Bill - 2003-04 PPGG
STATE OF NEW YORK
________________________________________________________________________
S. 1408 A. 2108
SENATE - ASSEMBLY
January 29, 2003
___________
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
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
AN ACT to repeal chapter 174 of the laws of 1990, constituting the youth
opportunity program act (Part A); to amend the executive law, in
relation to community services for the elderly, and to repeal certain
provisions of such law relating thereto (Part B); to amend the state
finance law, in relation to the alzheimer's disease fund; to repeal
subdivision 2-a of section 89-e of the state finance law relating to
the alzheimer's disease fund; to repeal chapter 438 of the laws of
2002 relating to sterilizing flexible endoscopies, to repeal article
27-I of the public health law, relating to reflex sympathetic dystro-
phy syndrome; to repeal title 5 of article 2 of the public health law
relating to obesity prevention; and to repeal article 4-A of the
public health law relating to the licensing and regulation of tattoo-
ing and body piercing parlors (Part C); to amend the public health
law, the domestic relations law and the state finance law, in relation
to increasing fees charged for vital records services; and repealing
section 4178 of the public health law relating thereto (Part D); to
amend the public health law, in relation to eliminating the use of
funds of the office of professional medical conduct for activities of
the patient health information and quality improvement act of 2000
(Part E); to amend the mental hygiene law, in relation to the closure
of the Nathan S. Kline Institute for Psychiatric Research and consol-
idate its functions into the New York State Psychiatric Institute and
the closure of the Institute for Basic Research in Developmental Disa-
bilities (Part F); to amend the mental hygiene law, in relation to the
reinvestment of funds into community-based programs for persons with
serious mental illness, including children and adolescents with seri-
ous emotional disturbances, based upon inpatient bed closures and the
closure of state-operated psychiatric centers; to provide community
mental health support and workforce reinvestment; and to provide for
the repeal of certain provisions upon expiration thereof (Part G); to
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD12111-01-3
S. 1408 2 A. 2108
amend chapter 119 of the laws of 1997 relating to authorizing the
department of health to establish certain payments to general hospi-
tals, in relation to extending the authorization for the department of
health to continue those payments to general hospitals (Part H); to
amend the public health law, in relation to limitations on state aid
to municipalities for public health services (Part I); to amend the
executive law, in relation to the program for elderly pharmaceutical
insurance coverage (Part J); to amend the social services law and the
public health law, in relation to expanding Medicaid coverage and
rates of payment for residential health care facilities; to amend the
executive law, in relation to integrated settings for qualified
persons with disabilities; to amend chapter 1 of the laws of 2002,
amending the public health law, the social services law and the tax
law relating to the Health Care Reform Act of 2000, in relation to the
effective date 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 extending the effec-
tiveness of such rates; 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 the effectiveness
thereof; to amend chapter 629 of the laws of 1986, amending the social
services law relating to establishing a demonstration program for the
delivery of long-term home health care services to certain persons, in
relation to the effectiveness thereof; to amend chapter 165 of the
laws of 1991, amending the public health law and other laws, relating
to establishing payments for medical assistance, in relation to making
certain provisions permanent; to amend chapter 433 of the laws of
1997, amending the public health law and other laws relating to the
rate of reimbursement paid to hospitals and residential health care
facilities, in relation to extending the provisions thereof; to amend
chapter 639 of the laws of 1996 amending the public health law and
other laws relating to welfare reform, in relation to trend factor
elimination; to amend chapter 483 of the laws of 1978, amending the
public health law relating to rate of payment for each residential
health care facility to real property costs, in relation to the effec-
tiveness thereof; to amend chapter 649 of the laws of 1996, amending
the public health law, the mental hygiene law and the social services
law, relating to authorizing the establishment of special needs plans,
in relation to making provisions permanent; to amend chapter 710 of
the laws of 1988, amending the social services law and the education
law relating to medical assistance eligibility of certain persons and
providing for managed medical care demonstration programs, in relation
to making certain provisions permanent; to amend chapter 904 of the
laws of 1984, amending the public health law and the social services
law, relating to encouraging comprehensive health services, in
relation to extending the provisions thereof; to amend chapter 535 of
the laws of 1983, amending the social services law relating to eligi-
bility of certain enrollees for medical assistance, in relation to
making provisions permanent; to amend chapter 19 of the laws of 1998,
amending the social services law relating to limiting the method of
payment for prescription drugs under the medical assistance program,
in relation to extending the provisions thereof; and to repeal subdi-
vision 21 of section 364-j and section 364-jj of the social services
law relating to rate adjustments for certain managed care providers
and to the special advisory review panel on Medicaid managed care, and
repealing paragraph (x) of section 165 of chapter 41 of the laws of
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1992 amending the public health law and other laws relating to health
care provider reimbursement rates, relating to the effectiveness of
certain provisions of such chapter (Part K); to amend chapter 639 of
the laws of 1996 relating to the Health Care Reform Act of 1996, and
to amend chapter 1 of the laws of 1999 relating to the New York Health
Care Reform Act of 2000, in relation to extending certain provisions
relating thereto; to amend the public health law, in relation to
hospitals; to amend chapter 433 of the laws of 1997 amending the
public health law and other laws relating to rates of reimbursement
paid to hospitals and residential health care facilities, in relation
to allocation for grants; to amend chapter 2 of the laws of 1998
amending the public health law, the social services law and the insur-
ance law relating to expanding the child health insurance plan, in
relation to extending the effectiveness thereof; to amend the public
health law, in relation to the definition of covered health care
services; to amend the social services law, in relation to the family
health plus program; to amend the insurance law, in relation to stop
loss funds; to amend chapter 82 of the laws of 2002 amending chapter 1
of the laws of 2002 amending the public health law, the social
services law, and the tax law relating to the Health Care Reform Act
of 2000 relating to health care reform, in relation to authorizing the
commissioner of health to utilize existing cash balances in certain
pools or transfer money from certain funds; to amend the public health
law, in relation to patient services payments; to amend chapter 63 of
the laws of 2001 amending chapter 20 of the laws of 2001 amending the
military law and other laws relating to making appropriations for the
support of government, the public health law and the social services
law, in relation to making technical corrections relating thereto; to
amend the insurance law, in relation to non-profit medical and dental
indemnity, or health and hospital service corporations; to amend chap-
ter 731 of the laws of 1993 amending the public health law and other
laws relating to reimbursement, delivery and capital costs of ambula-
tory health care services and inpatient hospital services, in relation
to extending certain provisions relating thereto; to amend the social
services law, in relation to extending certain provisions of the
medical assistance information and payment system; to amend chapter
520 of the laws of 1978 relating to providing for a comprehensive
survey of health care financing, education and illness prevention and
creating councils for the conduct thereof, in relation to extending
the time period for the inpatient financing system; to amend chapter
600 of the laws of 1986 amending the public health law relating to the
development of pilot reimbursement program for ambulatory care
services, in relation to extending the effectiveness of such chapter;
and to amend chapter 753 of the laws of 1989 amending the public
health law and other laws relating to general hospital reimbursement
for inpatient and ambulatory surgery, in relation to extending the
effectiveness of certain provisions relating thereto; to amend the
public health law, in relation to patient services payment; to repeal
title 11-A of the social services law relating to the catastrophic
health care expense program; and to repeal paragraph (g) of subdivi-
sion 2 of section 2511 of the public health law relating to the child
health insurance plan (Part L); to amend the public health law and the
penal law, in relation to control of forged and altered prescriptions;
and to repeal sections 3335 and 3336 of the public health law relating
to written prescriptions (Part M); and to amend the insurance law and
the public health law, in relation to establishing early intervention
S. 1408 4 A. 2108
program third party insurance standards and instituting parental cost
sharing on a sliding fee scale (Part N)
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 2003-2004
3 state fiscal year. Each component is wholly contained within a Part
4 identified as Parts A through N. 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 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. Chapter 174 of the laws of 1990, constituting the youth
14 opportunity program act, is REPEALED.
15 § 2. This act shall take effect April 1, 2003; provided, however, if
16 this act shall become a law after such date it shall take effect imme-
17 diately and shall be deemed to have been in full force and effect on and
18 after April 1, 2003.
19 PART B
20 Section 1. Section 541 of the executive law is REPEALED and a new
21 section 541 is added to read as follows:
22 § 541. Community services for the elderly. 1. Definitions. As used in
23 this section, the following words shall have the following meanings:
24 (a) "Director" shall mean the director of the state office for the
25 aging.
26 (b) "Designated agency" shall mean an agency which is designated by
27 the chief executive officer of the county if there be one, or otherwise
28 the governing board of such county, or the chief executive officer of
29 the city of New York, or the governing board of an Indian tribal coun-
30 cil; which is either a unit of county government or the city of New York
31 or an Indian tribal organization or a private non-profit agency, and
32 which is the area agency on aging created pursuant to the federal older
33 Americans act of nineteen hundred sixty-five.
34 (c) "Elderly person" shall mean a person sixty years of age or older.
35 (d) "County" shall mean a county, as defined in section three of the
36 county law, except that the city of New York shall be considered one
37 county.
38 (e) "Community services" shall mean services for elderly persons which
39 are provided by a public or governmental agency or non-profit agency,
40 and which are provided in the home of an elderly person or in community
41 settings such as senior citizens centers, housing projects, or agency
42 offices. Such services shall not include any services provided pursuant
43 to the public health law other than home care services.
44 (f) "County plan" shall mean a comprehensive plan for community
45 services prepared by a county pursuant to this section.
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1 (g) "Non-profit agency" shall mean a corporation organized or existing
2 pursuant to the not-for-profit corporation law.
3 (h) "Program year" shall mean the period from April first through
4 March thirty-first of the following calendar year.
5 2. County plans for the availability of community services to the
6 elderly. (a) Counties with a designated agency are required to submit a
7 county plan for the delivery of community services for elderly persons
8 living within the county. The plan shall be for a two, three, or four
9 year period, as determined by the director, with annual adjustments as
10 may be necessary. Such plan shall provide the information, and be in the
11 format, prescribed by the director.
12 (b) The county plan for community services or annual adjustments shall
13 be prepared by the designated agency and approved by the chief executive
14 officer of the county, if there be one, or otherwise the governing board
15 of the county, or the chief executive of the city of New York and
16 submitted to the director no later than ninety days prior to the begin-
17 ning of the program period covered by such plan or annual update.
18 (c) The director shall review such county plan and may approve or
19 disapprove such plan, or any part thereof, and shall propose such
20 modifications and conditions as are deemed appropriate and necessary.
21 Compliance with paragraphs (a) and (b) of this subdivision shall be the
22 basis for approval of a county plan. In the event the director shall
23 disapprove the proposed county plan, the county submitting such applica-
24 tion shall be afforded an opportunity for an adjudicatory hearing, as
25 prescribed by article three of the state administrative procedure act.
26 (d) Notwithstanding any provision of this section, nothing contained
27 herein shall give the director or a designated agency any administra-
28 tive, fiscal, supervisory, or other authority whatsoever over any plans,
29 programs or expenditures authorized pursuant to titles eighteen, nine-
30 teen and twenty of the federal social security act, or over any unit of
31 state or local government.
32 3. Funding. (a) The director shall, within the amounts appropriated
33 therefor, make funds available to designated agencies for the provision
34 of services provided for in the approved plans. The annual state
35 reimbursement shall be at a rate of seventy per centum of the total
36 annual expenditures for such approved plans.
37 (b) The director shall distribute such funds based on a formula devel-
38 oped by the state office for the aging which shall take into account the
39 geographic distribution of older persons within the state, and any other
40 factors deemed appropriate by the director including, but not limited
41 to, the geographic distribution of persons over the age of seventy-five.
42 (c) The designated agency may use up to ten per centum of the state
43 aid for planning and implementation of the community services under its
44 approved plan.
45 (d) The director shall provide that certain non-county moneys and
46 in-kind equivalents may be used to comprise the county share of such
47 total annual approved expenditures, provided that such county share
48 shall not include monies received from the federal government for
49 services for the elderly allocated to the state or local governments
50 according to the population or other such non-competitive basis.
51 (e) The director shall provide the requirements for any participant
52 contribution used for community services and the manner for the account-
53 ing and use of any such revenue.
54 (f) Reimbursement shall not be available for community services under
55 the plan provided to elderly persons who are eligible for, or are
56 receiving services, to meet their needs pursuant to titles eighteen,
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1 nineteen or twenty of the federal social security act or any other
2 governmental programs, or for services provided to residents in adult
3 residential care facilities which had previously been provided by the
4 facility, or which are required by law to be provided by such facility.
5 (g) For the purpose of determining the amount of state reimbursement
6 for which a county is eligible pursuant to this section, the last
7 preceding federal decennial census shall be used.
8 (h) Claims for reimbursement shall be submitted in accordance with
9 procedures developed by the director in consultation with designated
10 agencies. Reimbursement shall be available for approved expenditures
11 incurred in accordance with an approved county plan for community
12 services.
13 (i) The director shall provide for the extent of cost-sharing to be
14 required of elderly persons receiving services.
15 4. Contracts for services. (a) For the purposes of this section, coun-
16 ties are authorized to contract with public agencies, municipalities,
17 non-profit agencies, or such other entities as the director may author-
18 ize.
19 (b) Pursuant to an agreement, two or more counties may join together
20 for the purposes of this section. Such agreements shall make provision
21 for the proportionate cost to be borne by each county, the employment of
22 personnel, the receipt and disbursement of funds, and any other matters
23 deemed necessary by the director. Claims for reimbursement pursuant to
24 subdivision three of this section shall be paid to each county and shall
25 be limited to the amount to which each county would be entitled pursuant
26 to such subdivision.
27 5. Tribal organization agencies. For the purposes of obtaining state
28 aid within the amounts appropriated therefor under this section, a
29 designated agency of an Indian tribal organization shall qualify as
30 though it were a designated agency for a county.
31 § 2. This act shall take effect immediately and shall be deemed to
32 have been in full force and effect on April 1, 2003.
33 PART C
34 Section 1. Subdivision 2 of section 89-e of the state finance law, as
35 amended by chapter 359 of the laws of 2002, is amended to read as
36 follows:
37 2. Such fund shall consist of all revenues received by the department
38 of taxation and finance, pursuant to the provisions of section six
39 hundred twenty-nine of the tax law and all other moneys appropriated,
40 credited, or transferred thereto from any other fund or source pursuant
41 to law. [For each state fiscal year, there shall be appropriated to the
42 fund by the state, in addition to all other moneys required to be depos-
43 ited into such fund, an amount equal to the amounts of monies collected
44 and deposited into the fund pursuant to section six hundred twenty-nine
45 of the tax law during the preceding calendar year, as certified by the
46 comptroller.] Nothing contained herein shall prevent the state from
47 receiving grants, gifts or bequests for the purposes of the fund as
48 defined in this section and depositing them into the fund according to
49 law.
50 § 2. Subdivision 2-a of section 89-e of the state finance law is
51 REPEALED.
52 § 3. Chapter 438 of the laws of 2002 relating to sterilizing flexible
53 endoscopies is REPEALED.
54 § 4. Article 27-I of the public health law is REPEALED.
S. 1408 7 A. 2108
1 § 5. Title 5 of article 2 of the public health law, as added by chap-
2 ter 538 of the laws of 2002, is REPEALED.
3 § 6. Article 4-A of the public health law is REPEALED.
4 § 7. This act shall take effect immediately.
5 PART D
6 Section 1. Subdivisions 6 and 7 of section 4139 of the public health
7 law, subdivision 6 as amended by chapter 61 of the laws of 1989 and
8 subdivision 7 as amended by chapter 103 of the laws of 1981, are amended
9 to read as follows:
10 6. The commissioner shall be entitled to a fee of [fifteen] thirty
11 dollars for each certification, certified copy or certified transcript
12 of certificate of dissolution of marriage furnished [by him].
13 7. For a search of the files where no such certification, certified
14 copy, or certified transcript is furnished, or for a certification that
15 a search discloses no record of a dissolution of marriage, the commis-
16 sioner shall be entitled to a fee of [five] thirty dollars.
17 § 2. Subdivisions 2 and 3 of section 4174 of the public health law,
18 subdivision 2 as amended by chapter 61 of the laws of 1989 and subdivi-
19 sion 3 as amended by chapter 413 of the laws of 1991, are amended to
20 read as follows:
21 2. Each applicant for a certification of birth or death, certificate
22 of birth data or for a certified copy or certified transcript of a birth
23 or death certificate or certificate of birth data shall remit to the
24 commissioner with such application a fee of [fifteen] thirty dollars in
25 payment for the search of the files and records and the furnishing of a
26 certification, certified copy or certified transcript if such record is
27 found or for a certification that a search discloses no record of a
28 birth or of a death.
29 3. For any search of the files and records conducted for authorized
30 genealogical or research purposes, the commissioner or any person
31 authorized by him shall be entitled to, and the applicant shall pay, a
32 fee of [ten] twenty dollars for each hour or fractional part of an hour
33 of time of search, together with a fee of [one dollar] two dollars for
34 each uncertified copy or abstract of such record requested by the appli-
35 cant or for a certification that a search discloses no record.
36 § 3. Section 4174 of the public health law is amended by adding a new
37 subdivision 9 to read as follows:
38 9. The commissioner may institute an additional fee of fifteen dollars
39 for priority handling for each certification, certified copy or certi-
40 fied transcript of certificates of birth, death, or dissolution of
41 marriage; or fifteen dollars for priority handling for each certif-
42 ication, certified copy or certified transcript of certificate of
43 marriage.
44 § 4. Section 4178 of the public health law is REPEALED.
45 § 5. Subdivision 3 of section 15 of the domestic relations law, as
46 amended by chapter 61 of the laws of 1989, is amended to read as
47 follows:
48 3. If it shall appear upon an application for a marriage license that
49 either party is under the age of sixteen years, the town or city clerk
50 shall require, in addition to any consents provided for in this section,
51 the written approval and consent of a justice of the supreme court or of
52 a judge of the family court, having jurisdiction over the town or city
53 in which the application is made, to be attached to or endorsed upon the
54 application, before the license is issued. The application for such
S. 1408 8 A. 2108
1 approval and consent shall be heard by the judge at chambers. All papers
2 and records pertaining to any such application shall be sealed by him
3 and withheld from inspection, except by order of a court of competent
4 jurisdiction. Before issuing any licenses herein provided for, the town
5 or city clerk shall be entitled to a fee of [fifteen] thirty dollars,
6 which sum shall be paid by the applicants before or at the time the
7 license is issued. Any town or city clerk who shall issue a license to
8 marry any persons one or both of whom shall not be at the time of the
9 marriage under such license legally competent to marry without first
10 requiring the parties to such marriage to make such affidavits and
11 statements or who shall not require the production of documentary proof
12 of age or the procuring of the approval and consents provided for by
13 this article, which shall show that the parties authorized by said
14 license to be married are legally competent to marry, shall be guilty of
15 a misdemeanor and on conviction thereof shall be fined in the sum of one
16 hundred dollars for each and every offense. On or before the fifteenth
17 day of each month, each town and city clerk, except in the city of New
18 York, shall transmit to the state commissioner of health [eleven] twen-
19 ty-two dollars and [twenty-five] fifty cents of the amount received for
20 each fee collected, which shall be paid into the [state treasury] vital
21 records management account as provided by section [one hundred twenty-
22 one] ninety-seven-cccc of the state finance law. In any city the balance
23 of all fees collected for the issuing of a marriage license, or for
24 solemnizing a marriage, so far as collected for services rendered by any
25 officer or employee of such city, shall be paid monthly into the city
26 treasury and may by ordinance be credited to any fund therein desig-
27 nated, and said ordinance, when duly enacted, shall have the force of
28 law in such city. Notwithstanding any other provisions of this article,
29 the clerk of any city with the approval of the governing body of such
30 city is hereby authorized to designate, in writing filed in the city
31 clerk's office, a deputy clerk, if any, and/or other city employees in
32 such office to receive applications for, examine applications, investi-
33 gate and issue marriage licenses in the absence or inability of the
34 clerk of said city to act, and said deputy and/or employees so desig-
35 nated are hereby vested with all the powers and duties of said city
36 clerk relative thereto. Such deputy and/or employees shall perform said
37 duties without additional compensation.
38 § 6. Section 20-a of the domestic relations law, as amended by chapter
39 103 of the laws of 1981, is amended to read as follows:
40 § 20-a. Certified transcripts of records; state commissioner of health
41 may furnish. The state commissioner of health or person authorized by
42 him shall, upon request, supply to any applicant a certified transcript
43 of any marriage registered under the provisions of this article, unless
44 he is satisfied that the same does not appear to be necessary or
45 required for judicial or other proper purposes. Any transcript of the
46 record of a marriage, when properly certified by the state commissioner
47 of health or person authorized to act for him, shall be prima facie
48 evidence in all courts and places of the facts therein stated. For any
49 search of the files and records conducted for authorized research
50 purposes, the state commissioner of health shall be entitled to a fee of
51 [five] twenty dollars for each hour or fractional part of an hour of
52 time of search, together with a fee of [one dollar] two dollars for each
53 uncertified copy or abstract of such marriage record requested by the
54 applicant, said fees to be paid by the applicant. Each applicant for a
55 certified transcript of a marriage record shall remit to the state
56 commissioner of health a fee of [five] thirty dollars in payment for the
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1 search of the files and records and the furnishing of a certified copy
2 if such record is found or for a certification that a search discloses
3 no record of a marriage.
4 § 7. Subdivision 3 of section 20-b of the domestic relations law, as
5 amended by chapter 103 of the laws of 1981, is amended to read as
6 follows:
7 3. Each applicant for a certification of marriage shall remit to the
8 commissioner with such application a fee of [five] thirty dollars in
9 payment for the search of the files and records and the furnishing of
10 such certification if a record thereof is found or for a certification
11 that a search discloses no record of a marriage.
12 § 8. The state finance law is amended by adding a new section 97-cccc
13 to read as follows:
14 § 97-cccc. Vital records management account. 1. There is hereby estab-
15 lished in the joint custody of the state comptroller and the commission-
16 er of taxation and finance an account of the miscellaneous special
17 revenue fund to be known as the vital records management account.
18 2. Notwithstanding any other law, rule or regulation to the contrary,
19 the state comptroller is hereby authorized and directed to receive for
20 deposit to the credit of the health department payments relating to the
21 responsibilities of the vital records management program, including fees
22 for certification, certified copy or certified transcripts of certif-
23 icates of birth, death, or dissolution of marriage; or for certif-
24 ication, certified copy or certified transcript of certificate of
25 marriage.
26 3. Moneys of this account, following appropriation by the legislature,
27 shall be available to the health department for services and expenses of
28 the vital records management program.
29 § 9. This act shall take effect immediately.
30 PART E
31 Section 1. Paragraph (a) of subdivision 1 of section 2995 of the
32 public health law, as added by chapter 542 of the laws of 2000, is
33 amended to read as follows:
34 (a) The department shall undertake an initiative for the purposes of
35 increasing the information available to patients about health care
36 providers and health care plans, and improving the quality of health
37 care in this state, by creating a statewide health information system,
38 collecting health information for dissemination by means of such system,
39 and studying additional uses of such information. Such moneys as may be
40 necessary to effect the purpose of this section may be appropriated to
41 the department for its expenses[, but in no event shall funds be
42 diverted from existing uses of the office of professional medical
43 conduct in order to fulfill the purposes of this section].
44 § 2. This act shall take effect immediately and shall be deemed to
45 have been in full force and effect on and after April 1, 2003.
46 PART F
47 Section 1. Subdivision (b) of section 7.17 of the mental hygiene law,
48 as amended by chapter 333 of the laws of 1998, is amended to read as
49 follows:
50 (b) There shall be in the office the hospitals named below for the
51 care, treatment, and rehabilitation of the mentally disabled and for
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1 research and teaching in the science and skills required for the care,
2 treatment, and rehabilitation of such mentally disabled.
3 Binghamton Psychiatric Center
4 Bronx Psychiatric Center
5 Buffalo Psychiatric Center
6 Capital District Psychiatric Center
7 Central New York Psychiatric Center
8 Creedmoor Psychiatric Center
9 Elmira Psychiatric Center
10 Hudson River Psychiatric Center
11 Kingsboro Psychiatric Center
12 Kirby Forensic Psychiatric Center
13 Manhattan Psychiatric Center
14 Middletown Psychiatric Center
15 Mid-Hudson Forensic Psychiatric Center
16 Mohawk Valley Psychiatric Center
17 [Nathan S. Kline Institute for Psychiatric Research]
18 New York State Psychiatric Institute
19 Pilgrim Psychiatric Center
20 Richard H. Hutchings Psychiatric Center
21 Rochester Psychiatric Center
22 Rockland Psychiatric Center
23 St. Lawrence Psychiatric Center
24 South Beach Psychiatric Center
25 Bronx Children's Psychiatric Center
26 Brooklyn Children's Psychiatric Center
27 Queens Children's Psychiatric Center
28 Rockland Children's Psychiatric Center
29 Sagamore Children's Psychiatric Center
30 Western New York Children's Psychiatric Center
31 The New York State Psychiatric Institute [and The Nathan S. Kline
32 Institute for Psychiatric Research are] is designated as [institutes] an
33 institute for the conduct of medical research and other scientific
34 investigation directed towards furthering knowledge of the etiology,
35 diagnosis, treatment, and prevention of mental illness.
36 § 2. Paragraph 3 of subdivision (e) of section 7.17 of the mental
37 hygiene law, as amended by chapter 83 of the laws of 1995, is amended to
38 read as follows:
39 3. provide for a mechanism which may reasonably be expected to provide
40 notice to local governments, community organizations, employee labor
41 organizations, managerial and confidential employees, and consumer and
42 advocacy groups of the potential for significant service reductions at
43 such state-operated hospitals and state-operated research institutes at
44 least twelve months prior to commencing such service reduction[,];
45 provided, however, that this requirement shall be deemed satisfied with
46 respect to reductions at Central Islip Psychiatric Center, Gowanda
47 Psychiatric Center, Harlem Valley Psychiatric Center, Kings Park Psychi-
48 atric Center, Willard Psychiatric Center [and], Manhattan Children's
49 Psychiatric Center, and Nathan S. Kline Institute for Psychiatric
50 Research; and
51 § 3. The second undesignated paragraph of section 13.01 of the mental
52 hygiene law, as amended by chapter 676 of the laws of 1994, is amended
53 to read as follows:
54 Therefore, it shall be the policy of the state to [conduct research
55 and to] develop programs to further the prevention and early detection
56 of mental retardation and developmental disabilities; to develop a
S. 1408 11 A. 2108
1 comprehensive, integrated system of services which has as its primary
2 purposes the promotion and attainment of independence, inclusion, indi-
3 viduality, and productivity for persons with mental retardation and
4 developmental disabilities; to serve the full range of needs of persons
5 with mental retardation and developmental disabilities by expanding the
6 number and types of community based services and developing new methods
7 of service delivery; and to improve the equity, effectiveness, and effi-
8 ciency of services for persons with mental retardation and developmental
9 disabilities by serving persons in the community as well as those in
10 developmental centers, by improving the conditions in developmental
11 centers, and by establishing accountability for carrying out the poli-
12 cies of the state with regard to such persons.
13 § 4. Subdivision (b) of section 13.17 of the mental hygiene law, as
14 amended by section 1 of part N of chapter 57 of the laws of 2000, is
15 amended to read as follows:
16 (b) There shall be in the office the developmental disabilities
17 services offices named below, serving the areas either currently or
18 previously served by a school, for the care and treatment of the mental-
19 ly retarded and developmentally disabled and for research and teaching
20 in the science and skills required for the care and treatment of such
21 mentally retarded and developmentally disabled:
22 Bernard M. Fineson Developmental Disabilities Services Office
23 Brooklyn Developmental Disabilities Services Office
24 Broome Developmental Disabilities Services Office
25 Capital District Developmental Disabilities Services Office
26 Central New York Developmental Disabilities Services Office
27 Finger Lakes Developmental Disabilities Services Office
28 [Institute for Basic Research in Developmental Disabilities]
29 Hudson Valley Developmental Disabilities Services Office
30 Metro New York Developmental Disabilities Services Office
31 Long Island Developmental Disabilities Services Office
32 Sunmount Developmental Disabilities Services Office
33 Taconic Developmental Disabilities Services Office
34 Western New York Developmental Disabilities Services Office
35 Staten Island Developmental Disabilities Services Office
36 Valley Ridge Center for Intensive Treatment
37 [The New York State Institute for Basic Research in Developmental
38 Disabilities is designated as an institute for the conduct of medical
39 research and other scientific investigation directed towards furthering
40 knowledge of the etiology, diagnosis, treatment and prevention of mental
41 retardation and developmental disabilities.]
42 § 5. (a) Closure and consolidation. Notwithstanding any other
43 provision of law to the contrary, the commissioner of mental health is
44 authorized to close the Nathan S. Kline Institute for Psychiatric
45 Research and consolidate the remaining functions pursuant to subdivision
46 (b) of this section into the New York State Psychiatric Institute,
47 effective April 1, 2003.
48 (b) Transfer of functions and employees. The remaining functions,
49 obligations, and duties of the Nathan S. Kline Institute for Psychiatric
50 Research, as designated by the commissioner of mental health, shall be
51 transferred and assigned to the New York State Psychiatric Institute.
52 Upon such transfer of functions, obligations, and duties of the Nathan
53 S. Kline Institute for Psychiatric Research to the New York State
54 Psychiatric Institute pursuant to this act, the transfer of affected
55 employees shall be in accordance with section 70 of the civil service
56 law.
S. 1408 12 A. 2108
1 (c) Terms occurring in regulations, contracts, and other documents.
2 Whenever the term Nathan S. Kline Institute for Psychiatric Research is
3 referred to or designated in any regulation, contract, or document
4 pertaining to the functions, powers, obligations, and duties which are
5 transferred and assigned, as designated by the commissioner of mental
6 health, pursuant to this section, such reference or designation shall be
7 deemed to refer to the New York State Psychiatric Institute.
8 (d) Notwithstanding any other law to the contrary, including section
9 7.17 of the mental hygiene law, the commissioner of mental health shall
10 be authorized to implement any service reduction at any state operated
11 research institute as he or she shall deem necessary and appropriate.
12 § 6. Notwithstanding any other provision of law to the contrary, the
13 commissioner of mental retardation and developmental disabilities is
14 authorized to close the Institute for Basic Research in Developmental
15 Disabilities, effective April 1, 2003.
16 § 7. This act shall take effect April 1, 2003.
17 PART G
18 Section 1. Subdivision (b) of section 7.17 of the mental hygiene law,
19 as amended by chapter 333 of the laws of 1998, is amended to read as
20 follows:
21 (b) There shall be in the office the hospitals named below for the
22 care, treatment and rehabilitation of the mentally disabled and for
23 research and teaching in the science and skills required for the care,
24 treatment and rehabilitation of such mentally disabled.
25 Binghamton Psychiatric Center
26 [Bronx Psychiatric Center]
27 Buffalo Psychiatric Center
28 Capital District Psychiatric Center
29 Central New York Psychiatric Center
30 Creedmoor Psychiatric Center
31 [Elmira Psychiatric Center]
32 Hudson River Psychiatric Center
33 Kingsboro Psychiatric Center
34 Kirby Forensic Psychiatric Center
35 Manhattan Psychiatric Center
36 [Middletown Psychiatric Center]
37 Mid-Hudson Forensic Psychiatric Center
38 Mohawk Valley Psychiatric Center
39 Nathan S. Kline Institute for Psychiatric Research
40 New York State Psychiatric Institute
41 Pilgrim Psychiatric Center
42 [Richard H. Hutchings Psychiatric Center]
43 Rochester Psychiatric Center
44 Rockland Psychiatric Center
45 St. Lawrence Psychiatric Center
46 South Beach Psychiatric Center
47 [Bronx Children's Psychiatric Center]
48 Brooklyn Children's Psychiatric Center
49 Queens Children's Psychiatric Center
50 Rockland Children's Psychiatric Center
51 Sagamore Children's Psychiatric Center
52 Western New York Children's Psychiatric Center
53 The New York State Psychiatric Institute and The Nathan S. Kline
54 Institute for Psychiatric Research are designated as institutes for the
S. 1408 13 A. 2108
1 conduct of medical research and other scientific investigation directed
2 towards furthering knowledge of the etiology, diagnosis, treatment and
3 prevention of mental illness.
4 § 2. Paragraph 3 of subdivision (e) of section 7.17 of the mental
5 hygiene law, as amended by chapter 83 of the laws of 1995, is amended to
6 read as follows:
7 3. provide for a mechanism which may reasonably be expected to provide
8 notice to local governments, community organizations, employee labor
9 organizations, managerial and confidential employees, consumer and advo-
10 cacy groups of the potential for significant service reductions at such
11 state-operated hospitals and state-operated research institutes at least
12 twelve months prior to commencing such service reduction, provided,
13 however, that this requirement shall be deemed satisfied with respect to
14 reductions at Central Islip Psychiatric Center, Gowanda Psychiatric
15 Center, Harlem Valley Psychiatric Center, Kings Park Psychiatric Center,
16 Willard Psychiatric Center [and], Manhattan Children's Psychiatric
17 Center, Bronx Psychiatric Center, Elmira Psychiatric Center, Richard H.
18 Hutchings Psychiatric Center, Middletown Psychiatric Center and Bronx
19 Children's Psychiatric Center; and
20 § 3. Subdivisions (a) and (b) of section 41.11 of the mental hygiene
21 law, subdivision (a) as amended by chapter 672 of the laws of 1982 and
22 subdivision (b) as amended by chapter 206 of the laws of 1989, are
23 amended to read as follows:
24 (a) In all local governments with a population less than one hundred
25 thousand, community services [board] boards, at the option of the local
26 government, shall have either nine or fifteen members appointed by the
27 local government. In all other local governments, a community services
28 board shall have fifteen members appointed by the local government.
29 Whenever practicable at least one member shall be a licensed physician
30 and one member shall be a certified psychologist and otherwise at least
31 two members shall be licensed physicians, such members to have demon-
32 strated an interest in the field of services for the mentally disabled.
33 The other members shall represent the community interest in all the
34 problems of the mentally disabled and shall include representatives from
35 community agencies for the mentally ill, the mentally retarded and
36 developmentally disabled, and those suffering from alcoholism and
37 substance abuse. The community services board shall have separate
38 subcommittees for mental health, mental retardation and developmental
39 disabilities, and alcoholism or, at the discretion of the local govern-
40 ment, alcoholism and substance abuse. Each separate subcommittee shall
41 have no more than nine members appointed by the local government, except
42 that each subcommittee for mental health shall have no more than eleven
43 members appointed by the local government. Three of each such subcom-
44 mittee shall be members of the board. Each separate subcommittee shall
45 be composed of persons who have demonstrated an interest in the field of
46 services for the particular class of mentally disabled and shall include
47 former patients, parents or relatives of such mentally disabled persons
48 and community agencies serving the particular class of mentally
49 disabled, except that each subcommittee for mental health shall include
50 at least two members who are or were consumers of mental health
51 services, and at least two members who are parents or relatives of
52 persons with mental illness. Each separate subcommittee shall advise
53 the community services board and the director of community services
54 regarding the exercise of all policy-making functions vested in such
55 board or director, as such functions pertain to the field of services
56 for the particular class of mentally disabled individuals represented by
S. 1408 14 A. 2108
1 such subcommittee. In addition, each subcommittee for mental health
2 shall be authorized to annually evaluate the local services plan or the
3 unified services plan, as appropriate, and shall be authorized to report
4 on the consistency of such plans with the needs of persons with serious
5 mental illness, including children and adolescents with serious
6 emotional disturbances. Any such report shall be forwarded annually to
7 the community services board and the director of community services and
8 a copy shall also be sent to the commissioner prior to the submission of
9 the local services plan or unified services plan. Provided however that
10 the provisions of this paragraph shall not apply to cities of over a
11 million in population.
12 (b) In cities of over a million a community services board shall
13 consist of fifteen members to be appointed by the mayor. There shall be
14 at least two residents of each county within such cities on the board.
15 At least one shall be a licensed physician and at least one shall be a
16 certified psychologist. The other members shall represent the community
17 interest in all of the problems of the mentally disabled and shall
18 include representatives from community agencies for the mentally ill,
19 the mentally retarded and developmentally disabled, and those suffering
20 from alcoholism and substance abuse. The community services board shall
21 have separate subcommittees for mental health, mental retardation and
22 developmental disabilities, and alcoholism or, at the discretion of the
23 local government, alcoholism and substance abuse. Each separate subcom-
24 mittee shall have no more than nine members appointed by the local
25 government, except that each subcommittee for mental health shall have
26 no more than eleven members appointed by the local government. Three
27 members of each such subcommittee shall be members of the board. Each
28 separate subcommittee shall be composed of persons who have demonstrated
29 an interest in the field of services for the particular class of mental-
30 ly disabled and shall include former patients, parents or relatives of
31 such mentally disabled persons and community agencies serving the
32 particular class of mentally disabled, except that each subcommittee for
33 mental health shall include at least two members who are or were consum-
34 ers of mental health services, and two members who are parents or rela-
35 tives of persons with mental illness. Each separate subcommittee shall
36 advise the community services board and the director of community
37 services regarding the exercise of all policy-making functions vested in
38 such board or director, as such functions pertain to the field of
39 services for the particular class of mentally disabled individuals
40 represented by such subcommittee. In addition, each subcommittee for
41 mental health shall be authorized to annually evaluate the local
42 services plan or the unified services plan, as appropriate, and shall be
43 authorized to report on the consistency of such plans with the needs of
44 persons with serious mental illness, including children and adolescents
45 with serious emotional disturbances. Any such report shall be forwarded
46 annually to the community services board and the director of community
47 services, and a copy shall also be sent to the commissioner prior to the
48 submission of the local services plan or unified services plan.
49 § 4. The mental hygiene law is amended by adding a new section 41.56
50 to read as follows:
51 § 41.56 Community mental health support and workforce reinvestment
52 program.
53 (a) Community mental health support and workforce reinvestment funds
54 shall be annually allocated by the commissioner based upon the following
55 criteria:
S. 1408 15 A. 2108
1 (1) the efficiency and effectiveness of the use of funding for the
2 delivery of services to persons with serious mental illness who are
3 discharged to the community in order to fund necessary mental health
4 services; and
5 (2) other relevant factors that require the maintenance of existing
6 mental health services and the development or support of community
7 mental health services.
8 (b) Amounts provided pursuant to this section shall be used to fund
9 mental health workforce related activities, or other general programmat-
10 ic activities to help ensure a stable mental health system.
11 (c) The commissioner is authorized and empowered to make inspections,
12 examine records and conduct on-site audits of books and records of a
13 local governmental unit or a provider of services receiving such funds
14 pursuant to this section. Such inspections, examinations or audits shall
15 be authorized to include all financial, statistical, program or other
16 information that the commissioner may determine to be necessary, includ-
17 ing but not limited to all medical, service, financial and other
18 records, receipts, disbursements, contracts, loans and other moneys
19 relating to the financial operation of the local governmental unit or
20 provider.
21 (d) Nothing in this section shall create or be deemed to create any
22 right, interest or entitlement to services or funds that are the subject
23 of this section, or to any other services or funds, whether to individ-
24 uals, localities, providers or others, individually or collectively.
25 (e) Notwithstanding any other provision of law to the contrary, each
26 of the provisions of this section shall be subject to annual appropri-
27 ations made therefor.
28 § 5. (a) The amount of community mental health support and workforce
29 reinvestment funds for the office of mental health shall be determined
30 in the annual budget and shall include the amount of actual state oper-
31 ations general fund appropriation reductions directly attributed to each
32 non-geriatric adult inpatient bed closed. For the purposes of this
33 section a bed shall be considered to be closed upon the elimination of
34 funding for such bed in the annual budget. The appropriation reductions
35 as a result of non-geriatric adult inpatient bed closures shall be no
36 less than $70,000 per bed closed on a full annual basis, as annually
37 recommended by the commissioner of mental health, subject to the
38 approval of the director of the budget, provided, however, in no event
39 shall the full annual value of community mental health support and work-
40 force reinvestment funds attributable to beds closed as a result of
41 non-geriatric adult inpatient bed closures exceed the twelve month value
42 of the office of mental health state operations general fund reductions
43 resulting from such bed closures. Such funds made available pursuant to
44 this subdivision shall be at the same amount by which the office of
45 mental health's state operations general fund appropriations are reduced
46 each year as a result of non-geriatric adult inpatient bed closures.
47 (b) An additional amount of community mental health support and work-
48 force reinvestment funds shall be made available, subject to annual
49 appropriations made therefor, in the annual budget based upon state
50 operations general fund appropriation reductions directly attributed to
51 the closure of state psychiatric centers pursuant to this act. Such
52 funds shall be made available at the same amount by which the office of
53 mental health's state operations general fund appropriations are reduced
54 each year as a result of such facility closures.
55 (c) The annual community mental health support and workforce reinvest-
56 ment appropriation shall reflect, subject to appropriations made there-
S. 1408 16 A. 2108
1 for, the amount of state operations general fund appropriation
2 reductions resulting from subdivisions (a) and (b) of this section.
3 Within any fiscal year where appropriation increases are recommended for
4 the community mental health support and workforce reinvestment program,
5 insofar as projected non-geriatric adult inpatient census decline and/or
6 facility closure or closures do not occur as estimated, and state oper-
7 ations general fund savings do not result, then the reinvestment appro-
8 priations shall be made available, as needed, for transfer from the
9 office of mental health general fund - aid to localities account to the
10 office of mental health general fund - state purposes account to pay for
11 any necessary adult inpatient expenses.
12 (d) For purposes of this section, the term "state operations general
13 fund" shall mean the office of mental health state operations general
14 fund appropriations before any offset from the special revenue funds -
15 other, miscellaneous special revenue fund - 339, mental hygiene patient
16 income account.
17 (e) Nothing in this act shall create or be deemed to create any right,
18 interest or entitlement to services or funds that are the subject of
19 this act, or to any other services or funds, whether to individuals,
20 localities, providers or others, individually or collectively.
21 (f) All methodologies used to determine allocation amounts made pursu-
22 ant to this section and section 41.56 of the mental hygiene law, as
23 added by section four of this act, shall be developed in the sole
24 discretion of the commissioner of mental health and the director of the
25 budget.
26 (g) Notwithstanding any other provision of law to the contrary, each
27 of the provisions of this section shall be subject to annual appropri-
28 ations made therefor.
29 § 6. Actual state operations general fund appropriation reductions
30 directly attributed to children's inpatient bed closures, pursuant to
31 this act, shall be made available to the office of mental health,
32 subject to annual appropriations made therefor, for the development and
33 expansion of community mental health services for children and adoles-
34 cents with serious emotional disturbances, which may include, but are
35 not limited to, crisis intervention beds, home-based crisis intervention
36 teams, and home and community-based waiver slots.
37 § 7. Notwithstanding section 7.21 of the mental hygiene law, the
38 commissioner of mental health, or his or her designee, shall be the
39 appointing and removing authority for all officers and employees of the
40 office of mental health, including but not limited to, the officers and
41 employees of the psychiatric hospitals and institutes listed in subdivi-
42 sion (b) of section 7.17 of the mental hygiene law, and he or she shall
43 have the power, within amounts appropriated therefor, to appoint and
44 remove, in accordance with the law and applicable rules of the state
45 civil service commissioner, such officers and employees as are necessary
46 for the efficient administration of the office.
47 § 8. This act shall take effect immediately; except that:
48 (a) notwithstanding any other law to the contrary, including, but not
49 limited to, subdivision (e) of section 7.17 of the mental hygiene law,
50 the closure of Elmira Psychiatric Center, Richard H. Hutchings Psychi-
51 atric Center, and Middletown Psychiatric Center, pursuant to section one
52 of this act, shall take effect on July 1, 2003; the closure of Bronx
53 Psychiatric Center and Bronx Children's Psychiatric Center, pursuant to
54 section one of this act, shall take effect on October 1, 2005; and
55 (b) sections four, five and six of this act shall take effect on April
56 1, 2004 and shall expire and be deemed repealed March 31, 2007.
S. 1408 17 A. 2108
1 PART H
2 Section 1. Sections 1 and 3 of chapter 119 of the laws of 1997 relat-
3 ing to authorizing the department of health to establish certain
4 payments to general hospitals, section 1 as amended by section 1 of part
5 M of chapter 57 of the laws of 2000 and section 3 as separately amended
6 by chapter 13 and section 1 of part M of chapter 57 of the laws of 2000,
7 are amended to read as follows:
8 Section 1. 1. Notwithstanding any inconsistent provision of law or
9 regulation, effective for the period April 1, 1997 through March 31,
10 1998 and for annual periods beginning April 1 thereafter, the department
11 of health is authorized to pay voluntary non-profit general hospitals as
12 defined in subdivision 10 of section 2801 of the public health law addi-
13 tional payments for inpatient hospital services as medical assistance
14 payments pursuant to title 11 of article 5 of the social services law
15 and federal law and regulations governing disproportionate share
16 payments, based on the amount of state aid for which such general hospi-
17 tals are eligible pursuant to articles 25, 26 and 41 of the mental
18 hygiene law and as identified in subdivision 2 of this section. Payment
19 made pursuant to this section shall not exceed each such general hospi-
20 tal's cost of providing services to uninsured patients and patients
21 eligible for medical assistance pursuant to title 11 of article 5 of the
22 social services law after taking into consideration all other medical
23 assistance received, including disproportionate share payments made to
24 such general hospital, and payments from or on behalf of such uninsured
25 patients, and shall also not exceed the total amount of state aid, iden-
26 tified by subdivision 2 of this section, available to such general
27 hospital by law. Payments made to such general hospitals pursuant to
28 this section shall be made in lieu of any state aid payments available
29 to such general hospital by law.
30 2. The commissioners of mental health and alcoholism and substance
31 abuse services, after consultation with county directors of community
32 services, shall identify to the commissioner of health for the office of
33 mental health and office of alcoholism and substance abuse services
34 respectively, each such general hospital and the amounts to be distrib-
35 uted to each such general hospital pursuant to this section. For annual
36 periods beginning April 1, 1998 and thereafter, in determining the
37 disproportionate share amounts to be distributed to each such general
38 hospital pursuant to this section, such commissioners shall consider
39 whether such general hospital has served populations and/or provided
40 services in the prior year similar to the populations served and
41 services provided with the state aid payments and/or the additional
42 disproportionate share payments approved by such commissioner in the
43 prior state fiscal year [1996-97 utilized to determine the dispropor-
44 tionate share payments made pursuant to this section]. All amounts to be
45 distributed pursuant to this section shall be approved by the director
46 of the budget.
47 3. Notwithstanding any other provision of law regarding a local social
48 services district's share of payments pursuant to title 11 of article 5
49 of the social services law, the local social services district share of
50 the non-federal share of the amount approved in subdivision 2 of this
51 section associated with mental health, chemical dependence, and alcohol-
52 ism and substance abuse state aid payments shall be the same proportion
53 of the total non-federal share as the amount expended for services
54 provided pursuant to an approved local plan required by section 41.16 of
S. 1408 18 A. 2108
1 the mental hygiene law [for the local district fiscal year commencing on
2 or prior to January 1, 1997].
3 4. Revenues from payments pursuant to this section shall not be
4 included in gross revenue for purposes of the assessments pursuant to
5 section 2807-d of the public health law, subject to the provisions of
6 subdivision 12 of section 2807-d of the public health law and shall not
7 be included in gross revenue received for purposes of the assessments
8 pursuant to subdivision 18 of section 2807-c of the public health law
9 subject to the provisions of paragraph (e) of subdivision 18 of section
10 2807-c of the public health law.
11 5. The commissioners of mental health and alcoholism and substance
12 abuse services may adopt or amend or promulgate any regulation he or she
13 determines necessary to implement any provision of this section.
14 6. Payments made pursuant to this section shall be based initially on
15 reported 1995 reconciled data as further reconciled to actual reported
16 [2000] reconciled data. The payments may be made as quarterly aggregate
17 payments to an eligible general hospital.
18 § 3. This act shall take effect immediately and shall be deemed to
19 have been in full force and effect on and after April 1, 1997. This act
20 shall expire [June 30, 2003] March 31, 2006.
21 § 2. This act shall take effect immediately; provided that the amend-
22 ments to section 1 of chapter 119 of the laws of 1997 made by section
23 one of this act shall not affect the expiration of such chapter and
24 shall be deemed expired therewith.
25 PART I
26 Section 1. Subdivisions 2 and 3 of section 605 of the public health
27 law, subdivision 2 as amended by chapter 474 of the laws of 1996 and
28 subdivision 3 as added by chapter 901 of the laws of 1986, are amended
29 to read as follows:
30 2. State aid reimbursement for public health services provided by a
31 municipality under this title, shall be made as follows:
32 (a) if the municipality is providing some or all of the basic public
33 health services identified in paragraph (b) of subdivision three of
34 section six hundred two of this title, pursuant to an approved plan, at
35 a rate of up to fifty per centum but no less than [thirty-six] thirty
36 per centum, except for vector emergencies pursuant to subdivision three
37 of section six hundred eleven of this article, of the difference between
38 the amount of moneys expended by the municipality for public health
39 services required by paragraph (b) of subdivision three of section six
40 hundred two of this title during the fiscal year and the base grant
41 provided pursuant to subdivision one of this section. No such
42 reimbursement shall be provided for services if they are not approved in
43 a plan or if no plan is submitted for such services.
44 (b) [if the municipality is providing] there shall be no reimbursement
45 for other public health services [within limits to be] prescribed by
46 regulation by the commissioner in addition to some or all of the public
47 health services required in paragraph (b) of subdivision three of
48 section six hundred two of this title, pursuant to an approved plan[, at
49 a rate of up to fifty per centum but not less than thirty per centum of
50 the moneys expended by the municipality for such other services. No such
51 reimbursement shall be provided for services if they are not approved in
52 a plan or if no plan is submitted for such services].
53 3. Municipalities shall make every reasonable effort to collect
54 payments for public health services provided. All such revenues related
S. 1408 19 A. 2108
1 to services reimbursed under paragraph (a) of subdivision two of this
2 section shall be reported to the commissioner and will be deducted from
3 expenditures identified under subdivision two of this section to produce
4 a net cost eligible for state aid. Municipalities are authorized to
5 collect payments for any public health service provided pursuant to
6 paragraph (b) of subdivision two of this section.
7 § 2. Subdivision 1 of section 616 of the public health law, as amended
8 by chapter 474 of the laws of 1996, is amended to read as follows:
9 1. The total amount of state aid provided pursuant to this article
10 shall be limited to the amount of the annual appropriation made by the
11 legislature. In no event, however, shall such state aid be less than an
12 amount to provide the full base grant [and, as otherwise provided by
13 paragraph (a) of subdivision two of section six hundred five of this
14 article, at least thirty-six per centum of the difference between the
15 amount of moneys expended by the municipality for public health services
16 required by paragraph (b) of subdivision three of section six hundred
17 two of this article during the fiscal year and the base grant] provided
18 pursuant to subdivision one of section six hundred five of this arti-
19 cle[. A municipality shall also receive at least thirty per centum of
20 the moneys expended for other public health services pursuant to para-
21 graph (b) of subdivision two of section six hundred five of this arti-
22 cle, and, at least the minimum amount so required for the services iden-
23 tified in title two of this article. Moreover, for services provided
24 during calendar year nineteen hundred ninety-six, no county with a popu-
25 lation of fifty thousand or less shall receive less reimbursement pursu-
26 ant to subdivision one and paragraphs (a) and (b) of subdivision two of
27 section six hundred five of this article than it would have had a chap-
28 ter of the laws of nineteen hundred ninety-six amending these provisions
29 as of August first, nineteen hundred ninety-six not been enacted].
30 § 3. This act shall take effect immediately and shall be deemed to
31 have been in full force and effect on and after December 31, 2002.
32 PART J
33 Section 1. Subparagraph (i) of paragraph (b) of subdivision 1 of
34 section 547-j of the executive law, as amended by section 12 of part J
35 of chapter 82 of the laws of 2002, is amended to read as follows:
36 (i) Average wholesale price discounted by [ten] fifteen percent, plus
37 a dispensing fee as defined in paragraph (c) of this subdivision, or
38 § 2. Section 547-e of the executive law is amended by adding a new
39 subdivision 5 to read as follows:
40 5. Transition program participants to the revised quarterly registra-
41 tion fees under section five hundred forty-seven-g of this article and
42 the deductible requirements under section five hundred forty-seven-h of
43 this article within sixty days of the effective date of this subdivi-
44 sion, except that any registration fees for annual coverage periods paid
45 prior to such transition in an annual lump sum in accordance with subdi-
46 vision two of section five hundred forty-seven-g of this article shall
47 not be revised.
