Bill Text: NY A01807 | 2009-2010 | General Assembly | Amended
Bill Title: Provides for the exclusion of certain costs associated with home health care and the formula for calculating state reimbursements to such programs.
Spectrum: Partisan Bill (Democrat 6-0)
Status: (Introduced - Dead) 2010-07-01 - held for consideration in ways and means [A01807 Detail]
Download: New_York-2009-A01807-Amended.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 1807--A 2009-2010 Regular Sessions I N A S S E M B L Y January 12, 2009 ___________ Introduced by M. of A. GOTTFRIED, DINOWITZ, SCHIMEL, N. RIVERA, ROSEN- THAL -- Multi-Sponsored by -- M. of A. TOWNS -- read once and referred to the Committee on Health -- recommitted to the Committee on Health in accordance with Assembly Rule 3, sec. 2 -- reported and referred to the Committee on Ways and Means -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law, in relation to rate of payment for home health care programs using statewide average calculation excluding certain costs THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. Subdivision 7 of section 3614 of the public health law, as 2 added by chapter 41 of the laws of 1992, the opening paragraph as 3 amended by section 18 of part C of chapter 109 of the laws of 2006, the 4 second undesignated paragraph as added by chapter 170 of the laws of 5 1994 and the third undesignated paragraph as added and the closing para- 6 graph as amended by chapter 59 of the laws of 1993, is amended to read 7 as follows: 8 7. (A) Notwithstanding any inconsistent provision of law or regu- 9 lation, for purposes of establishing rates of payment by governmental 10 agencies for certified home health agencies for the period April first, 11 nineteen hundred ninety-five through December thirty-first, nineteen 12 hundred ninety-five and for rate periods beginning on or after January 13 first, nineteen hundred ninety-six, the reimbursable base year adminis- 14 trative and general costs of a provider of services shall not exceed the 15 statewide average of total reimbursable base year administrative and 16 general costs of such providers of services; PROVIDED, HOWEVER, THAT FOR 17 PURPOSES OF ESTABLISHING SUCH RATES OF PAYMENT FOR PERIODS ON AND AFTER 18 APRIL FIRST, TWO THOUSAND TEN, SUCH STATEWIDE AVERAGE CALCULATION SHALL 19 EXCLUDE ANY COSTS REPORTED AND ALLOCABLE AS ADMINISTRATIVE AND GENERAL 20 BUT ATTRIBUTABLE TO THE PROVISION AND MANAGEMENT OF PATIENT CARE INCLUD- EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00404-03-0 A. 1807--A 2 1 ING, BUT NOT LIMITED TO, COSTS ATTRIBUTABLE TO: PATIENT OUTREACH; 2 ASSESSMENT; COORDINATION AND MANAGEMENT OF SERVICES; TELEPHONE AND OTHER 3 TELEHEALTH MONITORING AND COMMUNICATION; MEDICAL SUPPLIES; STAFF TRANS- 4 PORTATION AND ESCORT SERVICES; FAMILY AND/OR INFORMAL CAREGIVER SUPPORT 5 SERVICES; PATIENT RECORDKEEPING; AND TECHNOLOGY INVESTMENTS FOR PATIENT 6 CARE. The amount of such reduction in certified home health agency 7 rates of payments made during the period April first, nineteen hundred 8 ninety-five through March thirty-first, nineteen hundred ninety-six 9 shall be adjusted in the nineteen hundred ninety-six rate period on a 10 pro-rata basis, if it is determined upon post-audit review by June 11 fifteenth, nineteen hundred ninety-six and reconciliation that the 12 savings for the state share, excluding the federal and local government 13 shares, of medical assistance payments pursuant to title eleven of arti- 14 cle five of the social services law based on the limitation of such 15 payment pursuant to this subdivision is in excess of one million five 16 hundred thousand dollars or is less than one million five hundred thou- 17 sand dollars for payments made on or before March thirty-first, nineteen 18 hundred ninety-six to reflect the amount by which such savings are in 19 excess of or lower than one million five hundred thousand dollars. For 20 rate periods on and after January first, two thousand five through 21 December thirty-first, two thousand six, there shall be no such recon- 22 ciliation of the amount of savings in excess of or lower than one 23 million five hundred thousand dollars. 24 (B) No such limit shall be applied to a provider of services reim- 25 bursed on an initial budget basis, or a new provider, excluding changes 26 in ownership or changes in name, who begins operations in the year prior 27 to the year which is used as a base year in determining rates of 28 payment. 29 (C) For the purposes of this subdivision, reimbursable base year oper- 30 ational costs shall mean those base year operational costs remaining 31 after application of all other efficiency standards, including, but not 32 limited to, peer group cost ceilings or guidelines. 33 (D) The limitation on reimbursement for provider administrative and 34 general expenses provided by this subdivision shall be expressed as a 35 percentage reduction for the rate promulgated by the commissioner to 36 each certified home health agency and long term home health care program 37 provider; PROVIDED, HOWEVER, THAT SUCH REDUCTION PERCENTAGE SHALL NOT BE 38 INCREASED FOR ANY PROVIDER AS A CONSEQUENCE OF THE EXCLUSIONS PROVIDED 39 FOR IN PARAGRAPH (A) OF THIS SUBDIVISION. 