NY State Senate Bill 2017-S1098A

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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 06, 2018	print number 1098a
Jun 06, 2018	amend and recommit to health
Jan 03, 2018	referred to health
Jan 06, 2017	referred to health

Bill Amendments

Original

A (Active)

2017-S1098 - Details

See Assembly Version of this Bill:: A2358
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§4403-f, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2013-2014: S6583, A3781
2015-2016: S379, A7354, A414
2019-2020: A2406, A2797
2021-2022: A6034

2017-S1098 - Summary

Relates to prohibiting ownership or control of managed long term care plans by health maintenance organizations or insurers.

2017-S1098 - Sponsor Memo

                                 BILL NUMBER:  S1098

 TITLE OF BILL :  An act to amend the public health law, in relation
to managed long term care plans not being controlled or owned by
for-profit health maintenance organizations or insurers

 PURPOSE :

To assure that managed long term care plans are primarily owned by not
for profit providers or service entities, to promote best practices
consistent with the interests of the recipient.

 SUMMARY OF PROVISIONS :

Amends the definition of "eligible applicant" for certification as a
managed long term care (MLTC) plan to require eligible insurers and
health maintenance organizations be not-for-profit. An exception would
recognize entities already certified.

 JUSTIFICATION :

Medicaid long term care (over 120 days) has been reformed to be
delivered by care coordination entities, predominantly through
risk-bearing managed long term care plans. Currently, this transition
is applied to home and community-based services, with institutional
(nursing home)care contemplated, to be phased in.

MLTCs have, until now, been almost exclusively entities owned by long
term care providers, not by HMOs or insurance companies. When
participation in an MLTC was voluntary, there was little concern that
insurance carriers would enter the field. However, now participation
in an MLTC is mandatory for many and will become mandatory for more
long term care recipients. There is growing interest by for-profit
HMOs and insurance companies in forming MLTCs. With their economic
resources they could easily come to dominate the field. So there is
growing concern that patients may ultimately have no choice but to
enroll in for-profit insurance carrier-owned MLTCs.

The individuals affected by this transition are primarily those with
chronic conditions, many who are elderly or otherwise affected with
life-limiting illness. Care and service decisions for these
individuals should not be measured against profit margins of
shareholders. Other states' experience in this area has proven that
provider-based MLTCs, which most all of New York MLTCs currently are,
deliver both the quality and the savings expected.

 LEGISLATIVE HISTORY :

2013-2014: S6583
2015-2016: S379A

 FISCAL IMPLICATIONS :

None.

 EFFECTIVE DATE :
Immediately

2017-S1098 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1098
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                              January 6, 2017
                                ___________
 
 Introduced  by  Sen.  RIVERA -- 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 managed long  term
   care  plans not being controlled or owned by for-profit health mainte-
   nance organizations or insurers

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (b)  of subdivision 1 of section 4403-f of the
 public health law, as added by chapter 659  of  the  laws  of  1997,  is
 amended to read as follows:
   (b) "Eligible applicant" means an entity controlled or wholly owned by
 one  or  more of the following: a hospital as defined in subdivision one
 of section twenty-eight hundred one of this chapter; a home care  agency
 licensed  or  certified  pursuant to article thirty-six of this chapter;
 [an] A NOT-FOR-PROFIT entity that has received a certificate of authori-
 ty pursuant to sections forty-four  hundred  three,  forty-four  hundred
 three-a or AN INTEGRATED DELIVERY SYSTEM THAT HAS RECEIVED A CERTIFICATE
 OF  AUTHORITY  PURSUANT  TO  SECTION  forty-four hundred eight-a of this
 article (as added by chapter six hundred  thirty-nine  of  the  laws  of
 nineteen  hundred  ninety-six),  or  a NOT-FOR-PROFIT health maintenance
 organization authorized under article forty-three of the insurance  law;
 or  a  not-for-profit  organization  which has a history of providing or
 coordinating health care services and long term  care  services  to  the
 elderly  and  disabled.    HOWEVER,  AN ENTITY OWNED OR CONTROLLED BY AN
 ENTITY THAT HAS RECEIVED A CERTIFICATE OF AUTHORITY PURSUANT TO  SECTION
 FORTY-FOUR  HUNDRED  THREE OR FORTY-FOUR HUNDRED THREE-A OF THIS ARTICLE
 AND HAS RECEIVED A CERTIFICATE OF AUTHORITY UNDER THIS SECTION PRIOR  TO
 THE  EFFECTIVE DATE OF THE CHAPTER OF THE LAWS OF TWO THOUSAND SEVENTEEN
 WHICH ENACTED THIS SENTENCE SHALL BE DEEMED TO BE AN ELIGIBLE APPLICANT.
   § 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 repealed therewith.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00870-01-7

2017-S1098A (ACTIVE) - Details

See Assembly Version of this Bill:: A2358
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§4403-f, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2013-2014: S6583, A3781
2015-2016: S379, A7354, A414
2019-2020: A2406, A2797
2021-2022: A6034

2017-S1098A (ACTIVE) - Summary

Relates to prohibiting ownership or control of managed long term care plans by health maintenance organizations or insurers.

