BILL NUMBER: S6266
SPONSOR: SALAZAR
 
TITLE OF BILL:
An act to amend the social services law and the public health law, in
relation to establishing a quality incentive program for managed care
providers
 
PURPOSE:
The purpose of this bill is to require the Commissioner of Health to
establish a quality incentive program for Medicaid Managed Care (MMC)
plans, and to consult with representatives of managed care providers and
other relevant stakeholders in establishing the criteria for the
distribution of funds under the MMC quality incentive program.
 
SUMMARY OF PROVISIONS:
Section 1 of this bill would amend the Social Services Law to require
the Commissioner of Health to establish a quality incentive program for
Medicaid Managed Care plans, and to consult with representatives of
managed care providers and other relevant stakeholders in establishing
the criteria for the distribution of funds under the MMC quality incen-
tive program.
Section 2 of this bill would amend the Public Health Law to require the
Commissioner of Health to establish a quality incentive program for MMC
plans, and to consult with representatives of managed care providers and
other relevant stakeholders in establishing the criteria for the
distribution of funds under the MMC quality incentive program.
Section 3 of this bill provides that the effective date shall take
effect immediately; provided, however, that the amendments to section
364-j of the Social Services Law and section 4403-f of the Public Health
Law made by sections one and two of this act shall not affect the repeal
of such sections and shall be deemed repealed therewith.
 
JUSTIFICATION:
The State's quality incentive program is a powerful tool for improving
and maintaining high-quality and high-value care in the Medicaid program
by funding programs that aim to address social determinants of health
and health disparities and improve health outcomes. Currently, the
State authorizes a quality incentive program through allocation of fund-
ing in the budget, however this legislation would codify such a program
in law, subject to appropriation.
Indeed, quality incentive funds are central to the State's value-based
payment (VBP) program and Medicaid redesign efforts, providing plans
with the resources needed to incentivize providers to deliver high-qual-
ity care, not just more care.
An essential resource for MMC plans, quality incentive program dollars
fund critical investments in quality initiatives and the delivery of
cost-effective services that are not otherwise covered by Medicaid but
improve quality. For example, the quality incentive program has
supported the development and testing of new care models, numerous
"Continuing Medical Education" opportunities aimed at improving health
care quality and outcomes, and enhanced reimbursement for primary and
behavioral health providers supporting high-need members.
Accordingly, the MMC quality incentive program is a crucial tool to
leverage federal dollars to advance the State's Medicaid policy goals of
improving access to higher-quality care and controlling the rate of cost
increases. It is imperative that the MMC quality incentive program be
adequately and consistently funded. This bill will require the Commis-
sioner of Health to establish a quality incentive program for Medicaid
Managed Care (MMC) plans, and to consult with representatives of managed
care providers and other relevant stakeholders in establishing the
criteria for the distribution of funds under the MMC quality incentive
program.
 
LEGISLATIVE HISTORY:
SENATE:
2024 - S 7992 (Mannion) - Referred to Health.
2023 - S 3146-A (Mannion) - Referred to Health, reported to Finance,
substituted for A 6021-A, passed Senate, vetoed (memo 126).
2021-2022 - S 7594-A (Mannion) - Referred to Health, reported to
Finance, passed Senate.
ASSEMBLY:
2024 - A 8922 (Paulin) - Referred to Health.
2023 - A 6021-A (Paulin) - Referred to Health, reported to Ways & Means,
reported to Rules, passed Assembly.
2022 - A 10031 (Gottfried) - Referred to Health.
 
FISCAL IMPLICATIONS:
This will impact the State budget to the extent that funds are allocated
and appropriated for such program.
 
EFFECTIVE DATE:
This act shall take effect immediately; provided, however, that the
amendments to section 364-j of the Social Services Law and section
4403-f of the Public Health Law made by sections one and two of this act
shall not affect the repeal of such sections and shall be deemed
repealed therewith.

Statutes affected:
S6266: 364-j social services law, 364-j(18) social services law, 4403-f public health law, 4403-f(8) public health law