S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6153
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                               May 11, 2017
                                ___________
 
 Introduced by Sen. HANNON -- (at request of the Department of Health) --
   read  twice  and  ordered printed, and when printed to be committed to
   the Committee on Health
 
 AN ACT to amend chapter 474 of the laws of 1996, amending the  education
   law  and  other  laws  relating  to  rates for residential health care
   facilities, in relation to  extending  the  effectiveness  of  certain
   provisions  thereof; to amend chapter 81 of the laws of 1995, amending
   the public health law and other laws relating to medical reimbursement
   and welfare reform, in relation  to  extending  the  effectiveness  of
   certain  provisions  thereof; to amend chapter 58 of the laws of 2008,
   amending the social services law and the public health law relating to
   adjustments of rates, in relation to extending the date of the expira-
   tion of certain provisions thereof; and to amend chapter  779  of  the
   laws of 1986, amending the social services law relating to authorizing
   services  for  non-residents in adult homes, residences for adults and
   enriched housing programs, in relation to extending the  effectiveness
   of certain provisions thereof

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 228 of chapter 474 of the laws  of  1996,  amending
 the  education  law  and  other  laws  relating to rates for residential
 health care facilities, as amended by section 10 of part D of chapter 57
 of the laws of 2015, is amended to read as follows:
   § 228. 1. Definitions. (a) Regions,  for  purposes  of  this  section,
 shall  mean  a downstate region to consist of Kings, New York, Richmond,
 Queens, Bronx, Nassau and Suffolk counties  and  an  upstate  region  to
 consist  of  all  other New York state counties. A certified home health
 agency or long term home health care program shall  be  located  in  the
 same county utilized by the commissioner of health for the establishment
 of rates pursuant to article 36 of the public health law.
   (b)  Certified  home  health  agency  (CHHA)  shall  mean such term as
 defined in section 3602 of the public health law.
   (c) Long term home health care program (LTHHCP) shall mean  such  term
 as defined in subdivision 8 of section 3602 of the public health law.
              

 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09944-01-7

 S. 6153                             2
 
   (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
 ly, located within a region.
   (e)  Medicaid  revenue percentage, for purposes of this section, shall
 mean CHHA and LTHHCP  revenues  attributable  to  services  provided  to
 persons  eligible  for payments pursuant to title 11 of article 5 of the
 social services law divided by such revenues plus CHHA and LTHHCP reven-
 ues attributable to services provided to beneficiaries of Title XVIII of
 the federal social security act (medicare).
   (f) Base period, for purposes of this  section,  shall  mean  calendar
 year 1995.
   (g) Target period. For purposes of this section, the 1996 target peri-
 od  shall  mean  August  1, 1996 through March 31, 1997, the 1997 target
 period shall mean January 1, 1997 through November 30,  1997,  the  1998
 target  period shall mean January 1, 1998 through November 30, 1998, the
 1999 target period shall mean January 1, 1999 through November 30, 1999,
 the 2000 target period shall mean January 1, 2000 through  November  30,
 2000, the 2001 target period shall mean January 1, 2001 through November
 30,  2001,  the  2002  target  period shall mean January 1, 2002 through
 November 30, 2002, the 2003 target period shall  mean  January  1,  2003
 through  November 30, 2003, the 2004 target period shall mean January 1,
 2004 through November 30, 2004, and the 2005 target  period  shall  mean
 January  1, 2005 through November 30, 2005, the 2006 target period shall
 mean January 1, 2006 through November 30,  2006,  and  the  2007  target
 period shall mean January 1, 2007 through November 30, 2007 and the 2008
 target  period shall mean January 1, 2008 through November 30, 2008, and
 the 2009 target period shall mean January 1, 2009 through  November  30,
 2009  and  the  2010  target  period  shall mean January 1, 2010 through
 November 30, 2010 and the 2011 target period shall mean January 1,  2011
 through  November 30, 2011 and the 2012 target period shall mean January
 1, 2012 through November 30, 2012 and the 2013 target period shall  mean
 January  1,  2013  through November 30, 2013, and the 2014 target period
 shall mean January 1, 2014 through November 30, 2014 and the 2015 target
 period shall mean January 1, 2015 through November 30, 2015 and the 2016
 target period shall mean January 1, 2016 through November 30,  2016  and
 the  2017  target period shall mean January 1, 2017 through November 30,
 2017 AND THE 2018 TARGET PERIOD  SHALL  MEAN  JANUARY  1,  2018  THROUGH
 NOVEMBER  30, 2018 AND THE 2019 TARGET PERIOD SHALL MEAN JANUARY 1, 2019
 THROUGH NOVEMBER 30, 2019 AND THE 2020 TARGET PERIOD SHALL MEAN  JANUARY
 1, 2020 THROUGH NOVEMBER 30, 2020.
   2.  (a) Prior to February 1, 1997, for each regional group the commis-
 sioner of health shall calculate the 1996 medicaid  revenue  percentages
 for the period commencing August 1, 1996 to the last date for which such
 data is available and reasonably accurate.
   (b)  Prior  to  February  1, 1998, prior to February 1, 1999, prior to
 February 1, 2000, prior to February 1, 2001, prior to February 1,  2002,
 prior  to February 1, 2003, prior to February 1, 2004, prior to February
 1, 2005, prior to February 1, 2006, prior to February 1, 2007, prior  to
 February  1, 2008, prior to February 1, 2009, prior to February 1, 2010,
 prior to February 1, 2011, prior to February 1, 2012, prior to  February
 1,  2013,  prior  to  February 1, 2014, prior to February 1, 2015, [and]
 prior to February 1, 2016 [and], prior to February  1,  2017,  PRIOR  TO
 FEBRUARY  1,  2018,  PRIOR TO FEBRUARY 1, 2019, AND PRIOR TO FEBRUARY 1,
 2020 for each regional group the commissioner of health shall  calculate
 the  prior year's medicaid revenue percentages for the period commencing
 January 1 through November 30 of such prior year.

