NY State Senate Bill 2023-S4791B

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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 21, 2024	reported and committed to finance
May 06, 2024	print number 4791b
May 06, 2024	amend and recommit to health
Jan 03, 2024	referred to health
Dec 18, 2023	print number 4791a
Dec 18, 2023	amend and recommit to health
Feb 14, 2023	referred to health

Votes

- May 21, 2024 - Health Committee Vote
  S4791B
  
  10
  
  Aye
  
  0
  
  Nay
  
  5
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: May 21, 2024
      
      aye (10)
      
      Brouk
      
      Felder
      
      Hoylman-Sigal
      
      Mannion
      
      May
      
      Myrie
      
      Rivera
      
      Salazar
      
      Thomas
      
      Webb
      
      aye wr (5)
      
      Ashby
      
      Gallivan
      
      Martins
      
      Rhoads
      
      Stec

Bill Amendments

Original

B (Active)

co-Sponsors

View additional co-sponsors

2023-S4791 - Details

Current Committee:: Senate Finance
Law Section:: Public Health Law
Laws Affected:: Amd §3614, add §3614-g, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S5915
2021-2022: S2117

2023-S4791 - Summary

Provides increases in the rates of payment for certified home health agencies; directs the commissioner of health to establish minimum standards and a minimum benchmark for home care service payments by any Medicaid payor.

2023-S4791 - Sponsor Memo

                                 
BILL NUMBER: S4791

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law, in relation to rates of payment
for certified home health agencies

 
PURPOSE:

Increases rates of payment for certified home health agencies

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends paragraph (b) of subdivision 13 of section 3614 of the
public health law as it relates to payments for certified home health
agencies. This section authorizes the commissioner to provide a 10%
increase in the base episodic payment from the available funds for the
Medical Assistant program.The commissioner may also authorize an
increase in the episodic payment level based on matters that are deemed
appropriate by the commissioner, including but not limited to inflation-
ary increases in the healthcare market, new program regulatory require-

ments, and staff recruitment and retention needs.

Section 2 adds a new section 3614-g to the public health law by adding
the legislative intent and establishing standards for home care services
payments.

Section 3 provides the effective date.

 
JUSTIFICATION:

Certified home health agencies (CHHAs) provide acute and post-acute
nursing and home health aide services other than long term care. In the
Medicaid program, episodic payments relate to a 60 day plan of care.
Other non-episodic service rates are subject to ceiling limitations that
were set in 2009. Unlike other Medicaid service providers, CHHAs have
not received a payment rate trend adjustment to either rate in over 12
years. During this time, unfunded mandates, labor obligations, and oper-
ation costs have escalated.

Hospitals are under pressure to discharge patients sooner and in more
acute condition than in the past. The need for reliable CHHA services
has increased without a commensurate reimbursement. The vast majority of
New York's CHHAs have incurred ongoing, steep financial losses.

A way to address these issues is through benchmarking. Benchmarking is a
method of equalizing payment rates within the Medicaid service system
for purposes of system stability. This bill directs the Commissioner of
Health to establish a minimum benchmark for Medicaid payers and to post
the benchmarks for other third-party payers' use.  This benchmark would
ensure that home health agencies are able to operate at sustainable
rates in order to provide services to the state's frail and vulnerable
populations.

 
LEGISLATIVE HISTORY:

2019-2020: S5915A/A7798A Gottfried

2021-2022: S2117A/A293A Gottfried

 
FISCAL IMPLICATIONS:

To be determined

 
EFFECTIVE DATE:
This act shall be effective immediately

2023-S4791 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4791
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 14, 2023
                                ___________
 
 Introduced  by  Sens.  RIVERA,  ADDABBO, COMRIE, HOYLMAN-SIGAL, JACKSON,
   SEPULVEDA, STAVISKY -- read twice and ordered printed, and when print-
   ed to be committed to the Committee on Health
 
 AN ACT to amend the public health law, in relation to rates  of  payment
   for certified home health agencies

