Prohibits medical assistance providers from refusing to furnish care, services or supplies to any person who is entitled to receive such care, services or supplies under this title if such medical assistance provider furnishes the same care, services or supplies under the Medicare program pursuant to title XVIII of the federal social security act and the person is dually eligible under that program.
Summary
Bill S05173 aims to amend the social services law in New York by prohibiting medical assistance providers from refusing to furnish care, services, or supplies to individuals who are entitled to receive such benefits under Medicaid, particularly when these individuals are also dually eligible for Medicare. The bill specifies that if a medical assistance provider offers the same services under Medicare, they cannot deny those services to eligible Medicaid recipients based on their secondary insurance status. This legislative change seeks to ensure that dually eligible individuals receive the necessary medical care without discrimination based on their insurance coverage.
Impact
The passage of this bill would significantly impact the operations of medical assistance providers in New York by mandating that they provide care to dually eligible individuals regardless of their Medicaid or Medicare status. This could lead to an increase in the number of patients receiving care, as providers would be legally obligated to serve those who qualify under both programs. Additionally, it may require amendments to the state plan for medical assistance and could influence how providers manage their billing and service delivery processes.
Sentiment
The general sentiment around Bill S05173 appears to be supportive, as it addresses a critical issue of access to healthcare for vulnerable populations. Discussions indicate a recognition of the importance of ensuring that individuals with dual eligibility are not denied necessary services. However, there may be concerns regarding the administrative burden this could place on providers and the potential financial implications for the Medicaid system.
Contention
Notable points of contention surrounding the bill may include concerns from medical assistance providers regarding the feasibility of complying with the new requirements, especially in terms of financial reimbursement and administrative processes. Some stakeholders may argue that the bill could lead to increased costs for providers, while advocates for the bill emphasize the need for equitable access to healthcare for all eligible individuals, regardless of their insurance status.
Same As
Prohibits medical assistance providers from refusing to furnish care, services or supplies to any person who is entitled to receive such care, services or supplies under this title if such medical assistance provider furnishes the same care, services or supplies under the Medicare program pursuant to title XVIII of the federal social security act and the person is dually eligible under that program.
Prohibits medical assistance providers from refusing to furnish care, services or supplies to any person who is entitled to receive such care, services or supplies under this title if such medical assistance provider furnishes the same care, services or supplies under the Medicare program pursuant to title XVIII of the federal social security act and the person is dually eligible under that program.
Prohibits medical assistance providers from refusing to furnish care, services or supplies to any person who is entitled to receive such care, services or supplies under this title if such medical assistance provider furnishes the same care, services or supplies under the Medicare program pursuant to title XVIII of the federal social security act and the person is dually eligible under that program.
Requires medical assistance to include medical care, services or supplies to monitor blood pressure that have been validated for accuracy and are furnished without prior authorization to eligible pregnant women.
Requires medical assistance to include medical care, services or supplies to monitor blood pressure that have been validated for accuracy and are furnished without prior authorization to eligible pregnant women.
To amend titles XVIII and XIX of the Social Security Act to require coverage of certain food and nutrition services under the Medicare and Medicaid programs.
To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology.
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.