§ 364-M — Statewide patient centered medical home program

* § 364-m. Statewide patient centered medical home program. 1. The\ncommissioner of health is authorized to certify certain clinicians and\nclinics as health care homes in order to improve health outcomes and\nefficiency through patient care continuity and coordination of health\nservices. These providers will be eligible for enhanced payments for\nservices provided to: recipients eligible for Medicaid fee-for-service;\nenrollees eligible for Medicaid managed care; enrollees eligible for and\nenrolled in Family Health Plus organizations pursuant to title eleven-D\nof this article ("Family Health Plus"); and enrollees eligible for and\nenrolled in Child Health Plus. As used in this section "clinic" means a\ngeneral hospital providing outpatient care or a diagnostic and treatment\ncenter, licensed under article twenty-eight of the public health law.\n 2. By December first, two thousand nine, the commissioner of health\nshall develop and implement standards of certification for patient\ncentered medical homes for Medicaid fee-for-service and Medicaid managed\ncare, Family Health Plus and Child Health Plus programs. In developing\nsuch standards, the commissioner of health shall: (a) consider existing\nstandards developed by national accrediting and professional\norganizations; and (b) consult with national and local organizations\nworking on medical home models, physicians, hospitals, clinics, health\nplans and consumers and their representatives.\n 3. To maintain their certification, patient centered medical homes\nmust: (a) renew their certification at a frequency determined by the\ncommissioner of health; and (b) provide data to the department of health\nand to health plans in which the patient is enrolled to permit the\ncommissioner of health to evaluate the impact of patient centered\nmedical homes on quality, outcomes and cost.\n 4. Subject to the availability of funding and federal financial\nparticipation, the commissioner of health is authorized:\n (a) To pay enhanced rates of payment to clinics and clinicians that\nare certified as patient centered medical homes under this section. Such\nenhancements may be tiered based on the level of standard achieved by\nthe clinician or clinic; and\n (b) To pay additional amounts for patient centered medical homes that\nmeet specific process or outcome standards specified by the commissioner\nof health.\n 5. By December thirty-first, two thousand twelve, the commissioner of\nhealth shall report to the governor and the legislature on the impact of\nthe statewide patient centered medical home program on quality, cost and\noutcomes for enrollees in Medicaid fee-for-service, Medicaid managed\ncare, Family Health Plus and Child Health Plus.\n * NB Repealed April 1, 2028\n