NY State Senate Bill 2023-S87

Current Bill Status - In Senate Committee Insurance 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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to insurance
Jan 04, 2023	referred to insurance

co-Sponsors

2023-S87 (ACTIVE) - Details

See Assembly Version of this Bill:: A6012
Current Committee:: Senate Insurance
Law Section:: Financial Services Law
Laws Affected:: Amd §206, Fin Serv L; amd §1502-a, Tax L; amd §§2807-j & 2807-s, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2019-2020: A9029
2021-2022: S9522, A4911

2023-S87 (ACTIVE) - Summary

Enacts the Health Care Tax Reform Act; eliminates certain taxes and assessments on health insurance.

2023-S87 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S87

SPONSOR: GALLIVAN
 
TITLE OF BILL:

An act to amend the financial services law, the tax law and the public
health law, in relation to enacting the Health Care Tax Reform Act

 
PURPOSE OR GENERAL IDEA OF BILL:

The purpose of this legislation is to reduce the amount of taxes imposed
on health care and health insurance consumers. These taxes collectively
are over $5 Billion annually, which exceeds the amount of annual fran-
chise taxes paid by corporations. In fact, health care and health insur-
ance taxes account for the third highest tax burden on New York resi-
dents, exceeded only by the income tax and the general sales tax.

These health care and health insurance taxes are regressive because
these taxes are unrelated to a person's income, wealth, or ability to
pay. In addition, these taxes directly impact hospitalization costs at a
time when consumers are facing some their greatest health care chal-
lenges, directly increase the cost of health insurance, and are coun-
ter-productive to the public policy objective of making health insurance

as affordable as possible. A reduction in health care and health insur-
ance costs will result in more people being able to afford health care
and health insurance.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 names the bill the "Health Care Tax Reform Act."

Section 2 sets forth legislative findings that lowering the cost of
health care and health insurance is extremely important in maximizing
the number of New York State residents who can afford high quality
health care insurance; that New York State taxes on health care and
health insurance amount to over $5 Billion a year and have a substantial
negative impact on the affordability of health care; and that reducing
these tax burdens would help make health care and health insurance more
affordable.

Section 3 amends section 206 of the financial services law to phase out
over a five year period the tax assessment on health insurance compa-
nies.

Section 4 amends section 1502-a of the tax law to phase out over a five
year period the commercial 1.75% health insurance premium tax.

Section 5 amends section 2807-j(2) of the public health law to phase out
the sales tax surcharge on certain hospital based health services
created by the Health Care Reform Act (HCRA Surcharge), and

Section 6 amends section 2807-s(2) of the public health law to phase out
the covered lives assessment that imposes a flat tax on health insurance
policies based on the residence of the insured.

Section 7 provides that the act shall take effect immediately, but would
not affect the existing expiration date of section 2807-j or 2807-s of
the public health law.

 
JUSTIFICATION:

The State of New York imposes over $5 Billion in taxes on health care
and health insurance, which significantly increases costs to patients
and consumers. Collectively, these taxes exceed the taxes imposed on
corporation through the annual franchise tax. Only income taxes and the
sales taxes exceed the tax burden placed on the health care and health
insurance.

In addition to directly affecting the affordability of health care and
health insurance, these taxes are extremely regressive. These taxes are
completely unrelated to the taxpayers' wealth, income, or ability to
pay, but instead impose additional costs on residents based on flat
taxes on premiums, sales taxes on hospital care when people are at their
most vulnerable condition, and gross receipt taxes on health insurance
companies.

These health care taxes are counterproductive to the public policy
objective of making health insurance as affordable as possible and maxi-
mizing the number of people covered by quality health insurance.  The
size of these taxes is astounding. The HCRA surcharge, a 9.63% sales tax
on certain hospital services, increased the cost of these hospital
services by $3.3 Billion in 2019.

The covered lives assessment, a flat annual surcharge (tax) on all
privately insured people, increases the cost of health insurance in New
York City by $173.55 per year for single coverage and $572.70 per year
for family coverage. For insurance companies that do not "elect" to
participate in the flat annual covered lives assessment, there is an
additional tax for all in-hospital charges that ranges from a high of
27.28% for a New York City hospital, 13.89% in Long Island, and a low of
2.25% in the Utica area. The covered lives assessment cost consumers
approximately $1.1 Billion in 2018.

The commercial health insurance premium tax is a 1.75% tax applied to
all premiums paid by those with commercial health insurance policies and
raises the cost of these policies by about $350 Million a year.  The
section 206 assessment applies to all life, property, casualty and
health insurers and is based on the premium amount. This tax costs
consumers $149 Million annually.

