March 11, 2024
REALLY GOOD early results in the Senate bill that was just released:
- The Senate budget bill supports COLA being increased to 3.2 % (from Governor’s original proposal of 1.5%). The Senate Health/Mental Hygiene (HMH) Article VII language states that the COLA can only be used for wages and salaries for non-executive staff. “…the funding received will be used solely to increase the hourly and/or salary wages of non-executive direct care staff, direct support professionals, and non-executive clinical staff.” We will work to get further details first thing in the a.m.
- Senate one-house rejects the Governor’s Competitive Procurement proposal, however it also rejects an executive proposal that would have increased fines on health plans for failure to comply with terms of the Model Contract (contains the rules of the road for the carve-in of certain Medicaid services provided to special needs populations, including mental health and substance use disorder services that were carved in to the MMC Program in 2015-2017).
- Senate one-house bill includes a proposal that would require at least 10% of opioid stewardship funds be invested in recovery services and supports, to supplement not replace other funds. Adds a reporting requirement. See page 8 of Senate Resolution (attached)
- Senate one-house appears to add FQHCs to the list of provider types that would receive a telehealth rate equal to the face-to-face rate for FQ services. See page 7 of Senate Resolution (attached)
- The Senate budget bill INCLUDES our our commercial rate mandate proposal (Part AA) ! Looks like our language!!
- The Senate included OMIG Audit Reform language although it does not appear to be a direct cut and paste from the language we have developed with our attorneys.
We need to do a side-by-side to understand what if ANY language is different from the original proposals, but the really good news is that all of these proposals are included in the Senate one-house bill and this puts them in play for final budget negotiations.
I’ve pasted the Senate language for each of the three proposals (discussed above) below:
Senate COLA language
PART FF — HUMAN SERVICES COLA
Section 1. Section 3 of part A of chapter 111 of the laws of 2010
33 34 director of the budget, the commissioners of the office of mental 35 health, office for people with developmental disabilities, office of 36 addiction services and supports, office of temporary and disability 37 assistance, office of children and family services, the state office for 38 the aging, the state education department, the department of health, and 39 the director of the office of victim services, shall establish a state 40 fiscal year 2024-2025 cost of living adjustment (COLA), effective April 41 1, 2024, for projecting for the effects of inflation upon rates of 42 payments, contracts, or any other form of reimbursement for the programs 43 and services listed in paragraphs (i), (ii), (iii), (iv), (v), (vi), 44 (vii), (viii), and (ix) of subdivision three of this section. The COLA 45 established herein shall be applied to the appropriate portion of reim- 46 bursable costs or contract amounts. Where appropriate, transfers to the
Section 1. 1. Subject to available appropriations and approval of the
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1 department of health (DOH) shall be made as reimbursement for the state 2 share of medical assistance. 3 2. Notwithstanding any inconsistent provision of law, subject to the 4 approval of the director of the budget and available appropriations 5 therefore, for the period of April 1, 2024 through March 31, 2025, the 6 commissioners and directors shall provide funding to support a three and 7 two-tenths percent (3.2%) cost of living adjustment under this section 8 for all eligible programs and services as determined pursuant to subdi- 9 vision four of this section.
