Requires review and approval by the commissioner of health of contracts for home care services provided to a licensed home care services agency from a managed care organization or a managed long term care plan; directs the commissioner of health to establish a dispute resolution process independent dispute resolution relating to billing under a contract for home care services.
Summary
S09562 would amend the Public Health Law to add new oversight and dispute-resolution rules for home care service contracts between licensed home care services agencies and managed care organizations or managed long term care plans. The bill requires the Commissioner of Health to review and approve certain contract changes at least three months before modifications related to billing, rates, services, contract expiration, amendments, or changes tied to minimum wage or other labor-law wage and benefit requirements.
The bill also directs the commissioner to create an independent dispute resolution process for billing and contract disputes. Licensed home care services agencies could submit disputes to a certified independent dispute resolution entity, which would have to decide the matter within 30 business days. The decision would be binding, and any affected contract or bill would need to be amended and filed with the Department of Health. The bill further bars retaliation by managed care organizations or managed long term care plans against agencies that seek dispute resolution, and it contemplates Medicaid directed payments for wage increases if approved by the federal Centers for Medicare and Medicaid Services.
Impact
This bill would expand state regulatory control over home care reimbursement and contracting by giving the Department of Health a formal review role before certain contract changes take effect and by creating a binding arbitration-style process for disputes. It would affect licensed home care services agencies, managed care organizations, managed long term care plans, and the Commissioner of Health, while also tying contract review to wage parity, minimum wage increases, labor-law compliance, and related provider costs. If federal approval is obtained, it could also support directed Medicaid payments to help cover wage and labor-cost increases for home care providers.
Sentiment
Based on the bill text and available context, the measure appears generally supportive of home care providers and workers, especially in light of minimum wage and labor-cost pressures. The bill is framed as a mechanism to ensure contracts reflect the real costs of direct care, operations, and compliance, suggesting a policy goal of stabilizing the home care workforce and provider finances. No committee transcript or vote record is available, so there is no documented opposition or recorded legislative sentiment in the provided materials.
Contention
The main likely point of contention is the bill’s shift of leverage toward home care agencies by requiring advance review of contract changes, mandating binding dispute resolution, and prohibiting retaliation by managed care entities. Managed care organizations and managed long term care plans may object to the added administrative burden, potential cost increases, and limits on their contracting flexibility. Another possible issue is the bill’s dependence on federal CMS approval for directed Medicaid payments, which could raise implementation and funding concerns.
Same As
Requires review and approval by the commissioner of health of contracts for home care services provided to a licensed home care services agency from a managed care organization or a managed long term care plan; directs the commissioner of health to establish a dispute resolution process independent dispute resolution relating to billing under a contract for home care services.
Requires review and approval by the commissioner of health of contracts for home care services provided to a licensed home care services agency from a managed care organization or a managed long term care plan; directs the commissioner of health to establish a dispute resolution process independent dispute resolution relating to billing under a contract for home care services.
Establishes a home care services bill of rights for patients of home care services agencies and certified home health agencies; requires training for staff and contractors of such agencies to eliminate certain discriminations; makes related provisions.
Establishes a home care services bill of rights for patients of home care services agencies and certified home health agencies; requires training for staff and contractors of such agencies to eliminate certain discriminations; makes related provisions.
Enacts "Ella's law"; requires care managers employed by or under contract with a care coordination organization to provide care management services to an individual unless such care manager has completed all training requirements.
Amends the definition of "health care personnel" to define the term "temporary services" as health care services contracted for an initial term of less than twenty-four continuous months; requires a temporary health care services agency to annually submit to the department of health copies of all contracts between the agency and a health care entity to which it assigns or refers health care personnel.
Amends the definition of "health care personnel" to define the term "temporary services" as health care services contracted for an initial term of less than twenty-four continuous months; requires a temporary health care services agency to annually submit to the department of health copies of all contracts between the agency and a health care entity to which it assigns or refers health care personnel.
Community Health, Department of; contracts with care management organizations for the provision of healthcare services for Medicaid or PeachCare for Kids recipients; establish requirements
Relates to reimbursement of home care aides; requires the commissioner of health to ensure rate ranges for Medicaid managed care organizations comply with certain reimbursement rates.
Relating to contracts with managed care organizations, including the procurement of managed care contracts, under Medicaid and the child health plan program.