Bill Text: NY A05980 | 2023-2024 | General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Provides for automatic enrollment and recertification simplification for Medicaid managed care plans and long term care plans.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced) 2024-04-02 - amended by restoring to previous print 5980a [A05980 Detail]

Download: New_York-2023-A05980-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         5980--A

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                     March 24, 2023
                                       ___________

        Introduced  by  M.  of A. PAULIN, DINOWITZ, BICHOTTE HERMELYN, SAYEGH --
          read once and referred to the Committee  on  Health  --  reported  and
          referred  to  the Committee on Ways and Means -- committee discharged,
          bill amended, ordered reprinted as amended  and  recommitted  to  said
          committee

        AN  ACT  to  amend the public health law and the social services law, in
          relation to automatic enrollment  and  recertification  simplification
          for Medicaid eligible recipients

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Paragraph (b) of subdivision 7 of  section  4403-f  of  the
     2  public  health  law is amended by adding a new subparagraph (iv) to read
     3  as follows:
     4    (iv) Where a person determined eligible for Medicaid ("Medicaid recip-
     5  ient") has been determined by the commissioner or his or her designee to
     6  require community-based long term care services for more than a  contin-
     7  uous  period  of one hundred twenty days, and the Medicaid recipient has
     8  not selected and enrolled in a managed long term care plan prior to  any
     9  expiration  date of such determination of need for long term care, after
    10  being provided with information to make an informed choice, the  commis-
    11  sioner  shall  assign  the  recipient  to a managed long term care plan,
    12  taking into account consistency with any  prior  community-based  direct
    13  care  workers  having recently served the recipient, quality performance
    14  criteria, capacity, and geographic accessibility.  The commissioner  may
    15  assign  participants  pursuant  to such criteria on a weighted basis.  A
    16  recipient assigned to a managed long term care plan under this  subpara-
    17  graph shall be deemed to have been determined to be in need of long term
    18  care  services  for  more than a continuous period of one hundred twenty
    19  days and eligible to be enrolled in a managed long term care plan.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02420-04-3
        A. 5980--A                          2

     1    § 2. Paragraph (b) of subdivision 2 of section  366-a  of  the  social
     2  services  law, as added by section 51 of part A of chapter 1 of the laws
     3  of 2002, is amended to read as follows:
     4    (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
     5  sion, an applicant or recipient may attest to the amount of his  or  her
     6  accumulated  resources,  unless  such  applicant or recipient is seeking
     7  medical assistance payment for long term care  services  for  the  first
     8  time.  A  recipient  who has already provided documentation of resources
     9  may attest to the amount of accumulated resources if it has remained the
    10  same or is less than the amount originally documented.  For purposes  of
    11  this  paragraph,  long  term  care  services shall mean care, treatment,
    12  maintenance, and services described in paragraph (b) of subdivision  [1]
    13  one  of  section  three  hundred  sixty-seven-f  of this title, with the
    14  exception of short term rehabilitation, as defined by  the  commissioner
    15  of health.
    16    §  3.  Paragraph  (d)  of subdivision 5 of section 366-a of the social
    17  services law, as amended by section 12 of part D of chapter  56  of  the
    18  laws  of 2013, is relettered paragraph (e) and three new paragraphs (f),
    19  (g) and (h) are added to read as follows:
    20    (f) Notwithstanding paragraph (b) of subdivision two of  this  section
    21  and  paragraphs (a), (b), (c) and (d) of this subdivision, the following
    22  recipients will be recertified automatically, unless there  has  been  a
    23  finding of lack of eligibility for Medicaid:
    24    (i)  enrollees  in Medicaid managed long term care plans as defined in
    25  section forty-four hundred three-f of the public health law;
    26    (ii) enrollees in Medicaid managed care plans as  defined  in  section
    27  three  hundred  sixty-four-j  of  this  title  who receive personal care
    28  services pursuant to paragraph (e) of subdivision two of  section  three
    29  hundred sixty-five-a of this title or consumer directed personal assist-
    30  ance  services  pursuant  to  section three hundred sixty-five-f of this
    31  title;
    32    (iii) enrollees receiving Medicaid in the  Aged,  Blind  and  Disabled
    33  category  who  receive  fixed  income  from the Social Security Adminis-
    34  tration (SSA); and
    35    (iv) Medicare Savings Program (MSP) recipients who have a fixed income
    36  from the Social Security Administration (SSA).
    37    (g) Nothing in paragraph (e) of this subdivision should  be  construed
    38  to  alter a Medicaid recipient's obligation to inform the public welfare
    39  district of changes in income or other factors that might impact  eligi-
    40  bility pursuant to subdivision four of this section.
    41    (h)  Upon  a  finding of lack of eligibility, recipients identified in
    42  paragraph (e) of this subdivision will be entitled to notice and hearing
    43  rights as provided in section twenty-two of this chapter.
    44    § 4. This act shall take effect on the one hundred eightieth day after
    45  it shall have become a law; provided that the  amendments  to  paragraph
    46  (b)  of subdivision 7 of section 4403-f of the public health law made by
    47  section one of this act shall be subject to the expiration and reversion
    48  of such paragraph and shall expire and be deemed repealed therewith  and
    49  provided  further  that  such  amendments shall not affect the repeal of
    50  such section and shall expire and be deemed repealed  therewith.  Effec-
    51  tive  immediately, the commissioner of health shall make regulations and
    52  take other actions reasonably necessary to implement this  act  on  that
    53  date.  Provided,  further, that sections two and three of this act shall
    54  only take effect when the  federal  center  for  Medicaid  and  Medicare
    55  services  (CMS)  approves in writing to the state commissioner of health
    56  that the changes do not affect federal financial participation; provided
        A. 5980--A                          3

     1  that the commissioner of health shall notify the legislative bill draft-
     2  ing commission upon the occurrence of the enactment of  the  legislation
     3  provided  for  in  sections  two and three of this act in order that the
     4  commission  may  maintain  an accurate and timely effective data base of
     5  the official text of the laws of the state of New York in furtherance of
     6  effectuating the provisions of section 44 of  the  legislative  law  and
     7  section 70-b of the public officers law.