Bill Text: NY A04058 | 2009-2010 | General Assembly | Amended
Bill Title: Provides for state grant funding to municipalities for early intervention services for toddlers with disabilities and their families.
Spectrum: Partisan Bill (Democrat 30-1)
Status: (Introduced - Dead) 2010-07-01 - held for consideration in ways and means [A04058 Detail]
Download: New_York-2009-A04058-Amended.html
S T A T E O F N E W Y O R K
________________________________________________________________________
4058--A
2009-2010 Regular Sessions
I N A S S E M B L Y
January 29, 2009
___________
Introduced by M. of A. PAULIN, GOTTFRIED, CAHILL, CANESTRARI, CLARK,
COOK, FIELDS, GALEF, GUNTHER, JACOBS, JAFFEE, LIFTON, MARKEY, MAYER-
SOHN, REILLY, SCHROEDER, LAVINE, LATIMER, MAGNARELLI, DINOWITZ, PHEF-
FER -- Multi-Sponsored by -- M. of A. ESPAILLAT, KOON, MAISEL, McENE-
NY, MOLINARO, SWEENEY, TOWNS, WEINSTEIN, WEISENBERG -- read once and
referred to the Committee on Health -- recommitted to the Committee on
Health in accordance with Assembly Rule 3, sec. 2 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the public health law, in relation to funding early
intervention services
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 S 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. GRANTS FOR EARLY INTERVENTION SERVICES. (A) THE COMMISSIONER SHALL,
15 FROM FUNDS ALLOCATED FOR SUCH PURPOSE UNDER PARAGRAPH (G) OF SUBDIVISION
16 SIX OF SECTION TWENTY-EIGHT HUNDRED SEVEN-S OF THIS ARTICLE, MAKE GRANTS
17 TO MUNICIPALITIES FOR THE DELIVERY OF EARLY INTERVENTION SERVICES. SUCH
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03304-03-0
A. 4058--A 2
1 GRANTS SHALL BE DEEMED REIMBURSEMENT FROM THIRD PARTY PAYORS TO SUCH
2 MUNICIPALITIES FOR THE PURPOSES OF THE EARLY INTERVENTION PROGRAM.
3 (B) GRANTS UNDER THIS SUBDIVISION SHALL BE AWARDED TO MUNICIPALITIES
4 BY THE COMMISSIONER. EACH MUNICIPALITY SHALL RECEIVE A SHARE OF SUCH
5 GRANTS EQUAL TO ITS PROPORTIONATE SHARE OF THE TOTAL APPROVED STATEWIDE
6 DOLLARS NOT REIMBURSABLE BY THE MEDICAL ASSISTANCE PROGRAM PAID TO
7 PROVIDERS OF EARLY INTERVENTION SERVICES BY MUNICIPALITIES, NOT INCLUD-
8 ING PROVIDERS OF TRANSPORTATION, ON ACCOUNT OF EARLY INTERVENTION
9 SERVICES, IN THE LAST COMPLETE STATE FISCAL YEAR FOR WHICH SUCH DATA IS
10 AVAILABLE.
11 S 2. Subdivision 6 of section 2807-s of the public health law is
12 amended by adding two new paragraphs (g) and (h) to read as follows:
13 (G) A FURTHER GROSS STATEWIDE AMOUNT FOR TWO THOUSAND ELEVEN SHALL BE
14 ONE HUNDRED MILLION DOLLARS.
15 (H) THE AMOUNT SPECIFIED IN PARAGRAPH (G) OF THIS SUBDIVISION SHALL BE
16 ALLOCATED AMONG THE MUNICIPALITIES BASED ON EACH MUNICIPALITY'S SHARE OF
17 EARLY INTERVENTION PROGRAM EXPENDITURES NOT REIMBURSABLE BY THE MEDICAL
18 ASSISTANCE PROGRAM FOR THE LATEST TWELVE MONTH PERIOD FOR WHICH SUCH
19 DATA IS AVAILABLE.
20 S 3. Subdivision 7 of section 2807-s of the public health law is
21 amended by adding a new paragraph (d) to read as follows:
