2005-06 Budget - Article 7 Bill s992
STATE OF NEW YORK
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S. 992 A. 1922
SENATE - ASSEMBLY
January 21, 2005
___________
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 amend the public health law, in relation to state aid for
municipalities, implementing parental cost sharing and negotiation of
rate reimbursement in certain circumstances, and collapsing the rate
reimbursement structure for early intervention services; to amend the
insurance law, in relation to early intervention services; to amend
the tax law, in relation to the program for elderly pharmaceutical
insurance coverage; to amend the elder law, in relation to medicare
part d prescription drug coverage; to amend chapter 62 of the laws of
2003, amending the public health law relating to allowing for the use
of funds of the office of professional medical conduct for activities
of the patient health information and quality improvement act of 2000,
in relation to the effectiveness of such provisions; to repeal various
provisions of the public health law relating thereto; and to repeal
chapter 438 of the laws of 2002, relating to a study of infection
control in flexible endoscopy, relating thereto (Part A); to amend the
New York Health Care Reform Act of 1996 and the public health law, in
relation to extending certain provisions relating thereto; to amend
the New York Health Care Reform Act of 2000, in relation to extending
the effectiveness of provisions thereof; to amend the public health
law, in relation to extending the distribution of pool allocations and
graduate medical education; to amend chapter 2 of the laws of 1998
amending the public health law and other laws relating to expanding
the child health insurance plan, in relation to extending the effec-
tiveness of certain provisions thereof; to amend chapter 62 of the
laws of 2003 amending the general business law and other laws relating
to enacting major components necessary to implement the state fiscal
plan for the 2003-2004 state fiscal year, in relation to extending
certain provisions thereof; to amend the public health law, in
relation to continuing the priority restoration adjustment; to amend
chapter 731 of the laws of 1993 amending the public health law and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD12171-01-5
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other laws relating to reimbursement, delivery and capital costs of
ambulatory health care services and inpatient hospital services, in
relation to extending the effectiveness of portions thereof; to amend
the social services law, in relation to extending payment provisions
for general hospitals; to amend chapter 520 of the laws of 1978 relat-
ing 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 effectiveness of portions there-
of; to amend chapter 600 of the laws of 1986 amending the public
health law relating to the development of pilot reimbursement programs
for ambulatory care services, in relation to extending the effective-
ness of such chapter; to amend chapter 753 of the laws of 1989 amend-
ing the public health law and other laws relating to general hospital
reimbursement for inpatient and ambulatory surgery, in relation to
extending the effectiveness of portions thereof; to amend the public
health law, in relation to increasing surcharges and assessments; to
amend the public authorities law, in relation to financing the HEAL NY
program; to amend chapter 82 of the laws of 2002 amending the environ-
mental conservation law and other laws relating to enacting major
components necessary to implement the state fiscal plan for the 2002-
2003 state fiscal year; to amend the insurance law, in relation to
insurance conversions; to amend the state finance law, in relation to
the establishment of the health care reform act (HCRA) resources fund;
to amend chapter 266 of the laws of 1986 amending the civil practice
law and rules and other laws relating to malpractice and professional
medical conduct, in relation to extending the applicability of certain
provisions thereof; 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,
in relation to extending the applicability of certain provisions ther-
eof; to amend chapter 495 of the laws of 2004 amending the insurance
law and the public health law relating to the New York state health
insurance continuation assistance demonstration project, in relation
to the effectiveness of such provisions; to repeal title 11-A of arti-
cle 5 of the social services law relating to the catastrophic health
care expense program; and to repeal paragraph (d) of subdivision 5 of
section 2807-j of the public health law relating to civil penalties;
and providing for the repeal of certain provisions of the public
health law upon the expiration thereof (Part B); authorizing
reimbursements for expenditures made by or on behalf of social
services districts for medical assistance for needy persons and the
administration thereof; to amend the tax law, in relation to sales tax
revenue intercepts for Medicaid purposes and the deposit and disposi-
tion of certain revenues; to amend the social services law, in
relation to state reimbursement; to amend the public health law, in
relation to a preferred drug program; to amend the social services
law, in relation to certain therapeutic class drugs subject to such
preferred drug program or the clinical drug review program; to amend
the elder law, in relation to implementing a preferred drug program
and clinical drug program; to amend the social services law, in
relation to requiring prior authorization of certain prescription
drugs for nursing home residents; to amend the public health law, in
relation to general hospitals' assessments and gross receipts; and in
relation to reimbursement of specialized services for which the rate
of payment is established by the office of mental health; and in
relation to providing payments to certain diagnosis-related group
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patients discharged on and after April 1, 2005 on a per diem basis;
and in relation to the assessment for general hospitals; and in
relation to certain rates of payment by governmental agencies; to
amend the tax law and the administrative code of the city of New York,
in relation to nursing home assessment deduction; to amend the social
services law, in relation to establishing the long term care demon-
stration program; and in relation to excluding certain services from
the Family Health Plus Program; and in relation to co-payments under
the Family Health Plus Program; and in relation to effecting the
eligibility requirements for the Family Health Plus Program; to amend
chapter 474 of the laws of 1996, amending the education law and other
laws relating to rates for residential health care facilities, in
relation to the April 1, 2005 state beginning fiscal year; to amend
the public health law, in relation to rates of payment for residential
health care facilities; to amend the social services law, in relation
to the recovery of certain costs; and in relation to certain medical
assistance; to amend the general municipal law and the public health
law, in relation to continuing care retirement communities; 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 amending fiscal periods and statewide target percentages;
to amend the public health law, in relation to amending fiscal peri-
ods; to amend chapter 639 of the laws of 1996, amending the public
health law and other laws relating to welfare reform, in relation to
certain trend factors used to project reimbursable operating costs; 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 effectiveness thereof; to
amend chapter 659 of the laws of 1997, amending the public health law
and other laws relating to the creating of continuing care retirement
communities, in relation to the effectiveness thereof; to amend chap-
ter 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 the effectiveness
thereof; 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 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 assist-
ance, in relation to the effectiveness thereof; 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 the effectiveness thereof; to amend chapter 535 of the
laws of 1983, amending the social services law relating to eligibility
of certain enrollees for medical assistance, in relation to the effec-
tiveness thereof; to repeal section 3-a of part Z2 of chapter 62 of
the laws of 2003 amending the social services law and other laws
relating to implementing the state fiscal plan for the 2003-2004 state
fiscal year relating to prior authorization programs for the medical
assistance program; to repeal subdivision (x) of section 165 of chap-
ter 41 of the laws of 1992, amending the public health law and other
laws relating to assessing certain health care providers relating
thereto; and to repeal certain provisions of the social services law
relating thereto (Part C); to amend the mental hygiene law, in
relation to closing the Middletown Psychiatric Center (Part D); to
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amend chapter 642 of the laws of 2004, constituting chapter 35-A of
the consolidated laws relating to the elderly and amending the elder
law and other laws relating to the elderly, in relation to the effec-
tive date thereof (Part E); and to amend the mental hygiene law, in
relation to consolidating the office of advocate for persons with
disabilities into a redesignated state commission on quality of care
and advocacy for persons with disabilities; and to repeal article 43
of the executive law relating thereto (Part F)
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 2005-2006
3 state fiscal year. Each component is wholly contained within a Part
4 identified as Parts A through F. 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. Subdivision 1, paragraph (d) of subdivision 2 and subpara-
14 graph 2 of paragraph (b) of subdivision 3 of section 602 of the public
15 health law, as added by chapter 901 of the laws of 1986, are amended to
16 read as follows:
17 1. Every municipality shall [biennially] every four years, on such
18 dates as may be fixed by the commissioner, submit to the commissioner
19 for his or her approval a public health services plan.
20 (d) a projected [two-year] four-year plan of expenditures necessary to
21 implement the programs;
22 (2) disease control, which shall include activities to control and
23 mitigate the extent of non-infectious diseases, particularly those of a
24 chronic, degenerative nature, and infectious diseases. Such activities
25 shall include surveillance and epidemiological programs, and programs to
26 detect diseases in their early stages. Specific activities shall include
27 immunizations against infectious diseases [and], prevention and treat-
28 ment of sexually transmissible diseases, and vector-borne disease
29 prevention.
30 § 2. Subdivision 2 of section 605 of the public health law, as amended
31 by chapter 474 of the laws of 1996, is amended to read as follows:
32 2. State aid reimbursement for public health services provided by a
33 municipality under this title, shall be made as follows:
34 (a) if the municipality is providing some or all of the basic public
35 health services identified in paragraph (b) of subdivision three of
36 section six hundred two of this title, pursuant to an approved plan, at
37 a rate of [up to fifty per centum but] no less than thirty-six per
38 centum of the difference between the amount of moneys expended by the
39 municipality for public health services required by paragraph (b) of
40 subdivision three of section six hundred two of this title during the
41 fiscal year and the base grant provided pursuant to subdivision one of
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1 this section. No such reimbursement shall be provided for services if
2 they are not approved in a plan or if no plan is submitted for such
3 services.
4 (b) if the municipality is providing other public health services
5 within limits to be prescribed by regulation by the commissioner in
6 addition to some or all of the public health services required in para-
7 graph (b) of subdivision three of section six hundred two of this title,
8 pursuant to an approved plan, at a rate of [up to fifty per centum but]
9 not less than thirty per centum of the moneys expended by the munici-
10 pality for such other services. No such reimbursement shall be provided
11 for services if they are not approved in a plan or if no plan is submit-
12 ted for such services.
13 § 3. Section 611 of the public health law is REPEALED.
14 § 4. Subdivision 1 of section 616 of the public health law, as amended
15 by chapter 474 of the laws of 1996, is amended to read as follows:
16 1. The total amount of state aid provided pursuant to this article
17 shall be limited to the amount of the annual appropriation made by the
18 legislature. [In no event, however, shall such state aid be less than an
19 amount to provide the full base grant and, as otherwise provided by
20 paragraph (a) of subdivision two of section six hundred five of this
21 article, at least thirty-six per centum of the difference between the
22 amount of moneys expended by the municipality for public health services
23 required by paragraph (b) of subdivision three of section six hundred
24 two of this article during the fiscal year and the base grant provided
25 pursuant to subdivision one of section six hundred five of this article.
26 A municipality shall also receive at least thirty per centum of the
27 moneys expended for other public health services pursuant to paragraph
28 (b) of subdivision two of section six hundred five of this article, and,
29 at least the minimum amount so required for the services identified in
30 title two of this article. Moreover, for services provided during
31 calendar year nineteen hundred ninety-six, no county with a population
32 of fifty thousand or less shall receive less reimbursement pursuant to
33 subdivision one and paragraphs (a) and (b) of subdivision two of section
34 six hundred five of this article than it would have had a chapter of the
35 laws of nineteen hundred ninety-six amending these provisions as of
36 August first, nineteen hundred ninety-six not been enacted.] For the
37 program year commencing January first, two thousand six, unless other-
38 wise provided in section six hundred twenty-one of this title,
39 reimbursement for each municipality will be limited to an allocation
40 amount to be established annually by the commissioner, the total of
41 which shall not exceed the appropriation made by the legislature. Each
42 municipal allocation will include the base grant amount as specified in
43 subdivision one of section six hundred five of this article, and a
44 percentage of the total appropriation remaining after the distribution
45 of the total base grant amount for all municipalities. The percentage
46 will be calculated based on the average reimbursement for that munici-
47 pality in relation to the statewide state aid reimbursement in the
48 preceding three years for which data is available. This allocation will
49 allow for reimbursement of the base grant amount, basic and other costs
50 as specified in paragraphs (a) and (b) of subdivision two of section six
51 hundred five of this article. In no event shall a municipality receive
52 more than the amounts authorized and actually spent in accordance with
53 its approved municipal public health services plan.
54 § 5. Subdivision 2 of section 616 of the public health law is renum-
55 bered subdivision 3 and a new subdivision 2 is added to read as follows:
S. 992 6 A. 1922
1 2. If the total amount of state aid provided pursuant to this article
2 has not been disbursed, the commissioner may, subject to the approval of
3 the director of the budget, redistribute the undistributed appropriation
4 to those municipalities which the commissioner determines have received
5 their full allocation amount, have complied with the requirements of
6 section six hundred seventeen of this title and can demonstrate expendi-
7 tures beyond the requirements of section six hundred seventeen of this
8 title. Each such municipality meeting the aforementioned criteria, shall
9 be eligible for a proration determined by the commissioner as follows:
10 the proration of each eligible municipality shall be calculated by
11 determining the proportion of the amount claimed by each eligible muni-
12 cipality during the entire year that exceeds the amount required by
13 section six hundred seventeen of this title to the total expenditures of
14 all such eligible municipal claimants exceeding the amount required by
15 section hundred seventeen of this title. Each such eligible municipality
16 may receive no more than their prorated portion of the undistributed
17 appropriation.
18 § 6. The public health law is amended by adding a new section 621 to
19 read as follows:
20 § 621. State aid; public health emergencies. If the commissioner or a
21 county health department or part-county department of health or munici-
22 pality, with the approval of the commissioner, determines that there is
23 an imminent threat to public health, the department shall reimburse
24 counties or municipalities at fifty per centum for the cost of emergency
25 measures as approved by the department and subject to the approval of
26 the director of the budget. Such funds shall be made available from
27 funds appropriated for public health emergencies, only to those counties
28 or municipalities, which have expended all other state aid which may be
29 available for related activities and have developed measures to
30 adequately address the emergency. Reimbursement is conditioned upon
31 availability of appropriated funds.
32 § 7. Subsections (b), (c) and (d) of section 3235-a of the insurance
33 law, as added by section 3 of part C of chapter 1 of the laws of 2002,
34 are amended to read as follows:
35 (b) Where a policy of accident and health insurance, including a
36 contract issued pursuant to article forty-three of this chapter,
37 provides coverage for an early intervention program service, such cover-
38 age shall not be applied against any maximum annual or lifetime monetary
39 limits set forth in such policy or contract. Visit limitations [and
40 other terms and conditions of the policy] will continue to apply to
41 early intervention services. However, any visits used for early inter-
42 vention program services shall not reduce the number of visits otherwise
43 available under the policy or contract for such services. Where such
44 policy provides coverage for an early intervention program service, the
45 individualized family services plan certified by the early intervention
46 official, as defined in section twenty-five hundred forty-one of the
47 public health law, or such official's designee, shall be deemed to meet
48 any precertification, preauthorization and medical necessity require-
49 ments imposed on benefits under the policy.
50 (c) Coverage shall not be denied based upon the following:
51 (i) the location where services are provided;
52 (ii) the duration of the child's condition and/or that the child's
53 condition is not amenable to significant improvement within a certain
54 period of time as specified in the policy; or
55 (iii) that the provider of services is not a participating provider in
56 the insurer's network.
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1 (d) Any right of subrogation to benefits which a municipality is enti-
2 tled in accordance with paragraph (d) of subdivision three of section
3 twenty-five hundred fifty-nine of the public health law shall be valid
4 and enforceable to the extent benefits are available under any accident
5 and health insurance policy. The right of subrogation does not attach to
6 insurance benefits paid or provided under any accident and health insur-
7 ance policy prior to receipt by the insurer of written notice from the
8 municipality. Upon the insurer's receipt of written notice from the
9 municipality, the insurer shall provide the municipality with informa-
10 tion on the extent of benefits available to an insured under the policy.
11 [(d)] (e) No insurer, including a health maintenance organization
12 issued a certificate of authority under article forty-four of the public
13 health law and a corporation organized under article forty-three of this
14 chapter, shall refuse to issue an accident and health insurance policy
15 or contract or refuse to renew an accident and health insurance policy
16 or contract solely because the applicant or insured is receiving
17 services under the early intervention program.
18 § 8. Subdivision 2 of section 2557 of the public health law, as added
19 by chapter 428 of the laws of 1992, is amended and two new subdivisions
20 6 and 7 are added to read as follows:
21 2. The department shall reimburse the approved costs paid by a munici-
22 pality for the purposes of this title, other than those reimbursable by
23 the medical assistance program or by third party payors, in an amount of
24 fifty percent of the amount expended in accordance with the rules and
25 regulations of the commissioner, less fifty percent of the amount
26 collected by the municipality from parents pursuant to section twenty-
27 five hundred fifty-seven-a of this title. Such state reimbursement to
28 the municipality shall not be paid prior to April first of the year in
29 which the approved costs are paid by the municipality.
30 6. Effective January first, two thousand six, each municipality may
31 negotiate rates, except medical assistance rates of payment, which are
32 lower than the rates established by the department for evaluations and
33 approved early intervention services provided to eligible children who
34 reside within the municipality. The municipality must ensure that there
35 are sufficient providers to provide service coordination services, eval-
36 uations and/or early intervention services.
37 7. A municipality which has negotiated rates for early intervention
38 services and evaluations shall not seek reimbursement from the depart-
39 ment in an amount exceeding fifty percent of the rate negotiated and
40 paid to the actual provider of the early intervention services and eval-
41 uations. A municipality shall provide such information as is requested
42 by the department relative to the rates negotiated with providers for
43 early intervention services and evaluations.
44 § 9. The public health law is amended by adding a new section 2557-a
45 to read as follows:
46 § 2557-a. Parental fees. 1. Notwithstanding any other provisions of
47 law, rule or regulation, there is hereby created a system of payments by
48 parents, including a sliding schedule of fees as set forth in subdivi-
49 sion two of this section. The system of payments, called parental fees,
50 shall be structured on a sliding scale based upon household gross yearly
51 income. The parental fee obligation shall be established for each family
52 on an annual basis and shall be a monthly fee to be paid by parents to
53 the municipality. No parental fees, however, may be charged for: imple-
54 menting child find, evaluation and assessment, service coordination,
55 development, review, and evaluation of individualized family services
56 plans (IFSPs), or the implementation of procedural safeguards and other
S. 992 8 A. 1922
1 administrative components of the early intervention system. Parental
2 fees shall apply without regard to whether payment for services is
3 available under a private insurance plan or policy. Parents shall pay
4 one monthly fee as determined by the schedule of fees set forth in
5 subdivision two of this section regardless of the number of children in
6 the family receiving early intervention services.
7 2. Parental fees for the early intervention program are as follows:
8 Household Gross Income Parental Fee Per Month
9 251% Federal Poverty Level (FPL) to 350% FPL $25.00
10 351% FPL to 400% FPL $40.00
11 401% FPL to 500% FPL $80.00
12 501% FPL to 600% FPL $150.00
13 601% FPL to 700% FPL $185.00
14 701% FPL and above $215.00
15 3. At the written request of the parent, the parental fee obligation
16 may be adjusted prospectively at any point during the year upon proof of
17 a change in household gross income.
18 4. The inability of the parents of an eligible child to pay parental
19 fees due to catastrophic circumstances or extraordinary expenses shall
20 not result in the denial of services to the child or the child's family.
21 (a) Parents must document extraordinary expenses or other catastrophic
22 circumstances by providing documentation of one of the following:
23 (i) out-of-pocket medical expenses in excess of fifteen percent of
24 gross income; or
25 (ii) other extraordinary expenses or catastrophic circumstances caus-
26 ing direct out-of-pocket losses in excess of fifteen percent of gross
27 income.
28 (b) Parents must present proof of loss to the early intervention offi-
29 cial who shall document it. The early intervention official shall deter-
30 mine whether the parental fee obligation shall be reduced, forgiven, or
31 suspended within ten business days after receipt of the parent's request
32 and supporting documentation. A parent who disagrees with the determi-
33 nation of the early intervention official shall have the due process
34 rights set forth in section twenty-five hundred forty-nine of this
35 title.
36 5. Parents shall provide such information and documentation as is
37 necessary and sufficient for the municipality to determine the parents'
38 gross household income. The municipality shall document a parental fee
39 obligation and collect the same from the parents. If a parental fee
40 obligation has not been suspended or forgiven pursuant to subdivision
41 four of this section and the parental fee has not been paid to the muni-
42 cipality, the municipality shall notify the parents that nonpayment of
43 the parental fee shall result in the suspension of early intervention
44 services. If a parent was denied a suspension, reduction or forgiveness
45 of the parental fee obligation pursuant to subdivision four of this
46 section, and the parent is pursuing due process rights as provided in
47 said subdivision, early intervention services shall not be suspended
48 pending resolution of the due process. If after notification by the
49 municipality, the parental fee is not paid, the municipality shall
50 suspend the early intervention services effective thirty days from the
51 date of the notice, except those services set forth in subdivision one
52 of this section for which no parental fee may be charged. The munici-
53 pality shall notify the early intervention service providers of the
54 suspension of services. A provider of early intervention services shall
55 be paid for approved services rendered until such time as the provider
56 is notified by the municipality that the early intervention services
S. 992 9 A. 1922
1 have been suspended. Upon payment or agreement between the municipality
2 and parent for payment of the outstanding parental fees, the munici-
3 pality shall notify the early intervention providers that the child and
4 family may resume receiving early intervention services as set forth in
5 the IFSP.
6 6. The municipality shall provide the department with such information
7 as may be requested by the department. The municipality shall deduct
8 fifty percent of the amount collected from parents from the amount of
9 reimbursement for approved costs to be paid by the department as set
10 forth in subdivision two of section twenty-five hundred fifty-seven of
11 this title.
12 § 10. Notwithstanding any inconsistent law, rule or regulation, effec-
13 tive on and after July 1, 2005, home and community-based
14 individual/collateral visit shall mean the provision by appropriate
15 qualified personnel of early intervention services to an eligible child
16 and/or parent(s) or other designated caregiver at the child's home or
17 other natural setting in which children under three years of age are
18 typically found (including day care centers, other than those located at
19 the same premises as the early intervention provider, and family day
20 care homes). The definitions of basic and extended visits as established
21 in regulation are hereby eliminated and a single rate for home and
22 community-based individual/collateral visits shall be determined annual-
23 ly by the commissioner of health in accordance with section 69-4.30 of
24 Title 10 of the New York Codes, Rules and Regulations. The billing
25 limits set forth in regulation, as applicable to basic and extended
26 visits or as may be amended, shall continue to apply to home and commu-
27 nity-based individual/collateral visits defined by this act.
28 § 11. Subdivision 5 of section 171-a of the tax law, as added by chap-
29 ter 170 of the laws of 1994 and as renumbered by chapter 302 of the laws
30 of 1995, is amended to read as follows:
31 5. Notwithstanding any provision of law to the contrary, the commis-
32 sioner shall enter into a cooperative agreement with the department of
33 health, which agreement shall provide for the utilization of information
34 obtained pursuant to subdivision one of this section, for the purpose of
35 verifying eligibility for child health insurance plan subsidy payments
36 and required premium payments under sections two thousand five hundred
37 ten and two thousand five hundred eleven of the public health law, and
38 for the purpose of verifying eligibility for the program for elderly
39 pharmaceutical insurance coverage under title three of article two of
40 the elder law, when requested by the department of health.
41 § 12. Paragraph 3 of subsection (e) of section 697 of the tax law, as
42 separately amended by section 12 of part R and section 4 of part V of
43 chapter 60 of the laws of 2004, is amended to read as follows:
44 (3) Nothing herein shall be construed to prohibit the department, its
45 officers or employees from furnishing information to the office of
46 temporary and disability assistance relating to the payment of the cred-
47 it for certain household and dependent care services necessary for gain-
48 ful employment under subsection (c) of section six hundred six of this
49 article and the earned income credit under subsection (d) of section six
50 hundred six of this article, or pursuant to a local law enacted by a
51 city having a population of one million or more pursuant to subsection
52 (f) of section thirteen hundred ten of this chapter, only to the extent
53 necessary to calculate qualified state expenditures under paragraph
54 seven of subdivision (a) of section four hundred nine of the federal
55 social security act or to document the proper expenditure of federal
56 temporary assistance for needy families funds under section four hundred
S. 992 10 A. 1922
1 three of such act. The office of temporary and disability assistance may
2 redisclose such information to the United States department of health
3 and human services only to the extent necessary to calculate such quali-
4 fied state expenditures or to document the proper expenditure of such
5 federal temporary assistance for needy families funds. Nothing herein
6 shall be construed to prohibit the delivery by the commissioner to a
7 commissioner of jurors, appointed pursuant to section five hundred four
8 of the judiciary law, or, in counties within cities having a population
9 of one million or more, to the county clerk of such county, of a mailing
10 list of individuals to whom income tax forms are mailed by the commis-
11 sioner for the sole purpose of compiling a list of prospective jurors as
12 provided in article sixteen of the judiciary law. Provided, however,
13 such delivery shall only be made pursuant to an order of the chief
14 administrator of the courts, appointed pursuant to section two hundred
15 ten of the judiciary law. No such order may be issued unless such chief
16 administrator is satisfied that such mailing list is needed to compile a
17 proper list of prospective jurors for the county for which such order is
18 sought and that, in view of the responsibilities imposed by the various
19 laws of the state on the department, it is reasonable to require the
20 commissioner to furnish such list. Such order shall provide that such
21 list shall be used for the sole purpose of compiling a list of prospec-
22 tive jurors and that such commissioner of jurors, or such county clerk,
23 shall take all necessary steps to insure that the list is kept confiden-
24 tial and that there is no unauthorized use or disclosure of such list.