 S. 6153                             3
 
   3. By September 15, 1996, for each regional group the commissioner  of
 health shall calculate the base period medicaid revenue percentage.
   4.  (a)  For  each  regional  group,  the 1996 target medicaid revenue
 percentage shall be calculated by subtracting the 1996 medicaid  revenue
 reduction percentages from the base period medicaid revenue percentages.
 The  1996  medicaid  revenue  reduction  percentage, taking into account
 regional and program differences in utilization of medicaid and medicare
 services, for the following regional groups shall be equal to:
   (i) one and one-tenth percentage points for CHHAs located  within  the
 downstate region;
   (ii)  six-tenths  of one percentage point for CHHAs located within the
 upstate region;
   (iii) one and eight-tenths percentage points for LTHHCPs located with-
 in the downstate region; and
   (iv) one and seven-tenths percentage points for LTHHCPs located within
 the upstate region.
   (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004,  2005,  2006,  2007,
 2008,  2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016 [and], 2017, 2018,
 2019 AND 2020 for each  regional  group,  the  target  medicaid  revenue
 percentage  for  the  respective year shall be calculated by subtracting
 the respective year's medicaid revenue  reduction  percentage  from  the
 base  period medicaid revenue percentage. The medicaid revenue reduction
 percentages for 1997, 1998, 2000, 2001, 2002, 2003,  2004,  2005,  2006,
 2007,  2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016 [and], 2017,
 2018, 2019 AND 2020, taking into account regional  and  program  differ-
 ences  in utilization of medicaid and medicare services, for the follow-
 ing regional groups shall be equal to for each such year:
   (i) one and one-tenth percentage points for CHHAs located  within  the
 downstate region;
   (ii)  six-tenths  of one percentage point for CHHAs located within the
 upstate region;
   (iii) one and eight-tenths percentage points for LTHHCPs located with-
 in the downstate region; and
   (iv) one and seven-tenths percentage points for LTHHCPs located within
 the upstate region.
   (c) For each regional group, the 1999 target medicaid revenue percent-
 age shall  be  calculated  by  subtracting  the  1999  medicaid  revenue
 reduction  percentage  from the base period medicaid revenue percentage.
 The 1999 medicaid revenue reduction  percentages,  taking  into  account
 regional and program differences in utilization of medicaid and medicare
 services, for the following regional groups shall be equal to:
   (i)  eight  hundred  twenty-five  thousandths (.825) of one percentage
 point for CHHAs located within the downstate region;
   (ii) forty-five hundredths (.45) of one  percentage  point  for  CHHAs
 located within the upstate region;
   (iii)  one  and  thirty-five  hundredths  percentage points (1.35) for
 LTHHCPs located within the downstate region; and
   (iv) one and two hundred seventy-five  thousandths  percentage  points
 (1.275) for LTHHCPs located within the upstate region.
   5.  (a) For each regional group, if the 1996 medicaid revenue percent-
 age is not equal to or  less  than  the  1996  target  medicaid  revenue
 percentage,  the  commissioner of health shall compare the 1996 medicaid
 revenue percentage to the 1996 target  medicaid  revenue  percentage  to
 determine  the  amount  of the shortfall which, when divided by the 1996
 medicaid  revenue  reduction  percentage,  shall  be  called  the   1996
 reduction  factor.  These  amounts, expressed as a percentage, shall not

