Senate Bill S2553

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

                                 2553--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            February 23, 2009
                               ___________

Introduced by Sens. KLEIN, ADDABBO, HASSELL-THOMPSON, ONORATO, SAVINO --
  read  twice  and  ordered printed, and when printed to be committed to
  the Committee on Health -- recommitted to the Committee on  Health  in
  accordance  with  Senate  Rule 6, sec. 8 -- committee discharged, bill
  amended, ordered reprinted as amended and recommitted to said  commit-
  tee

AN  ACT  to  amend the public health law, in relation to rate of payment
  for home health care  programs  using  statewide  average  calculation
  excluding certain costs

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

  Section 1. Subdivision 7 of section 3614 of the public health law,  as
added  by  chapter  41  of  the  laws  of 1992, the opening paragraph as
amended by section 18 of part C of chapter 109 of the laws of 2006,  the
second  undesignated  paragraph  as  added by chapter 170 of the laws of
1994 and the third undesignated paragraph as added and the closing para-
graph as amended by chapter 59 of the laws of 1993, is amended  to  read
as follows:
  7.  (A)  Notwithstanding  any  inconsistent  provision of law or regu-
lation, for purposes of establishing rates of  payment  by  governmental
agencies  for certified home health agencies for the period April first,
nineteen hundred ninety-five  through  December  thirty-first,  nineteen
hundred  ninety-five  and for rate periods beginning on or after January
first, nineteen hundred ninety-six, the reimbursable base year  adminis-
trative and general costs of a provider of services shall not exceed the
statewide  average  of  total  reimbursable base year administrative and
general costs of such providers of services; PROVIDED, HOWEVER, THAT FOR
PURPOSES OF ESTABLISHING SUCH RATES OF PAYMENT FOR PERIODS ON AND  AFTER
APRIL  FIRST, TWO THOUSAND TEN, SUCH STATEWIDE AVERAGE CALCULATION SHALL
EXCLUDE ANY COSTS REPORTED AND ALLOCABLE AS ADMINISTRATIVE  AND  GENERAL
BUT ATTRIBUTABLE TO THE PROVISION AND MANAGEMENT OF PATIENT CARE INCLUD-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00404-04-0
              

S. 2553--A                          2

ING,  BUT  NOT  LIMITED  TO,  COSTS  ATTRIBUTABLE  TO: PATIENT OUTREACH;
ASSESSMENT; COORDINATION AND MANAGEMENT OF SERVICES; TELEPHONE AND OTHER
TELEHEALTH MONITORING AND COMMUNICATION; MEDICAL SUPPLIES; STAFF  TRANS-
PORTATION  AND ESCORT SERVICES; FAMILY AND/OR INFORMAL CAREGIVER SUPPORT
SERVICES; PATIENT RECORDKEEPING; AND TECHNOLOGY INVESTMENTS FOR  PATIENT
CARE.    The  amount  of  such reduction in certified home health agency
rates of payments made during the period April first,  nineteen  hundred
ninety-five  through  March  thirty-first,  nineteen  hundred ninety-six
shall be adjusted in the nineteen hundred ninety-six rate  period  on  a
pro-rata  basis,  if  it  is  determined  upon post-audit review by June
fifteenth, nineteen  hundred  ninety-six  and  reconciliation  that  the
savings  for the state share, excluding the federal and local government
shares, of medical assistance payments pursuant to title eleven of arti-
cle five of the social services law based  on  the  limitation  of  such
payment  pursuant  to  this subdivision is in excess of one million five
hundred thousand dollars or is less than one million five hundred  thou-
sand dollars for payments made on or before March thirty-first, nineteen
hundred  ninety-six  to  reflect the amount by which such savings are in
excess of or lower than one million five hundred thousand  dollars.  For
rate  periods  on  and  after  January  first, two thousand five through
December thirty-first, two thousand six, there shall be no  such  recon-
ciliation  of  the  amount  of  savings  in  excess of or lower than one
million five hundred thousand dollars.
  (B) No such limit shall be applied to a  provider  of  services  reim-
bursed  on an initial budget basis, or a new provider, excluding changes
in ownership or changes in name, who begins operations in the year prior
to the year which is used  as  a  base  year  in  determining  rates  of
payment.
  (C) For the purposes of this subdivision, reimbursable base year oper-
ational  costs  shall  mean  those base year operational costs remaining
after application of all other efficiency standards, including, but  not
limited to, peer group cost ceilings or guidelines.
  (D)  The  limitation  on reimbursement for provider administrative and
general expenses provided by this subdivision shall be  expressed  as  a
percentage  reduction  for  the  rate promulgated by the commissioner to
each certified home health agency and long term home health care program
provider; PROVIDED, HOWEVER, THAT SUCH REDUCTION PERCENTAGE SHALL NOT BE
INCREASED FOR ANY PROVIDER AS A CONSEQUENCE OF THE  EXCLUSIONS  PROVIDED
FOR IN PARAGRAPH (A) OF THIS SUBDIVISION.
  S  2.  The  opening  paragraph of subdivision 7 of section 3614 of the
public health law, as amended by chapter 170 of the  laws  of  1994,  is
amended to read as follows:
  (A) Notwithstanding any inconsistent provision of law or regulation to
the  contrary,  for purposes of establishing rates of payment by govern-
mental agencies for certified home health agencies and  long  term  home
health  care  programs  for  rate  period  beginning on or after January
first, nineteen hundred ninety-five, the department of health may not by
rule or regulation limit the reimbursable base year  administrative  and
general  costs  of a provider of services to a percentage which is other
than thirty percent of total reimbursable base year operational costs of
such provider of services;  PROVIDED,  HOWEVER,  THAT  FOR  PURPOSES  OF
ESTABLISHING SUCH RATES OF PAYMENT FOR PERIODS ON AND AFTER APRIL FIRST,
TWO  THOUSAND  TEN, SUCH STATEWIDE AVERAGE CALCULATION SHALL EXCLUDE ANY
COSTS REPORTED AND ALLOCABLE AS ADMINISTRATIVE AND GENERAL BUT ATTRIBUT-
ABLE TO THE PROVISION AND MANAGEMENT OF PATIENT CARE INCLUDING, BUT  NOT
LIMITED TO, COSTS ATTRIBUTABLE TO: PATIENT OUTREACH; ASSESSMENT; COORDI-

