Expands entities eligible to apply for a certificate of authority to operate a long term care plan as a health maintenance organization; requires all applicants to comply with regulations relating to managed care.
Ayes (59): Adams, Addabbo, Alesi, Avella, Ball, Bonacic, Breslin, Carlucci, DeFrancisco, Diaz, Dilan, Duane, Espaillat, Farley, Flanagan, Fuschillo, Gallivan, Gianaris, Golden, Griffo, Grisanti, Hannon, Hassell-Thomps, Johnson, Kennedy, Klein, Krueger, Lanza, Larkin, LaValle, Libous, Little, Marcellino, Martins, Maziarz, 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
Excused (2): Huntley, McDonald
TITLE OF BILL: An act to amend the public health law, in relation to applicants for certificates of authority to operate managed long term care plans
PURPOSE: An act to amend the public health law, in relation to applicants for certificates of authority to operate managed long term care plans.
SUMMARY OF PROVISIONS: Amends the definition of eligible applicant in Public Health Law 4403-f to clarify that such an applicant may be a new entity applying for a certificate of authority.
JUSTIFICATION: The Managed Long Term Care program was initially established as a demonstration program in 1997. The program has evolved over the years and, more recently, as a result of the Medicaid Redesign Team recommendations and the subsequent budget actions, individuals who require long term care services are required to enroll in managed long term care plans. In order to ensure that this population of Medicaid consumers have access to a sufficient amount of plans and providers, it is necessary to clarify that new entities may apply to become an MLTC. Such entities must comply with Department of Health regulations related to certification and programmatic requirements, and the Department has the authority to approve or disapprove applicants.
LEGISLATIVE HISTORY: New Bill.
FISCAL IMPLICATIONS: Medicaid Redesign Team has determined that as a result of managed care enrollment, savings will accrue to the State.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 7149 IN SENATE May 1, 2012 ___________Introduced by Sen. HANNON -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to applicants for certificates of authority to operate managed long term care plans THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (b) of subdivision 1 of section 4403-f of the public health law, as added by chapter 659 of the laws of 1997, is amended to read as follows: (b) "Eligible applicant" means an entity controlled or wholly owned by one or more of the following: a hospital as defined in subdivision one of section twenty-eight hundred one of this chapter; a home care agency licensed or certified pursuant to article thirty-six of this chapter; A NEW APPLICANT THAT IS APPLYING FOR A CERTIFICATE OF AUTHORITY PURSUANT TO THIS SECTION, OR an entity that has received a certificate of author- ity pursuant to sections forty-four hundred three, forty-four hundred three-a or forty-four hundred eight-a of this article (as added by chap- ter six hundred thirty-nine of the laws of nineteen hundred ninety-six), or a health maintenance organization authorized under article forty- three of the insurance law; or a not-for-profit organization which has a history of providing or coordinating health care services and long term care services to the elderly and disabled; PROVIDED, HOWEVER, THAT ALL SUCH ENTITIES SHALL ALSO COMPLY WITH THE REGULATIONS OF THE DEPARTMENT RELATING TO MANAGED CARE. S 2. This act shall take effect immediately; provided, however, that the amendments to section 4403-f of the public health law, made by section one of this act, shall not affect the expiration and repeal of such section, and shall expire and be deemed repealed therewith.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD15425-01-2