Bill Text: NY A08229 | 2023-2024 | General Assembly | Introduced

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Bill Title: Requires the commissioner of health to set rates of payment for medical assistance for needy persons to reflect more current base year information.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced) 2024-01-03 - referred to health [A08229 Detail]

Download: New_York-2023-A08229-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          8229

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                    November 6, 2023
                                       ___________

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

        AN  ACT  to  amend the public health law and the social services law, in
          relation to rates of payment for services under medical assistance  to
          needy persons

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

     1    Section 1. Section 2807 of the public health law is amended by  adding
     2  a new subdivision 22 to read follows:
     3    22.  Notwithstanding  any  contrary  provision  of this section or any
     4  other law  or  regulation,  the  commissioner  shall  establish  medical
     5  assistance  rates  of  payment  for hospital services and health-related
     6  services  that  are  reasonably  related  to  the  costs  of   efficient
     7  production  of  such  services  and which are reasonable and adequate to
     8  meet the costs which must be incurred by  efficiently  and  economically
     9  operated  facilities  and service providers. Such rates of payment shall
    10  not be based on information or a base year  calculation  which  is  more
    11  than four calendar years old.
    12    §  2.  Section  2807-c of the public health law is amended by adding a
    13  new subdivision 34-a to read as follows:
    14    34-a. The commissioner shall establish discrete rates of  payment  for
    15  general  hospitals  for  payments  under  the medical assistance program
    16  pursuant to title eleven of article five of the social services law  for
    17  persons eligible for medical assistance who are enrolled in health main-
    18  tenance  organizations  and  for  payments  under the family health plus
    19  program for persons enrolled in approved organizations pursuant to title
    20  eleven-D of article five of the social services law and the child health
    21  insurance plan under section twenty-five hundred eleven of this  chapter
    22  which  are  reasonably  related  to the costs of efficient production of
    23  such services and which shall be reasonable and  adequate  to  meet  the
    24  costs  which  must  be incurred by efficiently and economically operated

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13466-01-3
        A. 8229                             2

     1  facilities and service providers. Such rates of  payment  shall  not  be
     2  based  on information or a base year calculation which is more than four
     3  calendar years old.
     4    §  3.  Paragraph  (a) of subdivision 18 of section 364-j of the social
     5  services law, as amended by chapter 649 of the laws of 1996, is  amended
     6  to read as follows:
     7    (a) The department of health may, where not inconsistent with the rate
     8  setting authority of other state agencies and subject to approval of the
     9  director  of the division of the budget, develop reimbursement methodol-
    10  ogies and fee schedules for determining the amount of payment to be made
    11  to  managed  care  providers  under  the  managed  care  program.   Such
    12  reimbursement methodologies and fee schedules may include provisions for
    13  payment   of   managed  care  fees  and  capitation  arrangements.  Such
    14  reimbursement methodologies  and  fee  schedules  of  payment  shall  be
    15  reasonably related to the costs of efficient production of such services
    16  and  shall  be  reasonable  and adequate to meet the costs which must be
    17  incurred by efficiently and economically operated facilities and service
    18  providers. Rates of payment shall not be based on information or a  base
    19  year calculation which is more than four calendar years old.
    20    §  4. The social services law is amended by adding a new section 363-g
    21  to read as follows:
    22    § 363-g. Disclosure of Medicaid reimbursement methodology. The commis-
    23  sioner of health shall annually develop and  post  on  the  department's
    24  website   a  list  of  all  Medicaid  provider  types  with  a  detailed
    25  description of the Medicaid reimbursement methodology applicable to each
    26  provider type. Such description shall include information on both  oper-
    27  ating  and  capital  reimbursement methodologies. The commissioner shall
    28  also develop and publish on the department's website a  detailed  yearly
    29  workplan  for  reimbursement  modernization  across  Medicaid  and other
    30  public insurance programs.
    31    § 5. This act shall take effect on the thirtieth day  after  it  shall
    32  have  become  a  law;  provided, however, that the amendments to section
    33  364-j of the social services law made by section three of this act shall
    34  not affect the repeal of such section and shall be deemed repealed ther-
    35  ewith.