 
PRIOR LEGISLATIVE HISTORY:

2021-22: S.9522/A.4911 Referred to Rules/Held in Ways and Means

2020:  A.9029 Held for consideration in Ways and Means

 
FISCAL IMPLICATIONS:

This bill would cut health care and health insurance taxes by about $1
Billion per year. Some of that loss in tax revenue would be off-set by
reductions in the cost of health insurance paid by New York State for
its employees, lower Medicaid costs, and lower uninsured losses.

 
EFFECTIVE DATE:
This Act would take effect immediately, but would not affect the exist-
ing expiration date of section 2807-j or 2807-s of the public health law
relating to the HCRA surcharge.

2023-S87 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    87
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 4, 2023
                                ___________
 
 Introduced  by Sen. GALLIVAN -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the financial services law, the tax law and  the  public
   health law, in relation to enacting the Health Care Tax Reform Act

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be  cited  as  the  "Health
 Care Tax Reform Act".
   § 2. Legislative findings. The Legislature hereby finds that:
   (a) The affordability of health care and health insurance is extremely
 important  in  ensuring  that the maximum number of New York State resi-
 dents can obtain high quality affordable health care;
   (b) Health care and health insurance are currently subject to  several
 taxes that directly and indirectly increase the cost of health insurance
 coverage,  including  an annual flat tax on all privately insured people
 in New York State called the covered lives assessment  that  raises  the
 costs  to  health  plans by $1.1 Billion, a 9.63% sales tax surcharge on
 certain  hospital  based  health  services  that  costs  consumers  $3.6
 Billion,  a  1.75%  flat tax on all commercial health insurance policies
 that costs consumers $350 Million, and a gross receipts tax on insurance
 companies called a section 206 assessment that costs health  plans  $149
 Million a year;
   (c)  Collectively,  the taxes on health care and health insurance cost
 consumers a total of over $5 Billion in 2018, which  exceeds  the  total
 amount  of  taxes  paid  by corporations through the franchise taxes and
 exceeds all other types of taxes except for personal  income  taxes  and
 general sales taxes; and
   (d)  The  taxes  on health care and health insurance are fundamentally
 regressive taxes because the taxes are unrelated to a consumer's  wealth
 or  ability to pay, directly impact hospitalization costs at a time when

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD00606-01-3
 S. 87                               2
 
