NY State Senate Bill 2019-S5546A

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 13, 2020	print number 5546a
Jan 13, 2020	amend and recommit to health
Jan 08, 2020	referred to health
May 06, 2019	referred to health

Bill Amendments

Original

A (Active)

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2019-S5546 - Details

See Assembly Version of this Bill:: A6677
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2807-k, 2807 & 2807-c, Pub Health L; amd §§211 & 212, Chap 474 of 1996

2019-S5546 - Summary

Relates to general hospital and safety net hospital reimbursement rates and Medicaid adjustments.

2019-S5546 - Sponsor Memo

                                
 
BILL NUMBER: S5546

SPONSOR: RIVERA
 
TITLE OF BILL:  An act to amend the public health law, in relation to
the general hospital indigent care pool, hospital reimbursements and
adjustments to medical assistance rates to enhanced safety net hospi-
tals; and to amend chapter 474 of the laws of 1996 amending the educa-
tion law and other laws relating to rates for residential health care
facilities, in relation to extending the effectiveness of such rates

 
PURPOSE OR GENERAL IDEA OF BILL:

Reform the distribution of indigent care pool (ICP) funds intended for
hospitals that are serving a disproportionate share of individuals on
Medicaid or uninsured.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends Public Health Law 2807-k, subdiv. 5d, to proportionate-
ly reduce allocations to major public and voluntary hospitals by $300
million April 1, 2019 through December 31, 2019 (prorated accordingly),

and annually thereafter. The bill eliminates the ICP transition method-
ology, and the $25 million transition support for voluntary hospitals.
These funds are distributed under other provisions of the bill.

Section 2 of the bill adds a new Subdivision 23 to PHL 2807 to authorize
adjustments to Medicaid rates for Enhanced Safety Net hospitals as
defined in the NIL, and to a newly defined category of Qualified Safety
Net hospitals. The new definition of Qualified Safety Net hospital is
intended for hospitals that fall outside of the enhanced safety net
definition, but provide significant indigent care, such as those that
have received financial assistance through the existing VAPAP or VBP QIP
programs and hospitals on the state's financial watch list. This section
also requires the commissioner to increase Medicaid payments for inpa-
tient and outpatient services by $37.7 million to major public general
hospitals and $262.3 million to Enhanced Safety Net and Qualified Safety
Net hospitals other than major public general hospitals. An additional
$12.5 million is dedicated to federally designated critical access and
sole community hospitals. This section increases rates/lump sum payments
or using either VBP QIP or other supplemental programs to safety net
hospitals (other than major public general hospitals) that lose funds
compared to the current ICP distribution.

Section 3 amends subdivision 1 of PHL 2807-c, which provides for hospi-
tal inpatient Medicaid payment rates, to allow adjustments under the
revised PHL 2807(23).

Section 4 adds a new paragraph (d) to subdivision - of PHL 2807-c to
make clear that payments to Enhanced Safety Net and Qualified Safety Net
hospitals do not supplant other funding streams to Enhanced Safety Net
hospitals.

Sections 5 and 6 amend Chapter 474 of the Laws of 1996, to allow addi-
tional $200 million in DSH payments to NYC Health + Hospitals, and addi-
tional $100M DSH to all other major public hospitals, including those
operated by the state, the State University of New York, or Erie, Nassau
or Westchester counties.

 
JUSTIFICATION:
This legislation is needed to fix inequities in distribution of ICP
funds for hospitals serving low income and at-risk communities under the
existing ICP funding and related Medicaid payments. The current law does
not allocate 100% of the funds to those hospitals providing high levels
of care to the uninsured or Medicaid enrollees.  Approximately 15% of
the funds, referred to as a "transition collar," still go to hospitals
that are not providing significant care to the uninsured based on an old
formula.

This legislation would correct these inequities by eliminating the ICP
transition collar without hurting hospitals providing services to low
income and at risk communities; increasing Medicaid rates for safety net
and qualified safety net hospitals; optimizing new federal Medicaid
funds; and retaining all existing federal DSH funds to support these
essential services.

This legislation will rebalance the distribution of hospital indigent
care funding, while staying within the constraints of the State's Medi-
caid Global Cap and without additional financial impact to the State.
The bill removes ICP funding linked to historic bad debt and better
targets ICP funds to uninsured patient care. To address the Medicaid
rate issue, the bill would invest $300 million of ICP funds into Medi-
caid increases for enhanced and qualified safety net hospitals. The
investment by hospital ownership type is proportional to the current
pool funding with public shares of ICP at 12.6% and voluntary shares of
the ICP at 87%.

The bill builds on the Enhanced Safety Net Hospitals statute, and recog-
nizes that additional hospitals are providing essential services to
safety net communities and face serious financial jeopardy. Those hospi-
tals are defined as qualified safety net hospitals and may be identified
by criteria including having been awarded VAPAP or VBP QIP funds, or
placed on the DOH Financially Distressed Watch List; the volume of Medi-
caid or uninsured patients served; or the importance of the hospital in
the hospital's region in providing services to Medicaid and uninsured
patients. The bill would retain all existing federal DSH by allowing
public hospitals access to $150 million federal DSH formerly used for
ICP.

The bill would increase Medicaid reimbursement rates for safety net and
qualified safety net hospitals; dedicate funding for critical access
hospitals and sole community hospitals; expand existing programs for
financially distressed hospitals to ensure no harm to safety net or
qualified safety net hospitals. Leveraging public hospitals' access to
federal DSH will minimize federal DSH cuts to New York State which are
set to begin on October 1, 2019.

 
PRIOR LEGISLATIVE HISTORY:

New bill

 
FISCAL IMPLICATIONS:

No impact on state general fund or Medicaid global cap.

