NY State Senate Bill 2013-S3966B

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Apr 02, 2014	print number 3966b
Apr 02, 2014	amend and recommit to health
Jan 08, 2014	referred to health
Mar 07, 2013	print number 3966a
Mar 07, 2013	amend (t) and recommit to health
Mar 01, 2013	referred to health

Bill Amendments

Original

B (Active)

2013-S3966 - Details

See Assembly Version of this Bill:: A9262
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Ren §3622 to be §3625, add §§3614-d & 3622, amd §4406-c, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: S2902, A379
2017-2018: A564
2019-2020: A2864
2021-2022: A5185

2013-S3966 - Summary

Enacts the "home care stabilization act"; establishes standards for the prompt, fair and equitable settlement of claims for payments for personal care, home health care services, consumer directed personal assistance services and long term care services; provides that recoupments and reductions of medical assistance payments for home care services shall not be subject to interest.

2013-S3966 - Sponsor Memo

                                BILL NUMBER:S3966

TITLE OF BILL:  An act to amend the public health law, in relation to
enacting the "home care stabilization act"; and providing for the
repeal of certain provisions upon the expiration thereof

PURPOSE:  The Home Care Stabilization Act will address the home care
fiscal crisis by ensuring managed long term care contracts support
wage parity, providing for prompt payments and waiving interest and
penalties on recoupments and reductions.

SUMMARY OF PROVISIONS:

Section one provides that this act shall be known as the Home Care
Stabilization Act.

Section two amends the Public Health Law (PHL) by adding a new
3614-d to provide standards for prompt, fair and equitable settlement
of claims for payments for personal care, home health care services or
other long term care services. This section also adds a new PHL § 3621
providing that on and after April 1, 2009, any recoupments or
reductions in medical assistance payments for licensed home care
services agencies (LHCSAs), certified home health agencies (CHHAs) and
consumer directed personal assistance programs (CDPAPs) shall not be
subject to interest.

Section three adds a new 4406-c(9) to the PHL to ensure that funds
made available to licensed home care service programs, certified home
health agencies, long term home health care programs through contracts
with health care plans shall provide compensation sufficient to
satisfy the statutory provisions set forth in Section 3614-c, the wage
parity law.

Section four provides that this act shall take effect immediately,
provided however section three shall expire and be deemed repealed on
March 31, 2015.

JUSTIFICATION:  This legislation aims to stabilize the home health
care system in New York which has been hit with hundreds of millions
of dollars in cuts, unfunded wage mandates, the transition to managed
long term care, a devastating storm and rate recoupments in 2012 of
$250 million.  Providers, workers and patients are shifting into a new
system of managed long term care with fewer resources meanwhile
working hard to maintain the high quality of home care which New York
State is regarded for across the country.

Currently, agencies seeking to pay wage parity rates are not
guaranteed the proper payment amounts by managed long term care
entities. In addition, agencies are reporting exploding accounts
receivables from lags in the payment of claims under managed care and
the frequent rejection of the payment of claims. This together with
State's Medicaid rate recoupment efforts have lead many agencies into
financial crisis impacting workers and more importantly the patients
they serve.


This legislation attempts to assist patients, workers and providers in
keeping the promise to people facing illness or disability -
maintaining their independence in the comfort, security and privacy of
their homes. Specifically, the legislation works to ensure worker's
wages under the wage parity law are supported in payments to home
health care agencies by managed long term care plans. The bill
eliminates interest and penalties on Medicaid recoupment from home
care agencies and mandates that managed long term care plans must pay
clean claims promptly.

LEGISLATIVE HISTORY: New bill.

FISCAL IMPLICATIONS:  No net fiscal impact as this legislation will
not reduce the amounts recouped.

EFFECTIVE DATE:  Immediately, provided however section three shall
expire and be deemed repealed on March 31, 2015.

2013-S3966 - Bill Text download pdf

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

                                  3966

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                              March 1, 2013
                               ___________

Introduced  by  Sen.  HANNON -- 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 enacting the "home
  care stabilization act"; and  providing  for  the  repeal  of  certain
  provisions upon the expiration thereof

