Bill Text: NY S04881 | 2023-2024 | General Assembly | Amended

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

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Bill Title: Increases the amount of the savings exemption for eligibility for Medicaid.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Engrossed) 2024-06-05 - referred to health [S04881 Detail]

Download: New_York-2023-S04881-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         4881--A

                               2023-2024 Regular Sessions

                    IN SENATE

                                    February 16, 2023
                                       ___________

        Introduced  by  Sen.  CLEARE -- read twice and ordered printed, and when
          printed to be committed  to  the  Committee  on  Health  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee

        AN  ACT  to amend the social services law, in relation to increasing the
          amount of the savings exemption for eligibility for Medicaid and elim-
          inating the asset test for certain individuals; and to repeal  certain
          provisions of such law relating thereto

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

     1    Section 1. Subparagraph 4 of paragraph (a) of subdivision 2 of section
     2  366 of the social services law, as amended by section 43 of  part  C  of
     3  chapter 58 of the laws of 2008, is amended to read as follows:
     4    (4)  savings  in  amounts  equal  to [one hundred fifty percent of the
     5  income amount permitted under  subparagraph  seven  of  this  paragraph,
     6  provided,  however,  that  the amounts for one and two person households
     7  shall not be less than the amounts permitted to be  retained  by  house-
     8  holds of the same size in order to qualify for benefits under the feder-
     9  al supplemental security income program] three hundred thousand dollars;
    10    § 1-a. Subparagraph 4 of paragraph (a) of subdivision 2 of section 366
    11  of the social services law, as amended by section 3 of part AAA of chap-
    12  ter 56 of the laws of 2022, is amended to read as follows:
    13    (4)  savings  in  amounts  equal  to [one hundred fifty percent of the
    14  income amount permitted under  subparagraph  seven  of  this  paragraph,
    15  provided,  however,  that  the amounts for one and two person households
    16  shall not be less than the amounts permitted to be  retained  by  house-
    17  holds of the same size in order to qualify for benefits under the feder-
    18  al supplemental security income program] three hundred thousand dollars;
    19    §  2.  Subparagraph 5 of paragraph (c) of subdivision 1 of section 366
    20  of the social services law, as amended by chapter 583  of  the  laws  of
    21  2023, is amended to read as follows:

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09634-02-3
        S. 4881--A                          2