 S. 6153                             4
 
 exceed one hundred percent. If the 1996 medicaid revenue  percentage  is
 equal  to  or less than the 1996 target medicaid revenue percentage, the
 1996 reduction factor shall be zero.
   (b)  For  1997,  1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, [and]  2017,
 2018 AND 2019, for each regional group, if the medicaid revenue percent-
 age  for  the  respective  year  is not equal to or less than the target
 medicaid revenue percentage for such respective year,  the  commissioner
 of health shall compare such respective year's medicaid revenue percent-
 age  to  such  respective  year's  target medicaid revenue percentage to
 determine the amount of the shortfall which, when divided by the respec-
 tive year's medicaid revenue reduction percentage, shall be  called  the
 reduction factor for such respective year. These amounts, expressed as a
 percentage, shall not exceed one hundred percent. If the medicaid reven-
 ue  percentage for a particular year is equal to or less than the target
 medicaid revenue percentage for that year, the reduction factor for that
 year shall be zero.
   6. (a) For each regional group, the 1996  reduction  factor  shall  be
 multiplied  by  the following amounts to determine each regional group's
 applicable 1996 state share reduction amount:
   (i) two million three hundred ninety thousand dollars ($2,390,000) for
 CHHAs located within the downstate region;
   (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
 within the upstate region;
   (iii) one million two hundred seventy  thousand  dollars  ($1,270,000)
 for LTHHCPs located within the downstate region; and
   (iv)  five  hundred  ninety  thousand  dollars  ($590,000) for LTHHCPs
 located within the upstate region.
   For each regional group reduction, if the 1996 reduction factor  shall
 be zero, there shall be no 1996 state share reduction amount.
   (b)  For  1997,  1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016 [and], 2017,  2018,
 2019  AND  2020,  for  each regional group, the reduction factor for the
 respective year shall be multiplied by the following amounts  to  deter-
 mine  each  regional group's applicable state share reduction amount for
 such respective year:
   (i) two million three hundred ninety thousand dollars ($2,390,000) for
 CHHAs located within the downstate region;
   (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
 within the upstate region;
   (iii) one million two hundred seventy  thousand  dollars  ($1,270,000)
 for LTHHCPs located within the downstate region; and
   (iv)  five  hundred  ninety  thousand  dollars  ($590,000) for LTHHCPs
 located within the upstate region.
   For each regional group reduction,  if  the  reduction  factor  for  a
 particular  year  shall be zero, there shall be no state share reduction
 amount for such year.
   (c) For each regional group, the 1999 reduction factor shall be multi-
 plied by the following amounts to determine each regional group's appli-
 cable 1999 state share reduction amount:
   (i) one million seven hundred ninety-two thousand five hundred dollars
 ($1,792,500) for CHHAs located within the downstate region;
   (ii) five hundred sixty-two thousand five hundred  dollars  ($562,500)
 for CHHAs located within the upstate region;
   (iii)  nine hundred fifty-two thousand five hundred dollars ($952,500)
 for LTHHCPs located within the downstate region; and

