Bill Text: NY A08213 | 2011-2012 | General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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-Amended.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        8213--B
                              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, ROSENTHAL, WEISENBERG, LAVINE, SCHIMEL --  read  once
         and  referred  to  the Committee on Health -- reported and referred to
         the Committee on Ways and Means -- committee discharged, bill amended,
         ordered reprinted as amended and  recommitted  to  said  committee  --
         again  reported from said committee with amendments, ordered reprinted
         as amended and recommitted to said committee
       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.   Such  agencies  shall
   15  submit  to  providers  with  which  they contract written certifications
   16  attesting that such funds will  be  used  solely  for  the  purposes  of
   17  recruitment  and retention of non-supervisory home care services workers
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD10978-08-2
       A. 8213--B                          2
    1  or any worker with direct patient care responsibility and shall maintain
    2  in their files expenditure plans specifying how such funds will be  used
    3  for  such purposes.  PROVIDERS SHALL REPORT TO THE COMMISSIONER ANNUALLY
    4  ON  THE  AMOUNT  OF  SUCH FUNDS PROVIDED THROUGH CONTRACTS. SUCH REPORTS
    5  SHALL LIST THE AMOUNT OF FUNDS BY LICENSED HOME CARE SERVICES  AGENCIES.
    6  The  commissioner is authorized to audit such agencies to ensure compli-
    7  ance with such certifications and expenditure plans and shall recoup any
    8  funds determined to have been used for purposes  other  than  those  set
    9  forth  in  this  subdivision. Such recoupment will be in addition to any
   10  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. Such agencies
   25  or programs shall submit to providers with which they  contract  written
   26  certifications  attesting  that  such  funds will be used solely for the
   27  purposes of recruitment, training and retention of non-supervisory  home
   28  health  aides or other personnel with direct patient care responsibility
   29  and shall maintain in their files expenditure plans specifying how  such
   30  funds  will  be  used for such purposes.   PROVIDERS SHALL REPORT TO THE
   31  COMMISSIONER ANNUALLY ON THE  AMOUNT  OF  SUCH  FUNDS  PROVIDED  THROUGH
   32  CONTRACTS.  SUCH REPORTS SHALL LIST THE AMOUNT OF FUNDS BY LICENSED HOME
   33  CARE SERVICES AGENCY. The commissioner is authorized to audit such agen-
   34  cies or programs to  ensure  compliance  with  such  certifications  and
   35  expenditure  plans  and  shall  recoup any funds determined to have been
   36  used for purposes other than those set forth in this  subdivision.  Such
   37  recoupment shall be in addition to any other penalties provided by law.
   38    S  3.  The public health law is amended by adding a new section 3614-d
   39  to read as follows:
   40    S 3614-D. STANDARDS FOR  PROMPT,  FAIR  AND  EQUITABLE  SETTLEMENT  OF
   41  CLAIMS  FOR  PAYMENTS  FOR  PERSONAL  CARE, HOME HEALTH CARE SERVICES OR
   42  OTHER LONG TERM CARE SERVICES. IN THE  PROCESSING  OF  CLAIMS  SUBMITTED
   43  UNDER  CONTRACTS  OR AGREEMENTS ISSUED OR ENTERED INTO OR BETWEEN CERTI-
   44  FIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, LICENSED
   45  HOME CARE SERVICES PROGRAMS, INSURERS, MANAGED  LONG  TERM  CARE  PLANS,
   46  MANAGED CARE PLANS OR ORGANIZATIONS LICENSED OR OPERATED PURSUANT TO THE
   47  PROVISIONS  OF  THE PUBLIC HEALTH, SOCIAL SERVICES, OR INSURANCE LAW AND
   48  FOR ALL BILLS FOR PERSONAL CARE, HOME HEALTH CARE SERVICES OR OTHER LONG
   49  TERM CARE SERVICES RENDERED BY LICENSED  HOME  CARE  SERVICES  PROGRAMS,
   50  CERTIFIED  HOME  HEALTH  AGENCIES OR LONG TERM HOME HEALTH CARE PROGRAMS
   51  PURSUANT TO SUCH CONTRACTS OR AGREEMENTS, ANY CERTIFIED HOME HEALTH CARE
   52  AGENCY, LONG TERM HOME HEALTH CARE PROGRAM, INSURER, MANAGED  LONG  TERM
   53  CARE  PLANS,  MANAGED  CARE  PLAN, OR ORGANIZATIONS LICENSED OR OPERATED
   54  PURSUANT TO THE PROVISIONS OF THE PUBLIC HEALTH, SOCIAL SERVICES, EXECU-
   55  TIVE OR INSURANCE LAW, SHALL ADHERE TO THE FOLLOWING STANDARDS:
       A. 8213--B                          3
    1    (1) SHALL PAY THE BILL OR CLAIM  TO  A  LICENSED  HOME  CARE  SERVICES
    2  PROGRAM,  CERTIFIED  HOME  HEALTH  AGENCY  OR LONG TERM HOME HEALTH CARE
    3  PROGRAM WITHIN THIRTY DAYS OF RECEIPT OF A CLAIM OR  BILL  FOR  SERVICES
    4  RENDERED  THAT  IS  TRANSMITTED  VIA THE INTERNET OR ELECTRONIC MAIL, OR
    5  FORTY-FIVE DAYS OF RECEIPT OF A CLAIM OR BILL FOR SERVICES RENDERED THAT
    6  IS SUBMITTED BY OTHER MEANS, SUCH AS PAPER OR FACSIMILE.
    7    (2) EACH BILL, CLAIM OR PAYMENT FOR SERVICES PROCESSED IN VIOLATION OF
    8  THIS  SECTION  SHALL CONSTITUTE A SEPARATE VIOLATION. IN ADDITION TO THE
    9  PENALTIES PROVIDED IN THIS CHAPTER, ANY ORGANIZATION OR CORPORATION THAT
   10  FAILS TO ADHERE TO THE STANDARDS CONTAINED  IN  THIS  SECTION  SHALL  BE
   11  OBLIGATED  TO  PAY  TO  THE  LICENSED  HOME  HEALTH CARE PROGRAM IN FULL
   12  SETTLEMENT OF THE BILL, CLAIM OR PAYMENT PLUS INTEREST ON THE AMOUNT  OF
   13  SUCH BILL, CLAIM OR PAYMENT OF THE GREATER OF THE RATE EQUAL TO THE RATE
   14  SET  BY  THE  COMMISSIONER  OF  TAXATION AND FINANCE FOR CORPORATE TAXES
   15  PURSUANT TO PARAGRAPH ONE OF SUBSECTION  (E)  OF  SECTION  ONE  THOUSAND
   16  NINETY-SIX  OF  THE  TAX LAW OR TWELVE PERCENT PER ANNUM, TO BE COMPUTED
   17  FROM THE DATE THE BILL, CLAIM OR PAYMENT WAS REQUIRED TO BE MADE.
   18    S 4. This act shall take effect immediately.