BILL NUMBER: S1963
SPONSOR: RIVERA
 
TITLE OF BILL:
An act to amend the public health law, in relation to retail clinics
 
PURPOSE OR GENERAL IDEA OF BILL:
To limit the services that may be offered by a health care practice that
is operated within a retail business space or is labeled, branded, or
marketed by a retail business entity.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 amends Public Health Law by adding a new section 230-f as it
relates to retail clinics. Subdivision 1 defines "retail clinics" as
professional health care practices that operate within the space of a
retail business, such as a pharmacy or a store open to the general
public; is labeled, branded, advertised, or marketed with the name or
symbol of a retail business; or is labeled, branded, advertised, or
marketed with the name or symbol of a business other than the health
care practice itself. This definition would exclude facilities that only
provide healthcare to employees of a retail business, as well as pharma-
cy and ophthalmic dispensing and ophthalmologic or optometric services
provided in connection with ophthalmic dispensing. Current restrictions
on referrals considered self-dealing would apply.
Subdivision 2 would limit retail clinics to providing episodic services
that do not require multiple visits, such as minor acute conditions,
episodic prevention and wellness services such as immunizations, and
treatment of minor injuries. This subdivision would prohibit retail
clinics from treating children under age two, treating any patient for
the same condition or illness more than three times in a year, and
require retail clinics to have access to walk-ins and extended business
hours.
Subdivision 3 would deem a retail clinic a "health care provider" for
the purposes of title two-D of this article, and clarifies that a pres-
criber practicing in a retail clinic would not be deemed to be employed
by a pharmacy or hospital.
Subdivision 4 would direct the Commissioner of Health (COH) to make
regulations that: require accreditation; provide guidelines for adver-
tising and signage that prescriptions and supplies do not need to be
purchased on-site; issue guidelines for informed consent, record keep-
ing, referral, continuity of care, and case reporting; and address
design, construction, fixtures, and equipment. The regulations would
promote and strengthen primary care by requiring retail clinics to
inquire of each patient whether they have a primary care provider and
for those who do not have one, the retail clinic would be required to
provide a list drawn from a searchable website list of primary care
providers maintained by the Department of Health, which would include
providers who serve Medicaid, low-income and uninsured patients, and
people with disabilities, and identify cultural and linguistic capabili-
ties.
Subdivision 5 would require a retail clinic to provide treatment without
discrimination as to the source of payment.
Subdivision 6 would direct DOH to post an annual report on its website
showing locations of retail clinics, including which clinics are located
in medically underserved areas, and analysis as to whether retail clin-
ics have improved access to health care in underserved areas, with
recommendations or other information the DOH may deem necessary.
Subdivision 7 provides that this bill does not authorize any form of
ownership or organization of a retail clinic or practice of any profes-
sion that would not otherwise be legal, and would not expand the scope
of practice of any health care practitioner.
Subdivision 8 provides that the host business entity of a retail clinic
would be prohibited from directly or indirectly, by contract, policy,
communication, incentive, or otherwise, influencing or seeking to influ-
ence any clinical decision, policy, or practice of any health care prac-
titioner providing any health care service in the retail clinic, includ-
ing prescribing or recommending drugs, devices, or supplies.
Section 2 provides the effective date
 
JUSTIFICATION:
Retail clinics already exist in several locations throughout New York
State. One concern is that high-profile retail branding may influence
clinical judgment, such as prescribing, or skew public perception of the
value of a retail clinic's services to the detriment of primary care
providers who instead choose a normal neighborhood location.
Today there is nothing to limit the scope of services offered by a
retail clinic. Around the country, they are purporting themselves to be
full-service medical practices. With the marketing power and capital
support they receive, they would out-compete more conventional prac-
tices. Healthcare would become increasingly dominated by corporate
controlled providers. As retail entities become merged with insurers,
healthcare providers could become controlled by health insurers. Regu-
lating retail clinics is necessary to prevent this scenario.
New York law prohibits business corporations from actually owning
healthcare practices or healthcare providers. However, a corporation can
rent health providers space and offer various services such as market-
ing, equipment rental, management support, and electronic health record
systems. Combined with the power of a commercial landlord, the corpo-
ration virtually owns the retail clinic, undermining professional inde-
pendence. This makes it all the more compelling to limit the scope of
services that these clinics are allowed to offer and provide.
The consolidation of pharmacies and insurers, with pharmacy benefit
managers influencing clinical decisions and costs, adds concern that
without sufficient regulation retail clinics become the final link in a
vertically integrated closed loop. Even if the host business is only
renting space to the practice, the proximity and branding may blur how
the practice is perceived. Patients deserve unfettered power to consent
to or refuse treatment, and to purchase prescribed drugs or supplies at
their own discretion, free of the overwhelming influence that retailers
seek to exert over the public.
This bill would ensure that all retail clinics are operated according to
set standards that assure convenience, clinical autonomy, and support
rather than detract from regional primary care.
Family practice and primary care are already stressed by a healthcare
delivery system that is disproportionately driven by hospitals, special-
ists, drug manufacturers, and insurers. Population health improves when
access to preventative and necessary care is available and timely, which
retail clinics can offer, and even more so when such care is connected
to systems that offer continuity and follow-up, which this bill would
assure.
 
PRIOR LEGISLATIVE HISTORY:
2021-2022: S9276 Rivera/A216 Gottfried
2023-2024: S2942 Rivera/A 3729 Paulin
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
Effective 180 days after enactment.