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (b) of subdivision 13  of  section  3614  of  the
 public  health law, as added by section 4 of part H of chapter 59 of the
 laws of 2011, is amended to read as follows:
   (b) Initial base year episodic payments shall  be  based  on  Medicaid
 paid  claims,  as determined and adjusted by the commissioner to achieve
 savings comparable to the prior state fiscal year, for services provided
 by all certified home health agencies in  the  base  year  two  thousand
 nine.  Subsequent  base  year episodic payments may be based on Medicaid
 paid claims for services provided by all certified home health  agencies
 in  a  base  year  subsequent to two thousand nine, as determined by the
 commissioner, provided, however, that such base year adjustment shall be
 made not less frequently than every three  years.  In  determining  case
 mix,  each  patient shall be classified using a system based on measures
 which may include, but not limited to, clinical and functional measures,
 as reported on  the  federal  Outcome  and  Assessment  Information  Set
 (OASIS),  as  may be amended. NOTWITHSTANDING ANY INCONSISTENT PROVISION
 OF LAW OR REGULATION, IN ADDITION TO THE BASE YEAR  ADJUSTMENT  PROVIDED
 FOR  IN  THIS  PARAGRAPH,  FOR THE RATE YEAR COMMENCING APRIL FIRST, TWO
 THOUSAND TWENTY-THREE, THE COMMISSIONER SHALL PROVIDE FOR A TEN  PERCENT
 INCREASE  IN  THE BASE EPISODIC PAYMENT, AND IN THE INDIVIDUAL RATES FOR
 SERVICES EXEMPT FROM EPISODIC  PAYMENTS  UNDER  PARAGRAPH  (A)  OF  THIS
 SUBDIVISION,  FROM  FUNDS  AVAILABLE FOR THE MEDICAL ASSISTANCE PROGRAM.
 PROVIDED, FURTHER, THAT FOR RATE YEARS BEGINNING APRIL FIRST, TWO  THOU-
 SAND  TWENTY-THREE AND AFTER, THE COMMISSIONER IS AUTHORIZED TO INCREASE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08058-01-3

