NY State Senate Bill 2009-S4108

Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 16, 2010	print number 4108a
Mar 16, 2010	amend and recommit to health
Jan 06, 2010	referred to health
Apr 09, 2009	referred to health

Bill Amendments

Original

A (Active)

2009-S4108 - Details

See Assembly Version of this Bill:: A5347
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2807-c & 2807, Pub Health L
Versions Introduced in 2011-2012 Legislative Session:: S5431, A5366

2009-S4108 - Summary

Relates to reimbursements to rural health care facilities.

2009-S4108 - Sponsor Memo

                                 BILL NUMBER:  S4108

 TITLE OF BILL :
An act to amend the public health law, in relation to reimbursements
to rural health care facilities


 PURPOSE :
To allow that on and after January 1, 2008, primary care hospitals and
upgraded diagnostic and treatment centers be reimbursed by Medicaid in
the same manner that Medicare reimburses critical access hospitals,
which is on the basis of reasonable costs.

 SUMMARY OF PROVISIONS :
Amends section 2807 of the Public Health Law by adding a new provision
that on and after January 1, 2008, primary care hospitals and upgraded
diagnostic and treatment centers shall have Medicaid payments for
emergency services and all outpatient services equal to one hundred
and one percent of the reasonable costs of such facility in providing
these services.

Subdivision four of Section 2807-c of the Public Health Law is amended
to add a new provision that sets the Medicaid acute care inpatient
payment for primary care hospitals at one hundred and one percent of
the reasonable costs of such hospital in providing such services.

 JUSTIFICATION :
Primary care hospitals serve medically underserved geographically
isolated communities. They provide limited stay special care, acute
care and swing bed services, as well as 24 hour emergency service
capability. The maintenance of primary care hospital emergency and
inpatient capacity is critical for preserving access to basic health
care services for rural New Yorkers.

Cost based Medicaid reimbursement would help ensure the long range
financial viability of primary care hospitals. New York State Medicaid
reimbursement rates are presently capped at lower than operational
costs. The problem is exacerbated for primary care hospitals because
of the need to spread substantial fixed costs over a small number of
emergency room visits and inpatient admissions.  Medicare reimburses
such hospitals (called critical access hospitals under Medicare) on
the basis of reasonable costs. This has helped stabilize such
hospitals and ensure that isolated communities continue to have access
to needed health care services. Having Medicaid payments also equal
reasonable costs will further ensure the financial viability of such
hospitals.

Upgraded diagnostic and treatment centers are currently provided for
in law. However, an inadequate Medicaid reimbursement system has
effectively not allowed them to become a reality. In addition to a
range of outpatient services, up-graded diagnostic and treatment
centers can provide emergency services similar to the emergency
services provided by primary care hospitals. They are intended to
serve rural underserved areas. By providing for cost based Medicaid
reimbursement, upgraded diagnostic and treatment centers can become a
viable resource available to serve rural areas.

 LEGISLATIVE HISTORY :
2007-2008: A8783-A/S.7232 (Winner)

 FISCAL IMPLICATIONS :
To be determined.

 EFFECTIVE DATE :
Immediately.

2009-S4108 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4108

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                              April 9, 2009
                               ___________

Introduced by Sen. AUBERTINE -- 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 reimbursements to
  rural health care facilities