S. 2553--A                          3

NATION  AND MANAGEMENT OF SERVICES; TELEPHONE AND OTHER TELEHEALTH MONI-
TORING AND COMMUNICATION; MEDICAL  SUPPLIES;  STAFF  TRANSPORTATION  AND
ESCORT  SERVICES;  FAMILY  AND/OR  INFORMAL  CAREGIVER SUPPORT SERVICES;
PATIENT RECORDKEEPING; AND TECHNOLOGY INVESTMENTS FOR PATIENT CARE.
  S  3.  Subdivision  7-a  of  section 3614 of the public health law, as
amended by section 89 of part C of chapter 58 of the laws  of  2007  and
the  opening  paragraph as amended by section 46 of part B of chapter 58
of the laws of 2009, is amended to read as follows:
  7-a.  (A) Notwithstanding any inconsistent provision of law  or  regu-
lation,  for  the  purposes  of establishing rates of payment by govern-
mental agencies for long term home health care programs for  the  period
April first, two thousand five, through December thirty-first, two thou-
sand  five,  and  for the period January first, two thousand six through
March thirty-first, two thousand seven, and on and  after  April  first,
two thousand seven through March thirty-first, two thousand nine, and on
and after April first, two thousand nine through March thirty-first, two
thousand  eleven,  the reimbursable base year administrative and general
costs of a provider of services shall not exceed the  statewide  average
of total reimbursable base year administrative and general costs of such
providers  of  services;  PROVIDED,  HOWEVER,  THAT  FOR THE PURPOSES OF
ESTABLISHING SUCH RATES OF PAYMENT FOR PERIODS ON AND AFTER APRIL FIRST,
TWO THOUSAND TEN, SUCH STATEWIDE AVERAGE CALCULATION SHALL  EXCLUDE  ANY
COSTS REPORTED AND ALLOCABLE AS ADMINISTRATIVE AND GENERAL BUT ATTRIBUT-
ABLE  TO THE PROVISION AND MANAGEMENT OF PATIENT CARE INCLUDING, BUT NOT
LIMITED TO, COSTS ATTRIBUTABLE TO: PATIENT OUTREACH; ASSESSMENT; COORDI-
NATION AND MANAGEMENT OF SERVICES; TELEPHONE AND OTHER TELEHEALTH  MONI-
TORING  AND  COMMUNICATION;  MEDICAL  SUPPLIES; STAFF TRANSPORTATION AND
ESCORT SERVICES; FAMILY  AND/OR  INFORMAL  CAREGIVER  SUPPORT  SERVICES;
PATIENT RECORDKEEPING; AND TECHNOLOGY INVESTMENTS FOR PATIENT CARE.
  (B)  No  such  limit  shall be applied to a provider of services reim-
bursed on an initial budget basis, or a new provider, excluding  changes
in ownership or changes in name, who begins operations in the year prior
to  the  year  which  is  used  as  a  base year in determining rates of
payment.
  (C) For the purposes of this subdivision, reimbursable base year oper-
ational costs shall mean those base  year  operational  costs  remaining
after  application of all other efficiency standards, including, but not
limited to, cost guidelines.
  (D) The limitation on reimbursement for  provider  administrative  and
general  expenses  provided  by this subdivision shall be expressed as a
percentage reduction for the rate promulgated  by  the  commissioner  to
each  long  term  home  health care program provider; PROVIDED, HOWEVER,
THAT SUCH REDUCTION PERCENTAGE SHALL NOT BE INCREASED FOR  ANY  PROVIDER
AS A CONSEQUENCE OF THE EXCLUSIONS PROVIDED FOR IN PARAGRAPH (A) OF THIS
SUBDIVISION.
  S  4. This act shall take effect on the first of April next succeeding
the date on which it shall have become law; provided, however, that  the
amendments  to the opening paragraph of subdivision 7 of section 3614 of
the public health law made by section one of this act shall  be  subject
to  the  expiration  and reversion of such opening paragraph pursuant to
section 64-b and subdivision 5-a of section 246 of  chapter  81  of  the
laws  of 1995, as amended, when upon such date the provisions of section
two of this act shall take effect.