New York Senate Bill S08838

New York 2025-2026 Regular Session

• Introduced: 1/8/26
• Refer: 1/8/26

Caption

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 fee schedule for the same service or item.

Impact

The introduction of this bill could significantly alter reimbursement policies for durable medical equipment within the state. By enforcing parity in reimbursement rates, the bill aims to reduce the financial disparities that may currently exist within the system. This would not only benefit DME providers, who may struggle with lower reimbursement rates, but also improve accessibility for Medicaid recipients who rely on these essential medical supplies for their health and well-being.

Summary

Bill S08838 seeks to amend the social services law of New York in a manner that mandates Medicaid managed care organizations to provide reimbursement for durable medical equipment (DME) to providers at no less than one hundred percent of the established medical assistance DME fee schedule. This is intended to ensure that providers are fairly compensated for the services and items they offer, thereby enhancing the overall quality and availability of DME services available to patients covered under Medicaid.

Contention

While the bill's objectives are commendable in aiming to improve access to durable medical equipment, it may face contention among stakeholders in the healthcare system. Opponents might argue that the increased reimbursement rates could lead to higher costs for Medicaid managed care organizations, which could in turn affect premiums or other coverage aspects. There may also be concerns regarding how this bill could impact the budgets of these organizations and the overall sustainability of Medicaid funding in New York.