Requires review and approval by the commissioner of health of contracts for home care services provided to a licensed home care services agency from a managed care organization or a managed long term care plan; directs the commissioner of health to establish a dispute resolution process independent dispute resolution relating to billing under a contract for home care services.
Impact
The legislation introduces an independent dispute resolution process for conflicts arising from billing or contracts pertaining to home care services. This process not only seeks to expedite resolution times—claims must be settled within ninety days—but also aims to prevent retaliatory actions by managed care organizations against licensed home care agencies that seek dispute resolution. Such mechanisms could improve fairness and accessibility in the home care sector, providing agencies with a reliable way to address grievances without fear of retribution.
Summary
Bill A09607 proposes significant amendments to New York's public health law concerning home care services. The bill mandates that contracts for these services provided by licensed home care agencies from managed care organizations undergo review and approval by the commissioner of health. This requirement aims to ensure transparency and accountability regarding billing rates and the provision of services. Additionally, the bill includes provisions for adapting contracts related to possible increases in minimum wage, thus reflecting changes in labor law directly in the agreements made between service providers and payers.
Contention
Notable points of contention surrounding A09607 might stem from concerns related to the bureaucratic nature of the new review process and the potential impact on care delivery efficiency. Critics may argue that the additional layer of oversight could delay necessary healthcare service implementations and lead to operational inefficiencies. Supporters, conversely, may advocate that these regulations will ultimately enhance quality and standardize practices across the home care industry, ensuring better care for vulnerable populations and fair treatment of care providers.
Same As
Requires review and approval by the commissioner of health of contracts for home care services provided to a licensed home care services agency from a managed care organization or a managed long term care plan; directs the commissioner of health to establish a dispute resolution process independent dispute resolution relating to billing under a contract for home care services.
Requires review and approval by the commissioner of health of contracts for home care services provided to a licensed home care services agency from a managed care organization or a managed long term care plan; directs the commissioner of health to establish a dispute resolution process independent dispute resolution relating to billing under a contract for home care services.
Establishes a home care services bill of rights for patients of home care services agencies and certified home health agencies; requires training for staff and contractors of such agencies to eliminate certain discriminations; makes related provisions.
Establishes a home care services bill of rights for patients of home care services agencies and certified home health agencies; requires training for staff and contractors of such agencies to eliminate certain discriminations; makes related provisions.
Enacts "Ella's law"; requires care managers employed by or under contract with a care coordination organization to provide care management services to an individual unless such care manager has completed all training requirements.
Amends the definition of "health care personnel" to define the term "temporary services" as health care services contracted for an initial term of less than twenty-four continuous months; requires a temporary health care services agency to annually submit to the department of health copies of all contracts between the agency and a health care entity to which it assigns or refers health care personnel.
Amends the definition of "health care personnel" to define the term "temporary services" as health care services contracted for an initial term of less than twenty-four continuous months; requires a temporary health care services agency to annually submit to the department of health copies of all contracts between the agency and a health care entity to which it assigns or refers health care personnel.
Community Health, Department of; contracts with care management organizations for the provision of healthcare services for Medicaid or PeachCare for Kids recipients; establish requirements
Relates to reimbursement of home care aides; requires the commissioner of health to ensure rate ranges for Medicaid managed care organizations comply with certain reimbursement rates.
Relating to contracts with managed care organizations, including the procurement of managed care contracts, under Medicaid and the child health plan program.
Relating to contracts with managed care organizations, including the procurement of managed care contracts, under Medicaid and the child health plan program.