48 § 3. Paragraphs (i) and (ii) of subdivision 2 of section 547-g of the
49 executive law, as amended by section 6 of part J of chapter 57 of the
50 laws of 2000, are amended to read as follows:
51 (i) quarterly registration fees for unmarried individual program
52 participants:
53 individual income of $5,000 or less .................... [$2.00] $2.25
S. 1408 20 A. 2108
1 individual income of $5,001 to $6,000 .................. [$2.00] $2.25
2 individual income of $6,001 to $7,000 .................. [$4.00] $4.50
3 individual income of $7,001 to $8,000 .................. [$5.50] $6.00
4 individual income of $8,001 to $9,000 .................. [$7.00] $7.75
5 individual income of $9,001 to $10,000 ................ [$9.00] $10.00
6 individual income of $10,001 to $11,000 .............. [$10.00] $11.00
7 individual income of $11,001 to $12,000 .............. [$11.50] $12.75
8 individual income of $12,001 to $13,000 .............. [$13.50] $14.75
9 individual income of $13,001 to $14,000 .............. [$15.00] $16.50
10 individual income of $14,001 to $15,000 .............. [$20.00] $22.00
11 individual income of $15,001 to $16,000 .............. [$27.50] $30.25
12 individual income of $16,001 to $17,000 .............. [$35.00] $38.50
13 individual income of $17,001 to $18,000 .............. [$42.50] $46.75
14 individual income of $18,001 to $19,000 .............. [$50.00] $55.00
15 individual income of $19,001 to $20,000 .............. [$57.50] $63.25
16 (ii) quarterly registration fees for each married individual program
17 participant:
18 joint income of $5,000 or less ......................... [$2.00] $2.25
19 joint income of $5,001 to $6,000 ....................... [$2.00] $2.25
20 joint income of $6,001 to $7,000 ....................... [$3.00] $3.25
21 joint income of $7,001 to $8,000 ....................... [$4.00] $4.50
22 joint income of $8,001 to $9,000 ........................ [$5.00]$5.50
23 joint income of $9,001 to $10,000 .......................[$6.00] $6.50
24 joint income of $10,001 to $11,000 ..................... [$7.00] $7.75
25 joint income of $11,001 to $12,000 ..................... [$8.00] $8.75
26 joint income of $12,001 to $13,000 .................... [$9.00] $10.00
27 joint income of $13,001 to $14,000 ................... [$10.00] $11.00
28 joint income of $14,001 to $15,000 ................... [$10.00] $11.00
29 joint income of $15,001 to $16,000 ................... [$21.00] $23.00
30 joint income of $16,001 to $17,000 ................... [$26.50] $29.25
31 joint income of $17,001 to $18,000 ................... [$31.50] $34.75
32 joint income of $18,001 to $19,000 ................... [$37.50] $41.25
33 joint income of $19,001 to $20,000 ................... [$43.00] $47.25
34 joint income of $20,001 to $21,000 ................... [$48.50] $53.25
35 joint income of $21,001 to $22,000 ................... [$54.00] $59.50
36 joint income of $22,001 to $23,000 ................... [$59.50] $65.50
37 joint income of $23,001 to $24,000 ................... [$65.00] $71.50
38 joint income of $24,001 to $25,000 ................... [$68.75] $75.75
39 joint income of $25,001 to $26,000 ................... [$75.00] $82.50
40 § 4. Paragraphs (i) and (ii) of subdivision 2 of section 547-h of the
41 executive law, as amended by section 7 of part J of chapter 57 of the
42 laws of 2000, are amended to read as follows:
43 (i) annual personal covered drug expenditures for unmarried individual
44 eligible program participants:
45 individual income of $20,001 to $21,000 .................. [$530] $583
46 individual income of $21,001 to $22,000 .................. [$550] $605
47 individual income of $22,001 to $23,000 .................. [$580] $638
48 individual income of $23,001 to $24,000 .................. [$720] $792
49 individual income of $24,001 to $25,000 .................. [$750] $825
50 individual income of $25,001 to $26,000 .................. [$780] $858
51 individual income of $26,001 to $27,000 .................. [$810] $891
52 individual income of $27,001 to $28,000 .................. [$840] $924
53 individual income of $28,001 to $29,000 .................. [$870] $957
S. 1408 21 A. 2108
1 individual income of $29,001 to $30,000 .................. [$900] $990
2 individual income of $30,001 to $31,000 ................ [$930] $1,023
3 individual income of $31,001 to $32,000 ................ [$960] $1,056
4 individual income of $32,001 to $33,000 .............. [$1,160] $1,276
5 individual income of $33,001 to $34,000 .............. [$1,190] $1,309
6 individual income of $34,001 to $35,000 .............. [$1,230] $1,353
7 (ii) annual personal covered drug expenditures for each married indi-
8 vidual eligible program participant:
9 joint income of $26,001 to $27,000 ....................... [$650] $715
10 joint income of $27,001 to $28,000 ....................... [$675] $743
11 joint income of $28,001 to $29,000 ....................... [$700] $770
12 joint income of $29,001 to $30,000 ....................... [$725] $798
13 joint income of $30,001 to $31,000 ....................... [$900] $990
14 joint income of $31,001 to $32,000 ..................... [$930] $1,023
15 joint income of $32,001 to $33,000 ..................... [$960] $1,056
16 joint income of $33,001 to $34,000 ..................... [$990] $1,089
17 joint income of $34,001 to $35,000 ................... [$1,020] $1,122
18 joint income of $35,001 to $36,000 ................... [$1,050] $1,155
19 joint income of $36,001 to $37,000 ................... [$1,080] $1,188
20 joint income of $37,001 to $38,000 ................... [$1,110] $1,221
21 joint income of $38,001 to $39,000 ................... [$1,140] $1,254
22 joint income of $39,001 to $40,000 ................... [$1,170] $1,287
23 joint income of $40,001 to $41,000 ................... [$1,200] $1,320
24 joint income of $41,001 to $42,000 ................... [$1,230] $1,353
25 joint income of $42,001 to $43,000 ................... [$1,260] $1,386
26 joint income of $43,001 to $44,000 ................... [$1,290] $1,419
27 joint income of $44,001 to $45,000 ................... [$1,320] $1,452
28 joint income of $45,001 to $46,000 ................... [$1,575] $1,733
29 joint income of $46,001 to $47,000 ................... [$1,610] $1,771
30 joint income of $47,001 to $48,000 ................... [$1,645] $1,810
31 joint income of $48,001 to $49,000 ................... [$1,680] $1,848
32 joint income of $49,001 to $50,000 ................... [$1,715] $1,887
33 § 5. Subdivision 1 of section 547-a of the executive law, as amended
34 by chapter 474 of the laws of 1996, is amended to read as follows:
35 1. "Covered drug" shall mean a drug dispensed subject to a legally
36 authorized prescription pursuant to section sixty-eight hundred ten of
37 the education law, and insulin, an insulin syringe, or an insulin
38 needle. Such term shall not include: (a) any drug determined by the
39 commissioner of the federal food and drug administration to be ineffec-
40 tive or unsafe; (b) any drug dispensed in a package, or form of dosage
41 or administration, as to which the state commissioner of health finally
42 determines in accordance with the provisions of section five hundred
43 forty-seven-l of this article that a less expensive package, or form of
44 dosage or administration, is available that is pharmaceutically equiv-
45 alent and equivalent in its therapeutic effect for the general health
46 characteristics of the eligible program participant population; and (c)
47 any device for the aid or correction of vision, or any drug, including
48 vitamins, which is generally available without a physician's
49 prescription. For the purpose of this article, except as otherwise
50 provided herein, a covered drug shall be dispensed in quantities no
51 greater than a thirty day supply or one hundred units, whichever is
52 greater. In the case of a drug dispensed in a form of administration
53 other than a tablet or capsule, the maximum allowed quantity shall be a
54 thirty day supply[; the]. The panel is authorized to approve exceptions
S. 1408 22 A. 2108
1 to these limits, or require prior authorization based on certification
2 of medical indication by the prescriber, for specific products following
3 consideration of recommendations from pharmaceutical or medical experts
4 regarding commonly packaged quantities, unusual forms of administration,
5 length of treatment, health and safety concerns, or cost effectiveness.
6 In the case of a drug prescribed pursuant to section thirty-three
7 hundred thirty-two of the public health law to treat one of the condi-
8 tions that have been enumerated by the commissioner of health pursuant
9 to regulation as warranting the prescribing of greater than a thirty day
10 supply, such drug shall be dispensed in quantities not to exceed a three
11 month supply.
12 § 6. Subparagraph (ii) of paragraph (a) of subdivision 3 of section
13 547-j of the executive law, as amended by section 7 of part C of chapter
14 1 of the laws of 2002, is amended to read as follows:
15 (ii) the program may reimburse for any covered drugs pursuant to
16 subdivisions one and two of this section, [which are rated 1-A by the
17 federal food and drug administration and] for which a rebate agreement
18 does not exist and which are determined by the elderly pharmaceutical
19 insurance coverage panel to be essential to the health of persons
20 participating in the program; and likely to provide effective therapy or
21 diagnosis for a disease not adequately treated or diagnosed by any other
22 covered drug; and which are recommended for reimbursement by the panel
23 and approved by the commissioner of health.
24 § 7. This act shall take effect immediately.
25 PART K
26 Section 1. Subdivision 1 of section 368-a of the social services law
27 is amended by adding two new paragraphs (y) and (z) to read as follows:
28 (y) Notwithstanding any other provision of law, one hundred percent of
29 the amount expended for outpatient drugs provided in accordance with
30 paragraph (g) of subdivision two of section three hundred sixty-five-a
31 of this title, after first deducting therefrom any federal funds proper-
32 ly received or to be received on account thereof.
33 (z) Subject to the provisions of paragraphs (c), (f), (h), (i), (j),
34 (l), (n), (q), (r) and (u) of this subdivision, twenty-six percent of
35 the amount expended for inpatient hospital services provided by a gener-
36 al hospital in accordance with paragraph (b) of subdivision two of
37 section three hundred sixty-five-a of this title and for outpatient
38 hospital and clinic services in a facility under the authority of an
39 operating certificate issued pursuant to article twenty-eight of the
40 public health law in accordance with paragraph (c) of subdivision two of
41 section three hundred sixty-five-a of this title, after first deducting
42 therefrom any federal funds properly received or to be received on
43 account thereof.
44 § 2. Subparagraph (ii) of paragraph (b) of subdivision 9 of section
45 367-a of the social services law, as amended by chapter 19 of the laws
46 of 1998, is amended to read as follows:
47 (ii) if the drug dispensed is a multiple source prescription drug or a
48 brand-name prescription drug for which no specific upper limit has been
49 set by such federal agency, the lower of the estimated acquisition cost
50 of such drug to pharmacies, or the dispensing pharmacy's usual and
51 customary price charged to the general public. Estimated acquisition
52 cost means the average wholesale price of a prescription drug based upon
53 the package size dispensed from, as reported by the prescription drug
S. 1408 23 A. 2108
1 pricing service used by the department, less [ten] fifteen percent ther-
2 eof, and updated monthly by the department.
3 § 3. Paragraph (c) of subdivision 6 of section 367-a of the social
4 services law is amended by adding a new subparagraph (iii) to read as
5 follows:
6 (iii) Notwithstanding any other provision of this paragraph, co-pay-
7 ments charged for each generic prescription drug dispensed shall be
8 $1.00 and for each brand name prescription drug dispensed shall be
9 $3.00.
10 § 4. Paragraph (f) of subdivision 6 of section 367-a of the social
11 services law, as added by chapter 41 of the laws of 1992, is amended to
12 read as follows:
13 (f) (i) In the year commencing April first, nineteen hundred ninety-
14 three and for each year thereafter, and ending in the year concluding on
15 March thirty-first, two thousand three, no recipient shall be required
16 to pay more than a total of one hundred dollars in co-payments required
17 by this subdivision, nor shall reductions in payments as a result of
18 such co-payments exceed one hundred dollars for any recipient.
19 (ii) In the year commencing April first, two thousand three and for
20 each year thereafter, no recipient shall be required to pay more than a
21 total of one hundred fifty dollars in co-payments required by this
22 subdivision, nor shall reductions in payments as a result of such
23 co-payments exceed one hundred fifty dollars for any recipient.
24 § 5. Paragraph (b) of subdivision 6 of section 367-a of the social
25 services law, as added by chapter 41 of the laws of 1992, subparagraph
26 (iii) as amended by chapter 843 of the laws of 1992, is amended to read
27 as follows:
28 (b) Co-payments shall apply to all eligible persons for the services
29 defined in paragraph (d) of this subdivision with the exception of:
30 (i) individuals under twenty-one years of age;
31 (ii) pregnant women;
32 (iii) individuals who are inpatients in a medical facility who have
33 been required to spend all of their income for medical care, except
34 their personal needs allowance or residents of community based residen-
35 tial facilities licensed by the office of mental health or the office of
36 mental retardation and developmental disabilities who have been required
37 to spend all of their income, except their personal needs allowance;
38 (iv) individuals enrolled in health maintenance organizations or other
39 entities which provide comprehensive health services, or other managed
40 care programs for services covered by such programs, except that such
41 persons shall be subject to co-payments as described in subparagraph (v)
42 of paragraph (d) of this subdivision; and
43 (v) any other individuals required to be excluded by federal law or
44 regulations.
45 § 6. Paragraph (a) of subdivision 2 of section 2807-d of the public
46 health law is amended by adding a new subparagraph (v) to read as
47 follows:
48 (v) Notwithstanding any contrary provisions of this paragraph or any
49 other provision of law or regulation to the contrary, for general hospi-
50 tals the assessment shall be seven-tenths of one percent of each general
51 hospital's gross receipts received from all patient care services and
52 other operating income on a cash basis beginning April first, two thou-
53 sand three for hospital or health-related services, including, but not
54 limited to inpatient service, outpatient service, emergency service,
55 referred ambulatory service and ambulatory surgical services, but not
56 including residential health care facilities services or home health
S. 1408 24 A. 2108
1 care services; provided, however, that for all such gross receipts
2 received on or after April first, two thousand four, such assessment
3 shall be fifty-three hundredths of one percent, and further provided
4 that for all such gross receipts received on or after April first, two
5 thousand five, such assessment shall be thirty-five hundredths of one
6 percent and further provided that for all such gross receipts received
7 on and after April first, two thousand six such assessment shall be
8 eighteen hundredths of one percent, and further provided that for all
9 such gross receipts received on or after April first, two thousand
10 seven, such assessment shall be zero.
11 § 7. Paragraph (b) of subdivision 9 of section 2807-d of the public
12 health law, as amended by section 25 of part J of chapter 82 of the laws
13 of 2002, is amended to read as follows:
14 (b) provided, however, that funds accumulated, including income from
15 invested funds, from the [further additional assessment] assessments
16 provided in accordance with subparagraph (v) of paragraph (a) and
17 subparagraphs (iii), (iv), (v) and (vi) of paragraph (b) of subdivision
18 two of this section, including interest and penalties, shall be deposit-
19 ed by the commissioner and credited to a special revenue-other medical
20 assistance account to be established by the comptroller. To the extent
21 of funds appropriated therefor, funds shall be made available for
22 payments under the medical assistance program provided pursuant to title
23 eleven of article five of the social services law;
24 § 8. 1. Notwithstanding paragraph (c) of subdivision 10 of section
25 2807-c of the public health law and section 21 of chapter 1 of the laws
26 of 1999 and any other inconsistent provision of law or regulation to the
27 contrary, in determining rates of payment by state governmental agencies
28 effective for services provided on and after April 1, 2003, for inpa-
29 tient and outpatient services provided by general hospitals and inpa-
30 tient services provided by residential health care facilities pursuant
31 to article 28 of the public health law, for home care services provided
32 by certified home health agencies and long term home health care
33 programs pursuant to article 36 of the public health law, and for
34 personal care services provided pursuant to section 365-a of the social
35 services law, the commissioner of health shall apply no trend factor
36 projections attributable to the period January 1, 2003 through December
37 31, 2003.
38 2. The commissioner of health shall adjust rates of payment to reflect
39 the exclusion pursuant to this section of such specified trend factor
40 projections or adjustments.
41 § 9. Notwithstanding any law, rule or regulation to the contrary,
42 volume adjustments made pursuant to paragraph (e) or (f) of subdivision
43 9 of section 2807-c of the public health law to rates of payment by
44 state governmental agencies for inpatient services provided by a general
45 hospital on and after April 1, 2003, shall not contain any adjustment
46 reflecting a reduction in such general hospital's case mix adjusted
47 patient length of stay for non-Medicare beneficiaries based on a compar-
48 ison of the rate year to 1987.
49 § 10. Subdivision 5 of section 2807-c of the public health law is
50 amended by adding a new paragraph (e) to read as follows:
51 (e) Notwithstanding any inconsistent provision of this section,
52 commencing on and after April first, two thousand three, rates of
53 payment for general hospitals, including hospitals reimbursed pursuant
54 to paragraphs (f) and (k) of subdivision four of this section, for
55 patients eligible for payments made by state governmental agencies shall
56 be reduced by the commissioner to reflect more appropriate reimbursement
S. 1408 25 A. 2108
1 for indirect graduate medical education. Rates shall be reduced by the
2 result of subtracting the amount calculated pursuant to subparagraph (i)
3 of this paragraph from the amount calculated pursuant to subparagraph
4 (ii) of this paragraph:
5 (i) This amount shall equal the product of:
6 (A) the general hospital's group category average inpatient reimbursa-
7 ble operating cost per discharge calculated in accordance with subpara-
8 graph (i) of paragraph (a) of subdivision seven of this section without
9 adjustments made pursuant to subparagraph (ii) of paragraph (c) of
10 subdivision seven of this section; and
11 (B) for the period April first, two thousand three through December
12 thirty-first, two thousand three, the general hospital's indirect teach-
13 ing adjustment percentage determined by the following formula:
14 .405
15 1.72 ((( 1 + r) ) - 1)
16 where "r" equals the hospital's weighted residents and fellows per bed
17 calculated pursuant to subparagraph (iii) of this paragraph, and for
18 those specialty hospitals defined in subparagraph (vi) of this para-
19 graph, where "r" equals the hospital's ratio of residents and fellows
20 per bed calculated pursuant to subparagraph (vii) of this paragraph; or
21 (C) for the period January first, two thousand four through December
22 thirty-first, two thousand four, the general hospital's indirect teach-
23 ing adjustment percentage determined by the following formula:
24 .405
25 1.60 ((( 1 + r) ) - 1)
26 where "r" equals the hospital's weighted residents and fellows per bed
27 calculated pursuant to subparagraph (iii) of this paragraph, and for
28 those specialty hospitals defined in subparagraph (vi) of this para-
29 graph, where "r" equals the hospital's ratio of residents and fellows
30 per bed calculated pursuant to subparagraph (vii) of this paragraph; or
31 (D) for the period January first, two thousand five through December
32 thirty-first, two thousand five, the general hospital's indirect teach-
33 ing adjustment percentage determined by the following formula:
34 .405
35 1.47 ((( 1 + r) ) - 1)
36 where "r" equals the hospital's weighted residents and fellows per bed
37 calculated pursuant to subparagraph (iii) of this paragraph, and for
38 those specialty hospitals defined in subparagraph (vi) of this para-
39 graph, where "r" equals the hospital's ratio of residents and fellows
40 per bed calculated pursuant to subparagraph (vii) of this paragraph; or
41 (E) for periods on and after January first, two thousand six, the
42 general hospital's indirect teaching adjustment percentage determined by
43 the following formula:
44 .405
45 1.35 ((( 1 + r) ) - 1)
46 where "r" equals the hospital's weighted residents and fellows per bed
47 calculated pursuant to subparagraph (iii) of this paragraph, and for
48 those specialty hospitals defined in subparagraph (vi) of this para-
49 graph, where "r" equals the hospital's ratio of residents and fellows
50 per bed calculated pursuant to subparagraph (vii) of this paragraph.
51 (ii) This amount shall equal the product of:
52 (A) the general hospital's group category average inpatient reimbursa-
53 ble operating cost per discharge calculated in accordance with subpara-
54 graph (i) of paragraph (a) of subdivision seven of this section without
55 adjustments made pursuant to subparagraph (ii) of paragraph (c) of
56 subdivision seven of this section; and
S. 1408 26 A. 2108
1 (B) the indirect teaching adjustment percentage determined in accord-
2 ance with rules and regulations adopted by the state hospital review and
3 planning council and approved by the commissioner for purposes of imple-
4 menting subparagraph (ii) of paragraph (c) of subdivision seven of this
5 section and subdivision twenty-five of this section and in effect on
6 July first, nineteen hundred ninety-eight.
7 (iii) Weighted residents and fellows per bed shall be calculated as
8 follows:
9 (A) for each general hospital, the residents and fellows, as defined
10 in subparagraph (iv) of this paragraph, shall be aggregated into the
11 categories defined in rules and regulations adopted by the state hospi-
12 tal review and planning council and approved by the commissioner for
13 purposes of implementing subdivision twenty-five of this section and in
14 effect on July first, nineteen hundred ninety-eight and summed to deter-
15 mine total residents and fellows by category.
16 (B) the total residents and fellows for each category shall be multi-
17 plied by the physician specialty weighting factor for that category set
18 forth in rules and regulations adopted by the state hospital review and
19 planning council and approved by the commissioner for purposes of imple-
20 menting subdivision twenty-five of this section and in effect on July
21 first, nineteen hundred ninety-eight; all categories' results shall be
22 summed, and the result divided by the total residents and fellows to
23 determine the resident weighting factor. Weighted residents and fellows
24 shall be determined by multiplying the resident weighting factor by the
25 lower of (a) the number of residents and fellows, as defined in subpara-
26 graph (iv) of this paragraph, as of September fourth, nineteen hundred
27 ninety, and contained in the survey documents forwarded by the hospital
28 to the department which was to be forwarded no later than November
29 first, nineteen hundred ninety; or (b) the number of residents and
30 fellows for the current rate period. Weighted residents and fellows per
31 bed shall be calculated by dividing the weighted residents and fellows
32 as determined by this subparagraph by the certified beds for the general
33 hospital as of January first, nineteen hundred ninety, excluding exempt
34 unit beds.
35 (iv) For purposes of this paragraph, the number of residents and
36 fellows are those full-time equivalents (FTEs) working in the general
37 hospital or those non-hospital residents and fellows in ambulatory
38 settings that are enrolled in the residency program at such hospital
39 excluding the portion of FTEs assigned to exempt units.
40 (v) The indirect teaching adjustment percentage calculated pursuant to
41 subparagraph (i) of this paragraph shall be weighted based on projected
42 medical education statistics for the general hospital as of July first
43 for the period and subsequently reconciled to the actual allocation of
44 residents and fellows for the period.
45 (vi) Specialty hospitals shall be those hospitals, specified by the
46 commissioner, whose primary care mission is to engage in research,
47 training and clinical care in specialty eye and ear, special surgery,
48 orthopedic, joint disease, cancer, chronic care or rehabilitation
49 services.
50 (vii) The ratio of residents and fellows per bed for those specialty
51 hospitals defined in subparagraph (vi) of this paragraph shall be calcu-
52 lated by dividing:
53 (A) the lower of (a) the number of residents and fellows, as defined
54 in subparagraph (iv) of this paragraph, as of September four, nineteen
55 hundred ninety, and contained in the survey documents forwarded by the
56 hospital to the department which was to be forwarded no later than
S. 1408 27 A. 2108
1 November first, nineteen hundred ninety; or (b) the number of residents
2 and fellows for the current rate period; by
3 (B) the certified beds for the hospital as of January first, nineteen
4 hundred ninety, excluding exempt unit beds.
5 (viii) Discrete rates of payment calculated in accordance with para-
6 graph a-three of subdivision one of this section shall reflect the
7 reduction in rates of payment calculated in accordance with this para-
8 graph.
9 (ix) Hospitals shall furnish to the department such reports and infor-
10 mation required by the commissioner to assess the cost, quality and
11 health system needs for medical education provided.
12 § 11. Subparagraph (iii) of paragraph (b) of subdivision 5 of section
13 2807-c of the public health law, as amended by chapter 81 of the laws of
14 1995, clause (A) as separately amended by chapters 194 and 474 of the
15 laws of 1996, clause (A) as amended by chapter 433 of the laws of 1997,
16 is amended to read as follows:
17 (iii) [(A) Except as provided in clause (B) of this subparagraph and
18 subparagraph (iv) of this paragraph, for annual rate years commencing on
19 or after January first, nineteen hundred ninety, average reimbursable
20 inpatient operating cost per discharge shall be a composite sum of no
21 less than forty-five percent of the general hospital's hospital-specific
22 average reimbursable inpatient operating cost per discharge determined
23 in accordance with paragraph (a) of subdivision six of this section and
24 a percentage amount not to exceed fifty-five percent of the general
25 hospital's group category average inpatient reimbursable operating cost
26 per discharge (price) determined in accordance with paragraph (a) of
27 subdivision seven of this section, such that the composite sum equals
28 one hundred percent.]
29 (A) Except as provided in [clause] clauses (B) and (C) of this subpar-
30 agraph and subparagraphs (iv), (v) and (vi) of this paragraph, for annu-
31 al rate years commencing on or after January first, nineteen hundred
32 ninety, average reimbursable inpatient operating cost per discharge
33 shall be a composite sum of no less than forty-five percent of the
34 general hospital's hospital-specific average reimbursable inpatient
35 operating cost per discharge determined in accordance with paragraph (a)
36 of subdivision six of this section and a percentage amount not to exceed
37 fifty-five percent of the general hospital's group category average
38 inpatient reimbursable operating cost per discharge (price) determined
39 in accordance with paragraph (a) of subdivision seven of this section,
40 such that the composite sum equals one hundred percent.
41 (B) For discharges on or after April first, nineteen hundred ninety-
42 five through March thirty-first, two thousand three, for purposes of
43 reimbursement of inpatient hospital services for patients eligible for
44 payments made by state governmental agencies assigned to one of the
45 twenty most common diagnosis-related groups for all general hospitals,
46 the average reimbursable inpatient operating cost per discharge of a
47 general hospital shall be the lower of (I) the amount determined in
48 accordance with clause (A) of this subparagraph or (II) the average
49 amount determined in accordance with clause (A) of this subparagraph for
50 all general hospitals in the group category to which the hospital is
51 assigned. The twenty most common diagnosis-related groups shall be
52 determined using discharge data for the year two years prior to the rate
53 year for all general hospitals, excluding beneficiaries of title XVIII
54 of the federal social security act (medicare) and patients assigned to
55 [diagnosis related] diagnosis-related groups for human immunodeficiency
56 virus (HIV) infection, acquired immune deficiency syndrome, alcohol/drug
S. 1408 28 A. 2108
1 use or alcohol/drug induced organic mental disorders, and exempt unit or
2 exempt hospital patients.
3 (C) For discharges on and after April first, two thousand three, for
4 purposes of reimbursement of inpatient hospital services for patients
5 eligible for payments made by state governmental agencies, the reimburs-
6 able inpatient operating cost component of case based rates of payment
7 per diagnosis-related group shall be the lower of (I) the average reim-
8 bursable inpatient operating cost per discharge determined in accordance
9 with clause (A) of this subparagraph, or (II) the general hospital's
10 group category average reimbursable inpatient operating cost per
11 discharge determined in accordance with paragraph (a) of subdivision
12 seven of this section. Hospitals reimbursed pursuant to paragraph (f)
13 of subdivision four of this section shall not be subject to the
14 provisions of this clause.
15 § 12. Notwithstanding paragraph (e) of subdivision 4 of section 2807-c
16 of the public health law or any other inconsistent provision of law,
17 rule or regulation to the contrary, for periods on and after April 1,
18 2003, reimbursement for the operating component of the inpatient per-
19 diem hospital rates for general hospitals or distinct units of a general
20 hospital, excluding those general hospitals or distinct units of a
21 general hospital whose primary mission is the treatment of AIDS
22 patients, for patients eligible for payments made by state governmental
23 agencies, shall be reduced by five percent.
24 § 13. Notwithstanding any inconsistent provision of law, rule or
25 regulation, rates or other payments in effect on April 1, 2003, for
26 general hospital outpatient services established in accordance with
27 subparagraph (i) of paragraph (g) of subdivision 2 of section 2807 of
28 the public health law, which have been designated as specialized
29 services for purposes of waiving the maximum allowable payment set forth
30 in such subparagraph or established in accordance with paragraph (e) or
31 (h) of subdivision 2 of section 2807 of the public health law, shall
32 continue in effect, provided, however, that this provision shall not
33 apply to general hospital outpatient clinics whose primary mission is
34 the treatment of AIDS/HIV.
35 § 14. Section 2808 of the public health law is amended by adding a
36 new subdivision 20 to read as follows:
37 20. Notwithstanding any inconsistent provision of law or regulation to
38 the contrary:
39 (a) (i) For services provided by residential health care facilities
40 beginning April first, two thousand three, except for services identi-
41 fied in subparagraph (ii) of this paragraph, and for facilities
42 described in paragraph (d) of this subdivision for purposes of estab-
43 lishing the operating component of rates of payment by governmental
44 agencies, the commissioner shall utilize the lower of the operating
45 component of facility specific certified rates as determined by the
46 department or the average of such operating component for residential
47 health care facilities within the region determined as of January first,
48 two thousand three, trended pursuant to law to the applicable rate peri-
49 od and adjusted for each facility's case mix index. Region shall mean
50 those regions as listed in paragraph (c) of this subdivision. In deter-
51 mining such regional average rate, the commissioner shall equalize the
52 allowable costs of different base year periods used to establish rates
53 within each region.
54 (ii) This subdivision shall not apply to rates paid for residential
55 health care facility services provided to:
S. 1408 29 A. 2108
1 (A) residents residing in a residential health care facility desig-
2 nated as an AIDS residential health care facility or residing in a
3 discrete AIDS unit approved by the commissioner;
4 (B) residents residing in discrete units for the care of patients
5 under the long-term inpatient rehabilitation program for traumatic brain
6 injured patients established pursuant to department regulations;
7 (C) residents residing in department approved discrete units for the
8 care of long-term ventilator dependent residents;
9 (D) residents residing in department approved discrete units specif-
10 ically designated for the purpose of providing specialized programs for
11 residents requiring behavioral interventions; or
12 (E) residents in residential health care facilities or discrete units
13 which provide extensive nursing, medical, psychological and counseling
14 support services solely to children, as determined by the department.
15 (b) The operating component of the rate of payment shall mean all
16 components of the rate except for the capital component.
17 (c) The regions are established as follows:
18 (i) Albany: Albany, Columbia, Greene, Montgomery, Rensselaer, Sarato-
19 ga, Schenectady, Schoharie, and Fulton counties;
20 (ii) Binghamton: Broome, and Tioga counties;
21 (iii) Erie: Cattaraugus, Chautauqua, Erie, Niagara, and Orleans coun-
22 ties;
23 (iv) Elmira: Chemung, Steuben, and Schuyler counties;
24 (v) Glens Falls: Essex, Warren, and Washington counties;
25 (vi) Long Island: Nassau, and Suffolk counties;
26 (vii) Orange: Chenango, Delaware, Orange, Otsego, Sullivan, and
27 Ulster counties;
28 (viii) New York City: Bronx, Kings, Queens, Richmond, and New York
29 counties;
30 (ix) Poughkeepsie: Dutchess, and Putnam counties;
31 (x) Rochester: Livingston, Monroe, Ontario, and Wayne counties;
32 (xi) Central Rural: Cayuga, Cortland, Seneca, Tompkins, and Yates
33 counties;
34 (xii) Syracuse: Madison, and Onondaga counties;
35 (xiii) Utica: Herkimer, Jefferson, Lewis, Oneida, and Oswego counties;
36 (xiv) Westchester: Rockland, and Westchester counties;
37 (xv) Northern Rural: Clinton, Franklin, Hamilton, and St. Lawrence
38 counties; and
39 (xvi) Western Rural: Allegany, Genesee, and Wyoming counties.
40 (d) For any newly constructed residential health care facility which
41 receives establishment approval by the public health council in accord-
42 ance with section twenty-eight hundred one-a of this article on or after
43 April first, two thousand three; any new operator of an ongoing residen-
44 tial health care facility established pursuant to section twenty-eight
45 hundred one-a of this article on or after April first, two thousand
46 three; or any facility in receivership on and after April first, two
47 thousand three, the operating component of the rate of payment shall
48 equal the average of the operating component of certified rates of
49 facilities within its region as determined pursuant to this subdivision.
50 (e) Notwithstanding any inconsistent provision of the state adminis-
51 trative procedure act or any other provision of law or regulation to the
52 contrary, the commissioner is authorized to adopt or amend or promulgate
53 on an emergency basis any regulation the commissioner determines neces-
54 sary to implement any provision of this subdivision.
55 (f) Notwithstanding this subdivision, effective on or after April
56 first, two thousand three, the amount of any governmental agency rate
S. 1408 30 A. 2108
1 reductions effectuated pursuant to this subdivision shall not exceed ten
2 percent of the facility's governmental agency rate of payment in effect
3 as of March thirty-first, two thousand three for patient care services
4 provided by such residential health care facility.
5 § 15. Notwithstanding any inconsistent provision of law or regulation
6 to the contrary, residential health care facility rates of payment
7 determined pursuant to article 28 of the public health law for services
8 provided on and after April 1, 2003 through March 31, 2004, except for
9 the establishment of any statewide or any peer group base, mean, or
10 ceiling prices per day, shall be calculated utilizing only the number of
11 residents properly assessed and reported in each patient classification
12 group and eligible for medical assistance pursuant to title 11 of arti-
13 cle 5 of the social services law.
14 § 16. Notwithstanding any inconsistent provision of law or regulation
15 to the contrary, effective on and after April 1, 2003, the capital cost
16 component of every proprietary residential health care facility rate of
17 payment determined pursuant to article 28 of the public health law shall
18 not include a payment factor to pay an annual rate of return on owner's
19 equity or a payment factor to pay an annual rate of return on average
20 equity capital.
21 § 17. Paragraph (a) of subdivision 2 of section 3614-a of the public
22 health law is amended by adding a new subparagraph (iv) to read as
23 follows:
24 (iv) Notwithstanding any contrary provisions of this paragraph or any
25 other provision of law or regulation to the contrary, for certified home
26 health agencies the assessment shall be six-tenths of one percent of
27 each certified home health agency's gross receipts received from all
28 patient care services and other operating income on a cash basis begin-
29 ning April first, two thousand three for home care services; provided,
30 however, that for all such gross receipts received on or after April
31 first, two thousand four, such assessment shall be forty-five hundredths
32 of one percent, and further provided that for all such gross receipts
33 received on or after April first, two thousand five, such assessment
34 shall be three-tenths of one percent, and further provided that for all
35 such gross receipts received on or after April first, two thousand six,
36 such assessment shall be fifteen-hundredths of one percent, and further
37 provided that for all such gross receipts received on or after April
38 first, two thousand seven, such assessment shall be zero.
39 § 18. Paragraph (b) of subdivision 2 of section 3614-a of the public
40 health law is amended by adding a new subparagraph (iv) to read as
41 follows:
42 (iv) Notwithstanding any contrary provisions of this paragraph or any
43 other provision of law or regulation to the contrary, for long term home
44 health care programs the assessment shall be six-tenths of one percent
45 of each long term home health care program's gross receipts received
46 from all patient care services and other operating income on a cash
47 basis beginning April first, two thousand three for long term home
48 health care services; provided, however, that for all such gross
49 receipts received on or after April first, two thousand four, such
50 assessment shall be forty-five hundredths of one percent, and further
51 provided that for all such gross receipts received on or after April
52 first, two thousand five, such assessment shall be three-tenths of one
53 percent, and further provided that for all such gross receipts received
54 on or after April first, two thousand six, such assessment shall be
55 fifteen-hundredths of one percent, and further provided that for all
S. 1408 31 A. 2108
1 such gross receipts received on or after April first, two thousand
2 seven, such assessment shall be zero.
3 § 19. Subdivision 9 of section 3614-a of the public health law, as
4 added by chapter 938 of the laws of 1990, is amended to read as follows:
5 9. (a) Funds accumulated, including income from invested funds, from
6 the assessments specified in this section, including interest and penal-
7 ties, shall be deposited by the commissioner and credited to the general
8 fund[.];
9 (b) Provided, however, that funds accumulated, including income from
10 invested funds, from the assessment provided in accordance with subpara-
11 graph (iv) of paragraph (a) and subparagraph (iv) of paragraph (b) of
12 subdivision two of this section, including interest and penalties, shall
13 be deposited by the commissioner and credited to a special revenue-other
14 medical assistance account to be established by the comptroller. To the
15 extent of funds appropriated therefor, funds shall be made available for
16 payments under the medical assistance program provided pursuant to title
17 eleven of article five of the social services law.
18 § 20. Subdivision 2 of section 367-i of the social services law, as
19 amended by section 10 of part CC of chapter 407 of the laws of 1999, is
20 amended to read as follows:
21 2. (a) The assessment shall be six-tenths of one percent of each such
22 provider's gross receipts received from all personal care services and
23 other operating income on a cash basis beginning January first, nineteen
24 hundred ninety-one; provided, however, that for all such gross receipts
25 received on or after April first, nineteen hundred ninety-nine, such
26 assessment shall be two-tenths of one percent, and further provided that
27 such assessment shall expire and be of no further effect for all such
28 gross receipts received on or after January first, two thousand.
29 (b) Notwithstanding paragraph (a) of this subdivision, the assessment
30 shall be six-tenths of one percent of each such provider's gross
31 receipts received from all personal care services and other operating
32 income on a cash basis beginning April first, two thousand three;
33 provided, however, that for all such gross receipts received on or after
34 April first, two thousand four, such assessment shall be forty-five
35 hundredths of one percent, and further provided that for all such gross
36 receipts received on or after April first, two thousand five, such
37 assessment shall be three-tenths of one percent, and further provided
38 that for all such gross receipts received on or after April first, two
39 thousand six such assessment shall be fifteen hundredths of one percent,
40 and further provided that for all such gross receipts received on or
41 after April first, two thousand seven, such assessment shall be zero.
42 § 21. Subdivision 8 of section 367-i of the social services law, as
43 added by chapter 938 of the laws of 1990, is amended to read as follows:
44 8. (a) Funds accumulated, including income from invested funds, from
45 the assessments specified in this section, including interest and penal-
46 ties, shall be deposited by the commissioner of health and credited to
47 the general fund[.];
48 (b) Provided, however, that funds accumulated, including income from
49 invested funds, from the assessment provided in accordance with para-
50 graph (b) of subdivision two of this section, including interest and
51 penalties, shall be deposited by the commissioner of health and credited
52 to a special revenue-other medical assistance account to be established
53 by the comptroller. To the extent of funds appropriated therefor, funds
54 shall be made available for payments under the medical assistance
55 program provided pursuant to this title.
S. 1408 32 A. 2108
1 § 22. Subdivision 2 of section 3614-b of the public health law as
2 amended by section 9 of part CC of chapter 407 of the laws of 1999, is
3 amended to read as follows:
4 2. (a) The assessment shall be six-tenths of one percent of such
5 licensed home care services agency's gross receipts received from all
6 patient care services and other operating income on a cash basis begin-
7 ning April first, nineteen hundred ninety-two; provided, however, that
8 for all such gross receipts received on or after April first, nineteen
9 hundred ninety-nine, such assessment shall be two-tenths of one percent,
10 and further provided that such assessment shall expire and be of no
11 further effect for all such gross receipts received on or after January
12 first, two thousand.
13 (b) Notwithstanding any contrary provisions of this paragraph or any
14 other provision of law or regulation to the contrary, for licensed home
15 care services agencies the assessment shall be six-tenths of one percent
16 of each such agency's gross receipts received from all patient care
17 services and other operating income on a cash basis beginning April
18 first, two thousand three for home care services; provided, however,
19 that for all such gross receipts received on or after April first, two
20 thousand four, such assessment shall be forty-five hundredths of one
21 percent, and further provided that for all such gross receipts received
22 on or after April first, two thousand five, such assessment shall be
23 three-tenths of one percent, and further provided that for all such
24 gross receipts received on or after April first, two thousand six, such
25 assessment shall be fifteen-hundredths of one percent, and further
26 provided that for all such gross receipts received on or after April
27 first, two thousand seven, such assessment shall be zero.
28 § 23. Subdivision 9 of section 3614-b of the public health law, as
29 added by chapter 41 of the laws of 1992, is amended to read as follows:
30 9. (a) Funds accumulated, including income from invested funds, from
31 the assessments specified in this section, including interest and penal-
32 ties, shall be deposited by the commissioner and credited to the general
33 fund[.];
34 (b) Provided, however, that funds accumulated, including income from
35 invested funds, from the assessment provided in accordance with para-
36 graph (b) of subdivision two of this section, including interest and
37 penalties, shall be deposited by the commissioner and credited to a
38 special revenue-other medical assistance account to be established by
39 the comptroller. To the extent of funds appropriated therefor, funds
40 shall be made available for payments under the medical assistance
41 program provided pursuant to title eleven of article five of the social
42 services law.
43 § 24. Subdivision 4 of section 3614-a of the public health law, as
44 added by chapter 938 of the laws of 1990, is amended to read as follows:
45 4. The commissioner is authorized to contract with the article forty-
46 three insurance law plans, or such other administrators as the commis-
47 sioner shall designate, to receive and distribute home care provider
48 assessment funds and personal care services provider assessment funds
49 assessed pursuant to section three hundred sixty-seven-i of the social
50 services law. In the event contracts with the article forty-three insur-
51 ance law plans or other commissioner's designees are effectuated, the
52 commissioner shall conduct annual audits of the receipt and distribution
53 of the assessment funds. The reasonable costs and expenses of an admin-
54 istrator as approved by the commissioner, not to exceed for personnel
55 services on an annual basis [two] four hundred thousand dollars for all
56 assessments established pursuant to this section and the personal care
S. 1408 33 A. 2108
1 services provider assessment established pursuant to section three
2 hundred sixty-seven-i of the social services law, shall be paid from the
3 assessment funds.
4 § 25. Paragraph (d) of subdivision 1 of section 367-a of the social
5 services law, as amended by section 22 of part E of chapter 58 of the
6 laws of 1998, is amended to read as follows:
7 (d) [Amounts] (i) Except as provided in subparagraph (ii) of this
8 paragraph, amounts payable under this title for medical assistance for
9 items and services provided to eligible persons who are also benefici-
10 aries under part A and/or part B of title XVIII of the federal social
11 security act and items and services provided to qualified medicare bene-
12 ficiaries under part A of title XVIII of the federal social security act
13 shall not be [less than the amount of any deductible and co-insurance
14 liability of such eligible persons or for which such eligible persons or
15 such qualified medicare beneficiaries would be liable under federal law
16 were they not eligible for medical assistance or were they not qualified
17 medicare beneficiaries with respect to such benefits under such part A
18 and such part B] made to the extent that payment under title XVIII of
19 the federal social security act for the item or service would exceed the
20 amount that otherwise would be made under this title for such item or
21 service if provided to an eligible person other than a person who is
22 also a beneficiary under Part A and/or Part B or who is a qualified
23 medicare beneficiary.
24 (ii) Amounts payable under this title with respect to items and
25 services provided by a facility under the authority of an operating
26 certificate issued pursuant to article sixteen or thirty-one of the
27 mental hygiene law and with respect to services provided to AIDS
28 patients and HIV-positive patients by a clinic licensed pursuant to
29 article twenty-eight of the public health law which is designated in the
30 regulations of the department of health as eligible for special rates
31 for the provision of such services, to eligible persons who are also
32 beneficiaries under Part A and/or Part B of title XVIII of the federal
33 social security act and such items and services provided to qualified
34 medicare beneficiaries under Part A of title XVIII of the federal social
35 security act shall not be less than the amount of any deductible and
36 co-insurance liability of such eligible persons or for which such eligi-
37 ble persons or such qualified medicare beneficiaries would be liable
38 under federal law were they not eligible for medical assistance or were
39 they not qualified medicare beneficiaries with respect to such benefits
40 under such Part A or such Part B.
41 § 26. Notwithstanding the provisions of paragraph (h) of subdivision 1
42 of section 368-a of the social services law, payments made to a district
43 pursuant to such paragraph (h) during the period April 1, 2003 through
44 March 31, 2004, and during each subsequent year commencing April 1 and
45 ending March 31, shall not exceed the payments made to such district
46 during the period January 1, 2002 through December 31, 2002 as adjusted
47 by changes in state medicaid reimbursement percentages as set forth in
48 section 368-a of the social services law between the base year of 2002
49 and the payment years commencing April 1, 2003. Nothing in this section
50 shall prohibit the office of mental health, in consultation with the
51 department of health and subject to the approval of the division of the
52 budget, from expending funds to pay for the local share of medical
53 assistance, or a portion thereof, when such expenditures are for
54 services that were funded by the state in calendar year 2002, and to the
55 extent such expenditures will be offset by the receipt of federal finan-
56 cial participation.
S. 1408 34 A. 2108
1 § 27. Section 20 of part A of chapter 1 of the laws of 2002, amending
2 the public health law, the social services law and the tax law relating
3 to the health care reform act of 2000, as amended by section 19 of part
4 J of chapter 82 of the laws of 2002, is amended to read as follows:
5 § 20. Notwithstanding any law, rule or regulation to the contrary, the
6 commissioner of health shall credit, from the funds collected pursuant
7 to the provisions of sections nineteen and twenty-one of this act, up to
8 five hundred thirty-four million dollars for the state fiscal year
9 beginning April 1, 2002 and ending March 31, 2003 [and up to three
10 hundred fifty-six million dollars for the state fiscal year beginning
11 April 1, 2003 and each state fiscal year thereafter,] to the tobacco
12 control and insurance initiatives pool as established pursuant to
13 section 2807-v of the public health law[. For], and up to three hundred
14 fifty-six million dollars annually for state fiscal years on and after
15 April 1, 2003, to the medical assistance program, general fund/aid to
16 localities, local assistance account-001, provided, however, that for
17 the state fiscal year beginning April 1, 2002 [and each state fiscal
18 year thereafter,] and ending March 31, 2003, all funds collected pursu-
19 ant to sections nineteen and twenty-one of this act which are not cred-
20 ited to the tobacco control and insurance initiatives pool shall be
21 credited to the medical assistance program, general fund/aid to locali-
22 ties, local assistance account - 001.
23 § 28. Paragraph (a) of subdivision 3 of section 2807-d of the public
24 health law, as amended by chapter 41 of the laws of 1992, is amended to
25 read as follows:
26 (a) for general hospitals, all monies received for or on account of
27 inpatient hospital service, outpatient service, emergency service,
28 referred ambulatory service and ambulatory surgical service, or other
29 hospital or health-related services, excluding subject to the provisions
30 of subdivision twelve of this section distributions from bad debt and
31 charity care regional pools, primary health care services regional
32 pools, bad debt and charity care for financially distressed hospitals
33 statewide pools and bad debt and charity care and capital statewide
34 pools created in accordance with section twenty-eight hundred seven-c of
35 this article and the components of rates of payment or charges related
36 to the allowances provided in accordance with subdivisions fourteen,
37 fourteen-b and fourteen-c of section twenty-eight hundred seven-c, the
38 adjustment provided in accordance with subdivision fourteen-a of section
39 twenty-eight hundred seven-c, the adjustment provided in accordance with
40 subdivision fourteen-d of section twenty-eight hundred seven-c, the
41 adjustment for health maintenance organization reimbursement rates
42 provided in accordance with subdivision two-a, the adjustment for
43 [commerical] commercial insurer reimbursement rates provided in accord-
44 ance with paragraph (i) of subdivision eleven or, if effective, the
45 adjustment provided in accordance with subdivision fifteen of section
46 twenty-eight hundred seven-c of this article or the adjustment provided
47 in accordance with section eighteen of chapter two hundred sixty-six of
48 the laws of nineteen hundred eighty-six as amended and physician prac-
49 tice or faculty practice plan revenue received by a general hospital
50 based on discrete billings for private practicing physician services
51 [and], revenue received by a general hospital from a public hospital
52 pursuant to an affiliation agreement contract for the delivery of health
53 care services to such public hospital[;], and revenue received pursuant
54 to sections twelve and fourteen of part A and sections thirteen and
55 fourteen of part B of chapter one of the laws of two thousand two.
S. 1408 35 A. 2108
1 § 29. Paragraph (e) of subdivision 12 of section 2808 of the public
2 health law, as amended by chapter 1 of the laws of 1999, is amended to
3 read as follows:
4 (e) Notwithstanding any inconsistent provision of law or regulation,
5 the commissioner shall provide, in addition to payments established
6 pursuant to this article prior to application of this section, addi-
7 tional payments under the medical assistance program pursuant to title
8 eleven of article five of the social services law for non-state operated
9 public residential health care facilities, including public residential
10 health care facilities located in the county of Nassau and the county of
11 Westchester, but excluding public residential health care facilities
12 operated by a town or city within a county, in an aggregate amount of up
13 to $991.5 million in additional payments each state fiscal year for the
14 period beginning April first, two thousand [through March thirty-first,
15 two thousand three] and annually thereafter.
16 § 30. Paragraph (f) of subdivision 12 of section 2808 of the public
17 health law, as amended by chapter 1 of the laws of 1999, is amended to
18 read as follows:
19 (f) The amount allocated to each eligible public residential health
20 care facility for each period shall be calculated as the result of (A)
21 the total payment for each period multiplied by (B) the ratio of patient
22 days for patients eligible for medical assistance pursuant to title
23 eleven of article five of the social services law provided by the public
24 residential health care facility, divided by the total of such patient
25 days summed for all eligible public residential health care facilities.
26 For the period August first, nineteen hundred ninety-six through March
27 thirty-first, nineteen hundred ninety-seven, nineteen hundred ninety-
28 four patient days shall be utilized; for the period April first, nine-
29 teen hundred ninety-seven through March thirty-first, nineteen hundred
30 ninety-eight, nineteen hundred ninety-five patient days shall be
31 utilized; for the period April first, nineteen hundred ninety-eight
32 through March thirty-first, nineteen hundred ninety-nine, nineteen
33 hundred ninety-six patient days shall be utilized; for the period April
34 first, nineteen hundred ninety-nine through March thirty-first, two
35 thousand, nineteen hundred ninety-seven patient days shall be utilized;
36 for the period April first, two thousand through March thirty-first, two
37 thousand one, nineteen hundred ninety-eight patient days shall be
38 utilized; for the period April first, two thousand one through March
39 thirty-first, two thousand two, nineteen hundred ninety-nine patient
40 days shall be utilized; for the period April first, two thousand two
41 through March thirty-first, two thousand three, two thousand patient
42 days shall be utilized and for each state fiscal year on and after April
43 first, two thousand three patient days from two years prior to each such
44 state fiscal year shall be utilized.
45 § 31. Subdivision 1 of section 212 of chapter 474 of the laws of 1996,
46 amending the education law and other laws relating to rates for residen-
47 tial health care facilities, as amended by section 8 of part B of chap-
48 ter 1 of the laws of 2002, is amended to read as follows:
49 1. (a) Notwithstanding any inconsistent provision of law or regulation
50 to the contrary, effective beginning August 1, 1996, for the period
51 April 1, 1997 through March 31, 1998, April 1, 1998 for the period April
52 1, 1998 through March 31, 1999, August 1, 1999, for the period April 1,
53 1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
54 through March 31, 2001, April 1, 2001, for the period April 1, 2001
55 through March 31, 2002, April 1, 2002, for the period April 1, 2002
56 through March 31, 2003, the department of health is authorized to pay
S. 1408 36 A. 2108
1 public general hospitals, as defined in subdivision 10 of section 2801
2 of the public health law, operated by the state of New York or by the
3 state university of New York or by a county, which shall not include a
4 city with a population of over one million, of the state of New York,
5 and those public general hospitals located in the county of Westchester
6 or the county of Nassau, additional payments for inpatient hospital
7 services as medical assistance payments pursuant to title 11 of article
8 5 of the social services law for patients eligible for federal financial
9 participation under title XIX of the federal social security act in
10 medical assistance pursuant to the federal laws and regulations govern-
11 ing disproportionate share payments to hospitals based on each such
12 public general hospital's medical assistance and uninsured patient loss-
13 es after all other medical assistance, including disproportionate share
14 payments to such public general hospital for 1996, 1997, 1998, and 1999,
15 based initially for 1996 on reported 1994 reconciled data as further
16 reconciled to actual reported 1996 reconciled data, and for 1997 based
17 initially on reported 1995 reconciled data as further reconciled to
18 actual reported 1997 reconciled data, for 1998 based initially on
19 reported 1995 reconciled data as further reconciled to actual reported
20 1998 reconciled data, for 1999 based initially on reported 1995 recon-
21 ciled data as further reconciled to actual reported 1999 reconciled
22 data, for 2000 based initially on reported 1995 reconciled data as
23 further reconciled to actual reported 2000 data, for 2001 based initial-
24 ly on reported 1995 reconciled data as further reconciled to actual
25 reported 2001 data, for 2002 based initially on reported 2000 reconciled
26 data as further reconciled to actual reported 2002 data. The payments
27 may be added to rates of payment or made as aggregate payments to an
28 eligible public general hospital.
29 (b) Notwithstanding any inconsistent provision of law or regulation to
30 the contrary, for state fiscal year periods beginning April 1, 2003 and
31 ending March 31, 2005, the department of health is authorized to pay
32 public general hospitals, as defined in subdivision 10 of section 2801
33 of the public health law, operated by the state of New York or by the
34 state university of New York or by a county, or by a city with a popu-
35 lation of over one million persons, additional payments for inpatient
36 hospital services as medical assistance payments pursuant to title 11 of
37 article 5 of the social services law for patients eligible for federal
38 financial participation under title XIX of the federal social security
39 act in medical assistance pursuant to the federal laws and regulations
40 governing disproportionate share payments to hospitals up to 175 percent
41 of each such public general hospital's medical assistance and uninsured
42 patient losses after all other medical assistance, including dispropor-
43 tionate share payments to such public general hospital, based initially
44 on reported 2000 reconciled data. Such payments for the period ending
45 March 31, 2004 and March 31, 2005 shall be further reconciled to actual
46 reported 2003 and 2004 data respectively, provided, however, that for
47 public general hospitals located in a city with a population of over one
48 million persons, other than hospitals operated by the state of New York
49 or the state university of New York, such payments for the period ending
50 March 31, 2004, shall be further reconciled to actual reported 2003 or
51 2004 data and such payments for the period ending March 31, 2005 shall
52 be further reconciled to actual reported 2004 or 2005 data and further
53 provided that such payments for all eligible hospitals shall be reduced
54 to the extent such payments would result in the exceeding of the
55 disproportionate share allotment limit as set forth in subdivision (f)
56 of section 1923 of the federal social security act, provided, however,
S. 1408 37 A. 2108
1 that such reduction shall be based on each such hospital's proportionate
2 share of the sum of all such payments that would be made without regard
3 to such allotment limit. Such payments may be added to rates of payment
4 or made as aggregate payments to an eligible public general hospital.
