Bill Text: NY A05802 | 2017-2018 | General Assembly | Introduced


Bill Title: Relates to having the state reimburse all local costs for medicaid.

Spectrum: Partisan Bill (Republican 8-0)

Status: (Introduced - Dead) 2018-05-01 - held for consideration in health [A05802 Detail]

Download: New_York-2017-A05802-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          5802
                               2017-2018 Regular Sessions
                   IN ASSEMBLY
                                    February 15, 2017
                                       ___________
        Introduced  by  M. of A. ERRIGO, RAIA, PALMESANO, GIGLIO, CROUCH, HAWLEY
          -- Multi-Sponsored by -- M. of A. LOPEZ -- read once and  referred  to
          the Committee on Health
        AN  ACT  to  amend  the  social  services  law,  in relation to medicaid
          reimbursement; and repealing certain provisions of such  law  relating
          thereto
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. Section 368-a of the social services law is REPEALED and  a
     2  new section 368-a is added to read as follows:
     3    §  368-a.  State  reimbursement.  1.  The  department shall review the
     4  expenditures made by local social services districts for medial  assist-
     5  ance  for  needy  persons, and the administration thereof, before making
     6  reimbursement. Before approving such expenditures for reimbursement, the
     7  department shall give due consideration to the results  of  the  reviews
     8  and audits conducted by the department of health pursuant to subdivision
     9  two  of  section  three hundred sixty-four of this title. If approved by
    10  the department, such expenditures shall not be subject to  reimbursement
    11  by  the  state  pursuant  to  section  one  hundred  fifty-three  or any
    12  provision of this chapter other than this section, but shall be  subject
    13  to  reimbursement  by  the state in accordance with this section and the
    14  regulations of the department, as follows:
    15    There shall be paid to each such district:
    16    (a) the amount of federal funds, if any, properly received  or  to  be
    17  received on account of such expenditures;
    18    (b)  the  full amount expended on behalf of the department for medical
    19  assistance furnished under this title  to  eligible  patients  in  state
    20  institutions  for  the mentally disabled, in facilities or parts thereof
    21  for the care and treatment of drug dependent persons  operated  pursuant
    22  to the mental hygiene law and in other hospitals while such patients are
    23  on release from an institution in the state department of mental hygiene
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09057-01-7