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

  Section 1. Short title. This act shall be known and may  be  cited  as
the "home care stabilization act".
  S  2.  The  public  health  law  is amended by adding two new sections
3614-d and 3621 to read as follows:
  S 3614-D. STANDARDS FOR  PROMPT,  FAIR  AND  EQUITABLE  SETTLEMENT  OF
CLAIMS  FOR  PAYMENTS  FOR  PERSONAL  CARE, HOME HEALTH CARE SERVICES OR
OTHER LONG TERM CARE SERVICES. 1. IN THE PROCESSING OF CLAIMS  SUBMITTED
UNDER  CONTRACTS  OR AGREEMENTS ISSUED OR ENTERED INTO OR BETWEEN CERTI-
FIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, LICENSED
HOME CARE SERVICES PROGRAMS, INSURERS, MANAGED  LONG  TERM  CARE  PLANS,
MANAGED CARE PLANS OR ORGANIZATIONS LICENSED OR OPERATED PURSUANT TO THE
PROVISIONS OF THIS CHAPTER, THE SOCIAL SERVICES LAW OR THE INSURANCE LAW
AND  FOR ALL BILLS FOR PERSONAL CARE, HOME HEALTH CARE SERVICES OR OTHER
LONG  TERM  CARE  SERVICES  RENDERED  BY  LICENSED  HOME  CARE  SERVICES
PROGRAMS,  CERTIFIED  HOME HEALTH AGENCIES OR LONG TERM HOME HEALTH CARE
PROGRAMS PURSUANT TO SUCH CONTRACTS OR AGREEMENTS,  ANY  CERTIFIED  HOME
HEALTH CARE AGENCY, LONG TERM HOME HEALTH CARE PROGRAM, INSURER, MANAGED
LONG TERM CARE PLAN, MANAGED CARE PLAN OR ORGANIZATION LICENSED OR OPER-
ATED  PURSUANT  TO  THE  PROVISIONS OF THIS CHAPTER, THE SOCIAL SERVICES
LAW, THE EXECUTIVE LAW OR THE INSURANCE LAW, SHALL ADHERE TO THE FOLLOW-
ING STANDARDS:
  (A) SHALL   PAY A CLEAN  CLAIM  SUBMITTED  BY  A  LICENSED  HOME  CARE
SERVICES  PROGRAM, CERTIFIED HOME HEALTH AGENCY OR LONG TERM HOME HEALTH
CARE PROGRAM WITHIN THIRTY DAYS  OF  RECEIPT  OF  THE  CLEAN  CLAIM  FOR
SERVICES  RENDERED  THAT  IS  TRANSMITTED VIA THE INTERNET OR ELECTRONIC
MAIL, OR FORTY-FIVE DAYS OF RECEIPT OF  THE  CLEAN  CLAIM  FOR  SERVICES
RENDERED THAT IS SUBMITTED BY OTHER MEANS, SUCH AS PAPER OR FACSIMILE;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09417-02-3

