Bill Text: NY A08336 | 2011-2012 | General Assembly | Introduced

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Bill Title: Chapter amends S.5553 and A.8085 to authorize the commissioner of health to extend the use of prior settlements to subsequent un-audited periods with regard to payments to patient service providers and assessments on covered lives.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Passed) 2011-08-03 - signed chap.319 [A08336 Detail]

Download: New_York-2011-A08336-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         8336
                              2011-2012 Regular Sessions
                                 I N  A S S E M B L Y
                                     June 14, 2011
                                      ___________
       Introduced  by  M. of A. ROBERTS, GOTTFRIED -- read once and referred to
         the Committee on Health
       AN ACT to amend the public health law, in relation to prior  settlements
         and general hospitals
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Paragraph (f) of subdivision 8-a of section 2807-j  of  the
    2  public  health law, as amended by a chapter of the laws of 2011 amending
    3  the public health law relating to authorizing the commissioner of health
    4  to extend the use of audit findings  to  subsequent  un-audited  periods
    5  with  regard to payments to patient service providers and assessments on
    6  covered lives as proposed in legislative bills numbers S.  5553  and  A.
    7  8085, is amended to read as follows:
    8    (f) The commissioner may enter into agreements with designated provid-
    9  ers  of  services, and with third-party payors, in regard to which audit
   10  findings OR PRIOR SETTLEMENTS have been made pursuant to this section or
   11  section twenty-eight hundred seven-s  of  this  article,  extending  and
   12  applying such audit findings OR PRIOR SETTLEMENTS, or a portion thereof,
   13  in settlement and satisfaction of potential audit liabilities for subse-
   14  quent  un-audited periods.  The commissioner may reduce or waive payment
   15  of interest and penalties otherwise applicable to such subsequent  unau-
   16  dited periods when such amounts due as a result of such agreement, other
   17  than  reduced  or waived penalties and interest, are paid in full to the
   18  commissioner  or  the  commissioner's  designee  within  sixty  days  of
   19  execution  of  such  agreement  by  all  parties  to  the agreement. Any
   20  payments made pursuant to agreements entered  into  in  accordance  with
   21  this paragraph shall be deemed to be in full satisfaction of any liabil-
   22  ity  arising under this section and section twenty-eight hundred seven-s
   23  of this article, as referenced in such agreements and for the time peri-
   24  ods covered by such agreements, provided, however, that the commissioner
   25  may audit future retroactive adjustments to payments made for such peri-
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD13079-01-1
       A. 8336                             2
    1  ods based on reports filed by providers and payors  subsequent  to  such
    2  agreements.
    3    S  2.  Paragraph (f) of subdivision 10 of section 2807-t of the public
    4  health law, as amended by a chapter of the laws  of  2011  amending  the
    5  public  health law relating to authorizing the commissioner of health to
    6  extend the use of audit findings to subsequent un-audited  periods  with
    7  regard  to  payments  to  patient  service  providers and assessments on
    8  covered lives as proposed in legislative bills numbers S.  5553  and  A.
    9  8085, is amended to read as follows:
   10    (f)  The  commissioner may enter into agreements with specified third-
   11  party payors in regard to which audit findings OR PRIOR SETTLEMENTS have
   12  been made pursuant to this section, extending and  applying  such  audit
   13  findings  OR  PRIOR SETTLEMENTS, or a portion thereof, in settlement and
   14  satisfaction of potential audit liabilities  for  subsequent  un-audited
   15  periods.    The commissioner may reduce or waive payment of interest and
   16  penalties otherwise applicable to such subsequent unaudited periods when
   17  such amounts due as a result of such agreement, other  than  reduced  or
   18  waived  interest  and penalties, are paid in full to the commissioner or
   19  the commissioner's designee within  sixty  days  of  execution  of  such
   20  agreement by all parties to the agreement. Any payments made pursuant to
   21  agreements  entered  into  in  accordance  with  this paragraph shall be
   22  deemed to be in full satisfaction of any liability  arising  under  this
   23  section,  as  referenced  in  such  agreements  and for the time periods
   24  covered by such agreements, provided, however, that the commissioner may
   25  audit future retroactive adjustments to payments made for  such  periods
   26  based on reports filed by payors subsequent to such agreements.
   27    S  3.    Subdivision  18 of section 2807-c of the public health law is
   28  amended by adding a new paragraph (i) to read as follows:
   29    (I) THE COMMISSIONER MAY ENTER INTO AGREEMENTS WITH GENERAL  HOSPITALS
   30  SUBJECT  TO THIS SUBDIVISION, IN REGARD TO WHICH AUDIT FINDINGS OR PRIOR
   31  SETTLEMENTS HAVE BEEN MADE PURSUANT TO THIS SUBDIVISION,  EXTENDING  AND
   32  APPLYING  SUCH AUDIT FINDINGS OR PRIOR SETTLEMENTS OR A PORTION THEREOF,
   33  IN SETTLEMENT AND SATISFACTION OF POTENTIAL AUDIT LIABILITIES FOR SUBSE-
   34  QUENT UN-AUDITED PERIODS. THE COMMISSIONER MAY REDUCE OR  WAIVE  PAYMENT
   35  OF INTEREST AND PENALTIES OTHERWISE APPLICABLE TO SUCH SUBSEQUENT UN-AU-
   36  DITED PERIODS WHEN SUCH AMOUNTS DUE AS A RESULT OF SUCH AGREEMENT, OTHER
   37  THAN  REDUCED  OR WAIVED PENALTIES AND INTEREST, ARE PAID IN FULL TO THE
   38  COMMISSIONER  OR  THE  COMMISSIONER'S  DESIGNEE  WITHIN  SIXTY  DAYS  OF
   39  EXECUTION  OF  SUCH  AGREEMENT  BY  ALL  PARTIES  TO  THE AGREEMENT. ANY
   40  PAYMENTS MADE PURSUANT TO AGREEMENTS ENTERED  INTO  IN  ACCORDANCE  WITH
   41  THIS PARAGRAPH SHALL BE DEEMED TO BE IN FULL SATISFACTION OF ANY LIABIL-
   42  ITY ARISING UNDER THIS SUBDIVISION, AS REFERENCED IN SUCH AGREEMENTS AND
   43  FOR THE TIME PERIODS COVERED BY SUCH AGREEMENTS, PROVIDED, HOWEVER, THAT
   44  THE  COMMISSIONER  MAY  AUDIT FUTURE RETROACTIVE ADJUSTMENTS TO PAYMENTS
   45  MADE FOR SUCH PERIODS BASED ON REPORTS FILED BY HOSPITALS SUBSEQUENT  TO
   46  SUCH AGREEMENTS.
   47    S  4.  This  act  shall  take  effect on the same date and in the same
   48  manner as a chapter of the laws of 2011 amending the public  health  law
   49  relating  to authorizing the commissioner of health to extend the use of
   50  audit findings to subsequent un-audited periods with regard to  payments
   51  to  patient  service  providers  and  assessments  on  covered  lives as
   52  proposed in legislative bills numbers S. 5553 and A. 8085 takes  effect;
   53  provided  that  the  amendments  to  paragraph (f) of subdivision 8-a of
   54  section 2807-j of the public health law, made by  section  one  of  this
   55  act,  shall  not  affect the expiration of such section and shall expire
   56  therewith; provided, further, that the amendments to  paragraph  (f)  of
       A. 8336                             3
    1  subdivision  10  of  section  2807-t  of  the public health law, made by
    2  section two of this act, shall not affect the expiration of such section
    3  and shall expire therewith.