Bill Text: NY S07023 | 2021-2022 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          7023

                               2021-2022 Regular Sessions

                    IN SENATE

                                      May 24, 2021
                                       ___________

        Introduced  by  Sen. MANNION -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health

        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;
    15    (ii) codes on the Medicare fee schedule but not included  on  the  New
    16  York  state  Medicaid  durable medical equipment, orthotics, prosthetics
    17  and supplies program fee schedule;
    18    (iii)  recommendations  for  changing   reimbursement   methodologies.
    19  Recommendations under this subparagraph shall be consistent with federal
    20  law  and  shall include recommendations for appropriate changes in state
    21  law and regulations. Such  recommendations  shall  consider  appropriate

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11559-01-1
        S. 7023                             2

     1  payment  methodologies for codes not included on the Medicaid fee sched-
     2  ule;
     3    (c)  assessment  of  barriers  to  timely service provision as well as
     4  racial and socioeconomic disparities in access including, but not limit-
     5  ed to, travel time required, geographic variability, access to and  cost
     6  of technology;
     7    (d)  the  workforce needed to provide orthotic and prosthetic services
     8  in the next five years to eligible children and adults, disaggregated by
     9  county;
    10    (e) opportunities for stakeholder input on current rate methodologies;
    11  and
    12    (f) assessment of cost savings associated with percentage of  Medicaid
    13  population returning to work after orthotic and/or prosthetic provision.
    14    § 2. Within one year after the effective date of this act, the commis-
    15  sioner  of  health shall submit a report of the findings and recommenda-
    16  tions pursuant to this act to the governor, the temporary  president  of
    17  the senate, the speaker of the assembly and the chairs of the senate and
    18  assembly  committees on health and shall post such report on the depart-
    19  ment of health's website.
    20    § 3. The commissioner of health  shall  be  authorized  to  promulgate
    21  rules  and  regulations  to  provide for the orderly effectuation of the
    22  provisions of this act.
    23    § 4. This act shall take effect immediately and shall  expire  and  be
    24  deemed  repealed  upon the submission of the report required pursuant to
    25  section two of this act.