senate Bill S3197

2011-2012 Legislative Session

Relates to medicaid management by the commissioner of health and the department of health

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Archive: Last Bill Status - In Committee


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

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 04, 2012 referred to health
Feb 11, 2011 referred to health

Co-Sponsors

S3197 - Bill Details

Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Amd ยง363-c, Soc Serv L
Versions Introduced in 2009-2010 Legislative Session:
S2640

S3197 - Bill Texts

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Relates to medicaid management; authorizes the commissioner of health and the department of health to report to the legislature and for the department to develop outcome results-based objectives for medicaid service and administrative contracts to promote efficiency and prevent waste and abuse.

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BILL NUMBER:S3197

TITLE OF BILL:
An act
to amend the social services law, in relation to providing for medicaid
management

PURPOSE:
The bill is aimed at gaining better management of the
Medicaid System in New York State which is expected to spend over
$44.5 billion in state, federal and local dollars in 2005. The bill
directs the Department of Health to convene periodic meetings of the
Commissioners of all state agencies receiving Medicaid funds and
appropriate representation of local departments of social services
to, among other things, contain the growth of Medicaid spending and
improve the efficiency, effectiveness and quality of existing service
delivery. It also directs the department to report annually on 1) the
results of the multi-agency meetings and 2) Medicaid expenditures
made to other state agencies in the preceding state fiscal year. It
requires the department to develop an annual plan to conduct periodic
audits, reviews and inspections of state agencies receiving Medicaid
funds to, among other things, promote accountability, economy,
effectiveness, and efficiency.

SUMMARY OF PROVISIONS:
Section 1 creates a new section 363-c of the
Social Services Law directing the Department of Health to:

*Convene meetings at least quarterly with all state agencies receiving
Medicaid funds and appropriate representation of local departments of
social services to identify: 1) methods to contain the growth of
Medicaid spending; 2) methods to improve the quality of and recipient
satisfaction with Medicaid state agency services; 3) opportunities
for consolidation and methods to improve the efficiency and
effectiveness of existing service delivery; 4) opportunities for
education and prevention; 5) annually the number of persons on
waiting lists to receive services for each list; and 6) the
collective priority of critical needs for the Medicaid population.

*Report annually on 1) the results of the multi-agency meetings and 2)
Medicaid expenditures made to other state agencies in the preceding
state fiscal year.

*Develop outcome results-based objectives for Medicaid service and
administrative contracts with other state agencies.

*Develop an annual plan to conduct periodic audits, reviews and
inspections of state agencies receiving Medicaid funds to, among
other things, promote accountability, economy, effectiveness and
efficiency.

Section 2 provides an effective date of 120 days after it shall have
become law.

JUSTIFICATION:


One of the largest expenses in the New York State
Budget is Medicaid with $45.7 billion spent in 2006. This bill,
modeled after a proposal under consideration in South Carolina, is an
attempt to more effectively manage Medicaid which is dispersed
through many different programs and administered by many different
agencies. These agencies, along with the representation of the local
social services districts which determine eligibility at the front
end, must come together more regularly with the goal of making a more
effective, efficient, and accountable program.

LEGISLATIVE HISTORY:
2005 - S.5069/A.7972 -- PASSED SENATE/Health
2006 - S.5069/ A. 7972 -- RULES/Health
2007 - S.1304/A.5286 -- HEALTH/Health
2008 - S.1304/ A.5286 -- HEALTH/Health
2010 - S.2639/A.1212 -- HEALTH/Health

FISCAL IMPLICATIONS:
Savings as Medicaid is managed more efficiently and effectively.

EFFECTIVE DATE:
This act shall take effect immediately.

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

                                  3197

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            February 11, 2011
                               ___________

Introduced  by  Sens.  RANZENHOFER,  MAZIARZ,  O'MARA  -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Health

AN  ACT  to  amend the social services law, in relation to providing for
  medicaid management

