NY State Senate Bill 2023-S6959A

Current Bill Status - On Floor Calendar

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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Actions

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 07, 2024	2nd report cal. amended 6959a
May 06, 2024	1st report cal.922
Jan 22, 2024	reported and committed to finance
Jan 03, 2024	referred to health
May 23, 2023	reported and committed to finance
May 16, 2023	referred to health

Votes

- Jan 22, 2024 - Health Committee Vote
  S6959A
  
  15
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: Jan 22, 2024
      
      aye (15)
      
      Ashby
      
      Brouk
      
      Felder
      
      Gallivan
      
      Hoylman-Sigal
      
      Mannion
      
      Martins
      
      May
      
      Myrie
      
      Rhoads
      
      Rivera
      
      Salazar
      
      Stec
      
      Thomas
      
      Webb
  May 23, 2023 - Health Committee Vote
  S6959A
  
  15
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: May 23, 2023
      
      aye (15)
      
      Ashby
      
      Brouk
      
      Felder
      
      Gallivan
      
      Hoylman-Sigal
      
      Mannion
      
      Martins
      
      May
      
      Myrie
      
      Rhoads
      
      Rivera
      
      Salazar
      
      Stec
      
      Thomas
      
      Webb
  May 6, 2024 - Finance Committee Vote
  S6959A
  
  20
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  1
  
  Excused
  
  0
  
  Abstained
  - - Finance Committee Vote: May 6, 2024
      
      aye (20)
      
      Bailey
      
      Borrello
      
      Breslin
      
      Comrie
      
      Cooney
      
      Gallivan
      
      Gounardes
      
      Griffo
      
      Hinchey
      
      Hoylman-Sigal
      
      Krueger
      
      Liu
      
      Martins
      
      Oberacker
      
      Parker
      
      Rivera
      
      Salazar
      
      Skoufis
      
      Stavisky
      
      Thomas
      
      excused (1)
      
      O'Mara

Bill Amendments

Original

A (Active)

co-Sponsors

View additional co-sponsors

2023-S6959 - Details

Law Section:: Public Health Law
Laws Affected:: Amd §2807, Pub Health L

2023-S6959 - Summary

Provides for the calculation and analysis of certain health center costs.

2023-S6959 - Sponsor Memo

                                 
BILL NUMBER: S6959

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law, in relation to federally quali-
fied health center rate adequacy

 
PURPOSE OR GENERAL IDEA OF BILL:

Requires the Department of Health to analyze and update federally quali-
fied health center (FQHC) rates that are over two decades old.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends Public Health Law 2807(8)(b), which authorizes feder-
ally qualified health center (FQHC) reimbursement rates, to implement an
updated methodology to ensure that the two-decade old rates are updated
to reflect actual costs incurred by FQHCs.

Section 2 amends Public Health Law 2807(8) to require the Department of
Health (DOH) to analyze historical FQHC cost data as well as related

factors to set an adequate rate; eliminate arbitrary caps on rates,
subject to federal financial participation; and requires that prior to
implementation, the DOH consult with relevant stakeholders.

Section 3 provides an immediate effective date.

 
JUSTIFICATION:

Federally qualified health centers (FQHCs), also known as community
health centers (CHCs), are located in medically underserved neighbor-
hoods, providing quality and affordable healthcare services to all,
regardless of immigration status, insurance coverage, or ability to pay.
CHCs are a critical safety net for quality health care services, partic-
ularly for low-income communities and communities of color. Among CHC
patients, 89% are low-income, 68% are Black, Hispanic/Latinx, or other-
wise people of color, 13% are uninsured, and nearly 60% of CHCs'
patients are enrolled in Medicaid, CHIP, or are dually enrolled in Medi-
care and Medicaid.

CHCs deliver a full spectrum of services, including many social care
supports, such as housing, transportation vouchers, and food, many of
which were never envisioned when the CHCs' base rate was developed over
20 years ago. Current rates are actually based on costs from 1999 and
2000. These reimbursement rates are the oldest cost-based rates, among
all New York State Medicaid provider types. CHC rates are further
suppressed by arbitrary rate ceilings regulatorily imposed by the
Department of Health. Costs today for personnel, benefits, equipment,
medical supplies, and office space are all significantly higher than
they were decades ago and have risen exponentially since the pandemic.
Adding to the inadequacy of these outdated rates is the onset of more
widely used health care delivery modes such as telehealth, further driv-
ing down the ability of rates to meet contemporary cost pressures. The
outdated reimbursement methodology for CHCs does not account for the
current model of comprehensive primary care including behavioral health
services, oral health services, reproductive health services, and
services addressing social needs. CHCs are also experiencing
unprecedented workforce attrition and workforce shortages that are
affecting operations. CHCs' insufficient reimbursement rates undermine
their ability to engage in long term sustainability and expansion plan-
ning, limiting access to care.

