New York State Assembly

 
•  Summary 
 
•  Actions 
 
•  Committee Votes 
 
•  Floor Votes 
 
•  Memo 
 
•  Text 
 
•  LFIN 
 
•  Chamber Video/Transcript 

S03131 Summary:

S03131 Actions:

S03131 Committee Votes:

S03131 Floor Votes:

S03131 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          3131
 
                               2023-2024 Regular Sessions
 
                    IN SENATE
 
                                    January 27, 2023
                                       ___________
 
        Introduced  by Sens. MANNION, KENNEDY, SKOUFIS -- read twice and ordered
          printed, and when printed to be committed to the Committee on Health
 
        AN ACT directing the commissioner of health to conduct a  study  on  the
          rates  of reimbursement made through the New York state Medicaid dura-
          ble medical equipment, orthotics, prosthetics and supplies program for
          rate adequacy and patient access; and providing for the repeal of such
          provisions upon expiration thereof
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. The commissioner of health shall conduct a study to review
     2  the rates of reimbursement made through  the  New  York  state  Medicaid
     3  durable  medical  equipment, orthotics, prosthetics and supplies program
     4  for rate adequacy and patient access, including  those  made  under  all
     5  capitated and contract coverage models. Such review shall include:
     6    (a)  an  analysis of rules, regulations and policies for orthotics and
     7  prosthetics  service/device  provisions  under  the  New  York  Medicaid
     8  program, including all contracted and capitated models;
     9    (b)  a  comprehensive  assessment  of the existing methodology used to
    10  determine payment or nonpayment for prosthetic and orthotic care includ-
    11  ing but not limited to:
    12    (i) all orthotic and prosthetic codes  on  the  current  Medicaid  fee
    13  schedule,  including but not limited to a comparison of prevailing Medi-
    14  care fee schedule amounts and New York Medicaid amounts;
    15    (ii) codes on the Medicare fee schedule but not included  on  the  New
    16  York  state  Medicaid  durable medical equipment, orthotics, prosthetics
    17  and supplies program fee schedule;
    18    (iii)  recommendations  for  changing   reimbursement   methodologies.
    19  Recommendations under this subparagraph shall be consistent with federal
    20  law  and  shall include recommendations for appropriate changes in state
    21  law and regulations. Such  recommendations  shall  consider  appropriate
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04992-01-3
        S. 3131                             2
 
     1  payment  methodologies for codes not included on the Medicaid fee sched-
     2  ule;
     3    (c)  assessment  of  barriers  to  timely service provision as well as
     4  racial and socioeconomic disparities in access including, but not limit-
     5  ed to, travel time required, geographic variability, access to and  cost
     6  of technology;
     7    (d)  the  workforce needed to provide orthotic and prosthetic services
     8  in the next five years to eligible children and adults, disaggregated by
     9  county;
    10    (e) opportunities for stakeholder input on current rate methodologies;
    11  and
    12    (f) assessment of cost savings associated with percentage of  Medicaid
    13  population returning to work after orthotic and/or prosthetic provision.
    14    § 2. Within one year after the effective date of this act, the commis-
    15  sioner  of  health shall submit a report of the findings and recommenda-
    16  tions pursuant to this act to the governor, the temporary  president  of
    17  the senate, the minority leader of the senate, the speaker of the assem-
    18  bly,  the  minority  leader  of the assembly, and the chairs and ranking
    19  members of the senate and assembly committees on health and  shall  post
    20  such report on the department of health's website.
    21    §  3.  The  commissioner  of  health shall be authorized to promulgate
    22  rules and regulations to provide for the  orderly  effectuation  of  the
    23  provisions of this act.
    24    §  4.  This  act shall take effect immediately and shall expire and be
    25  deemed repealed upon the submission of the report required  pursuant  to
    26  section two of this act.