Directs the state comptroller to conduct an audit of the department of health and other agencies to ensure that the agency meets its responsibilities to review and assess Medicaid managed care organizations for compliance with federal and state requirements to maintain adequate health care providers within network, and to meet mental health and substance use disorder parity requirements.
STATE OF NEW YORK
________________________________________________________________________
5825
2025-2026 Regular Sessions
IN ASSEMBLY
February 20, 2025
___________
Introduced by M. of A. K. BROWN -- read once and referred to the Commit-
tee on Governmental Operations
AN ACT to amend the executive law, in relation to directing the state
comptroller to conduct an audit of the department of health and other
agencies to ensure that the agency meets its responsibilities to
review and assess Medicaid managed care organizations for compliance
with federal and state requirements to maintain adequate health care
providers within network, and to meet mental health and substance use
disorder parity requirements
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The executive law is amended by adding a new section 41-b
2 to read as follows:
3 § 41-b. Audits of agencies by the comptroller. 1. At least once every
4 three years, the state comptroller shall conduct an audit of the depart-
5 ment of health, and any other department, bureau, board, commission,
6 authority or any other agency or instrumentality of the state deemed
7 necessary by the state comptroller, for the purpose of ensuring the
8 state meets its responsibility to review and assess managed care organ-
9 izations, including health management organizations, prepaid health
10 services plans, and HIV special need plans that provide health insurance
11 coverage through the New York state Medicaid program, for compliance
12 with federal and state mental health and substance use disorder parity
13 requirements.
14 2. (a) Upon completion of such audit, the state comptroller shall
15 publish a report that details the results of such audit including, but
16 not limited to, a determination of the state's effectiveness in measur-
17 ing and evaluating Medicaid managed care organizations for compliance
18 with statutory and regulatory requirements pursuant to article forty-
19 four of the public health law. Such requirements to be considered and
20 evaluated shall include annual reports of complaints of fraud and abuse,
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09647-01-5
A. 5825 2
1 as well as a plan to remedy such deficiencies submitted by Medicaid
2 managed care organizations, managed care organization compliance in
3 maintaining a network of health care providers adequate to meet the
4 needs of plan enrollees, and adherence to federal and state mental
5 health and substance use disorder parity requirements by managed care
6 organizations. The state comptroller shall also determine if each Medi-
7 caid managed care organization is compliant with federal and state
8 requirements and provide thorough explanations detailing the reason, or
9 reasons for each Medicaid managed care organization compliance determi-
10 nation.
11 (b) The state comptroller shall provide such report to the governor,
12 the attorney general, the temporary president of the senate, the speaker
13 of the assembly, the minority leader of the senate, the minority leader
14 of the assembly, the chair and the ranking member of the senate commit-
15 tee on alcoholism and substance use disorders, the chair and the ranking
16 member of the assembly committee on alcoholism and drug abuse, the
17 chairs and the ranking members of the senate and the assembly committees
18 on health, and the chairs and the ranking members of the senate and the
19 assembly committees on mental health no later than the first day of July
20 of the year immediately succeeding the effective date of this section.
21 Subsequent reports detailing results and determinations of the comp-
22 troller shall be completed and published at least once every three years
23 following publication of the first such report on or before the first
24 day of July.
25 § 2. This act shall take effect immediately.
