•  Summary 
  •  
  •  Actions 
  •  
  •  Committee Votes 
  •  
  •  Floor Votes 
  •  
  •  Memo 
  •  
  •  Text 
  •  
  •  LFIN 
  •  
  •  Chamber Video/Transcript 

A07488 Summary:

BILL NOA07488
 
SAME ASNo Same As
 
SPONSORPaulin
 
COSPNSR
 
MLTSPNSR
 
Amd 3614, Pub Health L; amd 364-j, Soc Serv L
 
Relates to Medicaid reimbursement rates for private duty nursing.
Go to top    

A07488 Actions:

BILL NOA07488
 
05/25/2023referred to health
01/03/2024referred to health
Go to top

A07488 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A7488
 
SPONSOR: Paulin
  TITLE OF BILL: An act to amend the public health law and the social services law, in relation to rates of reimbursement for private duty nursing   PURPOSE OR GENERAL IDEA OF BILL: To set a benchmark rate for private duty nursing services consistent with the current fee for services rate   SUMMARY OF SPECIFIC PROVISIONS: Section 1 amends Public Health Law § 3614 subdivision 11 to ass a new paragraph which mandates organizations operating under article 44 of the public health law and article 43 of the insurance law pay private duty services at a rate no lower,than the Medicaid fee for service rate. Section 2 amends section 364-j of the social services law to provide for the same rate mandate as in section 1.   JUSTIFICATION: Access to Private Duty Nursing (PDN) allows eligible medically fragile individuals, to remain in their home and continue to receive quality skilled nursing care. When access to PDN services is not available to these vulnerable and high-acuity patients, they are relegated to care in a hospital or facility, which is not only a more expensive option but also often not the best option for the patient's or family's quality of life and responsiveness to care. The state sets fee for service reimbursement rates for PDN services. Unfortunately, Medicaid managed care organizations often reimburse at a lower rate, making it difficult to recruit nurses to this program and for agencies to continue to provide PDN services. This bill would set the floor for Medicaid managed care reimbursement at the same level at the fee for service rate thus ensuring this vulnerable population continues to have access to the professional and quality services of private duty nursing. This is generally a relatively small cohort of the patient population, who require intensive long. term continuous care due to a birth condi- tion that requires a ventilator, tracheostomy, intubation tube, etc and this care also cares for adults who may suffer from conditions such as ALS or Parkinson's disease or following a stroke. PDNs provide compre- hensive hourly long-term nursing care, anywhere from four to 24 hours per day. They are skilled in managing medical equipment and technology and have specific training to manage pediatric acuities and other medical complexities.   PRIOR LEGISLATIVE HISTORY: New bill   FISCAL IMPLICATIONS: None   EFFECTIVE DATE: Immediate
Go to top

A07488 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          7488
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                      May 25, 2023
                                       ___________
 
        Introduced by M. of A. PAULIN -- read once and referred to the Committee
          on Health
 
        AN  ACT  to  amend the public health law and the social services law, in
          relation to rates of reimbursement for private duty nursing
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1. Subdivision 11 of section 3614 of the public health law is
     2  amended by adding a new paragraph (d) to read as follows:
     3    (d) For enrollees covered by Medicaid as of January first,  two  thou-
     4  sand  twenty-four  under a payment rate methodology agreement negotiated
     5  with a licensed home care services provider, including but  not  limited
     6  to  services  provided  through  licensed  home  care services agencies,
     7  payments for all hourly home care services provided through private duty
     8  nursing, including but not limited  to  nursing  services,  provided  to
     9  patients  eligible  for  medical  assistance pursuant to title eleven of
    10  article five of the social services law made by organizations  operating
    11  in  accordance with the provisions of article forty-four of this chapter
    12  or by  health  maintenance  organizations  organized  and  operating  in
    13  accordance  with  article  forty-three  of the insurance law shall, at a
    14  minimum, be at a benchmark rate which is to be the fee-for-service  rate
    15  calculated  pursuant  to  this chapter and as in effect at the time such
    16  services were provided.
    17    § 2. Section 364-j of the social services law is amended by  adding  a
    18  new subdivision 40 to read as follows:
    19    40.  For  enrollees covered by Medicaid as of January first, two thou-
    20  sand twenty-four under a payment rate methodology  agreement  negotiated
    21  with  a  licensed home care services provider, including but not limited
    22  to services provided  through  licensed  home  care  services  agencies,
    23  payments for all hourly home care services provided through private duty
    24  nursing,  including  but  not  limited  to nursing services, provided to
    25  patients eligible for medical assistance under this title made by organ-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11370-01-3

        A. 7488                             2
 
     1  izations operating in accordance with the provisions of  article  forty-
     2  four  of  the  public  health law or by health maintenance organizations
     3  organized and operating in accordance with article  forty-three  of  the
     4  insurance law shall, at a minimum, be the rates of payment that would be
     5  paid for such patients pursuant to subdivision fourteen of section thir-
     6  ty-six hundred fourteen of the public health law.
     7    § 3. This act shall take effect immediately.
Go to top