10 3. Eligible programs and services. (i) Programs and services funded, 11 licensed, or certified by the office of mental health (OMH) eligible for 12 the cost of living adjustment established herein, pending federal 13 approval where applicable, include: office of mental health licensed 14 outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of 15 the office of mental health regulations including clinic, continuing day 16 treatment, day treatment, intensive outpatient programs and partial 17 hospitalization; outreach; crisis residence; crisis stabilization, 18 crisis/respite beds; mobile crisis, part 590 comprehensive psychiatric 19 emergency program services; crisis intervention; home based crisis 20 intervention; family care; supported single room occupancy; supported 21 housing; supported housing community services; treatment congregate; 22 supported congregate; community residence - children and youth; 23 treatment/apartment; supported apartment; community residence single 24 room occupancy; on-site rehabilitation; employment programs; recreation; 25 respite care; transportation; psychosocial club; assertive community 26 treatment; case management; care coordination, including health home 27 plus services; local government unit administration; monitoring and 28 evaluation; children and youth vocational services; single point of 29 access; school-based mental health program; family support children and 30 youth; advocacy/support services; drop in centers; recovery centers; 31 transition management services; bridger; home and community based waiver 32 services; behavioral health waiver services authorized pursuant to the 33 section 1115 MRT waiver; self-help programs; consumer service dollars; 34 conference of local mental hygiene directors; multicultural initiative; 35 ongoing integrated supported employment services; supported education; 36 mentally ill/chemical abuse (MICA) network; personalized recovery 37 oriented services; children and family treatment and support services; 38 residential treatment facilities operating pursuant to part 584 of title 39 14-NYCRR; geriatric demonstration programs; community-based mental 40 health family treatment and support; coordinated children's service 41 initiative; homeless services; and promises zone.
42 (ii) Programs and services funded, licensed, or certified by the 43 office for people with developmental disabilities (OPWDD) eligible for 44 the cost of living adjustment established herein, pending federal 45 approval where applicable, include: local/unified services; chapter 620 46 services; voluntary operated community residential services; article 16 47 clinics; day treatment services; family support services; 100% day 48 training; epilepsy services; traumatic brain injury services; hepatitis 49 B services; independent practitioner services for individuals with 50 intellectual and/or developmental disabilities; crisis services for 51 individuals with intellectual and/or developmental disabilities; family 52 care residential habilitation; supervised residential habilitation; 53 supportive residential habilitation; respite; day habilitation; prevoca- 54 tional services; supported employment; community habilitation; interme- 55 diate care facility day and residential services; specialty hospital; 56 pathways to employment; intensive behavioral services; basic home and
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1 community based services (HCBS) plan support; health home services 2 provided by care coordination organizations; community transition 3 services; family education and training; fiscal intermediary; support 4 broker; and personal resource accounts.
5 (iii) Programs and services funded, licensed, or certified by the 6 office of addiction services and supports (OASAS) eligible for the cost 7 of living adjustment established herein, pending federal approval where 8 applicable, include: medically supervised withdrawal services - residen- 9 tial; medically supervised withdrawal services - outpatient; medically
10 managed detoxification; medically monitored withdrawal; inpatient reha- 11 bilitation services; outpatient opioid treatment; residential opioid 12 treatment; KEEP units outpatient; residential opioid treatment to absti- 13 nence; problem gambling treatment; medically supervised outpatient; 14 outpatient rehabilitation; specialized services substance abuse 15 programs; home and community based waiver services pursuant to subdivi- 16 sion 9 of section 366 of the social services law; children and family 17 treatment and support services; continuum of care rental assistance case 18 management; NY/NY III post-treatment housing; NY/NY III housing for 19 persons at risk for homelessness; permanent supported housing; youth 20 clubhouse; recovery community centers; recovery community organizing 21 initiative; residential rehabilitation services for youth (RRSY); inten- 22 sive residential; community residential; supportive living; residential 23 services; job placement initiative; case management; family support 24 navigator; local government unit administration; peer engagement; voca- 25 tional rehabilitation; support services; HIV early intervention 26 services; dual diagnosis coordinator; problem gambling resource centers; 27 problem gambling prevention; prevention resource centers; primary 28 prevention services; other prevention services; community services, and 29 addiction treatment centers.
30 (iv) Programs and services funded, licensed, or certified by the 31 office of temporary and disability assistance (OTDA) eligible for the 32 cost of living adjustment established herein, pending federal approval 33 where applicable, include: nutrition outreach and education program 34 (NOEP), community action agencies; New York state supportive housing 35 program; solutions to end homelessness program; and state supplemental 36 nutrition assistance program outreach program.
