What's happening
This bill limits Medicaid payments for reserved bed days in nursing homes during hospitalizations and other absences, aiming to reduce costs.
Why it matters
Caps Medicaid payments for "reserved bed days" during temporary hospitalizations to a maximum of 14 days per year per resident. , which could pressure nursing homes to fill empty beds more quickly and may affect continuity of care for patients with lengthy hospital stays.
Separately limits Medicaid payments for non-hospitalization absences (such as therapeutic leave) to 10 days per year. , potentially making it harder for residents to take extended personal or therapeutic leaves without risking loss of their place in the facility.
Requires the state to adopt new reimbursement rules and to project and report anticipated Medicaid savings. , increasing accountability and transparency while aiming for at least $40 million in annual Medicaid savings; if savings targets aren’t met, the state can further lower daily rates for all nursing homes except those serving primarily children.
May have broader implications for nursing home finances and patient/family decisions. , as facilities could face revenue reductions and patients might be less likely to retain their beds during longer absences, raising concerns about access and stability for vulnerable populations.
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Who cares
Headline styles
Limit Nursing Home Bed Payments
Plain English, a few words. Used as the page title.
Sponsors
Senator · Senate District 3
No co-sponsors yet.
History
- Referred to health
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
5997
2017-2018 Regular Sessions
IN SENATE
May 10, 2017
Introduced by Sen. CROCI -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the public health law, in relation to reserved bed days
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 25 of section 2808 of the public health law, as amended by section 2 of part E of chapter 57 of the laws of 2017, is amended to read as follows:
25. Reserved bed days. (a) For purposes of this subdivision, a "reserved bed day" is a day for which a governmental agency pays a residential health care facility to reserve a bed for a person eligible for medical assistance pursuant to title eleven of article five of the social services law while he or she is temporarily hospitalized on [therapeutic] leave of absence from the facility.
(b) Notwithstanding any other provisions of this section or any other law or regulation to the contrary, for reserved bed days provided on behalf of persons twenty-one years of age or older:
(i) payments for reserved bed days shall be made at ninety-five percent of the Medicaid rate otherwise payable to the facility for services provided on behalf of such person; [and]
(ii) payment to a facility for reserved bed days provided on behalf of such person for temporary hospitalizations may not exceed fourteen days in any twelve month period; and
(iii) payment to a facility for reserved bed days provided on behalf of such person for [therapeutic] non-hospitalization leaves of absence may not exceed ten days in any twelve month period.
(c)(i) Notwithstanding any contrary provision of this subdivision or any other law and subject to the availability of federal financial participation, with regard to services provided to residential health care facility residents twenty-one years of age and older, the commissioner shall promulgate regulations, and may promulgate emergency regu-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11475-01-7
S. 5997 2
lations, effective for periods on and after July first, two thousand twelve, establishing reimbursement rates for reserved bed days.
(ii) Such regulations shall, for each Medicaid patient for any twelve month period, provide for reimbursement for reserved bed days for: (A) up to an aggregate of fourteen days for hospitalizations and for other therapeutic leaves for absence consistent with a plan of care ordered by such patient's treating health care professional; and (B) up to an aggregate of ten days of other leaves of absence.
(iii) No later than thirty days after promulgation of such regulations, the commissioner shall advise the chairs of the senate finance and health committees and the assembly ways and means and health committees of the projected reductions expected to be achieved under the methodology set forth in such regulations.
(iv) In the event the commissioner determines, in consultation with the director of the budget, that the regulations promulgated pursuant to subparagraph (i) of this paragraph shall achieve projected aggregate Medicaid savings, as determined by the commissioner, of less than forty million dollars for the state fiscal year beginning April first, two thousand twelve, and each state fiscal year thereafter, the commissioner shall establish a prospective per diem rate adjustment for all nursing homes, other than nursing homes providing services primarily to children under the age of twenty-one, sufficient to achieve such forty million dollars in savings for each such state fiscal year.
§ 2. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to reserved bed days
Purpose
To provide a reimbursement rate for persons who need a residential health care facility bed reserved while the person is on leave of absence from the facility due to hospitalization.
Summary of specific provisions
Section one amends subdivision 25 of section 2808 of the public health law by requiring the commissioner of health to promulgate regulations for establishing reimbursement rates for reserved bed days.
Section two is the effective date.
Justification
In the event that a person who resides in a residential health care facility, is on a temporary leave of absence from that facility due to hospitalization, there is no guarantee that he or she will be able to return into the same facility bed upon reentry into the facility. Before the passage of the Fiscal Year 2018 Budget, persons entitled to Medicaid assistance were guaranteed, upon reentry, the same bed that they occupied before leaving the facility on a temporary leave of absence due to hospitalization so long as they were not hospitalized for a period exceeding fourteen days in a twelve-month period. Due to the budget no longer providing the necessary funding to reserve these beds, residents will be forced to make a decision to go to the hospital and receive the care they need, or refuse hospitalization in order to reserve their current bed in a particular nursing home.
The reverse in policy contained in the 2017-18 Budget saved the state 10.2 million dollars, but has a life-altering impact on nursing home residents across the state. The Fiscal Year 2018 Budget encompasses 153.1 billion dollars in spending. Ultimately, this program would have amounted to 0.006% of the total budget. This bill reverts changes made in the 2017-18 Budget, in order to protect our most vulnerable constituents.
Prior legislative history
New Bill.
Fiscal implications
$10.2 million.
Effective date
This act shall take effect immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.