This legislation will ensure that the Department of Health evaluates and
implements updated payment rates to sufficiently account for increases
in operation costs and the new, expanded model of health and social care
that is the hallmark of community health centers.

 
PRIOR LEGISLATIVE HISTORY:

New bill

 
EFFECTIVE DATE:
Immediately.

2023-S6959 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6959
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                               May 16, 2023
                                ___________
 
 Introduced  by  Sen.  RIVERA -- 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  federally  quali-
   fied health center rate adequacy
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (b) of subdivision  8  of  section  2807  of  the
 public  health law, as added by section 28 of part B of chapter 1 of the
 laws of 2002, is amended to read as follows:
   (b) For each twelve month period following  September  thirtieth,  two
 thousand  one  AND  CONTINUING THROUGH SEPTEMBER THIRTIETH, TWO THOUSAND
 TWENTY-FOUR, the operating cost component of such rates of payment shall
 reflect the operating cost component in effect on September thirtieth of
 the prior period as increased by the percentage increase in the Medicare
 Economic Index as computed in accordance with the requirements of 42 USC
 § 1396a(aa)(3) and as adjusted pursuant  to  applicable  regulations  to
 take  into  account  any  increase  or decrease in the scope of services
 furnished by the facility.   FOR  EACH  TWELVE  MONTH  PERIOD  FOLLOWING
 SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR, THE OPERATING COST COMPO-
 NENT  SHALL  BE  CALCULATED CONSISTENT WITH RATES OF PAYMENT ESTABLISHED
 PURSUANT TO PARAGRAPH (C-1)  OF  THIS  SUBDIVISION,  AND  THEN  ANNUALLY
 ADJUSTED BY USING THE FQHC MARKET BASKET INFLATOR AS CALCULATED PURSUANT
 TO  42  USC  § 1395M(O)(2), AND AS ADJUSTED PURSUANT TO APPLICABLE REGU-
 LATIONS TO TAKE INTO ACCOUNT ANY INCREASE OR DECREASE IN  THE  SCOPE  OF
 SERVICES FURNISHED BY THE FACILITY.
   § 2. Subdivision 8 of section 2807 of the public health law is amended
 by adding a new paragraph (c-1) to read as follows:
   (C-1)  AS  SOON AS PRACTICABLE THE DEPARTMENT SHALL ANALYZE THE ACTUAL
 FEDERALLY QUALIFIED HEALTH CENTER  COSTS  FILED  PURSUANT  TO  10  NYCRR
 86-4.3  DURING  THE  PRIOR  FIVE YEAR REPORTING PERIODS.  IN ADDITION TO
 SUCH DATA, THE COMMISSIONER  SHALL  CONSIDER,  THE  SCOPE  OF  SERVICES,
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11404-01-3

 S. 6959                             2
 
 INCLUDING TYPE, INTENSITY, DURATION AND AMOUNT, PROVIDED BY SUCH FACILI-
 TIES;  STAFFING  TO  MEET COMPETITIVE MARKET AND CASE MIX NEEDS OF POPU-
 LATIONS SERVED; PHYSICAL PLANT AND  MAINTENANCE  COSTS,  INFRASTRUCTURE;
 TECHNOLOGY  COSTS  ASSOCIATED WITH TELEHEALTH MODALITY OF SERVICE DELIV-
 ERY; INFORMATIONAL TECHNOLOGY COSTS; AND OTHER COSTS DEEMED NECESSARY BY
 THE COMMISSIONER.   NOTWITHSTANDING ANY OTHER STATUTE,  RULE,  OR  REGU-
 LATION  OTHERWISE  IMPOSING  CEILINGS  OR  CAPS ON PAYMENTS TO FEDERALLY
 QUALIFIED HEALTH CENTERS, PROVIDED THAT SUCH PAYMENTS ARE STILL  SUBJECT
 TO  FEDERAL FINANCIAL PARTICIPATION, BEGINNING ON APRIL FIRST, TWO THOU-
 SAND TWENTY-FOUR, THE DEPARTMENT SHALL DEVELOP AND ISSUE  UPDATED  RATES
 OF  PAYMENTS  REFLECTING  THE  ACTUAL COSTS AND UPDATED AGGREGATED DATA.
 PRIOR TO IMPLEMENTING THE UPDATED RATES OF PAYMENT, THE DEPARTMENT SHALL
 CONSULT WITH RELEVANT STAKEHOLDERS INCLUDING  BUT  NOT  LIMITED  TO  THE
 STATEWIDE TRADE ASSOCIATION REPRESENTING SUCH FEDERALLY QUALIFIED HEALTH
 CENTERS  FOR  REVIEW, REVISION, AND CONFIRMATION OF THE UPDATED RATES OF
 PAYMENT, AS APPROPRIATE.
   § 3.  This act shall take effect immediately.

co-Sponsors

View additional co-sponsors

2023-S6959A (ACTIVE) - Details

Law Section:: Public Health Law
Laws Affected:: Amd §2807, Pub Health L

2023-S6959A (ACTIVE) - Summary

Provides for the calculation and analysis of certain health center costs.