37 (v) Programs and services funded, licensed, or certified by the office 38 of children and family services (OCFS) eligible for the cost of living 39 adjustment established herein, pending federal approval where applica- 40 ble, include: programs for which the office of children and family 41 services establishes maximum state aid rates pursuant to section 398-a 42 of the social services law and section 4003 of the education law; emer- 43 gency foster homes; foster family boarding homes and therapeutic foster 44 homes; supervised settings as defined by subdivision twenty-two of 45 section 371 of the social services law; adoptive parents receiving 46 adoption subsidy pursuant to section 453 of the social services law; 47 congregate and scattered supportive housing programs and supportive 48 services provided under the NY/NY III supportive housing agreement to 49 young adults leaving or having recently left foster care; advantage 50 after-school program; child care resource and referral agencies; empire 51 state after-school program; healthy families New York; maternal, infant, 52 and early childhood home visiting initiative; New York state commission 53 for the blind; residential and non-residential domestic violence 54 services and preventative services as defined by section 409 of the 55 social services law.
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1 (vi) Programs and services funded, licensed, or certified by the state 2 office for the aging (SOFA) eligible for the cost of living adjustment 3 established herein, pending federal approval where applicable, include: 4 community services for the elderly; expanded in-home services for the 5 elderly; supplemental nutrition assistance program; New York connects 6 program; long term ombudsman program; Medicaid transportation program; 7 naturally occurring retirement communities (NORCs); neighborhood 8 naturally occurring retirement communities (NNORCs); and social adult 9 day services program.
10 (vii) Programs and services funded, licensed, or certified by the 11 state education department eligible for the cost of living adjustment 12 established herein, pending federal approval where applicable, include: 13 community schools; adult literacy education programs; and independent 14 living centers.
15 (viii) Programs and services funded, licensed, or certified by the 16 office of victim services eligible for the cost of living adjustment 17 established herein, pending federal approval where applicable, include: 18 crime victim service programs as defined by section 631-a of the execu- 19 tive law.
20 (ix) Programs and services funded, licensed, or certified by the 21 department of health eligible for the cost of living adjustment estab- 22 lished herein, pending federal approval where applicable, include: 23 health home care management agencies authorized under section 365-l of 24 the social services law; and rape crisis programs.
25 4. Each local government unit or direct contract provider receiving 26 funding for the cost of living adjustment established herein shall 27 submit a written certification, in such form and at such time as each 28 commissioner shall prescribe, attesting how such funding will be or was 29 used for purposes eligible under this section. Further, providers shall 30 submit a resolution from their governing body to the appropriate 31 commissioner or director, attesting that the funding received will be 32 used solely to increase the hourly and/or salary wages of non-executive 33 direct care staff, non-executive direct support professionals, and non- 34 executive clinical staff.
35 5. Notwithstanding any inconsistent provision of law to the contrary, 36 agency commissioners shall be authorized to recoup funding from a local 37 governmental unit or direct contract provider for the cost of living 38 adjustment established herein determined to have been used in a manner 39 inconsistent with the appropriation, or any other provision of this 40 section. Such agency commissioners shall be authorized to employ any 41 legal mechanism to recoup such funds, including an offset of other funds 42 that are owed to such local governmental unit or direct contract provid- 43 er.
44 § 2. This act shall take effect immediately and shall be deemed to 45 have been in full force and effect on and after April 1, 2024.