S. 3966                             2

  (B)  SHALL  PAY  ANY UNDISPUTED PORTION OF A CLAIM AS A CLEAN CLAIM AS
SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION SUBMITTED BY  A  LICENSED
HOME  CARE  SERVICES  PROGRAM, CERTIFIED HOME HEALTH AGENCY OR LONG TERM
HOME HEALTH CARE PROGRAM, AND  NOTIFY  SUCH  AGENCY  IN  WRITING  WITHIN
FIFTEEN CALENDAR DAYS OF RECEIPT OF THE CLAIM OF ALL SPECIFIC DEFECTS OR
DISPUTES  OF  SUCH  CLAIM  AND SPECIFICALLY REQUEST IN WRITING THE ADDI-
TIONAL INFORMATION OR REMEDY NEEDED TO PROCESS THE DISPUTED PORTIONS  OF
THE CLAIM; AND
  (C)  ANY DISPUTED CLAIM REMEDIED SHALL BE PAID AS A CLEAN CLAIM AS SET
FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION.
  2. FOR THE PURPOSES OF THIS SECTION, A "CLEAN CLAIM" SHALL:
  (A) IDENTIFY THE LICENSED HOME CARE SERVICES PROGRAM,  CERTIFIED  HOME
HEALTH AGENCY OR LONG TERM HOME HEALTH CARE PROGRAM;
  (B) SUFFICIENTLY IDENTIFY THE ELIGIBLE COVERED PERSON;
  (C) LIST THE DATE AND PLACE OF SERVICE;
  (D) SUBSTANTIATE THE APPROPRIATENESS OF THE SERVICE PROVIDED;
  (E) STATE IF PRIOR AUTHORIZATION IS REQUIRED FOR SUCH ELIGIBLE COVERED
PERSON AND SERVICE; AND
  (F)  STATE  ANY  DOCUMENTATION  AS  REASONABLY  REQUIRED BY ANY ENTITY
REFERENCED IN THIS SECTION.
  3. EACH CLEAN CLAIM OR PAYMENT FOR SERVICES PROCESSED IN VIOLATION  OF
THIS  SECTION  SHALL CONSTITUTE A SEPARATE VIOLATION. IN ADDITION TO THE
PENALTIES PROVIDED IN THIS CHAPTER, ANY ORGANIZATION OR CORPORATION THAT
FAILS TO ADHERE TO THE STANDARDS CONTAINED  IN  THIS  SECTION  SHALL  BE
OBLIGATED  TO  PAY  TO  CERTIFIED  HOME  HEALTH AGENCIES, LONG TERM HOME
HEALTH CARE PROGRAMS OR LICENSED  HOME  HEALTH  CARE  PROGRAMS  IN  FULL
SETTLEMENT  OF THE BILL, CLAIM OR PAYMENT PLUS INTEREST ON THE AMOUNT OF
SUCH BILL, CLAIM OR PAYMENT OF THE GREATER OF THE RATE EQUAL TO THE RATE
SET BY THE COMMISSIONER OF TAXATION  AND  FINANCE  FOR  CORPORATE  TAXES
PURSUANT  TO  PARAGRAPH  ONE  OF  SUBSECTION (E) OF SECTION ONE THOUSAND
NINETY-SIX OF THE TAX LAW OR TWELVE PERCENT PER ANNUM,  TO  BE  COMPUTED
FROM THE DATE THE BILL, CLAIM OR PAYMENT WAS REQUIRED TO BE MADE.
  S  3621. MEDICAL ASSISTANCE RECOUPMENTS AND REDUCTIONS.  NOTWITHSTAND-
ING ANY OTHER PROVISION OF LAW TO  THE  CONTRARY,  ON  AND  AFTER  APRIL
FIRST,  TWO  THOUSAND  NINE,  ANY  RECOUPMENTS  OR REDUCTIONS IN MEDICAL
ASSISTANCE PAYMENTS FOR LICENSED HOME CARE SERVICES AGENCIES AND  CERTI-
FIED  HOME  HEALTH  AGENCIES LICENSED PURSUANT TO THIS ARTICLE OR FISCAL
INTERMEDIARIES OPERATING PURSUANT TO SECTION THREE HUNDRED  SIXTY-FIVE-F
OF  THE SOCIAL SERVICES LAW SHALL NOT BE SUBJECT TO INTEREST OR INTEREST
PENALTIES.
  S 3. Section 4406-c of the public health law is amended  by  adding  a
new subdivision 9 to read as follows:
  9.  NOTWITHSTANDING  ANY INCONSISTENT PROVISION OF LAW, CONTRACTS WITH
CERTIFIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE  PROGRAMS  OR
LICENSED  HOME CARE SERVICES PROGRAMS TO PROVIDE HOME CARE AIDE SERVICES
AS DEFINED IN SECTION THIRTY-SIX  HUNDRED  FOURTEEN-C  OF  THIS  CHAPTER
SHALL  AT  A  MINIMUM  ENSURE  THAT THE RESOURCES MADE AVAILABLE BY SUCH
CONTRACTS SHALL SUPPORT COMPENSATION FOR  PERSONS  PROVIDING  SUCH  HOME
CARE  AIDE  SERVICES  TO  ENSURE  THE RETENTION OF A QUALIFIED WORKFORCE
CAPABLE OF PROVIDING HIGH QUALITY CARE TO RECIPIENTS  OF  SUCH  SERVICES
CONSISTENT WITH THE PROVISIONS OF SUCH SECTION.
  S  4.  This  act  shall take effect immediately, provided that section
3621 of the public health law, as added by  section  two  of  this  act,
shall expire and be deemed repealed March 31, 2015.

co-Sponsors

2013-S3966A - Details

See Assembly Version of this Bill:: A9262
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Ren §3622 to be §3625, add §§3614-d & 3622, amd §4406-c, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: S2902, A379
2017-2018: A564
2019-2020: A2864
2021-2022: A5185

2013-S3966A - Summary

2013-S3966A - Sponsor Memo

                                BILL NUMBER:S3966A

TITLE OF BILL:  An act to amend the public health law, in relation to
enacting the "home care stabilization act"; and providing for the
repeal of certain provisions upon expiration thereof

PURPOSE:  The Home Care Stabilization Act will address the home care
fiscal crisis by ensuring managed long term care contracts support
wage parity, providing for prompt payments and waiving interest and
penalties on recoupments and reductions.

SUMMARY OF PROVISIONS:

Section one provides that this act shall be known as the Home Care
Stabilization Act.

Section two amends the Public Health Law (PHL) by adding a new
3614-d to provide standards for prompt, fair and equitable settlement
of claims for payments for personal care, home health care services,
consumer directed personal assistance services or other long term care
services. This section also adds a new PHL § 3621 providing that on
and after April 1, 2009, any recoupments or reductions in medical
assistance payments for licensed home care services agencies (LHCSAs),
certified home health agencies (CHHAs) and consumer directed personal
assistance programs (CDPAPs) shall not be subject to interest.

Section three adds a new 4406-c(9) to the PHL to ensure that funds
made available to licensed home care service programs, certified home
health agencies, long term home health care programs and consumer
directed personal assistance services through contracts with health
care plans shall provide compensation sufficient to satisfy the
statutory provisions set forth in Section 3614-c, the wage parity law.

