Statewide patient centered medical home program

* § 364-m. Statewide patient centered medical home program. 1. The commissioner of health is authorized to certify certain clinicians and clinics as health care homes in order to improve health outcomes and efficiency through patient care continuity and coordination of health services. These providers will be eligible for enhanced payments for services provided to: recipients eligible for Medicaid fee-for-service; enrollees eligible for Medicaid managed care; enrollees eligible for and enrolled in Family Health Plus organizations pursuant to title eleven-D of this article ("Family Health Plus"); and enrollees eligible for and enrolled in Child Health Plus. As used in this section "clinic" means a general hospital providing outpatient care or a diagnostic and treatment center, licensed under article twenty-eight of the public health law.

2. By December first, two thousand nine, the commissioner of health shall develop and implement standards of certification for patient centered medical homes for Medicaid fee-for-service and Medicaid managed care, Family Health Plus and Child Health Plus programs. In developing such standards, the commissioner of health shall: (a) consider existing standards developed by national accrediting and professional organizations; and (b) consult with national and local organizations working on medical home models, physicians, hospitals, clinics, health plans and consumers and their representatives.

3. To maintain their certification, patient centered medical homes must: (a) renew their certification at a frequency determined by the commissioner of health; and (b) provide data to the department of health and to health plans in which the patient is enrolled to permit the commissioner of health to evaluate the impact of patient centered medical homes on quality, outcomes and cost.

4. Subject to the availability of funding and federal financial participation, the commissioner of health is authorized:

(a) To pay enhanced rates of payment to clinics and clinicians that are certified as patient centered medical homes under this section. Such enhancements may be tiered based on the level of standard achieved by the clinician or clinic; and

(b) To pay additional amounts for patient centered medical homes that meet specific process or outcome standards specified by the commissioner of health.

5. By December thirty-first, two thousand twelve, the commissioner of health shall report to the governor and the legislature on the impact of the statewide patient centered medical home program on quality, cost and outcomes for enrollees in Medicaid fee-for-service, Medicaid managed care, Family Health Plus and Child Health Plus.

* NB Repealed April 1, 2028