S6219/A8011 – New Bill from the NYS Council Introduced this Week in Assembly & Senate

May 25, 2017

 

We are delighted to share the news that a new bill, S6219/A8011 drafted by the NYS Council was introduced this week in both houses of the NYS Legislature.

 

As you know, our focus continues to be on addressing access, continuity, payment and contracting problems experienced by providers and consumers that have come into sharper focus as result of the implementation of Medicaid Managed Care in our sector. Now in addition to our All Products bill that seeks to level the contract negotiating playing field between providers and insurers, we have our MCO Timely Payment bill that would codify what should be but is not always taking place on the ground with regards to payments from MCOs.

 

The bill requires that when the state increases rates, or changes the terms or scope of payment for behavioral health services where payment is made to a Managed Care service provider, such changes will be deemed in effect on the same date that the change would have taken effect if payment were made outside of the Managed Care payment environment. Furthermore it requires that where payment is not made as of the effective date, the managed care insurer shall make retroactive payments to the appropriate service providers back to the effective date.

 

As always, we are grateful to Senator Ortt and Assemblyman Gottfried for their commitment to our sector and their willingness to sponsor our bill! Stand by for more and (in the meantime) please make the calls we’ve requested you place on behalf of our All Products bill and let us know how it goes. Also many thanks to NYS Council consultants Adam Falcone and Marcy Savage for assisting us with the drafting of this bill.

 

S 6219-A  ORTT   Same as A 8011  Gottfried
ON FILE: 05/22/17 Social Services Law
TITLE….Relates to payments for behavioral health services
05/11/17 REFERRED TO HEALTH
05/22/17 AMEND (T) AND RECOMMIT TO HEALTH
05/22/17 PRINT NUMBER 6219A
A8011 Gottfried    Same as S 6219-A  ORTT
Social Services Law
TITLE….Relates to payments for behavioral health services
05/25/17 referred to health

 
                STATE OF NEW YORK
        ________________________________________________________________________

                                         6219--A

                               2017-2018 Regular Sessions

                    IN SENATE

                                      May 11, 2017
                                       ___________

        Introduced  by  Sen.  ORTT  --  read twice and ordered printed, and when
          printed to be committed  to  the  Committee  on  Health  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee

        AN  ACT  to  amend the social services law and the public health law, in
          relation to payments for behavioral health services

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1. Subdivision 18 of section 364-j of the social services law
     2  is amended by adding a new paragraph (e) to read as follows:
     3    (e) Increased rates, terms or scope of payment for  behavioral  health
     4  services  under  this  title,  where  payment  is made by a managed care
     5  provider under this section, as a result of a rate,  coverage  or  other
     6  change  made  pursuant  to a law, regulation, rule or official guidance,
     7  shall be deemed in effect on the same date that such change  would  have
     8  taken effect if payment were made other than by the managed care provid-
     9  er. Where payment is not made as of the effective date, the managed care
    10  provider  shall  make  retroactive  payments  to the appropriate service
    11  providers.
    12    § 2. Section 2511 of the public health law is amended by adding a  new
    13  subdivision 22 to read as follows:
    14    22.  Increased  rates, terms or scope of payment for behavioral health
    15  services under this title, where payment is made by an  approved  organ-
    16  ization,  as  a result of a rate, coverage or other change made pursuant
    17  to a law, regulation, rule or  official  guidance  shall  be  deemed  in
    18  effect  on  the  same  date  that such change would have taken effect if
    19  payment were made other than by the approved organization. Where payment
    20  is not made as of the effective date, the  approved  organization  shall
    21  make retroactive payments to the appropriate service providers.
    22    §  3.  Subdivision  7  of  section  4403-f of the public health law is
    23  amended by adding a new paragraph (i) to read as follows:

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11698-02-7
        S. 6219--A                          2

     1    (i) Increased rates, terms or scope of payment for  behavioral  health
     2  services  under  this  section, where payment is made by an entity under
     3  this section, as a result of a  rate,  coverage  or  other  change  made
     4  pursuant  to  a  law,  regulation,  rule  or official guidance, shall be
     5  deemed  in  effect  on  the  same date that such change would have taken
     6  effect if payment were made other than by the entity. Where  payment  is
     7  not  made  as  of  the effective date, the entity shall make retroactive
     8  payments to the appropriate service providers.
     9    § 4. This act shall take effect immediately; provided,  however,  that
    10  the  amendments  to section 364-j of the social services law and section
    11  4403-f of the public health law made by sections one and three  of  this
    12  act,  respectively,  shall  not  affect  the repeal of such sections and
    13  shall be deemed repealed therewith.