A 4162: Relates to Medicaid reimbursement rates for private duty nursing; requires DOH to publish a private duty rate schedule.

  
  STATE OF NEW YORK ________________________________________________________________________ 4162 2025-2026 Regular Sessions  IN ASSEMBLY January 31, 2025 ___________ Introduced by M. of A. PAULIN -- read once and referred to the Committee on Health AN ACT to amend the public health law and the social services law, in relation to rates of reimbursement for private duty nursing The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subdivision 11 of section 3614 of the public health law is 2 amended by adding a new paragraph (d) to read as follows: 3 (d) For enrollees covered by Medicaid as of January first, two thou- 4 sand twenty-six under a payment rate methodology agreement negotiated 5 with a licensed home care services provider, including but not limited 6 to services provided through licensed home care services agencies, 7 payments for all hourly home care services provided through private duty 8 nursing, including but not limited to nursing services, provided to 9 patients eligible for medical assistance pursuant to title eleven of 10 article five of the social services law made by organizations operating 11 in accordance with the provisions of article forty-four of this chapter 12 or by health maintenance organizations organized and operating in 13 accordance with article forty-three of the insurance law shall, at a 14 minimum, be at a benchmark rate which is to be the fee-for-service rate 15 calculated pursuant to this chapter and as in effect at the time such 16 services were provided. 17 § 2. Section 364-j of the social services law is amended by adding a 18 new subdivision 40 to read as follows: 19 40. For enrollees covered by Medicaid as of January first, two thou- 20 sand twenty-six under a payment rate methodology agreement negotiated 21 with a licensed home care services provider, including but not limited 22 to services provided through licensed home care services agencies, 23 payments for all hourly home care services provided through private duty 24 nursing, including but not limited to nursing services, provided to 25 patients eligible for medical assistance under this title made by organ- EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD03865-01-5 
 A. 4162 2 1 izations operating in accordance with the provisions of article forty- 2 four of the public health law or by health maintenance organizations 3 organized and operating in accordance with article forty-three of the 4 insurance law shall, at a minimum, be the rates of payment that would be 5 paid for such patients pursuant to subdivision fourteen of section thir- 6 ty-six hundred fourteen of the public health law. 7 § 3. This act shall take effect immediately; provided, however, that 8 the amendments to section 364-j of the social services law made by 9 section two of this act shall not affect the repeal of such section and 10 shall be deemed repealed therewith.