 
EFFECTIVE DATE:
Immediately

2019-S5546 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5546
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                                May 6, 2019
                                ___________
 
 Introduced  by  Sens.  RIVERA,  BENJAMIN,  LIU -- 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 the general hospi-
   tal indigent care pool, hospital  reimbursements  and  adjustments  to
   medical  assistance  rates  to  enhanced  safety net hospitals; and 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 such rates
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivision 5-d of section 2807-k of the public health law,
 as  amended by section 6 of part H of chapter 57 of the laws of 2019, is
 amended to read as follows:
   5-d. (a) Notwithstanding any inconsistent provision of  this  section,
 section  twenty-eight  hundred  seven-w  of  this  article  or any other
 contrary provision of law, and subject to the  availability  of  federal
 financial participation, for periods [on and after January] APRIL first,
 two thousand [thirteen,] NINETEEN through [March] DECEMBER thirty-first,
 two  thousand  [twenty]  NINETEEN AND EACH CALENDAR YEAR THEREAFTER, all
 funds available for distribution pursuant to this section,  [except  for
 funds  distributed  pursuant  to  subparagraph  (v)  of paragraph (b) of
 subdivision five-b  of  this  section,]  and  all  funds  available  for
 distribution  pursuant  to  section twenty-eight hundred seven-w of this
 article, shall be reserved and set aside and distributed  in  accordance
 with the provisions of this subdivision.
   (b)  The commissioner shall promulgate regulations, and may promulgate
 emergency regulations, establishing methodologies for  the  distribution
 of  funds  as  described  in  paragraph (a) of this subdivision and such
 regulations shall include, but not be limited to, the following:
   (i) Such regulations shall  establish  methodologies  for  determining
 each  facility's  relative uncompensated care need amount based on unin-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD10355-03-9

 S. 5546                             2
 
 sured inpatient and outpatient units of service from the cost  reporting
 year  two years prior to the distribution year, multiplied by the appli-
 cable medicaid rates in effect January first of the  distribution  year,
 as summed and adjusted by a statewide cost adjustment factor and reduced
 by  the  sum  of  all  payment  amounts  collected  from  such uninsured
 patients, and as further adjusted  by  application  of  a  nominal  need
 computation  that shall take into account each facility's medicaid inpa-
 tient share.
   (ii) Annual distributions pursuant to such regulations  for  [the  two
 thousand  thirteen  through  two  thousand  twenty  calendar years] EACH
 CALENDAR YEAR BEGINNING WITH THE TWO  THOUSAND  NINETEEN  CALENDAR  YEAR
 shall be in accord with the following:
   (A)  [one  hundred  thirty-nine million four hundred thousand dollars]
 ONE HUNDRED ONE MILLION SEVEN HUNDRED THOUSAND DOLLARS FOR EACH CALENDAR
 YEAR (PRORATED, AS MAY BE NECESSARY, TO REFLECT ANY PERIOD LESS  THAN  A
 YEAR)  shall  be distributed as Medicaid Disproportionate Share Hospital
 ("DSH") payments to major public general hospitals; and
   (B) [nine hundred ninety-four million nine hundred  thousand  dollars]
 SEVEN HUNDRED SEVEN MILLION SIX HUNDRED THOUSAND DOLLARS FOR EACH CALEN-
 DAR YEAR (PRORATED, AS MAY BE NECESSARY, TO REFLECT ANY PERIOD LESS THAN
 A  YEAR)  as  Medicaid DSH payments to eligible general hospitals, other
 than major public general hospitals.
   (iii)[(A) Such regulations shall establish transition  adjustments  to
 the  distributions  made pursuant to clauses (A) and (B) of subparagraph
 (ii) of this paragraph such that no facility experiences a reduction  in
 indigent care pool payments pursuant to this subdivision that is greater
 than the percentages, as specified in clause (C) of this subparagraph as
 compared  to  the  average distribution that each such facility received
 for the three calendar years prior to two thousand thirteen pursuant  to
 this section and section twenty-eight hundred seven-w of this article.
   (B)  Such  regulations  shall  also establish adjustments limiting the
 increases in indigent  care  pool  payments  experienced  by  facilities
 pursuant to this subdivision by an amount that will be, as determined by
 the  commissioner  and  in conjunction with such other funding as may be
 available for this purpose, sufficient to ensure full  funding  for  the
 transition adjustment payments authorized by clause (A) of this subpara-
 graph.
   (C)  No  facility  shall  experience a reduction in indigent care pool
 payments pursuant to this subdivision that: for the calendar year begin-
 ning January first, two thousand thirteen, is greater than two and  one-
 half  percent;  for the calendar year beginning January first, two thou-
 sand fourteen, is greater than five percent; and, for the calendar  year
 beginning  on January first, two thousand fifteen; is greater than seven
 and one-half percent, and for the calendar  year  beginning  on  January
 first,  two  thousand  sixteen, is greater than ten percent; and for the
 calendar year beginning on January first,  two  thousand  seventeen,  is
 greater  than  twelve  and  one-half  percent; and for the calendar year
 beginning on January first,  two  thousand  eighteen,  is  greater  than
 fifteen  percent;  and for the calendar year beginning on January first,
 two thousand nineteen, is greater than seventeen and  one-half  percent;
 and for the calendar year beginning on January first, two thousand twen-
 ty, is greater than twenty percent.
   (iv)]  Such  regulations shall reserve one percent of the funds avail-
 able for distribution in the two  thousand  fourteen  and  two  thousand
 fifteen  calendar  years, and for calendar years thereafter, pursuant to
 this subdivision, subdivision fourteen-f of section twenty-eight hundred

