Provides per diem rates of payment by governmental agencies for inpatient services provided by facilities designated by the federal department of health and human services as exempt extended neoplastic disease care hospitals.
Summary
Bill A02359 amends the public health law to establish specific reimbursement rates for hospitals designated as exempt extended neoplastic disease care hospitals by the federal Department of Health and Human Services. The bill outlines how the operating cost component of hospital reimbursement rates will be calculated based on 2023 operating costs, adjusted for inflation and other necessary modifications as deemed appropriate by the commissioner. It also mandates that these rates be updated at least every three years and includes provisions for outpatient specialty services.
Impact
The bill will directly impact the reimbursement rates for inpatient and outpatient services provided by the specified hospitals, ensuring that they are compensated at rates reflective of their operating costs. This change aims to enhance the financial stability of these facilities and ensure they can continue to provide specialized care for neoplastic diseases. Additionally, it establishes a framework for Medicaid managed care plans to reimburse these hospitals at no less than the applicable Medicaid fee-for-service rates, which could improve access to care for Medicaid patients.
Sentiment
The sentiment surrounding Bill A02359 appears to be generally supportive among health care advocates and hospital administrators, who argue that it will provide necessary financial support to specialized hospitals. However, there may be concerns from budget-conscious lawmakers regarding the implications of increased spending on Medicaid and the overall state budget.
Contention
Notable points of contention include concerns about the potential financial impact on the state budget and the adequacy of the reimbursement rates set forth in the bill. Some lawmakers may argue that while the intent is to support specialized care, the long-term fiscal implications need thorough examination. Additionally, there may be differing opinions on how frequently the reimbursement rates should be updated and the criteria for adjustments.
Same As
Provides per diem rates of payment by governmental agencies for inpatient services provided by facilities designated by the federal department of health and human services as exempt extended neoplastic disease care hospitals.
Provides per diem rates of payment by governmental agencies for inpatient services provided by facilities designated by the federal department of health and human services as exempt extended neoplastic disease care hospitals.
Requires the executive office of health and human services to increase Medicaid payment rates for primary care services furnished by primary care providers to be commensurate with Medicare rates.
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2026-2027 state fiscal year; extends provisions requiring the quarterly assessment of known and projected department of health state fund Medicaid expenditures (Part A); extends certain health provisions (Part B); extends certain provisions of law relating to the health care reform act; extends provisions relating to the distribution of pool allocations and graduate medical education; extends provisions relating to health care initiative pool distributions; extends payment provisions for general hospitals; and extends provisions relating to assessments on covered lives (Part C); relates to insurance coverage for medical malpractice paid for by funds from the hospital excess liability pool; extends portions of the New York Health Care Reform Act of 1996 (Part D); relates to temporary health care services agencies and protecting individuals engaged to provide health care services by such agencies (Part J); relates to capital rate reductions for nursing homes (Part L); clarifies Medicaid requirements for biomarker testing (Part M); relates to hospital and nursing home fee-for-service reimbursement rates (Part O); directs the commissioners of the office of mental health, office for people with developmental disabilities, office of addiction services and supports, office of temporary and disability assistance, office of children and family services and the director of the state office for the aging to establish a state fiscal year 2026-2027 targeted inflationary increase for projecting for the effects of inflation upon rates of payments, contracts, or any other form of reimbursement for certain programs and services; requires such commissioners and director to provide funding to support a 4.0% targeted inflationary increase for such programs and services (Part P); relates to the effectiveness of provisions of law relating to Medicaid management; removes certain provisions providing for lower minimum amounts of certain state aid for the city of New York than the rest of the state (Part T); extends provisions of law relating to general hospital reimbursement for annual rates for behavioral services; extends provisions of law relating to increasing Medicaid payments to providers through managed care organizations and providing equivalent fees through an ambulatory patient group methodology (Part U); ensures services provided in school-based health centers are not provided to medical assistance recipients through managed care programs (Part V); extends the effectiveness of the requirement that upon the closure or transfer of a state-operated individualized residential alternative (Part W); extends the care demonstration program (Part X); sunsets certain hospital capital rate add-on adjustments (Part Y); creates an essential plan contingency fund to maintain access to health care coverage for Essential Plan enrollees in the event that the federal government does not approve certain waiver submission necessary to make funds available by July 1, 2026, in the amount not to exceed $2,400,000,000 (Part Z).
AN ACT Relating to allowing payments to be made for services provided by any rural hospital that is located on a federally recognized Indian reservation;
An Act Establishing Licensure For Long-term Acute Care Hospitals And Requiring The Department Of Public Health To Study The Designation Of Long-term Care Facilities And Chronic Disease Hospitals.