What's happening
This bill authorizes a demonstration program to allow qualified providers, including for-profits, to deliver and receive Medicaid reimbursement for care to people with developmental or physical disabilities, aiming to improve service efficiency and effectiveness.
Why it matters
Expands the types of organizations eligible for Medicaid reimbursement. , including for-profit providers, which may increase service options and competition, potentially improving quality and access for individuals with developmental or physical disabilities.
Targets individuals currently underserved or whose needs are not fully met. by existing Medicaid waivers and intermediate care facilities, aiming to fill gaps for those with similar characteristics and needs.
Requires rigorous oversight and certification. by the state commissioner, ensuring only providers with demonstrated experience and expertise—and proven ability to partner with states—can participate, which is intended to safeguard service quality during the demonstration.
Mandates annual reporting to the governor and legislature. on the demonstration program’s outcomes, creating transparency and accountability in evaluating whether new provider models actually improve efficiency, effectiveness, and cost savings in disability services.
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Who cares
People with developmental or physical disabilities
The bill would authorize qualified providers to deliver Medicaid-reimbursed care and services, including to waiver recipients, intermediate care facility service recipients and people with similar needs.
Qualified care providers
Providers could receive Medicaid reimbursement for covered care and services after obtaining the required certification and approval from the commissioner.
For-profit disability service providers
One or more qualified providers with demonstrated care delivery and state partnership experience would be selected for a demonstration program aimed at improving effectiveness, efficiency and economy.
Office for People With Developmental Disabilities
Its commissioner would conduct the demonstration program and report annually to the governor and Legislature on its operation and effectiveness.
Headline styles
Expand Disability Care Options
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Referred to health
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
3777
2019-2020 Regular Sessions
IN ASSEMBLY
January 31, 2019
Introduced by M. of A. ORTIZ, SANTABARBARA -- read once and referred to the Committee on Health
AN ACT to amend the mental hygiene law, in relation to the provision of care and services to persons with developmental or physical disabilities and to directing the commissioner of the office for people with developmental disabilities to conduct a demonstration program to identify ways to more efficiently provide such care
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The mental hygiene law is amended by adding a new section 13.45 to read as follows: § 13.45 Medicaid reimbursement; demonstration program.
(a) Notwithstanding any other provision of law or regulation to the contrary, any qualified provider shall be authorized to provide care and services, and to receive Medicaid reimbursement for such care and services, to persons with developmental or physical disabilities, including:
(1) persons with developmental or physical disabilities who receive home and community-based services or care-at-home services through existing waivers under section 1915(c) of the federal social security act or who have characteristics and needs similar to such persons; and
(2) persons receiving services provided by an intermediate care facility for the developmentally disabled or who have characteristics and needs similar to such persons; provided such qualified provider applies for and obtains the requisite certification and approval from the commissioner to provide such care and services.
(b) The commissioner shall conduct a demonstration program with one or more qualified for-profit providers that provide care and services to persons with developmental or physical disabilities in order to identify ways to more effectively, efficiently and economically provide such care and services to persons with developmental or physical disabilities;
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07659-01-9
A. 3777 2
provided such qualified provider applies for and obtains the requisite certification and approval from the commissioner to provide such care and services. The commissioner shall select a provider or providers with demonstrated experience and expertise in:
(1) providing such care and services; and
(2) partnering with states to improve the delivery of such care and services.
The commissioner may, in the commissioner's discretion, conduct such demonstration program as part of a pilot program in accordance with an application made under section 1115 or section 1915 of the federal social security act. The commissioner shall annually report to the governor and legislature on the operation of the demonstration program and its effectiveness in identifying ways to more effectively, efficiently and economically provide care and services to persons with developmental or physical disabilities.
§ 2. 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.