Signed by Governor David Paterson

Vote Smart's Synopsis:

Vote to pass a bill that amends various existing laws to implement the state fiscal plan, including, but not limited to, the following highlights.

Highlights:

-Reduces Medicaid payments to non-public hospitals for the recruitment and retention of health care employees from $243.5 million for fiscal years 2009-2010 and 2010-2011 respectively to $163.15 million for the period of April 1, 2009 through November 13, 2009 (Part C). -Rescinds the authorization of $49 million for grants to public general hospitals for the recruitment and retention of health care employees for fiscal years 2009-2010 and 2010-2011 respectively (Part C). -Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for non-public hospitals for the recruitment and retention of health care employees as follows (Part C):

-Existing law:
-$53.1 million for the year of 2009; -$30.25 million for the year of 2010; and -$8.8 million for the period of January 1, 2011 through March 31, 2011;
-New Law: $48.72 million for the period of January 1, 2009 through November 13, 2009.

-Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for grants to public hospitals for the recruitment and retention of health care employees as follows (Part C):

-Existing law:
-$49 million for the year of 2009; -$49 million for the year of 2010; and -$12.25 million for the period of January 1, 2011 through March 31, 2011;
-New Law: $12.25 million for the period of January 1, 2009 through March 31, 2009.

-Reduces the maximum amount of funds available from the Tobacco Control and Insurance Initiatives Pool for the Commissioner of Health to increase annual rates of inpatient reimbursement to voluntary non-profit and private proprietary general hospitals that qualified for rate adjustments as follows (Part C.):

-Existing law:
-$24 million for the year of 2009; -$24 million for the year of 2010; and -$6 million for the period of January 1, 2011 through March 31, 2011;
-New law: $22 million for for the period of January 1, 2009 through November 13, 2009.

-Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for Medicaid payments for hospital translation services as follows (Part C):

-Existing law:
-$16 million for the year of 2009; -$16 million for the year of 2010; and -$4 million for the period of January 1, 2011 through March 31, 2011;
-New law: $14.7 million for the period of January 1, 2009 through November 13, 2009.

-Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for the Commissioner to increase annual rates of inpatient reimbursement to rural hospitals as follows (Part C.):

-Existing law:
-$3.5 million for the year of 2009; -$3.5 million for the year of 2010; -$875,000 for the period of January 1, 2011 through March 31, 2011; and -If federal financial participation is unavailable, the above appropriations shall be increased to $7 million;
-New law: $3.28 million for the period of January 1, 2009 through November 13, 2009.

-Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for Medicaid payments for adjustments of inpatient rates of payment for general hospitals located in the counties of Nassau and Suffolk (Part C):

-Existing law:
-$2.5 million for the year of 2009; -$2.5 million for the year of 2010; and -$625,000 for the period of January 1, 2011 through March 31, 2011;
-New law: $2.29 million for the period of January 1, 2009 through November 13, 2009.

-Revises eligibility requirements for the child health insurance plan as follows (Part C):

-Existing law:
-No payment required for children whose family household income is less than 133 percent of the non-farm federal poverty level, or children that are American Indians or Alaskan Natives; -$9 per month for children whose family household income is between 133 and 185 percent of the non-farm federal poverty level, but no more than $27 per month per family; -$15 per month for children whose family household income is between 186 and 250 percent of the non-farm federal poverty level, but no more than $45 per month per family; -$20 per month for children whose family household income is between 251 and 300 percent of the non-farm federal poverty level, but no more than $60 per month per family; -$30 per month for children whose family household income is between 301 and 350 percent of the non-farm federal poverty level, but no more than $90 per month per family; and -$40 per month for children whose family household income is between 351 and 400 percent of the non-farm federal poverty level, but no more than $120 per month per family;
-New law:
-No payment required for children whose family household income is less than 160 percent of the non-farm federal poverty level, or children that are American Indians or Alaskan Natives whose household income is less than 250 percent of the non-farm federal poverty level; -$9 per month for children whose family household income is between 160 and 222 percent of the non-farm federal poverty level, but no more than $27 per month per family; -$15 per month for children whose family household income is between 223 and 250 percent of the non-farm federal poverty level, but no more than $45 per month per family; -$30 per month for children whose family household income is between 251 and 300 percent of the non-farm federal poverty level, but no more than $90 per month per family; -$45 per month for children whose family household income is between 301 and 350 percent of the non-farm federal poverty level, but no more than $135 per month per family; and -$60 per month for children whose family household income is between 351 and 400 percent of the non-farm federal poverty level, but no more than $180 per month per family.

-Establishes the following fees for applications to establish a hospital (Part C):

-$3,000 for general hospitals and nursing homes; -$1,000 for safety net diagnostic and treatment centers; and -$2,000 for all other diagnostic and treatment centers.

