NY State Senate Bill 2017-S6219B

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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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2018	referred to health
Jun 14, 2017	print number 6219b
Jun 14, 2017	amend and recommit to health
May 22, 2017	print number 6219a
May 22, 2017	amend (t) and recommit to health
May 11, 2017	referred to health

Bill Amendments

Original

B (Active)

2017-S6219 - Details

See Assembly Version of this Bill:: A8011
Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §364-j, Soc Serv L; amd §4403-f, Pub Health L
Versions Introduced in 2019-2020 Legislative Session:: S3960, A2787

2017-S6219 - Summary

Provides that increased rates of payment for behavioral health services shall be deemed to be effective on the date of the law, rule or regulation under which the change or increase is required.

2017-S6219 - Sponsor Memo

                                 BILL NUMBER:  S6219

 TITLE OF BILL :

An act to amend the social services law and the public health law, in
relation to timely payments to behavioral health providers

 PURPOSE OR GENERAL IDEA OF BILL :

The purpose of this bill is to require Medicaid Managed Care plans and
plans under Child Health Plus to implement changes in rates, coverage
or other payments for behavioral health providers on the same date as
the change was enacted in law, regulation, rule or guidance.

 SUMMARY OF SPECIFIC PROVISIONS :

Section 1 adds a new subdivision 6 to section 365-m of social services
law and provides that Medicaid Managed Care plans shall make
adjustments in payments to behavioral health providers on the same
date as changes in rates, coverage or other areas take effect. If such
plans require additional time to make technical or other system
updates, the bill states that they shall pay providers within 45 days
and shall pay retroactively.

Section 2 adds a new subdivision 22 to section 2511 of public health
law and provides that Child Health Plus organizations shall make

adjustments in payments to behavioral health providers on the same
date as changes in rates, coverage or other areas take effect. If such
organizations require additional time to make technical or other
system updates, the bill states that they shall pay providers within
45 days and shall pay retroactively.

Section 3 adds a new subdivision 6 to section 4406 of public health
law and provides that Medicaid Managed Care plans shall make
adjustments in payments to behavioral health providers on the same
date as changes in rates, coverage or other areas take effect. If such
plans require additional time to make technical or other system
updates, the bill states that they shall pay providers within 45 days
and shall pay retroactively.

Section 4 provides an effective date.

 JUSTIFICATION :

Occasionally, adjustments are made to the rates paid to behavioral
health providers by the State due to statutory or budget changes,
re-basing, workforce increases and market forces. Currently,
behavioral health providers are paid under Medicaid Managed Care and
Child Health Plus using ambulatory patient group (APG) rates. As
adjustments are made, these rates are then updated and applied to
behavioral health provider payments. Such .adjustments are factored
into the premiums that the state pays to Medicaid Managed Care and
Child Health Plus plans to be used to pay such providers.

However, plans can delay making necessary system updates to reflect
new rates that should be paid to providers, despite the fact that the
state is factoring these changes into their premiums. As a result
there are delays in when providers see these adjustment made and often
plans refuse to pay retroactively back to the effective date of when
the rate change was made. This bill would address this serious issue
in the interest of basic fairness and out of concern for the continued
viability of community behavioral health clinics and other providers
who rely greatly on this funding.

The bill requires Medicaid Managed Care and Child Health Plus plans to
pay behavioral health providers the new rates on the effective date of
the change. If more time is needed to make necessary adjustments, the
bill provides 45 days but states that such payments by plans shall be
retroactive to providers back to the effective date of the change.

 PRIOR LEGISLATIVE HISTORY :

None

 FISCAL IMPLICATIONS :

None

 EFFECTIVE DATE :
This act shall take effect in 60 days.

2017-S6219 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6219
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                               May 11, 2017
                                ___________
 