 consumers are facing some of  their  greatest  health  care  challenges,
 directly  increase  the cost of health insurance, and are counterproduc-
 tive to the public  policy  objective  of  making  health  insurance  as
 affordable as possible.
   §  3. Section 206 of the financial services law is amended by adding a
 new subsection (g) to read as follows:
   (G) FOR THE FISCAL YEAR COMMENCING ON APRIL FIRST, TWO THOUSAND  TWEN-
 TY-THREE,  THE  COMMISSIONER SHALL ONLY COLLECT EIGHTY PER CENTUM OF ANY
 ASSESSMENTS COLLECTED PURSUANT  TO  THIS  SECTION  IN  THE  FISCAL  YEAR
 COMMENCING  ON  APRIL  FIRST,  TWO  THOUSAND  TWENTY-FOUR,  AND PROVIDED
 FURTHER, HOWEVER, THAT FOR THE FISCAL YEAR COMMENCING  ON  APRIL  FIRST,
 TWO  THOUSAND  TWENTY-SIX, THE COMMISSIONER SHALL ONLY COLLECT SIXTY PER
 CENTUM OF ANY ASSESSMENTS COLLECTED PURSUANT  TO  THIS  SECTION  IN  THE
 FISCAL  YEAR  COMMENCING  ON  APRIL FIRST, TWO THOUSAND TWENTY-FOUR, AND
 PROVIDED FURTHER, HOWEVER, THAT FOR THE FISCAL YEAR COMMENCING ON  APRIL
 FIRST,  TWO  THOUSAND  TWENTY-SEVEN, THE COMMISSIONER SHALL ONLY COLLECT
 FORTY PER CENTUM OF ANY ASSESSMENTS COLLECTED PURSUANT TO  THIS  SECTION
 IN  THE FISCAL YEAR COMMENCING ON APRIL FIRST, TWO THOUSAND TWENTY-FOUR,
 AND PROVIDED FURTHER, HOWEVER, THAT FOR THE FISCAL  YEAR  COMMENCING  ON
 APRIL  FIRST,  TWO  THOUSAND  TWENTY-EIGHT,  THE COMMISSIONER SHALL ONLY
 COLLECT TWENTY PER CENTUM OF ANY ASSESSMENTS COLLECTED PURSUANT TO  THIS
 SECTION IN THE FISCAL YEAR COMMENCING ON APRIL FIRST, TWO THOUSAND TWEN-
 TY-FOUR,  AND  PROVIDED  FURTHER,  HOWEVER,  THAT  FOR  THE  FISCAL YEAR
 COMMENCING ON APRIL FIRST, TWO THOUSAND TWENTY-NINE, NO SUCH  ASSESSMENT
 UNDER THIS SECTION SHALL BE COLLECTED.
   §  4.  Section  1502-a of the tax law, as amended by section 2 of part
 B-1 of chapter 57 of the laws of 2009 and as further amended by  section
 104  of  part A of chapter 62 of the laws of 2011, is amended to read as
 follows:
   § 1502-a. Tax on non-life insurance corporations. (A) In lieu  of  the
 tax imposed by section fifteen hundred one of this article, every domes-
 tic insurance corporation, every foreign insurance corporation and every
 alien  insurance  corporation,  other than such corporations transacting
 the business of life insurance, (1) authorized to transact  business  in
 this  state  under a certificate of authority from the superintendent of
 financial services[,] OR (2) that is a risk retention group  as  defined
 in  subsection  (n)  of  section  five  thousand nine hundred two of the
 insurance law,  [or  (3)  that  is  a  health  maintenance  organization
 required  to  obtain a certificate of authority under article forty-four
 of the public health law,] shall, for the privilege of exercising corpo-
 rate franchises or for carrying on business in a corporate or  organized
 capacity  within  this state, and in addition to any other taxes imposed
 for such privilege, pay a tax on all gross direct premiums, less  return
 premiums  thereon,  written  on risks located or resident in this state.
 The tax imposed by this section shall be  computed  in  the  manner  set
 forth  in subdivision (a) of section fifteen hundred ten of this article
 as such subdivision applied to taxable years  beginning  before  January
 first,  two  thousand three, except that the rate of tax imposed by this
 section shall be [one and seventy-five hundredths percent on  all  gross
 direct  premiums,  less return premiums thereon, for accident and health
 insurance contracts, including contracts with health maintenance  organ-
 izations  for  health  services,  and]  two  percent on all [other] such
 premiums EXCEPT  ACCIDENT  AND  HEALTH  INSURANCE  CONTRACTS,  INCLUDING
 CONTRACTS WITH HEALTH MAINTENANCE ORGANIZATIONS FOR HEALTH SERVICES.
   (B)  IN LIEU OF THE TAX IMPOSED BY SECTION FIFTEEN HUNDRED ONE OF THIS
 ARTICLE, EVERY DOMESTIC INSURANCE CORPORATION, EVERY  FOREIGN  INSURANCE
 S. 87                               3
 