 S. 4791                             2
 
 THE EPISODIC PAYMENT LEVEL FOR COSTS  NOT  REFLECTED  IN  THE  STATEWIDE
 BASE,  SUBJECT  TO  THE APPROVAL OF THE STATE BUDGET DIRECTOR, INCLUDING
 THE COST OF: INFLATIONARY INCREASES IN THE  HEALTH  CARE  MARKET  BASKET
 AND/OR  CONSUMER PRICE INDEX IMPACTING PROVIDERS; NEW STATE OR FEDERALLY
 MANDATED PROGRAM REGULATORY REQUIREMENTS; HOME  CARE  STAFF  RECRUITMENT
 AND  RETENTION  NEEDS,  PARTICULARLY  IN SHORTAGE AREAS AND DISCIPLINES;
 FACILITATING PROVIDER CAPABILITY TO  FURTHER  ALIGN  WITH  STATE  HEALTH
 REFORM  MODELS  AND  POLICY  GOALS; HEALTH CARE CLINICAL AND INFORMATION
 TECHNOLOGY INVESTMENTS APPROVED BY THE COMMISSIONER; AND  OTHER  MATTERS
 THE COMMISSIONER DETERMINES APPROPRIATE.
   §  2.  The public health law is amended by adding a new section 3614-g
 to read as follows:
   § 3614-G. STANDARDS FOR HOME CARE SERVICES  PAYMENTS.  1.  LEGISLATIVE
 INTENT.  ADEQUATE  REIMBURSEMENT  FOR HOME CARE SERVICES IS ESSENTIAL TO
 THE POLICIES SET FORTH IN SECTION THIRTY-SIX HUNDRED OF THIS ARTICLE  AS
 WELL AS STATE POLICIES CONTINGENT ON ACCESS, AVAILABILITY AND QUALITY OF
 THESE  SERVICES.  THE  DEGREE OF VARIABILITY ACROSS STATE REGULATED HOME
 CARE RATES, EPISODIC PAYMENTS, FEES FOR INDIVIDUAL HOME  CARE  SERVICES,
 AND  NEGOTIATED PAYMENTS, LEAVES THE HOME CARE SYSTEM WITHOUT A STANDARD
 BASIS OF PAYMENT AND STABLE REVENUE NECESSARY TO BUDGET, PLAN AND ENSURE
 SUSTAINABILITY. TO HELP ENSURE  THE  HOME  CARE  SYSTEM'S  VIABILITY  TO
 DELIVER  THE  NEEDED  SERVICES, THE COMMISSIONER SHALL ESTABLISH MINIMUM
 STANDARDS AND A  MINIMUM  BENCHMARK  WITHIN  THE  MEDICAID  PROGRAM  FOR
 PAYMENT  OF  HOME  HEALTH  AGENCY  SERVICES,  INCLUDING  THE SERVICES OF
 SUBCONTRACTING LICENSED HOME CARE SERVICES AGENCIES, THAT CAN ALSO SERVE
 AS THE BENCHMARK TO BE CONSIDERED IN RATES PAID BY  NON-MEDICAID  THIRD-
 PARTY PAYORS.
   2. ESTABLISHMENT OF STANDARDS. EFFECTIVE FOR RATES ISSUED APRIL FIRST,
 TWO THOUSAND TWENTY-THREE AND FOR EACH RATE YEAR THEREAFTER, THE COMMIS-
 SIONER  SHALL  ESTABLISH  MINIMUM  STANDARDS AND A MINIMUM BENCHMARK FOR
 HOME CARE SERVICE PAYMENT BY ANY MEDICAID PAYOR. THE COMMISSIONER  SHALL
 ALSO POST SUCH STANDARDS AND BENCHMARK IN AN ADMINISTRATIVE DIRECTIVE TO
 THE  ATTENTION  OF ALL OTHER THIRD-PARTY PAYORS OF HOME CARE SERVICES IN
 THE STATE FOR CONSIDERED USE IN PAYMENT OF HOME CARE SERVICES. IN ESTAB-
 LISHING THE BENCHMARK, THE COMMISSIONER SHALL UTILIZE THE  RATES  ESTAB-
 LISHED  UNDER  THE EPISODIC PAYMENT SYSTEM UNDER SUBDIVISION THIRTEEN OF
 SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS ARTICLE, AND THE  INDIVIDUAL
 SERVICES RATES ESTABLISHED UNDER SUCH SECTION.
   § 3. This act shall take effect immediately.

co-Sponsors

View additional co-sponsors

2023-S4791A - Details

Current Committee:: Senate Finance
Law Section:: Public Health Law
Laws Affected:: Amd §3614, add §3614-g, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S5915
2021-2022: S2117

2023-S4791A - Summary

2023-S4791A - Sponsor Memo

                                 
BILL NUMBER: S4791A

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law, in relation to rates of payment
for certified home health agencies

 
PURPOSE:

Increases rates of payment for certified home health agencies

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends paragraph (b) of subdivision 13 of section 3614 of the
public health law as it relates to payments for certified home health
agencies. This section authorizes the commissioner to provide a 10%
increase in the base episodic payment from the available funds for the
Medical Assistant program. The commissioner may also authorize an
increase in the episodic payment level based on matters that are deemed
appropriate by the commissioner, including but not limited to inflation-
ary increases in the healthcare market, new program regulatory require-

ments, and staff recruitment and retention needs.

Section 2 adds a new section 3614-g standards for home care service
payments to the public health law and adds legislative intent and the
establishment of standards.

Section 3 provides the effective date.