 Introduced  by  Sen.  ORTT  --  read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the social services law and the public  health  law,  in
   relation to timely payments to behavioral health providers
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 365-m of the social  services  law  is  amended  by
 adding a new subdivision 6 to read as follows:
   6.  INCREASED  RATES  OR PAYMENTS FOR BEHAVIORAL HEALTH PROVIDERS AS A
 RESULT OF A RATE, COVERAGE OR OTHER CHANGE MADE PURSUANT TO A LAW, REGU-
 LATION, RULE OR GUIDANCE  SHALL  BE  DEEMED  IN  EFFECT  UNDER  MEDICAID
 MANAGED  CARE  ON  THE  SAME  DATE THAT SUCH CHANGE TAKES EFFECT IN LAW,
 REGULATION, RULE OR GUIDANCE. ANY DELAYS THAT RESULT FROM  TECHNICAL  OR
 OTHER NECESSARY UPDATES OR UPGRADES TO A MANAGED CARE PROVIDER'S PAYMENT
 SYSTEM  SHALL  RESULT  IN THE RETROACTIVE PAYMENT ADJUSTMENT OF THE FULL
 AMOUNT OF THE REQUIRED INCREASED RATES OR PAYMENTS TO IMPACTED PROVIDERS
 BACK TO THE EFFECTIVE DATE OF THE CHANGE SET FORTH IN  LAW,  REGULATION,
 RULE  OR  GUIDANCE,  PROVIDED  THAT  ALL RETROACTIVE PAYMENT ADJUSTMENTS
 SHALL BE MADE NO LATER THAN FORTY-FIVE DAYS AFTER SUCH ADDITIONAL  FUNDS
 WERE MADE AVAILABLE TO MANAGED CARE PROVIDERS.
   §  2. Section 2511 of the public health law is amended by adding a new
 subdivision 22 to read as follows:
   22. INCREASED RATES OR PAYMENTS FOR BEHAVIORAL HEALTH PROVIDERS  AS  A
 RESULT OF A RATE, COVERAGE OR OTHER CHANGE MADE PURSUANT TO A LAW, REGU-
 LATION,  RULE  OR  GUIDANCE SHALL BE DEEMED IN EFFECT UNDER CHILD HEALTH
 PLUS ON THE SAME DATE THAT SUCH CHANGE TAKES EFFECT IN LAW,  REGULATION,
 RULE  OR GUIDANCE. ANY DELAYS THAT RESULT FROM TECHNICAL OR OTHER NECES-
 SARY UPDATES OR UPGRADES TO SUCH  ORGANIZATION'S  PAYMENT  SYSTEM  SHALL
 RESULT  IN  THE RETROACTIVE PAYMENT ADJUSTMENT OF THE FULL AMOUNT OF THE
 REQUIRED INCREASED RATES OR PAYMENTS TO IMPACTED PROVIDERS BACK  TO  THE
 EFFECTIVE DATE OF THE CHANGE SET FORTH IN LAW, REGULATION, RULE OR GUID-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD11698-01-7

 S. 6219                             2
 
 ANCE, PROVIDED THAT ALL RETROACTIVE PAYMENT ADJUSTMENTS SHALL BE MADE NO
 LATER  THAN FORTY-FIVE DAYS AFTER SUCH ADDITIONAL FUNDS WERE MADE AVAIL-
 ABLE TO SUCH ORGANIZATIONS.
   §  3. Section 4406 of the public health law is amended by adding a new
 subdivision 6 to read as follows:
   6. INCREASED RATES OR PAYMENTS FOR BEHAVIORAL HEALTH  PROVIDERS  AS  A
 RESULT OF A RATE, COVERAGE OR OTHER CHANGE MADE PURSUANT TO A LAW, REGU-
 LATION,  RULE  OR  GUIDANCE  SHALL  BE  DEEMED  IN EFFECT UNDER MEDICAID
 MANAGED CARE ON THE SAME DATE THAT SUCH  CHANGE  TAKES  EFFECT  IN  LAW,
 REGULATION,  RULE  OR GUIDANCE. ANY DELAYS THAT RESULT FROM TECHNICAL OR
 OTHER NECESSARY UPDATES OR UPGRADES TO MEDICAID MANAGED  CARE  PROVIDERS
 PAYMENT SYSTEM SHALL RESULT IN THE RETROACTIVE PAYMENT ADJUSTMENT OF THE
 FULL  AMOUNT  OF  THE  REQUIRED  INCREASED RATES OR PAYMENTS TO IMPACTED
 PROVIDERS BACK TO THE EFFECTIVE DATE OF THE CHANGE  SET  FORTH  IN  LAW,
 REGULATION,  RULE  OR  GUIDANCE,  PROVIDED  THAT ALL RETROACTIVE PAYMENT
 ADJUSTMENTS SHALL BE MADE NO LATER THAN FORTY-FIVE DAYS AFTER SUCH ADDI-
 TIONAL FUNDS WERE MADE AVAILABLE TO MEDICAID MANAGED CARE PROVIDERS.
   § 4. This act shall take effect on the sixtieth  day  after  it  shall
 have become a law.

