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Assembly Bill A5368A

2021-2022 Legislative Session

Provides parity to durable medical equipment providers by requiring Medicaid managed care organizations to reimburse such providers

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Archive: Last Bill Status - In Assembly Committee

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Bill Amendments

co-Sponsors

2021-A5368 - Details

See Senate Version of this Bill:
S5118
Current Committee:
Assembly Ways And Means
Law Section:
Social Services Law
Laws Affected:
Amd §364-j, Soc Serv L
Versions Introduced in Other Legislative Sessions:
2023-2024: A3408, S3468
2025-2026: A2520, S1616

2021-A5368 - Summary

Provides parity to durable medical equipment providers by requiring Medicaid managed care organizations to reimburse such providers at no less than one hundred percent of the medical assistance durable medical equipment and complex rehabilitation technology fee schedule for the same service or item.

2021-A5368 - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5368
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 16, 2021
                                ___________
 
 Introduced  by M. of A. McDONALD, GOTTFRIED -- read once and referred to
   the Committee on Health
 
 AN ACT to amend the social services law, in relation to providing parity
   to durable medical equipment providers by requiring  Medicaid  managed
   care  organizations  to  reimburse  such providers at no less than one
   hundred percent of the state's Medicaid durable medical equipment  and
   complex  rehabilitation  technology fee schedule for the same services
   and supplies
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. The social services law is amended by adding a new section
 367-k to read as follows:
   §   367-K. REIMBURSEMENT FOR DURABLE  MEDICAL  EQUIPMENT  AND  COMPLEX
 REHABILITATION  TECHNOLOGY. THE COMMISSIONER OF THE DEPARTMENT OF HEALTH
 SHALL REQUIRE MANAGED CARE ORGANIZATIONS TO REIMBURSE AT  NO  LESS  THAN
 ONE HUNDRED PERCENT OF THE STATE MEDICAID PROGRAM DURABLE MEDICAL EQUIP-
 MENT  AND  COMPLEX  REHABILITATION  TECHNOLOGY FEE SCHEDULE FOR THE SAME
 SERVICE OR ITEM OF DURABLE MEDICAL  EQUIPMENT,  PROSTHETICS,  ORTHOTICS,
 AND  SUPPLIES.   THIS PROVISION SHALL APPLY TO MANAGED CARE CONTRACTORS,
 SUBCONTRACTORS AND THIRD-PARTY ADMINISTRATORS.
   § 2. This act shall take effect on the ninetieth day  after  it  shall
 have become a law.
 
 
 
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09509-01-1

co-Sponsors

2021-A5368A (ACTIVE) - Details

See Senate Version of this Bill:
S5118
Current Committee:
Assembly Ways And Means
Law Section:
Social Services Law
Laws Affected:
Amd §364-j, Soc Serv L
Versions Introduced in Other Legislative Sessions:
2023-2024: A3408, S3468
2025-2026: A2520, S1616

2021-A5368A (ACTIVE) - Summary

Provides parity to durable medical equipment providers by requiring Medicaid managed care organizations to reimburse such providers at no less than one hundred percent of the medical assistance durable medical equipment and complex rehabilitation technology fee schedule for the same service or item.

2021-A5368A (ACTIVE) - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5368--A
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 16, 2021
                                ___________
 
 Introduced  by  M.  of  A.  McDONALD, GOTTFRIED, BYRNES -- read once and
   referred to the Committee on  Health  --  committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee
 
 AN ACT to amend the social services law, in relation to providing parity
   to durable medical equipment providers by requiring  Medicaid  managed
   care  organizations  to  reimburse  such providers at no less than one
   hundred percent of the medical assistance  durable  medical  equipment
   and  complex  rehabilitation  technology  fee  schedule  for  the same
   service or item
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subdivision 4 of section 364-j of the social services law
 is amended by adding a new paragraph (w) to read as follows:
   (W) MANAGED CARE PROVIDERS SHALL  PAY,  DIRECTLY  OR  INDIRECTLY,  FOR
 DURABLE  MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS, AND RELATED SUPPLIES
 AT NO LESS THAN ONE HUNDRED PERCENT OF THE  MEDICAL  ASSISTANCE  DURABLE
 MEDICAL EQUIPMENT AND COMPLEX REHABILITATION TECHNOLOGY FEE SCHEDULE FOR
 THE SAME SERVICE OR ITEM.
   §  2. This act shall take effect on the ninetieth day  after  it shall
 have become a law, provided, however, that the amendments to subdivision
 4 of section 364-j of the social services law made  by  section  one  of
 this act shall not affect the repeal of such section and shall be deemed
 repealed therewith.
 
 
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09509-02-1

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