Section four provides that this act shall take effect immediately,
provided however section three shall expire and be deemed repealed on
March 31, 2015.

JUSTIFICATION:  This legislation aims to stabilize the home health
care system in New York which has been hit with hundreds of millions
of dollars in cuts, unfunded wage mandates, the transition to managed
long term care, a devastating storm and rate recoupments in 2012 of
$250 million.  Providers, workers and patients are shifting into a new
system of managed long term care with fewer resources meanwhile
working hard to maintain the high quality of home care which New York
State is regarded for across the country.

Currently, agencies seeking to pay wage parity rates are not
guaranteed the proper payment amounts by managed long term care
entities. In addition, agencies are reporting exploding accounts
receivables from lags in the payment of claims under managed care and
the frequent rejection of the payment of claims. This together with
State's Medicaid rate recoupment efforts have lead many agencies into
financial crisis impacting workers and more importantly the patients
they serve.


This legislation attempts to assist patients, workers and providers in
keeping the promise to people facing illness or disability -
maintaining their independence in the comfort, security and privacy of
their homes. Specifically, the legislation works to ensure worker's
wages under the wage parity law are supported in payments to home
health care agencies by managed long term care plans. The bill
eliminates interest and penalties on Medicaid recoupment from home
care agencies and mandates that managed long term care plans must pay
clean claims promptly.

LEGISLATIVE HISTORY: New bill.

FISCAL IMPLICATIONS:  No net fiscal impact as this legislation will
not reduce the amounts recouped.

EFFECTIVE DATE:  Immediately, provided however section three shall
expire and be deemed repealed on March 31, 2015.

2013-S3966A - Bill Text download pdf

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

                                 3966--A

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                              March 1, 2013
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed  to  the  Committee  on  Health  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN ACT to amend the public health law, in relation to enacting the "home
  care  stabilization  act";  and  providing  for  the repeal of certain
  provisions upon expiration thereof

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

  Section  1.  Short  title. This act shall be known and may be cited as
the "home care stabilization act".
  S 2. The public health law is  amended  by  adding  two  new  sections
3614-d and 3621 to read as follows:
  S  3614-D.  STANDARDS  FOR  PROMPT,  FAIR  AND EQUITABLE SETTLEMENT OF
CLAIMS FOR PAYMENTS FOR PERSONAL CARE,  HOME  HEALTH  CARE  SERVICES  OR
OTHER  LONG TERM CARE SERVICES. 1. IN THE PROCESSING OF CLAIMS SUBMITTED
UNDER CONTRACTS OR AGREEMENTS ISSUED OR ENTERED INTO OR  BETWEEN  CERTI-
FIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, LICENSED
HOME CARE SERVICES PROGRAMS, FISCAL INTERMEDIARIES OPERATING PURSUANT TO
SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW, INSURERS,
MANAGED  LONG  TERM  CARE  PLANS,  MANAGED  CARE  PLANS OR ORGANIZATIONS
LICENSED OR OPERATED PURSUANT TO THE PROVISIONS  OF  THIS  CHAPTER,  THE
SOCIAL  SERVICES LAW OR THE INSURANCE LAW AND FOR ALL BILLS FOR PERSONAL
CARE, HOME HEALTH CARE SERVICES, CONSUMER DIRECTED  PERSONAL  ASSISTANCE
SERVICES OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE
SOCIAL  SERVICES  LAW  OR  OTHER  LONG  TERM  CARE  SERVICES RENDERED BY
LICENSED HOME CARE SERVICES PROGRAMS, CERTIFIED  HOME  HEALTH  AGENCIES,
LONG  TERM  HOME HEALTH CARE PROGRAMS OR A FISCAL INTERMEDIARY OPERATING
PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF  THE  SOCIAL  SERVICES
LAW  PURSUANT TO SUCH CONTRACTS OR AGREEMENTS, ANY CERTIFIED HOME HEALTH
CARE AGENCY, LONG TERM HOME HEALTH CARE PROGRAM, INSURER,  MANAGED  LONG

