NY State Senate Bill 2023-S3146

Current Bill Status Via A6021 - Vetoed by Governor

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Vetoed By Governor
Signed By Governor

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Actions

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Dec 22, 2023	tabled vetoed memo.126
Dec 12, 2023	delivered to governor
Jun 09, 2023	returned to assembly passed senate 3rd reading cal.1366 substituted for s3146a
Jun 09, 2023	substituted by a6021a
Jun 05, 2023	amended on third reading 3146a
May 30, 2023	ordered to third reading cal.1366 committee discharged and committed to rules
Apr 18, 2023	reported and committed to finance
Jan 27, 2023	referred to health

Votes

- Jun 9, 2023 - Floor Vote
  A6021
  
  63
  
  Aye
  
  0
  
  Nay
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Floor Vote: Jun 9, 2023
      
      aye (63)
      
      Addabbo Jr.
      
      Ashby
      
      Bailey
      
      Borrello
      
      Breslin
      
      Brisport
      
      Brouk
      
      Canzoneri-Fitzpatrick
      
      Chu
      
      Cleare
      
      Comrie
      
      Cooney
      
      Felder
      
      Fernandez
      
      Gallivan
      
      Gianaris
      
      Gonzalez
      
      Gounardes
      
      Griffo
      
      Harckham
      
      Helming
      
      Hinchey
      
      Hoylman-Sigal
      
      Jackson
      
      Kavanagh
      
      Kennedy
      
      Krueger
      
      Lanza
      
      Liu
      
      Mannion
      
      Martinez
      
      Martins
      
      Mattera
      
      May
      
      Mayer
      
      Murray
      
      Myrie
      
      O'Mara
      
      Oberacker
      
      Ortt
      
      Palumbo
      
      Parker
      
      Persaud
      
      Ramos
      
      Rhoads
      
      Rivera
      
      Rolison
      
      Ryan
      
      Salazar
      
      Sanders Jr.
      
      Scarcella-Spanton
      
      Sepúlveda
      
      Serrano
      
      Skoufis
      
      Stavisky
      
      Stec
      
      Stewart-Cousins
      
      Tedisco
      
      Thomas
      
      Walczyk
      
      Webb
      
      Weber
      
      Weik
      
      The following Member(s) participated via videoconferencing: Cooney
  May 30, 2023 - Rules Committee Vote
  S3146
  
  20
  
  Aye
  
  0
  
  Nay
  
  1
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Rules Committee Vote: May 30, 2023
      
      aye (20)
      
      Addabbo Jr.
      
      Bailey
      
      Breslin
      
      Comrie
      
      Fernandez
      
      Gallivan
      
      Gianaris
      
      Griffo
      
      Kennedy
      
      Krueger
      
      Lanza
      
      Liu
      
      Mayer
      
      O'Mara
      
      Ortt
      
      Parker
      
      Sepúlveda
      
      Stec
      
      Stewart-Cousins
      
      Thomas
      
      aye wr (1)
      
      Helming
  Apr 18, 2023 - Health Committee Vote
  S3146
  
  14
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  1
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: Apr 18, 2023
      
      aye (14)
      
      Ashby
      
      Brouk
      
      Felder
      
      Hoylman-Sigal
      
      Mannion
      
      Martins
      
      May
      
      Myrie
      
      Rhoads
      
      Rivera
      
      Salazar
      
      Stec
      
      Thomas
      
      Webb
      
      excused (1)
      
      Gallivan

Bill Amendments

Original

A (Active)

co-Sponsors

2023-S3146 - Details

Law Section:: Social Services Law
Laws Affected:: Amd §364-j, Soc Serv L; amd §4403-f, Pub Health L
Versions Introduced in 2021-2022 Legislative Session:: S7594

2023-S3146 - Summary

Establishes a quality incentive program for managed care providers that is distributed based on managed care providers' performance in meeting quality objectives.

2023-S3146 - Sponsor Memo

                                 
BILL NUMBER: S3146

SPONSOR: MANNION
 
PURPOSE:

The purpose of this bill is to direct the Commissioner of Health to
establish a quality incentive program funded at a minimum of 1% of
premium paid to Medicaid managed care plans or $300 million, and to
consult with managed care plans and other relevant stakeholders in
establishing the criteria for distribution of funds under the Medicaid
managed care quality incentive program.

 
SUMMARY OF PROVISIONS:

  Section  1 of this bill would amend the Social Services Law to require
the Commissioner of Health to codify a  quality  incentive  program  for
Medicaid  managed care (MMC) plans funded at 1% of total annual premiums
or $300 million, whichever is greater.

