NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8137
SPONSOR: Paulin TITLE OF BILL:
An act to repeal section 3605-c of the public health law, relating to
authorization to enroll and provide medical assistance
PURPOSE OR GENERAL IDEA OF BILL:
To repeal the 2020 law that allows the Dept. of Health to arbitrarily
limit the number of LHCSAs that may participate in Medicaid.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1: Repeals Public Health Law § 3605-c, enacted in 2020, that
requires a LHCSA to apply for a special DOH contract/approval 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 provider integrity that apply to all Medicaid providers.
Section 2: This act shall take effect immediately
JUSTIFICATION:
In 2020 Section 3605-C was enacted to require LHCSA to compete for an
arbitrarily limited number of contracts with DOH to continue operation
in the Medicaid program. This is an attempt to limit the availability -
and use - of home care under Medicaid. LHCSAs do not bill Medicaid
directly. They are required to contract with a social services district,
a Medicaid waivered program, or a managed care plan. Federal Medicaid
rules and state laws set criteria for quality, character, and compe-
tence. LHCSAs 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 the number of
LCHSAs they are in the plan network.
Increases or decreases in Medicaid recipients utilizing personal care or
home health care services are the sole responsibility of the state which
contracts with an independent assessor to assess care needs and approval
of coverage. LHCHSAs who provide personal care services or home health
service simply provide the care deemed approved by the state consistent
with, eligibility standards established in state law.
A public need methodology exists for new LHCSAs seeking to enter the
market and LHCSA change of ownership transactions are subject to finan-
cial feasibility and character and competence review. Both transactions
are must be submitted to the Department of Health and are subject to
approval by the Public Health and Health Planning Council. These
requirements curtail any proliferation of LHCSAs in New York.
Whin the ongoing CDPAP transition and new single FI there is the possi-
bility of this authority being used to do an RFP to limit the number of
licensed home care services agencies. The bill would prevent the Depart-
ment of Health from implementing this section and threatening those who
rely on LHSCAs for their care.
LHCSAs are providers that deliver personal care and home health aides
and other skilled services to the homes of people who are elderly or
disabled, and who would otherwise go without care, need a family member
to give up life and career to provide care, or require• alternative
placements. This arbitrary limitation is bad health policy and should be
repealed.
PRIOR LEGISLATIVE HISTORY:
A7304, 2021-2022 (Gottfried)
FISCAL IMPLICATIONS:
None
EFFECTIVE DATE:
Immediately
STATE OF NEW YORK
________________________________________________________________________
8137
2025-2026 Regular Sessions
IN ASSEMBLY
May 1, 2025
___________
Introduced by M. of A. PAULIN -- read once and referred to the Committee
on Health
AN ACT to repeal section 3605-c of the public health law, relating to
authorization to enroll and provide medical assistance
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.
LBD11490-01-5
