S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7293
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                               May 19, 2023
                                ___________
 
 Introduced  by  Sen.  RYAN  --  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  the  performance
   standards that must be met by managed long term care plans
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (a) of subdivision 6-a of section 4403-f  of  the
 public  health law, as added by section 4 of part I of chapter 57 of the
 laws of 2023, is amended to read as follows:
   (a) On or before January first, two thousand twenty-four, each managed
 long term care plan that has been  issued  a  certificate  of  authority
 pursuant  to  this  section  shall  have an active INSTITUTIONAL SPECIAL
 NEEDS PLAN OR A Medicare Dual Eligible Special Needs Plan  in  operation
 whose  H-contract  either  has  a  current  quality star rating from the
 Centers for Medicare and Medicaid Services of three stars or higher,  or
 has  not been issued a quality star rating from the Centers for Medicare
 and Medicaid Services, OR A PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDER-
 LY (PACE).  In addition, the managed long term care  plan  shall  suffi-
 ciently demonstrate success in the following performance categories:
   (i) in addition to meeting the requirements of paragraph (j) of subdi-
 vision  seven  of  this  section,  in order to ensure network adequacy a
 commitment to contracting with an adequate number of licensed home  care
 service  agencies  needed to provide necessary personal care services to
 the greatest practicable number  of  enrollees,  and  with  an  adequate
 number  of  fiscal  intermediaries  needed to provide necessary consumer
 directed personal assistance services to the greatest practicable number
 of enrollees in accordance with section three  hundred  sixty-five-f  of
 the social services law;
   (ii)  readiness  to  timely  implement and adhere to maximum wait time
 criteria for key categories of service in accordance  with  laws,  rules
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11574-01-3
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 and  regulations of the department or the Centers for Medicare and Medi-
 caid Services;
   (iii) commitment to quality improvement;
   (iv)  accessibility  and geographic distribution of network providers,
 taking into account the needs  of  persons  with  disabilities  and  the
 differences between rural, suburban, and urban settings;
   (v)  demonstrated  cultural  and language competencies specific to the
 population of participants;
   (vi) ability to serve enrollees  across  the  continuum  of  care,  as
 demonstrated  by  the  type and number of products the managed long term
 care operates or has applied to operate, including integrated  care  for
 participants  who  are  dually  eligible for Medicaid and Medicare[, and
 those operated under title one-A of article twenty-five of this  chapter
 and section three hundred sixty-nine-gg of the social services law]; and
   (vii) value based care readiness and experience.
   §  2.  This act shall take effect immediately; provided, however, that
 the amendments to section 4403-f  of  the  public  health  law  made  by
 section  one of this act shall not affect the repeal of such section and
 shall be deemed repealed therewith.