2023-S6959A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S6959A

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law, in relation to federally quali-
fied health center rate adequacy

 
PURPOSE OR GENERAL IDEA OF BILL:

Requires the Department of Health to analyze and update federally quali-
fied health center (FQHC) rates that are over two decades old.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends Public Health Law 2807(8)(b), which authorizes feder-
ally qualified health center (FQHC) reimbursement rates, to implement an
updated methodology to ensure that the two-decade old rates are updated
to reflect actual costs incurred by FQHCs by extending the twelve month
period into 2025. After September 13, 2025 the operating costs will be
calculated using existing metrics.

Section 2 amends Public Health Law 2807(8) to require the Department of
Health (DOH) to analyze historical FQHC cost data as well as related
factors to set an adequate rate; eliminate arbitrary caps on rates,
subject to federal financial participation.

Section 3 provides an immediate effective date.

 
JUSTIFICATION:

Federally qualified health centers (FQHCs), also known as community
health centers (CHCs), are located in medically underserved neighbor-
hoods, providing quality and affordable healthcare services to all,
regardless of immigration status, insurance coverage, or ability to pay.

CHCs are a critical safety net for quality health care services, partic-
ularly for low-income communities and communities of color.  Among CHC
patients, 89% are low-income, 68% are Black, Hispanic/Latinx, or other-
wise people of color, 13% are uninsured, and nearly 60% of CHCs'
patients are enrolled in Medicaid, CHIP, or are dually enrolled in Medi-
care and Medicaid.

CHCs deliver a full spectrum of services, including many social care
supports, such as housing, transportation vouchers, and food, many of
which were never envisioned when the CHCs' base rate was developed over
20 years ago. Current rates are actually based on costs from 1999 and
2000. These reimbursement rates are the oldest cost-based rates, among
all New York State Medicaid provider types. CHC rates are further
suppressed by arbitrary rate ceilings regulatorily imposed by the
Department of Health. Costs today for personnel, benefits, equipment,
medical supplies, and office space are all significantly higher than
they were decades ago and have risen exponentially since the pandemic.
Adding to the inadequacy of these outdated rates is the onset of more
widely used health care delivery modes such as telehealth, further driv-
ing down the ability of rates to meet contemporary cost pressures. The
outdated reimbursement methodology for CHCs does not account for the
current model of comprehensive primary care including behavioral health
services, oral health services, reproductive health services, and
services addressing social needs. CHCs are also experiencing
unprecedented workforce attrition and workforce shortages that are
affecting operations.  CHCs' insufficient reimbursement rates undermine
their ability to engage in long term sustainability and expansion plan-
ning, limiting access to care.

This legislation will ensure that the Department of Health evaluates and
implements updated payment rates to sufficiently account for increases
in operation costs and the new, expanded model of health and social care
that is the hallmark of community health centers.

 
PRIOR LEGISLATIVE HISTORY:

New bill

 
EFFECTIVE DATE:
Immediately.

2023-S6959A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6959--A
     Cal. No. 922
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                               May 16, 2023
                                ___________
 
 Introduced  by  Sens.  RIVERA, BORRELLO, BRESLIN, BROUK, CLEARE, COMRIE,
   COONEY, FERNANDEZ, GALLIVAN, GOUNARDES,  HARCKHAM,  HELMING,  HINCHEY,
   HOYLMAN-SIGAL,  JACKSON, KAVANAGH, LIU, MARTINS, MAY, OBERACKER, PARK-
   ER, SALAZAR, SEPULVEDA, SKOUFIS, STAVISKY, STEC, THOMAS, WEBB --  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 -- reported favorably from said
   committee and committed to the Committee on Finance -- reported favor-
   ably from said committee, ordered to first report,  amended  on  first
   report,  ordered  to  a second report and ordered reprinted, retaining
   its place in the order of second report
 
