STATE OF NEW YORK
________________________________________________________________________
6602
2017-2018 Regular Sessions
IN SENATE
June 6, 2017
___________
Introduced by Sen. HANNON -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
AN ACT to amend the public health law, in relation to partially rein-
stating a Medicaid reserved bed benefit for temporarily hospitalized
nursing home residents
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 25 of section 2808 of the public health law, as
2 amended by section 2 of part E of chapter 57 of the laws of 2017, is
3 amended to read as follows:
4 25. Reserved bed days. (a) For purposes of this subdivision, a
5 "reserved bed day" is a day for which a governmental agency pays or
6 otherwise requires a residential health care facility to reserve a bed
7 for a person eligible for medical assistance pursuant to title eleven of
8 article five of the social services law while he or she is temporarily
9 hospitalized or on therapeutic leave of absence from the facility.
10 (b) Notwithstanding any other provisions of this section or any other
11 law or regulation to the contrary, for reserved bed days provided on
12 behalf of persons twenty-one years of age or older:
13 (i) payments for reserved bed days shall be made at ninety-five
14 percent of the Medicaid rate otherwise payable to the facility for
15 services provided on behalf of such person; [and]
16 (ii) notwithstanding subparagraph (i) of this paragraph, for periods
17 on and after July first, two thousand seventeen, payments for reserved
18 bed days for temporary hospitalizations shall be made at fifty percent
19 of the Medicaid rate otherwise payable to the facility for services
20 provided on behalf of such person, and payments for reserved bed days
21 for therapeutic leaves of absence shall be made at ninety-five percent
22 of the Medicaid rate otherwise payable to the facility for services
23 provided on behalf of such person;
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13089-01-7
S. 6602 2
1 (iii) for periods on and after July first, two thousand seventeen,
2 payment to a facility for reserved bed days provided on behalf of such
3 person for temporary hospitalizations may not exceed seven days in any
4 twelve month period; provided however that such payments on behalf of
5 persons receiving services in discrete units for long-term ventilator
6 dependent residents may not exceed fourteen days in any twelve month
7 period; and further provided that such facility shall reserve the same
8 bed and room the person occupied before being hospitalized for up to
9 fourteen days in any twelve month period, notwithstanding the seven day
10 limitation of payment established by this subparagraph; and
11 (iv) payment to a facility for reserved bed days provided on behalf of
12 such person for therapeutic leaves of absence may not exceed ten days in
13 any twelve month period.
14 (c) Subject to the provisions of this subdivision and to the avail-
15 ability of federal financial participation, the commissioner shall
16 promulgate regulations, and may promulgate emergency regulations, effec-
17 tive for periods on and after July first, two thousand seventeen, estab-
18 lishing payments for reserved bed days and applicable requirements
19 permitting residents to return to a facility after they are hospitalized
20 or placed on therapeutic leave of absence. Such regulations shall
21 provide as follows:
22 (i) the limitations on payment established by this subdivision shall
23 not apply to reserved bed days provided on behalf of persons less than
24 twenty-one years of age, or to reserved bed days payments to hospices
25 for persons residing in residential health care facilities who are in
26 receipt of hospice services;
27 (ii) in order to qualify for coverage of reserved bed days, the person
28 must have resided in the residential health care facility for at least
29 thirty days since the date of his or her initial admission; and the part
30 of the facility to which the person will return must have a vacancy rate
31 of no more than five percent on the first day the person is hospitalized
32 or on a therapeutic leave of absence;
33 (iii) unless medically contraindicated, the residential health care
34 facility shall reserve the same bed and room the person occupied before
35 being hospitalized or placed on therapeutic leave of absence;
36 (iv) a residential health care facility shall not reserve a person's
37 bed when:
38 (A) it is clear when the person is hospitalized that he or she will
39 not return to the facility within fourteen days or fewer;
40 (B) after hospitalization, the person will need a level of care the
41 facility does not provide; or
42 (C) the recipient does not want to return to the facility; and
43 (v) a residential health care facility shall establish and follow a
44 written policy under which a person whose hospitalization or therapeutic
45 leave exceeds the bed hold period established under this subdivision, or
46 who has resided in the nursing home for thirty days or more and who has
47 been hospitalized or who has been placed on therapeutic leave without
48 being given a bed hold, is readmitted to the facility immediately upon
49 the first availability of a bed in a semi-private room if the resident
50 wants to return to the facility; requires the services provided by the
51 facility; and is eligible for Medicaid covered residential health care
52 facility services.
53 § 2. This act shall take effect immediately and shall be deemed to
54 have been in full force and effect on and after April 1, 2017.