5 § 32. Section 75 of part A of chapter 1 of the laws of 2002 amending
6 the public health law, the social services law and the tax law relating
7 to the Health Care Reform Act of 2000, as amended by section 1 of part J
8 of chapter 82 of the laws of 2002, is amended to read as follows:
9 § 75. This act shall take effect April 1, 2002; provided, however, if
10 this act shall become a law after such date it shall take effect imme-
11 diately and shall be deemed to have been in full force and effect on and
12 after April 1, 2002; provided further that sections eleven, twelve,
13 fifteen, sixteen, seventeen, eighteen, twenty-one and twenty-two of this
14 act shall take effect immediately and shall be deemed to have been in
15 full force and effect on and after September 1, 2001; and provided
16 further that sections thirteen and fourteen of this act shall take
17 effect immediately and shall be deemed to have been in full force and
18 effect on and after January 1, 2002; provided further that sections
19 fifty-six, fifty-seven, fifty-eight and sixty-seven of this act shall
20 take effect October 1, 2002; provided further that sections forty-four,
21 forty-five, forty-six, forty-seven, forty-nine through fifty-four, and
22 sixty-one through sixty-six, sixty-seven-a and sixty-eight of this act
23 shall take effect April 1, 2003 provided, however, that the provisions
24 of paragraph (b) of subdivision 2 of section 366-a of the social
25 services law added by section fifty-one of this act shall take effect
26 April 1, 2004, and the commissioner of health may take any steps,
27 including the promulgation of regulations on an emergency basis, which
28 he or she determines to be necessary to implement such provisions on
29 their effective date or as soon as practicable thereafter, and that the
30 amendments to subdivision 2 of section 2511 of the public health law
31 made by sections forty-four and forty-five of this act and subdivision 9
32 of section 2511 of the public health law made by section forty-six of
33 this act shall not affect the expiration of certain provisions of
34 section 2511 of the public health law, and shall expire and be deemed
35 repealed therewith; provided further that section thirty-two of this act
36 shall take effect immediately; provided further that sections thirty,
37 thirty-one and thirty-three of this act shall take effect April 3, 2002
38 and shall apply to all cigarettes possessed in the state by any person
39 for sale and use in the state by any person on and after April 3, 2002
40 and to taxes, interest and penalties collected or received by the
41 commissioner of taxation and finance under sections 471 and 471-a of the
42 tax law on and after such date; provided, however, that the commissioner
43 of taxation and finance shall be authorized on and after this act shall
44 have become a law to take steps necessary to implement these provisions
45 on their effective date; provided further, however, that effective imme-
46 diately, the commissioner of health and the superintendent of insurance
47 may take any steps, including the promulgation of any rules or regu-
48 lations on an emergency basis, which he or she determines to be neces-
49 sary to assure the timely implementation of any provisions of this act.
50 The provisions of this act shall become effective notwithstanding the
51 failure of the commissioner of health or superintendent of insurance to
52 promulgate any rules or regulations implementing this act; and provided
53 further that the amendments to paragraph (a) of subdivision 6 of section
54 2807-s of the public health law made by section twenty-eight of this act
55 and the amendments to paragraphs (c) and (d) of subdivision 3 of section
56 364-j of the social services law made by sections sixty-six, sixty-seven
S. 1408 38 A. 2108
1 and sixty-seven-a of this act shall not affect the repeal of such
2 sections and shall be deemed repealed therewith.
3 § 33. Sections 700, 701, 702 and 703 of the executive law, as added by
4 chapter 551 of the laws of 2002, are amended to read as follows:
5 § 700. Legislative findings and intent. The Americans with Disabili-
6 ties Act requires [New York state to ensure that people of all ages with
7 disabilities reside and function in the most integrated setting possi-
8 ble.] that all public entities shall administer services, programs and
9 activities in the most integrated setting appropriate to the needs of
10 qualified persons with disabilities. This requirement was recognized and
11 upheld by the Supreme Court in the case of Olmstead[, Commissioner,
12 Georgia Department of Human Resources, et al.] v. L.C., [by zimring,
13 guardian ad litem and next friend, et al. (138 F. 3d 893)] 527 U.S. 581
14 (1999). The Olmstead decision held that unjustified institutionalization
15 of persons with disabilities violates the Americans with Disabilities
16 Act, and further held that states are required to provide community
17 based treatment for persons with mental disabilities when the state's
18 treatment professionals determine that such placement is appropriate,
19 the affected persons do not oppose such treatment and, the placement can
20 be reasonably accommodated, taking into account the resources available
21 to the state and to the needs of others with similar disabilities.
22 While New York state provides community supports for people of all ages
23 with disabilities and while the state of New York does operate a home
24 and community-based waiver medicaid program, the legislature hereby
25 finds that New York state [has no centralized mechanism in place to
26 determine whether or not] should evaluate the need to take additional
27 steps to ensure that people of all ages with disabilities are residing
28 in the most integrated setting [possible]. In order to ensure that the
29 state of New York is in compliance with the requirements of the Olmstead
30 decision, the legislature hereby finds that it [is incumbent upon] would
31 be beneficial for New York state to develop and implement a plan to
32 reasonably accommodate the desire of people of all ages with disabili-
33 ties to avoid institutionalization and be appropriately placed in the
34 most integrated setting [possible] and further finds that a most inte-
35 grated setting coordinating council should be established to develop
36 such a plan, and advise and make recommendations to state agencies.
37 § 701. Definitions. As used in this article the following terms shall
38 mean:
39 1. "council" means the most integrated setting coordinating council.
40 2. "disability" means, with respect to an individual:
41 (a) a physical or mental impairment that substantially limits one or
42 more of the major life activities of such individual;
43 (b) a record of such an impairment; or
44 (c) being regarded as having such an impairment.
45 3. "most integrated setting" means a setting that is appropriate to
46 the needs of the individual with the disability and enables that indi-
47 vidual to interact with nondisabled persons to the fullest extent possi-
48 ble. A placement shall be considered the most integrated setting if a
49 determination is made by the state's treatment professionals that such
50 placement is appropriate; the affected individual does not oppose such
51 placement; and the placement can be reasonably accommodated, taking into
52 account the resources available to the state and the needs of others
53 with similar disabilities. Further, any modifications made by state
54 agencies to accommodate such placements shall not fundamentally alter
55 the nature of the affected services or programs.
S. 1408 39 A. 2108
1 § 702. Most integrated setting coordinating council; organization. 1.
2 The most integrated setting coordinating council is hereby created with-
3 in the executive department to have and exercise the functions, powers
4 and duties provided by the provisions of this article and any other
5 provision of law. The council shall be comprised of the commissioners
6 of: the department of health, the office of mental retardation and
7 developmental disabilities, the office of mental health, the department
8 of transportation, the office of children and family services, the
9 office of [alcohol] alcoholism and substance abuse services, the depart-
10 ment of education, and the division of housing and community renewal. In
11 addition, the council shall consist of the director of the office for
12 the aging, a representative from the office of the advocate for persons
13 with disabilities, a representative from the commission on quality of
14 care for the mentally disabled, three consumers of services for individ-
15 uals with disabilities, one to be appointed by the governor, one to be
16 appointed by the temporary president of the senate, and one to be
17 appointed by the speaker of the assembly, three individuals with exper-
18 tise in the field of community services for people of all ages with
19 disabilities, one to be appointed by the governor, one to be appointed
20 by the temporary president of the senate, and one to be appointed by the
21 speaker of the assembly, and three individuals with expertise in or
22 recipients of services available to senior citizens with disabilities,
23 one to be appointed by the governor, one to be appointed by the tempo-
24 rary president of the senate, and one to be appointed by the speaker of
25 the assembly.
26 2. The governor shall appoint the chairperson of the council from
27 among the commissioners of the department of health, the office of
28 mental health, the office of mental retardation and developmental disa-
29 bilities, and the director of the office for the aging [shall rotate as
30 chairperson of the council on a quarterly basis].
31 3. The council shall meet as necessary to carry out its functions,
32 powers and duties, but such meetings shall occur at least once each
33 quarter.
34 § 703. Functions, powers and duties of the council. 1. The council
35 shall develop [and oversee the implementation of] a comprehensive state-
36 wide plan which shall make recommendations to the affected state agen-
37 cies for providing services to individuals of all ages with disabilities
38 in the most integrated setting. Such plan shall be completed within one
39 year of the effective date of this article. Such plan shall include, but
40 not be limited to
41 (a) [the number of] an evaluation of individuals of all ages with
42 disabilities who are currently institutionalized and are eligible for
43 services in community-based settings, [the number of] individuals resid-
44 ing in the community who are dependent on the assistance of community-
45 based services to avoid institutionalization and any improvements neces-
46 sary to be made to current data collection systems or any new data
47 collection initiatives necessary to obtain such information;
48 (b) a description of the current assessment procedures utilized to
49 identify individuals of all ages with disabilities who could benefit
50 from services in a more integrated setting and guidelines for the devel-
51 opment of a [single assessment process for individuals of all ages with
52 disabilities in need of services, to be implemented] comprehensive
53 community-based information and assistance service, coordinated, by one
54 community-based agency in each county with expertise in community-based
55 services for people of all ages with disabilities [through the use of a
56 uniform assessment tool]. Such agency would develop, maintain, and peri-
S. 1408 40 A. 2108
1 odically update a list of community-based services and supports avail-
2 able to individuals with disabilities of all ages, and assist such indi-
3 viduals in obtaining needed services and supports in the most integrated
4 setting;
5 (c) the identification of what community-based services are available
6 to individuals of all ages with disabilities in the state of New York
7 and an assessment of the extent to which these programs are able to
8 serve people in the most integrated settings;
9 (d) the identification of what improvements need to be made to the
10 system of community-based services to [ensure] provide that the system
11 is comprehensive, accessible, meets the needs of persons who are likely
12 to require assistance in order to live in the community and provides
13 high quality, adequate supports for individuals of all ages with disa-
14 bilities;
15 (e) an evaluation of the supports and services available to assist
16 individuals of all ages with disabilities who reside in their own homes
17 with the presence of other family members or other informal caregivers
18 and an evaluation of the supports and services available to address the
19 needs of individuals of all ages with disabilities who reside in their
20 own homes without family members or other informal caregivers;
21 (f) an examination of how the identified community-based supports and
22 services integrate individuals of all ages with disabilities into the
23 community;
24 (g) a review of what funding sources are available to [increase the
25 availability of] provide adequate community-based services to meet needs
26 identified and an analysis of how the varied funding sources available
27 to meet the needs of individuals of all ages with disabilities in the
28 most integrated setting can be organized into a more coherent system of
29 long term care which affords people reasonable and timely access to
30 community-based services;
31 (h) an assessment of how well the current service system [works] is
32 operating for different populations, including but not limited to,
33 elderly people with disabilities, people with physical disabilities,
34 people with developmental disabilities, people with mental illness, and
35 people with HIV and AIDS, and a review of changes that might be desira-
36 ble to make services a reality in the most integrated setting for all
37 populations;
38 (i) an examination of waiting lists which may exist for community-
39 based services and what might be done to ensure that waiting lists are
40 [created and] accurately maintained and that people are [able to come
41 off] placed into community-based services from waiting lists and receive
42 needed community-based services at a reasonable pace;
43 (j) an examination of what information, education, outreach and refer-
44 ral systems might be useful to [ensure] complement community-based
45 information and assistance services to provide that individuals of all
46 ages with disabilities receive the information necessary to make
47 informed choices regarding how their needs can best be met, including
48 the evaluation of the creation of a toll free hotline with information
49 on community-based services for individuals of all ages with disabili-
50 ties;
51 (k) an evaluation of how quality assurance and quality improvement can
52 be conducted effectively as more people of all ages with disabilities
53 live in community settings; and
54 (l) an examination of how the overall system of health and long term
55 care can best be managed so that placement in the most integrated
56 setting [becomes the norm] occurs when appropriate.
S. 1408 41 A. 2108
1 2. The council shall contract with an independent organization with
2 expertise in the provision of community-based services for individuals
3 of all ages with disabilities and with expertise in the area of program
4 evaluation research to conduct an evaluation of the council's plan
5 created pursuant to subdivision one of this section and the implementa-
6 tion of such plan. Such evaluation shall be completed three years after
7 the effective date of this article.
8 3. Each commissioner and director serving on the council shall [ensure
9 that his or her agency implements] evaluate every aspect of the plan
10 developed pursuant to subdivision one of this section which falls under
11 the responsibilities of his or her agency, and submit to the governor
12 and the legislature a proposed operational plan for each such agency
13 designed to implement the most integrated setting plan developed by the
14 council, taking into account the resources available to the state and
15 the needs of other with similar disabilities. Such operational plans
16 will be submitted one year after the submission of the most integrated
17 setting plan and shall be revised to reflect the findings contained in
18 the independent plan evaluation provided for in subdivision two of this
19 section, and thereafter, as needed or requested by the council. The
20 council shall oversee the implementation of the plan created pursuant to
21 subdivision one of this section and shall update such plan as necessary
22 to ensure that waiting lists for community-based services for people of
23 all ages with disabilities are moving at a reasonable pace and to ensure
24 that the state of New York is developing a system of long term care that
25 allows individuals of all ages with disabilities to reside and function
26 in the most integrated setting.
27 4. The council shall provide a report to the governor, the temporary
28 president of the senate and the speaker of the assembly one year after
29 the effective date of this article and annually thereafter. Such report
30 shall detail the plan developed pursuant to subdivision one of this
31 section, any changes made to such plan, all steps taken to implement
32 such plan and their outcome, and any future actions planned.
33 5. The plan to be developed under this article shall not be construed
34 to increase, decrease, or change the statutory authority of any person
35 or entity and shall be implemented consistent with all otherwise appli-
36 cable law.
37 § 34. Subdivisions 2 and 4 of section 246 of chapter 81 of the laws
38 of 1995, amending the public health law and other laws relating to
39 medical reimbursement and welfare reform, as amended by chapter 1 of the
40 laws of 1999, are amended to read as follows:
41 2. Sections five, seven through nine, twelve through fourteen, and
42 eighteen of this act shall be deemed to have been in full force and
43 effect on and after April 1, 1995 through March 31, 1999 and on and
44 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
45 through March 31, 2003 and on and after April 1, 2003 through March 31,
46 2004 and annually thereafter;
47 4. Section one of this act shall be deemed to have been in full force
48 and effect on and after April 1, 1995 through March 31, 1999 and on and
49 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
50 through March 31, 2003 and on and after April 1, 2003 through March 31,
51 2004 and annually thereafter.
52 § 35. Section 194 of chapter 474 of the laws of 1996 amending the
53 education law and other laws relating to rates for residential health
54 care facilities, as amended by section 7 of part A of chapter 57 of the
55 laws of 2000, is amended to read as follows:
S. 1408 42 A. 2108
1 § 194. 1. Notwithstanding any inconsistent provision of law or regu-
2 lation, the trend factors used to project reimbursable operating costs
3 to the rate period for purposes of determining rates of payment pursuant
4 to article 28 of the public health law for residential health care
5 facilities for reimbursement of inpatient services provided to patients
6 eligible for payments made by state governmental agencies on and after
7 April 1, 1996 through March 31, 1999 and for payments made on and after
8 July 1, 1999 through March 31, 2000 and on and after April 1, 2000
9 through March 31, 2003 and on and after April 1, 2003 through March 31,
10 2004 and annually thereafter shall reflect no trend factor projections
11 or adjustments for the period April 1, 1996, through March 31, 1997.
12 2. The commissioner of health shall adjust such rates of payment to
13 reflect the exclusion pursuant to this section of such specified trend
14 factor projections or adjustments.
15 § 36. Notwithstanding any inconsistent provision of law, rule or regu-
16 lation to the contrary, the provisions of section 1 of chapter 41 of the
17 laws of 1992, as amended, shall remain and be in full force and effect
18 on and after April 1, 2000 through March 31, 2003 and on and after April
19 1, 2003 through March 31, 2004 and annually thereafter.
20 § 37. Subdivision 5-a of section 246 of chapter 81 of the laws of
21 1995, amending the public health law and other laws relating to medical
22 reimbursement and welfare reform, as amended by chapter 1 of the laws of
23 1999, is amended to read as follows:
24 5-a. Section sixty-four-a of this act shall be deemed to have been in
25 full force and effect on and after April 1, 1995 through March 31, 1999
26 and on and after July 1, 1999 through March 31, 2000 and on and after
27 April 1, 2000 through March 31, 2003 and on and after April 1, 2003
28 through March 31, 2004 and annually thereafter;
29 § 38. Section 64-b of chapter 81 of the laws of 1995, amending the
30 public health law and other laws relating to medical reimbursement and
31 welfare reform, as amended by chapter 1 of the laws of 1999, is amended
32 to read as follows:
33 § 64-b. Notwithstanding any inconsistent provision of law, the
34 provisions of subdivision 7 of section 3614 of the public health law, as
35 amended, shall remain and be in full force and effect on April 1, 1995
36 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
37 and after April 1, 2000 through March 31, 2003 and on and after April 1,
38 2003 through March 31, 2004 and annually thereafter.
39 § 39. Section 4 of chapter 81 of the laws of 1995, amending the public
40 health law and other laws relating to medical reimbursement and welfare
41 reform, as amended by chapter 1 of the laws of 1999, is amended to read
42 as follows:
43 § 4. Notwithstanding any inconsistent provision of law, except subdi-
44 vision 15 of section 2807 of the public health law and section 364-j-2
45 of the social services law and section 32-g of part F of chapter 412 of
46 the laws of 1999, rates of payment for diagnostic and treatment centers
47 established in accordance with paragraphs (b) and (h) of subdivision 2
48 of section 2807 of the public health law for the period ending September
49 30, 1995 shall continue in effect through September 30, 2000 and for the
50 periods October 1, 2000 through September 30, 2003 and October 1, 2003
51 through September 30, 2004 and annually thereafter and further provided
52 that rates in effect on March 31, 2003 as established in accordance with
53 paragraph (e) of subdivision 2 of section 2807 of the public health law
54 shall continue in effect for the period April 1, 2003 through September
55 30, 2003 and annually thereafter.
S. 1408 43 A. 2108
1 § 40. Subdivision 5 of section 246 of chapter 81 of the laws of 1995,
2 amending the public health law and other laws relating to medical
3 reimbursement and welfare reform, as amended by chapter 1 of the laws of
4 1999, is amended to read as follows:
5 5. Section three of this act shall be deemed to have been in full
6 force and effect on and after April 1, 1995 through March 31, 1999 and
7 on and after July 1, 1999 through March 31, 2000 and on and after April
8 1, 2000 through March 31, 2003 and on and after April 1, 2003 through
9 March 31, 2004 and annually thereafter;
10 § 41. The opening paragraph and paragraph (a) of subdivision 16 of
11 section 2808 of the public health law, as amended by chapter 1 of the
12 laws of 1999, are amended to read as follows:
13 Notwithstanding any inconsistent provision of law or regulation to the
14 contrary, residential health care facility rates of payment determined
15 pursuant to this article for governmental agencies for services provided
16 on or after April first, nineteen hundred ninety-six through March thir-
17 ty-first, nineteen hundred ninety-nine and on or after July first, nine-
18 teen hundred ninety-nine through March thirty-first, two thousand and on
19 and after April first, two thousand through March thirty-first, two
20 thousand three and on and after April first, two thousand three through
21 March thirty-first, two thousand four and annually thereafter, shall be
22 further reduced by the commissioner to encourage improved productivity
23 and efficiency by providers by a factor determined as follows:
24 (a) an aggregate reduction shall be calculated for each residential
25 health care facility commencing April first, nineteen hundred ninety-six
26 through March thirty-first, nineteen hundred ninety-nine and on or after
27 July first, nineteen hundred ninety-nine through March thirty-first, two
28 thousand and on and after April first, two thousand through March thir-
29 ty-first, two thousand three and on and after April first, two thousand
30 three through March thirty-first, two thousand four and annually there-
31 after as the result of (i) fifty-six million dollars on an annualized
32 basis multiplied by (ii) the ratio of patient days for patients eligible
33 for payments made by governmental agencies provided in a base year two
34 years prior to the rate year by a residential health care facility, or
35 for residential health care facility beds not fully in operation in such
36 base year by an estimate of projected utilization for the rate year,
37 divided by the total of such patient days summed for all residential
38 health care facilities; and
39 § 42. Paragraph (a) of subdivision 14 of section 2808 of the public
40 health law, as amended by section 1 of part H of chapter 57 of the laws
41 of 2000, is amended to read as follows:
42 (a) Notwithstanding any inconsistent provision of law or regulation to
43 the contrary, for purposes of establishing rates of payment by govern-
44 mental agencies for residential health care facilities for services
45 provided on or after April first, nineteen hundred ninety-five through
46 March thirty-first, nineteen hundred ninety-nine and for services
47 provided on or after July first, nineteen hundred ninety-nine through
48 March thirty-first, two thousand and on and after April first, two thou-
49 sand through March thirty-first, two thousand three and on and after
50 April first, two thousand three through March thirty-first, two thousand
51 four and annually thereafter, the reimbursable base year administrative
52 services and fiscal services costs, as defined in the New York state
53 residential health care facility accounting and reporting manual, of a
54 residential health care facility, excluding a provider of services reim-
55 bursed on an initial budget basis, shall, except as otherwise provided
56 in this subdivision, not exceed the statewide average of total reimburs-
S. 1408 44 A. 2108
1 able base year administrative and fiscal services costs of residential
2 health care facilities. For the purposes of this subdivision, reimbursa-
3 ble base year administrative and fiscal services costs shall mean those
4 base year administrative and fiscal services costs remaining after
5 application of all other efficiency standards, including but not limited
6 to, peer group cost ceilings or guidelines.
7 § 43. Paragraph (b) of subdivision 14 of section 2808 of the public
8 health law, as added by section 1 of part H of chapter 57 of the laws of
9 2000, is amended to read as follows:
10 (b) A separate statewide average of total reimbursable base year
11 administrative and fiscal services costs shall be determined for each of
12 those facilities wherein eighty percent or more of its patients are
13 classified with a patient acuity equal to or less than .83 which is used
14 as the basis for a facility's case mix adjustment. For the period July
15 first, two thousand through March thirty-first, two thousand one, the
16 total reimbursable base year administrative and fiscal services costs of
17 such facilities shall not exceed such separate statewide average plus
18 one and one-half percentage points. For annual periods thereafter
19 [through March thirty-first, two thousand three,] the total reimbursable
20 base year administrative and fiscal services costs of such facilities
21 shall not exceed such separate statewide average. In no event shall the
22 calculation of such separate statewide average result in a change in the
23 statewide average determined under paragraph (a) of this subdivision.
24 § 44. Paragraph (f) of subdivision 1 of section 64 of chapter 81 of
25 the laws of 1995, amending the public health law and other laws relating
26 to medical reimbursement and welfare reform, as added by chapter 1 of
27 the laws of 1999, is amended to read as follows:
28 (f) Prior to February 1, 2001, February 1, 2002, February 1, 2003
29 [and], February 1, 2004, and February 1 of each year thereafter, the
30 commissioner of health shall calculate the result of the statewide total
31 of residential health care facility days of care provided to benefici-
32 aries of title XVIII of the federal social security act (medicare),
33 divided by the sum of such days of care plus days of care provided to
34 residents eligible for payments pursuant to title 11 of article 5 of the
35 social services law minus the number of days provided to residents
36 receiving hospice care, expressed as a percentage, for the period
37 commencing January 1, through November 30, of the prior year respective-
38 ly, based on such data for such period. This value shall be called the
39 2000, 2001, 2002, [and] 2003, and each year thereafter statewide target
40 percentage respectively.
41 § 45. Paragraph (b) of subdivision 3 of section 64 of chapter 81 of
42 the laws of 1995, amending the public health law and other laws relating
43 to medical reimbursement and welfare reform, as amended by chapter 1 of
44 the laws of 1999, is amended to read as follows:
45 (b) (i) If the 1996 statewide target percentage is not at least two
46 percentage points higher than the statewide base percentage, the commis-
47 sioner of health shall determine the percentage by which the 1996 state-
48 wide target percentage is not at least two percentage points higher than
49 the statewide base percentage. The percentage calculated pursuant to
50 this paragraph shall be called the 1996 statewide reduction percentage.
51 If the 1996 statewide target percentage is at least two percentage
52 points higher than the statewide base percentage, the 1996 statewide
53 reduction percentage shall be zero.
54 (ii) If the 1997, 1998, 2000, 2001, 2002 [and], 2003, and each year
55 thereafter statewide target percentages are not for each year at least
56 three percentage points higher than the statewide base percentage, the
S. 1408 45 A. 2108
1 commissioner of health shall determine the percentage by which the
2 statewide target percentage for each year is not at least three percent-
3 age points higher than the statewide base percentage. The percentage
4 calculated pursuant to this paragraph shall be called the 1997, 1998,
5 2000, 2001, 2002 [or], 2003, and each year thereafter statewide
6 reduction percentage respectively. If the 1997, 1998, 2000, 2001, 2002
7 [or], 2003, and each year thereafter statewide target percentage for the
8 respective year is at least three percentage points higher than the
9 statewide base percentage, the statewide reduction percentage for the
10 respective year shall be zero.
11 (iii) If the 1999 statewide target percentage is not at least two and
12 one-quarter percentage points higher than the statewide base percentage,
13 the commissioner of health shall determine the percentage by which the
14 1999 statewide target percentage is not at least two and one-quarter
15 percentage points higher than the statewide base percentage. The
16 percentage calculated pursuant to this paragraph shall be called the
17 1999 statewide reduction percentage. If the 1999 statewide target
18 percentage is at least two and one-quarter percentage points higher than
19 the statewide base percentage, the 1999 statewide reduction percentage
20 shall be zero.
21 § 46. Paragraph (b) of subdivision 4 of section 64 of chapter 81 of
22 the laws of 1995, amending the public health law and other laws relating
23 to medical reimbursement and welfare reform, as amended by chapter 1 of
24 the laws of 1999, is amended to read as follows:
25 (b) (i) The 1996 statewide reduction percentage shall be multiplied by
26 sixty-eight million dollars to determine the 1996 statewide aggregate
27 reduction amount. If the 1996 statewide reduction percentage shall be
28 zero, there shall be no 1996 reduction amount.
29 (ii) The 1997 statewide reduction percentage shall be multiplied by
30 one hundred two million dollars to determine the 1997 statewide aggre-
31 gate reduction amount. If the 1997 statewide reduction percentage shall
32 be zero, there shall be no 1997 reduction amount.
33 (iii) The 1998, 2000, 2001, 2002 [and], 2003, and each year thereafter
34 statewide reduction percentage shall be multiplied by one hundred two
35 million dollars respectively to determine the 1998, 2000, 2001, 2002
36 [or], 2003, and each year thereafter statewide aggregate reduction
37 amount. If the 1998 and the 2000, 2001, 2002 [and], 2003, and each year
38 thereafter statewide reduction percentage shall be zero respectively,
39 there shall be no 1998, 2000, 2001, 2002 [or], 2003, and each year ther-
40 eafter reduction amount.
41 (iv) The 1999 statewide reduction percentage shall be multiplied by
42 seventy-six million five hundred thousand dollars to determine the 1999
43 statewide aggregate reduction amount. If the 1999 statewide reduction
44 percentage shall be zero, there shall be no 1999 reduction amount.
45 § 47. Paragraph (b) of subdivision 5 of section 64 of chapter 81 of
46 the laws of 1995, amending the public health law and other laws relating
47 to medical reimbursement and welfare reform, as amended by chapter 1 of
48 the laws of 1999, is amended to read as follows:
49 (b) The 1996, 1997, 1998, 1999, 2000, 2001, 2002 [and], 2003, and each
50 year thereafter statewide aggregate reduction amounts shall for each
51 year be allocated by the commissioner of health among residential health
52 care facilities that are eligible to provide services to beneficiaries
53 of title XVIII of the federal social security act (medicare) and resi-
54 dents eligible for payments pursuant to title 11 of article 5 of the
55 social services law on the basis of the extent of each facility's fail-
56 ure to achieve a two percentage points increase in the 1996 target
S. 1408 46 A. 2108
1 percentage, a three percentage point increase in the 1997, 1998, 2000,
2 2001, 2002 [and], 2003, and each year thereafter target percentage and a
3 two and one-quarter percentage point increase in the 1999 target
4 percentage for each year, compared to the base percentage, calculated on
5 a facility specific basis for this purpose, compared to the statewide
6 total of the extent of each facility's failure to achieve a two percent-
7 age points increase in the 1996 and a three percentage point increase in
8 the 1997 and a three percentage point increase in the 1998 and a two and
9 one-quarter percentage point increase in the 1999 target percentage and
10 a three percentage point increase in the 2000, 2001, 2002 [and], 2003,
11 and each year thereafter target percentage compared to the base percent-
12 age. These amounts shall be called the 1996, 1997, 1998, 1999, 2000,
13 2001, 2002 [and], 2003, and each year thereafter facility specific
14 reduction amounts respectively.
15 § 48. Section 228 of chapter 474 of the laws of 1996, amending the
16 education law and other laws relating to rates for residential health
17 care facilities, as amended by chapter 1 of the laws of 1999, is amended
18 to read as follows:
19 § 228. 1. Definitions. (a) Regions, for purposes of this section,
20 shall mean a downstate region to consist of Kings, New York, Richmond,
21 Queens, Bronx, Nassau and Suffolk counties and an upstate region to
22 consist of all other New York state counties. A certified home health
23 agency or long term home health care program shall be located in the
24 same county utilized by the commissioner of health for the establishment
25 of rates pursuant to article 36 of the public health law.
26 (b) Certified home health agency (CHHA) shall mean such term as
27 defined in section 3602 of the public health law.
28 (c) Long term home health care program (LTHHCP) shall mean such term
29 as defined in subdivision 8 of section 3602 of the public health law.
30 (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
31 ly, located within a region.
32 (e) Medicaid revenue percentage, for purposes of this section, shall
33 mean CHHA and LTHHCP revenues attributable to services provided to
34 persons eligible for payments pursuant to title 11 of article 5 of the
35 social services law divided by such revenues plus CHHA and LTHHCP reven-
36 ues attributable to services provided to beneficiaries of Title XVIII of
37 the federal social security act (medicare).
38 (f) Base period, for purposes of this section, shall mean calendar
39 year 1995.
40 (g) Target period. For purposes of this section, the 1996 target peri-
41 od shall mean August 1, 1996 through March 31, 1997, the 1997 target
42 period shall mean January 1, 1997 through November 30, 1997, the 1998
43 target period shall mean January 1, 1998 through November 30, 1998, the
44 1999 target period shall mean January 1, 1999 through November 30, 1999,
45 the 2000 target period shall mean January 1, 2000 through November 30,
46 2000, the 2001 target period shall mean January 1, 2001 through November
47 30, 2001, the 2002 target period shall mean January 1, 2002 through
48 November 30, 2002, [and] the 2003 target period shall mean January 1,
49 2003 through November 30, 2003, and each year thereafter the target
50 period shall be January 1 through November 30 for that respective year.
51 2. (a) Prior to February 1, 1997, for each regional group the commis-
52 sioner of health shall calculate the 1996 medicaid revenue percentages
53 for the period commencing August 1, 1996 to the last date for which such
54 data is available and reasonably accurate.
55 (b) Prior to February 1, 1998, prior to February 1, 1999, prior to
56 February 1, 2000, prior to February 1, 2001, prior to February 1, 2002,
S. 1408 47 A. 2108
1 prior to February 1, 2003, [and] prior to February 1, 2004, and prior to
2 February 1 of each year thereafter for each regional group the commis-
3 sioner of health shall calculate the prior year's medicaid revenue
4 percentages for the period commencing January 1 through November 30 of
5 such prior year.
6 3. By September 15, 1996, for each regional group the commissioner of
7 health shall calculate the base period medicaid revenue percentage.
8 4. (a) For each regional group, the 1996 target medicaid revenue
9 percentage shall be calculated by subtracting the 1996 medicaid revenue
10 reduction percentages from the base period medicaid revenue percentages.
11 The 1996 medicaid revenue reduction percentage, taking into account
12 regional and program differences in utilization of medicaid and medicare
13 services, for the following regional groups shall be equal to:
14 (i) one and one-tenth percentage points for CHHAs located within the
15 downstate region;
16 (ii) six-tenths of one percentage point for CHHAs located within the
17 upstate region;
18 (iii) one and eight-tenths percentage points for LTHHCPs located with-
19 in the downstate region; and
20 (iv) one and seven-tenths percentage points for LTHHCPs located within
21 the upstate region.
22 (b) For 1997, 1998, 2000, 2001, 2002, [and] 2003, and each year there-
23 after for each regional group, the target medicaid revenue percentage
24 for the respective year shall be calculated by subtracting the respec-
25 tive year's medicaid revenue reduction percentage from the base period
26 medicaid revenue percentage. The medicaid revenue reduction percentages
27 for 1997, 1998, 2000, 2001, 2002 [and], 2003, and each year thereafter
28 taking into account regional and program differences in utilization of
29 medicaid and medicare services, for the following regional groups shall
30 be equal to for each such year:
31 (i) one and one-tenth percentage points for CHHAs located within the
32 downstate region;
33 (ii) six-tenths of one percentage point for CHHAs located within the
34 upstate region;
35 (iii) one and eight-tenths percentage points for LTHHCPs located with-
36 in the downstate region; and
37 (iv) one and seven-tenths percentage points for LTHHCPs located within
38 the upstate region.
39 (c) For each regional group, the 1999 target medicaid revenue percent-
40 age shall be calculated by subtracting the 1999 medicaid revenue
41 reduction percentage from the base period medicaid revenue percentage.
42 The 1999 medicaid revenue reduction percentages, taking into account
43 regional and program differences in utilization of medicaid and medicare
44 services, for the following regional groups shall be equal to:
45 (i) eight hundred twenty-five thousandths (.825) of one percentage
46 point for CHHAs located within the downstate region;
47 (ii) forty-five hundredths (.45) of one percentage point for CHHAs
48 located within the upstate region;
49 (iii) one and thirty-five hundredths percentage points (1.35) for
50 LTHHPs located within the downstate region; and
51 (iv) one and two hundred seventy-five thousandths percentage points
52 (1.275) for LTHHCPs located within the upstate region.
53 5. (a) For each regional group, if the 1996 medicaid revenue percent-
54 age is not equal to or less than the 1996 target medicaid revenue
55 percentage, the commissioner of health shall compare the 1996 medicaid
56 revenue percentage to the 1996 target medicaid revenue percentage to
S. 1408 48 A. 2108
1 determine the amount of the shortfall which, when divided by the 1996
2 medicaid revenue reduction percentage, shall be called the 1996
3 reduction factor. These amounts, expressed as a percentage, shall not
4 exceed one hundred percent. If the 1996 medicaid revenue percentage is
5 equal to or less than the 1996 target medicaid revenue percentage, the
6 1996 reduction factor shall be zero.
7 (b) For 1997, 1998, 1999, 2000, 2001, 2002, [and] 2003, and each year
8 thereafter for each regional group, if the medicaid revenue percentage
9 for the respective year is not equal to or less than the target medicaid
10 revenue percentage for such respective year, the commissioner of health
11 shall compare such respective year's medicaid revenue percentage to such
12 respective year's target medicaid revenue percentage to determine the
13 amount of the shortfall which, when divided by the respective year's
14 medicaid revenue reduction percentage, shall be called the reduction
15 factor for such respective year. These amounts, expressed as a percent-
16 age, shall not exceed one hundred percent. If the medicaid revenue
17 percentage for a particular year is equal to or less than the target
18 medicaid revenue percentage for that year, the reduction factor for that
19 year shall be zero.
20 6. (a) For each regional group, the 1996 reduction factor shall be
21 multiplied by the following amounts to determine each regional group's
22 applicable 1996 state share reduction amount:
23 (i) two million three hundred ninety thousand dollars ($2,390,000) for
24 CHHAs located within the downstate region;
25 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
26 within the upstate region;
27 (iii) one million two hundred seventy thousand dollars ($1,270,000)
28 for LTHHCPs located within the downstate region; and
29 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
30 located within the upstate region.
31 For each regional group reduction, if the 1996 reduction factor shall
32 be zero, there shall be no 1996 state share reduction amount.
33 (b) For 1997, 1998, 2000, 2001, 2002, [and] 2003, and each year there-
34 after for each regional group, the reduction factor for the respective
35 year shall be multiplied by the following amounts to determine each
36 regional group's applicable state share reduction amount for such
37 respective year:
38 (i) two million three hundred ninety thousand dollars ($2,390,000) for
39 CHHAs located within the downstate region;
40 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
41 within the upstate region;
42 (iii) one million two hundred seventy thousand dollars ($1,270,000)
43 for LTHHCPs located within the downstate region; and
44 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
45 located within the upstate region.
46 For each regional group reduction, if the reduction factor for a
47 particular year shall be zero, there shall be no state share reduction
48 amount for such year.
49 (c) For each regional group, the 1999 reduction factor shall be multi-
50 plied by the following amounts to determine each regional group's appli-
51 cable 1999 state share reduction amount:
52 (i) one million seven hundred ninety-two thousand five hundred dollars
53 $1,792,500) for CHHAs located within the downstate region;
54 (ii) five hundred sixty-two thousand five hundred dollars ($562,500)
55 for CHHAs located within the upstate region;
S. 1408 49 A. 2108
1 (iii) nine hundred fifty-two thousand five hundred dollars ($952,500)
2 for LTHHCPs located within the downstate region; and
3 (iv) four hundred forty-two thousand five hundred dollars ($442,500)
4 for LTHHCPs located within the upstate region.
5 For each regional group reduction, if the 1999 reduction factor shall
6 be zero, there shall be no 1999 state share reduction amount.
7 7. (a) For each regional group, the 1996 state share reduction amount
8 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
9 on the basis of the extent of each CHHA's and LTHHCP's failure to
10 achieve the 1996 target medicaid revenue percentage, calculated on a
11 provider specific basis utilizing revenues for this purpose, expressed
12 as a proportion of the total of each CHHA's and LTHHCP's failure to
13 achieve the 1996 target medicaid revenue percentage within the applica-
14 ble regional group. This proportion shall be multiplied by the applica-
15 ble 1996 state share reduction amount calculation pursuant to paragraph
16 (a) of subdivision 6 of this section. This amount shall be called the
17 1996 provider specific state share reduction amount.
18 (b) For 1997, 1998, 1999, 2000, 2001, 2002, [and] 2003, and each year
19 thereafter for each regional group, the state share reduction amount for
20 the respective year shall be allocated by the commissioner of health
21 among CHHAs and LTHHCPs on the basis of the extent of each CHHA's and
22 LTHHCP's failure to achieve the target medicaid revenue percentage for
23 the applicable year, calculated on a provider specific basis utilizing
24 revenues for this purpose, expressed as a proportion of the total of
25 each CHHA's and LTHHCP's failure to achieve the target medicaid revenue
26 percentage for the applicable year within the applicable regional group.
27 This proportion shall be multiplied by the applicable year's state share
28 reduction amount calculation pursuant to paragraph (b) or (c) of subdi-
29 vision 6 of this section. This amount shall be called the provider
30 specific state share reduction amount for the applicable year.
31 8. (a) The 1996 provider specific state share reduction amount shall
32 be due to the state from each CHHA and LTHHCP and may be recouped by the
33 state by March 31, 1997 in a lump sum amount or amounts from payments
34 due to the CHHA and LTHHCP pursuant to title 11 of article 5 of the
35 social services law.
36 (b) The provider specific state share reduction amount for 1997, 1998,
37 1999, 2000, 2001, 2002 [and], 2003, and each year thereafter respective-
38 ly, shall be due to the state from each CHHA and LTHHCP and each year
39 the amount due for such year may be recouped by the state by March 31 of
40 the following year in a lump sum amount or amounts from payments due to
41 the CHHA and LTHHCP pursuant to title 11 of article 5 of the social
42 services law.
43 9. CHHAs and LTHHCPs shall submit such data and information at such
44 times as the commissioner of health may require for purposes of this
45 section. The commissioner of health may use data available from third-
46 party payors.
47 10. On or about June 1, 1997, for each regional group the commissioner
48 of health shall calculate for the period August 1, 1996 through March
49 31, 1997 a medicaid revenue percentage, a reduction factor, a state
50 share reduction amount, and a provider specific state share reduction
51 amount in accordance with the methodology provided in paragraph (a) of
52 subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
53 sion 6 and paragraph (a) of subdivision 7 of this section. The provider
54 specific state share reduction amount calculated in accordance with this
55 subdivision shall be compared to the 1996 provider specific state share
56 reduction amount calculated in accordance with paragraph (a) of subdivi-
S. 1408 50 A. 2108
1 sion 7 of this section. Any amount in excess of the amount determined in
2 accordance with paragraph (a) of subdivision 7 of this section shall be
3 due to the state from each CHHA and LTHHCP and may be recouped in
4 accordance with paragraph (a) of subdivision 8 of this section. If the
5 amount is less than the amount determined in accordance with paragraph
6 (a) of subdivision 7 of this section, the difference shall be refunded
7 to the CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
8 and LTHHCPs shall submit data for the period August 1, 1996 through
9 March 31, 1997 to the commissioner of health by April 15, 1997.
10 11. If a CHHA or LTHHCP fails to submit data and information as
11 required for purposes of this section:
12 (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
13 caid revenue percentage between the applicable base period and the
14 applicable target period for purposes of the calculations pursuant to
15 this section; and
16 (b) the commissioner of health shall reduce the current rate paid to
17 such CHHA and such LTHHCP by state governmental agencies pursuant to
18 article 36 of the public health law by one percent for a period begin-
19 ning on the first day of the calendar month following the applicable due
20 date as established by the commissioner of health and continuing until
21 the last day of the calendar month in which the required data and infor-
22 mation are submitted.
23 12. The commissioner of health shall inform in writing the director of
24 the budget and the chair of the senate finance committee and the chair
25 of the assembly ways and means committee of the results of the calcu-
26 lations pursuant to this section.
27 § 49. Notwithstanding any inconsistent provision of law, rule or regu-
28 lation, the annual percentage reductions set forth in sections forty-
29 four through forty-eight of this act shall be prorated by the commis-
30 sioner of health for the period January 1, 2000 through March 31, 2003
31 and each respective year thereafter.
32 § 50. Section 3 of chapter 629 of the laws of 1986, amending the
33 social services law relating to establishing a demonstration program for
34 the delivery of long-term home health care services to certain persons,
35 as amended by chapter 1 of the laws of 1999, is amended to read as
36 follows:
37 § 3. This act shall take effect July 1, 1986[, and shall remain in
38 effect until March 31, 2003, when upon such date the provisions of this
39 act shall be deemed repealed].
40 § 51. Paragraph (x) of section 165 of chapter 41 of the laws of 1992
41 amending the public health law and other laws relating to assessing
42 certain healthcare providers, is REPEALED.
43 § 52. The opening paragraph, subdivisions 2, 3, 4, 5 and 6 of section
44 36 of chapter 433 of the laws of 1997, amending the public health law
45 and other laws relating to the rate of reimbursement paid to hospitals
46 and residential health care facilities, as amended by chapter 1 of the
47 laws of 1999, are amended to read as follows:
48 Notwithstanding any provision of law to the contrary, for the period
49 commencing July 1, 2000 and ending March 31, 2001 and for each year
50 thereafter [through March 31, 2003]:
51 (2)(a) For the purposes of developing district-specific targets to
52 enhance incentives for the efficient management of home care services,
53 the department of health shall employ a methodology which includes the
54 following components:
55 (i) districts shall be assigned to one of two peer groups for the
56 purpose of creating standards for the comparison of home care utiliza-
S. 1408 51 A. 2108
1 tion across districts, the first group being comprised of the districts
2 of Rockland, Suffolk, Westchester, Nassau and New York city and the
3 second group being comprised of all districts not assigned to the first
4 group;
5 (ii) a base period which shall be defined, for target calculation
6 purposes, as July 1, 1996 through March 31, 1997;
7 (iii) target periods, which shall be defined as July 1, 2000 through
8 March 31, 2001 and each year thereafter [through March 31, 2003];
9 (iv) each district's home care services expenditures per recipient in
10 the base period shall be arrayed within each peer group as established
11 pursuant to subparagraph (i) of this paragraph;
12 (v) standards of efficiency, which shall be defined as the median of
13 each peer group's array, provided that no standard of efficiency shall
14 be less than one hundred seventy-five percent of the statewide median
15 and provided, further, that no standard of efficiency shall exceed two
16 hundred fifty percent of the statewide median; and
17 (vi) a district-specific expenditure per recipient variance, which
18 shall be defined, for those districts whose home care services expendi-
19 tures per recipient exceed the applicable standard of efficiency, as the
20 difference between each district's expenditures per recipient and the
21 standard of efficiency.
22 (b) The district-specific expenditure per recipient variance shall be
23 multiplied by the number of home care services recipients in that
24 district in the base period and the product of that calculation shall be
25 trended forward to the target period to account for projected price and
26 recipient changes by a trend factor to be determined by the department
27 of health in consultation with the director of the division of the budg-
28 et.
29 (c) The state share of the product obtained by the calculation made
30 pursuant to paragraph (b) of this subdivision shall be reduced in an
31 amount equal to sixty percent of the state share of the savings attrib-
32 utable to the amount by which the district's utilization of long term
33 nursing facility beds by Medicaid recipients is below the national aver-
34 age (adjusted for population age sixty-five or older). For the purpose
35 of this calculation, the department of health may utilize the same data
36 utilized by the department of social services in its calculation of the
37 nursing facility adjustment for savings targets for the target period of
38 July 1, 1996 through March 31, 1997.
39 (d) The department of health shall calculate savings targets by
40 adjusting all products obtained by the calculation made pursuant to
41 paragraph (c) of this subdivision by an implementation factor such that
42 the sum of all such products equals thirty-three million five hundred
43 sixty-five thousand dollars after first reducing any such sums which are
44 less than twenty thousand dollars to zero.
45 (e) Notwithstanding the calculation of savings targets made pursuant
46 to paragraph (d) of this subdivision, any district for which a savings
47 target is calculated pursuant to such paragraph and which was not
48 assigned a savings target pursuant to the provisions of section 226 of
49 chapter 474 of the laws of 1996 shall be assigned a savings target equal
50 to twenty-five percent of the amount calculated pursuant to such para-
51 graph.
52 (3) On or about January 1, 2001 and on and about January 1 of each
53 year thereafter [through January 1, 2003], the department of health
54 shall notify districts as to the progress made toward reaching the
55 savings targets. Such notice shall provide districts with aggregate data
56 accumulated by such department from the beginning of each target period
S. 1408 52 A. 2108
1 through the most recent full calendar month for which data is available
2 and shall include information on the number of recipients in receipt of
3 home care services, the type of home care services provided and the cost
4 of such services.
5 (4)(a) On or before March 1, 2001 and on or before March 1 of each
6 year thereafter [through March 1, 2003], the department of health shall
7 notify districts as to: the progress made toward reaching the savings
8 targets; the amount, if any, by which the department projects, pursuant
9 to paragraph (b) of this subdivision, the district will not achieve the
10 savings targets; and the amount of state payments, if any, to be inter-
11 cepted by the department pursuant to subdivision five of this section.
12 (b) For purposes of the assessment as to achievement of savings
13 targets required by paragraph (a) of this subdivision, the department of
14 health shall take the following steps:
15 (i) calculate the state share district-specific home care expenditures
16 per recipient from the beginning of the target period through the most
17 recent full calendar month for which data is available and project such
18 calculation to the full target period; provided, however, that such
19 calculation shall exclude any expenditures during such period caused
20 solely by adjustments to rates of payment for service periods prior to
21 the target period;
22 (ii) calculate the state share district-specific home care expendi-
23 tures per recipient for the base period trended forward by the price
24 projection factor utilized pursuant to paragraph (b) of subdivision 2 of
25 this section;
26 (iii) the district-specific projected savings shall be determined by
27 subtracting the result of the calculation performed pursuant to subpara-
28 graph (i) of this paragraph from the result of the calculation performed
29 pursuant to subparagraph (ii) of this paragraph and, where the result of
30 such subtraction is a positive number, multiplying the difference by the
31 number of home care services recipients in the base period as projected
32 forward by the utilization projection factor used pursuant to paragraph
33 (b) of subdivision 2 of this section to the target period;
34 (5)(a) The department of health is authorized and directed to inter-
35 cept, on or before March 31, 2001 and on or before March 31 of each year
36 thereafter [through March 31, 2003], state payments for public assist-
37 ance and care, and any other payments otherwise to be made, to any
38 district which the department projects, pursuant to subdivision 4 of
39 this section, will fail to achieve the savings target calculated pursu-
40 ant to subdivision 2 of this section.
41 (b)(i) The department of health shall intercept the amount by which
42 the savings calculated pursuant to subparagraph (iii) of paragraph (b)
43 of subdivision 4 of this section is less than the savings targets calcu-
44 lated pursuant to subdivision 2 of this section.
45 (ii) Notwithstanding the provisions of subparagraph (i) of this para-
46 graph, the commissioner of health, in consultation with the director of
47 the division of the budget, may exercise discretion not to intercept
48 from a district if the commissioner of health reasonably anticipates
49 that the district's projected additional savings through the end of the
50 target period will exceed the amount otherwise subject to interception
51 pursuant to this paragraph.
52 (c) Payments intercepted pursuant to this subdivision shall be paid to
53 the state general fund and credited to the aid to localities, medical
54 assistance program.
55 (6) As soon as practicable after March 31, 2001 and as soon as possi-
56 ble after March 31 of each year thereafter [up to and including March
S. 1408 53 A. 2108
1 31, 2003], the department of health shall determine the actual home care
2 services state share medical assistance savings achieved by a district.
3 The department shall calculate actual savings in the same manner set
4 forth in subdivision 4 of this section, except that the calculation as
5 to actual home care services expenditures per recipient set forth in
6 subparagraph (i) of paragraph (b) of subdivision 4 of this section shall
7 be based on data for the entire target period. If the department deter-
8 mines that payments to any district were intercepted, pursuant to subdi-
9 visions 4 and 5 of this section, in an amount greater than was necessary
10 to reimburse the department for the savings target, the department shall
11 authorize payment of such amount to such district as soon as possible,
12 but in no event later than three months after the end of the target
13 period. In the case of a district for which, pursuant to subdivisions 4
14 and 5 of this section, either no intercept, or an insufficient inter-
15 cept, of state funds was made, if the department determines that such
16 district failed to achieve savings sufficient to meet its home care
17 services state share medical assistance savings target, the department
18 shall as soon as possible, but in no event later than three months after
19 the end of the target period, intercept state payments for public
20 assistance and care and any other payments otherwise to be made to such
21 district in an amount sufficient to reimburse the state for the savings
22 target.
23 § 53. Subdivision 11 of section 2807-c of the public health law is
24 amended by adding a new paragraph (s-6) to read as follows
25 (s-6) To the extent funds are available otherwise notwithstanding any
26 inconsistent provision of law to the contrary, for rate periods April
27 first, two thousand through March thirty-first, two thousand five, the
28 commissioner shall increase rates of payment for patients eligible for
29 payments made by state governmental agencies by an amount not to exceed
30 forty-eight million dollars annually in the aggregate. Such amount
31 shall be allocated among those voluntary non-profit and private proprie-
32 tary general hospitals which continue to provide inpatient services as
33 of July first, nineteen hundred ninety-nine under a previous or new name
34 and which qualified for rate adjustments pursuant to paragraph (s) of
35 this subdivision as in effect for the period July first, nineteen
36 hundred ninety-five through June thirtieth, nineteen hundred ninety-six
37 proportionally based on each such general hospital's proportional share
38 of total funds allocated pursuant to paragraph (s) of this subdivision
39 as in effect for the period of July first, nineteen hundred ninety-five
40 through June thirtieth, nineteen hundred ninety-six, provided however,
41 that amounts allocable to previously but no longer qualified hospitals
42 shall be proportionally reallocated to the remaining qualified hospi-
43 tals. The rate adjustments calculated in accordance with this paragraph
44 shall be subject to retrospective reconciliation to ensure that each
45 hospital receives in the aggregate its proportionate share of the full
46 allocation, to the extent allowable under federal law, provided however
47 that the department shall not be required to reconcile payments made
48 pursuant to paragraph (s) of this subdivision applicable to periods
49 prior to September first, nineteen hundred ninety-seven.
50 § 54. Subparagraph (iii) of paragraph (f) of subdivision 4 of section
51 2807-c of the public health law, as amended by chapter 1 of the laws of
52 1999, is amended to read as follows:
53 (iii) commencing April first, nineteen hundred ninety-seven through
54 March thirty-first, nineteen hundred ninety-nine and commencing July
55 first, nineteen hundred ninety-nine through March thirty-first, two
56 thousand and on and after April first, two thousand [through March thir-
S. 1408 54 A. 2108
1 ty-first, two thousand three], the reimbursable inpatient operating cost
2 component of case based rates of payment per diagnosis-related group,
3 excluding any operating cost components related to direct and indirect
4 expenses of graduate medical education, for patients eligible for
5 payments made by state governmental agencies shall be reduced by three
6 and thirty-three hundredths percent to encourage improved productivity
7 and efficiency. Such election shall not alter the calculation of the
8 group price component calculated pursuant to subparagraph (i) of para-
9 graph (a) of subdivision seven of this section;
10 § 55. Subparagraph (iii) of paragraph (k) of subdivision 4 of section
11 2807-c of the public health law, as amended by chapter 1 of the laws of
12 1999, is amended to read as follows:
13 (iii) commencing April first, nineteen hundred ninety-seven through
14 March thirty-first, nineteen hundred ninety-nine and commencing July
15 first, nineteen hundred ninety-nine through March thirty-first, two
16 thousand and on and after April first, two thousand [through March thir-
17 ty-first, two thousand three], the operating cost component of rates of
18 payment, excluding any operating cost components related to direct and
19 indirect expenses of graduate medical education, for patients eligible
20 for payments made by a state governmental agency shall be reduced by
21 three and thirty-three hundredths percent to encourage improved produc-
22 tivity and efficiency. The facility will be eligible to receive the
23 financial incentives for the physician specialty weighting incentive
24 towards primary care pursuant to subparagraph (ii) of paragraph (a) of
25 subdivision twenty-five of this section.