        A. 5802                             2
     1  or  from  a  drug  abuse  treatment facility or part thereof operated in
     2  compliance with applicable provisions  of  law  and  supervised  by  the
     3  office  of alcoholism and substance abuse services, to eligible veterans
     4  and  their dependents in that part of the New York state home for veter-
     5  ans and their dependants at Oxford that has been  approved  pursuant  to
     6  law  as a nursing home and in a hospital while on release from that home
     7  for the purpose of receiving care in such hospital, in that  part  of  a
     8  public  institution  operated for the care of the mentally disabled that
     9  has been approved pursuant to law as an intermediate care  facility,  to
    10  eligible  veterans  and  their  dependents  in that part of the New York
    11  state home for veterans and their dependents at  Oxford  that  has  been
    12  approved  pursuant  to  law  as  an  intermediate care facility and in a
    13  hospital while on release from such intermediate care facilities for the
    14  purpose of receiving care in such hospital, and for  the  administration
    15  thereof,  after  first  deducting  therefrom  any federal funds properly
    16  received or to be received on account thereof;
    17    (c) the full amount expended for medical  assistance  furnished  under
    18  this title to eligible Indians and members of their families residing on
    19  any  Indian reservation in this state, and for the administration there-
    20  of, after first deducting therefrom any federal funds properly  received
    21  or to be received on account thereof;
    22    (d)  the  full  amount expended for medical assistance furnished under
    23  this title to other eligible persons, and for the administration  there-
    24  of,  after first deducting therefrom any federal funds properly received
    25  or to be received on account thereof including:
    26    (i) the development of medical assistance data systems;
    27    (ii) medical assistance furnished to persons described in  subdivision
    28  five of section three hundred sixty-five of this title;
    29    (iii) the following services: care, treatment, maintenance and nursing
    30  services in nursing homes and health related care and services in inter-
    31  mediate  care  facilities  provided  in accordance with paragraph (b) of
    32  subdivision two of section three hundred  sixty-five-a  of  this  title;
    33  home health services provided in accordance with paragraph (d) of subdi-
    34  vision two of section three hundred sixty-five-a of this title; personal
    35  care  services  provided in accordance with paragraph (e) of subdivision
    36  two of section three hundred sixty-five-a of this title; long term  home
    37  health  care programs services provided in accordance with section three
    38  hundred sixty-seven-c of this title; and  nursing  home  transition  and
    39  diversion  services  provided  in  accordance  with subdivision six-a of
    40  section three hundred sixty-six of this title;
    41    (iv) medical assistance for those individuals who are eligible  pursu-
    42  ant  to section three hundred sixty-six of this article as a result of a
    43  mental disability as determined by the commissioner in consultation with
    44  the commissioner of the office of mental health and the commissioner  of
    45  the  office  for  people  with  developmental  disabilities and with the
    46  approval of the director of the budget;
    47    (v) medical assistance furnished to persons described  in  subdivision
    48  eight of section three hundred sixty-five of this article, including the
    49  administration thereof;
    50    (vi)  reimbursements  for  the  care  and  services  provided to those
    51  persons eligible pursuant to subparagraphs seven  of  paragraph  (a)  of
    52  subdivision one of section three hundred sixty-six of this title;
    53    (vii)  payments  made,  whether by the department on behalf of a local
    54  social services district pursuant to section three hundred sixty-seven-b
    55  of this article or by a local social services district directly,  for  a
    56  supplementary bad debt and charity care adjustment component of rates of

        A. 5802                             3
     1  payment  determined in accordance with subdivision fourteen-a of section
     2  twenty-eight hundred seven-c of the public health law for general hospi-
     3  tal inpatient hospital services provided in  accordance  with  paragraph
     4  (b)  of  subdivision  two  of section three hundred sixty-five-a of this
     5  article, limited to the amount of federal funds properly received or  to
     6  be  received  on  account  of such expenditures; provided, however, that
     7  reimbursement shall be made by the state for the  full  amount  expended
     8  for  a  supplementary bad debt and charity care adjustment for a general
     9  hospital operated by the state of New York or by the state university of
    10  New York;
    11    (viii) payments made for a supplementary low income patient adjustment
    12  component of rates of payment for a public general  hospital  determined
    13  in  accordance  with  subdivision  fourteen-d  of  section  twenty-eight
    14  hundred seven-c of the public health law for general hospital  inpatient
    15  hospital  services provided in accordance with paragraph (b) of subdivi-
    16  sion two of section three hundred sixty-five-a of this article,  limited
    17  to  the  amount  of federal funds properly received or to be received on
    18  account of such  expenditures;  provided,  however,  that  reimbursement
    19  shall be made by the state for the full amount expended for a supplemen-
    20  tary  low  income  patient adjustment for a general hospital operated by
    21  the state of New York or by the state university of New York;
    22    (ix) medical assistance furnished under this title to eligible persons
    23  pursuant to a statewide managed care plan or managed care  demonstration
    24  program,  or  to  eligible  persons  enrolled  in any health maintenance
    25  organization or other entity authorized by law to furnish  comprehensive
    26  health services pursuant to a plan;
    27    (x)  payments made for the component of rates of payment for a general
    28  hospital determined in accordance  with  paragraph  (s)  of  subdivision
    29  eleven  of section twenty-eight hundred seven-c of the public health law
    30  for general hospital inpatient hospital services provided in  accordance
    31  with  paragraph  (b)  of subdivision two of section three hundred sixty-
    32  five-a of this article;
    33    (xi) payments made for a public general hospital indigent care adjust-
    34  ment payment for a public general hospital determined in accordance with
    35  subdivision fourteen-f of section twenty-eight hundred  seven-c  of  the
    36  public  health  law  for  general  hospital  inpatient hospital services
    37  provided in accordance with paragraph (b) of subdivision two of  section
    38  three  hundred  sixty-five-a  of  this article, limited to the amount of
    39  federal funds properly received or to be received  on  account  of  such
    40  expenditures; provided, however, that reimbursement shall be made by the
    41  state  for  the full amount expended for a public general hospital indi-
    42  gent care adjustment for a general hospital operated by the state of New
    43  York or by the state university of New York;
    44    (xii) health care services as determined in accordance with  paragraph
    45  (c)  of  subdivision  ten of section twenty-eight hundred seven-d of the
    46  public health law; and
    47    (xiii) health  care  services  described  in  sections  three  hundred
    48  sixty-eight-d and three hundred sixty-eight-e of this title.
    49    2.  (a)  For  the  purpose  of  state  reimbursement under this title,
    50  expenditures for administration of medical assistance for needy  persons
    51  shall  include  expenditures  for salaries of employees of local welfare
    52  departments, except for those  excluded  under  paragraph  (b)  of  this
    53  subdivision;  operation,  maintenance  and service costs; and such other
    54  expenditures, such as equipment costs, depreciation charges, and  rental
    55  values,  as  may  be  approved by the department.   It shall not include
    56  expenditures for capital additions or improvements.

