Bill Text: NY S02007 | 2015-2016 | General Assembly | Amended
Bill Title: Amends various provisions to achieve statutory savings; makes changes necessary to continue implementation of Medicaid redesign team recommendations; makes statutory changes necessary to align child health plus rates with Medicaid managed care rates for certain providers; extend various provisions of public health social services and mental hygiene laws, including continued authorization of previously enacted Medicaid savings initiatives; makes statutory changes necessary related to payments of indigent care pool funds for uncompensated care for three years; makes statutory changes necessary to implement value based payments within the delivery system reform incentive payment programs; makes statutory changes necessary to establish an assessment on individual small group and large group health insurers that will sustain New York state of health operations; modifies provisions regarding establishing an operating limited services clinics, standardizing urgent care centers, eliminating certain upgraded diagnostic and treatment centers and charging the public health and health planning council with reviewing sedation and anesthesia procedures in outpatient settings; modifies various provisions of law to remove barriers to obtaining HIV/AIDS treatment and to engaging in appropriate risk reduction activities to limit the spread of HIV/AIDS; provides an exemption to the nurse practice act for advanced home health aides to authorize such individuals to perform advanced tasks in home care and hospice settings with appropriate training and supervision; implements various provisions related to streamlining the certificate of need process for hospitals and diagnostic treatment centers; modifies various provisions of the public health law to expand office-based surgery requirements to include office-based anesthesia, to standardize and limit the procedures permitted in such settings and to strengthen accreditation requirements; requires local governments to notify the public and the department of health of their intent to discontinue water fluoridation and to establish a grant program to provide assistance to local governments to cover the costs of installing, replacing, repairing or upgrading water fluoridation equipment; authorizes state office for the aging to seek public input on the creation of an office of community living to address the expansion of community living integration services for older adults and disabled individuals; authorizes OMH to continue to recover Medicaid exempt income from providers of community residences; extends pilot program to restructure educational services for children and youth residing in OMH hospitals; establishes a private equity pilot program allowing up to five business corporations to make private capital investments to assist in restructuring health care delivery systems; authorizes OMH facility directors who act as representative payees to continue to use funds for care and treatment consistent with federal law and regulations; makes technical amendments required to implement the expansion of the nurse practice act exemption for direct care staff in non-certified settings funding, authorized or approved by OPWDD; relates to time limited demonstration programs; relates to rates and fees for OPWDD providers; relates to opioid overdose prevention; relates to HCRA; extends risk based capital provisions; and relates to excess medical malpractice.
Spectrum: Committee Bill
Status: (Introduced - Dead) 2015-03-30 - SUBSTITUTED BY A3007B [S02007 Detail]
Download: New_York-2015-S02007-Amended.html
S T A T E O F N E W Y O R K
________________________________________________________________________
S. 2007--B A. 3007--B
S E N A T E - A S S E M B L Y
January 21, 2015
___________
IN SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
cle seven of the Constitution -- read twice and ordered printed, and
when printed to be committed to the Committee on Finance -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
IN ASSEMBLY -- A BUDGET BILL, submitted by the Governor pursuant to
article seven of the Constitution -- read once and referred to the
Committee on Ways and Means -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee --
again reported from said committee with amendments, ordered reprinted
as amended and recommitted to said committee
AN ACT to amend the public health law, in relation to physician
profiles; to amend part X2 of chapter 62 of the laws of 2003, amending
the public health law relating to allowing for the use of funds of the
office of professional medical conduct for activities of the patient
health information and quality improvement act of 2000, in relation to
extending the provisions thereof; to amend the social services law, in
relation to enhancing the quality of adult living program for adult
care facilities; to amend the education law, in relation to delivery
of prescriptions off premises of a pharmacy; to amend the public
health law, in relation to providing more accountability in expendi-
tures made by the Statewide Health Information Network for New York
(SHIN-NY), including information on donating umbilical cord blood as
part of the health care and wellness education and outreach program;
to amend part A of chapter 58 of the laws of 2008, amending the elder
law and other laws relating to reimbursement to participating provider
pharmacies and prescription drug coverage, in relation to extending
the expiration of certain provisions thereof; to repeal paragraph (e)
of subdivision 13 of section 2995-a of the public health law relating
to physician profiles; and to repeal section 2801-h of the public
health law relating to the community forum on establishment of certain
facilities in the county of Bronx; and providing for the repeal of
certain provisions upon expiration thereof (Part A); to amend the
social services law, in relation to supplemental rebates; to amend
part H of chapter 59 of the laws of 2011, amending the public health
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD12571-03-5
S. 2007--B 2 A. 3007--B
law and other laws relating to known and projected department of
health state fund medical expenditures, in relation to extending the
provisions thereof; to repeal section 280 of the public health law
relating to prescription drug discount program; to amend the public
health law, in relation to hospital reimbursement provisions and
temporary adjustments to reimbursement rates; to amend the social
services law, in relation to exceptions to copayments; to amend part A
and part B of chapter 1 of the laws of 2002, relating to the health
care reform act of 2000, in relation to upper payment limits; to amend
the public health law, in relation to reimbursement rate promulgation
for residential health care facilities; to amend the public health
law, in relation to project advisory committees; to amend the social
services law, in relation to grants for coordination between health
homes and the criminal justice system and for the integration of
information of health homes with state and local correctional facili-
ties; to amend the social services law, in relation to basic health
program and rates of payment; to amend part B of chapter 59 of the
laws of 2011, amending the public health law relating to rates of
payment and medical assistance, in relation to managed care supple-
mental payments; in relation to part H of chapter 59 of the laws of
2011, amending the public health law relating to general hospital
inpatient reimbursement for annual rates, in relation to supplemental
Medicaid managed care payments; to amend the social services law, in
relation to spousal support; to amend the social services law, in
relation to temporary preinvestigation emergency needs assistance or
care; to amend the social services law, in relation to supplies and
the medical assistance presumptive eligibility program; to amend the
social services law, in relation to personal care services and adequa-
cy of assistance; to amend the social services law, in relation to
expedited procedures for approving personal care services; to amend
the social services law, in relation to expedited procedures for
determining medical assistance eligibility; in relation to monies
equal to the amount of enhanced federal medical assistance percentage
monies available as a result of the state's participation in the
community first choice state plan option; to amend the public health
law, in relation to an energy audit and/or disaster preparedness
review of residential health care facilities; to amend the public
health law, in relation to payment rates for managed long term care
plan enrollees eligible for medical assistance; to amend the social
services law, in relation to reimbursement methodologies for managed
care programs; to amend the social services law, in relation to insur-
ance payments; to amend the social services law, in relation to eligi-
bility; to amend the social services law, in relation to transition to
managed care; to amend the social services law, in relation to cover-
age of certain noncitizens; to amend the social services law, in
relation to basic health program and eligibility of a non-citizen in a
valid nonimmigrant status; to repeal section 365-d of the social
services law, relating to early and periodic screening diagnosis and
treatment outreach demonstration projects; to amend the social
services law, in relation to the Medicaid evidence based benefit
review advisory committee; to amend the social services law, in
relation to the young adult special populations demonstration program;
in relation to amending the public health law, in relation to the
hospital-home care - physician collaboration program; to amend the
public health law, in relation to universal standards for coding of
payment for medical assistance claims for long term care and electron-
S. 2007--B 3 A. 3007--B
ic payment of claims; to amend the social services law, in relation to
provision and reimbursement of transportation costs; to amend the
public health law, in relation to temporary adjustment to reimburse-
ment rates; to amend the public health law, in relation to residential
health care facilities and rates of payment; to amend the social
services law, in relation to the long term care demonstration program;
to repeal paragraph (e) of subdivision 8 of section 2511 of the public
health law relating to subsidy payments; to amend the social services
law, in relation to managed care programs and complete actuarial memo-
randum; to amend part B of chapter 58 of the laws of 2007 amending the
elder law and other laws, relating to authorizing the adjustment of
the Medical nursing home capital reimbursement cap, in relation to
effectuating a residential health care facility construction project
by the Jewish Home of Rochester; to repeal certain provisions of the
public health law relating thereto; and providing for the repeal of
certain provisions upon expiration thereof (Part B); to amend part A
of chapter 56 of the laws of 2013 amending chapter 59 of the laws of
2011 amending the public health law and other laws relating to general
hospital reimbursement for annual rates relating to the cap on local
Medicaid expenditures, in relation to rates of payment paid to certain
providers by the Child Health Plus Program; and to amend chapter 111
of the laws of 2010 relating to increasing Medicaid payments to
providers through managed care organizations and providing equivalent
fees through an ambulatory patient group methodology, in relation to
rates of payment paid to certain providers by the Child Health Plus
Program (Part C); to amend chapter 884 of the laws of 1990, amending
the public health law relating to authorizing bad debt and charity
care allowances for certified home health agencies, in relation to the
effectiveness thereof; to amend chapter 81 of the laws of 1995, amend-
ing the public health law and other laws relating to medical
reimbursement and welfare reform, in relation to the effectiveness
thereof; to amend the public health law, in relation to hospital
assessments; to amend chapter 659 of the laws of 1997, constituting
the long term care integration and finance act of 1997, in relation to
the effectiveness thereof; to amend chapter 474 of the laws of 1996,
amending the education law and other laws relating to rates for resi-
dential health care facilities, in relation to the effectiveness ther-
eof; to amend part C of chapter 58 of the laws of 2007, amending the
social services law and other laws relating to enacting the major
components of legislation necessary to implement the health and mental
hygiene budget for the 2007-2008 state fiscal year, in relation to
delay of certain administrative costs; to amend chapter 81 of the laws
of 1995, amending the public health law and other laws relating to
medical reimbursement and welfare reform, in relation to reimburse-
ments and the effectiveness thereof; to amend chapter 474 of the laws
of 1996, amending the education law and other laws relating to rates
for residential healthcare facilities, in relation to reimbursements;
to amend chapter 451 of the laws of 2007, amending the public health
law, the social services law and the insurance law, relating to
providing enhanced consumer and provider protections, in relation to
the effectiveness thereof; to amend the public health law, in relation
to rates of payment for long term home health care programs and making
such provisions permanent; to amend chapter 303 of the laws of 1999,
amending the New York state medical care facilities finance agency act
relating to financing health facilities, in relation to the effective-
ness thereof; to amend chapter 165 of the laws of 1991, amending the
S. 2007--B 4 A. 3007--B
public health law and other laws relating to establishing payments for
medical assistance, in relation to the effectiveness thereof; to amend
the public authorities law, in relation to the transfer of certain
funds; to amend subdivision (i) of section 111 of part H of chapter 59
of the laws of 2011, relating to enacting into law major components of
legislation necessary to implement the health and mental hygiene budg-
et for the 2011-2012 state fiscal plan, in relation to the effective-
ness of program oversight and administration of managed long term care
plans; to amend chapter 659 of the laws of 1997, amending the public
health law and other laws relating to creation of continuing care
retirement communities, in relation to the effectiveness thereof; to
amend the public health law, in relation to residential health care
facility, and certified home health agency services payments; to amend
part B of chapter 109 of the laws of 2010, amending the social
services law relating to transportation costs; to amend the social
services law, in relation to contracting for transportation services;
to amend chapter 459 of the laws of 1996 amending the public health
law relating to recertification of persons providing emergency medical
care, in relation to making such provisions permanent; to amend chap-
ter 505 of the laws of 1995, amending the public health law relating
to the operation of department of health facilities, in relation to
extending the provisions thereof; to amend subdivision (o) of section
111 of part H of chapter 59 of the laws of 2011, amending the public
health law relating to state wide planning and research cooperative
system and general powers and duties, in relation to the effectiveness
of certain provisions; and to amend chapter 56 of the laws of 2013
amending chapter 59 of the laws of 2011 amending the public health law
and other laws relating to general hospital reimbursement for annual
rates relating to the cap on local Medicaid expenditures, in relation
to extending the provisions of such chapter (Part D); to amend the
public health law, in relation to the payment of certain funds for
uncompensated care (Part E); Intentionally omitted (Part F); Inten-
tionally omitted (Part G); Intentionally omitted (Part H); to amend
the criminal procedure law, in relation to the admissibility of
condoms as trial evidence of prosecution; to amend the penal law, in
relation to criminal possession of a controlled substance; and to
repeal subdivision 2-a of section 2781 of the public health law,
relating to certain informed consent for HIV related testing (Part I);
Intentionally omitted (Part J); to amend the public health law, in
relation to improper delegation of authority by the governing authori-
ty or operator of a general hospital (Part K); to amend the public
health law, in relation to the enhanced oversight of office-based
surgery (Part L); to amend the public health law, in relation to
requiring notice and submission of a plan prior to discontinuing fluo-
ridation of a public water supply (Part M); relating to conducting a
study to develop a report addressing the feasibility of creating an
office of community living for older adults and individuals of all
ages with disabilities (Part N); Intentionally omitted (Part O);
Intentionally omitted (Part P); Intentionally omitted (Part Q); Inten-
tionally omitted (Part R); Intentionally omitted (Part S); Inten-
tionally omitted (Part T); Intentionally omitted (Part U); to amend
the public health law and the education law, in relation to opioid
overdose prevention (Part V); to amend the public health law, in
relation to requiring the commissioner of health to provide certain
records to the temporary president of the senate and the speaker of
the assembly; requiring the commissioner of health to convene a task
S. 2007--B 5 A. 3007--B
force to evaluate and make recommendations related to increasing the
transparency and accountability of the health care reform act
resources fund; and to amend the public health law, in relation to
physician loan repayment awards (Part W); to amend the insurance law,
in relation to an exemption to certain provisions of law relating to
risk-based capital for property/casualty insurance companies (Part X);
and to amend chapter 266 of the laws of 1986 amending the civil prac-
tice law and rules and other laws relating to malpractice and profes-
sional medical conduct; and to amend part J of chapter 63 of the laws
of 2001 amending chapter 266 of the laws of 1986, amending the civil
practice law and rules and other laws relating to malpractice and
professional medical conduct, in relation to extending certain
provisions concerning the hospital excess liability pool and requiring
a tax clearance for doctors and dentists to be eligible for such
excess coverage (Part Y)
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. This act enacts into law major components of legislation
2 which are necessary to implement the state fiscal plan for the 2015-2016
3 state fiscal year. Each component is wholly contained within a Part
4 identified as Parts A through Y. The effective date for each particular
5 provision contained within such Part is set forth in the last section of
6 such Part. Any provision in any section contained within a Part, includ-
7 ing the effective date of the Part, which makes a reference to a section
8 "of this act", when used in connection with that particular component,
9 shall be deemed to mean and refer to the corresponding section of the
10 Part in which it is found. Section three of this act sets forth the
11 general effective date of this act.
12 PART A
13 Section 1. Paragraph (h) of subdivision 1 of section 2995-a of the
14 public health law, as added by chapter 542 of the laws of 2000, is
15 amended to read as follows:
16 (h) current [speciality] SPECIALTY board certification and date of
17 certification;
18 S 2. The opening paragraph of subdivision 1-a of section 2995-a of the
19 public health law, as added by section 8 of part A of chapter 58 of the
20 laws of 2010, is amended to read as follows:
21 Each physician licensed and registered to practice in this state shall
22 within [one hundred twenty] THIRTY days of the [effective date of this
23 subdivision] TRANSMITTAL OF AN INITIAL PROFILE SURVEY and upon entering
24 or updating his or her profile information:
25 S 3. Subdivisions 3, 4 and 9 of section 2995-a of the public health
26 law, subdivisions 3 and 9 as added by chapter 542 of the laws of 2000,
27 and subdivision 4 as amended by chapter 477 of the laws of 2008, are
28 amended to read as follows:
29 3. Each physician who is self-insured for professional medical malp-
30 ractice shall periodically report to the department on forms and in the
31 time and manner required by the commissioner the information specified
32 in paragraph [(f)] (E) of subdivision one of this section, except that
33 the physician shall report the dollar amount (to the extent of the
S. 2007--B 6 A. 3007--B
1 physician's information and belief) for each judgment, award and settle-
2 ment and not a level of significance or context.
3 4. Each physician shall periodically report to the department on forms
4 and in the time and manner required by the commissioner any other infor-
5 mation as is required by the department for the development of profiles
6 under this section which is not otherwise reasonably obtainable. In
7 addition to such periodic reports and providing the same information,
8 each physician shall update his or her profile information within the
9 six months prior to the expiration date of such physician's registration
10 period, as a condition of registration renewal under article one hundred
11 thirty-one of the education law. EXCEPT FOR OPTIONAL INFORMATION
12 PROVIDED, PHYSICIANS SHALL NOTIFY THE DEPARTMENT OF ANY CHANGE IN THE
13 PROFILE INFORMATION WITHIN THIRTY DAYS OF SUCH CHANGE.
14 9. The department shall, in addition to hard copy physician profiles,
15 provide for electronic access to and copying of physician profiles
16 developed pursuant to this section through the system commonly known as
17 the Internet. THE DEPARTMENT SHALL UPDATE A PHYSICIAN'S ONLINE PROFILE
18 WITHIN THIRTY DAYS OF RECEIPT OF A COMPLETED PHYSICIAN PROFILE SURVEY OR
19 ANY CHANGE IN PROFILE INFORMATION.
20 S 4. Paragraphs (a) and (d) of subdivision 13 of section 2995-a of the
21 public health law, as added by chapter 542 of the laws of 2000, are
22 amended to read as follows:
23 (a) Data sources. The department shall identify the types of physician
24 data to which the public has access, including all information available
25 from federal, state or local agencies which is useful for making deter-
26 minations concerning health care quality determinations. The department
27 shall study all physician data reporting requirements and develop recom-
28 mendations to consolidate data collection and eliminate duplicate and
29 unnecessary reporting requirements, or to supplement existing reporting
30 requirements in order to satisfy the requirements of this section. THE
31 DEPARTMENT SHALL STUDY THE FEASIBILITY OF INCORPORATING HEALTH PLAN
32 REPORTING REQUIREMENTS, WITHOUT IMPOSING ANY EXTRA BURDEN ON THE PHYSI-
33 CIAN, REGARDING NETWORK PARTICIPATION INTO THIS SECTION TO ENSURE THIS
34 INFORMATION IS AVAILABLE, ACCURATE, UP-TO-DATE AND ACCESSIBLE TO CONSUM-
35 ERS.
36 (d) Report. The department shall provide a report of its determi-
37 nations and recommendations UNDER THIS SUBDIVISION to the governor and
38 legislature, and make such report publicly available, [within six months
39 of the effective date of this section] ON OR BEFORE JANUARY FIRST, TWO
40 THOUSAND SIXTEEN. THE DEPARTMENT SHALL REPORT ANNUALLY THEREAFTER TO
41 THE LEGISLATURE ON THE STATUS OF THE PHYSICIAN PROFILES AND ANY RECOM-
42 MENDATIONS FOR ADDITIONS, CONSOLIDATIONS OR OTHER CHANGES DEEMED APPRO-
43 PRIATE.
44 S 4-a. Paragraph (e) of subdivision 13 of section 2995-a of the public
45 health law is REPEALED.
46 S 4-b. Section 4 of part X2 of chapter 62 of the laws of 2003, amend-
47 ing the public health law relating to allowing for the use of funds of
48 the office of professional medical conduct for activities of the patient
49 health information and quality improvement act of 2000, as amended by
50 section 25 of part B of chapter 56 of the laws of 2013, is amended to
51 read as follows:
52 S 4. This act shall take effect immediately; provided that the
53 provisions of section one of this act shall be deemed to have been in
54 full force and effect on and after April 1, 2003, and shall expire March
55 31, [2015] 2017 when upon such date the provisions of such section shall
56 be deemed repealed.
S. 2007--B 7 A. 3007--B
1 S 5. Intentionally omitted.
2 S 6. Subdivision 3 of section 461-s of the social services law, as
3 added by section 21 of part D of chapter 56 of the laws of 2012, is
4 amended and a new subdivision 4 is added to read as follows:
5 3. Prior to applying for EQUAL program funds, a facility shall receive
6 approval of its expenditure plan from the residents' council for the
7 facility. THE RESIDENTS' COUNCIL SHALL ADOPT A PROCESS TO IDENTIFY THE
8 PRIORITIES OF THE RESIDENTS FOR THE USE OF THE PROGRAM FUNDS AND DOCU-
9 MENT RESIDENTS' TOP PREFERENCES BY MEANS THAT MAY INCLUDE A VOTE OR
10 SURVEY. THE PLAN SHALL DETAIL HOW PROGRAM FUNDS WILL BE USED TO IMPROVE
11 THE PHYSICAL ENVIRONMENT OF THE FACILITY OR THE QUALITY OF CARE AND
12 SERVICES RENDERED TO RESIDENTS AND MAY INCLUDE, BUT NOT BE LIMITED TO,
13 STAFF TRAINING, AIR CONDITIONING IN RESIDENTS' AREAS, CLOTHING, IMPROVE-
14 MENTS IN FOOD QUALITY, FURNISHINGS, EQUIPMENT, SECURITY, AND MAINTENANCE
15 OR REPAIRS TO THE FACILITY. THE FACILITY'S APPLICATION FOR EQUAL PROGRAM
16 FUNDS SHALL INCLUDE A SIGNED ATTESTATION FROM THE PRESIDENT OR
17 CHAIR-PERSON OF THE RESIDENTS' COUNCIL OR, IN THE ABSENCE OF A RESI-
18 DENTS' COUNCIL, AT LEAST THREE RESIDENTS OF THE FACILITY, STATING THAT
19 THE APPLICATION REFLECTS THE PRIORITIES OF THE RESIDENTS OF THE FACILI-
20 TY. THE DEPARTMENT SHALL INVESTIGATE REPORTS OF RESIDENT ABUSE AND
21 RETALIATION RELATED TO PROGRAM APPLICATIONS AND EXPENDITURES.
22 4. EQUAL PROGRAM FUNDS SHALL NOT BE EXPENDED FOR A FACILITY'S DAILY
23 OPERATING EXPENSES, INCLUDING EMPLOYEE SALARIES OR BENEFITS, OR FOR
24 EXPENSES INCURRED RETROSPECTIVELY. EQUAL PROGRAM FUNDS MAY BE USED FOR
25 EXPENDITURES RELATED TO CORRECTIVE ACTION AS REQUIRED BY AN INSPECTION
26 REPORT, PROVIDED SUCH EXPENDITURE IS CONSISTENT WITH SUBDIVISION THREE
27 OF THIS SECTION.
28 S 7. The second undesignated paragraph of paragraph (a) of subdivision
29 2 of section 6810 of the education law, as added by chapter 413 of the
30 laws of 2014, is amended to read as follows:
31 A pharmacy registered with the department pursuant to section sixty-
32 eight hundred eight OR SIXTY-EIGHT HUNDRED EIGHT-B of this article may
33 not deliver a new or refilled prescription off premises without the
34 consent of the patient or an individual authorized to consent on the
35 patient's behalf. [Consent shall include one of the following:
36 (1) the patient or authorized individual's signature of acceptance of
37 each prescription delivered;
38 (2) the pharmacy may contact the patient or other authorized individ-
39 ual for consent to deliver and must document consent in the patient
40 record; or
41 (3) for pharmacies that administer refill reminder or medication
42 adherence programs and deliver off premises, if a signature is not
43 received on each prescription, then the refill reminder program or medi-
44 cation adherence program shall be an OPT-IN program that is updated with
45 patient consent every one hundred eighty days accompanied by a docu-
46 mented patient record review by a licensed pharmacist from the providing
47 pharmacy and the patient before continuation of medication delivery can
48 occur] FOR THE PURPOSES OF THIS SECTION, CONSENT MAY BE OBTAINED IN THE
49 SAME MANNER AND PROCESS BY WHICH CONSENT IS DEEMED ACCEPTABLE UNDER THE
50 FEDERAL MEDICARE PART D PROGRAM.
51 S 8. Subdivision 18-a of section 206 of the public health law, as
52 amended by section 11 of part A of chapter 58 of the laws of 2010, para-
53 graphs (b) and (d) as amended by section 16 of part A of chapter 60 of
54 the laws of 2014, paragraph (c) as amended by chapter 132 of the laws of
55 2014, is amended to read as follows:
S. 2007--B 8 A. 3007--B
1 18-a. [(a)] Health information technology demonstration program. (A)
2 (i) The commissioner is authorized to issue grant funding to one or more
3 organizations broadly representative of physicians licensed in this
4 state, from funds made available for the purpose of funding research and
5 demonstration projects under subparagraph (ii) of this paragraph
6 designed to promote the development of electronic health information
7 exchange technologies in order to facilitate the adoption of interopera-
8 ble health records.
9 (ii) Project funding shall be disbursed to projects pursuant to a
10 request for proposals based on criteria relating to promoting the effi-
11 cient and effective delivery of quality physician services. Demon-
12 stration projects eligible for funding under this paragraph shall
13 include, but not be limited to:
14 (A) efforts to incentivize electronic health record adoption;
15 (B) interconnection of physicians through regional collaborations;
16 (C) efforts to promote personalized health care and consumer choice;
17 (D) efforts to enhance health care outcomes and health status general-
18 ly through interoperable public health surveillance systems and stream-
19 lined quality monitoring.
20 (iii) The department shall issue a report to the governor, the tempo-
21 rary president of the senate and the speaker of the assembly within one
22 year following the issuance of the grants. Such report shall contain, at
23 a minimum, the following information: the demonstration projects imple-
24 mented pursuant to this paragraph, their date of implementation, their
25 costs and the appropriateness of a broader application of the health
26 information technology program to increase the quality and efficiency of
27 health care across the state.
28 (b) The commissioner shall:
29 (i) POST ON ITS WEBSITE BY SEPTEMBER FIRST, TWO THOUSAND FIFTEEN AND
30 QUARTERLY THEREAFTER, INFORMATION ON THE USES OF FUNDING IN SUPPORT OF
31 THE STATEWIDE HEALTH INFORMATION NETWORK OF NEW YORK (SHIN-NY), INCLUD-
32 ING HOW SUCH FUNDS MAY BE USED TO:
33 (A) SUPPORT HOSPITALS, PHYSICIANS, AND OTHER PROVIDERS IN THE ACHIEVE-
34 MENT OF FEDERAL MEANINGFUL USE REQUIREMENTS;
35 (B) SUPPORT DSRIP HEALTH INFORMATION EXCHANGE AND DATA REQUIREMENTS TO
36 HELP PERFORMING PROVIDER SYSTEMS AND THE STATE MEET DSRIP QUALITY GOALS;
37 AND
38 (C) INCREASE PARTICIPATION IN REGIONAL HEALTH INFORMATION ORGANIZA-
39 TIONS BY PROVIDERS AT REASONABLE COSTS TO THE PROVIDERS; AND
40 (II) convene a workgroup to:
41 (A) evaluate the state's health information technology infrastructure
42 and systems, as well as other related plans and projects designed to
43 make improvements or modifications to such infrastructure and systems
44 including, but not limited to, the all payor database (APD), the state
45 planning and research cooperative system (SPARCS), regional health
46 information organizations (RHIOs), the statewide health information
47 network of New York (SHIN-NY) and medical assistance eligibility
48 systems; and
49 (B) develop recommendations for the state to move toward a comprehen-
50 sive health claims and clinical database aimed at improving quality of
51 care, efficiency, cost of care and patient satisfaction available in a
52 self-sustainable, non-duplicative, interactive and interoperable manner
53 that ensures safeguards for privacy, confidentiality and security;
54 [(ii)] (III) submit [a] AN INTERIM report to the governor [and], the
55 temporary president of the senate and the speaker of the assembly, which
56 shall [fully consider the evaluation and recommendations of the work-
S. 2007--B 9 A. 3007--B
1 group] DETAIL THE CONCERNS AND ISSUES ASSOCIATED WITH ESTABLISHING THE
2 STATE'S HEALTH INFORMATION TECHNOLOGY INFRASTRUCTURE CONSIDERED BY THE
3 WORKGROUP, on or before December first, two thousand fourteen[.]; AND
4 [(iii)] (IV) SUBMIT A REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT
5 OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY, WHICH SHALL FULLY CONSID-
6 ER THE EVALUATION AND RECOMMENDATIONS OF THE WORKGROUP, ON OR BEFORE
7 DECEMBER FIRST, TWO THOUSAND FIFTEEN.
8 (c) The members of the workgroup shall include, at a minimum, three
9 members who represent RHIOs, two members employed by the department who
10 are involved in the development of the SHIN-NY and the APD, two members
11 who represent physicians, two members who represent hospitals, two
12 members who represent home care agencies, one member who represents
13 federally qualified health centers, ONE MEMBER WHO REPRESENTS COUNTY
14 HEALTH COMMISSIONERS, the chair of the senate health committee or his or
15 her designee, the chair of the assembly health committee or his or her
16 designee, and other individuals with expertise in matters relevant to
17 the charge of the workgroup.
18 (d) The commissioner may make such rules and regulations as may be
19 necessary to implement federal policies and disburse funds as required
20 by the American Recovery and Reinvestment Act of 2009 and to promote the
21 development of a self-sufficient SHIN-NY to enable widespread, non-du-
22 plicative interoperability among disparate health information systems,
23 including electronic health records, personal health records, health
24 care claims, payment and other administrative data, and public health
25 information systems, while protecting privacy and security. Such rules
26 and regulations shall include, but not be limited to, requirements for
27 organizations covered by 42 U.S.C. 17938 or any other organizations that
28 exchange health information through the SHIN-NY or any other statewide
29 health information system recommended by the workgroup. [The] IF THE
30 COMMISSIONER SEEKS TO PROMULGATE RULES AND REGULATIONS PRIOR TO ISSUANCE
31 OF THE REPORT IDENTIFIED IN SUBPARAGRAPH (IV) OF PARAGRAPH (B) OF THIS
32 SUBDIVISION, THE COMMISSIONER SHALL SUBMIT THE PROPOSED REGULATIONS TO
33 THE WORKGROUP FOR ITS INPUT. IF THE COMMISSIONER SEEKS TO PROMULGATE
34 RULES AND REGULATIONS AFTER THE ISSUANCE OF THE REPORT IDENTIFIED IN
35 SUCH SUBPARAGRAPH (IV) THEN THE commissioner shall consider the REPORT
36 AND recommendations of the workgroup. If the commissioner acts in a
37 manner inconsistent with the INPUT OR recommendations of the workgroup,
38 he or she shall provide the reasons therefor.
39 S 9. Intentionally omitted.
40 S 10. Section 206 of the public health law is amended by adding a new
41 subdivision 29 to read as follows:
42 29. THE COMMISSIONER SHALL PREPARE A REPORT ON THE IMPLEMENTATION OF
43 THE STATE HEALTH INNOVATION PLAN (SHIP) WHICH SHALL INCLUDE:
44 (1) THE RECOMMENDATIONS OF THE WORKGROUPS ESTABLISHED TO ASSIST THE
45 STATE IN IMPLEMENTATION OF THE SHIP;
46 (2) THE DEPARTMENT'S EFFORTS IN ADVANCING THE SHIP'S GOALS; AND
47 (3) INFORMATION ON THE EXPENDITURES OF THE STATE INNOVATION MODEL
48 GRANT.
49 THE REPORT SHALL BE SUBMITTED TO THE GOVERNOR, THE TEMPORARY PRESIDENT
50 OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, THE CHAIRS OF THE SENATE
51 HEALTH COMMITTEE AND ASSEMBLY HEALTH COMMITTEE ON OR BEFORE JANUARY
52 FIRST, TWO THOUSAND SIXTEEN AND ANNUALLY THEREAFTER.
53 S 11. Subdivision 1 of section 207 of the public health law is amended
54 by adding a new paragraph (k) to read as follows:
55 (K) DONATING UMBILICAL CORD BLOOD TO A PUBLIC CORD BLOOD BANK.
56 S 12. Section 2801-h of the public health law is REPEALED.
S. 2007--B 10 A. 3007--B
1 S 13. Section 32 of part A of chapter 58 of the laws of 2008, amending
2 the elder law and other laws relating to reimbursement to participating
3 provider pharmacies and prescription drug coverage, as amended by
4 section 37 of part A of chapter 60 of the laws of 2014, is amended to
5 read as follows:
6 S 32. This act shall take effect immediately and shall be deemed to
7 have been in full force and effect on and after April 1, 2008; provided
8 however, that sections one, six-a, nineteen, twenty, twenty-four, and
9 twenty-five of this act shall take effect July 1, 2008; provided however
10 that sections sixteen, seventeen and eighteen of this act shall expire
11 April 1, 2017; provided, however, that the amendments made by section
12 twenty-eight of this act shall take effect on the same date as section 1
13 of chapter 281 of the laws of 2007 takes effect; provided further, that
14 sections twenty-nine, thirty, and thirty-one of this act shall take
15 effect October 1, 2008; provided further, that section twenty-seven of
16 this act shall take effect January 1, 2009; and provided further, that
17 section twenty-seven of this act shall expire and be deemed repealed
18 March 31, [2015] 2017; and provided, further, however, that the amend-
19 ments to subdivision 1 of section 241 of the education law made by
20 section twenty-nine of this act shall not affect the expiration of such
21 subdivision and shall be deemed to expire therewith and provided that
22 the amendments to section 272 of the public health law made by section
23 thirty of this act shall not affect the repeal of such section and shall
24 be deemed repealed therewith.
