Senate Bill S9196

                                 
BILL NUMBER: S9196

SPONSOR: KRUEGER
 
TITLE OF BILL:

An act to amend the public health law, in relation to the establishment,
incorporation, construction, or increase in capacity of for-profit
hospice

 
PURPOSE OR GENERAL IDEA OF BILL::

To prohibit future establishment or Increased capacity of for-profit
hospice.

 
SUMMARY OF SPECIFIC PROVISIONS::

The bill amends Public Health Law 4004 (3) to prohibit the Public Health
and Health Planning Council of-the Department of Health from approving
new applications for establishment, construction or increased capacity
by for-profit hospice entities. Existing for profit hospice will remain
approved but may not expand capacity.

              

 
JUSTIFICATION::

An article recently published by ProPublica and digitally released in
The New Yorker, titled "Hospice Became a For-Profit Hustle" shines a,
light on multiple instances of fraud targeting the Medicare hospice
benefit. It illustrates how patient care suffers when bad actors are
able to manipulate its original intent and purpose.

An earlier article published in the Journal of the American Medical
Association* found that "for-profit compared with nonprofit hospices
provide narrower ranges of services to patients, use less skilled clin-
ical staff, care for patients with lower-skilled needs over longer
enrollment periods, have higher rates of complaint allegations and deft-
ciencies, and provide fewer community benefits, including training,
research, and charity care. For-profit hospices are more likely than
nonprofit hospices to discharge patients prior to death, to discharge
patients with dementia, and to have higher rates of hospital and emer-
gency department use."

For-profit organizations have a duty to their owners to generate as much
profit as possible and distribute net income to the owners.  Their obli-
gations to the people they ostensibly serve are secondary.  This is.
especially troubling in the case of hospice. The mission of hospice,
providing compassionate end-of-life care, should not be subservient to
providing profit to investors. New York is uniquely situated to prevent
the deterioration of end-of-life care described above, as currently only
two of 41 hospice in New York are for-profit, compared to a national
average of two-thirds as of 2017. Now is the time to place the care and
safety of persons who are dying first and foremost over profit.

In her 2022 veto message 149, Governor Hochul says she will direct the
New York State Master Plan for the Aging "to assess the services offered
by for-profit hospices" and "to include a recommendation on their
continued need." It is important for the Master Plan for the Aging to
consider these issues however we already know from the experience of
patients, the advocates working on their behalf and the experiences

described in the articles referenced above that New York should take the
proactive step of prohibiting new for-profit hospices.

In her 2025 veto message 118, Governor Hochul underlines the need "(t)o
ensure that residents of New York have adequate access to hospice and
palliative care", directing the Department of Health "to update and
modernize its methodology for determining need and pursue efforts to
increase awareness and expand the use of hospice care in appropriate
settings."

* Hospice Tax

Status and Ownership Matters for Patients and Families JAMA Internal
Medicine, August 1, 2021 By Melissa D. Aldridge.

 
PRIOR LEGISLATIVE HISTORY::

2025: S3437 vetoed memo .118 / Same as A565

2023-24: S.6460/A.6032 Passed Senate

2022: S.9387/A8472 - vetoed