25 Furthermore, nothing herein shall be construed to prohibit the delivery
26 to a taxpayer or his or her duly authorized representative of a certi-
27 fied copy of any return or report filed in connection with his or her
28 tax or to prohibit the publication of statistics so classified as to
29 prevent the identification of particular reports or returns and the
30 items thereof, or the inspection by the attorney general or other legal
31 representatives of the state of the report or return of any taxpayer or
32 of any employer filed under section one hundred seventy-one-h of this
33 chapter, where such taxpayer or employer shall bring action to set aside
34 or review the tax based thereon, or against whom an action or proceeding
35 under this chapter or under this chapter and article eighteen of the
36 labor law has been recommended by the commissioner, the commissioner of
37 labor with respect to unemployment insurance matters, or the attorney
38 general or has been instituted, or the inspection of the reports or
39 returns required under this article by the comptroller or duly desig-
40 nated officer or employee of the state department of audit and control,
41 for purposes of the audit of a refund of any tax paid by a taxpayer
42 under this article, or the furnishing to the state department of labor
43 of unemployment insurance information obtained or derived from quarterly
44 combined withholding, wage reporting and unemployment insurance returns
45 required to be filed by employers pursuant to paragraph four of
46 subsection (a) of section six hundred seventy-four of this article, for
47 purposes of administration of such department's employment security
48 programs, evaluation of employment and training programs for which such
49 department has administrative, reporting, monitoring or evaluating
50 responsibilities, and redisclosure of such information when necessary to
51 enable such department to comply with the provisions of section five
52 hundred thirty-seven of the labor law or any other applicable law, or
53 the furnishing to the state office of temporary and disability assist-
54 ance of information obtained or derived from New York state personal
55 income tax returns as described in paragraph (b) of subdivision two of
56 section one hundred seventy-one-g of this chapter for the purpose of
S. 992 11 A. 1922
1 reviewing support orders enforced pursuant to title six-A of article
2 three of the social services law to aid in the determination of whether
3 such orders should be adjusted, or the furnishing of information
4 obtained from the reports required to be submitted by employers regard-
5 ing newly hired or re-hired employees pursuant to section one hundred
6 seventy-one-h of this chapter to the state office of temporary and disa-
7 bility assistance, the state department of health, the state department
8 of labor and the workers' compensation board for purposes of adminis-
9 tration of the child support enforcement program, verification of indi-
10 viduals' eligibility for one or more of the programs specified in
11 subsection (b) of section eleven hundred thirty-seven of the federal
12 social security act and for other public assistance programs authorized
13 by state law, and administration of the state's employment security and
14 workers' compensation programs, and to the national directory of new
15 hires established pursuant to section four hundred fifty-three-A of the
16 federal social security act for the purposes specified in such section,
17 or the furnishing to the state office of temporary and disability
18 assistance of the amount of an overpayment of income tax and interest
19 thereon certified to the comptroller to be credited against past-due
20 support pursuant to section one hundred seventy-one-c of this chapter
21 and of the name and social security number of the taxpayer who made such
22 overpayment, or the disclosing to the commissioner of finance of the
23 city of New York, pursuant to section one hundred seventy-one-l of this
24 chapter, of the amount of an overpayment and interest thereon certified
25 to the comptroller to be credited against a city of New York tax warrant
26 judgment debt and of the name and social security number of the taxpayer
27 who made such overpayment, or the furnishing to the New York state high-
28 er education services corporation of the amount of an overpayment of
29 income tax and interest thereon certified to the comptroller to be cred-
30 ited against the amount of a default in repayment of a guaranteed
31 student loan pursuant to section one hundred seventy-one-d of this chap-
32 ter and of the name and social security number of the taxpayer who made
33 such overpayment, or the furnishing to the state department of health of
34 the information required by subdivision two-a of section two thousand
35 five hundred eleven of the public health law, or the furnishing to the
36 state university of New York or the city university of New York respec-
37 tively or the attorney general on behalf of such state or city universi-
38 ty the amount of an overpayment of income tax and interest thereon
39 certified to the comptroller to be credited against the amount of a
40 default in repayment of a state university loan pursuant to section one
41 hundred seventy-one-e of this chapter and of the name and social securi-
42 ty number of the taxpayer who made such overpayment, or the disclosing
43 to a state agency, pursuant to section one hundred seventy-one-f of this
44 chapter, of the amount of an overpayment and interest thereon certified
45 to the comptroller to be credited against a past-due legally enforceable
46 debt owed to such agency and of the name and social security number of
47 the taxpayer who made such overpayment, or the furnishing of employee
48 and employer information obtained through the wage reporting system,
49 pursuant to section one hundred seventy-one-a of this chapter, as added
50 by chapter five hundred forty-five of the laws of nineteen hundred
51 seventy-eight, to the state office of temporary and disability assist-
52 ance for the purpose of verifying eligibility for and entitlement to
53 amounts of benefits under the social services law or similar law of
54 another jurisdiction, locating absent parents or other persons legally
55 responsible for the support of applicants for or recipients of public
56 assistance and care under the social services law and persons legally
S. 992 12 A. 1922
1 responsible for the support of a recipient of services under section one
2 hundred eleven-g of the social services law and, in appropriate cases,
3 establishing support obligations pursuant to the social services law and
4 the family court act or similar provision of law of another jurisdiction
5 for the purpose of evaluating the effect on earnings of participation in
6 employment, training or other programs designed to promote self-suffici-
7 ency authorized pursuant to the social services law by current recipi-
8 ents of public assistance and care and by former applicants and recipi-
9 ents of public assistance and care, (except that with regard to former
10 recipients, information which relates to a particular former recipient
11 shall be provided with client identifying data deleted), and to the
12 state department of labor, or other individuals designated by the
13 commissioner of labor, for the purpose of the administration of such
14 department's employment security programs, public assistance work
15 programs, or for other purposes deemed appropriate by the commissioner
16 of labor consistent with the provisions of the labor law, as well as for
17 the evaluation of the effect on earnings of participation in training
18 programs with respect to which the department of labor has reporting,
19 monitoring, administration, or evaluation responsibilities, or the
20 furnishing of information, which is obtained from the wage reporting
21 system operated pursuant to section one hundred seventy-one-a of this
22 chapter, as added by chapter five hundred forty-five of the laws of
23 nineteen hundred seventy-eight, to the state office of temporary and
24 disability assistance so that it may furnish such information to public
25 agencies of other jurisdictions with which the state office of temporary
26 and disability assistance has an agreement pursuant to paragraph (h) or
27 (i) of subdivision three of section twenty of the social services law,
28 and to the state office of temporary and disability assistance for the
29 purpose of fulfilling obligations and responsibilities otherwise incum-
30 bent upon the state department of labor, under section one hundred twen-
31 ty-four of the federal family support act of nineteen hundred eighty-
32 eight, by giving the federal parent locator service, maintained by the
33 federal department of health and human services, prompt access to such
34 information as required by such act, or to the state department of
35 health to establish eligibility under the child health insurance plan
36 pursuant to subdivision two-a of section two thousand five hundred elev-
37 en of the public health law and to verify eligibility for the program
38 for elderly pharmaceutical insurance coverage under title three of arti-
39 cle two of the elder law, or to the office of vocational and educational
40 services for individuals with disabilities of the education department,
41 the commission for the blind and visually handicapped and any other
42 state vocational rehabilitation agency, for purposes of obtaining
43 reimbursement from the federal social security administration for
44 expenditures made by such office, commission or agency on behalf of
45 disabled individuals who have achieved economic self-sufficiency.
46 Provided, however, that with respect to employee information the office
47 of temporary and disability assistance shall only be furnished with the
48 names, social security account numbers and gross wages of those employ-
49 ees who are (A) applicants for or recipients of benefits under the
50 social services law, or similar provision of law of another jurisdiction
51 (pursuant to an agreement under subdivision three of section twenty of
52 the social services law) or, (B) absent parents or other persons legally
53 responsible for the support of applicants for or recipients of public
54 assistance and care under the social services law or similar provision
55 of law of another jurisdiction (pursuant to an agreement under subdivi-
56 sion three of section twenty of the social services law), or (C) persons
S. 992 13 A. 1922
1 legally responsible for the support of a recipient of services under
2 section one hundred eleven-g of the social services law or similar
3 provision of law of another jurisdiction (pursuant to an agreement under
4 subdivision three of section twenty of the social services law), or (D)
5 employees about whom wage reporting system information is being
6 furnished to public agencies of other jurisdictions, with which the
7 state office of temporary and disability assistance has an agreement
8 pursuant to paragraph (h) or (i) of subdivision three of section twenty
9 of the social services law, or (E) employees about whom wage reporting
10 system information is being furnished to the federal parent locator
11 service, maintained by the federal department of health and human
12 services, for the purpose of enabling the state office of temporary and
13 disability assistance to fulfill obligations and responsibilities other-
14 wise incumbent upon the state department of labor, under section one
15 hundred twenty-four of the federal family support act of nineteen
16 hundred eighty-eight, and, only if, the office of temporary and disabil-
17 ity assistance certifies to the commissioner that such persons are such
18 applicants, recipients, absent parents or persons legally responsible
19 for support or persons about whom information has been requested by a
20 public agency of another jurisdiction or by the federal parent locator
21 service and further certifies that in the case of information requested
22 under agreements with other jurisdictions entered into pursuant to
23 subdivision three of section twenty of the social services law, that
24 such request is in compliance with any applicable federal law. Provided,
25 further, that where the office of temporary and disability assistance
26 requests employee information for the purpose of evaluating the effects
27 on earnings of participation in employment, training or other programs
28 designed to promote self-sufficiency authorized pursuant to the social
29 services law, the office of temporary and disability assistance shall
30 only be furnished with the quarterly gross wages (excluding any refer-
31 ence to the name, social security number or any other information which
32 could be used to identify any employee or the name or identification
33 number of any employer) paid to employees who are former applicants for
34 or recipients of public assistance and care and who are so certified to
35 the commissioner by the commissioner of the office of temporary and
36 disability assistance. Provided, further, that with respect to employee
37 information, the department of health shall only be furnished with the
38 information required pursuant to subdivision two-a of section two thou-
39 sand five hundred eleven of the public health law with respect to those
40 children whose eligibility under the child health insurance plan is to
41 be determined pursuant to such subdivision two-a and with respect to
42 those members of any such child's household whose income affects such
43 child's eligibility and who are so certified to the commissioner or by
44 the department of health. Provided, further, that wage reporting infor-
45 mation shall be furnished to the office of vocational and educational
46 services for individuals with disabilities of the education department,
47 the commission for the blind and visually handicapped and any other
48 state vocational rehabilitation agency only if such office, commission
49 or agency, as applicable, certifies to the commissioner that such infor-
50 mation is necessary to obtain reimbursement from the federal social
51 security administration for expenditures made on behalf of disabled
52 individuals who have achieved self-sufficiency. Reports and returns
53 shall be preserved for three years and thereafter until the commissioner
54 orders them to be destroyed.
S. 992 14 A. 1922
1 § 13. Paragraph (c) of subdivision 3 of section 242 of the elder law,
2 as amended by section 1 of part A of chapter 49 of the laws of 2004, is
3 amended to read as follows:
4 (c) The fact that some of an individual's prescription drug expenses
5 are paid or reimbursable under the provisions of the medicare program
6 shall not disqualify an individual, if he or she is otherwise eligible,
7 from receiving assistance under this [article] title. In such cases,
8 the state shall pay the portion of the cost of those prescriptions for
9 qualified drugs for which no payment or reimbursement is made by the
10 medicare program or any federally funded prescription drug benefit, less
11 the participant's co-payment required on the amount not paid by the
12 medicare program. In addition, the participant registration fee charged
13 to eligible program participants for comprehensive coverage pursuant to
14 section [five hundred forty-seven-g] two hundred forty-seven of this
15 [article] title shall be waived for the portion of the annual coverage
16 period that the participant is also enrolled as a transitional assist-
17 ance beneficiary in the medicare prescription drug discount card
18 program, authorized pursuant to title XVIII of the federal social secu-
19 rity act, provided that: (i) any sponsor of such drug discount card
20 program has signed an agreement to complete coordination of benefit
21 functions with EPIC, and has been endorsed by the EPIC panel; or (ii)
22 any exclusive sponsor of such drug discount card program authorized
23 pursuant to title XVIII of the federal social security act that limits
24 the participants to the medicare prescription drug discount card program
25 sponsored by such exclusive sponsor, shall coordinate benefits available
26 under such discount card program with EPIC. The participant registra-
27 tion fee charged to eligible program participants for comprehensive
28 coverage pursuant to section two hundred forty-seven of this title shall
29 be waived for the portion of the annual coverage period that the partic-
30 ipant is also enrolled as a full subsidy individual in a prescription
31 drug or MA-PD plan under Part D of title XVIII of the federal social
32 security act.
33 § 14. Subdivision 3 of section 242 of the elder law is amended by
34 adding a new paragraph (e) to read as follows:
35 (e) In order to maximize prescription drug coverage under Part D of
36 title XVIII of the federal social security act, the elderly pharmaceu-
37 tical insurance coverage program is authorized to represent program
38 participants under this title in the pursuit of such coverage. Such
39 representation shall not result in any additional financial liability on
40 behalf of such program participants and shall include, but not be limit-
41 ed to, the following actions:
42 (i) application for the premium and cost-sharing subsidies on behalf
43 of eligible program participants;
44 (ii) enrollment in a prescription drug plan or MA-PD plan; the elderly
45 pharmaceutical insurance coverage program shall provide program partic-
46 ipants with prior written notice of, and the opportunity to decline,
47 such enrollment;
48 (iii) pursuit of appeals, grievances, or coverage determinations.
49 § 15. Paragraph (k) of subdivision 5 of section 244 of the elder law,
50 as added by section 3 of part A of chapter 49 of the laws of 2004, is
51 amended to read as follows:
52 (k) enter into an agreement with one or more sponsors of a drug
53 discount card program or a prescription drug plan authorized under title
54 XVIII of the federal social security act, to serve as an endorsed EPIC
55 drug discount card program or prescription drug plan for the purposes of
56 effective coordination of benefits.
S. 992 15 A. 1922
1 § 16. Notwithstanding any inconsistent provision of section 112 or
2 article 11 of the state finance law or section 142 of the economic
3 development law or any other law, the elderly pharmaceutical insurance
4 coverage panel established pursuant to section 244 of the elder law is
5 authorized to enter into an agreement authorized under paragraph (k) of
6 subdivision five of section 244 of the elder law, without a competitive
7 bid or request for proposal process, with a prescription drug plan spon-
8 sor authorized under Part D of title XVIII of the federal social securi-
9 ty act, to serve as an endorsed EPIC prescription drug plan for purposes
10 of effective coordination of benefits.
11 § 17. Chapter 438 of the laws of 2002, relating to a study of
12 infection control in flexible endoscopy, is REPEALED.
13 § 18. Article 27-I of the public health law is REPEALED.
14 § 19. Article 4-A of the public health law is REPEALED.
15 § 20. Article 36-A of the public health law is REPEALED.
16 § 21. Section 4 of part X2 of chapter 62 of the laws of 2003, amending
17 the public health law relating to allowing for the use of funds of the
18 office of professional medical conduct for activities of the patient
19 health information and quality improvement act of 2000, as amended by
20 section 2 of part A of chapter 58 of the laws of 2004, is amended to
21 read as follows:
22 § 4. This act shall take effect immediately; provided that the
23 provisions of section one of this act shall be deemed to have been in
24 full force and effect on and after April 1, 2003[, and shall expire
25 March 31, 2005 when upon such date the provisions of such section shall
26 be deemed repealed].
27 § 22. This act shall take effect immediately and shall be deemed to
28 have been in full force and effect on and after April 1, 2005; provided,
29 however, that sections one through five, nine, eleven and twelve of this
30 act shall take effect January 1, 2006.
31 PART B
32 Section 1. Subdivision 5 of section 168 of chapter 639 of the laws of
33 1996, constituting the New York Health Care Reform Act of 1996, as
34 amended by section 1 of part A3 of chapter 62 of the laws of 2003, is
35 amended to read as follows:
36 5. sections 2807-c, 2807-j, 2807-s and 2807-t of the public health
37 law, as amended or as added by this act, shall expire on July 1, [2005]
38 2007, and shall be thereafter effective only in respect to any act done
39 on or before such date or action or proceeding arising out of such act
40 including continued collections of funds from assessments and allowances
41 and surcharges established pursuant to sections 2807-c, 2807-j, 2807-s
42 and 2807-t of the public health law, and administration and distrib-
43 utions of funds from pools established pursuant to sections 2807-c,
44 2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public health
45 law related to patient services provided before July 1, [2005] 2007, and
46 continued expenditure of funds authorized for programs and grants until
47 the exhaustion of funds therefor;
48 § 2. Subdivision 1 of section 138 of chapter 1 of the laws of 1999,
49 constituting the New York Health Care Reform Act of 2000, as amended by
50 section 2 of part A3 of chapter 62 of the laws of 2003, is amended to
51 read as follows:
52 1. sections 2807-c, 2807-j, 2807-s, and 2807-t of the public health
53 law, as amended by this act, shall expire on July 1, [2005] 2007, and
54 thereafter effective only in respect to any act done before such date or
S. 992 16 A. 1922
1 action or proceeding arising out of such act including continued
2 collections of funds from assessments and allowances and surcharges
3 established pursuant to sections 2807-c, 2807-j, 2807-s and 2807-t of
4 the public health law, and administration and distributions of funds
5 from pools established pursuant to sections 2807-c, 2807-j, 2807-k,
6 2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the public health
7 law, as amended or added by this act, related to patient services
8 provided before July 1, [2005] 2007, and continued expenditure of funds
9 authorized for programs and grants until the exhaustion of funds there-
10 for;
11 § 3. Section 2807-v of the public health law, as amended by section 17
12 of part A3 of chapter 62 of the laws of 2003, the opening paragraph,
13 subparagraphs (v) and (vi) of paragraph (c), and the opening paragraph
14 of paragraph (k) as amended by chapter 114 of the laws of 2004, para-
15 graph (i-1) as added by chapter 495 of the laws of 2004, subparagraphs
16 (iv), (v) and (vi) of paragraph (l) as amended by section 29 of part H
17 of chapter 686 of the laws of 2003, the opening paragraph of paragraph
18 (n) as amended by chapter 642 of the laws of 2004, paragraph (s) as
19 amended by section 2 of part K1 of chapter 63 of the laws of 2003,
20 subparagraphs (v) and (vi) of paragraph (k) as amended by section 14 of
21 part B of chapter 58 of the laws of 2004, subparagraphs (v) and (vi) of
22 paragraph (n) as amended by section 15 of part B of chapter 58 of the
23 laws of 2004, subparagraphs (v) and (vi) of paragraph (o) as amended by
24 section 16 of part B of chapter 58 of the laws of 2004, the opening
25 paragraph of paragraph (hh) as amended by section 25 of part C of chap-
26 ter 58 of the laws of 2004, paragraph (mm) as amended by section 1 of
27 part C of chapter 58 of the laws of 2004, paragraph (oo) as added by
28 section 10 of part B of chapter 58 of the laws of 2004, paragraph (pp)
29 as added by section 22 of part B of chapter 58 of the laws of 2004,
30 paragraph (qq) as added by section 26 of part B of chapter 58 of the
31 laws of 2004, paragraph (ss) as amended by chapter 745 of the laws of
32 2004, paragraph (tt) as added by section 5 of part D of chapter 58 of
33 the laws of 2004, and paragraph (vv) as added by section 23 of part C of
34 chapter 58 of the laws of 2004, of subdivision 1, is amended to read as
35 follows:
36 § 2807-v. Tobacco control and insurance initiatives pool distrib-
37 utions. 1. Funds accumulated in the tobacco control and insurance
38 initiatives pool, including income from invested funds, shall be
39 distributed or retained by the commissioner or by the state comptroller,
40 as applicable, in accordance with the following:
41 (a) Funds shall be deposited by the commissioner, within amounts
42 appropriated, and the state comptroller is hereby authorized and
43 directed to receive for deposit to the credit of the state special
44 revenue funds - other, HCRA transfer fund, medicaid fraud hotline and
45 medicaid administration account, or any successor fund or account, for
46 purposes of services and expenses related to the toll-free medicaid
47 fraud hotline established pursuant to section one hundred eight of chap-
48 ter one of the laws of nineteen hundred ninety-nine from the tobacco
49 control and insurance initiatives pool established for the following
50 periods in the following amounts: four hundred thousand dollars annually
51 for the periods January first, two thousand through December thirty-
52 first, two thousand two, up to four hundred thousand dollars for the
53 period January first, two thousand three through December thirty-first,
54 two thousand three, up to four hundred thousand dollars for the period
55 January first, two thousand four through December thirty-first, two
56 thousand four, [and] up to [two] four hundred thousand dollars for the
S. 992 17 A. 1922
1 period January first, two thousand five through [June thirtieth] Decem-
2 ber thirty-first, two thousand five, up to four hundred thousand dollars
3 for the period January first, two thousand six through December thirty-
4 first, two thousand six, and up to two hundred thousand dollars for the
5 period January first, two thousand seven through June thirtieth, two
6 thousand seven.
7 (b) Funds shall be reserved and accumulated from year to year [by the
8 commissioner] and shall be available, including income from invested
9 funds, for purposes of payment of audits or audit contracts necessary to
10 determine payor and provider compliance with requirements set forth in
11 sections twenty-eight hundred seven-j, twenty-eight hundred seven-s and
12 twenty-eight hundred seven-t of this article and hospital compliance
13 with paragraph six of subdivision (a) of section 405.4 of title 10 of
14 the official compilation of codes, rules and regulations of the state of
15 New York in accordance with subdivision nine of section twenty-eight
16 hundred three of this article from the tobacco control and insurance
17 initiatives pool established for the following periods in the following
18 amounts: five million six hundred thousand dollars annually for the
19 periods January first, two thousand through December thirty-first, two
20 thousand two, up to five million dollars for the period January first,
21 two thousand three through December thirty-first, two thousand three, up
22 to five million dollars for the period January first, two thousand four
23 through December thirty-first, two thousand four, [and] up to [two] five
24 million [five hundred thousand] dollars for the period January first,
25 two thousand five through [June thirtieth] December thirty first, two
26 thousand five, up to five million dollars for the period January first,
27 two thousand six through December thirty-first, two thousand six, and up
28 to two million five hundred thousand dollars for the period January
29 first, two thousand seven through June thirtieth, two thousand seven.
30 (c) Funds shall be deposited by the commissioner, within amounts
31 appropriated, and the state comptroller is hereby authorized and
32 directed to receive for deposit to the credit of the state special
33 revenue funds - other, HCRA transfer fund, enhanced community services
34 account, or any successor fund or account, for mental health services
35 programs for case management services for adults and children; supported
36 housing; home and community based waiver services; family based treat-
37 ment; family support services; mobile mental health teams; transitional
38 housing; and community oversight, established pursuant to articles seven
39 and forty-one of the mental hygiene law and subdivision nine of section
40 three hundred sixty-six of the social services law; and for comprehen-
41 sive care centers for eating disorders pursuant to section twenty-seven
42 hundred ninety-nine-l of this chapter, provided however that, for such
43 centers, funds in the amount of five hundred thousand dollars on an
44 annual basis shall be transferred from the enhanced community services
45 account and deposited into the fund established by section ninety-five-e
46 of the state finance law; from the tobacco control and insurance initi-
47 atives pool established for the following periods in the following
48 amounts:
49 (i) forty-eight million dollars to be reserved, to be retained or for
50 distribution pursuant to a chapter of the laws of two thousand, for the
51 period January first, two thousand through December thirty-first, two
52 thousand;
53 (ii) eighty-seven million dollars to be reserved, to be retained or
54 for distribution pursuant to a chapter of the laws of two thousand one,
55 for the period January first, two thousand one through December thirty-
56 first, two thousand one;
S. 992 18 A. 1922
1 (iii) eighty-seven million dollars to be reserved, to be retained or
2 for distribution pursuant to a chapter of the laws of two thousand two,
3 for the period January first, two thousand two through December thirty-
4 first, two thousand two;
5 (iv) eighty-eight million dollars to be reserved, to be retained or
6 for distribution pursuant to a chapter of the laws of two thousand
7 three, for the period January first, two thousand three through December
8 thirty-first, two thousand three;
9 (v) eighty-eight million dollars, plus five hundred thousand dollars,
10 to be reserved, to be retained or for distribution pursuant to a chapter
11 of the laws of two thousand four, and pursuant to section twenty-seven
12 hundred ninety-nine-l of this chapter, for the period January first, two
13 thousand four through December thirty-first, two thousand four; [and]
14 (vi) [forty-four] forty-eight million dollars, plus [two] five hundred
15 [fifty] thousand dollars, to be reserved, to be retained or for distrib-
16 ution pursuant to a chapter of the laws of two thousand five, and pursu-
17 ant to section twenty-seven hundred ninety-nine-l of this chapter, for
18 the period January first, two thousand five through [June thirtieth]
19 December thirty-first, two thousand five;
20 (vii) eighty-eight million dollars, plus five hundred thousand
21 dollars, to be reserved, to be retained or for distribution pursuant to
22 a chapter of the laws of two thousand six, and pursuant to section twen-
23 ty-seven hundred ninety-nine-l of this chapter, for the period January
24 first, two thousand six through December thirty-first, two thousand six;
25 and
26 (viii) forty-four million dollars, plus two hundred fifty thousand
27 dollars, to be reserved, to be retained or for distribution pursuant to
28 a chapter of the laws of two thousand seven and pursuant to section
29 twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
30 ary first, two thousand seven through June thirtieth, two thousand
31 seven.
32 (d) 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 funds - other, HCRA transfer fund, medical assistance account,
36 or any successor fund or account, for purposes of funding the state
37 share of services and expenses related to the family health plus program
38 including up to two and one-half million dollars annually for the period
39 January first, two thousand through December thirty-first, two thousand
40 two, for administration and marketing costs associated with such program
41 established pursuant to clause (A) of subparagraph (v) of paragraph (a)
42 of subdivision two of section three hundred sixty-nine-ee of the social
43 services law from the tobacco control and insurance initiatives pool
44 established for the following periods in the following amounts:
45 (i) three million five hundred thousand dollars for the period January
46 first, two thousand through December thirty-first, two thousand;
47 (ii) twenty-seven million dollars for the period January first, two
48 thousand one through December thirty-first, two thousand one; and
49 (iii) fifty-seven million dollars for the period January first, two
50 thousand two through December thirty-first, two thousand two.
51 (e) Funds shall be deposited by the commissioner, within amounts
52 appropriated, and the state comptroller is hereby authorized and
53 directed to receive for deposit to the credit of the state special
54 revenue funds - other, HCRA transfer fund, medical assistance account,
55 or any successor fund or account, for purposes of funding the state
56 share of services and expenses related to the family health plus program
S. 992 19 A. 1922
1 including up to two and one-half million dollars annually for the period
2 January first, two thousand through December thirty-first, two thousand
3 two for administration and marketing costs associated with such program
4 established pursuant to clause (B) of subparagraph (v) of paragraph (a)
5 of subdivision two of section three hundred sixty-nine-ee of the social
6 services law from the tobacco control and insurance initiatives pool
7 established for the following periods in the following amounts:
8 (i) two million five hundred thousand dollars for the period January
9 first, two thousand through December thirty-first, two thousand;
10 (ii) thirty million five hundred thousand dollars for the period Janu-
11 ary first, two thousand one through December thirty-first, two thousand
12 one; and
13 (iii) sixty-six million dollars for the period January first, two
14 thousand two through December thirty-first, two thousand two.
