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.