New York A 4162: Relates to the powers, functions and duties of the New York state public authorities control board

Bill Text

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A04162 Summary:

BILL NOA04162B

&nbsp

SAME ASSAME AS S07705-A

&nbsp

SPONSORPaulin

&nbsp

COSPNSR

&nbsp

MLTSPNSR

&nbsp

Amd §3614, Pub Health L; amd §364-j, Soc Serv L

&nbsp

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

Go to top A04162 Actions:

BILL NOA04162B

&nbsp

01/31/2025referred to health

04/14/2025amend and recommit to health

04/14/2025print number 4162a

01/07/2026referred to health

01/08/2026amend and recommit to health

01/08/2026print number 4162b

Go to topA04162 Committee&nbspVotes:

Go to topA04162 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA04162 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 4162--B

 2025-2026 Regular Sessions

 IN ASSEMBLY

 January 31, 2025
 ___________

 Introduced by M. of A. PAULIN -- read once and referred to the Committee
 on Health -- committee discharged, bill amended, ordered reprinted as
 amended and recommitted to said committee -- again reported from said
 committee with amendments, ordered reprinted as amended and recommit-
 ted to said committee

 AN ACT to amend the public health law and the social services law, in
 relation to rates of reimbursement for private duty nursing

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Subdivision 11 of section 3614 of the public health law is
 2 amended by adding a new paragraph (d) to read as follows:
 3 (d) For enrollees covered by Medicaid as of October first, two thou-
 4 sand twenty-six under a payment rate methodology agreement negotiated
 5 with a licensed home care services provider, including but not limited
 6 to services provided through licensed home care services agencies,
 7 payments for all hourly home care services provided through private duty
 8 nursing, including but not limited to nursing services, provided to
 9 patients eligible for medical assistance pursuant to title eleven of
 10 article five of the social services law made by organizations operating
 11 in accordance with the provisions of article forty-four of this chapter
 12 or by health maintenance organizations organized and operating in
 13 accordance with article forty-three of the insurance law shall, at a
 14 minimum, be at a benchmark rate which is to be the fee-for-service rate
 15 calculated pursuant to this chapter and as in effect at the time such
 16 services were provided.
 17 § 2. Section 364-j of the social services law is amended by adding a
 18 new subdivision 41 to read as follows:
 19 41. For enrollees covered by Medicaid as of October first, two thou-
 20 sand twenty-six under a payment rate methodology agreement negotiated
 21 with a licensed home care services provider, including but not limited
 22 to services provided through licensed home care services agencies,

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD03865-06-5

 A. 4162--B 2

 1 payments for all hourly home care services provided through private duty
 2 nursing, including but not limited to nursing services, provided to
 3 patients eligible for medical assistance under this title made by organ-
 4 izations operating in accordance with the provisions of article forty-
 5 four of the public health law or by health maintenance organizations
 6 organized and operating in accordance with article forty-three of the
 7 insurance law shall, at a minimum, be the rates of payment that would be
 8 paid for such patients pursuant to subdivision eleven of section thir-
 9 ty-six hundred fourteen of the public health law.
 10 § 3. Effective October 1, 2026, payments for private duty nursing
 11 services shall be no less than eighty percent of the appropriate
 12 CHAMPUS/TRICARE maximum allowable charge based on the New York locality.
 13 For purposes of implementation, the appropriate CHAMPUS/TRICARE maximum
 14 allowable charge shall be the CHAMPUS/TRICARE maximum allowable charge
 15 in effect as of April 1 of the state fiscal year in which the services
 16 are rendered. The department of health shall publish a private duty rate
 17 schedule at least thirty days prior to the effective date of such
 18