15 (f) 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 funds - other, HCRA transfer fund, medicaid fraud hotline and
19 medicaid administration account, or any successor fund or account, for
20 purposes of payment of administrative expenses of the department related
21 to the family health plus program established pursuant to section three
22 hundred sixty-nine-ee of the social services law from the tobacco
23 control and insurance initiatives pool established for the following
24 periods in the following amounts: five hundred thousand dollars on an
25 annual basis for the periods January first, two thousand through Decem-
26 ber thirty-first, two thousand [four] six, and two hundred fifty thou-
27 sand dollars for the period January first, two thousand [five] seven
28 through June thirtieth, two thousand [five] seven.
29 (g) Funds shall be reserved and accumulated from year to year [by the
30 commissioner] and shall be available, including income from invested
31 funds, contingent upon meeting all funding amounts established pursuant
32 to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
33 and (s) of this subdivision, paragraph (a) of subdivision nine of
34 section twenty-eight hundred seven-j of this article, and paragraphs
35 (a), (i) and (k) of subdivision one of section twenty-eight hundred
36 seven-l of this article for purposes of services and expenses related to
37 the health maintenance organization direct pay market program estab-
38 lished pursuant to sections forty-three hundred twenty-one-a and forty-
39 three hundred twenty-two-a of the insurance law from the tobacco control
40 and insurance initiatives pool established for the following periods in
41 the following amounts:
42 (i) up to thirty-five million dollars for the period January first,
43 two thousand through December thirty-first, two thousand of which fifty
44 percentum shall be allocated to the program pursuant to section four
45 thousand three hundred twenty-one-a of the insurance law and fifty
46 percentum to the program pursuant to section four thousand three hundred
47 twenty-two-a of the insurance law;
48 (ii) up to thirty-six million dollars for the period January first,
49 two thousand one through December thirty-first, two thousand one of
50 which fifty percentum shall be allocated to the program pursuant to
51 section four thousand three hundred twenty-one-a of the insurance law
52 and fifty percentum to the program pursuant to section four thousand
53 three hundred twenty-two-a of the insurance law;
54 (iii) up to thirty-nine million dollars for the period January first,
55 two thousand two through December thirty-first, two thousand two of
56 which fifty percentum shall be allocated to the program pursuant to
S. 992 20 A. 1922
1 section four thousand three hundred twenty-one-a of the insurance law
2 and fifty percentum to the program pursuant to section four thousand
3 three hundred twenty-two-a of the insurance law;
4 (iv) up to forty million dollars for the period January first, two
5 thousand three through December thirty-first, two thousand three of
6 which fifty percentum shall be allocated to the program pursuant to
7 section four thousand three hundred twenty-one-a of the insurance law
8 and fifty percentum to the program pursuant to section four thousand
9 three hundred twenty-two-a of the insurance law;
10 (v) up to forty million dollars for the period January first, two
11 thousand four through December thirty-first, two thousand four of which
12 fifty percentum shall be allocated to the program pursuant to section
13 four thousand three hundred twenty-one-a of the insurance law and fifty
14 percentum to the program pursuant to section four thousand three hundred
15 twenty-two-a of the insurance law; [and]
16 (vi) up to [twenty] forty million dollars for the period January
17 first, two thousand five through [June thirtieth] December thirty-first,
18 two thousand five of which fifty percentum shall be allocated to the
19 program pursuant to section four thousand three hundred twenty-one-a of
20 the insurance law and fifty percentum to the program pursuant to section
21 four thousand three hundred twenty-two-a of the insurance law;
22 (vii) up to forty million dollars for the period January first, two
23 thousand six through December thirty-first, two thousand six of which
24 fifty percentum shall be allocated to the program pursuant to section
25 four thousand three hundred twenty-one-a of the insurance law and fifty
26 percentum shall be allocated to the program pursuant to section four
27 thousand three hundred twenty-two-a of the insurance law; and
28 (viii) up to twenty million dollars for the period January first, two
29 thousand seven through June thirtieth, two thousand seven of which fifty
30 percentum shall be allocated to the program pursuant to section four
31 thousand three hundred twenty-one-a of the insurance law and fifty
32 percentum shall be allocated to the program pursuant to section four
33 thousand three hundred twenty-two-a of the insurance law.
34 (h) Funds shall be reserved and accumulated from year to year [by the
35 commissioner] and shall be available, including income from invested
36 funds, contingent upon meeting all funding amounts established pursuant
37 to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
38 and (s) of this subdivision, paragraph (a) of subdivision nine of
39 section twenty-eight hundred seven-j of this article, and paragraphs
40 (a), (i) and (k) of subdivision one of section twenty-eight hundred
41 seven-l of this article for purposes of services and expenses related to
42 the healthy New York individual program established pursuant to sections
43 four thousand three hundred twenty-six and four thousand three hundred
44 twenty-seven of the insurance law from the tobacco control and insurance
45 initiatives pool established for the following periods in the following
46 amounts:
47 (i) up to six million dollars for the period January first, two thou-
48 sand one through December thirty-first, two thousand one;
49 (ii) up to twenty-nine million dollars for the period January first,
50 two thousand two through December thirty-first, two thousand two;
51 (iii) up to [twenty-nine] five million [four] one hundred thousand
52 dollars for the period January first, two thousand three through Decem-
53 ber thirty-first, two thousand three;
54 (iv) [up to twenty-four million six hundred thousand dollars for the
55 period January first, two thousand four through December thirty-first,
56 two thousand four; and
S. 992 21 A. 1922
1 (v)] up to [twenty-two] thirty-four million six hundred thousand
2 dollars for the period January first, two thousand five through [June
3 thirtieth] December thirty-first, two thousand five;
4 (v) up to fifty-four million eight hundred thousand dollars for the
5 period January first, two thousand six through December thirty-first,
6 two thousand six; and
7 (vi) up to forty-two million six hundred thousand dollars for the
8 period January first, two thousand seven through June thirtieth, two
9 thousand seven.
10 (i) Funds shall be reserved and accumulated from year to year [by the
11 commissioner] and shall be available, including income from invested
12 funds, contingent upon meeting all funding amounts established pursuant
13 to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
14 and (s) of this subdivision, paragraph (a) of subdivision nine of
15 section twenty-eight hundred seven-j of this article, and paragraphs
16 (a), (i) and (k) of subdivision one of section twenty-eight hundred
17 seven-l of this article for purposes of services and expenses related to
18 the healthy New York group program established pursuant to sections four
19 thousand three hundred twenty-six and four thousand three hundred twen-
20 ty-seven of the insurance law from the tobacco control and insurance
21 initiatives pool established for the following periods in the following
22 amounts:
23 (i) up to thirty-four million dollars for the period January first,
24 two thousand one through December thirty-first, two thousand one;
25 (ii) up to seventy-seven million dollars for the period January first,
26 two thousand two through December thirty-first, two thousand two;
27 (iii) up to [sixty] ten million [four] five hundred thousand dollars
28 for the period January first, two thousand three through December thir-
29 ty-first, two thousand three;
30 (iv) [up to twenty-four million six hundred thousand dollars for the
31 period January first, two thousand four through December thirty-first,
32 two thousand four; and
33 (v)] up to [twenty-two] thirty-four million six hundred thousand
34 dollars for the period January first, two thousand five through [June
35 thirtieth] December thirty-first, two thousand five;
36 (v) up to fifty-four million eight hundred thousand dollars for the
37 period January first, two thousand six through December thirty-first,
38 two thousand six; and
39 (vi) up to forty-two million six hundred thousand dollars for the
40 period January first, two thousand seven through June thirtieth, two
41 thousand seven.
42 (i-1) Notwithstanding the provisions of paragraphs (h) and (i) of this
43 subdivision, the commissioner shall reserve and accumulate up to two
44 million five hundred thousand dollars annually for the [period] periods
45 January first, two thousand four through December thirty-first, two
46 thousand [four] six and one million two hundred fifty thousand dollars
47 for the period January first, two thousand [five] seven through June
48 thirtieth, two thousand [five] seven from funds otherwise available for
49 distribution under such paragraphs for the services and expenses related
50 to the pilot program for entertainment industry employees included in
51 subsection (b) of section one thousand one hundred twenty-two of the
52 insurance law, and an additional seven hundred thousand dollars annually
53 for the [period] periods January first, two thousand four through Decem-
54 ber thirty-first, two thousand [four] six, and an additional three
55 hundred thousand dollars for the period January first, two thousand
56 [five] seven through June thirtieth, two thousand [five] seven for
S. 992 22 A. 1922
1 services and expenses related to the pilot program for displaced workers
2 included in subsection (c) of section one thousand one hundred twenty-
3 two of the insurance law.
4 (j) Funds shall be reserved and accumulated from year to year [by the
5 commissioner] and shall be available, including income from invested
6 funds, contingent upon meeting all funding amounts established pursuant
7 to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
8 and (s) of this subdivision, paragraph (a) of subdivision nine of
9 section twenty-eight hundred seven-j of this article, and paragraphs
10 (a), (i) and (k) of subdivision one of section twenty-eight hundred
11 seven-l of this article for purposes of services and expenses related to
12 the tobacco use prevention and control program established pursuant to
13 sections thirteen hundred ninety-nine-ii and thirteen hundred ninety-
14 nine-jj of this chapter, from the tobacco control and insurance initi-
15 atives pool established for the following periods in the following
16 amounts:
17 (i) up to thirty million dollars for the period January first, two
18 thousand through December thirty-first, two thousand;
19 (ii) up to forty million dollars for the period January first, two
20 thousand one through December thirty-first, two thousand one;
21 (iii) up to forty million dollars for the period January first, two
22 thousand two through December thirty-first, two thousand two;
23 (iv) up to thirty-six million nine hundred fifty thousand dollars for
24 the period January first, two thousand three through December thirty-
25 first, two thousand three;
26 (v) up to thirty-six million nine hundred fifty thousand dollars for
27 the period January first, two thousand four through December thirty-
28 first, two thousand four; [and]
29 (vi) up to [twenty] forty million [two] six hundred [seventy-five]
30 thousand dollars for the period January first, two thousand five through
31 [June thirtieth] December thirty-first, two thousand five;
32 (vii) up to forty million six hundred thousand dollars for the period
33 January first, two thousand six through December thirty-first, two thou-
34 sand six; and
35 (viii) up to twenty million three hundred thousand dollars for the
36 period January first, two thousand seven through June thirtieth, two
37 thousand seven.
38 (k) Funds shall be deposited by the commissioner, within amounts
39 appropriated, and the state comptroller is hereby authorized and
40 directed to receive for deposit to the credit of the state special
41 revenue fund - other, HCRA transfer fund, health care services account,
42 or any successor fund or account, contingent upon meeting all funding
43 amounts established pursuant to paragraphs (a), (b), (c), (d), (e), (f),
44 (l), (m), (n), (p), (q), (r) and (s) of this subdivision, paragraph (a)
45 of subdivision nine of section twenty-eight hundred seven-j of this
46 article, and paragraphs (a), (i) and (k) of subdivision one of section
47 twenty-eight hundred seven-l of this article for purposes of services
48 and expenses related to public health programs, including comprehensive
49 care centers for eating disorders pursuant to section twenty-seven
50 hundred ninety-nine-l of this chapter, provided however that, for such
51 centers, funds in the amount of five hundred thousand dollars on an
52 annual basis shall be transferred from the health care services account
53 and deposited into the fund established by section ninety-five-e of the
54 state finance law, from the tobacco control and insurance initiatives
55 pool established for the following periods in the following amounts:
S. 992 23 A. 1922
1 (i) up to thirty-one million dollars for the period January first, two
2 thousand through December thirty-first, two thousand;
3 (ii) up to forty-one million dollars for the period January first, two
4 thousand one through December thirty-first, two thousand one;
5 (iii) up to eighty-one million dollars for the period January first,
6 two thousand two through December thirty-first, two thousand two;
7 (iv) one hundred twenty-two million five hundred thousand dollars for
8 the period January first, two thousand three through December thirty-
9 first, two thousand three;
10 (v) one hundred eight million five hundred seventy-five thousand
11 dollars, plus an additional five hundred thousand dollars, for the peri-
12 od January first, two thousand four through December thirty-first, two
13 thousand four; [and]
14 (vi) [seventy-five] eighty-one million [four] eight hundred [seventy-
15 five] thousand dollars, plus an additional [two] five hundred [fifty]
16 thousand dollars, for the period January first, two thousand five
17 through [June thirtieth] December thirty-first, two thousand five;
18 (vii) one hundred thirty-one million eight hundred thousand dollars,
19 plus an additional five hundred thousand dollars, for the period January
20 first, two thousand six through December thirty-first, two thousand six;
21 and
22 (viii) sixty-five million six hundred thousand dollars, plus an addi-
23 tional two hundred fifty thousand dollars, for the period January first,
24 two thousand seven through June thirtieth, two thousand seven.
25 (l) 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, medical assistance account,
29 or any successor fund or account, for purposes of funding the state
30 share of the personal care and certified home health agency rate or fee
31 increases established pursuant to subdivision three of section three
32 hundred sixty-seven-o of the social services law from the tobacco
33 control and insurance initiatives pool established for the following
34 periods in the following amounts:
35 (i) twenty-three million two hundred thousand dollars for the period
36 January first, two thousand through December thirty-first, two thousand;
37 (ii) twenty-three million two hundred thousand dollars for the period
38 January first, two thousand one through December thirty-first, two thou-
39 sand one;
40 (iii) twenty-three million two hundred thousand dollars for the period
41 January first, two thousand two through December thirty-first, two thou-
42 sand two;
43 (iv) up to sixty-five million two hundred thousand dollars for the
44 period January first, two thousand three through December thirty-first,
45 two thousand three;
46 (v) up to sixty-five million two hundred thousand dollars for the
47 period January first, two thousand four through December thirty-first,
48 two thousand four; [and]
49 (vi) up to [thirty-two] sixty-five million [six] two hundred thousand
50 dollars for the period January first, two thousand five through [June
51 thirtieth] December thirty-first, two thousand five;
52 (vii) up to sixty-five million two hundred thousand dollars for the
53 period January first, two thousand six through December thirty-first,
54 two thousand six; and
S. 992 24 A. 1922
1 (viii) up to thirty-two million six hundred thousand dollars for the
2 period January first, two thousand seven through June thirtieth, two
3 thousand seven.
4 (m) Funds shall be deposited by the commissioner, within amounts
5 appropriated, and the state comptroller is hereby authorized and
6 directed to receive for deposit to the credit of the state special
7 revenue funds - other, HCRA transfer fund, medical assistance account,
8 or any successor fund or account, for purposes of funding the state
9 share of services and expenses related to home care workers insurance
10 pilot demonstration programs established pursuant to subdivision two of
11 section three hundred sixty-seven-o of the social services law from the
12 tobacco control and insurance initiatives pool established for the
13 following periods in the following amounts:
14 (i) three million eight hundred thousand dollars for the period Janu-
15 ary first, two thousand through December thirty-first, two thousand;
16 (ii) three million eight hundred thousand dollars for the period Janu-
17 ary first, two thousand one through December thirty-first, two thousand
18 one;
19 (iii) three million eight hundred thousand dollars for the period
20 January first, two thousand two through December thirty-first, two thou-
21 sand two;
22 (iv) up to three million eight hundred thousand dollars for the period
23 January first, two thousand three through December thirty-first, two
24 thousand three;
25 (v) up to three million eight hundred thousand dollars for the period
26 January first, two thousand four through December thirty-first, two
27 thousand four; [and]
28 (vi) up to [two] three million eight hundred thousand dollars for the
29 period January first, two thousand five through [June thirtieth] Decem-
30 ber thirty-first, two thousand five;
31 (vii) up to three million eight hundred thousand dollars for the peri-
32 od January first, two thousand six through December thirty-first, two
33 thousand six; and
34 (viii) up to two million dollars for the period January first, two
35 thousand seven through June thirtieth, two thousand seven.
36 (n) Funds shall be transferred by the commissioner and shall be depos-
37 ited to the credit of the special revenue funds - other, miscellaneous
38 special revenue fund - 339, elderly pharmaceutical insurance coverage
39 program premium account authorized pursuant to the provisions of title
40 three of article two of the elder law, or any successor fund or account,
41 for funding state expenses relating to the program from the tobacco
42 control and insurance initiatives pool established for the following
43 periods in the following amounts:
44 (i) one hundred seven million dollars for the period January first,
45 two thousand through December thirty-first, two thousand;
46 (ii) one hundred sixty-four million dollars for the period January
47 first, two thousand one through December thirty-first, two thousand one;
48 (iii) three hundred twenty-two million seven hundred thousand dollars
49 for the period January first, two thousand two through December thirty-
50 first, two thousand two;
51 (iv) four hundred thirty-three million three hundred thousand dollars
52 for the period January first, two thousand three through December thir-
53 ty-first, two thousand three;
54 (v) five hundred four million one hundred fifty thousand dollars for
55 the period January first, two thousand four through December thirty-
56 first, two thousand four; [and]
S. 992 25 A. 1922
1 (vi) [two] five hundred [ninety-eight] sixty-six million [one] eight
2 hundred [fifty] thousand dollars for the period January first, two thou-
3 sand five through [June thirtieth] December thirty-first, two thousand
4 five;
5 (vii) six hundred twenty million dollars for the period January first,
6 two thousand six through December thirty-first, two thousand six; and
7 (viii) three hundred thirty-six million dollars for the period January
8 first, two thousand seven through June thirtieth, two thousand seven.
9 (o) Funds shall be reserved and accumulated [by the commissioner]
10 contingent upon meeting all funding amounts established pursuant to
11 paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
12 and (s) of this subdivision, paragraph (a) of subdivision nine of
13 section twenty-eight hundred seven-j of this article, and paragraphs
14 (a), (i) and (k) of subdivision one of section twenty-eight hundred
15 seven-l of this article and shall be transferred to the Roswell Park
16 Cancer Institute Corporation, from the tobacco control and insurance
17 initiatives pool established for the following periods in the following
18 amounts:
19 (i) up to ninety million dollars for the period January first, two
20 thousand through December thirty-first, two thousand;
21 (ii) up to sixty million dollars for the period January first, two
22 thousand one through December thirty-first, two thousand one;
23 (iii) up to eighty-five million dollars for the period January first,
24 two thousand two through December thirty-first, two thousand two;
25 (iv) eighty-five million two hundred fifty thousand dollars for the
26 period January first, two thousand three through December thirty-first,
27 two thousand three;
28 (v) seventy-eight million dollars for the period January first, two
29 thousand four through December thirty-first, two thousand four; [and]
30 (vi) [thirty-nine] seventy-eight million dollars for the period Janu-
31 ary first, two thousand five through [June thirtieth] December thirty-
32 first, two thousand five;
33 (vii) seventy-eight million dollars for the period January first, two
34 thousand six through December thirty-first, two thousand six; and
35 (viii) thirty-nine million dollars for the period January first, two
36 thousand seven through June thirtieth, two thousand seven.
37 (p) 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, indigent care fund - 068, indigent care account,
41 or any successor fund or account, contingent upon meeting all funding
42 amounts established pursuant to paragraphs (a), (b), (c), (d), (e), (f),
43 (l), (m), (n), (q) and (r) of this subdivision and paragraph (a) of
44 subdivision one of section twenty-eight hundred seven-l of this article
45 for purposes of providing a medicaid disproportionate share payment from
46 the high need indigent care adjustment pool established pursuant to
47 section twenty-eight hundred seven-w of this article, from the tobacco
48 control and insurance initiatives pool established for the following
49 periods in the following amounts:
50 (i) eighty-two million dollars annually for the periods January first,
51 two thousand through December thirty-first, two thousand two;
52 (ii) up to eighty-two million dollars for the period January first,
53 two thousand three through December thirty-first, two thousand three;
54 (iii) up to eighty-two million dollars for the period January first,
55 two thousand four through December thirty-first, two thousand four;
56 [and]
S. 992 26 A. 1922
1 (iv) up to [forty-one] eighty-two million dollars for the period Janu-
2 ary first, two thousand five through [June thirtieth] December thirty-
3 first, two thousand five;
4 (v) up to eighty-two million dollars for the period January first, two
5 thousand six through December thirty-first, two thousand six; and
6 (vi) up to forty-one million dollars for the period January first, two
7 thousand seven through June thirtieth, two thousand seven.
8 (q) 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 purposes of providing distributions to eligible school based
11 health centers established pursuant to chapter one of the laws of nine-
12 teen hundred ninety-nine which enacted the New York Health Care Reform
13 Act of 2000, from the tobacco control and insurance initiatives pool
14 established for the following periods in the following amounts:
15 (i) seven million dollars annually for the period January first, two
16 thousand through December thirty-first, two thousand two;
17 (ii) up to seven million dollars for the period January first, two
18 thousand three through December thirty-first, two thousand three;
19 (iii) up to seven million dollars for the period January first, two
20 thousand four through December thirty-first, two thousand four; [and]
21 (iv) up to [three] seven million [five hundred thousand] dollars for
22 the period January first, two thousand five through [June thirtieth]
23 December thirty-first, two thousand five;
24 (v) up to seven million dollars for the period January first, two
25 thousand six through December thirty-first, two thousand six; and
26 (vi) up to three million five hundred thousand dollars for the period
27 January first, two thousand seven through June thirtieth, two thousand
28 seven.
29 (r) Funds shall be deposited by the commissioner within amounts appro-
30 priated, and the state comptroller is hereby authorized and directed to
31 receive for deposit to the credit of the state special revenue funds -
32 other, HCRA transfer fund, medical assistance account, or any successor
33 fund or account, for purposes of providing distributions for supplemen-
34 tary medical insurance for Medicare part B premiums, physicians
35 services, outpatient services, medical equipment, supplies and other
36 health services, from the tobacco control and insurance initiatives pool
37 established for the following periods in the following amounts:
38 (i) forty-three million dollars for the period January first, two
39 thousand through December thirty-first, two thousand;
40 (ii) sixty-one million dollars for the period January first, two thou-
41 sand one through December thirty-first, two thousand one;
42 (iii) sixty-five million dollars for the period January first, two
43 thousand two through December thirty-first, two thousand two;
44 (iv) sixty-seven million five hundred thousand dollars for the period
45 January first, two thousand three through December thirty-first, two
46 thousand three;
47 (v) sixty-eight million dollars for the period January first, two
48 thousand four through December thirty-first, two thousand four; [and]
49 (vi) [thirty-four] sixty-eight million dollars for the period January
50 first, two thousand five through [June thirtieth] December thirty-first,
51 two thousand five;
52 (vii) sixty-eight million dollars for the period January first, two
53 thousand six through December thirty-first, two thousand six; and
54 (viii) thirty-four million dollars for the period January first, two
55 thousand seven through June thirtieth, two thousand seven.
S. 992 27 A. 1922
1 (s) Funds shall be deposited by the commissioner within amounts appro-
2 priated, and the state comptroller is hereby authorized and directed to
3 receive for deposit to the credit of the state special revenue funds -
4 other, HCRA transfer fund, medical assistance account, or any successor
5 fund or account, contingent upon meeting all funding amounts established
6 pursuant to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (q),
7 and (r) of this subdivision, and paragraph (a) of subdivision one of
8 section twenty-eight hundred seven-l of this article, for purposes of
9 providing distributions pursuant to paragraphs (s-5) [and], (s-6) and
10 (s-7) of subdivision eleven of section twenty-eight hundred seven-c of
11 this article from the tobacco control and insurance initiatives pool
12 established for the following periods in the following amounts:
13 (i) eighteen million dollars for the period January first, two thou-
14 sand through December thirty-first, two thousand;
15 (ii) twenty-four million dollars annually for the periods January
16 first, two thousand one through December thirty-first, two thousand two;
17 (iii) up to twenty-four million dollars for the period January first,
18 two thousand three through December thirty-first, two thousand three;
19 (iv) up to twenty-four million dollars for the period January first,
20 two thousand four through December thirty-first, two thousand four;
21 [and]
22 (v) up to [six] twenty-four million dollars for the period January
23 first, two thousand five through [March] December thirty-first, two
24 thousand five;
25 (vi) up to twenty-four million dollars for the period January first,
26 two thousand six through December thirty-first, two thousand six; and
27 (vii) up to six million dollars for the period January first, two
28 thousand seven through March thirty-first, two thousand seven.
29 (t) Funds shall be reserved and accumulated from year to year by the
30 commissioner and shall be made available, including income from invested
31 funds:
32 (i) For the purpose of making grants to a state owned and operated
33 medical school which does not have a state owned and operated hospital
34 on site and available for teaching purposes. Notwithstanding sections
35 one hundred twelve and one hundred sixty-three of the state finance law,
36 such grants shall be made in the amount of up to five hundred thousand
37 dollars for the period January first, two thousand through December
38 thirty-first, two thousand;
39 (ii) For the purpose of making grants to medical schools pursuant to
40 section eighty-six-a of chapter one of the laws of nineteen hundred
41 ninety-nine in the sum of up to four million dollars for the period
42 January first, two thousand through December thirty-first, two thousand;
43 and
44 (iii) The funds disbursed pursuant to subparagraphs (i) and (ii) of
45 this paragraph from the tobacco control and insurance initiatives pool
46 are contingent upon meeting all funding amounts established pursuant to
47 paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
48 and (s) of this subdivision, paragraph (a) of subdivision nine of
49 section twenty-eight hundred seven-j of this article, and paragraphs
50 (a), (i) and (k) of subdivision one of section twenty-eight hundred
51 seven-l of this article.
52 (u) Funds shall be deposited by the commissioner, within amounts
53 appropriated, and the state comptroller is hereby authorized and
54 directed to receive for deposit to the credit of the state special
55 revenue funds - other, HCRA transfer fund, medical assistance account,
56 or any successor fund or account, for purposes of funding the state
S. 992 28 A. 1922
1 share of services and expenses related to the nursing home quality
2 improvement demonstration program established pursuant to section twen-
3 ty-eight hundred eight-d of this article from the tobacco control and
4 insurance initiatives pool established for the following periods in the
5 following amounts:
6 (i) up to twenty-five million dollars for the period beginning April
7 first, two thousand two and ending December thirty-first, two thousand
8 two, and on an annualized basis, for each annual period thereafter
9 beginning January first, two thousand three and ending December thirty-
10 first, two thousand four[, and up to twelve million five hundred thou-
11 sand dollars for the period January first, two thousand five through
12 June thirtieth, two thousand five.];
13 (ii) up to eighteen million seven hundred fifty thousand dollars for
14 the period January first, two thousand five through December thirty-
15 first, two thousand five;
16 (iii) up to twelve million five hundred thousand dollars for the peri-
17 od January first, two thousand six through December thirty-first, two
18 thousand six; and
19 (iv) up to six million two hundred fifty thousand dollars for the
20 period January first, two thousand seven through June thirtieth, two
21 thousand seven.
