S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7935
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               May 28, 2019
                                ___________
 
 Introduced  by M. of A. GUNTHER -- read once and referred to the Commit-
   tee on Mental Health
 
 AN ACT to amend the mental hygiene law, in relation  to  establishing  a
   workgroup  to  conduct  analysis on the ambulatory patient group rates
   and commercial insurance rates for behavioral health services

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 7.07 of the mental hygiene law is amended by adding
 a new subdivision (h) to read as follows:
   (H)  1.  THE  COMMISSIONER  OF THE OFFICE OF MENTAL HEALTH, IN COLLAB-
 ORATION WITH THE COMMISSIONER  OF  THE  DEPARTMENT  OF  HEALTH  AND  THE
 COMMISSIONER  OF  THE  OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
 ARE DIRECTED TO CONVENE AND JOINTLY CHAIR, EITHER DIRECTLY OR THROUGH  A
 DESIGNEE  OR DESIGNEES, A WORKGROUP, WHICH SHALL INCLUDE MEMBERSHIP THAT
 ENSURES ADEQUATE STATEWIDE GEOGRAPHIC REPRESENTATION SELECTED WITH EQUAL
 CONTRIBUTIONS ON SUCH SELECTION FROM THE GOVERNOR, THE  SPEAKER  OF  THE
 ASSEMBLY  AND  TEMPORARY PRESIDENT OF THE SENATE AND BE COMPRISED OF THE
 FOLLOWING MEMBERS: (I) PROFESSIONAL ASSOCIATIONS REPRESENTING  SUBSTANCE
 USE,  MENTAL  HEALTH, AND/OR BEHAVIORAL HEALTH PROVIDERS; (II) REPRESEN-
 TATIVES FROM PROFESSIONAL ASSOCIATIONS REPRESENTING  PROVIDERS  OF  PEER
 AND  RECOVERY-BASED  PROGRAMS  AND  SERVICES; (III) REPRESENTATIVES FROM
 PROFESSIONAL  ASSOCIATIONS  REPRESENTING  MEDICATED  ASSISTED  TREATMENT
 PROVIDERS;  (IV)  REPRESENTATIVES FROM PROFESSIONAL ASSOCIATIONS REPRES-
 ENTING CHILDREN'S BEHAVIORAL HEALTH PROVIDERS; (V) REPRESENTATIVES  FROM
 HOSPITAL ASSOCIATIONS; (VI) REPRESENTATIVES FROM ASSOCIATIONS REPRESENT-
 ING  BEHAVIORAL HEALTH CONSUMERS AND FAMILY MEMBERS; AND (VII) ANY ADDI-
 TIONAL STAKEHOLDER OR EXPERT  THAT  THE  COMMISSIONERS  DEEM  NECESSARY.
 MEMBERS  OF  THE  WORKGROUP SHALL SERVE WITHOUT COMPENSATION, BUT MAY BE
 REIMBURSED FOR ACTUAL COSTS INCURRED FOR  PARTICIPATION  ON  SUCH  WORK-
 GROUP.  2.  THE  WORKGROUP  SHALL  CONDUCT AN ANALYSIS ON THE AMBULATORY
 PATIENT GROUP RATES AND COMMERCIAL INSURANCE RATES FOR BEHAVIORAL HEALTH
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD11227-01-9

 A. 7935                             2
 
 SERVICES FOR THE PURPOSE OF  DEVELOPING  A  REPORT  THAT  SHALL  PROVIDE
 RECOMMENDATIONS  ON  THE  FOLLOWING:  (I)  RATE  ADEQUACY RELATED TO THE
 EXISTING AMBULATORY PATIENT  GROUP-BASED  REIMBURSEMENT  PROVIDED  UNDER
 MEDICAID  MANAGED  CARE,  AS WELL AS FOR COMMERCIAL INSURANCE RATES WITH
 REGARDS TO SERVICES RENDERED UNDER CHILD HEALTH PLUS,  OR  FOR  SERVICES
 PROVIDED BY CLINICS LICENSED OR CERTIFIED PURSUANT TO ARTICLE THIRTY-ONE
 OR  THIRTY-TWO  OF  THIS  CHAPTER  OR DUALLY LICENSED OR CERTIFIED UNDER
 ARTICLE THIRTY-ONE OR THIRTY-TWO OF THIS  CHAPTER  AND  ARTICLE  TWENTY-
 EIGHT OF THE PUBLIC HEALTH LAW; (II) THE ACTUAL COSTS OF CARE ASSOCIATED
 WITH  THE  DELIVERY  OF  BEHAVIORAL  HEALTH  SERVICES; (III) ONE OR MORE
 ALTERNATIVE REIMBURSEMENT MODELS THAT WOULD ADEQUATELY COMPENSATE  CLIN-
 ICS  LICENSED  OR HOLDING AN OPERATING CERTIFICATE UNDER ARTICLE THIRTY-
 ONE OR THIRTY-TWO OF THIS CHAPTER OR DUALLY LICENSED UNDER ARTICLE THIR-
 TY-ONE OR THIRTY-TWO OF THIS CHAPTER AND  ARTICLE  TWENTY-EIGHT  OF  THE
 PUBLIC  HEALTH  LAW  FOR THEIR COSTS OF CARE UNDER MEDICAID MANAGED CARE
 AND CHILD HEALTH PLUS; AND (IV) ANY POLICY OR FISCAL RESOURCES NECESSARY
 TO CARRY OUT THE RECOMMENDATIONS OF THE  REPORT  DEVELOPED  PURSUANT  TO
 THIS SECTION. THE REPORT SHALL BE SUBMITTED TO THE GOVERNOR, THE SPEAKER
 OF  THE ASSEMBLY AND THE TEMPORARY PRESIDENT OF THE SENATE NO LATER THAN
 OCTOBER FIRST, TWO THOUSAND TWENTY-ONE.
   § 2. This act shall take effect on the ninetieth day  after  it  shall
 have become a law.