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

  Section 1. Paragraphs (d) and (e) of subdivision 1 of section 363-c of
the  social  services law, as amended by section 19 of part C of chapter
109 of the laws of 2006, are amended to read as follows:
  (d) opportunities for education and prevention; [and]
  (e) ANNUALLY THE  NUMBER  OF  PERSONS  ON  WAITING  LISTS  TO  RECEIVE
SERVICES AND THE TYPE OF SERVICES FOR EACH LIST; AND
  (F)  the  collective priority of critical needs for the medicaid popu-
lation.
  S 2. Section 363-c of the social services law  is  amended  by  adding
nine  new  subdivisions  4,  5,  6,  7,  8,  9, 10, 11 and 12 to read as
follows:
  4. THE DEPARTMENT SHALL DEVELOP OUTCOME RESULTS-BASED  OBJECTIVES  FOR
MEDICAID SERVICE AND ADMINISTRATIVE CONTRACTS WITH OTHER STATE AGENCIES.
REIMBURSEMENT SHALL BE BASED ON THE COMPLETION OF OUTCOMES, AS APPROPRI-
ATE.
  5.  THE  DEPARTMENT SHALL IDENTIFY PAYMENT RATES FOR MEDICAID SERVICES
PROVIDED BY OTHER STATE AGENCIES THAT EXCEED AVAILABLE COMPARABLE MARKET
RATES AND DEVELOP METHODS TO ENSURE THAT, WHERE APPROPRIATE,  RATES  ARE
THE  LOWER  OF  COST  OR  MARKET.  TO ENSURE THAT THE PROVISIONS OF THIS
SECTION ARE MET AND THAT DUPLICATIVE SERVICES ARE NOT PROVIDED TO  MEDI-
CAID  RECIPIENTS, THE DEPARTMENT MAY LIMIT MEDICAID SERVICES PROVIDED BY
OTHER STATE AGENCIES.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01493-01-1

S. 3197                             2

  6. THE DEPARTMENT SHALL DEVELOP AN ANNUAL  PLAN  TO  CONDUCT  PERIODIC
AUDITS,  REVIEWS,  AND  INSPECTIONS OF STATE AGENCIES RECEIVING MEDICAID
FUNDS FOR THE PURPOSE OF:
  (A) ENSURING COMPLIANCE WITH STATE AND FEDERAL REGULATIONS;
  (B)  PROMOTING ACCOUNTABILITY, ECONOMY, EFFECTIVENESS, AND EFFICIENCY;
AND
  (C) PREVENTING AND DETECTING WASTE, FRAUD, AND ABUSE.
  7. AUDITS AND REVIEWS SHALL BE PERFORMED IN ACCORDANCE WITH  GENERALLY
ACCEPTED GOVERNMENT AUDITING STANDARDS.
  8.  REPORTS  SHALL BE ISSUED IN ACCORDANCE WITH PROFESSIONAL STANDARDS
AND SHALL INCLUDE A DESCRIPTION OF ANY SIGNIFICANT PROBLEMS, ABUSES, AND
DEFICIENCIES ENCOUNTERED IN THE ADMINISTRATION AND OPERATION OF MEDICAID
SERVICES ALONG WITH RECOMMENDATIONS FOR CORRECTIVE ACTION. REPORTS SHALL
INCLUDE THE FINANCIAL VALUE OF ANY ITEMS REPORTED.
  9. THE DEPARTMENT  IS  AUTHORIZED  TO  DIRECTLY  ACCESS  ALL  SYSTEMS,
RECORDS,  REPORTS, REVIEWS, FILES, DOCUMENTS, PAPERS, AND SIMILAR INFOR-
MATION RELATED TO MEDICAID PAYMENTS WITHIN STATE AGENCIES  AND  ENTITIES
DOING BUSINESS WITH THESE AGENCIES.
  10.  THE  DEPARTMENT MAY ENTER INTO EXTERNAL CONTRACTS AS NECESSARY IN
FULFILLING THE REQUIREMENTS OF THIS SECTION.
  11. THE DEPARTMENT SHALL WITHHOLD ANY AMOUNTS RELATED TO FRAUD, ABUSE,
AND NON-COMPLIANCE.
  12. THE DEPARTMENT SHALL MAKE ALL REPORTS AVAILABLE TO  THE  GOVERNOR,
THE SENATE FINANCE COMMITTEE, THE ASSEMBLY WAYS AND MEANS COMMITTEE, THE
SENATE  HEALTH  COMMITTEE,  THE  ASSEMBLY  HEALTH  COMMITTEE, THE SENATE
SOCIAL SERVICES, CHILDREN  AND  FAMILIES  COMMITTEE,  AND  THE  ASSEMBLY
SOCIAL SERVICES COMMITTEE.
  S 3. This act shall take effect immediately.

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