Bill Text: NY A04472 | 2013-2014 | General Assembly | Introduced
Bill Title: Relates to long term home health care program enhancement; expands availability thereto; provides for prospective payment methodology.
Sponsorship: Partisan Bill (Democrat 3)
Status: (Introduced - Dead) 2014-01-08 - referred to health [A04472 Detail]
Download: New_York-2013-A04472-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
4472
2013-2014 Regular Sessions
I N A S S E M B L Y
February 5, 2013
___________
Introduced by M. of A. GOTTFRIED, JAFFEE, QUART -- read once and
referred to the Committee on Health
AN ACT to amend the public health law and the social services law, in
relation to long term home health care program enhancement
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Section 3614 of the public health law is amended by adding
2 a new subdivision 14 to read as follows:
3 14. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGU-
4 LATION AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTIC-
5 IPATION AND TO THE PROVISIONS OF PARAGRAPH (G) OF THIS SUBDIVISION,
6 EFFECTIVE SIXTY DAYS AFTER THE EFFECTIVE DATE OF THIS SUBDIVISION OR AS
7 SOON AS PRACTICABLE, THEREAFTER, PAYMENTS BY GOVERNMENT AGENCIES FOR
8 SERVICES PROVIDED BY LONG TERM HOME HEALTH CARE PROGRAMS SHALL BE BASED
9 ON EPISODIC PAYMENTS, EXCEPT FOR SUCH SERVICES PROVIDED TO CHILDREN
10 UNDER EIGHTEEN YEARS OF AGE. IN ESTABLISHING SUCH PAYMENTS, A STATEWIDE
11 BASE PRICE SHALL BE ESTABLISHED, BASED ON THE STATEWIDE AVERAGE OF MEDI-
12 CAID CLAIMS PAID IN THE BASE PERIOD, FOR EACH SIXTY DAY EPISODE OF CARE
13 AND ADJUSTED BY A REGIONAL WAGE INDEX FACTOR BASED ON THE DEPARTMENT OF
14 LABOR'S TEN LABOR MARKET REGIONS AND AN INDIVIDUAL PATIENT CASE MIX
15 INDEX; PROVIDED HOWEVER THAT THE COMMISSIONER MAY SET AN INTERVAL OTHER
16 THAN SIXTY DAYS FOR SUCH EPISODIC PAYMENT IF THE COMMISSIONER DETERMINES
17 THAT SUCH INTERVAL WOULD MORE EFFECTIVELY ACCOMPLISH THE PURPOSES OF
18 THIS SECTION, SECTION THIRTY-SIX HUNDRED SIXTEEN OF THIS ARTICLE AND
19 SUBDIVISION SIX-A OF SECTION THREE HUNDRED SIXTY-SEVEN-C OF THE SOCIAL
20 SERVICES LAW. SUCH EPISODIC PAYMENTS MAY BE FURTHER ADJUSTED FOR AND
21 SHALL EXCLUDE LOW UTILIZATION CASES WHICH MAY BE REIMBURSED ON AN ALTER-
22 NATE BASIS AND TO REFLECT A PERCENTAGE LIMITATION OF THE COST FOR HIGH-
23 UTILIZATION CASES THAT EXCEED OUTLIER THRESHOLDS OF SUCH PAYMENTS;
24 PROVIDED HOWEVER THAT THE OUTLIER METHODOLOGY SHALL BE ALIGNED TO
25 PATIENT CASE MIX AND SHALL ALSO INCLUDE A MECHANISM FOR ADJUSTMENT WHERE
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01608-01-3
A. 4472 2
1 COST AND UTILIZATION NOT RECOGNIZED BY THE OUTLIER PAYMENT ARE NECESSARY
2 FOR THE SAFE AND ADEQUATE CARE OF THE PATIENT; AND PROVIDED FURTHER
3 HOWEVER THAT, PRIOR TO FINALIZATION, THE OUTLIER METHODOLOGY SHALL BE
4 PROVIDED FOR REVIEW AND CONSIDERATION OF ITS EFFECTS ON PATIENT ACCESS
5 TO CARE AND PROVIDER FISCAL STABILITY BY THE LEGISLATURE, REPRESEN-
6 TATIVES OF CONSUMERS AND STATEWIDE ASSOCIATIONS REPRESENTATIVE OF LONG
7 TERM HOME HEALTH CARE PROGRAMS.
