Assembly Bill A10547

2009-2010 Legislative Session

Relates to medicaid payments to free-standing clinics licensed pursuant to article thirty-one of the mental hygiene law

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Archive: Last Bill Status - In Assembly Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 03, 2010	held for consideration in health
May 25, 2010	print number 10547a
May 25, 2010	amend and recommit to health
Apr 02, 2010	referred to health

Bill Amendments

Original

A (Active)

co-Sponsors

2009-A10547 - Details

Current Committee:: Assembly Health
Law Section:: Public Health Law
Laws Affected:: Amd §2807, Pub Health L

2009-A10547 - Summary

Relates to medicaid payments to free-standing clinics licensed pursuant to article thirty-one of the mental hygiene law.

2009-A10547 - Sponsor Memo

                                BILL NUMBER:A10547

TITLE OF BILL:
An act
to amend the public health law, in relation to Medicaid payments to
free-standing clinics licensed pursuant to article thirty-one of the
mental hygiene law

PURPOSE OR GENERAL IDEA OF BILL:
To ensure that people with serious and persistent mental illness
(SPMI) have access to outpatient mental health services.

SUMMARY OF SPECIFIC PROVISIONS:
Section one amends Public Health Law (PHL) Section 2807 (2-a) (e) (ii)
to provide that payments to outpatient mental health clinics must be
based on the methodologies used by the New York State Department of
Health for the development of Ambulatory Patient Group (APG)
reimbursement, including but not limited to, the diagnosis of the
patient and intensity of the services provided.

JUSTIFICATION:
In 1991, the Office of Mental Health (OMH) implemented a new Medicaid
supplement to the rates for outpatient mental health clinics called
Comprehensive Outpatient Programs (COPs). This Medicaid supplement
permitted the State to access federal matching dollars thereby
reducing the State's funding for the clinics.

The COPs clinics serve a significant number of people with severe and
multiple diagnoses such as schizophrenia and drug and alcohol
addictions. The children that these clinics care for are in
significant.
distress and are often victims of physical and mental abuse and the
juvenile justice system. The COPs clinics are frequently utilized to
shorten an inpatient hospital stay or even eliminate the need for a
hospitalization.

This enhanced federal payment is now projected to be eliminated over
the next four years by the OMH Restructuring Plan. The OMH plan will
redistribute current Medicaid payments by taking funds from COPs
clinics and giving them to non-Cops clinics. When this plan goes into
effect, the financial viability of many clinics will be seriously
jeopardized. This change is being implemented by regulation and does
not require legislative approval.

This bill requires OMH to consider the severity of a patient's illness
when developing the new payment rates under the Restructuring Plan.

This will ensure that incentives are built into the rates to provide
services to patients who are most in need, and that more costly care
such as ER visits and hospitalizations care are avoided.

This is consistent with the Executive's policy for the new APG
reimbursement reform with respect to Article 28 clinics regulated by
the Department of Health (DOH). APG reimbursement rates for primary
care clinics are weighted to take into account the severity of the
illness and the resources needed to provide treatment and disease
management. There is no rational reason to provide these incentives
in one clinic setting but not in another.

PRIOR LEGISLATIVE HISTORY:
None.

FISCAL IMPLICATION:
This bill will save the State money by improving the mental health of
individuals living with serious and persistent mental illness and
preventing hospital stays and emergency visits.

EFFECTIVE DATE:
Immediate.

2009-A10547 - Bill Text download pdf

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

                                  10547

                          I N  A S S E M B L Y

                              April 2, 2010
                               ___________

Introduced  by  M.  of  A.  WEISENBERG  -- read once and referred to the
  Committee on Health

AN ACT to amend the public health law, in relation to Medicaid  payments
  to  free-standing  clinics  licensed pursuant to article thirty-one of
  the mental hygiene law

