New York Senate Bill S03131 Latest Draft

   
  STATE OF NEW YORK ________________________________________________________________________ 3131 2023-2024 Regular Sessions  IN SENATE January 27, 2023 ___________ Introduced by Sens. MANNION, KENNEDY, SKOUFIS -- 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. LBD04992-01-3 
 S. 3131 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 minority leader of the senate, the speaker of the assem- 18 bly, the minority leader of the assembly, and the chairs and ranking 19 members of the senate and assembly committees on health and shall post 20 such report on the department of health's website. 21 § 3. The commissioner of health shall be authorized to promulgate 22 rules and regulations to provide for the orderly effectuation of the 23 provisions of this act. 24 § 4. This act shall take effect immediately and shall expire and be 25 deemed repealed upon the submission of the report required pursuant to 26 section two of this act.