Healthcare (Long-Term Care)

Bill A 6586 requires health insurance plans and Medicaid to cover patient navigation services for individuals with serious conditions expected to last at least three months and at high risk of hospitalization, nursing home placement, or health decline. These services help connect patients to social supports like transportation, housing, food assistance, and healthcare appointments, and include referrals, enrollment help, and care coordination. Certified navigators (trained through approved programs) must provide these services under a healthcare provider's supervision. The law applies to all medical, major medical, and comprehensive insurance policies, ensuring coverage for high-risk patients who need help accessing care.

Enacts the "Nurse of Tomorrow Act" to provide for grants from the state commissioner of education to public and not-for-profit hospitals, skilled nursing facilities, schools and other entities for nurse recruitment, education and retention costs and activities as described herein.

S 3365 requires payors (like insurance companies or government programs) to pay healthcare agencies - such as licensed home care services, certified home health agencies, and long-term care programs - within specific deadlines for complete, error-free claims. Payors must pay electronic claims within 30 days and paper claims within 45 days, and if a claim is disputed, they must notify providers in writing within 15 days detailing the issues. The bill defines a "clean claim" as one fully identifying the service, patient, and provider, with all required documentation, and imposes penalties including 12% annual interest for late or improper payments. This directly affects healthcare agencies by streamlining payment processes and holding payors accountable for delays.

Bill S 5332 allows an insured individual's spouse or domestic partner to activate their long-term care health insurance coverage if the insured becomes incapacitated and did not previously execute a power of attorney for this purpose. This authority begins when the insured is determined to lack decision-making capacity, and it ceases if they regain capacity. The bill applies to long-term care health insurance plans issued or renewed after the effective date, aiming to facilitate access to care coverage for incapacitated individuals through their partners.