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History
- Signed chap.396
- Delivered to governor
- Returned to senate
- Passed assembly
- Ordered to third reading rules cal.548
- Substituted for A7636
- Referred to health
- Delivered to assembly
- Passed senateVote 61–0
- Advanced to third reading
- 2nd report cal.
- 1st report cal.572
Show 3 earlier actions
- Print number 3912a
- Amend and recommit to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Directs the department of health to provide oversight of the transitioning of individuals to managed long term care operated by health maintenance organizations
Assembly Floor Calendar · Sponsor Richard Gottfried
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:S3912A
Title of bill
An act to amend the public health law, in relation to managed long term care plans operated by health maintenance organizations
Purpose
This bill directs the Department of Health to provide over-sight of the transitioning of individuals to managed long term care.
Summary of provisions
Section one amends § 4403-f of the Public Health Law by adding a new subdivision 11-a to require the Department of Health to provide oversight in the transition of individuals to managed long term care by ensuring: access to quality care; adequate notice and enrollment assistance; accountability from providers; periodic assessments of plans and providers; mechanisms to prevent waste and abuse; and incentives for such indicators as appropriate enrollment and quality.
Section two provides that this act shall take effect immediately and shall expire and be deemed related with the remainder of the section
Justification
As part of New York's Medicaid reform, dually eligible individuals (those in receipt of Medicare and Medicaid) who are 21 years of age or older and are in need of community based long term care services for more than 120 days are or will soon have their care provided through managed long term care plans (MLTCPs) or care coordination models (CCMs). This is a major transformation for Medicaid recipients, service providers, health insurers and the state. This legislation will ensure the state provides oversight of the enrollment, quality, adequacy and cost of care as health plans take on many of the roles formerly held by the state under the traditional Medicaid fee for service system of care.
According to the Department of Health's February 2013 report on Managed Long Term Care Mandatory Enrollment, approximately 75,000 Medicaid recipients statewide were enrolled in a managed long term care plan (MLTCP) as of December 2012. This number has more than doubled in two years and is expected to continue to grow as the phase-in continues and ultimately nursing home residents are included. In addition to many more individuals being placed in MLTCPs, the number of plans approved by the department has also risen sharply.
While the Department's report indicates high customer satisfaction with MLTCPs, concerns have been raised about appropriate services and enrollment. It is imperative that the Department of Health continue to be vigilant in ensuring individuals transition smoothly into managed long term care and that appropriate oversight is in place as this legislation provides
Prior legislative history
Similar to S.7773 of 2012
Fiscal implications
None.
Effective date
Immediately and shall expire and be deemed related with the remainder of the section.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.