BILL NUMBER: S4788A
SPONSOR: RIVERA
 
TITLE OF BILL:
An act to amend the social services law, in relation to the use of
transportation management brokers
 
PURPOSE:
Provides reimbursement of certain transportation costs under Medicaid.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 amends subparagraph (vi) of paragraph (b) of subdivision 4 of
section 365-h of the social services law as it relates to the reimburse-
ment of transportation costs for medicaid enrollees. This section
provides language to remove responsibility for transportation services
from the broker for Managed Long Term Care (MLTC) plans unless the plan
chooses to utilize the broker's services.
Section 2 provides the effective date.
 
JUSTIFICATION:
Managed Long Term Care (MLTC) plans are a form of managed care organiza-
tion (MCO) specifically covering the delivery of long-term care services
to chronically ill or disabled New Yorkers on Medicaid. Until 2020,
Non-Emergency Medical Transportation (NEMT) services for Medicaid enrol-
lees were "carved in" to MCO benefits, meaning that the MCO was respon-
sible for procurement and provision of such services as part of the
enrollee's overall benefit. The 2020 Medicaid Redesign Team (MRT) then
authorized a statewide broker system under which a State-contracted
transportation broker would be solely responsible for NEMT delivery.
Due to the fragile nature of the MLTC population, MLTC NEMT is histor-
ically subject to stricter standards than the general Medicaid NEMT
benefit, such as more restrictive background checks, extensive reporting
and accountability mechanisms, and other requirements reflecting the
sensitivity of the population and significantly higher NEMT use in the
MLTC sector than in mainstream Medicaid. Removing NEMT from the MLTC
package severs the coordination between an enrollee's overall care pack-
age and their transportation, potentially resulting in disruptions of
care and worse patient outcomes.
The MRT broker initiative estimated a cost savings of $49.1M for the
overall transition of NEMT benefits from MCOs to the broker, of which
$13.7M savings was specifically for the MLTC benefit. This was pushed
through in response to a multi-billion dollar Medicaid deficit, which is
no longer the case. This bill seeks to maintain the carve-in for the
most vulnerable population by excluding MLTC from this scheduled transi-
tion.
 
LEGISLATIVE HISTORY:
2023: S4788 (Rivera) Reported to Finance
2022: S8806 (Rivera) Reported to Rules
 
FISCAL IMPLICATIONS:
To be determined.
 
EFFECTIVE DATE:
This act shall take effect on the 90th day after it shall become law.

Statutes affected:
S4788: 365-h social services law, 365-h(4) social services law
S4788A: 365-h social services law, 365-h(4) social services law