Provides that such rates of payment shall be updated to reflect the most current mean price for free-standing residential health care facilities with less than three hundred beds each time that the cost basis of residential health care facility rates is updated.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7553a
SPONSOR: Paulin TITLE OF BILL:
An act to amend the public health law, in relation to certain rates of
payment for services provided by assisted living programs
PURPOSE: OF THE BILL:
This legislation would update rates of payment for Medicaid assisted
living program providers based on 2022 costs, and require that the
Department of Health periodically update those rates.
SUMMARY OF SPECIFIC PROVISIONS:
Section one of the bill amends paragraph (a) of subdivision 6 of section
3416 of the public health Law to require rates of payment to Medicaid
assisted living program providers to be updated based on costs estab-
lished in 2022. It further requires that the Department of Health update
those rates whenever Medicaid rates of payment for residential health
care facilities are updated.
Section two of the bill establishes an effective date of January 1,
2025.
JUSTIFICATION:
Medicaid rates of payment for assisted living providers are set in stat-
ute at fifty percent of nursing home prices established in 1992.
Although this thirty year old statutory base year was trended to 2002,
it remains too Low to support the program. This update will more
adequately reflect program costs. The base year should also continue to
be updated on a regular basis. Medicaid funded assisted living programs
serve individuals who are medically eligible for nursing home care in a
less intensive, Lower cost setting. They has saved New York tens of
millions of dollars since the program's inception by keeping frail,
elderly people out of nursing homes. However, the current inadequate
rates result in programs closing their doors. Unfortunately, this
program is at risk of being decimated due to the historically Low
reimbursement rates. Assisted living programs are starting to close
because of the increasing costs of providing services, and residents
most often end up being transferred to nursing homes at a much higher
cost to the State.
PRIOR LEGISLATIVE HISTORY:
New bill.
FISCAL IMPLICATIONS FOR STATE AND LOCAL :
Positive to the State. Since assisted living programs, which serve nurs-
ing home eligible patients, are paid fifty percent of the nursing home
rate, updating their payment rates will generate savings to the State by
avoiding more costly placements and will prevent program from closing.
EFFECTIVE DATE:
This act shall take effect April 1, 2025
STATE OF NEW YORK
________________________________________________________________________
7553--A
2023-2024 Regular Sessions
IN ASSEMBLY
May 25, 2023
___________
Introduced by M. of A. PAULIN, SANTABARBARA, STIRPE, SEPTIMO, LUPARDO --
read once and referred to the Committee on Health -- recommitted to
the Committee on Health in accordance with Assembly Rule 3, sec. 2 --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee
AN ACT to amend the public health law, in relation to certain rates of
payment for services provided by assisted living programs
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph (a) of subdivision 6 of section 3614 of the
2 public health law, as amended by section 4-a of part D of chapter 56 of
3 the laws of 2012, is amended to read as follows:
4 (a) The commissioner shall, subject to the approval of the state
5 director of the budget, establish capitated rates of payment for
6 services provided by assisted living programs as defined by paragraph
7 (a) of subdivision one of section four hundred sixty-one-l of the social
8 services law. Such rates of payment shall be related to costs incurred
9 by residential health care facilities. The rates shall reflect the wage
10 equalization factor established by the commissioner for residential
11 health care facilities in the region in which the assisted living
12 program is provided and real property capital construction costs associ-
13 ated with the construction of a free-standing assisted living program
14 such rate shall include a payment equal to the cost of interest owed and
15 depreciation costs of such construction. The rates shall also reflect
16 the efficient provision of a quality and quantity of services to
17 patients in such residential health care facilities, with needs compara-
18 ble to the needs of residents served in such assisted living programs.
19 Such rates of payment shall be equal to fifty percent of the amounts
20 which otherwise would have been expended, based upon the [mean prices]
21 costs for [the first of July, nineteen hundred ninety-two (utilizing
22 nineteen hundred eighty-three costs)] two thousand twenty-three for
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD11563-02-4
A. 7553--A 2
1 freestanding[, low intensity] residential health care facilities with
2 less than three hundred beds[, and for years subsequent to nineteen
3 hundred ninety-two,] adjusted for inflation in accordance with the
4 provisions of subdivision ten of section twenty-eight hundred seven-c of
5 this chapter, to provide the appropriate level of care for such resi-
6 dents in residential health care facilities in the applicable wage
7 equalization factor regions plus an amount equal to capital construction
8 costs associated with the construction of an assisted living program
9 facility as provided for in this subdivision. Such rates of payment
10 shall be updated to reflect the most current mean price for free-stand-
11 ing residential health care facilities with less than three hundred beds
12 each time that the cost basis of residential health care facility rates
13 is updated. The commissioner shall also promulgate regulations, and may
14 promulgate emergency regulations, to provide for reimbursement of the
15 cost of preadmission assessments conducted directly by assisted living
16 programs.
17 § 2. This act shall take effect April 1, 2025.
