Bill Text: NY A00356 | 2019-2020 | General Assembly | Introduced
Bill Title: Provides for state funding to municipalities for early intervention services for toddlers with disabilities and their families.
Spectrum: Moderate Partisan Bill (Democrat 14-3)
Status: (Introduced - Dead) 2020-01-08 - referred to ways and means [A00356 Detail]
Download: New_York-2019-A00356-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 356 2019-2020 Regular Sessions IN ASSEMBLY (Prefiled) January 9, 2019 ___________ Introduced by M. of A. PAULIN, GOTTFRIED, CAHILL, COOK, GALEF, GUNTHER, JAFFEE, LIFTON, MAGNARELLI, DINOWITZ, BENEDETTO, LUPARDO, ABINANTI, CROUCH, M. G. MILLER -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to funding early intervention services; and to repeal certain provisions of the public health law and the insurance law relating thereto The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The public health law is amended by adding a new section 2 2807-o to read as follows: 3 § 2807-o. Early intervention services pool. 1. Definitions. The 4 following words or phrases as used in this section shall have the 5 following meanings: 6 (a) "Early intervention services" shall mean services delivered to an 7 eligible child, pursuant to an individualized family service plan under 8 the early intervention program. 9 (b) "Early intervention program" shall mean the early intervention 10 program for toddlers with disabilities and their families as created by 11 title two-A of article twenty-five of this chapter. 12 (c) "Municipality" shall mean any county outside of the city of New 13 York or the city of New York. 14 2. Payments for early intervention services. (a) The commissioner 15 shall, from funds allocated for such purpose under paragraph (g) of 16 subdivision six of section twenty-eight hundred seven-s of this article, 17 make payments to municipalities and the state for the delivery of early 18 intervention services. 19 (b) Payments under this subdivision shall be made to municipalities 20 and the state by the commissioner. Each municipality and the state of 21 New York shall receive a share of such payments equal to its propor- EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD00634-01-9A. 356 2 1 tionate share of the total approved statewide dollars not reimbursable 2 by the medical assistance program paid to providers of early inter- 3 vention services by the state and municipalities on account of early 4 intervention services in the last complete state fiscal year for which 5 such data is available. 6 § 2. Subdivision 6 of section 2807-s of the public health law is 7 amended by adding two new paragraphs (g) and (h) to read as follows: 8 (g) A further gross statewide amount for the state fiscal year two 9 thousand twenty and each state fiscal year thereafter shall be fifteen 10 million dollars. 11 (h) The amount specified in paragraph (g) of this subdivision shall be 12 allocated under section twenty-eight hundred seven-o of this article 13 among the municipalities and the state of New York based on each munici- 14 pality's share and the state's share of early intervention program 15 expenditures not reimbursable by the medical assistance program for the 16 latest twelve month period for which such data is available. 17 § 3. Subdivision 7 of section 2807-s of the public health law is 18 amended by adding a new paragraph (d) to read as follows: 19 (d) funds shall be added to the funds collected by the commissioner 20 for distribution in accordance with section twenty-eight hundred seven-o 21 of this article, in the following amount: fifteen million dollars for 22 the period beginning April first, two thousand twenty, and continuing 23 each state fiscal year thereafter. 24 § 4. Subdivision 1 of section 2557 of the public health law, as 25 amended by section 4 of part C of chapter 1 of the laws of 2002, is 26 amended to read as follows: 27 1. The approved costs for an eligible child who receives an evaluation 28 and early intervention services pursuant to this title shall be a charge 29 upon the municipality wherein the eligible child resides or, where the 30 services are covered by the medical assistance program, upon the social 31 services district of fiscal responsibility with respect to those eligi- 32 ble children who are also eligible for medical assistance. All approved 33 costs shall be paid in the first instance and at least quarterly by the 34 appropriate governing body or officer of the municipality upon vouchers 35 presented and audited in the same manner as the case of other claims 36 against the municipality. Notwithstanding the insurance law or regu- 37 lations thereunder relating to the permissible exclusion of payments for 38 services under governmental programs, no such exclusion shall apply with 39 respect to payments made pursuant to this title. Notwithstanding the 40 insurance law or any other law or agreement to the contrary, benefits 41 under this title shall be considered secondary to [any plan of insurance42or state government benefit] the medical assistance program under which 43 an eligible child may have coverage. [Nothing in this section shall44increase or enhance coverages provided for within an insurance contract45subject to the provisions of this title.] 