 S. 5546                             3
 
 seven-c of this article, and sections two hundred eleven and two hundred
 twelve of chapter four hundred seventy-four  of  the  laws  of  nineteen
 hundred  ninety-six,  in  a  "financial  assistance compliance pool" and
 shall establish methodologies for the distribution of such pool funds to
 facilities  based  on  their  level  of compliance, as determined by the
 commissioner, with the provisions of subdivision nine-a of this section.
   (c) The commissioner shall annually report to  the  governor  and  the
 legislature  on the distribution of funds under this subdivision includ-
 ing, but not limited to:
   (i) the impact on safety net providers, including community providers,
 rural general hospitals and major public general hospitals;
   (ii) the provision of indigent care by units  of  services  and  funds
 distributed by general hospitals; and
   (iii) the extent to which access to care has been enhanced.
   §  2. Section 2807 of the public health law is amended by adding a new
 subdivision 23 to read follows:
   23. ADJUSTMENTS TO MEDICAID RATES. (A) THE COMMISSIONER IS  AUTHORIZED
 TO  MAKE ADJUSTMENTS TO MEDICAL ASSISTANCE RATES IN ACCORDANCE WITH THIS
 SUBDIVISION TO ENHANCED SAFETY NET HOSPITALS, AS  DEFINED  IN  PARAGRAPH
 (A)  OF  SUBDIVISION THIRTY-FOUR OF SECTION TWENTY-EIGHT HUNDRED SEVEN-C
 OF THIS ARTICLE, AND TO QUALIFIED SAFETY NET HOSPITALS,  AS  DEFINED  IN
 PARAGRAPH  (B) OF THIS SUBDIVISION, FOR THE PURPOSES OF SUPPORTING CRIT-
 ICALLY NEEDED HEALTH CARE SERVICES AND TO ENSURE THE  CONTINUED  MAINTE-
 NANCE AND OPERATION OF SUCH HOSPITALS.
   (B)  FOR  THE  PURPOSES  OF THIS SUBDIVISION, A "QUALIFIED SAFETY NET"
 HOSPITAL SHALL MEAN A HOSPITAL, OTHER THAN AN ENHANCED SAFETY NET HOSPI-
 TAL, SO DESIGNATED BY THE COMMISSIONER PURSUANT TO CRITERIA DEVELOPED BY
 THE COMMISSIONER THAT TAKE INTO ACCOUNT: (I)  THE  HOSPITAL'S  FINANCIAL
 HARDSHIP,  EVIDENCED  BY  THE  OPERATING  LOSSES  OF THE HOSPITAL OR THE
 SYSTEM OF HOSPITALS TO WHICH THE HOSPITAL BELONGS  AND/OR  PARTICIPATION
 BY  THE  HOSPITAL  IN PROGRAMS ESTABLISHED BY THE COMMISSIONER TO ENABLE
 HOSPITALS  IN  FINANCIAL  DISTRESS  TO  MAINTAIN  OPERATIONS  AND  VITAL
 SERVICES;  (II)  THE  VOLUME  OF  MEDICAID  AND/OR  MEDICALLY  UNINSURED
 PATIENTS SERVED BY THE HOSPITAL  COMPARED  TO  OTHER  HOSPITALS  IN  THE
 HOSPITAL'S  REGION;  AND/OR  (III) THE IMPORTANCE OF THE HOSPITAL IN THE
 HOSPITAL'S  REGION  IN  ENABLING  MEDICAID  AND/OR  MEDICALLY  UNINSURED
 PATIENTS'  ACCESS  TO  HEALTH CARE SERVICES IN INPATIENT, OUTPATIENT AND
 COMMUNITY SETTINGS.
   (C) FOR THE STATE FISCAL YEAR COMMENCING  APRIL  FIRST,  TWO  THOUSAND
 NINETEEN,  AND EACH STATE FISCAL YEAR THEREAFTER, THE COMMISSIONER SHALL
 INCREASE MEDICAL ASSISTANCE  RATES  OF  PAYMENTS  FOR  INPATIENT  AND/OR
 OUTPATIENT SERVICES MADE BY EITHER STATE GOVERNMENTAL AGENCIES OR ORGAN-
 IZATIONS  OPERATING IN ACCORDANCE WITH ARTICLE FORTY-THREE OF THE INSUR-
 ANCE LAW OR ARTICLE FORTY-FOUR OF THIS CHAPTER BY AN AGGREGATE OF:
   (I) THIRTY-SEVEN MILLION SEVEN HUNDRED THOUSAND DOLLARS  FOR  ENHANCED
 SAFETY NET HOSPITALS THAT ARE MAJOR PUBLIC GENERAL HOSPITALS;
   (II)  TWO  HUNDRED SEVENTY-FOUR MILLION EIGHT HUNDRED THOUSAND DOLLARS
 FOR QUALIFIED SAFETY NET HOSPITALS AND  ENHANCED  SAFETY  NET  HOSPITALS
 OTHER  THAN  MAJOR  PUBLIC  GENERAL  HOSPITALS, OF WHICH AT LEAST TWELVE
 MILLION FIVE HUNDRED THOUSAND DOLLARS SHALL  BE  ALLOCATED  TO  ENHANCED
 SAFETY NET HOSPITALS THAT ARE FEDERALLY DESIGNATED AS CRITICAL ACCESS OR
 SOLE COMMUNITY HOSPITALS; AND
   (III) TWELVE MILLION FIVE HUNDRED THOUSAND DOLLARS FOR THOSE HOSPITALS
 ELIGIBLE  UNDER  SUBPARAGRAPH  (II)  OF  THIS  PARAGRAPH  FOR  WHICH THE
 COMBINED PAYMENTS MADE, OR TO BE MADE, UNDER SUBPARAGRAPH (II)  OF  THIS
 PARAGRAPH  AND  SUBDIVISION  FIVE-D  OF  SECTION  TWENTY-EIGHT  THOUSAND