26 § 56. The opening clause of subparagraph (vi) of paragraph (b) of
27 subdivision 5 of section 2807-c of the public health law, as amended by
28 chapter 1 of the laws of 1999, is amended to read as follows:
29 for discharges on or after April first, nineteen hundred ninety-seven
30 through March thirty-first, nineteen hundred ninety-nine and for
31 discharges on or after July first, nineteen hundred ninety-nine through
32 March thirty-first, two thousand and for discharges on or after April
33 first, two thousand [through March thirty-first, two thousand three],
34 for purposes of reimbursement of inpatient hospital services for
35 patients eligible for payments made by state governmental agencies, the
36 average reimbursable inpatient operating cost per discharge of a general
37 hospital shall, to encourage improved productivity and efficiency, be
38 the sum of:
39 § 57. The opening paragraph and subparagraph (i) of paragraph (c) of
40 subdivision 5 of section 2807-c of the public health law, as amended by
41 chapter 1 of the laws of 1999, is amended to read as follows:
42 Notwithstanding any inconsistent provision of this section, commencing
43 July first, nineteen hundred ninety-six through March thirty-first,
44 nineteen hundred ninety-nine and July first, nineteen hundred ninety-
45 nine through March thirty-first, two thousand and on and after April
46 first, two thousand [through March thirty-first, two thousand three],
47 rates of payment for a general hospital for patients eligible for
48 payments made by state governmental agencies shall be further reduced by
49 the commissioner to encourage improved productivity and efficiency by
50 providers by a factor determined as follows:
51 (i) an aggregate reduction shall be calculated for each general hospi-
52 tal commencing July first, nineteen hundred ninety-six through March
53 thirty-first, nineteen hundred ninety-nine and July first, nineteen
54 hundred ninety-nine through March thirty-first, two thousand and on and
55 after April first, two thousand [through March thirty-first, two thou-
56 sand three], as the result of (A) eighty-nine million dollars on an
S. 1408 55 A. 2108
1 annualized basis for each year, multiplied by (B) the ratio of patient
2 days for patients eligible for payments made by state governmental agen-
3 cies provided in a base year two years prior to the rate year by a
4 general hospital, divided by the total of such patient days summed for
5 all general hospitals; and
6 § 58. Clause (B-1) of subparagraph (i) of paragraph (f) of subdivision
7 11 of section 2807-c of the public health law, as amended by chapter 1
8 of the laws of 1999, is amended to read as follows:
9 (B-1) The increase in the statewide average case mix in the periods
10 January first, nineteen hundred ninety-seven through March thirty-first,
11 two thousand and on and after April first, two thousand [through March
12 thirty-first, two thousand three], from the statewide average case mix
13 for the period January first, nineteen hundred ninety-six through Decem-
14 ber thirty-first, nineteen hundred ninety-six shall not exceed one
15 percent for nineteen hundred ninety-seven, two percent for nineteen
16 hundred ninety-eight, three percent for the period January first, nine-
17 teen hundred ninety-nine through September thirtieth, nineteen hundred
18 ninety-nine, four percent for the period October first, nineteen hundred
19 ninety-nine through December thirty-first, nineteen hundred ninety-nine
20 and four percent for two thousand plus an additional one percent per
21 year thereafter, based on comparison of data only for patients that are
22 eligible for medical assistance pursuant to title eleven of article five
23 of the social services law, including such patients enrolled in health
24 maintenance organizations.
25 § 59. Subdivision 1 of section 46 of chapter 639 of the laws of 1996
26 amending the public health law and other laws relating to welfare
27 reform, as amended by chapter 1 of the laws of 1999, is amended to read
28 as follows:
29 1. Notwithstanding any inconsistent provision of law or regulation to
30 the contrary, the trend factors used to project reimbursable operating
31 costs to the rate period for purposes of determining rates of payment
32 pursuant to article 28 of the public health law for general hospitals
33 for reimbursement of inpatient hospital services provided to patients
34 eligible for payments made by state governmental agencies on and after
35 April 1, 1996 through June 30, 1996 and on or after July 1, 1996 through
36 March 31, 1999 and on and after July 1, 1999 through March 31, 2000 and
37 on and after April 1, 2000 [through March 31, 2003], shall reflect no
38 trend factor projections or adjustments for the period April 1, 1996,
39 through March 31, 1997.
40 § 60. Section 3 of chapter 483 of the laws of 1978, amending the
41 public health law relating to rate of payment for each residential
42 health care facility to real property costs, as amended by section 24 of
43 part B of chapter 1 of the laws of 2002, is amended to read as follows:
44 § 3. This act shall take effect immediately [provided, however, that
45 the provisions of subdivision 2-a of section 2808 of the public health
46 law, as added by section one of this act, shall remain in full force and
47 effect until December 31, 2003].
48 § 61. Notwithstanding any provision of law, rule or regulation to the
49 contrary, assessments due for any period prior to January 1, 2003, which
50 are paid in full and accompanied by appropriate reports pursuant to
51 subparagraph (vi) of paragraph (b) of subdivision 2 of section 2807-d of
52 the public health law and which are received on or before July 1, 2003,
53 shall not be subject to interest or penalties as otherwise provided in
54 section 2807-d of the public health law, provided, however, that with
55 regard to all assessment, interest and penalty amounts collected by the
56 commissioner of health by the effective date of this act the interest
S. 1408 56 A. 2108
1 and penalty provisions of section 2807-d of the public health law shall
2 remain in full force and effect and such amounts collected shall not be
3 subject to further reconciliation or adjustment and further provided
4 that the provisions of this section shall not apply to any assessment
5 payment made in response to an audit finding made by the commissioner of
6 health or the commissioner of health's designee.
7 § 62. Section 10 of chapter 649 of the laws of 1996 amending the
8 public health law, the mental hygiene law and the social services law
9 relating to authorizing the establishment of special needs plans, as
10 amended by section 1 of part B of chapter 57 of the laws of 2000, is
11 amended to read as follows:
12 § 10. This act shall take effect immediately and shall be deemed to
13 have been in full force and effect on and after July 1, 1996; [provided,
14 however, that sections one, two and three of this act shall expire and
15 be deemed repealed on December 31, 2003 provided, however that the
16 amendments to section 364-j of the social services law made by section
17 four of this act shall not affect the expiration of such section and
18 shall be deemed to expire therewith and] provided, further, that the
19 provisions of subdivisions 8, 9 and 10 of section 4401 of the public
20 health law, as added by section one of this act; section 4403-d of the
21 public health law as added by section two of this act and the provisions
22 of section seven of this act, except for the provisions relating to the
23 establishment of no more than twelve comprehensive HIV special needs
24 plans, shall expire and be deemed repealed on July 1, 2000.
25 § 63. Section 11 of chapter 710 of the laws of 1988, amending the
26 social services law and the education law relating to medical assistance
27 eligibility of certain persons and providing for managed medical care
28 demonstration programs, as amended by section 2 of part B of chapter 57
29 of the laws of 2000, is amended to read as follows:
30 § 11. This act shall take effect immediately; except that the
31 provisions of sections one, two, three, four, eight and ten of this act
32 shall take effect on the ninetieth day after it shall have become a law;
33 and except that the provisions of sections five, six and seven of this
34 act shall take effect January 1, 1989; and except that effective imme-
35 diately, the addition, amendment and/or repeal of any rule or regulation
36 necessary for the implementation of this act on its effective date are
37 authorized and directed to be made and completed on or before such
38 effective date; [provided, however, that the provisions of section 364-j
39 of the social services law, as added by section one of this act shall
40 expire and be deemed repealed on and after December 31, 2003,] the
41 provisions of section 364-k of the social services law, as added by
42 section two of this act, except subdivision 10 of such section, shall
43 expire and be deemed repealed on and after January 1, 1994, and the
44 provisions of subdivision 10 of section 364-k of the social services
45 law, as added by section two of this act, shall expire and be deemed
46 repealed on January 1, 1995.
47 § 64. Subdivision (c) of section 62 of chapter 165 of the laws of
48 1991, amending the public health law and other laws relating to estab-
49 lishing payments for medical assistance, as amended by section 3 of part
50 B of chapter 57 of the laws of 2000, is amended to read as follows:
51 (c) [section 364-j of the social services law, as amended by section
52 eight of this act and subdivision 6 of section 367-a of the social
53 services law as added by section twelve of this act shall expire and be
54 deemed repealed on December 31, 2003 and provided further, that] the
55 amendments to the provisions of section 364-j of the social services law
S. 1408 57 A. 2108
1 shall only apply to managed care programs approved on or after the
2 effective date of this act;
3 § 65. Section 364-jj of the social services law is REPEALED.
4 § 66. Subdivision 1 of section 365-c of the social services law, as
5 amended by chapter 477 of the laws of 1972, is amended to read as
6 follows:
7 1. A medical advisory committee is hereby established to consist of
8 twenty members who shall be appointed by the governor, by and with the
9 advice and consent of the senate, for the following terms: seven shall
10 be appointed for a term to expire on May thirty-first, nineteen hundred
11 seventy-four: seven shall be appointed for a term to expire on May
12 thirty-first, nineteen hundred seventy-five: and six shall be appointed
13 for a term to expire on May thirty-first, nineteen hundred seventy-six.
14 Thereafter members appointed upon expiration of a term of office shall
15 be appointed for a term of three years. Vacancies caused by death,
16 resignation or refusal to act or by removal from the state shall be
17 filled for the unexpired term only. At least seven members of such
18 committee shall be duly licensed physicians. The governor shall desig-
19 nate a chairman from among the members of the medical advisory commit-
20 tee, to serve as such at the pleasure of the governor. In appointing
21 the members of the medical advisory committee, the governor shall give
22 consideration to professional qualifications and experience and to
23 achieving representation of the professions of medicine, osteopathy,
24 podiatry, mental health, social work, dentistry, optometry, chiroprac-
25 tic, physical therapy, pharmacy, nursing, hospital and health adminis-
26 tration and education for the health professions, of public and private
27 agencies in the field of medical assistance, of entities certified under
28 article forty-four of the public health law or article forty-three of
29 the insurance law and provide services pursuant to section three hundred
30 sixty-four-j of this title, and of recipients and consumers of medical
31 assistance for needy persons.
32 § 67. Subdivision 2 of section 365-c of the social services law, as
33 added by chapter 256 of the laws of 1966, is amended to read as follows:
34 2. The medical advisory committee shall advise the commissioner with
35 respect to health and medical care services provided pursuant to this
36 title. Provided further, the medical advisory committee shall limit its
37 recommendations pertaining to managed care programs authorized under
38 section three hundred sixty-four-j of this title to the following areas
39 quality of care, marketing and enrollment, capacity of managed care
40 providers to accept managed care enrollees, and enrollee satisfaction
41 with managed care providers.
42 § 68. Section 364-j of the social services law is amended by adding a
43 new subdivision 22 to read as follows:
44 22. (a) As a means of protecting the health, safety and welfare of
45 recipients, in addition to any other sanctions that may be imposed the
46 commissioner of health shall appoint temporary management of a managed
47 care provider upon determining that the managed care provider has
48 repeatedly failed to meet the substantive requirements of sections
49 1903(m) and 1932 of the federal Social Security Act and regulations. A
50 hearing shall not be required prior to the appointment of temporary
51 management.
52 (b) The commissioner of health and/or his or her designees, which may
53 be individuals within the department or other individuals or entities
54 with appropriate knowledge and experience, may be appointed as temporary
55 management. The commissioner of health may appoint the superintendent of
56 insurance and/or his or her designees as temporary management of any
S. 1408 58 A. 2108
1 managed care provider which is subject to rehabilitation pursuant to
2 article seventy-four of the insurance law.
3 (c) The responsibilities of temporary management shall include over-
4 sight of the managed care provider for the purpose of removing the caus-
5 es and conditions which led to the determination requiring temporary
6 management, the imposition of improvements to remedy violations and,
7 where necessary, the orderly reorganization, termination or liquidation
8 of the managed care provider.
9 (d) Temporary management may hire and fire managed care provider
10 personnel and expend managed care provider funds in carrying out the
11 responsibilities imposed pursuant to this subdivision, and shall only be
12 liable for acts or omissions that constitute gross, wilful or wanton
13 negligence.
14 (e) The commissioner of health, in consultation with the superinten-
15 dent of insurance with respect to any managed care provider subject to
16 rehabilitation pursuant to article seventy-four of the insurance law,
17 may make available to temporary management for the benefit of a managed
18 care provider for the maintenance of required reserves and deposits
19 monies from such funds as are appropriated for such purpose.
20 (f) The commissioner of health is authorized to establish in regu-
21 lation provisions for the payment of fees and expenses from funds appro-
22 priated for such purpose for non-governmental individuals and entities
23 appointed as temporary management pursuant to this subdivision.
24 (g) The commissioner of health may not terminate temporary management
25 prior to his or her determination that the managed care provider has the
26 capability to ensure that the sanctioned behavior will not recur.
27 (h) During any period of temporary management individuals enrolled in
28 the managed care provider being managed may disenroll without cause.
29 Upon reaching a determination that requires temporary management of a
30 managed care provider, the commissioner of health shall notify all
31 recipient enrollees of such provider that they may terminate enrollment
32 without cause during the period of temporary management.
33 (i) The commissioner of health may adopt and amend rules and regu-
34 lations to effectuate the purposes and provisions of this subdivision.
35 § 69. Subparagraph (i) of paragraph (e) of subdivision 4 of section
36 364-j of the social services law, as amended by chapter 433 of the laws
37 of 1997, is amended to read as follows:
38 (i) In any social services district which has not implemented a manda-
39 tory managed care program pursuant to this section, the commissioner of
40 health shall establish marketing and enrollment guidelines, including
41 but not limited to regulations governing face-to-face marketing and
42 enrollment encounters between managed care providers and recipients of
43 medical assistance and locations for such encounters. Such regulations
44 shall prohibit, at a minimum, telephone cold-calling and door-to-door
45 solicitation at the homes of medical assistance recipients. The regu-
46 lations shall also require the commissioner of health to approve any
47 local district marketing guidelines. Managed care providers shall be
48 permitted to assist participants in completion of enrollment forms at
49 approved health care provider sites and other approved locations. In no
50 case may an emergency room be deemed an approved location. Upon enroll-
51 ment, participants will sign an attestation that: they have been
52 informed that managed care is a voluntary program; participants have a
53 choice of managed care providers; participants have a choice of primary
54 care practitioners; and participants must exclusively use their primary
55 care practitioner and plan providers except as otherwise provided in
56 this section including but not limited to the exceptions listed in
S. 1408 59 A. 2108
1 subparagraph (iii) of paragraph (a) of this subdivision. Managed care
2 providers must submit enrollment forms to the local department of social
3 services. The local department of social services will provide or
4 arrange for an audit of managed care provider enrollment forms; includ-
5 ing telephone contacts to determine if participants were provided with
6 the information required by this subparagraph. The commissioner of
7 health or the local department of social services may suspend or curtail
8 enrollment or impose sanctions for failure to appropriately notify
9 clients as required in this subparagraph.
10 § 70. Subparagraph (v) of paragraph (e) of subdivision 4 of section
11 364-j of the social services law, as amended by chapter 433 of the laws
12 of 1997, is amended to read as follows:
13 (v) Upon delivery of the pre-enrollment information, the local
14 district or the enrollment organization shall certify the participant's
15 receipt of such information. Upon verification that the participant has
16 received the pre-enrollment education information, a managed care
17 provider, a local district or the enrollment organization may enroll a
18 participant into a managed care plan. Managed care providers must submit
19 enrollment forms to the local department of social services. Upon
20 enrollment, participants will sign an attestation that they have been
21 informed that: participants have a choice of managed care providers;
22 participants have a choice of primary care practitioners; and, except as
23 otherwise provided in this section, including but not limited to the
24 exceptions listed in subparagraph (iii) of paragraph (a) of this subdi-
25 vision, participants must exclusively use their primary care practition-
26 ers and plan providers. The commissioner of health or the local depart-
27 ment of social services may suspend or curtail enrollment or impose
28 sanctions for failure to appropriately notify clients as required in
29 this subparagraph.
30 § 71. Subdivision 19 of section 364-j of the social services law, as
31 amended by chapter 649 of the laws of 1996, is amended to read as
32 follows:
33 19. [(a)] The commissioner of health[, in consultation with the
34 commissioner,] shall promulgate such regulations as are necessary to
35 implement the provisions of this section, including regulations to
36 suspend or curtail enrollment or impose sanctions on a managed care
37 provider, including imposition of civil penalties, for failure to comply
38 with the provisions of this section; provided, however, that the
39 provisions of this subdivision shall not limit specific actions taken by
40 the department of health or the department in order to ensure federal
41 financial participation.
42 § 72. Section 18 of chapter 904 of the laws of 1984, amending the
43 public health law and the social services law relating to encouraging
44 comprehensive health services, as amended by section 23 of part B of
45 chapter 1 of the laws of 2002, is amended to read as follows:
46 § 18. This act shall take effect immediately, except that sections
47 six, nine, ten and eleven of this act shall take effect on the sixtieth
48 day after it shall have become a law, [sections] section three of this
49 act shall expire and be of no further force or effect on or after July
50 1, 2003, section four [and nine] of this act shall expire and be of no
51 further force or effect on or after July 1, [2003] 2005, section two of
52 this act shall take effect on April 1, 1985 or seventy-five days follow-
53 ing the submission of the report required by section one of this act,
54 whichever is later, [and shall expire and be of no further force or
55 effect after July 1, 2003] and sections eleven and thirteen of this act
S. 1408 60 A. 2108
1 shall expire and be of no further force or effect on or after March 31,
2 1988.
3 § 73. Section 2 of chapter 535 of the laws of 1983, amending the
4 social services law relating to eligibility of certain enrollees for
5 medical assistance, as amended by section 22 of part B of chapter 1 of
6 the laws of 2002, is amended to read as follows:
7 § 2. This act shall take effect immediately [and shall remain in full
8 force and effect through June 30, 2003].
9 § 74. Paragraphs (c), (s), (t), (u), (v) and (w) of subdivision 1 of
10 section 364-j of the social services law, paragraph (c) as amended by
11 chapter 649 of the laws of 1996, paragraphs (s), (u), (v) and (w) as
12 added by chapter 433 of the laws of 1997 and paragraph (t) as amended by
13 section 24 of part E of chapter 58 of the laws of 1998, are amended to
14 read as follows:
15 (c) "Managed care program". A statewide program [in a social services
16 district] in which medical assistance recipients enroll on a voluntary
17 or mandatory basis to receive medical assistance services, including
18 case management, directly and indirectly (including by referral) from a
19 managed care provider, and as applicable, a mental health special needs
20 plan or a comprehensive HIV special needs plan, under this section.
21 (s) "Existing rates". The rates paid pursuant to the most recent
22 executed contract between a local social services district or the state
23 and a managed care provider[, which shall include any increase effective
24 January first, nineteen hundred ninety-seven, except those rate
25 increases resulting from subdivision twenty-one of this section; and
26 further provided that any adjustments made pursuant to a chapter of the
27 laws of nineteen hundred ninety-seven, related to pharmacy benefits, if
28 any, shall be reflected in such rates].
29 (t) ["Competitive bidding process". The health plan procurement proc-
30 ess undertaken by the department of health to select managed care
31 providers under the Partnership Plan RFP released November fourteenth,
32 nineteen hundred ninety-five, and with respect to any rate adjustments
33 made under this section for any period commencing on or after April
34 first, nineteen hundred ninety-eight, the health plan procurement proc-
35 ess undertaken by Westchester county to select managed care providers
36 pursuant to an RFP released September twelfth, nineteen hundred ninety-
37 six.
38 (u)] "Managed care rating regions". The regions established [pursuant
39 to the competitive bidding process] by the department of health for the
40 purpose of setting regional premium rates for managed care providers.
41 [(v)] (u)"Premium group". The various demographic, gender and recipi-
42 ent categories utilized for rate-setting purposes by the department of
43 health [in the competitive bidding process].
44 [(w)] (v) "Upper payment limit". The maximum reimbursement that the
45 department of health may pay a managed care provider for providing or
46 arranging for medical services to participants in a managed care program
47 in accordance with the federal social security act and regulations
48 promulgated thereunder.
49 § 75. Paragraphs (a) and (b) of subdivision 3 of section 364-j of the
50 social services law, as amended by chapter 649 of the laws of 1996,
51 subparagraph (iii) of paragraph (b) as amended by section 4 of part B of
52 chapter 57 of the laws of 2000, are amended to read as follows:
53 (a) Every person eligible for or receiving medical assistance under
54 this article, who resides in a social services district providing
55 medical assistance [under a managed care program approved by the commis-
56 sioner of health in cooperation with the commissioner and the commis-
S. 1408 61 A. 2108
1 sioner of the responsible special care agencies pursuant to this
2 section], which has implemented the state's managed care program shall
3 participate in the program authorized by this section. Provided, howev-
4 er, that participation in a comprehensive HIV special needs plan also
5 shall be in accordance with article forty-four of the public health law
6 and participation in a mental health special needs plan shall also be in
7 accordance with article forty-four of the public health law and article
8 thirty-one of the mental hygiene law.
9 (b) A medical assistance recipient shall not be required to partic-
10 ipate in, and shall be permitted to withdraw from [a] the managed care
11 program upon a showing that:
12 (i) a managed care provider is not geographically accessible to the
13 person so as to reasonably provide services to the person, or upon a
14 showing of other good cause as defined in regulation. A managed care
15 provider is not geographically accessible if the person cannot access
16 its services in a timely fashion due to distance or travel time;
17 (ii) a pregnant woman with an established relationship, as defined by
18 the commissioner of health, with a comprehensive prenatal primary care
19 provider, including a prenatal care assistance program as defined in
20 title two of article twenty-five of the public health law, that is not
21 associated with a managed care provider in the [managed care program of
22 the] participant's social services district, may defer participation in
23 the managed care program while pregnant and for sixty days post-partum;
24 (iii) an individual with a chronic medical condition being treated by
25 a specialist physician that is not associated with a managed care
26 provider in the [managed care program of the] participant's social
27 services district, may defer participation in the managed care program
28 until the course of treatment is complete; and
29 (iv) a participant cannot be served by a managed care provider who
30 participates in a managed care program due to a language barrier.
31 § 76. The opening paragraph and paragraphs (a), (e), (f) and (g) of
32 subdivision 4 of section 364-j of the social services law, the opening
33 paragraph and paragraphs (a) and (f) as amended and paragraph (e) as
34 added by chapter 649 of the laws of 1996, subparagraph (i) of paragraph
35 (a) as amended by chapter 558 of the laws of 1999, subparagraphs (i) and
36 (v) of paragraph (e) and paragraph (g) as amended and subparagraph
37 (viii) of paragraph (e) as added by chapter 433 of the laws of 1997 and
38 subparagraph (iv) of paragraph (e) as amended by section 6 of part B of
39 chapter 57 of the laws of 2000, are amended to read as follows:
40 [Managed care programs] The managed care program shall provide partic-
41 ipants access to comprehensive and coordinated health care delivered in
42 a cost effective manner consistent with the following provisions:
43 (a) (i) a managed care provider shall arrange for access to and
44 enrollment of primary care practitioners and other medical services
45 providers. Each managed care provider shall possess the expertise and
46 sufficient resources to assure the delivery of quality medical care to
47 participants in an appropriate and timely manner and may include physi-
48 cians, nurse practitioners, county health departments, providers of
49 comprehensive health service plans licensed pursuant to article forty-
50 four of the public health law, and hospitals and diagnostic and treat-
51 ment centers licensed pursuant to article twenty-eight of the public
52 health law or otherwise authorized by law to offer comprehensive health
53 services or facilities licensed pursuant to articles sixteen, [twenty-
54 three,] thirty-one and thirty-two of the mental hygiene law.
55 (ii) provided, however, if a major public hospital, as defined in the
56 public health law, is designated by [a social services district] the
S. 1408 62 A. 2108
1 commissioner of health as a managed care provider, the [social services
2 district] commissioner of health shall designate at least one other
3 managed care provider which is not a major public hospital or facility
4 operated by a major public hospital; and
5 (iii) under a managed care program, not all managed care providers
6 must be required to provide the same set of medical assistance services.
7 [A] The managed care program shall establish procedures through which
8 participants will be assured access to all medical assistance services
9 to which they are otherwise entitled, other than through the managed
10 care provider, where:
11 (A) the service is not reasonably available directly or indirectly
12 from the managed care provider,
13 (B) it is necessary because of emergency or geographic unavailability,
14 or
15 (C) the services provided are family planning services; or
16 (D) other services as defined by the commissioner of health.
17 (e) (i) In any social services district which has not implemented a
18 mandatory managed care program pursuant to this section, the commission-
19 er of health shall establish marketing and enrollment guidelines,
20 including but not limited to regulations governing face-to-face market-
21 ing and enrollment encounters between managed care providers and recipi-
22 ents of medical assistance and locations for such encounters. Such regu-
23 lations shall prohibit, at a minimum, telephone cold-calling and
24 door-to-door solicitation at the homes of medical assistance recipients.
25 The regulations shall also require the commissioner of health to approve
26 any local district marketing guidelines. Managed care providers shall be
27 permitted to assist participants in completion of enrollment forms at
28 approved health care provider sites and other approved locations. In no
29 case may an emergency room be deemed an approved location. Upon enroll-
30 ment, participants will sign an attestation that: they have been
31 informed that managed care is a voluntary program; participants have a
32 choice of managed care providers; participants have a choice of primary
33 care practitioners; and participants must exclusively use their primary
34 care practitioner and plan providers except as otherwise provided in
35 this section including but not limited to the exceptions listed in
36 subparagraph (iii) of paragraph (a) of this subdivision. Managed care
37 providers must submit enrollment forms to the local department of social
38 services. The local department of social services will provide or
39 arrange for an audit of managed care provider enrollment forms; includ-
40 ing telephone contacts to determine if participants were provided with
41 the information required by this subparagraph. The [local department of
42 social services] commissioner of health may suspend or curtail enroll-
43 ment or impose sanctions for failure to appropriately notify clients as
44 required in this subparagraph.
45 (ii) In any social services district which has implemented a mandatory
46 managed care program pursuant to this section, the requirements of this
47 subparagraph shall apply to the extent consistent with federal law and
48 regulations. The department of health, may contract with one or more
49 independent organizations to provide enrollment counseling and enroll-
50 ment services, for participants required to enroll in managed care
51 programs, for each social services district requesting the services of
52 an enrollment broker. To select such organizations, the department of
53 health shall issue a request for proposals (RFP), shall evaluate
54 proposals submitted in response to such RFP and, pursuant to such RFP,
55 shall award a contract to one or more qualified and responsive organiza-
56 tions. Such organizations shall not be owned, operated, or controlled by
S. 1408 63 A. 2108
1 any governmental agency, managed care provider, comprehensive HIV
2 special needs plan, mental health special needs plan, or medical
3 services provider.
4 (iii) Such independent organizations shall develop enrollment guides
5 for participants which shall be approved by the department of health
6 prior to distribution.
7 (iv) Local social services districts or enrollment organizations
8 through their enrollment counselors shall provide participants with the
9 opportunity for face to face counseling including individual counseling
10 upon request of the participant. Local social services districts or
11 enrollment organizations through their enrollment counselors shall also
12 provide participants with information in a culturally and linguistically
13 appropriate and understandable manner, in light of the participant's
14 needs, circumstances and language proficiency, sufficient to enable the
15 participant to make an informed selection of a managed care provider.
16 Such information shall include, but shall not be limited to: how to
17 access care within the program; a description of the medical assistance
18 services that can be obtained other than through a managed care provid-
19 er, mental health special needs plan or comprehensive HIV special needs
20 plan; the available managed care providers, mental health special needs
21 plans and comprehensive HIV special needs plans and the scope of
22 services covered by each; a listing of the medical services providers
23 associated with each managed care provider; the participants' rights
24 within the managed care program; and how to exercise such rights.
25 Enrollment counselors shall inquire into each participant's existing
26 relationships with medical services providers and explain whether and
27 how such relationships may be maintained within the managed care
28 program. For enrollments made during face to face counseling, if the
29 participant has a preference for particular medical services providers,
30 enrollment counselors shall verify with the medical services providers
31 that such medical services providers whom the participant prefers
32 participate in the managed care provider's network and are available to
33 serve the participant.
34 (v) Upon delivery of the pre-enrollment information, the local
35 district or the enrollment organization shall certify the participant's
36 receipt of such information. Upon verification that the participant has
37 received the pre-enrollment education information, a managed care
38 provider, a local district or the enrollment organization may enroll a
39 participant into a managed care plan. Managed care providers must submit
40 enrollment forms to the local department of social services. Upon
41 enrollment, participants will sign an attestation that they have been
42 informed that: participants have a choice of managed care providers;
43 participants have a choice of primary care practitioners; and, except as
44 otherwise provided in this section, including but not limited to the
45 exceptions listed in subparagraph (iii) of paragraph (a) of this subdi-
46 vision, participants must exclusively use their primary care practition-
47 ers and plan providers. The [local department of social services]
48 commissioner of health may suspend or curtail enrollment or impose sanc-
49 tions for failure to appropriately notify clients as required in this
50 subparagraph.
51 (vi) Enrollment counselors or local social services districts shall
52 further inquire into each participant's health status in order to iden-
53 tify physical or behavioral conditions that require immediate attention
54 or continuity of care, and provide to participants information regarding
55 health care options available to persons with HIV and other illnesses or
56 conditions under the managed care program. Any information disclosed to
S. 1408 64 A. 2108
1 counselors shall be kept confidential in accordance with applicable
2 provisions of the public health law, and as appropriate, the mental
3 hygiene law.
4 (vii) Any marketing materials developed by a managed care provider,
5 comprehensive HIV special needs plan or mental health special needs plan
6 shall be approved by the department of health or the local social
7 services district and the commissioner of mental health, where appropri-
8 ate, within sixty days prior to distribution to recipients of medical
9 assistance. All marketing materials shall be reviewed within sixty days
10 of submission.
11 (viii) In any social services district which has implemented a manda-
12 tory managed care program pursuant to this section, the commissioner of
13 health shall establish marketing and enrollment guidelines, including
14 but not limited to regulations governing face-to-face marketing and
15 enrollment encounters between managed care providers and recipients of
16 medical assistance and locations for such encounters. Such regulations
17 shall prohibit, at a minimum, telephone cold-calling and door-to-door
18 solicitation at the homes of medical assistance recipients. The regu-
19 lations shall also require the commissioner of health to approve any
20 local district marketing guidelines.
21 (f) (i) Participants shall have no less than sixty days from the date
22 selected by the district to enroll in [its] the managed care program to
23 select a managed care provider, and as appropriate, a mental health
24 special needs plan, and shall be provided with information to make an
25 informed choice. Where a participant has not selected such a provider or
26 mental health special needs plan, [a social services official] the
27 commissioner of health shall assign such participant to a managed care
28 provider, and as appropriate, to a mental health special needs plan,
29 taking into account capacity and geographic accessibility. The commis-
30 sioner may after the period of time established in subparagraph (ii) of
31 this paragraph assign participants to a managed care provider taking
32 into account quality performance criteria and cost. Provided however,
33 cost criteria shall not be of greater value than quality criteria in
34 assigning participants.
35 (ii) The commissioner may assign participants pursuant to such crite-
36 ria on a weighted basis, provided however that for twelve months follow-
37 ing implementation of a mandatory program, pursuant to a federal waiver,
38 twenty-five percent of the participants that do not choose a managed
39 care provider shall be assigned to managed care providers that satisfy
40 the criteria set forth in subparagraph (i) of this paragraph, and are
41 controlled by, sponsored by, or otherwise affiliated through a common
42 governance or through a parent corporation with, one or more private
43 not-for-profit or public general hospitals or diagnostic and treatment
44 centers licensed pursuant to article twenty-eight of the public health
45 law.
46 (iii) For twelve months following the twelve months described in
47 subparagraph (ii) of this paragraph twenty-two and one-half percent of
48 the participants that do not choose a managed care provider shall be
49 assigned to managed care providers, that satisfy the criteria set forth
50 in subparagraph (i) of this paragraph and are controlled by, sponsored
51 by, or otherwise affiliated through a common governance or through a
52 parent corporation with, one or more private not-for-profit or public
53 general hospitals or diagnostic and treatment centers licensed pursuant
54 to article twenty-eight of the public health law.
55 (iv) For twelve months following the twelve months described in
56 subparagraph (iii) of this paragraph twenty percent of the participants
S. 1408 65 A. 2108
1 that do not choose a managed care provider shall be assigned equally
2 among each of the managed care providers, that satisfy the criteria set
3 forth in subparagraph (i) of this paragraph and are controlled by, spon-
4 sored by, or otherwise affiliated through a common governance or through
5 a parent corporation with one or more private not-for-profit or public
6 general hospitals or diagnostic and treatment centers licensed pursuant
7 to article twenty-eight of the public health law.
8 (v) The commissioner shall assign all participants not otherwise
9 assigned to a managed care plan pursuant to subparagraphs (ii), (iii)
10 and (iv) of this paragraph equally among each of the managed care
11 providers that meet the criteria established in subparagraph (i) of this
12 paragraph.
13 (g) If another managed care provider, mental health special needs plan
14 or comprehensive HIV special needs plan is available, participants may
15 change such provider or plan without cause within thirty days of notifi-
16 cation of enrollment or the effective date of enrollment, whichever is
17 later with a managed care provider, mental health special needs plan or
18 comprehensive HIV special needs plan by making a request of the local
19 social services district except that such period shall be forty-five
20 days for participants who have been assigned to a provider by [a social
21 services official] the commissioner of health. However, after such
22 thirty or forty-five day period, whichever is applicable, a participant
23 may be prohibited from changing managed care providers more frequently
24 than once every twelve months, as permitted by federal law except for
25 good cause as determined by the commissioner of health through regu-
26 lations.
27 § 77. Subdivision 5 of section 364-j of the social services law, as
28 amended by chapter 649 of the laws of 1996, paragraph (b) as amended by
29 chapter 433 of the laws of 1997, is amended to read as follows:
30 5. Managed care programs shall be conducted [only] in accordance with
31 [plans submitted by a social services district or any combination of
32 social services districts and approved by the commissioner of health, in
33 consultation with the commissioner and the commissioner of the responsi-
34 ble special care agency. Such plans shall be consistent with] the
35 requirements of this section and, to the extent practicable, encourage
36 the provision of comprehensive medical services, pursuant to this arti-
37 cle[, and shall:].
38 (a) [identify and document the specific problems which the managed
39 care program is designed to address including the current primary care
40 and specialist network actually available to medical assistance recipi-
41 ents within the district and a reasonable estimate of the program's
42 local cost effectiveness;
43 (b)] The managed care program shall provide for the selection of qual-
44 ified managed care providers by the commissioner of health and, as
45 appropriate, mental health special needs plans and comprehensive HIV
46 special needs plans to participate in the program, provided, however,
47 that the commissioner of health may contract directly with comprehensive
48 HIV special needs plans consistent with standards set forth in this
49 section, and assure that such providers are accessible taking into
50 account the needs of persons with disabilities and the differences
51 between rural, suburban, and urban settings, and in sufficient numbers
52 to meet the health care needs of participants, and shall consider the
53 extent to which major public hospitals are included within such provid-
54 ers' networks;
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1 [(c) demonstrate that health care providers, managed care providers,
2 insurers, medical assistance recipients and the general public were
3 provided the opportunity to participate in the development of the plan;
4 (d) describe the enrollment process and any marketing materials and
5 indicate whether enrollment will be conducted by the social services
6 district or some other entity;
7 (e) demonstrate that medical assistance recipients who are eligible to
8 participate in a managed care program shall be fully informed of how
9 services are provided through managed care programs, and provided suffi-
10 cient information, in reasonably understandable and culturally and
11 linguistically appropriate form, to assure that such recipients can make
12 an informed choice of managed care and primary care providers.]
13 (b) A proposal submitted by a managed care provider to participate in
14 the managed care program shall:
15 (i) designate the geographic area to be served by the program, and
16 estimate the number of eligible participants and actual participants in
17 such designated area;
18 (ii) include a network of health care providers in sufficient numbers
19 and geographically accessible to service program participants;
20 (iii) describe the procedures for marketing in the program location,
21 including the designation of other entities which may perform such func-
22 tions under contract with the organization;
23 (iv) describe the quality assurance, utilization review and case
24 management mechanisms to be implemented;
25 (v) demonstrate the applicant's ability to meet the data analysis and
26 reporting requirements of the program;
27 (vi) demonstrate financial feasibility of the program; and
28 (vii) include such other information as the commissioner of health may
29 deem appropriate.
30 (c) The commissioner of health shall make a determination whether to
31 approve, disapprove or recommend modification of the proposal.
32 (d) Notwithstanding any inconsistent provision of this title and
33 section one hundred sixty-three of the state finance law, the commis-
34 sioner of health may contract with managed care providers approved under
35 paragraph (b) of this subdivision, without a competitive bid or request
36 for proposal process, to provide coverage for participants pursuant to
37 this title.
38 (e) The care and services described in subdivision four of this
39 section will be furnished by a managed care provider pursuant to the
40 provisions of this section when such services are furnished in accord-
41 ance with an agreement with the department of health and meet applicable
42 federal law and regulations.
43 (f) The commissioner of health may delegate some or all of the tasks
44 identified in this section to the local districts.
45 (g) Any delegation pursuant to paragraph (f) of this subdivision shall
46 be reflected in the contract between a managed care provider and the
47 commissioner of health.
48 § 78. Paragraph (a) of subdivision 13 of section 364-j of the social
49 services law, as amended by chapter 649 of the laws of 1996, is amended
50 to read as follows:
51 (a) Notwithstanding any inconsistent provisions of this section,
52 participation in a managed care program will not diminish a recipient's
53 medical assistance eligibility or the scope of available medical
54 services to which he or she is entitled. Once a [plan] program is imple-
55 mented by the district, medical assistance for persons who require such
56 assistance, who are eligible for or in receipt of such assistance in the
S. 1408 67 A. 2108
1 district and who are covered by the [plan] program shall be limited to
2 payment of the cost of care, services and supplies covered by the
3 managed care program, only when furnished, prescribed, ordered or
4 approved by a managed care provider, mental health special needs plan or
5 comprehensive HIV special needs plan and otherwise under the [plan]
6 program, together with the costs of medically necessary medical and
7 remedial care, services or supplies which are not available to partic-
8 ipants under the [plan] program, but which would otherwise be available
9 to such persons under this title and the regulations of the department
10 provided, however, that the [plan] program may contain provision for
11 payment to be made for non-emergent care furnished in hospital emergency
12 rooms consistent with subdivision ten of this section.
13 § 79. Subdivision 21 of section 364-j of the social services law is
14 REPEALED.
15 § 80. Section 4 of chapter 19 of the laws of 1998, amending the
16 social services law relating to limiting the method of payment for
17 prescription drugs under the medical assistance program, as amended by
18 section 3 of part A of chapter 57 of the laws of 2000, is amended to
19 read as follows:
20 § 4. This act shall take effect 120 days after it shall have become a
21 law [and shall expire and be deemed repealed December 31, 2003].
22 § 81. Notwithstanding any inconsistent provision of law, rule or
23 regulation, the effectiveness of subdivisions 4, 7, 7-a and 7-b of
24 section 2807 of the public health law and section 18 of chapter 2 of the
25 laws of 1988, as they relate to time frames for notice, approval or
26 certification of rates of payment, and to the requirement of prior
27 notice of rates of payment, are hereby suspended and shall, for purposes
28 of implementing the provisions of this act, be deemed to have been with-
29 out any force or effect from and after November 1, 2002 for such rates
30 effective for the period January 1, 2003 through December 31, 2003.
31 § 82. Notwithstanding any inconsistent provision of law, rule or
32 regulation, for purposes of implementing the provisions of article 28 of
33 the public health law, references to titles XIX and XXI of the federal
34 social security act in article 28 of the public health law shall be
35 deemed to include and also to mean any successor titles thereto under
36 the federal social security act.
37 § 83. The commissioner of health is authorized to promulgate or adopt
38 any rules or regulations necessary to implement the provisions of this
39 act and any procedures, forms, or instructions necessary for such imple-
40 mentation may be adopted and issued on or after the effective date of
41 this act.
42 Notwithstanding any inconsistent provision of the state administrative
43 procedure act or any other provision of law, rule or regulation, the
44 commissioner of health and the superintendent of insurance and any
45 appropriate council is authorized to adopt or amend or promulgate on an
46 emergency basis any regulation he or she or such council determines
47 necessary to implement any provision of this act on its effective date.
48 § 84. If any clause, sentence, paragraph, section or part of this act
49 shall be adjudged by any court of competent jurisdiction to be invalid,
50 such judgment shall not affect, impair or invalidate the remainder ther-
51 eof, but shall be confined in its operation to the clause, sentence,
52 paragraph, section or part thereof directly involved in the controversy
53 in which such judgment shall have been rendered.
54 § 85. This act shall take effect April 1, 2003 and shall be deemed to
55 have been in full force and effect on and after such date; provided,
56 however, that:
S. 1408 68 A. 2108
1 1. section thirty-two of this act shall be deemed to have been in full
2 force and effect on and after January 25, 2002;
3 2. the amendments to clause (A) of subparagraph (iii) of paragraph (b)
4 of subdivision 5 of section 2807-c of the public health law made by
5 section eleven of this act shall survive the expiration and reversion of
6 any provision of such clause, as provided in subdivision 5 of section
7 168 of chapter 639 of the laws of 1996, as amended;
8 3. the amendments to subparagraph (iii) of paragraph (f) of subdivi-
9 sion 4 of section 2807-c of the public health law made by section
10 fifty-four of this act shall not affect the expiration and repeal of
11 such paragraph and shall expire and be deemed repealed therewith;
12 4. the amendments to subparagraph (iii) of paragraph (k) of subdivi-
13 sion 4 of section 2807-c of the public health law made by section
14 fifty-five of this act shall not affect the expiration and repeal of
15 such paragraph and shall expire and be deemed repealed therewith;
16 5. the amendments to the opening paragraph of subparagraph (vi) of
17 paragraph (b) of subdivision 5 of section 2807-c of the public health
18 law made by section fifty-six of this act shall not affect the expira-
19 tion and repeal of such subparagraph and shall expire and be deemed
20 repealed therewith;
21 6. the amendments to the opening paragraph and subparagraph (i) of
22 paragraph (c) of subdivision 5 of section 2807-c of the public health
23 law made by section fifty-seven of this act shall not affect the expira-
24 tion and repeal of such paragraph and shall expire and be deemed
25 repealed therewith; and
26 7. the amendments to clause (B-1) of subparagraph (i) of paragraph (f)
27 of subdivision 11 of section 2807-c of the public health law made by
28 section fifty-eight of this act shall survive the expiration of such
29 clause as provided by chapters 639 of the laws of 1996 and 1 of the laws
30 of 1999, as amended.
31 PART L
32 Section 1. Subdivision 5 of section 168 of chapter 639 of the laws of
33 1996, relating to the Health Care Reform Act of 1996, as amended by
34 chapter 419 of the laws of 2000, is amended to read as follows:
35 5. sections 2807-c, 2807-j, 2807-s and 2807-t of the public health
36 law, as amended or as added by this act, shall expire on [June 30, 2003]
37 July 1, 2005, and shall be thereafter effective only in respect to any
38 act done on or before such date or action or proceeding arising out of
39 such act including continued collections of funds from assessments and
40 allowances and surcharges established pursuant to sections 2807-c,
41 2807-j, 2807-s and 2807-t of the public health law, and administration
42 and distributions of funds from pools established pursuant to sections
43 2807-c, 2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public
44 health law related to patient services provided before July 1, [2003]
45 2005, and continued expenditure of funds authorized for programs and
46 grants until the exhaustion of funds therefor;
47 § 2. Subdivision 1 of section 138 of chapter 1 of the laws of 1999,
48 relating to the New York Health Care Reform Act of 2000, as amended by
49 chapter 419 of the laws of 2000, is amended to read as follows:
50 1. sections 2807-c, 2807-j, 2807-s, and 2807-t of the public health
51 law, as amended by this act, shall expire on [June 30, 2003] July 1,
52 2005, and thereafter effective only in respect to any act done before
53 such date or action or proceeding arising out of such act including
54 continued collections of funds from assessments and allowances and
S. 1408 69 A. 2108
1 surcharges established pursuant to sections 2807-c, 2807-j, 2807-s and
2 2807-t of the public health law, and administration and distributions of
3 funds from pools established pursuant to sections 2807-c, 2807-j,
4 2807-k, 2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the public
5 health law, as amended or added by this act, related to patient services
6 provided before July 1, [2003] 2005, and continued expenditure of funds
7 authorized for programs and grants until the exhaustion of funds there-
8 for;
9 § 3. Subdivision 2 of section 2807-j of the public health law, as
10 added by chapter 639 of the laws of 1996, paragraph (a) as amended by
11 chapter 1 of the laws of 1999, and the opening paragraph of paragraph
12 (b) and paragraph (d) as amended by section 16 of part C of chapter 63
13 of the laws of 2001, is amended to read as follows:
14 2. (a) The total percentage allowance for any period during the period
15 January first, nineteen hundred ninety-seven through December thirty-
16 first, nineteen hundred ninety-nine and on and after January first, two
17 thousand, for a designated provider of services applicable to a payor
18 shall be determined in accordance with this subdivision and applied to
19 net patient service revenues.
20 (b) The total percentage allowance for each payor, other than govern-
21 mental agencies, or health maintenance organizations for services
22 provided to subscribers eligible for medical assistance pursuant to
23 title eleven of article five of the social services law, or approved
24 organizations for services provided to subscribers eligible for the
25 family health plus program pursuant to title eleven-D of article five of
26 the social services law, and other than payments for a patient that has
27 no third-party coverage in whole or in part for services provided by a
28 designated provider of services, shall be:
29 (i) the sum of (A) eight and eighteen-hundredths percent, provided,
30 however, that for services provided on and after July first, two thou-
31 sand three, the percentage shall be eight and eighty-five hundredths
32 percent, plus (B) twenty-four percent, provided, however, that for
33 services provided on and after July first, two thousand three, the
34 percentage shall be twenty-five and ninety-seven hundredths percent, and
35 plus (C) for a specified third-party payor as defined in subdivision
36 one-a of section twenty-eight hundred seven-s of this article the
37 percentage allowance applicable for a general hospital for inpatient
38 hospital services pursuant to subdivision two of section twenty-eight
39 hundred seven-s of this article;
40 (ii) unless (A) an election in accordance with paragraph (a) of subdi-
41 vision five of this section to pay the allowance directly to the commis-
42 sioner or the commissioner's designee is in effect for a third-party
43 payor, and in addition (B) for a specified third-party payor an election
44 to pay the assessment in accordance with section twenty-eight hundred
45 seven-t of this article is in effect.
46 (c) If an election in accordance with subdivision five of this section
47 is in effect for a third-party payor and in addition in accordance with
48 section twenty-eight hundred seven-t of this article for a specified
49 third-party payor, the total percentage allowance factor shall be
50 reduced to eight and eighteen-hundredths percent, provided, however,
51 that for services provided on and after July first, two thousand three
52 the total percentage allowance factor shall be reduced to eight and
53 eighty-five hundredths percent.
54 (d) The total percentage allowance for payments by governmental agen-
55 cies, as determined in accordance with paragraphs (a) and (a-1) of
56 subdivision one of section twenty-eight hundred seven-c of [the public
S. 1408 70 A. 2108
1 health law] this article as in effect on December thirty-first, nineteen
2 hundred ninety-six, or health maintenance organizations for services
3 provided to subscribers eligible for medical assistance pursuant to
4 title eleven of article five of the social services law, or approved
5 organizations for services provided to subscribers eligible for the
6 family health plus program pursuant to title eleven-D of article five of
7 the social services law, shall be five and ninety-eight-hundredths
8 percent, provided, however, that for services provided on and after July
9 first, two thousand three the total percentage allowance shall be six
10 and forty-seven hundredths percent.
11 (e) The total percentage allowance for payments for services provided
12 by designated providers of services for which there is no third-party
13 coverage in whole or in part shall be eight and eighteen-hundredths
14 percent, provided, however, that for services provided on and after July
15 first, two thousand three the total percentage allowance shall be eight
16 and eighty-five hundredths percent. This paragraph shall not apply to
17 patient deductibles and coinsurance amounts.
18 (f) The total percentage allowance for patient deductibles and coinsu-
19 rance amounts shall be the same percentage allowance applicable to
20 payments by the primary third-party payor covering the patient in each
21 case determined in accordance with paragraphs (a), (b) and (c) of this
22 subdivision.
23 (g) The total percentage allowance for secondary third-party payors
24 under coordination of benefits principles shall be the same percentage
25 allowance applicable to payments by the primary third-party payor in the
26 case determined in accordance with paragraphs (a), (b) and (c) of this
27 subdivision.
28 § 4. The opening paragraph and paragraph (a) of subdivision 6 of
29 section 2807-s of the public health law, the opening paragraph as
30 amended by chapter 1 of the laws of 1999 and paragraph (a) as amended by
31 section 28 of part A of chapter 1 of the laws of 2002, are amended to
32 read as follows:
33 The amount allocated to each region for purposes of calculating the
34 regional allowance percentage pursuant to this section for each year
35 during the period January first, nineteen hundred ninety-seven through
36 December thirty-first, nineteen hundred ninety-nine and the regional
37 assessments pursuant to section twenty-eight hundred seven-t of this
38 article for each year during the period January first, nineteen hundred
39 ninety-seven through December thirty-first, nineteen hundred ninety-nine
40 and for each year on and after January first, two thousand, shall be the
41 sum of the factors computed in paragraphs (b), (d) and (f) of this
42 [section] subdivision as follows:
43 (a) (i) A gross annual statewide amount for nineteen hundred ninety-
44 seven shall be five hundred eighty-nine million dollars.
45 (ii) A gross annual statewide amount for nineteen hundred ninety-eight
46 shall be five hundred eighty-nine million dollars.
47 (iii) A gross annual statewide amount for nineteen hundred ninety-nine
48 shall be five hundred eighty-nine million dollars.
49 (iv) A gross annual statewide amount for two thousand shall be five
50 hundred eighty-nine million dollars.
51 (v) A gross annual statewide amount for two thousand one shall be five
52 hundred sixty-nine million dollars.
53 (vi) A gross annual statewide amount for two thousand two shall be
54 five hundred eighty-nine million dollars.
55 (vii) A gross annual statewide amount for [the period January first,
56 two thousand three through June thirtieth,] two thousand three shall be
S. 1408 71 A. 2108
1 [two hundred ninety-four million five hundred thousand] five hundred
2 eighty-nine million dollars.
3 (viii) A gross annual statewide amount for two thousand four shall be
4 six hundred twenty-four million dollars.
5 (ix) A gross annual statewide amount for the period January first, two
6 thousand five through June thirtieth, two thousand five shall be three
7 hundred twelve million dollars.
8 § 5. Paragraph (c) of subdivision 6 of section 2807-s of the public
9 health law, as amended by chapter 1 of the laws of 1999, is amended to
10 read as follows:
11 (c) (i) A further gross annual statewide amount for nineteen hundred
12 ninety-seven shall be sixty-four million dollars.
13 (ii) A further gross annual statewide amount for nineteen hundred
14 ninety-eight shall be sixty-four million dollars.
15 (iii) A further gross annual statewide amount for nineteen hundred
16 ninety-nine shall be eighty-nine million dollars.
17 (iv) A further gross annual statewide amount for two thousand, two
18 thousand one [and], two thousand two, two thousand three and two thou-
19 sand four, shall be eighty-nine million dollars.
20 (v) A further gross statewide amount for the period January first, two
21 thousand [three] five through June thirtieth, two thousand [three] five,
22 shall be forty-four million five hundred thousand dollars.
23 § 6. Paragraph (e) of subdivision 6 of section 2807-s of the public
24 health law, as amended by chapter 1 of the laws of 1999, is amended to
25 read as follows:
26 (e) (i) A further gross annual statewide amount shall be twelve
27 million dollars [annually] for each periods prior to January first, two
28 thousand [three] five.
29 (ii) A further gross statewide amount for the period January first,
30 two thousand [three] five through June thirtieth, two thousand [three]
31 five shall be six million dollars.
32 § 7. Subdivision 3 and paragraphs (a) and (a-1) of subdivision 4 of
33 section 2807-k of the public health law, as amended by chapter 419 of
34 the laws of 2000, are amended to read as follows:
35 3. (a) Each major public general hospital shall be allocated for
36 distribution from the pools established pursuant to this section for
37 each year through December thirty-first, two thousand [two] four, an
38 amount equal to the amount allocated to such major public general hospi-
39 tal from the regional pool established pursuant to subdivision seventeen
40 of section twenty-eight hundred seven-c of this article for the period
41 January first, nineteen hundred ninety-six through December thirty-
42 first, nineteen hundred ninety-six.
43 (b) For the period January first, two thousand [three] five through
44 June thirtieth, two thousand [three] five, each major public general
45 hospital shall be allocated for distribution from the pools established
46 pursuant to this section for such period, an amount equal to one-half
47 the amount calculated pursuant to paragraph (a) of this subdivision.
48 (a) From funds in the pool for each year, thirty-six million dollars
49 shall be reserved on an annual basis through December thirty-first, two
50 thousand [two] four and eighteen million dollars shall be reserved for
51 the period January first, two thousand [three] five through June thirti-
52 eth, two thousand [three] five, for distribution as high need adjust-
53 ments in accordance with subdivision six of this section.
54 (a-1) From funds in the pool for each year, twenty-seven million
55 dollars shall be reserved on an annual basis for the periods January
56 first, two thousand through December thirty-first, two thousand [two]
S. 1408 72 A. 2108
1 four and thirteen million five hundred thousand dollars shall be
2 reserved for the period January first, two thousand [three] five through
3 June thirtieth, two thousand [three] five, for distribution in accord-
4 ance with subdivision sixteen of this section.
5 § 8. Subparagraphs (iv) and (v) of paragraph (a) of subdivision 9 of
6 section 2807-j of the public health law, as added by chapter 1 of the
7 laws of 1999, are amended to read as follows:
8 (iv) seven hundred sixty-five million dollars annually of the funds
9 accumulated for the periods January first, two thousand through December
10 thirty-first, two thousand [two] four, and
11 (v) three hundred [eighty-three] eighty-two million five hundred thou-
12 sand dollars of the funds accumulated for the period January first, two
13 thousand [three] five through June thirtieth, two thousand [three] five,
14 and
15 § 9. The opening paragraph, paragraph (a) of subdivision 1, and subdi-
16 vision 2 of section 2807-w of the public health law, as amended by chap-
17 ter 419 of the laws of 2000, are amended to read as follows:
18 Funds allocated pursuant to paragraph (p) of subdivision one of
19 section twenty-eight hundred seven-v of this article, shall be deposited
20 as authorized and used for the purpose of making medicaid dispropor-
21 tionate share payments within the limits established on an annualized
22 basis pursuant to subdivision twenty-one of section twenty-eight hundred
23 seven-c of this article, for the period January first, two thousand
24 through June thirtieth, two thousand [three] five, in accordance with
25 the following:
26 (a) Each eligible rural hospital shall receive one hundred forty thou-
27 sand dollars on an annualized basis for the periods January first, two
28 thousand through December thirty-first, two thousand [two] four and
29 seventy thousand dollars for the period January first, two thousand
30 [three] five through June thirtieth, two thousand [three] five, provided
31 as a disproportionate share payment; provided, however, that if such
32 payment pursuant to this paragraph exceeds a hospital's applicable
33 disproportionate share limit, then the total amount in excess of such
34 limit shall be provided as a nondisproportionate share payment in the
35 form of a grant directly from this pool without allocation to the
36 special revenue funds - other, indigent care fund - 068;
37 2. From the funds in the pool each year, thirty-six million dollars on
38 an annualized basis for the periods January first, two thousand through
39 December thirty-first, two thousand [two] four and eighteen million
40 dollars for the period January first, two thousand [three] five through
41 June thirtieth, two thousand [three] five, of the funds not distributed
42 in accordance with subdivision one of this section, shall be distributed
43 in accordance with the formula set forth in subdivision six of section
44 twenty-eight hundred seven-k of this article.