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09417-04-3

S. 3966--A                          2

TERM  CARE  PLAN, MANAGED CARE PLAN OR ORGANIZATION LICENSED OR OPERATED
PURSUANT TO THE PROVISIONS OF THIS CHAPTER, THE SOCIAL SERVICES LAW, THE
EXECUTIVE LAW OR THE INSURANCE LAW, SHALL ADHERE TO THE FOLLOWING STAND-
ARDS:
  (A) SHALL PAY A CLEAN CLAIM SUBMITTED BY A LICENSED HOME CARE SERVICES
PROGRAM,  CERTIFIED  HOME  HEALTH  AGENCY,  LONG  TERM  HOME HEALTH CARE
PROGRAM OR A FISCAL INTERMEDIARY OPERATING  PURSUANT  TO  SECTION  THREE
HUNDRED  SIXTY-FIVE-F  OF  THE SOCIAL SERVICES LAW WITHIN THIRTY DAYS OF
RECEIPT OF THE CLEAN CLAIM FOR SERVICES RENDERED THAT IS TRANSMITTED VIA
THE INTERNET OR ELECTRONIC MAIL, OR FORTY-FIVE DAYS OF  RECEIPT  OF  THE
CLEAN CLAIM FOR SERVICES RENDERED THAT IS SUBMITTED BY OTHER MEANS, SUCH
AS PAPER OR FACSIMILE;
  (B)  SHALL  PAY  ANY UNDISPUTED PORTION OF A CLAIM AS A CLEAN CLAIM AS
SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION SUBMITTED BY  A  LICENSED
HOME CARE SERVICES PROGRAM, CERTIFIED HOME HEALTH AGENCY, LONG TERM HOME
HEALTH CARE PROGRAM OR FISCAL INTERMEDIARY OPERATING PURSUANT TO SECTION
THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW;
  (C)  NOTIFY ANY SUCH AGENCY, PROGRAM OR FISCAL INTERMEDIARY IN WRITING
WITHIN FIFTEEN CALENDAR DAYS OF THE RECEIPT OF AN INITIAL CLAIM  OF  ALL
SPECIFIC  DEFECTS  OR DISPUTES OF SUCH CLAIM AND SPECIFICALLY REQUEST IN
WRITING THE ADDITIONAL INFORMATION  OR  REMEDY  NEEDED  TO  PROCESS  ANY
DISPUTED PORTIONS OF THE CLAIM; AND
  (D)  ANY DISPUTED CLAIM REMEDIED SHALL BE PAID AS A CLEAN CLAIM AS SET
FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION.
  2. FOR THE PURPOSES OF THIS SECTION, A "CLEAN CLAIM" SHALL:
  (A) IDENTIFY THE LICENSED HOME CARE SERVICES PROGRAM,  CERTIFIED  HOME
HEALTH AGENCY, LONG TERM HOME HEALTH CARE PROGRAM OR FISCAL INTERMEDIARY
OPERATING  PURSUANT  TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
SERVICES LAW;
  (B) SUFFICIENTLY IDENTIFY THE ELIGIBLE COVERED PERSON;
  (C) LIST THE DATE AND PLACE OF SERVICE;
  (D) SUBSTANTIATE THE APPROPRIATENESS OF THE SERVICE PROVIDED;
  (E) STATE IF PRIOR AUTHORIZATION IS REQUIRED FOR SUCH ELIGIBLE COVERED
PERSON AND SERVICE; AND
  (F) STATE ANY DOCUMENTATION  AS  REASONABLY  REQUIRED  BY  ANY  ENTITY
REFERENCED IN THIS SECTION.
  3.  EACH CLEAN CLAIM OR PAYMENT FOR SERVICES PROCESSED IN VIOLATION OF
THIS SECTION SHALL CONSTITUTE A SEPARATE VIOLATION. IN ADDITION  TO  THE
PENALTIES PROVIDED IN THIS CHAPTER, ANY ORGANIZATION OR CORPORATION THAT
FAILS  TO  ADHERE  TO  THE  STANDARDS CONTAINED IN THIS SECTION SHALL BE
OBLIGATED TO PAY TO CERTIFIED  HOME  HEALTH  AGENCIES,  LONG  TERM  HOME
HEALTH  CARE  PROGRAMS,  LICENSED  HOME  HEALTH  CARE PROGRAMS OR FISCAL
INTERMEDIARIES OPERATING PURSUANT TO SECTION THREE HUNDRED  SIXTY-FIVE-F
OF  THE  SOCIAL  SERVICES  LAW  IN FULL SETTLEMENT OF THE BILL, CLAIM OR
PAYMENT PLUS INTEREST ON THE AMOUNT OF SUCH BILL, CLAIM  OR  PAYMENT  OF
THE  GREATER  OF  THE  RATE EQUAL TO THE RATE SET BY THE COMMISSIONER OF
TAXATION AND FINANCE FOR CORPORATE TAXES PURSUANT TO  PARAGRAPH  ONE  OF
SUBSECTION  (E)  OF  SECTION  ONE  THOUSAND NINETY-SIX OF THE TAX LAW OR
TWELVE PERCENT PER ANNUM, TO BE COMPUTED FROM THE DATE THE  BILL,  CLAIM
OR PAYMENT WAS REQUIRED TO BE MADE.
  S  3621. MEDICAL ASSISTANCE RECOUPMENTS AND REDUCTIONS.  NOTWITHSTAND-
ING ANY OTHER PROVISION OF LAW TO  THE  CONTRARY,  ON  AND  AFTER  APRIL
FIRST,  TWO  THOUSAND  NINE,  ANY  RECOUPMENTS  OR REDUCTIONS IN MEDICAL
ASSISTANCE PAYMENTS FOR LICENSED HOME CARE SERVICES AGENCIES AND  CERTI-
FIED  HOME  HEALTH  AGENCIES LICENSED PURSUANT TO THIS ARTICLE OR FISCAL
INTERMEDIARIES OPERATING PURSUANT TO SECTION THREE HUNDRED  SIXTY-FIVE-F

