S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6602
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                               June 6, 2017
                                ___________
 
 Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 AN ACT to amend the public health law, in relation  to  partially  rein-
   stating  a  Medicaid reserved bed benefit for temporarily hospitalized
   nursing home residents

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivision 25 of section 2808 of the public health law, as
 amended  by  section  2  of part E of chapter 57 of the laws of 2017, is
 amended to read as follows:
   25. Reserved bed  days.  (a)  For  purposes  of  this  subdivision,  a
 "reserved  bed  day"  is  a  day for which a governmental agency pays OR
 OTHERWISE REQUIRES a residential health care facility to reserve  a  bed
 for a person eligible for medical assistance pursuant to title eleven of
 article  five  of the social services law while he or she is TEMPORARILY
 HOSPITALIZED OR on therapeutic leave of absence from the facility.
   (b) Notwithstanding any other provisions of this section or any  other
 law  or  regulation  to  the contrary, for reserved bed days provided on
 behalf of persons twenty-one years of age or older:
   (i) payments for reserved  bed  days  shall  be  made  at  ninety-five
 percent  of  the  Medicaid  rate  otherwise  payable to the facility for
 services provided on behalf of such person; [and]
   (ii) NOTWITHSTANDING SUBPARAGRAPH (I) OF THIS PARAGRAPH,  FOR  PERIODS
 ON  AND  AFTER JULY FIRST, TWO THOUSAND SEVENTEEN, PAYMENTS FOR RESERVED
 BED DAYS FOR TEMPORARY HOSPITALIZATIONS SHALL BE MADE AT  FIFTY  PERCENT
 OF  THE  MEDICAID  RATE  OTHERWISE  PAYABLE TO THE FACILITY FOR SERVICES
 PROVIDED ON BEHALF OF SUCH PERSON, AND PAYMENTS FOR  RESERVED  BED  DAYS
 FOR  THERAPEUTIC  LEAVES OF ABSENCE SHALL BE MADE AT NINETY-FIVE PERCENT
 OF THE MEDICAID RATE OTHERWISE PAYABLE  TO  THE  FACILITY  FOR  SERVICES
 PROVIDED ON BEHALF OF SUCH PERSON;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD13089-01-7
              