        A. 5802                             4
     1    (b) State reimbursement shall not be made for any part of  the  salary
     2  of  a social services official, or a chief executive officer of a social
     3  services department, whose qualifications do not conform to those  fixed
     4  by  the  department,  or  a city or town service officer; nor shall such
     5  reimbursement  be made on the salary of a deputy commissioner, or deputy
     6  director or an employee, unless his  employment  is  necessary  for  the
     7  administration  of  medical assistance and his qualifications conform to
     8  those fixed by the department.
     9    (c) State reimbursement shall not be made for any part of  the  salary
    10  of  a  local medical director appointed after the effective date of this
    11  section whose qualifications do not conform to those established  pursu-
    12  ant to section three hundred sixty-four of this title.
    13    (d)  State reimbursement shall not be made for any part of the cost of
    14  those items of care, services, supplies and equipment, and  drugs  which
    15  represent  co-payment amounts for which a provider of medical assistance
    16  is authorized to charge a recipient in accordance with  subdivision  six
    17  of section three hundred sixty-seven-a of this article.
    18    3.  (a)  Claims for state reimbursement shall be made in such form and
    19  manner and at such times and for such periods as  the  department  shall
    20  determine.
    21    (b)  When  certified  by  the department, state reimbursement shall be
    22  paid from the state treasury upon the audit and  warrant  of  the  comp-
    23  troller out of funds made available therefor.
    24    (c) When the moneys allotted to the state by the federal department of
    25  health, education and welfare or other authorized federal agency for any
    26  quarter  shall  have  been  received  by  the department of taxation and
    27  finance, the department shall, as soon as possible, certify to the comp-
    28  troller the amount to which each public welfare district is entitled for
    29  such quarter and such amount shall be paid out  of  the  state  treasury
    30  after  audit  by  the  comptroller  to  the  respective  public  welfare
    31  districts.
    32    (d) The department is authorized in its discretion to make advances to
    33  public welfare districts in  anticipation  of  the  state  reimbursement
    34  provided for in this section.
    35    4.  Payment  of  state reimbursement and advances shall be made to the
    36  fiscal officer of the public welfare district entitled thereto  pursuant
    37  to the provisions of this chapter.
    38    § 2. Section 368-b of the social services law, as added by chapter 256
    39  of the laws of 1966, is amended to read as follows:
    40    §  368-b.  State reimbursement to local health districts; chargebacks.
    41  1.  Each approved local health district which  enters  into  a  contract
    42  with  the  department of health pursuant to section three hundred sixty-
    43  four-a of this title shall submit to the department of health a quarter-
    44  ly report of expenditures for administrative expenses  incurred  in  the
    45  performance  of  such  contract.   The department of health shall review
    46  such expenditures and, upon approval, shall submit  the  report  to  the
    47  department.    Upon receipt of such approved report, there shall be paid
    48  to each such district
    49    (a) the amount of federal funds, if any, properly received  or  to  be
    50  received on account of such expenditures; and
    51    (b)  [fifty]  one  hundred  per centum of the amount expended for such
    52  administrative expenses, after first  deducting  therefrom  any  federal
    53  funds properly received or to be received on account thereof.
    54    2.  The  department  of  health shall submit a quarterly report to the
    55  department of expenditures for administrative expenses incurred by  each
    56  of  the  state  health  districts  in the performance of the cooperative