S. 3966--A                          3

OF  THE SOCIAL SERVICES LAW SHALL NOT BE SUBJECT TO INTEREST OR INTEREST
PENALTIES.
  S  3.  Section  4406-c of the public health law is amended by adding a
new subdivision 9 to read as follows:
  9. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW,  CONTRACTS  WITH
CERTIFIED  HOME  HEALTH  AGENCIES,  LONG TERM HOME HEALTH CARE PROGRAMS,
LICENSED HOME CARE SERVICES PROGRAMS OR FISCAL INTERMEDIARIES  OPERATING
PURSUANT  TO  SECTION  THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES
LAW TO PROVIDE HOME CARE AIDE SERVICES AS DEFINED IN SECTION  THIRTY-SIX
HUNDRED FOURTEEN-C OF THIS CHAPTER OR CONSUMER DIRECTED PERSONAL ASSIST-
ANCE   SERVICES   AS   AUTHORIZED  PURSUANT  TO  SECTION  THREE  HUNDRED
SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW SHALL AT A MINIMUM  ENSURE  THAT
THE  RESOURCES  MADE  AVAILABLE  BY SUCH CONTRACTS SHALL SUPPORT COMPEN-
SATION FOR PERSONS PROVIDING SUCH HOME CARE AIDE SERVICES  AND  CONSUMER
DIRECTED PERSONAL ASSISTANCE SERVICES TO ENSURE THE RETENTION OF A QUAL-
IFIED  WORKFORCE CAPABLE OF PROVIDING HIGH QUALITY CARE TO RECIPIENTS OF
SUCH SERVICES CONSISTENT WITH THE PROVISIONS OF SUCH SECTION.
  S 4. This act shall take effect  immediately,  provided  that  section
3621  of  the  public  health  law, as added by section two of this act,
shall expire and be deemed repealed March 31, 2015.

co-Sponsors

2013-S3966B (ACTIVE) - Details

See Assembly Version of this Bill:: A9262
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Ren §3622 to be §3625, add §§3614-d & 3622, amd §4406-c, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: S2902, A379
2017-2018: A564
2019-2020: A2864
2021-2022: A5185

2013-S3966B (ACTIVE) - Summary

2013-S3966B (ACTIVE) - Bill Text download pdf

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

                                 3966--B

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                              March 1, 2013
                               ___________

Introduced  by  Sens.  HANNON,  DeFRANCISCO,  MARTINS  -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Health  --  committee  discharged,  bill amended, ordered reprinted as
  amended and recommitted  to  said  committee  --  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 enacting the "home
  care  stabilization  act";  and  providing  for  the repeal of certain
  provisions upon expiration thereof

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

  Section  1.  Short  title. This act shall be known and may be cited as
the "home care stabilization act".
  S 2. Section 3622 of the public health law, as renumbered  by  section
22  of  part  C of chapter 58 of the laws of 2004, is renumbered section
3625 and two new sections 3614-d and 3622 are added to read as follows:
  S 3614-D. STANDARDS FOR  PROMPT,  FAIR  AND  EQUITABLE  SETTLEMENT  OF
CLAIMS  FOR  PAYMENTS  FOR  PERSONAL  CARE, HOME HEALTH CARE SERVICES OR
OTHER LONG TERM CARE SERVICES. 1. IN THE PROCESSING OF CLAIMS  SUBMITTED
UNDER  CONTRACTS  OR AGREEMENTS ISSUED OR ENTERED INTO OR BETWEEN CERTI-
FIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, LICENSED
HOME CARE SERVICES PROGRAMS, FISCAL INTERMEDIARIES OPERATING PURSUANT TO
SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW, INSURERS,
MANAGED LONG TERM  CARE  PLANS,  MANAGED  CARE  PLANS  OR  ORGANIZATIONS
LICENSED  OR  OPERATED  PURSUANT  TO THE PROVISIONS OF THIS CHAPTER, THE
SOCIAL SERVICES LAW OR THE INSURANCE LAW AND FOR ALL BILLS FOR  PERSONAL
CARE,  HOME  HEALTH CARE SERVICES, CONSUMER DIRECTED PERSONAL ASSISTANCE
SERVICES OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE
SOCIAL SERVICES LAW  OR  OTHER  LONG  TERM  CARE  SERVICES  RENDERED  BY
LICENSED  HOME  CARE  SERVICES PROGRAMS, CERTIFIED HOME HEALTH AGENCIES,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09417-05-4

