Bill > S07518

This bill provides for supplemental quality improvement payments for managed long term care (MLTC) plans in New York State during the period from April 1, 2025, to March 31, 2026. Specifically, the bill creates a mechanism to adjust payment rates by providing financial incentives to high-performing MLTC plans. Plans will be eligible for additional payments if they have received four or five star ratings in the most recent managed long term care consumer regional quality guide and have a relative risk score greater than 1.1. The funding for these rate increases will come from a one percent reduction in payment rates for plans that do not meet the eligibility criteria, not to exceed $30 million. The additional payments will be distributed such that each eligible plan receives an equal base amount, with plans receiving a five-star rating getting 100% of that amount and four-star rated plans receiving 80% of the amount. This approach aims to incentivize and reward MLTC plans that demonstrate high-quality care and performance, while using a budget-neutral approach to redistribute existing funding.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/S7518