 
JUSTIFICATION:

Certified home health agencies (CHHAs) provide acute and post-acute
nursing and home health aide services other than long-term care. In the
Medicaid program, episodic payments relate to a 60-day plan of care.
Other non-episodic service rates are subject to ceiling limitations that
were set in 2009. Unlike other Medicaid service providers, CHHAs have
not received a payment rate trend adjustment to either rate in over 13
years. During this time, unfunded mandates, labor obligations, and oper-
ation costs have escalated.

Hospitals are under pressure to discharge patients sooner and in more
acute conditions than in the past. The need for reliable CHHA services
has increased without a commensurate reimbursement. The vast majority of
New York's CHHAs have incurred ongoing, steep financial losses.

A way to address these issues is through benchmarking. Benchmarking is a
method of equalizing payment rates within the Medicaid service system
for purposes of system stability. This bill directs the Commissioner of
Health to establish a minimum benchmark for Medicaid payers and to post
the benchmarks for other third-party payers' use.  This benchmark would
ensure that home health agencies are able to operate at sustainable
rates in order to provide services to the state's frail and vulnerable
populations.

 
LEGISLATIVE HISTORY:

2019-2020: S5915A/A7798A Gottfried

2021-2022: S2117A/A293A Gottfried

 
FISCAL IMPLICATIONS:

To be determined

 
EFFECTIVE DATE:
This act shall be effective immediately

2023-S4791A - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4791--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 14, 2023
                                ___________
 
 Introduced  by  Sens.  RIVERA,  ADDABBO, COMRIE, HOYLMAN-SIGAL, JACKSON,
   SEPULVEDA, STAVISKY -- read twice and ordered printed, and when print-
   ed to be committed to the Committee on Health -- committee discharged,
   bill amended, ordered reprinted as amended  and  recommitted  to  said
   committee

 AN  ACT  to amend the public health law, in relation to rates of payment
   for certified home health agencies
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (b)  of  subdivision 13 of section 3614 of the
 public health law, as added by section 4 of part H of chapter 59 of  the
 laws of 2011, is amended to read as follows:
   (b)  Initial  base  year  episodic payments shall be based on Medicaid
 paid claims, as determined and adjusted by the commissioner  to  achieve
 savings comparable to the prior state fiscal year, for services provided
 by  all  certified  home  health  agencies in the base year two thousand
 nine. Subsequent base year episodic payments may be  based  on  Medicaid
 paid  claims for services provided by all certified home health agencies
 in a base year subsequent to two thousand nine,  as  determined  by  the
 commissioner, provided, however, that such base year adjustment shall be
 made  not  less  frequently  than every three years. In determining case
 mix, each patient shall be classified using a system based  on  measures
 which may include, but not limited to, clinical and functional measures,
 as  reported  on  the  federal  Outcome  and  Assessment Information Set
 (OASIS), as may be amended. NOTWITHSTANDING ANY  INCONSISTENT  PROVISION
 OF  LAW  OR REGULATION, IN ADDITION TO THE BASE YEAR ADJUSTMENT PROVIDED
 FOR IN THIS PARAGRAPH, FOR THE RATE YEAR  COMMENCING  APRIL  FIRST,  TWO
 THOUSAND  TWENTY-FOUR,  THE COMMISSIONER SHALL PROVIDE FOR A TEN PERCENT
 INCREASE IN THE BASE EPISODIC PAYMENT, AND IN THE INDIVIDUAL  RATES  FOR
 SERVICES  EXEMPT  FROM  EPISODIC  PAYMENTS  UNDER  PARAGRAPH (A) OF THIS
 SUBDIVISION, FROM FUNDS AVAILABLE FOR THE  MEDICAL  ASSISTANCE  PROGRAM.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08058-02-3

