BILL NUMBER:  S7227

 TITLE OF BILL :
An act to amend the public health law, in relation to inpatient
reimbursement rates for general hospitals


 PURPOSE :
Ensure that general hospitals which are the most severely impacted by
Medicaid rebasing receive an add-on to their reimbursement rates that
is equivalent to the difference between uninsured units of service and
cost based methodologies for the 2009 indigent care pool distributions
divided 2005 Medicaid fee-for-service discharges.

 SUMMARY OF PROVISIONS :
Section 1. This legislation provides for the inpatient reimbursement
rate add-on for general hospitals whose total Medicaid revenues
resulting from Medicaid rebasing place an institution among the top
five (5) percent hardest hit hospitals in the State in terms of the
percentage of their Medicaid revenue losses.

Section 2. effective date: April 1, 2010

 JUSTIFICATION :
The Medicaid Fee for Service revenues resulting from the December 1,
2009 Medicaid rebasing had the unintended consequence of dramatically
              

reducing Medicaid revenues to certain general hospitals in New York
State. As a result, eight general hospitals rank among the top five
(5) percent hardest hit hospitals in the state, experiencing total
Medicaid revenue losses ranging from a reduction of 71.1 percent to a
reduction of 54.1 percent. These losses are as much as nine times
greater than the statewide average Medicaid loss of 7.8 percent. Five
of the most impacted hospitals are located in Western New York; one is
located in Central New York; one on Long Island; and one in the
Rochester area.The five most impacted Western New York hospitals are
located in the counties of Erie, Chautauqua and Niagara, which are
among the lowest ranked counties in New York State in terms of
morbidity rates, health behaviors and physical environment, according
to a major study commissioned by the Robert Wood Johnson Foundation.

To provide relief and correct the extreme inequities of Medicaid
rebasing, this legislation authorizes the use of an inpatient rate
add-on to the top five (5) percent hardest hit hospitals. This
legislation provides that, effective April 1, 2010, an add-on to those
qualifying hospitals shall be equivalent to the difference between the
uninsured units of service and cost based methodologies for 2009
indigent care pool distributions divided by 2005 Medicaid
fee-for-service discharges.  This legislation recognizes that higher
Medicaid Fee for Service revenues needs to be authorized for hospitals
with a significant share of Medicaid patients in order to preserve
access to Medicaid beneficiaries.

 LEGISLATIVE HISTORY :
None

 FISCAL IMPACT :
Budget neutral.

 EFFECTIVE DATE :
April 1, 2010, with provisions.