Bill > A02089

This bill establishes a comprehensive framework for reimbursing essential safety net hospitals at no less than the regional average commercial rates for health care services. The bill defines "essential safety net hospitals" as including hospitals participating in specific Medicaid payment templates, non-state public hospitals, acute children's hospitals with high Medicaid discharge rates, and voluntary hospitals meeting specific Medicaid and uninsured patient volume criteria. The legislation requires the health commissioner to ensure these hospitals are reimbursed at rates based on commercial rates in their geographic region, with specific provisions for calculating and updating these rates, including annual inflation adjustments. Managed care organizations must provide quarterly certifications of compliance, and hospitals must submit annual reports demonstrating how increased reimbursement has improved patient access, quality, and experience, with a specific focus on maternal health. The bill mandates that the commissioner make quality data publicly available and provide a report to state leadership by September 2025 on the feasibility of implementing these rate modifications through a Medicaid state plan amendment. The act is set to take effect on July 1, 2025, with immediate authorization for the health commissioner to develop implementation rules and seek necessary federal approvals.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/A2089