     1    (5) A disabled individual at least sixteen years of age, but under the
     2  age of sixty-five, who: would be eligible for benefits under the supple-
     3  mental  security income program but for earnings in excess of the allow-
     4  able limit; has net available income that does not  exceed  two  hundred
     5  fifty percent of the applicable federal income official poverty line, as
     6  defined  and updated by the United States department of health and human
     7  services, for a one-person or two-person household, as  defined  by  the
     8  commissioner in regulation; has household resources, as defined in para-
     9  graph  (e)  of  subdivision  two of section three hundred sixty-six-c of
    10  this title, other than retirement accounts,  that  do  not  exceed  [one
    11  hundred  fifty percent of the income amount permitted under subparagraph
    12  seven of paragraph (a) of subdivision two of this section,  for  a  one-
    13  person  or  two-person  household]  three  hundred  thousand dollars, as
    14  defined by the commissioner in regulation; and contributes to  the  cost
    15  of  medical assistance provided pursuant to this subparagraph in accord-
    16  ance with subdivision twelve of section three hundred  sixty-seven-a  of
    17  this  title;  for purposes of this subparagraph, disabled means having a
    18  medically determinable impairment of sufficient severity and duration to
    19  qualify for benefits under section 1902(a)(10)(A)(ii)(xv) of the  social
    20  security act.
    21    §  3.  Subparagraphs  2,  3 and 4 of paragraph (a) of subdivision 2 of
    22  section 366 of the social services law are REPEALED.
    23    § 4. Subparagraphs 5, 6, 7, 9, 10 and 11 of paragraph (a) of  subdivi-
    24  sion  2  of  section  366  of the social services law, subparagraph 5 as
    25  amended by chapter 576 of the laws of 2007, subparagraph 6 as amended by
    26  chapter 938 of the laws of 1990, subparagraph 7 as amended by section 47
    27  of part C of chapter 58 of the laws of 2008, subparagraph 9  as  amended
    28  by  chapter 110 of the laws of 1971, subparagraph 10 as added by chapter
    29  705 of the laws of 1988, clauses (i) and  (ii)  of  subparagraph  10  as
    30  amended by chapter 672 of the laws of 2019, clause (iii) of subparagraph
    31  10  as amended by chapter 170 of the laws of 1994 and subparagraph 11 as
    32  added by chapter 576 of the laws of 2015, are  renumbered  subparagraphs
    33  2,  3,  4,  5,  6 and 7 and clause (iii) of subparagraph 4 is amended to
    34  read as follows:
    35    (iii) No other  income  [or  resources],  including  federal  old-age,
    36  survivors  and disability insurance, state disability insurance or other
    37  payroll deductions, whether mandatory or optional, shall be  exempt  and
    38  all  other  income [and resources] shall be taken into consideration and
    39  required to be applied toward the payment or partial payment of the cost
    40  of medical care and services available under this title, to  the  extent
    41  permitted by federal law.
    42    §  4-a.  Subparagraphs  5,  6,  7, 8, 9, 10 and 11 of paragraph (a) of
    43  subdivision 2 of section 366 of the social services law, as  amended  by
    44  section  3 of part AAA of chapter 56 of the laws of 2022, are renumbered
    45  subparagraphs 2, 3, 4, 5, 6, 7 and 8 and subparagraph 5  is  amended  to
    46  read as follows:
    47    (5)  No other income [or resources], including federal old-age, survi-
    48  vors and disability  insurance,  state  disability  insurance  or  other
    49  payroll  deductions,  whether mandatory or optional, shall be exempt and
    50  all other income [and resources] shall be taken into  consideration  and
    51  required to be applied toward the payment or partial payment of the cost
    52  of  medical  care and services available under this title, to the extent
    53  permitted by federal law.
    54    § 5. Subparagraphs 2, 5 and 10 of paragraph (c) of  subdivision  1  of
    55  section  366 of the social services law, subparagraphs 2 and 10 as added
    56  by section 1 of part D of chapter 56 of the laws of  2013  and  subpara-
        S. 4881--A                          3

     1  graph  5  as  amended by section two of this act, are amended to read as
     2  follows:
     3    (2)  An  individual  who,  although not receiving public assistance or
     4  care for his or her maintenance under other provisions of this  chapter,
     5  has income [and resources], including available support from responsible
     6  relatives,  that  does not exceed the amounts set forth in paragraph (a)
     7  of subdivision two of this section, and is (i) sixty-five years  of  age
     8  or  older,  or certified blind or certified disabled or (ii) for reasons
     9  other than income [or resources], is eligible for  federal  supplemental
    10  security income benefits and/or additional state payments.
    11    (5) A disabled individual at least sixteen years of age, but under the
    12  age of sixty-five, who: would be eligible for benefits under the supple-
    13  mental  security income program but for earnings in excess of the allow-
    14  able limit; has net available income that does not  exceed  two  hundred
    15  fifty percent of the applicable federal income official poverty line, as
    16  defined  and updated by the United States department of health and human
    17  services, for a one-person or two-person household, as  defined  by  the
    18  commissioner  in  regulation;  [has  household  resources, as defined in
    19  paragraph (e) of subdivision two of section three hundred sixty-six-c of
    20  this title, other than retirement accounts, that  do  not  exceed  three
    21  hundred  thousand dollars, as defined by the commissioner in regulation;
    22  and contributes to the cost of medical assistance provided  pursuant  to
    23  this subparagraph in accordance with subdivision twelve of section three
    24  hundred sixty-seven-a of this title;] for purposes of this subparagraph,
    25  disabled  means having a medically determinable impairment of sufficient
    26  severity  and  duration  to   qualify   for   benefits   under   section
    27  1902(a)(10)(A)(ii)(xv) of the social security act.
    28    (10)  A  resident  of  a home for adults operated by a social services
    29  district, or a residential care center for adults or community residence
    30  operated or certified by the office  of  mental  health,  and  has  not,
    31  according to criteria promulgated by the department consistent with this
    32  title, sufficient income, or in the case of a person sixty-five years of
    33  age  or older, certified blind, or certified disabled, sufficient income
    34  [and resources], including available support from responsible relatives,
    35  to meet all the costs of required medical care  and  services  available
    36  under this title.
    37    §  6.  Subparagraphs  1  and  2  of  paragraph (b) of subdivision 2 of
    38  section 366 of the social services law, subparagraph  1  as  amended  by
    39  chapter  638  of  the  laws  of  1993,  subparagraph 1 as designated and
    40  subparagraph 2 as added by chapter 170 of the laws of 1994, clause (iii)
    41  of subparagraph 2 as amended by chapter 187 of the laws of 2017,  clause
    42  (iv)  of subdivision 2 as amended by chapter 656 of the laws of 1997 and
    43  as further amended by section 104 of part A of chapter 62 of the laws of
    44  2011, clause (vi) of subparagraph 2 as added by chapter 435 of the  laws
    45  of 2018, are amended to read as follows:
    46    (1)  In  establishing  standards  for  determining eligibility for and
    47  amount of such assistance, the department shall take into  account  only
    48  such income [and resources], in accordance with federal requirements, as
    49  [are]  is  available  to  the applicant or recipient and as would not be
    50  required to be disregarded or set aside  for  future  needs,  and  there
    51  shall  be a reasonable evaluation of any such income [or resources]. The
    52  department shall not consider the  availability  of  an  option  for  an
    53  accelerated  payment of death benefits or special surrender value pursu-
    54  ant to paragraph one of subsection  (a)  of  section  one  thousand  one
    55  hundred  thirteen  of  the  insurance  law, or an option to enter into a
    56  viatical settlement pursuant to the provisions of article  seventy-eight
        S. 4881--A                          4