  Section 2 of this bill would  amend  the  Public  Health  Law  to  set
payment  rates  for  the  managed long term care plans. Adds language to
codify and expand the quality incentive program for LTC  at  1%  of  the
total annual premium paid.

  Section  3  of  this  bill provides that the effective date shall take
effect immediately; provided, however, that the  amendments  to  section
364-j of the social services law and section 4403-f of the public health
law made by sections one and two of this act shall not affect the repeal
of such sections and shall be deemed repealed therewith.

 
JUSTIFICATION:

The  State's  quality incentive program is a powerful tool for improving
and maintaining high-quality and high-value care in the Medicaid program
by funding programs that aim to address social  determinants  of  health
and  health  disparities  and  improve health outcomes.   Currently, the
State authorizes a quality incentive program through allocation of fund-
ing in the budget, however this legislation would codify such program in
law, subject to appropriation.

Indeed, quality incentive funds are central to the  State's  value-based
payment  (VBP)  program  and  Medicaid redesign efforts, providing plans
with the resources needed to incentivize providers to deliver high-qual-
ity care, not just more care.

An essential resource for Medicaid Managed  Care  (MMC)  plans,  quality
incentive  program  dollars  fund critical investments in quality initi-
atives and the delivery of cost-effective services that are  not  other-
wise  covered  by Medicaid but improve quality. For example, the quality
incentive program has supported the development and testing of new  care
models,  numerous  "Continuing Medical Education" opportunities aimed at
improving health care quality and outcomes, and  enhanced  reimbursement
for   primary  and  behavioral  health  providers  supporting  high-need
members.

Accordingly, the Medicaid managed care quality incentive  program  is  a
crucial tool to leverage federal dollars to advance the State's Medicaid
policy  goals of improving access to higher-quality care and controlling
the rate of cost increases. It is imperative that the  Medicaid  managed
care  quality  incentive  program be adequately and consistently funded.
This bill will help preserve the ongoing funding to support the  quality
of  the  Medicaid  program  and further advancements in VBP and Medicaid
redesign.

 
LEGISLATIVE HISTORY:

2021-22: S.7594-A (Mannion) - Passed Senate.

 
FISCAL IMPLICATIONS:

This  will impact the State budget to the extent funds are allocated and
appropriated for such program.

 
EFFECTIVE DATE:
This act shall take effect  immediately;  provided,  however,  that  the
amendments  to  section  364-j  of  the  social services law and section
4403-f of the public health law made by sections one and two of this act
shall not affect the  repeal  of  such  sections  and  shall  be  deemed
repealed therewith.

2023-S3146 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3146
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 27, 2023
                                ___________
 
 Introduced  by  Sens. MANNION, CLEARE -- read twice and ordered printed,
   and when printed to be committed to the Committee on Health
 
 AN ACT to amend the social services law and the public  health  law,  in
   relation  to establishing a quality incentive program for managed care
   providers

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Subdivision 18 of section 364-j of the social services law
 is amended by adding a new paragraph (c-1) to read as follows:
   (C-1) IN SETTING SUCH REIMBURSEMENT, THE COMMISSIONER OF HEALTH  SHALL
 ESTABLISH A QUALITY INCENTIVE PROGRAM FOR MANAGED CARE PROVIDERS THAT IS
 DISTRIBUTED  BASED  ON  MANAGED  CARE  PROVIDERS' PERFORMANCE IN MEETING
 QUALITY OBJECTIVES, WHICH SHALL BE SET BY THE COMMISSIONER IN ADVANCE OF
 THE PERIOD DURING WHICH QUALITY  IS  MEASURED.  SUCH  QUALITY  INCENTIVE
 PROGRAM  SHALL BE FUNDED AT A LEVEL OF AT LEAST ONE PERCENT OF THE TOTAL
 ANNUAL PREMIUM PAID TO MANAGED CARE PROVIDERS, OR THREE HUNDRED  MILLION
 DOLLARS,  WHICHEVER  IS  GREATER. IN ESTABLISHING THE MANNER IN WHICH TO
 MEASURE QUALITY AND DISTRIBUTE  QUALITY  INCENTIVE  PROGRAM  FUNDS,  THE
 COMMISSIONER  OF  HEALTH SHALL ESTABLISH A METHODOLOGY THAT PROVIDES THE
 GREATEST LEVEL OF FUNDING TO MANAGED CARE PROVIDERS RECEIVING THE  HIGH-
 EST  QUALITY  SCORES  AND  SHALL CONSULT WITH REPRESENTATIVES OF MANAGED
 CARE PROVIDERS AND OTHER KEY STAKEHOLDERS.
   § 2. Subdivision 8 of section 4403-f of  the  public  health  law,  as
 amended  by  section  21 of part B of chapter 59 of the laws of 2016, is
 amended to read as follows:
   8. Payment rates for managed long term care  plan  enrollees  eligible
 for  medical  assistance. The commissioner shall establish payment rates
 for services provided to enrollees  eligible  under  title  XIX  of  the
 federal  social  security  act.  Such  payment rates shall be subject to
 approval by the director of the division of the budget and shall reflect
 savings to both state and local governments when compared to costs which
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05012-01-3