        A. 5802                             5
     1  agreement entered into pursuant to section three hundred sixty-four-a of
     2  this title. Upon receipt of such report, the department shall deduct the
     3  amount of federal funds, if any, properly received or to be received  on
     4  account  of  such  expenditures from the total amounts reported for each
     5  such district [Fifty]. One hundred per centum of the  balance  shall  be
     6  apportioned  among  the public welfare districts served by such district
     7  [in the ratio that the total expenditures by each  such  public  welfare
     8  district  for medical assistance for needy persons for the quarter bears
     9  to the total expenditures by all such public welfare districts for  such
    10  quarter.    The  proportionate  share  shall  be  deducted from the next
    11  payment due each of such public welfare districts  pursuant  to  section
    12  three hundred sixty-eight-a of this title].
    13    §  3.  The  commissioners of the department of family assistance shall
    14  study and  propose  all  necessary  legislative  adjustments  needed  to
    15  correct erroneous references throughout the social services law necessi-
    16  tated through this act.
    17    §  4.  State  assumption  of  non-federal  share  Medicaid  costs.  1.
    18  Notwithstanding any other provision of law, the state shall  assume  one
    19  hundred  percent  of  the non-federal share of Medicaid costs by January
    20  first, two thousand twenty-two.
    21    2. (a) Commencing state fiscal year two thousand  eighteen  the  local
    22  share/county  share  of  Medicaid  costs  expended  through  the medical
    23  assistance amount for social services  districts  shall  be  reduced  by
    24  twenty percent under the year 2017 expenditure.
    25    (b)  Commencing  state  fiscal  year  two  thousand nineteen the local
    26  share/county share  of  Medicaid  costs  expended  through  the  medical
    27  assistance  amount  for  social  services  districts shall be reduced by
    28  forty percent under the year 2017 expenditure.
    29    (c) Commencing  state  fiscal  year  two  thousand  twenty  the  local
    30  share/county  share  of  Medicaid  costs  expended  through  the medical
    31  assistance amount for social services  districts  shall  be  reduced  by
    32  sixty percent under the year 2017 expenditure.
    33    (d)  Commencing  state  fiscal  year two thousand twenty-one the local
    34  share/county share  of  Medicaid  costs  expended  through  the  medical
    35  assistance  amount  for  social  services  districts shall be reduced by
    36  eighty percent under the year 2017 expenditure.
    37    (e) Commencing state fiscal year two  thousand  twenty-two  the  local
    38  share/county  share  of  Medicaid  costs  expended  through  the medical
    39  assistance amount for social services districts shall be reduced by  one
    40  hundred percent under the year 2017 expenditure.
    41    (f)  The  state by and through the governor may choose to override the
    42  cap established in this section after the year two thousand  twenty-two,
    43  however, any increases to expenditures approved by the governor shall be
    44  funded through the state budget.
    45    (g)  As used in this section the following term shall have the follow-
    46  ing meaning: "Local share/county share" shall mean the  portion  of  any
    47  expenses  covered  by  counties  for  the  administration,  benefits and
    48  service provided under the state's Medicaid program.
    49    § 5. This act shall take effect April 1, 2018.
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