New YorkA 14762025-2026 Regular SessionHouseWALLET

Defines medically fragile young adults for certain purposes

Sponsored By: J. Gary Pretlow (Democratic)

Became Law

HEALTHRULES

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

Medicaid pays full rate for held beds

Medicaid keeps the same rates and formula you had before age 21, unless the state approves a higher rate. This includes a daily per diem and coverage for bed holds. Medicaid pays 100% of the children's rate for reserved beds during hospital stays and for therapeutic or hospice leaves. There is no daily limit for these payments. These rules apply only while federal funds are available and start nine months after this law becomes law.

Medically fragile ages 21-35 keep pediatric care

The law defines “medically fragile young adults” as ages 21 to 35 who meet the child medical fragility test. If you live in a pediatric specialized nursing facility, you can stay there after 21 until you turn 36. The health department writes rules to run this. These changes apply only while federal funds are available. They start nine months after this law becomes law.

Timing and rulemaking for this law

Most of this law takes effect right away. Section one starts nine months after this law becomes law, the same date as the related 2024 chapter. Agencies can adopt, change, or repeal needed rules now and finish before that date.

Sponsors & Cosponsors

Sponsor

J. Gary Pretlow
Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 61 • No: 1

House vote • 2/5/2025

FLOOR Vote