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This bill updates how New York State calculates payment rates for federally qualified health centers (FQHCs), which provide primary care in underserved communities. It changes the rate calculation method: through 2025, rates use the Medicare Economic Index, and after 2025, they use a federal cost adjustment formula (FQHC Market Basket inflator) adjusted for service scope. The state health department must analyze actual FQHC costs every three years starting in 2025 to set updated rates, ensuring payments reflect real costs while guaranteeing no facility receives a rate lower than the 2025 level. This directly affects FQHCs by potentially increasing their state-funded payments based on verified operational expenses.
Directs the department of health to request guidance from the Centers for Medicare and Medicaid Services to determine whether the state can claim federal financial participation for coverage of and payment for certain evidence-based mobile medical applications.
Establishes the New York Health program, a comprehensive system of access to health insurance for New York state residents; provides for administrative structure of the plan; provides for powers and duties of the board of trustees, the scope of benefits, payment methodologies and care coordination; establishes the New York Health Trust Fund which would hold monies from a variety of sources to be used solely to finance the plan; enacts provisions relating to financing of New York Health, including a payroll assessment, similar to the Medicare tax; establishes a temporary commission on implementation of the plan; provides for collective negotiations by health care providers with New York Health.