 S. 4791--A                          2
 
 PROVIDED,  FURTHER, THAT FOR RATE YEARS BEGINNING APRIL FIRST, TWO THOU-
 SAND TWENTY-FOUR AND AFTER, THE COMMISSIONER IS AUTHORIZED  TO  INCREASE
 THE  EPISODIC  PAYMENT  LEVEL  FOR  COSTS NOT REFLECTED IN THE STATEWIDE
 BASE,  SUBJECT  TO  THE APPROVAL OF THE STATE BUDGET DIRECTOR, INCLUDING
 THE COST OF: INFLATIONARY INCREASES IN THE  HEALTH  CARE  MARKET  BASKET
 AND/OR  CONSUMER PRICE INDEX IMPACTING PROVIDERS; NEW STATE OR FEDERALLY
 MANDATED PROGRAM REGULATORY REQUIREMENTS; HOME  CARE  STAFF  RECRUITMENT
 AND  RETENTION  NEEDS,  PARTICULARLY  IN SHORTAGE AREAS AND DISCIPLINES;
 FACILITATING PROVIDER CAPABILITY TO  FURTHER  ALIGN  WITH  STATE  HEALTH
 REFORM  MODELS  AND  POLICY  GOALS; HEALTH CARE CLINICAL AND INFORMATION
 TECHNOLOGY INVESTMENTS APPROVED BY THE COMMISSIONER; AND  OTHER  MATTERS
 THE COMMISSIONER DETERMINES APPROPRIATE.
   §  2.  The public health law is amended by adding a new section 3614-g
 to read as follows:
   § 3614-G. STANDARDS FOR HOME CARE SERVICES  PAYMENTS.  1.  LEGISLATIVE
 INTENT.  ADEQUATE  REIMBURSEMENT  FOR HOME CARE SERVICES IS ESSENTIAL TO
 THE POLICIES SET FORTH IN SECTION THIRTY-SIX HUNDRED OF THIS ARTICLE  AS
 WELL AS STATE POLICIES CONTINGENT ON ACCESS, AVAILABILITY AND QUALITY OF
 THESE  SERVICES.  THE  DEGREE OF VARIABILITY ACROSS STATE REGULATED HOME
 CARE RATES, EPISODIC PAYMENTS, FEES FOR INDIVIDUAL HOME  CARE  SERVICES,
 AND  NEGOTIATED PAYMENTS, LEAVES THE HOME CARE SYSTEM WITHOUT A STANDARD
 BASIS OF PAYMENT AND STABLE REVENUE NECESSARY TO BUDGET, PLAN AND ENSURE
 SUSTAINABILITY. TO HELP ENSURE  THE  HOME  CARE  SYSTEM'S  VIABILITY  TO
 DELIVER  THE  NEEDED  SERVICES, THE COMMISSIONER SHALL ESTABLISH MINIMUM
 STANDARDS AND A  MINIMUM  BENCHMARK  WITHIN  THE  MEDICAID  PROGRAM  FOR
 PAYMENT  OF  HOME  HEALTH  AGENCY  SERVICES,  INCLUDING  THE SERVICES OF
 SUBCONTRACTING LICENSED HOME CARE SERVICES AGENCIES, THAT CAN ALSO SERVE
 AS THE BENCHMARK TO BE CONSIDERED IN RATES PAID BY  NON-MEDICAID  THIRD-
 PARTY PAYORS.
   2. ESTABLISHMENT OF STANDARDS. EFFECTIVE FOR RATES ISSUED APRIL FIRST,
 TWO  THOUSAND TWENTY-FOUR AND FOR EACH RATE YEAR THEREAFTER, THE COMMIS-
 SIONER SHALL ESTABLISH MINIMUM STANDARDS AND  A  MINIMUM  BENCHMARK  FOR
 HOME  CARE SERVICE PAYMENT BY ANY MEDICAID PAYOR. THE COMMISSIONER SHALL
 ALSO POST SUCH STANDARDS AND BENCHMARK IN AN ADMINISTRATIVE DIRECTIVE TO
 THE ATTENTION OF ALL OTHER THIRD-PARTY PAYORS OF HOME CARE  SERVICES  IN
 THE STATE FOR CONSIDERED USE IN PAYMENT OF HOME CARE SERVICES. IN ESTAB-
 LISHING  THE  BENCHMARK, THE COMMISSIONER SHALL UTILIZE THE RATES ESTAB-
 LISHED UNDER THE EPISODIC PAYMENT SYSTEM UNDER SUBDIVISION  THIRTEEN  OF
 SECTION  THIRTY-SIX HUNDRED FOURTEEN OF THIS ARTICLE, AND THE INDIVIDUAL
 SERVICES RATES ESTABLISHED UNDER SUCH SECTION.
   § 3. This act shall take effect immediately.