2017-S6219A - Details

See Assembly Version of this Bill:: A8011
Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §364-j, Soc Serv L; amd §4403-f, Pub Health L
Versions Introduced in 2019-2020 Legislative Session:: S3960, A2787

2017-S6219A - Summary

Provides that increased rates of payment for behavioral health services shall be deemed to be effective on the date of the law, rule or regulation under which the change or increase is required.

2017-S6219A - Sponsor Memo

                                 BILL NUMBER:  S6219A

 TITLE OF BILL :  An act to amend the social services law and the
public health law, in relation to payments for behavioral health
services

 PURPOSE OR GENERAL IDEA OF BILL :

To require Medicaid managed care plans, managed long term care plans,
and plans under Child Health Plus to implement required changes in
rates, coverage or payments for behavioral health providers on the
same date as the change takes effect for Medicaid non-managed care, or
to make updated payments retroactively to that date.

 SUMMARY OF PROVISIONS :

Section 1 amends section 364-j of the social services law by adding a
new paragraph (e) to subdivision 18, providing that Medicaid managed
care plans shall adjust payments to behavioral health providers
required by law, regulations or guidelines, on the same date as
changes in rates, coverage or other areas take effect for non-managed
care. If such plans require additional time to make technical or other
system updates, they shall make retroactive payments to the providers.

Sections 2 and 3 amend sections 2511 and 4403-f of the public health
law respectively, to make the same change for Child Health Plus and

managed long-term care plans.

Section 4 makes the bill effective immediately.

 JUSTIFICATION :

Medicaid managed care plans, managed long term care plans, and Child
Health Plus organizations pay behavioral health providers using
ambulatory patient group (APG) rates, which are occasionally adjusted
by the state due to statutory or budgetary changes, re-basing,
workforce increases, and market forces. When rates are adjusted
upward, the state increases payments to managed care plans and Child
Health Plus organizations accordingly, and the plans are supposed to
pass the payment increase through to providers.

Under current law, however, plans can delay making the necessary
system updates to reflect new provider payment rates and are not
required to make retroactive payment adjustments, despite receiving
increased payments from the state for that purpose.

This bill will ensure that state payments intended to reimburse
behavioral health providers will be distributed appropriately, and
will improve the viability of community health care providers that New
Yorkers rely on.

 PRIOR LEGISLATIVE HISTORY :

New bill

 FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS :

None

 EFFECTIVE DATE :
Immediate

2017-S6219A - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6219--A
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                               May 11, 2017
                                ___________
 
 Introduced  by  Sen.  ORTT  --  read twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Health  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 AN  ACT  to  amend the social services law and the public health law, in
   relation to payments for behavioral health services
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Subdivision 18 of section 364-j of the social services law
 is amended by adding a new paragraph (e) to read as follows:
   (E) INCREASED RATES, TERMS OR SCOPE OF PAYMENT FOR  BEHAVIORAL  HEALTH
 SERVICES  UNDER  THIS  TITLE,  WHERE  PAYMENT  IS MADE BY A MANAGED CARE
 PROVIDER UNDER THIS SECTION, AS A RESULT OF A RATE,  COVERAGE  OR  OTHER
 CHANGE  MADE  PURSUANT  TO A LAW, REGULATION, RULE OR OFFICIAL GUIDANCE,
 SHALL BE DEEMED IN EFFECT ON THE SAME DATE THAT SUCH CHANGE  WOULD  HAVE
 TAKEN EFFECT IF PAYMENT WERE MADE OTHER THAN BY THE MANAGED CARE PROVID-
 ER. WHERE PAYMENT IS NOT MADE AS OF THE EFFECTIVE DATE, THE MANAGED CARE
 PROVIDER  SHALL  MAKE  RETROACTIVE  PAYMENTS  TO THE APPROPRIATE SERVICE
 PROVIDERS.
   § 2. Section 2511 of the public health law is amended by adding a  new
 subdivision 22 to read as follows:
   22.  INCREASED  RATES, TERMS OR SCOPE OF PAYMENT FOR BEHAVIORAL HEALTH
 SERVICES UNDER THIS TITLE, WHERE PAYMENT IS MADE BY AN  APPROVED  ORGAN-
 IZATION,  AS  A RESULT OF A RATE, COVERAGE OR OTHER CHANGE MADE PURSUANT
 TO A LAW, REGULATION, RULE OR  OFFICIAL  GUIDANCE  SHALL  BE  DEEMED  IN
 EFFECT  ON  THE  SAME  DATE  THAT SUCH CHANGE WOULD HAVE TAKEN EFFECT IF
 PAYMENT WERE MADE OTHER THAN BY THE APPROVED ORGANIZATION. WHERE PAYMENT
 IS NOT MADE AS OF THE EFFECTIVE DATE, THE  APPROVED  ORGANIZATION  SHALL
 MAKE RETROACTIVE PAYMENTS TO THE APPROPRIATE SERVICE PROVIDERS.
   §  3.  Subdivision  7  of  section  4403-f of the public health law is
 amended by adding a new paragraph (i) to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD11698-02-7