-Appropriates 90 percent of the funds in the General Hospital Indigent Care Pool for Medicaid disproportionate share (DHS) payments to the same hospitals in the same manner as required by existing law, and specifies the remaining 10 percent be appropriated as follows (Part C):

-The year of 2009:
-$307 million for Medicaid DHS payments to teaching hospitals; -$25 million for Medicaid DHS payments to non-major public hospitals having Medicaid discharge rates of 40 percent or more; and -$16 million for Medicaid DHS payments to non-teaching hospitals;
-The year of 2010:
-$269 million for Medicaid DHS payments to non-major public teaching hospitals; -$50 million for medical DHS payments to non-major public hospitals having Medicaid discharge rates of 40 percent or more, of which $25 million shall be distributed according to each facility's proportion of uninsured losses; -$24.5 million for non-Medicaid grants to non-major public academic medical centers; and -$16 million for Medicaid DHS payments to non-teaching hospitals.

-Requires the Commissioner to develop and implement standards of certification for patient centered medical homes for Medicaid fee-for-service and Medicaid managed care, and family health plus and child health plus programs for the purposes of improving health outcomes and efficiency by December 1, 2009 (Part C). -Establishes the Adirondack Home Multiprogram Demonstration Program in which the Commissioner is authorized to certify specific clinicians and clinics in the upper Northeastern region of New York as medical homes that are eligible for enhanced rates of payment for services provided to one of the following (Part C):

-Individuals receiving state medical assistance; -Individuals eligible for state medical assistance and enrolled in an approved managed care organization; -Individuals eligible for Family Health Plus Program; -Individuals eligible for the Child Health Insurance Program; -Individuals enrolled in commercial managed care plans or Health Maintenance Organizations; and -Individuals enrolled in an employer sponsored self-insured plan.

-Authorizes the Commissioner to pay enhanced rates of payments to clinics and clinicians that are certified as patient centered medical homes (Part C). -Authorizes the Commissioner to pay additional amounts for patient centered medical homes that meet specific process or outcome standards specified by the Commissioner (Part C). -Establishes the State Electronic Health Records Loan Program in which any health care provider may apply to receive loans issued by the Commissioner and the Dormitory Authority of the State of New York in a manner that will encourage improvements in the health care delivery system through the use of information technology, including improvements in electronic health records (Part C). -Authorizes the Commissioner to pay financial incentives to medical practitioners and pharmacies for the purpose of encouraging the electronic transmission of prescriptions for drugs, equal to $0.80 per dispensed electronic prescription for medical practitioners and $0.20 per dispensed electronic prescription (Part C).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that amends various existing laws to implement the state fiscal plan, including, but not limited to, the following highlights.

Highlights:

-Reduces Medicaid payments to non-public hospitals for the recruitment and retention of health care employees from $243.5 million for fiscal years 2009-2010 and 2010-2011 respectively to $163.15 million for the period of April 1, 2009 through November 13, 2009 (Part C). -Rescinds the authorization of $49 million for grants to public general hospitals for the recruitment and retention of health care employees for fiscal years 2009-2010 and 2010-2011 respectively (Part C). -Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for non-public hospitals for the recruitment and retention of health care employees as follows (Part C):

-Existing law:
-$53.1 million for the year of 2009; -$30.25 million for the year of 2010; and -$8.8 million for the period of January 1, 2011 through March 31, 2011;
-New Law: $48.72 million for the period of January 1, 2009 through November 13, 2009.

-Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for grants to public hospitals for the recruitment and retention of health care employees as follows (Part C):

-Existing law:
-$49 million for the year of 2009; -$49 million for the year of 2010; and -$12.25 million for the period of January 1, 2011 through March 31, 2011;
-New Law: $12.25 million for the period of January 1, 2009 through March 31, 2009.

-Reduces the maximum amount of funds available from the Tobacco Control and Insurance Initiatives Pool for the Commissioner of Health to increase annual rates of inpatient reimbursement to voluntary non-profit and private proprietary general hospitals that qualified for rate adjustments as follows (Part C.):

-Existing law:
-$24 million for the year of 2009; -$24 million for the year of 2010; and -$6 million for the period of January 1, 2011 through March 31, 2011;
-New law: $22 million for for the period of January 1, 2009 through November 13, 2009.

-Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for Medicaid payments for hospital translation services as follows (Part C):

-Existing law:
-$16 million for the year of 2009; -$16 million for the year of 2010; and -$4 million for the period of January 1, 2011 through March 31, 2011;
-New law: $14.7 million for the period of January 1, 2009 through November 13, 2009.

-Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for the Commissioner to increase annual rates of inpatient reimbursement to rural hospitals as follows (Part C.):

-Existing law:
-$3.5 million for the year of 2009; -$3.5 million for the year of 2010; -$875,000 for the period of January 1, 2011 through March 31, 2011; and -If federal financial participation is unavailable, the above appropriations shall be increased to $7 million;
-New law: $3.28 million for the period of January 1, 2009 through November 13, 2009.

