Relates to payments to rural hospitals that are critical access hospitals.
Ayes (62): Adams, Addabbo, Alesi, Avella, Ball, Bonacic, Breslin, Carlucci, DeFrancisco, Diaz, Dilan, Duane, Espaillat, Farley, Flanagan, Fuschillo, Gallivan, Gianaris, Golden, Griffo, Grisanti, Hannon, Hassell-Thomps, Huntley, Johnson, Kennedy, Klein, Krueger, Kruger, Lanza, Larkin, LaValle, Libous, Little, Marcellino, Martins, Maziarz, McDonald, Montgomery, Nozzolio, O'Mara, Oppenheimer, Parker, Peralta, Perkins, Ranzenhofer, Ritchie, Rivera, Robach, Saland, Sampson, Savino, Serrano, Seward, Skelos, Smith, Squadron, Stavisky, Stewart-Cousin, Valesky, Young, Zeldin
TITLE OF BILL: An act to amend the public health law, in relation to payments to rural hospitals designated as critical access hospitals
PURPOSE: To allow that on and after April 1, 2012, rural hospitals designated as critical access hospitals are paid by Medicaid in the same manner that Medicare pays critical access hospitals, which is on the basis of reasonable costs.
SUMMARY OF PROVISIONS: Amends Subdivision 2-a of section 2807 of the Public Health Law by adding a new paragraph (j) that on and after April 1, 2012, a rural hospital designated as a critical access hospital shall have Medicaid payments for emergency services, and all outpatient services equal to one hundred and one percent of the reasonable costs of such facility in providing these services.
JUSTIFICATION: Critical access hospitals serve medically underserved geographically isolated communities. They provide limited stay special care, acute care and swing bed services, as well as 24 hour emergency service capability. The maintenance of critical access hospitals is critical for preserving access to basic health care services for rural New Yorkers.
Cost based Medicaid reimbursement would help ensure the long range financial viability of primary care hospitals. New York State Medicaid reimbursement rates are presently capped at lower than operational costs. The problem is exacerbated for critical access hospitals because of the need to spread substantial fixed costs over a small number of visits and admissions. Medicare reimburses such hospitals (called critical access hospitals under Medicare) on the basis of reasonable costs. This line helped stabilize such hospitals and ensure that isolated communities continue to have access to needed health care services. Having Medicaid payments also equal reasonable costs will further ensure the financial viability of such hospitals.
LEGISLATIVE HISTORY: 2007-2008: A.8783-A/S.7232 (Winner) 2009-2010: A.5347-A/S.4108-A (Aubertine)
FISCAL IMPLICATIONS: This legislation is expected to cost the state $1.24 million and will ensure the financial viability of its thirteen critical access hospitals.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 5431--A 2011-2012 Regular Sessions IN SENATE May 20, 2011 ___________Introduced by Sens. YOUNG, BONACIC, RITCHIE -- (at request of the Legis- lative Commission on Rural Resources) -- read twice and ordered print- ed, and when printed to be committed to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law, in relation to payments to rural hospitals designated as critical access hospitals THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 2-a of section 2807 of the public health law is amended by adding a new paragraph (j) to read as follows: (J) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SUBDIVISION OR ANY OTHER PROVISION OF LAW TO THE CONTRARY, ON AND AFTER APRIL FIRST, TWO THOUSAND TWELVE, RATES OF PAYMENT FOR DIAGNOSTIC AND TREATMENT CENTER SERVICES, EMERGENCY SERVICES, GENERAL HOSPITAL OUTPATIENT SERVICES, AMBULATORY SURGICAL SERVICES AND REFERRED AMBULATORY SERVICES, PROVIDED BY A RURAL HOSPITAL DESIGNATED AS A CRITICAL ACCESS HOSPITAL IN ACCORD- ANCE WITH TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT SHALL BE EQUAL TO ONE HUNDRED ONE PERCENT OF THE REASONABLE COSTS OF A FACILITY IN PROVIDING SUCH SERVICES TO PATIENTS ELIGIBLE FOR PAYMENTS MADE IN ACCORDANCE WITH THIS SUBDIVISION. REASONABLE COSTS SHALL BE DETERMINED IN A MANNER CONSISTENT WITH THAT USED TO DETERMINE PAYMENT FOR OUTPA- TIENT CRITICAL ACCESS HOSPITAL SERVICES PROVIDED TO BENEFICIARIES OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT. FOR FACILITIES WITHOUT ADEQUATE COST EXPERIENCE, SUCH RATES SHALL BE BASED ON BUDGETED COSTS SUBSEQUENTLY ADJUSTED TO ONE HUNDRED ONE PERCENT OF REASONABLE ACTUAL COSTS. S 2. This act shall take effect immediately.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08758-05-1