 S. 5546                             4
 
 SEVEN-K OF THIS ARTICLE FOR CALENDAR YEAR  TWO  THOUSAND  NINETEEN,  AND
 EACH  CALENDAR  YEAR THEREAFTER, ARE PROJECTED BY THE COMMISSIONER TO BE
 LESS THAN PAYMENTS MADE TO SUCH HOSPITALS PURSUANT TO SUBDIVISION FIVE-D
 OF  SECTION  TWENTY-EIGHT  THOUSAND SEVEN-K OF THIS ARTICLE FOR CALENDAR
 YEAR TWO THOUSAND EIGHTEEN.
   (D) PAYMENTS MADE PURSUANT TO THIS SUBDIVISION MAY BE ADDED  TO  RATES
 OF  PAYMENT,  OR  MADE AS AGGREGATE PAYMENTS OF EQUAL AMOUNTS ON OCTOBER
 ONE AND APRIL ONE OF EACH STATE FISCAL YEAR, TO SUCH ENHANCED SAFETY NET
 HOSPITALS AND QUALIFIED SAFETY NET HOSPITALS IN ACCORDANCE WITH A  METH-
 ODOLOGY  TO BE ESTABLISHED BY THE COMMISSIONER; PROVIDED, HOWEVER, THAT,
 THE COMMISSIONER MAY MAKE  THE  TWELVE  MILLION  FIVE  HUNDRED  THOUSAND
 DOLLARS  IN  PAYMENTS DUE TO ELIGIBLE HOSPITALS UNDER SUBPARAGRAPH (III)
 OF PARAGRAPH (C) OF THIS SUBDIVISION BY INSTEAD  INCREASING  THE  AMOUNT
 OTHERWISE  AWARDED TO SUCH ELIGIBLE HOSPITALS UNDER PROGRAMS ESTABLISHED
 BY THE COMMISSIONER TO ENABLE HOSPITALS IN FINANCIAL DISTRESS  TO  MAIN-
 TAIN  OPERATIONS AND VITAL SERVICES WHILE WORKING TO ACHIEVE LONGER-TERM
 SUSTAINABILITY, INCLUDING, BUT NOT LIMITED TO, THE VALUE  BASED  PAYMENT
 QUALITY IMPROVEMENT PROGRAM.
   §  3.  Subparagraph  (v)  of paragraph (a) of subdivision 1 of section
 2807-c of the public health law, as amended by chapter 639 of  the  laws
 of  1996,  is  amended  and  a new subparagraph (vi) is added to read as
 follows:
   (v) adjustments for any modifications to the case payments  determined
 in accordance with paragraph (a), (b), (c) or (d) of subdivision four of
 this section[.]; AND
   (VI) ADJUSTMENTS FOR ANY MODIFICATIONS TO THE CASE PAYMENTS DETERMINED
 IN  ACCORDANCE  WITH  SUBDIVISION  TWENTY-THREE  OF SECTION TWENTY-EIGHT
 HUNDRED SEVEN OF THIS ARTICLE.
   § 4. Subparagraph (v) of paragraph (a) of  subdivision  1  of  section
 2807-c  of  the public health law, as amended by chapter 731 of the laws
 of 1993, is amended and a new subparagraph (vi)  is  added  to  read  as
 follows:
   (v)  adjustments for any modifications to the case payments determined
 in accordance with paragraph (a), (b), (c) or (d) of subdivision four of
 this section[.]; AND
   (VI) ADJUSTMENTS FOR ANY MODIFICATIONS TO THE CASE PAYMENTS DETERMINED
 IN ACCORDANCE WITH  SUBDIVISION  TWENTY-THREE  OF  SECTION  TWENTY-EIGHT
 HUNDRED SEVEN OF THIS ARTICLE.
   §  5.  Subdivision  34  of  section 2807-c of the public health law is
 amended by adding a new paragraph (d) to read as follows:
   (D) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO
 THE CONTRARY, ADJUSTMENTS MADE PURSUANT TO THIS SUBDIVISION SHALL BE  IN
 ADDITION TO ANY ADJUSTMENTS MADE TO MEDICAL ASSISTANCE RATES TO ENHANCED
 SAFETY  NET  HOSPITALS AUTHORIZED BY SUBDIVISION TWENTY-THREE OF SECTION
 TWENTY-EIGHT HUNDRED SEVEN OF THIS ARTICLE.
   § 6. Subdivision 1 of section 211 of chapter 474 of the laws  of  1996
 amending the education law and other laws relating to rates for residen-
 tial  health care facilities is amended by adding a new paragraph (g) to
 read as follows:
   (G) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO
 THE CONTRARY, EFFECTIVE FOR THE STATE FISCAL  YEAR  BEGINNING  APRIL  1,
 2019, AND ANNUALLY THEREAFTER, THE DEPARTMENT OF HEALTH IS AUTHORIZED TO
 PAY  PUBLIC GENERAL HOSPITALS, OTHER THAN THOSE OPERATED BY THE STATE OF
 NEW YORK OR THE STATE UNIVERSITY OF NEW YORK, AS DEFINED IN  SUBDIVISION
 10  OF  SECTION  2801 OF THE PUBLIC HEALTH LAW, LOCATED IN A CITY WITH A
 POPULATION OF OVER ONE MILLION, ADDITIONAL PAYMENTS FOR INPATIENT HOSPI-

 S. 5546                             5
 
 TAL SERVICES OF 200 MILLION  DOLLARS  ANNUALLY,  AS  MEDICAL  ASSISTANCE
 PURSUANT  TO  TITLE  11  OF  ARTICLE  5  OF  THE SOCIAL SERVICES LAW FOR
 PATIENTS ELIGIBLE FOR FEDERAL FINANCIAL PARTICIPATION UNDER TITLE XIX OF
 THE  FEDERAL  SOCIAL  SECURITY  ACT,  PURSUANT TO FEDERAL LAWS AND REGU-
 LATIONS GOVERNING DISPROPORTIONATE SHARE PAYMENTS TO HOSPITALS, BASED ON
 THE RELATIVE SHARE OF EACH SUCH NON-STATE OPERATED PUBLIC GENERAL HOSPI-
 TAL MEDICAL ASSISTANCE AND UNINSURED PATIENT LOSSES. THE PAYMENTS MAY BE
 ADDED TO RATES OF PAYMENT OR MADE AS AGGREGATE PAYMENTS TO  AN  ELIGIBLE
 PUBLIC GENERAL HOSPITAL.
   §  7.  Subdivision 1 of section 212 of chapter 474 of the laws of 1996
 amending the education law and other laws relating to rates for residen-
 tial health care facilities, is amended by adding a new paragraph (c) to
 read as follows:
   (C) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO
 THE CONTRARY, EFFECTIVE FOR THE STATE FISCAL  YEAR  BEGINNING  APRIL  1,
 2019, AND ANNUALLY THEREAFTER, THE DEPARTMENT OF HEALTH IS AUTHORIZED TO
 PAY  PUBLIC  GENERAL  HOSPITALS, AS DEFINED IN SUBDIVISION 10 OF SECTION
 2801 OF THE PUBLIC HEALTH LAW, OPERATED BY THE STATE OF NEW YORK OR  THE
 STATE  UNIVERSITY  OF NEW YORK OR BY A COUNTY, WHICH SHALL NOT INCLUDE A
 CITY WITH A POPULATION OF OVER ONE MILLION, OF THE STATE  OF  NEW  YORK,
 AND THOSE PUBLIC GENERAL HOSPITALS LOCATED IN THE COUNTY OF WESTCHESTER,
 THE  COUNTY  OF  ERIE  OR  THE COUNTY OF NASSAU, ADDITIONAL PAYMENTS FOR
 INPATIENT HOSPITAL SERVICES OF 100 MILLION DOLLARS ANNUALLY, AS  MEDICAL
 ASSISTANCE  PAYMENTS  PURSUANT  TO  TITLE  11 OF ARTICLE 5 OF THE SOCIAL
 SERVICES LAW FOR PATIENTS ELIGIBLE FOR FEDERAL  FINANCIAL  PARTICIPATION
 UNDER  TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT, PURSUANT TO FEDERAL
 LAWS AND REGULATIONS GOVERNING DISPROPORTIONATE SHARE PAYMENTS TO HOSPI-
 TALS. THE PAYMENTS MAY BE ADDED TO RATES OF PAYMENT OR MADE AS AGGREGATE
 PAYMENTS TO AN ELIGIBLE PUBLIC GENERAL HOSPITAL.
   § 8. This act shall take effect immediately;  provided  however,  that
 the  amendments made to paragraph (a) of subdivision 1 of section 2807-c
 of the public health law made by section three  of  this  act  shall  be
 subject to the expiration and reversion of such paragraph when upon such
 date the provisions of section four of this act shall take effect.

co-Sponsors

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2019-S5546A (ACTIVE) - Details

See Assembly Version of this Bill:: A6677
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2807-k, 2807 & 2807-c, Pub Health L; amd §§211 & 212, Chap 474 of 1996

2019-S5546A (ACTIVE) - Summary

Relates to general hospital and safety net hospital reimbursement rates and Medicaid adjustments.