8 (B) INITIAL BASE YEAR EPISODIC PAYMENTS SHALL BE BASED ON MEDICAID
9 PAID CLAIMS FOR SERVICES PROVIDED BY ALL LONG TERM HOME HEALTH CARE
10 PROGRAMS IN THE BASE YEAR TWO THOUSAND TEN, ADJUSTED BY ANNUAL TREND
11 FACTORS USING THE METHODOLOGY DESCRIBED IN PARAGRAPH (C) OF SUBDIVISION
12 TEN OF SECTION TWENTY-EIGHT HUNDRED SEVEN-C OF THIS CHAPTER; PROVIDED
13 HOWEVER THAT, AS AN ALTERNATIVE TO THE TWO THOUSAND TEN BASE YEAR, THE
14 COMMISSIONER MAY ESTABLISH A PROSPECTIVE BASE FOR THE EPISODIC SYSTEM,
15 BASED ON ANTICIPATED EXPENDITURE NEEDS FOR RATE PERIODS BEGINNING APRIL
16 FIRST, TWO THOUSAND THIRTEEN, OR AS SOON AS PRACTICABLE THEREAFTER, AND
17 BEYOND, IF THE COMMISSIONER DETERMINES THAT SUCH PROSPECTIVE BASE MORE
18 EFFECTIVELY ACCOMPLISHES THE PURPOSES OF THIS SECTION, SECTION
19 THIRTY-SIX HUNDRED SIXTEEN OF THIS ARTICLE AND SUBDIVISION SIX-A OF
20 SECTION THREE HUNDRED SIXTY-SEVEN-C OF THE SOCIAL SERVICES LAW. SUBSE-
21 QUENT BASE YEAR EPISODIC PAYMENTS SHALL BE BASED ON MEDICAID PAID CLAIMS
22 FOR SERVICES PROVIDED BY ALL LONG TERM HOME HEALTH CARE PROGRAMS IN A
23 SUBSEQUENT BASE YEAR, AS DETERMINED BY THE COMMISSIONER, PROVIDED,
24 HOWEVER, THAT SUCH BASE YEAR ADJUSTMENT SHALL BE MADE NOT LESS FREQUENT-
25 LY THAN EVERY THREE YEARS. IN DETERMINING CASE MIX, EACH PATIENT SHALL
26 BE CLASSIFIED USING A SYSTEM BASED ON MEASURES WHICH MAY INCLUDE, BUT
27 NOT LIMITED TO, CLINICAL AND FUNCTIONAL MEASURES, AS REPORTED ON THE
28 FEDERAL OUTCOME AND ASSESSMENT INFORMATION SET (OASIS), AS MAY BE
29 AMENDED, OR AS SUCCEEDED AND REPORTED ON A UNIFORM ASSESSMENT TOOL
30 APPROVED BY THE COMMISSIONER, WHICH SHALL ADEQUATELY CAPTURE THE SERVICE
31 REQUIREMENTS OF POST-ACUTE, REHABILITATIVE, CHRONICALLY ILL AND DISABLED
32 PERSONS IN THE LONG TERM HOME HEALTH CARE PROGRAM.
33 (C) THE COMMISSIONER MAY REQUIRE AGENCIES TO COLLECT AND SUBMIT DATA
34 REQUIRED TO IMPLEMENT THIS SUBDIVISION. THE COMMISSIONER MAY PROMULGATE
35 REGULATIONS TO IMPLEMENT THE PROVISIONS OF THIS SUBDIVISION.
36 (D) THE COMMISSIONER IS AUTHORIZED TO FURTHER ADJUST THE STATEWIDE
37 BASE YEAR AMOUNT, OR TO OTHERWISE ADJUST THE PAYMENT, AS MAY BE NECES-
38 SARY, TO REFLECT ACTUAL OR PROJECTED INCREASES IN THE COST OF DELIVERING
39 SERVICES IN THE RATE YEAR WHICH ARE NOT REFLECTED IN THE BASE YEAR,
40 INCLUDING COSTS ASSOCIATED WITH: (I) PATIENT POPULATIONS OR SERVICES NOT
41 INCLUDED IN THE BASE YEAR EXPENDITURES, INCLUDING SUCH ADDITIONAL INSTI-
42 TUTIONAL OR COMMUNITY BASED SERVICES AS THE COMMISSIONER DETERMINES TO
43 BE NECESSARY FOR THE COORDINATED AND EFFICIENT CARE OF LONG TERM HOME
44 HEALTH CARE PROGRAM RECIPIENTS IN THE MOST INTEGRATED SETTING FOR THE
45 PERSON; (II) NEW GOVERNMENTAL MANDATES AND REGULATIONS; (III) LABOR;
46 (IV) DISEASE OUTBREAK; (V) SEVERE SPIKES IN FUEL AND TRANSPORTATION
47 COSTS FOR DIRECT CARE STAFF; OR (VI) SUCH OTHER VARIABLES AS THE COMMIS-
48 SIONER DETERMINES APPROPRIATE.
49 (E) IN ADDITION, TO ADJUSTMENTS PROVIDED PURSUANT TO PARAGRAPH (D) OF
50 THIS SUBDIVISION, THE COMMISSIONER IS AUTHORIZED TO PROVIDE A MECHANISM
51 FOR AGENCY SPECIFIC ADJUSTMENTS IN PAYMENT AS ARE NECESSARY FOR THE