2017-S1098A (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S1098A

SPONSOR: RIVERA
 
TITLE OF BILL:  An act to amend the public health law, in relation to
managed long term care plans not being controlled or owned by for-profit
health maintenance organizations or insurers

 
PURPOSE:

To assure that managed long term care plans are primarily owned by not
for profit providers or service entities, to promote best practices
consistent with the interests of the recipient.

 
SUMMARY OF PROVISIONS:

Amends the definition of "eligible applicant" for certification as a
managed long term care (MLTC) plan to require eligible insurers and
health maintenance organizations be not-for-profit. An exception would
recognize entities already certified.

JUSTIFICATION:

Medicaid long term care (over 120 days) has been reformed to be deliv-
ered by care coordination entities, predominantly through risk-bearing
managed long term care plans. Currently, this transition is applied to
home and community-based services, with institutional (nursing home)care
contemplated, to be phased in.

MLTCs have, until now, been almost exclusively entities owned by long
term care providers, not by HMOs or insurance companies. When partic-
ipation in an MLTC was voluntary, there was little concern that insur-
ance carriers would enter the field. However, now participation in an
MLTC is mandatory for many and will become mandatory for more long term
care recipients. There is growing interest by for-profit HMOs and insur-
ance companies in forming MLTCs. With their economic resources they
could easily come to dominate the field. So there is growing concern
that patients may ultimately have no choice but to enroll in for-profit
insurance carrier-owned MLTCs.

The individuals affected by this transition are primarily those with
chronic conditions, many who are elderly or otherwise affected with
life-limiting illness. Care and service decisions for these individuals
should not be measured against profit margins of shareholders. Other
states' experience in this area has proven that provider-based MLTCs,
which most all of New York MLTCs currently are, deliver both the quality
and the savings expected.

 
LEGISLATIVE HISTORY:

2013-2014: S6583
2015-2016: S379A

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
Immediately

2017-S1098A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1098--A
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                              January 6, 2017
                                ___________
 
 Introduced  by  Sen.  RIVERA -- 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 managed long term
   care plans not being controlled or owned by for-profit health  mainte-
   nance organizations or insurers
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (b) of subdivision 1 of  section  4403-f  of  the
 public  health  law,  as  added  by  chapter 659 of the laws of 1997, is
 amended to read as follows:
   (b) "Eligible applicant" means an entity controlled or wholly owned by
 one or more of the following: a hospital as defined in  subdivision  one
 of  section twenty-eight hundred one of this chapter; a home care agency
 licensed or certified pursuant to article thirty-six  of  this  chapter;
 [an] A NOT-FOR-PROFIT entity that has received a certificate of authori-
 ty  pursuant  to  sections  forty-four hundred three, forty-four hundred
 three-a or AN INTEGRATED DELIVERY SYSTEM THAT HAS RECEIVED A CERTIFICATE
 OF AUTHORITY PURSUANT TO SECTION  forty-four  hundred  eight-a  of  this
 article  (as  added  by  chapter  six hundred thirty-nine of the laws of
 nineteen hundred ninety-six), or  a  NOT-FOR-PROFIT  health  maintenance
 organization  authorized under article forty-three of the insurance law;
 or a not-for-profit organization which has a  history  of  providing  or
 coordinating  health  care  services  and long term care services to the
 elderly and disabled.   HOWEVER, AN ENTITY OWNED  OR  CONTROLLED  BY  AN
 ENTITY  THAT HAS RECEIVED A CERTIFICATE OF AUTHORITY PURSUANT TO SECTION
 FORTY-FOUR HUNDRED THREE OR FORTY-FOUR HUNDRED THREE-A OF  THIS  ARTICLE
 AND  HAS RECEIVED A CERTIFICATE OF AUTHORITY UNDER THIS SECTION PRIOR TO
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00870-04-8

 S. 1098--A                          2
 
 THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS OF TWO  THOUSAND  EIGHTEEN
 WHICH ENACTED THIS SENTENCE SHALL BE DEEMED TO BE AN ELIGIBLE APPLICANT.
   §  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 repealed therewith.

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Senate Bill S1098A

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2017-S1098 - Details

2017-S1098 - Summary

2017-S1098 - Sponsor Memo

2017-S1098 - Bill Text download pdf

2017-S1098A (ACTIVE) - Details

2017-S1098A (ACTIVE) - Summary

2017-S1098A (ACTIVE) - Sponsor Memo

2017-S1098A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S1098A

Share this bill

Sponsored By

Gustavo Rivera

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2017-S1098 - Details

2017-S1098 - Summary

2017-S1098 - Sponsor Memo

2017-S1098 - Bill Text download pdf

2017-S1098A (ACTIVE) - Details

2017-S1098A (ACTIVE) - Summary

2017-S1098A (ACTIVE) - Sponsor Memo

2017-S1098A (ACTIVE) - Bill Text download pdf

Comments