senate Bill S4375A

2013-2014 Legislative Session

Directs the commissioner of health to make recommendations to the governor and legislature on increasing ambulatory patient group rates for services provided by rural critical access hospitals

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Committee


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

do you support this bill?

Actions

view actions (5)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 23, 2014 print number 4375a
amend and recommit to health
Jan 08, 2014 referred to health
Jun 04, 2013 reported and committed to finance
Mar 25, 2013 referred to health

Bill Amendments

Original
A (Active)
Original
A (Active)

Co-Sponsors

S4375 - Bill Details

Current Committee:
Law Section:
Public Health Law
Laws Affected:
Amd §2807, Pub Health L

S4375 - Bill Texts

view summary

Directs the commissioner of health to make recommendations to the governor and legislature on increasing ambulatory patient group rates, in the 2015-2016 state fiscal year, for services provided by rural critical access hospitals.

view sponsor memo
BILL NUMBER:S4375

TITLE OF BILL: An act to amend the public health law, in relation to
directing the commissioner of health to make recommendations relating
to increasing certain ambulatory patient group reimbursement rates

PURPOSE: Directs the commissioner of health to make recommendations
to the governor and the legislature on increasing ambulatory patient
group rates for services provided by rural critical access hospitals.

SUMMARY OF PROVISIONS: Amends Subdivision 2-a of section 2807 of the
Public Health Law by adding a new paragraph (j) directing the
commissioner of health, in conjunction with hospital industry
representatives, to make written recommendations to the Governor and
the legislature, including proposed legislation, for increasing
Ambulatory Patient group rates for rural critical access hospitals by
October 1, 2013. The recommendations must account for increased
operating expenses of inherent to these hospitals, as well as the need
to maintain access, in rural areas. The proposed language, subject to
legislative approval, would be for inclusion in the 2014-2015 state
budget, with rate increases to be effective April 1, 2014.

Section two states the enactment date.

JUSTIFICATION: Critical access hospitals (CAH) serve medically
underserved geographically isolated communities. They provide limited
stay special care, acute care and swing bed services, as well as 24
hour emergency service capability. The maintenance of CAHs is critical
for preserving access to basic health care services for rural New
Yorkers.

Currently, Medicare reimburses CAHs on the basis of reasonable costs,
while New York State Medicaid reimbursement rates are capped at lower
than operational costs.

Because these hospitals must distribute substantial fixed costs over a
small number of visits, an enhanced Medicaid reimbursement would help
to ensure their long range financial viability and preserve access to
needed health care services for isolated communities. Further, this
maintains the States shift in policy of preserving patient care while
improving population health through shifting to outpatient care. This
legislation would support these goals.

Beginning in late 2008, the Department of Health began to implement a
new outpatient payment system that focuses reimbursement based upon
the intensity of the services provided known as Ambulatory patient
groups (APGs).

This legislation would require the Commissioner of Health and the
Hospital industry to collaboratively produce recommendations and
legislative language to provide for an enhanced APG rate that
recognizes the low volume, costly nature of a rural safety net
provider. The legislative proposal will be for inclusion in the SFY
2014/2015 Budget and effective on April 1, 2014.


Because APGs are an already existing rate structure, this legislation
provides consistency with reimbursement methodologies currently used
to pay for outpatient services performed by hospitals, negates the
needs for DOH to implement a new payment methodology specific to CAHs,
and ensures CAHs will receive crucial funding to preserving their
fiscal viability.