45 § 10. Subparagraphs (iv) and (v) of paragraph (a) of subdivision 7 of
46 section 2807-s of the public health law, as added by chapter 1 of the
47 laws of 1999, are amended and a new subparagraph (vi) is added to read
48 as follows:
49 (iv) four hundred ninety-four million dollars on an annual basis for
50 the periods January first, two thousand through December thirty-first,
51 two thousand [two] four,
52 (v) two hundred forty-seven million dollars for the period January
53 first, two thousand [three] five through June thirtieth, two thousand
54 [three; and] five,
55 (vi) provided, however, amounts set forth in this paragraph may be
56 reduced by the commissioner in an amount to be approved by the director
S. 1408 73 A. 2108
1 of the budget to reflect the amount received from the federal government
2 under the state's 1115 waiver which is directed under its terms and
3 conditions to the graduate medical education program established pursu-
4 ant to section twenty-eight hundred seven-m of this article; and
5 § 11. Subparagraphs (i) and (iii) of paragraph (d) of subdivision 3 of
6 section 2807-m of the public health law, as amended by chapter 419 of
7 the laws of 2000, are amended to read as follows:
8 (i) the commissioner shall establish a reduction percentage by divid-
9 ing twenty-seven million dollars each year for the period January first,
10 two thousand through December thirty-first, two thousand [two] four and
11 thirteen million five hundred thousand dollars for the period January
12 first, two thousand [three] five through June thirtieth, two thousand
13 [three] five, by the sum of initial hospital distribution amounts calcu-
14 lated pursuant to paragraph (c) of this subdivision;
15 (iii) each teaching general hospital shall have its initial distrib-
16 ution amount as determined pursuant to paragraph (c) of this subdivision
17 reduced by an amount up to the amount calculated pursuant to subpara-
18 graph (ii) of this paragraph and subject to the requirements of subpara-
19 graph (iv) of this paragraph, provided, however, that if the sum of
20 reduction amounts for all facilities thus calculated is less than twen-
21 ty-seven million dollars on a statewide basis each year for the period
22 January first, two thousand through December thirty-first, two thousand
23 [two] four and thirteen million five hundred thousand dollars for the
24 period January first, two thousand [three] five through June thirtieth,
25 two thousand [three] five, the commissioner may increase the reduction
26 percentage subject to the provisions of subparagraph (iv) of this para-
27 graph so that the sum of the reduction amounts for all facilities is
28 twenty-seven million dollars each year for the period January first, two
29 thousand through December thirty-first, two thousand [two] four and
30 thirteen million five hundred thousand dollars for the period January
31 first, two thousand [three] five through June thirtieth, two thousand
32 [three] five.
33 § 12. Paragraph (a) of subdivision 5 of section 2807-m of the public
34 health law, as amended by chapter 1 of the laws of 1999, is amended to
35 read as follows:
36 (a) Up to thirty-one million dollars annually for the periods January
37 first, two thousand through December thirty-first, two thousand [two]
38 four, and up to fifteen million five hundred thousand dollars for the
39 period January first, two thousand [three] five through June thirtieth,
40 two thousand [three] five, shall be set aside and reserved by the
41 commissioner annually from the regional pools established pursuant to
42 subdivision two of this section for supplemental distributions in each
43 such region to be made by the commissioner to consortia and teaching
44 general hospitals in accordance with a distribution methodology devel-
45 oped in consultation with the council and specified in rules and regu-
46 lations adopted by the commissioner.
47 § 13. Paragraph (c) of subdivision 2 of section 2807-s of the public
48 health law, as added by chapter 1 of the laws of 1999, is amended to
49 read as follows:
50 (c) (i) The regional percentage allowance for the periods [on and
51 after] January first, two thousand through June thirtieth, two thousand
52 three, for all general hospitals in the region applicable to specified
53 third-party payors, and applicable to related patient coinsurance and
54 deductible amounts, shall be the same regional percentage allowance
55 calculated pursuant to paragraph (b) of this subdivision for the period
S. 1408 74 A. 2108
1 January first, nineteen hundred ninety-nine through December thirty-
2 first, nineteen hundred ninety-nine.
3 (ii) The regional percentage allowance for the periods July first, two
4 thousand three through June thirtieth, two thousand five, for all gener-
5 al hospitals in the region applicable to specified third-party payors,
6 and applicable to related patient coinsurance and deductible amounts,
7 shall be the same regional percentage allowance calculated pursuant to
8 paragraph (b) of this subdivision for the period January first, nineteen
9 hundred ninety-nine through December thirty-first, nineteen hundred
10 ninety-nine multiplied by one hundred eight and nineteen hundredths
11 percent.
12 § 14. Section 2807-1 of the public health law, as amended by chapter
13 1 of the laws of 1999, clauses (D), (E), (F), and (G) of subparagraph
14 (i) and subparagraph (ii) of paragraph (b), the opening paragraph of
15 paragraph (c), subparagraph (v) of paragraph (i), subparagraph (v) of
16 paragraph (k), and the opening paragraph of paragraph (m) of subdivision
17 1, subdivision 2, and subdivision 3 as amended by chapter 419 of the
18 laws of 2000, paragraph (f) of subdivision 1 as amended by section 6 of
19 part A of chapter 57 of the laws of 2000, is amended to read as follows:
20 § 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
21 lated in the health care initiatives pools pursuant to paragraph (b) of
22 subdivision nine of section twenty-eight hundred seven-j of this arti-
23 cle, including income from invested funds, shall be distributed or
24 retained by the commissioner in accordance with the following.
25 (a) Funds shall be reserved and accumulated from year to year by the
26 commissioner and shall be available, including income from invested
27 funds, for purposes of distributions to programs to provide health care
28 coverage for uninsured or underinsured children pursuant to sections
29 twenty-five hundred ten and twenty-five hundred eleven of this chapter
30 from the respective health care initiatives pools established for the
31 following periods in the following amounts:
32 (i) from the pool for the period January first, nineteen hundred nine-
33 ty-seven through December thirty-first, nineteen hundred ninety-seven,
34 up to one hundred twenty million six hundred thousand dollars;
35 (ii) from the pool for the period January first, nineteen hundred
36 ninety-eight through December thirty-first, nineteen hundred ninety-
37 eight, up to one hundred sixty-four million five hundred thousand
38 dollars;
39 (iii) from the pool for the period January first, nineteen hundred
40 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
41 up to one hundred eighty-one million dollars;
42 (iv) from the pool for the period January first, two thousand through
43 December thirty-first, two thousand, two hundred seven million dollars;
44 (v) from the pool for the period January first, two thousand one
45 through December thirty-first, two thousand one, two hundred thirty-five
46 million dollars;
47 (vi) from the pool for the period January first, two thousand two
48 through December thirty-first, two thousand two, three hundred twenty-
49 four million dollars;
50 (vii) from the pool for the period January first, two thousand three
51 through [June thirtieth] December thirty-first, two thousand three, [one
52 hundred seventy-four million] up to four hundred twenty-three million
53 nine hundred thousand dollars; [and]
54 (viii) from the pool for the period January first, two thousand four
55 through December thirty-first, two thousand four, up to three hundred
56 eighty-one million seven hundred thousand dollars;
S. 1408 75 A. 2108
1 (ix) from the pool for the period January first, two thousand five
2 through June thirtieth, two thousand five, up to two hundred two million
3 three hundred thousand dollars; and
4 (x) If funds allocated pursuant to this paragraph are insufficient to
5 cover the costs required to meet the state's obligations established in
6 [section] sections twenty-five hundred ten and twenty-five hundred elev-
7 en of this chapter, the commissioner [shall] may transfer and deposit
8 funds accumulated pursuant to this section and sections twenty-eight
9 hundred seven-j, twenty-eight hundred seven-k, twenty-eight hundred
10 seven-s, twenty-eight hundred seven-t and twenty-eight hundred seven-v
11 of this article into the special revenue fund-other, miscellaneous
12 special revenue fund-339, child health insurance account, such amounts
13 necessary to fully fund such obligations.
14 (b) Funds shall be reserved and accumulated from year to year by the
15 commissioner and shall be available, including income from invested
16 funds, for purposes of distributions for health insurance programs under
17 the New York state small business health insurance partnership program
18 established pursuant to article nine-A of this chapter, a voucher insur-
19 ance program established pursuant to section eleven hundred twenty-one
20 of the insurance law, individual subsidy programs established pursuant
21 to the expanded health care coverage act of nineteen hundred eighty-
22 eight as amended, and the catastrophic health care expense program
23 established pursuant to title eleven-A of article five of the social
24 services law and for evaluation of such programs from the respective
25 health care initiatives pools established for the following periods in
26 the following amounts:
27 (i) (A) from the pool for the period January first, nineteen hundred
28 ninety-seven through December thirty-first, nineteen hundred ninety-sev-
29 en, up to twenty-four million dollars;
30 (B) from the pool for the period January first, nineteen hundred nine-
31 ty-eight through December thirty-first, nineteen hundred ninety-eight,
32 up to twenty-four million dollars;
33 (C) from the pool for the period January first, nineteen hundred nine-
34 ty-nine through December thirty-first, nineteen hundred ninety-nine, up
35 to twenty-four million dollars;
36 (D) from the pool for the period January first, two thousand through
37 December thirty-first, two thousand, up to seventeen million dollars;
38 (E) from the pool for the period January first, two thousand one
39 through December thirty-first, two thousand one, up to fourteen million
40 [five] two hundred thousand dollars;
41 (F) from the pool for the period January first, two thousand two
42 through December thirty-first, two thousand two, up to [twelve million]
43 eleven million three hundred thousand dollars; and
44 (G) from the pool for the period January first, two thousand three
45 through June thirtieth, two thousand three, up to [four] one million
46 five hundred thousand dollars.
47 (ii) provided however, that from such funds allocated pursuant to
48 subparagraph (i) of this paragraph:
49 (A) an amount not to exceed six million dollars on an annualized basis
50 for the periods during the period January first, nineteen hundred nine-
51 ty-seven through December thirty-first, nineteen hundred ninety-nine; up
52 to six million dollars for the period January first, two thousand
53 through December thirty-first, two thousand; up to five million dollars
54 for the period January first, two thousand one through December thirty-
55 first, two thousand one; up to four million dollars for the period Janu-
56 ary first, two thousand two through December thirty-first, two thousand
S. 1408 76 A. 2108
1 two; and up to [one million] five hundred thousand dollars for the peri-
2 od January first, two thousand three through June thirtieth, two thou-
3 sand three shall be allocated to the health insurance programs under the
4 New York state small business health insurance partnership program
5 established pursuant to article nine-A of this chapter;
6 (B) an amount not to exceed five million dollars on an annualized
7 basis for the periods January first, nineteen hundred ninety-seven
8 through December thirty-first, nineteen hundred ninety-nine and up to
9 one million dollars for the period January first, two thousand through
10 December thirty-first, two thousand and up to [five] two hundred thou-
11 sand dollars for the period January first, two thousand one through
12 December thirty-first, two thousand one shall be allocated to the vouch-
13 er insurance program;
14 (C) an amount not to exceed six million dollars on an annualized basis
15 for the periods January first, nineteen hundred ninety-seven through
16 December thirty-first, nineteen hundred ninety-nine; up to six million
17 dollars for the period January first, two thousand through December
18 thirty-first, two thousand; up to five million dollars for the period
19 January first, two thousand one through December thirty-first, two thou-
20 sand one; up to four million dollars for the period January first, two
21 thousand two through December thirty-first, two thousand two; and up to
22 one million dollars for the period January first, two thousand three
23 through June thirtieth, two thousand three shall be allocated to indi-
24 vidual subsidy programs; and
25 (D) an amount not to exceed seven million dollars on an annualized
26 basis for the periods during the period January first, nineteen hundred
27 ninety-seven through December thirty-first, nineteen hundred ninety-nine
28 and four million dollars annually for the periods January first, two
29 thousand through December thirty-first, two thousand [two, and two
30 million dollars for the period January first, two thousand three through
31 June thirtieth, two thousand three,] one, and three million three
32 hundred thousand dollars for the period January first, two thousand two
33 through December thirty-first, two thousand two, shall be allocated to
34 the catastrophic health care expense program.
35 (iii) Notwithstanding any law to the contrary, the characterizations
36 of the New York state small business health insurance partnership
37 program, voucher program, individual subsidy program and catastrophic
38 health care expense program, may, for the purposes of identifying match-
39 ing funds for the community health care conversion demonstration project
40 described in a waiver of the provisions of title XIX of the federal
41 social security act granted to the state of New York and dated July
42 fifteenth, nineteen hundred ninety-seven, may continue to be used to
43 characterize the insurance programs in sections four thousand three
44 hundred twenty-one-a, four thousand three hundred twenty-two-a, four
45 thousand three hundred twenty-six and four thousand three hundred twen-
46 ty-seven of the insurance law, which are successor programs to these
47 programs.
48 (c) Up to seventy-eight million dollars shall be reserved and accumu-
49 lated from year to year by the commissioner from the pool for the period
50 January first, nineteen hundred ninety-seven through December thirty-
51 first, nineteen hundred ninety-seven, for purposes of public health
52 programs, up to seventy-six million dollars shall be reserved and accu-
53 mulated from year to year by the commissioner from the pools for the
54 periods January first, nineteen hundred ninety-eight through December
55 thirty-first, nineteen hundred ninety-eight and January first, nineteen
56 hundred ninety-nine through December thirty-first, nineteen hundred
S. 1408 77 A. 2108
1 ninety-nine, up to eighty-four million dollars shall be reserved and
2 accumulated from year to year by the commissioner from the pools for the
3 period January first, two thousand through December thirty-first, two
4 thousand, up to eighty-five million dollars shall be reserved and accu-
5 mulated from year to year by the commissioner from the pools for the
6 period January first, two thousand one through December thirty-first,
7 two thousand one, up to eighty-six million dollars shall be reserved and
8 accumulated from year to year by the commissioner from the pools for the
9 period January first, two thousand two through December thirty-first,
10 two thousand two, [and] up to [forty-four million] eighty-three million
11 eight hundred thousand dollars shall be reserved and accumulated from
12 year to year by the commissioner from the pools for the period January
13 first, two thousand three through [June thirtieth] December
14 thirty-first, two thousand three, up to eighty-three million eight
15 hundred thousand dollars shall be reserved and accumulated from year to
16 year by the commissioner from the pools for the period January first,
17 two thousand four through December thirty-first, two thousand four, and
18 up to forty-three million dollars shall be reserved and accumulated from
19 year to year by the commissioner from the pools for the period January
20 first, two thousand five through June thirtieth, two thousand five, and
21 shall be available, including income from invested funds, for:
22 (i) deposit by the commissioner, within amounts appropriated, and the
23 state comptroller is hereby authorized and directed to receive for
24 deposit to, to the credit of the department of health's special revenue
25 fund - other, hospital based grants program account, for purposes of
26 services and expenses related to general hospital based grant programs,
27 up to twenty-two million dollars annually from the nineteen hundred
28 ninety-seven pool, nineteen hundred ninety-eight pool, nineteen hundred
29 ninety-nine pool, two thousand pool, two thousand one pool and two thou-
30 sand two pool, respectively, [and] up to [eleven] twenty-two million
31 dollars from the two thousand three pool, up to twenty-two million
32 dollars for the period January first, two thousand four through December
33 thirty-first, two thousand four, and up to eleven million dollars for
34 the period January first, two thousand five through June thirtieth, two
35 thousand five;
36 (ii) deposit by the commissioner, within amounts appropriated, and the
37 state comptroller is hereby authorized and directed to receive for
38 deposit to, to the credit of the emergency medical services training
39 account established [for purposes of] in section ninety-seven-q of the
40 state finance law, up to sixteen million dollars on an annualized basis
41 for the periods January first, nineteen hundred ninety-seven through
42 December thirty-first, nineteen hundred ninety-nine, up to twenty
43 million dollars for the period January first, two thousand through
44 December thirty-first, two thousand, up to twenty-one million dollars
45 for the period January first, two thousand one through December thirty-
46 first, two thousand one, up to twenty-two million dollars for the period
47 January first, two thousand two through December thirty-first, two thou-
48 sand two, [and] up to [twelve million] twenty million seven hundred
49 thousand dollars for the period January first, two thousand three
50 through [June thirtieth] December thirty-first, two thousand three, up
51 to twenty million seven hundred thousand dollars for the period January
52 first, two thousand four through December thirty-first, two thousand
53 four, and up to eleven million two hundred thousand dollars for the
54 period January first, two thousand five through June thirtieth, two
55 thousand five;
S. 1408 78 A. 2108
1 (iii) priority distributions by the commissioner up to thirty-two
2 million dollars on an annualized basis to be allocated (A) for the
3 purposes established pursuant to subparagraph (ii) of paragraph (f) of
4 subdivision nineteen of section twenty-eight hundred seven-c of this
5 article as in effect on December thirty-first, nineteen hundred ninety-
6 six and as may thereafter be amended, up to fifteen million dollars
7 annually for the periods January first, two thousand through December
8 thirty-first, two thousand [two] four, and up to seven million five
9 hundred thousand dollars for the period January first, two thousand
10 [three] five through June thirtieth, two thousand [three] five; and
11 (B) pursuant to a memorandum of understanding entered into by the
12 commissioner, the majority leader of the senate and the speaker of the
13 assembly, for the purposes outlined in such memorandum upon the recom-
14 mendation of the majority leader of the senate, up to eight million
15 five hundred thousand dollars annually for the period January first, two
16 thousand through December thirty-first, two thousand [two] four, and up
17 to four million two hundred fifty thousand dollars for the period Janu-
18 ary first, two thousand [three] five through June thirtieth, two thou-
19 sand [three] five, and for the purposes outlined in such memorandum upon
20 the recommendation of the speaker of the assembly, up to eight million
21 five hundred thousand dollars annually for the periods January first,
22 two thousand through December thirty-first, two thousand [two] four, and
23 up to four million two hundred fifty thousand dollars for the period
24 January first, two thousand [three] five through June thirtieth, two
25 thousand [three] five;
26 (iv) distributions by the commissioner related to poison control
27 centers pursuant to subdivision seven of section twenty-five hundred-d
28 of this chapter, up to five million dollars for the period January
29 first, nineteen hundred ninety-seven through December thirty-first,
30 nineteen hundred ninety-seven, up to three million dollars on an annual-
31 ized basis for the periods during the period January first, nineteen
32 hundred ninety-eight through December thirty-first, nineteen hundred
33 ninety-nine, up to five million dollars annually for the periods January
34 first, two thousand through December thirty-first, two thousand two,
35 [and] up to [two million five hundred thousand] four million one hundred
36 thousand dollars annually for the [period] periods January first, two
37 thousand three through [June thirtieth, two thousand three] December
38 thirty-first, two thousand four, and up to two million three hundred
39 thousand dollars for the period January first, two thousand five through
40 June thirtieth, two thousand five; and
41 (v) deposit by the commissioner, within amounts appropriated, and the
42 state comptroller is hereby authorized and directed to receive for
43 deposit to, to the credit of the department of health's special revenue
44 fund - other, miscellaneous special revenue fund - 339 maternal and
45 child HIV services account, for purposes of a special program for HIV
46 services for infants and pregnant women pursuant to section seventy-one
47 of chapter seven hundred thirty-one of the laws of nineteen hundred
48 ninety-three, amending the public health law and other laws relating to
49 reimbursement, delivery and capital costs of ambulatory health care
50 services and inpatient hospital services, up to five million dollars
51 annually for the periods January first, two thousand through December
52 thirty-first, two thousand two, [and] up to [two million five hundred
53 thousand] five million dollars for the period January first, two thou-
54 sand three through [June thirtieth] December thirty-first, two thousand
55 three, up to five million dollars for the period January first, two
56 thousand four through December thirty-first, two thousand four, and up
S. 1408 79 A. 2108
1 to two million five hundred thousand dollars for the period January
2 first, two thousand five through June thirtieth, two thousand five, plus
3 such amounts as may be available from prior year pool reserves.
4 (d) (i) An amount of up to twenty million dollars annually for the
5 period January first, two thousand through December thirty-first, two
6 thousand [two] four, and up to ten million dollars for the period Janu-
7 ary first, two thousand [three] five through June thirtieth, two thou-
8 sand [three] five, shall be transferred by the commissioner to the
9 health facility restructuring pool established pursuant to section twen-
10 ty-eight hundred fifteen of this article;
11 (ii) provided, however, amounts transferred pursuant to subparagraph
12 (i) of this paragraph may be reduced by the commissioner in an amount to
13 be approved by the director of the budget to reflect the amount received
14 from the federal government under the state's 1115 waiver which is
15 directed under its terms and conditions to the health facility restruc-
16 turing program.
17 (e) Funds shall be reserved and accumulated from year to year by the
18 commissioner and shall be available, including income from invested
19 funds, for purposes of distributions to organizations to support the
20 health workforce retraining program established pursuant to section
21 twenty-eight hundred seven-g of this article from the respective health
22 care initiatives pools established for the following periods in the
23 following amounts from the pools during the period January first, nine-
24 teen hundred ninety-seven through December thirty-first, nineteen
25 hundred ninety-nine, up to fifty million dollars on an annualized basis,
26 up to thirty million dollars for the period January first, two thousand
27 through December thirty-first, two thousand, up to forty million dollars
28 for the period January first, two thousand one through December thirty-
29 first, two thousand one, up to fifty million dollars for the period
30 January first, two thousand two through December thirty-first, two thou-
31 sand two, [and] up to [thirty million] twenty-five million four hundred
32 thousand dollars for the period January first, two thousand three
33 through [June thirtieth] December thirty-first, two thousand three, up
34 to twenty-five million three hundred thousand dollars for the period
35 January first, two thousand four through December thirty-first, two
36 thousand four, and up to twenty-one million three hundred thousand
37 dollars for the period January first, two thousand five through June
38 thirtieth, two thousand five, less the amount of funds available for
39 allocations for rate adjustments for workforce training programs for
40 payments by state governmental agencies for inpatient hospital services.
41 (f) Funds shall be accumulated and transferred from as follows:
42 (i) from the pool for the period January first, nineteen hundred nine-
43 ty-seven through December thirty-first, nineteen hundred ninety-seven,
44 (A) thirty-four million six hundred thousand dollars shall be trans-
45 ferred to funds reserved and accumulated pursuant to paragraph (b) of
46 subdivision nineteen of section twenty-eight hundred seven-c of this
47 article, and (B) eighty-two million dollars shall be transferred and
48 deposited and credited to the credit of the state general fund medical
49 assistance local assistance account;
50 (ii) from the pool for the period January first, nineteen hundred
51 ninety-eight through December thirty-first, nineteen hundred ninety-
52 eight, eighty-two million dollars shall be transferred and deposited and
53 credited to the credit of the state general fund medical assistance
54 local assistance account;
55 (iii) from the pool for the period January first, nineteen hundred
56 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
S. 1408 80 A. 2108
1 eighty-two million dollars shall be transferred and deposited and cred-
2 ited to the credit of the state general fund medical assistance local
3 assistance account; [and]
4 (iv) from the pool for the period January first, two thousand through
5 December thirty-first, two thousand [two] four, eighty-two million
6 dollars annually, and for the period January first, two thousand [three]
7 five through June thirtieth, two thousand [three] five, forty-one
8 million dollars shall be deposited by the commissioner, and the state
9 comptroller is hereby authorized and directed to receive for deposit to
10 the credit of the state special revenue fund - other, HCRA transfer
11 fund, medical assistance account.
12 (g) Funds shall be transferred by the commissioner to primary health
13 care services pools created by the commissioner, and shall be available,
14 including income from invested funds, for distributions in accordance
15 with section twenty-eight hundred seven-bb of this article from the
16 respective health care initiatives pools for the following periods in
17 the following percentage amounts of funds remaining after allocations in
18 accordance with paragraphs (a) through (f) of this subdivision:
19 (i) from the pool for the period January first, nineteen hundred nine-
20 ty-seven through December thirty-first, nineteen hundred ninety-seven,
21 fifteen and [eighty-seven-hundreths] eighty-seven-hundredths percent;
22 (ii) from the pool for the period January first, nineteen hundred
23 ninety-eight through December thirty-first, nineteen hundred ninety-
24 eight, fifteen and eighty-seven-hundredths percent; and
25 (iii) from the pool for the period January first, nineteen hundred
26 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
27 sixteen and [thirteen-hundreths] thirteen-hundredths percent, less two
28 million five hundred thousand dollars.
29 (h) Funds shall be reserved and accumulated from year to year by the
30 commissioner and shall be available, including income from invested
31 funds, for purposes of primary care education and training pursuant to
32 article nine of this chapter from the respective health care initiatives
33 pools established for the following periods in the following percentage
34 amounts of funds remaining after allocations in accordance with para-
35 graphs (a) through (f) of this subdivision and shall be available for
36 distributions as follows:
37 (i) funds shall be reserved and accumulated:
38 (A) from the pool for the period January first, nineteen hundred nine-
39 ty-seven through December thirty-first, nineteen hundred ninety-seven,
40 six and [thirty-five-hundreths] thirty-five-hundredths percent;
41 (B) from the pool for the period January first, nineteen hundred nine-
42 ty-eight through December thirty-first, nineteen hundred ninety-eight,
43 six and thirty-five-hundredths percent; and
44 (C) from the pool for the period January first, nineteen hundred nine-
45 ty-nine through December thirty-first, nineteen hundred ninety-nine, six
46 and forty-five-hundredths percent;
47 (ii) funds shall be available for distributions including income from
48 invested funds as follows:
49 (A) for purposes of the primary care physician loan repayment program
50 in accordance with section nine hundred three of this chapter, up to
51 five million dollars on an annualized basis;
52 (B) for purposes of the primary care practitioner scholarship program
53 in accordance with section nine hundred four of this chapter, up to two
54 million dollars on an annualized basis; [and]
S. 1408 81 A. 2108
1 (C) for purposes of minority participation in medical education grants
2 in accordance with section nine hundred six of this chapter, up to one
3 million dollars on an annualized basis; and
4 (D) provided, however, that the commissioner may reallocate any funds
5 remaining or unallocated for distributions for the primary care practi-
6 tioner scholarship program in accordance with section nine hundred four
7 of this chapter.
8 (i) Funds shall be reserved and accumulated from year to year by the
9 commissioner and shall be available, including income from invested
10 funds, for distributions in accordance with section twenty-nine hundred
11 fifty-two and section twenty-nine hundred fifty-eight of this chapter
12 for rural health care delivery development and rural health care access
13 development, respectively, from the respective health care initiatives
14 pools for the following periods in the following percentage amounts of
15 funds remaining after allocations in accordance with paragraphs (a)
16 through (f) of this subdivision, and for periods on and after January
17 first, two thousand, in the following amounts:
18 (i) from the pool for the period January first, nineteen hundred nine-
19 ty-seven through December thirty-first, nineteen hundred ninety-seven,
20 thirteen and forty-nine-hundredths percent;
21 (ii) from the pool for the period January first, nineteen hundred
22 ninety-eight through December thirty-first, nineteen hundred ninety-
23 eight, thirteen and forty-nine-hundredths percent;
24 (iii) from the pool for the period January first, nineteen hundred
25 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
26 thirteen and seventy-one-hundredths percent;
27 (iv) from the pool for the periods January first, two thousand through
28 December thirty-first, two thousand two, seventeen million dollars annu-
29 ally, and for the period January first, two thousand three through [June
30 thirtieth] December thirty-first, two thousand three, [eight million
31 five hundred thousand] up to fourteen million three hundred thousand
32 dollars; [and]
33 (v) from the pool for the period January first, two thousand four
34 through December thirty-first, two thousand four, up to fourteen million
35 two hundred thousand dollars, and for the period January first, two
36 thousand five through June thirtieth, two thousand five, up to seven
37 million eight hundred thousand dollars; and
38 (vi) if funds accumulated for distributions pursuant to sections twen-
39 ty-nine hundred fifty-two and twenty-nine hundred fifty-eight of this
40 chapter are insufficient to meet the funding amounts established pursu-
41 ant to [subparagraph] subparagraphs (iv) and (v) of this paragraph, the
42 commissioner is authorized to transfer funds accumulated pursuant to
43 section twenty-eight hundred seven-v of this article to the health care
44 initiatives pool to fully fund the amounts specified in subparagraph
45 (iv) of this paragraph; provided however, the provisions of this subpar-
46 agraph shall only be effective contingent upon meeting all funding
47 amounts established pursuant to paragraphs (a), (b), (c), (d), (e), (f),
48 (l), (m), (n), (q) and (r) of subdivision one of section twenty-eight
49 hundred seven-v of this article, and paragraph (a) of this subdivision.
50 (j) Funds shall be reserved and accumulated from year to year and
51 shall be available, including income from invested funds, for purposes
52 of distributions related to health information and health care quality
53 improvement pursuant to section twenty-eight hundred seven-n of this
54 article from the respective health care initiatives pools established
55 for the following periods in the following percentage amounts of funds
S. 1408 82 A. 2108
1 remaining after allocations in accordance with paragraphs (a) through
2 (f) of this subdivision:
3 (i) from the pool for the period January first, nineteen hundred nine-
4 ty-seven through December thirty-first, nineteen hundred ninety-seven,
5 six and thirty-five-hundredths percent;
6 (ii) from the pool for the period January first, nineteen hundred
7 ninety-eight through December thirty-first, nineteen hundred ninety-
8 eight, six and thirty-five-hundredths percent; and
9 (iii) from the pool for the period January first, nineteen hundred
10 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
11 six and forty-five-hundredths percent.
12 (k) Funds shall be reserved and accumulated from year to year and
13 shall be available, including income from invested funds, for allo-
14 cations and distributions in accordance with section twenty-eight
15 hundred seven-p of this article for diagnostic and treatment center
16 uncompensated care from the respective health care initiatives pools for
17 the following periods in the following percentage amounts of funds
18 remaining after allocations in accordance with paragraphs (a) through
19 (f) of this subdivision, and for periods on and after January first, two
20 thousand, in the following amounts:
21 (i) from the pool for the period January first, nineteen hundred nine-
22 ty-seven through December thirty-first, nineteen hundred ninety-seven,
23 thirty-eight and [one-tenths] one-tenth percent;
24 (ii) from the pool for the period January first, nineteen hundred
25 ninety-eight through December thirty-first, nineteen hundred ninety-
26 eight, thirty-eight and [one-tenths] one-tenth percent;
27 (iii) from the pool for the period January first, nineteen hundred
28 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
29 thirty-eight and seventy-one-hundredths percent;
30 (iv) from the pool for the periods January first, two thousand through
31 December thirty-first, two thousand two, forty-eight million dollars
32 annually, and for the period January first, two thousand three through
33 June thirtieth, two thousand three, twenty-four million dollars; [and]
34 (v) from the pool for the period July first, two thousand three
35 through December thirty-first, two thousand three, up to three million
36 one hundred thousand dollars, for the period January first, two thousand
37 four through December thirty-first, two thousand four, up to six million
38 two hundred thousand dollars, and for the period January first, two
39 thousand five through June thirtieth, two thousand five, up to three
40 million one hundred thousand dollars;
41 (vi) if funds accumulated for distributions pursuant to section twen-
42 ty-eight hundred seven-p of this article are insufficient to meet the
43 funding amounts established pursuant to subparagraph (iv) of this para-
44 graph, the commissioner is authorized to transfer funds accumulated
45 pursuant to section twenty-eight hundred seven-v of this article into
46 the health care initiatives pool to fully fund the amounts established
47 pursuant to [subparagraph] subparagraphs (iv) and (v) of this paragraph;
48 provided however, the provisions of this subparagraph shall only be
49 effective contingent upon meeting all funding amounts established pursu-
50 ant to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (q) and
51 (r) of subdivision one of section twenty-eight hundred seven-v of this
52 article, and paragraph (a) of this subdivision; and
53 (vii) funds reserved and accumulated pursuant to this paragraph for
54 periods on and after July first, two thousand three, shall be deposited
55 by the commissioner, within amounts appropriated, and the state comp-
56 troller is hereby authorized and directed to receive for deposit to the
S. 1408 83 A. 2108
1 credit of the state special revenue funds - other, HCRA transfer fund,
2 medical assistance account, for purposes of funding the state share of
3 rate adjustments made pursuant to twenty-eight hundred seven-p of this
4 article.
5 (l) Funds shall be reserved and accumulated from year to year by the
6 commissioner and shall be available, including income from invested
7 funds, for transfer to and allocation for services and expenses for the
8 payment of benefits to recipients of drugs under the AIDS drug assist-
9 ance program (ADAP) - HIV uninsured care program as administered by
10 Health Research Incorporated from the respective health care initi-
11 atives pools established for the following periods in the following
12 percentage amounts of funds remaining after allocations in accordance
13 with paragraphs (a) through (f) of this subdivision, and for periods on
14 and after January first, two thousand, in the following amounts:
15 (i) from the pool for the period January first, nineteen hundred nine-
16 ty-seven through December thirty-first, nineteen hundred ninety-seven,
17 nine and fifty-two-hundredths percent;
18 (ii) from the pool for the period January first, nineteen hundred
19 ninety-eight through December thirty-first, nineteen hundred ninety-
20 eight, nine and fifty-two-hundredths percent;
21 (iii) from the pool for the period January first, nineteen hundred
22 ninety-nine and December thirty-first, nineteen hundred ninety-nine,
23 nine and sixty-eight-hundredths percent; [and]
24 (iv) from the pool for the periods January first, two thousand through
25 December thirty-first, two thousand two, up to twelve million dollars
26 annually, and for the period January first, two thousand three through
27 [June thirtieth] December thirty-first, two thousand three, up to [six]
28 forty million dollars; and
29 (v) from the pool for the periods January first, two thousand four
30 through December thirty-first, two thousand four, up to fifty-six
31 million dollars, and for the period January first, two thousand five
32 through June thirtieth, two thousand five, up to thirty million dollars.
33 (m) Funds shall be reserved and accumulated from year to year by the
34 commissioner and shall be available, including income from invested
35 funds, for purposes of distributions pursuant to section twenty-eight
36 hundred seven-r of this article for cancer related services from the
37 respective health care initiatives pools established for the following
38 periods in the following percentage amounts of funds remaining after
39 allocations in accordance with paragraphs (a) through (f) of this subdi-
40 vision, and for periods on and after January first, two thousand, in the
41 following amounts:
42 (i) from the pool for the period January first, nineteen hundred nine-
43 ty-seven through December thirty-first, nineteen hundred ninety-seven,
44 seven and ninety-four-hundredths percent;
45 (ii) from the pool for the period January first, nineteen hundred
46 ninety-eight through December thirty-first, nineteen hundred ninety-
47 eight, seven and ninety-four-hundredths percent;
48 (iii) from the pool for the period January first, nineteen hundred
49 ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
50 and forty-five-hundredths percent;
51 (iv) from the pool for the [periods] period January first, two thou-
52 sand through December thirty-first, two thousand two, up to ten million
53 dollars on an annual basis; [and]
54 (v) from the pool for the period January first, two thousand three
55 through [June thirtieth] December thirty-first, two thousand [three]
S. 1408 84 A. 2108
1 four, up to [five million] seven million five hundred thousand dollars
2 on an annual basis; and
3 (vi) from the pool for the period January first, two thousand five
4 through June thirtieth, two thousand five, up to four million three
5 hundred thousand dollars.
6 2. In the event residual funds are available after allocations have
7 been made pursuant to this section, such funds may be allocated and
8 distributed in a manner determined by the commissioner for purposes set
9 forth in subdivision one of this section, section twenty-eight hundred
10 seven-k or section twenty-eight hundred seven-m of this article.
11 3. Notwithstanding any inconsistent provision of law, rule or regu-
12 lation, any funds accumulated in the health care initiatives pools
13 pursuant to paragraph (b) of subdivision nine of section twenty-eight
14 hundred seven-j of this article, as a result of surcharges, assessments
15 or other obligations during the periods January first, nineteen hundred
16 ninety-seven through December thirty-first, nineteen hundred ninety-
17 nine, which are unused or uncommitted for distributions pursuant to this
18 section shall be reserved and accumulated from year to year by the
19 commissioner and, within amounts appropriated, transferred and deposited
20 into the special revenue funds - other, miscellaneous special revenue
21 fund - 339, child health insurance account, for purposes of distrib-
22 utions to implement the child health insurance program established
23 pursuant to sections twenty-five hundred ten and twenty-five hundred
24 eleven of this chapter for periods on and after January first, two thou-
25 sand one; provided, however, funds reserved and accumulated for priority
26 distributions pursuant to subparagraph (iii) of paragraph (c) of subdi-
27 vision one of this section shall not be transferred and deposited into
28 such account pursuant to this subdivision; and provided further, howev-
29 er, the primary health care services grant program pursuant to section
30 twenty-eight hundred seven-bb of this article, as in effect prior to
31 January first, two thousand, shall be funded up to allocated amounts set
32 forth in paragraph (g) of subdivision one of this section less amounts
33 set aside and distributed by the commissioner in accordance with section
34 thirty-two-c of part F of chapter four hundred twelve of the laws of
35 nineteen hundred ninety-nine, and shall not be transferred and deposited
36 into such account pursuant to this subdivision; and provided further,
37 however, that any unused or uncommitted pool funds accumulated and allo-
38 cated pursuant to paragraph (j) of subdivision one of this section shall
39 be distributed for purposes of the health information and quality
40 improvement act of 2000.
41 4. Revenue from distributions pursuant to this section shall not be
42 included in gross revenue received for purposes of the assessments
43 pursuant to subdivision eighteen of section twenty-eight hundred seven-c
44 of this article, subject to the provisions of paragraph (e) of subdivi-
45 sion eighteen of section twenty-eight hundred seven-c of this article,
46 and shall not be included in gross revenue received for purposes of the
47 assessments pursuant to section twenty-eight hundred seven-d of this
48 article, subject to the provisions of subdivision twelve of section
49 twenty-eight hundred seven-d of this article.
50 5. Notwithstanding any inconsistent provision of law, the commissioner
51 may borrow from pool reserves from pools established or funded pursuant
52 to sections twenty-eight hundred seven-c, twenty-eight hundred seven-j,
53 twenty-eight hundred seven-k, twenty-eight hundred seven-m, twenty-eight
54 hundred seven-s and twenty-eight hundred seven-t of this article and
55 this section, and if not sufficient from pool funds collected pursuant
56 to section twenty-eight hundred seven-j of this article and allocated
S. 1408 85 A. 2108
1 for distributions pursuant to paragraph (b) of subdivision nine of
2 section twenty-eight hundred seven-j of this article, or pursuant to
3 sections twenty-eight hundred seven-s and twenty-eight hundred seven-t
4 of this article and allocated for distributions pursuant to paragraphs
5 (a) and (c) of subdivision seven of section twenty-eight hundred seven-s
6 of this article, such funds as shall be necessary, not to exceed the
7 amount projected to be available pursuant to paragraph (b) of subdivi-
8 sion nine of section twenty-eight hundred seven-j of this article, or
9 paragraphs (a) and (c) of subdivision seven of section twenty-eight
10 hundred seven-s of this article, for distributions in accordance with
11 any of paragraphs (a) through (j) of subdivision one of this section for
12 a period and shall refund such moneys when pool funds become available
13 pursuant to paragraph (b) of subdivision nine of section twenty-eight
14 hundred seven-j and paragraphs (a) and (c) of subdivision seven of
15 section twenty-eight hundred seven-s of this article for such purpose
16 for such period.
17 § 15. Section 84 of chapter 1 of the laws of 1999, relating to the
18 Health Care Reform Act of 2000, is amended to read as follows:
19 § 84. Notwithstanding any inconsistent provision of law, rule or
20 regulation, up to two hundred seventy-six million dollars ($276,000,000)
21 for the period January 1, 2000 through December 31, 2000; up to three
22 hundred five million dollars ($305,000,000) for the period January 1,
23 2001 through December 31, 2001; up to three hundred eighty-three million
24 dollars ($383,000,000) for the period January 1, 2002 through December
25 31, 2002; and up to [three hundred sixty] four hundred fifty-six million
26 dollars ($[360,000,000] 456,000,000) for the period January 1, 2003
27 through [June 30] December 31, 2003 shall be transferred by the state
28 comptroller from the tobacco settlement fund to the tobacco control and
29 insurance initiatives pool to be established and distributed by the
30 commissioner of health in accordance with section 2807-v of the public
31 health law. Such transfer shall be initiated upon direction by the
32 state director of the budget.
33 § 16. Section 2807-v of the public health law, as added by chapter 1
34 of the laws of 1999, paragraphs (a), (b), (f), (p), (s), the opening
35 paragraphs of paragraphs (c), (l), (m), (n), and (r), and subparagraphs
36 (i), (ii) and (iii) of paragraph (t) of subdivision 1, as amended by
37 chapter 419 of the laws of 2000, paragraph (d) of subdivision 1 as
38 amended by section 37 of part J of chapter 82 of the laws of 2002, para-
39 graph (e) of subdivision 1 as amended by section 38 of part J of chapter
40 82 of the laws of 2002, subparagraphs (iii) and (iv) of paragraph (n) of
41 subdivision 1 as amended by section 36 of part J of chapter 82 of the
42 laws of 2002, paragraph (v) of subdivision 1 as amended by section 8 of
43 part J of chapter 82 of the laws of 2002, subparagraph (iii) of para-
44 graph (x) of subdivision 1 as amended by section 4 of part J of chapter
45 82 of the laws of 2002, paragraph (y) of subdivision 1 as amended by
46 section 5 of part J of chapter 82 of the laws of 2002, paragraph (bb) of
47 subdivision 1 as amended by section 60 of part J of chapter 82 of the
48 laws of 2002, subparagraph (iv) of paragraph (cc) of subdivision 1 as
49 amended by section 6 of part J of chapter 82 of the laws of 2002, para-
50 graph (dd) of subdivision 1 as added by section 34 of part J of chapter
51 82 of the laws of 2002, paragraph (ii) of subdivision 1 as added by
52 section 33 of part J of chapter 82 of the laws of 2002, paragraph (ii)
53 of subdivision 1 as added by section 3 of part K of chapter 82 of the
54 laws of 2002, paragraph (jj) of subdivision 1 as added by section 42 of
55 part J of chapter 82 of the laws of 2002, paragraph (kk) of subdivision
56 1 as added by section 43 of part J of chapter 82 of the laws of 2002,
S. 1408 86 A. 2108
1 subparagraphs (ii), (iii) and (iv) of paragraph (k) of subdivision 1 as
2 amended by section 35 of part A of section 1 of the laws of 2002,
3 subparagraphs (iii) and (iv) of paragraph (o) of subdivision 1 as
4 amended by section 34 of part A of chapter 1 of the laws of 2002, para-
5 graph (u) of subdivision 1 as added by section 6 of part A of chapter 1
6 of the laws of 2002, paragraph (w) of subdivision 1 as added by section
7 60 of part A of chapter 1 of the laws of 2002, paragraph (x) of subdivi-
8 sion 1 as added by section 2 of part A of chapter 1 of the laws of 2002,
9 paragraphs (z), (aa) and (cc) of subdivision 1 as added by section 2 of
10 part A of chapter 1 of the laws of 2002, paragraph (ee) of subdivision 1
11 as added by section 7-b of part A of chapter 1 of the laws of 2002,
12 paragraph (ff) of subdivision 1 as added by section 69 of part A of
13 chapter 1 of the laws of 2002, paragraph (gg) of subdivision 1 as added
14 by section 1-a of part A of chapter 1 of the laws of 2002, paragraph
15 (hh) of subdivision 1 as added by section 26 of part A of chapter 1 of
16 the laws of 2002, subdivision 4 as amended by section 23 of part A of
17 chapter 1 of the laws of 2002, and the opening paragraph of paragraph
18 (o) of subdivision 1 as amended by chapter 13 of the laws of 2000, is
19 amended to read as follows:
20 § 2807-v. Tobacco control and insurance initiatives pool distrib-
21 utions. 1. Funds accumulated in the tobacco control and insurance
22 initiatives pool, including income from invested funds, shall be
23 distributed or retained by the commissioner in accordance with the
24 following:
25 (a) Funds shall be deposited by the commissioner, within amounts
26 appropriated, and the state comptroller is hereby authorized and
27 directed to receive for deposit to the credit of the state special
28 revenue funds - other, HCRA transfer fund, medicaid fraud hotline and
29 medicaid administration account, for purposes of services and expenses
30 related to the toll-free medicaid fraud hotline established pursuant to
31 section one hundred eight of chapter one of the laws of nineteen hundred
32 ninety-nine from the tobacco control and insurance initiatives pool
33 established for the following periods in the following amounts: four
34 hundred thousand dollars annually for the periods January first, two
35 thousand through December thirty-first, two thousand two, [and two
36 hundred thousand] up to four hundred thousand dollars for the period
37 January first, two thousand three through [June thirtieth,] December
38 thirty-first, two thousand three, up to four hundred thousand dollars
39 for the period January first, two thousand four through December thir-
40 ty-first, two thousand four, and up to two hundred thousand dollars for
41 the period January first, two thousand five through June thirtieth, two
42 thousand five.
43 (b) Funds shall be reserved and accumulated from year to year by the
44 commissioner and shall be available, including income from invested
45 funds, for purposes of payment of audits or audit contracts necessary to
46 determine payor and provider compliance with requirements set forth in
47 sections twenty-eight hundred seven-j, twenty-eight hundred seven-s and
48 twenty-eight hundred seven-t of this article and hospital compliance
49 with paragraph six of subdivision (a) of section 405.4 of title 10 of
50 the official compilation of codes, rules and regulations of the state of
51 New York in accordance with subdivision nine of section twenty-eight
52 hundred three of this article from the tobacco control and insurance
53 initiatives pool established for the following periods in the following
54 amounts: five million six hundred thousand dollars annually for the
55 periods January first, two thousand through December thirty-first, two
56 thousand two, [and two] up to five million [five hundred thousand]
S. 1408 87 A. 2108
1 dollars for the period January first, two thousand three through [June
2 thirtieth,] December thirty-first, two thousand three, up to five
3 million dollars for the period January first, two thousand four through
4 December thirty-first, two thousand four, and up to two million five
5 hundred thousand dollars for the period January first, two thousand five
6 through June thirtieth, two thousand five.
7 (c) Funds shall be deposited by the commissioner, within amounts
8 appropriated, and the state comptroller is hereby authorized and
9 directed to receive for deposit to the credit of the state special
10 revenue funds - other, HCRA transfer fund, enhanced community services
11 account, for mental health services programs for case management
12 services for adults and children; supported housing; home and community
13 based waiver services; family based treatment; family support services;
14 mobile mental health teams; transitional housing; and community over-
15 sight, established pursuant to articles seven and forty-one of the
16 mental hygiene law and subdivision nine of section three hundred sixty-
17 six of the social services law from the tobacco control and insurance
18 initiatives pool established for the following periods in the following
19 amounts:
20 (i) forty-eight million dollars to be reserved, to be retained or for
21 distribution pursuant to a chapter of the laws of two thousand, for the
22 period January first, two thousand through December thirty-first, two
23 thousand; [and]
24 (ii) eighty-seven million dollars to be reserved, to be retained or
25 for distribution pursuant to a chapter of the laws of two thousand one,
26 for the period January first, two thousand one through December thirty-
27 first, two thousand one;
28 (iii) eighty-seven million dollars to be reserved, to be retained or
29 for distribution pursuant to a chapter of the laws of two thousand two,
30 for the period January first, two thousand two through December thirty-
31 first, two thousand two;
32 (iv) [forty-four million] eighty-eight million dollars to be reserved,
33 to be retained or for distribution pursuant to a chapter of the laws of
34 two thousand three, for the period January first, two thousand three
35 through [June thirtieth,] December thirty-first, two thousand three;
36 (v) eighty-eight million dollars to be reserved, to be retained or for
37 distribution pursuant to a chapter of the laws of two thousand four, for
38 the period January first, two thousand four through December thirty-
39 first, two thousand four; and
40 (vi) forty-four million dollars to be reserved, to be retained or for
41 distribution pursuant to a chapter of the laws of two thousand five, for
42 the period January first, two thousand five through June thirtieth, two
43 thousand five.
44 (d) Funds shall be deposited by the commissioner, within amounts
45 appropriated, and the state comptroller is hereby authorized and
46 directed to receive for deposit to the credit of the state special
47 revenue funds - other, HCRA transfer fund, medical assistance account,
48 for purposes of funding the state share of services and expenses related
49 to the family health plus program including up to two and one-half
50 million dollars annually for the period January first, two thousand
51 through December thirty-first, two thousand two, [and one million two
52 hundred fifty thousand dollars for the period January first, two thou-
53 sand three through June thirtieth, two thousand three] for adminis-
54 tration and marketing costs associated with such program established
55 pursuant to clause (A) of subparagraph (v) of paragraph (a) of subdivi-
56 sion two of section three hundred sixty-nine-ee of the social services
S. 1408 88 A. 2108
1 law from the tobacco control and insurance initiatives pool established
2 for the following periods in the following amounts:
3 (i) three million five hundred thousand dollars for the period January
4 first, two thousand through December thirty-first, two thousand;
5 (ii) twenty-seven million dollars for the period January first, two
6 thousand one through December thirty-first, two thousand one; and
7 (iii) fifty-seven million dollars for the period January first, two
8 thousand two through December thirty-first, two thousand two[; and
9 (iv) forty-three million dollars for the period January first, two
10 thousand three through June thirtieth, two thousand three].
11 (e) Funds shall be deposited by the commissioner, within amounts
12 appropriated, and the state comptroller is hereby authorized and
13 directed to receive for deposit to the credit of the state special
14 revenue funds - other, HCRA transfer fund, medical assistance account,
15 for purposes of funding the state share of services and expenses related
16 to the family health plus program including up to two and one-half
17 million dollars annually for the period January first, two thousand
18 through December thirty-first, two thousand two [and one million two
19 hundred fifty thousand dollars for the period January first, two thou-
20 sand three through June thirtieth, two thousand three] for adminis-
21 tration and marketing costs associated with such program established
22 pursuant to clause (B) of subparagraph (v) of paragraph (a) of subdivi-
23 sion two of section three hundred sixty-nine-ee of the social services
24 law from the tobacco control and insurance initiatives pool established
25 for the following periods in the following amounts:
26 (i) two million five hundred thousand dollars for the period January
27 first, two thousand through December thirty-first, two thousand;
28 (ii) thirty million five hundred thousand dollars for the period Janu-
29 ary first, two thousand one through December thirty-first, two thousand
30 one; and
31 (iii) sixty-six million dollars for the period January first, two
32 thousand two through December thirty-first, two thousand two[; and
33 (iv) forty-four million dollars for the period January first, two
34 thousand three through June thirtieth, two thousand three].
35 (f) Funds shall be deposited by the commissioner, within amounts
36 appropriated, and the state comptroller is hereby authorized and
37 directed to receive for deposit to the credit of the state special
38 revenue funds - other, HCRA transfer fund, medicaid fraud hotline and
39 medicaid administration account, for purposes of payment of administra-
40 tive expenses of the department related to the family health plus
41 program established pursuant to section three hundred sixty-nine-ee of
42 the social services law from the tobacco control and insurance initi-
43 atives pool established for the following periods in the following
44 amounts: five hundred thousand dollars on an annual basis for the peri-
45 ods January first, two thousand through December thirty-first, two thou-
46 sand [two] four, and two hundred fifty thousand dollars for the period
47 January first, two thousand [three] five through June thirtieth, two
48 thousand [three] five.
49 (g) Funds shall be reserved and accumulated from year to year by the
50 commissioner and shall be available, including income from invested
51 funds, contingent upon meeting all funding amounts established pursuant
52 to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
53 and (s) of this subdivision, paragraph (a) of subdivision nine of
54 section twenty-eight hundred seven-j of this article, and paragraphs
55 (a), (i) and (k) of subdivision one of section twenty-eight hundred
56 seven-l of this article for purposes of services and expenses related to
S. 1408 89 A. 2108
1 the health maintenance organization direct pay market program estab-
2 lished pursuant to sections forty-three hundred twenty-one-a and forty-
3 three hundred twenty-two-a of the insurance law from the tobacco control
4 and insurance initiatives pool established for the following periods in
5 the following amounts:
6 (i) up to thirty-five million dollars for the period January first,
7 two thousand through December thirty-first, two thousand of which fifty
8 percentum shall be allocated to the program pursuant to section four
9 thousand three hundred twenty-one-a of the insurance law and fifty
10 percentum to the program pursuant to section four thousand three hundred
11 twenty-two-a of the insurance law;
12 (ii) up to thirty-six million dollars for the period January first,
13 two thousand one through December thirty-first, two thousand one of
14 which fifty percentum shall be allocated to the program pursuant to
15 section four thousand three hundred twenty-one-a of the insurance law
16 and fifty percentum to the program pursuant to section four thousand
17 three hundred twenty-two-a of the insurance law;
18 (iii) up to thirty-nine million dollars for the period January first,
19 two thousand two through December thirty-first, two thousand two of
20 which fifty percentum shall be allocated to the program pursuant to
21 section four thousand three hundred twenty-one-a of the insurance law
22 and fifty percentum to the program pursuant to section four thousand
23 three hundred twenty-two-a of the insurance law; [and]
24 (iv) up to [twenty] forty million dollars for the period January
25 first, two thousand three through [June thirtieth,] December thirty-
26 first, two thousand three of which fifty percentum shall be allocated to
27 the program pursuant to section four thousand three hundred twenty-one-a
28 of the insurance law and fifty percentum to the program pursuant to
29 section four thousand three hundred twenty-two-a of the insurance law;
30 (v) up to forty million dollars for the period January first, two
31 thousand four through December thirty-first, two thousand four of which
32 fifty percentum shall be allocated to the program pursuant to section
33 four thousand three hundred twenty-one-a of the insurance law and fifty
34 percentum to the program pursuant to section four thousand three hundred
35 twenty-two-a of the insurance law; and
36 (vi) up to twenty million dollars for the period January first, two
37 thousand five through June thirtieth, two thousand five of which fifty
38 percentum shall be allocated to the program pursuant to section four
39 thousand three hundred twenty-one-a of the insurance law and fifty
40 percentum to the program pursuant to section four thousand three hundred
41 twenty-two-a of the insurance law.