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SENATE COMMERCIAL RATE MANDATE -- PART AA 2 Section 1. Paragraph 31 of subsection (i) of section 3216 of the 3 insurance law is amended by adding a new subparagraph (J) to read as 4 follows: 5 (J) This subparagraph shall apply to facilities in this state that are 6 licensed, certified, or otherwise authorized by the office of addiction 7 services and supports for the provision of outpatient, intensive outpa- 8 tient, outpatient rehabilitation and opioid treatment that are partic- 9 ipating in the insurer's provider network. Reimbursement for covered 10 outpatient treatment provided by such facilities shall be at a rate that 11 is not less than the rate that would be paid for such treatment pursuant 12 to the medical assistance program under title eleven of article five of 13 the social services law. 14 § 2. Paragraph 35 of subsection (i) of section 3216 of the insurance 15 law is amended by adding a new subparagraph (K) to read as follows: 16 (K) This subparagraph shall apply to outpatient treatment provided in 17 a facility issued an operating certificate by the commissioner of mental 18 health pursuant to the provisions of article thirty-one of the mental 19 hygiene law, or in a facility operated by the office of mental health, 20 or in a crisis stabilization center licensed pursuant to section 36.01 21 of the mental hygiene law, that is participating in the insurer's 22 provider network. Reimbursement for covered outpatient treatment 23 provided by such a facility shall be at a rate that is not less than the 24 rate that would be paid for such treatment pursuant to the medical 25 assistance program under title eleven of article five of the social 26 services law. 27 § 3. Paragraph 5 of subsection (l) of section 3221 of the insurance 28 law is amended by adding a new subparagraph (K) to read as follows: 29 (K) This subparagraph shall apply to outpatient treatment provided in 30 a facility issued an operating certificate by the commissioner of mental 31 health pursuant to the provisions of article thirty-one of the mental 32 hygiene law, or in a facility operated by the office of mental health, 33 or in a crisis stabilization center licensed pursuant to section 36.01 34 of the mental hygiene law, that is participating in the insurer's 35 provider network. Reimbursement for covered outpatient treatment 36 provided by such a facility shall be at a rate that is not less than the 37 rate that would be paid for such treatment pursuant to the medical 38 assistance program under title eleven of article five of the social 39 services law. 40 § 4. Paragraph 7 of subsection (l) of section 3221 of the insurance 41 law is amended by adding a new subparagraph (J) to read as follows: 42 (J) This subparagraph shall apply to facilities in this state that are 43 licensed, certified, or otherwise authorized by the office of addiction 44 services and supports for the provision of outpatient, intensive outpa- 45 tient, outpatient rehabilitation and opioid treatment that are partic- 46 ipating in the insurer's provider network. Reimbursement for covered 47 outpatient treatment provided by such facilities shall be at a rate that 48 is not less than the rate that would be paid for such treatment pursuant 49 to the medical assistance program under title eleven of article five of 50 the social services law. 51 § 5. Subsection (g) of section 4303 of the insurance law is amended by 52 adding a new paragraph 12 to read as follows: 53 (12) This paragraph shall apply to outpatient treatment provided in a 54 facility issued an operating certificate by the commissioner of mental 55 health pursuant to the provisions of article thirty-one of the mental
S. 8307--B 64 1 hygiene law, or in a facility operated by the office of mental health, 2 or in a crisis stabilization center licensed pursuant to section 36.01 3 of the mental hygiene law, that is participating in the corporation's 4 provider network. Reimbursement for covered outpatient treatment 5 provided by such facility shall be at a rate that is not less than the 6 rate that would be paid for such treatment pursuant to the medical 7 assistance program under title eleven of article five of the social 8 services law. 9 § 6. Subsection (l) of section 4303 of the insurance law is amended by 10 adding a new paragraph 10 to read as follows: 11 (10) This paragraph shall apply to facilities in this state that are 12 licensed, certified, or otherwise authorized by the office of addiction 13 services and supports for the provision of outpatient, intensive outpa- 14 tient, outpatient rehabilitation and opioid treatment that are partic- 15 ipating in the corporation's provider network. Reimbursement for covered 16 outpatient treatment provided by such facilities shall be at a rate that 17 is not less than the rate that would be paid for such treatment pursuant 18 to the medical assistance program under title eleven of article five of 19 the social services law. 20 § 7. This act shall take effect January 1, 2025 and shall apply to 21 policies and contracts issued, renewed, modified, altered, or amended on 22 and after such date.