LEGISLATIVE HISTORY: This is a new bill

FISCAL IMPLICATIONS: Undetermined

EFFECTIVE DATE: This act shall take effect immediately.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4375

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                             March 25, 2013
                               ___________

Introduced by Sen. YOUNG -- (at request of the Legislative Commission on
  Rural  Resources)  -- read twice and ordered printed, and when printed
  to be committed to the Committee on Health

AN ACT to amend the public health law,  in  relation  to  directing  the
  commissioner  of health to make recommendations relating to increasing
  certain ambulatory patient group reimbursement rates

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

  Section 1. Subdivision 2-a of section 2807 of the public health law is
amended by adding a new paragraph (j) to read as follows:
  (J)  THE  COMMISSIONER  SHALL,  IN  CONJUNCTION WITH HOSPITAL INDUSTRY
REPRESENTATIVES, PROVIDE WRITTEN RECOMMENDATIONS TO THE GOVERNOR AND THE
LEGISLATURE ON OR  BEFORE  OCTOBER  FIRST,  TWO  THOUSAND  THIRTEEN,  ON
INCREASING  AMBULATORY  PATIENT  GROUPS  REIMBURSEMENT RATES ESTABLISHED
PURSUANT TO THIS SUBDIVISION FOR GENERAL HOSPITAL  OUTPATIENT  SERVICES,
GENERAL  HOSPITAL  EMERGENCY  SERVICES,  DIAGNOSTIC AND TREATMENT CENTER
SERVICES AND AMBULATORY SURGICAL SERVICES, PROVIDED BY  RURAL  HOSPITALS
DESIGNATED  AS  CRITICAL ACCESS HOSPITALS IN ACCORDANCE WITH TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT. SUCH RECOMMENDATIONS SHALL TAKE INTO
CONSIDERATION THE INCREASED COSTS OF PROVIDING SUCH  SERVICES  IN  RURAL
AREAS  AS  WELL AS THE NEED TO MAINTAIN ACCESS TO SUCH SERVICES IN RURAL
AREAS. IN ADDITION, THE RECOMMENDATIONS SHALL  CONTAIN  PROPOSED  LEGIS-
LATION,  FOR  INCORPORATION  INTO  THE STATE BUDGET FOR THE TWO THOUSAND
FOURTEEN--TWO THOUSAND FIFTEEN FISCAL YEAR, TO EFFECTUATE RATE INCREASES
EFFECTIVE APRIL FIRST, TWO THOUSAND FOURTEEN.
  S 2. This act shall take effect immediately.


 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10025-01-3

Co-Sponsors

S4375A (ACTIVE) - Bill Details

Current Committee:
Law Section:
Public Health Law
Laws Affected:
Amd §2807, Pub Health L

S4375A (ACTIVE) - Bill Texts

view summary

Directs the commissioner of health to make recommendations to the governor and legislature on increasing ambulatory patient group rates, in the 2015-2016 state fiscal year, for services provided by rural critical access hospitals.

view sponsor memo
BILL NUMBER:S4375A

TITLE OF BILL: An act to amend the public health law, in relation to
directing the commissioner of health to make recommendations relating
to increasing certain ambulatory patient group reimbursement rates

PURPOSE:

Directs the commissioner of health to make recommendations to the
governor and the legislature on increasing ambulatory patient group
rates for services provided by rural critical access hospitals.

SUMMARY OF PROVISIONS:

Amends Subdivision 2-a of section 2807 of the Public Health Law by
adding a new paragraph (j) directing the commissioner of health, in
conjunction with hospital industry representatives, to make written
recommendations to the Governor and the legislature, including
proposed legislation, for increasing Ambulatory Patient group rates
for rural critical access hospitals by October 1, 2014. The
recommendations must account for increased operating expenses of
inherent to these hospitals, as well as the need to maintain access,
in rural areas. The proposed language, subject to legislative
approval, would be for inclusion in the 2015-2016 state budget, with
rate increases to be effective April 1, 2015.

Section two states the enactment date.

JUSTIFICATION:

Critical access hospitals (CAH) serve medically under-served
geographically isolated communities. They provide limited stay special
care, acute care and swing bed services, as well as 24 hour emergency
service capability. The maintenance of CAHs is critical for preserving
access to basic health care services for rural New Yorkers.

Currently, Medicare reimburses CAHs on the basis of reasonable costs,
while New York State Medicaid reimbursement rates are capped at lower
than operational costs.

