Directs the department of health to establish an alternative payment methodology (APM) for federally qualified health centers to preserve and improve patient access to fertility care.
STATE OF NEW YORK
________________________________________________________________________
8257
2025-2026 Regular Sessions
IN SENATE
May 27, 2025
___________
Introduced by Sen. SUTTON -- read twice and ordered printed, and when
printed to be committed to the Committee on Health
AN ACT directing the department of health to establish an alternative
payment methodology (APM) for federally qualified health centers to
preserve and improve patient access to fertility care
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Under the authority of state plan amendment #17-0058, as
2 amended by state plan amendment #23-0050, the department of health shall
3 establish an alternative payment methodology (APM) for federally quali-
4 fied health centers to preserve and improve patient access to fertility
5 care. Such payments shall be in addition to any prospective payment
6 system (PPS) or any other alternative payment methodology for eligible
7 federally qualified health centers. The APM shall be determined by the
8 department and shall equal the difference between what the eligible
9 provider would have been paid for certain classes of fertility drugs
10 under section 340B of the federal public health services act between
11 January 1, 2024 and December 31, 2024 and the amount that the eligible
12 provider would have been reimbursed for such drugs by a managed care
13 organization, if covered by such managed care organization. For purposes
14 of this section, eligible fertility drugs shall be limited to gondotro-
15 pion, GNRH antagonists, and GNRH agonists.
16 § 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09276-02-5
