assembly Bill A10031

2021-2022 Legislative Session

Establishes a quality incentive program for managed care providers

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Current Bill Status - In Assembly Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Apr 29, 2022 referred to health

A10031 (ACTIVE) - Details

See Senate Version of this Bill:
S7594
Current Committee:
Assembly Health
Law Section:
Social Services Law
Laws Affected:
Amd §364-j, Soc Serv L; amd §4403-f, Pub Health L

A10031 (ACTIVE) - Summary

Establishes a quality incentive program for managed care providers that is distributed based on managed care providers' performance in meeting quality objectives.

A10031 (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   10031
 
                           I N  A S S E M B L Y
 
                              April 29, 2022
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
   Committee on Health
 
 AN ACT to amend the social services law and the public  health  law,  in
   relation  to establishing a quality incentive program for managed care
   providers
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section  1. Subdivision 18 of section 364-j of the social services law
 is amended by adding a new paragraph (c-1) to read as follows:
   (C-1) IN SETTING SUCH REIMBURSEMENT, THE COMMISSIONER OF HEALTH  SHALL
 ESTABLISH A QUALITY INCENTIVE PROGRAM FOR MANAGED CARE PROVIDERS THAT IS
 DISTRIBUTED  BASED  ON  MANAGED  CARE  PROVIDERS' PERFORMANCE IN MEETING
 QUALITY OBJECTIVES, WHICH SHALL BE SET BY THE COMMISSIONER IN ADVANCE OF
 THE PERIOD DURING WHICH QUALITY  IS  MEASURED.  SUCH  QUALITY  INCENTIVE
 PROGRAM  SHALL BE FUNDED AT A LEVEL OF AT LEAST ONE PERCENT OF THE TOTAL
 ANNUAL PREMIUM PAID TO MANAGED CARE PROVIDERS, OR THREE HUNDRED  MILLION
 DOLLARS,  WHICHEVER  IS  GREATER. IN ESTABLISHING THE MANNER IN WHICH TO
 MEASURE QUALITY AND DISTRIBUTE  QUALITY  INCENTIVE  PROGRAM  FUNDS,  THE
 COMMISSIONER  OF  HEALTH SHALL ESTABLISH A METHODOLOGY THAT PROVIDES THE
 GREATEST LEVEL OF FUNDING TO MANAGED CARE PROVIDERS RECEIVING THE  HIGH-
 EST  QUALITY  SCORES  AND  SHALL CONSULT WITH REPRESENTATIVES OF MANAGED
 CARE PROVIDERS AND OTHER KEY STAKEHOLDERS.
   § 2. Subdivision 8 of section 4403-f of  the  public  health  law,  as
 amended  by  section  21 of part B of chapter 59 of the laws of 2016, is
 amended to read as follows:
   8. Payment rates for managed long term care  plan  enrollees  eligible
 for  medical  assistance. The commissioner shall establish payment rates
 for services provided to enrollees  eligible  under  title  XIX  of  the
 federal  social  security  act.  Such  payment rates shall be subject to
 approval by the director of the division of the budget and shall reflect
 savings to both state and local governments when compared to costs which
 would be incurred by such program if enrollees were to receive  compara-
 ble health and long term care services on a fee-for-service basis in the
 geographic  region  in  which such services are proposed to be provided.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.