     1  of  the insurance law, as an available resource in determining eligibil-
     2  ity for an amount  of  such  assistance,  provided,  however,  that  the
     3  payment  of such benefits shall be considered in determining eligibility
     4  for and amount of such assistance. There shall not be taken into consid-
     5  eration the financial responsibility of any individual for any applicant
     6  or  recipient  of  assistance  under this title unless such applicant or
     7  recipient is such individual's spouse or such individual's child who  is
     8  under twenty-one years of age. In determining the eligibility of a child
     9  who  is categorically eligible as blind or disabled, as determined under
    10  regulations prescribed by the social security act  for  medical  assist-
    11  ance,  the  income  [and resources] of parents or spouses of parents are
    12  not considered available to that child  if  she/he  does  not  regularly
    13  share  the  common  household  even  if  the child returns to the common
    14  household for periodic visits. In the application of standards of eligi-
    15  bility with respect to income, costs incurred for medical care,  whether
    16  in  the  form  of  insurance  premiums or otherwise, shall be taken into
    17  account. Any person who is eligible for, or reasonably appears  to  meet
    18  the  criteria  of  eligibility  for,  benefits  under title XVIII of the
    19  federal social security act shall be required to  apply  for  and  fully
    20  utilize such benefits in accordance with this chapter.
    21    (2) In evaluating the income [and resources] available to an applicant
    22  for  or  recipient  of  medical  assistance, for purposes of determining
    23  eligibility for and the amount of such assistance, the  department  must
    24  consider  assets [held in or] paid from trusts created by such applicant
    25  or recipient, as determined pursuant to the regulations of  the  depart-
    26  ment, in accordance with the provisions of this subparagraph.
    27    (i) In the case of a revocable trust created by an applicant or recip-
    28  ient,  as  determined  pursuant  to  regulations of the department: [the
    29  trust corpus must be considered to be an available  resource;]  payments
    30  made from the trust to or for the benefit of such applicant or recipient
    31  must  be  considered to be available income; and any other payments from
    32  the trust must be considered to be assets disposed of by such  applicant
    33  or  recipient  for purposes of paragraph (d) of subdivision five of this
    34  section.
    35    (ii) In the case of an irrevocable trust created by  an  applicant  or
    36  recipient,  as determined pursuant to regulations of the department: any
    37  portion of the trust corpus, and of the income generated  by  the  trust
    38  corpus,  from  which  no  payment can under any circumstances be made to
    39  such applicant or recipient must be considered, as of the date of estab-
    40  lishment of the trust, or, if later, the date on which  payment  to  the
    41  applicant  or  recipient is foreclosed, to be assets disposed of by such
    42  applicant or recipient for purposes of paragraph (d) of subdivision five
    43  of this section; [any portion of the trust corpus,  and  of  the  income
    44  generated  by  the  trust corpus, from which payment could be made to or
    45  for the benefit of such applicant or recipient must be considered to  be
    46  an available resource;] payments made from the trust to or for the bene-
    47  fit  of  such  applicant or recipient must be considered to be available
    48  income; and any other payments from the trust must be considered  to  be
    49  assets  disposed of by such applicant or recipient for purposes of para-
    50  graph (d) of subdivision five of this section.
    51    (iii) Notwithstanding the provisions of clauses (i) and (ii)  of  this
    52  subparagraph,  in the case of an applicant or recipient who is disabled,
    53  as such term is defined in section  1614(a)(3)  of  the  federal  social
    54  security  act,  the department must not consider as available income [or
    55  resources] the [corpus or] income of the following trusts  which  comply
    56  with the provisions of the regulations authorized by clause (iv) of this
        S. 4881--A                          5