 AN ACT to amend the public health law, in relation to  federally  quali-
   fied health center rate adequacy
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (b) of subdivision  8  of  section  2807  of  the
 public  health law, as added by section 28 of part B of chapter 1 of the
 laws of 2002, is amended to read as follows:
   (b) For each twelve month period following  September  thirtieth,  two
 thousand  one  AND  CONTINUING THROUGH SEPTEMBER THIRTIETH, TWO THOUSAND
 TWENTY-FIVE, the operating cost component of such rates of payment shall
 reflect the operating cost component in effect on September thirtieth of
 the prior period as increased by the percentage increase in the Medicare
 Economic Index as computed in accordance with the requirements of 42 USC
 § 1396a(aa)(3) and as adjusted pursuant  to  applicable  regulations  to
 take  into  account  any  increase  or decrease in the scope of services
 furnished by the facility.   FOR  EACH  TWELVE  MONTH  PERIOD  FOLLOWING
 SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FIVE, THE OPERATING COST COMPO-
 NENT  SHALL  BE  CALCULATED CONSISTENT WITH RATES OF PAYMENT ESTABLISHED
 PURSUANT TO PARAGRAPH (C-1)  OF  THIS  SUBDIVISION,  AND  THEN  ANNUALLY
 ADJUSTED  BY  USING  THE FQHC MARKET BASKET INFLATOR AS CALCULATED UNDER
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD11404-04-4
 S. 6959--A                          2
 
 FEDERAL LAW, AND AS ADJUSTED PURSUANT TO APPLICABLE REGULATIONS TO  TAKE
 INTO ACCOUNT ANY INCREASE OR DECREASE IN THE SCOPE OF SERVICES FURNISHED
 BY THE FACILITY.
   § 2. Subdivision 8 of section 2807 of the public health law is amended
 by adding a new paragraph (c-1) to read as follows:
   (C-1)  AS  SOON AS PRACTICABLE THE DEPARTMENT SHALL ANALYZE THE ACTUAL
 FEDERALLY QUALIFIED HEALTH CENTER COSTS FILED AS REQUIRED BY  DEPARTMENT
 REGULATIONS,  DURING THE PRIOR FIVE YEAR REPORTING PERIODS.  IN ADDITION
 TO SUCH DATA, THE COMMISSIONER SHALL CONSIDER, THE  SCOPE  OF  SERVICES,
 INCLUDING TYPE, INTENSITY, DURATION AND AMOUNT, PROVIDED BY SUCH FACILI-
 TIES;  STAFFING  TO  MEET COMPETITIVE MARKET AND CASE MIX NEEDS OF POPU-
 LATIONS SERVED; PHYSICAL PLANT AND  MAINTENANCE  COSTS,  INFRASTRUCTURE;
 TECHNOLOGY  COSTS  ASSOCIATED WITH TELEHEALTH MODALITY OF SERVICE DELIV-
 ERY; INFORMATIONAL TECHNOLOGY COSTS; AND OTHER COSTS DEEMED NECESSARY BY
 THE COMMISSIONER.   NOTWITHSTANDING ANY OTHER STATUTE,  RULE,  OR  REGU-
 LATION  OTHERWISE  IMPOSING  CEILINGS  OR  CAPS ON PAYMENTS TO FEDERALLY
 QUALIFIED HEALTH CENTERS, PROVIDED THAT SUCH PAYMENTS ARE STILL  SUBJECT
 TO  FEDERAL FINANCIAL PARTICIPATION, BEGINNING ON APRIL FIRST, TWO THOU-
 SAND TWENTY-FIVE, THE DEPARTMENT SHALL DEVELOP AND ISSUE  UPDATED  RATES
 OF PAYMENTS REFLECTING THE ACTUAL COSTS AND UPDATED AGGREGATED DATA.
   § 3.  This act shall take effect immediately.

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Senate Bill S6959A

Sponsored By

Current Bill Status - On Floor Calendar

Jan 22, 2024 - Health Committee Vote

Health Committee Vote: Jan 22, 2024

May 23, 2023 - Health Committee Vote

Health Committee Vote: May 23, 2023

May 6, 2024 - Finance Committee Vote

Finance Committee Vote: May 6, 2024

Bill Amendments

co-Sponsors

2023-S6959 - Details

2023-S6959 - Summary

2023-S6959 - Sponsor Memo

2023-S6959 - Bill Text download pdf

co-Sponsors

2023-S6959A (ACTIVE) - Details

2023-S6959A (ACTIVE) - Summary

2023-S6959A (ACTIVE) - Sponsor Memo

2023-S6959A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S6959A

Share this bill

Sponsored By

Current Bill Status - On Floor Calendar

Bill Amendments

co-Sponsors

2023-S6959 - Details

2023-S6959 - Summary

2023-S6959 - Sponsor Memo

2023-S6959 - Bill Text download pdf

co-Sponsors

2023-S6959A (ACTIVE) - Details

2023-S6959A (ACTIVE) - Summary

2023-S6959A (ACTIVE) - Sponsor Memo

2023-S6959A (ACTIVE) - Bill Text download pdf

Comments