22 (v) Funds shall be transferred by the commissioner and shall be depos-
23 ited to the credit of the hospital excess liability pool created pursu-
24 ant to section eighteen of chapter two hundred sixty-six of the laws of
25 nineteen hundred eighty-six, or any successor account, for purposes of
26 expenses related to the purchase of excess medical malpractice insurance
27 and the cost of administrating the pool, including costs associated with
28 the risk management program established pursuant to section forty-two of
29 part A of chapter one of the laws of two thousand two required by para-
30 graph (a) of subdivision one of section eighteen of chapter two hundred
31 sixty-six of the laws of nineteen hundred eighty-six as may be amended
32 from time to time, from the tobacco control and insurance initiatives
33 pool established for the following periods in the following amounts:
34 (i) up to fifty million dollars or so much as is needed for the period
35 January first, two thousand two through December thirty-first, two thou-
36 sand two;
37 (ii) up to seventy-six million seven hundred thousand dollars for the
38 period January first, two thousand three through December thirty-first,
39 two thousand three;
40 (iii) up to sixty-five million dollars for the period January first,
41 two thousand four through December thirty-first, two thousand four;
42 [and]
43 (iv) up to [thirty-two] sixty-five million [five hundred thousand]
44 dollars for the period January first, two thousand five through [June
45 thirtieth] December thirty-first, two thousand five;
46 (v) up to sixty-five million dollars for the period January first, two
47 thousand six through December thirty-first, two thousand six; and
48 (vi) up to thirty-two million five hundred thousand dollars for the
49 period January first, two thousand seven through June thirtieth, two
50 thousand seven.
51 (w) Funds shall be deposited by the commissioner, within amounts
52 appropriated, and the state comptroller is hereby authorized and
53 directed to receive for deposit to the credit of the state special
54 revenue funds - other, HCRA transfer fund, medical assistance account,
55 or any successor fund or account, for purposes of funding the state
56 share of the treatment of breast and cervical cancer pursuant to para-
S. 992 29 A. 1922
1 graph (v) of subdivision four of section three hundred sixty-six of the
2 social services law, from the tobacco control and insurance initiatives
3 pool established for the following periods in the following amounts:
4 (i) up to four hundred fifty thousand dollars for the period January
5 first, two thousand two through December thirty-first, two thousand two;
6 (ii) up to two million one hundred thousand dollars for the period
7 January first, two thousand three through December thirty-first, two
8 thousand three;
9 (iii) up to two million one hundred thousand dollars for the period
10 January first, two thousand four through December thirty-first, two
11 thousand four; [and]
12 (iv) up to [one] two million one hundred thousand dollars for the
13 period January first, two thousand five through [June thirtieth] Decem-
14 ber thirty-first, two thousand five;
15 (v) up to two million one hundred thousand dollars for the period
16 January first, two thousand six through December thirty-first, two thou-
17 sand six; and
18 (vi) up to one million one hundred thousand dollars for the period
19 January first, two thousand seven through June thirtieth, two thousand
20 seven.
21 (x) Funds shall be deposited by the commissioner, within amounts
22 appropriated, and the state comptroller is hereby authorized and
23 directed to receive for deposit to the credit of the state special
24 revenue funds - other, HCRA transfer fund, medical assistance account,
25 or any successor fund or account, for purposes of funding the state
26 share of the non-public general hospital rates increases for recruitment
27 and retention of health care workers pursuant to paragraph (a) of subdi-
28 vision thirty and subdivision thirty-one of section twenty-eight hundred
29 seven-c of this article from the tobacco control and insurance initi-
30 atives pool established for the following periods in the following
31 amounts:
32 (i) twenty-seven million one hundred thousand dollars on an annualized
33 basis for the period January first, two thousand two through December
34 thirty-first, two thousand two;
35 (ii) fifty million eight hundred thousand dollars on an annualized
36 basis for the period January first, two thousand three through December
37 thirty-first, two thousand three;
38 (iii) sixty-nine million three hundred thousand dollars on an annual-
39 ized basis for the period January first, two thousand four through
40 December thirty-first, two thousand four; [and]
41 (iv) [thirty-four] sixty-nine million [six] three hundred [fifty]
42 thousand dollars for the period January first, two thousand five through
43 [June thirtieth] December thirty-first, two thousand five;
44 (v) sixty-nine million three hundred thousand dollars for the period
45 January first, two thousand six through December thirty-first, two thou-
46 sand six; and
47 (vi) thirty-four million six hundred fifty thousand dollars for the
48 period January first, two thousand seven through June thirtieth, two
49 thousand seven.
50 (y) Funds shall be reserved and accumulated from year to year [by the
51 commissioner] and shall be available, including income from invested
52 funds, for purposes of grants to public general hospitals for recruit-
53 ment and retention of health care workers pursuant to paragraph (b) of
54 subdivision thirty of section twenty-eight hundred seven-c of this arti-
55 cle from the tobacco control and insurance initiatives pool established
56 for the following periods in the following amounts:
S. 992 30 A. 1922
1 (i) eighteen million five hundred thousand dollars on an annualized
2 basis for the period January first, two thousand two through December
3 thirty-first, two thousand two;
4 (ii) thirty-seven million four hundred thousand dollars on an annual-
5 ized basis for the period January first, two thousand three through
6 December thirty-first, two thousand three;
7 (iii) fifty-two million two hundred thousand dollars on an annualized
8 basis for the period January first, two thousand four through December
9 thirty-first, two thousand four;
10 (iv) [twenty-six] fifty-two million [one] two hundred thousand dollars
11 for the period January first, two thousand five through [June thirtieth]
12 December thirty-first, two thousand five; [and]
13 (v) fifty-two million two hundred thousand dollars for the period
14 January first, two thousand six through December thirty-first, two thou-
15 sand six; and
16 (vi) twenty-six million one hundred thousand dollars for the period
17 January first, two thousand seven through June thirtieth, two thousand
18 seven;
19 [(v)] (vii) provided, however, amounts pursuant to this paragraph may
20 be reduced by the commissioner in an amount to be approved by the direc-
21 tor of the budget to reflect amounts received from the federal govern-
22 ment under the state's 1115 waiver which are directed under its terms
23 and conditions to the health workforce recruitment and retention
24 program.
25 (z) 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, medical assistance account,
29 or any successor fund or account, for purposes of funding the state
30 share of the non-public residential health care facility rate increases
31 for recruitment and retention of health care workers pursuant to para-
32 graph (a) of subdivision eighteen of section twenty-eight hundred eight
33 of this article from the tobacco control and insurance initiatives pool
34 established for the following periods in the following amounts:
35 (i) twenty-one million five hundred thousand dollars on an annualized
36 basis for the period January first, two thousand two through December
37 thirty-first, two thousand two;
38 (ii) thirty-three million three hundred thousand dollars on an annual-
39 ized basis for the period January first, two thousand three through
40 December thirty-first, two thousand three;
41 (iii) forty-six million three hundred thousand dollars on an annual-
42 ized basis for the period January first, two thousand four through
43 December thirty-first, two thousand four; [and]
44 (iv) [twenty-three] forty-six million [two] three hundred thousand
45 dollars for the period January first, two thousand five through [June
46 thirtieth] December thirty-first, two thousand five;
47 (v) forty-six million three hundred thousand dollars for the period
48 January first, two thousand six through December thirty-first, two thou-
49 sand six; and
50 (vi) twenty-three million two hundred thousand dollars for the period
51 January first, two thousand seven through June thirtieth, two thousand
52 seven.
53 (aa) Funds shall be reserved and accumulated from year to year [by the
54 commissioner] and shall be available, including income from invested
55 funds, for purposes of grants to public residential health care facili-
56 ties for recruitment and retention of health care workers pursuant to
S. 992 31 A. 1922
1 paragraph (b) of subdivision eighteen of section twenty-eight hundred
2 eight of this article from the tobacco control and insurance initiatives
3 pool established for the following periods in the following amounts:
4 (i) seven million five hundred thousand dollars on an annualized basis
5 for the period January first, two thousand two through December thirty-
6 first, two thousand two;
7 (ii) eleven million seven hundred thousand dollars on an annualized
8 basis for the period January first, two thousand three through December
9 thirty-first, two thousand three;
10 (iii) sixteen million two hundred thousand dollars on an annualized
11 basis for the period January first, two thousand four through December
12 thirty-first, two thousand four; [and]
13 (iv) [eight] sixteen million [one] two hundred thousand dollars for
14 the period January first, two thousand five through [June thirtieth]
15 December thirty-first, two thousand five;
16 (v) sixteen million two hundred thousand dollars for the period Janu-
17 ary first, two thousand six through December thirty-first, two thousand
18 six; and
19 (vi) eight million one hundred thousand dollars for the period January
20 first, two thousand seven through June thirtieth, two thousand seven.
21 (bb)(i) Funds shall be deposited by the commissioner, within amounts
22 appropriated, and subject to the availability of federal financial
23 participation, and the state comptroller is hereby authorized and
24 directed to receive for deposit to the credit of the state special
25 revenue funds - other, HCRA transfer fund, medical assistance account,
26 or any successor fund or account, for the purpose of supporting the
27 state share of adjustments to Medicaid rates of payment for personal
28 care services provided pursuant to paragraph (e) of subdivision two of
29 section three hundred sixty-five-a of the social services law, for local
30 social service districts which include a city with a population of over
31 one million persons and computed and distributed in accordance with
32 memorandums of understanding to be entered into between the state of New
33 York and such local social service districts for the purpose of support-
34 ing the recruitment and retention of personal care service workers or
35 any worker with direct patient care responsibility, from the tobacco
36 control and insurance initiatives pool established for the following
37 periods and the following amounts:
38 (A) forty-four million dollars, on an annualized basis, for the period
39 April first, two thousand two through December thirty-first, two thou-
40 sand two;
41 (B) seventy-four million dollars, on an annualized basis, for the
42 period January first, two thousand three through December thirty-first,
43 two thousand three;
44 (C) one hundred four million dollars, on an annualized basis, for the
45 period January first, two thousand four through December thirty-first,
46 two thousand four; [and]
47 (D) one hundred thirty-six million dollars, on an annualized basis,
48 for the period January first, two thousand five through December thir-
49 ty-first, two thousand five;
50 (E) one hundred thirty-six million dollars, on an annualized basis,
51 for the period January first, two thousand six through December thirty-
52 first, two thousand six; and
53 (F) sixty-eight million dollars for the period January first, two
54 thousand seven through June thirtieth, two thousand seven.
S. 992 32 A. 1922
1 (ii) Adjustments to Medicaid rates made pursuant to this paragraph
2 shall not, in aggregate, exceed the following amounts for the following
3 periods:
4 (A) for the period April first, two thousand two through December
5 thirty-first, two thousand two, one hundred ten million dollars;
6 (B) for the period January first, two thousand three through December
7 thirty-first, two thousand three, one hundred eighty-five million
8 dollars;
9 (C) for the period January first, two thousand four through December
10 thirty-first, two thousand four, two hundred sixty million dollars;
11 [and]
12 (D) for the period January first, two thousand five through December
13 thirty-first, two thousand five, three hundred forty million dollars;
14 (E) for the period January first, two thousand six through December
15 thirty-first, two thousand six, three hundred forty million dollars; and
16 (F) for the period January first, two thousand seven through June
17 thirtieth, two thousand seven, one hundred seventy million dollars.
18 (iii) Personal care service providers which have their rates adjusted
19 pursuant to this paragraph shall use such funds for the purpose of
20 recruitment and retention of non-supervisory personal care services
21 workers or any worker with direct patient care responsibility only and
22 are prohibited from using such funds for any other purpose. Each such
23 personal care services provider shall submit, at a time and in a manner
24 to be determined by the commissioner, a written certification attesting
25 that such funds will be used solely for the purpose of recruitment and
26 retention of non-supervisory personal care services workers or any work-
27 er with direct patient care responsibility. The commissioner is author-
28 ized to audit each such provider to ensure compliance with the written
29 certification required by this subdivision and shall recoup any funds
30 determined to have been used for purposes other than recruitment and
31 retention of non-supervisory personal care services workers or any work-
32 er with direct patient care responsibility. Such recoupment shall be in
33 addition to any other penalties provided by law.
34 (cc) Funds shall be deposited by the commissioner, within amounts
35 appropriated, and the state comptroller is hereby authorized and
36 directed to receive for deposit to the credit of the state special
37 revenue funds - other, HCRA transfer fund, medical assistance account,
38 or any successor fund or account, for the purpose of supporting the
39 state share of adjustments to Medicaid rates of payment for personal
40 care services provided pursuant to paragraph (e) of subdivision two of
41 section three hundred sixty-five-a of the social services law, for local
42 social service districts which shall not include a city with a popu-
43 lation of over one million persons for the purpose of supporting the
44 personal care services worker recruitment and retention program as
45 established pursuant to section three hundred sixty-seven-q of the
46 social services law, from the tobacco control and insurance initiatives
47 pool established for the following periods and the following amounts:
48 (i) two million eight hundred thousand dollars for the period April
49 first, two thousand two through December thirty-first, two thousand two;
50 (ii) five million six hundred thousand dollars, on an annualized
51 basis, for the period January first, two thousand three through December
52 thirty-first, two thousand three;
53 (iii) eight million four hundred thousand dollars, on an annualized
54 basis, for the period January first, two thousand four through December
55 thirty-first, two thousand four; [and]
S. 992 33 A. 1922
1 (iv) ten million eight hundred thousand dollars, on an annualized
2 basis, for the period January first, two thousand five through December
3 thirty-first, two thousand five;
4 (v) ten million eight hundred thousand dollars, on an annualized
5 basis, for the period January first, two thousand six through December
6 thirty-first, two thousand six; and
7 (vi) five million four hundred thousand dollars for the period January
8 first, two thousand seven through June thirtieth, two thousand seven.
9 (dd) 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, medical assistance account, or
13 any successor fund or account, for purposes of funding the state share
14 of Medicaid expenditures for physician services from the tobacco control
15 and insurance initiatives pool established for the following periods in
16 the following amounts:
17 (i) up to fifty-two million dollars for the period January first, two
18 thousand two through December thirty-first, two thousand two;
19 (ii) eighty-one million two hundred thousand dollars for the period
20 January first, two thousand three through December thirty-first, two
21 thousand three;
22 (iii) eighty-five million two hundred thousand dollars for the period
23 January first, two thousand four through December thirty-first, two
24 thousand four; [and]
25 (iv) [forty-two] eighty-five million [six] two hundred thousand
26 dollars for the period January first, two thousand five through [June
27 thirtieth] December thirty-first, two thousand five;
28 (v) eighty-five million two hundred thousand dollars for the period
29 January first, two thousand six through December thirty-first, two thou-
30 sand six; and
31 (vi) forty-two million six hundred thousand dollars for the period
32 January first, two thousand seven through June thirtieth, two thousand
33 seven.
34 (ee) Funds shall be deposited by the commissioner, within amounts
35 appropriated, and the state comptroller is hereby authorized and
36 directed to receive for deposit to the credit of the state special
37 revenue fund - other, HCRA transfer fund, medical assistance account, or
38 any successor fund or account, for purposes of funding the state share
39 of the free-standing diagnostic and treatment center rate increases for
40 recruitment and retention of health care workers pursuant to subdivision
41 seventeen of section twenty-eight hundred seven of this chapter from the
42 tobacco control and insurance initiatives pool established for the
43 following periods in the following amounts:
44 (i) three million two hundred fifty thousand dollars for the period
45 April first, two thousand two through December thirty-first, two thou-
46 sand two;
47 (ii) three million two hundred fifty thousand dollars on an annualized
48 basis for the period January first, two thousand three through December
49 thirty-first, two thousand three;
50 (iii) three million two hundred fifty thousand dollars on an annual-
51 ized basis for the period January first, two thousand four through
52 December thirty-first, two thousand four; [and]
53 (iv) [one] three million [six] two hundred [twenty-five] fifty thou-
54 sand dollars for the period January first, two thousand five through
55 [June thirtieth] December thirty-first, two thousand five;
S. 992 34 A. 1922
1 (v) three million two hundred fifty thousand dollars for the period
2 January first, two thousand six through December thirty-first, two thou-
3 sand six; and
4 (vi) one million six hundred twenty-five thousand dollars for the
5 period January first, two thousand seven through June thirtieth, two
6 thousand seven.
7 (ff) 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 fund - other, HCRA transfer fund, medical assistance account, or
11 any successor fund or account, for purposes of funding the state share
12 of Medicaid expenditures for disabled persons as authorized pursuant to
13 subparagraphs twelve and thirteen of paragraph (a) of subdivision one of
14 section three hundred sixty-six of the social services law from the
15 tobacco control and insurance initiatives pool established for the
16 following periods in the following amounts:
17 (i) one million eight hundred thousand dollars for the period April
18 first, two thousand two through December thirty-first, two thousand two;
19 (ii) sixteen million four hundred thousand dollars on an annualized
20 basis for the period January first, two thousand three through December
21 thirty-first, two thousand three;
22 (iii) eighteen million seven hundred thousand dollars on an annualized
23 basis for the period January first, two thousand four through December
24 thirty-first, two thousand four; [and]
25 (iv) [fifteen] thirty million [three] six hundred thousand dollars for
26 the period January first, two thousand five through [June thirtieth]
27 December thirty-first, two thousand five;
28 (v) thirty million six hundred thousand dollars for the period January
29 first, two thousand six through December thirty-first, two thousand six;
30 and
31 (vi) fifteen million three hundred thousand dollars for the period
32 January first, two thousand seven through June thirtieth, two thousand
33 seven.
34 (gg) Funds shall be reserved and accumulated from year to year [by the
35 commissioner] and shall be available, including income from invested
36 funds, for purposes of grants to non-public general hospitals pursuant
37 to paragraph (c) of subdivision thirty of section twenty-eight hundred
38 seven-c of this article from the tobacco control and insurance initi-
39 atives pool established for the following periods in the following
40 amounts:
41 (i) up to one million three hundred thousand dollars on an annualized
42 basis for the period January first, two thousand two through December
43 thirty-first, two thousand two;
44 (ii) up to three million two hundred thousand dollars on an annualized
45 basis for the period January first, two thousand three through December
46 thirty-first, two thousand three;
47 (iii) up to five million six hundred thousand dollars on an annualized
48 basis for the period January first, two thousand four through December
49 thirty-first, two thousand four; [and]
50 (iv) up to [two] five million [eight] six hundred thousand dollars for
51 the period January first, two thousand five through [June thirtieth]
52 December thirty-first, two thousand five;
53 (v) up to five million six hundred thousand dollars for the period
54 January first, two thousand six through December thirty-first, two thou-
55 sand six; and
S. 992 35 A. 1922
1 (vi) up to two million eight hundred thousand dollars for the period
2 January first, two thousand seven through June thirtieth, two thousand
3 seven.
4 (hh) Funds shall be reserved and accumulated from year to year [by the
5 commissioner] and shall be available, including income from invested
6 funds, for purposes of providing financial assistance to residential
7 health care facilities pursuant to subdivisions nineteen and twenty-one
8 of section twenty-eight hundred eight of this article, from the tobacco
9 control and insurance initiatives pool established for the following
10 periods in the following amounts:
11 (i) for the period April first, two thousand two through December
12 thirty-first, two thousand two, ten million dollars;
13 (ii) for the period January first, two thousand three through December
14 thirty-first, two thousand three, nine million four hundred fifty thou-
15 sand dollars;
16 (iii) for the period January first, two thousand four through December
17 thirty-first, two thousand four, nine million three hundred fifty thou-
18 sand dollars; [and]
19 (iv) up to [five] fifteen million [seventy-five thousand] dollars for
20 the period January first, two thousand five through [June thirtieth]
21 December thirty-first, two thousand five;
22 (v) up to fifteen million dollars for the period January first, two
23 thousand six through December thirty-first, two thousand six; and
24 (vi) up to seven million five hundred thousand dollars for the period
25 January first, two thousand seven through June thirtieth, two thousand
26 seven.
27 (ii) Funds shall be deposited by the commissioner, within amounts
28 appropriated, and the state comptroller is hereby authorized and
29 directed to receive for deposit to the credit of the state special
30 revenue funds - other, HCRA transfer fund, medical assistance account,
31 or any successor fund or account, for the purpose of supporting the
32 state share of Medicaid expenditures for disabled persons as authorized
33 by sections 1619 (a) and (b) of the federal social security act pursuant
34 to the tobacco control and insurance initiatives pool established for
35 the following periods in the following amounts:
36 (i) six million four hundred thousand dollars for the period April
37 first, two thousand two through December thirty-first, two thousand two;
38 (ii) eight million five hundred thousand dollars, for the period Janu-
39 ary first, two thousand three through December thirty-first, two thou-
40 sand three;
41 (iii) eight million five hundred thousand dollars for the period Janu-
42 ary first, two thousand four through December thirty-first, two thousand
43 four; [and]
44 (iv) [four] eight million [three] five hundred thousand dollars for
45 the period January first, two thousand five through [June thirtieth]
46 December thirty-first, two thousand five;
47 (v) eight million five hundred thousand dollars for the period January
48 first, two thousand six through December thirty-first, two thousand six;
49 and
50 (vi) four million three hundred thousand dollars for the period Janu-
51 ary first, two thousand seven through June thirtieth, two thousand
52 seven.
53 (jj) Funds shall be reserved and accumulated from year to year [by the
54 commissioner] and shall be available, including income from invested
55 funds, for the purposes of a grant program to improve access to infer-
56 tility services, treatments and procedures, from the tobacco control and
S. 992 36 A. 1922
1 insurance initiatives pool established for the period January first, two
2 thousand two through December thirty-first, two thousand two in the
3 amount of nine million one hundred seventy-five thousand dollars.
4 (kk) Funds shall be deposited by the commissioner, within amounts
5 appropriated, and the state comptroller is hereby authorized and
6 directed to receive for deposit to the credit of the state special
7 revenue funds -- other, HCRA transfer fund, medical assistance account,
8 or any successor fund or account, for purposes of funding the state
9 share of Medicaid expenditures for pharmacy services from the tobacco
10 control and insurance initiatives pool established for the following
11 periods in the following amounts:
12 (i) thirty-eight million eight hundred thousand dollars for the period
13 January first, two thousand two through December thirty-first, two thou-
14 sand two;
15 (ii) up to two hundred ninety-five million dollars for the period
16 January first, two thousand three through December thirty-first, two
17 thousand three;
18 (iii) up to four hundred seventy-two million dollars for the period
19 January first, two thousand four through December thirty-first, two
20 thousand four; [and]
21 (iv) up to [two] seven hundred [fifty-five] million dollars for the
22 period January first, two thousand five through [June thirtieth] Decem-
23 ber thirty-first, two thousand five;
24 (v) up to five hundred seventy million dollars for the period January
25 first, two thousand six through December thirty-first, two thousand six;
26 and
27 (vi) up to one hundred thirty million dollars for the period January
28 first, two thousand seven through June thirtieth, two thousand seven.
29 (ll) 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 or any successor fund or account, for purposes of funding the state
34 share of Medicaid expenditures related to the city of New York from the
35 tobacco control and insurance initiatives pool established for the
36 following periods in the following amounts:
37 (i) eighty-two million seven hundred thousand dollars for the period
38 January first, two thousand two through December thirty-first, two thou-
39 sand two;
40 (ii) one hundred twenty-four million six hundred thousand dollars for
41 the period January first, two thousand three through December thirty-
42 first, two thousand three;
43 (iii) one hundred twenty-four million seven hundred thousand dollars
44 for the period January first, two thousand four through December thir-
45 ty-first, two thousand four; [and]
46 (iv) [sixty-two] one hundred twenty-four million [four] seven hundred
47 thousand dollars for the period January first, two thousand five through
48 [June thirtieth] December thirty-first, two thousand five;
49 (v) one hundred twenty-four million seven hundred thousand dollars for
50 the period January first, two thousand six through December thirty-
51 first, two thousand six; and
52 (vi) sixty-two million four hundred thousand dollars for the period
53 January first, two thousand seven through June thirtieth, two thousand
54 seven.
55 (mm) Funds shall be deposited by the commissioner, within amounts
56 appropriated, and the state comptroller is hereby authorized and
S. 992 37 A. 1922
1 directed to receive for deposit to the credit of the state special
2 revenue funds - other, HCRA transfer fund, medical assistance account,
3 or any successor fund or account, for purposes of funding specified
4 percentages of the state share of services and expenses related to the
5 family health plus program in accordance with the following schedule:
6 (i) for the period [beginning] January first, two thousand three [and
7 ending] through December thirty-first, two thousand four, one hundred
8 percent of the state share;
9 (ii) for the period [beginning] January first, two thousand five [and
10 ending] through December thirty-first, two thousand five, seventy-five
11 percent of the state share; and,
12 (iii) for [the period] periods beginning on and after January first,
13 two thousand six [and ending December thirty-first, two thousand six,
14 and thereafter], fifty percent of the state share. Funding for the
15 family health plus program will include up to five million dollars annu-
16 ally for the period January first, two thousand three through December
17 thirty-first, two thousand [four] six, and up to two million five
18 hundred thousand dollars for the period January first, two thousand
19 [five] seven through June thirtieth, two thousand [five] seven for
20 administration and marketing costs associated with such program estab-
21 lished pursuant to clauses (A) and (B) of subparagraph (v) of paragraph
22 (a) of subdivision two of section three hundred sixty-nine-ee of the
23 social services law from the tobacco control and insurance initiatives
24 pool established for the following periods in the following amount:
25 (i) one hundred ninety million six hundred thousand dollars for the
26 period January first, two thousand three through December thirty-first,
27 two thousand three;
28 (ii) three hundred forty-eight million one hundred thirty thousand
29 dollars for the period January first, two thousand four through December
30 thirty-first, two thousand four; [and]
31 (iii) [one] three hundred [eighty-one] sixty-seven million [one]
32 hundred thousand dollars for the period January first, two thousand five
33 through [June thirtieth] December thirty-first, two thousand five;
34 (iv) three hundred three million dollars for the period January first,
35 two thousand six through December thirty-first, two thousand six; and
36 (v) one hundred fifty-seven million dollars for the period January
37 first, two thousand seven through June thirtieth, two thousand seven.