 CORPORATION  AND  EVERY  ALIEN  INSURANCE  CORPORATION,  OTHER THAN SUCH
 CORPORATIONS TRANSACTING THE BUSINESS OF LIFE INSURANCE THAT IS A HEALTH
 MAINTENANCE ORGANIZATION REQUIRED TO OBTAIN A CERTIFICATE  OF  AUTHORITY
 UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, SHALL, FOR THE PRIVI-
 LEGE OF EXERCISING CORPORATE FRANCHISES OR FOR CARRYING ON BUSINESS IN A
 CORPORATE  OR  ORGANIZED  CAPACITY WITHIN THIS STATE, AND IN ADDITION TO
 ANY OTHER TAXES IMPOSED FOR SUCH PRIVILEGE,  PAY  A  TAX  ON  ALL  GROSS
 DIRECT  PREMIUMS, LESS RETURN PREMIUMS THEREON, WRITTEN ON RISKS LOCATED
 OR RESIDENT IN THIS STATE. THE TAX IMPOSED  BY  THIS  SECTION  SHALL  BE
 COMPUTED  IN  THE MANNER SET FORTH IN SUBDIVISION (A) OF SECTION FIFTEEN
 HUNDRED TEN OF THIS ARTICLE AS SUCH SUBDIVISION APPLIED TO TAXABLE YEARS
 BEGINNING BEFORE JANUARY FIRST, TWO THOUSAND THREE, EXCEPT THAT THE RATE
 OF TAX IMPOSED BY THIS SECTION SHALL BE ONE AND SEVENTY-FIVE  HUNDREDTHS
 PERCENT  ON ALL GROSS DIRECT PREMIUMS, LESS RETURN PREMIUMS THEREON, FOR
 ACCIDENT AND HEALTH INSURANCE CONTRACTS, INCLUDING CONTRACTS WITH HEALTH
 MAINTENANCE ORGANIZATIONS FOR HEALTH SERVICES, PROVIDED,  HOWEVER,  THAT
 FOR  THE TAXABLE YEAR BEGINNING JANUARY FIRST, TWO THOUSAND TWENTY-FIVE,
 THE PERCENTAGE SHALL BE  ONE  AND  FOUR  TENTHS  PERCENT,  AND  PROVIDED
 FURTHER, HOWEVER, THAT FOR THE TAXABLE YEAR BEGINNING JANUARY FIRST, TWO
 THOUSAND  TWENTY-SIX,  THE  PERCENTAGE  SHALL BE ONE AND FIVE HUNDREDTHS
 PERCENT, AND PROVIDED FURTHER, HOWEVER, THAT FOR THE TAXABLE YEAR BEGIN-
 NING JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN, THE PERCENTAGE  SHALL  BE
 SEVEN TENTHS OF ONE PERCENT, AND PROVIDED FURTHER, HOWEVER, THAT FOR THE
 TAXABLE  YEAR  BEGINNING  JANUARY  FIRST, TWO THOUSAND TWENTY-EIGHT, THE
 PERCENTAGE SHALL BE THIRTY-SEVEN HUNDREDTHS OF ONE PERCENT, AND PROVIDED
 FURTHER, HOWEVER, THAT FOR THE TAXABLE  YEARS  BEGINNING  ON  AND  AFTER
 JANUARY FIRST, TWO THOUSAND TWENTY-NINE, NO SUCH TAX SHALL BE IMPOSED.
   (C)  All  the  other provisions in section fifteen hundred ten of this
 article as amended from time to time, other than subdivision (b) of such
 section, shall apply to the tax imposed by this  section.  In  no  event
 shall  the tax imposed under this section be less than two hundred fifty
 dollars.
   § 5. Subdivision 2 of section 2807-j of  the  public  health  law,  as
 amended  by  section  41 of part B of chapter 58 of the laws of 2005 and
 paragraphs (b), (c), (d), and (e) as amended by section 50 of part B  of
 chapter 58 of the laws of 2009, is amended to read as follows:
   2. (a) The total percentage allowance for any period during the period
 January  first,  nineteen  hundred ninety-seven through December thirty-
 first, nineteen hundred ninety-nine and on and after January first,  two
 thousand,  for  a  designated provider of services applicable to a payor
 shall be determined in accordance with this subdivision and  applied  to
 net patient service revenues.
   (b)  The total percentage allowance for each payor, other than govern-
 mental  agencies,  or  health  maintenance  organizations  for  services
 provided  to  subscribers  eligible  for  medical assistance pursuant to
 title eleven of article five of the social  services  law,  or  approved
 organizations  for  services  provided  to  subscribers eligible for the
 family health plus program pursuant to title eleven-D of article five of
 the social services law, and other than payments for a patient that  has
 no  third-party  coverage in whole or in part for services provided by a
 designated provider of services, shall be:
   (i) the sum of (A) eight and  eighteen-hundredths  percent,  provided,
 however,  that  for services provided on and after July first, two thou-
 sand three, the percentage shall be  eight  and  eighty-five  hundredths
 percent,  and  further  provided that for services provided on and after
 January first, two thousand six, the percentage shall be eight and nine-
 S. 87                               4
 