 S. 3146                             2
 
 would be incurred by such program if enrollees were to receive  compara-
 ble health and long term care services on a fee-for-service basis in the
 geographic  region  in  which such services are proposed to be provided.
 Payment rates shall be risk-adjusted to take into account the character-
 istics  of  enrollees, or proposed enrollees, including, but not limited
 to:   frailty, disability level,  health  and  functional  status,  age,
 gender,  the  nature  of  services provided to such enrollees, and other
 factors as determined by the commissioner. The  risk  adjusted  premiums
 may  also  be  combined  with  disincentives or requirements designed to
 mitigate any incentives to obtain higher payment categories. In  setting
 such  payment  rates, the commissioner shall consider costs borne by the
 managed care program to ensure actuarially sound and adequate  rates  of
 payment  to ensure quality of care shall comply with all applicable laws
 and regulations, state and federal, including regulations as to actuari-
 al soundness for medicaid managed care. IN SETTING  SUCH  REIMBURSEMENT,
 THE COMMISSIONER SHALL ESTABLISH A QUALITY INCENTIVE PROGRAM FOR MANAGED
 LONG  TERM  CARE  PLANS  THAT  SHALL BE DISTRIBUTED BASED ON SUCH PLANS'
 PERFORMANCE IN MEETING QUALITY OBJECTIVES, WHICH SHALL  BE  SET  BY  THE
 COMMISSIONER  IN ADVANCE OF THE PERIOD DURING WHICH QUALITY IS MEASURED.
 SUCH QUALITY INCENTIVE PROGRAM SHALL BE FUNDED AT A LEVEL  OF  AT  LEAST
 ONE  PERCENT  OF THE TOTAL ANNUAL PREMIUM PAID TO MANAGED LONG TERM CARE
 PLANS.   IN ESTABLISHING THE MANNER IN  WHICH  TO  MEASURE  QUALITY  AND
 DISTRIBUTE  QUALITY  INCENTIVE  PROGRAM  FUNDS,  THE  COMMISSIONER SHALL
 ESTABLISH A METHODOLOGY THAT PROVIDES THE GREATEST LEVEL OF  FUNDING  TO
 MANAGED  LONG  TERM  CARE PLANS RECEIVING THE HIGHEST QUALITY SCORES AND
 SHALL CONSULT WITH REPRESENTATIVES OF MANAGED LONG TERM CARE  PLANS  AND
 OTHER KEY STAKEHOLDERS.
   §  3.  This act shall take effect immediately; provided, however, that
 the amendments to section 364-j of the social services law  and  section
 4403-f of the public health law made by sections one and two of this act
 shall  not  affect  the  repeal  of  such  sections  and shall be deemed
 repealed therewith.

co-Sponsors

2023-S3146A (ACTIVE) - Details

Law Section:: Social Services Law
Laws Affected:: Amd §364-j, Soc Serv L; amd §4403-f, Pub Health L
Versions Introduced in 2021-2022 Legislative Session:: S7594

2023-S3146A (ACTIVE) - Summary

Establishes a quality incentive program for managed care providers that is distributed based on managed care providers' performance in meeting quality objectives.

2023-S3146A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S3146A

SPONSOR: MANNION
 
TITLE OF BILL:

An act to amend the social services law and the public health law, in
relation to establishing a quality incentive program for managed care
providers

 
PURPOSE:

The purpose of this bill is to require the Commissioner of Health to
establish a quality incentive program for Medicaid Managed Care (MMC)
plans, and to consult with representatives of managed care providers and
other relevant stakeholders in establishing the criteria for the
distribution of funds under the MMC quality incentive program.

 
SUMMARY OF PROVISIONS:

Section 1 of this bill would amend the Social Services Law to require
the Commissioner of Health to establish a quality incentive program for
MMC plans, and to consult with representatives of managed care providers

and other relevant stakeholders in establishing the criteria for the
distribution of funds under the MMC quality incentive program.

