Bill Text: NY S04178 | 2025-2026 | General Assembly | Introduced
Bill Title: Establishes a workgroup to conduct analysis on the ambulatory patient group rates and commercial insurance rates for behavioral health services.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2025-02-03 - REFERRED TO MENTAL HEALTH [S04178 Detail]
Download: New_York-2025-S04178-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 4178 2025-2026 Regular Sessions IN SENATE February 3, 2025 ___________ Introduced by Sen. PARKER -- read twice and ordered printed, and when printed to be committed to the Committee on Mental Health AN ACT to amend the mental hygiene law, in relation to establishing a workgroup to conduct analysis on the ambulatory patient group rates and commercial insurance rates 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. Section 7.07 of the mental hygiene law is amended by adding 2 a new subdivision (i) to read as follows: 3 (i) 1. The commissioner of the office of mental health, in collab- 4 oration with the commissioner of the department of health and the 5 commissioner of the office of addiction services and supports are 6 directed to convene and jointly chair, either directly or through a 7 designee or designees, a workgroup, which shall include membership that 8 ensures adequate statewide geographic representation selected with equal 9 contributions on such selection from the governor, the speaker of the 10 assembly and temporary president of the senate and be comprised of the 11 following members: (i) professional associations representing substance 12 use, mental health, and/or behavioral health providers; (ii) represen- 13 tatives from professional associations representing providers of peer 14 and recovery-based programs and services; (iii) representatives from 15 professional associations representing medicated assisted treatment 16 providers; (iv) representatives from professional associations repres- 17 enting children's behavioral health providers; (v) representatives from 18 hospital associations; (vi) representatives from associations represent- 19 ing behavioral health consumers and family members; and (vii) any addi- 20 tional stakeholder or expert that the commissioners deem necessary. 21 Members of the workgroup shall serve without compensation, but may be 22 reimbursed for actual costs incurred for participation on such work- 23 group. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD07782-01-5S. 4178 2 1 2. The workgroup shall conduct an analysis on the ambulatory patient 2 group rates and commercial insurance rates for behavioral health 3 services for the purpose of developing a report that shall provide 4 recommendations on the following: (i) rate adequacy related to the 5 existing ambulatory patient group-based reimbursement provided under 6 medicaid managed care, as well as for commercial insurance rates with 7 regards to services rendered under child health plus, or for services 8 provided by clinics licensed or certified pursuant to article thirty-one 9 or thirty-two of this chapter or dually licensed or certified under 10 article thirty-one or thirty-two of this chapter and article twenty- 11 eight of the public health law; (ii) the actual costs of care associated 12 with the delivery of behavioral health services; (iii) one or more 13 alternative reimbursement models that would adequately compensate clin- 14 ics licensed or holding an operating certificate under article thirty- 15 one or thirty-two of this chapter or dually licensed under article thir- 16 ty-one or thirty-two of this chapter and article twenty-eight of the 17 public health law for their costs of care under medicaid managed care 18 and child health plus; and (iv) any policy or fiscal resources necessary 19 to carry out the recommendations of the report developed pursuant to 20 this section. The report shall be submitted to the governor, the speaker 21 of the assembly and the temporary president of the senate no later than 22 October first, two thousand twenty-seven. 23 § 2. This act shall take effect on the ninetieth day after it shall 24 have become a law.
