Makes technical corrections to provisions of law relating to rates of payment for residential health care facilities.
Ayes (32): Kruger, Stachowski, Oppenheimer, Montgomery, Duane, Parker, Stavisky, Dilan, Stewart-Cousins, Thompson, Breslin, Diaz, Espada, Klein, Perkins, Valesky, Peralta, DeFrancisco, Johnson O, Volker, Padavan, LaValle, Seward, Saland, Farley, Hannon, Larkin, Nozzolio, Leibell, Maziarz, Marcellino, Robach
Ayes W/R (1): Krueger
BILL NUMBER: S6858
TITLE OF BILL : An act to amend the public health law, in relation to rates of payment for residential health care facilities
PURPOSE OR GENERAL IDEA OF BILL : The purpose of this legislation is to ensure continuation of a consistent Medicaid nursing home reimbursement rate for a specialty nursing home that treats neurologically impaired children who cannot be appropriately discharged into the community when they age.
SUMMARY OF SPECIFIC PROVISIONS : This legislation provides that a residential health care facility with fewer than sixty beds as of July 1, 2007, which provides services primarily to neurologically impaired individuals and is located in a county with of population between 290,000 - 310,000- as of July 1, 2007, shall receive one Medicaid reimbursement rate, which shall be based solely on the methodology to establish rates for a specialty children's nursing home.
JUSTIFICATION : Prior to the enactment of chapter 414 of the Laws of 2007, the facility received two different Medicaid rates under the Health Departments rate setting -one for individuals under 16 and one for individuals 16 and over, despite the fact that virtually the same services were provided. Because of the differences in the way the two rates were calculated, the rate for those 16 and over was considerably less than that for those under 16. The rate for those over 16 did not cover the cost of care for these vulnerable individuals. Chapter 414 of the laws of 2007 mandated that the facility receive one rate of payment based solely on the methodology used to establish rates for facilities which provide extensive nursing, medical, psychological and counseling support services solely to children,
However, the facility has now received certificate of need approval to add 36 beds, which will result in a facility with more than 60 beds. Without a change in the law, the facility would no longer receive one rate as it would no longer meet the qualification of having less than 60 beds (when chapter 414 of the Laws of 2007 was enacted, the facility did not envision increasing its number of beds) - even though the rationale that resulted in the enactment of chapter 414 of the Laws of 2007 still applies. The beds being added are pediatric beds, not beds for the young adult neurologically impaired population aged 16 and over, which will remain at 20 beds (therefore, there is no change in the number of beds the higher rate applies to).
PRIOR LEGISLATIVE HISTORY : New Bill.
FISCAL IMPLICATIONS : Since this amendment simply allows for the continuation of establishing one, rather than two, rates for the facility, there would be no increase in Medicaid expenditures _ the status quo would be continued.
EFFECTIVE DATE : Immediately.
STATE OF NEW YORK ________________________________________________________________________ S. 6858 A. 9944 S E N A T E - A S S E M B L Y February 17, 2010 ___________IN SENATE -- Introduced by Sen. BRESLIN -- read twice and ordered print- ed, and when printed to be committed to the Committee on Health IN ASSEMBLY -- Introduced by M. of A. McENENY, CANESTRARI -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to rates of payment for residential health care facilities THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 24 of section 2808 of the public health law, as added by chapter 414 of the laws of 2007, is amended to read as follows: 24. Notwithstanding any other provisions of this section and any other law, rule or regulation to the contrary, for periods on and after July first, two thousand seven, the operating component of all rates of payment made by governmental agencies for services to individuals eligi- ble for medical assistance pursuant to title eleven of article five of the social services law and provided by a residential health care facil- ity with fewer than sixty beds AS OF JULY FIRST, TWO THOUSAND SEVEN, which provides services primarily to neurologically impaired individuals and is located in a county with a population between two hundred ninety thousand and three hundred ten thousand AS OF JULY FIRST, TWO THOUSAND SEVEN shall be based solely on the methodology used to establish rates for facilities which provide extensive nursing, medical, psychological and counseling support services solely to children; provided, however, this subdivision shall not apply if the application would result in a lesser rate of payment than otherwise provided for under this section. Nothing in this subdivision shall be construed to limit the application to such facility of rate adjustments applied to other residential health care facilities. S 2. This act shall take effect immediately.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD15938-01-0