52 DELIVERY OF SERVICES OR THE QUALITY, COST-EFFECTIVENESS OR OPERATION OF
53 THE SYSTEM, INCLUDING ADJUSTMENTS FOR: (I) LABOR COSTS FOR DIRECT CARE
54 STAFF IN THE PARTICULAR MARKET AREA SERVED BY THE AGENCY; (II) CAPITAL
55 COSTS NECESSARY FOR THE AGENCY'S TECHNOLOGY INFRASTRUCTURE, INCLUDING
56 BUT NOT LIMITED TO ELECTRONIC HEALTH RECORDS, POINT OF CARE TECHNOLOGY
A. 4472 3
1 AND TELEHEALTH CARE; (III) HEALTH SYSTEMS IMPROVEMENT INITIATIVES,
2 INCLUDING CARE TRANSITIONS, PROVIDER COLLABORATION FOR IMPROVED PATIENT
3 OUTCOMES AND REDUCED AVOIDABLE HOSPITALIZATIONS, READMISSIONS, EMERGENCY
4 ROOM USE AND OTHER HIGH COST HEALTH CARE SERVICES USE; (IV) ENHANCEMENTS
5 TO THE AGENCY'S CARE MANAGEMENT CAPACITY, INCLUDING THE INTEGRATION OF
6 BEHAVIORAL HEALTH SERVICES, SPECIALTY NURSING CARE, PRIMARY CARE OR
7 OTHER CARE MANAGEMENT ENHANCEMENTS AS MAY BE APPROVED BY THE COMMISSION-
8 ER; AND (V) SUCH OTHER PURPOSES AS THE COMMISSIONER MAY DETERMINE TO BE
9 NECESSARY.
10 (F) THE EPISODIC SYSTEM SHALL PROVIDE FOR A REQUEST FOR ANTICIPATED
11 PAYMENT (RAP), CONSISTENT WITH THE RAP PROVISIONS UNDER THE EPISODIC
12 PAYMENT SYSTEM APPLICABLE TO LONG TERM HOME HEALTH CARE PROGRAMS UNDER
13 THE FEDERAL MEDICARE PROGRAM.
14 (G) PRIOR TO STATEWIDE IMPLEMENTATION OF THE EPISODIC SYSTEM, THE
15 COMMISSIONER SHALL CONDUCT A PILOT TEST OF THE SYSTEM BY SELECTED
16 PROVIDERS PARTICIPATING ON A VOLUNTARY BASIS. THE PILOT SHALL ASSESS THE
17 EFFECTS OF THE SYSTEM ON PATIENT CARE AND ACCESS AND ON PROVIDER OPER-
18 ATIONS AND FISCAL STATUS. THE COMMISSIONER, IN CONJUNCTION WITH REPRE-
19 SENTATIVES OF PILOT PROVIDERS, STATEWIDE ASSOCIATIONS REPRESENTATIVE OF
20 HOME CARE PROVIDERS AND CONSUMER REPRESENTATIVES, SHALL ASSESS THE
21 RESULTS OF THE PILOT AND REPORT TO THE LEGISLATURE, INCLUDING THE IDEN-
22 TIFICATION OF ANY ADJUSTMENTS NECESSARY FOR THE OPERATION OF THE EPISOD-
23 IC SYSTEM FOR STATEWIDE IMPLEMENTATION. UPON THE IMPLEMENTATION OF SUCH
24 ADJUSTMENTS, THE COMMISSIONER SHALL PROCEED TO FURTHER IMPLEMENT THE
25 EPISODIC SYSTEM.
26 (H) THE COMMISSIONER, IN CONSULTATION WITH REPRESENTATIVES OF LONG
27 TERM HOME HEALTH CARE PROGRAMS AND STATEWIDE ASSOCIATIONS REPRESENTATIVE
28 OF LONG TERM HOME HEALTH CARE PROGRAMS, SHALL REVIEW THE EPISODIC SYSTEM
29 AFTER THE FIRST FULL YEAR OF IMPLEMENTATION, AND, WITHIN NINETY DAYS
30 FOLLOWING THE COMPLETION OF SUCH PERIOD, SHALL REPORT TO THE LEGISLA-
31 TURE, INCLUDING THE IDENTIFICATION OF AND PLAN FOR EXECUTING ADJUSTMENTS
32 AS MAY BE NECESSARY FOR THE OPERATION OF THE EPISODIC SYSTEM.
33 S 2. The opening paragraph of subdivision 8 of section 3602 of the
34 public health law, as amended by chapter 622 of the laws of 1988, is
35 amended to read as follows:
36 "Long term home health care program" means a coordinated plan of care
37 and services provided at home TO PERSONS REQUIRING HOME AND
38 COMMUNITY-BASED SERVICES, INCLUDING to invalid, infirm, or disabled
39 persons who are medically eligible for placement in a hospital or resi-
40 dential health care facility for an extended period of time if such
