Update on Elective Surgeries in New York State

According to a recent executive order signed by Gov. Kathy Hochul, hospitals or health systems with limited capacity are required to limit non-essential elective surgeries in New York State.

The order is in response to the recent surge in COVID-19 transmission rates and seeks to ensure hospitals meet regional needs while still maintaining the State’s healthcare infrastructure. “New York is now experiencing COVID-19 transmission at rates the State has not seen since April 2021,” the statement explains. “The rate of new COVID-19 hospital admissions has been increasing over the past month to over 300 new admissions a day.”

Determinations were issued to facilities by December 6 and applied to procedures scheduled to occur on or after December 9.

Impacted Facilities

According to the executive order, impacted facilities may be required to limit non-essential elective procedures, both within the hospital and at hospital-owned ambulatory surgery centers, depending upon the following assessments:

1. High risk regional assessment (defined as “High Risk Regions”):

• Low current regional capacity: Staffed acute bed occupancy rate for the region at 90% or higher (based on the previous 7-day average); OR
• Decreasing current regional capacity: Staffed acute bed occupancy rate for the region at 85-90% (based on the previous 7-day average) AND New COVID-19 hospital admission rate for the region (previous 7-day average per 100,000 population) is greater than 4.0.

2. Facility-level risk assessment:

• Low current facility capacity: Staffed acute bed occupancy rate for the facility at 90% or higher (based on the previous 7-day average).

Thus far, local media describes the status of hospitals across the state as follows:

• WKBW Buffalo reports that, as of December 7, 2021, seven Western New York hospitals are affected by the order.
• Syracuse.com indicates four Central New York hospitals and three Capital Region hospitals are impacted, as of December 8, 2021.
• Fewer facilities downstate see effects, according to the New York Post, since New York City boasts higher vaccination rates and lower COVID-19 positivity rates.

Spectrum News provides a full list of hospitals affected as of December 6, 2021, here.

Non-Impacted Facilities and Procedures

The order does not apply to single specialty facilities (e.g., cancer treatment facility), nonhospital owned ambulatory surgery centers, office-based surgery practices or free-standing diagnostic and treatment centers.

According to Albany’s Times Union, the term “elective surgeries” has a more nuanced definition than it did earlier in the pandemic, and health professionals are glad to see this delineation. “We are encouraged by at least the procedures they consider essential,” said Dr. John DiPreta, president of the New York State Society of Orthopaedic Surgeons.

The following procedures are considered essential and are not impacted:

• Cancer, including diagnostic procedure of suspected cancer
• Neurosurgery
• Intractable pain
• Highly symptomatic patients
• Transplants
• Trauma
• Cardiac with symptoms
• Limb threatening vascular procedures
• Dialysis Vascular Access
• Patients that are at a clinically high risk of harm if their procedures are not completed

See the complete Executive Order for full details.

We will continue to monitor the situation in New York State regarding the status of elective surgeries. Our Insureds can find further guidance on the topic in this document on medical judgment and documentation. For all COVID-19-related developments, please visit MLMIC’s dedicated resources page.