Sayegh, Jackson, Tapia, Septimo, Lavine, De Los Santos, Simone, Weprin, Reyes, Brabenec, Joyner,
Simon, Stern
MLTSPNSR
Amd §3614-e, Pub Health L
Provides that the submission of claims for services provided by home care agencies shall be done on forms approved by the centers for Medicare and Medicaid services.
STATE OF NEW YORK
________________________________________________________________________
5750
2023-2024 Regular Sessions
IN ASSEMBLY
March 23, 2023
___________
Introduced by M. of A. PAULIN -- read once and referred to the Committee
on Health
AN ACT to amend the public health law, in relation to the submission of
claims for services provided by home care agencies
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 3614-e of the public health law, as added by
2 section 49 of part B of chapter 57 of the laws of 2015, is amended to
3 read as follows:
4 § 3614-e. Electronic payment of claims. 1. The payment of claims
5 submitted under contracts or agreements with insurers under the medical
6 assistance program for home and community-based long-term care services
7 provided under this article, by fiscal intermediaries operating pursuant
8 to section three hundred sixty-five-f of the social services law, and by
9 residential health care facilities operating pursuant to article twen-
10 ty-eight of this chapter shall be paid via electronic funds transfer.
11 Claims for services provided by home care agencies licensed or certified
12 under this article and by fiscal intermediaries operating pursuant to
13 section three hundred sixty-five-f of the social services law shall be
14 only submitted and remitted on forms approved by the centers for Medi-
15 care and Medicaid services. Claims shall be submitted to insurers
16 directly or by a billing entity selected by the home care agency
17 licensed or certified under this article or by a fiscal intermediary
18 operating pursuant to section three hundred sixty-five-f of the social
19 services law. Insurers shall not require the utilization by contract or
20 action any specific billing entity by a home care agency licensed or
21 certified under this article or by a fiscal intermediary operating
22 pursuant to section three hundred sixty-five-f of the social services
23 law; nor impede the timely processing and payment of claims.
24 2. Nothing shall limit an insurer's ability to review or audit claims
25 for fraud, waste, and abuse.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10102-01-3
A. 5750 2
1 3. Such insurers shall include but not be limited to Medicaid managed
2 care plans and managed long-term care plans.
3 § 2. This act shall take effect on the thirtieth day after it shall
4 have become a law.