co-Sponsors

View additional co-sponsors

2023-S4791B (ACTIVE) - Details

Current Committee:: Senate Finance
Law Section:: Public Health Law
Laws Affected:: Amd §3614, add §3614-g, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S5915
2021-2022: S2117

2023-S4791B (ACTIVE) - Summary

2023-S4791B (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S4791B

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law, in relation to rates of payment
for certified home health agencies

 
PURPOSE:

Increases rates of payment for certified home health agencies

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends paragraph (b) of subdivision 13 of section 3614 of the
public health law as it relates to payments for certified home health
agencies. This section authorizes the commissioner to provide a 10%
increase in the base episodic payment from the available funds for the
Medical Assistant program. The commissioner may also authorize an
increase in the episodic payment level based on matters that are deemed
appropriate by the commissioner, including but not limited to inflation-
ary increases in the healthcare market, new program regulatory require-

ments, and staff recruitment and retention needs.

Section 2 adds a new section 3614-g standards for home care service
payments to the public health law and adds legislative intent and the
establishment of standards.

Section 3 provides the effective date.

 
JUSTIFICATION:

Certified home health agencies (CHHAs) provide acute and post-acute
nursing and home health aide services other than long-term care.  In the
Medicaid program, episodic payments relate to a 60-day plan of care.
Other non-episodic service rates are subject to ceiling limitations that
were set in 2009. Unlike other Medicaid service providers, CHHAs have
not received a payment rate trend adjustment to either rate in over 13
years. During this time, unfunded mandates, labor obligations, and oper-
ation costs have escalated.

Hospitals are under pressure to discharge patients sooner and in more
acute conditions than in the past. The need for reliable CHHA services
has increased without a commensurate reimbursement. The vast majority of
New York's CHHAs have incurred ongoing, steep financial losses.

A way to address these issues is through benchmarking. Benchmarking is a
method of equalizing payment rates within the Medicaid service system
for purposes of system stability. This bill directs the Commissioner of
Health to establish a minimum benchmark for Medicaid payers and to post
the benchmarks for other third-party payers' use.  This benchmark would
ensure that home health agencies are able to operate at sustainable
rates in order to provide services to the state's frail and vulnerable
populations.

 
LEGISLATIVE HISTORY:

2019-2020: S5915A/A7798A Gottfried
2021-2022: S2117A/A293A Gottfried
 
FISCAL IMPLICATIONS:

To be determined

 
EFFECTIVE DATE:
Immediate

2023-S4791B (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4791--B
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 14, 2023
                                ___________
 
 Introduced  by  Sens.  RIVERA,  ADDABBO, COMRIE, HOYLMAN-SIGAL, JACKSON,
   SEPULVEDA, STAVISKY -- read twice and ordered printed, and when print-
   ed to be committed to the Committee on Health -- committee discharged,
   bill amended, ordered reprinted as amended  and  recommitted  to  said
   committee -- recommitted to the Committee on Health in accordance with
   Senate  Rule  6, sec. 8 -- committee discharged, bill amended, ordered
   reprinted as amended and recommitted to said committee
 
