Requires the commissioner of healh to annually make the system of episodic payments, including all pricing mechanisms, available to all Medicaid managed care plans, all child health insurance plans and all essential plans, and to notify all such managed care plans of their responsibilities for ensuring that their enrolled members have access to certified home health agency services.
STATE OF NEW YORK
________________________________________________________________________
7013--C
2025-2026 Regular Sessions
IN ASSEMBLY
March 18, 2025
___________
Introduced by M. of A. PAULIN, WEPRIN, REYES, LUNSFORD, TAPIA,
SEAWRIGHT, GONZALEZ-ROJAS, McDONALD, KELLES, GRIFFIN -- read once and
referred to the Committee on Health -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee -- again reported from said committee with amendments, ordered
reprinted as amended and recommitted to said committee -- 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 committee
AN ACT to amend the public health law, in relation to rates of payment
for certified home health agencies
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 13 of section 3614 of the public health law is
2 amended by adding a new paragraph (d) to read as follows:
3 (d) Notwithstanding any inconsistent law or regulation the commission-
4 er shall annually make the system of episodic payments, including all
5 pricing mechanisms, available to all Medicaid managed care plans
6 licensed to operate in New York state, all child health insurance plans
7 licensed to operate under section twenty-five hundred eleven of this
8 chapter, and all essential plans authorized by section three hundred
9 sixty-nine-gg of the social services law. The commissioner shall annu-
10 ally notify all such managed care plans of their responsibilities for
11 ensuring that their enrolled members have access to certified home
12 health agency services; that such services are critical to improving
13 patient care and reducing overall costs, particularly costs related to
14 avoidable hospital use; and that episodic payments as described in para-
15 graph (a) of this subdivision are considered the standard method of
16 certified home health agency payment by New York state government agen-
17 cies. Nothing in this paragraph shall preclude a managed care plan and
18 certified home health agency from agreeing upon an alternative rate
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10053-06-6
A. 7013--C 2
1 methodology and payment rate, including value-based payments related to
2 health outcome measurements.
3 § 2. This act shall take effect on the first of January next succeed-
4 ing the date on which it shall have become a law.