-Reduces appropriations from the Tobacco Control and Insurance Initiatives Pool for Medicaid payments for adjustments of inpatient rates of payment for general hospitals located in the counties of Nassau and Suffolk (Part C):

-Existing law:
-$2.5 million for the year of 2009; -$2.5 million for the year of 2010; and -$625,000 for the period of January 1, 2011 through March 31, 2011;
-New law: $2.29 million for the period of January 1, 2009 through November 13, 2009.

-Revises eligibility requirements for the child health insurance plan as follows (Part C):

-Existing law:
-No payment required for children whose family household income is less than 133 percent of the non-farm federal poverty level, or children that are American Indians or Alaskan Natives; -$9 per month for children whose family household income is between 133 and 185 percent of the non-farm federal poverty level, but no more than $27 per month per family; -$15 per month for children whose family household income is between 186 and 250 percent of the non-farm federal poverty level, but no more than $45 per month per family; -$20 per month for children whose family household income is between 251 and 300 percent of the non-farm federal poverty level, but no more than $60 per month per family; -$30 per month for children whose family household income is between 301 and 350 percent of the non-farm federal poverty level, but no more than $90 per month per family; and -$40 per month for children whose family household income is between 351 and 400 percent of the non-farm federal poverty level, but no more than $120 per month per family;
-New law:
-No payment required for children whose family household income is less than 160 percent of the non-farm federal poverty level, or children that are American Indians or Alaskan Natives whose household income is less than 250 percent of the non-farm federal poverty level; -$9 per month for children whose family household income is between 160 and 222 percent of the non-farm federal poverty level, but no more than $27 per month per family; -$15 per month for children whose family household income is between 223 and 250 percent of the non-farm federal poverty level, but no more than $45 per month per family; -$30 per month for children whose family household income is between 251 and 300 percent of the non-farm federal poverty level, but no more than $90 per month per family; -$45 per month for children whose family household income is between 301 and 350 percent of the non-farm federal poverty level, but no more than $135 per month per family; and -$60 per month for children whose family household income is between 351 and 400 percent of the non-farm federal poverty level, but no more than $180 per month per family.

-Establishes the following fees for applications to establish a hospital (Part C):

-$3,000 for general hospitals and nursing homes; -$1,000 for safety net diagnostic and treatment centers; and -$2,000 for all other diagnostic and treatment centers.

-Appropriates 90 percent of the funds in the General Hospital Indigent Care Pool for Medicaid disproportionate share (DHS) payments to the same hospitals in the same manner as required by existing law, and specifies the remaining 10 percent be appropriated as follows (Part C):

-The year of 2009:
-$307 million for Medicaid DHS payments to teaching hospitals; -$25 million for Medicaid DHS payments to non-major public hospitals having Medicaid discharge rates of 40 percent or more; and -$16 million for Medicaid DHS payments to non-teaching hospitals;
-The year of 2010:
-$269 million for Medicaid DHS payments to non-major public teaching hospitals; -$50 million for medical DHS payments to non-major public hospitals having Medicaid discharge rates of 40 percent or more, of which $25 million shall be distributed according to each facility's proportion of uninsured losses; -$24.5 million for non-Medicaid grants to non-major public academic medical centers; and -$16 million for Medicaid DHS payments to non-teaching hospitals.

-Requires the Commissioner to develop and implement standards of certification for patient centered medical homes for Medicaid fee-for-service and Medicaid managed care, and family health plus and child health plus programs for the purposes of improving health outcomes and efficiency by December 1, 2009 (Part C). -Establishes the Adirondack Home Multiprogram Demonstration Program in which the Commissioner is authorized to certify specific clinicians and clinics in the upper Northeastern region of New York as medical homes that are eligible for enhanced rates of payment for services provided to one of the following (Part C):

-Individuals receiving state medical assistance; -Individuals eligible for state medical assistance and enrolled in an approved managed care organization; -Individuals eligible for Family Health Plus Program; -Individuals eligible for the Child Health Insurance Program; -Individuals enrolled in commercial managed care plans or Health Maintenance Organizations; and -Individuals enrolled in an employer sponsored self-insured plan.

-Authorizes the Commissioner to pay enhanced rates of payments to clinics and clinicians that are certified as patient centered medical homes (Part C). -Authorizes the Commissioner to pay additional amounts for patient centered medical homes that meet specific process or outcome standards specified by the Commissioner (Part C). -Establishes the State Electronic Health Records Loan Program in which any health care provider may apply to receive loans issued by the Commissioner and the Dormitory Authority of the State of New York in a manner that will encourage improvements in the health care delivery system through the use of information technology, including improvements in electronic health records (Part C). -Authorizes the Commissioner to pay financial incentives to medical practitioners and pharmacies for the purpose of encouraging the electronic transmission of prescriptions for drugs, equal to $0.80 per dispensed electronic prescription for medical practitioners and $0.20 per dispensed electronic prescription (Part C).

Full Bill Text