Section 2 of this bill would amend the Public Health Law to require the
Commissioner of Health to establish a quality incentive program for MMC
plans, and to consult with representatives of managed care providers and
other relevant stakeholders in establishing the criteria for the
distribution of funds under the MMC quality incentive program.

Section 3 of this bill provides that the effective date shall take
effect immediately; provided, however, that the amendments to section
364-j of the Social Services Law and section 4403-f of the Public Health
Law made by sections one and two of this act shall not affect the repeal
of such sections and shall be deemed repealed therewith.

 
JUSTIFICATION:

The State's quality incentive program is a powerful tool for improving
and maintaining high-quality and high-value care in the Medicaid program
by funding programs that aim to address social determinants of health
and health disparities and improve health outcomes. Currently, the State
authorizes a quality incentive program through allocation of funding in
the budget, however this legislation would codify such a program in law,
subject to appropriation.

Indeed, quality incentive funds are central to the State's value-based
payment (VBP) program and Medicaid redesign efforts, providing plans
with the resources needed to incentivize providers to deliver high-qual-
ity care, not just more care.

An essential resource for MMC plans, quality incentive program dollars
fund critical investments in quality initiatives and the delivery of
cost-effective services that are not otherwise covered by Medicaid but
improve quality. For example, the quality incentive program has
supported the development and testing of new care models, numerous
"Continuing Medical Education" opportunities aimed at improving health

care quality and outcomes, and enhanced reimbursement for primary and
behavioral health providers supporting high-need members.

Accordingly, the MMC quality incentive program is a crucial tool to
leverage federal dollars to advance the State's Medicaid policy goals of
improving access to higher-quality care and controlling the rate of cost
increases. It is imperative that the MMC quality incentive program be
adequately and consistently funded. This bill will require the Commis-
sioner of Health to establish a quality incentive program for Medicaid
Managed Care (MMC) plans, and to consult with representatives of managed
care providers and other relevant stakeholders in establishing the
criteria for the distribution of funds under the MMC quality incentive
program.

 
LEGISLATIVE HISTORY:

2021-22: S.7594-A (Mannion) - Passed Senate.

 
FISCAL IMPLICATIONS:

This will impact the State budget to the extent that funds are allocated
and appropriated for such program.

 
EFFECTIVE DATE:
This act shall take effect immediately; provided, however, that the
amendments to section 364-j of the Social Services Law and section
4403-f of the Public Health Law made by sections one and two of this act
shall not affect the repeal of such sections and shall be deemed
repealed therewith.

2023-S3146A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  3146--A
     Cal. No. 1366
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 27, 2023
                                ___________
 
 Introduced  by  Sens.  MANNION, CLEARE, FERNANDEZ, HINCHEY -- read twice
   and ordered printed, and when printed to be committed to the Committee
   on Health -- reported favorably from said committee and  committed  to
   the Committee on Finance -- committee discharged and said bill commit-
   ted  to  the Committee on Rules -- ordered to a third reading, amended
   and ordered reprinted, retaining its place in the order of third read-
   ing
 
 AN ACT to amend the social services law and the public  health  law,  in
   relation  to establishing a quality incentive program for managed care
   providers
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Subdivision 18 of section 364-j of the social services law
 is amended by adding a new paragraph (c-1) to read as follows:
   (C-1) IN SETTING SUCH REIMBURSEMENT, THE COMMISSIONER OF HEALTH  SHALL
 ESTABLISH A QUALITY INCENTIVE PROGRAM FOR MANAGED CARE PROVIDERS THAT IS
 DISTRIBUTED  BASED  ON  MANAGED  CARE  PROVIDERS' PERFORMANCE IN MEETING
 QUALITY OBJECTIVES, WHICH SHALL BE SET BY THE COMMISSIONER IN ADVANCE OF
 THE PERIOD DURING WHICH QUALITY IS MEASURED. IN ESTABLISHING THE  MANNER
 IN  WHICH  TO  MEASURE  QUALITY AND DISTRIBUTE QUALITY INCENTIVE PROGRAM
 FUNDS, THE COMMISSIONER OF HEALTH SHALL  ESTABLISH  A  METHODOLOGY  THAT
 PROVIDES THE GREATEST LEVEL OF FUNDING TO MANAGED CARE PROVIDERS RECEIV-
 ING THE HIGHEST QUALITY SCORES AND SHALL CONSULT WITH REPRESENTATIVES OF
 MANAGED CARE PROVIDERS AND OTHER KEY STAKEHOLDERS.
   §  2.  Subdivision  8  of  section 4403-f of the public health law, as
 amended by section 21 of part B of chapter 59 of the laws  of  2016,  is
 amended to read as follows:
   8.  Payment  rates  for managed long term care plan enrollees eligible
 for medical assistance. The commissioner shall establish  payment  rates
 for  services  provided  to  enrollees  eligible  under title XIX of the
 federal social security act. Such payment  rates  shall  be  subject  to
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD05012-03-3
 S. 3146--A                          2
 
