Bill Text: NY A09894 | 2019-2020 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Provides for the provision of health care services under medicaid managed care programs by school-based health centers.

Spectrum: Partisan Bill (Democrat 12-0)

Status: (Introduced - Dead) 2020-11-06 - print number 9894b [A09894 Detail]

Download: New_York-2019-A09894-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          9894

                   IN ASSEMBLY

                                    February 25, 2020
                                       ___________

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

        AN ACT to amend the social services law,  in  relation  to  school-based
          health centers for purposes of managed care programs under medicaid

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

     1    Section 1. Subdivision 1 of section 364-j of the social  services  law
     2  is  amended  by  adding  two  new  paragraphs  (w)  and (w-1) to read as
     3  follows:
     4    (w) "School-based health center".  A  clinic  licensed  under  article
     5  twenty-eight  of  the  public  health  law  or sponsored either fully or
     6  partially by a facility  licensed  under  article  twenty-eight  of  the
     7  public  health  law  or  where  such sponsorship is dually shared with a
     8  facility licensed under article thirty-one of  the  mental  hygiene  law
     9  which  provides primary and preventive care which may include but is not
    10  limited to health maintenance, well-child care, diagnosis and  treatment
    11  of  injury  and  acute  illness,  diagnosis  and  management  of chronic
    12  disease, behavioral services, vision care, dental care, and  nutritional
    13  or other enhanced services to children and adolescents, any of which may
    14  be  provided  by referral, within an elementary, secondary or prekinder-
    15  garten public school setting.
    16    (w-1) "Sponsoring organization". A  facility  licensed  under  article
    17  twenty-eight  of  the  public health law which acts as the sponsor for a
    18  school-based health center, which such sponsorship may be dually  shared
    19  with  a facility licensed under article thirty-one of the mental hygiene
    20  law.
    21    § 2. Section 364-j of the social services law is amended by  adding  a
    22  new subdivision 4-a to read as follows:
    23    4-a.  (a)  Medical  assistance  services  and  supplies  provided by a
    24  school-based health center may be provided and paid for other than by  a
    25  managed  care provider. In such case, the services and supplies shall be
    26  paid in accordance with applicable  reimbursement  methodologies,  which
    27  shall mean:

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15128-02-0
        A. 9894                             2

     1    (i)  for a school-based health center that is sponsored by a federally
     2  qualified health center, rates  of  reimbursement  and  requirements  in
     3  accordance   with   those  mandated  by  42  U.S.C.  Secs.    1396a(bb),
     4  1396b(m)(2)(A)(ix) and 1936a(a)(13)(C); and
     5    (ii)  for  a school-based health center that is sponsored by an entity
     6  licensed pursuant to article twenty-eight of the public health law  that
     7  is  not  a federally qualified health center or is a federally qualified
     8  health center that chooses not  to  receive  reimbursement  pursuant  to
     9  subparagraph  (i)  of  this paragraph, rates of reimbursement at the fee
    10  for service rate for such services and supplies in effect on the  effec-
    11  tive date of this subparagraph for the ambulatory patient group rate for
    12  the  applicable  service  and  supply  and in accordance with any future
    13  adjustments made to such rates by the department of health.
    14    (b) This subdivision shall not preclude a school-based  health  center
    15  or  sponsoring  organization from choosing to provide medical assistance
    16  services and supplies through managed care providers.
    17    (c) The school-based health center or sponsoring organization and  the
    18  managed  care  provider shall enter into a standard memorandum of under-
    19  standing, which shall be developed by the commissioner for  the  purpose
    20  of  promoting  the delivery of coordinated health care and participation
    21  in quality improvement initiatives. The commissioner shall  periodically
    22  share  enrollment, encounter, and any other data the commissioner deter-
    23  mines necessary with each enrolled participant's medicaid  managed  care
    24  provider  to  allow  the  exchange of such data between medicaid managed
    25  care providers and school-based health centers for the purpose  of  this
    26  paragraph  and  facilitating  enrollee  access to services and improving
    27  coordination and quality of care.
    28    § 3. This act shall take effect on the one hundred eightieth day after
    29  it shall have become a law; provided  that  the  amendments  to  section
    30  364-j  of  the  social services law made by sections one and two of this
    31  act shall not affect the repeal of such section and shall expire and  be
    32  deemed  repealed therewith.   Effective immediately, the commissioner of
    33  health shall make regulations and take other actions  reasonably  neces-
    34  sary to implement this act on its effective date.