41 program were unavailable; PROVIDED, HOWEVER, THAT SUCH PROGRAM SHALL
42 PROVIDE OR ARRANGE FOR, AND COORDINATE SUCH SERVICES, INCLUDING SUCH
43 COMMUNITY AND INSTITUTIONAL SERVICES, AS THE COMMISSIONER DETERMINES
44 NECESSARY FOR THE PROVISION OF A COORDINATED, INTEGRATED PLAN OF CARE IN
45 THE MOST INTEGRATED SETTING FOR THE PERSON.
46 S 3. Section 367-c of the social services law is amended by adding a
47 new subdivision 6-a to read as follows:
48 6-A. NOTWITHSTANDING THE PROVISIONS OF SUBDIVISIONS ONE THROUGH FIVE
49 OF THIS SECTION, ON AND AFTER SIXTY DAYS AFTER THE EFFECTIVE DATE OF
50 THIS SUBDIVISION, AUTHORIZATION UNDER THIS TITLE FOR RECIPIENT PARTIC-
51 IPATION IN A LONG TERM HOME HEALTH CARE PROGRAM SHALL BE IN ACCORDANCE
52 WITH THIS SUBDIVISION.
53 IF A PERSON WHO REQUIRES HOME AND COMMUNITY BASED SERVICES, INCLUDING
54 A PERSON WHO REQUIRES CARE IN A NURSING FACILITY, DESIRES TO REMAIN AT
55 HOME AND IS DEEMED BY HIS OR HER PHYSICIAN ABLE TO RECEIVE CARE AT HOME,
56 SUCH PERSON SHALL HAVE THE OPTION TO ENROLL IN A LONG TERM HOME HEALTH
A. 4472 4
1 CARE PROGRAM IN ACCORDANCE WITH THE PROVISIONS OF THIS SUBDIVISION,
2 SECTION THIRTY-SIX HUNDRED SIXTEEN OF THE PUBLIC HEALTH LAW AND APPLICA-
3 BLE REGULATIONS OF THE DEPARTMENT. TO ENROLL IN SUCH PROGRAM, SUCH
4 PERSON OR SUCH PERSON'S REPRESENTATIVE SHALL SO INFORM A PROVIDER OF A
5 LONG TERM HOME HEALTH CARE PROGRAM. THE LONG TERM HOME HEALTH CARE
6 PROGRAM PROVIDER SHALL INFORM THE LOCAL SOCIAL SERVICES OFFICIAL OR
7 OTHER PERSON OR ENTITY DESIGNATED BY THE DEPARTMENT AND SHALL CONDUCT A
8 COMPREHENSIVE ASSESSMENT OF THE PATIENT'S NEEDS IN ACCORDANCE WITH
9 SECTION THIRTY-SIX HUNDRED SIXTEEN OF THE PUBLIC HEALTH LAW. IF THE
10 RESULTS OF THE ASSESSMENT INDICATE THAT THE PERSON CAN RECEIVE THE
11 APPROPRIATE LEVEL OF CARE AT HOME, A REPRESENTATIVE OF THE LONG TERM
12 HOME HEALTH CARE PROGRAM, WITH THE INPUT OF THE PERSON OR THE PERSON'S
13 REPRESENTATIVE, SHALL PREPARE FOR SUCH PERSON A PLAN OF CARE SUBJECT TO
14 THE APPROVAL OF SUCH PERSON'S PHYSICIAN. IF THE PLAN OF CARE INDICATES
15 THAT THE PERSON CAN BE CARED FOR APPROPRIATELY AT HOME BY THE LONG TERM
16 HOME HEALTH CARE PROGRAM, THE PERSON MAY BE ADMITTED TO THE PROGRAM. THE
17 LONG TERM HOME HEALTH CARE PROGRAM SHALL NOTIFY THE LOCAL SOCIAL
18 SERVICES OFFICIAL OR ALTERNATE ENTITY DESIGNATED BY THE DEPARTMENT OF
19 THE PERSON'S ADMISSION TO THE LONG TERM HOME HEALTH CARE PROGRAM. THE
20 PERSON'S ELIGIBILITY FOR THE LONG TERM HOME HEALTH CARE PROGRAM ALONG
21 WITH THE PLAN OF CARE THAT HAS BEEN PREPARED FOR SUCH PERSON SHALL BE
22 SUBJECT TO AUDIT BY THE LOCAL SOCIAL SERVICES OFFICIAL OR ALTERNATE
23 ENTITY IDENTIFIED BY THE DEPARTMENT. SUCH PERSON SHALL RECEIVE A COMPRE-
24 HENSIVE REASSESSMENT AT LEAST EVERY ONE HUNDRED EIGHTY DAYS, PURSUANT TO
25 SECTION THIRTY-SIX HUNDRED SIXTEEN OF THE PUBLIC HEALTH LAW, WHICH SHALL
26 BE THE BASIS FOR DETERMINING THE PERSON'S CONTINUED ELIGIBILITY AND CARE
27 UNDER THE LONG TERM HOME HEALTH CARE PROGRAM. THE COMMISSIONER SHALL
28 SUBMIT THE APPROPRIATE WAIVERS AND STATE PLAN AMENDMENTS NECESSARY TO
29 EFFECTUATE THIS SUBDIVISION.
