What's happening
This bill requires a study and report on preventing financial hardship for Medicaid-funded providers serving people with developmental disabilities.
Why it matters
May help prevent service disruptions for individuals with developmental disabilities. by requiring the state to find ways to keep Medicaid-funded providers financially stable, which is crucial for uninterrupted care.
Could lead to fairer reimbursement rates for providers. by examining whether current payment calculations accurately reflect the actual services delivered and true program costs, potentially addressing situations where providers lose income due to closures or enrollment caps.
Allows for responsive adjustments to provider rates. by exploring a process for appealing and increasing rates outside of scheduled rebasing periods, ensuring providers can cover unanticipated costs and aren't financially penalized while appeals are pending.
Aims to improve overall quality and stability of services. by recommending policies such as altering how and when base year rates are updated and ensuring any significant plan changes get federal approval, potentially leading to more predictable funding and better care outcomes.
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Who cares
Headline styles
Study Medicaid Disability Provider Rates
Plain English, a few words. Used as the page title.
Sponsors
2 Co-sponsors
History
- Print number 847a
- Amend and recommit to mental health
- Referred to mental health
- Referred to mental 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.
Study Medicaid Disability Provider Rates
In Senate Committee · Health · Sponsor Robert Ortt
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
847--A
2017-2018 Regular Sessions
IN ASSEMBLY
January 9, 2017
Introduced by M. of A. GUNTHER, LUPARDO, JENNE -- read once and referred to the Committee on Mental Health -- recommitted to the Committee on Mental Health in accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT directing the office for people with developmental disabilities to study and develop suitable measures to prevent financial hardship and/or failure of providers serving individuals with developmental disabilities funded by Medicaid to support the uninterrupted continuation of necessary services
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The commissioner of the office for people with developmental disabilities in conjunction with the commissioner of health, shall jointly prepare a report which shall include the following:
a. Recommendations for holding harmless from further rate reductions those efficient providers within a region that operate beneath the regional average rate. Severity of disability shall be taken into consideration for purposes of comparing efficient providers.
b. A methodology for adjusting rates so that total prospective reimbursement received by a provider for a program must equal the total costs of that program which shall include all necessary cost components for operating the program. The report shall examine the extent to which units used in rate calculations are reflective of the actual units delivered to ensure that providers are not penalized for lost revenue due to unforeseeable program closures, absenteeism and policies designed to curtail program enrollment.
c. Recommendations for a prospective rate appeal process designed to increase rates as necessary during a non-rebasing year to cover costs. Any recommended appeal process shall ensure that providers who prevail
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03798-03-8
A. 847--A 2
on such appeal receive additional reimbursement as of the date the appeal was submitted.
d. Recommendations to enhance program stability and the quality of care including but not limited to lengthening the period between base year updates and alternating base years by program.
e. Identification of those elements of the plan that must be approved by the Centers for Medicare and Medicaid Services and a plan for achieving such approval.
§ 2. The commissioner of the office for people with developmental disabilities shall submit a report detailing the issues set forth in this act and recommendations to the temporary president of the senate, the speaker of the assembly, the chairs of the senate committee on mental health and developmental disabilities and the assembly committee on mental health no later than February 1, 2019.
§ 3. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.