25 S 14. This act shall take effect immediately; provided that the amend-
26 ments to paragraphs (b) and (d) of subdivision 18-a of section 206 of
27 the public health law, made by section eight of this act shall not
28 affect the expiration of such paragraphs and shall be deemed to expire
29 therewith; provided, however, that section ten of this act shall expire
30 March 31, 2020 when upon such date it shall be deemed repealed.
31 PART B
32 Section 1. Subdivision 7 of section 367-a of the social services law
33 is amended by adding a new paragraph (e) to read as follows:
34 (E) DURING THE PERIOD FROM APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH
35 MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN, THE COMMISSIONER MAY, IN
36 LIEU OF A MANAGED CARE PROVIDER, NEGOTIATE DIRECTLY AND ENTER INTO AN
37 AGREEMENT WITH A PHARMACEUTICAL MANUFACTURER FOR THE PROVISION OF
38 SUPPLEMENTAL REBATES RELATING TO PHARMACEUTICAL UTILIZATION BY ENROLLEES
39 OF MANAGED CARE PROVIDERS PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J
40 OF THIS TITLE. SUCH REBATES SHALL BE LIMITED TO DRUG UTILIZATION IN THE
41 FOLLOWING CLASSES: ANTIRETROVIRALS APPROVED BY THE FDA FOR THE TREATMENT
42 OF HIV/AIDS AND HEPATITIS C AGENTS FOR WHICH THE PHARMACEUTICAL MANUFAC-
43 TURER HAS IN EFFECT A REBATE AGREEMENT WITH THE FEDERAL SECRETARY OF
44 HEALTH AND HUMAN SERVICES PURSUANT TO 42 U.S.C. S 1396R-8, AND FOR WHICH
45 THE STATE HAS ESTABLISHED STANDARD CLINICAL CRITERIA. NO AGREEMENT
46 ENTERED INTO PURSUANT TO THIS PARAGRAPH SHALL HAVE AN INITIAL TERM OR BE
47 EXTENDED BEYOND MARCH THIRTY-FIRST, TWO THOUSAND TWENTY.
48 (I) THE MANUFACTURER SHALL NOT PAY SUPPLEMENTAL REBATES TO A MANAGED
49 CARE PROVIDER, OR ANY OF A MANAGED CARE PROVIDER'S AGENTS, INCLUDING BUT
50 NOT LIMITED TO ANY PHARMACY BENEFIT MANAGER ON THE TWO CLASSES OF DRUGS
51 SUBJECT TO THIS PARAGRAPH WHEN THE STATE IS COLLECTING SUPPLEMENTAL
52 REBATES AND STANDARD CLINICAL CRITERIA ARE IMPOSED ON THE MANAGED CARE
53 PROVIDER.
S. 2007--B 11 A. 3007--B
1 (II) THE COMMISSIONER SHALL ESTABLISH ADEQUATE RATES OF REIMBURSEMENT
2 WHICH SHALL TAKE INTO ACCOUNT BOTH THE IMPACT OF THE COMMISSIONER NEGO-
3 TIATING SUCH REBATES AND ANY LIMITATIONS IMPOSED ON THE MANAGED CARE
4 PROVIDER'S ABILITY TO ESTABLISH CLINICAL CRITERIA RELATING TO THE UTILI-
5 ZATION OF SUCH DRUGS. IN DEVELOPING THE MANAGED CARE PROVIDER'S
6 REIMBURSEMENT RATE, THE COMMISSIONER SHALL IDENTIFY THE AMOUNT OF
7 REIMBURSEMENT FOR SUCH DRUGS AS A SEPARATE AND DISTINCT COMPONENT FROM
8 THE REIMBURSEMENT OTHERWISE MADE FOR PRESCRIPTION DRUGS AS PRESCRIBED BY
9 THIS SECTION.
10 (III) THE COMMISSIONER SHALL SUBMIT A REPORT TO THE TEMPORARY PRESI-
11 DENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ANNUALLY BY DECEMBER
12 THIRTY-FIRST. THE REPORT SHALL ANALYZE THE ADEQUACY OF RATES TO MANAGED
13 CARE PROVIDERS FOR DRUG EXPENDITURES RELATED TO THE CLASSES UNDER THIS
14 PARAGRAPH.
15 (IV) NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO REQUIRE A PHARMA-
16 CEUTICAL MANUFACTURER TO ENTER INTO A SUPPLEMENTAL REBATE AGREEMENT WITH
17 THE COMMISSIONER RELATING TO PHARMACEUTICAL UTILIZATION BY ENROLLEES OF
18 MANAGED CARE PROVIDERS PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF
19 THIS TITLE.
20 (V) ALL CLINICAL CRITERIA, INCLUDING REQUIREMENTS FOR PRIOR APPROVAL,
21 AND ALL UTILIZATION REVIEW DETERMINATIONS ESTABLISHED BY THE STATE AS
22 DESCRIBED IN THIS PARAGRAPH FOR EITHER OF THE DRUG CLASSES SUBJECT TO
23 THIS PARAGRAPH SHALL BE DEVELOPED USING EVIDENCE-BASED AND PEER-REVIEWED
24 CLINICAL REVIEW CRITERIA IN ACCORDANCE WITH ARTICLE TWO-A OF THE PUBLIC
25 HEALTH LAW, AS APPLICABLE.
26 (VI) ALL PRIOR AUTHORIZATION AND UTILIZATION REVIEW DETERMINATIONS
27 RELATED TO THE COVERAGE OF ANY DRUG SUBJECT TO THIS PARAGRAPH SHALL BE
28 SUBJECT TO ARTICLE FORTY-NINE OF THE PUBLIC HEALTH LAW, SECTION THREE
29 HUNDRED SIXTY-FOUR-J OF THIS TITLE, AND ARTICLE FORTY-NINE OF THE INSUR-
30 ANCE LAW, AS APPLICABLE. NOTHING IN THIS PARAGRAPH SHALL DIMINISH ANY
31 RIGHTS RELATING TO ACCESS, PRIOR AUTHORIZATION, OR APPEAL RELATING TO
32 ANY DRUG CLASS OR DRUG AFFORDED TO A RECIPIENT UNDER ANY OTHER PROVISION
33 OF LAW.
34 S 2. Intentionally omitted.
35 S 3. Intentionally omitted.
36 S 4. Intentionally omitted.
37 S 5. Intentionally omitted.
38 S 6. Intentionally omitted.
39 S 7. Intentionally omitted.
40 S 8. Subdivision 1 of section 92 of part H of chapter 59 of the laws
41 of 2011, amending the public health law and other laws relating to known
42 and projected department of health state fund medicaid expenditures, as
43 amended by section 33 of part C of chapter 60 of the laws of 2014, is
44 amended to read as follows:
45 1. For state fiscal years 2011-12 through [2015-16] 2016-17, the
46 director of the budget, in consultation with the commissioner of health
47 referenced as "commissioner" for purposes of this section, shall assess
48 on a monthly basis, as reflected in monthly reports pursuant to subdivi-
49 sion five of this section known and projected department of health state
50 funds medicaid expenditures by category of service and by geographic
51 regions, as defined by the commissioner, and if the director of the
52 budget determines that such expenditures are expected to cause medicaid
53 disbursements for such period to exceed the projected department of
54 health medicaid state funds disbursements in the enacted budget finan-
55 cial plan pursuant to subdivision 3 of section 23 of the state finance
56 law, the commissioner of health, in consultation with the director of
S. 2007--B 12 A. 3007--B
1 the budget, shall develop a medicaid savings allocation plan to limit
2 such spending to the aggregate limit level specified in the enacted
3 budget financial plan, provided, however, such projections may be
4 adjusted by the director of the budget to account for any changes in the
5 New York state federal medical assistance percentage amount established
6 pursuant to the federal social security act, changes in provider reven-
7 ues, reductions to local social services district medical assistance
8 administration, and beginning April 1, 2012 the operational costs of the
9 New York state medical indemnity fund AND STATE COSTS OR SAVINGS FROM
10 THE BASIC HEALTH PLAN. Such projections may be adjusted by the director
11 of the budget to account for increased or expedited department of health
12 state funds medicaid expenditures as a result of a natural or other type
13 of disaster, including a governmental declaration of emergency.
14 S 9. Section 280 of the public health law is REPEALED.
15 S 10. Intentionally omitted.
16 S 11. Section 2807 of the public health law is amended by adding a
17 new subdivision 14-a to read as follows:
18 14-A. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND
19 SUBJECT TO FEDERAL FINANCIAL PARTICIPATION, THE COMMISSIONER IS AUTHOR-
20 IZED TO ESTABLISH, PURSUANT TO REGULATIONS, A STATEWIDE GENERAL HOSPITAL
21 QUALITY POOL FOR THE PURPOSE OF INCENTIVIZING AND FACILITATING QUALITY
22 IMPROVEMENTS IN GENERAL HOSPITALS. AWARDS FROM SUCH POOL SHALL BE
23 SUBJECT TO APPROVAL BY THE DIRECTOR OF BUDGET. IF FEDERAL FINANCIAL
24 PARTICIPATION IS UNAVAILABLE, THEN THE NON-FEDERAL SHARE OF AWARDS MADE
25 PURSUANT TO THIS SUBDIVISION MAY BE MADE AS STATE GRANTS.
26 (A) THIRTY DAYS PRIOR TO ADOPTING OR APPLYING A METHODOLOGY OR PROCE-
27 DURE FOR MAKING AN ALLOCATION OR MODIFICATION TO AN ALLOCATION MADE
28 PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL PROVIDE WRITTEN
29 NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE, THE ASSEMBLY WAYS
30 AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY HEALTH COMMITTEES WITH
31 REGARD TO THE INTENT TO ADOPT OR APPLY THE METHODOLOGY OR PROCEDURE,
32 INCLUDING A DETAILED EXPLANATION OF THE METHODOLOGY OR PROCEDURE.
33 (B) THIRTY DAYS PRIOR TO EXECUTING AN ALLOCATION OR MODIFICATION TO AN
34 ALLOCATION MADE PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL
35 PROVIDE WRITTEN NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE,
36 THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY
37 HEALTH COMMITTEES WITH REGARD TO THE INTENT TO DISTRIBUTE SUCH FUNDS.
38 SUCH NOTICE SHALL INCLUDE, BUT NOT BE LIMITED TO, INFORMATION ON THE
39 METHODOLOGY USED TO DISTRIBUTE THE FUNDS, THE FACILITY SPECIFIC ALLO-
40 CATIONS OF THE FUNDS, ANY FACILITY SPECIFIC PROJECT DESCRIPTIONS OR
41 REQUIREMENTS FOR RECEIVING SUCH FUNDS, THE MULTI-YEAR IMPACTS OF THESE
42 ALLOCATIONS, AND THE AVAILABILITY OF FEDERAL MATCHING FUNDS. THE COMMIS-
43 SIONER SHALL PROVIDE QUARTERLY REPORTS TO THE CHAIR OF THE SENATE
44 FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE
45 ON THE DISTRIBUTION AND DISBURSEMENT OF SUCH FUNDS.
46 S 12. Section 2807 of the public health law is amended by adding a new
47 subdivision 22 to read as follows:
48 22. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
49 TO FEDERAL FINANCIAL PARTICIPATION, GENERAL HOSPITALS DESIGNATED AS SOLE
50 COMMUNITY HOSPITALS IN ACCORDANCE WITH TITLE XVIII OF THE FEDERAL SOCIAL
51 SECURITY ACT SHALL BE ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT
52 FOR INPATIENT AND/OR OUTPATIENT SERVICES OF UP TO TWELVE MILLION DOLLARS
53 UNDER A SUPPLEMENTAL OR REVISED RATE METHODOLOGY, ESTABLISHED BY THE
54 COMMISSIONER IN REGULATION, FOR THE PURPOSE OF PROMOTING ACCESS AND
55 IMPROVING THE QUALITY OF CARE. IF FEDERAL FINANCIAL PARTICIPATION IS
S. 2007--B 13 A. 3007--B
1 UNAVAILABLE, THEN THE NON-FEDERAL SHARE OF SUCH PAYMENTS PURSUANT TO
2 THIS SUBDIVISION MAY BE MADE AS STATE GRANTS.
3 (A) THIRTY DAYS PRIOR TO ADOPTING OR APPLYING A METHODOLOGY OR PROCE-
4 DURE FOR MAKING AN ALLOCATION OR MODIFICATION TO AN ALLOCATION MADE
5 PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL PROVIDE WRITTEN
6 NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE, THE ASSEMBLY WAYS
7 AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY HEALTH COMMITTEES WITH
8 REGARD TO THE INTENT TO ADOPT OR APPLY THE METHODOLOGY OR PROCEDURE,
9 INCLUDING A DETAILED EXPLANATION OF THE METHODOLOGY OR PROCEDURE.
10 (B) THIRTY DAYS PRIOR TO EXECUTING AN ALLOCATION OR MODIFICATION TO AN
11 ALLOCATION MADE PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL
12 PROVIDE WRITTEN NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE,
13 THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY
14 HEALTH COMMITTEES WITH REGARD TO THE INTENT TO DISTRIBUTE SUCH FUNDS.
15 SUCH NOTICE SHALL INCLUDE, BUT NOT BE LIMITED TO, INFORMATION ON THE
16 METHODOLOGY USED TO DISTRIBUTE THE FUNDS, THE FACILITY SPECIFIC ALLO-
17 CATIONS OF THE FUNDS, ANY FACILITY SPECIFIC PROJECT DESCRIPTIONS OR
18 REQUIREMENTS FOR RECEIVING SUCH FUNDS, THE MULTI-YEAR IMPACTS OF THESE
19 ALLOCATIONS, AND THE AVAILABILITY OF FEDERAL MATCHING FUNDS. THE COMMIS-
20 SIONER SHALL PROVIDE QUARTERLY REPORTS TO THE CHAIR OF THE SENATE
21 FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE
22 ON THE DISTRIBUTION AND DISBURSEMENT OF SUCH FUNDS.
23 S 13. Subdivision (e) of section 2826 of the public health law, as
24 added by section 27 of part C of chapter 60 of the laws of 2014, is
25 amended and a new subdivision (e-1) is added to read as follows:
26 (e) Notwithstanding any law to the contrary, general hospitals defined
27 as critical access hospitals pursuant to title XVIII of the federal
28 social security act shall be allocated no less than [five] SEVEN million
29 FIVE HUNDRED THOUSAND dollars annually pursuant to this section. The
30 department of health shall provide a report to the governor and legisla-
31 ture no later than [December] JUNE first, two thousand [fourteen]
32 FIFTEEN providing recommendations on how to ensure the financial stabil-
33 ity of, and preserve patient access to, critical access hospitals,
34 INCLUDING AN EXAMINATION OF PERMANENT MEDICAID RATE METHODOLOGY CHANGES.
35 (E-1) THIRTY DAYS PRIOR TO EXECUTING AN ALLOCATION OR MODIFICATION TO
36 AN ALLOCATION MADE PURSUANT TO THIS SECTION, THE COMMISSIONER SHALL
37 PROVIDE WRITTEN NOTICE TO THE CHAIR OF THE SENATE FINANCE COMMITTEE AND
38 THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE WITH REGARDS TO THE
39 INTENT TO DISTRIBUTE SUCH FUNDS. SUCH NOTICE SHALL INCLUDE, BUT NOT BE
40 LIMITED TO, INFORMATION ON THE METHODOLOGY USED TO DISTRIBUTE THE FUNDS,
41 THE FACILITY SPECIFIC ALLOCATIONS OF THE FUNDS, ANY FACILITY SPECIFIC
42 PROJECT DESCRIPTIONS OR REQUIREMENTS FOR RECEIVING SUCH FUNDS, THE
43 MULTI-YEAR IMPACTS OF THESE ALLOCATIONS, AND THE AVAILABILITY OF FEDERAL
44 MATCHING FUNDS. THE COMMISSIONER SHALL PROVIDE QUARTERLY REPORTS TO THE
45 CHAIR OF THE SENATE FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS
46 AND MEANS COMMITTEE ON THE DISTRIBUTION AND DISBURSEMENT OF SUCH FUNDS.
47 WITHIN SIXTY DAYS OF THE EFFECTIVENESS OF THIS SUBDIVISION, THE COMMIS-
48 SIONER SHALL PROVIDE A WRITTEN REPORT TO THE CHAIR OF THE SENATE FINANCE
49 COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE ON ALL
50 AWARDS MADE PURSUANT TO THIS SECTION PRIOR TO THE EFFECTIVENESS OF THIS
51 SUBDIVISION, INCLUDING ALL INFORMATION THAT IS REQUIRED TO BE INCLUDED
52 IN THE NOTICE REQUIREMENTS OF THIS SUBDIVISION.
53 S 14. Section 2826 of the public health law is amended by adding a new
54 subdivision (f) to read as follows:
55 (F) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
56 TO FEDERAL FINANCIAL PARTICIPATION, NO LESS THAN TEN MILLION DOLLARS
S. 2007--B 14 A. 3007--B
1 SHALL BE ALLOCATED TO PROVIDERS DESCRIBED IN THIS SUBDIVISION; PROVIDED,
2 HOWEVER THAT IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAILABLE FOR ANY
3 ELIGIBLE PROVIDER, OR FOR ANY POTENTIAL INVESTMENT UNDER THIS SUBDIVI-
4 SION THEN THE NON-FEDERAL SHARE OF PAYMENTS PURSUANT TO THIS SUBDIVISION
5 MAY BE MADE AS STATE GRANTS.
6 (I) PROVIDERS SERVING RURAL AREAS AS SUCH TERM IS DEFINED IN SECTION
7 TWO THOUSAND NINE HUNDRED FIFTY-ONE OF THIS CHAPTER, INCLUDING BUT NOT
8 LIMITED TO HOSPITALS, RESIDENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND
9 TREATMENT CENTERS, AMBULATORY SURGERY CENTERS AND CLINICS SHALL BE
10 ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT UNDER A SUPPLEMENTAL
11 RATE METHODOLOGY FOR THE PURPOSE OF PROMOTING ACCESS AND IMPROVING THE
12 QUALITY OF CARE.
13 (II) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
14 TO FEDERAL FINANCIAL PARTICIPATION, ESSENTIAL COMMUNITY PROVIDERS,
15 WHICH, FOR THE PURPOSES OF THIS SECTION, SHALL MEAN A PROVIDER THAT
16 OFFERS HEALTH SERVICES WITHIN A DEFINED AND ISOLATED GEOGRAPHIC REGION
17 WHERE SUCH SERVICES WOULD OTHERWISE BE UNAVAILABLE TO THE POPULATION OF
18 SUCH REGION, SHALL BE ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT
19 UNDER A SUPPLEMENTAL RATE METHODOLOGY FOR THE PURPOSE OF PROMOTING
20 ACCESS AND IMPROVING QUALITY OF CARE. ELIGIBLE PROVIDERS UNDER THIS
21 PARAGRAPH MAY INCLUDE, BUT ARE NOT LIMITED TO, HOSPITALS, RESIDENTIAL
22 HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT CENTERS, AMBULATORY
23 SURGERY CENTERS AND CLINICS.
24 (III) IN MAKING SUCH PAYMENTS THE COMMISSIONER MAY CONTEMPLATE THE
25 EXTENT TO WHICH ANY SUCH PROVIDER RECEIVES ASSISTANCE UNDER SUBDIVISION
26 (A) OF THIS SECTION AND MAY REQUIRE SUCH PROVIDER TO SUBMIT A WRITTEN
27 PROPOSAL DEMONSTRATING THAT THE NEED FOR MONIES UNDER THIS SUBDIVISION
28 EXCEEDS MONIES OTHERWISE DISTRIBUTED PURSUANT TO THIS SECTION.
29 (IV) PAYMENTS UNDER THIS SUBDIVISION MAY INCLUDE, BUT NOT BE LIMITED
30 TO, TEMPORARY RATE ADJUSTMENTS, LUMP SUM MEDICAID PAYMENTS, SUPPLEMENTAL
31 RATE METHODOLOGIES AND ANY OTHER PAYMENTS AS DETERMINED BY THE COMMIS-
32 SIONER.
33 (V) PAYMENTS UNDER THIS SUBDIVISION SHALL BE SUBJECT TO APPROVAL BY
34 THE DIRECTOR OF THE BUDGET.
35 (VI) THE COMMISSIONER MAY PROMULGATE REGULATIONS TO EFFECTUATE THE
36 PROVISIONS OF THIS SUBDIVISION.
37 (VII) THIRTY DAYS PRIOR TO ADOPTING OR APPLYING A METHODOLOGY OR
38 PROCEDURE FOR MAKING AN ALLOCATION OR MODIFICATION TO AN ALLOCATION MADE
39 PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL PROVIDE WRITTEN
40 NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE, THE ASSEMBLY WAYS
41 AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY HEALTH COMMITTEES WITH
42 REGARD TO THE INTENT TO ADOPT OR APPLY THE METHODOLOGY OR PROCEDURE,
43 INCLUDING A DETAILED EXPLANATION OF THE METHODOLOGY OR PROCEDURE.
44 (VIII) THIRTY DAYS PRIOR TO EXECUTING AN ALLOCATION OR MODIFICATION TO
45 AN ALLOCATION MADE PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL
46 PROVIDE WRITTEN NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE,
47 THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY
48 HEALTH COMMITTEES WITH REGARD TO THE INTENT TO DISTRIBUTE SUCH FUNDS.
49 SUCH NOTICE SHALL INCLUDE, BUT NOT BE LIMITED TO, INFORMATION ON THE
50 METHODOLOGY USED TO DISTRIBUTE THE FUNDS, THE FACILITY SPECIFIC ALLO-
51 CATIONS OF THE FUNDS, ANY FACILITY SPECIFIC PROJECT DESCRIPTIONS OR
52 REQUIREMENTS FOR RECEIVING SUCH FUNDS, THE MULTI-YEAR IMPACTS OF THESE
53 ALLOCATIONS, AND THE AVAILABILITY OF FEDERAL MATCHING FUNDS. THE COMMIS-
54 SIONER SHALL PROVIDE QUARTERLY REPORTS TO THE CHAIR OF THE SENATE
55 FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE
56 ON THE DISTRIBUTION AND DISBURSEMENT OF SUCH FUNDS.
S. 2007--B 15 A. 3007--B
1 S 15. Paragraph (b) of subdivision 6 of section 367-a of the social
2 services law, as added by chapter 41 of the laws of 1992, subparagraph
3 (iii) as amended by chapter 843 of the laws of 1992, subparagraph (iv)
4 as amended by section 40 of part C of chapter 58 of the laws of 2005, is
5 amended and a new paragraph (b-1) is added to read as follows:
6 (b) Co-payments shall apply to all eligible persons for the services
7 defined in paragraph (d) of this subdivision with the exception of:
8 (i) individuals under twenty-one years of age;
9 (ii) pregnant women;
10 (iii) individuals who are inpatients in a medical facility who have
11 been required to spend all of their income for medical care, except
12 their personal needs allowance or residents of community based residen-
13 tial facilities licensed by the office of mental health or the office of
14 mental retardation and developmental disabilities who have been required
15 to spend all of their income, except their personal needs allowance;
16 (iv) individuals enrolled in health maintenance organizations or other
17 entities which provide comprehensive health services, or other managed
18 care programs for services covered by such programs, except that such
19 persons, other than persons otherwise exempted from co-payments pursuant
20 to subparagraphs (i), (ii), (iii) and (v) of this paragraph, and other
21 than those persons enrolled in a managed long term care program, shall
22 be subject to co-payments as described in subparagraph (v) of paragraph
23 (d) of this subdivision; [and]
24 (v) INDIVIDUALS WHOSE FAMILY INCOME IS LESS THAN ONE HUNDRED PERCENT
25 OF THE FEDERAL POVERTY LINE, AS DEFINED IN SUBPARAGRAPH FOUR OF PARA-
26 GRAPH (A) OF SUBDIVISION ONE OF SECTION THREE HUNDRED SIXTY-SIX OF THIS
27 TITLE, FOR A FAMILY OF THE SAME SIZE; AND
28 (VI) any other individuals required to be excluded by federal law or
29 regulations.
30 (B-1) THE COMMISSIONER IS AUTHORIZED TO SUBMIT ANY REQUEST OR APPLICA-
31 TION TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS MAY BE NECES-
32 SARY TO BE GRANTED A WAIVER OF THE REQUIREMENT FOR THE DEPARTMENT OF
33 HEALTH TO CALCULATE ITS MEDICAID PAYMENTS TO MANAGED CARE ORGANIZATIONS
34 TO INCLUDE COST SHARING ESTABLISHED UNDER THE STATE PLAN FOR MEDICAL
35 ASSISTANCE FOR ENROLLEES WHO ARE NOT EXEMPT FROM COST SHARING. IN THE
36 ABSENCE OF SUCH A WAIVER, THE COMMISSIONER SHALL ADJUST MEDICAID
37 PAYMENTS TO MANAGED CARE ORGANIZATIONS BEGINNING OCTOBER FIRST, TWO
38 THOUSAND FIFTEEN OR ON THE DATE THE CENTERS FOR MEDICARE AND MEDICAID
39 SERVICES COMMENCES ENFORCEMENT OF SUCH REQUIREMENT, WHICHEVER IS LATER.
40 S 15-a. Paragraph (b) of subdivision 6 of section 367-a of the social
41 services law, as amended by section fifteen of this act, is amended to
42 read as follows:
43 (b) Co-payments shall apply to all eligible persons for the services
44 defined in paragraph (d) of this subdivision with the exception of:
45 (i) individuals under twenty-one years of age;
46 (ii) pregnant women;
47 (iii) individuals who are inpatients in a medical facility who have
48 been required to spend all of their income for medical care, except
49 their personal needs allowance or residents of community based residen-
50 tial facilities licensed by the office of mental health or the office of
51 mental retardation and developmental disabilities who have been required
52 to spend all of their income, except their personal needs allowance;
53 (iv) [individuals enrolled in health maintenance organizations or
54 other entities which provide comprehensive health services, or other
55 managed care programs for services covered by such programs, except that
56 such persons, other than persons otherwise exempted from co-payments
S. 2007--B 16 A. 3007--B
1 pursuant to subparagraphs (i), (ii), (iii) and (v) of this paragraph,
2 and other than those persons enrolled in a managed long term care
3 program, shall be subject to co-payments as described in subparagraph
4 (v) of paragraph (d) of this subdivision;
5 (v)] individuals whose family income is less than one hundred percent
6 of the federal poverty line, as defined in subparagraph four of para-
7 graph (a) of subdivision one of section three hundred sixty-six of this
8 title, for a family of the same size; and
9 [(vi)] (V) any other individuals required to be excluded by federal
10 law or regulations.
11 S 16. Section 12 of part A of chapter 1 of the laws of 2002, relating
12 to the health care reform act of 2000, is amended to read as follows:
13 S 12. Notwithstanding any inconsistent provision of law or regulation
14 to the contrary, and subject to the availability of federal financial
15 participation pursuant to title XIX of the federal social security act,
16 effective for the period September 1, 2001 through March 31, 2002, and
17 state fiscal years thereafter, UNTIL MARCH 31, 2012, the department of
18 health is authorized to pay a specialty hospital adjustment to public
19 general hospitals, as defined in subdivision 10 of section 2801 of the
20 public health law, other than those operated by the state of New York or
21 the state university of New York, receiving reimbursement for all inpa-
22 tient services under title XIX of the federal social security act pursu-
23 ant to paragraph (e) of subdivision 4 of section 2807-c of the public
24 health law, and located in a city with a population of over 1 million,
25 of up to four hundred sixty-three million dollars for the period Septem-
26 ber 1, 2001 through March 31, 2002 and up to seven hundred ninety-four
27 million dollars annually for state fiscal years thereafter as medical
28 assistance payments for inpatient services pursuant to title 11 of arti-
29 cle 5 of the social services law for patients eligible for federal
30 financial participation under title XIX of the federal social security
31 act based on each such hospital's proportionate share of the sum of all
32 inpatient discharges for all facilities eligible for an adjustment
33 pursuant to this section for the base year two years prior to the rate
34 year. Such proportionate share payment may be added to rates of payment
35 or made as aggregate payments to eligible public general hospitals.
36 S 17. Section 13 of part B of chapter 1 of the laws of 2002, relating
37 to the health care reform act of 2000, is amended to read as follows:
38 S 13. Notwithstanding any inconsistent provision of law or regulation
39 to the contrary, and subject to the availability of federal financial
40 participation pursuant to title XIX of the federal social security act,
41 effective for the period April 1, 2002 through March 31, 2003, and state
42 fiscal years thereafter UNTIL MARCH 31, 2012, the department of health
43 is authorized to pay a specialty hospital adjustment to public general
44 hospitals, as defined in subdivision 10 of section 2801 of the public
45 health law, other than those operated by the state of New York or the
46 state university of New York, receiving reimbursement for all inpatient
47 services under title XIX of the federal social security act pursuant to
48 paragraph (e) of subdivision 4 of section 2807-c of the public health
49 law, and located in a city with a population of over one million, of up
50 to two hundred eighty-six million dollars as medical assistance payments
51 for inpatient services pursuant to title 11 of article 5 of the social
52 services law for patients eligible for federal financial participation
53 under title XIX of the federal social security act based on each such
54 hospital's proportionate share of the sum of all inpatient discharges
55 for all facilities eligible for an adjustment pursuant to this section
56 for the base year two years prior to the rate year. Such proportionate
S. 2007--B 17 A. 3007--B
1 share payment may be added to rates of payment or made as aggregate
2 payments to eligible hospitals.
3 S 18. Notwithstanding any inconsistent provision of law or regulation
4 to the contrary, and subject to the availability of federal financial
5 participation pursuant to title XIX of the federal social security act,
6 effective for the period April 1, 2012, through March 31, 2013, and
7 state fiscal years thereafter, the department of health is authorized to
8 pay a public hospital adjustment to public general hospitals, as defined
9 in subdivision 10 of section 2801 of the public health law, other than
10 those operated by the state of New York or the state university of New
11 York, and located in a city with a population of over 1 million, of up
12 to one billion eighty million dollars annually as medical assistance
13 payments for inpatient services pursuant to title 11 of article 5 of the
14 social services law for patients eligible for federal financial partic-
15 ipation under title XIX of the federal social security act based on such
16 criteria and methodologies as the commissioner may from time to time set
17 through a memorandum of understanding with the New York city health and
18 hospitals corporation, and such adjustments shall be paid by means of
19 one or more estimated payments, with such estimated payments to be
20 reconciled to the commissioner of health's final adjustment determi-
21 nations after the disproportionate share hospital payment adjustment
22 caps have been calculated for such period under sections 1923(f) and (g)
23 of the federal social security act. Such adjustment payment may be added
24 to rates of payment or made as aggregate payments to eligible public
25 general hospitals.
26 S 19. Section 14 of part A of chapter 1 of the laws of 2002, relating
27 to the health care reform act of 2000, is amended to read as follows:
28 S 14. Notwithstanding any inconsistent provision of law, rule or regu-
29 lation to the contrary, and subject to the availability of federal
30 financial participation pursuant to title XIX of the federal social
31 security act, effective for the period January 1, 2002 through March 31,
32 2002, and state fiscal years thereafter UNTIL MARCH 31, 2011, the
33 department of health is authorized to increase the operating cost compo-
34 nent of rates of payment for general hospital outpatient services and
35 general hospital emergency room services issued pursuant to paragraph
36 (g) of subdivision 2 of section 2807 of the public health law for public
37 general hospitals, as defined in subdivision 10 of section 2801 of the
38 public health law, other than those operated by the state of New York or
39 the state university of New York, and located in a city with a popu-
40 lation of over one million, which experienced free patient visits in
41 excess of twenty percent of their total self-pay and free patient visits
42 based on data reported on exhibit 33 of their 1999 institutional cost
43 report and which experienced uninsured outpatient losses in excess of
44 seventy-five percent of their total inpatient and outpatient uninsured
45 losses based on data reported on exhibit 47 of their 1999 institutional
46 cost report, of up to thirty-four million dollars for the period January
47 1, 2002 through March 31, 2002 and up to one hundred thirty-six million
48 dollars annually for state fiscal years thereafter as medical assistance
49 payments for outpatient services pursuant to title 11 of article 5 of
50 the social services law for patients eligible for federal financial
51 participation under title XIX of the federal social security act based
52 on each such hospital's proportionate share of the sum of all outpatient
53 visits for all facilities eligible for an adjustment pursuant to this
54 section for the base year two years prior to the rate year. Such propor-
55 tionate share payment may be added to rates of payment or made as aggre-
56 gate payments to eligible public general hospitals.
S. 2007--B 18 A. 3007--B
1 S 20. Section 14 of part B of chapter 1 of the laws of 2002, relating
2 to the health care reform act of 2000, is amended to read as follows:
3 S 14. Notwithstanding any inconsistent provision of law or regulation
4 to the contrary, and subject to the availability of federal financial
5 participation pursuant to title XIX of the federal social security act,
6 effective for the period January 1, 2002 through March 31, 2002, and
7 state fiscal years thereafter UNTIL MARCH 31, 2011, the department of
8 health is authorized to increase the operating cost component of rates
9 of payment for general hospital outpatient services and general hospital
10 emergency room services issued pursuant to paragraph (g) of subdivision
11 2 of section 2807 of the public health law for public general hospitals,
12 as defined in subdivision 10 of section 2801 of the public health law,
13 other than those operated by the state of New York or the state univer-
14 sity of New York, and located in a city with a population of over one
15 million, which experienced free patient visits in excess of twenty
16 percent of their total self-pay and free patient visits based on data
17 reported on exhibit 33 of their 1999 institutional cost report and which
18 experienced uninsured outpatient losses in excess of seventy-five
19 percent of their total inpatient and outpatient uninsured losses based
20 on data reported on exhibit 47 of their 1999 institutional cost report,
21 of up to thirty-seven million dollars for the period January 1, 2002
22 through March 31, 2002 and one hundred fifty-one million dollars annual-
23 ly for state fiscal years thereafter as medical assistance payments for
24 outpatient services pursuant to title 11 of article 5 of the social
25 services law for patients eligible for federal financial participation
26 under title XIX of the federal social security act based on each such
27 hospital's proportionate share of the sum of all outpatient visits for
28 all facilities eligible for an adjustment pursuant to this section for
29 the base year two years prior to the rate year. Such proportionate share
30 payment may be added to rates of payment or made as aggregate payments
31 to eligible public general hospitals.
32 S 21. Notwithstanding any inconsistent provision of law, rule or regu-
33 lation to the contrary, and subject to the availability of federal
34 financial participation pursuant to title XIX of the federal social
35 security act, effective for the period April 1, 2011 through March 31,
36 2012, and state fiscal years thereafter, the department of health is
37 authorized to increase the operating cost component of rates of payment
38 for general hospital outpatient services and general hospital emergency
39 room services issued pursuant to paragraph (g) of subdivision 2 of
40 section 2807 of the public health law for public general hospitals, as
41 defined in subdivision 10 of section 2801 of the public health law,
42 other than those operated by the state of New York or the state univer-
43 sity of New York, and located in a city with a population over one
44 million, up to two hundred eighty-seven million dollars annually as
45 medical assistance payments for outpatient services pursuant to title 11
46 of article 5 of the social services law for patients eligible for feder-
47 al financial participation under title XIX of the federal social securi-
48 ty act based on such criteria and methodologies as the commissioner may
49 from time to time set through a memorandum of understanding with the New
50 York city health and hospitals corporation, and such adjustments shall
51 be paid by means of one or more estimated payments, with such estimated
52 payments to be reconciled to the commissioner of health's final adjust-
53 ment determinations after the disproportionate share hospital payment
54 adjustment caps have been calculated for such period under sections
55 1923(f) and (g) of the federal social security act. Such adjustment
S. 2007--B 19 A. 3007--B
1 payment may be added to rates of payment or made as aggregate payments
2 to eligible public general hospitals.
3 S 22. Section 16 of part A of chapter 1 of the laws of 2002, relating
4 to the health care reform act of 2000, is amended to read as follows:
5 S 16. Any amounts provided pursuant to sections eleven, twelve, thir-
6 teen and fourteen of this act shall be effective for purposes of deter-
7 mining payments for public general hospitals contingent on receipt of
8 all approvals required by federal law or regulations for federal finan-
9 cial participation in payments made pursuant to title XIX of the federal
10 social security act. If federal approvals are not granted for payments
11 based on such amounts or components thereof, payments to public general
12 hospitals shall be determined without consideration of such amounts or
13 such components. Public general hospitals shall refund to the state, or
14 the state may recoup from prospective payments, any overpayment
15 received, including those based on a retroactive reduction in the
16 payments. Any reduction in federal financial participation pursuant to
17 title XIX of the federal social security act related to federal upper
18 payment limits APPLICABLE TO PUBLIC GENERAL HOSPITALS OTHER THAN THOSE
19 OPERATED BY THE STATE OF NEW YORK OR THE STATE UNIVERSITY OF NEW YORK
20 shall be deemed to apply first to amounts provided pursuant to sections
21 eleven, twelve, thirteen and fourteen of this act AND SECTIONS EIGHTEEN
22 AND TWENTY-ONE OF THE CHAPTER OF THE LAWS OF TWO THOUSAND FIFTEEN THAT
23 AMENDED THIS SECTION.
24 S 23. Section 20 of part B of chapter 1 of the laws of 2002, relating
25 to the health care reform act of 2000, is amended to read as follows:
26 S 20. Any amounts provided pursuant to sections thirteen and fourteen
27 of this act shall be effective for purposes of determining payments for
28 public general hospitals contingent on receipt of all approvals required
29 by federal law or regulations for federal financial participation in
30 payments made pursuant to title XIX of the federal social security act.
31 If federal approvals are not granted for payments based on such amounts
32 or components thereof, payments to public general hospitals shall be
33 determined without consideration of such amounts or such components.
