\nfor providing out-patient emergency medical care must provide such care\nto any person who, in the opinion of a health care practitioner\nlicensed, certified, or authorized under title eight of the education\nlaw, acting within their lawful scope of practice, requires such care.\n 5. A general hospital within a city with a population of one million\nor more may request the emergency medical service of such city's health\nand hospitals corporation or any person, firm, organization or\ncorporation providing ambulance service to divert ambulances to another\nhospital only under the following circumstances:\n A request for diversion of emergency patients with life threatening\nconditions shall only be made by a hospital when acceptance of an\nadditional critical patient may endanger the life of that patient or the\nlife of another patient. A request for the diversion of other emergency\npatients shall only be made when all appropriate beds are filled and\nshall be withdrawn as soon as a bed is available. Notwithstanding the\nforegoing, all requests for diversion must be renewed at the beginning\nof each tour of duty as designated by the emergency medical service of\nsuch city's health and hospitals corporation.\n Diversion of patients with certain medical conditions which, in the\nbest interest of the patients, require their transport directly to\nspecialty referral centers shall be permitted following the designation\nof such specialty referral centers. Diversion of patients with\npsychiatric conditions to comprehensive psychiatric emergency programs,\nas such term is defined in section 1.03 of the mental hygiene law, and\nsubject to the provisions of section 31.27 of such law, shall only be\npermitted following the designation of the programs by the commissioners\nof health and mental health to receive such patients.\n 6. Nothing in this section shall be construed to deny to a health care\npractitioner licensed, certified, or authorized under title eight of the\neducation law, acting within their lawful scope of practice the right to\nevaluate the medical needs of persons arriving at the hospital for\nemergency treatment and to delay or deny medical treatment where, in the\nopinion of the health care practitioner, no emergency medical condition\nexists.\n 7. The staff of a general hospital shall: (a) inquire whether or not\nthe person admitted has served in the United States armed forces. Such\ninformation shall be listed on the admissions form; (b) notify any\nadmittee who is a veteran of the possible availability of services at a\nhospital operated by the United States veterans health administration,\nand, upon request by the admittee, such staff shall make arrangements\nfor the individual's transfer to a United States veterans health\nadministration hospital, provided, however, that transfers shall be\nauthorized only after it has been determined, according to accepted\nclinical and medical standards, that the patient's condition has\nstabilized and transfer can be accomplished safely and without\ncomplication; and (c) provide any admittee who has served in the United\nStates armed forces with a copy of the "Information for Veterans\nconcerning Health Care Options" fact sheet, maintained by the department\nof veterans' services pursuant to subdivision twenty-nine of section\nfour of the veterans' services law prior to discharging or transferring\nthe patient. The commissioner shall promulgate rules and regulations for\nnotifying such admittees of possible available services and for\narranging a requested transfer.\n * NB Effective July 1, 2027\n