Bill > A01359

This bill requires the New York State Commissioner of Health to update how medical assistance payment rates are calculated for various healthcare providers and services. Specifically, the bill mandates that reimbursement rates must be reasonably related to the costs of efficiently producing services and must be based on information no older than four calendar years. The bill introduces new requirements for establishing payment rates for hospital services, health-related services, managed care providers, and general hospitals, including those serving Medicaid, Family Health Plus, and Child Health Insurance Plan enrollees. Additionally, the bill introduces a transparency component by requiring the health commissioner to annually publish a detailed list of Medicaid reimbursement methodologies for different provider types on the department's website, along with a yearly workplan for modernizing reimbursement across public insurance programs. The goal appears to be ensuring that payment rates more accurately reflect current costs and are more transparent to stakeholders, while preventing the use of outdated financial information in rate calculations.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/A1359