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

                                  10501

                          I N  A S S E M B L Y

                              May 31, 2016
                               ___________

Introduced  by M. of A. GUNTHER -- read once and referred to the Commit-
  tee on Mental Health

AN ACT directing the office for people with  developmental  disabilities
  to  study  and develop suitable measures to prevent financial hardship
  and/or failure of providers  serving  individuals  with  developmental
  disabilities funded by Medicaid to support the uninterrupted continua-
  tion of necessary services

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

  Section 1. The commissioner of the office  for  people  with  develop-
mental  disabilities  in  conjunction  with  the commissioner of health,
shall jointly prepare a report which shall include the following:
  a. Recommendations for holding harmless from further  rate  reductions
those  efficient  providers  within  a  region  that operate beneath the
regional average rate.  Severity  of  disability  shall  be  taken  into
consideration for purposes of comparing efficient providers.
  b.  A  methodology  for  adjusting  rates  so  that  total prospective
reimbursement received by a provider for a program must equal the  total
costs  of that program which shall include all necessary cost components
for operating the program. The report shall examine the extent to  which
units  used  in  rate  calculations  are  reflective of the actual units
delivered to ensure that providers are not penalized  for  lost  revenue
due to unforeseeable program closures, absenteeism and policies designed
to curtail program enrollment.
  c.  Recommendations  for a prospective rate appeal process designed to
increase rates as necessary during a non-rebasing year to  cover  costs.
Any  recommended  appeal process shall ensure that providers who prevail
on such appeal receive additional  reimbursement  as  of  the  date  the
appeal was submitted.
  d.  Recommendations  to  enhance  program stability and the quality of
care including but not limited to lengthening the  period  between  base
year updates and alternating base years by program.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15247-05-6

              

A. 10501                            2

  e.  Identification of those elements of the plan that must be approved
by the Centers for Medicare and Medicaid Services and a plan for achiev-
ing such approval.
  S  2.  The  commissioner  of  the office for people with developmental
disabilities shall submit a report detailing the  issues  set  forth  in
this  act  and recommendations to the temporary president of the senate,
the speaker of the assembly, the  chairs  of  the  senate  committee  on
mental  health and developmental disabilities and the assembly committee
on mental health no later than February 1, 2017.
  S 3. This act shall take effect immediately.