40 S 2. The opening paragraph of subdivision 7 of section 3614 of the 41 public health law, as amended by chapter 170 of the laws of 1994, is 42 amended to read as follows: 43 (A) Notwithstanding any inconsistent provision of law or regulation to 44 the contrary, for purposes of establishing rates of payment by govern- 45 mental agencies for certified home health agencies and long term home 46 health care programs for rate period beginning on or after January 47 first, nineteen hundred ninety-five, the department of health may not by 48 rule or regulation limit the reimbursable base year administrative and 49 general costs of a provider of services to a percentage which is other 50 than thirty percent of total reimbursable base year operational costs of 51 such provider of services; PROVIDED, HOWEVER, THAT FOR PURPOSES OF 52 ESTABLISHING SUCH RATES OF PAYMENT FOR PERIODS ON AND AFTER APRIL FIRST, 53 TWO THOUSAND TEN, SUCH STATEWIDE AVERAGE CALCULATION SHALL EXCLUDE ANY 54 COSTS REPORTED AND ALLOCABLE AS ADMINISTRATIVE AND GENERAL BUT ATTRIBUT- 55 ABLE TO THE PROVISION AND MANAGEMENT OF PATIENT CARE INCLUDING, BUT NOT 56 LIMITED TO, COSTS ATTRIBUTABLE TO: PATIENT OUTREACH; ASSESSMENT; COORDI- A. 1807--A 3 1 NATION AND MANAGEMENT OF SERVICES; TELEPHONE AND OTHER TELEHEALTH MONI- 2 TORING AND COMMUNICATION; MEDICAL SUPPLIES; STAFF TRANSPORTATION AND 3 ESCORT SERVICES; FAMILY AND/OR INFORMAL CAREGIVER SUPPORT SERVICES; 4 PATIENT RECORDKEEPING; AND TECHNOLOGY INVESTMENTS FOR PATIENT CARE. 5 S 3. Subdivision 7-a of section 3614 of the public health law, as 6 amended by section 89 of part C of chapter 58 of the laws of 2007 and 7 the opening paragraph as amended by section 46 of part B of chapter 58 8 of the laws of 2009, is amended to read as follows: 9 7-a. (A) Notwithstanding any inconsistent provision of law or regu- 10 lation, for the purposes of establishing rates of payment by govern- 11 mental agencies for long term home health care programs for the period 12 April first, two thousand five, through December thirty-first, two thou- 13 sand five, and for the period January first, two thousand six through 14 March thirty-first, two thousand seven, and on and after April first, 15 two thousand seven through March thirty-first, two thousand nine, and on 16 and after April first, two thousand nine through March thirty-first, two 17 thousand eleven, the reimbursable base year administrative and general 18 costs of a provider of services shall not exceed the statewide average 19 of total reimbursable base year administrative and general costs of such 20 providers of services; PROVIDED, HOWEVER, THAT FOR THE PURPOSES OF 21 ESTABLISHING SUCH RATES OF PAYMENT FOR PERIODS ON AND AFTER APRIL FIRST, 22 TWO THOUSAND TEN, SUCH STATEWIDE AVERAGE CALCULATION SHALL EXCLUDE ANY 23 COSTS REPORTED AND ALLOCABLE AS ADMINISTRATIVE AND GENERAL BUT ATTRIBUT- 24 ABLE TO THE PROVISION AND MANAGEMENT OF PATIENT CARE INCLUDING, BUT NOT 25 LIMITED TO, COSTS ATTRIBUTABLE TO: PATIENT OUTREACH; ASSESSMENT; COORDI- 26 NATION AND MANAGEMENT OF SERVICES; TELEPHONE AND OTHER TELEHEALTH MONI- 27 TORING AND COMMUNICATION; MEDICAL SUPPLIES; STAFF TRANSPORTATION AND 28 ESCORT SERVICES; FAMILY AND/OR INFORMAL CAREGIVER SUPPORT SERVICES; 29 PATIENT RECORDKEEPING; AND TECHNOLOGY INVESTMENTS FOR PATIENT CARE. 30 (B) No such limit shall be applied to a provider of services reim- 31 bursed on an initial budget basis, or a new provider, excluding changes 32 in ownership or changes in name, who begins operations in the year prior 33 to the year which is used as a base year in determining rates of 34 payment. 35 (C) For the purposes of this subdivision, reimbursable base year oper- 36 ational costs shall mean those base year operational costs remaining 37 after application of all other efficiency standards, including, but not 38 limited to, cost guidelines. 39 (D) The limitation on reimbursement for provider administrative and 40 general expenses provided by this subdivision shall be expressed as a 41 percentage reduction for the rate promulgated by the commissioner to 42 each long term home health care program provider; PROVIDED, HOWEVER, 43 THAT SUCH REDUCTION PERCENTAGE SHALL NOT BE INCREASED FOR ANY PROVIDER 44 AS A CONSEQUENCE OF THE EXCLUSIONS PROVIDED FOR IN PARAGRAPH (A) OF THIS 45 SUBDIVISION. 46 S 4. This act shall take effect on the first of April next succeeding 47 the date on which it shall have become law; provided, however, that the 48 amendments to the opening paragraph of subdivision 7 of section 3614 of 49 the public health law made by section one of this act shall be subject 50 to the expiration and reversion of such opening paragraph pursuant to 51 section 64-b and subdivision 5-a of section 246 of chapter 81 of the 52 laws of 1995, as amended, when upon such date the provisions of section 53 two of this act shall take effect.