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OMIG AUDIT REFORM LANGUAGE
New Part AAA as follows:
PART AAA 49 Section 1. Section 30-a of the public health law, as added by chapter 50 442 of the laws of 2006, is amended to read as follows: 51 § 30-a. Definitions. For the purposes of this title, the following 52 definitions shall apply: 53 1. "Abuse" means provider practices that are inconsistent with sound 54 fiscal, business or medical practices, and result in an unnecessary cost
S. 8307--B 96 1 to the Medicaid program, or in reimbursement for services that are not 2 medically necessary or that fail to meet professionally recognized stan- 3 dards for health care. It also includes beneficiary practices that 4 result in unnecessary cost to the Medicaid program. 5 2. "Creditable allegation of fraud" (a) means an allegation which has 6 been verified by the inspector, from any source, including but not 7 limited to the following: 8 i. fraud hotlines tips verified by further evidence; 9 ii. claims data mining; and 10 iii. patterns identified through provider audits, civil false claims 11 cases, and law enforcement investigations. 12 (b) allegations are considered to be credible when they have an indi- 13 cia of reliability and the inspector has reviewed all allegations, facts 14 and evidence carefully and acts judiciously on a case-by-case basis. 15 3. "Fraud" means an intentional deception or misrepresentation made by 16 a person with the knowledge that the deception or misrepresentation 17 could result in some unauthorized benefit to the person or some other 18 person. It includes any act that constitutes fraud under applicable 19 federal or state law. 20 4. "Inspector" means the Medicaid inspector general created by this 21 title. 22 [2.] 5. "Investigation" means investigations of fraud, abuse, or ille- 23 gal acts perpetrated within the medical assistance program, by providers 24 or recipients of medical assistance care, services and supplies. 25 6. "Medical assistance," "Medicaid," and "recipient" shall have the 26 same meaning as those terms in title eleven of article five of the 27 social services law and shall include any payments to providers under 28 any Medicaid managed care program. 29 [3.] 7. "Office" means the office of the Medicaid inspector general 30 created by this title. 31 8. "Overpayment" shall mean any amount paid to a provider for medical 32 assistance in excess of the amount allowable for services furnished 33 under section nineteen hundred two of the federal social security act 34 and which is required to be refunded under section nineteen hundred 35 three of such act. 36 9. "Provider" means any person or entity enrolled as a provider in the 37 medical assistance program. 38 § 2. Subdivision 20 of section 32 of the public health law, as added 39 by chapter 442 of the laws of 2006, is amended to read as follows: 40 20. to, consistent with [provisions of] this title and applicable 41 federal laws, regulations, policies, guidelines and standards, implement 42 and amend, as needed, rules and regulations relating to the prevention, 43 detection, investigation and referral of fraud and abuse within the 44 medical assistance program and the recovery of improperly expended 45 medical assistance program funds; 46 § 3. The public health law is amended by adding two new sections 37 47 and 38 to read as follows: 48 § 37. Audit and recovery of medical assistance payments to providers. 49 Any audit or review of any provider contracts, cost reports, claims, 50 bills, or medical assistance payments by the inspector, anyone desig- 51 nated by the inspector or otherwise lawfully authorized to conduct such 52 audit or review, or any other agency with jurisdiction to conduct such 53 audit or review, shall comply with the following standards: 54 1. Recovery of any overpayment resulting from any audit or review of 55 provider contracts, cost reports, claims, bills, or medical assistance 56 payments shall not commence prior to sixty days after delivery to the
S. 8307--B 97 1 provider of a final audit report or final notice of agency action, or 2 where the provider requests a hearing or appeal within sixty days of 3 delivery of the final audit report or final notice of agency action, 4 until a final determination of such hearing or appeal is made. 5 2. Provider contracts, cost reports, claims, bills or medical assist- 6 ance payments that were the subject matter of a previous audit or review 7 within the last three years shall not be subject to review or audit 8 again except on the basis of new information, for good cause to believe 9 that the previous review or audit was erroneous, or where the scope of 10 the inspector's review or audit is significantly different from the 11 scope of the previous review or audit. 