On January 1, 2022, N.Y. Public Health Law § 2895-b(3)(a) will take effect, requiring nursing homes to maintain daily average staffing hours equal to 3.5 hours of care per resident per day. Nursing homes will be required to keep a payroll staffing journal and report it to the Centers for Medicare and Medicaid Services (CMS) to show not less than 1.1 hour of care per resident per day by a licensed nurse, and not less than 2.2 hours of care per resident per day by a certified nurse aide or a nurse aide. In 2023 the 2.2 nurse aide hours per day must be by a certified nurse aide.

N.Y. Public Health Law § 2828 will take effect on January 1, 2022, every nursing home is required to spend at least 70% of revenue on direct resident care, of which the nursing home is required to spend 40% of revenue on resident-facing staffing. Section 2828 also provides that nursing homes may deduct from the resident-facing staffing requirement at least 15% of the cost of the amount spent on staffing that is contracted out for services provided by registered professional nurses, licensed practical nurses, or certified nurse aides.

N.Y. Public Health Law § 2828 also requires that a nursing home’s total operating revenue must not exceed its total operating and non-operating expenses by 5%, and in the event it does, the overage will be owed to New York State, paid either through a lawsuit or deductions or offsets from payments made pursuant to the Medicaid program. The Department of Health will deposit the excess amounts collected in a nursing home quality pool. There are exceptions for

This Section 2828 will not apply to nursing homes that provide primary care for people with HIV/AIDS, medically fragile children, personally requiring behavioral intervention, or persons requiring neurodegenerative service.

January 6, 2022, N.Y. Public Health Law § 2808-e will take effect, requiring Nursing Homes to prominently post their current rating, as assigned by the federal CMS Five-Star Quality Rating System on their own website’s homepage, the website of any entity that owns the nursing home, and in the nursing home itself, visible to residents and the public. The rating system is based on health inspections, staffing, and quality measures. The New York State Department of Health will also be required to post each nursing home’s most recent overall star rating, or a link to access such information on the homepage of its website.


On January 1, 2022, parts of the new federal transparency rules, Transparency in Coverage and the No Surprises Act will go into effect, requiring employer plan sponsors and health plans to provide crucial pricing information to empower consumers to make better-informed purchases of health care.  

Federal Transparency Rules will, for the first time, give innovators the power to create private sector solutions to advance consumerism and price comparison shopping, using research studies and data analysis of the health care market that has for years been shrouded in secrecy.  

For plan years 2022 and later: most individual and group health insurance plans will be required to make detailed, standardized and readable pricing information with monthly updates available to consumers, researchers, employers, and third-party developers, including (1) negotiated rates for all covered items and services between the plan or issuer and in-network providers, (2) historical payments to, and billed charges from, out-of-network providers, with a minimum of 20 entries in each, and (3) in-network negotiated rates and historical net prices for all covered prescription drugs by plan or issuer at the pharmacy location level.

Delayed for plan years 2023 and later: health plan participants, beneficiaries and enrollees will be able to see real-time, accurate and personalized out-of-pocket cost information before making their health care service and product purchases. They will see the underlying negotiated rates for all covered health care items and services, including prescription drugs, through an internet-based self-service tool and in paper form upon request. For the first time, health care consumers will understand how costs for covered health care items and services are determined by their plan, and also shop and compare health care costs before receiving care. An initial list of 500 shoppable services will be required to be available via the internet based self-service tool for plan years that begin on or after January 1, 2023. The remainder of all items and services will be added for plan years that begin on or after January 1, 2024.

The No Surprises Act, also delayed for plans years 2023 and later, and will protect patients using air ambulance, out-of-network, and out of area emergency services. These providers will be required to negotiate reimbursement and if they cannot agree, must accept the payment as determined by a third party independent mediation company such that the patient cannot be billed in excess of that agreed upon amount. For the first time, health plans will have to disclose what their reimbursement rates are for given services, and providers will have to bring their requested fees in line with actual market rates.


Federal HealthCare.gov open enrollment will be expanded to November 1 through January 15. States including New York that operate their own exchanges can continue to set their own open enrollment window, as long as it does not end earlier than December 15. Low-income applicants and those with qualifying life events including moving, changing jobs, qualifying for Medicare, the end of one’s COBRA benefits, etc., will still have a year-round open enrollment windows.

Healthcare Marketplace Navigators will once again be required to provide various post-enrollment assistance to enrollees, including help with their eligibility appeals, marketplace aspects of their premium tax credit reconciliation and general help with how to use health insurance coverage.


Three new state privacy laws are expected to have national impact on businesses and their privacy policies. California, Colorado and Virginia each have new privacy laws that go into effect in 2023, and there are significant differences in the way these laws will handle common privacy issues, making one general business privacy policy less useful for companies that conduct interstate business. These differences include: customer opt-out rights; exemptions for B2B, healthcare, and human resources; the definitions of what qualifies as an acceptable risk analysis, and what activities require data protection assessments; required business contract provision requirements when protected data is controlled or processed; consumer rights to appeal denials of their rights, and duties to inform consumers of their rights in each state; and cure periods that are quite generous, from 30 to 60 days.