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

  Section  1.  Subparagraph  (ii) of paragraph (e) of subdivision 2-a of
section 2807 of the public health law, as amended by section 15 of  part
C of chapter 58 of the laws of 2009, is amended to read as follows:
  (ii) Notwithstanding this subdivision and any other contrary provision
of  law, the commissioner may incorporate within the payment methodology
described in subparagraph (i) of this  paragraph  payment  for  services
provided  by  facilities  pursuant to licensure under the mental hygiene
law, provided, however, that such APG payment methodology may be  phased
into effect in accordance with a schedule or schedules as jointly deter-
mined  by  the  commissioner,  the  commissioner  of  mental health, the
commissioner of alcoholism and substance abuse services, and the commis-
sioner of mental retardation and developmental disabilities.    NOTWITH-
STANDING  ANY  CONTRARY  PROVISION  OF  LAW, ANY SUCH APG PAYMENT OR ANY
OTHER NEW PAYMENT METHODOLOGY ESTABLISHED ON OR AFTER THE EFFECTIVE DATE
OF THE CHAPTER OF THE LAWS OF TWO THOUSAND TEN THAT AMENDED THIS SUBPAR-
AGRAPH,  FOR  FREE-STANDING  CLINICS  LICENSED   PURSUANT   TO   ARTICLE
THIRTY-ONE  OF  THE MENTAL HYGIENE LAW SHALL INCLUDE ENHANCED REIMBURSE-
MENT FOR SERVICES PROVIDED TO INDIVIDUALS UNDER THE AGE OF EIGHTEEN  WHO
ARE  SERIOUSLY  EMOTIONALLY  DISTURBED AND INDIVIDUALS EIGHTEEN YEARS OF
AGE AND OLDER WHO HAVE A SERIOUS AND PERSISTENT MENTAL ILLNESS. INDIVID-
UALS UNDER THE AGE OF EIGHTEEN WHO ARE SERIOUSLY  EMOTIONALLY  DISTURBED
AND  INDIVIDUALS  EIGHTEEN YEARS OF AGE AND OLDER WHO HAVE A SERIOUS AND
PERSISTENT MENTAL ILLNESS  SHALL  MEAN  INDIVIDUALS  WHO  MEET  CRITERIA
DEFINED BY THE COMMISSIONER OF MENTAL HEALTH IN REGULATION.
  S  2.  Paragraph  (e) of subdivision 2-a of section 2807 of the public
health law is amended by adding a new  subparagraph  (iii)  to  read  as
follows:

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

                                                           LBD16407-01-0

A. 10547                            2

  (III)  THE  COMMISSIONER  OF  MENTAL  HEALTH, IN CONSULTATION WITH THE
COMMISSIONER, SHALL PROVIDE INITIAL AND CONTINUING REPORTS TO THE GOVER-
NOR, TEMPORARY PRESIDENT OF THE SENATE, MINORITY LEADER OF  THE  SENATE,
SPEAKER  OF  THE  ASSEMBLY,  AND  MINORITY LEADER OF THE ASSEMBLY ON THE
IMPACT  OF THE PROPOSED APG PAYMENT METHODOLOGY OR ANY OTHER NEW PAYMENT
METHODOLOGY ESTABLISHED ON OR AFTER THE EFFECTIVE DATE OF THIS  SUBPARA-
GRAPH  ON  FREE-STANDING CLINICS LICENSED PURSUANT TO ARTICLE THIRTY-ONE
OF THE MENTAL HYGIENE LAW.
  (A) THE INITIAL REPORT SHALL BE PROVIDED PRIOR TO  THE  IMPLEMENTATION
OF  ANY  APG  PAYMENT  RATES OR ANY OTHER NEW PAYMENT METHODOLOGY ESTAB-
LISHED  ON  OR  AFTER  THE  EFFECTIVE  DATE  OF  THIS  SUBPARAGRAPH  FOR
FREE-STANDING  CLINICS  LICENSED  PURSUANT  TO ARTICLE THIRTY-ONE OF THE
MENTAL HYGIENE LAW AND SHALL INCLUDE AN ANALYSIS OF THE FINANCIAL IMPACT
ON SUCH CLINICS, INCLUDING MEDICAL ASSISTANCE PAYMENT LOSSES  AND  GAINS
FOR EACH CLINIC AFFECTED BY THE PROPOSED APG PAYMENT METHODOLOGY AND THE
POTENTIAL  IMPACT  ON  ACCESS  TO  MENTAL  HEALTH  SERVICES BY PATIENTS,
INCLUDING BUT NOT LIMITED TO INDIVIDUALS UNDER THE AGE OF  EIGHTEEN  WHO
ARE  SERIOUSLY  EMOTIONALLY  DISTURBED AND INDIVIDUALS EIGHTEEN YEARS OF
AGE AND OLDER WHO HAVE A SERIOUS AND PERSISTENT MENTAL ILLNESS.
  (B)  AN  ANNUAL  REPORT  SHALL  BE  PROVIDED  ON  OR  BEFORE  DECEMBER
THIRTY-FIRST  OF  EACH  YEAR THEREAFTER ON THE IMPACT OF THE APG PAYMENT
METHODOLOGY OR ANY OTHER NEW PAYMENT METHODOLOGY ESTABLISHED ON OR AFTER
THE  EFFECTIVE  DATE  OF  THIS  SUBPARAGRAPH  ON  FREE-STANDING  CLINICS
LICENSED  PURSUANT TO ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW. SUCH
REPORT SHALL INCLUDE AN ANALYSIS OF THE FINANCIAL IMPACT ON  SUCH  CLIN-
ICS,  INCLUDING  MEDICAL  ASSISTANCE  PAYMENT LOSSES AND GAINS FOR EVERY
INDIVIDUAL CLINIC AFFECTED BY THE APG PAYMENT METHODOLOGY, THE POTENTIAL
IMPACT ON ACCESS TO MENTAL HEALTH SERVICES BY  PATIENTS,  INCLUDING  BUT
NOT  LIMITED  TO INDIVIDUALS UNDER THE AGE OF EIGHTEEN WHO ARE SERIOUSLY
EMOTIONALLY DISTURBED AND INDIVIDUALS EIGHTEEN YEARS OF  AGE  AND  OLDER
WHO HAVE A SERIOUS AND PERSISTENT MENTAL ILLNESS, AND MEASUREMENT OF ANY
SHIFT  OF  MENTAL  HEALTH  SERVICES  FROM FREE-STANDING CLINICS LICENSED
PURSUANT TO ARTICLE THIRTY-ONE OF THE MENTAL  HYGIENE  LAW  TO  HOSPITAL
EMERGENCY DEPARTMENTS AND INPATIENT HOSPITAL SETTINGS.
  S 3. This act shall take effect immediately.