42 (h) Funds shall be reserved and accumulated from year to year by the
43 commissioner and shall be available, including income from invested
44 funds, contingent upon meeting all funding amounts established pursuant
45 to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
46 and (s) of this subdivision, paragraph (a) of subdivision nine of
47 section twenty-eight hundred seven-j of this article, and paragraphs
48 (a), (i) and (k) of subdivision one of section twenty-eight hundred
49 seven-l of this article for purposes of services and expenses related to
50 the healthy New York individual program established pursuant to sections
51 [forty-three] four thousand three hundred twenty-six and [forty-three]
52 four thousand three hundred twenty-seven of the insurance law from the
53 tobacco control and insurance initiatives pool established for the
54 following periods in the following amounts:
55 (i) up to six million dollars for the period January first, two thou-
56 sand one through December thirty-first, two thousand one;
S. 1408 90 A. 2108
1 (ii) up to twenty-nine million dollars for the period January first,
2 two thousand two through December thirty-first, two thousand two; [and]
3 (iii) up to [twenty-one] twenty-nine million four hundred thousand
4 dollars for the period January first, two thousand three through [June
5 thirtieth,] December thirty-first, two thousand three[.];
6 (iv) up to twenty-four million six hundred thousand dollars for the
7 period January first, two thousand four through December thirty-first,
8 two thousand four; and
9 (v) up to twenty-two million dollars for the period January first, two
10 thousand five through June thirtieth, two thousand five.
11 (i) Funds shall be reserved and accumulated from year to year by the
12 commissioner and shall be available, including income from invested
13 funds, contingent upon meeting all funding amounts established pursuant
14 to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
15 and (s) of this subdivision, paragraph (a) of subdivision nine of
16 section twenty-eight hundred seven-j of this article, and paragraphs
17 (a), (i) and (k) of subdivision one of section twenty-eight hundred
18 seven-l of this article for purposes of services and expenses related to
19 the healthy New York group program established pursuant to sections
20 [forty-three] four thousand three hundred twenty-six and [forty-three]
21 four thousand three hundred twenty-seven of the insurance law from the
22 tobacco control and insurance initiatives pool established for the
23 following periods in the following amounts:
24 (i) up to thirty-four million dollars for the period January first,
25 two thousand one through December thirty-first, two thousand one;
26 (ii) up to seventy-seven million dollars for the period January first,
27 two thousand two through December thirty-first, two thousand two; [and]
28 (iii) up to [fifty-two] sixty million four hundred thousand dollars
29 for the period January first, two thousand three through [June thirti-
30 eth,] December thirty-first, two thousand three;
31 (iv) up to twenty-four million six hundred thousand dollars for the
32 period January first, two thousand four through December thirty-first,
33 two thousand four; and
34 (v) up to twenty-two million dollars for the period January first, two
35 thousand five through June thirtieth, two thousand five.
36 (j) Funds shall be reserved and accumulated from year to year by the
37 commissioner and shall be available, including income from invested
38 funds, contingent upon meeting all funding amounts established pursuant
39 to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
40 and (s) of this subdivision, paragraph (a) of subdivision nine of
41 section twenty-eight hundred seven-j of this article, and paragraphs
42 (a), (i) and (k) of subdivision one of section twenty-eight hundred
43 seven-l of this article for purposes of services and expenses related to
44 the tobacco use prevention and control program established pursuant to
45 sections thirteen hundred ninety-nine-ii and thirteen hundred ninety-
46 nine-jj of this chapter, from the tobacco control and insurance initi-
47 atives pool established for the following periods in the following
48 amounts:
49 (i) up to thirty million dollars for the period January first, two
50 thousand through December thirty-first, two thousand;
51 (ii) up to forty million dollars for the period January first, two
52 thousand one through December thirty-first, two thousand one;
53 (iii) up to forty million dollars for the period January first, two
54 thousand two through December thirty-first, two thousand two; [and]
S. 1408 91 A. 2108
1 (iv) up to [twenty million] thirty-three million dollars for the peri-
2 od January first, two thousand three through [June thirtieth,] December
3 thirty-first, two thousand three;
4 (v) up to thirty-three million dollars for the period January first,
5 two thousand four through December thirty-first, two thousand four; and
6 (vi) up to eighteen million three hundred thousand dollars for the
7 period January first, two thousand five through June thirtieth, two
8 thousand five.
9 (k) Funds shall be deposited by the commissioner, within amounts
10 appropriated, and the state comptroller is hereby authorized and
11 directed to receive for deposit to the credit of the state special
12 revenue fund - other, HCRA transfer fund, health care services account,
13 contingent upon meeting all funding amounts established pursuant to
14 paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
15 and (s) of this subdivision, paragraph (a) of subdivision nine of
16 section twenty-eight hundred seven-j of this article, and paragraphs
17 (a), (i) and (k) of subdivision one of section twenty-eight hundred
18 seven-l of this article for purposes of services and expenses related to
19 public health programs from the tobacco control and insurance initi-
20 atives pool established for the following periods in the following
21 amounts;
22 (i) up to thirty-one million dollars for the period January first, two
23 thousand through December thirty-first, two thousand;
24 (ii) up to forty-one million dollars for the period January first, two
25 thousand one through December thirty-first, two thousand one;
26 (iii) up to eighty-one million dollars for the period January first,
27 two thousand two through December thirty-first, two thousand two; [and]
28 (iv) [up to sixty-five] one hundred twenty-two million five hundred
29 thousand dollars for the period January first, two thousand three
30 through [June thirtieth,] December thirty-first, two thousand three;
31 (v) eighty-one million five hundred thousand dollars for the period
32 January first, two thousand four through December thirty-first, two
33 thousand four; and
34 (vi) thirty-five million four hundred thousand dollars for the period
35 January first, two thousand five through June thirtieth, two thousand
36 five.
37 (l) Funds shall be deposited by the commissioner, within amounts
38 appropriated, and the state comptroller is hereby authorized and
39 directed to receive for deposit to the credit of the state special
40 revenue funds - other, HCRA transfer fund, medical assistance account
41 for purposes of funding the state share of the personal care and certi-
42 fied home health agency rate or fee increases established pursuant to
43 subdivision three of section three hundred sixty-seven-o of the social
44 services law from the tobacco control and insurance initiatives pool
45 established for the following periods in the following amounts:
46 (i) twenty-three million two hundred thousand dollars for the period
47 January first, two thousand through December thirty-first, two thousand;
48 (ii) twenty-three million two hundred thousand dollars for the period
49 January first, two thousand one through December thirty-first, two thou-
50 sand one;
51 (iii) twenty-three million two hundred thousand dollars for the period
52 January first, two thousand two through December thirty-first, two thou-
53 sand two; [and]
54 (iv) [twelve] up to twenty-three million two hundred thousand dollars
55 for the period January first, two thousand three through [June thirti-
56 eth,] December thirty-first two thousand three;
S. 1408 92 A. 2108
1 (v) up to twenty-three million two hundred thousand dollars for the
2 period January first, two thousand four through December thirty-first,
3 two thousand four; and
4 (vi) up to twelve million dollars for the period January first, two
5 thousand five through June thirtieth, two thousand five.
6 (m) Funds shall be deposited by the commissioner, within amounts
7 appropriated, and the state comptroller is hereby authorized and
8 directed to receive for deposit to the credit of the state special
9 revenue funds - other, HCRA transfer fund, medical assistance account
10 for purposes of funding the state share of services and expenses related
11 to home care workers insurance pilot demonstration programs established
12 pursuant to subdivision two of section three hundred sixty-seven-o of
13 the social services law from the tobacco control and insurance initi-
14 atives pool established for the following periods in the following
15 amounts:
16 (i) three million eight hundred thousand dollars for the period Janu-
17 ary first, two thousand through December thirty-first, two thousand;
18 (ii) three million eight hundred thousand dollars for the period Janu-
19 ary first, two thousand one through December thirty-first, two thousand
20 one;
21 (iii) three million eight hundred thousand dollars for the period
22 January first, two thousand two through December thirty-first, two thou-
23 sand two; [and]
24 (iv) [two] up to three million eight hundred thousand dollars for the
25 period January first, two thousand three through [June thirtieth,]
26 December thirty-first, two thousand three[.];
27 (v) up to three million eight hundred thousand dollars for the period
28 January first, two thousand four through December thirty-first, two
29 thousand four; and
30 (vi) up to two million dollars for the period January first, two thou-
31 sand five through June thirtieth, two thousand five.
32 (n) Funds shall be transferred by the commissioner and shall be depos-
33 ited to the credit of the special revenue funds - other, miscellaneous
34 special revenue fund - 339, elderly pharmaceutical insurance coverage
35 program premium account authorized pursuant to the provisions of article
36 nineteen-K of the executive law for funding state expenses relating to
37 the program from the tobacco control and insurance initiatives pool
38 established for the following periods in the following amounts:
39 (i) one hundred seven million dollars for the period January first,
40 two thousand through December thirty-first, two thousand;
41 (ii) one hundred sixty-four million dollars for the period January
42 first, two thousand one through December thirty-first, two thousand one;
43 (iii) three hundred twenty-two million seven hundred thousand dollars
44 for the period January first, two thousand two through December thirty-
45 first, two thousand two; [and]
46 (iv) [two hundred sixteen million] four hundred twenty million nine
47 hundred thousand dollars for the period January first, two thousand
48 three through [June thirtieth,] December thirty-first, two thousand
49 three;
50 (v) four hundred thirty-three million seven hundred thousand dollars
51 for the period January first, two thousand four through December thir-
52 ty-first, two thousand four; and
53 (vi) two hundred thirty-eight million three hundred thousand dollars
54 for the period January first, two thousand five through June thirtieth,
55 two thousand five.
S. 1408 93 A. 2108
1 (o) Funds shall be reserved and accumulated by the commissioner
2 contingent upon meeting all funding amounts established pursuant to
3 paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
4 and (s) of this subdivision, paragraph (a) of subdivision nine of
5 section twenty-eight hundred seven-j of this article, and paragraphs
6 (a), (i) and (k) of subdivision one of section twenty-eight hundred
7 seven-l of this article and shall be transferred to the Roswell Park
8 Cancer Institute Corporation, from the tobacco control and insurance
9 initiatives pool established for the following periods in the following
10 amounts:
11 (i) up to ninety million dollars for the period January first, two
12 thousand through December thirty-first, two thousand;
13 (ii) up to sixty million dollars for the period January first, two
14 thousand one through December thirty-first, two thousand one;
15 (iii) up to eighty-five million dollars for the period January first,
16 two thousand two through December thirty-first, two thousand two; [and]
17 (iv) [up to forty-three] eighty-two million five hundred thousand
18 dollars for the period January first, two thousand three through [June
19 thirtieth,] December thirty-first, two thousand three;
20 (v) eighty million dollars for the period January first, two thousand
21 four through December thirty-first, two thousand four; and
22 (vi) forty million dollars for the period January first, two thousand
23 five through June thirtieth, two thousand five.
24 (p) Funds shall be deposited by the commissioner, within amounts
25 appropriated, and the state comptroller is hereby authorized and
26 directed to receive for deposit to the credit of the state special
27 revenue funds - other, indigent care fund - 068, indigent care account,
28 contingent upon meeting all funding amounts established pursuant to
29 paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (q) and (r) of
30 this subdivision and paragraph (a) of subdivision one of section twen-
31 ty-eight hundred seven-l of this article for purposes of providing a
32 medicaid disproportionate share payment from the high need indigent care
33 adjustment pool established pursuant to section twenty-eight hundred
34 seven-w of this article, from the tobacco control and insurance initi-
35 atives pool established for the following periods in the following
36 amounts:
37 (i) eighty-two million dollars annually for the periods January first,
38 two thousand through December thirty-first, two thousand two; [and]
39 (ii) [forty-one] up to eighty-two million dollars for the period Janu-
40 ary first, two thousand three through [June thirtieth,] December thir-
41 ty-first, two thousand three;
42 (iii) up to eighty-two million dollars for the period January first,
43 two thousand four through December thirty-first, two thousand four; and
44 (iv) up to forty-one million dollars for the period January first, two
45 thousand five through June thirtieth, two thousand five.
46 (q) Funds shall be reserved and accumulated from year to year by the
47 commissioner and shall be available, including income from invested
48 funds, for purposes of providing distributions to eligible school based
49 health centers established pursuant to [the] chapter one of the laws of
50 nineteen hundred ninety-nine which enacted the New York Health Care
51 Reform Act of 2000, from the tobacco control and insurance initiatives
52 pool established for the following periods in the following amounts:
53 (i) seven million dollars annually for the period January first, two
54 thousand through December thirty-first, two thousand two; [and]
S. 1408 94 A. 2108
1 (ii) [three] up to seven million [five hundred thousand] dollars for
2 the period January first, two thousand three through [June thirtieth,]
3 December thirty-first, two thousand three;
4 (iii) up to seven million dollars for the period January first, two
5 thousand four through December thirty-first, two thousand four; and
6 (iv) up to three million five hundred thousand dollars for the period
7 January first, two thousand five through June thirtieth, two thousand
8 five.
9 (r) Funds shall be deposited by the commissioner within amounts appro-
10 priated, and the state comptroller is hereby authorized and directed to
11 receive for deposit to the credit of the state special revenue funds -
12 other, HCRA transfer fund, medical assistance account, for purposes of
13 providing distributions for supplementary medical insurance for Medicare
14 part B premiums, physicians services, outpatient services, medical
15 equipment, supplies and other health services, from the tobacco control
16 and insurance initiatives pool established for the following periods in
17 the following amounts:
18 (i) forty-three million dollars for the period January first, two
19 thousand through December thirty-first, two thousand;
20 (ii) sixty-one million dollars for the period January first, two thou-
21 sand one through December thirty-first, two thousand one;
22 (iii) sixty-five million dollars for the period January first, two
23 thousand two through December thirty-first, two thousand two; [and]
24 (iv) [thirty-four] sixty-seven million five hundred thousand dollars
25 for the period January first, two thousand three through [June thirti-
26 eth,] December thirty-first, two thousand three;
27 (v) sixty-eight million dollars for the period January first, two
28 thousand four through December thirty-first, two thousand four; and
29 (vi) thirty-four million dollars for the period January first, two
30 thousand five through June thirtieth, two thousand five.
31 (s) Funds shall be deposited by the commissioner within amounts appro-
32 priated, and the state comptroller is hereby authorized and directed to
33 receive for deposit to the credit of the state special revenue funds -
34 other, HCRA transfer fund, medical assistance account, contingent upon
35 meeting all funding amounts established pursuant to paragraphs (a), (b),
36 (c), (d), (e), (f), (l), (m), (n), (q), and (r) of this subdivision, and
37 paragraph (a) of subdivision one of section twenty-eight hundred seven-l
38 of this article, for purposes of providing distributions pursuant to
39 paragraph (s-5) of subdivision eleven of section twenty-eight hundred
40 seven-c of this article from the tobacco control and insurance initi-
41 atives pool established for the following periods in the following
42 amounts:
43 (i) eighteen million dollars for the period January first, two thou-
44 sand through December thirty-first, two thousand;
45 (ii) twenty-four million dollars annually for the periods January
46 first, two thousand one through December thirty-first, two thousand two;
47 [and]
48 (iii) [six] up to twenty-four million dollars for the period January
49 first, two thousand three through [March] December thirty-first, two
50 thousand three;
51 (iv) up to twenty-four million dollars for the period January first,
52 two thousand four through December thirty-first, two thousand four; and
53 (v) up to six million dollars for the period January first, two thou-
54 sand five through June thirtieth, two thousand five.
S. 1408 95 A. 2108
1 (t) Funds shall be reserved and accumulated from year to year by the
2 commissioner and shall be made available, including income from invested
3 funds:
4 (i) For the purpose of making grants to a state owned and operated
5 medical school which does not have a state owned and operated hospital
6 on site and available for teaching purposes. Notwithstanding sections
7 one hundred twelve and one hundred sixty-three of the state finance law,
8 such grants shall be made in the amount of up to five hundred thousand
9 dollars for the period January first, two thousand through December
10 thirty-first, two thousand;
11 (ii) For the purpose of making grants to medical schools pursuant to
12 section eighty-six-a of chapter one of the laws of nineteen hundred
13 ninety-nine in the sum of up to four million dollars for the period
14 January first, two thousand through December thirty-first, two thousand;
15 and
16 (iii) The funds disbursed pursuant to subparagraphs (i) and (ii) of
17 this paragraph from the tobacco control and insurance initiatives pool
18 are contingent upon meeting all funding amounts established pursuant to
19 paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
20 and (s) of this subdivision, paragraph (a) of subdivision nine of
21 section twenty-eight hundred seven-j of this article, and paragraphs
22 (a), (i) and (k) of subdivision one of section twenty-eight hundred
23 seven-l of this article.
24 (u) Funds shall be deposited by the commissioner, within amounts
25 appropriated, and the state comptroller is hereby authorized and
26 directed to receive for deposit to the credit of the state special
27 revenue funds - other, HCRA transfer fund, medical assistance account
28 for purposes of funding the state share of services and expenses related
29 to the nursing home quality improvement demonstration program estab-
30 lished pursuant to section twenty-eight hundred eight-d of this article
31 from the tobacco control and insurance initiatives pool established for
32 the following periods in the following amounts:
33 (i) up to twenty-five million dollars for the period beginning April
34 first, two thousand two and ending December thirty-first, two thousand
35 two, and on an annualized basis, for each annual period thereafter
36 beginning January first, two thousand three and ending December thirty-
37 first, two thousand four, and up to twelve million five hundred thousand
38 dollars for the period January first, two thousand five through June
39 thirtieth, two thousand five.
40 (v) Funds shall be transferred by the commissioner and shall be depos-
41 ited to the credit of the hospital excess liability pool created pursu-
42 ant to section eighteen of chapter two hundred sixty-six of the laws of
43 nineteen hundred eighty-six for purposes of expenses related to the
44 purchase of excess medical malpractice insurance and the cost of admin-
45 istrating the pool, including costs associated with the risk management
46 program established pursuant to section forty-two of part A of chapter
47 one of the laws of two thousand two required by paragraph (a) of subdi-
48 vision one of section eighteen of chapter two hundred sixty-six of the
49 laws of nineteen hundred eighty-six as may be amended from time to time,
50 from the tobacco control and insurance initiatives pool established for
51 the following periods in the following amounts:
52 (i) up to fifty million dollars or so much as is needed for the period
53 January first, two thousand two through December thirty-first, two thou-
54 sand two; [and]
55 (ii) up to [twenty-eight] seventy-six million seven hundred thousand
56 dollars [or so much as is needed] for the period January first, two
S. 1408 96 A. 2108
1 thousand three through [June thirtieth,] December thirty-first, two
2 thousand three;
3 (iii) up to sixty-five million dollars for the period January first,
4 two thousand four through December thirty-first, two thousand four; and
5 (iv) up to thirty-two million five hundred thousand dollars for the
6 period January first, two thousand five through June thirtieth, two
7 thousand five.
8 (w) Funds shall be deposited by the commissioner, within amounts
9 appropriated, and the state comptroller is hereby authorized and
10 directed to receive for deposit to the credit of the state special
11 revenue funds - other, HCRA transfer fund, medical assistance account
12 for purposes of funding the state share of the treatment of breast and
13 cervical cancer pursuant to paragraph (v) of subdivision four of section
14 three hundred sixty-six of the social services law, from the tobacco
15 control and insurance initiatives pool established for the following
16 periods in the following amounts:
17 (i) up to four hundred fifty thousand dollars for the period January
18 first, two thousand two through December thirty-first, two thousand two;
19 [and]
20 (ii) up to [one] two million [fifty] one hundred thousand dollars for
21 the period January first, two thousand three through [June thirtieth,]
22 December thirty-first two thousand three;
23 (iii) up to two million one hundred thousand dollars for the period
24 January first, two thousand four through December thirty-first, two
25 thousand four; and
26 (iv) up to one million one hundred thousand dollars for the period
27 January first, two thousand five through June thirtieth, two thousand
28 five.
29 (x) Funds shall be deposited by the commissioner, within amounts
30 appropriated, and the state comptroller is hereby authorized and
31 directed to receive for deposit to the credit of the state special
32 revenue funds - other, HCRA transfer fund, medical assistance account
33 for purposes of funding the state share of the non-public general hospi-
34 tal rates increases for recruitment and retention of health care workers
35 pursuant to paragraph (a) of subdivision thirty and subdivision thirty-
36 one of section twenty-eight hundred seven-c of this article from the
37 tobacco control and insurance initiatives pool established for the
38 following periods in the following amounts:
39 (i) twenty-seven million one hundred thousand dollars on an annualized
40 basis for the period January first, two thousand two through December
41 thirty-first, two thousand two;
42 (ii) [fifty] thirty-two million [eight] five hundred thousand dollars
43 on an annualized basis for the period January first, two thousand three
44 through December thirty-first, two thousand three; [and]
45 (iii) [sixty-nine] thirty-six million [three] one hundred thousand
46 dollars on an annualized basis for the period January first, two thou-
47 sand four through December thirty-first, two thousand four; and
48 (iv) eighteen million one hundred thousand dollars for the period
49 January first, two thousand five through June thirtieth, two thousand
50 five.
51 (y) Funds shall be reserved and accumulated from year to year by the
52 commissioner and shall be available, including income from invested
53 funds, for purposes of grants to public general hospitals for recruit-
54 ment and retention of health care workers pursuant to paragraph (b) of
55 subdivision thirty of section twenty-eight hundred seven-c of this arti-
S. 1408 97 A. 2108
1 cle from the tobacco control and insurance initiatives pool established
2 for the following periods in the following amounts:
3 (i) eighteen million five hundred thousand dollars on an annualized
4 basis for the period January first, two thousand two through December
5 thirty-first, two thousand two;
6 (ii) thirty-seven million four hundred thousand dollars on an annual-
7 ized basis for the period January first, two thousand three through
8 December thirty-first, two thousand three; [and]
9 (iii) fifty-two million two hundred thousand dollars on an annualized
10 basis for the period January first, two thousand four through December
11 thirty-first, two thousand four;
12 (iv) twenty-six million one hundred thousand dollars for the period
13 January first, two thousand five through June thirtieth, two thousand
14 five;
15 (v) provided, however, amounts pursuant to this paragraph may be
16 reduced by the commissioner in an amount to be approved by the director
17 of the budget to reflect amounts received from the federal government
18 under the state's 1115 waiver which are directed under its terms and
19 conditions to the health workforce recruitment and retention program.
20 (z) Funds shall be deposited by the commissioner, within amounts
21 appropriated, and the state comptroller is hereby authorized and
22 directed to receive for deposit to the credit of the state special
23 revenue funds - other, HCRA transfer fund, medical assistance account
24 for purposes of funding the state share of the non-public residential
25 health care facility rate increases for recruitment and retention of
26 health care workers pursuant to paragraph (a) of subdivision eighteen of
27 section twenty-eight hundred eight of this article from the tobacco
28 control and insurance initiatives pool established for the following
29 periods in the following amounts:
30 (i) twenty-one million five hundred thousand dollars on an annualized
31 basis for the period January first, two thousand two through December
32 thirty-first, two thousand two;
33 (ii) thirty-three million three hundred thousand dollars on an annual-
34 ized basis for the period January first, two thousand three through
35 December thirty-first, two thousand three; [and]
36 (iii) forty-six million three hundred thousand dollars on an annual-
37 ized basis for the period January first, two thousand four through
38 December thirty-first, two thousand four; and
39 (iv) twenty-three million two hundred thousand dollars for the period
40 January first, two thousand five through June thirtieth, two thousand
41 five.
42 (aa) Funds shall be reserved and accumulated from year to year by the
43 commissioner and shall be available, including income from invested
44 funds, for purposes of grants to public residential health care facili-
45 ties for recruitment and retention of health care workers pursuant to
46 paragraph (b) of subdivision eighteen of section twenty-eight hundred
47 eight of this article from the tobacco control and insurance initiatives
48 pool established for the following periods in the following amounts:
49 (i) seven million five hundred thousand dollars on an annualized basis
50 for the period January first, two thousand two through December thirty-
51 first, two thousand two;
52 (ii) eleven million seven hundred thousand dollars on an annualized
53 basis for the period January first, two thousand three through December
54 thirty-first, two thousand three; [and]
S. 1408 98 A. 2108
1 (iii) sixteen million two hundred thousand dollars on an annualized
2 basis for the period January first, two thousand four through December
3 thirty-first, two thousand four; and
4 (iv) eight million one hundred thousand dollars for the period January
5 first, two thousand five through June thirtieth, two thousand five.
6 (bb)(i) Funds shall be deposited by the commissioner, within amounts
7 appropriated, and subject to the availability of federal financial
8 participation, and the state comptroller is hereby authorized and
9 directed to receive for deposit to the credit of the state special
10 revenue funds - other, HCRA transfer fund, medical assistance account
11 for the purpose of supporting the state share of adjustments to Medicaid
12 rates of payment for personal care services provided pursuant to para-
13 graph (e) of subdivision two of section three hundred sixty-five-a of
14 the social services law, for local social service districts which
15 include a city with a population of over one million persons and
16 computed and distributed in accordance with memorandums of understanding
17 to be entered into between the state of New York and such local social
18 service districts for the purpose of supporting the recruitment and
19 retention of personal care service workers or any worker with direct
20 patient care responsibility, from the tobacco control and insurance
21 initiatives pool established for the following periods and the following
22 amounts:
23 (A) forty-four million dollars, on an annualized basis, for the period
24 April first, two thousand two through December thirty-first, two thou-
25 sand two;
26 (B) seventy-four million dollars, on an annualized basis, for the
27 period January first, two thousand three through December thirty-first,
28 two thousand three;
29 (C) one hundred four million dollars, on an annualized basis, for the
30 period January first, two thousand four through December thirty-first,
31 two thousand four; and
32 (D) one hundred thirty-six million dollars, on an annualized basis,
33 for the period January first, two thousand five through December thir-
34 ty-first, two thousand five.
35 (ii) Adjustments to Medicaid rates made pursuant to this paragraph
36 shall not, in aggregate, exceed the following amounts for the following
37 periods:
38 (A) for the period April first, two thousand two through December
39 thirty-first, two thousand two, one hundred ten million dollars;
40 (B) for the period January first, two thousand three through December
41 thirty-first, two thousand three, one hundred eighty-five million
42 dollars;
43 (C) for the period January first, two thousand four through December
44 thirty-first, two thousand four, two hundred sixty million dollars; and
45 (D) for the period January first, two thousand five through December
46 thirty-first, two thousand five, three hundred forty million dollars.
47 (iii) Personal care service providers which have their rates adjusted
48 pursuant to this paragraph shall use such funds for the purpose of
49 recruitment and retention of non-supervisory personal care services
50 workers or any worker with direct patient care responsibility only and
51 are prohibited from using such funds for any other purpose. Each such
52 personal care services provider shall submit, at a time and in a manner
53 to be determined by the commissioner, a written certification attesting
54 that such funds will be used solely for the purpose of recruitment and
55 retention of non-supervisory personal care services workers or any work-
56 er with direct patient care responsibility. The commissioner is author-
S. 1408 99 A. 2108
1 ized to audit each such provider to ensure compliance with the written
2 certification required by this subdivision and shall recoup any funds
3 determined to have been used for purposes other than recruitment and
4 retention of non-supervisory personal care services workers or any work-
5 er with direct patient care responsibility. Such recoupment shall be in
6 addition to any other penalties provided by law.
7 (cc) Funds shall be deposited by the commissioner, within amounts
8 appropriated, and the state comptroller is hereby authorized and
9 directed to receive for deposit to the credit of the state special
10 revenue funds - other, HCRA transfer fund, medical assistance account
11 for the purpose of supporting the state share of adjustments to Medicaid
12 rates of payment for personal care services provided pursuant to para-
13 graph (e) of subdivision two of section three hundred sixty-five-a of
14 the social services law, for local social service districts which shall
15 not include a city with a population of over one million persons for the
16 purpose of supporting the personal care services worker recruitment and
17 retention program as established pursuant to section three hundred
18 sixty-seven-q of the social services law, from the tobacco control and
19 insurance initiatives pool established for the following periods and the
20 following amounts:
21 (i) two million eight hundred thousand dollars for the period April
22 first, two thousand two through December thirty-first, two thousand two;
23 (ii) five million six hundred thousand dollars, on an annualized
24 basis, for the period January first, two thousand three through December
25 thirty-first, two thousand three;
26 (iii) eight million four hundred thousand dollars, on an annualized
27 basis, for the period January first, two thousand four through December
28 thirty-first, two thousand four; and
29 (iv) ten million eight hundred thousand dollars, on an annualized
30 basis, for the period January first, two thousand five through December
31 thirty-first, two thousand five.
32 (dd) Funds shall be deposited by the commissioner, within amounts
33 appropriated, and the state comptroller is hereby authorized and
34 directed to receive for deposit to the credit of the state special
35 revenue fund - other, HCRA transfer fund, medical assistance account for
36 purposes of funding the state share of Medicaid expenditures for physi-
37 cian services from the tobacco control and insurance initiatives pool
38 established for the following periods in the following amounts:
39 (i) up to fifty-two million dollars for the period January first, two
40 thousand two through December thirty-first, two thousand two; [and]
41 (ii) [up to forty-three] eighty-one million two hundred thousand
42 dollars for the period January first, two thousand three through [June
43 thirtieth,] December thirty-first, two thousand three;
44 (iii) eighty-five million two hundred thousand dollars for the period
45 January first, two thousand four through December thirty-first, two
46 thousand four; and
47 (iv) forty-two million six hundred thousand dollars for the period
48 January first, two thousand five through June thirtieth, two thousand
49 five.
50 (ee) Funds shall be deposited by the commissioner, within amounts
51 appropriated, and the state comptroller is hereby authorized and
52 directed to receive for deposit to the credit of the state special
53 revenue fund - other, HCRA transfer fund, medical assistance account for
54 purposes of funding the state share of the free-standing diagnostic and
55 treatment center rate increases for recruitment and retention of health
56 care workers pursuant to subdivision seventeen of section twenty-eight
S. 1408 100 A. 2108
1 hundred seven of this chapter from the tobacco control and insurance
2 initiatives pool established for the following periods in the following
3 amounts:
4 (i) three million two hundred fifty thousand dollars for the period
5 April first, two thousand two through December thirty-first, two thou-
6 sand two;
7 (ii) [three] two million [two] one hundred [fifty] thousand dollars on
8 an annualized basis for the period January first, two thousand three
9 through December thirty-first, two thousand three; [and]
10 (iii) [three] one million [two] seven hundred [fifty] thousand dollars
11 on an annualized basis for the period January first, two thousand four
12 through December thirty-first, two thousand four; and
13 (iv) nine hundred thousand dollars for the period January first, two
14 thousand five through June thirtieth, two thousand five.
15 (ff) Funds shall be deposited by the commissioner, within amounts
16 appropriated, and the state comptroller is hereby authorized and
17 directed to receive for deposit to the credit of the state special
18 revenue fund - other, HCRA transfer fund, medical assistance account for
19 purposes of funding the state share of Medicaid expenditures for disa-
20 bled persons as authorized pursuant to subparagraphs twelve and thirteen
21 of paragraph (a) of subdivision one of section three hundred sixty-six
22 of the social services law from the tobacco control and insurance initi-
23 atives pool established for the following periods in the following
24 amounts:
25 (i) one million eight hundred thousand dollars for the period April
26 first, two thousand two through December thirty-first, two thousand two;
27 (ii) [five] sixteen million [two] four hundred thousand dollars on an
28 annualized basis for the period January first, two thousand three
29 through December thirty-first, two thousand three; [and]
30 (iii) [twenty] eighteen million [four] seven hundred thousand dollars
31 on an annualized basis for the period January first, two thousand four
32 through December thirty-first, two thousand four; and
33 (iv) fifteen million three hundred thousand dollars for the period
34 January first, two thousand five through June thirtieth, two thousand
35 five.
36 (gg) Funds shall be reserved and accumulated from year to year by the
37 commissioner and shall be available, including income from invested
38 funds, for purposes of grants to non-public general hospitals pursuant
39 to paragraph (c) of subdivision thirty of section twenty-eight hundred
40 seven-c of this article from the tobacco control and insurance initi-
41 atives pool established for the following periods in the following
42 amounts:
43 (i) up to one million three hundred thousand dollars on an annualized
44 basis for the period January first, two thousand two through December
45 thirty-first, two thousand two;
46 (ii) up to three million [four] two hundred thousand dollars on an
47 annualized basis for the period January first, two thousand three
48 through December thirty-first, two thousand three; [and]
49 (iii) up to five million six hundred thousand dollars on an annualized
50 basis for the period January first, two thousand four through December
51 thirty-first, two thousand four; and
52 (iv) up to two million eight hundred thousand dollars for the period
53 January first, two thousand five through June thirtieth, two thousand
54 five.
55 (hh) Funds shall be reserved and accumulated from year to year by the
56 commissioner and shall be available, including income from invested
S. 1408 101 A. 2108
1 funds, for purposes of grants to residential health care facilities for
2 financial assistance pursuant to subdivision nineteen of section twen-
3 ty-eight hundred eight of this article, from the tobacco control and
4 insurance initiatives pool established for the following periods in the
5 following amounts:
6 (i) for the period April first, two thousand two through December
7 thirty-first, two thousand two, ten million dollars;
8 (ii) for the period January first, two thousand three through December
9 thirty-first, two thousand three, [ten] eight million seven hundred
10 thousand dollars; [and]
11 (iii) for the period January first, two thousand four through December
12 thirty-first, two thousand four, [ten] eight million six hundred thou-
13 sand dollars; and
14 (iv) up to four million seven hundred thousand dollars for the period
15 January first, two thousand five through June thirtieth, two thousand
16 five.
17 (ii) Funds shall be deposited by the commissioner, within amounts
18 appropriated, and the state comptroller is hereby authorized and
19 directed to receive for deposit to the credit of the state special
20 revenue funds - other, HCRA transfer fund, medical assistance account
21 for the purpose of supporting the state share of Medicaid expenditures
22 for disabled persons as authorized by sections 1619 (a) and (b) of the
23 federal social security act pursuant to the tobacco control and insur-
24 ance initiatives pool established for the following periods in the
25 following amounts:
26 (i) six million four hundred thousand dollars for the period April
27 first, two thousand two through December thirty-first, two thousand two;
28 [and]
29 (ii) [four] eight million [three] five hundred thousand dollars, for
30 the period January first, two thousand three through [June thirtieth,]
31 December thirty-first, two thousand three;
32 (iii) eight million five hundred thousand dollars for the period Janu-
33 ary first, two thousand four through December thirty-first, two thousand
34 four; and
35 (iv) four million three hundred thousand dollars for the period Janu-
36 ary first, two thousand five through June thirtieth, two thousand five.
37 [(ii)] (jj) Funds shall be reserved and accumulated from year to year
38 by the commissioner and shall be available, including income from
39 invested funds, for the purposes of a grant program to improve access to
40 infertility services, treatments and procedures, from the tobacco
41 control and insurance initiatives pool established for the period Janu-
42 ary first, two thousand two through December thirty-first, two thousand
43 two in the amount of [ten] eight million nine hundred thousand dollars.
44 [(jj)] (kk) Funds shall be deposited by the commissioner, within
45 amounts appropriated, and the state comptroller is hereby authorized and
46 directed to receive for deposit to the credit of the state special
47 revenue funds -- other, HCRA transfer fund, medical assistance account
48 for purposes of funding the state share of Medicaid expenditures for
49 pharmacy services from the tobacco control and insurance initiatives
50 pool established for the following periods in the following amounts:
51 (i) thirty-eight million eight hundred thousand dollars for the period
52 January first, two thousand two through December thirty-first, two thou-
53 sand two; [and]
54 (ii) [seventy-seven] two hundred ninety-five million [five hundred
55 thousand] dollars for the period January first, two thousand three
56 through [June thirtieth,] December thirty-first, two thousand three;
S. 1408 102 A. 2108
1 (iii) four hundred seventy-two million dollars for the period January
2 first, two thousand four through December thirty-first, two thousand
3 four; and
4 (iv) two hundred fifty-five million dollars for the period January
5 first, two thousand five through June thirtieth, two thousand five.
6 [(kk)] (ll) Funds shall be deposited by the commissioner, within
7 amounts appropriated, and the state comptroller is hereby authorized and
8 directed to receive for deposit to the credit of the state special
9 revenue funds -- other, HCRA transfer fund, medical assistance account
10 for purposes of funding the state share of Medicaid expenditures related
11 to the city of New York from the tobacco control and insurance initi-
12 atives pool established for the following periods in the following
13 amounts:
14 (i) eighty-two million seven hundred thousand dollars for the period
15 January first, two thousand two through December thirty-first, two thou-
16 sand two; [and]
17 (ii) [sixty-seven] one hundred twenty-four million [five] six hundred
18 thousand dollars for the period January first, two thousand three
19 through [June thirtieth,] December thirty-first, two thousand three[.];
20 (iii) one hundred twenty-four million seven hundred thousand dollars
21 for the period January first, two thousand four through December thir-
22 ty-first, two thousand four; and
23 (iv) sixty-two million four hundred thousand dollars for the period
24 January first, two thousand five through June thirtieth, two thousand
25 five.
26 (mm) Funds shall be deposited by the commissioner, within amounts
27 appropriated, and the state comptroller is hereby authorized and
28 directed to receive for deposit to the credit of the state special
29 revenue funds - other, HCRA transfer fund, medical assistance account,
30 for purposes of funding the state share of services and expenses related
31 to the family health plus program including up to five million dollars
32 annually for the period January first, two thousand three through Decem-
33 ber thirty-first, two thousand four, and up to two million five hundred
34 thousand dollars for the period January first, two thousand five through
35 June thirtieth, two thousand five for administration and marketing costs
36 associated with such program established pursuant to clauses (A) and (B)
37 of subparagraph (v) of paragraph (a) of subdivision two of section three
38 hundred sixty-nine-ee of the social services law from the tobacco
39 control and insurance initiatives pool established for the following
40 periods in the following amount:
41 (i) one hundred seventy million six hundred thousand dollars for the
42 period January first, two thousand three through December thirty-first,
43 two thousand three;
44 (ii) two hundred thirty-three million six hundred thousand dollars for
45 the period January first, two thousand four through December thirty-
46 first, two thousand four; and
47 (iii) one hundred forty-six million eight hundred thousand dollars for
48 the period January first, two thousand five through June thirtieth, two
49 thousand five.
50 (nn) Funds shall be deposited by the commissioner, within amounts
51 appropriated, and the state comptroller is hereby authorized and
52 directed to receive for deposit to the credit of the state special
53 revenue fund - other, HCRA transfer fund, health care services account,
54 for purposes related to an adult home initiative including, but not
55 limited to, assessments, social and recreational services, advocacy and
56 legal support, medication management and case management for medicaid
S. 1408 103 A. 2108
1 eligible residents of residential facilities licensed pursuant to
2 section four hundred sixty-b of the social services law from the tobacco
3 control and insurance initiatives pool established for the following
4 periods in the following amounts;
5 (i) up to four million dollars for the period January first, two thou-
6 sand three through December thirty-first, two thousand three;
7 (ii) up to six million dollars for the period January first, two thou-
8 sand four through December thirty-first, two thousand four; and
9 (iii) up to four million dollars for the period January first, two
10 thousand five through June thirtieth, two thousand five.
11 2. (a) The commissioner is authorized to contract with the article
12 forty-three insurance law plans, or such other contractors as the
13 commissioner shall designate, to receive and distribute funds from the
14 tobacco control and insurance initiatives pool established pursuant to
15 this section. In the event contracts with the article forty-three insur-
16 ance law plans or other commissioner's designees are effectuated, the
17 commissioner shall conduct annual audits of the receipt and distribution
18 of such funds. The reasonable costs and expenses of an administrator as
19 approved by the commissioner, not to exceed for personnel services on an
20 annual basis five hundred thousand dollars, for collection and distrib-
21 ution of funds pursuant to this section shall be paid from such funds.
22 (b) Notwithstanding any inconsistent provision of section one hundred
23 twelve or one hundred sixty-three of the state finance law or any other
24 law, at the discretion of the commissioner without a competitive bid or
25 request for proposal process, contracts in effect for administration of
26 pools established pursuant to sections twenty-eight hundred seven-k,
27 twenty-eight hundred seven-l and twenty-eight hundred seven-m of this
28 article for the period January first, nineteen hundred ninety-nine
29 through December thirty-first, nineteen hundred ninety-nine may be
30 extended to provide for administration pursuant to this section and may
31 be amended as may be necessary.
32 3. Revenue from distributions pursuant to this section shall not be
33 included in gross revenue received for purposes of the assessments
34 pursuant to subdivision eighteen of section twenty-eight hundred seven-c
35 of this article, subject to the provisions of paragraph (e) of subdivi-
36 sion eighteen of section twenty-eight hundred seven-c of this article,
37 and shall not be included in gross revenue received for purposes of the
38 assessments pursuant to section twenty-eight hundred seven-d of this
39 article, subject to the provisions of subdivision twelve of section
40 twenty-eight hundred seven-d of this article.
41 4. In the event residual funds are available in the tobacco control
42 and insurance initiatives pool established for the periods January
43 first, two thousand through June thirtieth, two thousand [three] five,
44 after allocations have been made pursuant to this section for the peri-
45 ods January first, two thousand through June thirtieth, two thousand
46 [three] five, any amount of such funds may be transferred to the health
47 care initiatives pool established pursuant to section twenty-eight
48 hundred seven-l of this article for the periods January first, two thou-
49 sand through June thirtieth, two thousand [three] five, to be allocated
50 and distributed proportionally among affected programs by the commis-
51 sioner to cover any shortfall in programs and purposes set forth in
52 subdivision one of section twenty-eight hundred seven-l of this article.
53 § 17. Section 2807-p of the public health law, as added by chapter 639
54 of the laws of 1996, subdivision 1, paragraph (a) of subdivision 3,
55 subparagraph (i) of paragraph (a) of subdivision 4 as amended and subdi-
56 vision 8 as added by chapter 1 of the laws of 1999, subparagraphs (iii)
S. 1408 104 A. 2108
1 and (iv) of paragraph (a) of subdivision 4 as amended by chapter 419 of
2 the laws of 2000, is amended to read as follows:
3 § 2807-p. Comprehensive diagnostic and treatment centers indigent care
4 program. 1. [The] (a) For periods prior to July first, two thousand
5 three, the commissioner is authorized to make payments to eligible diag-
6 nostic and treatment centers, to the extent of funds available therefor,
7 to assist in meeting losses resulting from uncompensated care. The
8 amount of funds available for such payments shall be the amount remain-
9 ing after the allocation provided in section seven of chapter four
10 hundred thirty-three of the laws of nineteen hundred ninety-seven.
11 (b) For periods on and after July first, two thousand three, the
12 commissioner shall, subject to the availability of federal financial
13 participation, adjust medical assistance rates of payment to assist in
14 meeting losses resulting from uncompensated care.
15 2. Definitions. (a) "Eligible diagnostic and treatment centers", for
16 purposes of this section, shall mean voluntary non-profit and publicly
17 sponsored diagnostic and treatment centers providing a comprehensive
18 range of primary health care services which can demonstrate losses from
19 disproportionate share of uncompensated care during a base period two
20 years prior to the grant period.
21 (b) "Uncompensated care need", for purposes of this section, means
22 losses from reported self-pay and free visits multiplied by the facili-
23 ty's medical assistance payment rate for the applicable distribution
24 year, offset by payments received from such patients during the report-
25 ing period.
26 3. (a) During the period January first, nineteen hundred ninety-seven
27 through September thirtieth, nineteen hundred ninety-seven and for each
28 fiscal year period commencing on October first thereafter through Decem-
29 ber thirty-first, nineteen hundred ninety-nine and for periods on and
30 after January first, two thousand, diagnostic and treatment centers
31 shall be eligible for allocations of funds or for rate adjustments
32 determined in accordance with this section to reflect the needs of the
33 diagnostic and treatment center for the financing of losses resulting
34 from uncompensated care.
35 (b) A diagnostic and treatment center qualifying for a distribution or
36 a rate adjustment pursuant to this section shall provide assurances
37 satisfactory to the commissioner that it shall undertake reasonable
38 efforts to maintain financial support from community and public funding
39 sources and reasonable efforts to collect payments for services from
40 third-party insurance payors, governmental payors and self-paying
41 patients.
42 (c) To be eligible for an allocation of funds or a rate adjustment
43 pursuant to this section, a diagnostic and treatment center must provide
44 a comprehensive range of primary health care services and must demon-
45 strate that a minimum of five percent of total clinic visits reported
46 during the applicable base year period were to uninsured individuals.
47 The commissioner may retrospectively reduce the allocations of funds or
48 the rate adjustments to a diagnostic and treatment center if it is
49 determined that provider management actions or decisions have caused a
50 significant reduction for the grant period in the delivery of comprehen-
51 sive primary health care services to uncompensated care residents of the
52 community.
53 4.(a) (i) The total amount of funds to be allocated and distributed
54 for uncompensated care to eligible voluntary non-profit diagnostic and
55 treatment centers for a distribution period prior to July first, two
56 thousand three in accordance with this subdivision shall be limited to
S. 1408 105 A. 2108
1 thirty-three percent of the funds available therefor pursuant to para-
2 graph (a) of subdivision one of this section.
3 (ii) The total amount of funds to be allocated and distributed for
4 uncompensated care to eligible publicly sponsored diagnostic and treat-
5 ment centers for a grant period prior to July first, two thousand three
6 in accordance with this subdivision shall be limited to sixty-seven
7 percent of funds available therefor pursuant paragraph (a) of to subdi-
8 vision one of this section; provided, however, that forty-one percent of
9 the amount of funds allocated for distribution to eligible publicly
10 sponsored diagnostic and treatment centers shall be available for clin-
11 ics operating under the auspices of the New York city health and hospi-
12 tals corporation as established by chapter one thousand sixteen of the
13 laws of nineteen hundred sixty-nine as amended.
14 (iii) (A) Notwithstanding the provisions of subparagraph (ii) of this
15 paragraph and any other provision of this chapter, municipalities which
16 received state aid pursuant to article two of [the public health law]
17 this chapter for the nineteen hundred eighty-nine--nineteen hundred
18 ninety state fiscal year in support of non-hospital based free-standing
19 or local health department operated general medical clinics shall
20 receive an uncompensated care grant allocation of funds on an annualized
21 basis through December thirty-first, two thousand two, of not less than
22 the amount received in the nineteen hundred eighty-nine--nineteen
23 hundred ninety state fiscal year for general medical clinics.
24 (B) For the period January first, two thousand three through June
25 thirtieth, two thousand three, each such municipality shall receive an
26 uncompensated care grant allocation of funds of not less than one-half
27 the amount calculated pursuant to clause (A) of this subparagraph.
28 (iv) (A) Notwithstanding any inconsistent provision of this paragraph,
29 for the period January first, nineteen hundred ninety-seven through
30 December thirty-first, nineteen hundred ninety-nine and for periods on
31 and after January first, two thousand through December thirty-first, two
32 thousand two, diagnostic and treatment centers which received an allow-
33 ance pursuant to paragraph (f) of subdivision two of section twenty-
34 eight hundred seven of this article for the period through December
35 thirty-first, nineteen hundred ninety-six shall receive an uncompensated
36 care distribution allocation of funds of not less than the amount that
37 would have been received for any losses associated with the delivery of
38 bad debt and charity care for nineteen hundred ninety-five had the
39 provisions of paragraph (f) of subdivision two of section twenty-eight
40 hundred seven of this article remained in effect.
41 (B) For the period January first, two thousand three through June
42 thirtieth, two thousand three, each such diagnostic and treatment center
43 shall receive an uncompensated care distribution allocation of funds of
44 not less than one-half the amount calculated pursuant to clause (A) of
45 this subparagraph.
46 (b) (i) A nominal payment amount for the financing of losses associ-
47 ated with the delivery of uncompensated care will be established for
48 each eligible diagnostic and treatment center. The nominal payment
49 amount shall be calculated as the sum of the dollars attributable to the
50 application of an incrementally increasing nominal coverage percentage
51 of base year period losses associated with the delivery of uncompensated
52 care for percentage increases in the relationship between base year
53 period eligible uninsured care clinic visits and base year period total
54 clinic visits according to the following scale:
55 % of eligible bad debt and charity care % of nominal financial
56 clinic visits to total visits loss coverage
S. 1408 106 A. 2108
1 up to 15% 50%
2 15 - 30% 75%
3 30% + 100%
4 (ii) If the sum of the nominal payment amounts for all eligible volun-
5 tary non-profit diagnostic and treatment centers or for all eligible
6 public diagnostic and treatment centers or for all clinics operating
7 under the auspices of the New York city health and hospitals corporation
8 is less than the amount allocated for uncompensated care allowances
9 pursuant to paragraph (a) of this subdivision for such diagnostic and
10 treatment centers respectively, the nominal coverage percentages of base
11 year period losses associated with the delivery of uncompensated care
12 pursuant to this scale may be increased to not more than one hundred
13 percent for voluntary non-profit diagnostic and treatment centers or for
14 public diagnostic and treatment centers or for all clinics operating
15 under the auspices of the New York city health and hospitals corporation
16 in accordance with rules and regulations adopted by the council and
17 approved by the commissioner.
18 (c) The uncompensated care allocations of funds for each eligible
19 voluntary non-profit diagnostic and treatment center shall be based on
20 the dollar value of the result of the ratio of total funds allocated for
21 distributions for voluntary non-profit diagnostic and treatment centers
22 pursuant to paragraph (a) of this subdivision to the total statewide
23 nominal payment amounts for all eligible voluntary non-profit diagnostic
24 and treatment centers determined in accordance with paragraph (b) of
25 this subdivision applied to the nominal payment amount for each such
26 diagnostic and treatment center.
27 (d) The uncompensated care allocations of funds for each eligible
28 public diagnostic and treatment center, other than clinics operating
29 under the auspices of the New York city health and hospitals corpo-
30 ration, shall be based on the dollar value of the result of the ratio of
31 total funds allocated for distributions for public diagnostic and treat-
32 ment centers, other than clinics operating under the auspices of the New
33 York city health and hospitals corporation, pursuant to paragraph (a) of
34 this subdivision to the total statewide nominal payment amounts for all
35 eligible public diagnostic and treatment centers, other than clinics
36 operating under the auspices of the New York city health and hospitals
37 corporation, determined in accordance with paragraph (b) of this subdi-
38 vision applied to the nominal payment amount for each such diagnostic
39 and treatment center.
40 (e) The uncompensated care grant allocations of funds for each eligi-
41 ble public diagnostic and treatment center operating under the auspices
42 of the New York city health and hospitals corporation shall be based on
43 the dollar value of the result of the ratio of total funds allocated for
44 distributions for public diagnostic and treatment centers operating
45 under the auspices of the New York city health and hospitals corporation
46 pursuant to paragraph (a) of this subdivision to the total statewide
47 nominal payment amounts for all eligible public diagnostic and treatment
48 centers operating under the auspices of the New York city health and
49 hospitals corporation determined in accordance with paragraph (b) of
50 this subdivision applied to the nominal payment amount for each such
51 diagnostic and treatment center.
52 (f) Any residual amount allocated for distribution to a classification
53 of diagnostic and treatment centers in accordance with this subdivision
54 shall be reallocated by the commissioner for distributions to the other
55 classifications based on remaining need.
S. 1408 107 A. 2108
1 4-a.(a)(i) For periods on and after July first, two thousand three,
2 funds shall be made available for adjustments to rates of payments made
3 pursuant to paragraph (b) of subdivision one of this section for eligi-
4 ble voluntary non-profit diagnostic and treatment centers in accordance
5 with subparagraphs (ii) and (iii) of this paragraph, for the following
6 periods in the following aggregate amounts:
7 (A) For the period July first, two thousand three through December
8 thirty-first, two thousand three, up to seven million five hundred thou-
9 sand dollars;
10 (B) For the period January first, two thousand four through December
11 thirty-first, two thousand four, up to fifteen million dollars;
12 (C) For the period January first, two thousand five through June thir-
13 tieth, two thousand five, up to seven million five hundred thousand
14 dollars.
15 (ii) A nominal payment amount for the financing of losses associated
16 with the delivery of uncompensated care will be established for each
17 eligible diagnostic and treatment center. The nominal payment amount
18 shall be calculated as the sum of the dollars attributable to the appli-
19 cation of an incrementally increasing nominal coverage percentage of
20 base year period losses associated with the delivery of uncompensated
21 care for percentage increases in the relationship between base year
22 period eligible uninsured care clinic visits and base year period total
23 clinic visits according to the following scale:
24 % of eligible bad debt and charity care % of nominal
25 clinic visits to total visits financial loss
26 coverage
27 up to 15% 50%
28 15-30% 75%
29 30% + 100%
30 (iii) The uncompensated care rate adjustments for each eligible volun-
31 tary non-profit diagnostic and treatment center shall be based on the
32 dollar value of the result of the ratio of total funds allocated for
33 distributions for voluntary non-profit diagnostic and treatment centers
34 pursuant to subparagraph (i) of this paragraph, to the total statewide
35 nominal payment amounts for all eligible voluntary non-profit diagnostic
36 and treatment centers determined in accordance with subparagraph (ii) of
37 this paragraph applied to the nominal payment amount for each such diag-
38 nostic and treatment center.
39 (b)(i) For periods on and after July first, two thousand three funds
40 shall be made available for adjustments to rates of payments made pursu-
41 ant to paragraph (b) of subdivision one of this section for eligible
42 public diagnostic and treatment centers, other than clinics operated
43 under the auspices of the New York city health and hospitals corpo-
44 ration, in accordance with subparagraphs (ii) and (iii) of this para-
45 graph, for the following periods in the following aggregate amounts:
46 (A) For the period July first, two thousand three through December
47 thirty-first, two thousand three, up to nine million dollars;
48 (B) For the period January first, two thousand four through December
49 thirty-first, two thousand four, up to eighteen million dollars;
50 (C) For the period January first, two thousand five through June thir-
51 tieth, two thousand five, up to nine million dollars.