12 3. Any reviews or audits of provider contracts, cost reports, claims, 13 bills or medical assistance payments shall apply the state laws, regu- 14 lations and the applicable, duly promulgated policies, guidelines, stan- 15 dards, protocols and interpretations of state agencies with jurisdiction 16 and in effect at the time the provider engaged in the applicable regu- 17 lated conduct or provision of services. For the purpose of this subdi- 18 vision, the state law, regulation or the applicable promulgated agency 19 policy, guideline, standard, protocol or interpretation shall not be 20 deemed in effect if federal governmental approval is pending or denied. 21 The inspector shall publish protocols applicable to and governing any 22 audit or review of a provider or provider contracts, cost reports, 23 claims, bills or medical assistance payments on the office of Medicaid 24 inspector general website. 25 4. (a) In the event of any overpayment based upon a provider's admin- 26 istrative or technical error, the provider shall have the longer of 27 sixty days from notice of the mistake or six years from the date of 28 service to submit a corrected claim provided (i) the error was a genuine 29 error without intent to falsify or defraud, (ii) the provider maintained 30 contemporaneous documentation to substantiate the correct claims infor- 31 mation, (iii) such error is the sole basis for the finding of an over- 32 payment, and (iv) there is no finding of any overpayment for such error 33 by a federal agency or official. 34 (b) No overpayment shall be calculated for any administrative or tech- 35 nical error corrected as required in paragraph (a) of this subdivision. 36 (c) "Administrative or technical error" shall include any error that 37 constitutes either a (i) minor error or omission or (ii) clerical error 38 or omission under the Medicare modernization act or centers for Medicaid 39 and Medicaid service regulations, and shall include human and clerical 40 errors that result in errors as to form or content of a claim. 41 5. (a) In determining the amount of any overpayment to a provider, the 42 inspector shall utilize sampling and extrapolation consistent with the 43 Centers for Medicare and Medicaid services policies as described in the 44 Centers for Medicare and Medicaid program integrity manual. 45 (b) The final audit report or final notice of agency action shall 46 include a statement of the specific factual and legal basis for utiliz- 47 ing extrapolation and the inappropriate use of extrapolation shall be a 48 basis for appeal. This subdivision shall not be construed to limit the 49 recoupment of an overpayment identified without the use of extrapo- 50 lation. 51 (c) Until the provider has waived its right to a hearing, or if a 52 provider requests a hearing, until the hearing determination is issued, 53 the provider shall have the right to pay the lower confidence limit plus 54 applicable interest in fulfillment of this paragraph, the applicable 55 lower confidence limit shall be calculated using at least a ninety 56 percent confidence level.
S. 8307--B 98 1 6. (a) The provider shall be provided as part of the draft audit find- 2 ings a detailed written explanation of the extrapolation method 3 employed, including the size of the sample, the sampling methodology, 4 the defined universe of claims, the specific claims included in the 5 sample, the results of the sample, the assumptions made about the accu- 6 racy and reliability of the sample and the level of confidence in the 7 sample results, and the steps undertaken and statistical methodology 8 utilized to calculate the alleged overpayment and any applicable offset 9 based on the sample results. This written information shall include a 10 description of the sampling and extrapolation methodology. 11 (b) The sampling and extrapolation methodologies utilized by the 12 inspector shall be consistent with accepted standards of sound auditing 13 practice and statistical analysis. 14 7. The requirements of this section shall be interpreted consistent 15 with and subject to any applicable federal law, rules and regulations, 16 or binding federal agency guidance and directives. The requirements of 17 this section shall not apply to any investigation by the inspector where 18 there is credible allegations of fraud or where there is a finding that 19 the provider has engaged in deliberate abuse of the medical assistance 20 program. 21 § 38. Procedures, practices and standards for recipients. 1. This 22 section applies to any adjustment or recovery of a medical assistance 23 payment from a recipient, and any investigation or other proceeding 24 relating thereto. 25 2. At least five business days prior to commencement of any interview 26 with a recipient as part of an investigation, the inspector or other 27 investigating entity shall provide the recipient with written notice of 28 the investigation. The notice of the investigation shall set forth the 29 basis for the investigation; the potential for referral for criminal 30 investigation; the individual's right to be accompanied by a relative, 31 friend, advocate or attorney during questioning; contact information for 32 local legal services offices; the individual's right to decline to be 33 interviewed or participate in an interview but terminate the questioning 34 at any time without loss of benefits; and the right to a fair hearing in 35 the event that the investigation results in a determination of incorrect 36 payment. 