Authorizes payments to home health agencies for the provision of nurse practitioner services

Title of bill

An act to amend the public health law, in relation to nurse practitioner services provided by home care agencies

Purpose

To create the home care-primary care initiative to increase critical opportunity for access to primary care for home care patients using nurse practitioners, working with the patient's physician, and targeting prevention of avoidable hospitalizations and long term care institutionalization.

Summary of provisions

Section one amends section 3614 of the public health law by adding a new subdivision 3-d establishing a home care-primary care initiative designed to provide reimbursement for nurse practitioner services through home care agencies and managed care plans for the purposes of providing, enhancing and expanding access to in-home care, and reducing negative outcomes such as avoidable hospitalizations, re-hospitalizations, emergency room visits and long term institutionalization. The bill also directs the Commissioner in consultation with home care agencies and managed long term care plans to establish criteria and procedures for implementation.

Section two provides for an immediate effective date.

Justification

The transition to a community-based model of healthcare services combined with an increasing elderly and all-age medically complex population at home has expanded the need for in-home care services. These services and overall patient care management and outcomes for the homebound and medically complex are greatly enhanced with close collaboration and integration of primary care with home care. This also especially so in underserved areas. This initiative was conceived through the State Home Care Association's workgroup of Managed Long Term Care plans and providers, focusing on how further incorporation of nurse practitioner services through home care, and specifically a home care-primary care initiative, would enhance patient care management, improve patient health outcomes, prevent avoidable high cost services use, and save costs.

This bill will incentivize expanded coverage and access to primary care services in the home care setting. By providing requisite reimbursement for such nurse practitioner services under home care agencies and managed care plans, the bill will enable these beneficial services to be provided and accessible timely and effectively per patients' needs. Home care agencies, patients and physicians will collaborate to drive this initiative.

Legislative history

New bill.

Fiscal implications

Health care cost savings to through primary and secondary illness prevention, and prevention of avoidable hospitalizations, emergency room visits and long term institutionalization.

Effective date

This act shall take effect immediately.