S T A T E O F N E W Y O R K
________________________________________________________________________
3609
2025-2026 Regular Sessions
I N A S S E M B L Y
January 29, 2025
___________
Introduced by M. of A. JONES -- read once and referred to the Committee
on Health
AN ACT to amend the social services law, in relation to Medicaid
reimbursement rates for rural home health care providers
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subdivision 1 of section 368-a of the social services law
is amended by adding a new paragraph (g-1) to read as follows:
(G-1) NOTWITHSTANDING PARAGRAPH (G) OF THIS SUBDIVISION, SECTION THREE
HUNDRED SIXTY-FOUR-J OF THIS TITLE OR ANY OTHER PROVISION OF LAW,
REIMBURSEMENT FOR HOME HEALTH SERVICES PROVIDED IN ACCORDANCE WITH PARA-
GRAPH (D) OF SUBDIVISION TWO OF SECTION THREE HUNDRED SIXTY-FIVE-A OF
THIS TITLE BY AN INDIVIDUAL OR SHARED AIDE PROVIDED BY AN APPROVED HOME
HEALTH AGENCY WHEN SUCH SERVICES ARE DETERMINED TO BE COST EFFECTIVE AND
APPROPRIATE TO MEET THE RECIPIENT'S NEEDS FOR ASSISTANCE, WHERE SUCH
SERVICES ARE DELIVERED IN A RURAL AREA OF THE STATE, TO BE DESIGNATED BY
THE COMMISSIONER IN REGULATION, SHALL BE INCREASED TO INCLUDE AN AMOUNT
NECESSARY TO COVER THE DISPARATE TRANSPORTATION COSTS ASSOCIATED WITH
PROVIDING SUCH SERVICES IN RURAL AREAS. THE COMMISSIONER SHALL DEVELOP
METHODOLOGIES FOR CALCULATING SUCH DELIVERY COSTS WHICH ARE SEPARATE
FROM DIRECT PERSONAL CARE. SUCH REIMBURSEMENT INCREASE SHALL INCLUDE ALL
HOME HEALTH SERVICES PROVIDED FOR ELIGIBLE RECIPIENTS UNDER THIS ARTI-
CLE, INCLUDING THOSE AVAILABLE OR OBTAINED THROUGH FEDERAL WAIVERS.
§ 2. Subdivision 1 of section 365-l of the social services law, as
added by section 37 of part H of chapter 59 of the laws of 2011, is
amended to read as follows:
1. Notwithstanding any law, rule or regulation to the contrary, the
commissioner of health is authorized, in consultation with the commis-
sioners of the office of mental health, office of [alcoholism and
substance abuse services] ADDICTION SERVICES AND SUPPORTS, and office
for people with developmental disabilities, to (a) establish, in accord-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05558-01-5
A. 3609 2
ance with applicable federal law and regulations, standards for the
provision of health home services to Medicaid enrollees with chronic
conditions, (b) establish payment methodologies for health home services
based on factors including but not limited to the complexity of the
conditions providers will be managing, the anticipated amount of patient
contact needed to manage such conditions, TRANSPORTATION COSTS, and the
health care cost savings realized by provision of health home services,
(c) establish the criteria under which a Medicaid enrollee will be
designated as being an eligible individual with chronic conditions for
purposes of this program, (d) assign any Medicaid enrollee designated as
an eligible individual with chronic conditions to a provider of health
home services.
§ 3. This act shall take effect immediately.