Bill Text: NY S06123 | 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: Partisan Bill (Democrat 4-0)

Status: (Introduced) 2024-03-14 - ADVANCED TO THIRD READING [S06123 Detail]

Download: New_York-2023-S06123-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          6123

                               2023-2024 Regular Sessions

                    IN SENATE

                                     March 30, 2023
                                       ___________

        Introduced  by  Sen.  RIVERA -- read twice and ordered printed, and when
          printed to be committed 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
        S. 6123                             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.