Bill > A07801

This bill aims to establish a new reimbursement system for essential safety net hospitals, which are defined as hospitals that predominantly serve marginalized communities and have a high percentage of Medicaid and uninsured patients. The legislation requires the New York State Commissioner of Health to ensure that these hospitals receive reimbursement rates from Medicaid managed care organizations that are no less than the regional average commercial rates for health care services. The bill creates two geographic regions for rate calculation: one covering New York City counties and another covering the rest of the state. Hospitals must meet specific criteria to qualify, such as having at least 36% of their patient volumes from Medicaid and uninsured individuals, and not being part of a large private health system. The bill mandates that these hospitals annually report on how the increased reimbursement has improved patient access and quality, and requires managed care organizations to provide quarterly certifications of their payment compliance. The goal is to address long-standing financial inequities faced by safety net hospitals, support their workforce and infrastructure, and ensure continued access to care in underserved communities. The new reimbursement system is set to take effect on April 1, 2025, with the health commissioner tasked with obtaining necessary federal approvals and implementing the program.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/A7801