NY State Senate Bill 2023-S8486

Senate Bill S8486

2023-2024 Legislative Session

Relates to medicaid reimbursement for treatment in place and transportation to alternative health care settings by ambulance services

download bill text pdf

Current Bill Status - In Senate Committee Health Committee

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 05, 2024	referred to health

co-Sponsors

2023-S8486 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Add §367-y, Soc Serv L

2023-S8486 (ACTIVE) - Summary

Provides for medicaid reimbursement for ambulance services when treatment in place is administered and/or when transportation is provided to alternative health care settings instead of a general hospital.

2023-S8486 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S8486

SPONSOR: HINCHEY
 
TITLE OF BILL:

An act to amend the social services law, in relation to Medicaid
reimbursement for treatment in place and transportation to alternative
health care settings by ambulance services

 
PURPOSE:

This bill would authorize Medicaid reimbursement to emergency medical
service agencies for:

*providing emergency medical care to Medicaid enrollees without requir-
ing the transportation of these patients from the location where the
medical care was administered

*providing emergency medical care to Medicaid enrollees and transporting
them to alternative destinations (i.e.locations other than a hospital),
such as an urgent care clinic or mental health or rehabilitation facili-
ty

 
SUMMARY OF PROVISIONS:

Section 1: Establishes and defines reimbursement for treatment in place
and transportation to alternative health care settings.

Section 2: Effective Date

 
JUSTIFICATION:

Under current law, when responding to a 911 call, EMS agencies must
transport Medicaid enrollees to a general hospital in order to receive
Medicaid reimbursement. Each medical scenario is unique. Not every call
requires a visit to a hospital or emergency room. In some cases, a
patient may be better served at the scene of the emergency, and in these
instances the EMS agency is faced with not being reimbursed for the cost
of care (let alone the cost of the time it takes to respond in more
rural or remote areas). This contributes to the already dire financial
situations that many EMS providers already experience. Furthermore, when
EMS agencies do transport enrollees to a hospital unnecessarily, that is
valuable time lost that could have been spent responding to more serious
emergencies while further burdening emergency rooms in the process.  The
first piece here would allow EMS practitioners to treat Medicaid enrol-
lees in place (when deemed appropriate by the agency's medical director)
and be reimbursed for such services, saving time and money for emergency
responders, patients, and hospital staff.

Additionally, since each emergency call is unique, there must be a
degree of discretion allowed regarding the best treatment options for
the patient. Whereas EMS agencies are hamstrung into a "one-size-fits-
all" approach of transporting a patient to a general hospital for
reimbursement, this bill would also authorize Medicaid reimbursement for
transportation to alternative destinations-"hospitals" as defined in NYS
Public Health Law-which can include mental health or rehabilitation
facilities.

 
LEGISLATIVE HISTORY:
New bill.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect January I after enactment.

2023-S8486 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8486
 
                             I N  S E N A T E
 
                             February 5, 2024
                                ___________
 
 Introduced  by Sens. HINCHEY, MAY -- read twice and ordered printed, and
   when printed to be committed to the Committee on Health
 
 AN ACT to amend  the  social  services  law,  in  relation  to  Medicaid
   reimbursement for treatment in place and transportation to alternative
   health care settings by ambulance services
 
   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-y to read as follows:
   §  367-Y.  REIMBURSEMENT  FOR TREATMENT IN PLACE AND TRANSPORTATION TO
 ALTERNATIVE HEALTH CARE SETTINGS. 1. NOTWITHSTANDING  ANY  PROVISION  OF
 LAW  TO  THE  CONTRARY,  ANY  PROVISION  OF  THIS  TITLE  PROVIDING  FOR
 REIMBURSEMENT OF TRANSPORTATION COSTS FOR  AN  AMBULANCE  SERVICE  SHALL
 ALSO  APPLY  WHERE,  INSTEAD  OF  PROVIDING  TRANSPORTATION TO A GENERAL
 HOSPITAL, SUCH AMBULANCE SERVICE:
   (A) ADMINISTERS TREATMENT IN PLACE, INCLUDING BUT NOT LIMITED TO TELE-
 HEALTH VISITS APPROVED BY MEDICAID FOR REIMBURSEMENT WHEN DEEMED  NECES-
 SARY; AND/OR
   (B) TRANSPORTS AN INDIVIDUAL TO AN ALTERNATIVE HEALTH CARE SETTING.
   2.  FOR  THE  PURPOSES OF THIS SECTION, THE FOLLOWING TERMS SHALL HAVE
 THE FOLLOWING MEANINGS:
   (A) "ALTERNATIVE HEALTH CARE SETTING" MEANS FACILITIES OR INSTITUTIONS
 APPROVED BY MEDICAID FOR REIMBURSEMENT INCLUDING BUT NOT LIMITED TO:
   (I) A CRISIS STABILIZATION CENTER OR  CERTIFIED  COMMUNITY  BEHAVIORAL
 HEALTH  CLINIC  OPERATING  PURSUANT  TO ARTICLE THIRTY-SIX OF THE MENTAL
 HYGIENE LAW;
   (II) A FACILITY UNDER SECTION 7.17 OF THE MENTAL HYGIENE LAW;
   (III) A FACILITY PROVIDING ADDICTION DISORDER SERVICES  AND/OR  BEHAV-
 IORAL  HEALTH SERVICES, AS SUCH TERMS ARE DEFINED BY SECTION 1.03 OF THE
 MENTAL HYGIENE LAW;
   (IV) A DIAGNOSTIC AND TREATMENT CENTER ESTABLISHED PURSUANT TO ARTICLE
 TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, OR  AN  UPGRADED  DIAGNOSTIC  AND
 TREATMENT  CENTER  DESIGNATED  AS  SUCH  PURSUANT TO SECTION TWENTY-NINE
 HUNDRED FIFTY-SIX OF THE PUBLIC HEALTH LAW;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD14413-01-4
 S. 8486                             2
 
   (V) A FEDERALLY QUALIFIED HEALTH CENTER; OR
   (VI)  ENGAGED PRINCIPALLY IN PROVIDING SERVICES BY OR UNDER THE SUPER-
 VISION OF A PHYSICIAN LICENSED UNDER ARTICLE ONE HUNDRED  THIRTY-ONE  OF
 THE EDUCATION LAW.
   (B)  "AMBULANCE  SERVICE"  SHALL  HAVE  THE SAME MEANING AS DEFINED BY
 SECTION THREE THOUSAND ONE OF THE PUBLIC HEALTH LAW.
   (C) "GENERAL HOSPITAL" SHALL HAVE  THE  SAME  MEANING  AS  DEFINED  BY
 SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW.
   (D) "TREATMENT IN PLACE" MEANS THE ADMINISTRATION OF EMERGENCY MEDICAL
 SERVICES,  AS DEFINED BY SECTION THREE THOUSAND ONE OF THE PUBLIC HEALTH
 LAW, BY AN EMPLOYEE OR VOLUNTEER OF AN AMBULANCE SERVICE.
   § 2. This act shall take effect on the first of January next  succeed-
 ing the date on which it shall have become a law.

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Senate Bill S8486

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Sponsored By

Michelle Hinchey