Senate Bill S3973A

2015-2016 Legislative Session

Authorizing the commissioner of health to apply for a medicaid reform demonstration waiver

download bill text pdf

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Archive: Last 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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Bill Amendments

2015-S3973 - Details

See Assembly Version of this Bill:
A5986
Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Amd §366, Soc Serv L
Versions Introduced in Other Legislative Sessions:
2009-2010: S2639, A6676
2011-2012: S3196, A2280
2013-2014: S1438, A5545

2015-S3973 - Summary

Authorizes the commissioner of health to apply for a medicaid reform demonstration waiver; creates an initiative to provide for a more efficient and effective medicaid services delivery system; sets forth a managed care pilot program and requires reporting to the governor, temporary president of the senate and speaker of the assembly by December 31, 2019.

2015-S3973 - Sponsor Memo

2015-S3973 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  3973

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            February 25, 2015
                               ___________

Introduced  by  Sen.  RANZENHOFER -- 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 authorizing  the
  commissioner  of  health  to apply for a medicaid reform demonstration
  waiver

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 366 of the social services law is amended by adding
a new subdivision 6-b to read as follows:
  6-B.  A.  THE COMMISSIONER OF HEALTH SHALL APPLY FOR A MEDICAID REFORM
DEMONSTRATION WAIVER PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN  OF  THE
FEDERAL  SOCIAL SECURITY ACT IN ORDER TO CREATE AN INITIATIVE TO PROVIDE
FOR A MORE EFFICIENT AND EFFECTIVE MEDICAID SERVICES DELIVERY SYSTEM  IN
NEW  YORK  THAT  EMPOWERS  MEDICAID PATIENTS, BRIDGES PUBLIC AND PRIVATE
COVERAGE, IMPROVES PATIENT OUTCOMES AND STABILIZES PROGRAM COSTS.
  B. THE DEMONSTRATION WAIVER SHALL INCLUDE, BUT SHALL  NOT  BE  LIMITED
TO, THE FOLLOWING COMPONENTS:
  (I)  A  RISK ADJUSTED CAPITATED MANAGED CARE PILOT PROGRAM FOR RECIPI-
ENTS CURRENTLY SERVED IN MEDICAID-FEE-FOR SERVICE  OR  MEDICAID  MANAGED
CARE  THAT  PROVIDES  BENEFIT  PLANS  THAT MORE CLOSELY RESEMBLE PRIVATE
PLANS YET ARE ACTUARIALLY EQUIVALENT TO  THE  CURRENT  MEDICAID  BENEFIT
PACKAGE.  RISK  ADJUSTED  CAPITATION RATES SHALL BE SEPARATED INTO THREE
COMPONENTS TO COVER COMPREHENSIVE CARE, CATASTROPHIC CARE  AND  ENHANCED
SERVICES AND MAY PHASE IN FINANCIAL RISK FOR APPROVED PROVIDERS.  HEALTH
PLANS  SHALL  PROVIDE  COMPREHENSIVE CARE WHICH SHALL COVER ALL EXPENSES
UNTIL A PREDETERMINED THRESHOLD OF EXPENSES IS REACHED AT WHICH TIME THE
CATASTROPHIC COMPONENT SHALL TAKE  OVER.  HEALTH  PLANS  MAY  CHOOSE  TO
ASSUME  THE  CATASTROPHIC  RISK  FOR  TARGET POPULATIONS THEY SERVE. THE
CATASTROPHIC COMPONENT SHALL ENCOURAGE  PROVIDER  NETWORKS  TO  IDENTIFY
RECIPIENTS  WITH  UNDIAGNOSED  CHRONIC ILLNESS AND ENSURE PROPER DISEASE
MANAGEMENT OF THE ENROLLEE'S CONDITION. THE ENHANCED SERVICES  COMPONENT

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09434-01-5
              

2015-S3973A (ACTIVE) - Details

See Assembly Version of this Bill:
A5986
Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Amd §366, Soc Serv L
Versions Introduced in Other Legislative Sessions:
2009-2010: S2639, A6676
2011-2012: S3196, A2280
2013-2014: S1438, A5545

2015-S3973A (ACTIVE) - Summary

Authorizes the commissioner of health to apply for a medicaid reform demonstration waiver; creates an initiative to provide for a more efficient and effective medicaid services delivery system; sets forth a managed care pilot program and requires reporting to the governor, temporary president of the senate and speaker of the assembly by December 31, 2019.

2015-S3973A (ACTIVE) - Sponsor Memo

2015-S3973A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 3973--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            February 25, 2015
                               ___________

Introduced  by  Sen.  RANZENHOFER -- 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 social services law, in relation to authorizing the
  commissioner of health to apply for a  medicaid  reform  demonstration
  waiver

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 366 of the social services law is amended by adding
a new subdivision 6-b to read as follows:
  6-B. A. THE COMMISSIONER OF HEALTH SHALL APPLY FOR A  MEDICAID  REFORM
DEMONSTRATION  WAIVER  PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE
FEDERAL SOCIAL SECURITY ACT IN ORDER TO CREATE AN INITIATIVE TO  PROVIDE
FOR  A MORE EFFICIENT AND EFFECTIVE MEDICAID SERVICES DELIVERY SYSTEM IN
NEW YORK THAT EMPOWERS MEDICAID PATIENTS,  BRIDGES  PUBLIC  AND  PRIVATE
COVERAGE, IMPROVES PATIENT OUTCOMES AND STABILIZES PROGRAM COSTS.
  B.  THE  DEMONSTRATION  WAIVER SHALL INCLUDE, BUT SHALL NOT BE LIMITED
TO, THE FOLLOWING COMPONENTS:
  (I) A RISK ADJUSTED CAPITATED MANAGED CARE PILOT PROGRAM  FOR  RECIPI-
ENTS  CURRENTLY  SERVED  IN MEDICAID-FEE-FOR SERVICE OR MEDICAID MANAGED
CARE THAT PROVIDES BENEFIT PLANS  THAT  MORE  CLOSELY  RESEMBLE  PRIVATE
PLANS  YET  ARE  ACTUARIALLY  EQUIVALENT TO THE CURRENT MEDICAID BENEFIT
PACKAGE. RISK ADJUSTED CAPITATION RATES SHALL BE  SEPARATED  INTO  THREE
COMPONENTS  TO  COVER COMPREHENSIVE CARE, CATASTROPHIC CARE AND ENHANCED
SERVICES AND MAY PHASE IN FINANCIAL RISK FOR APPROVED PROVIDERS.  HEALTH
PLANS SHALL PROVIDE COMPREHENSIVE CARE WHICH SHALL  COVER  ALL  EXPENSES
UNTIL A PREDETERMINED THRESHOLD OF EXPENSES IS REACHED AT WHICH TIME THE
CATASTROPHIC  COMPONENT  SHALL  TAKE  OVER.  HEALTH  PLANS MAY CHOOSE TO
ASSUME THE CATASTROPHIC RISK FOR  TARGET  POPULATIONS  THEY  SERVE.  THE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09434-02-6
              

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