S T A T E O F N E W Y O R K
________________________________________________________________________
847--A
2017-2018 Regular Sessions
I N A S S E M B L Y
January 9, 2017
___________
Introduced by M. of A. GUNTHER, LUPARDO, JENNE -- read once and referred
to the Committee on Mental Health -- recommitted to the Committee on
Mental Health in accordance with Assembly Rule 3, sec. 2 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT directing the office for people with developmental disabilities
to study and develop suitable measures to prevent financial hardship
and/or failure of providers serving individuals with developmental
disabilities funded by Medicaid to support the uninterrupted continua-
tion of necessary services
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The commissioner of the office for people with develop-
mental disabilities in conjunction with the commissioner of health,
shall jointly prepare a report which shall include the following:
a. Recommendations for holding harmless from further rate reductions
those efficient providers within a region that operate beneath the
regional average rate. Severity of disability shall be taken into
consideration for purposes of comparing efficient providers.
b. A methodology for adjusting rates so that total prospective
reimbursement received by a provider for a program must equal the total
costs of that program which shall include all necessary cost components
for operating the program. The report shall examine the extent to which
units used in rate calculations are reflective of the actual units
delivered to ensure that providers are not penalized for lost revenue
due to unforeseeable program closures, absenteeism and policies designed
to curtail program enrollment.
c. Recommendations for a prospective rate appeal process designed to
increase rates as necessary during a non-rebasing year to cover costs.
Any recommended appeal process shall ensure that providers who prevail
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03798-03-8
A. 847--A 2
on such appeal receive additional reimbursement as of the date the
appeal was submitted.
d. Recommendations to enhance program stability and the quality of
care including but not limited to lengthening the period between base
year updates and alternating base years by program.
e. Identification of those elements of the plan that must be approved
by the Centers for Medicare and Medicaid Services and a plan for achiev-
ing such approval.
§ 2. The commissioner of the office for people with developmental
disabilities shall submit a report detailing the issues set forth in
this act and recommendations to the temporary president of the senate,
the speaker of the assembly, the chairs of the senate committee on
mental health and developmental disabilities and the assembly committee
on mental health no later than February 1, 2019.
§ 3. This act shall take effect immediately.