 S. 6219--A                          2
 
   (I) INCREASED RATES, TERMS OR SCOPE OF PAYMENT FOR  BEHAVIORAL  HEALTH
 SERVICES  UNDER  THIS  SECTION, WHERE PAYMENT IS MADE BY AN ENTITY UNDER
 THIS SECTION, AS A RESULT OF A  RATE,  COVERAGE  OR  OTHER  CHANGE  MADE
 PURSUANT  TO  A  LAW,  REGULATION,  RULE  OR OFFICIAL GUIDANCE, SHALL BE
 DEEMED  IN  EFFECT  ON  THE  SAME DATE THAT SUCH CHANGE WOULD HAVE TAKEN
 EFFECT IF PAYMENT WERE MADE OTHER THAN BY THE ENTITY. WHERE  PAYMENT  IS
 NOT  MADE  AS  OF  THE EFFECTIVE DATE, THE ENTITY SHALL MAKE RETROACTIVE
 PAYMENTS TO THE APPROPRIATE SERVICE PROVIDERS.
   § 4. This act shall take effect immediately; provided,  however,  that
 the  amendments  to section 364-j of the social services law and section
 4403-f of the public health law made by sections one and three  of  this
 act,  respectively,  shall  not  affect  the repeal of such sections and
 shall be deemed repealed therewith.

co-Sponsors

2017-S6219B (ACTIVE) - Details

See Assembly Version of this Bill:: A8011
Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §364-j, Soc Serv L; amd §4403-f, Pub Health L
Versions Introduced in 2019-2020 Legislative Session:: S3960, A2787

2017-S6219B (ACTIVE) - Summary

Provides that increased rates of payment for behavioral health services shall be deemed to be effective on the date of the law, rule or regulation under which the change or increase is required.

2017-S6219B (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S6219B

 TITLE OF BILL :  An act to amend the social services law and the
public health law, in relation to payments for behavioral health
services

 PURPOSE OR GENERAL IDEA OF BILL :

To require Medicaid managed care plans, managed long term care plans,
and plans under Child Health Plus to implement required changes in
rates, coverage or payments for behavioral health providers on the
same date as the change takes effect for Medicaid non-managed care, or
to make updated payments retroactively to that date.

 SUMMARY OF PROVISIONS :

Section 1 amends section 364-j of the social services law by adding a
new paragraph (e) to subdivision 18, providing that Medicaid managed
care plans shall adjust payments to behavioral health providers
required by law, regulations or guidelines, on the same date as
changes in rates, coverage or other areas take effect for non-managed
care. If such plans require additional time to make technical or other
system updates, they shall make retroactive payments to the providers.

Sections 2 and 3 amend sections 2511 and 4403-f of the public health
law respectively, to make the same change for Child Health Plus and

managed long-term care plans.

Section 4 makes the bill effective immediately.

 JUSTIFICATION :

Medicaid managed care plans, managed long term care plans, and Child
Health Plus organizations pay behavioral health providers using
ambulatory patient group (APG) rates, which are occasionally adjusted
by the state due to statutory or budgetary changes, re-basing,
workforce increases, and market forces. When rates are adjusted
upward, the state increases payments to managed care plans and Child
Health Plus organizations accordingly, and the plans are supposed to
pass the payment increase through to providers.

Under current law, however, plans can delay making the necessary
system updates to reflect new provider payment rates and are not
required to make retroactive payment adjustments, despite receiving
increased payments from the state for that purpose.

This bill will ensure that state payments intended to reimburse behav-
ioral health providers will be distributed appropriately, and will
improve the viability of community health care providers that New
Yorkers rely on.

