Bill > S03358

This bill amends the public health law to establish specific requirements for how home care agencies and fiscal intermediaries submit claims for medical assistance and long-term care services. The bill mandates that claims must be submitted exclusively on forms approved by the Centers for Medicare and Medicaid Services (CMS), and can be submitted directly by home care agencies or through a billing entity of their choice. The legislation prohibits insurers from requiring a specific billing entity or impeding the timely processing and payment of claims, while still preserving insurers' rights to review and audit claims for fraud, waste, and abuse. The bill applies to various types of insurers, including Medicaid managed care plans and managed long-term care plans, and aims to standardize and potentially streamline the claims submission process for home care services. The new provisions will take effect 30 days after the bill becomes law, providing a transition period for agencies and insurers to adapt to the new requirements.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/S3358