co-Sponsors

2009-A10547A (ACTIVE) - Details

Current Committee:: Assembly Health
Law Section:: Public Health Law
Laws Affected:: Amd §2807, Pub Health L

2009-A10547A (ACTIVE) - Summary

Relates to medicaid payments to free-standing clinics licensed pursuant to article thirty-one of the mental hygiene law.

2009-A10547A (ACTIVE) - Bill Text download pdf

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

                                10547--A

                          I N  A S S E M B L Y

                              April 2, 2010
                               ___________

Introduced  by  M. of A. WEISENBERG, LAVINE -- read once and referred to
  the Committee on Health -- committee discharged, bill amended, ordered
  reprinted as amended and recommitted to said committee

AN ACT to amend the public health law, in relation to Medicaid  payments
  to  free-standing  clinics  licensed pursuant to article thirty-one of
  the mental hygiene law

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

  Section  1.  Subparagraph  (ii) of paragraph (e) of subdivision 2-a of
section 2807 of the public health law, as amended by section 15 of  part
C of chapter 58 of the laws of 2009, is amended to read as follows:
  (ii) Notwithstanding this subdivision and any other contrary provision
of  law, the commissioner may incorporate within the payment methodology
described in subparagraph (i) of this  paragraph  payment  for  services
provided  by  facilities  pursuant to licensure under the mental hygiene
law, provided, however, that such APG payment methodology may be  phased
into effect in accordance with a schedule or schedules as jointly deter-
mined  by  the  commissioner,  the  commissioner  of  mental health, the
commissioner of alcoholism and substance abuse services, and the commis-
sioner of mental retardation and developmental disabilities.   ANY  SUCH
APG  PAYMENT  OR  ANY  OTHER  NEW  PAYMENT  METHODOLOGY  ESTABLISHED FOR
FREE-STANDING CLINICS LICENSED PURSUANT TO  ARTICLE  THIRTY-ONE  OF  THE
MENTAL  HYGIENE  LAW  SHALL  INCLUDE ENHANCED REIMBURSEMENT FOR SERVICES
PROVIDED TO INDIVIDUALS UNDER THE AGE  OF  EIGHTEEN  WHO  ARE  SERIOUSLY
EMOTIONALLY  DISTURBED  AND  INDIVIDUALS EIGHTEEN YEARS OF AGE AND OLDER
WHO HAVE A SERIOUS AND  PERSISTENT  MENTAL  ILLNESS  WHO  MEET  CRITERIA
DEFINED BY THE COMMISSIONER OF MENTAL HEALTH IN REGULATION.
  S  2.  Paragraph  (e) of subdivision 2-a of section 2807 of the public
health law is amended by adding a new  subparagraph  (iii)  to  read  as
follows:
  (III)  THE  COMMISSIONER  OF  MENTAL  HEALTH, IN CONSULTATION WITH THE
COMMISSIONER, SHALL PROVIDE INITIAL AND CONTINUING REPORTS TO THE GOVER-
NOR, TEMPORARY PRESIDENT OF THE SENATE, MINORITY LEADER OF  THE  SENATE,
SPEAKER  OF  THE  ASSEMBLY,  AND  MINORITY LEADER OF THE ASSEMBLY ON THE

