NY
New York Assembly Bill A04162

New York 2025-2026 Regular Session

New York Assembly Bill A04162

Introduced
1/31/25  

Caption

Relates to Medicaid reimbursement rates for private duty nursing; requires DOH to publish a private duty rate schedule.

Impact

This legislative initiative represents a crucial step towards financial stability for home care providers by setting a minimum reimbursement rate. By aligning the state’s payment methods with broader public health benchmarks, the bill seeks to enhance the quality and accessibility of home care for vulnerable populations, particularly the elderly and those with chronic health issues. Additionally, this adjustment is anticipated to light a path to attracting more qualified professionals into the home care sector, potentially addressing workforce shortages in this essential field.

Summary

Bill A04162, titled 'Relates to Medicaid reimbursement rates for private duty nursing', proposes significant changes to the reimbursement structure for home care services provided under Medicaid in New York. The bill mandates that the Department of Health (DOH) establishes a private duty rate schedule to ensure that Medicaid enrollees receive adequate support for home care services, particularly private duty nursing. The bill stipulates that payments for these services should match or exceed 80% of the CHAMPUS/TRICARE maximum allowable charge based on local New York standards, effective from July 1, 2026.

Contention

While the bill's objectives are largely seen as beneficial by advocates for patients receiving home care, potential points of contention could arise surrounding funding allocations to support these new rates without straining the Medicaid budget. Critics may also express concerns regarding implementation timelines and the capacity of the DOH to effectively manage and communicate the new rate schedules, as well as the broader implications for existing agencies that provide these vital services. Overall, the debate may center around how effectively the proposed changes can be integrated into the current healthcare landscape without unintended negative consequences.

Latest A04162 Activity

Companion Bills

NY S07705

Same As Relates to Medicaid reimbursement rates for private duty nursing; requires DOH to publish a private duty rate schedule.

Previously Filed As

NY A07488

Relates to Medicaid reimbursement rates for private duty nursing.

NY A09034

Requires the state Medicaid director to establish a program for specific individuals to become complex care assistants and provide private duty nursing services to certain Medicaid enrollees under increased reimbursement rates.

NY S08599

Requires the state Medicaid director to establish a program for specific individuals to become complex care assistants and provide private duty nursing services to certain Medicaid enrollees under increased reimbursement rates.

NY A00091

Increases medicaid reimbursement payment aggregate for private duty nursing services and care by 15 million dollars for period 7/1/24 to 3/31/25, and by 20 million dollars annually thereafter for each period from April 1 to March 31.

NY S01090

Increases medicaid reimbursement payment aggregate for private duty nursing services and care by 15 million dollars for period 7/1/24 to 3/31/25, and by 20 million dollars annually thereafter for each period from April 1 to March 31.

NY A05381

Requires notice and additional review for managed care providers of the methodologies and fee schedules and other materials used for determining medicaid reimbursement rates.

NY S06075

Requires notice and additional review for managed care providers of the methodologies and fee schedules and other materials used for determining medicaid reimbursement rates.

NY S08360

Requires notice and additional review for managed care providers of the methodologies and fee schedules and other materials used for determining medicaid reimbursement rates.

NY A08877

Requires notice and additional review for managed care providers of the methodologies and fee schedules and other materials used for determining medicaid reimbursement rates.

NY S02116

Relates to a privately owned vacant property temporary public benefit use exemption.

Similar Bills

No similar bills found.