30 S 4. Subdivisions 1 and 2 of section 3616 of the public health law,
31 subdivision 1 as amended by chapter 622 of the laws of 1988 and subdivi-
32 sion 2 as amended by section 33 of part B of chapter 109 of the laws of
33 2010, are amended to read as follows:
34 1. A long term home health care program shall be provided [only] to
35 those patients who REQUIRE HOME AND COMMUNITY BASED SERVICES, INCLUDING
36 PERSONS WHO are medically eligible for placement in a hospital or resi-
37 dential health care facility. An AIDS home care program shall be
38 provided [only] to persons who REQUIRE HOME AND COMMUNITY BASED
39 SERVICES, INCLUDING PERSONS WHO are medically eligible for placement in
40 a hospital or residential health care facility and who (a) are diagnosed
41 by a physician as having acquired immune deficiency syndrome, or (b) are
42 deemed by a physician, within his judgment, to be infected with the
43 etiologic agent of acquired immune deficiency syndrome, and whose
44 illness, infirmity or disability can be reasonably ascertained to be
45 associated with such infection. Provision of certified home health agen-
46 cy services, a long term home health care program or an AIDS home care
47 program paid for by government funds shall be based upon, but not limit-
48 ed to, a comprehensive assessment that shall include, but not be limited
49 to, an evaluation of the medical, social and environmental needs of each
50 applicant for such services or program. This assessment shall also serve
51 as the basis for the development and provision of an appropriate plan of
52 care for the applicant. In cases in which the applicant is a patient in
53 a hospital or residential health care facility, the assessment shall be
54 completed by persons designated by the commissioner, including, but not
55 limited to, the applicant's physician, the discharge coordinator of the
56 hospital or residential health care facility referring the applicant, [a
A. 4472 5
1 representative of the local department of social services,] and a repre-
2 sentative of the provider of a long term home health care program, AIDS
3 home care program, or the certified home health agency that will provide
4 services for the patient. In cases in which the applicant is not a
5 patient in a hospital or residential health care facility, the assess-
6 ment shall be completed by persons designated by the commissioner
7 including, but not limited to, the applicant's physician[, a represen-
8 tative of the local department of social services] and a representative
9 of the provider of a long term home health care program, AIDS home care
10 program or the certified home health agency that will provide services
11 for the patient. [The assessment shall be completed prior to or within
12 thirty days after the provision of services begins. Payment for services
13 provided prior to the completion of the assessment shall be made only if
14 it is determined, based upon such assessment, that the recipient quali-
15 fies for such services.] The commissioner shall prescribe the forms on
16 which the assessment will be made.
