New York S 6266: Establishes a quality incentive program for managed care providers

Bill Text

Bill Search and Legislative Information | New York State Assembly 

• 

• 

• 

• 

• 

• 

• 

• 

 Skip to main content 

 New York State Assembly

 Speaker Carl E. Heastie

 --> 
 --> 

 --> 

• 
 Assembly Members 

• 
 Legislative Info 

• 
 Public Hearings 

• 
 Speaker's Press 

• 
 Assembly Reports 

• 
 Committees & More 

• Bill Search Home
• Laws
• Legislative Calendar
• Public Hearing Schedule
• Assembly Calendars
• Assembly Committee Agenda 

 Javascript must be enabled to properly view this page. 

 Bill No.: 

• Summary 
• Actions 
• Committee&nbspVotes 
• Floor&nbspVotes 
• Memo 
• Text 
• LFIN 
• Chamber&nbspVideo/Transcript 
S06266 Summary:

BILL NOS06266 

&nbsp

SAME ASSAME AS A02044

&nbsp

SPONSORSALAZAR

&nbsp

COSPNSRADDABBO, CLEARE, FERNANDEZ, PARKER, STAVISKY

&nbsp

MLTSPNSR

&nbsp

Amd §364-j, Soc Serv L; amd §4403-f, Pub Health L

&nbsp

Establishes a quality incentive program for managed care providers that is distributed based on managed care providers' performance in meeting quality objectives.

Go to top S06266 Actions:

BILL NOS06266 

&nbsp

03/07/2025REFERRED TO HEALTH

05/13/2025REPORTED AND COMMITTED TO FINANCE

06/12/2025COMMITTEE DISCHARGED AND COMMITTED TO RULES

06/12/2025ORDERED TO THIRD READING CAL.1884

06/12/2025PASSED SENATE

06/12/2025DELIVERED TO ASSEMBLY

06/12/2025referred to health

01/07/2026died in assembly

01/07/2026returned to senate

01/07/2026REFERRED TO HEALTH

02/24/2026REPORTED AND COMMITTED TO FINANCE

Go to topS06266 Committee&nbspVotes:

Go to topS06266 Floor&nbspVotes:

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

Go to topS06266 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 6266

 2025-2026 Regular Sessions

 IN SENATE

 March 7, 2025
 ___________

 Introduced by Sens. SALAZAR, ADDABBO, CLEARE, FERNANDEZ, PARKER -- read
 twice and ordered printed, and when printed to be committed to the
 Committee on Health

 AN ACT to amend the social services law and the public health law, in
 relation to establishing a quality incentive program for managed care
 providers

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

 1 Section 1. Subdivision 18 of section 364-j of the social services law
 2 is amended by adding a new paragraph (c-1) to read as follows:
 3 (c-1) In setting such reimbursement, the commissioner of health shall
 4 establish a quality incentive program for managed care providers that is
 5 distributed based on managed care providers' performance in meeting
 6 quality objectives, which shall be set by the commissioner in advance of
 7 the period during which quality is measured. Such quality incentive
 8 program shall be funded at a level of at least one percent of the total
 9 annual premium paid to managed care providers, or three hundred million
 10 dollars, whichever is greater. In establishing the manner in which to
 11 measure quality and distribute quality incentive program funds, the
 12 commissioner of health shall establish a methodology that provides the
 13 greatest level of funding to managed care providers receiving the high-
 14 est quality scores and shall consult with representatives of managed
 15 care providers and other key stakeholders.
 16 § 2. Subdivision 8 of section 4403-f of the public health law, as
 17 amended by section 21 of part B of chapter 59 of the laws of 2016, is
 18 amended to read as follows:
 19 8. Payment rates for managed long term care plan enrollees eligible
 20 for medical assistance. The commissioner shall establish payment rates
 21 for services provided to enrollees eligible under title XIX of the
 22 federal social security act. Such payment rates shall be subject to
 23 approval by the director of the division of the budget and shall reflect

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD05282-01-5

 S. 6266 2

 1 savings to both state and local governments when compared to costs which
 2 would be incurred by such program if enrollees were to receive compara-
 3 ble health and long term care services on a fee-for-service basis in the
 4 geographic region in which such services are proposed to be provided.
 5 Payment rates shall be risk-adjusted to take into account the character-
 6 istics of enrollees, or proposed enrollees, including, but not limited
 7 to: frailty, disability level, health and functional status, age,
 8 gender, the nature of services provided to such enrollees, and other
 9 factors as determined by the commissioner. The risk adjusted premiums
 10 may also be combined with disincentives or requirements designed to
 11 mitigate any incentives to obtain higher payment categories. In setting
 12 such payment rates, the commissioner shall consider costs borne by the
 13 managed care program to ensure actuarially sound and adequate rates of
 14 payment to ensure quality of care