46 § 5. Subdivision 2 of section 2557 of the public health law, as 47 amended by section 9-a of part A of chapter 56 of the laws of 2012, is 48 amended to read as follows: 49 2. The department shall reimburse the approved costs paid by a munici- 50 pality for the purposes of this title, other than those reimbursable by 51 the medical assistance program [or by third party payors], in an amount 52 of fifty percent of the amount expended in accordance with the rules and 53 regulations of the commissioner; provided, however, that in the 54 discretion of the department and with the approval of the director of 55 the division of the budget, the department may reimburse municipalities 56 in an amount greater than fifty percent of the amount expended. SuchA. 356 3 1 state reimbursement to the municipality shall not be paid prior to April 2 first of the year in which the approved costs are paid by the munici- 3 pality, provided, however that, subject to the approval of the director 4 of the budget, the department may pay such state aid reimbursement to 5 the municipality prior to such date. 6 § 6. The section heading of section 2559 of the public health law, as 7 added by chapter 428 of the laws of 1992, is amended to read as follows: 8 [Third party insurance and medical] Medical assistance program 9 payments. 10 § 7. Subdivision 3 of section 2559 of the public health law, as added 11 by chapter 428 of the laws of 1992, paragraphs (a), (c) and (d) as 12 amended by section 11 of part A of chapter 56 of the laws of 2012 and 13 paragraph (b) as further amended by section 104 of part A of chapter 62 14 of the laws of 2011, is amended to read as follows: 15 3. (a) [Providers of evaluations and early intervention services,16hereinafter collectively referred to in this subdivision as "provider"17or "providers", shall in the first instance and where applicable, seek18payment from all third party payors including governmental agencies19prior to claiming payment from a given municipality for evaluations20conducted under the program and for services rendered to eligible chil-21dren, provided that, the obligation to seek payment shall not apply to a22payment from a third party payor who is not prohibited from applying23such payment, and will apply such payment, to an annual or lifetime24limit specified in the insured's policy.25(i) Parents shall provide the municipality and service coordinator26information on any insurance policy, plan or contract under which an27eligible child has coverage.28(ii)] Parents shall provide the municipality and the service coordina- 29 tor with a written referral from a primary care provider as documenta- 30 tion, for eligible children, of the medical necessity of early inter- 31 vention services. 32 [(iii) providers] (b) Providers shall utilize the department's fiscal 33 agent and data system for claiming payment for evaluations and services 34 rendered under the early intervention program. 35 [(b) The commissioner, in consultation with the director of budget and36the superintendent of financial services, shall promulgate regulations37providing public reimbursement for deductibles and copayments which are38imposed under an insurance policy or health benefit plan to the extent39that such deductibles and copayments are applicable to early inter-40vention services.41(c) Payments made for early intervention services under an insurance42policy or health benefit plan, including payments made by the medical43assistance program or other governmental third party payor, which are44provided as part of an IFSP pursuant to section twenty-five hundred45forty-five of this title shall not be applied by the insurer or plan46administrator against any maximum lifetime or annual limits specified in47the policy or health benefits plan, pursuant to section eleven of the48chapter of the laws of nineteen hundred ninety-two which added this49title.50(d)] (c) A municipality, or its designee, and a provider shall be 51 subrogated, to the extent of the expenditures by such municipality or 52 for early intervention services furnished to persons eligible for bene- 53 fits under this title, to any rights such person may have or be entitled 54 to from [third party reimbursement] the medical assistance program. The 55 provider shall submit notice to the insurer or plan administrator of his 56 or her exercise of such right of subrogation upon the provider's assign-A. 356 4 1 ment as the early intervention service provider for the child. The right 2 of subrogation does not attach to benefits paid or provided [under any3health insurance policy or health benefits plan] prior to receipt of 4 written notice of the exercise of subrogation rights [by the insurer or5plan administrator providing such benefits]. Notwithstanding any incon- 6 sistent provision of this title, except as provided for herein, no third 7 party payor other than the medical assistance program shall be required 8 to reimburse for early intervention services provided under this title. 9 § 8. Subdivision 3 of section 2543 of the public health law is 10 REPEALED. 11 § 9. Section 3235-a of the insurance law is REPEALED. 12 § 10. Subparagraph (F) of paragraph 25 of subsection (i) of section 13 3216 of the insurance law is REPEALED. 14 § 11. Subparagraph (F) of paragraph 17 of subsection (1) of section 15 3221 of the insurance law is REPEALED. 16 § 12. Paragraph 6 of subsection (ee) of section 4303 of the insurance 17 law is REPEALED. 18 § 13. This act shall take effect January 1, 2020; provided, however, 19 that the amendments to section 2807-s of the public health law made by 20 sections two and three of this act shall not affect the expiration of 21 such section and shall be deemed to expire therewith. Effective imme- 22 diately, the addition, amendment and/or repeal of any rule or regulation 23 necessary for the implementation of this act on its effective date are 24 authorized to be made and completed by the commissioner of health, on or 25 before such effective date.