 ty-five hundredths percent,  and  further  provided  that  for  services
 provided  on  and  after  April first, two thousand nine, the percentage
 shall be nine and sixty-three hundredths percent, AND  FURTHER  PROVIDED
 THAT  FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND TWEN-
 TY-FOUR, THE PERCENTAGE SHALL BE  TWENTY-TWO  AND  SIXTY-ONE  HUNDREDTHS
 PERCENT,  AND  FURTHER  PROVIDED THAT FOR SERVICES PROVIDED ON AND AFTER
 APRIL FIRST, TWO THOUSAND TWENTY-FIVE, THE PERCENTAGE SHALL  BE  SIXTEEN
 AND  NINETY-SIX  HUNDREDTHS  PERCENT,  AND  FURTHER  PROVIDED  THAT  FOR
 SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE
 PERCENTAGE SHALL  BE  ELEVEN  AND  THIRTY-ONE  HUNDREDTHS  PERCENT,  AND
 FURTHER  PROVIDED  THAT  FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST,
 TWO THOUSAND TWENTY-SEVEN, THE PERCENTAGE SHALL BE FIVE  AND  SIXTY-FIVE
 HUNDREDTHS  PERCENT,  AND FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON
 AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-EIGHT, THE  PERCENTAGE  SHALL
 BE  ZERO  PERCENT, plus (B) twenty-four percent, provided, however, that
 for services provided on and after July first, two thousand  three,  the
 percentage shall be twenty-five and ninety-seven hundredths percent, and
 further  provided that for services provided on and after January first,
 two thousand six, the percentage  shall  be  twenty-six  and  twenty-six
 hundredths  percent,  and further provided that for services provided on
 and after April first, two thousand nine, the percentage shall be  twen-
 ty-eight  and twenty-seven hundredths percent, AND FURTHER PROVIDED THAT
 FOR SERVICES PROVIDED ON AND AFTER APRIL  FIRST,  TWO  THOUSAND  TWENTY-
 FOUR,  THE  PERCENTAGE  SHALL  BE  TWENTY-TWO  AND  SIXTY-ONE HUNDREDTHS
 PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES PROVIDED  ON  AND  AFTER
 APRIL  FIRST,  TWO THOUSAND TWENTY-FIVE, THE PERCENTAGE SHALL BE SIXTEEN
 AND  NINETY-SIX  HUNDREDTHS  PERCENT,  AND  FURTHER  PROVIDED  THAT  FOR
 SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE
 PERCENTAGE  SHALL  BE  ELEVEN  AND  THIRTY-ONE  HUNDREDTHS  PERCENT, AND
 FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON AND  AFTER  APRIL  FIRST,
 TWO  THOUSAND  TWENTY-SEVEN, THE PERCENTAGE SHALL BE FIVE AND SIXTY-FIVE
 HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES  PROVIDED  ON
 AND  AFTER  APRIL FIRST, TWO THOUSAND TWENTY-EIGHT, THE PERCENTAGE SHALL
 BE ZERO PERCENT, and plus (C)  for  a  specified  third-party  payor  as
 defined  in subdivision one-a of section twenty-eight hundred seven-s of
 this article the percentage allowance applicable for a general  hospital
 for  inpatient  hospital services pursuant to subdivision two of section
 twenty-eight hundred seven-s of this article;
   (ii) unless (A) an election in accordance with paragraph (a) of subdi-
 vision five of this section to pay the allowance directly to the commis-
 sioner or the commissioner's designee is in  effect  for  a  third-party
 payor, and in addition (B) for a specified third-party payor an election
 to  pay  the  assessment in accordance with section twenty-eight hundred
 seven-t of this article is in effect.
   (c) If an election in accordance with subdivision five of this section
 is in effect for a third-party payor and in addition in accordance  with
 section  twenty-eight  hundred  seven-t  of this article for a specified
 third-party payor,  the  total  percentage  allowance  factor  shall  be
 reduced  to  eight  and  eighteen-hundredths percent, provided, however,
 that for services provided on and after July first, two  thousand  three
 the  total  percentage  allowance  factor  shall be reduced to eight and
 eighty-five hundredths percent, and further provided that  for  services
 provided  on  and  after  January  first,  two  thousand  six, the total
 percentage allowance factor shall be reduced to  eight  and  ninety-five
 hundredths  percent,  and further provided that for services provided on
 and after April first, two thousand nine, the total percentage allowance
 S. 87                               5
 
