Final FY 2023-24 New York State Budget Provisions

The final FY 2023-24 State Budget, as agreed upon by the Governor and Legislative Leaders this weekend, includes/excludes the below provisions that will impact skilled nursing and assisted living providers:

SNF Medicaid Rate Increase

Provides a uniform Medicaid rate increase of up to 7.5% for the operating component of nursing homes, subject to federal financial participation.

ALP Medicaid Rate Increase

Provides a uniform Medicaid rate increase of 6.5% for the operating component of assisted living programs, subject to federal financial participation. 

Medicaid Global Cap

Continues the Medicaid Global Cap through 2025. The metric used to set Medicaid Global Cap spending continues to be based on a five-year rolling average of Medicaid spending projections. 

Cash Receipts Assessment (CRA)

Continues the CRA at 6% through March 31, 2024

Statewide Health care Facility Transformation Program (“Statewide V”)

Provides $990 million in grant funding for the creation of the Statewide V for the purpose of transforming, redesigning, and strengthening quality health care needs in nursing homes, adult care facilities, assisted living programs, and hospitals. $490 million is reserved for grants to health care providers for capital projects, debt retirement, working capital, or other non-capital projects that, among other things, increase access to care, improve quality of care, and ensure financial stability of health care providers. $500 million is reserved for investments in technological or telehealth projects, projects related to cybersecurity, and unfunded project applications submitted in response to Statewide IV. 

Temporary Health Care Services Agencies

Requires temporary health care services agencies to register annually with DOH and sets forth specific ownership and operational criteria that must be provided by each staffing agency to DOH.

Additionally, the law sets forth minimum standards for agencies, that include, among other things, a requirement to maintain a written agreement with every health care entity in which in does business, that sets forth maximum rates that can be billed or charged; minimum license, training, and continuing education requirements for all assigned personnel; and submission to DOH of copies of all contracts and invoices between an agency and a health care entity.

Moreover, the law further provides for:

• DOH to promulgate regulations to implement the law, including establishing additional minimum standards regarding pricing, fees, administrative costs and business practices;
• Agencies to report quarterly to DOH a full disclosure of charges and compensation, including a schedule of all hourly billing rates for each category of staff, and the names of all health care entities the agency has contracted with in the State;
• DOH to maintain authority to examine the books and records of the agency;
• DOH to be able to suspend, revoke or refuse to renew any staffing agency registration;
• DOH to publish on its website a quarterly report containing aggregated and de-identified staffing agency data;
• DOH and DOL to provide a report to the Governor and the Legislature by January 1, 2024 summarizing the key findings of the staffing agency data collected under the law; and,
• The AG to bring an action for an injunction against any person who violates any provision of the law. 

70/40 Amendments

While bill language agreed to by 1199 SEIU, NYSHFA, and several regional associations amending the 70/40 law with the goal of reducing the use of temporary staffing agencies in nursing homes was not included within the final State Budget, we anticipate this proposal to be introduced as a stand-alone bill in the Legislature.

Disclosure of Material Transactions

Creates a new article of law to set forth the definition of health care entities that must disclose material transactions to DOH to include “any other kind of health care facility, organization or plan providing healthcare services in this state.” Material transactions would include, among others:

• Merger with a health care entity;
• Acquisition of one or more health care entities;
• Affiliation agreement/contract among health care entities; and,
• Formation of a partnership or joint venture for the purpose of administering contracts with healthcare providers

The health care entity must submit a written notice and supporting documentation to DOH at least 30 days prior to a transaction closing date. 

Medication Aides

The FY 2023-24 State Budget does not include the Governor’s proposal for a two-year pilot program for the authorization of certified medication aides in nursing homes. However, we are actively pursuing pathways for a stand-alone bill in the Legislature.

Assisted Living Survey and Reporting Requirements

Omits the requirement for assisted living facilities to report to DOH annually on quality measures and other operational outcomes, in addition to new provisions regarding surveillance schedules and accreditation requirements.

NYSHFA | NYSCAL will continue to provide updates on these and other FY 2023-24 State Budget issues as more information becomes available.

NYSHFA | NYSCAL CONTACTS:

Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11

Kristin A. DeVries, MA, MPP
Director of Government Relations
518-462-4800 x14

Carl Pucci
518-462-4800 x36