S. 3966--B                          2

LONG TERM HOME HEALTH CARE PROGRAMS OR A FISCAL  INTERMEDIARY  OPERATING
PURSUANT  TO  SECTION  THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES
LAW PURSUANT TO SUCH CONTRACTS OR AGREEMENTS, ANY CERTIFIED HOME  HEALTH
CARE  AGENCY,  LONG TERM HOME HEALTH CARE PROGRAM, INSURER, MANAGED LONG
TERM CARE PLAN, MANAGED CARE PLAN OR ORGANIZATION LICENSED  OR  OPERATED
PURSUANT TO THE PROVISIONS OF THIS CHAPTER, THE SOCIAL SERVICES LAW, THE
EXECUTIVE LAW OR THE INSURANCE LAW, SHALL ADHERE TO THE FOLLOWING STAND-
ARDS:
  (A) SHALL PAY A CLEAN CLAIM SUBMITTED BY A LICENSED HOME CARE SERVICES
PROGRAM,  CERTIFIED  HOME  HEALTH  AGENCY,  LONG  TERM  HOME HEALTH CARE
PROGRAM OR A FISCAL INTERMEDIARY OPERATING  PURSUANT  TO  SECTION  THREE
HUNDRED  SIXTY-FIVE-F  OF  THE SOCIAL SERVICES LAW WITHIN THIRTY DAYS OF
RECEIPT OF THE CLEAN CLAIM FOR SERVICES RENDERED THAT IS TRANSMITTED VIA
THE INTERNET OR ELECTRONIC MAIL, OR FORTY-FIVE DAYS OF  RECEIPT  OF  THE
CLEAN CLAIM FOR SERVICES RENDERED THAT IS SUBMITTED BY OTHER MEANS, SUCH
AS PAPER OR FACSIMILE;
  (B)  SHALL  PAY  ANY UNDISPUTED PORTION OF A CLAIM AS A CLEAN CLAIM AS
SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION SUBMITTED BY  A  LICENSED
HOME CARE SERVICES PROGRAM, CERTIFIED HOME HEALTH AGENCY, LONG TERM HOME
HEALTH CARE PROGRAM OR FISCAL INTERMEDIARY OPERATING PURSUANT TO SECTION
THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW;
  (C)  NOTIFY ANY SUCH AGENCY, PROGRAM OR FISCAL INTERMEDIARY IN WRITING
WITHIN FIFTEEN CALENDAR DAYS OF THE RECEIPT OF AN INITIAL CLAIM  OF  ALL
SPECIFIC  DEFECTS  OR DISPUTES OF SUCH CLAIM AND SPECIFICALLY REQUEST IN
WRITING THE ADDITIONAL INFORMATION  OR  REMEDY  NEEDED  TO  PROCESS  ANY
DISPUTED PORTIONS OF THE CLAIM; AND
  (D)  ANY DISPUTED CLAIM REMEDIED SHALL BE PAID AS A CLEAN CLAIM AS SET
FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION.
  2. FOR THE PURPOSES OF THIS SECTION, A "CLEAN CLAIM" SHALL:
  (A) IDENTIFY THE LICENSED HOME CARE SERVICES PROGRAM,  CERTIFIED  HOME
HEALTH AGENCY, LONG TERM HOME HEALTH CARE PROGRAM OR FISCAL INTERMEDIARY
OPERATING  PURSUANT  TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
SERVICES LAW;
  (B) SUFFICIENTLY IDENTIFY THE ELIGIBLE COVERED PERSON;
  (C) LIST THE DATE AND PLACE OF SERVICE;
  (D) SUBSTANTIATE THE APPROPRIATENESS OF THE SERVICE PROVIDED;
  (E) STATE IF PRIOR AUTHORIZATION IS REQUIRED FOR SUCH ELIGIBLE COVERED
PERSON AND SERVICE; AND
  (F) STATE ANY DOCUMENTATION  AS  REASONABLY  REQUIRED  BY  ANY  ENTITY
REFERENCED IN THIS SECTION.
  3.  EACH CLEAN CLAIM OR PAYMENT FOR SERVICES PROCESSED IN VIOLATION OF
THIS SECTION SHALL CONSTITUTE A SEPARATE VIOLATION. IN ADDITION  TO  THE
PENALTIES PROVIDED IN THIS CHAPTER, ANY ORGANIZATION OR CORPORATION THAT
FAILS  TO  ADHERE  TO  THE  STANDARDS CONTAINED IN THIS SECTION SHALL BE
OBLIGATED TO PAY TO CERTIFIED  HOME  HEALTH  AGENCIES,  LONG  TERM  HOME
HEALTH  CARE  PROGRAMS,  LICENSED  HOME  HEALTH  CARE PROGRAMS OR FISCAL
INTERMEDIARIES OPERATING PURSUANT TO SECTION THREE HUNDRED  SIXTY-FIVE-F
OF  THE  SOCIAL  SERVICES  LAW  IN FULL SETTLEMENT OF THE BILL, CLAIM OR
PAYMENT PLUS INTEREST ON THE AMOUNT OF SUCH BILL, CLAIM  OR  PAYMENT  OF
THE  GREATER  OF  THE  RATE EQUAL TO THE RATE SET BY THE COMMISSIONER OF
TAXATION AND FINANCE FOR CORPORATE TAXES PURSUANT TO  PARAGRAPH  ONE  OF
SUBSECTION  (E)  OF  SECTION  ONE  THOUSAND NINETY-SIX OF THE TAX LAW OR
TWELVE PERCENT PER ANNUM, TO BE COMPUTED FROM THE DATE THE  BILL,  CLAIM
OR PAYMENT WAS REQUIRED TO BE MADE.
  S  3622. MEDICAL ASSISTANCE RECOUPMENTS AND REDUCTIONS.  NOTWITHSTAND-
ING ANY OTHER PROVISION OF LAW TO  THE  CONTRARY,  ON  AND  AFTER  APRIL

