NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A4051
SPONSOR: Cunningham TITLE OF BILL:
An act to amend the social services law, in relation to including
accountable care organizations within the definition of a managed care
provider
PURPOSE OR GENERAL IDEA OF BILL:
To allow provider-governed accountable care organizations (ACOs) to
function as Medicaid managed care providers
SUMMARY OF PROVISIONS:
Sections 1 and 2 amend the definition of "managed care provider" to
include accountable care organizations. Currently, only health mainte-
nance organizations (HMOd) and certain partially-capitated programs may
be Medicaid managed care providers.
Section 2 states that this act will take effect 180 days after it
becomes law.
DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE):
N/A
JUSTIFICATION:
In 2011 the Legislature provided authority for health care providers to
form accountable care organizations (ACOs). Democratic provider gover-
nance of an ACO and additional patient protections are required. ACOs
perform the functions of assembling provider networks, care coordi-
nation, and payment distribution without the administrative costs that
HMOs impose on the Medicaid program as well as the complications and
administrative costs that they impose on providers and patients. This
bill will enable New York to join other states, such as Connecticut,
that have well-run Medicaid programs using ACO provider networks as an
alternative option to traditional managed care plans.
PRIOR LEGISLATIVE HISTORY:
2023-24: A7848 - Referred to Health
2021-22: A114 - Referred to Health
2019-20: A10184 - Referred to Health
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None.
EFFECTIVE DATE:
This act will take effect 180 days after it shall have become a law.
STATE OF NEW YORK
________________________________________________________________________
4051
2025-2026 Regular Sessions
IN ASSEMBLY
January 31, 2025
___________
Introduced by M. of A. CUNNINGHAM -- read once and referred to the
Committee on Health
AN ACT to amend the social services law, in relation to including
accountable care organizations within the definition of a managed care
provider
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subparagraph (iii) of paragraph (b) of subdivision 1 of
2 section 364-j of the social services law, as added by section 77 of part
3 A of chapter 56 of the laws of 2013, is amended and a new subparagraph
4 (iv) is added to read as follows:
5 (iii) is authorized to operate under section forty-four hundred
6 three-g of the public health law[.]; or
7 (iv) is an accountable care organization under article twenty-nine-E
8 of the public health law.
9 § 2. Subparagraph (ii) of paragraph (b) of subdivision 1 of section
10 364-j of the social services law, as amended by chapter 433 of the laws
11 of 1997, is amended and a new subparagraph (iii) is added to read as
12 follows:
13 (ii) is authorized as a partially capitated program pursuant to
14 section three hundred sixty-four-f of this title or section forty-four
15 hundred three-e of the public health law or section 1915b of the social
16 security act[.]; or
17 (iii) is an accountable care organization under article twenty-nine-E
18 of the public health law.
19 § 3. This act shall take effect one hundred eighty days after it shall
20 have become a law; provided, that the amendments to subparagraph (iii)
21 of paragraph (b) of section 364-j of the social services law made by
22 section one of this act shall be subject to the expiration and repeal of
23 such subparagraph when upon such date the provisions of section two of
24 this act shall take effect; and provided further that the amendments to
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06470-01-5
A. 4051 2
1 section 364-j of the social services law made by this act shall be
2 subject to the expiration and repeal of such section and shall expire
3 and be deemed repealed therewith. Effective immediately, the commission-
4 er of health shall make regulations and take other actions reasonably
5 necessary to implement this act on that date.
