NY Soc Serv L § 367-R (2021)
2021 New York Laws SOS - Social Services Article 5 - Assistance and Care Title 11 - Medical Assistance for Needy Persons 367-R - Private Duty Nursing Services Worker Recruitment and Retention Program.

§ 367-r.   Private   duty  nursing  services  worker  recruitment  and retention program. 1. (a) The commissioner of health, with the  approval of   the   director   of  the  budget,  shall  establish  fees  for  the reimbursement of private duty nursing services.  (b) The commissioner of health shall, subject  to  the  provisions  of paragraph (b) of subdivision two of this section and to the availability of federal financial participation, increase medical assistance rates of payment  by  three  percent  for services provided on and after December first, two thousand two, for  private  duty  nursing  services  for  the purposes of improving recruitment and retention of private duty nurses.   2. Medically fragile children. (a) In addition, the commissioner shall further  increase  rates  for  private  duty  nursing  services that are provided to medically fragile children to  ensure  the  availability  of such  services  to such children. In establishing rates of payment under this subdivision, the commissioner shall consider the cost neutrality of such rates as related to the cost effectiveness of caring for  medically fragile  children  in  a  non-institutional  setting  as  compared to an institutional  setting.  Medically  fragile  children  shall,  for   the purposes  of  this  subdivision, have the same meaning as in subdivision three-a of section thirty-six hundred fourteen of the public health law. Such increased rates for services rendered to  such  children  may  take into  consideration  the elements of cost, geographical differentials in the elements of cost considered, economic factors in the area  in  which the  private duty nursing service is provided, costs associated with the provision  of  private  duty  nursing  services  to  medically   fragile children,  and the need for incentives to improve services and institute economies and such increased  rates  shall  be  payable  only  to  those private  duty  nurses  who  can  demonstrate, to the satisfaction of the department of health, satisfactory training and  experience  to  provide services  to  such  children.  Such  increased rates shall be determined based on application of the case mix adjustment  factor  for  AIDS  home care  program  services  rates  as  determined  pursuant  to  applicable regulations of the department of health. The commissioner may promulgate regulations to implement the provisions of this subdivision.  (b) Private duty nursing services providers  which  have  their  rates adjusted  pursuant  to  paragraph (b) of subdivision one of this section and paragraph (a) of this subdivision shall use such  funds  solely  for the  purposes  of recruitment and retention of private duty nurses or to ensure the delivery  of  private  duty  nursing  services  to  medically fragile  children and are prohibited from using such funds for any other purpose. Funds provided under paragraph (b) of subdivision one  of  this section  and  paragraph  (a)  of  this  subdivision  are not intended to supplant support provided by a local  government.  Each  such  provider, with  the  exception of self-employed private duty nurses, shall submit, at a time and in a manner  to  be  determined  by  the  commissioner  of health,  a  written certification attesting that such funds will be used solely for the purpose of recruitment  and  retention  of  private  duty nurses  or  to  ensure  the delivery of private duty nursing services to medically fragile children. The commissioner of health is authorized  to audit   each  such  provider  to  ensure  compliance  with  the  written certification required by this subdivision and shall  recoup  all  funds determined  to  have  been  used for purposes other than recruitment and retention of private duty nurses or the delivery of private duty nursing services to medically fragile children.  Such  recoupment  shall  be  in addition to any other penalties provided by law.  (c)  The  commissioner  of  health shall, subject to the provisions of paragraph (b) of this subdivision, and  the  provisions  of  subdivision three  of  this  section,  and  subject  to  the availability of federal  financial participation, annually increase fees for the  fee-for-service reimbursement  of  private  duty  nursing services provided to medically fragile  children  by  fee-for-service  private  duty  nursing  services providers  who enroll and participate in the provider directory pursuant to subdivision three of this section, over  a  period  of  three  years, commencing  October  first,  two  thousand  twenty,  by one-third annual increments, until such fees for reimbursement equal the final  benchmark payment designed to ensure adequate access to the service. In developing such  benchmark  the  commissioner of health may utilize the average two thousand eighteen Medicaid managed care payments  for  reimbursement  of such  private  duty  nursing  services.  The commissioner may promulgate regulations to implement the provisions of this paragraph.   3.  Provider  directory  for  fee-for-service  private  duty   nursing services  provided  to  medically  fragile children. The commissioner of health is authorized to establish a directory of qualified providers for the purpose of promoting  the  availability  and  ensuring  delivery  of fee-for-service  private  duty  nursing  services  to  medically fragile children and individuals transitioning out of  such  category  of  care. Qualified   providers  enrolling  in  the  directory  shall  ensure  the availability and delivery of and shall provide such  services  to  those individuals as are in need of such services, and shall receive increased reimbursement for such services pursuant to paragraph (c) of subdivision two of this section. The directory shall offer enrollment to all private duty  nursing services providers to promote and ensure the participation in the directory of all nursing services providers  available  to  serve medically fragile children.