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Sponsors
2 Co-sponsors
History
- Referred to health
- Delivered to assembly
- Passed senateVote 62–0
- Ordered to third reading cal.1251
- Committee discharged and committed to rules
- Referred 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.
Relates to a review of reimbursement methodologies under contracts or agreements with insurers under the medical assistance program for home and community-based long term care services
In Assembly Committee · Health · Sponsor Richard Gottfried
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:S5459
Title of bill
An act to amend the social services law, in relation to the review of reimbursement methodologies under contracts or agreements with insurers under the medical assistance program for home and community-based long term care services
Purpose
Directs the Department of Health to provide for the study and review of adequate reimbursement methodologies under managed care contracts and fee-for-service Medicaid rates to ensure such are sufficient to support compensation for persons providing home care aide services and consumer directed personal assistance services.
Summary of provisions
Section one adds a new paragraph (e) to section 364-j of the Social Services Law requiring the Department of Health to select and contract with an independent actuary to study and review adequate reimbursement methodologies for home and community based long term care providers. In addition, it provides that the Department shall report to the Governor, the Temporary President of the Senate, the Speaker of the Assembly, the Health Chairs on or before January 1, 2016 on the findings of such study and review.
Justification
New York State has long recognized the importance of home care services as a critical component of the State's health care delivery system. Home care plays an important role in reducing health care costs and improving consumer satisfaction by providing cost-effective care at a fraction of the cost of institutional settings - all in the patient-preferred setting of the home. However, compliance with existing State and Federal wage and benefit mandates, and the implementation of new requirements going into effect, are putting an enormous strain on home care providers operating within both the Medicaid fee-for-service and managed care environments.
This legislation aims to ensure that the home care industry in New York, whether provided by a agencies or through consumer directed care, can continue to provide a high level of quality care to the state's Medicaid population.
The review will assist the State in determining the overall adequacy of current home care reimbursement rates. Results will offer insight and a better understanding of the reimbursement needs of the home care system within the context of the changing health care delivery system and implementation of new and rising wage and benefit requirements, and help to identify reimbursement gaps or areas in need of additional oversight and/or State intervention.
Legislative history
New bill.
Fiscal implications
No net fiscal impact the state currently contracts with actuaries.
Effective date
Immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.