 approval by the director of the division of the budget and shall reflect
 savings to both state and local governments when compared to costs which
 would  be incurred by such program if enrollees were to receive compara-
 ble health and long term care services on a fee-for-service basis in the
 geographic  region  in  which such services are proposed to be provided.
 Payment rates shall be risk-adjusted to take into account the character-
 istics of enrollees, or proposed enrollees, including, but  not  limited
 to:    frailty,  disability  level,  health  and functional status, age,
 gender, the nature of services provided to  such  enrollees,  and  other
 factors  as  determined  by the commissioner. The risk adjusted premiums
 may also be combined with  disincentives  or  requirements  designed  to
 mitigate  any incentives to obtain higher payment categories. In setting
 such payment rates, the commissioner shall consider costs borne  by  the
 managed  care  program to ensure actuarially sound and adequate rates of
 payment to ensure quality of care shall comply with all applicable  laws
 and regulations, state and federal, including regulations as to actuari-
 al  soundness  for medicaid managed care. IN SETTING SUCH REIMBURSEMENT,
 THE COMMISSIONER SHALL ESTABLISH A QUALITY INCENTIVE PROGRAM FOR MANAGED
 LONG TERM CARE PLANS THAT SHALL BE  DISTRIBUTED  BASED  ON  SUCH  PLANS'
 PERFORMANCE  IN  MEETING  QUALITY  OBJECTIVES, WHICH SHALL BE SET BY THE
 COMMISSIONER IN ADVANCE OF THE PERIOD DURING WHICH QUALITY IS  MEASURED.
 IN  ESTABLISHING  THE  MANNER IN WHICH TO MEASURE QUALITY AND DISTRIBUTE
 QUALITY INCENTIVE PROGRAM FUNDS,  THE  COMMISSIONER  SHALL  ESTABLISH  A
 METHODOLOGY  THAT PROVIDES THE GREATEST LEVEL OF FUNDING TO MANAGED LONG
 TERM CARE PLANS RECEIVING THE HIGHEST QUALITY SCORES AND  SHALL  CONSULT
 WITH  REPRESENTATIVES  OF  MANAGED  LONG  TERM  CARE PLANS AND OTHER KEY
 STAKEHOLDERS.
   § 3. This act shall take effect immediately; provided,  however,  that
 the  amendments  to section 364-j of the social services law and section
 4403-f of the public health law made by sections one and two of this act
 shall not affect the  repeal  of  such  sections  and  shall  be  deemed
 repealed therewith.

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Senate Bill S3146

Sponsored By

Current Bill Status Via A6021 - Vetoed by Governor

Jun 9, 2023 - Floor Vote

Floor Vote: Jun 9, 2023

May 30, 2023 - Rules Committee Vote

Rules Committee Vote: May 30, 2023

Apr 18, 2023 - Health Committee Vote

Health Committee Vote: Apr 18, 2023

Bill Amendments

co-Sponsors

2023-S3146 - Details

2023-S3146 - Summary

2023-S3146 - Sponsor Memo

2023-S3146 - Bill Text download pdf

co-Sponsors

2023-S3146A (ACTIVE) - Details

2023-S3146A (ACTIVE) - Summary

2023-S3146A (ACTIVE) - Sponsor Memo

2023-S3146A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S3146

Share this bill

Sponsored By

John W. Mannion

Current Bill Status Via A6021 - Vetoed by Governor

Bill Amendments

co-Sponsors

Cordell Cleare

Nathalia Fernandez

Michelle Hinchey

2023-S3146 - Details

2023-S3146 - Summary

2023-S3146 - Sponsor Memo

2023-S3146 - Bill Text download pdf

co-Sponsors

Cordell Cleare

Nathalia Fernandez

Michelle Hinchey

2023-S3146A (ACTIVE) - Details

2023-S3146A (ACTIVE) - Summary

2023-S3146A (ACTIVE) - Sponsor Memo

2023-S3146A (ACTIVE) - Bill Text download pdf

Comments