Relates to the rates of payment for certified home health agencies

• Democratic1

◆ The sponsor's argument

Why Lea Webb says this is needed

CHHAs provide vital post-acute care but currently face financial strain, leading to many closures and reduced patient access. Since 2019, 20+ CHHAs have closed. Additionally, according to the Center for Medicare and Medicaid Services, Medicare CHHA admissions have dropped in New York State by nearly 25% and Medicaid access has also declined significantly. When compared to patients who receive CHHA services, those who do not receive services stay in hospitals longer and are more likely to be readmitted, resulting in higher cost. They also have higher mortality rates. EPS has been the standard Medicaid payment for CHHAs in New York since 2012 but has not been updated despite rising costs. Managed care plans, which cover the vast majority of CHHA Medicaid patients, often underpay CHHAs due to using other ways to reimburse home health care services. CHHAs cannot afford to admit poorly reimbursed cases, resulting in fewer CHHA admissions for low-in-come patients. This bill allows the Depart- ment of Health to modify the payment system to be responsive to current factors and provides for managed care plans to use that EPS system as a default for payment. Managed Care plans are free to implement alterna- tive payment systems as well as the EPS.

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.