     1  subparagraph: (A) a trust containing the assets of such a disabled indi-
     2  vidual  which was established for the benefit of the disabled individual
     3  while such individual was under sixty-five years of age by the  individ-
     4  ual, a parent, grandparent, legal guardian, or court of competent juris-
     5  diction, if upon the death of such individual the state will receive all
     6  amounts  remaining  in  the  trust  up to the total value of all medical
     7  assistance paid on behalf of such individual; (B) and a trust containing
     8  the assets of such a disabled individual established and  managed  by  a
     9  non-profit association which maintains separate accounts for the benefit
    10  of  disabled individuals, but, for purposes of investment and management
    11  of trust funds, pools the accounts, provided that accounts in the  trust
    12  fund are established solely for the benefit of individuals who are disa-
    13  bled as such term is defined in section 1614(a)(3) of the federal social
    14  security  act  by such disabled individual, a parent, grandparent, legal
    15  guardian, or court of competent jurisdiction, and  to  the  extent  that
    16  amounts  remaining  in  the individual's account are not retained by the
    17  trust upon the death of the individual, the state will receive all  such
    18  remaining  amounts  up to the total value of all medical assistance paid
    19  on behalf of such individual.  Notwithstanding any law to the  contrary,
    20  a not-for-profit corporation may, in furtherance of and as an adjunct to
    21  its corporate purposes, act as trustee of a trust for persons with disa-
    22  bilities  established  pursuant to this subclause, provided that a trust
    23  company, as defined in subdivision seven of section one hundred-c of the
    24  banking law, acts as co-trustee.
    25    (iv) The department shall promulgate such regulations as may be neces-
    26  sary to carry out the provisions of this subparagraph. Such  regulations
    27  shall  include  provisions  for:  assuring  the fulfillment of fiduciary
    28  obligations of the trustee with respect to the remainder interest of the
    29  department or state; monitoring pooled trusts; applying this subdivision
    30  to legal instruments and other devices similar to trusts, in  accordance
    31  with  applicable  federal rules and regulations; and establishing proce-
    32  dures under which the application of this  subdivision  will  be  waived
    33  with  respect  to  an  applicant or recipient who demonstrates that such
    34  application would work an undue hardship on him or  her,  in  accordance
    35  with  standards  specified by the secretary of the federal department of
    36  health and human services. Such regulations may require: notification of
    37  the department of the creation or funding of such a trust for the  bene-
    38  fit of an applicant for or recipient of medical assistance; notification
    39  of the department of the death of a beneficiary of such a trust who is a
    40  current  or  former  recipient  of  medical assistance; in the case of a
    41  trust, the corpus of which exceeds one hundred thousand dollars, notifi-
    42  cation of  the  department  of  transactions  tending  to  substantially
    43  deplete  the  trust corpus; notification of the department of any trans-
    44  actions involving transfers from the trust corpus  for  less  than  fair
    45  market value; the bonding of the trustee when the assets of such a trust
    46  equal  or exceed one million dollars, unless a court of competent juris-
    47  diction waives such requirement; and the bonding of the trustee when the
    48  assets of such a trust are less than one million dollars, upon order  of
    49  a  court  of  competent  jurisdiction. The department, together with the
    50  department of financial services, shall promulgate regulations governing
    51  the establishment,  management  and  monitoring  of  trusts  established
    52  pursuant  to subclause (B) of clause (iii) of this subparagraph in which
    53  a not-for-profit corporation and a trust company serve as co-trustees.
    54    (v) Notwithstanding any acts, omissions or failures to act of a  trus-
    55  tee  of a trust which the department or a local social services official
    56  has determined complies with the provisions  of  clause  (iii)  and  the
        S. 4881--A                          6

