Senate Bill S1197B

2023-2024 Legislative Session

Provides for primary care investment

download bill text pdf

Sponsored By

Current Bill Status - In Senate Committee Finance 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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Votes

Bill Amendments

co-Sponsors

2023-S1197 - Details

See Assembly Version of this Bill:
A8592
Current Committee:
Senate Finance
Law Section:
Insurance Law
Laws Affected:
Add §3217-k, Ins L; add §368-g, Soc Serv L
Versions Introduced in 2021-2022 Legislative Session:
S6534

2023-S1197 - Summary

Requires health care plans and payors to have a minimum of twelve and one-half percent of their total expenditures on physical and mental health annually be for primary care services.

2023-S1197 - Sponsor Memo

2023-S1197 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1197
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 10, 2023
                                ___________
 
 Introduced  by Sens. RIVERA, BROUK, COONEY, MAY, MYRIE, RAMOS, SEPULVEDA
   -- 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  establishing  the
   primary care reform commission

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The article heading of article 29-AA of the  public  health
 law, as added by section 35 of part H of chapter 59 of the laws of 2011,
 is amended to read as follows:
              PATIENT CENTERED MEDICAL HOMES AND PRIMARY CARE
   §  2.  The public health law is amended by adding a new section 2959-b
 to read as follows:
   § 2959-B. PRIMARY CARE REFORM COMMISSION.  1.  (A)  COMMISSION  ESTAB-
 LISHED.  THE PRIMARY CARE REFORM COMMISSION, REFERRED TO IN THIS SECTION
 AS THE "COMMISSION",  IS  HEREBY  ESTABLISHED  IN  THE  DEPARTMENT.  THE
 COMMISSION  SHALL  REVIEW,  EXAMINE,  AND  MAKE FINDINGS ON THE LEVEL OF
 PRIMARY CARE SPENDING BY ALL PAYERS IN THE CONTEXT OF  ALL  HEALTH  CARE
 SPENDING  IN  THE STATE, AND SHALL PUBLISH AN ANNUAL REPORT ON THE FIND-
 INGS. THE COMMISSION SHALL ALSO MAKE RECOMMENDATIONS TO INCREASE  SPEND-
 ING  ON  PRIMARY  CARE AND STRENGTHEN PRIMARY CARE INFRASTRUCTURE IN THE
 STATE, TAKING CARE TO AVOID INCREASING COSTS TO PATIENTS  OR  THE  TOTAL
 COST OF HEALTH CARE.
   (B) COMPOSITION AND POWERS. (I) THE COMMISSION SHALL CONSIST OF:
   (1)  THE  COMMISSIONER  AND  THE  SUPERINTENDENT  OF THE DEPARTMENT OF
 FINANCIAL SERVICES, WHO MAY BE REPRESENTED BY  THEIR  RESPECTIVE  DESIG-
 NEES;
   (2) SEVEN MEMBERS APPOINTED BY THE GOVERNOR; AND
   (3)  EIGHT  MEMBERS APPOINTED BY THE GOVERNOR AS FOLLOWS: THREE ON THE
 RECOMMENDATION OF THE SPEAKER OF THE ASSEMBLY, THREE ON THE  RECOMMENDA-
 TION OF THE TEMPORARY PRESIDENT OF THE SENATE, ONE ON THE RECOMMENDATION
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD03591-01-3
              

co-Sponsors

2023-S1197A - Details

See Assembly Version of this Bill:
A8592
Current Committee:
Senate Finance
Law Section:
Insurance Law
Laws Affected:
Add §3217-k, Ins L; add §368-g, Soc Serv L
Versions Introduced in 2021-2022 Legislative Session:
S6534

2023-S1197A - Summary

Requires health care plans and payors to have a minimum of twelve and one-half percent of their total expenditures on physical and mental health annually be for primary care services.

2023-S1197A - Sponsor Memo

2023-S1197A - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1197--A
     Cal. No. 519
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 10, 2023
                                ___________
 
 Introduced  by Sens. RIVERA, BROUK, COONEY, MAY, MYRIE, RAMOS, SEPULVEDA
   -- read twice and ordered printed, and when printed to be committed to
   the Committee on Health -- reported  favorably  from  said  committee,
   ordered  to  first  and  second report, ordered to a third reading, --
   committed to the Committee on  Rules  --  committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee
 
