S.4207, Part L


Director of Government Affairs


S.4207, Part L


Mandates health insurers to pay a facility fee for office-based surgical facilities



The Business Council opposes S.4207, Part L, which creates a mandate on health insurers to pay a facility fee for the utilization of office-based surgical facilities.  These new fees would be in addition to the fees already charged for the performance of covered office-based procedures, which are already enhanced to reflect the costs associated with office-based surgery.

Since 2009, physician offices that perform surgical or invasive procedures using anything other than mild sedation must be accredited by one of three national agencies.  However, accreditation is not the same as state regulation, such as that which regulates hospitals, ambulatory surgical centers and other facilities licensed under Article 28 of the New York State Public Health Law, in order to ensure quality of care and patient safety.  Heightened scrutiny and the accompanying increases in costs may justify facility fees in Article 28 facilities; there is no such justification for a new mandated facility fee for entities that do not share the same costs. 

New York premium payers are already subject to increased insurance costs resulting from too many mandates; as many as four dozen at last count. Each incremental growth of these mandates has a significant impact on the costs of our healthcare and health insurance.   The increased costs that would result from this legislation will be quickly reflected in premiums charged to employers and - increasingly - shared by employees. 

While we recognize that office-based procedures have a significant role to play in healthcare access and cost-containment in New York’s healthcare infrastructure, this bill does nothing to further improve patient care or access.  However, it will certainly increase the state’s already high healthcare costs.  In the end, this legislation would accomplish only one thing, increasing the reimbursements for office-based surgery providers.

For all these reasons the Business Council respectfully opposes the passage of S.4207, Part L.