34 Public general hospitals shall refund to the state, or the state may
35 recoup from prospective payments, any overpayment received, including
36 those based on a retroactive reduction in the payments. Any reduction in
37 federal financial participation pursuant to title XIX of the federal
38 social security act related to federal upper payment limits APPLICABLE
39 TO PUBLIC GENERAL HOSPITALS OTHER THAN THOSE OPERATED BY THE STATE OF
40 NEW YORK OR THE STATE UNIVERSITY OF NEW YORK shall be deemed to apply
41 first to amounts provided pursuant to sections thirteen and fourteen of
42 this act AND SECTIONS EIGHTEEN AND TWENTY-ONE OF THE CHAPTER OF THE LAWS
43 OF TWO THOUSAND FIFTEEN THAT AMENDED THIS SECTION.
44 S 24. Subdivision 7 of section 2807 of the public health law, as
45 amended by section 195 of part A of chapter 389 of the laws of 1997, is
46 amended to read as follows:
47 7. Reimbursement rate promulgation. The commissioner shall notify each
48 [hospital] RESIDENTIAL HEALTH CARE FACILITY and health-related service
49 of its approved rates of payment which shall be used in reimbursing for
50 services provided to persons eligible for payments made by state govern-
51 mental agencies at least sixty days prior to the beginning of an estab-
52 lished rate period for which the rate is to become effective AND FOR
53 GENERAL HOSPITALS AT LEAST THIRTY DAYS PRIOR TO THE BEGINNING OF AN
54 ESTABLISHED RATE PERIOD FOR WHICH THE RATE IS TO BECOME EFFECTIVE.
55 Notification shall be made only after approval of rate schedules by the
56 state director of the budget. The sixty and thirty day notice
S. 2007--B 20 A. 3007--B
1 provisions, herein, shall not apply to rates issued following judicial
2 annulment or invalidation of any previously issued rates, or rates
3 issued pursuant to changes in the methodology used to compute rates
4 which changes are promulgated following the judicial annulment or inval-
5 idation of previously issued rates. Notwithstanding any provision of
6 law to the contrary, nothing in this subdivision shall prohibit the
7 recalculation and payment of rates, including both positive and negative
8 adjustments, based on a reconciliation of amounts paid by residential
9 health care facilities beginning April first, nineteen hundred ninety-
10 seven for additional assessments or further additional assessments
11 pursuant to section twenty-eight hundred seven-d of this article with
12 the amounts originally recognized for reimbursement purposes.
13 S 24-a. Intentionally omitted.
14 S 24-b. Paragraphs (c), (d) and (e) of subdivision 20 of section 2807
15 of the public health law, as added by section 8-a of part A of chapter
16 60 of the laws of 2014, are relettered paragraphs (d), (e) and (f) and
17 amended and a new paragraph (c) is added to read as follows:
18 (C)(I) PROJECT ADVISORY COMMITTEES. 1. LEAD ENTITIES OF SYSTEMS ESTAB-
19 LISHED UNDER THE MEDICAID DELIVERY SYSTEM REFORM INCENTIVE PAYMENT
20 ("DSRIP") PROGRAM SHALL ESTABLISH A PROJECT ADVISORY COMMITTEE. THE
21 COMMITTEE SHALL CONSIDER AND ADVISE THE ENTITY ON MATTERS CONCERNING
22 SYSTEM OPERATIONS, SERVICE DELIVERY ISSUES, ELIMINATION OF HEALTH CARE
23 DISPARITIES, MEASUREMENT OF PROJECT OUTCOMES, THE DEGREE TO WHICH
24 PROJECT GOALS ARE BEING REACHED AND THE DEVELOPMENT OF ANY PLANS OR
25 PROGRAMS. THE ENTITY MAY ESTABLISH RULES WITH RESPECT TO ITS PROJECT
26 ADVISORY COMMITTEE.
27 (II) THE MEMBERS OF THE COMMITTEE SHALL BE REPRESENTATIVES OF THE
28 COMMUNITY, OR GEOGRAPHIC SERVICE AREAS, SERVED BY THE SYSTEM, INCLUDING
29 MEDICAID CONSUMERS ATTRIBUTED TO THAT SYSTEM, AND ANY OTHER MEMBERS
30 REQUIRED BY THE TERMS AND CONDITIONS OF THE DSRIP PROGRAM. THE LEAD
31 ENTITY SHALL FILE WITH THE COMMISSIONER, AND FROM TIME TO TIME UPDATE,
32 AN UP-TO-DATE LIST OF THE MEMBERS OF THE COMMITTEE, WHICH SHALL BE MADE
33 AVAILABLE TO THE PUBLIC BY THE DEPARTMENT ON ITS WEBSITE.
34 (III) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, NO OFFICER OR
35 EMPLOYEE OF THE STATE OR OF ANY CIVIL DIVISION THEREOF, SHALL BE DEEMED
36 TO HAVE FORFEITED OR SHALL FORFEIT HIS OR HER OFFICE OR EMPLOYMENT BY
37 REASON OF HIS OR HER ACCEPTANCE OF MEMBERSHIP ON A PROJECT ADVISORY
38 COMMITTEE. NO MEMBER OF A PROJECT ADVISORY COMMITTEE SHALL RECEIVE
39 COMPENSATION OR ALLOWANCE FOR SERVICES RENDERED ON THE COMMITTEE,
40 EXCEPT, HOWEVER, THAT MEMBERS OF A COMMITTEE MAY BE REIMBURSED BY THE
41 ENTITY OR SYSTEM FOR NECESSARY EXPENSES INCURRED IN RELATION TO SERVICE
42 ON A PROJECT ADVISORY COMMITTEE.
43 (d) For periods on and after April first, two thousand fourteen, the
44 commissioner shall provide a report on a quarterly basis to the chairs
45 of the senate finance, assembly ways and means, senate health and assem-
46 bly health committees with regard to the status of the DSRIP program.
47 Such reports shall be submitted no later than sixty days after the close
48 of the quarter, and shall include the most current information submitted
49 by providers to the state and the federal CMS. The reports shall
50 include:
51 (i) analysis of progress made toward DSRIP goals;
52 (ii) the impact on the state's health care delivery system;
53 (iii) information on the number and types of providers who partic-
54 ipate;
55 (iv) plans and progress for monitoring provider compliance with
56 requirements;
S. 2007--B 21 A. 3007--B
1 (v) a status update on project milestone progress;
2 (vi) information on project spending and budget;
3 (vii) analysis of impact on Medicaid beneficiaries served;
4 (viii) a summary of public engagement and public comments received;
5 (ix) a description of DSRIP funding applications that were denied;
6 (x) a description of all regulation waivers issued pursuant to para-
7 graph [(e)] (F) of this subdivision; and
8 (xi) a summary of the statewide geographic distribution of funds.
9 (e) For periods on and after April first, two thousand fourteen the
10 commissioner shall promptly make all DSRIP governing documents, includ-
11 ing 1115 waiver standard terms and conditions, supporting attachments
12 and detailed project descriptions, and all materials made available to
13 the legislature pursuant to paragraph [(c)] (D) of this subdivision,
14 available on the department's website. The commissioner shall also
15 provide a detailed overview on the department's website of the opportu-
16 nities for public comment on the DSRIP program.
17 (f) Notwithstanding any provision of law to the contrary, the commis-
18 sioners of the department of health, the office of mental health, the
19 office for people with developmental disabilities, and the office of
20 alcoholism and substance abuse services are authorized to waive any
21 regulatory requirements as are necessary, consistent with applicable
22 law, to allow applicants under this subdivision and paragraph (a) of
23 subdivision two of section twenty-eight hundred twenty-five of this
24 article to avoid duplication of requirements and to allow the efficient
25 implementation of the proposed project; provided, however, that regu-
26 lations pertaining to patient safety may not be waived, nor shall any
27 regulations be waived if such waiver would risk patient safety. Such
28 waiver shall not exceed the life of the project or such shorter time
29 periods as the authorizing commissioner may determine. Any regulatory
30 relief granted pursuant to this subdivision shall be described, includ-
31 ing each [regulations] REGULATION waived and the project it relates to,
32 in the report provided pursuant to paragraph [(c)] (D) of this subdivi-
33 sion.
34 S 25. Section 365-l of the social services law is amended by adding
35 two new subdivisions 2-b and 2-c to read as follows:
36 2-B. THE COMMISSIONER IS AUTHORIZED TO MAKE GRANTS UP TO A GROSS
37 AMOUNT OF FIVE MILLION DOLLARS, TO ESTABLISH COORDINATION BETWEEN THE
38 HEALTH HOMES AND THE CRIMINAL JUSTICE SYSTEM AND FOR THE INTEGRATION OF
39 INFORMATION OF HEALTH HOMES WITH STATE AND LOCAL CORRECTIONAL FACILI-
40 TIES, TO THE EXTENT PERMITTED BY LAW. HEALTH HOMES RECEIVING FUNDS UNDER
41 THIS SUBDIVISION SHALL BE REQUIRED TO DOCUMENT AND DEMONSTRATE THE
42 EFFECTIVE USE OF FUNDS DISTRIBUTED HEREIN.
43 2-C. THE COMMISSIONER IS AUTHORIZED TO MAKE GRANTS UP TO A GROSS
44 AMOUNT OF ONE MILLION DOLLARS FOR CERTIFIED APPLICATION COUNSELORS AND
45 ASSISTORS TO FACILITATE THE ENROLLMENT OF PERSONS IN HIGH RISK POPU-
46 LATIONS, INCLUDING BUT NOT LIMITED TO PERSONS WITH MENTAL HEALTH AND/OR
47 SUBSTANCE ABUSE CONDITIONS THAT HAVE BEEN RECENTLY DISCHARGED OR ARE
48 PENDING RELEASE FROM STATE AND LOCAL CORRECTIONAL FACILITIES. FUNDS
49 ALLOCATED FOR CERTIFIED APPLICATION COUNSELORS AND ASSISTORS SHALL BE
50 EXPENDED THROUGH A REQUEST FOR PROPOSAL PROCESS.
51 S 26. Intentionally omitted.
52 S 27. Intentionally omitted.
53 S 28. Subdivisions 6 and 7 of section 369-gg of the social services
54 law are renumbered 7 and 8 and a new subdivision 6 is added to read as
55 follows:
S. 2007--B 22 A. 3007--B
1 6. RATES OF PAYMENT. (A) THE COMMISSIONER SHALL SELECT THE CONTRACT
2 WITH AN INDEPENDENT ACTUARY TO STUDY AND RECOMMEND APPROPRIATE
3 REIMBURSEMENT METHODOLOGIES FOR THE COST OF HEALTH CARE SERVICE COVERAGE
4 PURSUANT TO THIS TITLE. SUCH INDEPENDENT ACTUARY SHALL REVIEW AND MAKE
5 RECOMMENDATIONS CONCERNING APPROPRIATE ACTUARIAL ASSUMPTIONS RELEVANT TO
6 THE ESTABLISHMENT OF REIMBURSEMENT METHODOLOGIES, INCLUDING BUT NOT
7 LIMITED TO; THE ADEQUACY OF RATES OF PAYMENT IN RELATION TO THE POPU-
8 LATION TO BE SERVED ADJUSTED FOR CASE MIX, THE SCOPE OF HEALTH CARE
9 SERVICES APPROVED ORGANIZATIONS MUST PROVIDE, THE UTILIZATION OF SUCH
10 SERVICES AND THE NETWORK OF PROVIDERS REQUIRED TO MEET STATE STANDARDS.
11 (B) UPON CONSULTATION WITH THE INDEPENDENT ACTUARY AND ENTITIES
12 REPRESENTING APPROVED ORGANIZATIONS, THE COMMISSIONER SHALL DEVELOP
13 REIMBURSEMENT METHODOLOGIES AND FEE SCHEDULES FOR DETERMINING RATES OF
14 PAYMENT, WHICH RATE SHALL BE APPROVED BY THE DIRECTOR OF THE DIVISION OF
15 THE BUDGET, TO BE MADE BY THE DEPARTMENT TO APPROVED ORGANIZATIONS FOR
16 THE COST OF HEALTH CARE SERVICES COVERAGE PURSUANT TO THIS TITLE. SUCH
17 REIMBURSEMENT METHODOLOGIES AND FEE SCHEDULES MAY INCLUDE PROVISIONS FOR
18 CAPITATION ARRANGEMENTS.
19 (C) THE COMMISSIONER SHALL HAVE THE AUTHORITY TO PROMULGATE REGU-
20 LATIONS, INCLUDING EMERGENCY REGULATIONS, NECESSARY TO EFFECTUATE THE
21 PROVISIONS OF THIS SUBDIVISION.
22 (D) THE DEPARTMENT SHALL REQUIRE THE INDEPENDENT ACTUARY SELECTED
23 PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION TO PROVIDE A COMPLETE
24 ACTUARIAL REPORT, ALONG WITH ALL ACTUARIAL ASSUMPTIONS MADE AND ALL
25 OTHER DATA, MATERIALS AND METHODOLOGIES USED IN THE DEVELOPMENT OF RATES
26 FOR THE BASIC HEALTH PLAN AUTHORIZED UNDER THIS SECTION. SUCH REPORT
27 SHALL BE PROVIDED ANNUALLY TO THE TEMPORARY PRESIDENT OF THE SENATE AND
28 THE SPEAKER OF THE ASSEMBLY.
29 S 28-a. Subdivision 2 of section 369-gg of the social services law, as
30 added by section 51 of part C of chapter 60 of the laws of 2014, is
31 amended and a new subdivision 9 is added to read as follows:
32 2. Authorization. If it is in the financial interest of the state to
33 do so, the commissioner of health is authorized, with the approval of
34 the director of the budget, to establish a basic health program. The
35 commissioner's authority pursuant to this section is contingent upon
36 obtaining and maintaining all necessary approvals from the secretary of
37 health and human services to offer a basic health program in accordance
38 with 42 U.S.C. 18051. The commissioner may take any and all actions
39 necessary to obtain such approvals. NOTWITHSTANDING THE FOREGOING, WITH-
40 IN NINETY DAYS OF THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS OF TWO
41 THOUSAND FIFTEEN WHICH AMENDED THIS SUBDIVISION THE COMMISSIONER SHALL
42 SUBMIT A REPORT TO THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER
43 OF THE ASSEMBLY DETAILING A CONTINGENCY PLAN IN THE EVENT ELIGIBILITY
44 RULES OR REGULATIONS ARE MODIFIED OR REPEALED; OR IN THE EVENT FEDERAL
45 PAYMENT IS REDUCED FROM NINETY FIVE PERCENT OF THE PREMIUM TAX CREDITS
46 AND COST-SHARING REDUCTIONS PURSUANT TO THE PATIENT PROTECTION AND
47 AFFORDABLE CARE ACT (P.L. 111-148). THE CONTINGENCY PLAN SHALL BE IMPLE-
48 MENTED WITHIN NINETY DAYS OF THE ABOVE STATED EVENTS OR THE TIME PERIOD
49 SPECIFIED IN FEDERAL LAW.
50 9. REPORTING. THE COMMISSIONER SHALL SUBMIT A REPORT TO THE TEMPORARY
51 PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ANNUALLY BY
52 DECEMBER THIRTY-FIRST. THE REPORT SHALL INCLUDE, AT A MINIMUM, AN ANALY-
53 SIS OF THE BASIC HEALTH PROGRAM AND ITS IMPACT ON THE FINANCIAL INTEREST
54 OF THE STATE; ITS IMPACT ON THE HEALTH BENEFIT EXCHANGE INCLUDING
55 ENROLLMENT AND PREMIUMS; ITS IMPACT ON THE NUMBER OF UNINSURED INDIVID-
56 UALS IN THE STATE; ITS IMPACT ON THE MEDICAID GLOBAL CAP; AND THE DEMO-
S. 2007--B 23 A. 3007--B
1 GRAPHICS OF BASIC HEALTH PROGRAM ENROLLEES INCLUDING AGE AND IMMIGRATION
2 STATUS.
3 S 29. Section 1 of part B of chapter 59 of the laws of 2011, amending
4 the public health law relating to rates of payment and medical assist-
5 ance, is amended to read as follows:
6 Section 1. (a) Notwithstanding any inconsistent provision of law,
7 rule or regulation to the contrary, and subject to the availability of
8 federal financial participation, effective for the period April 1, 2011
9 through March 31, 2012, and each state fiscal year thereafter, the
10 department of health is authorized to make supplemental Medicaid
11 payments OR SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS for professional
12 services provided by physicians, nurse practitioners and physician
13 assistants who are participating in a plan for the management of clin-
14 ical practice at the State University of New York, in accordance with
15 title 11 of article 5 of the social services law for patients eligible
16 for federal financial participation under title XIX of the federal
17 social security act, in amounts that will increase fees for such profes-
18 sional services to an amount equal to the average commercial or Medicare
19 rate that would otherwise be received for such services rendered by such
20 physicians, nurse practitioners and physician assistants. The calcu-
21 lation of such supplemental fee payments shall be made in accordance
22 with applicable federal law and regulation and subject to the approval
23 of the division of the budget. Such supplemental Medicaid fee payments
24 may be added to the professional fees paid under the fee schedule [or],
25 made as aggregate lump sum payments to eligible clinical practice plans
26 authorized to receive professional fees OR MADE AS SUPPLEMENTAL PAYMENTS
27 MADE FOR SUCH PURPOSE AS DESCRIBED HEREIN TO MEDICAID MANAGED CARE
28 ORGANIZATIONS. SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS UNDER THIS
29 SECTION SHALL BE DISTRIBUTED TO PROVIDERS AS DETERMINED BY THE MANAGED
30 CARE MODEL CONTRACT AND MAY UTILIZE MANAGED CARE ORGANIZATION REPORTED
31 ENCOUNTER DATA AND OTHER SUCH METRICS AS DETERMINED BY THE DEPARTMENT OF
32 HEALTH IN ORDER TO ENSURE RATES OF PAYMENT EQUIVALENT TO THE AVERAGE
33 COMMERCIAL OR MEDICARE RATE THAT WOULD OTHERWISE BE RECEIVED FOR SUCH
34 SERVICES RENDERED BY SUCH PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN
35 ASSISTANTS.
36 (b) The affiliated State University of New York health science centers
37 shall be responsible for payment of one hundred percent of the non-fed-
38 eral share of such supplemental Medicaid payments OR SUPPLEMENTAL MEDI-
39 CAID MANAGED CARE PAYMENTS for all services provided by physicians,
40 nurse practitioners and physician assistants who are participating in a
41 plan for the management of clinical practice, in accordance with section
42 365-a of the social services law, regardless of whether another social
43 services district or the department of health may otherwise be responsi-
44 ble for furnishing medical assistance to the eligible persons receiving
45 such services.
46 S 30. Section 93 of part H of chapter 59 of the laws of 2011, amending
47 the public health law relating to general hospital inpatient reimburse-
48 ment for annual rates, is amended to read as follows:
49 S 93. 1. Notwithstanding any inconsistent provision of law, rule or
50 regulation to the contrary, and subject to the availability of federal
51 financial participation, effective for the period April 1, 2011 through
52 March 31, 2012, and each state fiscal year thereafter, the department of
53 health is authorized to make supplemental Medicaid payments OR SUPPLE-
54 MENTAL MEDICAID MANAGED CARE PAYMENTS for professional services provided
55 by physicians, nurse practitioners and physician assistants who are
56 employed by a public benefit corporation or a non-state operated public
S. 2007--B 24 A. 3007--B
1 general hospital operated by a public benefit corporation or who are
2 providing professional services at a facility of such public benefit
3 corporation as either a member of a practice plan or an employee of a
4 professional corporation or limited liability corporation under contract
5 to provide services to patients of such a public benefit corporation, in
6 accordance with title 11 of article 5 of the social services law for
7 patients eligible for federal financial participation under title XIX of
8 the federal social security act, in amounts that will increase fees for
9 such professional services to an amount equal to either the Medicare
10 rate or the average commercial rate that would otherwise be received for
11 such services rendered by such physicians, nurse practitioners and
12 physician assistants, provided, however, that such supplemental fee
13 payments shall not be available with regard to services provided at
14 facilities participating in the Medicare Teaching Election Amendment.
15 The calculation of such supplemental fee payments shall be made in
16 accordance with applicable federal law and regulation and subject to the
17 approval of the division of the budget. Such supplemental Medicaid fee
18 payments may be added to the professional fees paid under the fee sched-
19 ule [or], made as aggregate lump sum payments to entities authorized to
20 receive professional fees OR MADE AS SUPPLEMENTAL PAYMENTS MADE FOR SUCH
21 PURPOSE AS DESCRIBED HEREIN TO MEDICAID MANAGED CARE ORGANIZATIONS.
22 SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS UNDER THIS SECTION SHALL BE
23 DISTRIBUTED TO PROVIDERS AS DETERMINED BY THE MANAGED CARE MODEL
24 CONTRACT AND MAY UTILIZE MANAGED CARE ORGANIZATION REPORTED ENCOUNTER
25 DATA AND OTHER SUCH METRICS AS DETERMINED BY THE DEPARTMENT OF HEALTH IN
26 ORDER TO ENSURE RATES OF PAYMENT EQUIVALENT TO THE AVERAGE COMMERCIAL OR
27 MEDICARE RATE THAT WOULD OTHERWISE BE RECEIVED FOR SUCH SERVICES
28 RENDERED BY SUCH PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSIST-
29 ANTS.
30 2. The supplemental Medicaid payments OR SUPPLEMENTAL MEDICAID MANAGED
31 CARE PAYMENTS for professional services authorized by subdivision one of
32 this section may be made only at the election of the public benefit
33 corporation or the local social services district in which the non-state
34 operated public general hospital is located. The electing public benefit
35 corporation or local social services district shall, notwithstanding the
36 social services district Medicaid cap provisions of Part C of chapter 58
37 of the laws of 2005, be responsible for payment of one hundred percent
38 of the non-federal share of such supplemental Medicaid payments, in
39 accordance with section 365-a of the social services law, regardless of
40 whether another social services district or the department of health may
41 otherwise be responsible for furnishing medical assistance to the eligi-
42 ble persons receiving such services. Social services district or public
43 benefit corporation funding of the non-federal share of any such
44 payments shall be deemed to be voluntary for purposes of the increased
45 federal medical assistance percentage provisions of the American Recov-
46 ery and Reinvestment Act of 2009, provided, however, that in the event
47 the federal Centers for Medicare and Medicaid Services determines that
48 such non-federal share payments are not voluntary payments for purposes
49 of such act, the provisions of this section shall be null and void.
50 S 31. Subparagraph (iii) of paragraph (d) of subdivision 1 of section
51 367-a of the social services law, as amended by section 65 of part H of
52 chapter 59 of the laws 2011, is amended to read as follows:
53 (iii) [When payment under part B of title XVIII of the federal social
54 security act for] WITH RESPECT TO items and services provided to eligi-
55 ble persons who are also beneficiaries under part B of title XVIII of
56 the federal social security act and [for] items and services provided to
S. 2007--B 25 A. 3007--B
1 qualified medicare beneficiaries under part B of title XVIII of the
2 federal social security act [would exceed the amount that otherwise
3 would be made under this title if provided to an eligible person other
4 than a person who is also a beneficiary under part B or is a qualified
5 medicare beneficiary, the amount payable for services covered under this
6 title shall be twenty percent of], THE AMOUNT PAYABLE FOR SERVICES
7 COVERED UNDER THIS TITLE SHALL BE the amount of any co-insurance liabil-
8 ity of such eligible persons pursuant to federal law were they not
9 eligible for medical assistance or were they not qualified medicare
10 beneficiaries with respect to such benefits under such part B, BUT SHALL
11 NOT EXCEED THE AMOUNT THAT OTHERWISE WOULD BE MADE UNDER THIS TITLE IF
12 PROVIDED TO AN ELIGIBLE PERSON OTHER THAN A PERSON WHO IS ALSO A BENEFI-
13 CIARY UNDER PART B OR IS A QUALIFIED MEDICARE BENEFICIARY MINUS THE
14 AMOUNT PAYABLE UNDER PART B; provided, however, amounts payable under
15 this title for items and services provided to eligible persons who are
16 also beneficiaries under part B or to qualified medicare beneficiaries
17 by an ambulance service under the authority of an operating certificate
18 issued pursuant to article thirty of the public health law, a psychol-
19 ogist licensed under article one hundred fifty-three of the education
20 law, or a facility under the authority of an operating certificate
21 issued pursuant to article sixteen, thirty-one or thirty-two of the
22 mental hygiene law and with respect to outpatient hospital and clinic
23 items and services provided by a facility under the authority of an
24 operating certificate issued pursuant to article twenty-eight of the
25 public health law, shall not be less than the amount of any co-insurance
26 liability of such eligible persons or such qualified medicare benefici-
27 aries, or for which such eligible persons or such qualified medicare
28 beneficiaries would be liable under federal law were they not eligible
29 for medical assistance or were they not qualified medicare beneficiaries
30 with respect to such benefits under part B.
31 S 32.Intentionally omitted.
32 S 33.Intentionally omitted.
33 S 34.Intentionally omitted.
34 S 35. Section 133 of the social services law, as amended by chapter
35 455 of the laws of 2010, is amended to read as follows:
36 S 133. Temporary preinvestigation emergency needs assistance or care.
37 Upon application for public assistance or care under this chapter, the
38 local social services district shall notify the applicant in writing of
39 the availability of a monetary grant adequate to meet emergency needs
40 assistance or care and shall, at such time, determine whether such
41 person is in immediate need. If it shall appear that a person is in
42 immediate need, emergency needs assistance or care shall be granted
43 pending completion of an investigation. The written notification
44 required by this section shall inform such person of a right to an expe-
45 dited hearing when emergency needs assistance or care is denied. A
46 public assistance applicant who has been denied emergency needs assist-
47 ance or care must be given reason for such denial in a written determi-
48 nation which sets forth the basis for such denial. NOTHING IN THIS
49 SECTION SHALL BE CONSTRUED TO REQUIRE THE SOCIAL SERVICES DISTRICT OR
50 ANY STATE AGENCY TO PROVIDE MEDICAL ASSISTANCE, EXCEPT AS OTHERWISE
51 REQUIRED BY TITLE ELEVEN OF THIS ARTICLE.
52 S 36. Subdivision 7 of section 364-i of the social services law, as
53 added by section 34 of part A of chapter 56 of the laws of 2013, is
54 amended to read as follows:
55 7. Notwithstanding [section one hundred thirty-three of this chapter]
56 ANY OTHER SECTION OF LAW, where care [or], services, OR SUPPLIES are
S. 2007--B 26 A. 3007--B
1 received prior to the date [the] AN individual is determined eligible
2 for assistance under this title, medical assistance reimbursement,
3 REGARDLESS OF FUNDING SOURCE, shall be available for such care [or],
4 services, OR SUPPLIES only (a) if the care [or], services, OR SUPPLIES
5 are received during the three month period preceding the month of appli-
6 cation for medical assistance and the recipient is determined to have
7 been eligible in the month in which the care [or], service, OR SUPPLY
8 was received, or (b) [as] IF provided [for in] DURING A PERIOD OF
9 PRESUMPTIVE ELIGIBILITY PURSUANT TO this section [or regulations of the
10 department].
11 S 36-a. Paragraph (e) of subdivision 2 of section 365-a of the social
12 services law, as amended by section 89 of part H of chapter 59 of the
13 laws of 2011, is amended to read as follows:
14 (e) (i) personal care services, including personal emergency response
15 services, shared aide and an individual aide, subject to the provisions
16 of subparagraphs (ii), (iii), and (iv) of this paragraph, furnished to
17 an individual who is not an inpatient or resident of a hospital, nursing
18 facility, intermediate care facility for the mentally retarded, or
19 institution for mental disease, as determined to meet the recipient's
20 needs for assistance when cost effective and appropriate, and when
21 prescribed by a physician, in accordance with the recipient's plan of
22 treatment and provided by individuals who are qualified to provide such
23 services, who are supervised by a registered nurse and who are not
24 members of the recipient's family, and furnished in the recipient's home
25 or other location;
26 (ii) the commissioner is authorized to adopt standards, pursuant to
27 emergency regulation, for the provision and management of services
28 available under this paragraph for individuals whose need for such
29 services exceeds a specified level to be determined by the commissioner;
30 (iii) the commissioner [is authorized to] SHALL provide assistance to
31 persons receiving services under this paragraph who are transitioning to
32 receiving care from a managed long term care plan certified pursuant to
33 section forty-four hundred three-f of the public health law, CONSISTENT
34 WITH SUBDIVISION THIRTY-ONE OF SECTION THREE HUNDRED SIXTY-FOUR-J OF
35 THIS TITLE;
36 (iv) personal care services available pursuant to this paragraph shall
37 not exceed eight hours per week for individuals whose needs are limited
38 to nutritional and environmental support functions;
39 S 36-b. Section 364-j of the social services law is amended by adding
40 a new subdivision 31 to read as follows:
41 31. (A) THE COMMISSIONER SHALL REQUIRE MANAGED CARE PROVIDERS UNDER
42 THIS SECTION, MANAGED LONG-TERM CARE PLANS UNDER SECTION FORTY-FOUR
43 HUNDRED THREE-F THE PUBLIC HEALTH LAW AND OTHER APPROPRIATE LONG-TERM
44 SERVICE PROGRAMS TO ADOPT EXPEDITED PROCEDURES FOR APPROVING PERSONAL
45 CARE SERVICES FOR A MEDICAL ASSISTANCE RECIPIENT WHO REQUIRES IMMEDIATE
46 PERSONAL CARE OR CONSUMER DIRECTED PERSONAL ASSISTANCE SERVICES PURSUANT
47 TO PARAGRAPH (E) OF SUBDIVISION TWO OF SECTION THREE HUNDRED
48 SIXTY-FIVE-A OF THIS TITLE OR SECTION THREE HUNDRED SIXTY-FIVE-F OF THIS
49 TITLE, RESPECTIVELY, OR OTHER LONG-TERM CARE, AND PROVIDE SUCH CARE OR
50 SERVICES AS APPROPRIATE, PENDING APPROVAL BY SUCH PROVIDER OR PROGRAM.
51 S 36-c. Section 366-a of the social services law is amended by adding
52 a new subdivision 12 to read as follows:
53 12. THE COMMISSIONER SHALL DEVELOP EXPEDITED PROCEDURES FOR DETERMIN-
54 ING MEDICAL ASSISTANCE ELIGIBILITY FOR ANY MEDICAL ASSISTANCE APPLICANT
55 WITH AN IMMEDIATE NEED FOR PERSONAL CARE OR CONSUMER DIRECTED PERSONAL
56 ASSISTANCE SERVICES PURSUANT TO PARAGRAPH (E) OF SUBDIVISION TWO OF
S. 2007--B 27 A. 3007--B
1 SECTION THREE HUNDRED SIXTY-FIVE-A OF THIS TITLE OR SECTION THREE
2 HUNDRED SIXTY-FIVE-F OF THIS TITLE, RESPECTIVELY. SUCH PROCEDURES SHALL
3 REQUIRE THAT A FINAL ELIGIBILITY DETERMINATION BE MADE WITHIN SEVEN DAYS
4 OF THE DATE OF A COMPLETE MEDICAL ASSISTANCE APPLICATION.
5 S 37. Notwithstanding any provision of law to the contrary, monies
6 equal to the amount of enhanced federal medical assistance percentage
7 monies available as a result of the state's participation in the commu-
8 nity first choice state plan option under section 1915 of title XIX of
9 the federal social security act, in each state fiscal year shall be made
10 available as additional funds to be used to implement the state's
11 comprehensive plan for serving New Yorkers with disabilities in the most
12 integrated setting, also know as the state's Olmstead plan. Such monies
13 shall be expended for the purposes consistent with the Olmstead plan,
14 including, additional funding for services provided pursuant to section
15 three hundred sixty-five-f of the social services law, supportive hous-
16 ing, wage supports for home and personal care workers, transportation
17 supports, and the transition of behavioral health services to managed
18 care. The department of health shall, after consultation with the senate
19 finance committee and assembly ways and means committee, stakeholders,
20 relevant state agencies, the division of budget and the Olmstead cabi-
21 net, submit a report to the temporary president of the senate, and the
22 speaker of the assembly, the chair of the senate finance committee, the
23 chair of the assembly ways and means committee, and the chairs of the
24 senate and assembly health committees, setting forth the plan to allo-
25 cate such investments, and shall notify the senate finance committee and
26 the assembly ways and means committee at least forty-five days prior to
27 implementation of such allocation. The commissioner of health shall
28 report annually to the chairs of the assembly and senate committees on
29 health, aging, and mental health, the chair of the senate committee on
30 finance, the chair of the assembly ways and means committee, and the
31 chair of the assembly task force on people with disabilities on the
32 amount of funding received and disbursed pursuant to this section, the
33 projects or proposals supported by these funds, and compliance with this
34 section.
35 S 38. Section 2808 of the public health law is amended by adding a new
36 subdivision 27 to read as follows:
37 27. THE COMMISSIONER IS AUTHORIZED TO CONDUCT AN ENERGY AUDIT AND/OR
38 DISASTER PREPAREDNESS REVIEW OF RESIDENTIAL HEALTH CARE FACILITIES. SUCH
39 AUDIT OR REVIEW SHALL EXPLORE THE ENERGY EFFICIENCY AND/OR DISASTER
40 PREPAREDNESS OF THE REAL PROPERTY CAPITAL ASPECTS OF EACH FACILITY AND
41 DEVELOP A COST/BENEFIT ANALYSIS OF POTENTIAL MODIFICATIONS FOR EACH
42 FACILITY. SUCH AUDIT OR REVIEW SHALL SERVE AS THE BASIS FOR AN ENERGY
43 EFFICIENCY AND/OR DISASTER PREPAREDNESS PROGRAM TO BE DEVELOPED BY THE
44 DEPARTMENT IN REGULATIONS. PARTICIPATION IN SUCH AUDIT OR REVIEW SHALL
45 BE A CONDITION TO PARTICIPATION IN ANY SUCH PROGRAM DEVELOPED AS A
46 RESULT THEREOF, AND SHALL ALSO BE A CONDITION TO RECEIPT OF ANY FUNDING
47 AVAILABLE UNDER SUCH PROGRAM. SUCH PROGRAM SHALL ONLY BE IMPLEMENTED IF
48 IT IS IN THE BEST FINANCIAL INTERESTS OF THE STATE, AS DETERMINED BY THE
49 COMMISSIONER. AT LEAST FORTY-FIVE DAYS PRIOR TO IMPLEMENTING SUCH
50 PROGRAM, THE DEPARTMENT SHALL REPORT TO THE SENATE AND ASSEMBLY HEALTH
51 COMMITTEES, THE ASSEMBLY WAYS AND MEANS COMMITTEE AND THE SENATE FINANCE
52 COMMITTEE THE RESULTS OF THE ENERGY AUDIT AUTHORIZED HEREIN AND THE
53 PROPOSED ELIGIBILITY CRITERIA, FUNDING SOURCES, THE MANNER IN WHICH
54 SAVINGS MAY BE SHARED BETWEEN THE STATE AND FACILITIES AND ANY OTHER
55 INFORMATION REQUESTED BY SUCH COMMITTEES ABOUT SUCH PROGRAM PRIOR TO THE
56 TRANSMITTAL OF THE REPORT.
S. 2007--B 28 A. 3007--B
1 S 39. Intentionally omitted.
2 S 40. Intentionally omitted.
3 S 40-a. Subdivision 8 of section 4403-f of the public health law, as
4 amended by section 21 of part C of chapter 58 of the laws of 2007, is
5 amended to read as follows:
6 8. Payment rates for managed long term care plan enrollees eligible
7 for medical assistance. The commissioner shall establish payment rates
8 for services provided to enrollees eligible under title XIX of the
9 federal social security act. Such payment rates shall be subject to
10 approval by the director of the division of the budget and shall reflect
11 savings to both state and local governments when compared to costs which
12 would be incurred by such program if enrollees were to receive compara-
13 ble health and long term care services on a fee-for-service basis in the
14 geographic region in which such services are proposed to be provided.
