Home Care Rate & Benchmarking Bills Introduced among Core of HCA Priorities

Recognizing the inadequacy of home care rates across payor lines, Assembly Health Committee Chairman Richard Gottfried and Senate Health Committee Chairman Gustavo Rivera have worked with HCA to introduce a vital rate stabilization bill (A.7798/S.5915). We thank the Health Committee chairs for their leadership on this critical issue and HCA urges their colleagues to cosponsor A.7798/S.5915 in both houses.

As you’ve read in past editions of the Capitol Report, home care rate stabilization is critical at a time when the majority of agencies are operating at a loss, due to lagging reimbursement, with agencies reporting underpayments: at 50% to 70% below costs in some payor categories.

A.7798/S.5915 does two things.

First it would result in the development and posting of voluntary benchmark rates that payors (managed care plans, commercial insurance, etc.) would consider to help stabilize rate levels for the majority of home care services that vulnerable New Yorkers rely upon.

Secondly, it would provide a 10% trend increase (like a COLA adjustment) to a minority portion of home care rates that are still directly set and reimbursed to providers by the state Medicaid program. These rates, known as fee-for-service and “episodic” payment system rates, have not had a trend increase to match costs in over ten years (in fact the episodic rates have been subject to arbitrary cuts known as “rebasing”); these rates support lines of service for medically intense care that is directly provided by Certified Home Health Agencies (CHHAs), as well as for CHHA care of pediatric patients under age 18.

HCA is happy to brief you and your offices on this important legislation as you consider cosponsorship.

HCA is working to advance other finance-related language as well, including measures aimed at rate transparency and actuarial soundness.

Below is a downloadable table with a status report on bills already introduced this legislative session and reasons to support them, including bills on workforce support, sepsis prevention, disparities, public health and mental health integration and collaboration and more. Please click the image for a full-screen table.

For questions, or to cosponsor legislation, do not hesitate to contact HCA’s Director of Public Policy and Advocacy Alyssa Lovelace at (518) 810-0658 or alovelace@hcanys.org

2019 Legislative Session Bill Status