 S. 6153                             5

   (iv) four hundred forty-two thousand five hundred  dollars  ($442,500)
 for LTHHCPs located within the upstate region.
   For  each regional group reduction, if the 1999 reduction factor shall
 be zero, there shall be no 1999 state share reduction amount.
   7. (a) For each regional group, the 1996 state share reduction  amount
 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
 on  the  basis  of  the  extent  of  each CHHA's and LTHHCP's failure to
 achieve the 1996 target medicaid revenue  percentage,  calculated  on  a
 provider  specific  basis utilizing revenues for this purpose, expressed
 as a proportion of the total of each  CHHA's  and  LTHHCP's  failure  to
 achieve  the 1996 target medicaid revenue percentage within the applica-
 ble regional group. This proportion shall be multiplied by the  applica-
 ble  1996 state share reduction amount calculation pursuant to paragraph
 (a) of subdivision 6 of this section. This amount shall  be  called  the
 1996 provider specific state share reduction amount.
   (b)  For  1997,  1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016 [and],  2017,
 2018,  2019  AND 2020 for each regional group, the state share reduction
 amount for the respective year shall be allocated by the commissioner of
 health among CHHAs and LTHHCPs on the basis of the extent of each CHHA's
 and LTHHCP's failure to achieve the target medicaid  revenue  percentage
 for the applicable year, calculated on a provider specific basis utiliz-
 ing revenues for this purpose, expressed as a proportion of the total of
 each  CHHA's and LTHHCP's failure to achieve the target medicaid revenue
 percentage for the applicable year within the applicable regional group.
 This proportion shall be multiplied by the applicable year's state share
 reduction amount calculation pursuant to paragraph (b) or (c) of  subdi-
 vision  6  of  this  section.  This  amount shall be called the provider
 specific state share reduction amount for the applicable year.
   8. (a) The 1996 provider specific state share reduction  amount  shall
 be due to the state from each CHHA and LTHHCP and may be recouped by the
 state  by  March  31, 1997 in a lump sum amount or amounts from payments
 due to the CHHA and LTHHCP pursuant to title 11  of  article  5  of  the
 social services law.
   (b) The provider specific state share reduction amount for 1997, 1998,
 1999,  2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
 2011, 2012, 2013, 2014, 2015, 2016 [and],  2017,  2018,  2019  AND  2020
 respectively,  shall  be  due to the state from each CHHA and LTHHCP and
 each year the amount due for such year may be recouped by the  state  by
 March  31  of  the  following  year in a lump sum amount or amounts from
 payments due to the CHHA and LTHHCP pursuant to title 11 of article 5 of
 the social services law.
   9. CHHAs and LTHHCPs shall submit such data and  information  at  such
 times  as  the  commissioner  of health may require for purposes of this
 section. The commissioner of health may use data available  from  third-
 party payors.
   10. On or about June 1, 1997, for each regional group the commissioner
 of  health  shall  calculate for the period August 1, 1996 through March
 31, 1997 a medicaid revenue percentage,  a  reduction  factor,  a  state
 share  reduction  amount,  and a provider specific state share reduction
 amount in accordance with the methodology provided in paragraph  (a)  of
 subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
 sion  6 and paragraph (a) of subdivision 7 of this section. The provider
 specific state share reduction amount calculated in accordance with this
 subdivision shall be compared to the 1996 provider specific state  share
 reduction amount calculated in accordance with paragraph (a) of subdivi-

 S. 6153                             6
 
 sion 7 of this section. Any amount in excess of the amount determined in
 accordance  with paragraph (a) of subdivision 7 of this section shall be
 due to the state from each CHHA  and  LTHHCP  and  may  be  recouped  in
 accordance  with  paragraph (a) of subdivision 8 of this section. If the
 amount is less than the amount determined in accordance  with  paragraph
 (a)  of  subdivision 7 of this section, the difference shall be refunded
 to the CHHA and LTHHCP by the state no later than July 15,  1997.  CHHAs
 and  LTHHCPs  shall  submit  data  for the period August 1, 1996 through
 March 31, 1997 to the commissioner of health by April 15, 1997.
   11. If a CHHA or LTHHCP  fails  to  submit  data  and  information  as
 required for purposes of this section:
   (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
 caid  revenue  percentage  between  the  applicable  base period and the
 applicable target period for purposes of the  calculations  pursuant  to
 this section; and
   (b)  the  commissioner of health shall reduce the current rate paid to
 such CHHA and such LTHHCP by state  governmental  agencies  pursuant  to
 article  36  of the public health law by one percent for a period begin-
 ning on the first day of the calendar month following the applicable due
 date as established by the commissioner of health and  continuing  until
 the last day of the calendar month in which the required data and infor-
 mation are submitted.
   12. The commissioner of health shall inform in writing the director of
 the  budget  and the chair of the senate finance committee and the chair
 of the assembly ways and means committee of the results  of  the  calcu-
 lations pursuant to this section.
   § 2. Paragraph (f) of subdivision 1 of section 64 of chapter 81 of the
 laws  of 1995, amending the public health law and other laws relating to
 medical reimbursement and welfare reform, as amended  by  section  7  of
 part D of chapter 57 of the laws of 2015, is amended to read as follows:
   (f)  Prior  to  February  1, 2001, February 1, 2002, February 1, 2003,
 February 1, 2004, February 1, 2005, February 1, 2006, February 1,  2007,
 February  1, 2008, February 1, 2009, February 1, 2010, February 1, 2011,
 February 1, 2012, February 1, 2013, February 1, 2014, February 1,  2015,
 February  1, 2016 [and], February 1, 2017, FEBRUARY 1, 2018, FEBRUARY 1,
 2019 AND FEBRUARY 1, 2020, the commissioner of  health  shall  calculate
 the  result  of  the statewide total of residential health care facility
 days of care provided to beneficiaries of title  XVIII  of  the  federal
 social  security act (medicare), divided by the sum of such days of care
 plus days of care provided to residents eligible for  payments  pursuant
 to  title 11 of article 5 of the social services law minus the number of
 days provided to  residents  receiving  hospice  care,  expressed  as  a
 percentage, for the period commencing January 1, through November 30, of
 the  prior  year  respectively, based on such data for such period. This
 value shall be called the 2000, 2001,  2002,  2003,  2004,  2005,  2006,
 2007,  2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016 [and], 2017,
 2018,  2019 AND 2020 statewide target percentage respectively.
   § 3. Subparagraph (ii) of paragraph (b) of subdivision 3 of section 64
 of chapter 81 of the laws of 1995, amending the public  health  law  and
 other  laws  relating  to  medical  reimbursement and welfare reform, as
 amended by section 8 of part D of chapter 57 of the  laws  of  2015,  is
 amended to read as follows:
   (ii)  If  the  1997,  1998,  2000, 2001, 2002, 2003, 2004, 2005, 2006,
 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016 [and],  2017,
 2018,  2019  AND 2020 statewide target percentages are not for each year
 at least three percentage points higher than the statewide base percent-