15 Payment rates shall be risk-adjusted to take into account the character-
16 istics of enrollees, or proposed enrollees, including, but not limited
17 to: frailty, disability level, health and functional status, age,
18 gender, the nature of services provided to such enrollees, and other
19 factors as determined by the commissioner. The risk adjusted premiums
20 may also be combined with disincentives or requirements designed to
21 mitigate any incentives to obtain higher payment categories. IN SETTING
22 SUCH PAYMENT RATES, THE COMMISSIONER SHALL CONSIDER COSTS BORNE BY THE
23 MANAGED CARE PROGRAM TO ENSURE ACTUARIALLY SOUND AND ADEQUATE RATES OF
24 PAYMENT TO ENSURE QUALITY OF CARE.
25 S 40-b. Intentionally omitted.
26 S 40-c. Subdivision 18 of section 364-j of the social services law is
27 amended by adding a new paragraph (c) to read as follows:
28 (C) IN SETTING SUCH REIMBURSEMENT METHODOLOGIES, THE DEPARTMENT SHALL
29 CONSIDER COSTS BORNE BY THE MANAGED CARE PROGRAM TO ENSURE ACTUARIALLY
30 SOUND AND ADEQUATE RATES OF PAYMENT TO ENSURE QUALITY OF CARE.
31 S 41. Intentionally omitted.
32 S 42. Subdivision 12 of section 367-a of the social services law, as
33 amended by section 63-a of part C of chapter 58 of the laws of 2007, is
34 amended to read as follows:
35 12. Prior to receiving medical assistance under subparagraphs [twelve]
36 FIVE and [thirteen] SIX of paragraph [(a)] (C) of subdivision one of
37 section three hundred sixty-six of this title, a person whose net avail-
38 able income is at least one hundred fifty percent of the applicable
39 federal income official poverty line, as defined and updated by the
40 United States department of health and human services, must pay a month-
41 ly premium, in accordance with a procedure to be established by the
42 commissioner. The amount of such premium shall be twenty-five dollars
43 for an individual who is otherwise eligible for medical assistance under
44 such subparagraphs, and fifty dollars for a couple, both of whom are
45 otherwise eligible for medical assistance under such subparagraphs. No
46 premium shall be required from a person whose net available income is
47 less than one hundred fifty percent of the applicable federal income
48 official poverty line, as defined and updated by the United States
49 department of health and human services.
50 S 43. Subparagraph 6 of paragraph (b) of subdivision 1 of section 366
51 of the social services law, as added by section 1 of part D of chapter
52 56 of the laws of 2013, is amended to read as follows:
53 (6) An individual who is not otherwise eligible for medical assistance
54 under this section is eligible for coverage of family planning services
55 reimbursed by the federal government at a rate of ninety percent, and
56 for coverage of those services identified by the commissioner of health
S. 2007--B 29 A. 3007--B
1 as services generally performed as part of or as a follow-up to a
2 service eligible for such ninety percent reimbursement, including treat-
3 ment for sexually transmitted diseases, if his or her income does not
4 exceed the MAGI-equivalent of two hundred percent of the federal poverty
5 line for the applicable family size, which shall be calculated in
6 accordance with guidance issued by the secretary of the United States
7 department of health and human services[.]; PROVIDED FURTHER THAT THE
8 COMMISSIONER OF HEALTH IS AUTHORIZED TO ESTABLISH CRITERIA FOR PRESUMP-
9 TIVE ELIGIBILITY FOR SERVICES PROVIDED PURSUANT TO THIS SUBPARAGRAPH IN
10 ACCORDANCE WITH ALL APPLICABLE REQUIREMENTS OF FEDERAL LAW OR REGULATION
11 PERTAINING TO SUCH ELIGIBILITY.
12 S 44. Subdivision 1 of section 398-b of the social services law, as
13 added by section 44 of part C of chapter 60 of the laws of 2014, is
14 amended to read as follows:
15 1. Notwithstanding any inconsistent provision of law to the contrary
16 and subject to the availability of federal financial participation, the
17 commissioner is authorized to make grants [from] UP TO a gross amount of
18 five million dollars FOR STATE FISCAL YEAR TWO THOUSAND FOURTEEN--FIF-
19 TEEN AND UP TO A GROSS AMOUNT OF FIFTEEN MILLION DOLLARS FOR STATE
20 FISCAL YEAR TWO THOUSAND FIFTEEN--SIXTEEN to facilitate the transition
21 of foster care children placed with voluntary foster care agencies to
22 managed care. The use of such funds may include providing training and
23 consulting services to voluntary agencies to [access] ASSESS readiness
24 and make necessary infrastructure and organizational modifications,
25 collecting service utilization and other data from voluntary agencies
26 and other entities, and making investments in health information tech-
27 nology, including the infrastructure necessary to establish and maintain
28 electronic health records. Such funds shall be distributed pursuant to a
29 formula to be developed by the commissioner of health, in consultation
30 with the commissioner of the office of CHILDREN AND family [and child]
31 services. In developing such formula the commissioners may take into
32 account size and scope of provider operations as a factor relevant to
33 eligibility for such funds. Each recipient of such funds shall be
34 required to document and demonstrate the effective use of funds distrib-
35 uted herein. IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAILABLE, THEN
36 THE NONFEDERAL SHARE OF PAYMENTS PURSUANT TO THIS SUBDIVISION MAY BE
37 MADE AS STATE GRANTS.
38 S 45. Paragraph (g) of subdivision 1 of section 366 of the social
39 services law, as added by section 50 of part C of chapter 60 of the laws
40 of 2014, is amended to read as follows:
41 (g) Coverage of certain noncitizens. (1) Applicants and recipients who
42 are lawfully admitted for permanent residence, or who are permanently
43 residing in the United States under color of law, OR WHO ARE NON-CITIZ-
44 ENS IN A VALID NONIMMIGRANT STATUS, AS DEFINED IN 8 U.S.C. 1101(A)(15);
45 who are MAGI eligible pursuant to paragraph (b) of this subdivision; and
46 who would be ineligible for medical assistance coverage under subdivi-
47 sions one and two of section three hundred sixty-five-a of this title
48 solely due to their immigration status if the provisions of section one
49 hundred twenty-two of this chapter were applied, shall only be eligible
50 for assistance under this title if enrolled in a standard health plan
51 offered by a basic health program established pursuant to section three
52 hundred sixty-nine-gg of this article if such program is established and
53 operating.
54 (2) With respect to a person described in subparagraph one of this
55 paragraph who is enrolled in a standard health plan, medical assistance
56 coverage shall mean:
S. 2007--B 30 A. 3007--B
1 (i) payment of required premiums and other cost-sharing obligations
2 under the standard health plan that exceed the person's co-payment obli-
3 gation under subdivision six of section three hundred sixty-seven-a of
4 this title; and
5 (ii) payment for services and supplies described in subdivision one or
6 two of section three hundred sixty-five-a of this title, as applicable,
7 but only to the extent that such services and supplies are not covered
8 by the standard health plan.
9 (3) Nothing in this subdivision shall prevent a person described in
10 subparagraph one of this paragraph from qualifying for or receiving
11 medical assistance while his or her enrollment in a standard health plan
12 is pending, in accordance with applicable provisions of this title.
13 S 46. Subdivision 8 of section 369-gg of the social services law, as
14 added by section 51 of part C of chapter 60 of the laws of 2014 and as
15 renumbered by section twenty-eight of this act, is amended to read as
16 follows:
17 8. An individual who is lawfully admitted for permanent residence
18 [or], permanently residing in the United States under color of law, OR
19 WHO IS A NON-CITIZEN IN A VALID NONIMMIGRANT STATUS, AS DEFINED IN 8
20 U.S.C. 1101(A)(15), and who would be ineligible for medical assistance
21 under title eleven of this article due to his or her immigration status
22 if the provisions of section one hundred twenty-two of this chapter were
23 applied, shall be considered to be ineligible for medical assistance for
24 purposes of paragraphs (b) and (c) of subdivision three of this section.
25 S 46-a. Section 365-d of the social services law is REPEALED and a new
26 section 365-d is added to read as follows:
27 S 365-D. MEDICAID EVIDENCE BASED BENEFIT REVIEW ADVISORY COMMITTEE. 1.
28 THE DEPARTMENT SHALL CONVENE A MEDICAID EVIDENCE BASED BENEFIT REVIEW
29 ADVISORY COMMITTEE. THE COMMITTEE SHALL PROVIDE ADVICE AND MAKE RECOM-
30 MENDATIONS REGARDING COVERAGE OF HEALTH TECHNOLOGY OR SERVICE FOR
31 PURPOSES OF THE MEDICAL ASSISTANCE PROGRAM. THE COMMISSIONER SHALL
32 CONSULT SUCH COMMITTEE PRIOR TO ANY DETERMINATION MADE REGARDING THE
33 COVERAGE STATUS OF A PARTICULAR ITEM, HEALTH TECHNOLOGY OR SERVICE BASED
34 ON PROCEDURES ESTABLISHED IN SUBDIVISION FIVE OF THIS SECTION UNDER THE
35 MEDICAL ASSISTANCE PROGRAM. FOR PURPOSES OF THIS SECTION, "HEALTH TECH-
36 NOLOGY" MEANS MEDICAL DEVICES AND SURGICAL PROCEDURES USED IN THE
37 PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE AND OTHER MEDICAL CONDI-
38 TIONS. FOR PURPOSES OF THIS SECTION "SERVICES" MEANS ANY MEDICAL OR
39 BEHAVIORAL HEALTH PROCEDURE.
40 2. (A) THE MEMBERSHIP OF SUCH COMMITTEE SHALL, AT A MINIMUM, INCLUDE:
41 (I) AT LEAST THREE PERSONS LICENSED AND ACTIVELY ENGAGED IN THE PRAC-
42 TICE OF MEDICINE IN THIS STATE;
43 (II) ONE PERSON LICENSED AND ACTIVELY ENGAGED IN THE PRACTICE OF NURS-
44 ING AS A NURSE PRACTITIONER, OR IN THE PRACTICE OF MIDWIFERY IN THIS
45 STATE;
46 (III) ONE PERSON WITH EXPERTISE IN HEALTH TECHNOLOGY ASSESSMENT OR
47 EVIDENCE BASED MEDICAL REVIEW WHO IS PREFERABLY A HEALTH CARE PROFES-
48 SIONAL LICENSED UNDER TITLE EIGHT OF THE EDUCATION LAW;
49 (IV) THREE PERSONS WHO SHALL BE CONSUMERS OR REPRESENTATIVES OF ORGAN-
50 IZATIONS WITH A REGIONAL OR STATEWIDE CONSTITUENCY AND WHO HAVE BEEN
51 INVOLVED IN ACTIVITIES RELATED TO HEALTH CARE CONSUMER ADVOCACY;
52 (V) ONE PERSON WHO IS A REPRESENTATIVE OF A HOSPITAL ORGANIZATION WITH
53 A REGIONAL, NATIONAL OR STATEWIDE CONSTITUENCY;
54 (VI) ONE PERSON WHO IS A REPRESENTATIVE OF A HEALTH INSURANCE OR
55 MANAGED CARE ORGANIZATION WITH A REGIONAL, STATEWIDE OR NATIONAL CONSTI-
56 TUENCY;
S. 2007--B 31 A. 3007--B
1 (VII) ONE PERSON WHO IS A HEALTH ECONOMIST;
2 (VIII) ONE PERSON WITH HEALTH CARE EXPERTISE WHO IS APPOINTED BY THE
3 TEMPORARY PRESIDENT OF THE SENATE;
4 (IX) ONE PERSON WITH HEALTH CARE EXPERTISE WHO IS APPOINTED BY THE
5 SPEAKER OF THE ASSEMBLY;
6 (X) A MEMBER OF THE DEPARTMENT WHO SHALL ACT AS CHAIRPERSON AS DESIG-
7 NATED BY THE COMMISSIONER; AND
8 (XI) THE COMMITTEE MAY INVITE AND CONSULT WITH SCIENTIFIC, TECHNICAL,
9 OR CLINICAL EXPERTS WITH DEMONSTRABLE EXPERIENCE OR KNOWLEDGE OF THE
10 TECHNOLOGY OR MEDICAL SPECIALTY AREA UNDER REVIEW.
11 3. THE DEPARTMENT SHALL PROVIDE VIDEO OR AUDIO ACCESS TO ALL MEETINGS
12 OF SUCH COMMITTEE THROUGH THE DEPARTMENT'S WEBSITE.
13 4. THE MEMBERS OF THE COMMITTEE SHALL RECEIVE NO COMPENSATION FOR
14 THEIR SERVICES BUT SHALL BE REIMBURSED FOR EXPENSES ACTUALLY AND NECES-
15 SARILY INCURRED IN THE PERFORMANCE OF THEIR DUTIES UNLESS EXPRESSLY
16 STATED OTHERWISE IN THIS SECTION, MEMBERS SHALL BE APPOINTED BY THE
17 COMMISSIONER. MEMBERS SHALL SERVE THREE YEAR TERMS, AND MAY BE REAP-
18 POINTED FOR SUBSEQUENT TERMS. COMMITTEE MEMBERS SHALL BE DEEMED TO BE
19 EMPLOYEES OF THE DEPARTMENT FOR PURPOSES OF SECTION SEVENTEEN OF THE
20 PUBLIC OFFICERS LAW, AND SHALL NOT PARTICIPATE IN ANY MATTER BEFORE THE
21 COMMITTEE FOR WHICH A CONFLICT OF INTEREST EXISTS.
22 5. THE COMMITTEE SHALL CONSIDER ANY MATTER REGARDING MATERIAL CHANGES
23 IN THE COVERAGE STATUS OF A PARTICULAR ITEM, HEALTH TECHNOLOGY OR
24 SERVICE, AND ANY MATTER RELATIVE TO NEW HEALTH TECHNOLOGY ASSESSMENT OR
25 MEDICAL EVIDENCE REVIEW FOR WHICH THE DEPARTMENT DETERMINES A SUFFICIENT
26 BODY OF EVIDENCE EXISTS TO WARRANT COMMITTEE DELIBERATION. THE COMMIS-
27 SIONER SHALL PROVIDE MEMBERS OF THE COMMITTEE WITH ANY EVIDENCE OR
28 INFORMATION RELATED TO THE HEALTH TECHNOLOGY OR MEDICAL SERVICE ASSESS-
29 MENT INCLUDING BUT NOT LIMITED TO, INFORMATION SUBMITTED BY MEMBERS OF
30 THE PUBLIC. THE DEPARTMENT SHALL REPORT TO THE COMMITTEE PROGRAMMATIC
31 CHANGES TO BENEFITS THAT DO NOT RISE TO THE LEVEL OF A MATERIAL CHANGE,
32 AS WELL AS DETERMINATIONS OF WHEN SUFFICIENT MEDICAL EVIDENCE EXISTS TO
33 WARRANT COMMITTEE DELIBERATIONS. THE COMMISSIONER SHALL PROVIDE
34 FORTY-FIVE DAYS PUBLIC NOTICE ON THE DEPARTMENT'S WEBSITE PRIOR TO ANY
35 MEETING OF THE COMMITTEE TO DEVELOP RECOMMENDATIONS CONCERNING HEALTH
36 TECHNOLOGY OR MEDICAL SERVICE COVERAGE DETERMINATIONS. SUCH NOTICE
37 SHALL INCLUDE A DESCRIPTION OF THE PROPOSED HEALTH TECHNOLOGY OR SERVICE
38 TO BE REVIEWED, THE CONDITIONS OR DISEASES IMPACTED BY THE HEALTH TECH-
39 NOLOGY OR SERVICE, THE PROPOSALS TO BE CONSIDERED BY THE COMMITTEE, AND
40 THE SYSTEMATIC EVIDENCE-BASED ASSESSMENT PREPARED IN ACCORDANCE WITH
41 THIS SUBDIVISION. THE COMMITTEE SHALL ALLOW INTERESTED PARTIES A REASON-
42 ABLE OPPORTUNITY TO MAKE AN ORAL PRESENTATION TO THE COMMITTEE RELATED
43 TO THE HEALTH TECHNOLOGY OR SERVICE TO BE REVIEWED AND TO SUBMIT WRITTEN
44 INFORMATION. THE COMMITTEE SHALL CONSIDER ANY INFORMATION PROVIDED BY
45 ANY INTERESTED PARTY, INCLUDING, BUT NOT LIMITED TO, HEALTH CARE PROVID-
46 ERS, HEALTH CARE FACILITIES, PATIENTS, CONSUMERS AND MANUFACTURERS. FOR
47 ALL HEALTH TECHNOLOGIES OR SERVICES SELECTED FOR REVIEW, THE DEPARTMENT
48 SHALL CONDUCT OR COMMISSION A SYSTEMATIC EVIDENCE-BASED ASSESSMENT OF
49 THE HEALTH TECHNOLOGY'S OR SERVICE'S SAFETY AND CLINICAL EFFICACY. THE
50 ASSESSMENT SHALL USE ESTABLISHED SYSTEMATIC REVIEW ELEMENTS, STUDY QUAL-
51 ITY ASSESSMENT, AND DATA SYNTHESIS. UPON COMPLETION, THE SYSTEMATIC,
52 EVIDENCE-BASED ASSESSMENT SHALL BE MADE AVAILABLE TO THE PUBLIC.
53 6. THE COMMISSIONER SHALL PROVIDE NOTICE OF ANY COVERAGE RECOMMENDA-
54 TIONS DEVELOPED BY THE COMMITTEE BY MAKING SUCH INFORMATION AVAILABLE ON
55 THE DEPARTMENT'S WEBSITE. SUCH PUBLIC NOTICE SHALL INCLUDE: A SUMMARY
56 OF THE DELIBERATIONS OF THE COMMITTEE; A SUMMARY OF THE POSITIONS OF
S. 2007--B 32 A. 3007--B
1 THOSE MAKING PUBLIC COMMENTS AT MEETINGS OF THE COMMITTEE AND ANY SAFETY
2 AND HEALTH OUTCOMES DATA SUBMITTED BY ANY INTERESTED PARTY; THE RESPONSE
3 OF THE COMMITTEE TO THOSE COMMENTS, IF ANY; THE CLINICAL EVIDENCE UPON
4 WHICH THE COMMITTEE BASES ITS RECOMMENDATIONS; AND THE FINDINGS AND
5 RECOMMENDATIONS OF THE COMMITTEE INCLUDING A FINAL EVIDENCE-BASED
6 SYSTEMATIC ASSESSMENT.
7 7. THE COMMISSIONER SHALL PROVIDE PUBLIC NOTICE ON THE DEPARTMENT'S
8 WEBSITE OF THE COMMITTEE'S RECOMMENDATION AND THE DEPARTMENT'S FINAL
9 DETERMINATION, INCLUDING: THE NATURE OF THE DETERMINATION; AN ANALYSIS
10 OF THE IMPACT OF THE DEPARTMENT'S DETERMINATION ON THE STATE MEDICAID
11 PLAN POPULATIONS AND PROVIDERS; AND THE PROJECTED FISCAL IMPACT TO THE
12 STATE MEDICAID PROGRAM.
13 8. THE RECOMMENDATIONS OF THE COMMITTEE, MADE PURSUANT TO THIS
14 SECTION, SHALL BE BASED ON A REVIEW OF THE EVIDENCE PRESENTED TO THE
15 COMMITTEE, INCLUDING THE CLINICAL EFFECTIVENESS, PATIENT OUTCOMES,
16 IMPACT ON AT RISK AND UNDERSERVED POPULATIONS, AND SAFETY. THE COMMITTEE
17 SHALL REVIEW PREVIOUS RECOMMENDATIONS OF THE COMMITTEE AS NEW EVIDENCE
18 BECOMES AVAILABLE AND PERMIT ORAL PRESENTATIONS AND THE SUBMISSION OF
19 NEW EVIDENCE AT ANY COMMITTEE MEETING. SUCH REVIEW SHALL OCCUR PURSUANT
20 TO THE PROCEDURE ESTABLISHED IN SUBDIVISIONS FIVE AND SIX OF THIS
21 SECTION. THE DEPARTMENT MAY ALTER OR REVOKE THE FINAL DETERMINATION
22 AFTER SUCH REVIEW PURSUANT TO THE PROCEDURE ESTABLISHED IN SUBDIVISION
23 SEVEN OF THIS SECTION.
24 9. THE DEPARTMENT SHALL PROVIDE ADMINISTRATIVE SUPPORT TO THE COMMIT-
25 TEE.
26 S 47. Young adult special populations demonstration programs. The
27 commissioner of health shall establish up to three young adult special
28 populations demonstration programs to provide cost effective, necessary
29 services and enhanced quality of care for targeted populations in order
30 to demonstrate the effectiveness of the programs. Eligible individuals
31 shall have severe and chronic medical or health problems, or multiple
32 disabling conditions which may be combined with developmental disabili-
33 ties. The programs shall provide more appropriate settings and services
34 for these individuals, help prevent out of state placements and allow
35 repatriation back to their home communities. Eligible operator appli-
36 cants shall have demonstrated expertise in caring for the targeted popu-
37 lation including persons with severe and chronic medical or health prob-
38 lems or multiple disabling conditions and a record of providing quality
39 care.
40 Funds may include, but not be limited to, start up funds, capital
41 investments and enhanced rates.
42 Of the demonstrations:
43 (a) at least one shall be designed to serve persons aged twenty-one to
44 thirty-five years of age who are aging out of pediatric acute care
45 hospitals or pediatric nursing homes; and
46 (b) at least one shall be designed to serve persons aged twenty-one to
47 thirty-five years of age who have a developmental disability in addition
48 to their severe and chronic medical or health problems and are aging out
49 of pediatric acute care hospitals, pediatric nursing homes or children's
50 residential homes operated under the jurisdiction of the office for
51 persons with developmental disabilities.
52 The department of health shall be responsible for monitoring the qual-
53 ity and appropriateness and effectiveness of the demonstration programs,
54 and shall report to the legislature no later than December 31, 2015 on
55 what efforts it has undertaken toward the establishment of these demon-
56 stration programs and shall report to the legislature two years follow-
S. 2007--B 33 A. 3007--B
1 ing the establishment of a demonstration program pursuant to this
2 section.
3 S 48. The public health law is amended by adding a new section 2805-x
4 to read as follows:
5 S 2805-X. HOSPITAL-HOME CARE-PHYSICIAN COLLABORATION PROGRAM. 1. THE
6 PURPOSE OF THIS SECTION SHALL BE TO FACILITATE INNOVATION IN HOSPITAL,
7 HOME CARE AGENCY AND PHYSICIAN COLLABORATION IN MEETING THE COMMUNITY'S
8 HEALTH CARE NEEDS. IT SHALL PROVIDE A FRAMEWORK TO SUPPORT VOLUNTARY
9 INITIATIVES IN COLLABORATION TO IMPROVE PATIENT CARE ACCESS AND MANAGE-
10 MENT, PATIENT HEALTH OUTCOMES, COST-EFFECTIVENESS IN THE USE OF HEALTH
11 CARE SERVICES AND COMMUNITY POPULATION HEALTH. SUCH COLLABORATIVE INITI-
12 ATIVES MAY ALSO INCLUDE PAYORS, SKILLED NURSING FACILITIES AND OTHER
13 INTERDISCIPLINARY PROVIDERS, PRACTITIONERS AND SERVICE ENTITIES.
14 2. FOR PURPOSES OF THIS SECTION:
15 (A) "HOSPITAL" SHALL INCLUDE A GENERAL HOSPITAL AS DEFINED IN THIS
16 ARTICLE OR OTHER INPATIENT FACILITY FOR REHABILITATION OR SPECIALTY CARE
17 WITHIN THE DEFINITION OF HOSPITAL IN THIS ARTICLE.
18 (B) "HOME CARE AGENCY" SHALL MEAN A CERTIFIED HOME HEALTH AGENCY, LONG
19 TERM HOME HEALTH CARE PROGRAM OR LICENSED HOME CARE SERVICES AGENCY AS
20 DEFINED IN ARTICLE THIRTY-SIX OF THIS CHAPTER.
21 (C) "PAYOR" SHALL MEAN A HEALTH PLAN APPROVED PURSUANT TO ARTICLE
22 FORTY-FOUR OF THIS CHAPTER, OR ARTICLE THIRTY-TWO OR FORTY-THREE OF THE
23 INSURANCE LAW.
24 (D) "PRACTITIONER" SHALL MEAN ANY OF THE HEALTH, MENTAL HEALTH OR
25 HEALTH RELATED PROFESSIONS LICENSED PURSUANT TO TITLE EIGHT OF THE
26 EDUCATION LAW.
27 3. THE COMMISSIONER IS AUTHORIZED TO PROVIDE FINANCING INCLUDING, BUT
28 NOT LIMITED TO, GRANTS OR POSITIVE ADJUSTMENTS IN MEDICAL ASSISTANCE
29 RATES OR PREMIUM PAYMENTS, TO THE EXTENT OF FUNDS AVAILABLE AND ALLO-
30 CATED OR APPROPRIATED THEREFOR, INCLUDING FUNDS PROVIDED TO THE STATE
31 THROUGH FEDERAL WAIVERS, FUNDS MADE AVAILABLE THROUGH STATE APPROPRI-
32 ATIONS AND/OR FUNDING THROUGH SECTION TWENTY-EIGHT HUNDRED SEVEN-V OF
33 THIS ARTICLE, AS WELL AS WAIVERS OF REGULATIONS UNDER TITLE TEN OF THE
34 NEW YORK CODES, RULES AND REGULATIONS, TO SUPPORT THE VOLUNTARY INITI-
35 ATIVES AND OBJECTIVES OF THIS SECTION.
36 4. HOSPITAL-HOME CARE-PHYSICIAN COLLABORATIVE INITIATIVES UNDER THIS
37 SECTION MAY INCLUDE, BUT SHALL NOT BE LIMITED TO:
38 (A) HOSPITAL-HOME CARE-PHYSICIAN INTEGRATION INITIATIVES, INCLUDING
39 BUT NOT LIMITED TO:
40 (I) TRANSITIONS IN CARE INITIATIVES TO HELP EFFECTIVELY TRANSITION
41 PATIENTS TO POST-ACUTE CARE AT HOME, COORDINATE FOLLOW-UP CARE AND
42 ADDRESS ISSUES CRITICAL TO CARE PLAN SUCCESS AND READMISSION AVOIDANCE;
43 (II) CLINICAL PATHWAYS FOR SPECIFIED CONDITIONS, GUIDING PATIENTS'
44 PROGRESS AND OUTCOME GOALS, AS WELL AS EFFECTIVE HEALTH SERVICES USE;
45 (III) APPLICATION OF TELEHEALTH/TELEMEDICINE SERVICES IN MONITORING
46 AND MANAGING PATIENT CONDITIONS, AND PROMOTING SELF-CARE/MANAGEMENT,
47 IMPROVED OUTCOMES AND EFFECTIVE SERVICES USE;
48 (IV) FACILITATION OF PHYSICIAN HOUSE CALLS TO HOMEBOUND PATIENTS
49 AND/OR TO PATIENTS FOR WHOM SUCH HOME VISITS ARE DETERMINED NECESSARY
50 AND EFFECTIVE FOR PATIENT CARE MANAGEMENT;
51 (V) ADDITIONAL MODELS FOR PREVENTION OF AVOIDABLE HOSPITAL READMIS-
52 SIONS AND EMERGENCY ROOM VISITS;
53 (VI) HEALTH HOME DEVELOPMENT;
54 (VII) DEVELOPMENT AND DEMONSTRATION OF NEW MODELS OF INTEGRATED OR
55 COLLABORATIVE CARE AND CARE MANAGEMENT NOT OTHERWISE ACHIEVABLE THROUGH
56 EXISTING MODELS; AND
S. 2007--B 34 A. 3007--B
1 (VIII) BUNDLED PAYMENT DEMONSTRATIONS FOR HOSPITAL-TO-POST-ACUTE-CARE
2 FOR SPECIFIED CONDITIONS OR CATEGORIES OF CONDITIONS, IN PARTICULAR,
3 CONDITIONS PREDISPOSED TO HIGH PREVALENCE OF READMISSION, INCLUDING
4 THOSE CURRENTLY SUBJECT TO FEDERAL/STATE PENALTY, AND OTHER DISCHARGES
5 WITH EXTENSIVE POST-ACUTE NEEDS;
6 (B) RECRUITMENT, TRAINING AND RETENTION OF HOSPITAL/HOME CARE DIRECT
7 CARE STAFF AND PHYSICIANS, IN GEOGRAPHIC OR CLINICAL AREAS OF DEMON-
8 STRATED NEED. SUCH INITIATIVES MAY INCLUDE, BUT ARE NOT LIMITED TO, THE
9 FOLLOWING ACTIVITIES:
10 (I) OUTREACH AND PUBLIC EDUCATION ABOUT THE NEED AND VALUE OF SERVICE
11 IN HEALTH OCCUPATIONS;
12 (II) TRAINING/CONTINUING EDUCATION AND REGULATORY FACILITATION FOR
13 CROSS-TRAINING TO MAXIMIZE FLEXIBILITY IN THE UTILIZATION OF STAFF,
14 INCLUDING:
15 (A) TRAINING OF HOSPITAL NURSES IN HOME CARE;
16 (B) DUAL CERTIFIED NURSE AIDE/HOME HEALTH AIDE CERTIFICATION; AND
17 (C) DUAL PERSONAL CARE AIDE/HHA CERTIFICATION;
18 (III) SALARY/BENEFIT ENHANCEMENT;
19 (IV) CAREER LADDER DEVELOPMENT; AND
20 (V) OTHER INCENTIVES TO PRACTICE IN SHORTAGE AREAS; AND
21 (C) HOSPITAL - HOME CARE - PHYSICIAN COLLABORATIVES FOR THE CARE AND
22 MANAGEMENT OF SPECIAL NEEDS, HIGH-RISK AND HIGH-COST PATIENTS, INCLUDING
23 BUT NOT LIMITED TO BEST PRACTICES, AND TRAINING AND EDUCATION OF DIRECT
24 CARE PRACTITIONERS AND SERVICE EMPLOYEES.
25 5. HOSPITALS AND HOME CARE AGENCIES WHICH ARE PROVIDED FINANCING OR
26 WAIVERS PURSUANT TO THIS SECTION SHALL REPORT TO THE COMMISSIONER ON THE
27 PATIENT, SERVICE AND COST EXPERIENCES PURSUANT TO THIS SECTION, INCLUD-
28 ING THE EXTENT TO WHICH THE PROJECT GOALS ARE ACHIEVED. THE COMMISSIONER
29 SHALL COMPILE AND MAKE SUCH REPORTS AVAILABLE ON THE DEPARTMENT'S
30 WEBSITE.
31 S 49. The public health law is amended by adding two new sections
32 3614-d and 3614-e to read as follows:
33 S 3614-D. UNIVERSAL STANDARDS FOR CODING OF PAYMENT FOR MEDICAL
34 ASSISTANCE CLAIMS FOR LONG TERM CARE. CLAIMS FOR PAYMENT SUBMITTED UNDER
35 CONTRACTS OR AGREEMENTS WITH INSURERS UNDER THE MEDICAL ASSISTANCE
36 PROGRAM FOR HOME AND COMMUNITY-BASED LONG-TERM CARE SERVICES PROVIDED
37 UNDER THIS ARTICLE, BY FISCAL INTERMEDIARIES OPERATING PURSUANT TO
38 SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW, AND BY
39 RESIDENTIAL HEALTH CARE FACILITIES OPERATING PURSUANT TO ARTICLE TWEN-
40 TY-EIGHT OF THIS CHAPTER SHALL HAVE STANDARD BILLING CODES. SUCH INSUR-
41 ERS SHALL INCLUDE BUT NOT BE LIMITED TO MEDICAID MANAGED CARE PLANS AND
42 MANAGED LONG TERM CARE PLANS. SUCH PAYMENTS SHALL BE BASED ON UNIVERSAL
43 BILLING CODES APPROVED BY THE DEPARTMENT OR A NATIONALLY ACCREDITED
44 ORGANIZATION AS APPROVED BY THE DEPARTMENT; PROVIDED, HOWEVER, SUCH
45 CODING SHALL BE CONSISTENT WITH ANY CODES DEVELOPED AS PART OF THE
46 UNIFORM ASSESSMENT SYSTEM FOR LONG TERM CARE ESTABLISHED BY THE DEPART-
47 MENT.
48 S 3614-E. ELECTRONIC PAYMENT OF CLAIMS. THE PAYMENT OF CLAIMS SUBMIT-
49 TED UNDER CONTRACTS OR AGREEMENTS WITH INSURERS UNDER THE MEDICAL
50 ASSISTANCE PROGRAM FOR HOME AND COMMUNITY-BASED LONG-TERM CARE SERVICES
51 PROVIDED UNDER THIS ARTICLE, BY FISCAL INTERMEDIARIES OPERATING PURSUANT
52 TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW, AND BY
53 RESIDENTIAL HEALTH CARE FACILITIES OPERATING PURSUANT TO ARTICLE TWEN-
54 TY-EIGHT OF THIS CHAPTER SHALL BE PAID VIA ELECTRONIC FUNDS TRANSFER.
55 SUCH INSURERS SHALL INCLUDE BUT NOT BE LIMITED TO MEDICAID MANAGED CARE
56 PLANS AND MANAGED LONG-TERM CARE PLANS.
S. 2007--B 35 A. 3007--B
1 S 50. Subdivision 4 of section 365-h of the social services law, as
2 amended by section 20 of part B of chapter 109 of the laws of 2010, is
3 amended to read as follows:
4 4. The commissioner of health is authorized to assume responsibility
5 from a local social services official for the provision and reimburse-
6 ment of transportation costs under this section. If the commissioner
7 elects to assume such responsibility, the commissioner shall notify the
8 local social services official in writing as to the election, the date
9 upon which the election shall be effective and such information as to
10 transition of responsibilities as the commissioner deems prudent. The
11 commissioner is authorized to contract with a transportation manager or
12 managers to manage transportation services in any local social services
13 district, OTHER THAN TRANSPORTATION SERVICES PROVIDED OR ARRANGED FOR
14 ENROLLEES OF MANAGED LONG TERM CARE PLANS ISSUED CERTIFICATES OF AUTHOR-
15 ITY UNDER SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW.
16 Any transportation manager or managers selected by the commissioner to
17 manage transportation services shall have proven experience in coordi-
18 nating transportation services in a geographic and demographic area
19 similar to the area in New York state within which the contractor would
20 manage the provision of services under this section. Such a contract or
21 contracts may include responsibility for: review, approval and process-
22 ing of transportation orders; management of the appropriate level of
23 transportation based on documented patient medical need; and development
24 of new technologies leading to efficient transportation services. If the
25 commissioner elects to assume such responsibility from a local social
26 services district, the commissioner shall examine and, if appropriate,
27 adopt quality assurance measures that may include, but are not limited
28 to, global positioning tracking system reporting requirements and
29 service verification mechanisms. Any and all reimbursement rates devel-
30 oped by transportation managers under this subdivision shall be subject
31 to the review and approval of the commissioner. [Notwithstanding any
32 inconsistent provision of sections one hundred twelve and one hundred
33 sixty-three of the state finance law, or section one hundred forty-two
34 of the economic development law, or any other law, the commissioner is
35 authorized to enter into a contract or contracts under this subdivision
36 without a competitive bid or request for proposal process, provided,
37 however, that:
38 (a) the department shall post on its website, for a period of no less
39 than thirty days:
40 (i) a description of the proposed services to be provided pursuant to
41 the contract or contracts;
42 (ii) the criteria for selection of a contractor or contractors;
43 (iii) the period of time during which a prospective contractor may
44 seek selection, which shall be no less than thirty days after such
45 information is first posted on the website; and
46 (iv) the manner by which a prospective contractor may seek such
47 selection, which may include submission by electronic means;
48 (b) all reasonable and responsive submissions that are received from
49 prospective contractors in timely fashion shall be reviewed by the
50 commissioner; and
51 (c) the commissioner shall select such contractor or contractors that,
52 in his or her discretion, are best suited to serve the purposes of this
53 section.]