37 3. Following completion of the investigation and at least thirty days 38 prior to commencing a recovery or adjustment action or requesting volun- 39 tary repayment, the inspector or other investigating entity shall 40 provide the recipient with written notice of the determination of incor- 41 rect payment to be recovered or adjusted. The notice of determination 42 shall identify the evidence relied upon, set forth the factual conclu- 43 sions of the investigation, and explain the recipient's right to request 44 a fair hearing in order to contest the outcome of the investigation. The 45 explanation of the right to a fair hearing shall conform to the require- 46 ments of subdivision twelve of section twenty-two of the social services 47 law and regulations thereunder. 48 4. A fair hearing under section twenty-two of the social services law 49 shall be available to any recipient who receives a notice of determi- 50 nation under subdivision three of this section, regardless of whether 51 the recipient is still enrolled in the medical assistance program. 52 § 4. Paragraph (c) of subdivision 3 of section 363-d of the social 53 services law, as amended by section 4 of part V of chapter 57 of the 54 laws of 2019, is amended and a new subdivision 8 is added to read as 55 follows:
S. 8307--B 99 1 (c) In the event that the commissioner of health or the Medicaid 2 inspector general finds that the provider does not have a satisfactory 3 program [within ninety days after the effective date of the regulations4issued pursuant to subdivision four of this section], the commissioner 5 or Medicaid inspector general shall so notify the provider, including 6 specification of the basis of the finding sufficient to enable the 7 provider to adopt a satisfactory compliance program. The provider shall 8 submit to the commissioner or Medicaid inspector general a proposed 9 satisfactory compliance program within sixty days of the notice and 10 shall adopt the program as expeditiously as possible. If the provider 11 does not propose and adopt a satisfactory program in such time period, 12 the provider may be subject to any sanctions or penalties permitted by 13 federal or state laws and regulations, including revocation of the 14 provider's agreement to participate in the medical assistance program. 15 8. Any regulation, determination or finding of the commissioner or the 16 Medicaid inspector general relating to a compliance program under this 17 section shall be subject to and consistent with subdivision three of 18 this section. 19 § 5. Section 32 of the public health law is amended by adding a new 20 subdivision 6-b to read as follows: 21 6-b. to consult with the commissioner on the preparation of an annual 22 report, to be made and filed by the commissioner on or before the first 23 day of July to the governor, the temporary president of the senate, the 24 speaker of the assembly, the minority leader of the senate, the minority 25 leader of the assembly, the commissioner, the commissioner of the office 26 of addiction services and supports, and the commissioner of the office 27 of mental health on the impacts that all civil and administrative 28 enforcement actions taken under subdivision six of this section in the 29 previous calendar year will have and have had on the quality and avail- 30 ability of medical care and services, the best interests of both the 31 medical assistance program and its recipients, and fiscal solvency of 32 the providers who were subject to the civil or administrative enforce- 33 ment action; 34 § 6. This act shall take effect immediately and shall be deemed to 35 have been in full force and effect on and after April 1, 2024. 36 § 2. Severability clause. If any clause, sentence, paragraph, subdivi- 37 sion, section or part of this act shall be adjudged by any court of 38 competent jurisdiction to be invalid, such judgment shall not affect, 39 impair, or invalidate the remainder thereof, but shall be confined in 40 its operation to the clause, sentence, paragraph, subdivision, section 41 or part thereof directly involved in the controversy in which such judg- 42 ment shall have been rendered. It is hereby declared to be the intent of 43 the legislature that this act would have been enacted even if such 44 invalid provisions had not been included herein. 45 § 3. This act shall take effect immediately provided, however, that 46 the applicable effective date of Parts A through AAA of this act shall 47 be as specifically set forth in the last section of such Parts.