2019-S5546A (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S5546A

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law, in relation to the general hospi-
tal indigent care pool, hospital reimbursements and adjustments to
medical assistance rates to enhanced safety net hospitals; and 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 such rates

 
PURPOSE OR GENERAL IDEA OF BILL:

Reform the distribution of indigent care pool (ICP) funds intended for
hospitals that are serving a disproportionate share of individuals on
Medicaid or uninsured.

 
SUMMARY OF SPECIFIC PROVISIONS:.

Section 1 amends Public Health Law 2807-k, subdiv. 5-d, to proportion-

ately reduce allocations to major public and voluntary hospitals by $300
million April 1, 2020 through December 31, 2020 (prorated accordingly),
and annually thereafter.  The bill eliminates the ICP transition method-
ology, and the $25 million transition support for voluntary hospitals.
These funds are distributed under other provisions of the bill.

Section 2 of the bill adds a new Subdivision 23 to PHL 2807 to authorize
adjustments to Medicaid rates for Enhanced Safety Net hospitals as
defined in the PHL, and to a newly defined category of Qualified Safety
Net hospitals. The new definition of Qualified Safety Net hospital is
intended for hospitals that fall outside of the enhanced safety net
definition, but provide significant indigent care, such as those that
have received financial assistance through the existing VBPQTNAPAP
programs and hospitals on the state's financial watch list. This section
also requires the commissioner to increase Medicaid payments for inpa-
tient and outpatient services by $37.7 million to major public general
hospitals and $262.3 million to Enhanced Safety Net and Qualified Safety
Net hospitals other than major public general hospitals. An additional
$12.5 million is dedicated to federally designated critical access and
sole community hospitals. This section increases rates/lump sum payments
or using either VBP QIP or other supplemental programs to safety net
hospitals (other than major public general hospitals) that lose funds
compared to the current ICP distribution.

Section 3 amends subdivision 1 of PHL 2807-c, which provides for hospi-
tal inpatient Medicaid payment rates, to allow adjustments under the
revised PHL 2807(23).

Section 4 adds a new paragraph (d) to subdivision - of PHL 2807-c to
make clear that payments to Enhanced Safety Net and Qualified Safety Net
hospitals do not supplant other funding streams to Enhanced Safety Net
hospitals.

Sections 5 and 6 amend Chapter 474 of the Laws of 1996, to allow addi-
tional $200 million in DSH payments to NYC Health + Hospitals, and addi-
tional $100M DSH to all other major public hospitals, including those
operated by the state, the State University of New York, or Erie, Nassau
or Westchester counties.
 
JUSTIFICATION:

This legislation is needed to fix inequities in distribution of ICP
funds for hospitals serving low income and at-risk communities under the
existing ICP funding and related Medicaid payments. The current law does
not allocate 100% of the funds to those hospitals providing high levels
of care to the uninsured or Medicaid enrollees. Approximately 15% of the
funds, referred to as a "transition collar," still go to hospitals that
are not providing significant care to the uninsured based on an old
formula.

This legislation would correct these inequities by eliminating the ICP
transition collar without hurting hospitals providing services to low
income and at risk communities; increasing Medicaid rates for safety net
and qualified safety net hospitals; optimizing new federal Medicaid
funds; and retaining all existing federal DSH funds to support these
essential services.

This legislation will rebalance the distribution of hospital indigent
care funding, while staying within the constraints of the State's Medi-
caid Global Cap and without additional financial impact to the State.
The bill removes ICP funding linked to historic bad debt and better
targets ICP funds to uninsured patient care. To address the Medicaid
rate issue, the bill would invest $300 million of ICP funds into Medi-
caid increases for enhanced and qualified safety net hospitals. The
investment by hospital ownership type is proportional to the current
pool funding with public shares of ICP at 12.6% and voluntary shares of
the ICP at 87%.

The bill builds on the Enhanced Safety Net Hospitals statute, and recog-
nizes that additional hospitals are providing essential services to
safety net communities and face serious financial jeopardy. Those hospi-
tals are defined as qualified safety net hospitals and may be identified
by criteria including having been awarded VAPAP or VBP QIP funds, or
placed on the DOH Financially Distressed Watch List; the volume of Medi-
caid or uninsured patients served; or the importance of the hospital in
the hospital's region in providing services to Medicaid and uninsured
patients. The bill would retain all existing federal DSH by allowing
public hospitals access to $150 million federal DSH formerly used for
ICP.

The bill would increase Medicaid reimbursement rates for safety net and
qualified safety net hospitals; dedicate funding for critical access
hospitals and sole community hospitals; expand existing programs for
financially distressed hospitals to ensure no harm to safety net or
qualified safety net hospitals. Leveraging public hospitals' access to
federal DSH will minimize federal DSH cuts to New York State which are
set to begin in federal fiscal year 2020.

 
PRIOR LEGISLATIVE HISTORY:

New bill

 
FISCAL IMPLICATIONS:

No impact on state general fund or Medicaid global cap.

 
EFFECTIVE DATE:
Immediately

2019-S5546A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5546--A
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                                May 6, 2019
                                ___________
 
 Introduced  by  Sens.  RIVERA,  BENJAMIN, LIU, GOUNARDES, MYRIE, PARKER,
   SALAZAR, STAVISKY -- 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 the general hospi-
   tal indigent care pool, hospital  reimbursements  and  adjustments  to
   medical  assistance  rates  to  enhanced  safety net hospitals; and 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 such rates
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivision 5-d of section 2807-k of the public health law,
 as  amended by section 6 of part H of chapter 57 of the laws of 2019, is
 amended to read as follows:
   5-d. (a) Notwithstanding any inconsistent provision of  this  section,
 section  twenty-eight  hundred  seven-w  of  this  article  or any other
 contrary provision of law, and subject to the  availability  of  federal
 financial participation, for periods [on and after January] APRIL first,
 two  thousand  [thirteen,] TWENTY through [March] DECEMBER thirty-first,
 two thousand twenty AND EACH CALENDAR YEAR THEREAFTER, all funds  avail-
 able  for  distribution  pursuant  to  this  section,  [except for funds
 distributed pursuant to subparagraph (v) of paragraph (b) of subdivision
 five-b of this section,] and all funds available for distribution pursu-
 ant to section twenty-eight hundred seven-w of this  article,  shall  be
 reserved and set aside and distributed in accordance with the provisions
 of this subdivision.
   (b)  The commissioner shall promulgate regulations, and may promulgate
 emergency regulations, establishing methodologies for  the  distribution
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD10355-06-0