 AN ACT to amend the public health law, in relation to rates  of  payment
   for certified home health agencies
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (b) of subdivision 13  of  section  3614  of  the
 public  health law, as added by section 4 of part H of chapter 59 of the
 laws of 2011, is amended to read as follows:
   (b) Initial base year episodic payments shall  be  based  on  Medicaid
 paid  claims,  as determined and adjusted by the commissioner to achieve
 savings comparable to the prior state fiscal year, for services provided
 by all certified home health agencies in  the  base  year  two  thousand
 nine.  Subsequent  base  year episodic payments may be based on Medicaid
 paid claims for services provided by all certified home health  agencies
 in  a  base  year  subsequent to two thousand nine, as determined by the
 commissioner, provided, however, that such base year adjustment shall be
 made not less frequently than every three  years.  In  determining  case
 mix,  each  patient shall be classified using a system based on measures
 which may include, but not limited to, clinical and functional measures,
 as reported on  the  federal  Outcome  and  Assessment  Information  Set
 (OASIS),  as  may be amended. NOTWITHSTANDING ANY INCONSISTENT PROVISION
 OF LAW OR REGULATION, IN ADDITION TO THE BASE YEAR  ADJUSTMENT  PROVIDED
 FOR  IN  THIS  PARAGRAPH,  FOR THE RATE YEAR COMMENCING APRIL FIRST, TWO
 THOUSAND TWENTY-FIVE, THE COMMISSIONER SHALL PROVIDE FOR A  TEN  PERCENT
 INCREASE  IN  THE BASE EPISODIC PAYMENT, AND IN THE INDIVIDUAL RATES FOR
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08058-05-4

 S. 4791--B                          2
 
 SERVICES EXEMPT FROM EPISODIC  PAYMENTS  UNDER  PARAGRAPH  (A)  OF  THIS
 SUBDIVISION,  FROM  FUNDS  AVAILABLE FOR THE MEDICAL ASSISTANCE PROGRAM.
 PROVIDED, FURTHER, THAT FOR RATE YEARS BEGINNING APRIL FIRST, TWO  THOU-
 SAND  TWENTY-FIVE  AND AFTER, THE COMMISSIONER IS AUTHORIZED TO INCREASE
 THE EPISODIC PAYMENT LEVEL FOR COSTS  NOT  REFLECTED  IN  THE  STATEWIDE
 BASE,  SUBJECT  TO  THE APPROVAL OF THE STATE BUDGET DIRECTOR, INCLUDING
 THE COST OF: INFLATIONARY INCREASES IN THE  HEALTH  CARE  MARKET  BASKET
 AND/OR  CONSUMER PRICE INDEX IMPACTING PROVIDERS; NEW STATE OR FEDERALLY
 MANDATED PROGRAM REGULATORY REQUIREMENTS; HOME  CARE  STAFF  RECRUITMENT
 AND  RETENTION  NEEDS,  PARTICULARLY  IN SHORTAGE AREAS AND DISCIPLINES;
 FACILITATING PROVIDER CAPABILITY TO  FURTHER  ALIGN  WITH  STATE  HEALTH
 REFORM  MODELS  AND  POLICY  GOALS; HEALTH CARE CLINICAL AND INFORMATION
 TECHNOLOGY INVESTMENTS APPROVED BY THE COMMISSIONER; AND  OTHER  MATTERS
 THE COMMISSIONER DETERMINES APPROPRIATE.
   §  2.  The public health law is amended by adding a new section 3614-g
 to read as follows:
   § 3614-G. STANDARDS FOR HOME CARE SERVICES  PAYMENTS.  1.  LEGISLATIVE
 INTENT.  ADEQUATE  REIMBURSEMENT  FOR HOME CARE SERVICES IS ESSENTIAL TO
 THE POLICIES SET FORTH IN SECTION THIRTY-SIX HUNDRED OF THIS ARTICLE  AS
 WELL AS STATE POLICIES CONTINGENT ON ACCESS, AVAILABILITY AND QUALITY OF
 THESE  SERVICES.  THE  DEGREE OF VARIABILITY ACROSS STATE REGULATED HOME
 CARE RATES, EPISODIC PAYMENTS, FEES FOR INDIVIDUAL HOME  CARE  SERVICES,
 AND  NEGOTIATED PAYMENTS, LEAVES THE HOME CARE SYSTEM WITHOUT A STANDARD
 BASIS OF PAYMENT AND STABLE REVENUE NECESSARY TO BUDGET, PLAN AND ENSURE
 SUSTAINABILITY. TO HELP ENSURE  THE  HOME  CARE  SYSTEM'S  VIABILITY  TO
 DELIVER  THE  NEEDED  SERVICES, THE COMMISSIONER SHALL ESTABLISH MINIMUM
 STANDARDS AND A  MINIMUM  BENCHMARK  WITHIN  THE  MEDICAID  PROGRAM  FOR
 PAYMENT  OF  HOME  HEALTH  AGENCY  SERVICES,  INCLUDING  THE SERVICES OF
 SUBCONTRACTING LICENSED HOME CARE SERVICES AGENCIES, THAT CAN ALSO SERVE
 AS THE BENCHMARK TO BE CONSIDERED IN RATES PAID BY  NON-MEDICAID  THIRD-
 PARTY PAYORS.
   2. ESTABLISHMENT OF STANDARDS. EFFECTIVE FOR RATES ISSUED APRIL FIRST,
 TWO  THOUSAND TWENTY-FIVE AND FOR EACH RATE YEAR THEREAFTER, THE COMMIS-
 SIONER SHALL ESTABLISH MINIMUM STANDARDS AND  A  MINIMUM  BENCHMARK  FOR
 HOME  CARE SERVICE PAYMENT BY ANY MEDICAID PAYOR. THE COMMISSIONER SHALL
 ALSO POST SUCH STANDARDS AND BENCHMARK IN AN ADMINISTRATIVE DIRECTIVE TO
 THE ATTENTION OF ALL OTHER THIRD-PARTY PAYORS OF HOME CARE  SERVICES  IN
 THE STATE FOR CONSIDERED USE IN PAYMENT OF HOME CARE SERVICES. IN ESTAB-
 LISHING  THE  BENCHMARK, THE COMMISSIONER SHALL UTILIZE THE RATES ESTAB-
 LISHED UNDER THE EPISODIC PAYMENT SYSTEM UNDER SUBDIVISION  THIRTEEN  OF
 SECTION  THIRTY-SIX HUNDRED FOURTEEN OF THIS ARTICLE, AND THE INDIVIDUAL
 SERVICES RATES ESTABLISHED UNDER SUCH SECTION.
   § 3. This act shall take effect immediately.