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivision 4 of section 2807-c of the public health law is
amended by adding a new paragraph (m) to read as follows:
  (M)  WHERE A GENERAL HOSPITAL IS DESIGNATED AS A PRIMARY CARE HOSPITAL
PURSUANT TO SECTION TWENTY-NINE HUNDRED FIFTY-SEVEN OF THIS CHAPTER, FOR
PERIODS BEGINNING ON OR AFTER JANUARY  FIRST,  TWO  THOUSAND  TEN,  SUCH
GENERAL  HOSPITAL'S  ACUTE  CARE  INPATIENT  RATE  SHALL BE EQUAL TO ONE
HUNDRED AND ONE PERCENT OF THE REASONABLE  COSTS  OF  THE  PRIMARY  CARE
HOSPITAL  IN  PROVIDING  SUCH SERVICES. REASONABLE COSTS SHALL BE DETER-
MINED IN A MANNER CONSISTENT WITH THAT USED  TO  DETERMINE  PAYMENT  FOR
INPATIENT  CRITICAL  ACCESS  SERVICES PROVIDED TO BENEFICIARIES OF TITLE
XVIII OF THE FEDERAL SOCIAL SECURITY ACT (MEDICARE).
  S 2. Section 2807 of the public health law is amended by adding a  new
subdivision 20 to read as follows:
  20.  NOTWITHSTANDING  ANY INCONSISTENT PROVISION OF LAW OR REGULATION,
FOR PERIODS BEGINNING ON OR AFTER JANUARY FIRST, TWO THOUSAND TEN, RATES
OF PAYMENT BY GOVERNMENTAL AGENCIES FOR TREATMENT OR DIAGNOSTIC  CENTER,
EMERGENCY,  GENERAL HOSPITAL OUTPATIENT, AMBULATORY SURGERY AND REFERRED
AMBULATORY SERVICES PROVIDED BY AN  UPGRADED  DIAGNOSTIC  AND  TREATMENT
CENTER,  AS  DEFINED  IN  SECTION  TWENTY-NINE HUNDRED FIFTY-SIX OF THIS
CHAPTER, OR A PRIMARY CARE HOSPITAL, AS DEFINED IN  SECTION  TWENTY-NINE
HUNDRED  FIFTY-SEVEN  OF THIS CHAPTER, SHALL BE EQUAL TO ONE HUNDRED AND
ONE PERCENT OF THE REASONABLE COSTS OF SUCH FACILITY IN  PROVIDING  SUCH
SERVICES.  NO MAXIMUM PAYMENT AMOUNT SHALL APPLY TO THE RATES OF PAYMENT
CALCULATED PURSUANT TO THIS SECTION. REASONABLE COSTS  SHALL  BE  DETER-
MINED  IN  A  MANNER  CONSISTENT WITH THAT USED TO DETERMINE PAYMENT FOR

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02505-01-9

S. 4108                             2

OUTPATIENT CRITICAL ACCESS HOSPITAL SERVICES PROVIDED  TO  BENEFICIARIES
OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT (MEDICARE). FOR FACIL-
ITIES  WITHOUT  ADEQUATE  COST  EXPERIENCE, SUCH RATES SHALL BE BASED ON
BUDGETED COSTS SUBSEQUENTLY ADJUSTED TO ACTUAL COSTS.
  S 3. This act shall take effect immediately.

2009-S4108A (ACTIVE) - Details

See Assembly Version of this Bill:: A5347
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2807-c & 2807, Pub Health L
Versions Introduced in 2011-2012 Legislative Session:: S5431, A5366

2009-S4108A (ACTIVE) - Summary

Relates to reimbursements to rural health care facilities.

2009-S4108A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S4108A

 TITLE OF BILL :
An act to amend the public health law, in relation to reimbursements
to rural health care facilities


 PURPOSE :
To allow that on and after January 1, 2008, primary care hospitals and
upgraded diagnostic and treatment centers be reimbursed by Medicaid in
the same manner that Medicare reimburses critical access hospitals,
which is on the basis of reasonable costs.

 SUMMARY OF PROVISIONS :
Amends section 2807 of the Public Health Law by adding a new provision
that on and after January 1, 2008, primary care hospitals and upgraded
diagnostic and treatment centers shall have Medicaid payments for
emergency services and all outpatient services equal to one hundred
and one percent of the reasonable costs of such facility in providing
these services.

Subdivision four of Section 2807-c of the Public Health Law is amended
to add a new provision that sets the Medicaid acute care inpatient
payment for primary care hospitals at one hundred and one percent of
the reasonable costs of such hospital in providing such services.

 JUSTIFICATION :
Primary care hospitals serve medically underserved geographically
isolated communities. They provide limited stay special care, acute
care and swing bed services, as well as 24 hour emergency service
capability. The maintenance of primary care hospital emergency and
inpatient capacity is critical for preserving access to basic health
care services for rural New Yorkers.

Cost based Medicaid reimbursement would help ensure the long range
financial viability of primary care hospitals. New York State Medicaid
reimbursement rates are presently capped at lower than operational
costs. The problem is exacerbated for primary care hospitals because
of the need to spread substantial fixed costs over a small number of
emergency room visits and inpatient admissions.  Medicare reimburses
such hospitals (called critical access hospitals under Medicare) on
the basis of reasonable costs. This has helped stabilize such
hospitals and ensure that isolated communities continue to have access
to needed health care services. Having Medicaid payments also equal
reasonable costs will further ensure the financial viability of such
hospitals.

Upgraded diagnostic and treatment centers are currently provided for
in law. However, an inadequate Medicaid reimbursement system has
effectively not allowed them to become a reality. In addition to a
range of outpatient services, up-graded diagnostic and treatment
centers can provide emergency services similar to the emergency
services provided by primary care hospitals. They are intended to
serve rural underserved areas. By providing for cost based Medicaid
reimbursement, upgraded diagnostic and treatment centers can become a
viable resource available to serve rural areas.

