S 1616: Provides parity to durable medical equipment providers by requiring Medicaid managed care organizations to reimburse such providers at no less than one hundred percent of the medical assistance durable medical equipment and complex rehabilitation technology fee schedule for the same service or item.
The bill aims to provide parity to durable medical equipment providers by requiring Medicaid managed care organizations to reimburse them at a rate of at least 100% of the medical assistance fee schedule for the same service or item. This means that managed care providers must pay for durable medical equipment, prosthetics, orthotics, and related supplies directly or indirectly without any deductions. The bill also states that this requirement will take effect 90 days after the bill becomes a law, and the amendments will be repealed after the repeal of the affected section.
| Jun. 12, 2025 | SUBSTITUTED BY A2520 |
| Jun. 04, 2025 | ADVANCED TO THIRD READING |
| May. 29, 2025 | 2ND REPORT CAL. |
| May. 28, 2025 | 1ST REPORT CAL.1345 |
| May. 13, 2025 | REPORTED AND COMMITTED TO FINANCE |
STATE OF NEW YORK ________________________________________________________________________ 1616 2025-2026 Regular Sessions IN SENATE January 13, 2025 ___________ Introduced by Sens. RIVERA, ASHBY, FERNANDEZ, GALLIVAN, HARCKHAM, HOYL- MAN-SIGAL, JACKSON, MAY, SKOUFIS, WEBER -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the social services law, in relation to providing parity to durable medical equipment providers by requiring Medicaid managed care organizations to reimburse such providers at no less than one hundred percent of the medical assistance durable medical equipment and complex rehabilitation technology fee schedule for the same service or item The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subdivision 4 of section 364-j of the social services law 2 is amended by adding a new paragraph (x) to read as follows: 3 (x) Managed care providers shall pay, directly or indirectly, for 4 durable medical equipment, prosthetics, orthotics, and related supplies 5 at no less than one hundred percent of the medical assistance durable 6 medical equipment and complex rehabilitation technology fee schedule for 7 the same service or item. 8 § 2. This act shall take effect on the ninetieth day after it shall 9 have become a law; provided, however, that the amendments to subdivision 10 4 of section 364-j of the social services law made by section one of 11 this act shall not affect the repeal of such section and shall be deemed 12 repealed therewith. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04119-01-5