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NY's 2023-2024 State Budget Law, Health Care Update

The $229 billion newly enacted New York 2023-2024 Budget Law (signed on May 2, 2023) contains sweeping updates to state health care laws that include the following: 

New Regulations on Temporary Health Care Service Agencies

Temporary staff in health care facilities can be controversial, especially when temp workers earn higher pay and benefits than full time permanent employees, and their agencies' contracts make it financially difficult for the facility to hire the temp on a permanent basis. Now temp agencies must register with the state, and meet new licensure, training and certifications and other qualifications.  N.Y Pub. Health Law Article 29-K now states their contracts shall “not require the payment of liquidated damages, employment fees or other compensation should the health care personnel be hired as a permanent employee of a health care entity.”

Privacy and Prohibition of Geofencing

The Budget bans “geofencing” around most health care facilities in the state by digital advertisers seeking to target individuals receiving health care services in order to collect their data, aim at them with digital ads, or build "consumer profiles, or to infer health status, medical condition, or medical treatment of any person."  

Protection and Privacy in Reproductive Care

The Budget includes several provisions to protect the privacy of reproductive health patients, providers, and records in the state, requiring warrants from out of state law enforcement.  

Electronic Health Information Protection

The Budget amends the General Business Law to prohibit any law enforcement agency or officers from purchasing or obtaining protected health information (PHI) without a warrant, except: (a) information processed by local, state and federal governments, (b) PHI collected by covered entity or business associate, (c) information collected as part of a clinical trial, (d) information processed under FERPA, among others.

Homecare and Home Health

The age of eligibility for Care at Home I and II waivers for children with physical disabilities was raised from age 18 to age 21.  

Home Care Medicare Maximization program extended authorization of bad debt and charity care allowances, and an extension of the limitation on reimbursement of administrative and general costs.  

Medicaid coverage for some patients in need of more than 120 days of long-term care has been extended to allow them to stay enrolled in Managed Long Term Care and establishes performance standards for those plans.

Home health aides’ scope of practice has been expanded, authorizing them to administer routine and prefilled medications under certain circumstances. 

The new  N.Y. Pub. Health Law § 2825-h also made tougher rules for payment of minimum wage for home health aides.

Statewide Health Care Facility Transformation Program

The Budget establishes a $1 billion Statewide Health Care Facility Transformation Program that will, among other issues, target telehealth and IT. Certified home health agencies and hospitals are eligible to apply for funds to improve and modernize IT systems. 

Hospitals

In addition to many hospital rate provisions, the Budget establishes a uniform application for patients seeking financial assistance. 

Increased mental hygiene law enforcement funds made available to, for example, target hospitals with psychiatric beds on their license, but that have not been brought online. 

The definition of a utilization review by a health plan will now include medical necessity reviews performed at a hospital-based outpatient clinic. 

Review of Material Transactions

Material transactions requiring disclosure to the New York State Attorney General's Office, Bureaus of Antitrust, Health Care, and Charities are those over $25 million in valuation including mergers with or acquisitions of a health care entity; an affiliation agreement or contract between a health care entity and another person; and/or the formation of a partnership, joint venture, accountable care organization, parent organization, or management services organization for the purpose of administering contracts with health plans, third-party administrators, pharmacy benefit managers, or health care providers as prescribed by the commissioner by regulation.

Under the new N.Y. Pub. Health Law §§ 4550-52, effective August 1, 2023, health care entities (including physician practices, groups, or management services organizations) must disclose their intent to engage in any of the above-described transactions to the Department of Health at least 30 days before the closing date. 

[T]he Budget touches almost every aspect of the New York healthcare system.