S T A T E O F N E W Y O R K
________________________________________________________________________
2844
2013-2014 Regular Sessions
I N A S S E M B L Y
January 18, 2013
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Introduced by M. of A. GOTTFRIED, BARRON, GALEF, PAULIN, ROSENTHAL,
TITONE, ENGLEBRIGHT, MILLMAN, JAFFEE, ABINANTI, STEVENSON -- Multi-
Sponsored by -- M. of A. BRENNAN, CLARK, FARRELL, McDONALD -- read
once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to the distribution
of funds to support the provision of general hospital indigent care;
and to amend chapter 119 of the laws of 1997 relating to authorizing
the department of health to establish certain payments to general
hospitals, in relation to the effectiveness thereof
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 2807-k of the public health law is amended by
adding a new subdivision 5-d to read as follows:
5-D. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION,
SECTION TWENTY-EIGHT HUNDRED SEVEN-W OF THIS ARTICLE OR ANY OTHER
CONTRARY PROVISION OF LAW, AND SUBJECT TO THE AVAILABILITY OF FEDERAL
FINANCIAL PARTICIPATION, FOR PERIODS ON AND AFTER JANUARY FIRST, TWO
THOUSAND THIRTEEN THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND FIFTEEN,
ALL FUNDS AVAILABLE FOR DISTRIBUTION PURSUANT TO THIS SECTION AND
SECTION TWENTY-EIGHT HUNDRED SEVEN-W OF THIS ARTICLE, SHALL BE RESERVED
AND SET ASIDE AND DISTRIBUTED IN ACCORDANCE WITH THE PROVISIONS OF THIS
SUBDIVISION.
(B) THE COMMISSIONER SHALL MAKE REGULATIONS UNDER THIS SECTION,
INCLUDING EMERGENCY REGULATIONS, ESTABLISHING METHODOLOGIES FOR THE
DISTRIBUTION OF FUNDS, IN ACCORDANCE WITH FEDERAL REQUIREMENTS. THE
REGULATIONS SHALL INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING:
(I) THE REGULATIONS SHALL ESTABLISH METHODOLOGIES FOR DETERMINING EACH
FACILITY'S RELATIVE UNCOMPENSATED CARE NEED AMOUNT BASED ON UNINSURED
INPATIENT AND OUTPATIENT UNITS OF SERVICE FROM THE COST REPORTING YEAR
TWO YEARS PRIOR TO THE DISTRIBUTION YEAR, MULTIPLIED BY THE APPLICABLE
MEDICAID RATES IN EFFECT JANUARY FIRST OF THE DISTRIBUTION YEAR, AS
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04591-01-3
A. 2844 2
SUMMED AND ADJUSTED BY A STATEWIDE COST ADJUSTMENT FACTOR AND REDUCED BY
THE SUM OF ALL PAYMENT AMOUNTS COLLECTED FROM SUCH UNINSURED PATIENTS,
AND AS FURTHER ADJUSTED BY APPLICATION OF A GRADUATED NOMINAL NEED
COMPUTATION THAT SHALL TAKE INTO ACCOUNT EACH FACILITY'S MEDICAID INPA-
TIENT SHARE.
(II) ANNUAL DISTRIBUTIONS UNDER THIS SUBDIVISION SHALL BE IN ACCORD
WITH THE FOLLOWING:
(A) ONE HUNDRED THIRTY-NINE MILLION FOUR HUNDRED THOUSAND DOLLARS
SHALL BE DISTRIBUTED AS MEDICAID DISPROPORTIONATE SHARE HOSPITAL ("DSH")
PAYMENTS TO MAJOR PUBLIC GENERAL HOSPITALS; AND
(B) NINE HUNDRED NINETY-FOUR MILLION NINE HUNDRED THOUSAND DOLLARS
SHALL BE DISTRIBUTED AS MEDICAID DSH PAYMENTS TO ELIGIBLE GENERAL HOSPI-
TALS, OTHER THAN MAJOR PUBLIC GENERAL HOSPITALS.
(III) (A) FOR THE TWO THOUSAND THIRTEEN AND TWO THOUSAND FOURTEEN
CALENDAR YEARS, THE REGULATIONS SHALL ESTABLISH TRANSITION ADJUSTMENTS
TO THE DISTRIBUTIONS MADE UNDER SUBPARAGRAPH (II) OF THIS PARAGRAPH SO
THAT NO FACILITY EXPERIENCES A REDUCTION IN INDIGENT CARE POOL PAYMENTS
UNDER THIS SUBDIVISION THAT IS GREATER THAN THE PERCENTAGES, AS SPECI-
FIED IN THE REGULATIONS, AS COMPARED TO THE AVERAGE DISTRIBUTION THAT
EACH SUCH FACILITY RECEIVED FOR THE THREE CALENDAR YEARS PRIOR TO TWO
THOUSAND THIRTEEN PURSUANT TO THIS SECTION AND SECTION TWENTY-EIGHT
HUNDRED SEVEN-W OF THIS ARTICLE.
