senate Bill S4375

Amended

Directs the commissioner of health to make recommendations to the governor and legislature on increasing ambulatory patient group rates for services provided by rural critical access hospitals

download pdf

Sponsor

Co-Sponsors

Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
view actions

actions

  • 25 / Mar / 2013
    • REFERRED TO HEALTH
  • 04 / Jun / 2013
    • REPORTED AND COMMITTED TO FINANCE
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 23 / Jan / 2014
    • AMEND AND RECOMMIT TO HEALTH
  • 23 / Jan / 2014
    • PRINT NUMBER 4375A

Summary

Directs the commissioner of health to make recommendations to the governor and legislature on increasing ambulatory patient group rates, in the 2015-2016 state fiscal year, for services provided by rural critical access hospitals.

do you support this bill?

Bill Details

See Assembly Version of this Bill:
A7543
Versions:
S4375
S4375A
Legislative Cycle:
2013-2014
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Amd ยง2807, Pub Health L

Votes

14
0
14
Aye
0
Nay
3
aye with reservations
0
absent
0
excused
0
abstained
show Health committee vote details

Sponsor Memo

BILL NUMBER:S4375

TITLE OF BILL: An act to amend the public health law, in relation to
directing the commissioner of health to make recommendations relating
to increasing certain ambulatory patient group reimbursement rates

PURPOSE: Directs the commissioner of health to make recommendations
to the governor and the legislature on increasing ambulatory patient
group rates for services provided by rural critical access hospitals.

SUMMARY OF PROVISIONS: Amends Subdivision 2-a of section 2807 of the
Public Health Law by adding a new paragraph (j) directing the
commissioner of health, in conjunction with hospital industry
representatives, to make written recommendations to the Governor and
the legislature, including proposed legislation, for increasing
Ambulatory Patient group rates for rural critical access hospitals by
October 1, 2013. The recommendations must account for increased
operating expenses of inherent to these hospitals, as well as the need
to maintain access, in rural areas. The proposed language, subject to
legislative approval, would be for inclusion in the 2014-2015 state
budget, with rate increases to be effective April 1, 2014.

Section two states the enactment date.

JUSTIFICATION: Critical access hospitals (CAH) serve medically
underserved geographically isolated communities. They provide limited
stay special care, acute care and swing bed services, as well as 24
hour emergency service capability. The maintenance of CAHs is critical
for preserving access to basic health care services for rural New
Yorkers.

Currently, Medicare reimburses CAHs on the basis of reasonable costs,
while New York State Medicaid reimbursement rates are capped at lower
than operational costs.

Because these hospitals must distribute substantial fixed costs over a
small number of visits, an enhanced Medicaid reimbursement would help
to ensure their long range financial viability and preserve access to
needed health care services for isolated communities. Further, this
maintains the States shift in policy of preserving patient care while
improving population health through shifting to outpatient care. This
legislation would support these goals.

Beginning in late 2008, the Department of Health began to implement a
new outpatient payment system that focuses reimbursement based upon
the intensity of the services provided known as Ambulatory patient
groups (APGs).

This legislation would require the Commissioner of Health and the
Hospital industry to collaboratively produce recommendations and
legislative language to provide for an enhanced APG rate that
recognizes the low volume, costly nature of a rural safety net
provider. The legislative proposal will be for inclusion in the SFY
2014/2015 Budget and effective on April 1, 2014.


Because APGs are an already existing rate structure, this legislation
provides consistency with reimbursement methodologies currently used
to pay for outpatient services performed by hospitals, negates the
needs for DOH to implement a new payment methodology specific to CAHs,
and ensures CAHs will receive crucial funding to preserving their
fiscal viability.

LEGISLATIVE HISTORY: This is a new bill

FISCAL IMPLICATIONS: Undetermined

EFFECTIVE DATE: This act shall take effect immediately.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4375

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                             March 25, 2013
                               ___________

Introduced by Sen. YOUNG -- (at request of the Legislative Commission on
  Rural  Resources)  -- read twice and ordered printed, and when printed
  to be committed to the Committee on Health

AN ACT to amend the public health law,  in  relation  to  directing  the
  commissioner  of health to make recommendations relating to increasing
  certain ambulatory patient group reimbursement rates

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivision 2-a of section 2807 of the public health law is
amended by adding a new paragraph (j) to read as follows:
  (J)  THE  COMMISSIONER  SHALL,  IN  CONJUNCTION WITH HOSPITAL INDUSTRY
REPRESENTATIVES, PROVIDE WRITTEN RECOMMENDATIONS TO THE GOVERNOR AND THE
LEGISLATURE ON OR  BEFORE  OCTOBER  FIRST,  TWO  THOUSAND  THIRTEEN,  ON
INCREASING  AMBULATORY  PATIENT  GROUPS  REIMBURSEMENT RATES ESTABLISHED
PURSUANT TO THIS SUBDIVISION FOR GENERAL HOSPITAL  OUTPATIENT  SERVICES,
GENERAL  HOSPITAL  EMERGENCY  SERVICES,  DIAGNOSTIC AND TREATMENT CENTER
SERVICES AND AMBULATORY SURGICAL SERVICES, PROVIDED BY  RURAL  HOSPITALS
DESIGNATED  AS  CRITICAL ACCESS HOSPITALS IN ACCORDANCE WITH TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT. SUCH RECOMMENDATIONS SHALL TAKE INTO
CONSIDERATION THE INCREASED COSTS OF PROVIDING SUCH  SERVICES  IN  RURAL
AREAS  AS  WELL AS THE NEED TO MAINTAIN ACCESS TO SUCH SERVICES IN RURAL
AREAS. IN ADDITION, THE RECOMMENDATIONS SHALL  CONTAIN  PROPOSED  LEGIS-
LATION,  FOR  INCORPORATION  INTO  THE STATE BUDGET FOR THE TWO THOUSAND
FOURTEEN--TWO THOUSAND FIFTEEN FISCAL YEAR, TO EFFECTUATE RATE INCREASES
EFFECTIVE APRIL FIRST, TWO THOUSAND FOURTEEN.
  S 2. This act shall take effect immediately.


 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10025-01-3

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.