54 S 51. Section 2826 of the public health law is amended by adding a new
55 subdivision (c-1) to read as follows:
S. 2007--B 36 A. 3007--B
1 (C-1) THE COMMISSIONER, UNDER APPLICATIONS SUBMITTED TO THE DEPARTMENT
2 PURSUANT TO SUBDIVISION (D) OF THIS SECTION, SHALL CONSIDER CRITERIA
3 THAT INCLUDES, BUT IS NOT LIMITED TO:
4 (I) SUCH APPLICANT'S FINANCIAL CONDITION AS EVIDENCED BY OPERATING
5 MARGINS, NEGATIVE FUND BALANCE OR NEGATIVE EQUITY POSITION;
6 (II) THE EXTENT TO WHICH SUCH APPLICANT FULFILLS OR WILL FULFILL AN
7 UNMET HEALTH CARE NEED FOR ACUTE INPATIENT, OUTPATIENT, PRIMARY OR RESI-
8 DENTIAL HEALTH CARE SERVICES IN A COMMUNITY;
9 (III) THE EXTENT TO WHICH SUCH APPLICATION WILL INVOLVE SAVINGS TO THE
10 MEDICAID PROGRAM;
11 (IV) THE QUALITY OF THE APPLICATION AS EVIDENCED BY SUCH APPLICATION'S
12 LONG TERM SOLUTIONS FOR SUCH APPLICANT TO ACHIEVE SUSTAINABLE HEALTH
13 CARE SERVICES, IMPROVING THE QUALITY OF PATIENT CARE, AND/OR TRANSFORM-
14 ING THE DELIVERY OF HEALTH CARE SERVICES TO MEET COMMUNITY NEEDS;
15 (V) THE EXTENT TO WHICH SUCH APPLICANT IS GEOGRAPHICALLY ISOLATED IN
16 RELATION TO OTHER PROVIDERS; OR
17 (VI) THE EXTENT TO WHICH SUCH APPLICANT PROVIDES SERVICES TO AN UNDER-
18 SERVED AREA IN RELATION TO OTHER PROVIDERS.
19 S 52. Paragraph (d) of subdivision 2-a of section 2808 of the public
20 health law, as added by chapter 483 of the laws of 1978, is amended to
21 read as follows:
22 (d) For facilities granted operating certificates on or after March
23 tenth, nineteen hundred seventy-five, recognition of real property costs
24 in such regulations shall be based upon historical costs to the owner of
25 the facility, provided that payment for real property costs shall not be
26 in excess of the actual debt service, including principal and interest,
27 and payment with respect to owner's equity, AND FURTHER PROVIDED THAT,
28 SUBJECT TO FEDERAL FINANCIAL PARTICIPATION, AND SUBJECT TO THE APPROVAL
29 OF THE COMMISSIONER, EFFECTIVE APRIL FIRST, TWO THOUSAND FIFTEEN, THE
30 COMMISSIONER MAY MODIFY SUCH PAYMENTS FOR REAL PROPERTY COSTS FOR
31 PURPOSES OF EFFECTUATING A SHARED SAVINGS PROGRAM, WHEREBY FACILITIES
32 SHARE A MINIMUM OF FIFTY PERCENT OF SAVINGS, FOR FACILITIES THAT ELECT
33 TO REFINANCE THEIR MORTGAGE LOANS. For purposes of this subdivision,
34 owner's equity shall be calculated without regard to any surplus created
35 by revaluation of assets and shall not include amounts resulting from
36 mortgage amortization where the payment therefor has been provided by
37 real property cost reimbursement.
38 S 53. The opening paragraph of subdivision 1 and subdivision 3 of
39 section 367-s of the social services law, as amended by section 8 of
40 part C of chapter 60 of the laws of 2014, are amended to read as
41 follows:
42 Notwithstanding any provision of law to the contrary, a supplemental
43 medical assistance payment shall be made on an annual basis to providers
44 of emergency medical transportation services in an aggregate amount not
45 to exceed four million dollars for two thousand six, six million dollars
46 for two thousand seven, six million dollars for two thousand eight,
47 [and] six million dollars for the period May first, two thousand four-
48 teen through March thirty-first, two thousand fifteen, AND SIX MILLION
49 DOLLARS ANNUALLY BEGINNING WITH THE PERIOD APRIL FIRST, TWO THOUSAND
50 FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SIXTEEN pursuant to the
51 following methodology:
52 3. If all necessary approvals under federal law and regulation are not
53 obtained to receive federal financial participation in the payments
54 authorized by this section, payments under this section shall be made in
55 an aggregate amount not to exceed two million dollars for two thousand
56 six, three million dollars for two thousand seven, three million dollars
S. 2007--B 37 A. 3007--B
1 for two thousand eight [and], three million dollars for the period May
2 first, two thousand fourteen through March thirty-first, two thousand
3 fifteen, AND THREE MILLION DOLLARS ANNUALLY BEGINNING WITH THE PERIOD
4 APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
5 SAND SIXTEEN. In such case, the multiplier set forth in paragraph (b) of
6 subdivision one of this section shall be deemed to be two million
7 dollars or three million dollars as applicable to the annual period.
8 S 54. Paragraph (e) of subdivision 8 of section 2511 of the public
9 health law is REPEALED.
10 S 55. Subdivision 18 of section 364-j of the social services law is
11 amended by adding two new paragraphs (c) and (d) to read as follows:
12 (C) THE DEPARTMENT OF HEALTH SHALL REQUIRE THE INDEPENDENT ACTUARY
13 SELECTED PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION TO PROVIDE A
14 COMPLETE ACTUARIAL MEMORANDUM, ALONG WITH ALL ACTUARIAL ASSUMPTIONS MADE
15 AND ALL OTHER DATA, MATERIALS AND METHODOLOGIES USED IN THE DEVELOPMENT
16 OF RATES, TO MANAGED CARE PROVIDERS THIRTY DAYS PRIOR TO SUBMISSION OF
17 SUCH RATES TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR
18 APPROVAL. MANAGED CARE PROVIDERS MAY REQUEST ADDITIONAL REVIEW OF THE
19 ACTUARIAL SOUNDNESS OF THE RATE SETTING PROCESS AND/OR METHODOLOGY.
20 (D) THE DEPARTMENT OF HEALTH SHALL ANNUALLY PROVIDE TO THE TEMPORARY
21 PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY THE ANNUAL MEDI-
22 CAID MANAGED CARE OPERATING REPORTS SUBMITTED TO THE DEPARTMENT FROM
23 MANAGED CARE PLANS THAT CONTRACT WITH THE STATE TO MANAGE SERVICES
24 PROVIDED UNDER THE MEDICAID PROGRAM.
25 S 56. Subdivisions 2 and 3 of section 19 of part B of chapter 58 of
26 the laws of 2007 amending the elder law and other laws relating to
27 authorizing the adjustment of the Medicaid nursing home capital
28 reimbursement cap are amended to read as follows:
29 2. Notwithstanding subdivision one of this section, on a demonstration
30 basis, without requirement for a request for proposals, the department
31 may adjust the medicaid nursing home capital reimbursement cap in order
32 to: (A) effectuate the construction of a residential health care facili-
33 ty described in subdivision one of this section, by the Capital Region
34 Rehabilitation Center also known as the Eddy Cohoes Rehabilitation
35 Center; AND (B) EFFECTUATE A RESIDENTIAL HEALTH CARE FACILITY
36 CONSTRUCTION PROJECT BY THE JEWISH HOME OF ROCHESTER.
37 3. Upon completion and occupation of the [first] residential unit of a
38 facility under this demonstration and annually thereafter, [the Capital
39 Region Rehabilitation Center also known as the Eddy Cohoes Rehabili-
40 tation Center] THE ELIGIBLE FACILITIES shall report to the department on
41 the number of patients served, the type of services provided, and
42 outcome and financial data that demonstrates the efficacy of this resi-
43 dential model.
44 S 57. Notwithstanding any inconsistent provision of law, rule or regu-
45 lation to the contrary, for purposes of implementing the provisions of
46 the public health law and the social services law, references to titles
47 XIX and XXI of the federal social security act in the public health law
48 and the social services law shall be deemed to include and also to mean
49 any successor titles thereto under the federal social security act.
50 S 58. Notwithstanding any inconsistent provision of law, rule or regu-
51 lation, the effectiveness of the provisions of sections 2807 and 3614 of
52 the public health law, section 18 of chapter 2 of the laws of 1988, and
53 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
54 or certification of rates of payment, are hereby suspended and without
55 force or effect for purposes of implementing the provisions of this act.
S. 2007--B 38 A. 3007--B
1 S 59. Severability clause. If any clause, sentence, paragraph, subdi-
2 vision, section or part of this act shall be adjudged by any court of
3 competent jurisdiction to be invalid, such judgment shall not affect,
4 impair or invalidate the remainder thereof, but shall be confined in its
5 operation to the clause, sentence, paragraph, subdivision, section or
6 part thereof directly involved in the controversy in which such judgment
7 shall have been rendered. It is hereby declared to be the intent of the
8 legislature that this act would have been enacted even if such invalid
9 provisions had not been included herein.
10 S 60. This act shall take effect immediately and shall be deemed to
11 have been in full force and effect on and after April 1, 2015 and
12 provided that:
13 1. sections one and fifty-two of this act shall expire and be deemed
14 repealed March 31, 2020;
15 2. sections nine, twelve and thirteen of this act shall take effect
16 June 1, 2015;
17 3. section thirty-one of this act shall take effect July 1, 2015;
18 4. section fifteen-a of this act shall take effect October 1, 2015;
19 provided however that such section shall not take effect if, on October
20 1, 2015: (a) federal law or regulation requires the department of health
21 to calculate its Medicaid payments to managed care organizations to
22 include cost sharing established under the State plan for medical
23 assistance for enrollees who are not exempt from cost sharing; and (b)
24 the department of health has obtained a waiver of such requirement from
25 the Centers for Medicare and Medicaid Services; provided further that
26 the commissioner of health shall notify the legislative bill drafting
27 commission of the grant or denial of such waiver by the Centers for
28 Medicare and Medicaid Services provided for in this section in order
29 that the commission may maintain an accurate and timely effective data
30 base of the official text of the laws of the state of New York in furth-
31 erance of effectuating the provisions of section 44 of the legislative
32 law.
33 5. section thirty-eight of this act shall expire and be deemed
34 repealed March 31, 2018;
35 6. section forty-nine of this act shall apply to any coding of payment
36 or claims for long term care on and after January 1, 2016;
37 7. sections twenty-eight and forty-six of this act shall take effect
38 on the same date and in the same manner as section 51 of part C of chap-
39 ter 60 of the laws of 2014 takes effect;
40 8. section forty-five of this act shall take effect on the same date
41 and in the same manner as section 50 of part C of chapter 60 of the laws
42 of 2014 takes effect;
43 9. the amendments made to section 364-j of the social services law by
44 sections thirty-six-b, forty-c and fifty-five of this act shall not
45 affect the repeal of such sections and shall be deemed repealed there-
46 with;
47 9-a. the amendments made to section 4403-f of the public health law by
48 section forty-a of this act shall not affect the repeal of such section
49 and shall be deemed repealed therewith;
50 9-b. the amendments made to section 365-h of the social services law
51 by section fifty of this act shall not affect the repeal of such section
52 and shall be deemed repealed therewith;
53 10. any rules or regulations necessary to implement the provisions of
54 this act may be promulgated and any procedures, forms, or instructions
55 necessary for such implementation may be adopted and issued on or after
56 the date this act shall have become a law;
S. 2007--B 39 A. 3007--B
1 11. this act shall not be construed to alter, change, affect, impair
2 or defeat any rights, obligations, duties or interests accrued, incurred
3 or conferred prior to the effective date of this act;
4 12. the commissioner of health and the superintendent of the depart-
5 ment of financial services and any appropriate council may take steps
6 necessary to implement this act prior to its effective date;
7 13. notwithstanding any inconsistent provision of the state adminis-
8 trative procedure act or any other provision of law, rule or regulation,
9 the commissioner of health and the superintendent of the department of
10 financial services and any appropriate council is authorized to adopt or
11 amend or promulgate any regulation he or she or such council determines
12 necessary to implement any provision of this act on its effective date;
13 and
14 14. the provisions of this act shall become effective notwithstanding
15 the failure of the commissioner of health or the superintendent of the
16 department of financial services or any council to adopt or amend or
17 promulgate regulations implementing this act.
18 PART C
19 Section 1. Section 48-a of part A of chapter 56 of the laws of 2013
20 amending chapter 59 of the laws of 2011 amending the public health law
21 and other laws relating to general hospital reimbursement for annual
22 rates relating to the cap on local Medicaid expenditures, as amended by
23 section 13 of part C of chapter 60 of the laws of 2014, is amended to
24 read as follows:
25 S 48-a. 1. Notwithstanding any contrary provision of law, the commis-
26 sioners of the office of alcoholism and substance abuse services and the
27 office of mental health are authorized, subject to the approval of the
28 director of the budget, to transfer to the commissioner of health state
29 funds to be utilized as the state share for the purpose of increasing
30 payments under the medicaid program to managed care organizations
31 licensed under article 44 of the public health law or under article 43
32 of the insurance law. Such managed care organizations shall utilize such
33 funds for the purpose of reimbursing providers licensed pursuant to
34 article 28 of the public health law or article 31 or 32 of the mental
35 hygiene law for ambulatory behavioral health services, as determined by
36 the commissioner of health, in consultation with the commissioner of
37 alcoholism and substance abuse services and the commissioner of the
38 office of mental health, provided to medicaid eligible outpatients. Such
39 reimbursement shall be in the form of fees for such services which are
40 equivalent to the payments established for such services under the ambu-
41 latory patient group (APG) rate-setting methodology as utilized by the
42 department of health, the office of alcoholism and substance abuse
43 services, or the office of mental health for rate-setting purposes;
44 provided, however, that the increase to such fees that shall result from
45 the provisions of this section shall not, in the aggregate and as deter-
46 mined by the commissioner of health, in consultation with the commis-
47 sioner of alcoholism and substance abuse services and the commissioner
48 of the office of mental health, be greater than the increased funds made
49 available pursuant to this section. The increase of such ambulatory
50 behavioral health fees to providers available under this section shall
51 be for all rate periods on and after the effective date of [the] SECTION
52 13 OF PART C OF chapter 60 of the laws of 2014 [which amended this
53 section] through [December 31, 2016] JUNE 30, 2017 for patients in the
54 city of New York, for all rate periods on and after the effective date
S. 2007--B 40 A. 3007--B
1 of [the] SECTION 13 OF PART C OF chapter 60 of the laws of 2014 [which
2 amended this section] through [June 30,] DECEMBER 31, 2017 for patients
3 outside the city of New York, and for all rate periods on and after the
4 effective date of such chapter [of the laws of 2014 which amended this
5 section] through December 31, 2017 for all services provided to persons
6 under the age of twenty-one; provided, however, that managed care organ-
7 izations and providers may negotiate different rates and methods of
8 payment during such periods described above, subject to the approval of
9 the department of health. The department of health shall consult with
10 the office of alcoholism and substance abuse services and the office of
11 mental health in determining whether such alternative rates shall be
12 approved. The commissioner of health may, in consultation with the
13 commissioner of alcoholism and substance abuse services and the commis-
14 sioner of the office of mental health, promulgate regulations, including
15 emergency regulations promulgated prior to October 1, 2015 to establish
16 rates for ambulatory behavioral health services, as are necessary to
17 implement the provisions of this section. Rates promulgated under this
18 section shall be included in the report required under section 45-c of
19 part A of this chapter.
20 2. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, THE FEES PAID BY
21 MANAGED CARE ORGANIZATIONS LICENSED UNDER ARTICLE 44 OF THE PUBLIC
22 HEALTH LAW OR UNDER ARTICLE 43 OF THE INSURANCE LAW, TO PROVIDERS
23 LICENSED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR ARTICLE 31
24 OR 32 OF THE MENTAL HYGIENE LAW, FOR AMBULATORY BEHAVIORAL HEALTH
25 SERVICES PROVIDED TO PATIENTS ENROLLED IN THE CHILD HEALTH INSURANCE
26 PROGRAM PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF THE PUBLIC HEALTH LAW,
27 SHALL BE IN THE FORM OF FEES FOR SUCH SERVICES WHICH ARE EQUIVALENT TO
28 THE PAYMENTS ESTABLISHED FOR SUCH SERVICES UNDER THE AMBULATORY PATIENT
29 GROUP (APG) RATE-SETTING METHODOLOGY. THE COMMISSIONER OF HEALTH SHALL
30 CONSULT WITH THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
31 AND THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH IN DETERMINING SUCH
32 SERVICES AND ESTABLISHING SUCH FEES. SUCH AMBULATORY BEHAVIORAL HEALTH
33 FEES TO PROVIDERS AVAILABLE UNDER THIS SECTION SHALL BE FOR ALL RATE
34 PERIODS ON AND AFTER THE EFFECTIVE DATE OF THIS CHAPTER THROUGH DECEMBER
35 31, 2017, PROVIDED, HOWEVER, THAT MANAGED CARE ORGANIZATIONS AND PROVID-
36 ERS MAY NEGOTIATE DIFFERENT RATES AND METHODS OF PAYMENT DURING SUCH
37 PERIODS DESCRIBED ABOVE, SUBJECT TO THE APPROVAL OF THE DEPARTMENT OF
38 HEALTH. THE DEPARTMENT OF HEALTH SHALL CONSULT WITH THE OFFICE OF ALCO-
39 HOLISM AND SUBSTANCE ABUSE SERVICES AND THE OFFICE OF MENTAL HEALTH IN
40 DETERMINING WHETHER SUCH ALTERNATIVE RATES SHALL BE APPROVED. THE
41 REPORT REQUIRED UNDER SECTION 16-A OF PART C OF CHAPTER 60 OF THE LAWS
42 OF 2014 SHALL ALSO INCLUDE THE POPULATION OF PATIENTS ENROLLED IN THE
43 CHILD HEALTH INSURANCE PROGRAM PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF
44 THE PUBLIC HEALTH LAW IN ITS EXAMINATION ON THE TRANSITION OF BEHAVIORAL
45 HEALTH SERVICES INTO MANAGED CARE.
46 S 2. Section 1 of part H of chapter 111 of the laws of 2010 relating
47 to increasing Medicaid payments to providers through managed care organ-
48 izations and providing equivalent fees through an ambulatory patient
49 group methodology, as amended by section 15 of part C of chapter 60 of
50 the laws of 2014, is amended to read as follows:
51 Section 1. A. Notwithstanding any contrary provision of law, the
52 commissioners of mental health and alcoholism and substance abuse
53 services are authorized, subject to the approval of the director of the
54 budget, to transfer to the commissioner of health state funds to be
55 utilized as the state share for the purpose of increasing payments under
56 the medicaid program to managed care organizations licensed under arti-
S. 2007--B 41 A. 3007--B
1 cle 44 of the public health law or under article 43 of the insurance
2 law. Such managed care organizations shall utilize such funds for the
3 purpose of reimbursing providers licensed pursuant to article 28 of the
4 public health law, or pursuant to article 31 or article 32 of the mental
5 hygiene law for ambulatory behavioral health services, as determined by
6 the commissioner of health in consultation with the commissioner of
7 mental health and commissioner of alcoholism and substance abuse
8 services, provided to medicaid eligible outpatients. Such reimbursement
9 shall be in the form of fees for such services which are equivalent to
10 the payments established for such services under the ambulatory patient
11 group (APG) rate-setting methodology as utilized by the department of
12 health or by the office of mental health or office of alcoholism and
13 substance abuse services for rate-setting purposes; provided, however,
14 that the increase to such fees that shall result from the provisions of
15 this section shall not, in the aggregate and as determined by the
16 commissioner of health in consultation with the commissioners of mental
17 health and alcoholism and substance abuse services, be greater than the
18 increased funds made available pursuant to this section. The increase of
19 such behavioral health fees to providers available under this section
20 shall be for all rate periods on and after the effective date of [the]
21 SECTION 15 OF PART C OF chapter 60 of the laws of 2014 [which amended
22 this section] through [December 31, 2016] JUNE 30, 2017 for patients in
23 the city of New York, for all rate periods on and after the effective
24 date of [the] SECTION 15 OF PART C OF chapter 60 of the laws of 2014
25 [which amended this section] through [June 30,] DECEMBER 31, 2017 for
26 patients outside the city of New York, and for all rate periods on and
27 after the effective date of [the] SECTION 15 OF PART C OF chapter 60 of
28 the laws of 2014 [which amended this section] through December 31, 2017
29 for all services provided to persons under the age of twenty-one;
30 provided, however, that managed care organizations and providers may
31 negotiate different rates and methods of payment during such periods
32 described, subject to the approval of the department of health. The
33 department of health shall consult with the office of alcoholism and
34 substance abuse services and the office of mental health in determining
35 whether such alternative rates shall be approved. The commissioner of
36 health may, in consultation with the commissioners of mental health and
37 alcoholism and substance abuse services, promulgate regulations, includ-
38 ing emergency regulations promulgated prior to October 1, 2013 that
39 establish rates for behavioral health services, as are necessary to
40 implement the provisions of this section. Rates promulgated under this
41 section shall be included in the report required under section 45-c of
42 part A of chapter 56 of the laws of 2013.
43 B. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, THE FEES PAID BY
44 MANAGED CARE ORGANIZATIONS LICENSED UNDER ARTICLE 44 OF THE PUBLIC
45 HEALTH LAW OR UNDER ARTICLE 43 OF THE INSURANCE LAW, TO PROVIDERS
46 LICENSED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR ARTICLE 31
47 OR 32 OF THE MENTAL HYGIENE LAW, FOR AMBULATORY BEHAVIORAL HEALTH
48 SERVICES PROVIDED TO PATIENTS ENROLLED IN THE CHILD HEALTH INSURANCE
49 PROGRAM PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF THE PUBLIC HEALTH LAW,
50 SHALL BE IN THE FORM OF FEES FOR SUCH SERVICES WHICH ARE EQUIVALENT TO
51 THE PAYMENTS ESTABLISHED FOR SUCH SERVICES UNDER THE AMBULATORY PATIENT
52 GROUP (APG) RATE-SETTING METHODOLOGY. THE COMMISSIONER OF HEALTH SHALL
53 CONSULT WITH THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
54 AND THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH IN DETERMINING SUCH
55 SERVICES AND ESTABLISHING SUCH FEES. SUCH AMBULATORY BEHAVIORAL HEALTH
56 FEES TO PROVIDERS AVAILABLE UNDER THIS SECTION SHALL BE FOR ALL RATE
S. 2007--B 42 A. 3007--B
1 PERIODS ON AND AFTER THE EFFECTIVE DATE OF THIS CHAPTER THROUGH DECEMBER
2 31, 2017, PROVIDED, HOWEVER, THAT MANAGED CARE ORGANIZATIONS AND PROVID-
3 ERS MAY NEGOTIATE DIFFERENT RATES AND METHODS OF PAYMENT DURING SUCH
4 PERIODS DESCRIBED ABOVE, SUBJECT TO THE APPROVAL OF THE DEPARTMENT OF
5 HEALTH. THE DEPARTMENT OF HEALTH SHALL CONSULT WITH THE OFFICE OF ALCO-
6 HOLISM AND SUBSTANCE ABUSE SERVICES AND THE OFFICE OF MENTAL HEALTH IN
7 DETERMINING WHETHER SUCH ALTERNATIVE RATES SHALL BE APPROVED. THE
8 REPORT REQUIRED UNDER SECTION 16-A OF PART C OF CHAPTER 60 OF THE LAWS
9 OF 2014 SHALL ALSO INCLUDE THE POPULATION OF PATIENTS ENROLLED IN THE
10 CHILD HEALTH INSURANCE PROGRAM PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF
11 THE PUBLIC HEALTH LAW IN ITS EXAMINATION ON THE TRANSITION OF BEHAVIORAL
12 HEALTH SERVICES INTO MANAGED CARE.
13 S 3. Notwithstanding any inconsistent provision of law, rule or regu-
14 lation, for purposes of implementing the provisions of the public health
15 law and the social services law, references to titles XIX and XXI of the
16 federal social security act in the public health law and the social
17 services law shall be deemed to include and also to mean any successor
18 titles thereto under the federal social security act.
19 S 4. Notwithstanding any inconsistent provision of law, rule or regu-
20 lation, the effectiveness of the provisions of sections 2807 and 3614 of
21 the public health law, section 18 of chapter 2 of the laws of 1988, and
22 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
23 or certification of rates of payment, are hereby suspended and without
24 force or effect for purposes of implementing the provisions of this act.
25 S 5. Severability clause. If any clause, sentence, paragraph, subdivi-
26 sion, section or part of this act shall be adjudged by any court of
27 competent jurisdiction to be invalid, such judgment shall not affect,
28 impair or invalidate the remainder thereof, but shall be confined in its
29 operation to the clause, sentence, paragraph, subdivision, section or
30 part thereof directly involved in the controversy in which such judgment
31 shall have been rendered. It is hereby declared to be the intent of the
32 legislature that this act would have been enacted even if such invalid
33 provisions had not been included herein.
34 S 6. This act shall take effect immediately and shall be deemed to
35 have been in full force and effect on and after April 1, 2015. Provided,
36 however that:
37 1. any rules or regulations necessary to implement the provisions of
38 this act may be promulgated and any procedures, forms, or instructions
39 necessary for such implementation may be adopted and issued on or after
40 the date this act shall have become a law;
41 2. this act shall not be construed to alter, change, affect, impair or
42 defeat any rights, obligations, duties or interests accrued, incurred or
43 conferred prior to the effective date of this act;
44 3. the commissioner of health and the superintendent of the department
45 of financial services and any appropriate council may take any steps
46 necessary to implement this act prior to its effective date;
47 4. notwithstanding any inconsistent provision of the state administra-
48 tive procedure act or any other provision of law, rule or regulation,
49 the commissioner of health and the superintendent of the department of
50 financial services and any appropriate council is authorized to adopt or
51 amend or promulgate on an emergency basis any regulation he or she or
52 such council determines necessary to implement any provision of this act
53 on its effective date;
54 5. the provisions of this act shall become effective notwithstanding
55 the failure of the commissioner of health or the superintendent of the
S. 2007--B 43 A. 3007--B
1 department of financial services or any council to adopt or amend or
2 promulgate regulations implementing this act; and
3 6. the amendments to section 48-a of part A of chapter 56 of the laws
4 of 2013 made by section one of this act and the amendments to section 1
5 of part H of chapter 111 of the laws of 2010 made by section two of this
6 act shall not affect the expiration of such sections and shall be deemed
7 to expire therewith.
8 PART D
9 Section 1. Section 11 of chapter 884 of the laws of 1990, amending the
10 public health law relating to authorizing bad debt and charity care
11 allowances for certified home health agencies, as amended by section 3
12 of part B of chapter 56 of the laws of 2013, is amended to read as
13 follows:
14 S 11. This act shall take effect immediately and:
15 (a) sections one and three shall expire on December 31, 1996,
16 (b) sections four through ten shall expire on June 30, [2015] 2017,
17 and
18 (c) provided that the amendment to section 2807-b of the public health
19 law by section two of this act shall not affect the expiration of such
20 section 2807-b as otherwise provided by law and shall be deemed to
21 expire therewith.
22 S 2. Subdivision 2 of section 246 of chapter 81 of the laws of 1995,
23 amending the public health law and other laws relating to medical
24 reimbursement and welfare reform, as amended by section 4 of part B of
25 chapter 56 of the laws of 2013, is amended to read as follows:
26 2. Sections five, seven through nine, twelve through fourteen, and
27 eighteen of this act shall be deemed to have been in full force and
28 effect on and after April 1, 1995 through March 31, 1999 and on and
29 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
30 through March 31, 2003 and on and after April 1, 2003 through March 31,
31 2006 and on and after April 1, 2006 through March 31, 2007 and on and
32 after April 1, 2007 through March 31, 2009 and on and after April 1,
33 2009 through March 31, 2011 and sections twelve, thirteen and fourteen
34 of this act shall be deemed to be in full force and effect on and after
35 April 1, 2011 through March 31, 2015 AND ON AND AFTER APRIL 1, 2015
36 THROUGH MARCH 31, 2017;
37 S 3. Subparagraph (vi) of paragraph (b) of subdivision 2 of section
38 2807-d of the public health law, as amended by section 5 of part B of
39 chapter 56 of the laws of 2013, is amended to read as follows:
40 (vi) Notwithstanding any contrary provision of this paragraph or any
41 other provision of law or regulation to the contrary, for residential
42 health care facilities the assessment shall be six percent of each resi-
43 dential health care facility's gross receipts received from all patient
44 care services and other operating income on a cash basis for the period
45 April first, two thousand two through March thirty-first, two thousand
46 three for hospital or health-related services, including adult day
47 services; provided, however, that residential health care facilities'
48 gross receipts attributable to payments received pursuant to title XVIII
49 of the federal social security act (medicare) shall be excluded from the
50 assessment; provided, however, that for all such gross receipts received
51 on or after April first, two thousand three through March thirty-first,
52 two thousand five, such assessment shall be five percent, and further
53 provided that for all such gross receipts received on or after April
54 first, two thousand five through March thirty-first, two thousand nine,
S. 2007--B 44 A. 3007--B
1 and on or after April first, two thousand nine through March thirty-
2 first, two thousand eleven such assessment shall be six percent, and
3 further provided that for all such gross receipts received on or after
4 April first, two thousand eleven through March thirty-first, two thou-
5 sand thirteen such assessment shall be six percent, and further provided
6 that for all such gross receipts received on or after April first, two
7 thousand thirteen through March thirty-first, two thousand fifteen such
8 assessment shall be six percent, AND FURTHER PROVIDED THAT FOR ALL SUCH
9 GROSS RECEIPTS RECEIVED ON OR AFTER APRIL FIRST, TWO THOUSAND FIFTEEN
10 THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN SUCH ASSESSMENT SHALL
11 BE SIX PERCENT.
12 S 4. Section 88 of chapter 659 of the laws of 1997, constituting the
13 long term care integration and finance act of 1997, as amended by
14 section 6 of part B of chapter 56 of the laws of 2013, is amended to
15 read as follows:
16 S 88. Notwithstanding any provision of law to the contrary, all oper-
17 ating demonstrations, as such term is defined in paragraph (c) of subdi-
18 vision 1 of section 4403-f of the public health law as added by section
19 eighty-two of this act, due to expire prior to January 1, 2001 shall be
20 deemed to [expire on December 31, 2015] REMAIN IN FULL FORCE AND EFFECT
21 SUBSEQUENT TO SUCH DATE.
22 S 5. Subdivision 1 of section 194 of chapter 474 of the laws of 1996,
23 amending the education law and other laws relating to rates for residen-
24 tial health care facilities, as amended by section 9 of part B of chap-
25 ter 56 of the laws of 2013, is amended to read as follows:
26 1. Notwithstanding any inconsistent provision of law or regulation,
27 the trend factors used to project reimbursable operating costs to the
28 rate period for purposes of determining rates of payment pursuant to
29 article 28 of the public health law for residential health care facili-
30 ties for reimbursement of inpatient services provided to patients eligi-
31 ble for payments made by state governmental agencies on and after April
32 1, 1996 through March 31, 1999 and for payments made on and after July
33 1, 1999 through March 31, 2000 and on and after April 1, 2000 through
34 March 31, 2003 and on and after April 1, 2003 through March 31, 2007 and
35 on and after April 1, 2007 through March 31, 2009 and on and after April
36 1, 2009 through March 31, 2011 and on and after April 1, 2011 through
37 March 31, 2013 and on and after April 1, 2013 through March 31, 2015,
38 AND ON AND AFTER APRIL 1, 2015 THROUGH MARCH 31, 2017 shall reflect no
39 trend factor projections or adjustments for the period April 1, 1996,
40 through March 31, 1997.
41 S 6. Subdivision 1 of section 89-a of part C of chapter 58 of the laws
42 of 2007, amending the social services law and other laws relating to
43 enacting the major components of legislation necessary to implement the
44 health and mental hygiene budget for the 2007-2008 state fiscal year, as
45 amended by section 10 of part B of chapter 56 of the laws of 2013, is
46 amended to read as follows:
47 1. Notwithstanding paragraph (c) of subdivision 10 of section 2807-c
48 of the public health law and section 21 of chapter 1 of the laws of
49 1999, as amended, and any other inconsistent provision of law or regu-
50 lation to the contrary, in determining rates of payments by state
51 governmental agencies effective for services provided beginning April 1,
52 2006, through March 31, 2009, and on and after April 1, 2009 through
53 March 31, 2011, and on and after April 1, 2011 through March 31, 2013,
54 and on and after April 1, 2013 through March 31, 2015, AND ON AND AFTER
55 APRIL 1, 2015 THROUGH MARCH 31, 2017 for inpatient and outpatient
56 services provided by general hospitals and for inpatient services and
S. 2007--B 45 A. 3007--B
1 outpatient adult day health care services provided by residential health
2 care facilities pursuant to article 28 of the public health law, the
3 commissioner of health shall apply a trend factor projection of two and
4 twenty-five hundredths percent attributable to the period January 1,
5 2006 through December 31, 2006, and on and after January 1, 2007,
6 provided, however, that on reconciliation of such trend factor for the
7 period January 1, 2006 through December 31, 2006 pursuant to paragraph
8 (c) of subdivision 10 of section 2807-c of the public health law, such
9 trend factor shall be the final US Consumer Price Index (CPI) for all
10 urban consumers, as published by the US Department of Labor, Bureau of
11 Labor Statistics less twenty-five hundredths of a percentage point.
12 S 7. Paragraph (f) of subdivision 1 of section 64 of chapter 81 of the
13 laws of 1995, amending the public health law and other laws relating to
14 medical reimbursement and welfare reform, as amended by section 11 of
15 part B of chapter 56 of the laws of 2013, is amended to read as follows:
16 (f) Prior to February 1, 2001, February 1, 2002, February 1, 2003,
17 February 1, 2004, February 1, 2005, February 1, 2006, February 1, 2007,
18 February 1, 2008, February 1, 2009, February 1, 2010, February 1, 2011,
19 February 1, 2012, February 1, 2013 [and], February 1, 2014 [and], Febru-
20 ary 1, 2015, FEBRUARY 1, 2016 AND FEBRUARY 1, 2017 the commissioner of
21 health shall calculate the result of the statewide total of residential
22 health care facility days of care provided to beneficiaries of title
23 XVIII of the federal social security act (medicare), divided by the sum
24 of such days of care plus days of care provided to residents eligible
25 for payments pursuant to title 11 of article 5 of the social services
26 law minus the number of days provided to residents receiving hospice
27 care, expressed as a percentage, for the period commencing January 1,
28 through November 30, of the prior year respectively, based on such data
29 for such period. This value shall be called the 2000, 2001, 2002, 2003,
30 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and],
31 2015, 2016 AND 2017 statewide target percentage respectively.
32 S 8. Subparagraph (ii) of paragraph (b) of subdivision 3 of section 64
33 of chapter 81 of the laws of 1995, amending the public health law and
34 other laws relating to medical reimbursement and welfare reform, as
35 amended by section 12 of part B of chapter 56 of the laws of 2013, is
36 amended to read as follows:
37 (ii) If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
38 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
39 2017 statewide target percentages are not for each year at least three
40 percentage points higher than the statewide base percentage, the commis-
41 sioner of health shall determine the percentage by which the statewide
42 target percentage for each year is not at least three percentage points
43 higher than the statewide base percentage. The percentage calculated
44 pursuant to this paragraph shall be called the 1997, 1998, 2000, 2001,
45 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013,
46 2014 [and], 2015, 2016 AND 2017 statewide reduction percentage respec-
47 tively. If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
48 2007, 2008, 2009, 2010, 2011, 2012, 2013[;], 2014 [and], 2015, 2016 AND
49 2017 statewide target percentage for the respective year is at least
50 three percentage points higher than the statewide base percentage, the
51 statewide reduction percentage for the respective year shall be zero.