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Senate Bill S4791B

Sponsored By

Current Bill Status - In Senate Committee Finance Committee

May 21, 2024 - Health Committee Vote

Health Committee Vote: May 21, 2024

Bill Amendments

co-Sponsors

2023-S4791 - Details

2023-S4791 - Summary

2023-S4791 - Sponsor Memo

2023-S4791 - Bill Text download pdf

co-Sponsors

2023-S4791A - Details

2023-S4791A - Summary

2023-S4791A - Sponsor Memo

2023-S4791A - Bill Text download pdf

co-Sponsors

2023-S4791B (ACTIVE) - Details

2023-S4791B (ACTIVE) - Summary

2023-S4791B (ACTIVE) - Sponsor Memo

2023-S4791B (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S4791B

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Sponsored By

Current Bill Status - In Senate Committee Finance Committee

Bill Amendments

co-Sponsors

2023-S4791 - Details

2023-S4791 - Summary

2023-S4791 - Sponsor Memo

2023-S4791 - Bill Text download pdf

co-Sponsors

2023-S4791A - Details

2023-S4791A - Summary

2023-S4791A - Sponsor Memo

2023-S4791A - Bill Text download pdf

co-Sponsors

2023-S4791B (ACTIVE) - Details

2023-S4791B (ACTIVE) - Summary

2023-S4791B (ACTIVE) - Sponsor Memo

2023-S4791B (ACTIVE) - Bill Text download pdf

Comments