The New York State Senate

                    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.