 factor shall be reduced to nine and sixty-three hundredths  percent  AND
 FURTHER  PROVIDED  THAT  FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST,
 TWO THOUSAND TWENTY-FOUR, THE PERCENTAGE SHALL BE SEVEN AND  SEVENTY-ONE
 HUNDREDTHS  PERCENT,  AND FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON
 AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-FIVE, THE PERCENTAGE SHALL BE
 FIVE AND SEVENTY-NINE HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT  FOR
 SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE
 PERCENTAGE SHALL BE THREE AND EIGHTY-SIX HUNDREDTHS PERCENT, AND FURTHER
 PROVIDED  THAT FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOU-
 SAND  TWENTY-SEVEN,  THE  PERCENTAGE  SHALL  BE  ONE  AND   NINETY-THREE
 HUNDREDTHS  PERCENT,  AND FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON
 AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-EIGHT, THE  PERCENTAGE  SHALL
 BE ZERO PERCENT.
   (d)  The total percentage allowance for payments by governmental agen-
 cies, as determined in accordance  with  paragraphs  (a)  and  (a-1)  of
 subdivision  one of section twenty-eight hundred seven-c of this article
 as in effect on December thirty-first, nineteen hundred  ninety-six,  or
 health  maintenance  organizations  for services provided to subscribers
 eligible for medical assistance pursuant to title eleven of article five
 of the social services  law,  or  approved  organizations  for  services
 provided  to  subscribers  eligible  for  the family health plus program
 pursuant to title eleven-D of article five of the social  services  law,
 shall  be  five  and ninety-eight-hundredths percent, provided, however,
 that for services provided on and after July first, two  thousand  three
 the  total  percentage allowance shall be six and forty-seven hundredths
 percent, and further provided that for services provided  on  and  after
 January first, two thousand six, the total percentage allowance shall be
 six  and  fifty-four  hundredths  percent, and further provided that for
 services provided on and after April first, two thousand nine, the total
 percentage allowance shall be seven  and  four  hundredths  percent  AND
 FURTHER  PROVIDED  THAT  FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST,
 TWO THOUSAND TWENTY-FOUR, THE PERCENTAGE SHALL BE FIVE  AND  SIXTY-THREE
 HUNDREDTHS  PERCENT,  AND FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON
 AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-FIVE, THE PERCENTAGE SHALL BE
 FOUR AND TWENTY-TWO HUNDREDTHS PERCENT, AND FURTHER  PROVIDED  THAT  FOR
 SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE
 PERCENTAGE  SHALL  BE TWO AND EIGHTY-TWO HUNDREDTHS PERCENT, AND FURTHER
 PROVIDED THAT FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO  THOU-
 SAND  TWENTY-SEVEN, THE PERCENTAGE SHALL BE ONE AND FORTY-ONE HUNDREDTHS
 PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES PROVIDED  ON  AND  AFTER
 APRIL  FIRST,  TWO  THOUSAND  TWENTY-EIGHT, THE PERCENTAGE SHALL BE ZERO
 PERCENT.
   (e) The total percentage allowance for payments for services  provided
 by  designated  providers  of services for which there is no third-party
 coverage in whole or in part  shall  be  eight  and  eighteen-hundredths
 percent, provided, however, that for services provided on and after July
 first,  two thousand three the total percentage allowance shall be eight
 and eighty-five  hundredths  percent,  and  further  provided  that  for
 services  provided  on  and  after  January first, two thousand six, the
 total percentage allowance shall be  eight  and  ninety-five  hundredths
 percent,  and  further  provided that for services provided on and after
 April first, two thousand nine, the total percentage allowance shall  be
 nine  and  sixty-three  hundredths percent AND FURTHER PROVIDED THAT FOR
 SERVICES PROVIDED ON AND AFTER APRIL FIRST,  TWO  THOUSAND  TWENTY-FOUR,
 THE  PERCENTAGE  SHALL  BE SEVEN AND SEVENTY-ONE HUNDREDTHS PERCENT, AND
 FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON AND  AFTER  APRIL  FIRST,
 S. 87                               6
 
 TWO  THOUSAND TWENTY-FIVE, THE PERCENTAGE SHALL BE FIVE AND SEVENTY-NINE
 HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES  PROVIDED  ON
 AND  AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE PERCENTAGE SHALL BE
 THREE  AND  EIGHTY-SIX HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR
 SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO  THOUSAND  TWENTY-SEVEN,
 THE  PERCENTAGE  SHALL  BE  ONE AND NINETY-THREE HUNDREDTHS PERCENT, AND
 FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON AND  AFTER  APRIL  FIRST,
 TWO  THOUSAND  TWENTY-EIGHT, THE PERCENTAGE SHALL BE ZERO PERCENT.  This
 paragraph  shall  not  apply  to  patient  deductibles  and  coinsurance
 amounts.
   (f) The total percentage allowance for patient deductibles and coinsu-
 rance  amounts  shall  be  the  same  percentage allowance applicable to
 payments by the primary third-party payor covering the patient  in  each
 case  determined  in accordance with paragraphs (a), (b) and (c) of this
 subdivision.
   (g) The total percentage allowance for  secondary  third-party  payors
 under  coordination  of benefits principles shall be the same percentage
 allowance applicable to payments by the primary third-party payor in the
 case determined in accordance with paragraphs (a), (b) and (c)  of  this
 subdivision.
   §  6.  Subdivision  2  of  section 2807-s of the public health law, as
 added by chapter 639 of the laws of 1996, subparagraph (ii) of paragraph
 (b) as amended by chapter 1 of  the  laws  of  1999,  paragraph  (c)  as
 amended  by  section  15  of part A-3 of chapter 62 of the laws of 2003,
 subparagraph (ii) of paragraph (c) as amended and subparagraph (iii)  of
 paragraph (c) as added by section 31 of part B of chapter 58 of the laws
 of  2005,  and subparagraph (iv) of paragraph (c) as added by section 21
 of part A of chapter 58 of the laws of  2007,  is  amended  to  read  as
 follows:
   2.  (a)  The  regional  percentage allowance for any period during the
 period January first, nineteen  hundred  ninety-seven  through  December
 thirty-first,  nineteen hundred ninety-nine for all general hospitals in
 the region applicable to a specified third-party payor,  and  applicable
 to  related  patient coinsurance and deductible amounts and to secondary
 third-party payors under coordination of benefits principles,  shall  be
 the  following,  and  shall be applied to inpatient hospital net patient
 service revenues:
   (b) the result expressed as a percentage of:
   (i) for each region, the amount allocated to the region in  accordance
 with subdivision six of this section, divided by
   (ii)  the total estimated nineteen hundred ninety-six general hospital
 inpatient revenue of all general hospitals in the region, excluding  (A)
 an  estimate of revenue from services provided to beneficiaries of title
 XVIII of the federal social security act (medicare), (B) an estimate  of
 revenue  from  services  provided  to  patients eligible for payments by
 governmental agencies, patients eligible for payments  pursuant  to  the
 comprehensive  motor  vehicle  insurance  reparations  act, the workers'
 compensation law, the  volunteer  firefighters'  benefit  law,  and  the
 volunteer  ambulance  workers'  benefit  law, and self-pay patients, (C)
 from general hospitals  providing  graduate  medical  education  in  the
 aggregate an amount equal to the amount specified in subparagraph (i) of
 this  subdivision, other than the components of such amount allocable to
 payors specified in clause (B) of this subparagraph, and (D) an estimate
 of revenue reductions related to negotiated  reimbursement  in  nineteen
 hundred  ninety-seven with specified third-party payors which shall be a
 uniform statewide percentage estimated reduction.
 S. 87                               7
 
