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A10629 Summary:

BILL NOA10629
 
SAME ASNo Same As
 
SPONSORRules (Rajkumar)
 
COSPNSR
 
MLTSPNSR
 
Amd §§367-a & 364-j, Soc Serv L
 
Requires capitated payments under the medical assistance program.
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A10629 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A10629
 
SPONSOR: Rules (Rajkumar)
  TITLE OF BILL: An act to amend the social services law, in relation to capitated payments under medical assistance for needy persons   PURPOSE OR GENERAL IDEA OF BILL: To move state healthcare spending toward a system of capitation payments.   SUMMARY OF PROVISIONS: Section 1. Section 367-a of the social services law is amended by adding a new subdivision 13 allowing the health commissioner to set different rates for patients for the purposes of capitation payments 2. Section 364-j of the social services law is amended by adding a new subdivision 3-a elaborating on terms available for capitation payments § 3. Provides that the commissioner of health shall draft legislation necessary Sec 4 is the effective date   DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE): Click here to enter text.   JUSTIFICATION: The current healthcare spending model of fee for service creates a perverse incentive for providers to perform unnecessary medical proce- dures without any incentive to reduce costs or improve outcomes. Under the capitation payment model, providers receive a flat fee for each patient, generally including incentives for improved outcomes and reduc- ing costs. SEIU 775NW stated this system "offers the best possibility for improving health outcomes and reducing Medicare costs." Switching to capitation payments will help control healthcare costs and produce better health outcomes.   PRIOR LEGISLATIVE HISTORY: New bill.   FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: To be determined.   EFFECTIVE DATE: This act shall take effect immediately, provided that sections one and two of this act shall take effect five years after such effective date; and provided, further, that the amendments to section 364-j of the social services law, made by section two of this act, shall not affect the repeal of such section, and shall be deemed repealed therewith. Effective immediately, the commissioner of health shall make regulations and take other actions, including applying for federal waivers and submitting state Medicaid plan amendments, reasonably necessary to implement the provisions of this act.
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A10629 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          10629
 
                   IN ASSEMBLY
 
                                      June 20, 2024
                                       ___________
 
        Introduced by COMMITTEE ON RULES -- (at request of M. of A. Rajkumar) --
          read once and referred to the Committee on Health
 
        AN  ACT  to  amend  the  social  services  law, in relation to capitated
          payments under medical assistance for needy persons
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Section  367-a  of  the social services law is amended by
     2  adding a new subdivision 13 to read as follows:
     3    13. (a) Any inconsistent  provision  of  this  chapter  or  other  law
     4  notwithstanding,  on  and  after the effective date of this subdivision,
     5  all payments with respect  to  medical  assistance  shall  be  capitated
     6  payments.
     7    (b) The commissioner may develop and assign patients rating categories
     8  based on risk for the purposes of developing reimbursement methodologies
     9  and payments under this subdivision.
    10    §  2.  Section 364-j of the social services law is amended by adding a
    11  new subdivision 3-a to read as follows:
    12    3-a. Special contract provisions. Any capitation  payment  system  for
    13  medical  assistance under this article may include contract arrangements
    14  that further adjust the payment amounts, including but  not  limited  to
    15  incentive arrangements, pass-through payments, risk corridor mechanisms,
    16  or withhold arrangements as defined by 42 CFR 438.6.
    17    § 3.  No later than one year after the effective date of this act, the
    18  commissioner  of health shall provide drafts of legislation necessary to
    19  convert all payments under the  medical  assistance  for  needy  persons
    20  program  from  fee-for-service  payments  to  capitated payments, to the
    21  governor, the temporary president of the senate and the speaker  of  the
    22  assembly.
    23    §  4.  This  act shall take effect immediately, provided that sections
    24  one and two of this act shall take effect five years after  such  effec-
    25  tive  date;  and provided, further, that the amendments to section 364-j
    26  of the social services law, made by section two of this act,  shall  not
    27  affect  the  repeal of such section, and shall be deemed repealed there-
    28  with. Effective immediately, the commissioner of health shall make regu-
    29  lations and take other actions, including applying for  federal  waivers
    30  and  submitting  state Medicaid plan amendments, reasonably necessary to
    31  implement the provisions of this act.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15520-03-4
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