Bill Text: NY S07293 | 2023-2024 | General Assembly | Introduced

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Bill Title: Relates to the performance standards that must be met by managed long term care plans; enables managed long term care plans operated by organizations that also operate an Institutional Special Needs Plan (ISNP) or a PACE program, but not a Medicare Dual Eligible Special Needs Plan, to continue to meet managed long term care plans performance standards.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-01-03 - REFERRED TO HEALTH [S07293 Detail]

Download: New_York-2023-S07293-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          7293

                               2023-2024 Regular Sessions

                    IN SENATE

                                      May 19, 2023
                                       ___________

        Introduced  by  Sen.  RYAN  --  read twice and ordered printed, and when
          printed to be committed to the Committee on Health

        AN ACT to amend the public health law, in relation  to  the  performance
          standards that must be met by managed long term care plans

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Paragraph (a) of subdivision 6-a of section 4403-f  of  the
     2  public  health law, as added by section 4 of part I of chapter 57 of the
     3  laws of 2023, is amended to read as follows:
     4    (a) On or before January first, two thousand twenty-four, each managed
     5  long term care plan that has been  issued  a  certificate  of  authority
     6  pursuant  to  this  section  shall  have an active Institutional Special
     7  Needs Plan or a Medicare Dual Eligible Special Needs Plan  in  operation
     8  whose  H-contract  either  has  a  current  quality star rating from the
     9  Centers for Medicare and Medicaid Services of three stars or higher,  or
    10  has  not been issued a quality star rating from the Centers for Medicare
    11  and Medicaid Services, or a Program of All-Inclusive Care for the Elder-
    12  ly (PACE).  In addition, the managed long term care  plan  shall  suffi-
    13  ciently demonstrate success in the following performance categories:
    14    (i) in addition to meeting the requirements of paragraph (j) of subdi-
    15  vision  seven  of  this  section,  in order to ensure network adequacy a
    16  commitment to contracting with an adequate number of licensed home  care
    17  service  agencies  needed to provide necessary personal care services to
    18  the greatest practicable number  of  enrollees,  and  with  an  adequate
    19  number  of  fiscal  intermediaries  needed to provide necessary consumer
    20  directed personal assistance services to the greatest practicable number
    21  of enrollees in accordance with section three  hundred  sixty-five-f  of
    22  the social services law;
    23    (ii)  readiness  to  timely  implement and adhere to maximum wait time
    24  criteria for key categories of service in accordance  with  laws,  rules

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11574-01-3
        S. 7293                             2

     1  and  regulations of the department or the Centers for Medicare and Medi-
     2  caid Services;
     3    (iii) commitment to quality improvement;
     4    (iv)  accessibility  and geographic distribution of network providers,
     5  taking into account the needs  of  persons  with  disabilities  and  the
     6  differences between rural, suburban, and urban settings;
     7    (v)  demonstrated  cultural  and language competencies specific to the
     8  population of participants;
     9    (vi) ability to serve enrollees  across  the  continuum  of  care,  as
    10  demonstrated  by  the  type and number of products the managed long term
    11  care operates or has applied to operate, including integrated  care  for
    12  participants  who  are  dually  eligible for Medicaid and Medicare[, and
    13  those operated under title one-A of article twenty-five of this  chapter
    14  and section three hundred sixty-nine-gg of the social services law]; and
    15    (vii) value based care readiness and experience.
    16    §  2.  This act shall take effect immediately; provided, however, that
    17  the amendments to section 4403-f  of  the  public  health  law  made  by
    18  section  one of this act shall not affect the repeal of such section and
    19  shall be deemed repealed therewith.