Requires the commissioner of health to annually make the system of episodic payments, including all pricing mechanisms, available to all Medicaid managed care plans, all child health insurance plans and all essential plans, and to notify all such managed care plans of their responsibilities for ensuring that their enrolled members have access to certified home health agency services.
Summary
Bill A07013 amends the public health law to establish a system of episodic payments for certified home health agencies in New York. The bill mandates that the commissioner of health annually make this payment system available to all Medicaid managed care plans, child health insurance plans, and essential plans. It aims to ensure that these plans notify their enrolled members about their access to home health services, which are deemed critical for improving patient care and reducing costs associated with avoidable hospitalizations.
Impact
The bill's passage is expected to enhance the financial sustainability of certified home health agencies by allowing for adjustments in payment rates based on various factors, including inflation and regulatory requirements. It will also standardize the payment methodology across different health plans, potentially leading to improved access to home health services for Medicaid recipients and other insured individuals in New York.
Sentiment
The sentiment around Bill A07013 appears to be positive, as indicated by the unanimous support in the Assembly Health Committee, where it received a favorable recommendation to proceed to the Ways and Means Committee. This suggests a consensus on the importance of home health services and the need for a structured payment system.
Contention
While there is general support for the bill, some points of contention may arise regarding the specifics of the payment adjustments and the potential impact on budget allocations for health services. Stakeholders, including home health agencies and managed care plans, may have differing views on the adequacy of the proposed payment rates and the implications for service delivery.
Requires health care plans and payors to have a minimum of twelve and one-half percent of their total expenditures on physical and mental health annually be for primary care services.
Relating to allowing Medicaid managed care organizations to engage in marketing about the availability of certain private health benefit plan coverage.
Relating to allowing Medicaid managed care organizations to engage in marketing about the availability of certain private health benefit plan coverage.