ALBANY, N.Y. – Last week the New York Senate passed long-sought Medicaid rate floor legislation, S. 1616, on a unanimous vote. The State Assembly affirmed a companion bill (A2520) earlier in the week, also by a unanimous tally.
The bills require Medicaid managed care organizations (MCOs) to reimburse DME providers at no less than 100% of the state’s published Medicaid DME and complex rehabilitation technology fee schedule. Currently, some MCOs reimburse DME providers at less than half of the Medicaid fee-for-service fee schedule for identical devices and supplies paid in the fee-for-service system.
“By providing parity, this will ensure access when beneficiaries transfer from one MCO plan to another and prevent multiple reimbursement rates for the same item and service,” said John Quinlan, president of Quinlan’s Home Medical and Chairman of the Northeast Medical Equipment Providers (NEMEP). “Setting rate parity will help protect access to care for NY Medicaid beneficiaries and support NY businesses who provide these valuable services.
“NEMEP, AAHomecare, VGM and other stakeholders advocated tirelessly for fair reimbursement that allows us to better support patients and reduce the time they spend in clinical or institutional settings,” continued Quinlan. “These sustained efforts ultimately paid off with unanimous support for rate floor legislation in both the Assembly and the Senate.”
“The New York DME community thanks Assemblymember John McDonald III and Senator Gustavo Rivera for their steadfast support and leadership in securing unanimous passage,” said David Chandler, AAHomecare vice president of Payer Relations. “I started working on this legislation with NEMEP leading up to its initial introduction in 2021. We have gained momentum each legislative session since and have finally secured a big win that improves access to quality home-based care in New York state. The leaders at NEMEP deserve a lot of credit for their persistence in making the case for this policy though multiple sessions.”
New York Governor Kathy Hochul has until December 31 to sign the measure into law.