 AN ACT to amend the insurance  law  and  the  social  services  law,  in
   relation to primary care investment
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The insurance law is amended by adding a new section 3217-k
 to read as follows:
   § 3217-K. PRIMARY CARE SPENDING. (A)  DEFINITIONS.  AS  USED  IN  THIS
 SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
   (1) "OVERALL HEALTHCARE SPENDING" MEANS THE TOTAL COST OF CARE FOR THE
 PATIENT  POPULATION  OF  A PAYOR OR PROVIDER ENTITY FOR A GIVEN CALENDAR
 YEAR, WHERE COST IS CALCULATED FOR SUCH YEAR  AS  THE  SUM  OF  (A)  ALL
 CLAIMS-BASED SPENDING PAID TO PROVIDERS BY PUBLIC AND PRIVATE PAYORS AND
 (B) ALL NON-CLAIM PAYMENTS FOR SUCH YEAR, INCLUDING, BUT NOT LIMITED TO,
 INCENTIVE PAYMENTS AND CARE COORDINATION PAYMENTS.
   (2)  "PLAN  OR  PAYOR"  MEANS EVERY INSURANCE ENTITY PROVIDING MANAGED
 CARE PRODUCTS, INDIVIDUAL COMPREHENSIVE ACCIDENT AND HEALTH INSURANCE OR
 GROUP OR BLANKET COMPREHENSIVE ACCIDENT AND HEALTH INSURANCE, AS DEFINED
 IN THIS CHAPTER, CORPORATION ORGANIZED UNDER ARTICLE FORTY-THREE OF THIS
 CHAPTER PROVIDING COMPREHENSIVE HEALTH INSURANCE, ENTITY LICENSED  UNDER
 ARTICLE FORTY-FOUR OF THIS CHAPTER PROVIDING COMPREHENSIVE HEALTH INSUR-
 ANCE,  EVERY  OTHER PLAN OVER WHICH THE DEPARTMENT HAS JURISDICTION, AND
 EVERY THIRD-PARTY PAYOR PROVIDING HEALTH COVERAGE.
   (3) "PRIMARY CARE" MEANS INTEGRATED, ACCESSIBLE  HEALTHCARE,  PROVIDED
 BY  CLINICIANS ACCOUNTABLE FOR ADDRESSING MOST OF A PATIENT'S HEALTHCARE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

co-Sponsors

2023-S1197B (ACTIVE) - Details

See Assembly Version of this Bill:
A8592
Current Committee:
Senate Finance
Law Section:
Insurance Law
Laws Affected:
Add §3217-k, Ins L; add §368-g, Soc Serv L
Versions Introduced in 2021-2022 Legislative Session:
S6534

2023-S1197B (ACTIVE) - Summary

Requires health care plans and payors to have a minimum of twelve and one-half percent of their total expenditures on physical and mental health annually be for primary care services.

2023-S1197B (ACTIVE) - Sponsor Memo

2023-S1197B (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1197--B
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 10, 2023
                                ___________
 
 Introduced  by Sens. RIVERA, BROUK, COONEY, MAY, MYRIE, RAMOS, SEPULVEDA
   -- read twice and ordered printed, and when printed to be committed to
   the Committee on Health -- reported  favorably  from  said  committee,
   ordered  to  first  and  second report, ordered to a third reading, --
   committed to the Committee on  Rules  --  committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee --  committee  discharged,  bill  amended,  ordered  reprinted  as
   amended and recommitted to said committee
 
 AN  ACT  to  amend  the  insurance  law  and the social services law, in
   relation to primary care investment
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The insurance law is amended by adding a new section 3217-k
 to read as follows:
   §  3217-K.  PRIMARY  CARE  SPENDING.  (A) DEFINITIONS. AS USED IN THIS
 SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
   (1) "OVERALL HEALTHCARE SPENDING" MEANS THE TOTAL COST OF CARE FOR THE
 PATIENT POPULATION OF A PAYOR OR PROVIDER ENTITY FOR  A  GIVEN  CALENDAR
 YEAR,  WHERE  COST  IS  CALCULATED  FOR  SUCH YEAR AS THE SUM OF (A) ALL
 CLAIMS-BASED SPENDING PAID TO PROVIDERS BY PUBLIC AND PRIVATE PAYORS AND
 (B) ALL NON-CLAIM PAYMENTS FOR SUCH YEAR, INCLUDING, BUT NOT LIMITED TO,
 INCENTIVE PAYMENTS AND CARE COORDINATION PAYMENTS.
   (2) "PLAN OR PAYOR" MEANS EVERY  INSURANCE  ENTITY  PROVIDING  MANAGED
 CARE PRODUCTS, INDIVIDUAL COMPREHENSIVE ACCIDENT AND HEALTH INSURANCE OR
 GROUP OR BLANKET COMPREHENSIVE ACCIDENT AND HEALTH INSURANCE, AS DEFINED
 IN THIS CHAPTER, CORPORATION ORGANIZED UNDER ARTICLE FORTY-THREE OF THIS
 CHAPTER  PROVIDING COMPREHENSIVE HEALTH INSURANCE, ENTITY LICENSED UNDER
 ARTICLE FORTY-FOUR OF THIS CHAPTER PROVIDING COMPREHENSIVE HEALTH INSUR-
 ANCE, EVERY OTHER PLAN OVER WHICH THE DEPARTMENT HAS  JURISDICTION,  AND
 EVERY THIRD-PARTY PAYOR PROVIDING HEALTH COVERAGE.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD03591-03-3
 S. 1197--B                          2
              

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