BILL NUMBER: S8473A

SPONSOR: HANNON
 
TITLE OF BILL:

An act to amend the public health law, in relation to payments for home
and community based long term care services

 
PURPOSE:

To amend the Public Health Law, in relation to prohibiting claims
submitted by home care providers from being subject to managed care risk
adjustments on insurers, and requiring any funds appropriated by the
State to compensate for labor mandates to be fully and timely disbursed
to home care providers.

 
SUMMARY OF PROVISIONS:

Section one of the bill amends the Public Health Law by adding a new
section 3614-f to prohibit claims submitted under the medical assistance
program for home and community based long term care services from being
              

subject to managed care risk adjustments. It requires any funds appro-
priated to Medicaid managed care plans or Medicaid managed long term
care plans to compensate for any law or regulation impacting wages to be
fully distributed to home and community based long term care service
providers in amendments to existing contracts ninety days prior to the
effective date of such labor law or regulation. Additionally, it prohib-
its such funds appropriated to Medicaid managed care plans or Medicaid
managed long term care plans to compensate for any law or regulation
impacting wages from being used to supplant payments for existing
services under the Medicaid assistance program.

Section two of the bill establishes the effective date.

 
JUSTIFICATION:

The 2018-19 enacted budget included $703 million for State Fiscal Year
(SFY) 2018-19 to support the direct care cost of minimum wage increases
for Medicaid funded services provided by home health care agencies and
other providers. However, there is a lack of clarifying language to
ensure that these monies, together with other public funds to address
statutory Federal and State requirements, are fully allocated to provid-
ers in a timely manner that allows them to pay workers for such require-
ments.

Without contract amendments and monies disbursed to home care providers
from plans by the implementation date, providers are still expected to
meet the statutory wage obligation and pay home care workers- irrespec-
tive of plans distributing funds as they are instructed to do by the
State Department of Health. This bill would create a process by which
plans must disburse funds to providers 90 days prior to the effective
date in order to avoid late contracts and rates, and guarantee that
insurers provide the funds in an amount that supplements any current
contracts. This bill would also disallow risk adjustment on managed care
providers to ensure that the full dollar amounts given by the State to
the plans are disbursed in their entirety to home care providers as it
relates to all statutory wage obligations. Risk adjustment of funds
designated under the State Budget to address direct care cost increases

for the minimum wage and other labor costs is inconsistent with the
purpose of such funding.

Ensuring that all monies appropriated by the State to support the direct
care cost of minimum wage increases for home care workers are distrib-
uted in a timely manner and in their entirety allows home care workers
to receive their deserved increase in wages, while also protecting the
economic viability of the home care industry.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.