Relates to reimbursement by Medicaid for services required by state law

2025 Regular Session Introduced by Dana Levenberg and 1 co-sponsor

Medicaid must reimburse services that state law requires, aligning funding with legal mandates and ensuring providers are paid for mandated health care.

REFERRED TO HEALTH

Overview

A 4650 is a bill introduced in the New York Legislature on February 4, 2025, titled “Relates to reimbursement by Medicaid for services required by state law.” The bill is currently REFERRED TO HEALTH, meaning it has been sent to the Health committee for consideration. The primary sponsor is Joseph Sempolinski, with Dana Levenberg listed as a cosponsor.

Purpose and Intent

The core aim of A 4650 is to ensure that Medicaid reimburses for services that are required by state law. In other words, when state law mandates that a particular health service be provided, Medicaid would reimburse those services under the terms established by the bill.

The provision seeks alignment between statutory requirements and Medicaid payment practices, potentially guaranteeing funding for services that state law mandates.

Key Provisions (as described by the bill’s title and status)

Reimbursement obligation: Medicaid must reimburse for services that state law requires the state to provide.

Scope and methodology: The specific services covered and the reimbursement methodology (rates, billing rules, and payment timelines) would be defined within the bill or subsequent regulations. The current information indicates that detailed provisions are to be included or clarified in the bill’s text.

Administrative integration: The bill is likely to interact with the state Medicaid program’s procedures, including possible amendments to state plan documents or related administrative rules to implement the reimbursement requirement.

Note: The available information does not include the exact list of covered services, rate structures, or timeline milestones beyond the introductory and referral actions.

Who Would Be Affected

Medicaid program: The primary payer responsible for reimbursing mandated services.

Healthcare providers and facilities: Eligible for reimbursement for services specified by state law.

State budget and administrative agencies: Potential implications for Medicaid spending, rate-setting, and regulatory implementation.

Procedural and Timeline Aspects

Introduced: February 4, 2025

Status: REFERRED TO HEALTH (committee referral for consideration and potential further action)

Legislative actions listed: Two identical entries for the 2025-02-04 referral to Health

Sponsors: Joseph Sempolinski (primary) and Dana Levenberg (cosponsor)

Related bills from prior sessions: A 5289, A 6347, A 1334, A 10348, A 4851, A 5830, A 2420, A 8247 (indicating ongoing interest in Medicaid-related reimbursement topics across sessions)

Potential Impact and Considerations

If enacted, the bill could improve consistency between state-law-mandated services and Medicaid coverage, potentially reducing gaps in access to required services.

Providers may experience clearer reimbursement obligations and payment timelines for mandated services.

The bill’s impact will depend on the final text, including which services are covered, reimbursement rates, and any phased implementation or funding provisions.

For readers seeking more detail, the bill’s full text and committee notes (when available) will provide the specific services covered, rate rules, and implementation timelines.

Bill