New York A 2044: Establishes a quality incentive program for managed care providers

Bill Text

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A02044 Summary:

BILL NOA02044 

&nbsp

SAME ASSAME AS S06266

&nbsp

SPONSORPaulin

&nbsp

COSPNSRLee, Hevesi, Simone, Weprin, Steck, Reyes, Seawright, Sayegh, Rosenthal

&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 A02044 Actions:

BILL NOA02044 

&nbsp

01/14/2025referred to health

01/07/2026referred to health

02/04/2026reported referred to ways and means

Go to topA02044 Committee&nbspVotes:

Committee:HEALTH Chair:Paulin 
DATE:02/04/2026AYE/NAY:24/0 Action: Favorable refer to committee Ways and Means PaulinAyeJensenAye

DinowitzAyeGandolfoAye

RosenthalAyeBlumencranzAye

HevesiAyeGrayAye

SteckAyeSlaterAye

BraunsteinAyeChludzinskiAye

Bichotte HermelExcusedNorberAye

SayeghAyeDursoAye

McDonaldAye

ReyesAye

Gonzalez-RojasAye

RajkumarAye

ForrestAye

KellesAye

LucasAye

MeeksAye

LunsfordAye

Go to topA02044 Floor&nbspVotes:

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

Go to topA02044 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 2044

 2025-2026 Regular Sessions

 IN ASSEMBLY

 January 14, 2025
 ___________

 Introduced by M. of A. PAULIN, LEE, HEVESI, SIMONE -- read once and
 referred 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
 24 savings to both state and local governments when compared to costs which

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

 A. 2044 2

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