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A10784 Summary:

BILL NOA10784
 
SAME ASSAME AS S04178
 
SPONSORMcMahon
 
COSPNSR
 
MLTSPNSR
 
Amd §7.07, Ment Hyg L
 
Establishes a workgroup to conduct analysis on the ambulatory patient group rates and commercial insurance rates for behavioral health services.
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A10784 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          10784
 
                   IN ASSEMBLY
 
                                      April 1, 2026
                                       ___________
 
        Introduced  by M. of A. McMAHON -- read once and referred to the Commit-
          tee on Mental Health
 
        AN ACT to amend the mental hygiene law, in relation  to  establishing  a
          workgroup  to  conduct  analysis on the ambulatory patient group rates
          and commercial insurance rates 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. Section 7.07 of the mental hygiene law is amended by adding
     2  a new subdivision (i) to read as follows:
     3    (i)  1.  The  commissioner  of the office of mental health, in collab-
     4  oration with the commissioner  of  the  department  of  health  and  the
     5  commissioner  of  the  office  of  addiction  services  and supports are
     6  directed to convene and jointly chair,  either  directly  or  through  a
     7  designee  or designees, a workgroup, which shall include membership that
     8  ensures adequate statewide geographic representation selected with equal
     9  contributions on such selection from the governor, the  speaker  of  the
    10  assembly  and  temporary president of the senate and be comprised of the
    11  following members: (i) professional associations representing  substance
    12  use,  mental  health, and/or behavioral health providers; (ii) represen-
    13  tatives from professional associations representing  providers  of  peer
    14  and  recovery-based  programs  and  services; (iii) representatives from
    15  professional  associations  representing  medicated  assisted  treatment
    16  providers;  (iv)  representatives from professional associations repres-
    17  enting children's behavioral health providers; (v) representatives  from
    18  hospital associations; (vi) representatives from associations represent-
    19  ing  behavioral health consumers and family members; and (vii) any addi-
    20  tional stakeholder or expert  that  the  commissioners  deem  necessary.
    21  Members  of  the  workgroup shall serve without compensation, but may be
    22  reimbursed for actual costs incurred for  participation  on  such  work-
    23  group.
    24    2.  The  workgroup shall conduct an analysis on the ambulatory patient
    25  group  rates  and  commercial  insurance  rates  for  behavioral  health
    26  services  for  the  purpose  of  developing  a report that shall provide
    27  recommendations on the following:  (i)  rate  adequacy  related  to  the
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07782-01-5

        A. 10784                            2

     1  existing  ambulatory  patient  group-based  reimbursement provided under
     2  medicaid managed care, as well as for commercial  insurance  rates  with
     3  regards  to  services  rendered under child health plus, or for services
     4  provided by clinics licensed or certified pursuant to article thirty-one
     5  or  thirty-two  of  this  chapter  or dually licensed or certified under
     6  article thirty-one or thirty-two of this  chapter  and  article  twenty-
     7  eight of the public health law; (ii) the actual costs of care associated
     8  with  the  delivery  of  behavioral  health  services; (iii) one or more
     9  alternative reimbursement models that would adequately compensate  clin-
    10  ics  licensed  or holding an operating certificate under article thirty-
    11  one or thirty-two of this chapter or dually licensed under article thir-
    12  ty-one or thirty-two of this chapter and  article  twenty-eight  of  the
    13  public  health  law  for their costs of care under medicaid managed care
    14  and child health plus; and (iv) any policy or fiscal resources necessary
    15  to carry out the recommendations of the  report  developed  pursuant  to
    16  this section. The report shall be submitted to the governor, the speaker
    17  of  the assembly and the temporary president of the senate no later than
    18  October first, two thousand twenty-seven.
    19    § 2. This act shall take effect on the ninetieth day  after  it  shall
    20  have become a law.
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