 S. 5546--A                          2
 
 of  funds  as  described  in  paragraph (a) of this subdivision and such
 regulations shall include, but not be limited to, the following:
   (i)  Such  regulations  shall  establish methodologies for determining
 each facility's relative uncompensated care need amount based  on  unin-
 sured  inpatient and outpatient units of service from the cost reporting
 year two years prior to the distribution year, multiplied by the  appli-
 cable  medicaid  rates in effect January first of the distribution year,
 as summed and adjusted by a statewide cost adjustment factor and reduced
 by the  sum  of  all  payment  amounts  collected  from  such  uninsured
 patients,  and  as  further  adjusted  by  application of a nominal need
 computation that shall take into account each facility's medicaid  inpa-
 tient share.
   (ii)  Annual  distributions  pursuant to such regulations for [the two
 thousand thirteen through  two  thousand  twenty  calendar  years]  EACH
 CALENDAR YEAR BEGINNING WITH THE TWO THOUSAND TWENTY CALENDAR YEAR shall
 be in accord with the following:
   (A)  [one  hundred  thirty-nine million four hundred thousand dollars]
 ONE HUNDRED ONE MILLION SEVEN HUNDRED THOUSAND DOLLARS FOR EACH CALENDAR
 YEAR (PRORATED, AS MAY BE NECESSARY, TO REFLECT ANY PERIOD LESS  THAN  A
 YEAR)  shall  be distributed as Medicaid Disproportionate Share Hospital
 ("DSH") payments to major public general hospitals; and
   (B) [nine hundred ninety-four million nine hundred  thousand  dollars]
 SEVEN HUNDRED SEVEN MILLION SIX HUNDRED THOUSAND DOLLARS FOR EACH CALEN-
 DAR YEAR (PRORATED, AS MAY BE NECESSARY, TO REFLECT ANY PERIOD LESS THAN
 A  YEAR)  as  Medicaid DSH payments to eligible general hospitals, other
 than major public general hospitals.
   (iii)[(A) Such regulations shall establish transition  adjustments  to
 the  distributions  made pursuant to clauses (A) and (B) of subparagraph
 (ii) of this paragraph such that no facility experiences a reduction  in
 indigent care pool payments pursuant to this subdivision that is greater
 than the percentages, as specified in clause (C) of this subparagraph as
 compared  to  the  average distribution that each such facility received
 for the three calendar years prior to two thousand thirteen pursuant  to
 this section and section twenty-eight hundred seven-w of this article.
   (B)  Such  regulations  shall  also establish adjustments limiting the
 increases in indigent  care  pool  payments  experienced  by  facilities
 pursuant to this subdivision by an amount that will be, as determined by
 the  commissioner  and  in conjunction with such other funding as may be
 available for this purpose, sufficient to ensure full  funding  for  the
 transition adjustment payments authorized by clause (A) of this subpara-
 graph.
   (C)  No  facility  shall  experience a reduction in indigent care pool
 payments pursuant to this subdivision that: for the calendar year begin-
 ning January first, two thousand thirteen, is greater than two and  one-
 half  percent;  for the calendar year beginning January first, two thou-
 sand fourteen, is greater than five percent; and, for the calendar  year
 beginning  on January first, two thousand fifteen; is greater than seven
 and one-half percent, and for the calendar  year  beginning  on  January
 first,  two  thousand  sixteen, is greater than ten percent; and for the
 calendar year beginning on January first,  two  thousand  seventeen,  is
 greater  than  twelve  and  one-half  percent; and for the calendar year
 beginning on January first,  two  thousand  eighteen,  is  greater  than
 fifteen  percent;  and for the calendar year beginning on January first,
 two thousand nineteen, is greater than seventeen and  one-half  percent;
 and for the calendar year beginning on January first, two thousand twen-
 ty, is greater than twenty percent.

