What's happening
This bill adds accountable care organizations to the definition of "managed care provider" under New York social services law.
Why it matters
Expanding the definition of "managed care provider" to include accountable care organizations (ACOs) could allow these organizations to participate more fully in Medicaid managed care programs, potentially changing how patients receive and coordinate their care.
This amendment may lead to increased integration and coordination of care for Medicaid recipients, as ACOs are designed to bring together various healthcare providers to improve outcomes and reduce costs.
By formally recognizing ACOs in this context, the bill may open up new funding streams, regulatory oversight, and accountability measures for these organizations, which could impact how healthcare services are delivered and monitored in New York.
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Who cares
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Add ACOs to Managed Care
Plain English, a few words. Used as the page title.
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History
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
10184
IN ASSEMBLY
March 24, 2020
Introduced by M. of A. GOTTFRIED -- read once and referred to the Committee on Health
AN ACT to amend the social services law, in relation to including accountable care organizations within the definition of a managed care provider
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Paragraph (b) of subdivision 1 of section 364-j of the social services law, as amended by chapter 649 of the laws of 1996, subparagraph (i) as amended by section 35-a, subparagraph (ii) as amended and subparagraph (iii) as added by section 77 of part A of chapter 56 of the laws of 2013, is amended to read as follows:
(b) "Managed care provider". An entity that provides or arranges for the provision of medical assistance services and supplies to participants directly or indirectly (including by referral), including case management; and:
(i) is authorized to operate under article forty-four of the public health law or article forty-three of the insurance law and provides or arranges, directly or indirectly (including by referral) for covered comprehensive health services on a full capitation basis, including a special needs managed care plan or comprehensive HIV special needs plan; or
(ii) is authorized as a partially capitated program pursuant to section three hundred sixty-four-f of this title or section forty-four hundred three-e of the public health law or section 1915b of the social security act; or
(iii) is authorized to operate under section forty-four hundred three-g of the public health law[.]; or
(iv) is an accountable care organization under article twenty-nine-E of the public health law.
§ 2. Paragraph (b) of subdivision 1 of section 364-j of the social services law, as amended by chapter 649 of the laws of 1996, subparagraph (i) as amended by section 35-a of part A of chapter 56 of the laws
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15756-01-0
A. 10184 2
of 2013, subparagraph (ii) as amended by chapter 433 of the laws of 1997, is amended to read as follows:
(b) "Managed care provider". An entity that provides or arranges for the provision of medical assistance services and supplies to participants directly or indirectly (including by referral), including case management; and:
(i) is authorized to operate under article forty-four of the public health law or article forty-three of the insurance law and provides or arranges, directly or indirectly (including by referral) for covered comprehensive health services on a full capitation basis, including a special needs managed care plan or comprehensive HIV special needs plan; or
(ii) is authorized as a partially capitated program pursuant to section three hundred sixty-four-f of this title or section forty-four hundred three-e of the public health law or section 1915b of the social security act[.]; or
(iii) is an accountable care organization under article twenty-nine-E of the public health law.
§ 3. This act shall take effect one hundred eighty days after it shall have become a law; provided, that the amendments to subparagraphs (ii) and (iii) of paragraph (b) of section 364-j of the social services law made by section one of this act shall be subject to the expiration and reversion and repeal of such subparagraphs when upon such date the provisions of section two of this act shall take effect; and provided further that the amendments to section 364-j of the social services law made by this act shall be subject to the expiration and repeal of such section and shall expire and be deemed repealed therewith. Effective immediately, the commissioner of health shall make regulations and take other actions reasonably necessary to implement this act on that date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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