Bill Text: NY S07668 | 2015-2016 | General Assembly | Introduced

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

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Bill Title: Directs the department of health to study and develop suitable measures to prevent financial hardship and/or failure of providers serving individuals with developmental disabilities funded by Medicaid to support the uninterrupted continuation of necessary services.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Engrossed - Dead) 2016-06-14 - referred to mental health [S07668 Detail]

Download: New_York-2015-S07668-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          7668
                    IN SENATE
                                      May 12, 2016
                                       ___________
        Introduced  by  Sens. ORTT, YOUNG -- read twice and ordered printed, and
          when printed to be committed to the Committee on Health
        AN ACT directing the department of health to study and develop  suitable
          measures  to  prevent  financial  hardship and/or failure of providers
          serving individuals with developmental disabilities funded by Medicaid
          to support the uninterrupted continuation of necessary services
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1. The commissioner of the department of health, in consulta-
     2  tion with the commissioner of the office for people  with  developmental
     3  disabilities, shall prepare a report which shall include the following:
     4    a.  Recommendations  for holding harmless from further rate reductions
     5  those efficient providers within  a  region  that  operate  beneath  the
     6  regional  average  rate.  Severity  of  disability  shall  be taken into
     7  consideration for purposes of comparing efficient providers.
     8    b. A  methodology  for  adjusting  rates  so  that  total  prospective
     9  reimbursement  received by a provider for a program must equal the total
    10  costs of that program which shall include all necessary cost  components
    11  for  operating  the  program. The department of health shall examine the
    12  extent to which units used in rate calculations are  reflective  of  the
    13  actual  units  delivered  to ensure that providers are not penalized for
    14  lost revenue due to  unforeseeable  program  closures,  absenteeism  and
    15  policies designed to curtail program enrollment.
    16    c.  The  department of health shall study and recommend the establish-
    17  ment of a prospective rate appeal process designed to increase rates  as
    18  necessary  during  a  non-rebasing  year to cover costs. Any recommended
    19  appeal process shall ensure providers who prevail on such appeal receive
    20  additional reimbursement at the same reimbursement rate as the date  the
    21  appeal was submitted.
    22    d.  The  department  of  health  shall  study  ways to enhance program
    23  stability and the quality of care including but not limited to lengthen-
    24  ing the period between base year updates and alternating base  years  by
    25  program.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15247-02-6
        S. 7668                             2
     1    e.  The department of health shall identify those elements of the plan
     2  that must be approved by the Centers for Medicare and Medicaid  Services
     3  and a plan for achieving such approval.
     4    §  2.  The  commissioner of health shall submit a report detailing the
     5  issues set forth in this act and recommendations to the temporary presi-
     6  dent of the senate, the speaker of  the  assembly,  the  chairs  of  the
     7  senate committee on mental health and developmental disabilities and the
     8  assembly  committee  on mental health no later than February 1, 2017 and
     9  regulations effectuating such recommendations  no  later  than  July  1,
    10  2017.
    11    § 3. This act shall take effect immediately.