Bill Text: NY A08213 | 2011-2012 | General Assembly | Introduced
Bill Title: Disqualifies providers for receipt of monies for the improvement of recruitment and retention of non-supervisory workers providing home health services, when such monies are not provided to the certified home health service agencies employing such workers and providing standards for payment of claims for certain long term care services.
Spectrum: Partisan Bill (Democrat 11-0)
Status: (Introduced - Dead) 2012-06-21 - ordered to third reading rules cal.577 [A08213 Detail]
Download: New_York-2011-A08213-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
8213
2011-2012 Regular Sessions
I N A S S E M B L Y
June 7, 2011
___________
Introduced by M. of A. GOTTFRIED, CAHILL, SWEENEY, JAFFEE, BENEDETTO,
WEPRIN, GUNTHER -- read once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to rate increases
payable for certified home health agency services for purposes of
improving recruitment and retention of non-supervisory workers and
providing standards for settlement of claims for payment for certain
long term care services
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Subparagraph (iii) of paragraph (b) of subdivision 8 of
2 section 3614 of the public health law, as added by section 54 of part J
3 of chapter 82 of the laws of 2002, is amended to read as follows:
4 (iii) In the case of services provided by such providers through
5 contracts with licensed home care services agencies, rate increases
6 received by such providers pursuant to this subdivision shall be
7 reflected, consistent with the purposes of subparagraph (i) of this
8 paragraph, in either the fees paid or benefits or other supports
9 provided to non-supervisory home care services workers or any worker
10 with direct patient care responsibility of such contracted licensed home
11 care services agencies and such fees, benefits or other supports shall
12 be proportionate to the contracted volume of services attributable to
13 each contracted agency AND SUCH RATE INCREASES SHALL BE MADE UPON
14 RECEIPT OF SUCH RECRUITMENT AND RETENTION FUNDS. IF FUNDS ARE MADE
15 AVAILABLE AND A PROVIDER FAILS TO PROVIDE A LICENSED HOME CARE SERVICE
16 AGENCY RATE INCREASES CONSISTENT WITH THE PROVISIONS OF THIS PARAGRAPH
17 THE COMMISSIONER SHALL DEDUCT AN AMOUNT EQUAL TO SUCH RATE INCREASE FROM
18 SUCH PROVIDER AND PAY SUCH FUNDS DIRECTLY TO THE LICENSED HOME CARE
19 SERVICE AGENCY OR THROUGH A MANDATORY PASS THROUGH CONTRACT WITH SUCH
20 PROVIDER. Such agencies shall submit to providers with which they
21 contract written certifications attesting that such funds will be used
22 solely for the purposes of recruitment and retention of non-supervisory
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10978-05-1
A. 8213 2
1 home care services workers or any worker with direct patient care
2 responsibility and shall maintain in their files expenditure plans spec-
3 ifying how such funds will be used for such purposes. PROVIDERS SHALL
4 REPORT TO THE COMMISSIONER ANNUALLY ON THE AMOUNT OF SUCH FUNDS PROVIDED
5 THROUGH CONTRACTS. SUCH REPORTS SHALL LIST THE AMOUNT OF FUNDS BY
6 LICENSED HOME CARE SERVICES AGENCIES. The commissioner is authorized to
7 audit such agencies to ensure compliance with such certifications and
8 expenditure plans and shall recoup any funds determined to have been
9 used for purposes other than those set forth in this subdivision. Such
10 recoupment will be in addition to any other penalties provided by law.
11 S 2. Paragraph (c) of subdivision 10 of section 3614 of the public
12 health law, as amended by section 5 of part C of chapter 109 of the laws
13 of 2006, is amended to read as follows:
14 (c) In the case of services provided by such agencies or programs
15 through contracts with licensed home care services agencies, rate
16 increases received by such agencies or programs pursuant to this subdi-
17 vision shall be reflected, consistent with the purposes of this subdivi-
18 sion, in either the fees paid or benefits or other supports, including
19 training, provided to non-supervisory home health aides or any other
20 personnel with direct patient care responsibility of such contracted
21 licensed home care services agencies and such fees, benefits or other
22 supports shall be proportionate to the contracted volume of services
23 attributable to each contracted agency AND SUCH RATE INCREASES SHALL BE
24 MADE UPON RECEIPT OF SUCH RECRUITMENT AND RETENTION FUNDS. IF FUNDS ARE
25 MADE AVAILABLE AND A PROVIDER FAILS TO PROVIDE A LICENSED HOME CARE
26 SERVICE AGENCY RATE INCREASES CONSISTENT WITH THE PROVISIONS OF THIS
27 PARAGRAPH THE COMMISSIONER SHALL DEDUCT AN AMOUNT EQUAL TO SUCH RATE
28 INCREASE FROM SUCH PROVIDER AND PAY SUCH FUNDS DIRECTLY TO THE LICENSED
29 HOME CARE SERVICE AGENCY OR THROUGH A MANDATORY PASS THROUGH CONTRACT
30 WITH SUCH PROVIDER. Such agencies or programs shall submit to providers
31 with which they contract written certifications attesting that such
32 funds will be used solely for the purposes of recruitment, training and
33 retention of non-supervisory home health aides or other personnel with
34 direct patient care responsibility and shall maintain in their files
35 expenditure plans specifying how such funds will be used for such
36 purposes. PROVIDERS SHALL REPORT TO THE COMMISSIONER ANNUALLY ON THE
37 AMOUNT OF SUCH FUNDS PROVIDED THROUGH CONTRACTS. SUCH REPORTS SHALL LIST
38 THE AMOUNT OF FUNDS BY LICENSED HOME CARE SERVICES AGENCY. The commis-
39 sioner is authorized to audit such agencies or programs to ensure
40 compliance with such certifications and expenditure plans and shall
41 recoup any funds determined to have been used for purposes other than
42 those set forth in this subdivision. Such recoupment shall be in addi-
43 tion to any other penalties provided by law.
