senate Bill S1438

2013-2014 Legislative Session

Authorizing the commissioner of health to apply for a medicaid reform demonstration waiver

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee


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

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Actions

view actions (2)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 08, 2014 referred to health
Jan 09, 2013 referred to health

Co-Sponsors

S1438 - Details

See Assembly Version of this Bill:
A5545
Law Section:
Social Services Law
Laws Affected:
Amd ยง366, Soc Serv L
Versions Introduced in Previous Legislative Sessions:
2011-2012: S3196A, A2280A
2009-2010: S2639, A6676

S1438 - Summary

Authorizes the commissioner of health to apply for a medicaid reform demonstration waiver; creates an initiative to provide for a more efficient and effective medicaid services delivery system; sets forth a managed care pilot program and requires reporting to the governor, temporary president of the senate and speaker of the assembly by December 31, 2016.

S1438 - Sponsor Memo

S1438 - Bill Text download pdf

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

                                  1438

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced by Sens. RANZENHOFER, DeFRANCISCO, GOLDEN, LARKIN, MAZIARZ --
  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 authorizing  the
  commissioner  of  health  to apply for a medicaid reform demonstration
  waiver

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

  Section 1. Section 366 of the social services law is amended by adding
a new subdivision 6-b to read as follows:
  6-B.  A.  THE COMMISSIONER OF HEALTH SHALL APPLY FOR A MEDICAID REFORM
DEMONSTRATION WAIVER PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN  OF  THE
FEDERAL  SOCIAL SECURITY ACT IN ORDER TO CREATE AN INITIATIVE TO PROVIDE
FOR A MORE EFFICIENT AND EFFECTIVE MEDICAID SERVICES DELIVERY SYSTEM  IN
NEW  YORK  THAT  EMPOWERS  MEDICAID PATIENTS, BRIDGES PUBLIC AND PRIVATE
COVERAGE, IMPROVES PATIENT OUTCOMES AND STABILIZES PROGRAM COSTS.
  B. THE DEMONSTRATION WAIVER SHALL INCLUDE, BUT SHALL  NOT  BE  LIMITED
TO, THE FOLLOWING COMPONENTS:
  (I)  A  RISK ADJUSTED CAPITATED MANAGED CARE PILOT PROGRAM FOR RECIPI-
ENTS CURRENTLY SERVED IN MEDICAID-FEE-FOR SERVICE  OR  MEDICAID  MANAGED
CARE  THAT  PROVIDES  BENEFIT  PLANS  THAT MORE CLOSELY RESEMBLE PRIVATE
PLANS YET ARE ACTUARIALLY EQUIVALENT TO  THE  CURRENT  MEDICAID  BENEFIT
PACKAGE.  RISK  ADJUSTED  CAPITATION RATES SHALL BE SEPARATED INTO THREE
COMPONENTS TO COVER COMPREHENSIVE CARE, CATASTROPHIC CARE  AND  ENHANCED
SERVICES AND MAY PHASE IN FINANCIAL RISK FOR APPROVED PROVIDERS.  HEALTH
PLANS  SHALL  PROVIDE  COMPREHENSIVE CARE WHICH SHALL COVER ALL EXPENSES
UNTIL A PREDETERMINED THRESHOLD OF EXPENSES IS REACHED AT WHICH TIME THE
CATASTROPHIC COMPONENT SHALL TAKE  OVER.  HEALTH  PLANS  MAY  CHOOSE  TO
ASSUME  THE  CATASTROPHIC  RISK  FOR  TARGET POPULATIONS THEY SERVE. THE
CATASTROPHIC COMPONENT SHALL ENCOURAGE  PROVIDER  NETWORKS  TO  IDENTIFY

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

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