52 (ii) A nominal payment amount for the financing of losses associated
53 with the delivery of uncompensated care will be established for each
54 eligible diagnostic and treatment center. The nominal payment amount
55 shall be calculated as the sum of the dollars attributable to the appli-
56 cation of an incrementally increasing nominal coverage percentage of
S. 1408 108 A. 2108
1 base year period losses associated with the delivery of uncompensated
2 care for percentage increases in the relationship between base year
3 period eligible uninsured care clinic visits and base year period total
4 clinic visits according to the following scale:
5 % of eligible bad debt and charity care % of nominal financial
6 clinic visits to total visits loss coverage
7 up to 15% 50%
8 15-30% 75%
9 30% + 100%
10 (iii) The uncompensated care rate adjustments for each eligible public
11 diagnostic and treatment center, other than clinics operating under the
12 auspices of the New York city health and hospitals corporation, shall be
13 based on the dollar value of the result of the ratio of total funds
14 allocated for distributions for public diagnostic and treatment centers,
15 other than clinics operating under the auspices of the New York city
16 health and hospitals corporation, pursuant to subparagraph (i) of this
17 paragraph to the total statewide nominal payment amounts for all eligi-
18 ble public diagnostic and treatment centers, other than clinics operat-
19 ing under the auspices of the New York city health and hospitals corpo-
20 ration, determined in accordance with subparagraph (ii) of this
21 paragraph applied to the nominal payment amount for each such diagnostic
22 and treatment center.
23 (c)(i) For periods on and after July first, two thousand three, funds
24 shall be made available for adjustments to rates of payments made pursu-
25 ant to paragraph (b) of subdivision one of this section for eligible
26 public diagnostic and treatment centers operating under the auspices of
27 the New York city health and hospitals corporation, in accordance with
28 subparagraphs (ii) and (iii) of this paragraph, for the following peri-
29 ods in the following aggregate amounts:
30 (A) For the period July first, two thousand three through December
31 thirty-first, two thousand three, up to six million dollars;
32 (B) For the period January first, two thousand four through December
33 thirty-first, two thousand four, up to twelve million dollars;
34 (C) For the period January first, two thousand five through June thir-
35 tieth, two thousand five, up to six million dollars.
36 (ii) A nominal payment amount for the financing of losses associated
37 with the delivery of uncompensated care will be established for each
38 eligible diagnostic and treatment center. The nominal payment amount
39 shall be calculated as the sum of the dollars attributable to the appli-
40 cation of an incrementally increasing nominal coverage percentage of
41 base year period losses associated with the delivery of uncompensated
42 care for percentage increases in the relationship between base year
43 period eligible uninsured care clinic visits and base year period total
44 clinic visits according to the following scale:
45 % of eligible bad debt and charity care % of nominal financial
46 clinic visits to total visits loss coverage
47 up to 15% 50%
48 15-30% 75%
49 30% + 100%
50 (iii) The uncompensated care rate adjustment, for each eligible public
51 diagnostic and treatment center operating under the auspices of the New
52 York city health and hospitals corporation shall be based on the dollar
53 value of the result of the ratio of total funds allocated for distrib-
54 utions for public diagnostic and treatment centers operating under the
55 auspices of the New York city health and hospitals corporation pursuant
56 to subparagraph (i) of this paragraph to the total statewide nominal
S. 1408 109 A. 2108
1 payment amounts for all eligible public diagnostic and treatment centers
2 operating under the auspices of the New York city health and hospitals
3 corporation determined in accordance with subparagraph (ii) of this
4 paragraph applied to the nominal payment amount for each such diagnostic
5 and treatment center.
6 (d) (i) Notwithstanding the provisions of paragraph (b) of this subdi-
7 vision and any other provisions of this chapter, municipalities which
8 received state aid pursuant to article two of this chapter for the nine-
9 teen hundred eighty-nine--nineteen hundred ninety state fiscal year in
10 support of non-hospital based free-standing or local health department
11 operated general medical clinics shall receive an uncompensated care
12 rate adjustment for the period July first, two thousand three through
13 December thirty-first, two thousand three, of not less than one-half the
14 amount received in the nineteen hundred eighty-nine--nineteen hundred
15 ninety state fiscal year for general medical clinics.
16 (ii) For the period January first, two thousand four through December
17 thirty-first, two thousand four, each such municipality shall receive an
18 uncompensated care rate adjustment of not less than twice the amount
19 calculated pursuant to subparagraph (i) of this paragraph.
20 (iii) For the period January first, two thousand five through June
21 thirtieth, two thousand five, each such municipality shall receive an
22 uncompensated care rate adjustment of not less than the amount calcu-
23 lated pursuant to subparagraph (i) of this paragraph.
24 (e) (i) Notwithstanding any inconsistent provision of this subdivi-
25 sion, for the period July first, two thousand three through December
26 thirty-first, two thousand three, diagnostic and treatment centers which
27 received an allowance pursuant to paragraph (f) of subdivision two of
28 section twenty-eight hundred seven of this article for the period
29 through December thirty-first, nineteen hundred ninety-six shall receive
30 an uncompensated care rate adjustment of not less than one-half the
31 amount that would have been received for any losses associated with the
32 delivery of bad debt and charity care for nineteen hundred ninety-five
33 had the provisions of paragraph (f) of subdivision two of section twen-
34 ty-eight hundred seven of this article remained in effect.
35 (ii) For the period January first, two thousand four through December
36 thirty-first, two thousand four, each such diagnostic and treatment
37 center shall receive an uncompensated care rate adjustment of not less
38 than twice the amount calculated pursuant to subparagraph (i) of this
39 paragraph.
40 (iii) For the period January first, two thousand five through June
41 thirtieth, two thousand five, each such diagnostic and treatment center
42 shall receive an uncompensated care rate adjustment of not less than the
43 amount calculated pursuant to subparagraph (i) of this paragraph, and
44 shall be subject to subsequent adjustment or reconciliation.
45 (f) Any residual amount allocated for distribution to a classification
46 of diagnostic and treatment centers in accordance with this subdivision
47 shall be reallocated by the commissioner for distributions to the other
48 classifications based on remaining need.
49 4-b.(a) For periods on and after July first, two thousand three funds
50 shall be made available for adjustments to rates of payment made pursu-
51 ant to paragraph (b) of subdivision one of this section for eligible
52 diagnostic and treatment centers with less than two years of operating
53 experience, and diagnostic and treatment centers which have received
54 certificate of need approval on applications which indicate a signif-
55 icant increase in uninsured visits, for the following periods and in the
56 following aggregate amounts:
S. 1408 110 A. 2108
1 (i) For the period July first, two thousand three through December
2 thirty-first, two thousand three, up to one million five hundred thou-
3 sand dollars;
4 (ii) For the period January first, two thousand four through December
5 thirty-first, two thousand four, up to three million dollars;
6 (iii) For the period January first, two thousand five through June
7 thirtieth, two thousand five, up to one million five hundred thousand
8 dollars.
9 (b) To be eligible for a rate adjustment pursuant to this section, a
10 diagnostic and treatment center shall be a voluntary, non-profit or
11 publicly sponsored diagnostic and treatment center providing a compre-
12 hensive range of primary health care services and be eligible to receive
13 a medicaid budgeted rate prior to April first of the applicable rate
14 adjustment period after which time, the department shall issue rate
15 adjustments pursuant to this subdivision for such periods. Rate adjust-
16 ments made pursuant to this subdivision shall be allocated based upon
17 each eligible facility's proportional share of costs for services
18 rendered to uninsured patients which have otherwise not been used for
19 establishing distributions pursuant to subdivision four-a of this
20 section. For the purposes of this subdivision costs shall be measured by
21 multiplying each facility's medicaid budgeted rate by the estimated
22 number of visits reported for services anticipated to be rendered to
23 uninsured patients meeting the aforementioned criteria, less any antic-
24 ipated patient service revenues received from such uninsured patients,
25 during the applicable rate adjustment period.
26 5. Diagnostic and treatment centers shall furnish to the department
27 such reports and information as may be required by the commissioner to
28 assess the cost, quality, access to, effectiveness and efficiency of
29 uncompensated care provided. The council shall adopt rules and regu-
30 lations, subject to the approval of the commissioner, to establish
31 uniform reporting and accounting principles designed to enable diagnos-
32 tic and treatment centers to fairly and accurately determine and report
33 uncompensated care visits and the costs of uncompensated care. In order
34 to be eligible for an allocation of funds pursuant to this section, a
35 diagnostic and treatment center must be [incompliance] in compliance
36 with uncompensated care reporting requirements.
37 6. Notwithstanding any inconsistent provision of law to the contrary,
38 the availability or payment of funds to a diagnostic and treatment
39 center pursuant to this section shall not be admissible as a defense,
40 offset or reduction in any action or proceeding relating to any bill or
41 claim for amounts due for services provided by a diagnostic and treat-
42 ment center.
43 7. Revenue from distributions to a diagnostic and treatment center
44 pursuant to this section shall not be included in gross revenue received
45 for purposes of the assessments pursuant to section twenty-eight hundred
46 seven-d of this article, subject to the provisions of subdivision twelve
47 of section twenty-eight hundred seven-d of this article.
48 8. (a) For periods on or after January first, two thousand through
49 June thirtieth, two thousand three, payments made to an eligible diag-
50 nostic and treatment center pursuant to this section shall be reduced or
51 increased by an amount equal to the amount of any overpayments or under-
52 payments made against grants awarded pursuant to section seven of chap-
53 ter four hundred thirty-three of the laws of nineteen hundred ninety-
54 seven for the period three years prior to the annual awards made
55 pursuant to this section.
S. 1408 111 A. 2108
1 (b) The determination of such overpayments or underpayments shall be
2 based on the submission by eligible facilities of reports reflecting
3 actual uncompensated care data, as required by the commissioner, which
4 are attributable to prior periods. Submission of such reports is a
5 condition for an eligible facility's receipt of payments pursuant to
6 this section.
7 (c) For any periods in which a facility does not receive payments
8 pursuant to this section, the amount of any prior period overpayment may
9 be offset against payments for medical assistance made to such facility
10 pursuant to title eleven of article five of the social services law and
11 credited to funds allocated pursuant to this section. Any prior period
12 underpayment to an eligible facility may be paid to such facility in a
13 subsequent period.
14 9. Adjustments to rates of payment made pursuant to this section may
15 be added to rates of payment or made as aggregate payments to eligible
16 diagnostic and treatment centers and shall not be subject to subsequent
17 adjustment or reconciliation.
18 § 18. Section 7 of chapter 433 of the laws of 1997, amending the
19 public health law and other laws relating to rates of reimbursement paid
20 to hospitals and residential health care facilities, as amended by chap-
21 ter 1 of the laws of 1999, is amended to read as follows:
22 § 7. Notwithstanding any inconsistent provision of law or regulation
23 to the contrary effective January 1, 1997 through [December 31, 1999,
24 and on and after January first, two thousand,] June 30, 2003, a sum of
25 6.25 percent of the total funds available pursuant to paragraph (a) of
26 subdivision one of section 2807-p of the public health law shall be
27 allocated for grants for indigent care for eligible diagnostic and
28 treatment centers with less than two years of operating experience, and
29 diagnostic and treatment centers which have received certificate of need
30 approval on applications which indicate a significant increase in unin-
31 sured visits. To be eligible for a grant pursuant to this section, a
32 diagnostic and treatment center shall: (a) be a voluntary, non-profit or
33 publicly sponsored diagnostic and treatment center providing a compre-
34 hensive range of primary health care services and (b) (i) for the 1997
35 grant period, be eligible to receive a medicaid budgeted rate on or
36 before the effective date of this chapter or (ii) for the 1998[, 1999
37 and subsequent] through June 30, 2003, grant periods, be eligible to
38 receive a medicaid budgeted rate prior to April 1 of the applicable
39 grant period after which time, the department of health shall award
40 grants for such periods. Awards granted pursuant to this section shall
41 be allocated based upon each eligible facility's proportional share of
42 costs for services rendered to uninsured patients which have otherwise
43 not been used for establishing distributions pursuant to section 2807-p
44 of the public health law. For the purposes of this section costs shall
45 be measured by multiplying each facility's medicaid budgeted rate by the
46 estimated number of visits reported for services anticipated to be
47 rendered to uninsured patients meeting the aforementioned criteria, less
48 any anticipated patient service revenues received from such uninsured
49 patients, during the applicable grant period.
50 § 19. Notwithstanding any law to the contrary, the commissioner of
51 health shall deposit and the state comptroller is hereby authorized and
52 directed to receive for deposit to the credit of the state special
53 revenue fund-other, CHCCDP transfer account, all federal matching funds
54 earned pursuant to the community health care conversion demonstration
55 project authorized in the amended terms and conditions included in the
56 extension of the section 1115 waiver demonstration project, which is
S. 1408 112 A. 2108
1 entitled the partnership plan, as approved by the secretary of the
2 federal department of health and human services and accepted by the
3 state for the extension period beginning April 1, 2003.
4 § 20. The opening paragraph of section 2952 of the public health law,
5 as amended by chapter 639 of the laws of 1996, is amended to read as
6 follows:
7 To the extent of funds available therefor, the sum of seven million
8 dollars shall annually be available for periods prior to January first,
9 two thousand three, and up to six million dollars annually for the peri-
10 od January first, two thousand three through December thirty-first, two
11 thousand four, and up to four million dollars for the period January
12 first, two thousand five through June thirtieth, two thousand five shall
13 be available to the commissioner from funds made available pursuant to
14 section twenty-eight hundred seven-l of this chapter for grants pursuant
15 to this section.
16 § 20-a. Subdivision 1 of section 2958 of the public health law, as
17 added by chapter 639 of the laws of 1996, is amended to read as follows:
18 1. To the extent of funds available therefor, the sum of ten million
19 dollars shall annually be made available for periods prior to January
20 first, two thousand three, and up to eight million three hundred thou-
21 sand dollars for the period January first, two thousand three through
22 December thirty-first, two thousand three, up to eight million two
23 hundred thousand dollars for the period January first, two thousand four
24 through December thirty-first, two thousand four, and up to three
25 million eight hundred thousand dollars for the period January first, two
26 thousand five through June thirtieth, two thousand five shall be avail-
27 able to the commissioner from funds pursuant to section twenty-eight
28 hundred seven-l of this chapter to provide assistance to general hospi-
29 tals classified as a rural hospital for purposes of determining payment
30 for inpatient services provided to beneficiaries of title XVIII of the
31 federal social security act (Medicare) or under state regulations, in
32 recognition of the unique costs incurred by these facilities to provide
33 hospital services in remote or sparsely populated areas pursuant to
34 [subdivisions] subdivision two [and three] of this section.
35 § 21. Subdivisions 3, 4 and 5 of section 47 of chapter 2 of the laws
36 of 1998, amending the public health law, the social services law and the
37 insurance law relating to expanding the child health insurance plan, as
38 amended by section 55 of part A of chapter 1 of the laws of 2002, are
39 amended to read as follows:
40 3. section six of this act shall take effect January 1, 1999;
41 provided, however, that subparagraph (iii) of paragraph (c) of subdivi-
42 sion 9 of section 2510 of the public health law, as added by this act,
43 shall expire on July 1, [2003] 2005;
44 4. sections two, three, four, seven, eight, nine, fourteen, fifteen,
45 sixteen, eighteen, eighteen-a, [twenty-three,] twenty-four, [twenty-
46 five] and twenty-nine of this act shall take effect January 1, 1999 and
47 shall expire on July 1, [2003] 2005, and sections twenty-three and twen-
48 ty-five of this act shall take effect January 1, 1999 and shall expire
49 on July 1, 2003;
50 5. section twelve of this act shall take effect January 1, 1999;
51 provided, however, [paragraphs] paragraph (g) [and (h)] of subdivision 2
52 of section 2511 of the public health law, as added by such section,
53 shall expire on July 1, 2003, and paragraph (h) of subdivision 2 of
54 section 2511 of the public health law, as added by this section, shall
55 expire on July 1, 2005;
S. 1408 113 A. 2108
1 § 22. Paragraph (g) of subdivision 2 of section 2511 of the public
2 health law is REPEALED and paragraphs (h) and (j) of subdivision 2 are
3 relettered paragraphs (g) and (h), respectively.
4 § 22-a. Notwithstanding the operation of subdivisions 4 and 6 of
5 section 47 of chapter 2 of the laws of 1998, subdivision 4 as amended by
6 section twenty-one of this act, a person who would be otherwise ineligi-
7 ble for medical assistance due solely to the expiration of paragraph (t)
8 or (u) of subdivision 4 of section 366 of the social services law shall
9 remain eligible for medical assistance until such time as such person's
10 eligibility is redetermined by the social services district pursuant to
11 such person's next scheduled recertification.
12 § 23. Notwithstanding any inconsistent provision of section 112 or 163
13 of the state finance law or any other law, at the discretion of the
14 commissioner of health, without a competitive bid or request for
15 proposal process, contractual arrangements with approved organizations,
16 as defined in subdivision 2 of section 2510 of the public health law,
17 and outreach and facilitated enrollment contractors pursuant to subdivi-
18 sion 9 of section 2511 of the public health law in effect in 2002 may be
19 extended through July 1, 2005 to provide an uninterrupted continuation
20 of services and may be amended as deemed necessary.
21 § 24. Clause (A) of subparagraph (v) of paragraph (a) of subdivision 2
22 of section 369-ee of the social services law, as amended by chapter 419
23 of the laws of 2000, is amended to read as follows:
24 (A) in the case of a parent or stepparent of a child under the age of
25 twenty-one who lives with such child, has gross family income equal to
26 or less than the applicable percent of the federal income official
27 poverty line (as defined and updated by the United States Department of
28 Health and Human Services) for a family of the same size; for purposes
29 of this clause, the applicable percent effective as of:
30 (I) January first, two thousand one, is one hundred twenty percent;
31 and
32 (II) October first, two thousand one, is one hundred thirty-three
33 percent; and
34 (III) October first, two thousand two, is one hundred fifty percent;
35 [or] and
36 (IV) February first, two thousand three, or upon receipt of all neces-
37 sary approvals under federal law and regulation to receive federal
38 financial participation under the program described in title eleven of
39 this article, whichever is later, one hundred thirty-three percent for
40 family health plus applicants whose eligibility is determined on or
41 after February first, two thousand three; or
42 § 25. Paragraph (c) of subdivision 3 of section 369-ee of the social
43 services law, as added by chapter 1 of the laws of 1999, is amended to
44 read as follows:
45 (c) Participants under this section who have lost their eligibility
46 for health care services before the end of a six month period beginning
47 on the date of the participant's initial enrollment in a family health
48 insurance plan shall have their eligibility for family health plus
49 continued until the end of the six month enrollment period, provided
50 that federal financial participation in the cost of such coverage is
51 available. The provisions of this paragraph shall not apply to persons
52 whose family income is in excess of the income standard specified in
53 subclause (IV) of clause (A) of subparagraph (v) of paragraph (a) of
54 subdivision two of this section, who are determined eligible for family
55 health plus on or after February first, two thousand three, but prior to
S. 1408 114 A. 2108
1 the effective date of such income standard, and who lose eligibility for
2 health care services due to such income standard taking effect.
3 § 26. Subsection (s) of section 4327 of the insurance law, as amended
4 by chapter 419 of the laws of 2000, is amended to read as follows:
5 (s) The superintendent may access funding from the small employer stop
6 loss fund and/or the qualifying individual stop loss fund for the
7 purposes of developing and implementing public education, outreach and
8 facilitated enrollment strategies targeted to small employers and work-
9 ing adults without health insurance. The superintendent may contract
10 with marketing organizations to perform or provide assistance with such
11 education, outreach, and enrollment strategies. [The superintendent
12 shall determine the amount of funding available for the purposes of this
13 subsection which in no event shall exceed ten percent of the annual
14 funding amounts for the small employer stop loss fund and the qualifying
15 individual stop loss fund.]
16 § 27. Section 59 of part J of chapter 82 of the laws of 2002, amending
17 chapter 1 of the laws of 2002 amending the public health law, the social
18 services law, and the tax law relating to the Health Care Reform Act of
19 2000 relating to health care reform, is amended to read as follows:
20 § 59. Notwithstanding any law, rule or regulation to the contrary, the
21 commissioner of health is authorized to [borrow] utilize any existing
22 cash balances in pools established or funded pursuant to sections
23 2807-j, 2807-k, 2807-m, 2807-s, 2807-t and 2807-v of the public health
24 law for the purpose of meeting any funding obligations set forth in
25 sections 2807-k, 2807-l, 2807-m or 2807-v of the public health law[,
26 provided, however, that such authorization shall expire and be of no
27 further effect in the event the two hundred million dollars transferred
28 from pools established pursuant to sections 2807-j and 2807-v of the
29 public health law pursuant to section fifty-eight of this act are trans-
30 ferred back to said pools from the state general fund or otherwise; and
31 further provided that such authorization shall in no event extend beyond
32 December 31, 2005; and further provided that, commencing with the effec-
33 tive date of this section, reports of cash transfers made pursuant to
34 this section shall be submitted on a semi-annual basis to the director
35 of the budget, the temporary president of the senate and the speaker of
36 the assembly].
37 § 28. Section 58 of part J of chapter 82 of the laws of 2002, amending
38 chapter 1 of the laws of 2002 amending the public health law, the social
39 services law, and the tax law relating to the Health Care Reform Act of
40 2000 relating to health care reform, is amended to read as follows:
41 § 58. (1) Notwithstanding any law, rule or regulation to the contrary,
42 and in accordance with section 4 of the state finance law, the commis-
43 sioner of health, with the approval of the director of the budget, is
44 authorized to [borrow] utilize two hundred million dollars from funds
45 collected or to be collected in pools established pursuant to paragraph
46 (b) of subdivision 9 of section 2807-j of the public health law and
47 section 2807-v of the public health law which shall be allocated pursu-
48 ant to subdivision two of this section, and [to transfer such funds]
49 transferred to the state special revenue funds - other, HCRA transfer
50 fund, medical assistance account for Medicaid purposes, including, but
51 not limited to, disaster relief Medicaid[, provided, however, that in
52 the event that the commissioner of health and the director of the budget
53 subsequently determine prior to the expiration date of such sections as
54 set forth in section 138 of chapter 1 of the laws of 1999 that addi-
55 tional funds are required to meet obligations set forth in sections
56 2807-k, 2807-l, 2807-m or 2807-v of the public health law, that up to
S. 1408 115 A. 2108
1 two hundred million dollars shall be transferred from the state general
2 fund to pools established pursuant to paragraph (b) of subdivision 9 of
3 section 2807-j of the public health law and section 2807-v of the public
4 health law; and further provided that the commissioner of health and
5 director of the budget shall ensure that the authorizations contained in
6 this section and section fifty-nine of this act shall in no event
7 impede, limit or otherwise impair, in any way, the implementation of, or
8 the time frames or levels of financial distributions for, any of the
9 initiatives financed pursuant to section 2807-k, 2807-l, 2807-m or
10 2807-v of the public health law].
11 (2) The two hundred million dollars transferred pursuant to subdivi-
12 sion one of this section shall be charged against the following programs
13 in the following amounts:
14 (a) From the allocations for the New York state small business health
15 insurance partnership program as set forth pursuant to clause (A) of
16 subparagraph (ii) of paragraph (b) of subdivision 1 of section 2807-l of
17 the public health law for the periods January 1, 2002 through June 30,
18 2003, four million two hundred thousand dollars;
19 (b) From the allocation for the hospital based grant programs as set
20 forth pursuant to subparagraph (i) of paragraph (c) of subdivision 1 of
21 section 2807-l of the public health law for the period January 1, 2003
22 through December 31, 2003, eight million dollars;
23 (c) From the allocation for the emergency medical services training
24 account as set forth pursuant to subparagraph (ii) of paragraph (c) of
25 subdivision 1 of section 2807-l of the public health law the period
26 January 1, 2003 through December 31, 2003, seven million dollars;
27 (d) From the allocation for the primary health care services grant
28 program as set forth pursuant to subparagraph (iii) of paragraph (g) of
29 subdivision 1 of 2807-l of the public health law for the period January
30 1, 1999 through December 31, 1999, five million eight hundred thousand
31 dollars;
32 (e) From the allocation for the healthy New York individual program as
33 set forth pursuant to subparagraphs (ii) and (iii) of paragraph (h) of
34 subdivision 1 of section 2807-v of the public health law for the period
35 January 1, 2002 two through December 31, 2003, forty-eight million
36 dollars; and
37 (f) From the allocation for the healthy New York group program as set
38 forth pursuant to subparagraphs (ii) and (iii) of paragraph (i) of
39 subdivision 1 of section 2807-v of the public health law for the period
40 January 1, 2002 through December 31, 2003, one hundred twenty-seven
41 million dollars.
42 § 29. Subparagraph (i) of paragraph (a) of subdivision 5 of section
43 2807-j of the public health law, as amended by chapter 1 of the laws of
44 1999, is amended to read as follows:
45 (i) The election pursuant to this paragraph to be effective must be in
46 writing, filed with the commissioner or the commissioner's designee on
47 such forms and in such manner as the commissioner shall require. An
48 election must apply to all classes of designated providers of service
49 and to all providers within each class. An election by a payor shall
50 take effect [for nineteen hundred ninety-seven,] on the next following
51 January first, April first, July first, or October first, [and for each
52 calendar year thereafter on the next following January first,] not less
53 than thirty days after the election is filed. [Beginning December first,
54 nineteen hundred ninety-seven, an election pursuant to this paragraph
55 must be made no later than December first of the year prior to the
56 assessment year. However, any payor licensed pursuant to the insurance
S. 1408 116 A. 2108
1 law or certified pursuant to article forty-four of this chapter between
2 December first of the year prior to the assessment year and December
3 thirty-first of the assessment year may make an election subsequent to
4 such licensure, and during said time period, to take effect on the next
5 following January first, April first, July first or October first not
6 less than thirty days after such election is filed. Payors other than
7 those licensed pursuant to the insurance law or certified pursuant to
8 this chapter which have not provided third-party coverage prior to
9 December first of the year prior to the assessment year may make an
10 election at any time from December first of the year prior to said
11 assessment year to December thirty-first of the assessment year, to take
12 effect on the next following January first, April first, July first or
13 October first not less than thirty days after the election is filed.]
14 § 30. Subparagraph (a) of subdivision 5-a of section 2807-j of the
15 public health law, as amended by chapter 419 of the laws of 2000, is
16 amended to read as follows:
17 (a) Payments by or on behalf of designated providers of services to
18 the commissioner or the commissioner's designee of funds due from the
19 allowances pursuant to subdivision two of this section or pursuant to
20 payment obligations incurred pursuant to section twenty-eight hundred
21 seven-s of this article or section twenty-eight hundred seven-t of this
22 article shall be made on a monthly basis, provided, however, that for
23 reporting periods relating to payments for services provided or dates of
24 inpatient discharge or contracted service obligations occurring on or
25 after January first, two thousand one, the commissioner may permit
26 certain third-party payors which have at least one full year of pool
27 payment experience to submit such payments on an annual basis, based on
28 an annual demonstration by a payor through its prior year's pool payment
29 experience that total pool obligations under this section and sections
30 twenty-eight hundred seven-s and twenty-eight hundred seven-t of this
31 article are not expected to exceed ten thousand dollars [in the current
32 pool year] for annual periods prior to January first, two thousand four,
33 and twenty-five thousand dollars for annual periods on and after January
34 first, two thousand four. Payments due by designated providers of
35 services on account of payors in accordance with paragraph (b) of subdi-
36 vision two of this section shall be two percentage points less than the
37 percentage specified in such paragraph. The designated provider of
38 services shall retain for compensation for such provider's administra-
39 tive responsibilities the amount that represents the difference.
40 Payments due by designated providers of services on account of all other
41 payors shall be calculated on the basis of the percentage allowance
42 applicable to such payor pursuant to paragraphs (d), (e), (f) and (g) of
43 subdivision two of this section. Payments shall be due on or before the
44 thirtieth day following the end of a calendar month to which an allow-
45 ance applies.
46 § 31. Paragraphs (a) and (b) of subdivision 7 of section 2807-j of the
47 public health law, paragraph (a) as added by chapter 639 of the laws of
48 1996, and paragraph (b) as amended by chapter 419 of the laws of 2000,
49 are amended to read as follows:
50 (a) Every designated provider of services shall submit reports of net
51 patient service revenues received for or on account of patient services
52 for each month which shall be in such form as may be prescribed by the
53 commissioner to accurately disclose information required to implement
54 this section. For periods on and after January first, two thousand
55 five, reports by designated providers of services shall be submitted
56 electronically in a form as may be required by the commissioner;
S. 1408 117 A. 2108
1 provided, however, any designated provider of services is not prohibited
2 from submitting reports electronically on a voluntary basis prior to
3 such date.
4 (b) (i) Every third-party payor making an election in accordance with
5 paragraph (a) of subdivision five of this section shall submit reports
6 of patient service expenditures for services provided by designated
7 providers of services for each month which shall be in such form as may
8 be prescribed by the commissioner to accurately disclose information
9 required to implement this section, provided, however, that for report-
10 ing periods relating to payments for services provided or dates of inpa-
11 tient discharge or contracted service obligations occurring on or after
12 January first, two thousand one, the commissioner may permit certain
13 third-party payors which have at least one full year of pool payment
14 experience to submit such reports on an annual basis, based on an annual
15 demonstration by a payor through its prior year's pool payment experi-
16 ence that total pool obligations under this section and sections twen-
17 ty-eight hundred seven-s and twenty-eight hundred seven-t of this arti-
18 cle are not expected to exceed ten thousand dollars [in the current pool
19 year] for annual periods prior to January first, two thousand four, and
20 twenty-five thousand dollars for annual periods on and after January
21 first, two thousand four.
22 (ii) For periods on and after July first, two thousand four, reports
23 submitted on a monthly basis by third-party payors in accordance with
24 subparagraph (i) of this paragraph and reports submitted on a monthly or
25 annual basis by payors acting in an administrative services capacity on
26 behalf of electing third-party payors in accordance with subparagraph
27 (i) of this paragraph shall be made electronically in a form as may be
28 required by the commissioner; provided, however, any third-party payor,
29 except payors acting in an administrative services capacity on behalf of
30 electing third-party payors, which, on or after January first, two thou-
31 sand four, elects to make payments directly to the commissioner or the
32 commissioner's designee pursuant to subdivision five of this section,
33 shall be subject to this subparagraph only after one full year of pool
34 payment experience which results in reports being submitted on a monthly
35 basis. This subparagraph shall not be interpreted to prohibit any third-
36 party payor from submitting reports electronically on a voluntary basis.
37 § 32. Paragraph (b) of subdivision 20 of section 2807-c of the public
38 health law, as amended by chapter 731 of the laws of 1993, is amended to
39 read as follows:
40 (b) (i) Payments by or on behalf of general hospitals to the bad debt
41 and charity care and capital statewide pool of funds due from the
42 assessments pursuant to subdivision eighteen of this section shall be
43 made on a time schedule established by the council, subject to the
44 approval of the commissioner, by regulation; provided, however, that
45 estimated payments of amounts due for patients discharged in a calendar
46 month commencing on or after October first, nineteen hundred ninety-one
47 must be made within sixty days of the end of each month unless payments
48 of actual amounts due for such calendar months have been made within
49 such sixty day time period. Upon receipt of notification from the
50 commissioner, the comptroller, or a fiscal intermediary designated by
51 the director of the budget, [or the commissioner of social services,] or
52 a corporation organized and operating in accordance with article forty-
53 three of the insurance law or an organization operating in accordance
54 with article forty-four of this chapter shall withhold from the amount
55 of any payment to be made by the state or such article forty-three
56 corporation or article forty-four organization to a general hospital the
S. 1408 118 A. 2108
1 amount of any arrearage resulting from such general hospital's failure
2 to make a timely payment to the bad debt and charity care and capital
3 statewide pool of funds due from the assessments. Upon withholding such
4 amount, the comptroller, or a designated fiscal intermediary, [or the
5 commissioner of social services,] or a corporation organized and operat-
6 ing in accordance with article forty-three of the insurance law or an
7 organization operating in accordance with article forty-four of this
8 chapter shall pay the commissioner, or his designee, such amount with-
9 held for deposit into the applicable pool. Any general hospital in
10 arrears resulting from failure to make a timely payment to the bad debt
11 and charity care and capital statewide pool shall not be eligible for a
12 distribution from the bad debt and charity care regional pools in
13 accordance with subdivision seventeen of this section or the bad debt
14 and charity care and capital statewide pool in accordance with subdivi-
15 sion nineteen of this section until such arrearage is satisfied.
16 (ii) For periods on and after January first, two thousand five,
17 reports submitted by general hospitals to implement the assessment set
18 forth in subdivision eighteen of this section shall be submitted elec-
19 tronically in a form as may be required by the commissioner; provided,
20 however, general hospitals are not prohibited from submitting reports
21 electronically on a voluntary basis prior to such date.
22 § 33. Notwithstanding any provision of law, rule or regulation to the
23 contrary, assessments and allowances due for any period prior to January
24 1, 2003, which are paid in full and accompanied by appropriate reports
25 pursuant to sections 2807-j, 2807-s, 2807-t, paragraph (a) of subdivi-
26 sion 18 of section 2807-c or subdivision 20 of section 2807-c of the
27 public health law and which are received on or before December 31, 2003,
28 shall not be subject to interest or penalties as otherwise provided in
29 sections 2807-j, 2807-s, 2807-t or 2807-c of the public health law,
30 provided, however, that with regard to all assessment, interest and
31 penalty amounts collected by the commissioner of health by the effective
32 date of this act the interest and penalty provisions of sections 2807-j,
33 2807-s, 2807-t and 2807-c of the public health law shall remain in full
34 force and effect and such amounts collected shall not be subject to
35 further reconciliation or adjustment and further provided that the
36 provisions of this section shall not apply to any assessment payment
37 made in response to an audit finding made by the commissioner of health
38 or the commissioner of health's designee.
39 § 34. Subdivisions (b) and (c) of section 6 of part J of chapter 63 of
40 the laws of 2001 amending chapter 20 of the laws of 2001 amending the
41 military law and other laws relating to making appropriations for the
42 support of government, as amended by section 4 of part T of chapter 383
43 of the laws of 2001, are amended to read as follows:
44 (b) Notwithstanding any law or regulation to the contrary, upon the
45 determination and certification made pursuant to subdivision (a) of this
46 section, the commissioner of health shall be authorized and directed to
47 [borrow] utilize for the purpose of transferring the amount specified in
48 subdivision (e) of this section from funds accumulated and pooled pursu-
49 ant to subdivision 14-b of section 2807-c of the public health law. If
50 however, at any time, the commissioner of health determines that the
51 funds pooled pursuant to subdivision 14-b of section 2807-c of the
52 public health law are insufficient to make payments which would have
53 been made except for the transfer authorized by this section, such
54 commissioner shall be authorized to transfer such amounts that shall be
55 necessary from any of the pooled funds established pursuant to the
56 following: chapters 536, 537 and 538 of the laws of 1982, chapters 807
S. 1408 119 A. 2108
1 and 906 of the laws of 1985, chapters 2 and 605 of the laws of 1988,
2 chapters 922 and 923 of the laws of 1990, chapter 731 of the laws of
3 1993 and chapter 81 of the laws of 1995, but in no event shall such
4 transfers exceed thirty-four million five hundred thousand dollars.
5 (c) Notwithstanding any law or regulation to the contrary, upon the
6 determination and certification made pursuant to subdivision (a) of this
7 section, the commissioner of health shall be authorized and directed to
8 [borrow] utilize for the purpose of transferring the amount specified in
9 subdivision (e) of this section from interest earnings associated with
10 the pooled funds established pursuant to the following: chapters 536,
11 537 and 538 of the laws of 1982, chapters 807 and 906 of the laws of
12 1985, chapters 2 and 605 of the laws of 1988, chapters 922 and 923 of
13 the laws of 1990, chapter 731 of the laws of 1993 and chapter 81 of the
14 laws of 1995, but in no event shall such transfers exceed ten million
15 three hundred thousand dollars.
16 § 35. Paragraphs 1 and 2 of subsection (j) of section 4301 of the
17 insurance law, paragraph 1 as amended and paragraph 2 as added by
18 section 8 of part A of chapter 1 of the laws of 2002, are amended to
19 read as follows:
20 (1) [No] Except as provided below, every medical expense indemnity
21 corporation, dental expense indemnity corporation, health service corpo-
22 ration, or hospital service corporation shall be [converted into a
23 corporation organized for pecuniary profit. Every such corporation shall
24 be] maintained and operated for the benefit of its members and subscrib-
25 ers as a co-operative corporation.
26 (2) An article forty-three corporation [which was the subject of an
27 initial opinion and decision issued by the superintendent on or before
28 December thirty-first, nineteen hundred ninety-nine, as the same may be
29 amended,] may be converted into a corporation or other entity organized
30 for pecuniary profit, or into a for-profit organization, in any such
31 case, in accordance with the provisions of section seven thousand three
32 hundred seventeen of this chapter.
33 § 36. Paragraph 1 of subsection (a) of section 7317 of the insurance
34 law, as added by section 10 of part A of chapter 1 of the laws of 2002,
35 is amended to read as follows:
36 (1) An article forty-three corporation [which was the subject of an
37 initial opinion and decision issued by the superintendent on or before
38 December thirty-first, nineteen hundred ninety-nine, as the same may be
39 amended,] which seeks to convert into a corporation or other entity
40 organized for pecuniary profit or into a for-profit organization of any
41 kind shall submit a proposed plan of conversion to the superintendent
42 for approval pursuant to this section.
43 § 37. Subdivision 1 of section 76 of chapter 731 of the laws of 1993,
44 amending the public health law and other laws relating to reimbursement,
45 delivery and capital costs of ambulatory health care services and inpa-
46 tient hospital services, as amended by chapter 1 of the laws of 1999, is
47 amended to read as follows:
48 (1) sections two through twenty-one, thirty through thirty-two, thir-
49 ty-four through thirty-seven, forty-six, fifty through fifty-two,
50 fifty-four, fifty-six, fifty-seven, fifty-nine through sixty-seven and
51 seventy through seventy-four of this act shall take effect on January 1,
52 1994, provided, however, that:
53 (a) section 2904-c of the public health law as added by section four-
54 teen of this act, and sections fifty-one, fifty-two, sixty-two, and
55 sixty-three of this act shall expire June 30, 1996; and
S. 1408 120 A. 2108
1 (b) sections fifteen through nineteen, subdivision 3 of section 2807-e
2 of the public health law as added by section twenty of this act, and
3 section seventy-four of this act shall expire on June 30, [2003] 2005;
4 § 38. Paragraph (a) of subdivision 12 of section 367-b of the social
5 services law, as amended by chapter 1 of the laws of 1999, is amended to
6 read as follows:
7 (a) For the purpose of regulating cash flow for general hospitals, the
8 department shall develop and implement a payment methodology to provide
9 for timely payments for inpatient hospital services eligible for case
10 based payments per discharge based on diagnosis-related groups provided
11 during the period January first, nineteen hundred eighty-eight through
12 June thirtieth, two thousand [three] five, by such hospitals which elect
13 to participate in the system.
14 § 39. Paragraph (i) of subdivision (b) of section 1 of chapter 520 of
15 the laws of 1978, relating to providing for a comprehensive survey of
16 health care financing, education and illness prevention and creating
17 councils for the conduct thereof, as amended by chapter 1 of the laws of
18 1999, is amended to read as follows:
19 (i) oversight and evaluation of the inpatient financing system in
20 place for 1988 through June 30, [2003] 2005, and the appropriateness and
21 effectiveness of the bad debt and charity care financing provisions;
22 § 40. Section 2 of chapter 600 of the laws of 1986, amending the
23 public health law relating to the development of pilot reimbursement
24 programs for ambulatory care services, as amended by chapter 1 of the
25 laws of 1999, is amended to read as follows:
26 § 2. This act shall take effect immediately, except that this act
27 shall expire and be of no further force and effect on and after June 30,
28 [2003] 2005; provided, however, that the commissioner of health shall
29 submit a report to the governor and the legislature detailing the objec-
30 tive, impact, design and computation of any pilot reimbursement program
31 established pursuant to this act, on or before March 31, 1994 and annu-
32 ally thereafter. Such report shall include an assessment of the finan-
33 cial impact of such payment system on providers, as well as the impact
34 of such system on access to care.
35 § 41. Section 11 of chapter 753 of the laws of 1989, amending the
36 public health law and other laws relating to general hospital reimburse-
37 ment for inpatient and ambulatory surgery, as amended by chapter 1 of
38 the laws of 1999, is amended to read as follows:
39 § 11. This act shall take effect immediately; provided, however, that
40 section one shall expire and have no further force or effect on or after
41 June 30, [2003] 2005, section two of this act shall be deemed to have
42 been in full force and effect on and after January 1, 1988, sections
43 three through eight of this act shall be deemed to have been in full
44 force and effect on and after January 1, 1989, and that the amendments
45 made to section 2807-c of the public health law by sections two through
46 six of this act shall expire on the same date as such section expires.
47 § 42. (1) Notwithstanding any inconsistent provision of law, rule or
48 regulation, the commissioner of health is authorized to transfer within
49 amounts appropriated and the state comptroller is authorized and
50 directed to receive for deposit to the credit of the department of
51 health's special revenue fund - other, miscellaneous special revenue
52 fund - 339, provider collection monitoring account, five hundred thou-
53 sand dollars ($500,000), or so much thereof as may be necessary, annual-
54 ly of funds collected and accumulated pursuant to section 2807-v of the
55 public health law, including income from invested funds, for the purpose
56 of payment for administrative costs of the department of health related
S. 1408 121 A. 2108
1 to administration of statutory duties for the collections and distrib-
2 utions authorized by section 2807-v of the public health law.
3 (2) Notwithstanding any inconsistent provision of law, rule or regu-
4 lation, the commissioner of health is authorized to transfer and the
5 comptroller is authorized to deposit five hundred thousand dollars
6 ($500,000), or so much thereof as may be necessary, annually of funds
7 collected and accumulated and interest earned through surcharges on
8 payments for health care services pursuant to section 2807-s of the
9 public health law and from assessments pursuant to section 2807-t of the
10 public health law for the purpose of payment for administrative costs of
11 the department of health related to administration of statutory duties
12 for the collections and distributions authorized by sections 2807-s,
13 2807-t, and 2807-m of the public health law into such accounts estab-
14 lished within the department of health for such purposes.
15 (3) Notwithstanding any inconsistent provision of law, rule or regu-
16 lations, the commissioner of health is authorized to transfer and the
17 comptroller is authorized to deposit, within amounts appropriated, those
18 funds authorized for distribution in accordance with the provisions of
19 paragraph (a) of subdivision 1 of section 2807-l of the public health
20 law for the purposes of payment for administrative costs of the depart-
21 ment of health related to the child health insurance plan program
22 authorized pursuant to title 1-A of article 25 of the public health law
23 into the special revenue funds - other, miscellaneous special revenue
24 fund - 339, child health insurance account established within the
25 department of health.
26 (4) Notwithstanding any inconsistent provision of law, rule or regu-
27 lation, the commissioner of health is authorized to transfer and the
28 comptroller is authorized to deposit, within amounts appropriated, those
29 funds authorized for distribution in accordance with the provisions of
30 paragraph (e) of subdivision 1 of section 2807-1 of the public health
31 law for the purpose of payment for administrative costs of the depart-
32 ment of health related to the health occupation development and work-
33 place demonstration program established pursuant to section 2807-h and
34 the health workforce retraining program established pursuant to section
35 2807-g of the public health law into the special revenue funds - other,
36 miscellaneous special revenue fund - 339, health occupation development
37 and workplace demonstration program account established within the
38 department of health.
39 (5) Notwithstanding any inconsistent provision of law, rule or regu-
40 lation, the commissioner of health is authorized to transfer and the
41 comptroller is authorized to deposit two million dollars ($2,000,000),
42 or so much thereof as may be necessary, annually of funds allocated
43 pursuant to paragraph (j) of subdivision 1 of section 2807-v of the
44 public health law for the purpose of payment for administrative costs of
45 the department of health related to administration of the state's tobac-
46 co control programs and cancer services provided pursuant to sections
47 2807-r and 1399-ii of the public health law into such accounts estab-
48 lished within the department of health for such purposes.
49 (6) Notwithstanding any inconsistent provision of law, rule or regu-
50 lation, the commissioner of health is authorized to transfer and deposit
51 six hundred fifty thousand dollars ($650,000), or so much thereof as may
52 be necessary, annually of funds authorized for distribution in accord-
53 ance with the provisions of section 2807-l of the public health law from
54 monies accumulated and interest earned through funds authorized for
55 distribution in accordance with the provisions of section 2807-l of the
56 public health law for the purpose of payment for administrative costs of
S. 1408 122 A. 2108
1 the department of health related to programs funded pursuant to section
2 2807-l of the public health law into the special revenue funds - other,
3 miscellaneous special revenue fund - 339, primary care initiatives moni-
4 toring account established within the department of health.
5 (7) Notwithstanding any inconsistent provision of law, rule or regu-
6 lation, the commissioner of health is authorized to transfer and deposit
7 one hundred thousand dollars ($100,000), or so much thereof as may be
8 necessary, annually of funds authorized for distribution in accordance
9 with the provisions of section 2807-l of the public health law for the
10 purposes of payment for administrative costs of the department of health
11 related to the programs funded pursuant to section 2807-l of the public
12 health law into the special revenue funds - other, miscellaneous special
13 revenue fund - 339, primary care initiatives monitoring account estab-
14 lished within the department of health.
15 (8) Notwithstanding any inconsistent provision of law, rule or regu-
16 lation, the commissioner of health is authorized to transfer and the
17 comptroller is authorized to deposit, within amounts appropriated, the
18 funds authorized for distribution in accordance with the provisions of
19 section 2807-l of the public health law for the purposes of payment for
20 administrative costs of the department of health related to the programs
21 funded pursuant to section 2807-l of the public health law into the
22 special revenue funds - other, miscellaneous special revenue fund - 339,
23 pilot health insurance account established within the department of
24 health.
25 (9) Notwithstanding any inconsistent provision of law, rule or regu-
26 lation, the commissioner of health is authorized to transfer and the
27 comptroller is authorized to deposit, within amounts appropriated, those
28 funds authorized for distribution in accordance with the provisions of
29 subparagraph (ii) of paragraph (f) of subdivision 19 of section 2807-c
30 of the public health law from monies accumulated and interest earned in
31 the bad debt and charity care and capital statewide pools through an
32 assessment charged to general hospitals pursuant to the provisions of
33 subdivision 18 of section 2807-c of the public health law and those
34 funds authorized for distribution in accordance with the provisions of
35 section 2807-l of the public health law for the purposes of payment for
36 administrative costs of the department of health related to monitoring
37 the implementation and effectiveness of programs funded under section
38 2807-l of the public health law into the special revenue funds - other,
39 miscellaneous special revenue fund - 339, primary care initiatives moni-
40 toring account established within the department of health.
41 (10) Notwithstanding any inconsistent provision of law, rule or regu-
42 lation, the commissioner of health is authorized to transfer and the
43 comptroller is authorized to deposit, within amounts appropriated, those
44 funds authorized for distribution in accordance with section 2807-l of
45 the public health law for the purposes of payment for administrative
46 costs of the department of health related to programs funded under
47 section 2807-l of the public health law into the special revenue funds -
48 other, miscellaneous special revenue fund - 339, health care delivery
49 improvement grant administration account established within the depart-
50 ment of health.
51 (11) Notwithstanding any inconsistent provision of law, rule or regu-
52 lation, the commissioner of health is authorized to transfer and the
53 comptroller is authorized to deposit, within amounts appropriated, those
54 funds authorized pursuant to sections 2807-d, 3614-a and 3614-b of the
55 public health law and section 367-i of the social services law and for
56 distribution in accordance with the provisions of subdivision 9 of
S. 1408 123 A. 2108
1 section 2807-j of the public health law for the purpose of payment for
2 administration of statutory duties for the collections and distributions
3 authorized by sections 2807-c, 2807-d, 2807-j, 2807-k, 2807-l, 3614-a
4 and 3614-b of the public health law and section 367-i of the social
5 services law into the special revenue funds - other, miscellaneous
6 special revenue fund - 339, provider collection monitoring account
7 established within the department of health.
8 § 43. Paragraph (a) of subdivision 4 of section 2807-j of the public
9 health law, as added by chapter 639 of the laws of 1996, is amended to
10 read as follows:
11 (a) The commissioner is authorized to contract with the article
12 forty-three insurance law plans, or such other contractors as the
13 commissioner shall designate, to receive and distribute funds from the
14 allowances established pursuant to this section, and funds from the
15 assessments established pursuant to subdivision eighteen of section
16 twenty-eight hundred seven-c of this article. In the event contracts
17 with the article forty-three insurance law plans or other commissioner's
18 designees are effectuated, the commissioner shall conduct annual audits
19 of the receipt and distribution of the funds. The reasonable costs and
20 expenses of an administrator as approved by the commissioner, not to
21 exceed for personnel services on an annual basis [six hundred thousand]
22 two million two hundred thousand dollars for collection and distribution
23 of allowances and assessments established pursuant to this section and
24 subdivision eighteen of section twenty-eight hundred seven-c of this
25 article [and four hundred thousand dollars for distributions of funds
26 from the allowances established pursuant to this section and assessments
27 established pursuant to subdivision eighteen of section twenty-eight
28 hundred seven-c of this article], shall be paid from the allowance and
29 assessment funds.
30 § 44. Paragraph (a) of subdivision 4 of section 2807-s of the public
31 health law, as added by chapter 639 of the laws of 1996, is amended to
32 read as follows:
33 (a) The commissioner is authorized to contract with the article
34 forty-three insurance law plans, or such other contractors as the
35 commissioner shall designate, to receive and distribute funds from the
36 allowances established pursuant to this section and funds from the
37 assessments established pursuant to section twenty-eight hundred seven-t
38 of this article. In the event contracts with the article forty-three
39 insurance law plans or other commissioner's designees are effectuated,
40 the commissioner shall conduct annual audits of the receipt and distrib-
41 ution of the funds. The reasonable costs and expenses of an administra-
42 tor as approved by the commissioner, not to exceed for personnel
43 services on an annual basis [four hundred] eight hundred fifty thousand
44 dollars for collection and distribution of allowances established pursu-
45 ant to this section and assessments established pursuant to this section
46 and assessments established pursuant to section twenty-eight hundred
47 seven-t of this article shall be paid from the allowance and assessment
48 funds.
49 § 45. Paragraph (f) of subdivision 1 and subdivision 10 of section 206
50 of the public health law, paragraph (f) of subdivision 1 as amended by
51 chapter 474 of the laws of 1996 and subdivision 10 as amended by chapter
52 703 of the laws of 1988, are amended to read as follows:
53 (f) enforce the public health law, the sanitary code and the
54 provisions of the medical assistance program, or its successor, pursuant
55 to titles eleven[, eleven-A] and eleven-B of the social services law, as
56 amended by this chapter;
S. 1408 124 A. 2108
1 10. The commissioner, with the approval of the state director of the
2 budget, shall establish and promulgate a schedule of proportional shares
3 for cost sharing [under subdivision one of section three hundred sixty-
4 nine-d of the social services law]. In developing such a schedule, the
5 commissioner shall take into consideration various options available for
6 obtaining health care services, the availability of such services, and
7 the impact of cost sharing on prudent utilization and efficient
8 provision of services [without undue barriers to care for persons eligi-
9 ble for assistance under the catastrophic health care expense program
10 established by section three hundred sixty-nine-c of the social services
11 law].
12 § 46. Subdivisions 1 and 6 of section 2 of the social services law, as
13 amended by chapter 474 of the laws of 1996, are amended to read as
14 follows:
15 1. Department means the state department of social services, provided
16 however that for purposes of titles eleven[, eleven-A] and eleven-B of
17 article five of this chapter, department means the state department of
18 health, except that in subdivisions two and three of section three
19 hundred sixty-four-i, clause (d) of subparagraph three of paragraph (b)
20 of subdivision two of section three hundred sixty-six, paragraph (b) of
21 subdivision four of section three hundred sixty-six, subdivisions one
22 through five of section three hundred sixty-six-a, subdivision seven of
23 section three hundred sixty-six-a, and section three hundred sixty-
24 eight-c of this chapter and where the context thereof clearly requires
25 otherwise, department means the state department of social services.
26 6. Commissioner means the state commissioner of social services,
27 provided however that for purposes of titles eleven[, eleven-A] and
28 eleven-B of article five of this chapter, commissioner means the state
29 commissioner of health, except that in clause (c) of subparagraph three
30 of paragraph (b) of subdivision two of section three hundred sixty-six
31 of this chapter and where the context thereof clearly requires other-
32 wise, commissioner means the state commissioner of social services.
33 § 47. Title 11-A of the social services law is REPEALED.
34 § 48. Notwithstanding such repeal, and within the amounts specifically
35 allocated to the catastrophic health care expense program prior to the
36 effective date of such repeal, participating social services districts
37 are authorized to provide reimbursement to families that, prior to such
38 effective date, incur health care expenses eligible for reimbursement
39 under the program and provided further that districts are authorized to
40 expend amounts within such allocation necessary to administer such
41 reimbursement.
42 § 49. Notwithstanding any inconsistent provision of law, rule or regu-
43 lation, for purposes of implementing the provisions of article 28 of the
44 public health law, references to titles XIX and XXI of the federal
45 social security act in article 28 of the public health law shall be
46 deemed to include and also to mean any successor titles thereto under
47 the federal social security act.
48 § 50. Notwithstanding any inconsistent provision of law, rule or regu-
49 lation, the effectiveness of subdivisions 4, 7, 7-a and 7-b of section
50 2807 of the public health law and section 18 of chapter 2 of the laws of
51 1998, as they relate to time frames for notice, approval or certif-
52 ication of rates of payment, and to the requirement of prior notice of
53 rates of payment, are hereby suspended and shall, for purposes of imple-
54 menting the provisions of this act, be deemed to have been without any
55 force or effect from and after November 1, 2002 for such rates effective
56 for the period January 1, 2003 through December 31, 2003.