38 (nn) Funds shall be deposited by the commissioner, within amounts
39 appropriated, and the state comptroller is hereby authorized and
40 directed to receive for deposit to the credit of the state special
41 revenue fund - other, HCRA transfer fund, health care services account,
42 or any successor fund or account, for purposes related to adult home
43 initiatives for medicaid eligible residents of residential facilities
44 licensed pursuant to section four hundred sixty-b of the social services
45 law from the tobacco control and insurance initiatives pool established
46 for the following periods in the following amounts:
47 (i) up to four million dollars for the period January first, two thou-
48 sand three through December thirty-first, two thousand three;
49 (ii) up to six million dollars for the period January first, two thou-
50 sand four through December thirty-first, two thousand four; [and]
51 (iii) up to [four] eight million dollars for the period January first,
52 two thousand five through [June thirtieth] December thirty-first, two
53 thousand five, provided, however, that up to five million two hundred
54 fifty thousand dollars of such funds shall be received by the comp-
55 troller and deposited to the credit of the special revenue fund -
56 other / aid to localities, HCRA transfer fund - 061, enhanced community
S. 992 38 A. 1922
1 services account - 05, or any successor fund or account, for the
2 purposes set forth in this paragraph;
3 (iv) up to eight million dollars for the period January first, two
4 thousand six through December thirty-first, two thousand six, provided,
5 however, that up to five million two hundred fifty thousand dollars of
6 such funds shall be received by the comptroller and deposited to the
7 credit of the special revenue fund - other / aid to localities, HCRA
8 transfer fund - 061, enhanced community services account - 05, or any
9 successor fund or account, for the purposes set forth in this paragraph;
10 and
11 (v) up to four million dollars for the period January first, two thou-
12 sand seven through June thirtieth, two thousand seven, provided, howev-
13 er, that up to five million two hundred fifty thousand dollars of such
14 funds shall be received by the comptroller and deposited to the credit
15 of the special revenue fund - other / aid to localities, HCRA transfer
16 fund - 061, enhanced community services account - 05, or any successor
17 fund or account, for the purposes set forth in this paragraph.
18 (oo) Funds shall be reserved and accumulated from year to year [by the
19 commissioner] and shall be available, including income from invested
20 funds, for purposes of grants to non-public general hospitals pursuant
21 to paragraph (e) of subdivision twenty-five of section twenty-eight
22 hundred seven-c of this article from the tobacco control and insurance
23 initiatives pool established for the following periods in the following
24 amounts:
25 (i) up to five million dollars on an annualized basis for the period
26 January first, two thousand four through December thirty-first, two
27 thousand four; [and]
28 (ii) up to [two] five million [five hundred thousand] dollars for the
29 period January first, two thousand five through [June thirtieth] Decem-
30 ber thirty-first, two thousand five;
31 (iii) up to five million dollars for the period January first, two
32 thousand six through December thirty-first, two thousand six; and
33 (iv) up to two million five hundred thousand dollars for the period
34 January first, two thousand seven through June thirtieth, two thousand
35 seven.
36 (pp) 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 the purpose of supporting the provision of tax credits for
39 long term care insurance pursuant to subdivision one of section one
40 hundred ninety of the tax law, paragraph (a) of subdivision
41 twenty-five-a of section two hundred ten of such law, subsection (aa) of
42 section six hundred six of such law, paragraph one of subsection (k) of
43 section fourteen hundred fifty-six of such law and paragraph one of
44 subdivision (m) of section fifteen hundred eleven of such law, in the
45 following amounts:
46 (i) ten million dollars for the period January first, two thousand
47 four through December thirty-first, two thousand four; [and]
48 (ii) [five] ten million dollars for the period January first, two
49 thousand five through [June thirtieth] December thirty-first, two thou-
50 sand five;
51 (iii) ten million dollars for the period January first, two thousand
52 six through December thirty-first, two thousand six; and
53 (iv) five million dollars for the period January first, two thousand
54 seven through June thirtieth, two thousand seven.
55 (qq) Funds shall be reserved and accumulated from year to year [by the
56 commissioner] and shall be available, including income from invested
S. 992 39 A. 1922
1 funds, for the purpose of supporting the long-term care insurance educa-
2 tion and outreach program established pursuant to section [five hundred
3 forty-four] two hundred seventeen-a of the [executive] elder law for the
4 following periods in the following amounts:
5 (i) up to five million dollars for the period January first, two thou-
6 sand four through December thirty-first, two thousand four; of such
7 funds one million nine hundred fifty thousand dollars shall be made
8 available to the department for the purpose of developing, implementing
9 and administering the long-term care insurance education and outreach
10 program and three million fifty thousand dollars shall be made available
11 to the office for the aging for the purpose of providing the long term
12 care insurance resource centers with the necessary resources to carry
13 out their operations.
14 (ii) up to [two] five million [five hundred thousand] dollars for the
15 period January first, two thousand five through [June thirtieth] Decem-
16 ber thirty-first, two thousand five; of such funds [nine hundred seven-
17 ty-five] one million nine hundred fifty thousand dollars shall be made
18 available to the department for the purpose of developing, implementing
19 and administering the long-term care insurance education and outreach
20 program and [one] three million [five hundred twenty-five] fifty thou-
21 sand dollars shall be made available to the office for the aging for the
22 purpose of providing the long term care insurance resource centers with
23 the necessary resources to carry out their operations.
24 (iii) up to five million dollars for the period January first, two
25 thousand six through December thirty-first, two thousand six; of such
26 funds one million nine hundred fifty thousand dollars shall be made
27 available to the department for the purpose of developing, implementing
28 and administering the long-term care insurance education and outreach
29 program and three million fifty thousand dollars shall be made available
30 to the office for the aging for the purpose of providing the long term
31 care insurance resource centers with the necessary resources to carry
32 out their operations.
33 (iv) up to two million five hundred thousand dollars for the period
34 January first, two thousand seven through June thirtieth, two thousand
35 seven; of such funds nine hundred seventy-five thousand dollars shall be
36 made available to the department for the purpose of developing, imple-
37 menting and administering the long-term care insurance education and
38 outreach program and one million five hundred twenty-five thousand
39 dollars shall be made available to the office for the aging for the
40 purpose of providing the long term care insurance resource centers with
41 the necessary resources to carry out their operations.
42 (rr) Funds shall be reserved and accumulated from the tobacco control
43 and insurance initiatives pool and shall be available, including income
44 from invested funds, for the purpose of supporting expenses related to
45 implementation of the provisions of title III of article twenty-nine-D
46 of this chapter, for the following periods and in the following amounts:
47 (i) up to ten million dollars for the period January first, two thou-
48 sand six through December thirty-first, two thousand six; and
49 (ii) up to five million dollars for the period January first, two
50 thousand seven through June thirtieth, two thousand seven.
51 (ss) Funds shall be reserved and accumulated [by the commissioner]
52 from the tobacco control and insurance initiatives pool and used for a
53 health care stabilization program established by the commissioner for
54 the purposes of stabilizing critical health care providers and health
55 care programs whose ability to continue to [proivde] provide appropriate
56 services are threatened by financial or other challenges, in the amount
S. 992 40 A. 1922
1 of up to [twenty-eight] fourteen million dollars for the period July
2 first, two thousand four through [June thirtieth] December thirty-first,
3 two thousand [five] four, and up to twenty-eight million dollars for
4 each annual period thereafter through December thirty-first, two thou-
5 sand six and up to fourteen million dollars for the period January
6 first, two thousand seven through June thirtieth, two thousand seven.
7 Notwithstanding the provisions of section one hundred twelve of the
8 state finance law or any other inconsistent provision of the state
9 finance law or any other law, funds available for distribution pursuant
10 to this paragraph may be allocated and distributed by the commissioner
11 without a competitive bid or request for proposal process. Consider-
12 ations relied upon by the commissioner in determining the allocation and
13 distribution of these funds shall include, but not be limited to, the
14 following: (i) the importance of the provider or program in meeting
15 critical health care needs in the community in which it operates; (ii)
16 the provider or program provision of care to under-served populations;
17 (iii) the quality of the care or services the provider or program deliv-
18 ers; (iv) the ability of the provider or program to continue to deliver
19 an appropriate level of care or services if additional funding is made
20 available; (v) the ability of the provider or program to access, in a
21 timely manner, alternative sources of funding, including other sources
22 of government funding; (vi) the ability of other providers or programs
23 in the community to meet the community health care needs; (vii) whether
24 the provider or program has an appropriate plan to improve its financial
25 condition; and (viii) whether additional funding would permit the
26 provider or program to consolidate, relocate, or close programs or
27 services where such actions would result in greater stability and effi-
28 ciency in the delivery of needed health care services or programs.
29 (tt) 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 providing grants for two long term care demon-
32 stration projects designed to test new models for the delivery of long
33 term care services established pursuant to section twenty-eight hundred
34 seven-x of this chapter, for the following periods and in the following
35 amounts:
36 (i) up to five hundred thousand dollars for the period January first,
37 two thousand four through December thirty-first, two thousand four;
38 [and]
39 (ii) up to [two] five hundred [fifty] thousand dollars for the period
40 January first, two thousand five through [June thirtieth] December thir-
41 ty-first, two thousand five;
42 (iii) up to five hundred thousand dollars for the period January
43 first, two thousand six through December thirty-first, two thousand six;
44 and
45 (iv) up to two hundred fifty thousand dollars for the period January
46 first, two thousand seven through June thirtieth, two thousand seven.
47 (uu) Funds shall be reserved and accumulated and shall be available,
48 including income from invested funds, for the purpose of supporting
49 studies or investigations relating to health care financing undertaken
50 by the commissioner, including grants or contracts which the commission-
51 er may, notwithstanding section one hundred twelve of the state finance
52 law or any other contrary provision of law, enter into, with the
53 approval of the director of the budget, without a competitive bid or
54 request for proposal process, from the tobacco control and insurance
55 initiatives pool established for the following periods in the following
56 amounts:
S. 992 41 A. 1922
1 (i) up to seven hundred fifty thousand dollars for the period January
2 first, two thousand five through December thirty-first, two thousand
3 five;
4 (ii) up to six hundred twenty-five thousand dollars for the period
5 January first, two thousand six through December thirty-first, two thou-
6 sand six; and
7 (iii) up to one hundred twenty-five thousand dollars for the period
8 January first, two thousand seven through June thirtieth, two thousand
9 seven.
10 (vv) Funds shall be reserved and accumulated from year to year [by the
11 commissioner] and shall be available, including income from invested
12 funds, for the purpose of supporting disease management and telemedicine
13 demonstration programs authorized pursuant to sections twenty-one
14 hundred eleven and thirty-six hundred twenty-one of this chapter,
15 respectively, for the following periods in the following amounts:
16 (i) five million dollars for the period January first, two thousand
17 four through December thirty-first, two thousand four, of which three
18 million dollars shall be available for disease management demonstration
19 programs and two million dollars shall be available for telemedicine
20 demonstration programs;
21 (ii) [two] five million [five hundred thousand] dollars for the period
22 January first, two thousand five through [June thirtieth] December thir-
23 ty-first, two thousand five, of which [one] three million [five hundred
24 thousand] dollars shall be available for disease management demon-
25 stration programs and [one] two million dollars shall be available for
26 telemedicine demonstration programs;
27 (iii) nine million five hundred thousand dollars for the period Janu-
28 ary first, two thousand six through December thirty-first, two thousand
29 six, of which seven million five hundred thousand dollars shall be
30 available for disease management demonstration programs and two million
31 dollars shall be available for telemedicine demonstration programs; and
32 (iv) four million seven hundred fifty thousand dollars for the period
33 January first, two thousand seven through June thirtieth, two thousand
34 seven, of which three million seven hundred fifty thousand dollars shall
35 be available for disease management demonstration programs and one
36 million dollars shall be available for telemedicine demonstration
37 programs.
38 (ww) Funds shall be reserved and accumulated from the tobacco control
39 and insurance initiatives pool and shall be available, including income
40 from invested funds, for the purpose of providing grants to facilities
41 licensed under this article for the purpose of the purchase and opera-
42 tion of mobile dental clinic units, pursuant to this chapter, for the
43 following periods in the following amounts:
44 (i) up to seven hundred fifty thousand dollars for the period January
45 first, two thousand five through December thirty-first, two thousand
46 five;
47 (ii) up to six hundred twenty-five thousand dollars for the period
48 January first, two thousand six through December thirty-first, two thou-
49 sand six; and
50 (iii) up to one hundred twenty-five thousand dollars for the period
51 January first, two thousand seven through June thirtieth, two thousand
52 seven.
53 2. (a) [The] For periods prior to January first, two thousand five,
54 the commissioner is authorized to contract with the article forty-three
55 insurance law plans, or such other contractors as the commissioner shall
56 designate, to receive and distribute funds from the tobacco control and
S. 992 42 A. 1922
1 insurance initiatives pool established pursuant to this section. In the
2 event contracts with the article forty-three insurance law plans or
3 other commissioner's designees are effectuated, the commissioner shall
4 conduct annual audits of the receipt and distribution of such funds. The
5 reasonable costs and expenses of an administrator as approved by the
6 commissioner, not to exceed for personnel services on an annual basis
7 five hundred thousand dollars, for collection and distribution of funds
8 pursuant to this section shall be paid from such funds.
9 (b) Notwithstanding any inconsistent provision of section one hundred
10 twelve or one hundred sixty-three of the state finance law or any other
11 law, at the discretion of the commissioner without a competitive bid or
12 request for proposal process, contracts in effect for administration of
13 pools established pursuant to sections twenty-eight hundred seven-k,
14 twenty-eight hundred seven-l and twenty-eight hundred seven-m of this
15 article for the period January first, nineteen hundred ninety-nine
16 through December thirty-first, nineteen hundred ninety-nine may be
17 extended to provide for administration pursuant to this section and may
18 be amended as may be necessary.
19 3. Revenue from distributions pursuant to this section shall not be
20 included in gross revenue received for purposes of the assessments
21 pursuant to subdivision eighteen of section twenty-eight hundred seven-c
22 of this article, subject to the provisions of paragraph (e) of subdivi-
23 sion eighteen of section twenty-eight hundred seven-c of this article,
24 and shall not be included in gross revenue received for purposes of the
25 assessments pursuant to section twenty-eight hundred seven-d of this
26 article, subject to the provisions of subdivision twelve of section
27 twenty-eight hundred seven-d of this article.
28 4. In the event residual funds are available in the tobacco control
29 and insurance initiatives pool established for the periods January
30 first, two thousand through June thirtieth, two thousand [five] seven,
31 after allocations have been made pursuant to this section for the peri-
32 ods January first, two thousand through June thirtieth, two thousand
33 [five] seven, any amount of such funds may be transferred to the health
34 care initiatives pool established pursuant to section twenty-eight
35 hundred seven-l of this article for the periods January first, two thou-
36 sand through June thirtieth, two thousand [five] seven, to be allocated
37 and distributed proportionally among affected programs by the commis-
38 sioner to cover any shortfall in programs and purposes set forth in
39 subdivision one of section twenty-eight hundred seven-l of this article.
40 § 4. Subdivision 5 of section 367-o of the social services law, as
41 amended by section 30 of part H of chapter 686 of the laws of 2003, is
42 amended to read as follows:
43 5. Between January first, two thousand and December thirty-first, two
44 thousand two, the state share amount for all demonstrations pursuant to
45 this section shall be no more than twenty-seven million dollars per
46 twelve month period if averaged over the term of the demonstration; and
47 between January first, two thousand three and June thirtieth, two thou-
48 sand [five] seven, the state share amount for all demonstrations pursu-
49 ant to this section shall be no more than sixty-nine million dollars per
50 twelve month period if averaged over the term of the demonstration.
51 § 5. Subdivision 4 of section 2808-d of the public health law, as
52 amended by section 13 of part H of chapter 686 of the laws of 2003, is
53 amended to read as follows:
54 4. Grants and adjustments to Medicaid rates of payment made pursuant
55 to this section shall not, in aggregate, exceed sixty-two million five
56 hundred thousand dollars for the period beginning April first, two thou-
S. 992 43 A. 1922
1 sand two and ending December thirty-first, two thousand two, and, on an
2 annualized basis, for each annual period thereafter beginning January
3 first, two thousand three and ending December thirty-first, two thousand
4 four, and shall not, in aggregate, exceed [thirty-one] forty-six million
5 [two] eight hundred [fifty] seventy-five thousand dollars for the period
6 January first, two thousand five through [June thirtieth] December thir-
7 ty-first, two thousand five and shall not, in aggregate, on an annual-
8 ized basis, exceed thirty-one million two hundred fifty thousand dollars
9 for the period January first, two thousand six through June thirtieth,
10 two thousand seven.
11 § 6. Clause (A) of subparagraph (i) of paragraph (a) of subdivision 30
12 of section 2807-c of the public health law, as amended by section 8 of
13 part H of chapter 686 of the laws of 2003, is amended to read as
14 follows:
15 (A) ninety-three million two hundred thousand dollars on an annualized
16 basis for the period April first, two thousand two through December
17 thirty-first, two thousand two; one hundred eighty-seven million eight
18 hundred thousand dollars on an annualized basis for the period January
19 first, two thousand three through December thirty-first, two thousand
20 three; two hundred sixty-two million one hundred thousand dollars on an
21 annualized basis for the period January first, two thousand four through
22 December thirty-first, two thousand [four] six; and one hundred thirty-
23 one million one hundred thousand dollars for the period January first,
24 two thousand [five] seven through June thirtieth, two thousand [five]
25 seven.
26 § 7. Paragraph (f) of subdivision 31 of section 2807-c of the public
27 health law, as amended by section 10 of part H of chapter 686 of the
28 laws of 2003, is amended to read as follows:
29 (f) Adjustments to Medicaid rates of payment made pursuant to this
30 section shall not, in aggregate, exceed fifteen million dollars for the
31 period beginning April first, two thousand two and ending December thir-
32 ty-first, two thousand two and, on an annualized basis, for each annual
33 period thereafter beginning January first, two thousand three and ending
34 December thirty-first, two thousand [four] six, and shall not, in aggre-
35 gate, exceed seven million five hundred thousand dollars for the period
36 January first, two thousand [five] seven through June thirtieth, two
37 thousand [five] seven.
38 § 8. Clause (A) of subparagraph (i) of paragraph (b) of subdivision 30
39 of section 2807-c of the public health law, as amended by section 9 of
40 part H of chapter 686 of the laws of 2003, is amended to read as
41 follows:
42 (A) eighteen million five hundred thousand dollars on an annualized
43 basis for the period April first, two thousand two through December
44 thirty-first, two thousand two; thirty-seven million four hundred thou-
45 sand dollars on an annualized basis for the period January first, two
46 thousand three through December thirty-first, two thousand three;
47 fifty-two million two hundred thousand dollars on an annualized basis
48 for the period January first, two thousand four through December thir-
49 ty-first, two thousand [four] six; and twenty-six million one hundred
50 thousand dollars for the period January first, two thousand [five] seven
51 through June thirtieth, two thousand [five] seven.
52 § 9. Clause (A) of subparagraph (i) of paragraph (a) of subdivision 18
53 of section 2808 of the public health law, as amended by section 11 of
54 part H of chapter 686 of the laws of 2003, is amended to read as
55 follows:
S. 992 44 A. 1922
1 (A) fifty-three million five hundred thousand dollars on an annualized
2 basis for the period April first, two thousand two through December
3 thirty-first, two thousand two; eighty-three million three hundred thou-
4 sand dollars on an annualized basis for the period January first, two
5 thousand three through December thirty-first, two thousand three; one
6 hundred fifteen million eight hundred thousand dollars on an annualized
7 basis for the period January first, two thousand four through December
8 thirty-first, two thousand [four] six; and fifty-seven million nine
9 hundred thousand dollars for the period January first, two thousand
10 [five] seven through June thirtieth, two thousand [five] seven.
11 § 10. Clause (A) of subparagraph (i) of paragraph (b) of subdivision
12 18 of section 2808 of the public health law, as amended by section 12 of
13 part H of chapter 686 of the laws of 2003, is amended to read as
14 follows:
15 (A) seven million five hundred thousand dollars on an annualized basis
16 for the period April first, two thousand two through December thirty-
17 first, two thousand two; eleven million seven hundred thousand dollars
18 on an annualized basis for the period January first, two thousand three
19 through December thirty-first, two thousand three; sixteen million two
20 hundred thousand dollars on an annualized basis for the period January
21 first, two thousand four through December thirty-first, two thousand
22 [four] six; and eight million one hundred thousand dollars for the peri-
23 od January first, two thousand [five] seven through June thirtieth, two
24 thousand [five] seven.
25 § 11. Paragraphs (c) and (d) of subdivision 1 of section 367-q of the
26 social services law, as amended by section 61 of part J of chapter 82 of
27 the laws of 2002, are amended and two new paragraphs (e) and (f) are
28 added to read as follows:
29 (c) for the period January first, two thousand four through December
30 thirty-first, two thousand four, twenty-one million dollars; [and]
31 (d) for the period January first, two thousand five through December
32 thirty-first, two thousand five, twenty-seven million dollars[.];
33 (e) for the period January first, two thousand six through December
34 thirty-first, two thousand six, twenty-seven million dollars; and
35 (f) for the period January first, two thousand seven through June
36 thirtieth, two thousand seven, thirteen million five hundred thousand
37 dollars.
38 § 12. Subparagraphs (iii) and (iv) of paragraph (a) of subdivision 17
39 of section 2807 of the public health law, as amended by section 7 of
40 part H of chapter 686 of the laws of 2003, are amended and two new
41 subparagraphs (v) and (vi) are added to read as follows:
42 (iii) for the period January first, two thousand four through December
43 thirty-first, two thousand four, thirteen million dollars; [and]
44 (iv) for the period January first, two thousand five through [June
45 thirtieth] December thirty-first, two thousand five, [six] thirteen
46 million [five hundred thousand] dollars[.];
47 (v) for the period January first, two thousand six through December
48 thirty-first, two thousand six, thirteen million dollars; and
49 (vi) for the period January first, two thousand seven through June
50 thirtieth, two thousand seven, six million five hundred thousand
51 dollars.
52 § 13. Section 2808-d of the public health law is amended by adding a
53 new subdivision 6 to read as follows:
54 6. Notwithstanding any other provisions of this section or any other
55 contrary provision of law, the commissioner may, from funds allocated
56 pursuant to subparagraph (ii) of paragraph (u) of subdivision one of
S. 992 45 A. 1922
1 section twenty-eight hundred seven-v of this article, make grants in an
2 aggregate amount not to exceed twelve million five hundred thousand
3 dollars, to residential health care facilities selected pursuant to a
4 competitive process, in support of projects or programs designed to
5 improve specific areas of quality of care, as determined by the commis-
6 sioner using established measures of such quality of care.
7 § 14. Subdivisions 3, 4, 5 and 6 of section 47 of chapter 2 of the
8 laws of 1998 amending the public health law and other laws relating to
9 expanding the child health insurance plan, subdivisions 3 and 5 as
10 amended by section 21 of part A3 of chapter 62 of the laws of 2003 and
11 subdivisions 4 and 6 as amended by section 5 of part B of chapter 58 of
12 the laws of 2004, are amended to read as follows:
13 3. section six of this act shall take effect January 1, 1999;
14 provided, however, that subparagraph (iii) of paragraph (c) of subdivi-
15 sion 9 of section 2510 of the public health law, as added by this act,
16 shall expire on July 1, [2005] 2007;
17 4. sections two, three, four, seven, eight, nine, fourteen, fifteen,
18 sixteen, eighteen, eighteen-a, twenty-three, twenty-four, and twenty-
19 nine of this act shall take effect January 1, 1999 and shall expire on
20 July 1, [2005] 2007; section twenty-five of this act shall take effect
21 on January 1, 1999 and shall expire on [October 1, 2004] April 1, 2005;
22 5. section twelve of this act shall take effect January 1, 1999;
23 provided, however, paragraphs (g) and (h) of subdivision 2 of section
24 2511 of the public health law, as added by such section, shall expire on
25 July 1, [2005] 2007;
26 6. sections twenty-four-a, twenty-six and twenty-six-a of this act
27 shall expire on [October 1, 2004] April 1, 2005.
28 § 15. Section 22 of part A3 of chapter 62 of the laws of 2003, amend-
29 ing the general business law and other laws relating to enacting major
30 components necessary to implement the state fiscal plan for the
31 2003-2004 state fiscal year, is amended to read as follows:
32 § 22. Notwithstanding any inconsistent provision of section 112 or 163
33 of the state finance law or any other law, at the discretion of the
34 commissioner of health, without a competitive bid or request for
35 proposal process, contractual arrangements with approved organizations,
36 as defined in subdivision 2 of section 2510 of the public health law,
37 and outreach and facilitated enrollment contractors pursuant to subdivi-
38 sion 9 of section 2511 of the public health law in effect in [2002] 2004
39 may be extended through July 1, [2005] 2007 to provide an uninterrupted
40 continuation of services and may be amended as deemed necessary.
41 § 16. Subdivision 8 of section 2511 of the public health law, as added
42 by chapter 922 of the laws of 1990, is amended to read as follows:
43 8. The commissioner shall determine the amount of funds to be allo-
44 cated to an approved organization for the purposes described in subdivi-
45 sion one of this section within such funds which may be available for
46 the purposes of this article. Subsidy payments made to approved organ-
47 izations on and after April first, two thousand five through March thir-
48 ty-first, two thousand six, shall be at amounts approved by the commis-
49 sioner, in consultation with the superintendent, prior to April first,
50 two thousand five. Applications for increases to subsidy payments
51 submitted by approved organizations to the commissioner and the super-
52 intendent on or after January first, two thousand five, shall not be
53 considered for approval by the commissioner until after March thirty-
54 first, two thousand six. Nothing in this subdivision shall prohibit the
55 commissioner from decreasing subsidy payments in accordance with rele-
56 vant contract provisions.