 S. 6602                             2
 
   (III)  FOR  PERIODS  ON  AND AFTER JULY FIRST, TWO THOUSAND SEVENTEEN,
 PAYMENT TO A FACILITY FOR RESERVED BED DAYS PROVIDED ON BEHALF  OF  SUCH
 PERSON  FOR  TEMPORARY HOSPITALIZATIONS MAY NOT EXCEED SEVEN DAYS IN ANY
 TWELVE MONTH PERIOD; PROVIDED HOWEVER THAT SUCH PAYMENTS  ON  BEHALF  OF
 PERSONS  RECEIVING  SERVICES  IN DISCRETE UNITS FOR LONG-TERM VENTILATOR
 DEPENDENT RESIDENTS MAY NOT EXCEED FOURTEEN DAYS  IN  ANY  TWELVE  MONTH
 PERIOD;  AND  FURTHER PROVIDED THAT SUCH FACILITY SHALL RESERVE THE SAME
 BED AND ROOM THE PERSON OCCUPIED BEFORE BEING  HOSPITALIZED  FOR  UP  TO
 FOURTEEN  DAYS IN ANY TWELVE MONTH PERIOD, NOTWITHSTANDING THE SEVEN DAY
 LIMITATION OF PAYMENT ESTABLISHED BY THIS SUBPARAGRAPH; AND
   (IV) payment to a facility for reserved bed days provided on behalf of
 such person for therapeutic leaves of absence may not exceed ten days in
 any twelve month period.
   (C) SUBJECT TO THE PROVISIONS OF THIS SUBDIVISION AND  TO  THE  AVAIL-
 ABILITY  OF  FEDERAL  FINANCIAL  PARTICIPATION,  THE  COMMISSIONER SHALL
 PROMULGATE REGULATIONS, AND MAY PROMULGATE EMERGENCY REGULATIONS, EFFEC-
 TIVE FOR PERIODS ON AND AFTER JULY FIRST, TWO THOUSAND SEVENTEEN, ESTAB-
 LISHING PAYMENTS FOR  RESERVED  BED  DAYS  AND  APPLICABLE  REQUIREMENTS
 PERMITTING RESIDENTS TO RETURN TO A FACILITY AFTER THEY ARE HOSPITALIZED
 OR  PLACED  ON  THERAPEUTIC  LEAVE  OF  ABSENCE.  SUCH REGULATIONS SHALL
 PROVIDE AS FOLLOWS:
   (I) THE LIMITATIONS ON PAYMENT ESTABLISHED BY THIS  SUBDIVISION  SHALL
 NOT  APPLY  TO RESERVED BED DAYS PROVIDED ON BEHALF OF PERSONS LESS THAN
 TWENTY-ONE YEARS OF AGE, OR TO RESERVED BED DAYS  PAYMENTS  TO  HOSPICES
 FOR  PERSONS  RESIDING  IN RESIDENTIAL HEALTH CARE FACILITIES WHO ARE IN
 RECEIPT OF HOSPICE SERVICES;
   (II) IN ORDER TO QUALIFY FOR COVERAGE OF RESERVED BED DAYS, THE PERSON
 MUST HAVE RESIDED IN THE RESIDENTIAL HEALTH CARE FACILITY FOR  AT  LEAST
 THIRTY DAYS SINCE THE DATE OF HIS OR HER INITIAL ADMISSION; AND THE PART
 OF THE FACILITY TO WHICH THE PERSON WILL RETURN MUST HAVE A VACANCY RATE
 OF NO MORE THAN FIVE PERCENT ON THE FIRST DAY THE PERSON IS HOSPITALIZED
 OR ON A THERAPEUTIC LEAVE OF ABSENCE;
   (III)  UNLESS  MEDICALLY  CONTRAINDICATED, THE RESIDENTIAL HEALTH CARE
 FACILITY SHALL RESERVE THE SAME BED AND ROOM THE PERSON OCCUPIED  BEFORE
 BEING HOSPITALIZED OR PLACED ON THERAPEUTIC LEAVE OF ABSENCE;
   (IV)  A  RESIDENTIAL HEALTH CARE FACILITY SHALL NOT RESERVE A PERSON'S
 BED WHEN:
   (A) IT IS CLEAR WHEN THE PERSON IS HOSPITALIZED THAT HE  OR  SHE  WILL
 NOT RETURN TO THE FACILITY WITHIN FOURTEEN DAYS OR FEWER;
   (B)  AFTER  HOSPITALIZATION,  THE PERSON WILL NEED A LEVEL OF CARE THE
 FACILITY DOES NOT PROVIDE; OR
   (C) THE RECIPIENT DOES NOT WANT TO RETURN TO THE FACILITY; AND
   (V) A RESIDENTIAL HEALTH CARE FACILITY SHALL ESTABLISH  AND  FOLLOW  A
 WRITTEN POLICY UNDER WHICH A PERSON WHOSE HOSPITALIZATION OR THERAPEUTIC
 LEAVE EXCEEDS THE BED HOLD PERIOD ESTABLISHED UNDER THIS SUBDIVISION, OR
 WHO  HAS RESIDED IN THE NURSING HOME FOR THIRTY DAYS OR MORE AND WHO HAS
 BEEN HOSPITALIZED OR WHO HAS BEEN PLACED ON  THERAPEUTIC  LEAVE  WITHOUT
 BEING  GIVEN  A BED HOLD, IS READMITTED TO THE FACILITY IMMEDIATELY UPON
 THE FIRST AVAILABILITY OF A BED IN A SEMI-PRIVATE ROOM IF  THE  RESIDENT
 WANTS  TO  RETURN TO THE FACILITY; REQUIRES THE SERVICES PROVIDED BY THE
 FACILITY; AND IS ELIGIBLE FOR MEDICAID COVERED RESIDENTIAL  HEALTH  CARE
 FACILITY SERVICES.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2017.