STATE OF NEW YORK
________________________________________________________________________
3609
2025-2026 Regular Sessions
IN ASSEMBLY
January 29, 2025
___________
Introduced by M. of A. JONES -- read once and referred to the Committee
on Health
AN ACT to amend the social services law, in relation to Medicaid
reimbursement rates for rural home health care providers
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 1 of section 368-a of the social services law
2 is amended by adding a new paragraph (g-1) to read as follows:
3 (g-1) Notwithstanding paragraph (g) of this subdivision, section three
4 hundred sixty-four-j of this title or any other provision of law,
5 reimbursement for home health services provided in accordance with para-
6 graph (d) of subdivision two of section three hundred sixty-five-a of
7 this title by an individual or shared aide provided by an approved home
8 health agency when such services are determined to be cost effective and
9 appropriate to meet the recipient's needs for assistance, where such
10 services are delivered in a rural area of the state, to be designated by
11 the commissioner in regulation, shall be increased to include an amount
12 necessary to cover the disparate transportation costs associated with
13 providing such services in rural areas. The commissioner shall develop
14 methodologies for calculating such delivery costs which are separate
15 from direct personal care. Such reimbursement increase shall include all
16 home health services provided for eligible recipients under this arti-
17 cle, including those available or obtained through federal waivers.
18 § 2. Subdivision 1 of section 365-l of the social services law, as
19 added by section 37 of part H of chapter 59 of the laws of 2011, is
20 amended to read as follows:
21 1. Notwithstanding any law, rule or regulation to the contrary, the
22 commissioner of health is authorized, in consultation with the commis-
23 sioners of the office of mental health, office of [alcoholism and
24 substance abuse services] addiction services and supports, and office
25 for people with developmental disabilities, to (a) establish, in accord-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05558-01-5
A. 3609 2
1 ance with applicable federal law and regulations, standards for the
2 provision of health home services to Medicaid enrollees with chronic
3 conditions, (b) establish payment methodologies for health home services
4 based on factors including but not limited to the complexity of the
5 conditions providers will be managing, the anticipated amount of patient
6 contact needed to manage such conditions, transportation costs, and the
7 health care cost savings realized by provision of health home services,
8 (c) establish the criteria under which a Medicaid enrollee will be
9 designated as being an eligible individual with chronic conditions for
10 purposes of this program, (d) assign any Medicaid enrollee designated as
11 an eligible individual with chronic conditions to a provider of health
12 home services.
13 § 3. This act shall take effect immediately.