S. 992 46 A. 1922
1 § 17. Section 27 of chapter 2 of the laws of 1998 amending the public
2 health law and other laws relating to expanding the child health insur-
3 ance plan, is amended to read as follows:
4 § 27. Notwithstanding any other law, rule or regulation to the contra-
5 ry, the commissioner of health is authorized to transfer and the comp-
6 troller is authorized to deposit into the special revenue funds - other,
7 miscellaneous special revenue fund - 339, child health insurance account
8 or any successor fund or account established within the department of
9 health, within amounts appropriated, those funds authorized for distrib-
10 ution in accordance with the provisions of paragraph (b-1) of subdivi-
11 sion 19 of section 2807-c of the public health law from monies accumu-
12 lated and interest earned in the bad debt and charity care and capital
13 statewide pool through an assessment charged to general hospitals pursu-
14 ant to the provisions of subdivision 18 of section 2807-c of the public
15 health law and those funds authorized for distribution in accordance
16 with the provisions of paragraph (a) of subdivision 1 of section 2807-l
17 of the public health law for the purposes of payment for costs of the
18 department of health related to the child health insurance plan program
19 authorized pursuant to title 1-A of article 25 of the public health law
20 and for payment for costs of the department of health for medical
21 assistance authorized pursuant to subparagraph (1) of paragraph (q) of
22 subdivision 4 of section 366 of the social services law for those chil-
23 dren born on or before September 30, 1983, or medical assistance author-
24 ized pursuant to paragraph (t) of subdivision 4 of section 366 of the
25 social services law.
26 § 18. Subdivision 11 of section 2807-c of the public health law is
27 amended by adding a new paragraph (s-7) to read as follows:
28 (s-7) To the extent funds are available otherwise notwithstanding any
29 inconsistent provision of law to the contrary, for rate periods April
30 first, two thousand five through March thirty-first, two thousand seven,
31 the commissioner shall increase rates of payment for patients eligible
32 for payments made by state governmental agencies by an amount not to
33 exceed forty-eight million dollars annually in the aggregate. Such
34 amount shall be allocated among those voluntary non-profit and private
35 proprietary general hospitals which continue to provide inpatient
36 services as of April first, two thousand five under a previous or new
37 name and which qualified for rate adjustments pursuant to paragraph (s)
38 of this subdivision as in effect for the period July first, nineteen
39 hundred ninety-five through June thirtieth, nineteen hundred ninety-six
40 proportionally based on each such general hospital's proportional share
41 of total funds allocated pursuant to paragraph (s) of this subdivision
42 as in effect for the period of July first, nineteen hundred ninety-five
43 through June thirtieth, nineteen hundred ninety-six, provided however,
44 that amounts allocable to previously but no longer qualified hospitals
45 shall be proportionally reallocated to the remaining qualified hospi-
46 tals. The rate adjustments calculated in accordance with this paragraph
47 shall be subject to retrospective reconciliation to ensure that each
48 hospital receives in the aggregate its proportionate share of the full
49 allocation, to the extent allowable under federal law, provided however
50 that the department shall not be required to reconcile payments made
51 pursuant to paragraph (s) of this subdivision applicable to periods
52 prior to September first, nineteen hundred ninety-seven.
53 § 19. Section 2807-l of the public health law, as amended by section
54 16 of part A3 of chapter 62 of the laws of 2003, clauses (F) and (G) of
55 subparagraph (i) of paragraph (b) as amended and clause (I) of subpara-
56 graph (i) of paragraph (b) as added by section 1 of part M1 of chapter
S. 992 47 A. 1922
1 63 of the laws of 2003, clause (H) of subparagraph (i) of paragraph (b)
2 as amended by section 13 of part B of chapter 58 of the laws of 2004,
3 clauses (C) and (D) of subparagraph (ii) of paragraph (b) as amended by
4 section 12 of part B of chapter 58 of the laws of 2004, the opening
5 paragraph of paragraph (c) as amended by section 5 of part H and subpar-
6 agraph (vii) of paragraph (k) as amended by section 14 of part H of
7 chapter 686 of the laws of 2003, of subdivision 1, is amended to read as
8 follows:
9 § 2807-l. Health care initiatives pool distributions. 1. Funds accu-
10 mulated in the health care initiatives pools pursuant to paragraph (b)
11 of subdivision nine of section twenty-eight hundred seven-j of this
12 article, including income from invested funds, shall be distributed or
13 retained by the commissioner or by the state comptroller, as applicable,
14 in accordance with the following.
15 (a) Funds shall be reserved and accumulated from year to year [by the
16 commissioner] and shall be available, including income from invested
17 funds, for purposes of distributions to programs to provide health care
18 coverage for uninsured or underinsured children pursuant to sections
19 twenty-five hundred ten and twenty-five hundred eleven of this chapter
20 from the respective health care initiatives pools established for the
21 following periods in the following amounts:
22 (i) from the pool for the period January first, nineteen hundred nine-
23 ty-seven through December thirty-first, nineteen hundred ninety-seven,
24 up to one hundred twenty million six hundred thousand dollars;
25 (ii) from the pool for the period January first, nineteen hundred
26 ninety-eight through December thirty-first, nineteen hundred ninety-
27 eight, up to one hundred sixty-four million five hundred thousand
28 dollars;
29 (iii) from the pool for the period January first, nineteen hundred
30 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
31 up to one hundred eighty-one million dollars;
32 (iv) from the pool for the period January first, two thousand through
33 December thirty-first, two thousand, two hundred seven million dollars;
34 (v) from the pool for the period January first, two thousand one
35 through December thirty-first, two thousand one, two hundred thirty-five
36 million dollars;
37 (vi) from the pool for the period January first, two thousand two
38 through December thirty-first, two thousand two, three hundred twenty-
39 four million dollars;
40 (vii) from the pool for the period January first, two thousand three
41 through December thirty-first, two thousand three, up to four hundred
42 fifty million three hundred thousand dollars;
43 (viii) from the pool for the period January first, two thousand four
44 through December thirty-first, two thousand four, up to four hundred
45 sixty million nine hundred thousand dollars;
46 (ix) from the pool for the period January first, two thousand five
47 through [June thirtieth,] December thirty-first, two thousand five, up
48 to [two hundred forty-one million nine hundred thousand] one hundred
49 fifty-three million eight hundred thousand dollars; [and]
50 (x) from the pool for the period January first, two thousand six
51 through December thirty-first, two thousand six, up to three hundred
52 twenty-five million four hundred thousand dollars; and
53 (xi) from the pool for the period January first, two thousand seven
54 through June thirtieth, two thousand seven, up to one hundred eighty-
55 eight million nine hundred thousand dollars.
S. 992 48 A. 1922
1 (xii) If funds allocated pursuant to this paragraph are insufficient
2 to cover the costs required to meet the state's obligations established
3 in sections twenty-five hundred ten and twenty-five hundred eleven of
4 this chapter, the commissioner or the state comptroller, as applicable,
5 shall transfer and deposit funds accumulated pursuant to section twen-
6 ty-eight hundred seven-v of this article into the special revenue fund-
7 other, miscellaneous special revenue fund-339, child health insurance
8 account or any successor fund or account, such amounts necessary to
9 fully fund such obligations.
10 (b) Funds shall be reserved and accumulated from year to year [by the
11 commissioner] and shall be available, including income from invested
12 funds, for purposes of distributions for health insurance programs under
13 the [New York state small business health insurance partnership program
14 established pursuant to article nine-A of this chapter, a voucher insur-
15 ance program established pursuant to section eleven hundred twenty-one
16 of the insurance law,] individual subsidy programs established pursuant
17 to the expanded health care coverage act of nineteen hundred eighty-
18 eight as amended, and the catastrophic health care expense program
19 established pursuant to title eleven-A of article five of the social
20 services law and for evaluation of such programs from the respective
21 health care initiatives pools established for the following periods in
22 the following amounts:
23 (i) (A) [from the pool for the period January first, nineteen hundred
24 ninety-seven through December thirty-first, nineteen hundred ninety-sev-
25 en, up to twenty-four million dollars;
26 (B) from the pool for the period January first, nineteen hundred nine-
27 ty-eight through December thirty-first, nineteen hundred ninety-eight,
28 up to twenty-four million dollars;
29 (C) from the pool for the period January first, nineteen hundred nine-
30 ty-nine through December thirty-first, nineteen hundred ninety-nine, up
31 to twenty-four million dollars;
32 (D) from the pool for the period January first, two thousand through
33 December thirty-first, two thousand, up to seventeen million dollars;
34 (E) from the pool for the period January first, two thousand one
35 through December thirty-first, two thousand one, up to fourteen million
36 two hundred thousand dollars;
37 (F) from the pool for the period January first, two thousand two
38 through December thirty-first, two thousand two, up to eleven million
39 three hundred thousand dollars;
40 (G) from the pool for the period January first, two thousand three
41 through December thirty-first, two thousand three, up to seven million
42 one hundred thousand dollars;
43 (H) from the pool for the period January first, two thousand four
44 through the period December thirty-first, two thousand four, up to three
45 million three hundred thousand dollars; and
46 (I) from the pool for the period January first, two thousand five
47 through the period June thirtieth, two thousand five, up to three
48 million three hundred thousand dollars.
49 (ii) provided however, that from such funds allocated pursuant to
50 subparagraph (i) of this paragraph:
51 (A) an amount not to exceed six million dollars on an annualized basis
52 for the periods during the period January first, nineteen hundred nine-
53 ty-seven through December thirty-first, nineteen hundred ninety-nine; up
54 to six million dollars for the period January first, two thousand
55 through December thirty-first, two thousand; up to five million dollars
56 for the period January first, two thousand one through December thirty-
S. 992 49 A. 1922
1 first, two thousand one; up to four million dollars for the period Janu-
2 ary first, two thousand two through December thirty-first, two thousand
3 two; and up to five hundred thousand dollars for the period January
4 first, two thousand three through June thirtieth, two thousand three
5 shall be allocated to the health insurance programs under the New York
6 state small business health insurance partnership program established
7 pursuant to article nine-A of this chapter;
8 (B) an amount not to exceed five million dollars on an annualized
9 basis for the periods January first, nineteen hundred ninety-seven
10 through December thirty-first, nineteen hundred ninety-nine and up to
11 one million dollars for the period January first, two thousand through
12 December thirty-first, two thousand and up to two hundred thousand
13 dollars for the period January first, two thousand one through December
14 thirty-first, two thousand one shall be allocated to the voucher insur-
15 ance program;
16 (C)] an amount not to exceed six million dollars on an annualized
17 basis for the periods January first, nineteen hundred ninety-seven
18 through December thirty-first, nineteen hundred ninety-nine; up to six
19 million dollars for the period January first, two thousand through
20 December thirty-first, two thousand; up to five million dollars for the
21 period January first, two thousand one through December thirty-first,
22 two thousand one; up to four million dollars for the period January
23 first, two thousand two through December thirty-first, two thousand two;
24 up to two million six hundred thousand dollars for the period January
25 first, two thousand three through December thirty-first, two thousand
26 three; up to one million three hundred thousand dollars for the period
27 January first, two thousand four through December thirty-first, two
28 thousand four; and up to [one million three hundred thousand] six
29 hundred seventy thousand dollars for the period January first, two thou-
30 sand five through June thirtieth, two thousand five shall be allocated
31 to individual subsidy programs; and
32 [(D)] (B) an amount not to exceed seven million dollars on an annual-
33 ized basis for the periods during the period January first, nineteen
34 hundred ninety-seven through December thirty-first, nineteen hundred
35 ninety-nine and four million dollars annually for the periods January
36 first, two thousand through December thirty-first, two thousand two, and
37 [four] three million dollars for the period January first, two thousand
38 three through December thirty-first, two thousand three, [and two
39 million dollars for the period January first, two thousand four through
40 December thirty-first, two thousand four, and two million dollars for
41 the period January first, two thousand five through June thirtieth, two
42 thousand five] shall be allocated to the catastrophic health care
43 expense program.
44 [(iii)] (ii) Notwithstanding any law to the contrary, the character-
45 izations of the New York state small business health insurance partner-
46 ship program as in effect prior to June thirtieth, two thousand three,
47 voucher program as in effect prior to December thirty-first, two thou-
48 sand one, individual subsidy program and catastrophic health care
49 expense program, may, for the purposes of identifying matching funds for
50 the community health care conversion demonstration project described in
51 a waiver of the provisions of title XIX of the federal social security
52 act granted to the state of New York and dated July fifteenth, nineteen
53 hundred ninety-seven, may continue to be used to characterize the insur-
54 ance programs in sections four thousand three hundred twenty-one-a, four
55 thousand three hundred twenty-two-a, four thousand three hundred twen-
S. 992 50 A. 1922
1 ty-six and four thousand three hundred twenty-seven of the insurance
2 law, which are successor programs to these programs.
3 (c) Up to seventy-eight million dollars shall be reserved and accumu-
4 lated from year to year [by the commissioner] from the pool for the
5 period January first, nineteen hundred ninety-seven through December
6 thirty-first, nineteen hundred ninety-seven, for purposes of public
7 health programs, up to seventy-six million dollars shall be reserved and
8 accumulated from year to year [by the commissioner] from the pools for
9 the periods January first, nineteen hundred ninety-eight through Decem-
10 ber thirty-first, nineteen hundred ninety-eight and January first, nine-
11 teen hundred ninety-nine through December thirty-first, nineteen hundred
12 ninety-nine, up to eighty-four million dollars shall be reserved and
13 accumulated from year to year [by the commissioner] from the pools for
14 the period January first, two thousand through December thirty-first,
15 two thousand, up to eighty-five million dollars shall be reserved and
16 accumulated from year to year [by the commissioner] from the pools for
17 the period January first, two thousand one through December thirty-
18 first, two thousand one, up to eighty-six million dollars shall be
19 reserved and accumulated from year to year [by the commissioner] from
20 the pools for the period January first, two thousand two through Decem-
21 ber thirty-first, two thousand two, up to eighty-six million one hundred
22 fifty thousand dollars shall be reserved and accumulated from year to
23 year [by the commissioner] from the pools for the period January first,
24 two thousand three through December thirty-first, two thousand three, up
25 to [eighty-six million one hundred fifty thousand] fifty-eight million
26 seven hundred eighty thousand dollars shall be reserved and accumulated
27 from year to year [by the commissioner] from the pools for the period
28 January first, two thousand four through December thirty-first, two
29 thousand four, [and] up to [forty-four million one hundred seventy-five
30 thousand] sixty-two million seven hundred thirty thousand dollars shall
31 be reserved and accumulated from year to year [by the commissioner] from
32 the pools for the period January first, two thousand five through [June
33 thirtieth] December thirty-first, two thousand five, up to eighty-eight
34 million three hundred fifty thousand dollars shall be reserved and accu-
35 mulated from year to year from the pools for the period January first,
36 two thousand six through December thirty-first, two thousand six, and up
37 to forty-four million one hundred eighty thousand dollars shall be
38 reserved and accumulated from year to year from the pools for the period
39 January first, two thousand seven through June thirtieth, two thousand
40 seven, and shall be available, including income from invested funds,
41 for:
42 (i) deposit by the commissioner, within amounts appropriated, and the
43 state comptroller is hereby authorized and directed to receive for
44 deposit to, to the credit of the department of health's special revenue
45 fund - other, hospital based grants program account or any successor
46 fund or account, for purposes of services and expenses related to gener-
47 al hospital based grant programs, up to twenty-two million dollars annu-
48 ally from the nineteen hundred ninety-seven pool, nineteen hundred nine-
49 ty-eight pool, nineteen hundred ninety-nine pool, two thousand pool, two
50 thousand one pool and two thousand two pool, respectively, up to twen-
51 ty-two million dollars from the two thousand three pool, up to [twenty-
52 two million] ten million dollars for the period January first, two thou-
53 sand four through December thirty-first, two thousand four, [and] up to
54 eleven million dollars for the period January first, two thousand five
55 through [June thirtieth] December thirty-first, two thousand five, up to
56 twenty-two million dollars for the period January first, two thousand
S. 992 51 A. 1922
1 six through December thirty-first, two thousand six, and up to eleven
2 million dollars for the period January first, two thousand seven through
3 June thirtieth, two thousand seven;
4 (ii) deposit by the commissioner, within amounts appropriated, and the
5 state comptroller is hereby authorized and directed to receive for
6 deposit to, to the credit of the emergency medical services training
7 account established in section ninety-seven-q of the state finance law
8 or any successor fund or account, up to sixteen million dollars on an
9 annualized basis for the periods January first, nineteen hundred nine-
10 ty-seven through December thirty-first, nineteen hundred ninety-nine, up
11 to twenty million dollars for the period January first, two thousand
12 through December thirty-first, two thousand, up to twenty-one million
13 dollars for the period January first, two thousand one through December
14 thirty-first, two thousand one, up to twenty-two million dollars for the
15 period January first, two thousand two through December thirty-first,
16 two thousand two, up to twenty-two million five hundred fifty thousand
17 dollars for the period January first, two thousand three through Decem-
18 ber thirty-first, two thousand three, up to [twenty-two million five
19 hundred fifty thousand] nine million six hundred eighty thousand dollars
20 for the period January first, two thousand four through December thir-
21 ty-first, two thousand four, [and] up to twelve million one hundred
22 [twenty-five] thirty thousand dollars for the period January first, two
23 thousand five through [June thirtieth] December thirty-first, two thou-
24 sand five, up to twenty-four million two hundred fifty thousand dollars
25 for the period January first, two thousand six through December thirty-
26 first, two thousand six, and up to twelve million one hundred thirty
27 thousand dollars for the period January first, two thousand seven
28 through June thirtieth, two thousand seven;
29 (iii) priority distributions by the commissioner up to thirty-two
30 million dollars on an annualized basis to be allocated (A) for the
31 purposes established pursuant to subparagraph (ii) of paragraph (f) of
32 subdivision nineteen of section twenty-eight hundred seven-c of this
33 article as in effect on December thirty-first, nineteen hundred ninety-
34 six and as may thereafter be amended, up to fifteen million dollars
35 annually for the periods January first, two thousand through December
36 thirty-first, two thousand [four] six, and up to seven million five
37 hundred thousand dollars for the period January first, two thousand
38 [five] seven through June thirtieth, two thousand [five] seven; and
39 (B) pursuant to a memorandum of understanding entered into by the
40 commissioner, the majority leader of the senate and the speaker of the
41 assembly, for the purposes outlined in such memorandum upon the recom-
42 mendation of the majority leader of the senate, up to eight million
43 five hundred thousand dollars annually for the period January first, two
44 thousand through December thirty-first, two thousand [four] six, and up
45 to four million two hundred fifty thousand dollars for the period Janu-
46 ary first, two thousand [five] seven through June thirtieth, two thou-
47 sand [five] seven, and for the purposes outlined in such memorandum upon
48 the recommendation of the speaker of the assembly, up to eight million
49 five hundred thousand dollars annually for the periods January first,
50 two thousand through December thirty-first, two thousand [four] six, and
51 up to four million two hundred fifty thousand dollars for the period
52 January first, two thousand [five] seven through June thirtieth, two
53 thousand [five] seven;
54 (iv) distributions by the commissioner related to poison control
55 centers pursuant to subdivision seven of section twenty-five hundred-d
56 of this chapter, up to five million dollars for the period January
S. 992 52 A. 1922
1 first, nineteen hundred ninety-seven through December thirty-first,
2 nineteen hundred ninety-seven, up to three million dollars on an annual-
3 ized basis for the periods during the period January first, nineteen
4 hundred ninety-eight through December thirty-first, nineteen hundred
5 ninety-nine, up to five million dollars annually for the periods January
6 first, two thousand through December thirty-first, two thousand two, up
7 to four million six hundred thousand dollars annually for the periods
8 January first, two thousand three through December thirty-first, two
9 thousand four, [and] up to [two million five hundred fifty thousand]
10 five million one hundred thousand dollars for the period January first,
11 two thousand five through [June thirtieth] December thirty-first, two
12 thousand [five] six annually, and up to two million five hundred fifty
13 thousand dollars for the period January first, two thousand seven
14 through June thirtieth, two thousand seven; and
15 (v) deposit by the commissioner, within amounts appropriated, and the
16 state comptroller is hereby authorized and directed to receive for
17 deposit to, to the credit of the department of health's special revenue
18 fund - other, miscellaneous special revenue fund - 339 maternal and
19 child HIV services account or any successor fund or account, for
20 purposes of a special program for HIV services for infants and pregnant
21 women pursuant to section seventy-one of chapter seven hundred thirty-
22 one of the laws of nineteen hundred ninety-three, amending the public
23 health law and other laws relating to reimbursement, delivery and capi-
24 tal costs of ambulatory health care services and inpatient hospital
25 services, up to five million dollars annually for the periods January
26 first, two thousand through December thirty-first, two thousand two, up
27 to five million dollars for the period January first, two thousand three
28 through December thirty-first, two thousand three, up to [five million]
29 two million five hundred thousand dollars for the period January first,
30 two thousand four through December thirty-first, two thousand four,
31 [and] up to two million five hundred thousand dollars for the period
32 January first, two thousand five through [June thirtieth] December thir-
33 ty-first, two thousand five, [plus such amounts as may be available from
34 prior year pool reserves] up to five million dollars for the period
35 January first, two thousand six through December thirty-first, two thou-
36 sand six, and up to two million five hundred thousand dollars for the
37 period January first, two thousand seven through June thirtieth, two
38 thousand seven.
39 (d) (i) An amount of up to twenty million dollars annually for the
40 period January first, two thousand through December thirty-first, two
41 thousand [four] six, and up to ten million dollars for the period Janu-
42 ary first, two thousand [five] seven through June thirtieth, two thou-
43 sand [five] seven, shall be transferred [by the commissioner] to the
44 health facility restructuring pool established pursuant to section twen-
45 ty-eight hundred fifteen of this article;
46 (ii) provided, however, amounts transferred pursuant to subparagraph
47 (i) of this paragraph may be reduced [by the commissioner] in an amount
48 to be approved by the director of the budget to reflect the amount
49 received from the federal government under the state's 1115 waiver which
50 is directed under its terms and conditions to the health facility
51 restructuring program.
52 (e) Funds shall be reserved and accumulated from year to year [by the
53 commissioner] and shall be available, including income from invested
54 funds, for purposes of distributions to organizations to support the
55 health workforce retraining program established pursuant to section
56 twenty-eight hundred seven-g of this article from the respective health
S. 992 53 A. 1922
1 care initiatives pools established for the following periods in the
2 following amounts from the pools during the period January first, nine-
3 teen hundred ninety-seven through December thirty-first, nineteen
4 hundred ninety-nine, up to fifty million dollars on an annualized basis,
5 up to thirty million dollars for the period January first, two thousand
6 through December thirty-first, two thousand, up to forty million dollars
7 for the period January first, two thousand one through December thirty-
8 first, two thousand one, up to fifty million dollars for the period
9 January first, two thousand two through December thirty-first, two thou-
10 sand two, up to forty-one million one hundred fifty thousand dollars for
11 the period January first, two thousand three through December thirty-
12 first, two thousand three, up to forty-one million one hundred fifty
13 thousand dollars for the period January first, two thousand four through
14 December thirty-first, two thousand four, [and] up to [twenty-nine
15 million one hundred eighty thousand] fifty-eight million three hundred
16 sixty thousand dollars for the period January first, two thousand five
17 through [June thirtieth] December thirty-first, two thousand [five] six
18 annually, and up to twenty-nine million one hundred eighty thousand
19 dollars for the period January first, two thousand seven through June
20 thirtieth, two thousand seven, less the amount of funds available for
21 allocations for rate adjustments for workforce training programs for
22 payments by state governmental agencies for inpatient hospital services.
23 (f) Funds shall be accumulated and transferred from as follows:
24 (i) from the pool for the period January first, nineteen hundred nine-
25 ty-seven through December thirty-first, nineteen hundred ninety-seven,
26 (A) thirty-four million six hundred thousand dollars shall be trans-
27 ferred to funds reserved and accumulated pursuant to paragraph (b) of
28 subdivision nineteen of section twenty-eight hundred seven-c of this
29 article, and (B) eighty-two million dollars shall be transferred and
30 deposited and credited to the credit of the state general fund medical
31 assistance local assistance account;
32 (ii) from the pool for the period January first, nineteen hundred
33 ninety-eight through December thirty-first, nineteen hundred ninety-
34 eight, eighty-two million dollars shall be transferred and deposited and
35 credited to the credit of the state general fund medical assistance
36 local assistance account;
37 (iii) from the pool for the period January first, nineteen hundred
38 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
39 eighty-two million dollars shall be transferred and deposited and cred-
40 ited to the credit of the state general fund medical assistance local
41 assistance account;
42 (iv) from the pool for the period January first, two thousand through
43 December thirty-first, two thousand four, eighty-two million dollars
44 annually, and for the period January first, two thousand five through
45 [June thirtieth] December thirty-first, two thousand five, [forty-one
46 million] sixty-nine million one hundred thousand dollars, and for the
47 period January first, two thousand six through December thirty-first,
48 two thousand six, eighty-two million dollars, and for the period January
49 first, two thousand seven through June thirtieth, two thousand seven,
50 forty-one million dollars shall be deposited by the commissioner, and
51 the state comptroller is hereby authorized and directed to receive for
52 deposit to the credit of the state special revenue fund - other, HCRA
53 transfer fund, medical assistance account or any successor fund or
54 account.
55 (g) Funds shall be transferred [by the commissioner] to primary health
56 care services pools created by the commissioner, and shall be available,
S. 992 54 A. 1922
1 including income from invested funds, for distributions in accordance
2 with former section twenty-eight hundred seven-bb of this article from
3 the respective health care initiatives pools for the following periods
4 in the following percentage amounts of funds remaining after allocations
5 in accordance with paragraphs (a) through (f) of this subdivision:
6 (i) from the pool for the period January first, nineteen hundred nine-
7 ty-seven through December thirty-first, nineteen hundred ninety-seven,
8 fifteen and eighty-seven-hundredths percent;
9 (ii) from the pool for the period January first, nineteen hundred
10 ninety-eight through December thirty-first, nineteen hundred ninety-
11 eight, fifteen and eighty-seven-hundredths percent; and
12 (iii) from the pool for the period January first, nineteen hundred
13 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
14 sixteen and thirteen-hundredths percent.