Because these hospitals must distribute substantial fixed costs over a
small number of visits, an enhanced Medicaid reimbursement would help
to ensure their long range financial viability and preserve access to
needed health care services for isolated communities. Further, this
maintains the States shift in policy of preserving patient care while
improving population health through shifting to outpatient care. This
legislation would support these goals.

Beginning in late 2008, the Department of Health began to implement a
new outpatient payment system that focuses reimbursement based upon
the intensity of the services provided known as Ambulatory patient
groups (APGs).

This legislation would require the Commissioner of Health and the
Hospital industry to collaboratively produce recommendations and
legislative language to provide for an enhanced APG rate that
recognizes the low volume, costly nature of a rural safety net


provider. The legislative proposal will be for inclusion in the SFY
2015/2016 Budget and effective on April 1, 2015.

Because APGs are an already existing rate structure, this legislation
provides consistency with reimbursement methodologies currently used
to pay for outpatient services performed by hospitals, negates the
needs for DOH to implement a new payment methodology specific to CAHs,
and ensures CAHs will receive crucial funding to preserving their
fiscal viability.

LEGISLATIVE HISTORY:

2013: S.4375 REPORTED AND COMMITTED TO FINANCE

FISCAL IMPLICATIONS:

Undetermined

EFFECTIVE DATE:

This act shall take effect immediately.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4375--A

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                             March 25, 2013
                               ___________

Introduced  by  Sens.  YOUNG, O'MARA, RITCHIE, VALESKY -- (at request of
  the Legislative Commission on  Rural  Resources)  --  read  twice  and
  ordered  printed, and when printed to be committed to the Committee on
  Health -- recommitted to the Committee on Health  in  accordance  with
  Senate  Rule  6, sec. 8 -- committee discharged, bill amended, ordered
  reprinted as amended and recommitted to said committee

AN ACT to amend the public health law,  in  relation  to  directing  the
  commissioner  of health to make recommendations relating to increasing
  certain ambulatory patient group reimbursement rates

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

  Section 1. Subdivision 2-a of section 2807 of the public health law is
amended by adding a new paragraph (j) to read as follows:
  (J)  THE  COMMISSIONER  SHALL,  IN  CONJUNCTION WITH HOSPITAL INDUSTRY
REPRESENTATIVES, PROVIDE WRITTEN RECOMMENDATIONS TO THE GOVERNOR AND THE
LEGISLATURE ON OR  BEFORE  OCTOBER  FIRST,  TWO  THOUSAND  FOURTEEN,  ON
INCREASING  AMBULATORY  PATIENT  GROUPS  REIMBURSEMENT RATES ESTABLISHED
PURSUANT TO THIS SUBDIVISION FOR GENERAL HOSPITAL  OUTPATIENT  SERVICES,
GENERAL  HOSPITAL  EMERGENCY  SERVICES,  DIAGNOSTIC AND TREATMENT CENTER
SERVICES AND AMBULATORY SURGICAL SERVICES, PROVIDED BY  RURAL  HOSPITALS
DESIGNATED  AS  CRITICAL ACCESS HOSPITALS IN ACCORDANCE WITH TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT. SUCH RECOMMENDATIONS SHALL TAKE INTO
CONSIDERATION THE INCREASED COSTS OF PROVIDING SUCH  SERVICES  IN  RURAL
AREAS  AS  WELL AS THE NEED TO MAINTAIN ACCESS TO SUCH SERVICES IN RURAL
AREAS. IN ADDITION, THE RECOMMENDATIONS SHALL  CONTAIN  PROPOSED  LEGIS-
LATION,  FOR  INCORPORATION  INTO  THE STATE BUDGET FOR THE TWO THOUSAND
FIFTEEN--TWO THOUSAND SIXTEEN FISCAL YEAR, TO EFFECTUATE RATE  INCREASES
EFFECTIVE APRIL FIRST, TWO THOUSAND FIFTEEN.
  S 2. This act shall take effect immediately.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10025-02-4

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.