   (c) (i) The regional percentage  allowance  for  the  periods  January
 first,  two thousand through June thirtieth, two thousand three, for all
 general hospitals in the  region  applicable  to  specified  third-party
 payors,  and  applicable  to  related patient coinsurance and deductible
 amounts,  shall  be  the  same  regional percentage allowance calculated
 pursuant to paragraph (b) of this subdivision  for  the  period  January
 first, nineteen hundred ninety-nine through December thirty-first, nine-
 teen hundred ninety-nine.
   (ii) The regional percentage allowance for the periods July first, two
 thousand three through December thirty-first, two thousand five, for all
 general  hospitals  in  the  region  applicable to specified third-party
 payors, and applicable to related  patient  coinsurance  and  deductible
 amounts,  shall  be  the  same  regional percentage allowance calculated
 pursuant to paragraph (b) of this subdivision  for  the  period  January
 first, nineteen hundred ninety-nine through December thirty-first, nine-
 teen  hundred  ninety-nine  multiplied by one hundred eight and nineteen
 hundredths percent.
   (iii) The regional percentage allowance for the periods January first,
 two thousand six through June thirtieth, two  thousand  seven,  for  all
 general  hospitals  in  the  region  applicable to specified third-party
 payors, and applicable to related  patient  coinsurance  and  deductible
 amounts,  shall  be  the  same  regional percentage allowance calculated
 pursuant to subparagraph (ii) of this paragraph for the  period  January
 first,  two  thousand  five  through December thirty-first, two thousand
 five multiplied by one hundred one and thirteen hundredths percent.
   (iv) The regional percentage allowance for periods [on and after] July
 first, two thousand seven THROUGH MARCH THIRTIETH, TWO THOUSAND  TWENTY-
 FOUR,  for  all  general hospitals in the region applicable to specified
 third-party payors, and applicable to related  patient  coinsurance  and
 deductible  amounts,  shall  be  the  same regional percentage allowance
 calculated pursuant to subparagraph (iii)  of  this  paragraph  for  the
 period January first, two thousand six through June thirtieth, two thou-
 sand seven.
   (V)  THE  REGIONAL  PERCENTAGE  ALLOWANCE FOR PERIODS APRIL FIRST, TWO
 THOUSAND TWENTY-FOUR THROUGH MARCH THIRTIETH, TWO THOUSAND  TWENTY-FIVE,
 FOR  ALL  GENERAL HOSPITALS IN THE REGION APPLICABLE TO SPECIFIED THIRD-
 PARTY PAYORS, AND APPLICABLE TO RELATED PATIENT COINSURANCE AND  DEDUCT-
 IBLE AMOUNTS, SHALL BE THE SAME REGIONAL PERCENTAGE ALLOWANCE CALCULATED
 PURSUANT  TO  PARAGRAPH  (B)  OF THIS SUBDIVISION FOR THE PERIOD JANUARY
 FIRST, NINETEEN HUNDRED NINETY-NINE THROUGH DECEMBER THIRTY-FIRST, NINE-
 TEEN HUNDRED NINETY-NINE  MULTIPLIED  BY  NINETY-SEVEN  AND  SEVENTY-ONE
 HUNDREDTHS PERCENT.
   (VI)  THE  REGIONAL  PERCENTAGE ALLOWANCE FOR PERIODS APRIL FIRST, TWO
 THOUSAND TWENTY-FIVE THROUGH MARCH THIRTIETH, TWO  THOUSAND  TWENTY-SIX,
 FOR  ALL  GENERAL HOSPITALS IN THE REGION APPLICABLE TO SPECIFIED THIRD-
 PARTY PAYORS, AND APPLICABLE TO RELATED PATIENT COINSURANCE AND  DEDUCT-
 IBLE AMOUNTS, SHALL BE THE SAME REGIONAL PERCENTAGE ALLOWANCE CALCULATED
 PURSUANT  TO  PARAGRAPH  (B)  OF THIS SUBDIVISION FOR THE PERIOD JANUARY
 FIRST, NINETEEN HUNDRED NINETY-NINE THROUGH DECEMBER THIRTY-FIRST, NINE-
 TEEN HUNDRED NINETY-NINE MULTIPLIED  BY  SEVENTY-THREE  AND  TWENTY-NINE
 HUNDREDTHS PERCENT.
   (VII)  THE  REGIONAL PERCENTAGE ALLOWANCE FOR PERIODS APRIL FIRST, TWO
 THOUSAND TWENTY-SIX THROUGH MARCH THIRTIETH, TWO THOUSAND  TWENTY-SEVEN,
 FOR  ALL  GENERAL HOSPITALS IN THE REGION APPLICABLE TO SPECIFIED THIRD-
 PARTY PAYORS, AND APPLICABLE TO RELATED PATIENT COINSURANCE AND  DEDUCT-
 IBLE AMOUNTS, SHALL BE THE SAME REGIONAL PERCENTAGE ALLOWANCE CALCULATED
 S. 87                               8
 