15 (h) [Funds shall be reserved and accumulated from year to year by the
16 commissioner and shall be available, including income from invested
17 funds, for purposes of primary care education and training pursuant to
18 article nine of this chapter from the respective health care initiatives
19 pools established for the following periods in the following percentage
20 amounts of funds remaining after allocations in accordance with para-
21 graphs (a) through (f) of this subdivision and shall be available for
22 distributions as follows:
23 (i) funds shall be reserved and accumulated:
24 (A) from the pool for the period January first, nineteen hundred nine-
25 ty-seven through December thirty-first, nineteen hundred ninety-seven,
26 six and thirty-five-hundredths percent;
27 (B) from the pool for the period January first, nineteen hundred nine-
28 ty-eight through December thirty-first, nineteen hundred ninety-eight,
29 six and thirty-five-hundredths percent; and
30 (C) from the pool for the period January first, nineteen hundred nine-
31 ty-nine through December thirty-first, nineteen hundred ninety-nine, six
32 and forty-five-hundredths percent;
33 (ii) funds shall be available for distributions including income from
34 invested funds as follows:
35 (A) for purposes of the primary care physician loan repayment program
36 in accordance with section nine hundred three of this chapter, up to
37 five million dollars on an annualized basis;
38 (B) for purposes of the primary care practitioner scholarship program
39 in accordance with section nine hundred four of this chapter, up to two
40 million dollars on an annualized basis;
41 (C) for purposes of minority participation in medical education grants
42 in accordance with section nine hundred six of this chapter, up to one
43 million dollars on an annualized basis; and
44 (D) provided, however, that the commissioner may reallocate any funds
45 remaining or unallocated for distributions for the primary care practi-
46 tioner scholarship program in accordance with section nine hundred four
47 of this chapter.
48 (i)] Funds shall be reserved and accumulated from year to year [by the
49 commissioner] and shall be available, including income from invested
50 funds, for distributions in accordance with section twenty-nine hundred
51 fifty-two and section twenty-nine hundred fifty-eight of this chapter
52 for rural health care delivery development and rural health care access
53 development, respectively, from the respective health care initiatives
54 pools for the following periods in the following percentage amounts of
55 funds remaining after allocations in accordance with paragraphs (a)
S. 992 55 A. 1922
1 through (f) of this subdivision, and for periods on and after January
2 first, two thousand, in the following amounts:
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 thirteen and forty-nine-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, thirteen and forty-nine-hundredths percent;
9 (iii) from the pool for the period January first, nineteen hundred
10 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
11 thirteen and seventy-one-hundredths percent;
12 (iv) from the pool for the periods January first, two thousand through
13 December thirty-first, two thousand two, seventeen million dollars annu-
14 ally, and for the period January first, two thousand three through
15 December thirty-first, two thousand three, up to fifteen million eight
16 hundred fifty thousand dollars;
17 (v) from the pool for the period January first, two thousand four
18 through December thirty-first, two thousand four, up to fifteen million
19 eight hundred fifty thousand dollars, and for the period January first,
20 two thousand five through [June thirtieth] December thirty-first, two
21 thousand five, up to [eight million five hundred seventy-five thousand]
22 nineteen million two hundred thousand dollars, and for the period Janu-
23 ary first, two thousand six through December thirty-first, two thousand
24 six, up to nineteen million two hundred thousand dollars, and for the
25 period January first, two thousand seven through June thirtieth, two
26 thousand seven, up to eight million six hundred thousand dollars; and
27 (vi) if funds accumulated for distributions pursuant to sections twen-
28 ty-nine hundred fifty-two and twenty-nine hundred fifty-eight of this
29 chapter are insufficient to meet the funding amounts established pursu-
30 ant to subparagraphs (iv) and (v) of this paragraph, the commissioner or
31 the state comptroller, as applicable, is authorized to transfer funds
32 accumulated pursuant to section twenty-eight hundred seven-v of this
33 article to the health care initiatives pool to fully fund the amounts
34 specified in subparagraph (iv) of this paragraph; provided however, the
35 provisions of this subparagraph shall only be effective contingent upon
36 meeting all funding amounts established pursuant to paragraphs (a), (b),
37 (c), (d), (e), (f), (l), (m), (n), (q) and (r) of subdivision one of
38 section twenty-eight hundred seven-v of this article, and paragraph (a)
39 of this subdivision.
40 [(j)] (i) Funds shall be reserved and accumulated from year to year
41 and shall be available, including income from invested funds, for
42 purposes of distributions related to health information and health care
43 quality improvement pursuant to former section twenty-eight hundred
44 seven-n of this article from the respective health care initiatives
45 pools established for the following periods in the following percentage
46 amounts of funds remaining after allocations in accordance with para-
47 graphs (a) through (f) of this subdivision:
48 (i) from the pool for the period January first, nineteen hundred nine-
49 ty-seven through December thirty-first, nineteen hundred ninety-seven,
50 six and thirty-five-hundredths percent;
51 (ii) from the pool for the period January first, nineteen hundred
52 ninety-eight through December thirty-first, nineteen hundred ninety-
53 eight, six and thirty-five-hundredths percent; and
54 (iii) from the pool for the period January first, nineteen hundred
55 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
56 six and forty-five-hundredths percent.
S. 992 56 A. 1922
1 [(k)] (j) Funds shall be reserved and accumulated from year to year
2 and shall be available, including income from invested funds, for allo-
3 cations and distributions in accordance with section twenty-eight
4 hundred seven-p of this article for diagnostic and treatment center
5 uncompensated care from the respective health care initiatives pools for
6 the following periods in the following percentage amounts of funds
7 remaining after allocations in accordance with paragraphs (a) through
8 (f) of this subdivision, and for periods on and after January first, two
9 thousand, in the following amounts:
10 (i) from the pool for the period January first, nineteen hundred nine-
11 ty-seven through December thirty-first, nineteen hundred ninety-seven,
12 thirty-eight and one-tenth percent;
13 (ii) from the pool for the period January first, nineteen hundred
14 ninety-eight through December thirty-first, nineteen hundred ninety-
15 eight, thirty-eight and one-tenth percent;
16 (iii) from the pool for the period January first, nineteen hundred
17 ninety-nine through December thirty-first, nineteen hundred ninety-nine,
18 thirty-eight and seventy-one-hundredths percent;
19 (iv) from the pool for the periods January first, two thousand through
20 December thirty-first, two thousand two, forty-eight million dollars
21 annually, and for the period January first, two thousand three through
22 June thirtieth, two thousand three, twenty-four million dollars;
23 (v) from the pool for the period July first, two thousand three
24 through December thirty-first, two thousand three, up to six million
25 dollars, for the period January first, two thousand four through Decem-
26 ber thirty-first, two thousand [four] six, up to twelve million dollars
27 annually, and for the period January first, two thousand [five] seven
28 through June thirtieth, two thousand [five] seven, up to six million
29 dollars; provided that if federal financial participation is not avail-
30 able for rate adjustments made pursuant to section twenty-eight hundred
31 seven-p of this article then the foregoing amounts shall be increased to
32 the following: for the period July first, two thousand three through
33 December thirty-first, two thousand three, twenty-four million dollars,
34 for the period January first, two thousand four through December thir-
35 ty-first, two thousand [four] six, forty-eight million dollars annually,
36 and for the period January first, two thousand [five] seven through June
37 thirtieth, two thousand [five] seven, twenty-four million dollars;
38 (vi) if funds accumulated for distributions pursuant to section twen-
39 ty-eight hundred seven-p of this article are insufficient to meet the
40 funding amounts established pursuant to subparagraph (iv) of this para-
41 graph, the commissioner or the state comptroller, as applicable, is
42 authorized to transfer funds accumulated pursuant to section twenty-
43 eight hundred seven-v of this article into the health care initiatives
44 pool to fully fund the amounts established pursuant to subparagraphs
45 (iv) and (v) of this paragraph; provided however, the provisions of this
46 subparagraph 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 and
51 (vii) funds reserved and accumulated pursuant to this paragraph for
52 periods on and after July first, two thousand three, shall be deposited
53 by the commissioner, within amounts appropriated, and the state comp-
54 troller is hereby authorized and directed to receive for deposit to the
55 credit of the state special revenue funds - other, HCRA transfer fund,
56 medical assistance account or any successor fund or account, for
S. 992 57 A. 1922
1 purposes of funding the state share of rate adjustments made pursuant to
2 section twenty-eight hundred seven-p of this article, provided, however,
3 that in the event federal financial participation is not available for
4 rate adjustments made pursuant to paragraph (b) of subdivision one of
5 section twenty-eight hundred seven-p of this article, funds shall be
6 distributed pursuant to paragraph (a) of subdivision one of section
7 twenty-eight hundred seven-p of this article from the respective health
8 care initiatives pools [and not be transferred and deposited to the
9 credit of the state special revenue funds - other, HCRA transfer fund,
10 medical assistance account].
11 [(l)] (k) Funds shall be reserved and accumulated from year to year by
12 the commissioner and shall be available, including income from invested
13 funds, for transfer to and allocation for services and expenses for the
14 payment of benefits to recipients of drugs under the AIDS drug assist-
15 ance program (ADAP) - HIV uninsured care program as administered by
16 Health Research Incorporated from the respective health care initi-
17 atives pools established for the following periods in the following
18 percentage amounts of funds remaining after allocations in accordance
19 with paragraphs (a) through (f) of this subdivision, and for periods on
20 and after January first, two 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 nine and fifty-two-hundredths 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, nine and fifty-two-hundredths percent;
27 (iii) from the pool for the period January first, nineteen hundred
28 ninety-nine and December thirty-first, nineteen hundred ninety-nine,
29 nine and sixty-eight-hundredths percent;
30 (iv) from the pool for the periods January first, two thousand through
31 December thirty-first, two thousand two, up to twelve million dollars
32 annually, and for the period January first, two thousand three through
33 December thirty-first, two thousand three, up to forty million dollars;
34 and
35 (v) from the pool for the periods January first, two thousand four
36 through December thirty-first, two thousand four, up to fifty-six
37 million dollars, [and] for the period January first, two thousand five
38 through [June thirtieth] December thirty-first, two thousand [five] six,
39 up to [thirty million] sixty million dollars annually, and for the peri-
40 od January first, two thousand seven through June thirtieth, two thou-
41 sand seven, up to thirty million dollars.
42 [(m)] (l) Funds shall be reserved and accumulated from year to year
43 [by the commissioner] and shall be available, including income from
44 invested funds, for purposes of distributions pursuant to section twen-
45 ty-eight hundred seven-r of this article for cancer related services
46 from the respective health care initiatives pools established for the
47 following periods in the following percentage amounts of funds remaining
48 after allocations in accordance with paragraphs (a) through (f) of this
49 subdivision, and for periods on and after January first, two thousand,
50 in the following amounts:
51 (i) from the pool for the period January first, nineteen hundred nine-
52 ty-seven through December thirty-first, nineteen hundred ninety-seven,
53 seven and ninety-four-hundredths percent;
54 (ii) from the pool for the period January first, nineteen hundred
55 ninety-eight through December thirty-first, nineteen hundred ninety-
56 eight, seven and ninety-four-hundredths percent;
S. 992 58 A. 1922
1 (iii) from the pool for the period January first, nineteen hundred
2 ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
3 and forty-five-hundredths percent;
4 (iv) from the pool for the period January first, two thousand through
5 December thirty-first, two thousand two, up to ten million dollars on an
6 annual basis;
7 (v) from the pool for the period January first, two thousand three
8 through December thirty-first, two thousand four, up to eight million
9 nine hundred fifty thousand dollars on an annual basis; and
10 (vi) from the pool for the period January first, two thousand five
11 through [June thirtieth] December thirty-first, two thousand [five] six,
12 up to [five million twenty-five thousand] ten million five hundred thou-
13 sand dollars on an annual basis, and for the period January first, two
14 thousand seven through June thirtieth, two thousand seven, up to five
15 million two hundred fifty thousand dollars.
16 2. In the event residual funds are available after allocations have
17 been made pursuant to this section, such funds may be allocated and
18 distributed in a manner determined by the commissioner for purposes set
19 forth in subdivision one of this section, section twenty-eight hundred
20 seven-k or section twenty-eight hundred seven-m of this article.
21 3. Notwithstanding any inconsistent provision of law, rule or regu-
22 lation, any funds accumulated in the health care initiatives pools
23 pursuant to paragraph (b) of subdivision nine of section twenty-eight
24 hundred seven-j of this article, as a result of surcharges, assessments
25 or other obligations during the periods January first, nineteen hundred
26 ninety-seven through December thirty-first, nineteen hundred ninety-
27 nine, which are unused or uncommitted for distributions pursuant to this
28 section shall be reserved and accumulated from year to year by the
29 commissioner and, within amounts appropriated, transferred and deposited
30 into the special revenue funds - other, miscellaneous special revenue
31 fund - 339, child health insurance account or any successor fund or
32 account, for purposes of distributions to implement the child health
33 insurance program established pursuant to sections twenty-five hundred
34 ten and twenty-five hundred eleven of this chapter for periods on and
35 after January first, two thousand one; provided, however, funds reserved
36 and accumulated for priority distributions pursuant to subparagraph
37 (iii) of paragraph (c) of subdivision one of this section shall not be
38 transferred and deposited into such account pursuant to this subdivi-
39 sion; [and provided further, however, the primary health care services
40 grant program pursuant to section twenty-eight hundred seven-bb of this
41 article, as in effect prior to January first, two thousand, shall be
42 funded up to allocated amounts set forth in paragraph (g) of subdivision
43 one of this section less amounts set aside and distributed by the
44 commissioner in accordance with section thirty-two-c of part F of chap-
45 ter four hundred twelve of the laws of nineteen hundred ninety-nine, and
46 shall not be transferred and deposited into such account pursuant to
47 this subdivision;] and provided further, however, that any unused or
48 uncommitted pool funds accumulated and allocated pursuant to paragraph
49 (j) of subdivision one of this section shall be distributed for purposes
50 of the health information and quality improvement act of 2000.
51 4. Revenue from distributions pursuant to this section shall not be
52 included in gross revenue received for purposes of the assessments
53 pursuant to subdivision eighteen of section twenty-eight hundred seven-c
54 of this article, subject to the provisions of paragraph (e) of subdivi-
55 sion eighteen of section twenty-eight hundred seven-c of this article,
56 and shall not be included in gross revenue received for purposes of the
S. 992 59 A. 1922
1 assessments pursuant to section twenty-eight hundred seven-d of this
2 article, subject to the provisions of subdivision twelve of section
3 twenty-eight hundred seven-d of this article.
4 5. Notwithstanding any inconsistent provision of law, the commissioner
5 may borrow from pool reserves from pools established or funded pursuant
6 to sections twenty-eight hundred seven-c, twenty-eight hundred seven-j,
7 twenty-eight hundred seven-k, twenty-eight hundred seven-m, twenty-eight
8 hundred seven-s and twenty-eight hundred seven-t of this article and
9 this section, and if not sufficient from pool funds collected pursuant
10 to section twenty-eight hundred seven-j of this article and allocated
11 for distributions pursuant to paragraph (b) of subdivision nine of
12 section twenty-eight hundred seven-j of this article, or pursuant to
13 sections twenty-eight hundred seven-s and twenty-eight hundred seven-t
14 of this article and allocated for distributions pursuant to paragraphs
15 (a) and (c) of subdivision seven of section twenty-eight hundred seven-s
16 of this article, such funds as shall be necessary, not to exceed the
17 amount projected to be available pursuant to paragraph (b) of subdivi-
18 sion nine of section twenty-eight hundred seven-j of this article, or
19 paragraphs (a) and (c) of subdivision seven of section twenty-eight
20 hundred seven-s of this article, for distributions in accordance with
21 any of paragraphs (a) through (j) of subdivision one of this section for
22 a period and shall refund such moneys when pool funds become available
23 pursuant to paragraph (b) of subdivision nine of section twenty-eight
24 hundred seven-j and paragraphs (a) and (c) of subdivision seven of
25 section twenty-eight hundred seven-s of this article for such purpose
26 for such period.
27 § 20. Title 11-A of article 5 of the social services law is REPEALED.
28 § 21. Notwithstanding the repeal of title 11-A of article 5 of the
29 social services law, and within the amounts specifically allocated to
30 the catastrophic health care expense program prior to the effective date
31 of such repeal, participating social services districts are authorized
32 to provide reimbursement to families that, prior to such effective date,
33 incur health care expenses eligible for reimbursement under the program
34 and provided further that districts are authorized to expend amounts
35 within such allocation necessary to administer such reimbursement.
36 § 21-a. The opening paragraph of section 2952 of the public health
37 law, as amended by section 18 of part TT of chapter 686 of the laws of
38 2003, is amended to read as follows:
39 To the extent of funds available therefor, the sum of seven million
40 dollars shall annually be available for periods prior to January first,
41 two thousand three, and up to six million five hundred thirty thousand
42 dollars annually for the period January first, two thousand three
43 through December thirty-first, two thousand four, [and] up to [three
44 million five hundred thirty-one thousand] seven million sixty-two thou-
45 sand dollars for the period January first, two thousand five through
46 [June thirtieth] December thirty-first, two thousand [five] six annual-
47 ly, and up to three million five hundred thirty-one thousand dollars for
48 the period January first, two thousand seven through June thirtieth, two
49 thousand seven, shall be available to the commissioner from funds made
50 available pursuant to section twenty-eight hundred seven-l of this chap-
51 ter for grants pursuant to this section.
52 § 22. Subdivision 1 of section 2958 of the public health law, as
53 amended by section 19 of part H of chapter 686 of the laws of 2003, is
54 amended to read as follows:
55 1. To the extent of funds available therefor, the sum of ten million
56 dollars shall annually be made available for periods prior to January
S. 992 60 A. 1922
1 first, two thousand three, and up to nine million three hundred twenty
2 thousand dollars for the period January first, two thousand three
3 through December thirty-first, two thousand three, up to nine million
4 three hundred twenty thousand dollars for the period January first, two
5 thousand four through December thirty-first, two thousand four, [and] up
6 to [five million forty-four thousand] twelve million eighty-eight thou-
7 sand dollars for the period January first, two thousand five through
8 [June thirtieth,] December thirty-first, two thousand five, up to twelve
9 million eighty-eight thousand dollars for the period January first, two
10 thousand six through December thirty-first, two thousand six, and up to
11 five million five hundred forty-four thousand dollars for the period
12 January first, two thousand seven through June thirtieth, two thousand
13 seven, shall be available to the commissioner from funds pursuant to
14 section twenty-eight hundred seven-l of this chapter to provide assist-
15 ance to general hospitals classified as a rural hospital for purposes of
16 determining payment for inpatient services provided to beneficiaries of
17 title XVIII of the federal social security act (Medicare) or under state
18 regulations, in recognition of the unique costs incurred by these facil-
19 ities to provide hospital services in remote or sparsely populated areas
20 pursuant to subdivision two of this section.
21 § 23. Subdivision 2 of section 2958 of the public health law, as
22 amended by chapter 1 of the laws of 1999, is amended to read as follows:
23 2. a. [The commissioner shall provide assistance to all rural hospi-
24 tals as defined in this section by distributing all amounts made avail-
25 able pursuant to section twenty-eight hundred seven-l of this chapter.
26 b.] For the purposes of this subdivision, the commissioner shall
27 devise a distribution methodology that takes into account the need for
28 rural hospitals to improve operational efficiencies, reduce the dupli-
29 cation of services, and develop affiliations with community based health
30 care providers and which recognizes whether a hospital is a federally
31 designated sole community hospital, rural referral center, rural hospi-
32 tal, state designated rural hospital, or a hospital that is at substan-
33 tial financial risk of failure and whose service area is threatened with
34 reduced access to essential health services. In no event shall the size
35 of the rural hospital be the sole contributing factor in such distrib-
36 ution methodology. Such methodology shall provide assistance at gradu-
37 ated levels from highest to lowest, in accordance with the following
38 criteria:
39 (i) The hospital shall be at substantial risk of financial failure,
40 using a combination of generally accepted standard measures of financial
41 viability and which is:
42 A. a federally designated sole community hospital or a rural referral
43 center and is both a federally designated rural hospital and is classi-
44 fied as a state rural hospital;
45 B. a federally designated sole community hospital or a rural referral
46 center and is a federally designated rural hospital;
47 C. both a federally designated rural hospital and is classified as a
48 state rural hospital, but is not a sole community hospital or a rural
49 referral center;
50 D. either a federally designated rural hospital or is classified as a
51 state rural hospital; or
52 E. the hospital is either a federally defined sole community hospital
53 or rural referral center.
54 (ii) The hospital is a sole community hospital or a rural referral
55 center and is both a federally designated rural hospital and is classi-
56 fied as a state rural hospital;
S. 992 61 A. 1922
1 (iii) The hospital is a sole community hospital or a rural referral
2 center and is a federally designated rural hospital, but is not classi-
3 fied as a state rural hospital;
4 (iv) The hospital is both a federally designated rural hospital and is
5 classified as a state rural hospital but is not a sole community hospi-
6 tal or a rural referral center;
7 (v) The hospital is either a federally designated rural hospital or is
8 classified as a state rural hospital; or
9 (vi) The hospital is either a federally defined sole community hospi-
10 tal or a rural referral center.
11 [c.] b. The commissioner may include [in regulation a factor] factors
12 to enhance the distribution to those hospitals that have taken actions
13 in accordance with the goals specified in paragraph [b] (a) of this
14 subdivision [to be applied effective January first, two thousand one],
15 except, however, in no event shall the distribution of the funds be
16 delayed because of the development of the [factor] factors pursuant to
17 this paragraph.
18 § 24. Paragraph (b) of subdivision 1 of section 76 of chapter 731 of
19 the laws of 1993 amending the public health law and other laws relating
20 to reimbursement, delivery and capital costs of ambulatory health care
21 services and inpatient hospital services, as amended by section 29 of
22 part A3 of chapter 62 of the laws of 2003, is amended to read as
23 follows:
24 (b) sections fifteen through nineteen, subdivision 3 of section 2807-e
25 of the public health law as added by section twenty of this act, and
26 section seventy-four of this act shall expire on [June 30, 2005] July 1,
27 2007;
28 § 25. Paragraph (a) of subdivision 12 of section 367-b of the social
29 services law, as amended by section 30 of part A3 of chapter 62 of the
30 laws of 2003, is amended to read as follows:
31 (a) For the purpose of regulating cash flow for general hospitals, the
32 department shall develop and implement a payment methodology to provide
33 for timely payments for inpatient hospital services eligible for case
34 based payments per discharge based on diagnosis-related groups provided
35 during the period January first, nineteen hundred eighty-eight through
36 June thirtieth, two thousand [five] seven, by such hospitals which elect
37 to participate in the system.
38 § 26. Paragraph (i) of subdivision (b) of section 1 of chapter 520 of
39 the laws of 1978, relating to providing for a comprehensive survey of
40 health care financing, education and illness prevention and creating
41 councils for the conduct thereof, as amended by section 31 of part A3 of
42 chapter 62 of the laws of 2003, is amended to read as follows:
43 (i) oversight and evaluation of the inpatient financing system in
44 place for 1988 through June 30, [2005] 2007, and the appropriateness and
45 effectiveness of the bad debt and charity care financing provisions;
46 § 27. Section 2 of chapter 600 of the laws of 1986 amending the public
47 health law relating to the development of pilot reimbursement programs
48 for ambulatory care services, as amended by section 32 of part A3 of
49 chapter 62 of the laws of 2003, is amended to read as follows:
50 § 2. This act shall take effect immediately, except that this act
51 shall expire and be of no further force and effect on and after [June
52 30, 2005] July 1, 2007; provided, however, that the commissioner of
53 health shall submit a report to the governor and the legislature detail-
54 ing the objective, impact, design and computation of any pilot
55 reimbursement program established pursuant to this act, on or before
56 March 31, 1994 and annually thereafter. Such report shall include an
S. 992 62 A. 1922
1 assessment of the financial impact of such payment system on providers,
2 as well as the impact of such system on access to care.
3 § 28. Section 11 of chapter 753 of the laws of 1989 amending the
4 public health law and other laws relating to general hospital reimburse-
5 ment for inpatient and ambulatory surgery, as amended by section 33 of
6 part A3 of chapter 62 of the laws of 2003, is amended to read as
7 follows:
8 § 11. This act shall take effect immediately; provided, however, that
9 section one shall expire and have no further force or effect on or after
10 [June 30, 2005] July 1, 2007, section two of this act shall be deemed to
11 have been in full force and effect on and after January 1, 1988,
12 sections three through eight of this act shall be deemed to have been in
13 full force and effect on and after January 1, 1989, and that the amend-
14 ments made to section 2807-c of the public health law by sections two
15 through six of this act shall expire on the same date as such section
16 expires.
17 § 29. Subparagraph (ii) of paragraph (c) of subdivision 2 of section
18 2807-s of the public health law, as added by section 15 of part A3 of
19 chapter 62 of the laws of 2003, is amended and a new subparagraph (iii)
20 is added to read as follows:
21 (ii) The regional percentage allowance for the periods July first, two
22 thousand three through [June thirtieth,] December thirty-first, two
23 thousand five, for all general hospitals in the region applicable to
24 specified third-party payors, and applicable to related patient coinsu-
25 rance and deductible amounts, shall be the same regional percentage
26 allowance calculated pursuant to paragraph (b) of this subdivision for
27 the period January first, nineteen hundred ninety-nine through December
28 thirty-first, nineteen hundred ninety-nine multiplied by one hundred
29 eight and nineteen hundredths percent.
30 (iii) The regional percentage allowance for the periods January first,
31 two thousand six through June thirtieth, two thousand seven, for all
32 general hospitals in the region applicable to specified third-party
33 payors, and applicable to related patient coinsurance and deductible
34 amounts, shall be the same regional percentage allowance calculated
35 pursuant to subparagraph (ii) of this paragraph for the period January
36 first, two thousand five through December thirty-first, two thousand
37 five multiplied by one hundred one and thirteen hundredths percent.
38 § 30. Subparagraphs (viii) and (ix) of paragraph (a) of subdivision 6
39 of section 2807-s of the public health law, as amended by section 4 of
40 part A3 of chapter 62 of the laws of 2003, are amended and a new subpar-
41 agraph (x) is added to read as follows:
42 (viii) A gross annual statewide amount for two thousand four and two
43 thousand five shall be six hundred twenty-four million dollars.
44 (ix) A gross annual statewide amount for [the period January first,
45 two thousand five through June thirtieth, two thousand five] two thou-
46 sand six shall be [three hundred twelve] six hundred seventy-four
47 million dollars.
