BILL NUMBER:  S6617

 TITLE OF BILL :  An act to amend the public health law, in relation
to payments to rural hospitals designated as critical access hospitals

 PURPOSE :  To allow that on and after April 1, 2017, rural hospitals
designated as critical access hospitals are paid by Medicaid in the
same manner that Medicare pays critical access hospitals, which is on
the basis of reasonable costs.

 SUMMARY OF PROVISIONS :  Amends Subdivision 2-a of section 2807 of
the Public Health Law by adding a new paragraph (j) that on and after
April 1, 2017, subject to funds being appropriated therefore, a rural
hospital designated as a critical access hospital 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.

Section two states the enactment date and requires that the
implementations of the provisions of the act be contingent upon moneys
being specifically appropriated for that purpose.

 JUSTIFICATION :  Critical access 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 critical access
              

hospitals 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 critical access hospitals
because of the need to spread substantial fixed costs over a small
number of visits and admissions. Medicare reimburses such hospitals
(called critical access hospitals under Medicare) on the basis of
reasonable costs. This line 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.

The provisions of the act cannot be implemented unless moneys are
specifically appropriated for that purpose.

 LEGISLATIVE HISTORY :  2015: S.1287 Referred to Health 2013,2014:
S.4376-A Referred to Health 2012: S.7371-B/A.10094-B Passed Both
Houses, Veto Memo. 148 2011: S.5431-A/A.5377-B Passed Both Houses,
Veto Memo. 80 2009,2010:  S.4108-A/A.5347-A Referred to Health
2007,2008: S.7232/A.8783-A Referred to Health

 FISCAL IMPLICATIONS :  This legislation is expected to cost the state
$1.24 million and will ensure the financial viability of its thirteen
critical access hospitals.

 EFFECTIVE DATE :  This act shall take effect immediately; provided
however, that the implementation of the provisions of this act shall
be subject to the appropriation of moneys specifically for the
purposes thereof.