Bill Text: NY S07023 | 2021-2022 | General Assembly | Amended

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Bill Title: Directs the commissioner of health to conduct a study on the rates of reimbursement made through the New York state Medicaid durable medical equipment, orthotics, prosthetics and supplies program for rate adequacy and patient access.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Engrossed - Dead) 2022-05-31 - referred to ways and means [S07023 Detail]

Download: New_York-2021-S07023-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         7023--A
            Cal. No. 118

                               2021-2022 Regular Sessions

                    IN SENATE

                                      May 24, 2021
                                       ___________

        Introduced  by Sens. MANNION, KENNEDY, REICHLIN-MELNICK, SKOUFIS -- read
          twice and ordered printed, and when printed to  be  committed  to  the
          Committee  on  Health  --  recommitted  to  the Committee on Health in
          accordance with Senate Rule 6, sec. 8 -- reported favorably from  said
          committee,  ordered  to  first  and  second report, ordered to a third
          reading, passed by Senate and delivered  to  the  Assembly,  recalled,
          vote  reconsidered,  restored  to  third  reading, amended and ordered
          reprinted, retaining its place in the order of third reading

        AN ACT directing the commissioner of health to conduct a  study  on  the
          rates  of reimbursement made through the New York state Medicaid dura-
          ble medical equipment, orthotics, prosthetics and supplies program for
          rate adequacy and patient access; and providing for the repeal of such
          provisions upon expiration thereof

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

     1    Section  1. The commissioner of health shall conduct a study to review
     2  the rates of reimbursement made through  the  New  York  state  Medicaid
     3  durable  medical  equipment, orthotics, prosthetics and supplies program
     4  for rate adequacy and patient access, including  those  made  under  all
     5  capitated and contract coverage models. Such review shall include:
     6    (a)  an  analysis of rules, regulations and policies for orthotics and
     7  prosthetics  service/device  provisions  under  the  New  York  Medicaid
     8  program, including all contracted and capitated models;
     9    (b)  a  comprehensive  assessment  of the existing methodology used to
    10  determine payment or nonpayment for prosthetic and orthotic care includ-
    11  ing but not limited to:
    12    (i) all orthotic and prosthetic codes  on  the  current  Medicaid  fee
    13  schedule,  including but not limited to a comparison of prevailing Medi-
    14  care fee schedule amounts and New York Medicaid amounts;

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11559-03-2
        S. 7023--A                          2

     1    (ii) codes on the Medicare fee schedule but not included  on  the  New
     2  York  state  Medicaid  durable medical equipment, orthotics, prosthetics
     3  and supplies program fee schedule;
     4    (iii)   recommendations   for  changing  reimbursement  methodologies.
     5  Recommendations under this subparagraph shall be consistent with federal
     6  law and shall include recommendations for appropriate changes  in  state
     7  law  and  regulations.  Such  recommendations shall consider appropriate
     8  payment methodologies for codes not included on the Medicaid fee  sched-
     9  ule;
    10    (c)  assessment  of  barriers  to  timely service provision as well as
    11  racial and socioeconomic disparities in access including, but not limit-
    12  ed to, travel time required, geographic variability, access to and  cost
    13  of technology;
    14    (d)  the  workforce needed to provide orthotic and prosthetic services
    15  in the next five years to eligible children and adults, disaggregated by
    16  county;
    17    (e) opportunities for stakeholder input on current rate methodologies;
    18  and
    19    (f) assessment of cost savings associated with percentage of  Medicaid
    20  population returning to work after orthotic and/or prosthetic provision.
    21    § 2. Within one year after the effective date of this act, the commis-
    22  sioner  of  health shall submit a report of the findings and recommenda-
    23  tions pursuant to this act to the governor, the temporary  president  of
    24  the senate, the minority leader of the senate, the speaker of the assem-
    25  bly,  the  minority  leader  of the assembly, and the chairs and ranking
    26  members of the senate and assembly committees on health and  shall  post
    27  such report on the department of health's website.
    28    §  3.  The  commissioner  of  health shall be authorized to promulgate
    29  rules and regulations to provide for the  orderly  effectuation  of  the
    30  provisions of this act.
    31    §  4.  This  act shall take effect immediately and shall expire and be
    32  deemed repealed upon the submission of the report required  pursuant  to
    33  section two of this act.