Relates to payments for home and community based long term care services; provides that funds appropriated to compensate for minimum wage requirements, shall not be subject to managed care risk adjustment on insurers.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A2788A
SPONSOR: Gottfried TITLE OF BILL:
An act to amend the public health law, in relation to payments for home
and community based long term care services
PURPOSE OR GENERAL IDEA OF BILL:
Use contractual mechanisms to assure that Medicaid managed care plans
pass through in whole the money provided by the state to finance the
incremental advancements in minimum wage.
SUMMARY OF SPECIFIC PROVISIONS:
The bill would add a new section 3614-f to the Public Health Law to
require Medicaid managed care plans to amend contracts with home care
providers(including consumer-directed personal assistance) 90 days prior
to the effective date of minimum wage mandates, and prohibit the use of
such funds to offset other debts owed to providers.
JUSTIFICATION:
The 2018-19 enacted budget included $703 million to support the direct-
care cost of minimum wage increases for Medicaid funded home care
services. The state adds the minimum wage payments onto the capitated
rates paid to managed care plans that are expected to pass the payment
on to the home care providers with whom they contract.
The direct care workers are employed by home care providers under
contract with the managed care plans, and so the statutory wage obli-
gation rests with the home care providers - irrespective of a plan's
diligence in distributing the funds as instructed by the Department of
Health. Providers complain of being abused by plans who claim their
payments are sufficient at current levels and should not have to
increase.
Ensuring that all the funds appropriated by the State to support the
direct care cost of minimum wage are distributed in a timely manner and
in their entirety allows-home care workers to receive their deserved
increase in wages, while also protecting the viability of the home care
industry.
PRIOR LEGISLATIVE HISTORY:
2017-2018: A.11200 -.referred to Health committee
FISCAL IMPLICATIONS:
None to the state.
EFFECTIVE DATE:
Immediately.
STATE OF NEW YORK
________________________________________________________________________
2788--A
2019-2020 Regular Sessions
IN ASSEMBLY
January 25, 2019
___________
Introduced by M. of A. GOTTFRIED, JAFFEE -- read once and referred to
the Committee on Health -- recommitted to the Committee on Health in
accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee
AN ACT to amend the public health law, in relation to payments for home
and community based 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. The public health law is amended by adding a new section
2 3614-f to read as follows:
3 § 3614-f. Payments for home and community based long term care
4 services. Contracts or agreements with insurers under the medical
5 assistance program for home and community based long term care services
6 provided under this article or by fiscal intermediaries operating pursu-
7 ant to section three hundred sixty-five-f of the social services law
8 shall provide terms and conditions for the pass-through of funds appro-
9 priated to compensate for minimum wage pursuant to section six hundred
10 fifty-two of the labor law. If necessary in order to comply with this
11 section, existing contracts with home and community based long term care
12 services providers under this article and to fiscal intermediaries oper-
13 ating pursuant to section three hundred sixty-five-f of the social
14 services law shall be amended at least ninety days prior to the effec-
15 tive date of any such law or regulation impacting wages. Insurers shall
16 not use such funds to supplant payments for existing services under the
17 Medicaid program. Such insurers shall include but not be limited to
18 Medicaid managed care plans and Medicaid managed long term care plans.
19 § 2. This act shall take effect immediately and shall apply to poli-
20 cies and contracts issued, renewed, modified, altered or amended on or
21 after such date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03873-02-0