22 (D) FUNDS SHALL BE ADDED TO THE FUNDS COLLECTED BY THE COMMISSIONER
23 FOR DISTRIBUTION IN ACCORDANCE WITH SECTION TWENTY-EIGHT HUNDRED SEVEN-O
24 OF THIS ARTICLE, IN THE FOLLOWING AMOUNT: ONE HUNDRED MILLION DOLLARS
25 FOR THE PERIOD JANUARY FIRST, TWO THOUSAND ELEVEN THROUGH DECEMBER THIR-
26 TY-FIRST, TWO THOUSAND ELEVEN.
27 S 4. Subdivision 1 and paragraphs (j) and (k) of subdivision 4 of
28 section 2557 of the public health law, subdivision 1 as amended by
29 section 4 of part C of chapter 1 of the laws of 2002 and paragraphs (j)
30 and (k) of subdivision 4 as amended by section 7 of part B3 of chapter
31 62 of the laws of 2003, are amended to read as follows:
32 1. The approved costs for an eligible child who receives an evaluation
33 and early intervention services pursuant to this title shall be a charge
34 upon the municipality wherein the eligible child resides or, where the
35 services are covered by the medical assistance program, upon the social
36 services district of fiscal responsibility with respect to those eligi-
37 ble children who are also eligible for medical assistance. All approved
38 costs shall be paid in the first instance and at least quarterly by the
39 appropriate governing body or officer of the municipality upon vouchers
40 presented and audited in the same manner as the case of other claims
41 against the municipality. Notwithstanding the insurance law or regu-
42 lations thereunder relating to the permissible exclusion of payments for
43 services under governmental programs, no such exclusion shall apply with
44 respect to payments made pursuant to this title. Notwithstanding the
45 insurance law or any other law or agreement to the contrary, benefits
46 under this title shall be considered secondary to any [plan of insurance
47 or] state government benefit program under which an eligible child may
48 have coverage. [Nothing in this section shall increase or enhance cover-
49 ages provided for within an insurance contract subject to the provisions
50 of this title.]
51 (j) The number of children that [have third party reimbursement] ARE
52 COVERED BY THE MEDICAL ASSISTANCE PROGRAM;
53 (k) The number of claims submitted to [third party payors] THE MEDICAL
54 ASSISTANCE PROGRAM by municipality. The percentage of claims denied by
55 [third party payors] THE MEDICAL ASSISTANCE PROGRAM. The reasons for the
56 denials.
A. 4058--A 3
1 S 5. Subdivision 2 of section 2557 of the public health law, as added
2 by chapter 428 of the laws of 1992, is amended to read as follows:
3 2. The department shall reimburse the approved costs paid by a munici-
4 pality for the purposes of this title, other than those reimbursable by
5 the medical assistance program [or by third party payors], in an amount
6 of fifty percent of the amount expended in accordance with the rules and
7 regulations of the commissioner. Such state reimbursement to the munici-
8 pality shall not be paid prior to April first of the year in which the
9 approved costs are paid by the municipality.
10 S 6. The section heading of section 2559 of the public health law, as
11 added by chapter 428 of the laws of 1992, is amended to read as follows:
12 [Third party insurance and medical] MEDICAL assistance program
13 payments.
14 S 7. Subdivision 3 of section 2559 of the public health law, as added
15 by chapter 428 of the laws of 1992, paragraph (a) as amended and para-
16 graph (d) as added by chapter 231 of the laws of 1993, is amended to
17 read as follows:
18 3. (a) Providers of early intervention services and transportation
19 services shall in the first instance and where applicable, seek payment
20 from [all third party payors including governmental agencies] THE
21 MEDICAL ASSISTANCE PROGRAM prior to claiming payment from a given muni-
22 cipality for services rendered to eligible children, provided that, for
23 the purpose of seeking payment from the medical assistance program [or
24 from other third party payors], the municipality shall be deemed the
25 provider of such early intervention services to the extent that the
26 provider has promptly furnished to the municipality adequate and
27 complete information necessary to support the municipality billing, and
28 provided further that the obligation to seek payment shall not apply [to
29 a payment from a third party payor who is not prohibited from applying
30 such payment, and will apply such payment, to an annual or lifetime
31 limit specified in the insured's policy] WHERE THE INSURED IS NOT ELIGI-
32 BLE FOR MEDICAL ASSISTANCE PURSUANT TO THE SOCIAL SERVICES LAW.
33 (b) [The commissioner, in consultation with the director of budget and
34 the superintendent of insurance, shall promulgate regulations providing
35 public reimbursement for deductibles and copayments which are imposed
36 under an insurance policy or health benefit plan to the extent that such
37 deductibles and copayments are applicable to early intervention
38 services.
39 (c) Payments made for early intervention services under an insurance
40 policy or health benefit plan which are provided as part of an IFSP
41 pursuant to section twenty-five hundred forty-five of this title shall
42 not be applied by the insurer or plan administrator against any maximum
43 lifetime or annual limits specified in the policy or health benefits
44 plan, pursuant to section eleven of the chapter of the laws of nineteen
45 hundred ninety-two which added this title.
46 (d)] A municipality, or its designee, shall be subrogated, to the
47 extent of the expenditures by such municipality for early intervention
48 services furnished to persons eligible for benefits under this title, to
49 any rights such person may have or be entitled to from [third party
50 reimbursement] THE MEDICAL ASSISTANCE PROGRAM. The right of subrogation
51 does not attach to benefits paid or provided [under any health insurance
52 policy or health benefits plan] prior to receipt of written notice of
53 the exercise of subrogation rights [by the insurer or plan administrator
54 providing such benefits]. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF
55 THIS TITLE, EXCEPT AS PROVIDED FOR HEREIN, NO THIRD PARTY PAYOR OTHER
A. 4058--A 4
1 THAN THE MEDICAL ASSISTANCE PROGRAM SHALL BE REQUIRED TO REIMBURSE FOR
2 EARLY INTERVENTION SERVICES PROVIDED UNDER THIS TITLE.
3 S 8. This act shall take effect January 1, 2011; provided, however,
4 that the amendments to section 2807-s of the public health law made by
5 sections two and three of this act shall not affect the expiration of
6 such section and shall be deemed to expire therewith.
