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A08011 Summary:

BILL NOA08011A
 
SAME ASSAME AS S06219-B
 
SPONSORGottfried
 
COSPNSRSepulveda
 
MLTSPNSR
 
Amd 364-j, Soc Serv L; amd 4403-f, Pub Health L
 
Provides that increased rates of payment for behavioral health services shall be deemed to be effective on the date of the law, rule or regulation under which the change or increase is required.
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A08011 Actions:

BILL NOA08011A
 
05/25/2017referred to health
06/06/2017reported referred to ways and means
06/14/2017amend and recommit to ways and means
06/14/2017print number 8011a
06/19/2017reported referred to rules
06/19/2017reported
06/19/2017rules report cal.517
06/19/2017ordered to third reading rules cal.517
06/20/2017passed assembly
06/20/2017delivered to senate
06/20/2017REFERRED TO RULES
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A08011 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A8011A
 
SPONSOR: Gottfried
  TITLE OF BILL: An act to amend the social services law and the public health law, in relation to payments for behavioral health services   PURPOSE OR GENERAL IDEA OF BILL:, To require Medicaid managed care plans, managed long term care plans, and plans under Child Health Plus to implement required changes in rates, coverage or payments for behavioral health providers on the same date as the change takes effect for Medicaid non-managed care, or to make updated payments retroactively to that date.   SUMMARY OF PROVISIONS:; Section 1 amends section 364-j of the social services law by adding a new paragraph (e) to subdivision 18, providing that Medicaid managed care plans shall adjust payments to behavioral health providers required by law, regulations or guidelines, on the same date as changes in rates, coverage or other areas take effect for non-managed care. If such plans require additional time to make technical or other system updates, they shall make retroactive payments to the providers. Sections 2 amends subdivision 7 of section 4403-f of the public health law to make the same change for Child Health Plus and managed long-term care plans. Section 3 makes the bill effective immediately.   JUSTIFICATION: Medicaid managed care plans, managed long term care plans, and Child Health Plus organizations pay behavioral health providers using ambula- tory patient group (APG) rates, which are occasionally adjusted by the state due to statutory or budgetary changes, re-basing, workforce increases, and market forces. When rates are adjusted upward, the state increases payments to managed care plans and Child Health Plus organiza- tions accordingly, and the plans are supposed to pass the payment increase through to providers. Under current law, however, plans can delay making the necessary system updates to reflect new provider payment rates and are not required to make retroactive payment adjustments, despite receiving increased payments from the state for that purpose. This bill will ensure that state payments intended to reimburse behav- ioral health providers will be distributed appropriately, and will improve the viability of community health care providers that New York- ers rely on.   PRIOR LEGISLATIVE HISTORY: New bill   FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None   EFFECTIVE DATE: Immediate
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A08011 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         8011--A
 
                               2017-2018 Regular Sessions
 
                   IN ASSEMBLY
 
                                      May 25, 2017
                                       ___________
 
        Introduced by M. of A. GOTTFRIED, SEPULVEDA -- 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
 
        AN  ACT  to  amend the social services law and the public health law, in
          relation to payments for behavioral health services
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. Subdivision 18 of section 364-j of the social services law
     2  is amended by adding a new paragraph (e) to read as follows:
     3    (e) Increased rates, terms or scope of payment for  behavioral  health
     4  services  under  this  title,  where  payment  is made by a managed care
     5  provider under this section, as a result of a rate,  coverage  or  other
     6  change  made  pursuant  to a law, regulation, rule or official guidance,
     7  shall be deemed in effect on the same date that such change  would  have
     8  taken effect if payment were made other than by the managed care provid-
     9  er. Where payment is not made as of the effective date, the managed care
    10  provider  shall  make  retroactive  payments  to the appropriate service
    11  providers.
    12    § 2. Subdivision 7 of section 4403-f  of  the  public  health  law  is
    13  amended by adding a new paragraph (i) to read as follows:
    14    (i)  Increased  rates, terms or scope of payment for behavioral health
    15  services under this section, where payment is made by  an  entity  under
    16  this  section,  as  a  result  of  a rate, coverage or other change made
    17  pursuant to a law, regulation,  rule  or  official  guidance,  shall  be
    18  deemed  in  effect  on  the  same date that such change would have taken
    19  effect if payment were made other than by the entity. Where  payment  is
    20  not  made  as  of  the effective date, the entity shall make retroactive
    21  payments to the appropriate service providers.
    22    § 3. This act shall take effect immediately; provided,  however,  that
    23  the  amendments  to section 364-j of the social services law and section
    24  4403-f of the public health law made by sections one  and  two  of  this
    25  act,  respectively,  shall  not  affect  the repeal of such sections and
    26  shall be deemed repealed therewith.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11787-04-7
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