Senate Bill S7600

2013-2014 Legislative Session

Directs the commissioner of health to provide for more comprehensive management and administration of providers of managed long term care

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 15, 2014	referred to health

2013-S7600 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §4403-f, Pub Health L

2013-S7600 (ACTIVE) - Summary

Directs the commissioner of health to provide for more comprehensive management and administration of providers of managed long term care.

2013-S7600 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S7600

TITLE OF BILL:  An act to amend the public health law, in relation to
the management and administration of managed long term care plans

PURPOSE:  To clarify service delivery and operational roles, duties
and activities, and to facilitate coordination, efficiency and
quality, in the delivery of managed care-home care contracted
services.

SUMMARY OF PROVISIONS:

Section one amends the public health law to direct the Commissioner of
Health to develop a listing of the respective responsibilities for the
provision of services by managed long term care plans and home care
providers. The delineation of plan-provider responsibilities would
include, but not be limited to, responsibilities for: enrollee
assessment; supervision of direct care personnel; procurement,
maintenance and updating of medical orders; recordkeeping; and
reporting.

The listing would provide for clarity of plan-provider responsibility,
minimize plan-provider duplication, reconcile any conflicting
regulations and program requirements, and otherwise streamline
plan-provider duties for program operation and delivery of care. The
commissioner would seek the participation and assistance of

representatives of the home care workgroup, managed long term care
plans, licensed home care services agencies, certified home health
agencies, long term home health care programs and statewide
associations representative of such plans and providers in the
delineation and streamlining of such responsibilities.

The bill requires that the Commissioner issue such delineation no
later than sixty days following the effective date of the bill.

The bill also requires the Commissioner, in consultation with the
department of financial services, to examine and, within sixty days of
the bill's effective day, make recommendations to the legislature
regarding the feasibility and appropriateness of creating system-wide
efficiencies through establishment of payment practices, including but
not limited to: uniform billing codes; timeframes for the provision of
written authorization for services and payment; payment assurances for
services provided based on verbal authorization; and, requirements for
electronic payment.

Section 2 establishes an immediate effective date for the bill.

JUSTIFICATION:  This bill is necessary to effectively and efficiently
implement the state's major policy changes and system redesign of
incorporating Medicaid and Medicaid-Medicare long term care services
under manage care plans.

The bill would implement key recommendations of the State's Home and
Community Based Services Regulatory Workgroup established by the
2013-14 state budget and continued in the 2014-15 state budget. These
recommendations were also substantially based in testimony, input and
proposals received from the affected health care sectors.


This bill would address vital concerns and system improvements for the
home care providers and health plans faithfully working to implement
the state's reform and redesign efforts.

LEGISLATIVE HISTORY: New bill.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE:  This bill shall take effect immediately.

2013-S7600 (ACTIVE) - Bill Text download pdf

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

                                  7600

                            I N  S E N A T E

                              May 15, 2014
                               ___________

Introduced  by  Sen.  HANNON -- 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 the management and
  administration of managed long term care plans