17 2. Continued provision of a long term home health care program, AIDS
18 home care program or certified home health agency services paid for by
19 government funds shall be based upon a comprehensive assessment of the
20 medical, social and environmental needs of the recipient of the
21 services. Such assessment shall be performed at least every one hundred
22 eighty days by the provider of a long term home health care program,
23 AIDS home care program or the certified home health agency providing
24 services for the patient [and the local department of social services],
25 and shall be reviewed by a physician charged with the responsibility by
26 the commissioner. The commissioner shall prescribe the forms on which
27 the assessment will be made.
28 S 5. The closing paragraph of subdivision 2 of section 3610 of the
29 public health law, as amended by section 65 of part A of chapter 58 of
30 the laws of 2010, is amended to read as follows:
31 If the application is approved, the applicant shall be so notified in
32 writing. The commissioner's written approval of the application shall
33 constitute authorization to provide a long term home health care
34 program. [In making his or her authorization, the commissioner shall
35 stipulate the maximum number of persons which a provider of a long term
36 home health care program may serve.] If the commissioner proposes to
37 disapprove the application, he or she shall notify the applicant in
38 writing, stating his or her reasons for disapproval, and afford the
39 applicant an opportunity for a public hearing.
40 S 6. Subdivision 5 of section 3610 of the public health law, as
41 amended by chapter 636 of the laws of 1980, is amended to read as
42 follows:
43 5. (a) Notwithstanding the provisions of subdivision four of this
44 section, the commissioner shall suspend, limit or revoke the authori-
45 zation of a provider of a long term home health care program after
46 taking into consideration the public need for the program and the avail-
47 ability of other services which may serve as alternatives or substi-
48 tutes, and after finding that suspending, limiting, or revoking the
49 authorization of such provider would be within the public interest in
50 order to conserve health resources by restricting the level of services
51 to those which are actually needed.
52 (b) [Notwithstanding the provisions of subdivision four of this
53 section, the commissioner may reduce the maximum number of persons which
54 a provider of a long term home health care program is authorized to
55 serve after finding that the number stipulated in such provider's
56 authorization is not being effectively utilized. In addition, the
A. 4472 6
1 commissioner may increase the number of persons which a provider of a
2 long term home health care program is authorized to serve after finding
3 that the number stipulated in such provider's authorization is insuffi-
4 cient to serve persons eligible to receive long term home health care
5 who reside in the area served by such provider.
6 (c)] Whenever any finding as described in paragraph (a) of this subdi-
7 vision is under consideration with respect to any particular provider of
8 a long term home health care program, the commissioner shall cause to be
9 published, in a newspaper of general circulation in the geographic area
10 of such provider, at least thirty days prior to making such a finding an
11 [annnouncement] ANNOUNCEMENT that such a finding is under consideration
12 and an address to which interested persons can write to make their views
13 known. The commissioner shall take all public comments into consider-
14 ation in making such a finding.
15 [(d)] (C) The commissioner shall, upon making any finding described in
16 paragraph (a) of this subdivision with respect to any provider of a long
17 term home health care program, cause such provider and the appropriate
18 health systems agency to be notified of the finding at least thirty days
19 in advance of taking the proposed action. Upon receipt of any such
20 notification and before the expiration of the thirty days or such longer
21 period as may be specified in the notice, the provider or the appropri-
22 ate health systems agency may request a public hearing to be held in the
23 county in which the provider is located. In no event shall the revoca-
24 tion, suspension or limitation take effect prior to the thirtieth day
25 after the date of the notice, or prior to the effective date specified
26 in the notice or prior to the date of the hearing decision, whichever is
27 later.
28 [(e)] (D) Except as otherwise provided by law, all appeals from a
29 finding of the commissioner made pursuant to paragraph (a) of this
30 subdivision shall be directly to the appellate division of the supreme
31 court in the third department. Except as otherwise expressly provided by
32 law, such appeals shall have preference over all issues in all courts.
33 S 7. This act shall take effect immediately.