S. 1408 125 A. 2108
1 § 51. 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 § 52. This act shall take effect immediately, provided, however, that:
11 1. The amendments to section 2807-s of the public health law made by
12 sections four, five, six, ten, thirteen and forty-four of this act shall
13 not affect the expiration of such section and shall be deemed to expire
14 therewith;
15 2. The amendments to section 2807-j of the public health law made by
16 sections three, eight, twenty-nine, thirty, thirty-one and forty-three
17 of this act shall not affect the expiration of such section and shall be
18 deemed to expire therewith;
19 3. The amendments to paragraph (h) of subdivision 2 of section 2511 of
20 the public health law, made by section twenty-two of this act, shall not
21 affect the expiration of such paragraph, as provided in subdivision 5 of
22 section 47 of chapter 2 of the laws of 1998, as amended;
23 4. The amendment made to paragraph (j) of subdivision 2 of section
24 2511 of the public health law, made by section twenty-two of this act
25 shall take effect on the same date as section 45 of part A of chapter 1
26 of the laws of 2002, as amended;
27 5. Sections forty-five through forty-eight of this act shall take
28 effect July 1, 2003;
29 6. Sections thirty-five and thirty-six of this act shall take effect
30 immediately and shall be deemed to have been in full force and effect on
31 and after April 1, 2001;
32 7. Provided, however, that any rules or regulations necessary to
33 implement the provisions of this act may be promulgated and any proce-
34 dures, forms, or instructions necessary for such implementation may be
35 adopted and issued on or after the date this act shall have become a
36 law;
37 8. This act shall not be construed to alter, change, affect, impair or
38 defeat any rights, obligations, duties or interests accrued, incurred or
39 conferred prior to the enactment of this act;
40 9. The commissioner of health and the superintendent of insurance and
41 any appropriate council may take any steps necessary to implement this
42 act prior to its effective date;
43 10. Notwithstanding any inconsistent provision of the state adminis-
44 trative procedure act or any other provision of law, rule or regulation,
45 the commissioner of health and the superintendent of insurance and any
46 appropriate council is authorized to adopt or amend or promulgate on an
47 emergency basis any regulation he or she or such council determines
48 necessary to implement any provision of this act on its effective date;
49 11. The provisions of this act shall become effective notwithstanding
50 the failure of the commissioner of health or the superintendent of
51 insurance or any council to adopt or amend or promulgate regulations
52 implementing this act; and
53 12. Nothing contained in this act shall be deemed to affect the appli-
54 cation, qualification, expiration, reversion or repeal of any provision
55 of law amended by any section of this act and the provisions of this act
56 shall be applied or qualified or shall expire or revert or be deemed
S. 1408 126 A. 2108
1 repealed in the same manner, to the same extent and on the same date as
2 the case may be as otherwise provided by law.
3 PART M
4 Section 1. Legislative findings. The legislature finds and declares
5 that the welfare of the citizens of this state and the financial integ-
6 rity of governmental reimbursement and private insurance programs admin-
7 istered for their benefit are threatened by the growing problem of
8 prescription drug abuse, particularly the trafficking in forged and
9 altered prescriptions for oral drugs and items; that the submission of
10 claims for payment for these forged prescriptions results in fiscal harm
11 to these programs and that the repackaging and resale of these drugs
12 creates a serious health hazard for the public. The legislature further
13 finds that the use of electronic mail and media for the transmission of
14 prescriptions requires appropriate measures to ensure the health and
15 safety of the citizens of this state. The legislature finds that this
16 act will promote the fiscal integrity of government funded programs and
17 private insurance coverage that cover the costs of such prescriptions;
18 deter the trafficking in forged and altered prescriptions for oral drugs
19 and items and protect the public from the hazards of repackaged and
20 adulterated drugs.
21 § 2. Short title. This act shall be known and may be cited as the
22 "Pharmacy Consumer Protection Act of 2003".
23 § 3. The public health law is amended by adding a new section 21 to
24 read as follows:
25 § 21. Official New York state prescription forms. 1. Notwithstanding
26 any inconsistent provision of section sixty-eight hundred ten of the
27 education law or article thirty-three of this chapter, all prescriptions
28 written in this state shall be on serialized official New York state
29 prescription forms provided by the department. Such forms shall be
30 furnished to practitioners authorized to write prescriptions and to
31 institutional dispensers, and shall be non-reproducible and non-trans-
32 ferable. The commissioner may promulgate regulations for the electronic
33 transmission of prescriptions from prescribers to pharmacists for
34 prescriptions written for recipients eligible for medical assistance
35 pursuant to title eleven of article five of the social services law, for
36 participants in the program for elderly pharmaceutical insurance cover-
37 age pursuant to article nineteen-k of the executive law and for
38 prescriptions written pursuant to article thirty-three of this chapter.
39 Nothing in this section shall prohibit the commissioner from permitting,
40 pursuant to emergency regulation, different formats of the prescription
41 blank for different types of prescribers or from permitting the use of
42 both the official New York state prescription form and prescriptions
43 written pursuant to the requirements of section sixty-eight hundred ten
44 of the education law or article thirty-three of this chapter for a peri-
45 od not longer than twelve months after the effective date of this
46 section.
47 2. The commissioner is authorized and empowered to make any rules,
48 regulations and determinations which in his or her judgment may be
49 necessary or proper to supplement the provisions of this section to
50 effectuate its purposes and intent thereof, or to clarify its provisions
51 so as to provide the procedure or details to secure effective and proper
52 enforcement of its provisions, including, but not limited to, the manner
53 in which the department shall furnish such prescription blanks to prac-
54 titioners and institutional dispensers.
S. 1408 127 A. 2108
1 § 4. Subdivision 31 of section 3302 of the public health law, as added
2 by chapter 878 of the laws of 1972 and as renumbered by chapter 537 of
3 the laws of 1998, is amended to read as follows:
4 31. "Prescription" shall mean an official New York state prescription
5 uniquely identified for controlled substances, a written prescription,
6 an oral prescription, or any one.
7 § 5. Subdivision 6 of section 3331 of the public health law, as
8 amended by chapter 537 of the laws of 1998, is amended to read as
9 follows:
10 6. A practitioner dispensing a schedule II controlled substance [which
11 may be prescribed only upon an official New York state prescription must
12 at the time of such dispensing prepare an official New York state
13 prescription in the manner set forth in subdivision two of section thir-
14 ty-three hundred thirty-two of this article. The practitioner shall
15 retain the original for a period of five years. The practitioner shall
16 file a copy of such prescription with the department or, solely at his
17 or her option,] or any schedule III or schedule IV controlled substance
18 that the commissioner may, by regulation, require, shall be required to
19 file [such prescription] information pursuant to such dispensing with
20 the department by electronic means in such a manner and detail as the
21 commissioner shall, by regulation, require. Such [copy or prescription]
22 information shall be filed by not later than the fifteenth day of the
23 next month following the month in which the controlled substance was
24 delivered. This requirement shall not apply to the dispensing by a prac-
25 titioner pursuant to subdivision five of section thirty-three hundred
26 fifty-one of this article.
27 § 6. Subdivision 1 of section 3332 of the public health law, as
28 amended by chapter 537 of the laws of 1998, is amended to read as
29 follows:
30 1. No controlled substance [for which an official New York state
31 prescription is required] may be prescribed by a practitioner except on
32 an official New York state prescription, and in good faith and in the
33 course of his or her professional practice only.
34 § 7. Section 3333 of the public health law, as added by chapter 878 of
35 the laws of 1972, subdivisions 1, 3 and 4 as amended and subdivision 5
36 as added by chapter 537 of the laws of 1998 and subdivision 2 as added
37 by chapter 415 of the laws of 1981, is amended to read as follows:
38 § 3333. Dispensing upon official New York state prescription. 1. A
39 licensed pharmacist may, in good faith and in the course of his or her
40 professional practice, sell and dispense to an ultimate user controlled
41 substances [for which an official New York state prescription is
42 required] listed in schedules II, III, IV and V of section thirty-three
43 hundred six of this article only upon the delivery to such pharmacist,
44 within thirty days of the date [such] the prescription was signed by an
45 authorized practitioner, of [the original and one copy of such] an offi-
46 cial New York state prescription; provided, however, a pharmacist may
47 dispense a part or portion of such prescription in accordance with the
48 regulations of the commissioner. No pharmacy or pharmacist may sell or
49 dispense greater than a thirty day supply of a controlled substance to
50 an ultimate user unless and until the ultimate user has exhausted all
51 but a seven day supply of the controlled substance provided pursuant to
52 any previously issued official New York state prescription, except that
53 a pharmacy or pharmacist may sell or dispense up to a three month supply
54 of a controlled substance if there appears, on the face of the official
55 New York state prescription, a statement that the controlled substance
56 has been prescribed to treat one of the conditions that have been
S. 1408 128 A. 2108
1 enumerated by the regulations of the commissioner as warranting the
2 prescribing of greater than a thirty day supply of a controlled
3 substance. A pharmacy or pharmacist may sell or dispense up to a six
4 month supply of any substance listed in subdivision (h) or [subdivision]
5 (j) of Schedule II of section [three thousand three hundred six] thir-
6 ty-three hundred six of this article if there appears, on the face of
7 the official New York state prescription, a statement that the substance
8 has been prescribed to treat one of the conditions that have been
9 enumerated by the regulations of the commissioner as warranting the
10 prescribing of a specified greater supply.
11 2. No [such] controlled substance may be so dispensed or sold unless
12 it is enclosed within a suitable container, and:
13 (a) Affixed to such container is a label upon which is indelibly
14 typed, printed, or otherwise legibly written the following:
15 (i) the name and address of the ultimate user for whom the substance
16 is intended, or if intended for use upon an animal, the species of such
17 animal and the name and address of the owner or person in custody of
18 such animal;
19 (ii) the name, address, and telephone number of the pharmacy from
20 which such substance is dispensed;
21 (iii) specific directions for use as stated on the prescription;
22 (iv) the name of the prescribing practitioner;
23 (v) the legend, prominently marked or printed in either boldface or
24 upper case lettering: "CONTROLLED SUBSTANCE, DANGEROUS UNLESS USED AS
25 DIRECTED";
26 (vi) the number of the prescription under which it is recorded in the
27 pharmacist's prescription file;
28 (vii) such code number assigned by the department for the particular
29 substance pursuant to section thirty-three hundred eighteen of this
30 article, or when requested by the practitioner, the name of such
31 substance;
32 (b) Such container shall be identified as a controlled substance by
33 either:
34 (i) an orange label;
35 (ii) a label of another color over which is superimposed an orange
36 transparent adhesive tape; or
37 (iii) an auxiliary orange label affixed to the front of such container
38 and bearing the legend, prominently marked or printed "Controlled
39 Substance, Dangerous Unless Used As Directed";
40 (c) Any label, transparency, or auxiliary label shall be applied in a
41 manner which would inhibit its removal.
42 3. The pharmacist filling the controlled substance prescription shall
43 endorse upon the original the date of delivery[,] and his or her signa-
44 ture[, and the Federal registration number of the pharmacy].
45 4. [The endorsed] Endorsed original [prescription] prescriptions for
46 controlled substances shall be retained by the proprietor of the pharma-
47 cy for a period of five years. The proprietor of the pharmacy shall file
48 [a copy of such prescription with the department or, solely at his or
49 her option, file such] prescription information for all prescriptions
50 for schedule II controlled substances or for any schedule III or sched-
51 ule IV controlled substances which the commissioner may, by regulation,
52 require, with the department by electronic means in such manner and
53 detail as the commissioner shall, by regulation, require. Such [copy or]
54 prescription information shall be filed by not later than the fifteenth
55 day of the next month following the month in which the substance was
56 delivered.
S. 1408 129 A. 2108
1 5. [If] When filing prescription information for controlled substances
2 electronically pursuant to subdivision four of this section, the propri-
3 etor of the pharmacy shall dispose of any electronically recorded
4 prescription information in such manner as the commissioner shall by
5 regulation require.
6 § 8. Section 3334 of the public health law, as added by chapter 878 of
7 the laws of 1972, subdivision 3 as amended by chapter 537 of the laws of
8 1998, is amended to read as follows:
9 § 3334. Emergency oral prescriptions for [schedule II drugs] certain
10 controlled substances. 1. In an emergency situation, as defined by rule
11 or regulation of the department, a practitioner may orally prescribe and
12 a pharmacist may dispense to an ultimate user controlled substances in
13 schedule II or those schedule III or schedule IV controlled substances
14 the commissioner may, by regulation, require; provided however the phar-
15 macist shall:
16 (a) contemporaneously reduce such prescription to writing;
17 (b) dispense the substance in conformity with the labeling require-
18 ments applicable to the type of prescription which would be required but
19 for the emergency; and
20 (c) make a good faith effort to verify the practitioner's identity, if
21 the practitioner is unknown to the pharmacist.
22 2. No oral prescription shall be filled for a quantity of controlled
23 substances which would exceed a five day supply if the substance were
24 used in accordance with the directions for use.
25 3. Within seventy-two hours after authorizing an emergency oral
26 prescription, the prescribing practitioner shall cause to be delivered
27 to the pharmacist the original of an official New York state
28 prescription. Such prescription shall, in addition to the information
29 otherwise required, also have written or typed upon its face the words:
30 "Authorization for emergency dispensing." If the pharmacist fails to
31 receive such prescription he or she shall notify the department in writ-
32 ing within seven days from the date of dispensing the substance.
33 4. Such official New York state prescription shall be endorsed,
34 retained and filed in the same manner as is otherwise required for such
35 prescriptions.
36 § 9. Sections 3335 and 3336 of the public health law are REPEALED.
37 § 10. Section 3337 of the public health law, as added by chapter 878
38 of the laws of 1972, subdivision 2 as amended by chapter 961 of the laws
39 of 1974 and subdivision 3 as amended by chapter 965 of the laws of 1974,
40 is amended to read as follows:
41 § 3337. Oral prescriptions schedule III, IV and V substances. 1. A
42 practitioner may orally prescribe and a pharmacist may dispense to an
43 ultimate user those controlled substances in schedules III, IV or V [for
44 which an official New York state prescription is not required;] provided
45 however the pharmacist shall:
46 (a) contemporaneously reduce such prescription to writing;
47 (b) dispense the substance in conformity with the labeling require-
48 ments applicable to a written prescription; and
49 (c) make a good faith effort to verify the practitioner's identity, if
50 the practitioner is unknown to the pharmacist.
51 2. No oral prescription shall be filled for a quantity of controlled
52 substances which would exceed a five day supply if the controlled
53 substance were used in accordance with the directions for use, except
54 that with respect to a schedule IV substance such prescription shall not
55 exceed a thirty-day supply or one hundred dosage units, whichever is
56 less; provided, however, that this provision shall not apply to any
S. 1408 130 A. 2108
1 schedule IV controlled substance required to be dispensed only upon an
2 official New York state prescription.
3 3. Within seventy-two hours after authorizing such an oral
4 prescription, the prescribing practitioner shall cause to be delivered
5 to the pharmacist [a written] an official New York state prescription.
6 If the pharmacist fails to receive such prescription he shall make a
7 record of such fact in such manner and detail as the commissioner, by
8 regulation, shall require.
9 4. Such [written] official New York state prescription shall be
10 endorsed, retained and filed in the same manner as is otherwise required
11 for such prescriptions.
12 § 11. Section 3338 of the public health law, as added by chapter 878
13 of the laws of 1972, subdivisions 1 and 4 as amended by chapter 537 of
14 the laws of 1998, is amended to read as follows:
15 § 3338. Official New York state prescription forms. 1. Official New
16 York state prescription forms shall be prepared and issued by the
17 department in [groups of twenty-five or one hundred forms] the manner
18 and detail as the commissioner may, by regulation, require, and, each
19 form [serially numbered] shall be serialized. Such forms shall be
20 furnished [at a cost of twelve dollars and fifty cents per group of
21 twenty-five forms or fifty dollars per group of one hundred forms] to
22 practitioners authorized to write such prescriptions and to institu-
23 tional dispensers. Such prescription blanks shall not be transferable.
24 2. Except as expressly authorized by section thirty-three hundred
25 thirty-four or thirty-three hundred thirty-seven of this article,
26 controlled substances [listed in schedule II] may be prescribed or
27 dispensed only upon an official New York state prescription.
28 3. The commissioner may, by rule or regulation, require that
29 prescription information or dispensing information for a particular
30 substance in schedule III or schedule IV, or particular preparations
31 containing such substance, be [prescribed or dispensed upon an official
32 New York state prescription] filed with the department by the dispenser
33 or that prescriptions for controlled substances in schedule III or sche-
34 dule IV may not be refilled.
35 4. The commissioner is hereby authorized and empowered to make rules
36 and regulations, not inconsistent with this article, with respect to the
37 retention or filing of such official New York state prescription forms,
38 including information required to be filed with the department, the
39 maximum number of forms which may be issued at any one time, the manner
40 in which such forms shall be issued, the period of time after issuance
41 by the department that such form shall remain valid for use, and the
42 manner in which practitioners associated with institutional dispensers
43 may use such forms, or any other matter of procedure or detail necessary
44 to effectuate or clarify the provisions of this section and to secure
45 proper and effective enforcement of the provisions of this article.
46 5. Upon a finding by the commissioner that a person has wilfully
47 failed to comply with the provisions of this article, the commissioner
48 may revoke, cancel or withhold official New York state prescription
49 forms which have been issued or for which application has been made.
50 § 12. Subdivisions 1, 2 and 3 of section 3339 of the public health
51 law, subdivisions 1 and 3 as added by chapter 878 of the laws of 1972
52 and subdivision 2 as amended by chapter 965 of the laws of 1974, are
53 amended to read as follows:
54 § 3339. Refilling of prescriptions for controlled substances. 1. An
55 official New York state prescription for a schedule II controlled
S. 1408 131 A. 2108
1 substance or those schedule III or schedule IV controlled substances
2 which the commissioner may, by regulation, require may not be refilled.
3 2. [A written] An official New York state prescription, except for a
4 schedule II controlled substance or those schedule III or schedule IV
5 controlled substances which the commissioner may, by regulation,
6 require, may be refilled not more than the number of times specifically
7 authorized by the prescriber upon the prescription, provided however no
8 such authorization shall be effective for a period greater than six
9 months from the date the prescription is signed. In the event that the
10 prescription authorizes the dispensing of more than a thirty day supply
11 of schedule III, schedule IV or schedule V substances pursuant to regu-
12 lations of the commissioner enumerating conditions warranting specified
13 greater supplies, the prescription may be refilled only once.
14 3. Unless an earlier refilling is authorized by the prescriber, no
15 [written] official New York state prescription may be refilled earlier
16 than seven days prior to the date the previously dispensed supply would
17 be exhausted if used in conformity with the directions for use.
18 § 13. Subdivision 1 of section 3343 of the public health law, as added
19 by chapter 878 of the laws of 1972, paragraph (a) as amended by chapter
20 537 of the laws of 1998, is amended to read as follows:
21 1. Prescriptions and copies of prescriptions shall be preserved in the
22 following manner:
23 (a) [dispensing] practitioners [shall preserve the original official
24 New York state prescription in a separate file maintained exclusively
25 for such records. If] dispensing schedule II controlled substances or
26 those schedule III or schedule IV controlled substances which the
27 commissioner may, by regulation, require, when filing prescription
28 information electronically pursuant to subdivision six of section thir-
29 ty-three hundred thirty-one of this article, [the dispensing practition-
30 er] shall dispose of any electronically recorded [prescription] informa-
31 tion in such manner as the commissioner shall by regulation require;
32 (b) pharmacists dispensing controlled substances upon prescription
33 shall preserve such prescriptions in such manner as the commissioner
34 shall, by regulation, require.
35 § 14. Section 155.35 of the penal law, as amended by chapter 515 of
36 the laws of 1986, is amended to read as follows:
37 § 155.35 Grand larceny in the third degree.
38 A person is guilty of grand larceny in the third degree when he or she
39 steals property and when the value of the property exceeds three thou-
40 sand dollars or where the property is an official New York state
41 prescription form as provided in section twenty-one or article thirty-
42 three of the public health law.
43 Grand larceny in the third degree is a class D felony.
44 § 15. Section 155.40 of the penal law, as amended by chapter 515 of
45 the laws of 1986, is amended to read as follows:
46 § 155.40 Grand larceny in the second degree.
47 A person is guilty of grand larceny in the second degree when he or
48 she steals property and when:
49 1. The value of the property exceeds fifty thousand dollars; or
50 2. The property, regardless of its nature and value, is obtained by
51 extortion committed by instilling in the victim a fear that the actor or
52 another person will (a) cause physical injury to some person in the
53 future, or (b) cause damage to property, or (c) use or abuse his or her
54 position as a public servant by engaging in conduct within or related to
55 his or her official duties, or by failing or refusing to perform an
56 official duty, in such manner as to affect some person adversely; or
S. 1408 132 A. 2108
1 3. The property is ten or more official New York state prescription
2 forms, as provided pursuant to section twenty-one or article thirty-
3 three of the public health law.
4 Grand larceny in the second degree is a class C felony.
5 § 16. Section 170.15 of the penal law is amended to read as follows:
6 § 170.15 Forgery in the first degree.
7 A person is guilty of forgery in the first degree when, with intent to
8 defraud, deceive or injure another, he or she falsely makes, completes
9 or alters a written instrument which is or purports to be, or which is
10 calculated to become or to represent if completed:
11 1. Part of an issue of money, stamps, securities or other valuable
12 instruments issued by a government or governmental instrumentality; or
13 2. Part of an issue of stock, bonds or other instruments representing
14 interests in or claims against a corporate or other organization or its
15 property; or
16 3. Ten or more official New York state prescription forms, as provided
17 pursuant to section twenty-one or article thirty-three of the public
18 health law.
19 Forgery in the first degree is a class C felony.
20 § 17. Article 178 of the penal law, as added by chapter 81 of the laws
21 of 1995, is amended to read as follows:
22 ARTICLE 178
23 CRIMINAL DIVERSION OF PRESCRIPTION MEDICATIONS
24 AND PRESCRIPTIONS
25 Section 178.00 Criminal diversion of prescription medications and
26 prescriptions; definitions.
27 178.05 Criminal diversion of prescription medications and
28 prescriptions; limitation.
29 178.10 Criminal diversion of prescription medications and
30 prescriptions in the fourth degree.
31 178.15 Criminal diversion of prescription medications and
32 prescriptions in the third degree.
33 178.20 Criminal diversion of prescription medications and
34 prescriptions in the second degree.
35 178.25 Criminal diversion of prescription medications and
36 prescriptions in the first degree.
37 178.30 Criminal possession of criminally diverted prescription
38 medications and devices in the fourth degree.
39 178.35 Criminal possession of criminally diverted prescription
40 medications and devices in the third degree.
41 178.40 Criminal possession of criminally diverted prescription
42 medications and devices in the second degree.
43 178.45 Criminal possession of criminally diverted prescription
44 medications and devices in the first degree.
45 178.50 Presumption.
46 § 178.00 Criminal diversion of prescription medications and
47 prescriptions; definitions.
48 The following definitions are applicable to this article:
49 1. "Prescription medication or device" means any article or articles
50 for which a prescription is or for which prescriptions are required in
51 order to be lawfully sold, delivered or distributed by any person or
52 persons authorized by law to engage in the practice of the profession of
53 pharmacy.
54 2. "Prescription" means a direction or authorization by means of a
55 written prescription form or an oral prescription which permits a person
S. 1408 133 A. 2108
1 to lawfully obtain a prescription medication or device from any person
2 authorized to dispense such prescription medication or device.
3 3. "Criminal diversion act" means an act or acts in which a person
4 knowingly:
5 (a) transfers or delivers, in exchange for anything of pecuniary
6 value, a prescription medication or device with knowledge or reasonable
7 grounds to know that the recipient has no medical need for it; or
8 (b) receives, in exchange for anything of pecuniary value, a
9 prescription medication or device with knowledge or reasonable grounds
10 to know that the [seller or transferor is not authorized by law to sell]
11 sale or transfer of such prescription medication or device is unlawful
12 and in violation of the law; or
13 (c) transfers or delivers a prescription or prescriptions in exchange
14 for anything of pecuniary value; or
15 (d) receives a prescription or prescriptions in exchange for anything
16 of pecuniary value.
17 4. "Total pecuniary value of the prescription medication or device or
18 prescription or prescriptions" means the lawful market value of all
19 prescription medications or devices or prescription or prescriptions
20 resulting from an act or series of acts which is in violation of this
21 article.
22 § 178.05 Criminal diversion of prescription medications and
23 prescriptions; limitation.
24 1. The provisions of this article shall not apply to:
25 (a) a duly licensed physician or other person authorized to issue a
26 prescription acting in good faith in the lawful course of his or her
27 profession; or
28 (b) a duly licensed pharmacist acting in good faith in the lawful
29 course of the practice of pharmacy; or
30 (c) a person acting in good faith seeking treatment for a medical
31 condition or assisting another person to obtain treatment for a medical
32 condition.
33 2. No provision of this article relating to the sale of a
34 prescription medication or device shall be deemed to authorize any act
35 prohibited by article thirty-three of the public health law or article
36 two hundred twenty of this chapter.
37 § 178.10 Criminal diversion of prescription medications and
38 prescriptions in the fourth degree.
39 A person is guilty of criminal diversion of prescription medications
40 and prescriptions in the fourth degree when he or she commits a criminal
41 diversion act.
42 Criminal diversion of prescription medications and prescriptions in
43 the fourth degree is a class A misdemeanor.
44 § 178.15 Criminal diversion of prescription medications and
45 prescriptions in the third degree.
46 A person is guilty of criminal diversion of prescription medications
47 and prescriptions in the third degree when he or she:
48 1. commits a criminal diversion act, and the [value of the benefit
49 exchanged] total pecuniary value of the prescription medication or
50 device or prescription or prescriptions is in excess of one thousand
51 dollars; or
52 2. commits the crime of criminal diversion of prescription medications
53 and prescriptions in the fourth degree, and has previously been
54 convicted of the crime of criminal diversion of prescription medications
55 and prescriptions in the fourth degree.
S. 1408 134 A. 2108
1 Criminal diversion of prescription medications and prescriptions in
2 the third degree is a class E felony.
3 § 178.20 Criminal diversion of prescription medications and
4 prescriptions in the second degree.
5 A person is guilty of criminal diversion of prescription medications
6 and prescriptions in the second degree when he or she commits a criminal
7 diversion act, and the [value of the benefit exchanged] total pecuniary
8 value of the prescription medication or device or prescription or
9 prescriptions is in excess of three thousand dollars.
10 Criminal diversion of prescription medications and prescriptions in
11 the second degree is a class D felony.
12 § 178.25 Criminal diversion of prescription medications and
13 prescriptions in the first degree.
14 A person is guilty of criminal diversion of prescription medications
15 and prescriptions in the first degree when he or she commits a criminal
16 diversion act, and the [value of the benefit exchanged] total pecuniary
17 value of the prescription medication or device or prescription or
18 prescriptions is in excess of fifty thousand dollars.
19 Criminal diversion of prescription medications and prescriptions in
20 the first degree is a class C felony.
21 § 178.30 Criminal possession of criminally diverted prescription medica-
22 tions and devices in the fourth degree.
23 A person is guilty of criminal possession of criminally diverted
24 prescription medications and devices in the fourth degree when he or she
25 knowingly possesses a prescription medication or device with knowledge
26 that such medication or device was transferred or delivered as the
27 result of a criminal diversion act or with intent to engage in a crimi-
28 nal diversion act.
29 Criminal possession of criminally diverted prescription medications
30 and devices in the fourth degree is a class A misdemeanor.
31 § 178.35 Criminal possession of criminally diverted prescription medica-
32 tions and devices in the third degree.
33 A person is guilty of criminal possession of criminally diverted
34 prescription medications and devices in the third degree when he or she
35 commits the crime of criminal possession of criminally diverted
36 prescription medications and devices in the fourth degree and:
37 1. has previously been convicted of any crime defined in this article;
38 or
39 2. the total pecuniary value of the prescription medication or device
40 possessed is in excess of one thousand dollars.
41 Criminal possession of criminally diverted prescription medications
42 and devices in the third degree is a class E felony.
43 § 178.40 Criminal possession of criminally diverted prescription medica-
44 tions and devices in the second degree.
45 A person is guilty of criminal possession of criminally diverted
46 prescription medications and devices in the second degree when he or she
47 commits the crime of criminal possession of criminally diverted
48 prescription medications and devices in the fourth degree and the total
49 pecuniary value of the prescription medication or device possessed is in
50 excess of three thousand dollars.
51 Criminal possession of criminally diverted prescription medications
52 and devices in the second degree is a class D felony.
53 § 178.45 Criminal possession of criminally diverted prescription medica-
54 tions and devices in the first degree.
55 A person is guilty of criminal possession of criminally diverted
56 prescription medications and devices in the first degree when he or she
S. 1408 135 A. 2108
1 commits the crime of criminal possession of criminally diverted
2 prescription medications and devices in the fourth degree and the total
3 pecuniary value of the prescription medication or device possessed is in
4 excess of fifty thousand dollars.
5 Criminal possession of criminally diverted prescription medications
6 and devices in the first degree is a class C felony.
7 § 178.50 Presumption.
8 Possession of a false, forged or stolen prescription by any person
9 other than a person in the lawful pursuit of their profession shall be
10 presumptive evidence of the intent to use the same to commit a criminal
11 act under this article.
12 § 18. Subdivision 3 of section 190.26 of the penal law, as added by
13 chapter 2 of the laws of 1998, is amended to read as follows:
14 3. Pretending to be a duly licensed physician or other person author-
15 ized to issue a prescription for any drug or any instrument or device
16 used in the taking or administering of drugs for which a prescription is
17 required by law, communicates to a pharmacist an oral prescription which
18 is required to be reduced to writing pursuant to section thirty-three
19 hundred [thirty-two] thirty-seven of the public health law.
20 § 19. This act shall take effect on the sixtieth day after it shall
21 have become a law; provided, however, that notwithstanding any incon-
22 sistent provision of the state administrative procedure act, or sections
23 three, four, five, six, seven, eight, nine, ten, eleven, twelve or thir-
24 teen of this act, the commissioner of health is authorized to adopt,
25 amend or promulgate on an emergency basis any regulation he or she
26 determines necessary to implement the provisions of sections three,
27 four, five, six, seven, eight, nine, ten, eleven, twelve and thirteen of
28 this act, including authority to permit prescriptions written in this
29 state to be written without regard to the provisions of section three of
30 this act for a period not to exceed twelve months after such section
31 three of this act takes effect; provided, further, that sections four-
32 teen, fifteen, sixteen and seventeen of this act shall take effect on
33 the first of November next succeeding the date on which this act shall
34 have become a law; provided, further, that the amendments to subdivision
35 6 of section 3331 of the public health law, made by section five of this
36 act and the amendments to subdivision 4 of section 3333 of the public
37 health law, made by section seven of this act, relating to filing
38 prescription information with the department of health by electronic
39 means, shall not be implemented until the commissioner of health has
40 promulgated regulations relating thereto, and the commissioner of health
41 shall notify the legislative bill drafting commission upon the promulga-
42 tion of such regulations in order that such commission may maintain an
43 accurate and timely effective data base of the official text of the laws
44 of the state of New York in furtherance of effecting the provisions of
45 section 44 of the legislative law and section 70-b of the public offi-
46 cers law.
47 PART N
48 Section 1. Subsection (k) of section 3221 of the insurance law is
49 amended by adding a new paragraph 14 to read as follows:
50 (14) Every group or blanket policy delivered or issued for delivery in
51 this state which includes coverage for physician services in a physi-
52 cian's office, and every policy which provides major medical or similar
53 comprehensive-type coverage shall provide coverage for early inter-
54 vention services as set forth under title two-A of article twenty-five
S. 1408 136 A. 2108
1 of the public health law at the rate established under such title. Such
2 coverage shall not be subject to annual deductibles and coinsurance,
3 provided however coverage shall not exceed five thousand dollars per
4 covered child per calendar year. The individualized family services plan
5 certified by the early intervention official, as defined in section
6 twenty-five hundred forty-one of the public health law, or such offi-
7 cial's designee, shall be deemed to meet any precertification, preau-
8 thorization and medical necessity requirements imposed on benefits under
9 the policy.
10 § 2. Section 4303 of the insurance law is amended by adding a new
11 subsection (dd) to read as follows:
12 (dd) Every group or blanket contract issued by a health service corpo-
13 ration or a medical expense indemnity corporation which includes cover-
14 age for physician services in a physician's office, and every contract
15 which provides major medical or similar comprehensive-type coverage,
16 shall provide coverage for early intervention services set forth under
17 title two-A of article twenty-five of the public health law at the rate
18 established under such title. Such coverage shall not be subject to
19 annual deductibles and coinsurance, provided however coverage shall not
20 exceed five thousand dollars per covered child per calendar year. The
21 individualized family services plan certified by the early intervention
22 official, as defined in section twenty-five hundred forty-one of the
23 public health law, or such official's designee, shall be deemed to meet
24 any precertification, preauthorization and medical necessity require-
25 ments imposed on benefits under the policy.
26 § 3. Section 3235-a of the insurance law, as added by section 3 of
27 part C of chapter 1 of the laws of 2002, is amended to read as follows:
28 § 3235-a. Payment for early intervention services. (a) [No policy of
29 accident and health insurance, including contracts issued pursuant to
30 article forty-three of this chapter, shall exclude coverage for other-
31 wise covered services solely on the basis that the services constitute
32 early intervention program services under title two-A of article twen-
33 ty-five of the public health law.
34 (b) Where a policy of accident and health insurance, including a
35 contract issued pursuant to article forty-three of this chapter,
36 provides coverage for an early intervention program service, such cover-
37 age shall not be applied against any maximum annual or lifetime monetary
38 limits set forth in such policy or contract. Visit limitations and other
39 terms and conditions of the policy will continue to apply to early
40 intervention services. However, any visits used for early intervention
41 program services shall not reduce the number of visits otherwise avail-
42 able under the policy or contract for such services.
43 (c)] Any right of subrogation to benefits which [a municipality] an
44 early intervention evaluator and service provider is entitled in accord-
45 ance with paragraph [(d)] (f) of subdivision three of section twenty-
46 five hundred fifty-nine of the public health law shall be valid and
47 enforceable to the extent benefits are available under any accident and
48 health insurance policy. The right of subrogation does not attach to
49 insurance benefits paid or provided under any accident and health insur-
50 ance policy prior to receipt by the insurer of written notice from the
51 [municipality] early intervention evaluator and service provider.
52 [(d)] (b) No insurer, including a health maintenance organization
53 issued a certificate of authority under article forty-four of the public
54 health law and a corporation organized under article forty-three of this
55 chapter, shall refuse to issue an accident and health insurance policy
56 or contract or refuse to renew an accident and health insurance policy
S. 1408 137 A. 2108
1 or contract solely because the applicant or insured is receiving
2 services under the early intervention program.
3 (c) No insurer, including a health maintenance organization issued a
4 certificate of authority under article forty-four of the public health
5 law and a corporation organized under article forty-three of this chap-
6 ter, shall deny coverage of a claim submitted for early intervention
7 services covered pursuant to paragraph fourteen of subsection (k) of
8 section three thousand two hundred twenty-one or subsection (dd) of
9 section four thousand three hundred three of this chapter solely upon
10 the basis that the provider of services is not a participating provider
11 in the insurer's network.
12 § 4. Subdivision 7 of section 2510 of the public health law, as
13 amended by chapter 526 of the laws of 2002, is amended to read as
14 follows:
15 7. "Covered health care services" means: the services of physicians,
16 optometrists, nurses, nurse practitioners, midwives and other related
17 professional personnel which are provided on an outpatient basis,
18 including routine well-child visits; diagnosis and treatment of illness
19 and injury; inpatient health care services; laboratory tests; diagnostic
20 x-rays; prescription and non-prescription drugs and durable medical
21 equipment; radiation therapy; chemotherapy; hemodialysis; emergency room
22 services; hospice services; emergency, preventive and routine dental
23 care, except orthodontia and cosmetic surgery; emergency, preventive and
24 routine vision care, including eyeglasses; speech and hearing services;
25 [and,] inpatient and outpatient mental health, alcohol and substance
26 abuse services; and early intervention services as defined by the
27 commissioner in consultation with the superintendent.
28 § 5. Subdivision 7 of section 2510 of the public health law, as added
29 by chapter 922 of the laws of 1990, paragraph a as amended by chapter
30 526 of the laws of 2002, is amended to read as follows:
31 7. a. "Primary and preventive health care services" means: the
32 services of physicians, optometrists, nurses, nurse practitioners,
33 midwives and other related professional personnel which are provided on
34 an outpatient basis, including routine well-child visits; diagnosis and
35 treatment of illness and injury; laboratory tests; diagnostic x-rays;
36 prescription drugs; radiation therapy; chemotherapy; hemodialysis; emer-
37 gency room services; hospice services; [and,] outpatient alcohol and
38 substance abuse services; and early intervention services as defined by
39 the commissioner in consultation with the superintendent.
40 b. "Optional primary and preventive health care services" means:
41 dental, vision, speech and hearing services as defined by the commis-
42 sioner in consultation with the superintendent.
43 § 6. Subdivision 10 of section 2511 of the public health law, as
44 amended by chapter 2 of the laws of 1998, is amended to read as follows:
45 10. (a) Notwithstanding any other law or agreement to the contrary,
46 and except in the case of a child or children who also becomes eligible
47 for medical assistance, benefits under this title shall be considered
48 secondary to any other plan of insurance or benefit program, except the
49 physically handicapped children's program and the early intervention
50 program, under which an eligible child may have coverage.
51 (b) Notwithstanding subdivision seven of section twenty-five hundred
52 ten of this article, coverage for early intervention services shall be
53 provided in accordance with section three thousand two hundred thirty-
54 five-a and subsection (dd) of section four thousand three hundred three
55 of the insurance law.
S. 1408 138 A. 2108
1 § 7. Paragraph (a) of subdivision 8 of section 2541 of the public
2 health law, as added by chapter 428 of the laws of 1992, is amended to
3 read as follows:
4 (a) "Eligible child" means an infant or toddler from birth through age
5 two who has a disability; provided, however, that any toddler with a
6 disability who has been determined to be eligible for program services
7 under section forty-four hundred ten of the education law and:
8 (i) who turns three years of age on or before the thirty-first day of
9 August shall, if requested by the parent, be eligible to receive early
10 intervention services contained in an IFSP until the first day of
11 September of that calendar year; or
12 (ii) who turns three years of age on or after the first day of Septem-
13 ber shall, if requested by the parent and if already receiving services
14 pursuant to this title, be eligible to continue receiving such services
15 until the second day of January of the following calendar year.
16 § 8. Section 2543 of the public health law is amended by adding a new
17 subdivision 3 to read as follows:
18 3. Prior to implementation of an IFSP and thereafter if necessary, the
19 parent of the eligible child shall provide and the early intervention
20 official shall collect such information and or documentation as is
21 necessary and sufficient to determine the eligible child's third party
22 payor coverage and to seek payment from all third party payors including
23 the medical assistance program and other governmental agency payors.
24 § 9. Section 2548 of the public health law, as added by chapter 428 of
25 the laws of 1992, is amended to read as follows:
26 § 2548. Transition plan. To the extent that a toddler with a disabil-
27 ity is thought to be eligible for services pursuant to section forty-
28 four hundred ten of the education law, the early intervention official
29 shall [notify] refer the child in writing to the committee on preschool
30 special education of the local school district in which an eligible
31 child resides [of the potential transition of such child] and, with
32 parental consent, [ensure that] arrange for a conference [is convened]
33 among the service coordinator, the parent and the chairperson of the
34 preschool committee on special education or his or her designee [at
35 least ninety days] to be held before [such child would be eligible for
36 services under section forty-four hundred ten of the education law] the
37 child reaches the age of two years and six months to review the child's
38 program options and to establish a transition plan, if appropriate. If
39 a parent does not consent to a conference with the service coordinator
40 and the chairperson of the preschool committee on special education or
41 his or her designee to determine whether the child is eligible for
42 services under section forty-four hundred ten of the education law, and
43 the child is therefore not determined to be eligible for such services
44 prior to the child's third birthday, the child's eligibility for early
45 intervention program services shall end at the child's third birthday.
46 § 10. Subdivision 2 of section 2550 of the public health law, as added
47 by chapter 428 of the laws of 1992, is amended to read as follows:
48 2. In meeting the requirements of subdivision one of this section, the
49 lead agency shall adopt and use proper methods of administering the
50 early intervention program, including:
51 (a) establishing standards for evaluators, service coordinators and
52 providers of early intervention services;
53 (b) approving, and periodically re-approving evaluators, service coor-
54 dinators and providers of early intervention services who meet depart-
55 ment standards;
S. 1408 139 A. 2108
1 (c) compiling and disseminating to the municipalities lists of
2 approved evaluators, service coordinators and providers of early inter-
3 vention services;
4 [(b)] (d) monitoring of agencies, institutions and organizations under
5 this title and agencies, institutions and organizations providing early
6 intervention services which are under the jurisdiction of a state early
7 intervention service agency;
8 [(c)] (e) enforcing any obligations imposed on those agencies under
9 this title or Part H of the federal individuals with disabilities educa-
10 tion act and its regulations;
11 [(d)] (f) providing training and technical assistance to those agen-
12 cies, institutions and organizations, including initial and ongoing
13 training and technical assistance to municipalities to help enable them
14 to identify, locate and evaluate eligible children, develop IFSPs,
15 ensure the provision of appropriate early intervention services, promote
16 the development of new services, where there is a demonstrated need for
17 such services and afford procedural safeguards to infants and toddlers
18 and their families;
19 [(e)] (g) correcting deficiencies that are identified through monitor-
20 ing; and
21 [(f)] (h) in monitoring early intervention services, the commissioner
22 shall provide municipalities with the results of any review of early
23 intervention services undertaken and shall provide the municipalities
24 with the opportunity to comment thereon.
25 § 11. Subdivision 8 of section 2551 of the public health law, as added
26 by chapter 428 of the laws of 1992, is amended to read as follows:
27 8. The early intervention service agencies, in consultation with the
28 director of the budget, shall, where appropriate, require as a condition
29 of approval that evaluators and providers of early intervention services
30 [participate] enroll as providers in the medical assistance program.
31 § 12. Section 2552 of the public health law is amended by adding a new
32 subdivision 4 to read as follows:
33 4. The early intervention official shall require an eligible child's
34 parent to furnish the parents' and eligible child's social security
35 numbers for the purpose of the department's and municipality's adminis-
36 tration of the program.
37 § 13. Section 2557 of the public health law, as added by chapter 428
38 of the laws of 1992, subdivision 1 as amended by section 4 of part C of
39 chapter 1 of the laws of 2002, is amended to read as follows:
40 § 2557. Financial responsibility and reimbursement. 1. The approved
41 costs for an evaluation and service coordination services received by an
42 eligible child [who receives an evaluation and early intervention
43 services] pursuant to this title shall be a charge upon the municipality
44 wherein the eligible child resides or, where the services are covered by
45 the medical assistance program, upon the local social services district
46 of fiscal responsibility with respect to those eligible children who are
47 also eligible for medical assistance. [All] Except for evaluations and
48 service coordination services covered by the medical assistance program
49 or third party payors, approved costs for an evaluation and service
50 coordination services shall be paid in the first instance and at least
51 quarterly by the appropriate governing body or officer of the munici-
52 pality upon vouchers presented and audited in the same manner as the
53 case of other claims against the municipality. Notwithstanding the
54 insurance law or regulations thereunder relating to the permissible
55 exclusion of payments for services under governmental programs, no such
56 exclusion shall apply with respect to payments made pursuant to this
S. 1408 140 A. 2108
1 title. Notwithstanding the insurance law or any other law or agreement
2 to the contrary, benefits under this title shall be considered secondary
3 to any plan of insurance or state government benefit program under which
4 an eligible child may have coverage. [Nothing in this section shall
5 increase or enhance coverages provided for within an insurance contract
6 subject to the provisions of this title.]
7 2. Except as provided in subdivision one of this section and in para-
8 graph (d) of subdivision three of section twenty-five hundred fifty-nine
9 of this title, the approved costs for an eligible child who receives
10 early intervention services pursuant to this title shall be a charge in
11 the amount of eighty percent of the service rate upon the municipality
12 wherein the eligible child resides or, where the services are covered by
13 the medical assistance program, one hundred percent of the service rate
14 of the approved costs shall be a charge upon the local social services
15 district of fiscal responsibility with respect to those eligible chil-
16 dren who are also eligible for medical assistance. Except for services
17 covered by the medical assistance program or third party payors,
18 approved costs in the amount of eighty percent of the service rate shall
19 be paid in the first instance and at least quarterly by the appropriate
20 governing body or officer of the municipality upon vouchers presented
21 and audited in the same manner as the case of other claims against the
22 municipality. Notwithstanding the insurance law or regulations there-
23 under relating to the permissible exclusion of payments for services
24 under governmental programs, no such exclusion shall apply with respect
25 to payments made pursuant to section twenty-five hundred fifty-nine of
26 this title.
27 3. The department shall reimburse the approved costs paid by a munici-
28 pality for the purposes of this title, other than those reimbursable by
29 the medical assistance program or by third party payors, in an amount of
30 fifty percent of the amount expended in accordance with the rules and
31 regulations of the commissioner. Such state reimbursement to the munici-
32 pality shall not be paid prior to April first of the year in which the
33 approved costs are paid by the municipality.
34 [3. Such] 4. The department may perform audits, which may include site
35 visitation, of the municipalities, service coordinators, evaluators and
36 or providers of early intervention services. The department shall
37 provide the municipalities with a copy of the findings of such audits.
38 Early intervention program state aid reimbursement or portion thereof
39 may be withheld if, on post-audit and review, the commissioner finds
40 that the early intervention services were not provided or those provided
41 were not in substantial conformance with the rules and regulations
42 established by the commissioner or that the recipient of such services
43 was not an eligible child as defined in section twenty-five hundred
44 forty-one of this title. In the event that the commissioner determines
45 that there may be a withholding of state reimbursement to any munici-
46 pality under this section, he shall inform the state early intervention
47 coordinating council and the relevant local early intervention coordi-
48 nating council and shall consider alternative courses of action recom-
49 mended within sixty days by either body prior to withholding state
50 reimbursement.
51 [4.] 5. Each municipality may perform an audit, which may include site
52 visitation, of evaluators and providers of such services within its
53 municipality in accordance with standards established by the commission-
54 er. Payment for services to an evaluator, service coordinator and
55 provider may be withheld by a municipality and a municipality is author-
56 ized to directly recover overpayments to an evaluator, service coordina-
S. 1408 141 A. 2108
1 tor and/or provider if, on post-audit and review, the municipality finds
2 that the early intervention services were not provided or those provided
3 were not in substantial conformance with the contractual agreement
4 between the municipality and the evaluator and/or provider, or with the
5 rules and regulations established by the commissioner. The municipality
6 shall submit the results of any such audit to the commissioner for
7 review and, if warranted, adjustments in state aid reimbursement pursu-
8 ant to subdivision [three] four of this section, as well as for recovery
9 by the municipality of its share of any disallowances identified in such
10 audit.
11 6. Each municipality may negotiate rates which are lower than the
12 rates established by the department for evaluations and approved early
13 intervention services provided to eligible children who reside within
14 the municipality. The municipality must ensure that there are suffi-
15 cient providers to provide service coordination services, evaluations
16 and/or early intervention services.
17 7. A municipality which has negotiated rates for early intervention
18 services and evaluations shall not seek reimbursement from the depart-
19 ment in an amount exceeding fifty percent of the rate negotiated and
20 actually paid to the provider.
21 8. The department may contract with an independent organization to act
22 as the fiscal agent for each of the municipalities and the department
23 and each municipality shall use such fiscal agent for early intervention
24 program fiscal management and claiming as determined by the commission-
25 er.
26 9. Municipalities and providers of services shall provide information
27 and documentation as required by the fiscal agent to carry out the
28 fiscal agent's duties.
29 § 14. Subdivision 3 of section 2558 of the public health law, as added
30 by chapter 428 of the laws of 1992, is amended to read as follows:
31 3. Contract and payment responsibility. The municipality of current
32 location shall be the municipality of record for an eligible foster
33 child or homeless child for the purposes of this title, provided that
34 notwithstanding the [provision] provisions of subdivision [two] three of
35 section twenty-five hundred fifty-seven of this title, the state shall
36 reimburse one hundred percent of the approved costs paid by such munici-
37 pality which shall be offset by the local contribution due pursuant to
38 subdivision four of this section.
39 § 15. Subdivision 3 of section 2559 of the public health law, as added
40 by chapter 428 of the laws of 1992, paragraph (a) as amended and para-
41 graph (d) as added by chapter 231 of the laws of 1993, is amended to
42 read as follows:
43 3. (a) Providers of evaluations, early intervention services and
44 transportation services shall in the first instance and where applica-
45 ble, seek payment from all third party payors including [governmental
46 agencies] the medical assistance program prior to claiming payment from
47 a given municipality for services rendered to eligible children[,
48 provided that, for the purpose of seeking payment from the medical
49 assistance program or from other third party payors, the municipality
50 shall be deemed the provider of such early intervention services to the
51 extent that the provider has promptly furnished to the municipality
52 adequate and complete information necessary to support the municipality
53 billing, and provided further that the obligation to seek payment shall
54 not apply to a payment from a third party payor who is not prohibited
55 from applying such payment, and will apply such payment, to an annual or
56 lifetime limit specified in the insured's policy].
S. 1408 142 A. 2108
1 (b) [The commissioner, in consultation with the director of budget and
2 the superintendent of insurance, shall promulgate regulations providing
3 public reimbursement for deductibles and copayments which are imposed
4 under an insurance policy or health benefit plan to the extent that such
5 deductibles and copayments are applicable to early intervention
6 services.
7 (c) Payments made for early intervention services under an insurance
8 policy or health benefit plan which are provided as part of an IFSP
9 pursuant to section twenty-five hundred forty-five of this title shall
10 not be applied by the insurer or plan administrator against any maximum
11 lifetime or annual limits specified in the policy or health benefits
12 plan, pursuant to section eleven of the chapter of the laws of nineteen
13 hundred ninety-two which added this title.
14 (d) A municipality, or its designee,] When medical assistance program
15 reimbursement or third party payment is not available or when third
16 party payment has been expended, providers of early intervention
17 services and transportation services, except providers of evaluations
18 and service coordination services, shall be responsible for obtaining
19 payment in the amount of twenty percent of the rate for services
20 rendered to an eligible child from the eligible child's parent to the
21 extent permissible under the sliding fee scale established under para-
22 graph (c) of this subdivision.
23 (c) The commissioner, in consultation with the director of the budget,
24 shall establish parent participation fees for early intervention
25 services based upon the following sliding fee scale:
26 Household Net Income Cap
27 Below 160 % Federal Poverty Level (FPL). No Fee
28 161% FPL to 300% FPL $500 per child, per year
29 301% FPL to 400% FPL $1500 per child, per year
30 401% FPL to 500% FPL $3000 per child, per year
31 501% FPL to 600% FPL $5000 per child, per year
32 Above 601% FPL No cap
33 The commissioner may waive a parent's participation fees based upon
34 the parent's financial resources and the costs of the services required
35 by the eligible child.
36 (d) The fiscal agent, or the service coordinator in the absence of a
37 fiscal agent, shall collect from an eligible child's parent documenta-
38 tion of payments made to providers of services as required under the
39 sliding fee scale and shall notify the early intervention official and
40 the eligible child's early intervention service providers of the date
41 upon which the parent's participation fee cap has been reached and that
42 the parent is therefore no longer required to participate in the payment
43 of early intervention services for the remainder of the program year.
44 (e) When parent participation is not required as set forth in para-
45 graph (c) of this subdivision, or when parent participation has been
46 expended and medical assistance program coverage is unavailable and/or
47 all other third party payor coverage is unavailable or expended, one
48 hundred percent of the service rate of approved costs shall be paid in
49 the first instance and at least quarterly by the appropriate governing
50 body or officer of the municipality upon vouchers presented and audited
51 in the same manner as the case of other claims against the municipality.
52 The department shall reimburse such approved costs to the municipality
53 in an amount of fifty percent of the amount expended in accordance with
54 the rules and regulations of the commissioner. Such state reimbursement
55 to the municipality shall not be paid prior to April first of the year
56 in which the approved costs are paid by the municipality.
S. 1408 143 A. 2108
1 (f) Early intervention evaluators and service providers shall be
2 subrogated, to the extent of the [expenditures by such municipality]
3 approved costs for early intervention services furnished to persons
4 eligible for benefits under this title, to any rights such person may
5 have or be entitled to from third party reimbursement. The right of
6 subrogation does not attach to benefits paid or provided under any
7 health insurance policy or health benefits plan prior to receipt of
8 written notice of the exercise of subrogation rights by the insurer or
9 plan administrator providing such benefits.
10 (g) Paragraphs (b) through (e) of this subdivision shall not apply to
11 providers of evaluations and service coordination services. When medical
12 assistance program reimbursement or third party payment is not available
13 or when third party payment has been expended, providers of evaluations
14 and service coordination services shall seek payment for such services
15 as provided for in subdivision one of section twenty-five hundred
16 fifty-seven of this title.
17 § 16. This act shall take effect immediately; provided however that
18 sections one, two, three, four and six of this act shall apply to all
19 policies issued, renewed, modified, altered or amended on and after such
20 date; provided further that sections twelve, thirteen and fourteen of
21 this act shall take effect on the sixtieth day after it shall have
22 become a law; and provided further, however, that the amendments to
23 subdivision 7 of section 2510 of the public health law made by section
24 four of this act shall be subject to the expiration and reversion of
25 such subdivision pursuant to section 47 of chapter 2 of the laws of
26 1998, as amended, when upon such date the provisions of section five of
27 this act shall take effect.
28 § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
29 sion, section or part of this act shall be adjudged by any court of
30 competent jurisdiction to be invalid, such judgment shall not affect,
31 impair, or invalidate the remainder thereof, but shall be confined in
32 its operation to the clause, sentence, paragraph, subdivision, section
33 or part thereof directly involved in the controversy in which such judg-
34 ment shall have been rendered. It is hereby declared to be the intent of
35 the legislature that this act would have been enacted even if such
36 invalid provisions had not been included herein.
37 § 3. This act shall take effect immediately provided, however, that
38 the applicable effective date of Parts A through N of this act shall be
39 as specifically set forth in the last section of such Parts.