     1  regulations  authorized by clause (iv) of this subparagraph, the depart-
     2  ment must not consider the [corpus or]  income  of  any  such  trust  as
     3  available  income  [or  resources]  of the applicant or recipient who is
     4  disabled,  as  such term is defined in section 1614(a)(3) of the federal
     5  social security act. The department's remedy for redress  of  any  acts,
     6  omissions  or failures to act by such a trustee which acts, omissions or
     7  failures are considered by the department to be  inconsistent  with  the
     8  terms  of  the trust, contrary to applicable laws and regulations of the
     9  department, or contrary to the  fiduciary  obligations  of  the  trustee
    10  shall  be  the commencement of an action or proceeding under subdivision
    11  one of section sixty-three of the executive law to safeguard or  enforce
    12  the  state's  remainder  interest  in the trust, or such other action or
    13  proceeding as may be lawful and appropriate as to assure  compliance  by
    14  the  trustee  or to safeguard and enforce the state's remainder interest
    15  in the trust.
    16    (vi) The department shall provide written notice to an  applicant  for
    17  or  recipient  of  medical assistance who is or reasonably appears to be
    18  eligible for medical  assistance  except  for  having  income  exceeding
    19  applicable  income  levels.  The  notice  shall  inform the applicant or
    20  recipient, in plain language, that in certain circumstances the  medical
    21  assistance  program does not count the income of disabled applicants and
    22  recipients if it is placed in a trust described in clause (iii) of  this
    23  subparagraph.  The  notice shall be included with the eligibility notice
    24  provided to such applicants and recipients  and  shall  reference  where
    25  additional  information  may  be found on the department's website. This
    26  clause shall not be construed to change any  criterion  for  eligibility
    27  for medical assistance.
    28    §  7.  Paragraph  (a)  of  subdivision  3 of section 366 of the social
    29  services law, as amended by chapter 110 of the laws of 1971, is  amended
    30  to read as follows:
    31    (a)  Medical  assistance  shall  be  furnished  to applicants in cases
    32  where, although such applicant has a responsible  relative  with  suffi-
    33  cient income [and resources] to provide medical assistance as determined
    34  by  the regulations of the department, the income [and resources] of the
    35  responsible relative are not available to such applicant because of  the
    36  absence  of  such relative or the refusal or failure of such relative to
    37  provide the necessary care and assistance.  In such cases, however,  the
    38  furnishing of such assistance shall create an implied contract with such
    39  relative,  and  the  cost thereof may be recovered from such relative in
    40  accordance with title six of article three of  this  chapter  and  other
    41  applicable provisions of law.
    42    §  8.  Paragraph  h  of  subdivision  6  of  section 366 of the social
    43  services law, as amended by section 69-b of part C of chapter 58 of  the
    44  laws of 2008, is amended to read as follows:
    45    h.  Notwithstanding  any  other provision of this chapter or any other
    46  law to the contrary, for  purposes  of  determining  medical  assistance
    47  eligibility  for  persons  specified in paragraph b of this subdivision,
    48  the income [and resources] of responsible relatives shall not be  deemed
    49  available for as long as the person meets the criteria specified in this
    50  subdivision.
    51    § 9. Subparagraph (vii) of paragraph b of subdivision 7 of section 366
    52  of  the  social  services  law, as amended by chapter 324 of the laws of
    53  2004, is amended to read as follows:
    54    (vii) be ineligible for medical assistance  because  the  income  [and
    55  resources]  of responsible relatives are deemed available to him or her,
        S. 4881--A                          7

