NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7304
SPONSOR: Gottfried TITLE OF BILL:
An act to repeal section 3605-c of the public health law requiring
authorization for a licensed home care services agency to enroll as a
provider under the medical assistance program
PURPOSE OR GENERAL IDEA OF BILL:
To restore the right of a qualified licensed home care service agency
(LHCSA) to serve Medicaid enrollees. To repeal the 2020 law that allows
the Dept. of Health to arbitrary limit the number of LHCSAs that may
participate in Medicaid.
SUMMARY OF SPECIFIC PROVISIONS:
Repeals Public Health Law § 3605-c , enacted in 2020, that requires a
LHCSA to apply for a special DOH contract in order to serve Medicaid
patients. The law gives DOH power to arbitrarily limit the number of
LHCSAs in the program and the services they may provide. The section is
in addition to the well-established requirements for quality and provid-
er integrity that apply to all Medicaid providers. Repealing § 3605-c
will keep all those provisions intact.
JUSTIFICATION:
The 2020 enactment of Section 3605-c to require LHCSA to compete for an
arbitrarily limited number of contracts with DOH in order continue oper-
ation in the Medicaid program, was an erroneous overreach. This is a
misguided and underhanded attempt to choke off the availability - and
use - of home care under Medicaid.
LHCSA's do not bill Medicaid directly. They have, since 1995, been
required to contract with a social services district, a waivered home
health care program, or a managed care plan. Federal Medicaid rules and
states laws set criteria for quality, character, and competence.
LHCSA's hire, train and employ home care workers while complying with
layers of public health and social services law, labor law, and Medicaid
rules. They negotiate network agreements with multiple managed long term
care plans (MLTCs), which since 2018 are limited as to the number of
LCHSAs they can contract with. Pre-qualification of quality and value
are deliberately built into the system. The vast majority of LHCSAs
today are participating with value-based contracts and so providing
additional measures of patients' quality of care. Finally, they submit
annual cost reports and statistical reports to DOH and are subject to
audits by the Medicaid Inspector General.
LHCSAs are the providers who deliver personal care and home health aids
to the homes of people who are elderly or disabled, and who would other-
wise go without care, need a family member to give up life and career to
provide care, or go into a nursing home. The pandemic has highlighted
the error of health care austerity typified by § 3605-c. This arbitrary
and extraneous contract limitation is bad health policy and morally
objectionable; it should be stricken from the books.
PRIOR LEGISLATIVE HISTORY:
New bill
FISCAL IMPLICATIONS:
None
EFFECTIVE DATE:
Immediately
STATE OF NEW YORK
________________________________________________________________________
7304
2021-2022 Regular Sessions
IN ASSEMBLY
May 5, 2021
___________
Introduced by M. of A. GOTTFRIED -- read once and referred to the
Committee on Health
AN ACT to repeal section 3605-c of the public health law requiring
authorization for a licensed home care services agency to enroll as a
provider under the medical assistance program
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 3605-c of the public health law is REPEALED.
2 § 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10960-01-1
