Senate Bill S3362A

                                BILL NUMBER:S3362

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 SPECIFIC 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, 2011

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.

PRIOR LEGISLATIVE HISTORY:


S. 7227 of 2010

FISCAL IMPLICATIONS:
To be determined.

EFFECTIVE DATE:
April 1, 2011