S. 3966--B                          3

FIRST,  TWO  THOUSAND  NINE,  ANY  RECOUPMENTS  OR REDUCTIONS IN MEDICAL
ASSISTANCE PAYMENTS FOR LICENSED HOME CARE SERVICES AGENCIES AND  CERTI-
FIED  HOME  HEALTH  AGENCIES LICENSED PURSUANT TO THIS ARTICLE OR FISCAL
INTERMEDIARIES  OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F
OF THE SOCIAL SERVICES LAW SHALL NOT BE SUBJECT TO INTEREST OR  INTEREST
PENALTIES.
  S  3.  Section  4406-c of the public health law is amended by adding a
new subdivision 9 to read as follows:
  9. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW,  CONTRACTS  WITH
CERTIFIED  HOME  HEALTH  AGENCIES,  LONG TERM HOME HEALTH CARE PROGRAMS,
LICENSED HOME CARE SERVICES PROGRAMS OR FISCAL INTERMEDIARIES  OPERATING
PURSUANT  TO  SECTION  THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES
LAW TO PROVIDE HOME CARE AIDE SERVICES AS DEFINED IN SECTION  THIRTY-SIX
HUNDRED FOURTEEN-C OF THIS CHAPTER OR CONSUMER DIRECTED PERSONAL ASSIST-
ANCE   SERVICES   AS   AUTHORIZED  PURSUANT  TO  SECTION  THREE  HUNDRED
SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW SHALL AT A MINIMUM  ENSURE  THAT
THE  RESOURCES  MADE  AVAILABLE  BY SUCH CONTRACTS SHALL SUPPORT COMPEN-
SATION FOR PERSONS PROVIDING SUCH HOME CARE AIDE SERVICES  AND  CONSUMER
DIRECTED PERSONAL ASSISTANCE SERVICES TO ENSURE THE RETENTION OF A QUAL-
IFIED  WORKFORCE CAPABLE OF PROVIDING HIGH QUALITY CARE TO RECIPIENTS OF
SUCH SERVICES CONSISTENT WITH THE PROVISIONS OF SUCH SECTION.
  S 4. This act shall take effect  immediately,  provided  that  section
3622  of  the  public  health  law, as added by section two of this act,
shall expire and be deemed repealed March 31, 2015.

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Senate Bill S3966B

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2013-S3966 - Details

2013-S3966 - Summary

2013-S3966 - Sponsor Memo

2013-S3966 - Bill Text download pdf

co-Sponsors

2013-S3966A - Details

2013-S3966A - Summary

2013-S3966A - Sponsor Memo

2013-S3966A - Bill Text download pdf

co-Sponsors

2013-S3966B (ACTIVE) - Details

2013-S3966B (ACTIVE) - Summary

2013-S3966B (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S3966B

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Sponsored By

Kemp Hannon

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2013-S3966 - Details

2013-S3966 - Summary

2013-S3966 - Sponsor Memo

2013-S3966 - Bill Text download pdf

co-Sponsors

John A. DeFrancisco

Jack M. Martins

2013-S3966A - Details

2013-S3966A - Summary

2013-S3966A - Sponsor Memo

2013-S3966A - Bill Text download pdf

co-Sponsors

John A. DeFrancisco

Jack M. Martins

2013-S3966B (ACTIVE) - Details

2013-S3966B (ACTIVE) - Summary

2013-S3966B (ACTIVE) - Bill Text download pdf

Comments