 LEGISLATIVE HISTORY :
2007-2008: A.8783-A/S.7232 (Winner)

 FISCAL IMPLICATIONS :
To be determined.

 EFFECTIVE DATE :
Immediately.

2009-S4108A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4108--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                              April 9, 2009
                               ___________

Introduced by Sen. AUBERTINE -- read twice and ordered printed, and when
  printed  to  be committed to the Committee on Health -- recommitted to
  the Committee on Health in accordance with Senate Rule 6,  sec.  8  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee

AN ACT to amend the public health law, in relation to reimbursements  to
  rural health care facilities

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivision 4 of section 2807-c of the public health law is
amended by adding a new paragraph (m) to read as follows:
  (M) WHERE A GENERAL HOSPITAL IS DESIGNATED AS A PRIMARY CARE  HOSPITAL
PURSUANT TO SECTION TWENTY-NINE HUNDRED FIFTY-SEVEN OF THIS CHAPTER, FOR
PERIODS  BEGINNING  ON OR AFTER JANUARY FIRST, TWO THOUSAND ELEVEN, SUCH
GENERAL HOSPITAL'S ACUTE CARE INPATIENT  RATE  SHALL  BE  EQUAL  TO  ONE
HUNDRED  AND  ONE  PERCENT  OF  THE REASONABLE COSTS OF THE PRIMARY CARE
HOSPITAL IN PROVIDING SUCH SERVICES. REASONABLE COSTS  SHALL  BE  DETER-
MINED  IN  A  MANNER  CONSISTENT WITH THAT USED TO DETERMINE PAYMENT FOR
INPATIENT CRITICAL ACCESS SERVICES PROVIDED TO  BENEFICIARIES  OF  TITLE
XVIII OF THE FEDERAL SOCIAL SECURITY ACT (MEDICARE).
  S  2. Section 2807 of the public health law is amended by adding a new
subdivision 20 to read as follows:
  20. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW  OR  REGULATION,
FOR  PERIODS  BEGINNING  ON OR AFTER JANUARY FIRST, TWO THOUSAND ELEVEN,
RATES OF PAYMENT BY GOVERNMENTAL AGENCIES FOR  TREATMENT  OR  DIAGNOSTIC
CENTER,  EMERGENCY,  GENERAL HOSPITAL OUTPATIENT, AMBULATORY SURGERY AND
REFERRED AMBULATORY SERVICES PROVIDED  BY  AN  UPGRADED  DIAGNOSTIC  AND
TREATMENT CENTER, AS DEFINED IN SECTION TWENTY-NINE HUNDRED FIFTY-SIX OF
THIS  CHAPTER, OR A PRIMARY CARE HOSPITAL, AS DEFINED IN SECTION TWENTY-
NINE HUNDRED FIFTY-SEVEN OF THIS CHAPTER, SHALL BE EQUAL TO ONE  HUNDRED
AND  ONE  PERCENT  OF THE REASONABLE COSTS OF SUCH FACILITY IN PROVIDING

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02505-02-0

S. 4108--A                          2

SUCH SERVICES. NO MAXIMUM PAYMENT AMOUNT SHALL APPLY  TO  THE  RATES  OF
PAYMENT  CALCULATED  PURSUANT TO THIS SECTION. REASONABLE COSTS SHALL BE
DETERMINED IN A MANNER CONSISTENT WITH THAT USED  TO  DETERMINE  PAYMENT
FOR  OUTPATIENT  CRITICAL ACCESS HOSPITAL SERVICES PROVIDED TO BENEFICI-
ARIES OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT (MEDICARE).  FOR
FACILITIES  WITHOUT  ADEQUATE COST EXPERIENCE, SUCH RATES SHALL BE BASED
ON BUDGETED COSTS SUBSEQUENTLY ADJUSTED TO ACTUAL COSTS.
  S 3. This act shall take effect immediately.

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Senate Bill S4108

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2009-S4108 - Details

2009-S4108 - Summary

2009-S4108 - Sponsor Memo

2009-S4108 - Bill Text download pdf

2009-S4108A (ACTIVE) - Details

2009-S4108A (ACTIVE) - Summary

2009-S4108A (ACTIVE) - Sponsor Memo

2009-S4108A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S4108

Share this bill

Sponsored By

Darrel J. Aubertine

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2009-S4108 - Details

2009-S4108 - Summary

2009-S4108 - Sponsor Memo

2009-S4108 - Bill Text download pdf

2009-S4108A (ACTIVE) - Details

2009-S4108A (ACTIVE) - Summary

2009-S4108A (ACTIVE) - Sponsor Memo

2009-S4108A (ACTIVE) - Bill Text download pdf

Comments