Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Jan 03, 2024 |
referred to health |
Apr 24, 2023 |
print number 6072a |
Apr 24, 2023 |
amend and recommit to health |
Mar 28, 2023 |
referred to health |
Senate Bill S6072A
2023-2024 Legislative Session
Sponsored By
(D) 30th Senate District
Archive: Last Bill Status - In Senate Committee Health 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
Actions
Bill Amendments
2023-S6072 - Details
- See Assembly Version of this Bill:
- A5795
- Current Committee:
- Senate Health
- Law Section:
- Public Health Law
- Laws Affected:
- Amd §4403-f, Pub Health L
2023-S6072 - Sponsor Memo
BILL NUMBER: S6072 SPONSOR: CLEARE TITLE OF BILL: An act to amend the public health law, in relation to payment rates for managed long term care plans PURPOSE OR GENERAL IDEA OF BILL: To reward managed long-term care plans that have above average quality and high-risk scores. SUMMARY OF SPECIFIC PROVISIONS: The bill amends Public Health Law section 4403-f to add a new subdivi- sion 8 which establishes supplemental quality improvement payments for MLTC plans who have received a four of five-star rating on the latest DOH quality rating guide and have a relative risk score of 1.1 or high- er. The payments are capped at $80 million or one percent of total capi- tation whichever is less. Payments will be made based on allocated share with higher quality getting a higher amount.
2023-S6072 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 6072 2023-2024 Regular Sessions I N S E N A T E March 28, 2023 ___________ Introduced by Sen. CLEARE -- 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 payment rates for managed long term care plans THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. 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. (A) Payment rates for managed long term care plan enrollees eligi- ble 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 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. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD10268-01-3 S. 6072 2
2023-S6072A (ACTIVE) - Details
- See Assembly Version of this Bill:
- A5795
- Current Committee:
- Senate Health
- Law Section:
- Public Health Law
- Laws Affected:
- Amd §4403-f, Pub Health L
2023-S6072A (ACTIVE) - Sponsor Memo
BILL NUMBER: S6072A SPONSOR: CLEARE TITLE OF BILL: An act to amend the public health law, in relation to payment rates for managed long term care plans PURPOSE OR GENERAL IDEA OF BILL: To reward managed long-term care plans that have above average quality and high-risk scores. SUMMARY OF SPECIFIC PROVISIONS: The bill amends Public Health Law section 4403-f to add a new subdivi- sion 8 which establishes supplemental quality improvement payments for MLTC plans who have received a four of five-star rating on the latest DOH quality rating guide and have a relative risk score of 1.1 or high- er. The payments are capped at $30 million or one percent of total capi- tation whichever is less. Payments will be made based on allocated share with higher quality getting a higher amount.
2023-S6072A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 6072--A 2023-2024 Regular Sessions I N S E N A T E March 28, 2023 ___________ Introduced by Sen. CLEARE -- read twice and ordered printed, and when printed 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 payment rates for managed long term care plans THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. 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. (A) Payment rates for managed long term care plan enrollees eligi- ble 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 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 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD10268-03-3 S. 6072--A 2
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