52 S 9. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
53 64 of chapter 81 of the laws of 1995, amending the public health law and
54 other laws relating to medical reimbursement and welfare reform, as
55 amended by section 13 of part B of chapter 56 of the laws of 2013, is
56 amended to read as follows:
S. 2007--B 46 A. 3007--B
1 (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008,
2 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 statewide
3 reduction percentage shall be multiplied by one hundred two million
4 dollars respectively to determine the 1998, 2000, 2001, 2002, 2003,
5 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and],
6 2015, 2016 AND 2017 statewide aggregate reduction amount. If the 1998
7 and the 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009,
8 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 statewide
9 reduction percentage shall be zero respectively, there shall be no 1998,
10 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,
11 2012, 2013, 2014 [and], 2015, 2016 AND 2017 reduction amount.
12 S 10. Section 228 of chapter 474 of the laws of 1996, amending the
13 education law and other laws relating to rates for residential health
14 care facilities, as amended by section 14-a of part B of chapter 56 of
15 the laws of 2013, is amended to read as follows:
16 S 228. 1. Definitions. (a) Regions, for purposes of this section,
17 shall mean a downstate region to consist of Kings, New York, Richmond,
18 Queens, Bronx, Nassau and Suffolk counties and an upstate region to
19 consist of all other New York state counties. A certified home health
20 agency or long term home health care program shall be located in the
21 same county utilized by the commissioner of health for the establishment
22 of rates pursuant to article 36 of the public health law.
23 (b) Certified home health agency (CHHA) shall mean such term as
24 defined in section 3602 of the public health law.
25 (c) Long term home health care program (LTHHCP) shall mean such term
26 as defined in subdivision 8 of section 3602 of the public health law.
27 (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
28 ly, located within a region.
29 (e) Medicaid revenue percentage, for purposes of this section, shall
30 mean CHHA and LTHHCP revenues attributable to services provided to
31 persons eligible for payments pursuant to title 11 of article 5 of the
32 social services law divided by such revenues plus CHHA and LTHHCP reven-
33 ues attributable to services provided to beneficiaries of Title XVIII of
34 the federal social security act (medicare).
35 (f) Base period, for purposes of this section, shall mean calendar
36 year 1995.
37 (g) Target period. For purposes of this section, the 1996 target peri-
38 od shall mean August 1, 1996 through March 31, 1997, the 1997 target
39 period shall mean January 1, 1997 through November 30, 1997, the 1998
40 target period shall mean January 1, 1998 through November 30, 1998, the
41 1999 target period shall mean January 1, 1999 through November 30, 1999,
42 the 2000 target period shall mean January 1, 2000 through November 30,
43 2000, the 2001 target period shall mean January 1, 2001 through November
44 30, 2001, the 2002 target period shall mean January 1, 2002 through
45 November 30, 2002, the 2003 target period shall mean January 1, 2003
46 through November 30, 2003, the 2004 target period shall mean January 1,
47 2004 through November 30, 2004, and the 2005 target period shall mean
48 January 1, 2005 through November 30, 2005, the 2006 target period shall
49 mean January 1, 2006 through November 30, 2006, and the 2007 target
50 period shall mean January 1, 2007 through November 30, 2007 and the 2008
51 target period shall mean January 1, 2008 through November 30, 2008, and
52 the 2009 target period shall mean January 1, 2009 through November 30,
53 2009 and the 2010 target period shall mean January 1, 2010 through
54 November 30, 2010 and the 2011 target period shall mean January 1, 2011
55 through November 30, 2011 and the 2012 target period shall mean January
56 1, 2012 through November 30, 2012 and the 2013 target period shall mean
S. 2007--B 47 A. 3007--B
1 January 1, 2013 through November 30, 2013, and the 2014 target period
2 shall mean January 1, 2014 through November 30, 2014 and the 2015 target
3 period shall mean January 1, 2015 through November 30, 2015 AND THE 2016
4 TARGET PERIOD SHALL MEAN JANUARY 1, 2016 THROUGH NOVEMBER 30, 2016 AND
5 THE 2017 TARGET PERIOD SHALL MEAN JANUARY 1, 2017 THROUGH NOVEMBER 30,
6 2017.
7 2. (a) Prior to February 1, 1997, for each regional group the commis-
8 sioner of health shall calculate the 1996 medicaid revenue percentages
9 for the period commencing August 1, 1996 to the last date for which such
10 data is available and reasonably accurate.
11 (b) Prior to February 1, 1998, prior to February 1, 1999, prior to
12 February 1, 2000, prior to February 1, 2001, prior to February 1, 2002,
13 prior to February 1, 2003, prior to February 1, 2004, prior to February
14 1, 2005, prior to February 1, 2006, prior to February 1, 2007, prior to
15 February 1, 2008, prior to February 1, 2009, prior to February 1, 2010,
16 prior to February 1, 2011, prior to February 1, 2012, prior to February
17 1, 2013, prior to February 1, 2014 [and], prior to February 1, 2015, AND
18 PRIOR TO FEBRUARY 1, 2016 AND PRIOR TO FEBRUARY 1, 2017 for each
19 regional group the commissioner of health shall calculate the prior
20 year's medicaid revenue percentages for the period commencing January 1
21 through November 30 of such prior year.
22 3. By September 15, 1996, for each regional group the commissioner of
23 health shall calculate the base period medicaid revenue percentage.
24 4. (a) For each regional group, the 1996 target medicaid revenue
25 percentage shall be calculated by subtracting the 1996 medicaid revenue
26 reduction percentages from the base period medicaid revenue percentages.
27 The 1996 medicaid revenue reduction percentage, taking into account
28 regional and program differences in utilization of medicaid and medicare
29 services, for the following regional groups shall be equal to:
30 (i) one and one-tenth percentage points for CHHAs located within the
31 downstate region;
32 (ii) six-tenths of one percentage point for CHHAs located within the
33 upstate region;
34 (iii) one and eight-tenths percentage points for LTHHCPs located with-
35 in the downstate region; and
36 (iv) one and seven-tenths percentage points for LTHHCPs located within
37 the upstate region.
38 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
39 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 for
40 each regional group, the target medicaid revenue percentage for the
41 respective year shall be calculated by subtracting the respective year's
42 medicaid revenue reduction percentage from the base period medicaid
43 revenue percentage. The medicaid revenue reduction percentages for 1997,
44 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
45 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017, taking into account
46 regional and program differences in utilization of medicaid and medicare
47 services, for the following regional groups shall be equal to for each
48 such year:
49 (i) one and one-tenth percentage points for CHHAs located within the
50 downstate region;
51 (ii) six-tenths of one percentage point for CHHAs located within the
52 upstate region;
53 (iii) one and eight-tenths percentage points for LTHHCPs located with-
54 in the downstate region; and
55 (iv) one and seven-tenths percentage points for LTHHCPs located within
56 the upstate region.
S. 2007--B 48 A. 3007--B
1 (c) For each regional group, the 1999 target medicaid revenue percent-
2 age shall be calculated by subtracting the 1999 medicaid revenue
3 reduction percentage from the base period medicaid revenue percentage.
4 The 1999 medicaid revenue reduction percentages, taking into account
5 regional and program differences in utilization of medicaid and medicare
6 services, for the following regional groups shall be equal to:
7 (i) eight hundred twenty-five thousandths (.825) of one percentage
8 point for CHHAs located within the downstate region;
9 (ii) forty-five hundredths (.45) of one percentage point for CHHAs
10 located within the upstate region;
11 (iii) one and thirty-five hundredths percentage points (1.35) for
12 LTHHCPs located within the downstate region; and
13 (iv) one and two hundred seventy-five thousandths percentage points
14 (1.275) for LTHHCPs located within the upstate region.
15 5. (a) For each regional group, if the 1996 medicaid revenue percent-
16 age is not equal to or less than the 1996 target medicaid revenue
17 percentage, the commissioner of health shall compare the 1996 medicaid
18 revenue percentage to the 1996 target medicaid revenue percentage to
19 determine the amount of the shortfall which, when divided by the 1996
20 medicaid revenue reduction percentage, shall be called the 1996
21 reduction factor. These amounts, expressed as a percentage, shall not
22 exceed one hundred percent. If the 1996 medicaid revenue percentage is
23 equal to or less than the 1996 target medicaid revenue percentage, the
24 1996 reduction factor shall be zero.
25 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
26 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016, AND
27 2017, for each regional group, if the medicaid revenue percentage for
28 the respective year is not equal to or less than the target medicaid
29 revenue percentage for such respective year, the commissioner of health
30 shall compare such respective year's medicaid revenue percentage to such
31 respective year's target medicaid revenue percentage to determine the
32 amount of the shortfall which, when divided by the respective year's
33 medicaid revenue reduction percentage, shall be called the reduction
34 factor for such respective year. These amounts, expressed as a percent-
35 age, shall not exceed one hundred percent. If the medicaid revenue
36 percentage for a particular year is equal to or less than the target
37 medicaid revenue percentage for that year, the reduction factor for that
38 year shall be zero.
39 6. (a) For each regional group, the 1996 reduction factor shall be
40 multiplied by the following amounts to determine each regional group's
41 applicable 1996 state share reduction amount:
42 (i) two million three hundred ninety thousand dollars ($2,390,000) for
43 CHHAs located within the downstate region;
44 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
45 within the upstate region;
46 (iii) one million two hundred seventy thousand dollars ($1,270,000)
47 for LTHHCPs located within the downstate region; and
48 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
49 located within the upstate region.
50 For each regional group reduction, if the 1996 reduction factor shall
51 be zero, there shall be no 1996 state share reduction amount.
52 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
53 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017, for
54 each regional group, the reduction factor for the respective year shall
55 be multiplied by the following amounts to determine each regional
S. 2007--B 49 A. 3007--B
1 group's applicable state share reduction amount for such respective
2 year:
3 (i) two million three hundred ninety thousand dollars ($2,390,000) for
4 CHHAs located within the downstate region;
5 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
6 within the upstate region;
7 (iii) one million two hundred seventy thousand dollars ($1,270,000)
8 for LTHHCPs located within the downstate region; and
9 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
10 located within the upstate region.
11 For each regional group reduction, if the reduction factor for a
12 particular year shall be zero, there shall be no state share reduction
13 amount for such year.
14 (c) For each regional group, the 1999 reduction factor shall be multi-
15 plied by the following amounts to determine each regional group's appli-
16 cable 1999 state share reduction amount:
17 (i) one million seven hundred ninety-two thousand five hundred dollars
18 ($1,792,500) for CHHAs located within the downstate region;
19 (ii) five hundred sixty-two thousand five hundred dollars ($562,500)
20 for CHHAs located within the upstate region;
21 (iii) nine hundred fifty-two thousand five hundred dollars ($952,500)
22 for LTHHCPs located within the downstate region; and
23 (iv) four hundred forty-two thousand five hundred dollars ($442,500)
24 for LTHHCPs located within the upstate region.
25 For each regional group reduction, if the 1999 reduction factor shall
26 be zero, there shall be no 1999 state share reduction amount.
27 7. (a) For each regional group, the 1996 state share reduction amount
28 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
29 on the basis of the extent of each CHHA's and LTHHCP's failure to
30 achieve the 1996 target medicaid revenue percentage, calculated on a
31 provider specific basis utilizing revenues for this purpose, expressed
32 as a proportion of the total of each CHHA's and LTHHCP's failure to
33 achieve the 1996 target medicaid revenue percentage within the applica-
34 ble regional group. This proportion shall be multiplied by the applica-
35 ble 1996 state share reduction amount calculation pursuant to paragraph
36 (a) of subdivision 6 of this section. This amount shall be called the
37 1996 provider specific state share reduction amount.
38 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
39 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
40 2017 for each regional group, the state share reduction amount for the
41 respective year shall be allocated by the commissioner of health among
42 CHHAs and LTHHCPs on the basis of the extent of each CHHA's and LTHHCP's
43 failure to achieve the target medicaid revenue percentage for the appli-
44 cable year, calculated on a provider specific basis utilizing revenues
45 for this purpose, expressed as a proportion of the total of each CHHA's
46 and LTHHCP's failure to achieve the target medicaid revenue percentage
47 for the applicable year within the applicable regional group. This
48 proportion shall be multiplied by the applicable year's state share
49 reduction amount calculation pursuant to paragraph (b) or (c) of subdi-
50 vision 6 of this section. This amount shall be called the provider
51 specific state share reduction amount for the applicable year.
52 8. (a) The 1996 provider specific state share reduction amount shall
53 be due to the state from each CHHA and LTHHCP and may be recouped by the
54 state by March 31, 1997 in a lump sum amount or amounts from payments
55 due to the CHHA and LTHHCP pursuant to title 11 of article 5 of the
56 social services law.
S. 2007--B 50 A. 3007--B
1 (b) The provider specific state share reduction amount for 1997, 1998,
2 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
3 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 respectively, shall be
4 due to the state from each CHHA and LTHHCP and each year the amount due
5 for such year may be recouped by the state by March 31 of the following
6 year in a lump sum amount or amounts from payments due to the CHHA and
7 LTHHCP pursuant to title 11 of article 5 of the social services law.
8 9. CHHAs and LTHHCPs shall submit such data and information at such
9 times as the commissioner of health may require for purposes of this
10 section. The commissioner of health may use data available from third-
11 party payors.
12 10. On or about June 1, 1997, for each regional group the commissioner
13 of health shall calculate for the period August 1, 1996 through March
14 31, 1997 a medicaid revenue percentage, a reduction factor, a state
15 share reduction amount, and a provider specific state share reduction
16 amount in accordance with the methodology provided in paragraph (a) of
17 subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
18 sion 6 and paragraph (a) of subdivision 7 of this section. The provider
19 specific state share reduction amount calculated in accordance with this
20 subdivision shall be compared to the 1996 provider specific state share
21 reduction amount calculated in accordance with paragraph (a) of subdivi-
22 sion 7 of this section. Any amount in excess of the amount determined in
23 accordance with paragraph (a) of subdivision 7 of this section shall be
24 due to the state from each CHHA and LTHHCP and may be recouped in
25 accordance with paragraph (a) of subdivision 8 of this section. If the
26 amount is less than the amount determined in accordance with paragraph
27 (a) of subdivision 7 of this section, the difference shall be refunded
28 to the CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
29 and LTHHCPs shall submit data for the period August 1, 1996 through
30 March 31, 1997 to the commissioner of health by April 15, 1997.
31 11. If a CHHA or LTHHCP fails to submit data and information as
32 required for purposes of this section:
33 (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
34 caid revenue percentage between the applicable base period and the
35 applicable target period for purposes of the calculations pursuant to
36 this section; and
37 (b) the commissioner of health shall reduce the current rate paid to
38 such CHHA and such LTHHCP by state governmental agencies pursuant to
39 article 36 of the public health law by one percent for a period begin-
40 ning on the first day of the calendar month following the applicable due
41 date as established by the commissioner of health and continuing until
42 the last day of the calendar month in which the required data and infor-
43 mation are submitted.
44 12. The commissioner of health shall inform in writing the director of
45 the budget and the chair of the senate finance committee and the chair
46 of the assembly ways and means committee of the results of the calcu-
47 lations pursuant to this section.
48 S 11. Subdivision 5-a of section 246 of chapter 81 of the laws of
49 1995, amending the public health law and other laws relating to medical
50 reimbursement and welfare reform, as amended by section 15 of part B of
51 chapter 56 of the laws of 2013, is amended to read as follows:
52 5-a. Section sixty-four-a of this act shall be deemed to have been in
53 full force and effect on and after April 1, 1995 through March 31, 1999
54 and on and after July 1, 1999 through March 31, 2000 and on and after
55 April 1, 2000 through March 31, 2003 and on and after April 1, 2003
56 through March 31, 2007, and on and after April 1, 2007 through March 31,
S. 2007--B 51 A. 3007--B
1 2009, and on and after April 1, 2009 through March 31, 2011, and on and
2 after April 1, 2011 through March 31, 2013, and on and after April 1,
3 2013 through March 31, 2015, AND ON AND AFTER APRIL 1, 2015 THROUGH
4 MARCH 31, 2017;
5 S 12. Section 64-b of chapter 81 of the laws of 1995, amending the
6 public health law and other laws relating to medical reimbursement and
7 welfare reform, as amended by section 16 of part B of chapter 56 of the
8 laws of 2013, is amended to read as follows:
9 S 64-b. Notwithstanding any inconsistent provision of law, the
10 provisions of subdivision 7 of section 3614 of the public health law, as
11 amended, shall remain and be in full force and effect on April 1, 1995
12 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
13 and after April 1, 2000 through March 31, 2003 and on and after April 1,
14 2003 through March 31, 2007, and on and after April 1, 2007 through
15 March 31, 2009, and on and after April 1, 2009 through March 31, 2011,
16 and on and after April 1, 2011 through March 31, 2013, and on and after
17 April 1, 2013 through March 31, 2015, AND ON AND AFTER APRIL 1, 2015
18 THROUGH MARCH 31, 2017.
19 S 13. Subdivision 1 of section 20 of chapter 451 of the laws of 2007,
20 amending the public health law, the social services law and the insur-
21 ance law, relating to providing enhanced consumer and provider
22 protections, as amended by section 17 of part B of chapter 56 of the
23 laws of 2013, is amended to read as follows:
24 1. sections four, eleven and thirteen of this act shall take effect
25 immediately and shall expire and be deemed repealed June 30, [2015]
26 2017;
27 S 14. The opening paragraph of subdivision 7-a of section 3614 of the
28 public health law, as amended by section 18 of part B of chapter 56 of
29 the laws of 2013, is amended to read as follows:
30 Notwithstanding any inconsistent provision of law or regulation, for
31 the purposes of establishing rates of payment by governmental agencies
32 for long term home health care programs for the period April first, two
33 thousand five, through December thirty-first, two thousand five, and for
34 the period January first, two thousand six through March thirty-first,
35 two thousand seven, and on and after April first, two thousand seven
36 through March thirty-first, two thousand nine, and on and after April
37 first, two thousand nine through March thirty-first, two thousand elev-
38 en, and on and after April first, two thousand eleven through March
39 thirty-first, two thousand thirteen and on and after April first, two
40 thousand thirteen through March thirty-first, two thousand fifteen, AND
41 ON AND AFTER APRIL 1ST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST,
42 TWO THOUSAND SEVENTEEN the reimbursable base year administrative and
43 general costs of a provider of services shall not exceed the statewide
44 average of total reimbursable base year administrative and general costs
45 of such providers of services.
46 S 15. Subdivision 12 of section 246 of chapter 81 of the laws of 1995,
47 amending the public health law and other laws relating to medical
48 reimbursement and welfare reform, as amended by section 21 of part B of
49 chapter 56 of the laws of 2013, is amended to read as follows:
50 12. Sections one hundred five-b through one hundred five-f of this act
51 shall expire March 31, [2015] 2017.
52 S 16. Section 3 of chapter 303 of the laws of 1999, amending the New
53 York state medical care facilities finance agency act relating to
54 financing health facilities, as amended by section 30 of part A of chap-
55 ter 59 of the laws of 2011, is amended to read as follows:
S. 2007--B 52 A. 3007--B
1 S 3. This act shall take effect immediately, provided, however, that
2 subdivision 15-a of section 5 of section 1 of chapter 392 of the laws of
3 1973, as added by section one of this act, shall expire and be deemed
4 repealed June 30, [2015] 2019; and provided further, however, that the
5 expiration and repeal of such subdivision 15-a shall not affect or
6 impair in any manner any health facilities bonds issued, or any lease or
7 purchase of a health facility executed, pursuant to such subdivision
8 15-a prior to its expiration and repeal and that, with respect to any
9 such bonds issued and outstanding as of June 30, [2015] 2019, the
10 provisions of such subdivision 15-a as they existed immediately prior to
11 such expiration and repeal shall continue to apply through the latest
12 maturity date of any such bonds, or their earlier retirement or redemp-
13 tion, for the sole purpose of authorizing the issuance of refunding
14 bonds to refund bonds previously issued pursuant thereto.
15 S 17. Subdivision (c) of section 62 of chapter 165 of the laws of
16 1991, amending the public health law and other laws relating to estab-
17 lishing payments for medical assistance, as amended by section 26 of
18 part D of chapter 59 of the laws of 2011, is amended to read as follows:
19 (c) section 364-j of the social services law, as amended by section
20 eight of this act and subdivision 6 of section 367-a of the social
21 services law as added by section twelve of this act shall expire and be
22 deemed repealed on March 31, [2015] 2019 and provided further, that the
23 amendments to the provisions of section 364-j of the social services law
24 made by section eight of this act shall only apply to managed care
25 programs approved on or after the effective date of this act;
26 S 18. Subdivision 3 of section 1680-j of the public authorities law,
27 as amended by section 9 of part C of chapter 59 of the laws of 2011, is
28 amended to read as follows:
29 3. Notwithstanding any law to the contrary, and in accordance with
30 section four of the state finance law, the comptroller is hereby author-
31 ized and directed to transfer from the health care reform act (HCRA)
32 resources fund (061) to the general fund, upon the request of the direc-
33 tor of the budget, up to $6,500,000 on or before March 31, 2006, and the
34 comptroller is further hereby authorized and directed to transfer from
35 the healthcare reform act (HCRA); Resources fund (061) to the Capital
36 Projects Fund, upon the request of the director of budget, up to
37 $139,000,000 for the period April 1, 2006 through March 31, 2007, up to
38 $171,100,000 for the period April 1, 2007 through March 31, 2008, up to
39 $208,100,000 for the period April 1, 2008 through March 31, 2009, up to
40 $151,600,000 for the period April 1, 2009 through March 31, 2010, up to
41 $215,743,000 for the period April 1, 2010 through March 31, 2011, up to
42 $433,366,000 for the period April 1, 2011 through March 31, 2012, up to
43 $150,806,000 for the period April 1, 2012 through March 31, 2013, up to
44 $78,071,000 for the period April 1, 2013 through March 31, 2014, and up
45 to $86,005,000 for the period April 1, 2014 through March 31, 2015, AND
46 UP TO $86,005,000 FOR THE PERIOD APRIL 1, 2015 THROUGH DECEMBER 31,
47 2017.
48 S 19. Subdivision (i) of section 111 of part H of chapter 59 of the
49 laws of 2011, relating to enacting into law major components of legis-
50 lation necessary to implement the health and mental hygiene budget for
51 the 2011-2012 state fiscal plan, is amended to read as follows:
52 (i) the amendments to paragraph (b) and subparagraph (i) of paragraph
53 (g) of subdivision 7 of section 4403-f of the public health law made by
54 section forty-one-b of this act shall expire and be repealed April 1,
55 [2015] 2019;
S. 2007--B 53 A. 3007--B
1 S 20. Section 97 of chapter 659 of the laws of 1997, amending the
2 public health law and other laws relating to creation of continuing care
3 retirement communities, as amended by section 65-b of part A of chapter
4 57 of the laws of 2006, is amended to read as follows:
5 S 97. This act shall take effect immediately, provided, however, that
6 the amendments to subdivision 4 of section 854 of the general municipal
7 law made by section seventy of this act shall not affect the expiration
8 of such subdivision and shall be deemed to expire therewith and provided
9 further that sections sixty-seven and sixty-eight of this act shall
10 apply to taxable years beginning on or after January 1, 1998 and
11 provided further that sections eighty-one through eighty-seven of this
12 act shall expire and be deemed repealed on December 31, [2015] 2019 and
13 provided further, however, that the amendments to section ninety of this
14 act shall take effect January 1, 1998 and shall apply to all policies,
15 contracts, certificates, riders or other evidences of coverage of long
16 term care insurance issued, renewed, altered or modified pursuant to
17 section 3229 of the insurance law on or after such date.
18 S 21. Paragraph (b) of subdivision 17 of section 2808 of the public
19 health law, as amended by section 98 of part H of chapter 59 of the laws
20 of 2011, is amended to read as follows:
21 (b) Notwithstanding any inconsistent provision of law or regulation to
22 the contrary, for the state fiscal [year] YEARS beginning April first,
23 two thousand ten and ending March thirty-first, two thousand [fifteen]
24 NINETEEN, the commissioner shall not be required to revise certified
25 rates of payment established pursuant to this article for rate periods
26 prior to April first, two thousand [fifteen] NINETEEN, based on consid-
27 eration of rate appeals filed by residential health care facilities or
28 based upon adjustments to capital cost reimbursement as a result of
29 approval by the commissioner of an application for construction under
30 section twenty-eight hundred two of this article, in excess of an aggre-
31 gate annual amount of eighty million dollars for each such state fiscal
32 year provided, however, that for the period April first, two thousand
33 eleven through March thirty-first, two thousand twelve such aggregate
34 annual amount shall be fifty million dollars. In revising such rates
35 within such fiscal limit, the commissioner shall, in prioritizing such
36 rate appeals, include consideration of which facilities the commissioner
37 determines are facing significant financial hardship as well as such
38 other considerations as the commissioner deems appropriate and, further,
39 the commissioner is authorized to enter into agreements with such facil-
40 ities or any other facility to resolve multiple pending rate appeals
41 based upon a negotiated aggregate amount and may offset such negotiated
42 aggregate amounts against any amounts owed by the facility to the
43 department, including, but not limited to, amounts owed pursuant to
44 section twenty-eight hundred seven-d of this article; provided, however,
45 that the commissioner's authority to negotiate such agreements resolving
46 multiple pending rate appeals as hereinbefore described shall continue
47 on and after April first, two thousand [fifteen] NINETEEN. Rate adjust-
48 ments made pursuant to this paragraph remain fully subject to approval
49 by the director of the budget in accordance with the provisions of
50 subdivision two of section twenty-eight hundred seven of this article.
51 S 22. Paragraph (a) of subdivision 13 of section 3614 of the public
52 health law, as added by section 4 of part H of chapter 59 of the laws of
53 2011, is amended to read as follows:
54 (a) Notwithstanding any inconsistent provision of law or regulation
55 and subject to the availability of federal financial participation,
56 effective April first, two thousand twelve through March thirty-first,
S. 2007--B 54 A. 3007--B
1 two thousand [fifteen] NINETEEN, payments by government agencies for
2 services provided by certified home health agencies, except for such
3 services provided to children under eighteen years of age and other
4 discreet groups as may be determined by the commissioner pursuant to
5 regulations, shall be based on episodic payments. In establishing such
6 payments, a statewide base price shall be established for each sixty day
7 episode of care and adjusted by a regional wage index factor and an
8 individual patient case mix index. Such episodic payments may be further
9 adjusted for low utilization cases and to reflect a percentage limita-
10 tion of the cost for high-utilization cases that exceed outlier thresh-
11 olds of such payments.
12 S 23. Subdivision (a) of section 40 of part B of chapter 109 of the
13 laws of 2010, amending the social services law relating to transporta-
14 tion costs, is amended to read as follows:
15 (a) sections two, three, three-a, three-b, three-c, three-d, three-e
16 and twenty-one of this act shall take effect July 1, 2010; sections
17 fifteen, sixteen, seventeen, eighteen and nineteen of this act shall
18 take effect January 1, 2011; and provided further that section twenty of
19 this act shall be deemed repealed [four] SIX years after the date the
20 contract entered into pursuant to section 365-h of the social services
21 law, as amended by section twenty of this act, is executed; provided
22 that the commissioner of health shall notify the legislative bill draft-
23 ing commission upon the execution of the contract entered into pursuant
24 to section 367-h of the social services law in order that the commission
25 may maintain an accurate and timely effective data base of the official
26 text of the laws of the state of New York in furtherance of effectuating
27 the provisions of section 44 of the legislative law and section 70-b of
28 the public officers law;
29 S 24. Subdivision 4 of section 365-h of the social services law, as
30 added by section 20 of part B of chapter 109 of the laws of 2010, is
31 amended to read as follows:
32 4. The commissioner of health is authorized to assume responsibility
33 from a local social services official for the provision and reimburse-
34 ment of transportation costs under this section. If the commissioner
35 elects to assume such responsibility, the commissioner shall notify the
36 local social services official in writing as to the election, the date
37 upon which the election shall be effective and such information as to
38 transition of responsibilities as the commissioner deems prudent. The
39 commissioner is authorized to contract with a transportation manager or
40 managers to manage transportation services in any local social services
41 district. Any transportation manager or managers selected by the commis-
42 sioner to manage transportation services shall have proven experience in
43 coordinating transportation services in a geographic and demographic
44 area similar to the area in New York state within which the contractor
45 would manage the provision of services under this section. Such a
46 contract or contracts may include responsibility for: review, approval
47 and processing of transportation orders; management of the appropriate
48 level of transportation based on documented patient medical need; and
49 development of new technologies leading to efficient transportation
50 services. If the commissioner elects to assume such responsibility from
51 a local social services district, the commissioner shall examine and, if
52 appropriate, adopt quality assurance measures that may include, but are
53 not limited to, global positioning tracking system reporting require-
54 ments and service verification mechanisms. Any and all reimbursement
55 rates developed by transportation managers under this subdivision shall
56 be subject to the review and approval of the commissioner. [Notwith-
S. 2007--B 55 A. 3007--B
1 standing any inconsistent provision of sections one hundred twelve and
2 one hundred sixty-three of the state finance law, or section one hundred
3 forty-two of the economic development law, or any other law, the commis-
4 sioner is authorized to enter into a contract or contracts under this
5 subdivision without a competitive bid or request for proposal process,
6 provided, however, that:
7 (a) the department shall post on its website, for a period of no less
8 than thirty days:
9 (i) a description of the proposed services to be provided pursuant to
10 the contract or contracts;
11 (ii) the criteria for selection of a contractor or contractors;
12 (iii) the period of time during which a prospective contractor may
13 seek selection, which shall be no less than thirty days after such
14 information is first posted on the website; and
15 (iv) the manner by which a prospective contractor may seek such
16 selection, which may include submission by electronic means;
17 (b) all reasonable and responsive submissions that are received from
18 prospective contractors in timely fashion shall be reviewed by the
19 commissioner; and
20 (c) the commissioner shall select such contractor or contractors that,
21 in his or her discretion, are best suited to serve the purposes of this
22 section.]
23 S 25. Intentionally omitted.
24 S 26. Section 2 of chapter 459 of the laws of 1996, amending the
25 public health law relating to recertification of persons providing emer-
26 gency medical care, as amended by chapter 106 of the laws of 2011, is
27 amended to read as follows:
28 S 2. This act shall take effect immediately and shall expire and be
29 deemed repealed July 1, [2015] 2019.
30 S 27. Section 4 of chapter 505 of the laws of 1995, amending the
31 public health law relating to the operation of department of health
32 facilities, as amended by section 29 of part A of chapter 59 of the laws
33 of 2011, is amended to read as follows:
34 S 4. This act shall take effect immediately; provided, however, that
35 the provisions of paragraph (b) of subdivision 4 of section 409-c of the
36 public health law, as added by section three of this act, shall take
37 effect January 1, 1996 and shall expire and be deemed repealed [twenty]
38 TWENTY-FOUR years from the effective date thereof.
39 S 28. Subdivision (o) of section 111 of part H of chapter 59 of the
40 laws of 2011, amending the public health law relating to the statewide
41 health information network of New York and the statewide planning and
42 research cooperative system and general powers and duties, is amended to
43 read as follows:
44 (o) sections thirty-eight and thirty-eight-a of this act shall expire
45 and be deemed repealed March 31, [2015] 2017;
46 S 29. Section 4-a of part A of chapter 56 of the laws of 2013 amending
47 chapter 59 of the laws of 2011 amending the public health law and other
48 laws relating to general hospital reimbursement for annual rates relat-
49 ing to the cap on local Medicaid expenditures, is amended to read as
50 follows:
51 S 4-a. Notwithstanding paragraph (c) of subdivision 10 of section
52 2807-c of the public health law, section 21 of chapter 1 of the laws of
53 1999, or any other contrary provision of law, in determining rates of
54 payments by state governmental agencies effective for services provided
55 on and after January 1, [2015] 2017 through March 31, [2015] 2017, for
56 inpatient and outpatient services provided by general hospitals, for
S. 2007--B 56 A. 3007--B
1 inpatient services and adult day health care outpatient services
2 provided by residential health care facilities pursuant to article 28 of
3 the public health law, except for residential health care facilities or
4 units of such facilities providing services primarily to children under
5 twenty-one years of age, for home health care services provided pursuant
6 to article 36 of the public health law by certified home health agen-
7 cies, long term home health care programs and AIDS home care programs,
8 and for personal care services provided pursuant to section 365-a of the
9 social services law, the commissioner of health shall apply no greater
10 than zero trend factors attributable to the [2015] 2017 calendar year in
11 accordance with paragraph (c) of subdivision 10 of section 2807-c of the
12 public health law, provided, however, that such no greater than zero
13 trend factors attributable to such [2015] 2017 calendar year shall also
14 be applied to rates of payment provided on and after January 1, [2015]
15 2017 through March 31, [2015] 2017 for personal care services provided
16 in those local social services districts, including New York city, whose
17 rates of payment for such services are established by such local social
18 services districts pursuant to a rate-setting exemption issued by the
19 commissioner of health to such local social services districts in
20 accordance with applicable regulations, and provided further, however,
21 that for rates of payment for assisted living program services provided
22 on and after January 1, [2015] 2017 through March 31, [2015] 2017, such
23 trend factors attributable to the [2015] 2017 calendar year shall be
24 established at no greater than zero percent.
25 S 29-a. Notwithstanding paragraph (c) of subdivision 10 of section
26 2807-c of the public health law, section 21 of chapter 1 of the laws of
27 1999, or any other contrary provision of law, in determining rates of
28 payments by state governmental agencies effective for services provided
29 on and after January 1, 2015, for inpatient and outpatient services
30 provided by general hospitals, for inpatient services and adult day
31 health care outpatient services provided by residential health care
32 facilities pursuant to article 28 of the public health law, except for
33 residential health care facilities or units of such facilities providing
34 services primarily to children under twenty-one years of age, for home
35 health care services provided pursuant to article 36 of the public
36 health law by certified home health agencies, long term home health care
37 programs and AIDS home care programs, and for personal care services
38 provided pursuant to section 365-a of the social services law, the
39 commissioner of health shall apply no greater than zero trend factors
40 attributable to the 2015 and 2016 calendar year in accordance with para-
41 graph (c) of subdivision 10 of section 2807-c of the public health law,
42 provided, however, that such no greater than zero trend factors attrib-
43 utable to such 2015 and 2016 calendar year shall also be applied to
44 rates of payment provided on and after January 1, 2015 for personal care
45 services provided in those local social services districts, including
46 New York city, whose rates of payment for such services are established
47 by such local social services districts pursuant to a rate-setting
48 exemption issued by the commissioner of health to such local social
49 services districts in accordance with applicable regulations, and
50 provided further, however, that for rates of payment for assisted living
51 program services provided on and after January 1, 2015, such trend
52 factors attributable to the 2015 and 2016 calendar year shall be estab-
53 lished at no greater than zero percent.
54 S 30. Notwithstanding any inconsistent provision of law, rule or regu-
55 lation, for purposes of implementing the provisions of the public health
56 law and the social services law, references to titles XIX and XXI of the
S. 2007--B 57 A. 3007--B
1 federal social security act in the public health law and the social
2 services law shall be deemed to include and also to mean any successor
3 titles thereto under the federal social security act.
4 S 31. Notwithstanding any inconsistent provision of law, rule or regu-
5 lation, the effectiveness of the provisions of sections 2807 and 3614 of
6 the public health law, section 18 of chapter 2 of the laws of 1988, and
7 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
8 or certification of rates of payment, are hereby suspended and without
9 force or effect for purposes of implementing the provisions of this act.
10 S 32. Severability clause. If any clause, sentence, paragraph, subdi-
11 vision, section or part of this act shall be adjudged by any court of
12 competent jurisdiction to be invalid, such judgment shall not affect,
13 impair or invalidate the remainder thereof, but shall be confined in its
14 operation to the clause, sentence, paragraph, subdivision, section or
15 part thereof directly involved in the controversy in which such judgment
16 shall have been rendered. It is hereby declared to be the intent of the
17 legislature that this act would have been enacted even if such invalid
18 provisions had not been included herein.