 S. 6153                             7
 
 age, the commissioner of health shall determine the percentage by  which
 the  statewide  target  percentage  for  each year is not at least three
 percentage  points  higher  than  the  statewide  base  percentage.  The
 percentage  calculated  pursuant  to  this paragraph shall be called the
 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008,  2009,
 2010,  2011,  2012,  2013,  2014, 2015, 2016 [and], 2017, 2018, 2019 AND
 2020 statewide reduction percentage respectively.   If the  1997,  1998,
 2000,  2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,
 2012, 2013, 2014, 2015, 2016 [and], 2017, 2018, 2019 AND 2020  statewide
 target  percentage  for the respective year is at least three percentage
 points  higher  than  the  statewide  base  percentage,  the   statewide
 reduction percentage for the respective year shall be zero.
   §  4.  Subparagraph (iii) of paragraph (b) of subdivision 4 of section
 64 of chapter 81 of the laws of 1995, amending the public health law and
 other laws relating to medical  reimbursement  and  welfare  reform,  as
 amended  by  section  9  of part D of chapter 57 of the laws of 2015, is
 amended to read as follows:
   (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,  2008,
 2009,  2010,  2011, 2012, 2013, 2014, 2015, 2016 [and], 2017, 2018, 2019
 AND 2020 statewide reduction  percentage  shall  be  multiplied  by  one
 hundred  two  million  dollars respectively to determine the 1998, 2000,
 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,  2012,
 2013, 2014, 2015, 2016 [and], 2017, 2018, 2019 AND 2020 statewide aggre-
 gate reduction amount. If the 1998 and the 2000, 2001, 2002, 2003, 2004,
 2005,  2006,  2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016
 [and], 2017, 2018, 2019 AND 2020 statewide reduction percentage shall be
 zero respectively, there shall be no 1998, 2000, 2001, 2002, 2003, 2004,
 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014,  2015,  2016
 [and], 2017, 2018, 2019 AND 2020 reduction amount.
   §  5.  Subdivision  (i-1) of section 79 of part C of chapter 58 of the
 laws of 2008, amending the social services law and the public health law
 relating to adjustments of rates, as amended by section 64 of part C  of
 chapter 60 of the laws of 2014, is amended to read as follows:
   (i-1)  section  thirty-one-a of this act shall be deemed repealed July
 1, [2017] 2020;
   § 6. Subdivision 12 of section 246 of chapter 81 of the laws of  1995,
 amending  the  public  health  law  and  other  laws relating to medical
 reimbursement and welfare reform, as amended by section 15 of part D  of
 chapter 57 of the laws of 2015, is amended to read as follows:
   12. Sections one hundred five-b through one hundred five-f of this act
 shall expire [March 31, 2017] JUNE 30, 2018.
   § 7. Section 4 of chapter 779 of the laws of 1986, amending the social
 services law relating to authorizing services for non-residents in adult
 homes,  residences  for adults and enriched housing programs, as amended
 by section 63 of part C of chapter 60 of the laws of 2014, is amended to
 read as follows:
   § 4. This act shall take effect on the one hundred twentieth day after
 it shall have become a law and shall remain in  full  force  and  effect
 until July 1, [2017] 2020, provided however, that effective immediately,
 the addition, amendment and/or repeal of any rules or regulations neces-
 sary for the implementation of the foregoing sections of this act on its
 effective  date  are authorized and directed to be made and completed on
 or before such effective date.
   § 8. This act shall take effect immediately.