Senate Bill S7705A

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7705--A
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                              April 30, 2025
                                ___________
 
 Introduced  by  Sen. C. RYAN -- 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 --
   committee discharged, bill amended, ordered reprinted as  amended  and
   recommitted to said committee

 AN  ACT  to  amend the public health law and the social services law, in
   relation to rates of reimbursement for private duty nursing
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Subdivision 11 of section 3614 of the public health law is
 amended by adding a new paragraph (d) to read as follows:
   (D) FOR ENROLLEES COVERED BY MEDICAID AS OF OCTOBER FIRST,  TWO  THOU-
 SAND  TWENTY-SIX  UNDER  A PAYMENT RATE METHODOLOGY AGREEMENT NEGOTIATED
 WITH A LICENSED HOME CARE SERVICES PROVIDER, INCLUDING BUT  NOT  LIMITED
 TO  SERVICES  PROVIDED  THROUGH  LICENSED  HOME  CARE SERVICES AGENCIES,
 PAYMENTS FOR ALL HOURLY HOME CARE SERVICES PROVIDED THROUGH PRIVATE DUTY
 NURSING, INCLUDING BUT NOT LIMITED  TO  NURSING  SERVICES,  PROVIDED  TO
 PATIENTS  ELIGIBLE  FOR  MEDICAL  ASSISTANCE PURSUANT TO TITLE ELEVEN OF
 ARTICLE FIVE OF THE SOCIAL SERVICES LAW MADE BY ORGANIZATIONS  OPERATING
 IN  ACCORDANCE WITH THE PROVISIONS OF ARTICLE FORTY-FOUR OF THIS CHAPTER
 OR BY  HEALTH  MAINTENANCE  ORGANIZATIONS  ORGANIZED  AND  OPERATING  IN
 ACCORDANCE  WITH  ARTICLE  FORTY-THREE  OF THE INSURANCE LAW SHALL, AT A
 MINIMUM, BE AT A BENCHMARK RATE WHICH IS TO BE THE FEE-FOR-SERVICE  RATE
 CALCULATED  PURSUANT  TO  THIS CHAPTER AND AS IN EFFECT AT THE TIME SUCH
 SERVICES WERE PROVIDED.
   § 2. Section 364-j of the social services law is amended by  adding  a
 new subdivision 41 to read as follows:
   41.  FOR  ENROLLEES COVERED BY MEDICAID AS OF OCTOBER FIRST, TWO THOU-
 SAND TWENTY-SIX UNDER A PAYMENT RATE  METHODOLOGY  AGREEMENT  NEGOTIATED
 WITH  A  LICENSED HOME CARE SERVICES PROVIDER, INCLUDING BUT NOT LIMITED
 TO SERVICES PROVIDED  THROUGH  LICENSED  HOME  CARE  SERVICES  AGENCIES,
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD03865-07-5
              

 S. 7705--A                          2
 
 PAYMENTS FOR ALL HOURLY HOME CARE SERVICES PROVIDED THROUGH PRIVATE DUTY
 NURSING,  INCLUDING  BUT  NOT  LIMITED  TO NURSING SERVICES, PROVIDED TO
 PATIENTS ELIGIBLE FOR MEDICAL ASSISTANCE UNDER THIS TITLE MADE BY ORGAN-
 IZATIONS  OPERATING  IN ACCORDANCE WITH THE PROVISIONS OF ARTICLE FORTY-
 FOUR OF THE PUBLIC HEALTH LAW OR  BY  HEALTH  MAINTENANCE  ORGANIZATIONS
 ORGANIZED  AND  OPERATING  IN ACCORDANCE WITH ARTICLE FORTY-THREE OF THE
 INSURANCE LAW SHALL, AT A MINIMUM, BE THE RATES OF PAYMENT THAT WOULD BE
 PAID FOR SUCH PATIENTS PURSUANT TO SUBDIVISION ELEVEN OF  SECTION  THIR-
 TY-SIX HUNDRED FOURTEEN OF THE PUBLIC HEALTH LAW.
   §  3.  Effective  October  1,  2026, payments for private duty nursing
 services shall be  no  less  than  eighty  percent  of  the  appropriate
 CHAMPUS/TRICARE maximum allowable charge based on the New York locality.
 For  purposes of implementation, the appropriate CHAMPUS/TRICARE maximum
 allowable charge shall be the CHAMPUS/TRICARE maximum  allowable  charge
 in  effect  as of April 1 of the state fiscal year in which the services
 are rendered. The department of health shall publish a private duty rate
 schedule at least thirty days prior to  the  effective  date  of    such
 increase and annually thereafter.
   §  4.  This act shall take effect immediately; provided, however, that
 the amendments to section 364-j of  the  social  services  law  made  by
 section  two of this act shall not affect the repeal of such section and
 shall be deemed repealed therewith.