     1  causing him or her to exceed the income [or resource] eligibility  level
     2  for such assistance;
     3    §  10.  Paragraph  j  of  subdivision  7  of section 366 of the social
     4  services law, as amended by chapter 324 of the laws of 2004, is  amended
     5  to read as follows:
     6    j.  Notwithstanding  any  other  provision  of this chapter other than
     7  subdivision six of this section or any other law to  the  contrary,  for
     8  purposes of determining medical assistance eligibility for persons spec-
     9  ified  in paragraph b of this subdivision, the income [and resources] of
    10  a responsible relative shall not be deemed available for as long as  the
    11  person meets the criteria specified in this subdivision.
    12    §  11.  Subdivision  8  of  section 366 of the social services law, as
    13  added by chapter 41 of the laws of 1992, is amended to read as follows:
    14    8. Notwithstanding any inconsistent provision of this chapter  or  any
    15  other  law to the contrary, income [and resources] which [are] is other-
    16  wise exempt from consideration in determining a person's eligibility for
    17  medical care, services and supplies available under this title, shall be
    18  considered available for the payment or part payment  of  the  costs  of
    19  such  medical care, services and supplies as required by federal law and
    20  regulations.
    21    § 12. Subparagraph (vi) of paragraph b of subdivision 9 of section 366
    22  of the social services law, as added by chapter 170 of the laws of 1994,
    23  is amended to read as follows:
    24    (vi) be eligible or, if discharged,  would  be  eligible  for  medical
    25  assistance,  or are ineligible for medical assistance because the income
    26  [and resources] of responsible relatives are or, if discharged, would be
    27  deemed available to such persons causing them to exceed the  income  [or
    28  resource] eligibility level for such assistance;
    29    §  13.  Paragraph  k  of  subdivision  9  of section 366 of the social
    30  services law, as added by chapter 170 of the laws of 1994, is amended to
    31  read as follows:
    32    k. Notwithstanding any provision of this chapter other  than  subdivi-
    33  sion six or seven of this section, or any other law to the contrary, for
    34  purposes of determining medical assistance eligibility for persons spec-
    35  ified  in  paragraphs  b  and  c  of  this  subdivision, the income [and
    36  resources] of a responsible relative shall not be deemed  available  for
    37  as long as the person meets the criteria specified in this subdivision.
    38    §  14.  Paragraph  (d)  of subdivision 12 of section 366 of the social
    39  services law, as added by section 1 of part E of chapter 58 of the  laws
    40  of 2006, is amended to read as follows:
    41    (d)  Notwithstanding any provision of this chapter or any other law to
    42  the contrary, for purposes of determining medical assistance eligibility
    43  for persons specified in paragraph (b) of this subdivision,  the  income
    44  [and  resources]  of  a legally responsible relative shall not be deemed
    45  available for as long as the person meets the criteria specified in this
    46  subdivision; provided, however, that such income shall  continue  to  be
    47  deemed  unavailable  should responsibility for the care and placement of
    48  the person be returned to his or her parent or other legally responsible
    49  person.
    50    § 15. Paragraph (b) of subdivision 16 of section  366  of  the  social
    51  services  law, as added by section 1 of part N of chapter 57 of the laws
    52  of 2023, is amended to read as follows:
    53    (b) Individuals eligible for participation in such waiver shall:
    54    (i) be a disabled individual, defined as having a medically determina-
    55  ble impairment of sufficient severity and duration to qualify for  bene-
    56  fits under Titles II or XVI of the social security act;
        S. 4881--A                          8

