New York A 2089: Sets reimbursement rates for essential safety net hospitals

Bill Text

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A02089 Summary:

BILL NOA02089 

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SAME ASNo Same As

&nbsp

SPONSORPaulin

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COSPNSRSeptimo, Simon, Weprin, Bichotte Hermelyn, Levenberg, Kim, Kelles

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MLTSPNSR

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Amd §2807-c, Pub Health L

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Sets reimbursement rates for essential safety net hospitals at no less than regional average commercial rates for health care services provided by all hospitals in the same geographic region.

Go to top A02089 Actions:

BILL NOA02089 

&nbsp

01/15/2025referred to health

01/07/2026referred to health

Go to topA02089 Committee&nbspVotes:

Go to topA02089 Floor&nbspVotes:

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

Go to topA02089 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 2089

 2025-2026 Regular Sessions

 IN ASSEMBLY

 January 15, 2025
 ___________

 Introduced by M. of A. PAULIN, SEPTIMO, SIMON, WEPRIN, BICHOTTE HERME-
 LYN, LEVENBERG, KIM, KELLES -- read once and referred to the Committee
 on Health

 AN ACT to amend the public health law, in relation to setting reimburse-
 ment rates for essential safety net hospitals

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

 1 Section 1. Section 2807-c of the public health law is amended by
 2 adding a new subdivision 34-a to read as follows:
 3 34-a. Health equity stabilization and transformation act. (a) For the
 4 purposes of this subdivision, "essential safety net hospital" shall
 5 mean:
 6 (i) Any hospital eligible for participation in the directed payment
 7 template (DPT) preprint submitted by the state to the Centers for Medi-
 8 caid and Medicare Services for fiscal year two thousand twenty-five;
 9 (ii) Any non-state public hospital operated by a county, municipality
 10 or public benefit corporation; or
 11 (iii) is an acute children's hospital licensed by the department
 12 primarily for the provision of pediatric and neonatal services for which
 13 a discrete institutional cost report was filed for the past three
 14 calendar years, and which has medicaid discharges in excess of fifty
 15 percent of it's total discharges.
 16 (iv) Any voluntary hospital certified under this article that is a
 17 general hospital, which, in any of the previous three calendar years,
 18 has met the following criteria:
 19 (A) at least thirty-six percent of inpatient volumes are associated
 20 with Medicaid and uninsured individuals;
 21 (B) at least thirty-six percent of outpatient volumes are associated
 22 with Medicaid and uninsured individuals; and
 23 (C) no more than twenty percent of inpatient volumes are associated
 24 with commercially insured individuals.

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD05789-01-5

 A. 2089 2

 1 (b) For purposes of this subdivision, "essential safety net hospital"
 2 shall not include hospitals that are (i) public hospitals operated by
 3 the state; (ii) federally designated as a critical access hospital;
 4 (iii) federally designated as a sole community hospital; or (iv) a
 5 specialty hospital.
 6 (c) For purposes of this subdivision, "health care services" shall
 7 include, but is not limited to, acute inpatient discharges, inpatient
 8 psychiatric days, ambulatory surgery visits, emergency room visits, and
 9 outpatient clinic services.
 10 (d) For essential safety net hospitals that qualify pursuant to para-
 11 graph (a) of this subdivision, the commissioner shall, subject to feder-
 12 al approval, require inpatient hospital rates and hospital outpatient
 13 rates paid by the medical assistance program for services provided to
 14 patients enrolled in Medicaid managed care to reimburse the entire class
 15 of essential safety net hospitals in each geographic region at no less
 16 than regional average commercial rates for health care services provided
 17 by all hospitals in the same geographic region, as reported in a bench-
 18 marking database maintained by a nonprofit organization specified by the
 19 commissioner. Such nonprofit organization shall not be affiliated with
 20 an insurer, a corporation subject to article forty-three of the insur-
 21 ance law, a municipal cooperative health benefit plan certified pursuant
 22 to article forty-seven of the ins