What's happening
This bill amends eligibility requirements to ensure managed long term care plans are not owned or controlled by for-profit entities.
Why it matters
Limits for-profit influence over managed long-term care (MLTC) plans,. aiming to ensure that only not-for-profit entities, hospitals, and similar organizations can own or control these plans, which could prioritize patient care over profit.
Closes a potential loophole by specifying that only not-for-profit entities or those with a history of providing care to vulnerable populations are eligible,. possibly reducing the risk of cost-cutting or service reductions sometimes associated with for-profit ownership.
Includes a "grandfather" clause for certain existing for-profit controlled plans,. allowing entities that already received authorization before the new law to continue operating—this balances reform with stability for current enrollees.
Could impact the structure and competition within New York’s MLTC market,. potentially leading to fewer new entrants from the for-profit sector and strengthening the role of community-based or mission-driven organizations in long-term care.
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Who cares
Headline styles
Ban For-Profit LTC Plans
Plain English, a few words. Used as the page title.
Sponsors
4 Multi-sponsors
History
- Referred to health
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2797
2019-2020 Regular Sessions
IN ASSEMBLY
January 25, 2019
Introduced by M. of A. GOTTFRIED, L. ROSENTHAL, JAFFEE, STECK, D'URSO -- Multi-Sponsored by -- M. of A. ABINANTI, CARROLL, COOK, GUNTHER -read once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to managed long term care plans not being controlled or owned by for-profit health maintenance organizations or insurers
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 4403-f of the public health law, as added by chapter 659 of the laws of 1997, is amended to read as follows:
(b) "Eligible applicant" means an entity controlled or wholly owned by one or more of the following: a hospital as defined in subdivision one of section twenty-eight hundred one of this chapter; a home care agency licensed or certified pursuant to article thirty-six of this chapter; [an] a not-for-profit entity that has received a certificate of authority pursuant to sections forty-four hundred three, forty-four hundred three-a or an integrated delivery system that has received a certificate of authority pursuant to section forty-four hundred eight-a of this article (as added by chapter six hundred thirty-nine of the laws of nineteen hundred ninety-six), or a not-for-profit health maintenance organization authorized under article forty-three of the insurance law; or a not-for-profit organization which has a history of providing or coordinating health care services and long term care services to the elderly and disabled. However, an entity owned or controlled by an entity that has received a certificate of authority pursuant to section forty-four hundred three or forty-four hundred three-a of this article and has received a certificate of authority under this section prior to the effective date of a chapter of the laws of two thousand nineteen which enacted this sentence shall be deemed to be an eligible applicant.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03357-01-9
A. 2797 2
§ 2. This act shall take effect immediately; provided, however, that the amendments to section 4403-f of the public health law made by section one of this act shall not affect the repeal of such section and shall be deemed repealed therewith.
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.