44 S 3. The public health law is amended by adding a new section 3614-d
45 to read as follows:
46 S 3614-D. STANDARDS FOR PROMPT, FAIR AND EQUITABLE SETTLEMENT OF
47 CLAIMS FOR PAYMENTS FOR PERSONAL CARE, HOME HEALTH CARE SERVICES OR
48 OTHER LONG TERM CARE SERVICES. IN THE PROCESSING OF CLAIMS SUBMITTED
49 UNDER CONTRACTS OR AGREEMENTS ISSUED OR ENTERED INTO OR BETWEEN CERTI-
50 FIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, LICENSED
51 HOME CARE SERVICES PROGRAMS, INSURERS, MANAGED LONG TERM CARE PLANS,
52 MANAGED CARE PLANS OR ORGANIZATIONS LICENSED OR OPERATED PURSUANT TO THE
53 PROVISIONS OF THE PUBLIC HEALTH, SOCIAL SERVICES, OR INSURANCE LAW AND
54 FOR ALL BILLS FOR PERSONAL CARE, HOME HEALTH CARE SERVICES OR OTHER LONG
55 TERM CARE SERVICES RENDERED BY LICENSED HOME CARE SERVICES PROGRAMS,
56 CERTIFIED HOME HEALTH AGENCIES OR LONG TERM HOME HEALTH CARE PROGRAMS
A. 8213 3
1 PURSUANT TO SUCH CONTRACTS OR AGREEMENTS, ANY CERTIFIED HOME HEALTH CARE
2 AGENCY, LONG TERM HOME HEALTH CARE PROGRAM, INSURER, MANAGED LONG TERM
3 CARE PLANS, MANAGED CARE PLAN, OR ORGANIZATIONS LICENSED OR OPERATED
4 PURSUANT TO THE PROVISIONS OF THE PUBLIC HEALTH, SOCIAL SERVICES, EXECU-
5 TIVE OR INSURANCE LAW, SHALL ADHERE TO THE FOLLOWING STANDARDS:
6 (1) SHALL PAY THE BILL OR CLAIM TO A LICENSED HOME CARE SERVICES
7 PROGRAM, CERTIFIED HOME HEALTH AGENCY OR LONG TERM HOME HEALTH CARE
8 PROGRAM WITHIN THIRTY DAYS OF RECEIPT OF A CLAIM OR BILL FOR SERVICES
9 RENDERED THAT IS TRANSMITTED VIA THE INTERNET OR ELECTRONIC MAIL, OR
10 FORTY-FIVE DAYS OF RECEIPT OF A CLAIM OR BILL FOR SERVICES RENDERED THAT
11 IS SUBMITTED BY OTHER MEANS, SUCH AS PAPER OR FACSIMILE.
12 (2) EACH BILL, CLAIM OR PAYMENT FOR SERVICES PROCESSED IN VIOLATION OF
13 THIS SECTION SHALL CONSTITUTE A SEPARATE VIOLATION. IN ADDITION TO THE
14 PENALTIES PROVIDED IN THIS CHAPTER, ANY ORGANIZATION OR CORPORATION THAT
15 FAILS TO ADHERE TO THE STANDARDS CONTAINED IN THIS SECTION SHALL BE
16 OBLIGATED TO PAY TO THE LICENSED HOME HEALTH CARE PROGRAM IN FULL
17 SETTLEMENT OF THE BILL, CLAIM OR PAYMENT PLUS INTEREST ON THE AMOUNT OF
18 SUCH BILL, CLAIM OR PAYMENT OF THE GREATER OF THE RATE EQUAL TO THE RATE
19 SET BY THE COMMISSIONER OF TAXATION AND FINANCE FOR CORPORATE TAXES
20 PURSUANT TO PARAGRAPH ONE OF SUBSECTION (E) OF SECTION ONE THOUSAND
21 NINETY-SIX OF THE TAX LAW OR TWELVE PERCENT PER ANNUM, TO BE COMPUTED
22 FROM THE DATE THE BILL, CLAIM OR PAYMENT WAS REQUIRED TO BE MADE.
23 S 4. This act shall take effect immediately.