     1    (ii) be at least sixteen years of age;
     2    (iii)  be  otherwise eligible for medical assistance benefits, but for
     3  earnings [and/or resources] in excess of the allowable limit;
     4    (iv) have net available income, determined in accordance with subdivi-
     5  sion two of this section, that does not exceed two thousand two  hundred
     6  fifty  percent  of  the  applicable federal poverty line, as defined and
     7  updated by the United States department of health and human services;
     8    (v) [have resources, as defined in paragraph (e) of subdivision two of
     9  section three hundred sixty-six-c of this title, other  than  retirement
    10  accounts, that do not exceed three hundred thousand dollars;
    11    (vi)]  contribute  to the cost of medical assistance provided pursuant
    12  to this paragraph in accordance with paragraph (d) of this  subdivision;
    13  and
    14    [(vii)]  (vi)  meet  such  other criteria as may be established by the
    15  commissioner as may be necessary to administer the  provisions  of  this
    16  subdivision in an equitable manner.
    17    §  16.  Paragraph  (b) of subdivision 2 of section 366-a of the social
    18  services law is REPEALED and paragraphs (c) and (d)  of  subdivision  2,
    19  paragraph (d) as added by section 29 of part B of chapter 58 of the laws
    20  of  2010,  are  relettered  paragraphs  (b) and (c) and paragraph (c) is
    21  amended to read as follows:
    22    (c) Notwithstanding the provisions of paragraph (a) of  this  subdivi-
    23  sion,  an  applicant or recipient [whose eligibility under this title is
    24  determined without regard to  the  amount  of  his  or  her  accumulated
    25  resources] may attest to the amount of interest income generated by such
    26  resources  if the amount of such interest income is expected to be imma-
    27  terial to medical assistance eligibility, as determined by  the  commis-
    28  sioner  of  health.  In  the event there is an inconsistency between the
    29  information reported by the applicant or recipient and  any  information
    30  obtained  by  the  commissioner  of  health  from other sources and such
    31  inconsistency is material to medical assistance eligibility, the commis-
    32  sioner of health shall request that the applicant or  recipient  provide
    33  adequate documentation to verify his or her interest income.
    34    §  17.  Paragraph  (a) of subdivision 8 of section 366-a of the social
    35  services law, as amended by section 7 of part B of  chapter  58  of  the
    36  laws of 2010, is amended to read as follows:
    37    (a)  Notwithstanding subdivisions two and five of this section, infor-
    38  mation concerning income [and resources] of applicants for  and  recipi-
    39  ents  of  medical assistance may be verified by matching client informa-
    40  tion with information contained in the wage reporting system established
    41  by section one hundred seventy-one-a of  the  tax  law  and  in  similar
    42  systems operating in other geographically contiguous states, by means of
    43  an income verification performed pursuant to a memorandum of understand-
    44  ing  with the department of taxation and finance pursuant to subdivision
    45  four of section one hundred seventy-one-b of the tax law,  and,  to  the
    46  extent  required  by federal law, with information contained in the non-
    47  wage income file  maintained  by  the  United  States  internal  revenue
    48  service,  in  the  beneficiary  data  exchange  maintained by the United
    49  States department of health and human services, and in the  unemployment
    50  insurance  benefits  file.  Such  matching  shall provide for procedures
    51  which document significant inconsistent results of matching  activities.
    52  Nothing  in  this  section shall be construed to prohibit activities the
    53  department  reasonably  believes  necessary  to  conform  with   federal
    54  requirements  under section one thousand one hundred thirty-seven of the
    55  social security act.
        S. 4881--A                          9

     1    § 18. Subdivision 1 of section 366-c of the social  services  law,  as
     2  added by chapter 558 of the laws of 1989, is amended to read as follows:
     3    1.  Notwithstanding  any  other  provision  of law to the contrary, in
     4  determining the eligibility for medical assistance of a  person  defined
     5  as  an  institutionalized  spouse,  the  income  [and resources] of such
     6  person and the person's community spouse shall be treated as provided in
     7  this section.
     8    § 19. Paragraphs (c), (d) and (e) of subdivision 2 of section 366-c of
     9  the social services law are REPEALED and paragraphs (f), (g), (h),  (i),
    10  (j)  and  (k)  of subdivision 2 are relettered paragraphs (c), (d), (e),
    11  (f), (g) and (h).
    12    § 20. Subdivisions 5 and 6 of section 366-c of the social services law
    13  are REPEALED and subdivisions 7 and 8, as added by chapter  558  of  the
    14  laws of 1989, are renumbered subdivisions 5 and 6 and amended to read as
    15  follows:
    16    5.  (a)  At  the  beginning  or after the commencement of a continuous
    17  period of institutionalization, either spouse may request [an assessment
    18  of the total value of their resources or] a determination of the  commu-
    19  nity  spouse  monthly  income allowance, the amount of the family allow-
    20  ance, or the method of computing the amount of the family allowance,  or
    21  the method of computing the amount of the community spouse income allow-
    22  ance.
    23    (b)  [(i)  Upon receipt of a request pursuant to paragraph (a) of this
    24  subdivision together with all relevant documentation of the resources of
    25  both spouses, the social services district shall assess and document the
    26  total value of the spouses' resources and provide  each  spouse  with  a
    27  copy of the assessment and the documentation upon which it was based. If
    28  the  request  is not part of an application for medical assistance bene-
    29  fits, the social services district may charge a fee for  the  assessment
    30  which is related to the cost of preparing and copying the assessment and
    31  documentation which fee may not exceed twenty-five dollars.
    32    (ii)] The social services district shall [also] notify each requesting
    33  spouse  of the community spouse monthly income allowance, of the amount,
    34  if any, of the family allowances, and of the  method  of  computing  the
    35  amount of the community spouse monthly income allowance.
    36    (c)  The  social  services district shall also provide to the spouse a
    37  notice of the right to a fair hearing at the time of  provision  of  the
    38  information requested under paragraph (a) of this subdivision or after a
    39  determination  of  eligibility for medical assistance. Such notice shall
    40  be in the form prescribed or approved by the commissioner and include  a
    41  statement  advising the spouse of the right to a fair hearing under this
    42  section.
    43    6. (a) If, after a determination on an application for medical assist-
    44  ance has been made, either spouse is dissatisfied with the determination
    45  of the community spouse monthly allowance[,] or the  amount  of  monthly
    46  income  otherwise available to the community spouse[, the computation of
    47  the spousal share of resources, the  attribution  of  resources  or  the
    48  determination of the community spouse's resource allocation], the spouse
    49  may  request  a fair hearing to dispute such determination. Such hearing
    50  shall be held within thirty days of the request therefor.
    51    (b) If either spouse  establishes  that  the  community  spouse  needs
    52  income  above  the  level established by the social services district as
    53  the minimum monthly maintenance needs allowance, based upon  exceptional
    54  circumstances which result in significant financial distress (as defined
    55  by  the commissioner in regulations), the department shall substitute an
        S. 4881--A                         10