 PRIOR LEGISLATIVE HISTORY :

New bill

 FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS :

None

 EFFECTIVE DATE :
Immediate

2017-S6219B (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6219--B
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                               May 11, 2017
                                ___________
 
 Introduced  by  Sen.  ORTT  --  read twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Health  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to  said  committee  --  committee  discharged,  bill amended, ordered
   reprinted as amended and recommitted to said committee

 AN ACT to amend the social services law and the public  health  law,  in
   relation to payments for behavioral health services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivision 18 of section 364-j of the social services  law
 is amended by adding a new paragraph (e) to read as follows:
   (E)  INCREASED  RATES, TERMS OR SCOPE OF PAYMENT FOR BEHAVIORAL HEALTH
 SERVICES UNDER THIS TITLE, WHERE PAYMENT  IS  MADE  BY  A  MANAGED  CARE
 PROVIDER  UNDER  THIS  SECTION, AS A RESULT OF A RATE, COVERAGE OR OTHER
 CHANGE MADE PURSUANT TO A LAW, REGULATION, RULE  OR  OFFICIAL  GUIDANCE,
 SHALL  BE  DEEMED IN EFFECT ON THE SAME DATE THAT SUCH CHANGE WOULD HAVE
 TAKEN EFFECT IF PAYMENT WERE MADE OTHER THAN BY THE MANAGED CARE PROVID-
 ER. WHERE PAYMENT IS NOT MADE AS OF THE EFFECTIVE DATE, THE MANAGED CARE
 PROVIDER SHALL MAKE RETROACTIVE  PAYMENTS  TO  THE  APPROPRIATE  SERVICE
 PROVIDERS.
   §  2.  Subdivision  7  of  section  4403-f of the public health law is
 amended by adding a new paragraph (i) to read as follows:
   (I) INCREASED RATES, TERMS OR SCOPE OF PAYMENT FOR  BEHAVIORAL  HEALTH
 SERVICES  UNDER  THIS  SECTION, WHERE PAYMENT IS MADE BY AN ENTITY UNDER
 THIS SECTION, AS A RESULT OF A  RATE,  COVERAGE  OR  OTHER  CHANGE  MADE
 PURSUANT  TO  A  LAW,  REGULATION,  RULE  OR OFFICIAL GUIDANCE, SHALL BE
 DEEMED IN EFFECT ON THE SAME DATE THAT  SUCH  CHANGE  WOULD  HAVE  TAKEN
 EFFECT  IF  PAYMENT WERE MADE OTHER THAN BY THE ENTITY. WHERE PAYMENT IS
 NOT MADE AS OF THE EFFECTIVE DATE, THE  ENTITY  SHALL  MAKE  RETROACTIVE
 PAYMENTS TO THE APPROPRIATE SERVICE PROVIDERS.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11698-03-7

 S. 6219--B                          2
 
   §  3.  This act shall take effect immediately; provided, however, that
 the amendments to section 364-j of the social services law  and  section
 4403-f  of  the  public  health law made by sections one and two of this
 act, respectively, shall not affect the  repeal  of  such  sections  and
 shall be deemed repealed therewith.

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Senate Bill S6219B

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

Bill Amendments

2017-S6219 - Details

2017-S6219 - Summary

2017-S6219 - Sponsor Memo

2017-S6219 - Bill Text download pdf

2017-S6219A - Details

2017-S6219A - Summary

2017-S6219A - Sponsor Memo

2017-S6219A - Bill Text download pdf

co-Sponsors

2017-S6219B (ACTIVE) - Details

2017-S6219B (ACTIVE) - Summary

2017-S6219B (ACTIVE) - Sponsor Memo

2017-S6219B (ACTIVE) - Bill Text download pdf

Comments

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Senate Bill S6219B

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Sponsored By

Robert G. Ortt

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

Bill Amendments

2017-S6219 - Details

2017-S6219 - Summary

2017-S6219 - Sponsor Memo

2017-S6219 - Bill Text download pdf

2017-S6219A - Details

2017-S6219A - Summary

2017-S6219A - Sponsor Memo

2017-S6219A - Bill Text download pdf

co-Sponsors

Luis R. Sepúlveda

2017-S6219B (ACTIVE) - Details

2017-S6219B (ACTIVE) - Summary

2017-S6219B (ACTIVE) - Sponsor Memo

2017-S6219B (ACTIVE) - Bill Text download pdf

Comments