 S. 5546--A                          3

   (iv)]  Such  regulations shall reserve one percent of the funds avail-
 able for distribution in the two  thousand  fourteen  and  two  thousand
 fifteen  calendar  years, and for calendar years thereafter, pursuant to
 this subdivision, subdivision fourteen-f of section twenty-eight hundred
 seven-c of this article, and sections two hundred eleven and two hundred
 twelve  of  chapter  four  hundred  seventy-four of the laws of nineteen
 hundred ninety-six, in a  "financial  assistance  compliance  pool"  and
 shall establish methodologies for the distribution of such pool funds to
 facilities  based  on  their  level  of compliance, as determined by the
 commissioner, with the provisions of subdivision nine-a of this section.
   (c) The commissioner shall annually report to  the  governor  and  the
 legislature  on the distribution of funds under this subdivision includ-
 ing, but not limited to:
   (i) the impact on safety net providers, including community providers,
 rural general hospitals and major public general hospitals;
   (ii) the provision of indigent care by units  of  services  and  funds
 distributed by general hospitals; and
   (iii) the extent to which access to care has been enhanced.
   §  2. Section 2807 of the public health law is amended by adding a new
 subdivision 23 to read follows:
   23. ADJUSTMENTS TO MEDICAID RATES. (A) THE COMMISSIONER IS  AUTHORIZED
 TO  MAKE ADJUSTMENTS TO MEDICAL ASSISTANCE RATES IN ACCORDANCE WITH THIS
 SUBDIVISION TO ENHANCED SAFETY NET HOSPITALS, AS  DEFINED  IN  PARAGRAPH
 (A)  OF  SUBDIVISION THIRTY-FOUR OF SECTION TWENTY-EIGHT HUNDRED SEVEN-C
 OF THIS ARTICLE, AND TO QUALIFIED SAFETY NET HOSPITALS,  AS  DEFINED  IN
 PARAGRAPH  (B) OF THIS SUBDIVISION, FOR THE PURPOSES OF SUPPORTING CRIT-
 ICALLY NEEDED HEALTH CARE SERVICES AND TO ENSURE THE  CONTINUED  MAINTE-
 NANCE AND OPERATION OF SUCH HOSPITALS.
   (B)  FOR  THE  PURPOSES  OF THIS SUBDIVISION, A "QUALIFIED SAFETY NET"
 HOSPITAL SHALL MEAN A HOSPITAL, OTHER THAN AN ENHANCED SAFETY NET HOSPI-
 TAL, SO DESIGNATED BY THE COMMISSIONER PURSUANT TO CRITERIA DEVELOPED BY
 THE COMMISSIONER THAT TAKE INTO ACCOUNT: (I)  THE  HOSPITAL'S  FINANCIAL
 HARDSHIP,  EVIDENCED  BY  THE  OPERATING  LOSSES  OF THE HOSPITAL OR THE
 SYSTEM OF HOSPITALS TO WHICH THE HOSPITAL BELONGS  AND/OR  PARTICIPATION
 BY  THE  HOSPITAL  IN PROGRAMS ESTABLISHED BY THE COMMISSIONER TO ENABLE
 HOSPITALS  IN  FINANCIAL  DISTRESS  TO  MAINTAIN  OPERATIONS  AND  VITAL
 SERVICES;  (II)  THE  VOLUME  OF  MEDICAID  AND/OR  MEDICALLY  UNINSURED
 PATIENTS SERVED BY THE HOSPITAL  COMPARED  TO  OTHER  HOSPITALS  IN  THE
 HOSPITAL'S  REGION;  AND/OR  (III) THE IMPORTANCE OF THE HOSPITAL IN THE
 HOSPITAL'S  REGION  IN  ENABLING  MEDICAID  AND/OR  MEDICALLY  UNINSURED
 PATIENTS'  ACCESS  TO  HEALTH CARE SERVICES IN INPATIENT, OUTPATIENT AND
 COMMUNITY SETTINGS.
   (C) FOR THE STATE FISCAL YEAR COMMENCING  APRIL  FIRST,  TWO  THOUSAND
 TWENTY,  AND  EACH  STATE FISCAL YEAR THEREAFTER, THE COMMISSIONER SHALL
 INCREASE MEDICAL ASSISTANCE  RATES  OF  PAYMENTS  FOR  INPATIENT  AND/OR
 OUTPATIENT SERVICES MADE BY EITHER STATE GOVERNMENTAL AGENCIES OR ORGAN-
 IZATIONS  OPERATING IN ACCORDANCE WITH ARTICLE FORTY-THREE OF THE INSUR-
 ANCE LAW OR ARTICLE FORTY-FOUR OF THIS CHAPTER BY AN AGGREGATE OF:
   (I) THIRTY-SEVEN MILLION SEVEN HUNDRED THOUSAND DOLLARS  FOR  ENHANCED
 SAFETY NET HOSPITALS THAT ARE MAJOR PUBLIC GENERAL HOSPITALS;
   (II)  TWO  HUNDRED SEVENTY-FOUR MILLION EIGHT HUNDRED THOUSAND DOLLARS
 FOR QUALIFIED SAFETY NET HOSPITALS AND  ENHANCED  SAFETY  NET  HOSPITALS
 OTHER  THAN  MAJOR  PUBLIC  GENERAL  HOSPITALS, OF WHICH AT LEAST TWELVE
 MILLION FIVE HUNDRED THOUSAND DOLLARS SHALL  BE  ALLOCATED  TO  ENHANCED
 SAFETY NET HOSPITALS THAT ARE FEDERALLY DESIGNATED AS CRITICAL ACCESS OR
 SOLE COMMUNITY HOSPITALS; AND

 S. 5546--A                          4
 
   (III) TWELVE MILLION FIVE HUNDRED THOUSAND DOLLARS FOR THOSE HOSPITALS
 ELIGIBLE  UNDER  SUBPARAGRAPH  (II)  OF  THIS  PARAGRAPH  FOR  WHICH THE
 COMBINED PAYMENTS MADE, OR TO BE MADE, UNDER SUBPARAGRAPH (II)  OF  THIS
 PARAGRAPH AND SUBDIVISION FIVE-D OF SECTION TWENTY-EIGHT HUNDRED SEVEN-K
 OF THIS ARTICLE FOR CALENDAR YEAR TWO THOUSAND TWENTY, AND EACH CALENDAR
 YEAR  THEREAFTER,  ARE  PROJECTED  BY  THE  COMMISSIONER TO BE LESS THAN
 PAYMENTS MADE TO  SUCH  HOSPITALS  PURSUANT  TO  SUBDIVISION  FIVE-D  OF
 SECTION  TWENTY-EIGHT  HUNDRED SEVEN-K OF THIS ARTICLE FOR CALENDAR YEAR
 TWO THOUSAND EIGHTEEN.
   (D) PAYMENTS MADE PURSUANT TO THIS SUBDIVISION MAY BE ADDED  TO  RATES
 OF  PAYMENT,  OR  MADE AS AGGREGATE PAYMENTS OF EQUAL AMOUNTS ON OCTOBER
 ONE AND APRIL ONE OF EACH STATE FISCAL YEAR, TO SUCH ENHANCED SAFETY NET
 HOSPITALS AND QUALIFIED SAFETY NET HOSPITALS IN ACCORDANCE WITH A  METH-
 ODOLOGY  TO BE ESTABLISHED BY THE COMMISSIONER; PROVIDED, HOWEVER, THAT,
 THE COMMISSIONER MAY MAKE  THE  TWELVE  MILLION  FIVE  HUNDRED  THOUSAND
 DOLLARS  IN  PAYMENTS DUE TO ELIGIBLE HOSPITALS UNDER SUBPARAGRAPH (III)
 OF PARAGRAPH (C) OF THIS SUBDIVISION BY INSTEAD  INCREASING  THE  AMOUNT
 OTHERWISE  AWARDED TO SUCH ELIGIBLE HOSPITALS UNDER PROGRAMS ESTABLISHED
 BY THE COMMISSIONER TO ENABLE HOSPITALS IN FINANCIAL DISTRESS  TO  MAIN-
 TAIN  OPERATIONS AND VITAL SERVICES WHILE WORKING TO ACHIEVE LONGER-TERM
 SUSTAINABILITY, INCLUDING, BUT NOT LIMITED TO, THE VALUE  BASED  PAYMENT
 QUALITY IMPROVEMENT PROGRAM.
   §  3.  Subparagraph  (v)  of paragraph (a) of subdivision 1 of section
 2807-c of the public health law, as amended by chapter 639 of  the  laws
 of  1996,  is  amended  and  a new subparagraph (vi) is added to read as
 follows:
   (v) adjustments for any modifications to the case payments  determined
 in accordance with paragraph (a), (b), (c) or (d) of subdivision four of
 this section[.]; AND
   (VI) ADJUSTMENTS FOR ANY MODIFICATIONS TO THE CASE PAYMENTS DETERMINED
 IN  ACCORDANCE  WITH  SUBDIVISION  TWENTY-THREE  OF SECTION TWENTY-EIGHT
 HUNDRED SEVEN OF THIS ARTICLE.
   § 4. Subparagraph (v) of paragraph (a) of  subdivision  1  of  section
 2807-c  of  the public health law, as amended by chapter 731 of the laws
 of 1993, is amended and a new subparagraph (vi)  is  added  to  read  as
 follows:
   (v)  adjustments for any modifications to the case payments determined
 in accordance with paragraph (a), (b), (c) or (d) of subdivision four of
 this section[.]; AND
   (VI) ADJUSTMENTS FOR ANY MODIFICATIONS TO THE CASE PAYMENTS DETERMINED
 IN ACCORDANCE WITH  SUBDIVISION  TWENTY-THREE  OF  SECTION  TWENTY-EIGHT
 HUNDRED SEVEN OF THIS ARTICLE.
   §  5.  Subdivision  34  of  section 2807-c of the public health law is
 amended by adding a new paragraph (d) to read as follows:
   (D) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO
 THE CONTRARY, ADJUSTMENTS MADE PURSUANT TO THIS SUBDIVISION SHALL BE  IN
 ADDITION TO ANY ADJUSTMENTS MADE TO MEDICAL ASSISTANCE RATES TO ENHANCED
 SAFETY  NET  HOSPITALS AUTHORIZED BY SUBDIVISION TWENTY-THREE OF SECTION
 TWENTY-EIGHT HUNDRED SEVEN OF THIS ARTICLE.
   § 6. Subdivision 1 of section 211 of chapter 474 of the laws  of  1996
 amending the education law and other laws relating to rates for residen-
 tial  health care facilities is amended by adding a new paragraph (g) to
 read as follows:
   (G) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO
 THE CONTRARY, EFFECTIVE FOR THE STATE FISCAL  YEAR  BEGINNING  APRIL  1,
 2020, AND ANNUALLY THEREAFTER, THE DEPARTMENT OF HEALTH IS AUTHORIZED TO