19 S 33. This act shall take effect immediately and shall be deemed to
20 have been in full force and effect on and after April 1, 2015 provided,
21 that:
22 1. any rules or regulations necessary to implement the provisions of
23 this act may be promulgated and any procedures, forms, or instructions
24 necessary for such implementation may be adopted and issued on or after
25 the date this act shall have become a law;
26 2. this act shall not be construed to alter, change, affect, impair or
27 defeat any rights, obligations, duties or interests accrued, incurred or
28 conferred prior to the effective date of this act;
29 3. the commissioner of health and the superintendent of the department
30 of financial services and any appropriate council may take any steps
31 necessary to implement this act prior to its effective date; and
32 4. the provisions of this act shall become effective notwithstanding
33 the failure of the commissioner of health or the superintendent of the
34 department of financial services or any council to adopt or amend or
35 promulgate regulations implementing this act.
36 PART E
37 Section 1. Subdivision 5-d of section 2807-k of the public health
38 law, as added by section 1 of part C of chapter 56 of the laws of 2013,
39 is amended to read as follows:
40 5-d. (a) Notwithstanding any inconsistent provision of this section,
41 section twenty-eight hundred seven-w of this article or any other
42 contrary provision of law, and subject to the availability of federal
43 financial participation, for periods on and after January first, two
44 thousand thirteen, through December thirty-first, two thousand [fifteen]
45 EIGHTEEN, all funds available for distribution pursuant to this section,
46 except for funds distributed pursuant to subparagraph (v) of paragraph
47 (b) of subdivision five-b of this section, and all funds available for
48 distribution pursuant to section twenty-eight hundred seven-w of this
49 article, shall be reserved and set aside and distributed in accordance
50 with the provisions of this subdivision.
51 (b) The commissioner shall promulgate regulations, and may promulgate
52 emergency regulations, establishing methodologies for the distribution
53 of funds as described in paragraph (a) of this subdivision and such
54 regulations shall include, but not be limited to, the following:
S. 2007--B 58 A. 3007--B
1 (i) Such regulations shall establish methodologies for determining
2 each facility's relative uncompensated care need amount based on unin-
3 sured inpatient and outpatient units of service from the cost reporting
4 year two years prior to the distribution year, multiplied by the appli-
5 cable medicaid rates in effect January first of the distribution year,
6 as summed and adjusted by a statewide cost adjustment factor and reduced
7 by the sum of all payment amounts collected from such uninsured
8 patients, and as further adjusted by application of a nominal need
9 computation that shall take into account each facility's medicaid inpa-
10 tient share.
11 (ii) Annual distributions pursuant to such regulations for the two
12 thousand thirteen through two thousand [fifteen] EIGHTEEN calendar years
13 shall be in accord with the following:
14 (A) one hundred thirty-nine million four hundred thousand dollars
15 shall be distributed as Medicaid Disproportionate Share Hospital ("DSH")
16 payments to major public general hospitals; and
17 (B) nine hundred ninety-four million nine hundred thousand dollars as
18 Medicaid DSH payments to eligible general hospitals, other than major
19 public general hospitals.
20 (iii)(A) Such regulations shall establish transition adjustments to
21 the distributions made pursuant to clauses (A) and (B) of subparagraph
22 (ii) of this paragraph such that no facility experiences a reduction in
23 indigent care pool payments pursuant to this subdivision that is greater
24 than the percentages, as specified in clause (C) of this subparagraph as
25 compared to the average distribution that each such facility received
26 for the three calendar years prior to two thousand thirteen pursuant to
27 this section and section twenty-eight hundred seven-w of this article.
28 (B) Such regulations shall also establish adjustments limiting the
29 increases in indigent care pool payments experienced by facilities
30 pursuant to this subdivision by an amount that will be, as determined by
31 the commissioner and in conjunction with such other funding as may be
32 available for this purpose, sufficient to ensure full funding for the
33 transition adjustment payments authorized by clause (A) of this subpara-
34 graph.
35 (C) No facility shall experience a reduction in indigent care pool
36 payments pursuant to this subdivision that: for the calendar year begin-
37 ning January first, two thousand thirteen, is greater than two and one-
38 half percent; for the calendar year beginning January first, two thou-
39 sand fourteen, is greater than five percent; and, for the calendar year
40 beginning on January first, two thousand fifteen, is greater than seven
41 and one-half percent, AND FOR THE CALENDAR YEAR BEGINNING ON JANUARY
42 FIRST, TWO THOUSAND SIXTEEN, IS GREATER THAN TEN PERCENT; AND FOR THE
43 CALENDAR YEAR BEGINNING ON JANUARY FIRST, TWO THOUSAND SEVENTEEN, IS
44 GREATER THAN TWELVE AND ONE-HALF PERCENT; AND FOR THE CALENDAR YEAR
45 BEGINNING ON JANUARY FIRST, TWO THOUSAND EIGHTEEN, IS GREATER THAN
46 FIFTEEN PERCENT.
47 (iv) Such regulations shall reserve one percent of the funds available
48 for distribution in the two thousand fourteen and two thousand fifteen
49 calendar years, AND FOR CALENDAR YEARS THEREAFTER, pursuant to this
50 subdivision, subdivision fourteen-f of section twenty-eight hundred
51 seven-c of this article, and sections two hundred eleven and two hundred
52 twelve of chapter four hundred seventy-four of the laws of nineteen
53 hundred ninety-six, in a "financial assistance compliance pool" and
54 shall establish methodologies for the distribution of such pool funds to
55 facilities based on their level of compliance, as determined by the
56 commissioner, with the provisions of subdivision nine-a of this section.
S. 2007--B 59 A. 3007--B
1 (c) The commissioner shall annually report to the governor and the
2 legislature on the distribution of funds under this subdivision includ-
3 ing, but not limited to:
4 (i) the impact on safety net providers, including community providers,
5 rural general hospitals and major public general hospitals;
6 (ii) the provision of indigent care by units of services and funds
7 distributed by general hospitals; and
8 (iii) the extent to which access to care has been enhanced.
9 S 2. Notwithstanding any inconsistent provision of law, rule or regu-
10 lation to the contrary, and subject to the availability of federal
11 financial participation pursuant to title XIX of the federal social
12 security act, effective for periods on and after April 1, 2015, payments
13 pursuant to paragraph (i) of subdivision 35 of section 2807-c of the
14 public health law may be made as outpatient upper payment limit payments
15 for outpatient hospital services, not to exceed an amount of three
16 hundred thirty-nine million dollars annually between payments authorized
17 under this section and such section of the public health law. Such
18 payments shall be made as medical assistance payments for outpatient
19 services pursuant to title 11 of article 5 of the social services law
20 for patients eligible for federal financial participation under title
21 XIX of the federal social security act for general hospital outpatient
22 services and general hospital emergency room services issued pursuant to
23 paragraph (g) of subdivision 2 of section 2807 of the public health law
24 to general hospitals, other than major public general hospitals, provid-
25 ing emergency room services and including safety net hospitals, which
26 shall, for the purpose of this paragraph, be defined as having either: a
27 Medicaid share of total inpatient hospital discharges of at least thir-
28 ty-five percent, including both fee-for-service and managed care
29 discharges for acute and exempt services; or a Medicaid share of total
30 discharges of at least thirty percent, including both fee-for-service
31 and managed care discharges for acute and exempt services, and also
32 providing obstetrical services. Eligibility to receive such additional
33 payments shall be based on data from the period two years prior to the
34 rate year, as reported on the institutional cost report submitted to the
35 department as of October first of the prior rate year. No eligible
36 general hospital's annual payment amount pursuant to this section shall
37 exceed the lower of the sum of the annual amounts due that hospital
38 pursuant to section twenty-eight hundred seven-k and section twenty-
39 eight hundred seven-w of the public health law; or the hospital's facil-
40 ity specific projected disproportionate share hospital payment ceiling
41 established pursuant to federal law, provided, however, that payment
42 amounts to eligible hospitals in excess of the lower of such sum or
43 payment ceiling shall be reallocated to eligible hospitals that do not
44 have excess payment amounts. Such reallocations shall be proportional to
45 each such hospital's aggregate payment amount pursuant to paragraph (i)
46 of subdivision 35 of section 2807-c of the public health law and this
47 section to the total of all payment amounts for such eligible hospitals.
48 Such adjustment payment may be added to rates of payment or made as
49 aggregate payments to eligible general hospitals other than major public
50 general hospitals. The distribution of such payments shall be pursuant
51 to a methodology approved by the commissioner of health in regulation.
52 S 3. Notwithstanding any inconsistent provision of law, rule or regu-
53 lation, for purposes of implementing the provisions of the public health
54 law and the social services law, references to titles XIX and XXI of the
55 federal social security act in the public health law and the social
S. 2007--B 60 A. 3007--B
1 services law shall be deemed to include and also to mean any successor
2 titles thereto under the federal social security act.
3 S 4. Notwithstanding any inconsistent provision of law, rule or regu-
4 lation, the effectiveness of the provisions of sections 2807 and 3614 of
5 the public health law, section 18 of chapter 2 of the laws of 1988, and
6 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
7 or certification of rates of payment, are hereby suspended and without
8 force or effect for purposes of implementing the provisions of this act.
9 S 5. Severability clause. If any clause, sentence, paragraph, subdivi-
10 sion, section or part of this act shall be adjudged by any court of
11 competent jurisdiction to be invalid, such judgment shall not affect,
12 impair or invalidate the remainder thereof, but shall be confined in its
13 operation to the clause, sentence, paragraph, subdivision, section or
14 part thereof directly involved in the controversy in which such judgment
15 shall have been rendered. It is hereby declared to be the intent of the
16 legislature that this act would have been enacted even if such invalid
17 provisions had not been included herein.
18 S 6. This act shall take effect immediately and shall be deemed to
19 have been in full force and effect on and after April 1, 2015; provided,
20 that:
21 a. any rules or regulations necessary to implement the provisions of
22 this act may be promulgated and any procedures, forms, or instructions
23 necessary for such implementation may be adopted and issued on or after
24 the date this act shall have become a law;
25 b. this act shall not be construed to alter, change, affect, impair or
26 defeat any rights, obligations, duties or interests accrued, incurred or
27 conferred prior to the effective date of this act;
28 c. the commissioner of health and the superintendent of financial
29 services and any appropriate council may take any steps necessary to
30 implement this act prior to its effective date; and
31 d. the provisions of this act shall become effective notwithstanding
32 the failure of the commissioner of health or the superintendent of
33 financial services or any council to adopt or amend or promulgate regu-
34 lations implementing this act.
35 PART F
36 Intentionally Omitted
37 PART G
38 Intentionally Omitted
39 PART H
40 Intentionally Omitted
41 PART I
42 Section 1. Subdivision 2-a of section 2781 of the public health law is
43 REPEALED.
44 S 2. The criminal procedure law is amended by adding a new section
45 60.47 to read as follows:
S. 2007--B 61 A. 3007--B
1 S 60.47 POSSESSION OF CONDOMS; RECEIPT INTO EVIDENCE.
2 EVIDENCE THAT A PERSON WAS IN POSSESSION OF ONE OR MORE CONDOMS MAY
3 NOT BE ADMITTED AT ANY TRIAL, HEARING, OR OTHER PROCEEDING IN A PROSE-
4 CUTION FOR SECTION 230.00 OR SECTION 240.37 OF THE PENAL LAW FOR THE
5 PURPOSE OF ESTABLISHING PROBABLE CAUSE FOR AN ARREST OR PROVING ANY
6 PERSON'S COMMISSION OR ATTEMPTED COMMISSION OF SUCH OFFENSE.
7 S 3. Section 220.45 of the penal law, as amended by chapter 284 of the
8 laws of 2010, is amended to read as follows:
9 S 220.45 Criminally possessing a hypodermic instrument.
10 A person is guilty of criminally possessing a hypodermic instrument
11 when he or she knowingly and unlawfully possesses or sells a hypodermic
12 syringe or hypodermic needle. It shall not be a violation of this
13 section when a person obtains and possesses a hypodermic syringe or
14 hypodermic needle pursuant to section thirty-three hundred eighty-one of
15 the public health law, WHICH INCLUDES THE STATE'S SYRINGE EXCHANGE AND
16 PHARMACY AND MEDICAL PROVIDER-BASED EXPANDED SYRINGE ACCESS PROGRAMS.
17 Criminally possessing a hypodermic instrument is a class A misdemea-
18 nor.
19 S 4. Section 220.03 of the penal law, as amended by chapter 284 of the
20 laws of 2010, the opening paragraph as amended by chapter 154 of the
21 laws of 2011, is amended to read as follows:
22 S 220.03 Criminal possession of a controlled substance in the seventh
23 degree.
24 A person is guilty of criminal possession of a controlled substance in
25 the seventh degree when he or she knowingly and unlawfully possesses a
26 controlled substance; provided, however, that it shall not be a
27 violation of this section when a person possesses a residual amount of a
28 controlled substance and that residual amount is in or on a hypodermic
29 syringe or hypodermic needle obtained and possessed pursuant to section
30 thirty-three hundred eighty-one of the public health law, WHICH INCLUDES
31 THE STATE'S SYRINGE EXCHANGE AND PHARMACY AND MEDICAL PROVIDER-BASED
32 EXPANDED SYRINGE ACCESS PROGRAMS; nor shall it be a violation of this
33 section when a person's unlawful possession of a controlled substance is
34 discovered as a result of seeking immediate health care as defined in
35 paragraph (b) of subdivision three of section 220.78 of the penal law,
36 for either another person or him or herself because such person is expe-
37 riencing a drug or alcohol overdose or other life threatening medical
38 emergency as defined in paragraph (a) of subdivision three of section
39 220.78 of the penal law.
40 Criminal possession of a controlled substance in the seventh degree is
41 a class A misdemeanor.
42 S 5. Intentionally omitted.
43 S 6. Intentionally omitted.
44 S 7. Intentionally omitted.
45 S 8. This act shall take effect immediately.
46 PART J
47 Intentionally Omitted
48 PART K
49 Section 1. Intentionally omitted.
50 S 2. Intentionally omitted.
51 S 3. Intentionally omitted.
S. 2007--B 62 A. 3007--B
1 S 4. Intentionally omitted.
2 S 5. Intentionally omitted.
3 S 6. Intentionally omitted.
4 S 7. Subdivision 1 of section 2806-a of the public health law is
5 amended by adding a new paragraph (g) to read as follows:
6 (G) "IMPROPER DELEGATION OF MANAGEMENT AUTHORITY BY THE GOVERNING
7 AUTHORITY OR OPERATOR" OF A GENERAL HOSPITAL SHALL INCLUDE, BUT NOT BE
8 LIMITED TO, THE DELEGATION TO AN ENTITY THAT HAS NOT BEEN ESTABLISHED AS
9 AN OPERATOR OF THE GENERAL HOSPITAL OF (I) AUTHORITY TO HIRE OR FIRE THE
10 ADMINISTRATOR OR OTHER KEY MANAGEMENT EMPLOYEES; (II) MAINTENANCE AND
11 CONTROL OF THE BOOKS AND RECORDS; (III) AUTHORITY OVER THE DISPOSITION
12 OF ASSETS AND THE INCURRING OF LIABILITIES ON BEHALF OF THE FACILITY;
13 AND (IV) THE ADOPTION AND ENFORCEMENT OF POLICIES REGARDING THE OPERA-
14 TION OF THE FACILITY. THE CRITERIA SET FORTH IN THIS PARAGRAPH SHALL NOT
15 BE THE SOLE DETERMINING FACTORS, BUT INDICATORS TO BE CONSIDERED WITH
16 SUCH OTHER FACTORS THAT MAY BE PERTINENT IN PARTICULAR INSTANCES.
17 PROFESSIONAL EXPERTISE SHALL BE EXERCISED IN THE UTILIZATION OF THE
18 CRITERIA. ALL OF THE LISTED INDICIA NEED NOT BE PRESENT IN A GIVEN
19 INSTANCE FOR THERE TO BE AN IMPROPER DELEGATION OF AUTHORITY.
20 S 8. Paragraph (a) of subdivision 2 of section 2806-a of the public
21 health law, as added by section 50 of part E of chapter 56 of the laws
22 of 2013, is amended to read as follows:
23 (a) In the event that: (i) a facility seeks extraordinary financial
24 assistance and the commissioner finds that the facility is experiencing
25 serious financial instability that is jeopardizing existing or continued
26 access to essential services within the community, or (ii) the commis-
27 sioner finds that there are conditions within the facility that serious-
28 ly endanger the life, health or safety of residents or patients, the
29 commissioner may appoint a temporary operator to assume sole control and
30 sole responsibility for the operations of that facility, OR (III) THE
31 COMMISSIONER FINDS THAT THERE HAS BEEN AN IMPROPER DELEGATION OF MANAGE-
32 MENT AUTHORITY BY THE GOVERNING AUTHORITY OR OPERATOR OF A GENERAL
33 HOSPITAL, THE COMMISSIONER SHALL APPOINT A TEMPORARY OPERATOR TO ASSUME
34 SOLE CONTROL AND SOLE RESPONSIBILITY FOR THE OPERATIONS OF THAT
35 FACILITY. The appointment of the temporary operator shall be effectuated
36 pursuant to this section and shall be in addition to any other remedies
37 provided by law.
38 S 9. Subparagraph (iii) of paragraph (c) of subdivision 5 of section
39 2806-a of the public health law, as added by section 50 of part E of
40 chapter 56 of the laws of 2013, is amended to read as follows:
41 (iii) recommended actions for the ongoing operation of the facility
42 subsequent to the term of the temporary operator INCLUDING RECOMMENDA-
43 TIONS REGARDING THE PROPER MANAGEMENT OF THE FACILITY AND ONGOING AGREE-
44 MENTS WITH INDIVIDUALS OR ENTITIES WITH PROPER DELEGATION OF MANAGEMENT
45 AUTHORITY; and
46 S 10. Subdivision 4 of section 2801-a of the public health law is
47 amended by adding a new paragraph (i) to read as follows:
48 (I) UPON RECOMMENDATION BY THE COMMISSIONER, IF THE PUBLIC HEALTH AND
49 HEALTH PLANNING COUNCIL FINDS BY SUBSTANTIAL EVIDENCE THAT AN IMPROPER
50 DELEGATION OF MANAGEMENT AUTHORITY BY A GOVERNING AUTHORITY OR OPERATOR
51 OF A GENERAL HOSPITAL HAS OCCURRED AS DEFINED BY PARAGRAPH (G) OF SUBDI-
52 VISION ONE OF SECTION TWENTY-EIGHT HUNDRED SIX-A OF THIS ARTICLE, THE
53 ESTABLISHMENT APPROVAL OF SUCH HOSPITAL SHALL BE SUBJECT TO REVOCATION
54 OR SUSPENSION.
55 S 11. This act shall take effect immediately; provided, however, that
56 the amendments to section 2806-a of the public health law, made by
S. 2007--B 63 A. 3007--B
1 sections seven, eight and nine of this act, shall not affect the expira-
2 tion and repeal of such section, and shall be deemed repealed therewith.
3 PART L
4 Section 1. Paragraph (b) of subdivision 1 of section 230-d of the
5 public health law, as added by chapter 365 of the laws of 2007, is
6 amended to read as follows:
7 (b) "Adverse event" means (i) patient death within thirty days; (ii)
8 unplanned transfer to a hospital OR EMERGENCY DEPARTMENT VISIT WITHIN
9 SEVENTY-TWO HOURS OF OFFICE-BASED SURGERY FOR REASONS RELATED TO THE
10 OFFICE-BASED SURGERY ENCOUNTER; (iii) unscheduled hospital admission OR
11 ASSIGNMENT TO OBSERVATION SERVICES, within seventy-two hours of the
12 office-based surgery, for longer than twenty-four hours; or (iv) any
13 other serious or life-threatening event.
14 S 2. Subdivision 4 of section 230-d of the public health law, as
15 amended by chapter 477 of the laws of 2008, is amended to read as
16 follows:
17 4. (A) Licensees shall report adverse events to the department's
18 patient safety center within [one] THREE business [day] DAYS of the
19 occurrence of such adverse event. Licensees shall also report any
20 suspected health care disease transmission originating in their prac-
21 tices to the patient safety center within [one] THREE business [day]
22 DAYS of becoming aware of such suspected transmission. For purposes of
23 this section, health care disease transmission shall mean the trans-
24 mission of a reportable communicable disease that is blood borne from a
25 health care professional to a patient or between patients as a result of
26 improper infection control practices by the health care professional.
27 (B) THE DEPARTMENT MAY ALSO REQUIRE LICENSEES TO REPORT ADDITIONAL
28 DATA SUCH AS PROCEDURAL INFORMATION AS NEEDED FOR THE INTERPRETATION OF
29 ADVERSE EVENTS.
30 (C) The DATA reported [data] UNDER THIS SUBDIVISION shall be subject
31 to all confidentiality provisions provided by section twenty-nine
32 hundred ninety-eight-e of this chapter.
33 S 3. The section heading and subdivisions 1 and 2 of section 2998-e of
34 the public health law, as added by chapter 365 of the laws of 2007, are
35 amended to read as follows:
36 Reporting [of adverse events] in office based surgery. 1. The commis-
37 sioner [shall] MAY enter into agreements with accrediting agencies
38 [pursuant] to [which the accrediting agencies shall] REQUIRE ALL
39 OFFICE-BASED SURGICAL PRACTICES TO CONDUCT QUALITY IMPROVEMENT AND QUAL-
40 ITY ASSURANCE ACTIVITIES AND UTILIZE CERTIFICATION BY AN APPROPRIATE
41 CERTIFYING ORGANIZATION, HOSPITAL PRIVILEGING OR OTHER EQUIVALENT METH-
42 ODS TO DETERMINE COMPETENCY OF PRACTITIONERS TO PERFORM OFFICE-BASED
43 SURGERY, CARRY OUT SURVEYS OR COMPLAINT/INCIDENT INVESTIGATIONS AND
44 SHALL report, at a minimum, [aggregate data on adverse events] FINDINGS
45 OF SURVEYS AND COMPLAINT/INCIDENT INVESTIGATIONS, AND DATA for all
46 office-based surgical practices accredited by the accrediting agencies
47 to the department. The department may disclose reports of aggregate data
48 to the public.
49 2. The information required to be collected, maintained and reported
50 directly to the department AND THE ACCREDITING AGENCIES AND MAINTAINED
51 BY OFFICE-BASED SURGERY PRACTICES UNDER ADVERSE EVENT REPORTING, QUALITY
52 IMPROVEMENT AND QUALITY ASSURANCE ACTIVITIES pursuant to section two
53 hundred thirty-d of this chapter shall be kept confidential and shall
54 not be released, except to the department and except as required or
S. 2007--B 64 A. 3007--B
1 permitted under subdivision nine-a and subparagraph (v) of paragraph (a)
2 of subdivision ten of section two hundred thirty of this chapter.
3 Notwithstanding any other provision of law, none of [such information]
4 THE INFORMATION COLLECTED, MAINTAINED AND REPORTED TO THE DEPARTMENT OR
5 THE ACCREDITING AGENCIES, AND MAINTAINED BY THE OFFICE-BASED SURGERY
6 PRACTICES UNDER ADVERSE EVENT REPORTING, QUALITY IMPROVEMENT AND QUALITY
7 ASSURANCE ACTIVITIES PURSUANT TO THIS SECTION shall be subject to
8 disclosure under article six of the public officers law or article thir-
9 ty-one of the civil practice law and rules.
10 S 4. This act shall take effect one year after it shall have become a
11 law.
12 PART M
13 Section 1. Subdivisions 1 and 2 of section 1100-a of the public health
14 law, as added by chapter 258 of the laws of 1996, are amended and two
15 new subdivisions 3 and 4 are added to read as follows:
16 1. Notwithstanding any contrary provision of law, rule, regulation or
17 code, any county, city, town or village that owns both its public water
18 system and the water supply for such system may by local law provide
19 whether a fluoride compound shall [or shall not] be added to such public
20 water supply.
21 2. Any county, wherein a public authority owns both its public water
22 system and the water supply for such system, may by local law provide
23 whether a fluoride compound shall [or shall not] be added to such public
24 water supply.
25 3. NO COUNTY, CITY, TOWN OR VILLAGE, INCLUDING A COUNTY WHEREIN A
26 PUBLIC AUTHORITY OWNS BOTH ITS PUBLIC WATER SYSTEM AND THE WATER SUPPLY
27 FOR SUCH SYSTEM, THAT FLUORIDATES A PUBLIC WATER SUPPLY OR CAUSES A
28 PUBLIC WATER SUPPLY TO BE FLUORIDATED, SHALL DISCONTINUE THE ADDITION OF
29 A FLUORIDE COMPOUND TO SUCH PUBLIC WATER SUPPLY UNLESS IT HAS FIRST
30 COMPLIED WITH THE FOLLOWING REQUIREMENTS:
31 (A) ISSUE A NOTICE TO THE PUBLIC OF THE PRELIMINARY DETERMINATION TO
32 DISCONTINUE FLUORIDATION FOR COMMENT, WHICH SHALL INCLUDE THE JUSTIFICA-
33 TION FOR THE PROPOSED DISCONTINUANCE, ALTERNATIVES TO FLUORIDATION
34 AVAILABLE, AND A SUMMARY OF CONSULTATIONS WITH HEALTH PROFESSIONALS AND
35 THE DEPARTMENT CONCERNING THE PROPOSED DISCONTINUANCE. SUCH NOTICE MAY,
36 BUT IS NOT REQUIRED TO, INCLUDE PUBLICATION IN LOCAL NEWSPAPERS.
37 "CONSULTATIONS WITH HEALTH PROFESSIONALS" MAY INCLUDE FORMAL STUDIES BY
38 HIRED PROFESSIONALS, INFORMAL CONSULTATIONS WITH LOCAL PUBLIC HEALTH
39 OFFICIALS OR OTHER HEALTH PROFESSIONALS, OR OTHER CONSULTATIONS,
40 PROVIDED THAT THE NATURE OF SUCH CONSULTATIONS AND THE IDENTITY OF SUCH
41 PROFESSIONALS SHALL BE IDENTIFIED IN THE PUBLIC NOTICE. "ALTERNATIVES TO
42 FLUORIDATION" MAY INCLUDE FORMAL ALTERNATIVES PROVIDED BY OR AT THE
43 EXPENSE OF THE COUNTY, CITY, TOWN OR VILLAGE, OR OTHER ALTERNATIVES
44 AVAILABLE TO THE PUBLIC. ANY PUBLIC COMMENTS RECEIVED IN RESPONSE TO
45 SUCH NOTICE SHALL BE ADDRESSED BY THE COUNTY, CITY, TOWN OR VILLAGE IN
46 THE ORDINARY COURSE OF BUSINESS; AND
47 (B) PROVIDE THE DEPARTMENT AT LEAST NINETY DAYS PRIOR WRITTEN NOTICE
48 OF THE INTENT TO DISCONTINUE AND SUBMIT A PLAN FOR DISCONTINUANCE THAT
49 INCLUDES BUT IS NOT LIMITED TO THE NOTICE THAT WILL BE PROVIDED TO THE
50 PUBLIC, CONSISTENT WITH PARAGRAPH (A) OF THIS SUBDIVISION, OF THE DETER-
51 MINATION TO DISCONTINUE FLUORIDATION OF THE WATER SUPPLY, INCLUDING THE
52 DATE OF SUCH DISCONTINUANCE AND ALTERNATIVES TO FLUORIDATION, IF ANY,
53 THAT WILL BE MADE AVAILABLE IN THE COMMUNITY, AND THAT INCLUDES INFORMA-
54 TION AS MAY BE REQUIRED UNDER THE SANITARY CODE.
S. 2007--B 65 A. 3007--B
1 4. THE COMMISSIONER IS HEREBY AUTHORIZED, WITHIN AMOUNTS APPROPRIATED
2 THEREFOR, TO MAKE GRANTS TO COUNTIES, CITIES, TOWNS OR VILLAGES THAT OWN
3 THEIR PUBLIC WATER SYSTEM AND THE WATER SUPPLY FOR SUCH SYSTEM, INCLUD-
4 ING A COUNTY WHEREIN A PUBLIC AUTHORITY OWNS BOTH ITS PUBLIC WATER
5 SYSTEM AND THE WATER SUPPLY FOR SUCH SYSTEM, FOR THE PURPOSE OF PROVID-
6 ING ASSISTANCE TOWARDS THE COSTS OF INSTALLATION, INCLUDING BUT NOT
7 LIMITED TO TECHNICAL AND ADMINISTRATIVE COSTS ASSOCIATED WITH PLANNING,
8 DESIGN AND CONSTRUCTION, AND START-UP OF FLUORIDATION SYSTEMS, AND
9 REPLACING, REPAIRING OR UPGRADING OF FLUORIDATION EQUIPMENT FOR SUCH
10 PUBLIC WATER SYSTEMS. GRANT FUNDING SHALL NOT BE AVAILABLE FOR ASSIST-
11 ANCE TOWARDS THE COSTS AND EXPENSES OF OPERATION OF THE FLUORIDATION
12 SYSTEM, AS DETERMINED BY THE DEPARTMENT. THE GRANT APPLICATIONS SHALL
13 INCLUDE SUCH INFORMATION AS REQUIRED BY THE COMMISSIONER. IN MAKING THE
14 GRANT AWARDS, THE COMMISSIONER SHALL CONSIDER THE DEMONSTRATED NEED FOR
15 INSTALLATION OF NEW FLUORIDATION EQUIPMENT OR REPLACING, REPAIRING OR
16 UPGRADING OF EXISTING FLUORIDATION EQUIPMENT, AND SUCH OTHER CRITERIA AS
17 DETERMINED BY THE COMMISSIONER. GRANT AWARDS SHALL BE MADE ON A COMPET-
18 ITIVE BASIS AND BE SUBJECT TO SUCH CONDITIONS AS MAY BE DETERMINED BY
19 THE COMMISSIONER.
20 S 2. This act shall take effect immediately.
21 PART N
22 Section 1. Purpose. The purpose of this act is to seek public input
23 about the creation of an office of community living with the goal of
24 providing improvements in service delivery and improved program outcomes
25 that would result from the expansion of community living integration
26 services for older adults and persons of all ages with disabilities.
27 S 2. Data and information collection. (1) The director of the state
28 office for the aging, in collaboration with other state agencies, will
29 consult with stakeholders, providers, individuals and their families to
30 gather data and information on the creation of an office for community
31 living. Areas of focus shall include, but not be limited to, furthering
32 the goals of the governor's Olmstead plan, strengthening the No Wrong
33 Door approach to accessing information and services, reinforcing initi-
34 atives of the Balancing Incentive Program, creating opportunities to
35 better leverage resources, evaluating methods for service delivery
36 improvements, and analyzing the fiscal impact of creating such an office
37 on services, individuals and providers. The state office for the aging
38 shall also examine recent federal initiatives to create an adminis-
39 tration on community living; and examine other states' efforts to expand
40 services supporting community living integration, and local and/or
41 regional coordination efforts within New York.
42 (2) In order to ensure meaningful public input and comment regarding
43 the activities of subdivision one of this section, there shall be a
44 series of public meetings held across the state, organized to ensure
45 that stakeholders in all regions of the state are afforded an opportu-
46 nity to comment.
47 S 3. Reporting. The director of the state office for the aging shall
48 submit to the governor, and to the temporary president of the senate and
49 the speaker of the assembly, a report and recommendations by December
50 15, 2015, that outlines the results and findings associated with the
51 aforementioned collection of data and solicitation of feedback. Such
52 report shall include, but not be limited to, the director's assessment,
53 after taking into consideration input from all stakeholders, whether
54 establishment of such an office would be beneficial to the populations
S. 2007--B 66 A. 3007--B
1 served and the state as a whole, the information gathered to make such
2 assessment, an analysis of all information gathered, all alternatives
3 considered, the impact and effect any proposed change may have on exist-
4 ing programs and services, and an assessment of related fiscal impacts
5 on localities, the state and non-governmental entities serving the
6 elderly and disabled communities in each of the respective communities.
7 S 4. This act shall take effect immediately.
8 PART O
9 Intentionally Omitted
10 PART P
11 Intentionally Omitted
12 PART Q
13 Intentionally Omitted
14 PART R
15 Intentionally Omitted
16 PART S
17 Intentionally Omitted
18 PART T
19 Intentionally Omitted
20 PART U
21 Intentionally Omitted
22 PART V
23 Section 1. Subparagraph (iv) of paragraph (a) of subdivision 3 of
24 section 3309 of the public health law, as added by chapter 42 of the
25 laws of 2014, is amended to read as follows:
26 (iv) "Opioid antagonist recipient" or "recipient" means a person at
27 risk of experiencing an opioid-related overdose, or a family member,
28 friend or other person in a position to assist a person experiencing or
29 at risk of experiencing an opioid-related overdose, or an organization
30 registered as an opioid overdose prevention program pursuant to this
31 section OR A SCHOOL DISTRICT, BOARD OF COOPERATIVE EDUCATIONAL SERVICES,
32 COUNTY VOCATIONAL EDUCATION AND EXTENSION BOARD, CHARTER SCHOOL,
S. 2007--B 67 A. 3007--B
1 NON-PUBLIC ELEMENTARY AND/OR SECONDARY SCHOOL IN THIS STATE OR ANY
2 PERSON EMPLOYED BY SUCH DISTRICT, BOARD OR SCHOOL.
3 S 2. Subdivision 4 of section 3309 of the public health law, as
4 amended by chapter 42 of the laws of 2014, is amended to read as
5 follows:
6 4. Use of an opioid antagonist pursuant to this section shall be
7 considered first aid or emergency treatment for the purpose of any stat-
8 ute relating to liability.
9 A recipient [or], opioid overdose prevention program, SCHOOL DISTRICT,
10 BOARD OF COOPERATIVE EDUCATIONAL SERVICES, COUNTY VOCATIONAL EDUCATION
11 AND EXTENSION BOARD, CHARTER SCHOOL, NON-PUBLIC ELEMENTARY SCHOOL AND/OR
12 SECONDARY SCHOOL IN THE STATE, OR ANY PERSON EMPLOYED BY SUCH DISTRICT,
13 BOARD OR SCHOOL under this section, acting reasonably and in good faith
14 in compliance with this section, shall not be subject to criminal, civil
15 or administrative liability solely by reason of such action.
16 S 3. Subdivision 3 of section 3309 of the public health law, as added
17 by chapter 34 of the laws of 2014, is renumbered subdivision 3-a.