(B) THE REGULATIONS SHALL ALSO ESTABLISH ADJUSTMENTS LIMITING THE
INCREASES IN INDIGENT CARE POOL PAYMENTS EXPERIENCED BY FACILITIES UNDER
THIS SUBDIVISION BY AN AMOUNT THAT WILL BE, AS DETERMINED BY THE COMMIS-
SIONER AND IN CONJUNCTION WITH SUCH OTHER FUNDING AS MAY BE AVAILABLE
FOR THIS PURPOSE, SUFFICIENT TO ENSURE FULL FUNDING FOR THE TRANSITION
ADJUSTMENT PAYMENTS AUTHORIZED BY CLAUSE (A) OF THIS SUBPARAGRAPH.
(IV) THE REGULATIONS SHALL RESERVE ONE PERCENT OF THE FUNDS AVAILABLE
FOR DISTRIBUTION IN THE TWO THOUSAND FOURTEEN THROUGH TWO THOUSAND
SEVENTEEN CALENDAR YEARS UNDER THIS SUBDIVISION, PARAGRAPH (I) OF SUBDI-
VISION THIRTY-FIVE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-C OF THIS ARTI-
CLE, AND SECTIONS TWO HUNDRED ELEVEN AND TWO HUNDRED TWELVE OF CHAPTER
FOUR HUNDRED SEVENTY-FOUR OF THE LAWS OF NINETEEN HUNDRED NINETY-SIX, IN
A "FINANCIAL ASSISTANCE COMPLIANCE POOL." THE REGULATIONS SHALL ESTAB-
LISH METHODOLOGIES AND STANDARDS UNDER WHICH SUCH POOL FUNDS SHALL BE
DISTRIBUTED TO FACILITIES BASED ON THEIR LEVEL OF COMPLIANCE, AS DETER-
MINED BY THE COMMISSIONER, WITH THE PROVISIONS OF SUBDIVISION NINE-A OF
THIS SECTION.
(C) THE COMMISSIONER SHALL ANNUALLY REPORT TO THE GOVERNOR AND THE
LEGISLATURE ON THE DISTRIBUTION OF FUNDS UNDER THIS SUBDIVISION INCLUD-
ING, BUT NOT LIMITED TO:
(I) THE IMPACT ON SAFETY NET PROVIDERS, INCLUDING SOLE COMMUNITY
PROVIDERS, RURAL GENERAL HOSPITALS AND MAJOR PUBLIC GENERAL HOSPITALS;
(II) THE PROVISION OF INDIGENT CARE BY UNITS OF SERVICE AND FUNDS
DISTRIBUTED BY GENERAL HOSPITALS; AND
(III) THE EXTENT TO WHICH ACCESS TO CARE HAS BEEN ENHANCED.
S 2. Section 3 of chapter 119 of the laws of 1997 relating to author-
izing the department of health to establish certain payments to general
hospitals, as amended by section 1 of part N of chapter 58 of the laws
of 2009, is amended to read as follows:
S 3. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 1997. This act
shall expire April 1, [2012] 2015.
S 3. The opening paragraph of subparagraph (i) of paragraph (i) of
subdivision 35 of section 2807-c of the public health law, as added by
A. 2844 3
section 3-a of part B of chapter 109 of the laws of 2010, is amended to
read as follows:
Notwithstanding any inconsistent provision of this subdivision or any
other contrary provision of law and subject to the availability of
federal financial participation, for the period July first, two thousand
ten through March thirty-first, two thousand eleven, and each state
fiscal year period thereafter, the commissioner shall make additional
inpatient hospital payments up to the aggregate upper payment limit for
inpatient hospital services after all other medical assistance payments,
but not to exceed two hundred thirty-five million five hundred thousand
dollars for the period July first, two thousand ten through March thir-
ty-first, two thousand eleven [and], three hundred fourteen million
dollars for each state fiscal year BEGINNING APRIL FIRST, TWO THOUSAND
ELEVEN, THROUGH MARCH THIRTY-FIRST, TWO THOUSAND THIRTEEN, AND NO LESS
THAN THREE HUNDRED THIRTY-NINE MILLION DOLLARS FOR EACH STATE FISCAL
YEAR thereafter, to general hospitals, other than major public general
hospitals, providing emergency room services and including safety net
hospitals, which shall, for the purpose of this paragraph, be defined as
having either: a Medicaid share of total inpatient hospital discharges
of at least thirty-five percent, including both fee-for-service and
managed care discharges for acute and exempt services; or a Medicaid
share of total discharges of at least thirty percent, including both
fee-for-service and managed care discharges for acute and exempt
services, and also providing obstetrical services. Eligibility to
receive such additional payments shall be based on data from the period
two years prior to the rate year, as reported on the institutional cost
report submitted to the department as of October first of the prior rate
year. Such payments shall be made as medical assistance payments for
fee-for-service inpatient hospital services pursuant to title eleven of
article five of the social services law for patients eligible for feder-
al financial participation under title XIX of the federal social securi-
ty act and in accordance with the following:
S 4. This act shall take effect immediately; provided, however, that
section two of this act shall be deemed to have been in full force and
effect on and after April 1, 2012.