Bill > A06785

This bill aims to set reimbursement rates for essential safety net hospitals at no less than the regional average commercial rates for health care services provided by all hospitals in the same geographic region. Essential safety net hospitals are defined as those that predominantly serve marginalized communities, with Medicaid and uninsured patients making up at least 36% of their patient population. The bill requires the Commissioner of Health to establish two geographic regions within the state for setting the regional average commercial rate, which will be updated every three years to adjust for inflation. The bill also includes provisions for managed care organizations to provide quarterly certifications on compliance with the reimbursement requirements and report on claim denials, as well as requirements for essential safety net hospitals to report on how the increased reimbursement has been utilized to improve patient access, quality, and experience.