 PURSUANT  TO  PARAGRAPH  (B)  OF THIS SUBDIVISION FOR THE PERIOD JANUARY
 FIRST, NINETEEN HUNDRED NINETY-NINE THROUGH DECEMBER THIRTY-FIRST, NINE-
 TEEN  HUNDRED  NINETY-NINE  MULTIPLIED  BY  FORTY-EIGHT  AND  EIGHTY-SIX
 HUNDREDTHS PERCENT.
   (VIII)  THE REGIONAL PERCENTAGE ALLOWANCE FOR PERIODS APRIL FIRST, TWO
 THOUSAND TWENTY-SEVEN THROUGH  MARCH  THIRTIETH,  TWO  THOUSAND  TWENTY-
 EIGHT,  FOR  ALL GENERAL HOSPITALS IN THE REGION APPLICABLE TO SPECIFIED
 THIRD-PARTY PAYORS, AND APPLICABLE TO RELATED  PATIENT  COINSURANCE  AND
 DEDUCTIBLE  AMOUNTS,  SHALL  BE  THE  SAME REGIONAL PERCENTAGE ALLOWANCE
 CALCULATED PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION FOR THE  PERIOD
 JANUARY  FIRST,  NINETEEN  HUNDRED  NINETY-NINE THROUGH DECEMBER THIRTY-
 FIRST,  NINETEEN  HUNDRED  NINETY-NINE  MULTIPLIED  BY  TWENTY-FOUR  AND
 FORTY-THREE HUNDREDTHS PERCENT.
   §  7.  This act shall take effect immediately; provided, however, that
 the amendments to section 2807-j  of  the  public  health  law  made  by
 section five of this act shall not affect the expiration of such section
 and shall be deemed to expire therewith; provided further, however, that
 the  amendments  to  section  2807-s  of  the  public health law made by
 section six of this act shall not affect the expiration of such  section
 and shall be deemed to expire therewith.

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Senate Bill S87

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee

co-Sponsors

2023-S87 (ACTIVE) - Details

2023-S87 (ACTIVE) - Summary

2023-S87 (ACTIVE) - Sponsor Memo

2023-S87 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S87

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Sponsored By

Patrick M. Gallivan

Current Bill Status - In Senate Committee Insurance Committee

co-Sponsors

George M. Borrello

2023-S87 (ACTIVE) - Details

2023-S87 (ACTIVE) - Summary

2023-S87 (ACTIVE) - Sponsor Memo

2023-S87 (ACTIVE) - Bill Text download pdf

Comments