Bill > A07013

This bill amends the New York public health law to require the state commissioner of health to make a system of episodic payments available to all Medicaid managed care plans, child health insurance plans, and Essential Plans by October 1, 2025, and annually thereafter. Episodic payments are a specific payment method for certified home health agencies, where reimbursement is based on a per-episode or per-patient basis rather than traditional fee-for-service models. The bill mandates that the commissioner notify these plans about their responsibility to ensure enrolled members have access to certified home health agency services, emphasizing that these services are crucial for improving patient care and reducing overall healthcare costs, particularly hospital-related expenses. The legislation also clarifies that while episodic payments are considered the standard payment method, managed care plans and home health agencies retain the flexibility to negotiate alternative payment methodologies, including value-based payments tied to health outcome measurements. The act is set to take effect immediately upon passage.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/A7013