Bill > S03592

This bill aims to establish a new reimbursement framework for essential safety net hospitals, which are defined as hospitals serving marginalized communities with high percentages of Medicaid and uninsured patients. The legislation requires the New York State Commissioner of Health to set Medicaid reimbursement rates for these hospitals at no less than the regional average commercial rates for healthcare services. The bill creates two geographic regions (New York City counties and all other counties) and mandates that rates be based on the most recent twelve-month commercial rate data, updated every three years and adjusted annually for inflation. Essential safety net hospitals must meet specific criteria, such as having at least 36% of patient volumes from Medicaid and uninsured individuals, and cannot be part of large private health systems or be specialty or children's hospitals. Managed care organizations will be required to provide quarterly certifications of their payments and report claim denial information. Participating hospitals must also annually report how increased reimbursements have been used to improve patient access, quality, and experience. The bill's intent is to address long-standing funding inequities, support safety net hospital infrastructure, stabilize their workforce, and ensure continued healthcare access in underserved communities.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/S3592