     1  amount adequate to provide additional necessary income from  the  income
     2  otherwise available to the institutionalized spouse.
     3    [(c)  If either spouse establishes that income generated by the commu-
     4  nity spouse resource  allowance,  established  by  the  social  services
     5  district,  is  inadequate  to raise the community spouse's income to the
     6  minimum monthly maintenance needs allowance, the department shall estab-
     7  lish a resource allowance for the spousal share of the institutionalized
     8  spouse adequate to provide such minimum monthly maintenance needs allow-
     9  ance.]
    10    § 21. The commissioner of health shall, expeditiously  and  as  neces-
    11  sary,  submit  any  state plan amendment or waiver requests necessary to
    12  maintain federal financial participation under this act.
    13    § 22. This act shall take effect immediately; provided  however,  that
    14  sections  one  and  two  of  this act shall take effect January 1, 2025;
    15  provided, further, however, that sections three, four, five, six, seven,
    16  eight, nine, ten, eleven, twelve, thirteen, fourteen, fifteen,  sixteen,
    17  seventeen,  eighteen,  nineteen and twenty of this act shall take effect
    18  January 1, 2026; provided, further, however, that if section 3  of  part
    19  AAA  of chapter 56 of the laws of 2022 shall not have taken effect on or
    20  before such dates then sections one-a and four-a of this act shall  take
    21  effect  on  the same date and in the same manner as such section of such
    22  part of such chapter of  the  laws  of  2022,  takes  effect;  provided,
    23  further, however, that the amendments to subdivision 6 of section 366 of
    24  the  social  services  law  made  by section eight of this act shall not
    25  affect the repeal of such subdivision and shall be deemed repealed ther-
    26  ewith; provided, further, however, that if section 1 of part N of  chap-
    27  ter 57 of the laws of 2023 shall not have taken effect on or before such
    28  date then section fifteen of this act shall take effect on the same date
    29  and  in  the same manner as such section of such part of such chapter of
    30  the laws of 2023, takes effect; provided,  further,  however,  that  the
    31  effectiveness  of  sections  one  through  twenty  of  this act shall be
    32  subject to federal financial participation; provided, further,  however,
    33  that the commissioner of health shall notify the legislative bill draft-
    34  ing commission upon the occurrence of federal financial participation in
    35  order  that the commission may maintain an accurate and timely effective
    36  data base of the official text of the laws of the state of New  York  in
    37  furtherance of effectuating the provisions of section 44 of the legisla-
    38  tive  law  and  section 70-b of the public officers law. Effective imme-
    39  diately, the addition, amendment and/or repeal of any rule or regulation
    40  necessary for the implementation of this act on its effective  date  are
    41  authorized to be made and completed on or before such effective date.