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A07848 Summary:

BILL NOA07848
 
SAME ASNo Same As
 
SPONSORCunningham
 
COSPNSR
 
MLTSPNSR
 
Amd §364-j, Soc Serv L
 
Includes accountable care organizations within the definition of a managed care provider.
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A07848 Actions:

BILL NOA07848
 
07/07/2023referred to health
01/03/2024referred to health
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A07848 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A7848
 
SPONSOR: Cunningham
  TITLE OF BILL: An act to amend the social services law, in relation to including accountable care organizations within the definition of a managed care provider   PURPOSE OR GENERAL IDEA OF BILL: To allow provider-governed accountable care organizations (ACOs) to function as Medicaid managed care providers   SUMMARY OF PROVISIONS: Sections 1 and 2 amend the definition of "managed care provider" to include accountable care organizations. Currently, only health mainte- nance organizations (HMOd) and certain partially-capitated programs may be Medicaid managed care providers. Section 2 states that this act will take effect 180 days after it becomes law.   DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE): N/A   JUSTIFICATION: In 2011 the Legislature provided authority for health care providers to form accountable care organizations (ACOs). Democratic provider gover- nance of an ACO and additional patient protections are required. ACOs perform the functions of assembling provider networks, care coordi- nation, and payment distribution without the administrative costs that HMOs impose on the Medicaid program as well as the complications and administrative costs that they impose on providers and patients. This bill will enable New York to join other states, such as Connecticut, that have well-run Medicaid programs using ACO provider networks as an alternative option to traditional managed care plans.   PRIOR LEGISLATIVE HISTORY: 2021-22: A114 - Referred to Health 2019-20: A10184 - Referred to Health   FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None.   EFFECTIVE DATE: This act will take effect 180 days after it shall have become a law.
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A07848 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          7848
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                      July 7, 2023
                                       ___________
 
        Introduced  by  M.  of  A.  CUNNINGHAM  -- read once and referred to the
          Committee on Health
 
        AN ACT to amend the  social  services  law,  in  relation  to  including
          accountable care organizations within the definition of a managed care
          provider
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Subparagraph (iii) of paragraph (b)  of  subdivision  1  of
     2  section 364-j of the social services law, as added by section 77 of part
     3  A  of  chapter 56 of the laws of 2013, is amended and a new subparagraph
     4  (iv) is added to read as follows:
     5    (iii) is  authorized  to  operate  under  section  forty-four  hundred
     6  three-g of the public health law[.]; or
     7    (iv)  is  an accountable care organization under article twenty-nine-E
     8  of the public health law.
     9    § 2. Subparagraph (ii) of paragraph (b) of subdivision  1  of  section
    10  364-j  of the social services law, as amended by chapter 433 of the laws
    11  of 1997, is amended and a new subparagraph (iii) is  added  to  read  as
    12  follows:
    13    (ii)  is  authorized  as  a  partially  capitated  program pursuant to
    14  section three hundred sixty-four-f of this title or  section  forty-four
    15  hundred  three-e of the public health law or section 1915b of the social
    16  security act[.]; or
    17    (iii) is an accountable care organization under article  twenty-nine-E
    18  of the public health law.
    19    § 3. This act shall take effect one hundred eighty days after it shall
    20  have  become  a law; provided, that the amendments to subparagraph (iii)
    21  of paragraph (b) of section 364-j of the social  services  law  made  by
    22  section one of this act shall be subject to the expiration and repeal of
    23  such  subparagraph  when upon such date the provisions of section two of
    24  this act shall take effect; and provided further that the amendments  to
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11350-01-3

        A. 7848                             2
 
     1  section  364-j  of  the  social  services  law made by this act shall be
     2  subject to the expiration and repeal of such section  and  shall  expire
     3  and be deemed repealed therewith. Effective immediately, the commission-
     4  er  of  health  shall make regulations and take other actions reasonably
     5  necessary to implement this act on that date.
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