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

                                                           LBD16407-02-0

A. 10547--A                         2

IMPACT OF THE PROPOSED APG PAYMENT METHODOLOGY OR ANY OTHER NEW  PAYMENT
METHODOLOGY  ESTABLISHED ON OR AFTER THE EFFECTIVE DATE OF THIS SUBPARA-
GRAPH ON FREE-STANDING CLINICS LICENSED PURSUANT TO  ARTICLE  THIRTY-ONE
OF THE MENTAL HYGIENE LAW.
  (A)  THE  INITIAL REPORT SHALL BE PROVIDED PRIOR TO THE IMPLEMENTATION
OF ANY APG PAYMENT RATES OR ANY OTHER  NEW  PAYMENT  METHODOLOGY  ESTAB-
LISHED  ON  OR  AFTER  THE  EFFECTIVE  DATE  OF  THIS  SUBPARAGRAPH  FOR
FREE-STANDING CLINICS LICENSED PURSUANT TO  ARTICLE  THIRTY-ONE  OF  THE
MENTAL HYGIENE LAW AND SHALL INCLUDE AN ANALYSIS OF THE FINANCIAL IMPACT
ON  SUCH  CLINICS, INCLUDING MEDICAL ASSISTANCE PAYMENT LOSSES AND GAINS
FOR EACH CLINIC AFFECTED BY THE PROPOSED APG PAYMENT METHODOLOGY AND THE
POTENTIAL IMPACT ON  ACCESS  TO  MENTAL  HEALTH  SERVICES  BY  PATIENTS,
INCLUDING  BUT  NOT LIMITED TO INDIVIDUALS UNDER THE AGE OF EIGHTEEN WHO
ARE SERIOUSLY EMOTIONALLY DISTURBED AND INDIVIDUALS  EIGHTEEN  YEARS  OF
AGE AND OLDER WHO HAVE A SERIOUS AND PERSISTENT MENTAL ILLNESS.
  (B)  AN  ANNUAL  REPORT  SHALL  BE  PROVIDED  ON  OR  BEFORE  DECEMBER
THIRTY-FIRST OF EACH YEAR THEREAFTER ON THE IMPACT OF  THE  APG  PAYMENT
METHODOLOGY OR ANY OTHER NEW PAYMENT METHODOLOGY ESTABLISHED ON OR AFTER
THE  EFFECTIVE  DATE  OF  THIS  SUBPARAGRAPH  ON  FREE-STANDING  CLINICS
LICENSED PURSUANT TO ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW.  SUCH
REPORT  SHALL  INCLUDE AN ANALYSIS OF THE FINANCIAL IMPACT ON SUCH CLIN-
ICS, INCLUDING MEDICAL ASSISTANCE PAYMENT LOSSES  AND  GAINS  FOR  EVERY
INDIVIDUAL CLINIC AFFECTED BY THE APG PAYMENT METHODOLOGY, THE POTENTIAL
IMPACT  ON  ACCESS  TO MENTAL HEALTH SERVICES BY PATIENTS, INCLUDING BUT
NOT LIMITED TO INDIVIDUALS UNDER THE AGE OF EIGHTEEN WHO  ARE  SERIOUSLY
EMOTIONALLY  DISTURBED  AND  INDIVIDUALS EIGHTEEN YEARS OF AGE AND OLDER
WHO HAVE A SERIOUS AND PERSISTENT MENTAL ILLNESS, AND MEASUREMENT OF ANY
SHIFT OF MENTAL HEALTH  SERVICES  FROM  FREE-STANDING  CLINICS  LICENSED
PURSUANT  TO  ARTICLE  THIRTY-ONE  OF THE MENTAL HYGIENE LAW TO HOSPITAL
EMERGENCY DEPARTMENTS AND INPATIENT HOSPITAL SETTINGS.
  S 3. This act shall take effect immediately.

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Assembly Bill A10547

Sponsored By

Archive: Last Bill Status - In Assembly Committee

Actions

Bill Amendments

co-Sponsors

2009-A10547 - Details

2009-A10547 - Summary

2009-A10547 - Sponsor Memo

2009-A10547 - Bill Text download pdf

co-Sponsors

2009-A10547A (ACTIVE) - Details

2009-A10547A (ACTIVE) - Summary

2009-A10547A (ACTIVE) - Bill Text download pdf

Comments

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Sponsored By

WEISENBERG

Archive: Last Bill Status - In Assembly Committee

Actions

Bill Amendments

co-Sponsors

Charles Lavine

2009-A10547 - Details

2009-A10547 - Summary

2009-A10547 - Sponsor Memo

2009-A10547 - Bill Text download pdf

co-Sponsors

Charles Lavine

2009-A10547A (ACTIVE) - Details

2009-A10547A (ACTIVE) - Summary

2009-A10547A (ACTIVE) - Bill Text download pdf

Comments