Bill Text: NY A05750 | 2023-2024 | General Assembly | Introduced

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Bill Title: Provides that the submission of claims for services provided by home care agencies shall be done on forms approved by the centers for Medicare and Medicaid services.

Spectrum: Strong Partisan Bill (Democrat 13-1)

Status: (Introduced) 2024-01-03 - referred to ways and means [A05750 Detail]

Download: New_York-2023-A05750-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          5750

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                     March 23, 2023
                                       ___________

        Introduced by M. of A. PAULIN -- read once and referred to the Committee
          on Health

        AN  ACT to amend the public health law, in relation to the submission of
          claims for services provided by home care agencies

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Section  3614-e  of  the  public  health law, as added by
     2  section 49 of part B of chapter 57 of the laws of 2015,  is  amended  to
     3  read as follows:
     4    §  3614-e.  Electronic  payment  of  claims.  1. The payment of claims
     5  submitted under contracts or agreements with insurers under the  medical
     6  assistance  program for home and community-based long-term care services
     7  provided under this article, by fiscal intermediaries operating pursuant
     8  to section three hundred sixty-five-f of the social services law, and by
     9  residential health care facilities operating pursuant to  article  twen-
    10  ty-eight  of  this  chapter shall be paid via electronic funds transfer.
    11  Claims for services provided by home care agencies licensed or certified
    12  under this article and by fiscal intermediaries  operating  pursuant  to
    13  section  three  hundred sixty-five-f of the social services law shall be
    14  only submitted and remitted on forms approved by the centers  for  Medi-
    15  care  and  Medicaid  services.    Claims  shall be submitted to insurers
    16  directly or by a  billing  entity  selected  by  the  home  care  agency
    17  licensed  or  certified  under  this article or by a fiscal intermediary
    18  operating pursuant to section three hundred sixty-five-f of  the  social
    19  services  law. Insurers shall not require the utilization by contract or
    20  action any specific billing entity by a home  care  agency  licensed  or
    21  certified  under  this  article  or  by  a fiscal intermediary operating
    22  pursuant to section three hundred sixty-five-f of  the  social  services
    23  law; nor impede the timely processing and payment of claims.
    24    2.  Nothing shall limit an insurer's ability to review or audit claims
    25  for fraud, waste, and abuse.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10102-01-3
        A. 5750                             2

     1    3. Such insurers shall include but not be limited to Medicaid  managed
     2  care plans and managed long-term care plans.
     3    §  2.  This  act shall take effect on the thirtieth day after it shall
     4  have become a law.