What's happening
This bill requires managed care providers and certain entities to apply increased behavioral health payments retroactively from the effective date of any official change.
Why it matters
Ensures timely access to increased funding for behavioral health providers. by mandating that managed care organizations and related entities apply new payment rates or expanded coverage retroactively from the official effective date, not from when they actually update their systems or contracts.
Closes a common loophole that can delay increased payments. , which helps behavioral health providers receive the full intended benefit of any state-mandated rate hikes or service enhancements, improving their financial stability and capacity to serve patients.
Promotes parity between payment systems. , requiring that providers paid through managed care are not disadvantaged compared to those paid directly by the state or fee-for-service systems when laws or regulations change.
May improve behavioral health service availability and quality. by ensuring providers are promptly and fully compensated as intended by state policy changes, reducing administrative burdens and potential cash flow issues that could otherwise disrupt care.
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Who cares
Headline styles
Pay More for Mental Health
Plain English, a few words. Used as the page title.
Sponsors
3 Co-sponsors
History
- Signed chap.451
- Delivered to governor
- Returned to assembly
- Passed senateVote 57–5
- 3rd reading cal.1494
- Substituted for S3960
- Referred to rules
- Delivered to senate
- Passed assembly
- Ordered to third reading rules cal.104
- Rules report cal.104
- Reported
Show 3 earlier actions
- Reported referred to rules
- Reported referred to ways and means
- 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.
Retroactive Behavioral Health Payments
Senate Floor Calendar · Sponsor Gustavo Rivera
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2787
2019-2020 Regular Sessions
IN ASSEMBLY
January 25, 2019
Introduced by M. of A. GOTTFRIED, JAFFEE -- read once and referred to the Committee on Health
AN ACT to amend the social services law and the public health law, in relation to payments for behavioral health services
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 18 of section 364-j of the social services law is amended by adding a new paragraph (e) to read as follows:
(e) Increased rates, terms or scope of payment for behavioral health services under this title, where payment is made by a managed care provider under this section, as a result of a rate, coverage or other change made pursuant to a law, regulation, rule or official guidance, shall be deemed in effect on the same date that such change would have taken effect if payment were made other than by the managed care provider. Where payment is not made as of the effective date, the managed care provider shall make retroactive payments to the appropriate service providers.
§ 2. Subdivision 7 of section 4403-f of the public health law is amended by adding a new paragraph (k) to read as follows:
(k) Increased rates, terms or scope of payment for behavioral health services under this section, where payment is made by an entity under this section, as a result of a rate, coverage or other change made pursuant to a law, regulation, rule or official guidance, shall be deemed in effect on the same date that such change would have taken effect if payment were made other than by the entity. Where payment is not made as of the effective date, the entity shall make retroactive payments to the appropriate service providers.
§ 3. This act shall take effect immediately; provided, however, that the amendments to section 364-j of the social services law and section 4403-f of the public health law made by sections one and two of this act, respectively, shall not affect the repeal of such sections and shall be deemed repealed therewith.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02696-01-9
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.