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A08781 Summary:

BILL NOA08781
 
SAME ASNo Same As
 
SPONSORSteck
 
COSPNSRBrown K
 
MLTSPNSR
 
Add §41-b, Exec L
 
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.
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A08781 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          8781
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                      June 2, 2025
                                       ___________
 
        Introduced  by M. of A. STECK, K. BROWN -- read once and referred to the
          Committee 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. 8781                             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.
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