Bill > A01933

This bill requires the New York State Department of Health to provide more comprehensive and transparent information to managed care providers regarding Medicaid reimbursement rates. Specifically, the bill mandates that the department's independent actuary provide a detailed actuarial memorandum to managed care providers 30 days before submitting rates to the Centers for Medicare and Medicaid Services (CMS). The memorandum must include additional materials submitted to CMS, correspondence between the state and CMS, data and methodologies considered but not used in rate development, and any federally required disclosures. Managed care providers can request an additional review of the rate-setting process, and the department must either agree to the review and delay rate submission or decline the request with a written explanation. Furthermore, the bill requires the department to notify managed care providers of reimbursement rates before they become effective. This legislation aims to increase transparency and provide managed care providers with more insight into how Medicaid reimbursement rates are calculated, potentially allowing for more informed feedback and review of the rate-setting process.

Budget and Finance, Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/A1933