 S. 5546--A                          5
 
 PAY  PUBLIC GENERAL HOSPITALS, OTHER THAN THOSE OPERATED BY THE STATE OF
 NEW YORK OR THE STATE UNIVERSITY OF NEW YORK, AS DEFINED IN  SUBDIVISION
 10  OF  SECTION  2801 OF THE PUBLIC HEALTH LAW, LOCATED IN A CITY WITH A
 POPULATION OF OVER ONE MILLION, ADDITIONAL PAYMENTS FOR INPATIENT HOSPI-
 TAL  SERVICES  OF  200  MILLION  DOLLARS ANNUALLY, AS MEDICAL ASSISTANCE
 PURSUANT TO TITLE 11 OF  ARTICLE  5  OF  THE  SOCIAL  SERVICES  LAW  FOR
 PATIENTS ELIGIBLE FOR FEDERAL FINANCIAL PARTICIPATION UNDER TITLE XIX OF
 THE  FEDERAL  SOCIAL  SECURITY  ACT,  PURSUANT TO FEDERAL LAWS AND REGU-
 LATIONS GOVERNING DISPROPORTIONATE SHARE PAYMENTS TO HOSPITALS, BASED ON
 THE RELATIVE SHARE OF EACH SUCH NON-STATE OPERATED PUBLIC GENERAL HOSPI-
 TAL MEDICAL ASSISTANCE AND UNINSURED PATIENT LOSSES. THE PAYMENTS MAY BE
 ADDED TO RATES OF PAYMENT OR MADE AS AGGREGATE PAYMENTS TO  AN  ELIGIBLE
 PUBLIC GENERAL HOSPITAL.
   §  7.  Subdivision 1 of section 212 of chapter 474 of the laws of 1996
 amending the education law and other laws relating to rates for residen-
 tial health care facilities, is amended by adding a new paragraph (c) to
 read as follows:
   (C) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO
 THE CONTRARY, EFFECTIVE FOR THE STATE FISCAL  YEAR  BEGINNING  APRIL  1,
 2020, AND ANNUALLY THEREAFTER, THE DEPARTMENT OF HEALTH IS AUTHORIZED TO
 PAY  PUBLIC  GENERAL  HOSPITALS, AS DEFINED IN SUBDIVISION 10 OF SECTION
 2801 OF THE PUBLIC HEALTH LAW, OPERATED BY THE STATE OF NEW YORK OR  THE
 STATE  UNIVERSITY  OF NEW YORK OR BY A COUNTY, WHICH SHALL NOT INCLUDE A
 CITY WITH A POPULATION OF OVER ONE MILLION, OF THE STATE  OF  NEW  YORK,
 AND THOSE PUBLIC GENERAL HOSPITALS LOCATED IN THE COUNTY OF WESTCHESTER,
 THE  COUNTY  OF  ERIE  OR  THE COUNTY OF NASSAU, ADDITIONAL PAYMENTS FOR
 INPATIENT HOSPITAL SERVICES OF 100 MILLION DOLLARS ANNUALLY, AS  MEDICAL
 ASSISTANCE  PAYMENTS  PURSUANT  TO  TITLE  11 OF ARTICLE 5 OF THE SOCIAL
 SERVICES LAW FOR PATIENTS ELIGIBLE FOR FEDERAL  FINANCIAL  PARTICIPATION
 UNDER  TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT, PURSUANT TO FEDERAL
 LAWS AND REGULATIONS GOVERNING DISPROPORTIONATE SHARE PAYMENTS TO HOSPI-
 TALS. THE PAYMENTS MAY BE ADDED TO RATES OF PAYMENT OR MADE AS AGGREGATE
 PAYMENTS TO AN ELIGIBLE PUBLIC GENERAL HOSPITAL.
   § 8. This act shall take effect immediately;  provided  however,  that
 the  amendments made to paragraph (a) of subdivision 1 of section 2807-c
 of the public health law made by section three  of  this  act  shall  be
 subject to the expiration and reversion of such paragraph when upon such
 date the provisions of section four of this act shall take effect.

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Senate Bill S5546A

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

co-Sponsors

2019-S5546 - Details

2019-S5546 - Summary

2019-S5546 - Sponsor Memo

2019-S5546 - Bill Text download pdf

co-Sponsors

2019-S5546A (ACTIVE) - Details

2019-S5546A (ACTIVE) - Summary

2019-S5546A (ACTIVE) - Sponsor Memo

2019-S5546A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S5546A

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Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

co-Sponsors

2019-S5546 - Details

2019-S5546 - Summary

2019-S5546 - Sponsor Memo

2019-S5546 - Bill Text download pdf

co-Sponsors

2019-S5546A (ACTIVE) - Details

2019-S5546A (ACTIVE) - Summary

2019-S5546A (ACTIVE) - Sponsor Memo

2019-S5546A (ACTIVE) - Bill Text download pdf

Comments