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

  Section  1.    Subparagraph  (i)  of paragraph (a) of subdivision 7 of
section 4403-f of the public health law, as amended by section  41-b  of
part H of chapter 59 of the laws of 2011, is amended to read as follows:
  (i)  The  commissioner  shall promulgate regulations to implement this
section and to ensure the quality, appropriateness  and  cost-effective-
ness  of  the  services  provided  by  managed long term care plans. The
commissioner may waive rules and regulations of the department,  includ-
ing  but  not  limited  to, those pertaining to duplicative requirements
concerning record keeping, boards of directors, staffing and  reporting,
when  such  waiver  will  promote the efficient delivery of appropriate,
quality, cost-effective services and when the health, safety and general
welfare of enrollees will not be impaired as a result of such waiver. In
order to achieve managed long term care  plan  system  efficiencies  and
coordination  and  to promote the objectives of high quality, integrated
and cost effective care, the commissioner [may]:
  (A) SHALL DEVELOP A LISTING OF THE RESPECTIVE RESPONSIBILITIES FOR THE
PROVISION OF SERVICES UNDER THIS SECTION BY MANAGED LONG TERM CARE PLANS
AND HOME CARE PROVIDERS LICENSED OR CERTIFIED UNDER  ARTICLE  THIRTY-SIX
OF  THIS  CHAPTER.  SUCH  DELINEATION  OF PLAN-PROVIDER RESPONSIBILITIES
SHALL INCLUDE, BUT NOT BE LIMITED  TO,  RESPONSIBILITIES  FOR:  ENROLLEE
ASSESSMENT;  SUPERVISION  OF DIRECT CARE PERSONNEL; PROCUREMENT, MAINTE-
NANCE AND UPDATING OF MEDICAL ORDERS; RECORDKEEPING; AND REPORTING.  THE
LISTING SHALL PROVIDE FOR CLARITY OF PLAN-PROVIDER RESPONSIBILITY, MINI-
MIZE  PLAN-PROVIDER  DUPLICATION,  RECONCILE ANY CONFLICTING REGULATIONS
AND PROGRAM REQUIREMENTS, AND OTHERWISE STREAMLINE PLAN-PROVIDER  DUTIES
REQUIRED  UNDER  THIS  SECTION.  THE COMMISSIONER SHALL SEEK THE PARTIC-
IPATION AND ASSISTANCE OF REPRESENTATIVES OF THE  HOME  CARE  WORKGROUP,
MANAGED  LONG  TERM  CARE  PLANS,  LICENSED HOME CARE SERVICES AGENCIES,

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

                                                           LBD15267-01-4

S. 7600                             2

CERTIFIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS  AND
STATEWIDE ASSOCIATIONS REPRESENTATIVE OF SUCH PLANS AND PROVIDERS IN THE
DELINEATION AND STREAMLINING OF SUCH RESPONSIBILITIES.  THE COMMISSIONER
SHALL  ISSUE  SUCH  DELINEATION  NO  LATER THAN SIXTY DAYS FOLLOWING THE
EFFECTIVE DATE OF THIS CLAUSE; AND
  (B) SHALL, IN CONSULTATION WITH THE DEPARTMENT OF FINANCIAL  SERVICES,
EXAMINE  AND,  WITHIN  SIXTY  DAYS OF THE EFFECTIVE DATE OF THIS CLAUSE,
MAKE RECOMMENDATIONS TO THE LEGISLATURE REGARDING  THE  FEASIBILITY  AND
APPROPRIATENESS  OF CREATING SYSTEM-WIDE EFFICIENCIES THROUGH ESTABLISH-
MENT OF PAYMENT PRACTICES, INCLUDING BUT NOT LIMITED TO: UNIFORM BILLING
CODES;  TIMEFRAMES  FOR  THE  PROVISION  OF  WRITTEN  AUTHORIZATION  FOR
SERVICES  AND PAYMENT; PAYMENT ASSURANCES FOR SERVICES PROVIDED BASED ON
VERBAL AUTHORIZATION; AND, REQUIREMENTS FOR ELECTRONIC PAYMENT; AND
  (C) MAY establish a single coordinated surveillance process, allow for
a comprehensive quality improvement and review process to meet component
quality requirements, and require a uniform cost report. The commission-
er shall require  managed  long  term  care  plans  to  utilize  quality
improvement measures, based on health outcomes data, for internal quali-
ty  assessment  processes  and  may utilize such measures as part of the
single coordinated surveillance process.
  S 2. This act shall take effect immediately; provided,  however,  that
the  amendments  to  section  4403-f  of  the  public health law made by
section one of this act shall not affect the repeal of such section  and
shall be deemed to be repealed therewith.

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Senate Bill S7600

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

2013-S7600 (ACTIVE) - Details

2013-S7600 (ACTIVE) - Summary

2013-S7600 (ACTIVE) - Sponsor Memo

2013-S7600 (ACTIVE) - Bill Text download pdf

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Sponsored By

Kemp Hannon

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

2013-S7600 (ACTIVE) - Details

2013-S7600 (ACTIVE) - Summary

2013-S7600 (ACTIVE) - Sponsor Memo

2013-S7600 (ACTIVE) - Bill Text download pdf

Comments