Bill Text: NY S07023 | 2021-2022 | General Assembly | Amended
Bill Title: Directs the commissioner of health to conduct a study on the rates of reimbursement made through the New York state Medicaid durable medical equipment, orthotics, prosthetics and supplies program for rate adequacy and patient access.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Engrossed - Dead) 2022-05-31 - referred to ways and means [S07023 Detail]
Download: New_York-2021-S07023-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 7023--A Cal. No. 118 2021-2022 Regular Sessions IN SENATE May 24, 2021 ___________ Introduced by Sens. MANNION, KENNEDY, REICHLIN-MELNICK, SKOUFIS -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- recommitted to the Committee on Health in accordance with Senate Rule 6, sec. 8 -- reported favorably from said committee, ordered to first and second report, ordered to a third reading, passed by Senate and delivered to the Assembly, recalled, vote reconsidered, restored to third reading, amended and ordered reprinted, retaining its place in the order of third reading AN ACT directing the commissioner of health to conduct a study on the rates of reimbursement made through the New York state Medicaid dura- ble medical equipment, orthotics, prosthetics and supplies program for rate adequacy and patient access; and providing for the repeal of such provisions upon expiration thereof The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The commissioner of health shall conduct a study to review 2 the rates of reimbursement made through the New York state Medicaid 3 durable medical equipment, orthotics, prosthetics and supplies program 4 for rate adequacy and patient access, including those made under all 5 capitated and contract coverage models. Such review shall include: 6 (a) an analysis of rules, regulations and policies for orthotics and 7 prosthetics service/device provisions under the New York Medicaid 8 program, including all contracted and capitated models; 9 (b) a comprehensive assessment of the existing methodology used to 10 determine payment or nonpayment for prosthetic and orthotic care includ- 11 ing but not limited to: 12 (i) all orthotic and prosthetic codes on the current Medicaid fee 13 schedule, including but not limited to a comparison of prevailing Medi- 14 care fee schedule amounts and New York Medicaid amounts; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD11559-03-2S. 7023--A 2 1 (ii) codes on the Medicare fee schedule but not included on the New 2 York state Medicaid durable medical equipment, orthotics, prosthetics 3 and supplies program fee schedule; 4 (iii) recommendations for changing reimbursement methodologies. 5 Recommendations under this subparagraph shall be consistent with federal 6 law and shall include recommendations for appropriate changes in state 7 law and regulations. Such recommendations shall consider appropriate 8 payment methodologies for codes not included on the Medicaid fee sched- 9 ule; 10 (c) assessment of barriers to timely service provision as well as 11 racial and socioeconomic disparities in access including, but not limit- 12 ed to, travel time required, geographic variability, access to and cost 13 of technology; 14 (d) the workforce needed to provide orthotic and prosthetic services 15 in the next five years to eligible children and adults, disaggregated by 16 county; 17 (e) opportunities for stakeholder input on current rate methodologies; 18 and 19 (f) assessment of cost savings associated with percentage of Medicaid 20 population returning to work after orthotic and/or prosthetic provision. 21 § 2. Within one year after the effective date of this act, the commis- 22 sioner of health shall submit a report of the findings and recommenda- 23 tions pursuant to this act to the governor, the temporary president of 24 the senate, the minority leader of the senate, the speaker of the assem- 25 bly, the minority leader of the assembly, and the chairs and ranking 26 members of the senate and assembly committees on health and shall post 27 such report on the department of health's website. 28 § 3. The commissioner of health shall be authorized to promulgate 29 rules and regulations to provide for the orderly effectuation of the 30 provisions of this act. 31 § 4. This act shall take effect immediately and shall expire and be 32 deemed repealed upon the submission of the report required pursuant to 33 section two of this act.