18 S 4. The education law is amended by adding a new section 922 to read
19 as follows:
20 S 922. OPIOID OVERDOSE PREVENTION. 1. SCHOOL DISTRICTS, BOARDS OF
21 COOPERATIVE EDUCATIONAL SERVICES, COUNTY VOCATIONAL EDUCATION AND EXTEN-
22 SION BOARDS, CHARTER SCHOOLS, AND NON-PUBLIC ELEMENTARY AND SECONDARY
23 SCHOOLS IN THIS STATE MAY PROVIDE AND MAINTAIN ON-SITE IN EACH INSTRUC-
24 TIONAL SCHOOL FACILITY OPIOID ANTAGONISTS, AS DEFINED IN SECTION THREE
25 THOUSAND THREE HUNDRED NINE OF THE PUBLIC HEALTH LAW, IN QUANTITIES AND
26 TYPES DEEMED BY THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER
27 OF HEALTH, TO BE ADEQUATE TO ENSURE READY AND APPROPRIATE ACCESS FOR USE
28 DURING EMERGENCIES TO ANY STUDENT OR STAFF SUSPECTED OF HAVING OPIOID
29 OVERDOSE WHETHER OR NOT THERE IS A PREVIOUS HISTORY OF OPIOID ABUSE.
30 2. SCHOOL DISTRICTS, BOARDS OF COOPERATIVE EDUCATIONAL SERVICES, COUN-
31 TY VOCATIONAL EDUCATION AND EXTENSION BOARDS, CHARTER SCHOOLS, AND NON-
32 PUBLIC ELEMENTARY AND SECONDARY SCHOOLS IN THIS STATE MAY ELECT TO
33 PARTICIPATE AS AN OPIOID ANTAGONIST RECIPIENT AND ANY PERSON EMPLOYED BY
34 ANY SUCH ENTITY THAT HAS ELECTED TO PARTICIPATE MAY ADMINISTER AN OPIOID
35 ANTAGONIST IN THE EVENT OF AN EMERGENCY, PROVIDED THAT SUCH PERSON SHALL
36 HAVE BEEN TRAINED BY A PROGRAM APPROVED UNDER SECTION THREE THOUSAND
37 THREE HUNDRED NINE OF THE PUBLIC HEALTH LAW. ANY SCHOOL DISTRICT, BOARD
38 OF COOPERATIVE EDUCATIONAL SERVICES, COUNTY VOCATIONAL EDUCATION AND
39 EXTENSION BOARD, CHARTER SCHOOL, AND NON-PUBLIC ELEMENTARY AND SECONDARY
40 SCHOOL THAT HAS EMPLOYEES TRAINED IN ACCORDANCE WITH THIS SECTION SHALL
41 COMPLY WITH THE REQUIREMENTS OF SECTION THREE THOUSAND THREE HUNDRED
42 NINE OF THE PUBLIC HEALTH LAW INCLUDING, BUT NOT LIMITED TO, APPROPRIATE
43 CLINICAL OVERSIGHT, RECORD KEEPING AND REPORTING. NO PERSON SHALL BE
44 REQUIRED TO PARTICIPATE IN THE PROGRAM AND ANY PARTICIPATION BY AN INDI-
45 VIDUAL SHALL BE VOLUNTARY.
46 S 5. Subdivision 4 of section 6909 of the education law is amended by
47 adding a new paragraph (f) to read as follows:
48 (F) THE URGENT OR EMERGENCY TREATMENT OF OPIOID RELATED OVERDOSE OR
49 SUSPECTED OPIOID RELATED OVERDOSE.
50 S 6. Subdivision 6 of section 6527 of the education law is amended by
51 adding a new paragraph (f) to read as follows:
52 (F) THE URGENT OR EMERGENCY TREATMENT OF OPIOID RELATED OVERDOSE OR
53 SUSPECTED OPIOID RELATED OVERDOSE.
54 S 7. This act shall take effect on the one hundred twentieth day after
55 it shall have become a law, provided that any rules and regulations
56 necessary to implement the provisions of this act on its effective date
S. 2007--B 68 A. 3007--B
1 are authorized and directed to be promulgated, repealed, and/or amended
2 by such effective date.
3 PART W
4 Section 1. Subdivision 2 of section 2807-y of the public health law,
5 as added by section 67 of part B of chapter 58 of the laws of 2005, is
6 amended to read as follows:
7 2. In the event contracts with the article forty-three insurance law
8 plans or other commissioner's designees are effectuated, the commission-
9 er shall conduct annual audits of the receipt and distribution of the
10 funds AND BEGINNING JANUARY FIRST, TWO THOUSAND SIXTEEN SHALL PROVIDE
11 RECORDS OF ALL REVENUES AND DISBURSEMENTS MADE FROM ALLOCATIONS AND
12 ASSESSMENTS LISTED IN SUBDIVISION ONE OF THIS SECTION TO THE TEMPORARY
13 PRESIDENT OF THE SENATE AND SPEAKER OF THE ASSEMBLY ON AN ANNUAL BASIS.
14 S 2. HCRA modernization task force: the commissioner of health shall
15 convene a task force to evaluate and make recommendations regarding the
16 efficacy and transparency of the Health Care Reform Act resources fund
17 (HCRA fund) and to evaluate and modernize the provisions of law related
18 to the Health Care Reform Acts of 1996 and 2000 (HCRA). The task force
19 shall consist of the commissioner of health, or his or her designee,
20 employees of the department of health with expertise in health care
21 financing, the director of the division of budget, or his or her desig-
22 nee, an individual to be appointed by the temporary president of the
23 senate, an individual to be appointed by the speaker of the assembly,
24 and stakeholders impacted by charges and disbursements of HCRA and the
25 HCRA fund, including, but not limited to: representatives of health
26 plans, consumers, managed care plans, hospitals, health care practition-
27 ers, and other health care providers. The commissioner of health, or his
28 or her designee, shall chair the task force. The HCRA pool administrator
29 shall provide material support to the task force and submit documenta-
30 tion and analysis necessary for deliberations by such task force,
31 including, but not limited to, an accounting of revenues collected and
32 disbursements made through HCRA and the HCRA fund. The task force shall
33 consider and evaluate: the purposes for which the HCRA fund was estab-
34 lished and whether such purposes may be continually served by such fund;
35 the impact that any reduction or recalculation of indigent care and
36 disproportionate share payments pursuant to federal law may have on the
37 HCRA fund, and the cost that such reductions or recalculations will have
38 to the state; the extent to which provisions of law in the HCRA statutes
39 have become obsolete; the extent to which the Balanced Budget Act of
40 1997, Public Health Law 105-33, mandates a particular form of charges or
41 assessments under HCRA and the impact any proposed change would have on
42 the protections by such law; and any other purpose that would contribute
43 to the streamlining and modernization of HCRA and the HCRA fund. The
44 task force shall convene no later than June 30, 2015. The task force
45 shall report to the governor, the temporary president of the senate and
46 the speaker of the assembly its considerations, evaluations, and find-
47 ings and make recommendations of changes to any rule, regulation, law or
48 practice necessary to effectuate its conclusions. Such report shall be
49 submitted no later than December 31, 2015, at which time such task force
50 shall be disbanded and its work completed.
51 S 3. Intentionally omitted.
52 S 4. Paragraph (d) of subdivision 5-a of section 2807-m of the public
53 health law is amended by adding three new subparagraphs (iv), (v) and
54 (vi) to read as follows:
S. 2007--B 69 A. 3007--B
1 (IV) IN ADDITION TO THE FUNDS ALLOCATED UNDER THIS PARAGRAPH, FOR THE
2 PERIOD APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO
3 THOUSAND SIXTEEN, TWO MILLION DOLLARS SHALL BE AVAILABLE FOR THE
4 PURPOSES DESCRIBED IN SUBDIVISION TEN OF THIS SECTION;
5 (V) IN ADDITION TO THE FUNDS ALLOCATED UNDER THIS PARAGRAPH, FOR THE
6 PERIOD APRIL FIRST, TWO THOUSAND SIXTEEN THROUGH MARCH THIRTY-FIRST, TWO
7 THOUSAND SEVENTEEN, TWO MILLION DOLLARS SHALL BE AVAILABLE FOR THE
8 PURPOSES DESCRIBED IN SUBDIVISION TEN OF THIS SECTION;
9 (VI) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
10 TO THE EXTENSION OF THE HEALTH CARE REFORM ACT OF 1996, SUFFICIENT FUNDS
11 SHALL BE AVAILABLE FOR THE PURPOSES DESCRIBED IN SUBDIVISION TEN OF THIS
12 SECTION IN AMOUNTS NECESSARY TO FUND THE REMAINING YEAR COMMITMENTS FOR
13 AWARDS MADE PURSUANT TO SUBPARAGRAPHS (IV) AND (V) OF THIS PARAGRAPH.
14 S 5. Intentionally omitted.
15 S 6. Intentionally omitted.
16 S 7. Intentionally omitted.
17 S 8. This act shall take effect immediately.
18 PART X
19 Section 1. Section 1325 of the insurance law, as added by chapter 489
20 of the laws of 2012, is amended to read as follows:
21 S 1325. Exemption. For the purposes of exempting certain insurance
22 companies from the provisions of section one thousand three hundred
23 twenty-four of this article, the superintendent shall exempt, through
24 December thirty-first, two thousand [sixteen] NINETEEN, those stock and
25 non-stock insurance companies to which subparagraph (B) of paragraph two
26 of subsection (b) of such section applies.
27 S 2. Subsection (c) of section 2343 of the insurance law, as amended
28 by chapter 489 of the laws of 2012, is amended to read as follows:
29 (c) Notwithstanding any other provision of this chapter, no applica-
30 tion for an order of rehabilitation or liquidation of a domestic insurer
31 whose primary liability arises from the business of medical malpractice
32 insurance, as that term is defined in subsection (b) of section five
33 thousand five hundred one of this chapter, shall be made on the grounds
34 specified in subsection (a) or (c) of section seven thousand four
35 hundred two of this chapter at any time prior to December thirty-first,
36 two thousand [sixteen] NINETEEN.
37 S 3. This act shall take effect immediately.
38 PART Y
39 Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
40 of the laws of 1986, amending the civil practice law and rules and other
41 laws relating to malpractice and professional medical conduct, as
42 amended by section 18 of part B of chapter 60 of the laws of 2014, is
43 amended to read as follows:
44 (a) The superintendent of [insurance] FINANCIAL SERVICES and the
45 commissioner of health or their designee shall, from funds available in
46 the hospital excess liability pool created pursuant to subdivision 5 of
47 this section, purchase a policy or policies for excess insurance cover-
48 age, as authorized by paragraph 1 of subsection (e) of section 5502 of
49 the insurance law; or from an insurer, other than an insurer described
50 in section 5502 of the insurance law, duly authorized to write such
51 coverage and actually writing medical malpractice insurance in this
52 state; or shall purchase equivalent excess coverage in a form previously
S. 2007--B 70 A. 3007--B
1 approved by the superintendent of [insurance] FINANCIAL SERVICES for
2 purposes of providing equivalent excess coverage in accordance with
3 section 19 of chapter 294 of the laws of 1985, for medical or dental
4 malpractice occurrences between July 1, 1986 and June 30, 1987, between
5 July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989,
6 between July 1, 1989 and June 30, 1990, between July 1, 1990 and June
7 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992
8 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July
9 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996,
10 between July 1, 1996 and June 30, 1997, between July 1, 1997 and June
11 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999
12 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July
13 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003,
14 between July 1, 2003 and June 30, 2004, between July 1, 2004 and June
15 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006
16 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July
17 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010,
18 between July 1, 2010 and June 30, 2011, between July 1, 2011 and June
19 30, 2012, between July 1, 2012 and June 30, 2013, between July 1, 2013
20 and June 30, 2014, [and] between July 1, 2014 and June 30, 2015, AND
21 BETWEEN JULY 1, 2015 AND JUNE 30, 2016 or reimburse the hospital where
22 the hospital purchases equivalent excess coverage as defined in subpara-
23 graph (i) of paragraph (a) of subdivision 1-a of this section for
24 medical or dental malpractice occurrences between July 1, 1987 and June
25 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
26 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
27 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
28 between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
29 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
30 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
31 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
32 between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
33 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
34 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
35 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
36 between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
37 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
38 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
39 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, [and]
40 between July 1, 2014 and June 30, 2015, AND BETWEEN JULY 1, 2015 AND
41 JUNE 30, 2016 for physicians or dentists certified as eligible for each
42 such period or periods pursuant to subdivision 2 of this section by a
43 general hospital licensed pursuant to article 28 of the public health
44 law; provided that no single insurer shall write more than fifty percent
45 of the total excess premium for a given policy year; and provided,
46 however, that such eligible physicians or dentists must have in force an
47 individual policy, from an insurer licensed in this state of primary
48 malpractice insurance coverage in amounts of no less than one million
49 three hundred thousand dollars for each claimant and three million nine
50 hundred thousand dollars for all claimants under that policy during the
51 period of such excess coverage for such occurrences or be endorsed as
52 additional insureds under a hospital professional liability policy which
53 is offered through a voluntary attending physician ("channeling")
54 program previously permitted by the superintendent of [insurance] FINAN-
55 CIAL SERVICES during the period of such excess coverage for such occur-
56 rences. During such period, such policy for excess coverage or such
S. 2007--B 71 A. 3007--B
1 equivalent excess coverage shall, when combined with the physician's or
2 dentist's primary malpractice insurance coverage or coverage provided
3 through a voluntary attending physician ("channeling") program, total an
4 aggregate level of two million three hundred thousand dollars for each
5 claimant and six million nine hundred thousand dollars for all claimants
6 from all such policies with respect to occurrences in each of such years
7 provided, however, if the cost of primary malpractice insurance coverage
8 in excess of one million dollars, but below the excess medical malprac-
9 tice insurance coverage provided pursuant to this act, exceeds the rate
10 of nine percent per annum, then the required level of primary malprac-
11 tice insurance coverage in excess of one million dollars for each claim-
12 ant shall be in an amount of not less than the dollar amount of such
13 coverage available at nine percent per annum; the required level of such
14 coverage for all claimants under that policy shall be in an amount not
15 less than three times the dollar amount of coverage for each claimant;
16 and excess coverage, when combined with such primary malpractice insur-
17 ance coverage, shall increase the aggregate level for each claimant by
18 one million dollars and three million dollars for all claimants; and
19 provided further, that, with respect to policies of primary medical
20 malpractice coverage that include occurrences between April 1, 2002 and
21 June 30, 2002, such requirement that coverage be in amounts no less than
22 one million three hundred thousand dollars for each claimant and three
23 million nine hundred thousand dollars for all claimants for such occur-
24 rences shall be effective April 1, 2002.
25 S 2. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
26 amending the civil practice law and rules and other laws relating to
27 malpractice and professional medical conduct, as amended by section 19
28 of part B of chapter 60 of the laws of 2014, is amended to read as
29 follows:
30 (3)(a) The superintendent of [insurance] FINANCIAL SERVICES shall
31 determine and certify to each general hospital and to the commissioner
32 of health the cost of excess malpractice insurance for medical or dental
33 malpractice occurrences between July 1, 1986 and June 30, 1987, between
34 July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
35 between July 1, 1990 and June 30, 1991, between July 1, 1991 and June
36 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993
37 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July
38 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997,
39 between July 1, 1997 and June 30, 1998, between July 1, 1998 and June
40 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000
41 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July
42 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004,
43 between July 1, 2004 and June 30, 2005, between July 1, 2005 and June
44 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007
45 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July
46 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011,
47 between July 1, 2011 and June 30, 2012, between July 1, 2012 and June
48 30, 2013, and between July 1, 2013 and June 30, 2014, [and] between July
49 1, 2014 and June 30, 2015, AND BETWEEN JULY 1, 2015 AND JUNE 30, 2016
50 allocable to each general hospital for physicians or dentists certified
51 as eligible for purchase of a policy for excess insurance coverage by
52 such general hospital in accordance with subdivision 2 of this section,
53 and may amend such determination and certification as necessary.
54 (b) The superintendent of [insurance] FINANCIAL SERVICES shall deter-
55 mine and certify to each general hospital and to the commissioner of
56 health the cost of excess malpractice insurance or equivalent excess
S. 2007--B 72 A. 3007--B
1 coverage for medical or dental malpractice occurrences between July 1,
2 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between
3 July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991,
4 between July 1, 1991 and June 30, 1992, between July 1, 1992 and June
5 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994
6 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July
7 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998,
8 between July 1, 1998 and June 30, 1999, between July 1, 1999 and June
9 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001
10 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July
11 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005,
12 between July 1, 2005 and June 30, 2006, between July 1, 2006 and June
13 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008
14 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July
15 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012,
16 between July 1, 2012 and June 30, 2013, between July 1, 2013 and June
17 30, 2014, [and] between July 1, 2014 and June 30, 2015, AND BETWEEN JULY
18 1, 2015 AND JUNE 30, 2016 allocable to each general hospital for physi-
19 cians or dentists certified as eligible for purchase of a policy for
20 excess insurance coverage or equivalent excess coverage by such general
21 hospital in accordance with subdivision 2 of this section, and may amend
22 such determination and certification as necessary. The superintendent of
23 [insurance] FINANCIAL SERVICES shall determine and certify to each
24 general hospital and to the commissioner of health the ratable share of
25 such cost allocable to the period July 1, 1987 to December 31, 1987, to
26 the period January 1, 1988 to June 30, 1988, to the period July 1, 1988
27 to December 31, 1988, to the period January 1, 1989 to June 30, 1989, to
28 the period July 1, 1989 to December 31, 1989, to the period January 1,
29 1990 to June 30, 1990, to the period July 1, 1990 to December 31, 1990,
30 to the period January 1, 1991 to June 30, 1991, to the period July 1,
31 1991 to December 31, 1991, to the period January 1, 1992 to June 30,
32 1992, to the period July 1, 1992 to December 31, 1992, to the period
33 January 1, 1993 to June 30, 1993, to the period July 1, 1993 to December
34 31, 1993, to the period January 1, 1994 to June 30, 1994, to the period
35 July 1, 1994 to December 31, 1994, to the period January 1, 1995 to June
36 30, 1995, to the period July 1, 1995 to December 31, 1995, to the period
37 January 1, 1996 to June 30, 1996, to the period July 1, 1996 to December
38 31, 1996, to the period January 1, 1997 to June 30, 1997, to the period
39 July 1, 1997 to December 31, 1997, to the period January 1, 1998 to June
40 30, 1998, to the period July 1, 1998 to December 31, 1998, to the period
41 January 1, 1999 to June 30, 1999, to the period July 1, 1999 to December
42 31, 1999, to the period January 1, 2000 to June 30, 2000, to the period
43 July 1, 2000 to December 31, 2000, to the period January 1, 2001 to June
44 30, 2001, to the period July 1, 2001 to June 30, 2002, to the period
45 July 1, 2002 to June 30, 2003, to the period July 1, 2003 to June 30,
46 2004, to the period July 1, 2004 to June 30, 2005, to the period July 1,
47 2005 and June 30, 2006, to the period July 1, 2006 and June 30, 2007, to
48 the period July 1, 2007 and June 30, 2008, to the period July 1, 2008
49 and June 30, 2009, to the period July 1, 2009 and June 30, 2010, to the
50 period July 1, 2010 and June 30, 2011, to the period July 1, 2011 and
51 June 30, 2012, to the period July 1, 2012 and June 30, 2013, to the
52 period July 1, 2013 and June 30, 2014, [and] to the period July 1, 2014
53 and June 30, 2015, AND TO THE PERIOD JULY 1, 2015 AND JUNE 30, 2016.
54 S 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
55 18 of chapter 266 of the laws of 1986, amending the civil practice law
56 and rules and other laws relating to malpractice and professional
S. 2007--B 73 A. 3007--B
1 medical conduct, as amended by section 20 of part B of chapter 60 of the
2 laws of 2014, are amended to read as follows:
3 (a) To the extent funds available to the hospital excess liability
4 pool pursuant to subdivision 5 of this section as amended, and pursuant
5 to section 6 of part J of chapter 63 of the laws of 2001, as may from
6 time to time be amended, which amended this subdivision, are insuffi-
7 cient to meet the costs of excess insurance coverage or equivalent
8 excess coverage for coverage periods during the period July 1, 1992 to
9 June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
10 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
11 to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
12 during the period July 1, 1997 to June 30, 1998, during the period July
13 1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
14 2000, during the period July 1, 2000 to June 30, 2001, during the period
15 July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
16 June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
17 the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
18 to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
19 during the period July 1, 2006 to June 30, 2007, during the period July
20 1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
21 2009, during the period July 1, 2009 to June 30, 2010, during the period
22 July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
23 30, 2012, during the period July 1, 2012 to June 30, 2013, during the
24 period July 1, 2013 to June 30, 2014, [and] during the period July 1,
25 2014 to June 30, 2015, AND DURING THE PERIOD JULY 1, 2015 AND JUNE 30,
26 2016 allocated or reallocated in accordance with paragraph (a) of subdi-
27 vision 4-a of this section to rates of payment applicable to state
28 governmental agencies, each physician or dentist for whom a policy for
29 excess insurance coverage or equivalent excess coverage is purchased for
30 such period shall be responsible for payment to the provider of excess
31 insurance coverage or equivalent excess coverage of an allocable share
32 of such insufficiency, based on the ratio of the total cost of such
33 coverage for such physician to the sum of the total cost of such cover-
34 age for all physicians applied to such insufficiency.
35 (b) Each provider of excess insurance coverage or equivalent excess
36 coverage covering the period July 1, 1992 to June 30, 1993, or covering
37 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
38 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
39 1996, or covering the period July 1, 1996 to June 30, 1997, or covering
40 the period July 1, 1997 to June 30, 1998, or covering the period July 1,
41 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
42 2000, or covering the period July 1, 2000 to June 30, 2001, or covering
43 the period July 1, 2001 to October 29, 2001, or covering the period
44 April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
45 June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
46 covering the period July 1, 2004 to June 30, 2005, or covering the peri-
47 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
48 June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
49 covering the period July 1, 2008 to June 30, 2009, or covering the peri-
50 od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
51 June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
52 covering the period July 1, 2012 to June 30, 2013, or covering the peri-
53 od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
54 June 30, 2015, OR COVERING THE PERIOD JULY 1, 2015 TO JUNE 30, 2016
55 shall notify a covered physician or dentist by mail, mailed to the
56 address shown on the last application for excess insurance coverage or
S. 2007--B 74 A. 3007--B
1 equivalent excess coverage, of the amount due to such provider from such
2 physician or dentist for such coverage period determined in accordance
3 with paragraph (a) of this subdivision. Such amount shall be due from
4 such physician or dentist to such provider of excess insurance coverage
5 or equivalent excess coverage in a time and manner determined by the
6 superintendent of [insurance] FINANCIAL SERVICES.
7 (c) If a physician or dentist liable for payment of a portion of the
8 costs of excess insurance coverage or equivalent excess coverage cover-
9 ing the period July 1, 1992 to June 30, 1993, or covering the period
10 July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
11 June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
12 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
13 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
14 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
15 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
16 od July 1, 2001 to October 29, 2001, or covering the period April 1,
17 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
18 2003, or covering the period July 1, 2003 to June 30, 2004, or covering
19 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
20 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
21 2007, or covering the period July 1, 2007 to June 30, 2008, or covering
22 the period July 1, 2008 to June 30, 2009, or covering the period July 1,
23 2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
24 2011, or covering the period July 1, 2011 to June 30, 2012, or covering
25 the period July 1, 2012 to June 30, 2013, or covering the period July 1,
26 2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
27 2015, OR COVERING THE PERIOD JULY 1, 2015 TO JUNE 30, 2016 determined in
28 accordance with paragraph (a) of this subdivision fails, refuses or
29 neglects to make payment to the provider of excess insurance coverage or
30 equivalent excess coverage in such time and manner as determined by the
31 superintendent of [insurance] FINANCIAL SERVICES pursuant to paragraph
32 (b) of this subdivision, excess insurance coverage or equivalent excess
33 coverage purchased for such physician or dentist in accordance with this
34 section for such coverage period shall be cancelled and shall be null
35 and void as of the first day on or after the commencement of a policy
36 period where the liability for payment pursuant to this subdivision has
37 not been met.
38 (d) Each provider of excess insurance coverage or equivalent excess
39 coverage shall notify the superintendent of [insurance] FINANCIAL
40 SERVICES and the commissioner of health or their designee of each physi-
41 cian and dentist eligible for purchase of a policy for excess insurance
42 coverage or equivalent excess coverage covering the period July 1, 1992
43 to June 30, 1993, or covering the period July 1, 1993 to June 30, 1994,
44 or covering the period July 1, 1994 to June 30, 1995, or covering the
45 period July 1, 1995 to June 30, 1996, or covering the period July 1,
46 1996 to June 30, 1997, or covering the period July 1, 1997 to June 30,
47 1998, or covering the period July 1, 1998 to June 30, 1999, or covering
48 the period July 1, 1999 to June 30, 2000, or covering the period July 1,
49 2000 to June 30, 2001, or covering the period July 1, 2001 to October
50 29, 2001, or covering the period April 1, 2002 to June 30, 2002, or
51 covering the period July 1, 2002 to June 30, 2003, or covering the peri-
52 od July 1, 2003 to June 30, 2004, or covering the period July 1, 2004 to
53 June 30, 2005, or covering the period July 1, 2005 to June 30, 2006, or
54 covering the period July 1, 2006 to June 30, 2007, or covering the peri-
55 od July 1, 2007 to June 30, 2008, or covering the period July 1, 2008 to
56 June 30, 2009, or covering the period July 1, 2009 to June 30, 2010, or
S. 2007--B 75 A. 3007--B
1 covering the period July 1, 2010 to June 30, 2011, or covering the peri-
2 od July 1, 2011 to June 30, 2012, or covering the period July 1, 2012 to
3 June 30, 2013, or covering the period July 1, 2013 to June 30, 2014, or
4 covering the period July 1, 2014 to June 30, 2015, OR COVERING THE PERI-
5 OD JULY 1, 2015 TO JUNE 30, 2016 that has made payment to such provider
6 of excess insurance coverage or equivalent excess coverage in accordance
7 with paragraph (b) of this subdivision and of each physician and dentist
8 who has failed, refused or neglected to make such payment.
9 (e) A provider of excess insurance coverage or equivalent excess
10 coverage shall refund to the hospital excess liability pool any amount
11 allocable to the period July 1, 1992 to June 30, 1993, and to the period
12 July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
13 30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
14 period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
15 June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
16 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
17 to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
18 and to the period April 1, 2002 to June 30, 2002, and to the period July
19 1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
20 2004, and to the period July 1, 2004 to June 30, 2005, and to the period
21 July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
22 30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
23 period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
24 June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
25 the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
26 to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
27 to the period July 1, 2014 to June 30, 2015, AND TO THE PERIOD JULY 1,
28 2015 TO JUNE 30, 2016 received from the hospital excess liability pool
29 for purchase of excess insurance coverage or equivalent excess coverage
30 covering the period July 1, 1992 to June 30, 1993, and covering the
31 period July 1, 1993 to June 30, 1994, and covering the period July 1,
32 1994 to June 30, 1995, and covering the period July 1, 1995 to June 30,
33 1996, and covering the period July 1, 1996 to June 30, 1997, and cover-
34 ing the period July 1, 1997 to June 30, 1998, and covering the period
35 July 1, 1998 to June 30, 1999, and covering the period July 1, 1999 to
36 June 30, 2000, and covering the period July 1, 2000 to June 30, 2001,
37 and covering the period July 1, 2001 to October 29, 2001, and covering
38 the period April 1, 2002 to June 30, 2002, and covering the period July
39 1, 2002 to June 30, 2003, and covering the period July 1, 2003 to June
40 30, 2004, and covering the period July 1, 2004 to June 30, 2005, and
41 covering the period July 1, 2005 to June 30, 2006, and covering the
42 period July 1, 2006 to June 30, 2007, and covering the period July 1,
43 2007 to June 30, 2008, and covering the period July 1, 2008 to June 30,
44 2009, and covering the period July 1, 2009 to June 30, 2010, and cover-
45 ing the period July 1, 2010 to June 30, 2011, and covering the period
46 July 1, 2011 to June 30, 2012, and covering the period July 1, 2012 to
47 June 30, 2013, and covering the period July 1, 2013 to June 30, 2014,
48 and covering the period July 1, 2014 to June 30, 2015, AND COVERING THE
49 PERIOD JULY 1, 2015 TO JUNE 30, 2016 for a physician or dentist where
50 such excess insurance coverage or equivalent excess coverage is
51 cancelled in accordance with paragraph (c) of this subdivision.
52 S 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
53 practice law and rules and other laws relating to malpractice and
54 professional medical conduct, as amended by section 21 of part B of
55 chapter 60 of the laws of 2014, is amended to read as follows:
S. 2007--B 76 A. 3007--B
1 S 40. The superintendent of [insurance] FINANCIAL SERVICES shall
2 establish rates for policies providing coverage for physicians and
3 surgeons medical malpractice for the periods commencing July 1, 1985 and
4 ending June 30, [2015] 2016; provided, however, that notwithstanding any
5 other provision of law, the superintendent shall not establish or
6 approve any increase in rates for the period commencing July 1, 2009 and
7 ending June 30, 2010. The superintendent shall direct insurers to estab-
8 lish segregated accounts for premiums, payments, reserves and investment
9 income attributable to such premium periods and shall require periodic
10 reports by the insurers regarding claims and expenses attributable to
11 such periods to monitor whether such accounts will be sufficient to meet
12 incurred claims and expenses. On or after July 1, 1989, the superinten-
13 dent shall impose a surcharge on premiums to satisfy a projected defi-
14 ciency that is attributable to the premium levels established pursuant
15 to this section for such periods; provided, however, that such annual
16 surcharge shall not exceed eight percent of the established rate until
17 July 1, [2015] 2016, at which time and thereafter such surcharge shall
18 not exceed twenty-five percent of the approved adequate rate, and that
19 such annual surcharges shall continue for such period of time as shall
20 be sufficient to satisfy such deficiency. The superintendent shall not
21 impose such surcharge during the period commencing July 1, 2009 and
22 ending June 30, 2010. On and after July 1, 1989, the surcharge
23 prescribed by this section shall be retained by insurers to the extent
24 that they insured physicians and surgeons during the July 1, 1985
25 through June 30, [2015] 2016 policy periods; in the event and to the
26 extent physicians and surgeons were insured by another insurer during
27 such periods, all or a pro rata share of the surcharge, as the case may
28 be, shall be remitted to such other insurer in accordance with rules and
29 regulations to be promulgated by the superintendent. Surcharges
30 collected from physicians and surgeons who were not insured during such
31 policy periods shall be apportioned among all insurers in proportion to
32 the premium written by each insurer during such policy periods; if a
33 physician or surgeon was insured by an insurer subject to rates estab-
34 lished by the superintendent during such policy periods, and at any time
35 thereafter a hospital, health maintenance organization, employer or
36 institution is responsible for responding in damages for liability aris-
37 ing out of such physician's or surgeon's practice of medicine, such
38 responsible entity shall also remit to such prior insurer the equivalent
39 amount that would then be collected as a surcharge if the physician or
40 surgeon had continued to remain insured by such prior insurer. In the
41 event any insurer that provided coverage during such policy periods is
42 in liquidation, the property/casualty insurance security fund shall
43 receive the portion of surcharges to which the insurer in liquidation
44 would have been entitled. The surcharges authorized herein shall be
45 deemed to be income earned for the purposes of section 2303 of the
46 insurance law. The superintendent, in establishing adequate rates and
47 in determining any projected deficiency pursuant to the requirements of
48 this section and the insurance law, shall give substantial weight,
49 determined in his discretion and judgment, to the prospective antic-
50 ipated effect of any regulations promulgated and laws enacted and the
51 public benefit of stabilizing malpractice rates and minimizing rate
52 level fluctuation during the period of time necessary for the develop-
53 ment of more reliable statistical experience as to the efficacy of such
54 laws and regulations affecting medical, dental or podiatric malpractice
55 enacted or promulgated in 1985, 1986, by this act and at any other time.
56 Notwithstanding any provision of the insurance law, rates already estab-
S. 2007--B 77 A. 3007--B
1 lished and to be established by the superintendent pursuant to this
2 section are deemed adequate if such rates would be adequate when taken
3 together with the maximum authorized annual surcharges to be imposed for
4 a reasonable period of time whether or not any such annual surcharge has
5 been actually imposed as of the establishment of such rates.
6 S 5. Section 5 and subdivisions (a) and (e) of section 6 of part J of
7 chapter 63 of the laws of 2001, amending chapter 266 of the laws of
8 1986, amending the civil practice law and rules and other laws relating
9 to malpractice and professional medical conduct, as amended by section
10 22 of part B of chapter 60 of the laws of 2014, are amended to read as
11 follows:
12 S 5. The superintendent of [insurance] FINANCIAL SERVICES and the
13 commissioner of health shall determine, no later than June 15, 2002,
14 June 15, 2003, June 15, 2004, June 15, 2005, June 15, 2006, June 15,
15 2007, June 15, 2008, June 15, 2009, June 15, 2010, June 15, 2011, June
16 15, 2012, June 15, 2013, June 15, 2014, [and] June 15, 2015, AND JUNE
17 15, 2016 the amount of funds available in the hospital excess liability
18 pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
19 and whether such funds are sufficient for purposes of purchasing excess
20 insurance coverage for eligible participating physicians and dentists
21 during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
22 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
23 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
24 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30,
25 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30,
26 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30,
27 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
28 2015, OR JULY 1, 2015 TO JUNE 30, 2016, as applicable.
29 (a) This section shall be effective only upon a determination, pursu-
30 ant to section five of this act, by the superintendent of [insurance]
31 FINANCIAL SERVICES and the commissioner of health, and a certification
32 of such determination to the state director of the budget, the chair of
33 the senate committee on finance and the chair of the assembly committee
34 on ways and means, that the amount of funds in the hospital excess
35 liability pool, created pursuant to section 18 of chapter 266 of the
36 laws of 1986, is insufficient for purposes of purchasing excess insur-
37 ance coverage for eligible participating physicians and dentists during
38 the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
39 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
40 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
41 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30,
42 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30,
43 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30,
44 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
45 2015, OR JULY 1, 2015 TO JUNE 30, 2016, as applicable.
46 (e) The commissioner of health shall transfer for deposit to the
47 hospital excess liability pool created pursuant to section 18 of chapter
48 266 of the laws of 1986 such amounts as directed by the superintendent
49 of [insurance] FINANCIAL SERVICES for the purchase of excess liability
50 insurance coverage for eligible participating physicians and dentists
51 for the policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to
52 June 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June
53 30, 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
54 2007, as applicable, and the cost of administering the hospital excess
55 liability pool for such applicable policy year, pursuant to the program
56 established in chapter 266 of the laws of 1986, as amended, no later
S. 2007--B 78 A. 3007--B
1 than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
2 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
3 June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, [and] June
4 15, 2015, AND JUNE 15, 2016, as applicable.
5 S 6. Notwithstanding any law, rule or regulation to the contrary, only
6 physicians or dentists who were eligible, and for whom the superinten-
7 dent of financial services and the commissioner of health, or their
8 designee, purchased, with funds available in the hospital excess liabil-
9 ity pool, a full or partial policy for excess coverage or equivalent
10 excess coverage for the coverage period ending the thirtieth of June,
11 two thousand fifteen, shall be eligible to apply for such coverage for
12 the coverage period beginning the first of July, two thousand fifteen;
13 provided, however, if the total number of physicians or dentists for
14 whom such excess coverage or equivalent excess coverage was purchased
15 for the policy year ending the thirtieth of June, two thousand fifteen
16 exceeds the total number of physicians or dentists certified as eligible
17 for the coverage period beginning the first of July, two thousand
18 fifteen, then the general hospitals may certify additional eligible
19 physicians or dentists in a number equal to such general hospital's
20 proportional share of the total number of physicians or dentists for
21 whom excess coverage or equivalent excess coverage was purchased with
22 funds available in the hospital excess liability pool as of the thirti-
23 eth of June, two thousand fifteen, as applied to the difference between
24 the number of eligible physicians or dentists for whom a policy for
25 excess coverage or equivalent excess coverage was purchased for the
26 coverage period ending the thirtieth of June, two thousand fifteen and
27 the number of such eligible physicians or dentists who have applied for
28 excess coverage or equivalent excess for the coverage period beginning
29 the first of July, two thousand fifteen.
30 S 7. This act shall take effect immediately.
31 S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
32 sion, section or part of this act shall be adjudged by any court of
33 competent jurisdiction to be invalid, such judgment shall not affect,
34 impair, or invalidate the remainder thereof, but shall be confined in
35 its operation to the clause, sentence, paragraph, subdivision, section
36 or part thereof directly involved in the controversy in which such judg-
37 ment shall have been rendered. It is hereby declared to be the intent of
38 the legislature that this act would have been enacted even if such
39 invalid provisions had not been included herein.
40 S 3. This act shall take effect immediately provided, however, that
41 the applicable effective date of Parts A through Y of this act shall be
42 as specifically set forth in the last section of such Parts.
