BILL NUMBER: S3445

SPONSOR: HELMING
 
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, 2023, 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, 2025, 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 implementa-
tions 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 crit-
ical 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:

2022: S.1327 referred to Health/A.2668 referred to Health

2020: S.449 referred to Health/A.4561 referred to Health

2019: S.449 referred to Health/A.4561 referred to Health
2018: S.4536-A passed Senate

2017: S.4536 Referred to Rules

2016: S.6617 Passed Senate

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 hospi-
tals.

 
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.