48 (x) A gross statewide amount for the period January first, two thou-
49 sand seven through June thirtieth, two thousand seven shall be three
50 hundred thirty-seven million dollars.
51 § 31. Subparagraphs (iv) and (v) of paragraph (c) of subdivision 6 of
52 section 2807-s of the public health law, as amended by section 5 of part
53 A3 of chapter 62 of the laws of 2003, are amended to read as follows:
54 (iv) A further gross annual statewide amount for two thousand, two
55 thousand one, two thousand two, two thousand three [and], two thousand
S. 992 63 A. 1922
1 four, two thousand five and two thousand six, shall be eighty-nine
2 million dollars.
3 (v) A further gross statewide amount for the period January first, two
4 thousand [five] seven through June thirtieth, two thousand [five] seven,
5 shall be forty-four million five hundred thousand dollars.
6 § 32. Subparagraphs (i) and (ii) of paragraph (e) of subdivision 6 of
7 section 2807-s of the public health law, as amended by section 6 of part
8 A3 of chapter 62 of the laws of 2003, are amended to read as follows:
9 (i) A further gross annual statewide amount shall be twelve million
10 dollars for each period prior to January first, two thousand [five]
11 seven.
12 (ii) A further gross statewide amount for the period January first,
13 two thousand [five] seven through June thirtieth, two thousand [five]
14 seven shall be six million dollars.
15 § 33. Subparagraphs (iv) and (v) of paragraph (a) of subdivision 7 of
16 section 2807-s of the public health law, as amended by section 11 of
17 part A3 of chapter 62 of the laws of 2003, are amended to read as
18 follows:
19 (iv) four hundred ninety-four million dollars on an annual basis for
20 the periods January first, two thousand through December thirty-first,
21 two thousand [four] six,
22 (v) two hundred forty-seven million dollars for the period January
23 first, two thousand [five] seven through June thirtieth, two thousand
24 [five] seven,
25 § 34. Subdivision 2 of section 2807-j of the public health law, as
26 amended by section 3 of part A3 of chapter 62 of the laws of 2003, is
27 amended to read as follows:
28 2. (a) The total percentage allowance for any period during the period
29 January first, nineteen hundred ninety-seven through December thirty-
30 first, nineteen hundred ninety-nine and on and after January first, two
31 thousand, for a designated provider of services applicable to a payor
32 shall be determined in accordance with this subdivision and applied to
33 net patient service revenues.
34 (b) The total percentage allowance for each payor, other than govern-
35 mental agencies, or health maintenance organizations for services
36 provided to subscribers eligible for medical assistance pursuant to
37 title eleven of article five of the social services law, or approved
38 organizations for services provided to subscribers eligible for the
39 family health plus program pursuant to title eleven-D of article five of
40 the social services law, and other than payments for a patient that has
41 no third-party coverage in whole or in part for services provided by a
42 designated provider of services, shall be:
43 (i) the sum of (A) eight and eighteen-hundredths percent, provided,
44 however, that for services provided on and after July first, two thou-
45 sand three, the percentage shall be eight and eighty-five hundredths
46 percent, and further provided that for services provided on and after
47 January first, two thousand six, the percentage shall be eight and nine-
48 ty-five hundredths percent, plus (B) twenty-four percent, provided,
49 however, that for services provided on and after July first, two thou-
50 sand three, the percentage shall be twenty-five and ninety-seven
51 hundredths percent, and further provided that for services provided on
52 and after January first, two thousand six, the percentage shall be twen-
53 ty-six and twenty-six hundredths percent, and plus (C) for a specified
54 third-party payor as defined in subdivision one-a of section twenty-
55 eight hundred seven-s of this article the percentage allowance applica-
S. 992 64 A. 1922
1 ble for a general hospital for inpatient hospital services pursuant to
2 subdivision two of section twenty-eight hundred seven-s of this article;
3 (ii) unless (A) an election in accordance with paragraph (a) of subdi-
4 vision five of this section to pay the allowance directly to the commis-
5 sioner or the commissioner's designee is in effect for a third-party
6 payor, and in addition (B) for a specified third-party payor an election
7 to pay the assessment in accordance with section twenty-eight hundred
8 seven-t of this article is in effect.
9 (c) If an election in accordance with subdivision five of this section
10 is in effect for a third-party payor and in addition in accordance with
11 section twenty-eight hundred seven-t of this article for a specified
12 third-party payor, the total percentage allowance factor shall be
13 reduced to eight and eighteen-hundredths percent, provided, however,
14 that for services provided on and after July first, two thousand three
15 the total percentage allowance factor shall be reduced to eight and
16 eighty-five hundredths percent, and further provided that for services
17 provided on and after January first, two thousand six, the total
18 percentage allowance factor shall be reduced to eight and ninety-five
19 hundredths percent.
20 (d) The total percentage allowance for payments by governmental agen-
21 cies, as determined in accordance with paragraphs (a) and (a-1) of
22 subdivision one of section twenty-eight hundred seven-c of this article
23 as in effect on December thirty-first, nineteen hundred ninety-six, or
24 health maintenance organizations for services provided to subscribers
25 eligible for medical assistance pursuant to title eleven of article five
26 of the social services law, or approved organizations for services
27 provided to subscribers eligible for the family health plus program
28 pursuant to title eleven-D of article five of the social services law,
29 shall be five and ninety-eight-hundredths percent, provided, however,
30 that for services provided on and after July first, two thousand three
31 the total percentage allowance shall be six and forty-seven hundredths
32 percent, and further provided that for services provided on and after
33 January first, two thousand six, the total percentage allowance shall be
34 six and fifty-four hundredths percent.
35 (e) The total percentage allowance for payments for services provided
36 by designated providers of services for which there is no third-party
37 coverage in whole or in part shall be eight and eighteen-hundredths
38 percent, provided, however, that for services provided on and after July
39 first, two thousand three the total percentage allowance shall be eight
40 and eighty-five hundredths percent, and further provided that for
41 services provided on and after January first, two thousand six, the
42 total percentage allowance shall be eight and ninety-five hundredths
43 percent. This paragraph shall not apply to patient deductibles and coin-
44 surance amounts.
45 (f) The total percentage allowance for patient deductibles and coinsu-
46 rance amounts shall be the same percentage allowance applicable to
47 payments by the primary third-party payor covering the patient in each
48 case determined in accordance with paragraphs (a), (b) and (c) of this
49 subdivision.
50 (g) The total percentage allowance for secondary third-party payors
51 under coordination of benefits principles shall be the same percentage
52 allowance applicable to payments by the primary third-party payor in the
53 case determined in accordance with paragraphs (a), (b) and (c) of this
54 subdivision.
55 § 35. Subdivision 18 of section 2807-c of the public health law is
56 amended by adding a new paragraph (f) to read as follows:
S. 992 65 A. 1922
1 (f) Payments of assessments required to be submitted by general hospi-
2 tals pursuant to this subdivision shall be subject to audit by the
3 commissioner for a period of ten years following the close of the calen-
4 dar year in which such payments are due, after which such payments shall
5 be deemed final and not subject to further adjustment or reconciliation.
6 General hospitals which, in the course of such an audit, fail to produce
7 data or documentation requested in furtherance of such an audit, in a
8 computer data format or such other format as may be required by the
9 commissioner, within thirty days of such request may be assessed a civil
10 penalty of up to ten thousand dollars for each such failure, provided,
11 however, that such civil penalty shall not be imposed if the hospital
12 demonstrates good cause for such failure. General hospitals which have
13 previously been assessed a civil penalty pursuant to this paragraph and
14 which, in the course of a subsequent audit conducted pursuant to this
15 paragraph, fail to produce data or documentation in accordance with the
16 requirements of this paragraph may be assessed a civil penalty of up to
17 twenty thousand dollars for each such failure, provided, however, that
18 such civil penalty shall not be imposed if the hospital demonstrates
19 good cause for such failure. The imposition of such civil penalties
20 shall be subject to the provisions of section twelve-a of this chapter.
21 § 36. Section 2807-j of the public health law is amended by adding a
22 new subdivision 8-a to read as follows:
23 8-a. (a) Payments and reports submitted or required to be submitted to
24 the commissioner or to the commissioner's designee pursuant to this
25 section and section twenty-eight hundred seven-s of this article by
26 designated providers of services and by third-party payors which have
27 elected to make payments directly to the commissioner or to the commis-
28 sioner's designee in accordance with subdivision five-a of this section,
29 shall be subject to audit by the commissioner for a period of ten years
30 following the close of the calendar year in which such payments and
31 reports are due, after which such payments shall be deemed final and not
32 subject to further adjustment or reconciliation.
33 (b) Designated providers of services or third-party payors which, in
34 the course of an audit pursuant to this section or section twenty-eight
35 hundred seven-s of this article, fail to produce data or documentation
36 requested in furtherance of such an audit, in a computer data format or
37 such other format as may be required by the commissioner, within thirty
38 days of such request, may be assessed a civil penalty of up to ten thou-
39 sand dollars for each such failure, provided, however, that such civil
40 penalty shall not be imposed if the audited entity demonstrates good
41 cause for such failure. Audited entities which have previously been
42 assessed a civil penalty pursuant to this section and which, in the
43 course of a subsequent audit conducted pursuant to this section or
44 section twenty-eight hundred seven-s of this article, fail to produce
45 data or documentation in accordance with the requirements of such
46 sections may be assessed a civil penalty of up to twenty thousand
47 dollars for each such failure, provided, however, that such civil penal-
48 ty shall not be imposed if the audited entity demonstrates good cause
49 for such failure. The imposition of civil penalties pursuant to this
50 section shall be subject to the provisions of section twelve-a of this
51 chapter.
52 (c) Records required to be retained for audit verification purposes by
53 designated providers of services and third-party payors in accordance
54 with this section and section twenty-eight hundred seven-s of this arti-
55 cle shall include, but not be limited to, on a monthly basis, the source
56 records generated by supporting information systems, detailed claims
S. 992 66 A. 1922
1 information, detailed patient revenue information, capitation arrange-
2 ments, financial accounting records, relevant correspondence and such
3 other records as may be required to prove compliance with, and to
4 support the reports submitted in accordance with, this section and
5 section twenty-eight hundred seven-s of this article. Such records shall
6 be maintained in a computer data format or such other format as may be
7 specified by the commissioner.
8 § 37. Paragraph (d) of subdivision 5 of section 2807-j of the public
9 health law is REPEALED.
10 § 38. Section 2807-t of the public health law is amended by adding a
11 new subdivision 10 to read as follows:
12 10. (a) Payments and reports submitted or required to be submitted to
13 the commissioner or to the commissioner's designee pursuant to this
14 section by specified third-party payors shall be subject to audit by the
15 commissioner for a period of ten years following the close of the calen-
16 dar year in which such payments and reports are due, after which such
17 payments shall be deemed final and not subject to further adjustment or
18 reconciliation.
19 (b) Specified third-party payors which, in the course of an audit
20 pursuant to this section fail to produce data or documentation requested
21 in furtherance of such an audit, in a computer data format or such other
22 format as may be required by the commissioner, within thirty days of
23 such request, may be assessed a civil penalty of up to ten thousand
24 dollars for each such failure, provided, however, that such civil penal-
25 ty shall not be imposed if such specified third-party payor demonstrates
26 good cause for such failure. Specified third-party payors which have
27 previously been assessed a civil penalty pursuant to this section and
28 which, in the course of a subsequent audit conducted pursuant to this
29 section, fail to produce data or documentation in accordance with the
30 requirements of this section may be assessed a civil penalty of up to
31 twenty thousand dollars for each such failure, provided, however, that
32 such civil penalty shall not be imposed if such specified third-party
33 payors demonstrates good cause for such failure. The imposition of civil
34 penalties pursuant to this section shall be subject to the provisions of
35 section twelve-a of this chapter.
36 (c) Records required to be retained for audit verification purposes by
37 specified third-party payors in accordance with this section shall
38 include, but not be limited to, on a monthly basis, the source records
39 generated by supporting information systems, financial accounting
40 records, relevant correspondence and the addresses and dates of coverage
41 for all individuals and family units, as defined by paragraphs (a) and
42 (b) of subdivision one of this section, and such other records as may be
43 required to prove compliance with, and to support reports submitted in
44 accordance with, this section. Such records shall be maintained in a
45 computer data format or such other format as may be specified by the
46 commissioner.
47 § 39. Subparagraphs (i) and (iii) of paragraph (d) of subdivision 3 of
48 section 2807-m of the public health law, as amended by section 12 of
49 part A3 of chapter 62 of the laws of 2003, are amended to read as
50 follows:
51 (i) the commissioner shall establish a reduction percentage by divid-
52 ing twenty-seven million dollars each year for the period January first,
53 two thousand through December thirty-first, two thousand [four] six and
54 thirteen million five hundred thousand dollars for the period January
55 first, two thousand [five] seven through June thirtieth, two thousand
S. 992 67 A. 1922
1 [five] seven, by the sum of initial hospital distribution amounts calcu-
2 lated pursuant to paragraph (c) of this subdivision;
3 (iii) each teaching general hospital shall have its initial distrib-
4 ution amount as determined pursuant to paragraph (c) of this subdivision
5 reduced by an amount up to the amount calculated pursuant to subpara-
6 graph (ii) of this paragraph and subject to the requirements of subpara-
7 graph (iv) of this paragraph, provided, however, that if the sum of
8 reduction amounts for all facilities thus calculated is less than twen-
9 ty-seven million dollars on a statewide basis each year for the period
10 January first, two thousand through December thirty-first, two thousand
11 [four] six and thirteen million five hundred thousand dollars for the
12 period January first, two thousand [five] seven through June thirtieth,
13 two thousand [five] seven, the commissioner may increase the reduction
14 percentage subject to the provisions of subparagraph (iv) of this para-
15 graph so that the sum of the reduction amounts for all facilities is
16 twenty-seven million dollars each year for the period January first, two
17 thousand through December thirty-first, two thousand [four] six and
18 thirteen million five hundred thousand dollars for the period January
19 first, two thousand [five] seven through June thirtieth, two thousand
20 [five] seven.
21 § 40. Paragraph (a) of subdivision 5 of section 2807-m of the public
22 health law, as amended by section 13 of part A3 of chapter 62 of the
23 laws of 2003, is amended to read as follows:
24 (a) Up to thirty-one million dollars annually for the periods January
25 first, two thousand through December thirty-first, two thousand [four]
26 six, and up to fifteen million five hundred thousand dollars for the
27 period January first, two thousand [five] seven through June thirtieth,
28 two thousand [five] seven, shall be set aside and reserved by the
29 commissioner [annually] from the regional pools established pursuant to
30 subdivision two of this section for supplemental distributions in each
31 such region to be made by the commissioner to consortia and teaching
32 general hospitals in accordance with a distribution methodology devel-
33 oped in consultation with the council and specified in rules and regu-
34 lations adopted by the commissioner.
35 § 41. Subdivision 7 of section 2807-m of the public health law, as
36 amended by section 14 of part A3 of chapter 62 of the laws of 2003, is
37 amended to read as follows:
38 7. Notwithstanding any inconsistent provision of section one hundred
39 twelve or one hundred sixty-three of the state finance law or any other
40 law, up to one million dollars for the period January first, two thou-
41 sand through December thirty-first, two thousand, up to one million six
42 hundred thousand dollars annually for the periods January first, two
43 thousand one through December thirty-first, two thousand [four] six, and
44 up to eight hundred thousand dollars for the period January first, two
45 thousand [five] seven through June thirtieth, two thousand [five] seven,
46 shall be set aside and reserved by the commissioner from the regional
47 pools established pursuant to subdivision two of this section for
48 distributions to the New York state area health education center program
49 for the purpose of expanding community-based training of medical
50 students. The New York state area health education center program shall
51 report to the commissioner on an annual basis regarding the use of funds
52 for such purpose in such form and manner as specified by the commission-
53 er.
54 § 42. Subdivision 3 and paragraphs (a) and (a-1) of subdivision 4 of
55 section 2807-k of the public health law, as amended by section 7 of part
56 A3 of chapter 62 of the laws of 2003, are amended to read as follows:
S. 992 68 A. 1922
1 3. (a) Each major public general hospital shall be allocated for
2 distribution from the pools established pursuant to this section for
3 each year through December thirty-first, two thousand [four] six, an
4 amount equal to the amount allocated to such major public general hospi-
5 tal from the regional pool established pursuant to subdivision seventeen
6 of section twenty-eight hundred seven-c of this article for the period
7 January first, nineteen hundred ninety-six through December thirty-
8 first, nineteen hundred ninety-six.
9 (b) For the period January first, two thousand [five] seven through
10 June thirtieth, two thousand [five] seven, each major public general
11 hospital shall be allocated for distribution from the pools established
12 pursuant to this section for such period, an amount equal to one-half
13 the amount calculated pursuant to paragraph (a) of this subdivision.
14 (a) From funds in the pool for each year, thirty-six million dollars
15 shall be reserved on an annual basis through December thirty-first, two
16 thousand [four] six and eighteen million dollars shall be reserved for
17 the period January first, two thousand [five] seven through June thirti-
18 eth, two thousand [five] seven, for distribution as high need adjust-
19 ments in accordance with subdivision six of this section.
20 (a-1) From funds in the pool for each year, twenty-seven million
21 dollars shall be reserved on an annual basis for the periods January
22 first, two thousand through December thirty-first, two thousand [four]
23 six and thirteen million five hundred thousand dollars shall be reserved
24 for the period January first, two thousand [five] seven through June
25 thirtieth, two thousand [five] seven, for distribution in accordance
26 with subdivision sixteen of this section.
27 § 43. The opening paragraph, paragraph (a) of subdivision 1, and
28 subdivision 2 of section 2807-w of the public health law, as amended by
29 section 10 of part A3 of chapter 62 of the laws of 2003, are amended to
30 read as follows:
31 Funds allocated pursuant to paragraph (p) of subdivision one of
32 section twenty-eight hundred seven-v of this article, shall be deposited
33 as authorized and used for the purpose of making medicaid dispropor-
34 tionate share payments within the limits established on an annualized
35 basis pursuant to subdivision twenty-one of section twenty-eight hundred
36 seven-c of this article, for the period January first, two thousand
37 through June thirtieth, two thousand [five] seven, in accordance with
38 the following:
39 (a) Each eligible rural hospital shall receive one hundred four thou-
40 sand dollars on an annualized basis for the periods January first, two
41 thousand through December thirty-first, two thousand [four] six and
42 seventy thousand dollars for the period January first, two thousand
43 [five] seven through June thirtieth, two thousand [five] seven, provided
44 as a disproportionate share payment; provided, however, that if such
45 payment pursuant to this paragraph exceeds a hospital's applicable
46 disproportionate share limit, then the total amount in excess of such
47 limit shall be provided as a nondisproportionate share payment in the
48 form of a grant directly from this pool without allocation to the
49 special revenue funds - other, indigent care fund - 068, or any succes-
50 sor fund or account;
51 2. From the funds in the pool each year, thirty-six million dollars on
52 an annualized basis for the periods January first, two thousand through
53 December thirty-first, two thousand [four] six and eighteen million
54 dollars for the period January first, two thousand [five] seven through
55 June thirtieth, two thousand [five] seven, of the funds not distributed
56 in accordance with subdivision one of this section, shall be distributed
S. 992 69 A. 1922
1 in accordance with the formula set forth in subdivision six of section
2 twenty-eight hundred seven-k of this article.
3 § 44. Subparagraphs (iv), (v) and (vi) of paragraph (a) of subdivision
4 9 of section 2807-j of the public health law, subparagraphs (iv) and (v)
5 as amended by section 8 of part A3 of chapter 62 of the laws of 2003 and
6 subparagraph (vi) as added by chapter 1 of the laws of 1999, are amended
7 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 [four] six, and
11 (v) three hundred eighty-two million five hundred thousand dollars of
12 the funds accumulated for the period January first, two thousand [five]
13 seven through June thirtieth, two thousand [five] seven, and
14 (vi) if funds accumulated for distributions pursuant to section twen-
15 ty-eight hundred seven-k of this article are insufficient to meet the
16 funding requirements established pursuant to subparagraphs (iv) and (v)
17 of this paragraph, the commissioner is authorized to transfer and depos-
18 it funds accumulated pursuant to section twenty-eight hundred seven-v of
19 this article into the special revenue funds - other, indigent care fund
20 - 068, or any successor fund or account, to fully fund the amounts
21 established pursuant to subparagraphs (iv) and (v) of this paragraph;
22 provided however, the provisions of this subparagraph shall only be
23 effective after funding amounts specified in subparagraph (viii) of
24 paragraph (a) of subdivision one of section twenty-eight hundred seven-l
25 of this article.
26 § 45. Section 1680-j of the public authorities law, as added by
27 section 2 of part D of chapter 58 of the laws of 2004, is amended to
28 read as follows:
29 § 1680-j. Authorization for the issuance of bonds for the health care
30 system improvement capital grant program. Notwithstanding any other
31 provision of law to the contrary, the dormitory authority of the state
32 of New York is hereby authorized to issue bonds or notes in one or more
33 series in an aggregate principal amount not to exceed [two] seven
34 hundred fifty million dollars excluding bonds issued to fund one or more
35 debt service reserve funds, to pay costs of issuance of such bonds, and
36 bonds or notes issued to refund or otherwise repay such bonds or notes
37 previously issued, for the purposes of financing project costs author-
38 ized under section twenty-eight hundred eighteen of the public health
39 law. Of such [two] seven hundred fifty million dollars, ten million
40 dollars shall be made available to the community health centers capital
41 program established pursuant to section twenty-eight hundred seventeen
42 of the public health law.
43 1. Such bonds and notes of the dormitory authority shall not be a debt
44 of the state and the state shall not be liable thereon, nor shall they
45 be payable out of any funds other than those appropriated by the state
46 to the authority for debt service and related expenses pursuant to any
47 service contract executed pursuant to subdivision two of this section,
48 and such bonds and notes shall contain on the face thereof a statement
49 to such effect. Except for purposes of complying with the internal
50 revenue code, any interest income earned on bond proceeds shall only be
51 used to pay debt service on such bonds. All of the provisions of the
52 dormitory authority act relating to bonds and notes which are not incon-
53 sistent with the provisions of this section shall apply to obligations
54 authorized by this section, including but not limited to the power to
55 establish adequate reserves therefore and to issue renewal notes or
56 refunding bonds thereof. The issuance of any bonds or notes hereunder
S. 992 70 A. 1922
1 shall further be subject to the approval of the director of the division
2 of the budget, and any projects funded through the issuance of bonds or
3 notes hereunder shall be approved by the New York state public authori-
4 ties control board, as required under section fifty-one of this chapter.
5 2. Notwithstanding any other law, rule or regulation to the contrary,
6 in order to assist the dormitory authority in undertaking the adminis-
7 tration and financing of projects authorized under this section, the
8 director of the budget is hereby authorized to enter into one or more
9 service contracts with the dormitory authority, none of which shall
10 exceed more than thirty years in duration, upon such terms and condi-
11 tions as the director of the budget and the dormitory authority agree,
12 so as to annually provide to the dormitory authority, in the aggregate,
13 a sum not to exceed the annual debt service payments and related
14 expenses required for the bonds and notes issued pursuant to this
15 section. Any service contract entered into pursuant to this subdivision
16 shall provide that the obligation of the state to pay the amount therein
17 provided shall not constitute a debt of the state within the meaning of
18 any constitutional or statutory provision and shall be deemed executory
19 only to the extent of monies available and that no liability shall be
20 incurred by the state beyond the monies available for such purposes,
21 subject to annual appropriation by the legislature. Any such contract or
22 any payments made or to be made thereunder may be assigned or pledged by
23 the dormitory authority as security for its bonds and notes, as author-
24 ized by this section.
25 § 46. Paragraphs 1 and 2 of subsection (j) of section 4301 of the
26 insurance law, paragraph 1 as amended and paragraph 2 as added by
27 section 8 of part A of chapter 1 of the laws of 2002, are amended to
28 read as follows:
29 (1) [No] Except as provided in this subsection, every medical expense
30 indemnity corporation, dental expense indemnity corporation, health
31 service corporation, or hospital service corporation shall be [converted
32 into a corporation organized for pecuniary profit. Every such corpo-
33 ration shall be] maintained and operated for the benefit of its members
34 and subscribers as a co-operative corporation.
35 (2) An article forty-three corporation [which was the subject of an
36 initial opinion and decision issued by the superintendent on or before
37 December thirty-first, nineteen hundred ninety-nine, as the same may be
38 amended,] and its not-for-profit subsidiaries (including, without limi-
39 tation, any such subsidiary licensed as a health service corporation
40 pursuant to this chapter or as a health maintenance organization organ-
41 ized pursuant to article forty-four of the public health law) may be
42 converted into [a corporation or other entity] one or more corporations
43 or other entities organized for pecuniary profit, or into [a for-profit
44 organization] one or more for-profit organizations, in any such case, in
45 accordance with the provisions of section seven thousand three hundred
46 seventeen of this chapter.
47 § 47. Subparagraph (G) of paragraph 4 of subsection (j) of section
48 4301 of the insurance law, as added by section 8 of part A of chapter 1
49 of the laws of 2002, is amended to read as follows:
50 (G) (1) Neither the members of the board nor any agent or other person
51 or persons acting on its behalf, while acting within the scope of their
52 authority as members or agents of the board, shall be subject to any
53 personal liability resulting from the carrying out of the powers
54 conferred hereunder; and (2) the provisions of section seventeen of the
55 public officers law shall apply to members of the board and agents or
56 other persons acting on its behalf, in connection with any and all
S. 992 71 A. 1922
1 claims, demands, suits, actions or proceedings which may be made or
2 brought against any of them arising out of any determination made or
3 actions taken or omitted to be taken in compliance with any obligations
4 under or pursuant to the terms of this section or section seven thousand
5 three hundred seventeen of this chapter. The provisions of this subpara-
6 graph shall be severable from and shall survive any legal challenge to
7 the legality, validity, or constitutionality of this section;
8 § 48. Paragraph 4 of subsection (j) of section 4301 of the insurance
9 law is amended by adding a new subparagraph (P) to read as follows:
10 (P) For purposes of the state finance law, including, but not limited
11 to, section one hundred twelve thereof, the fund established pursuant to
12 subsection (e) of section seven thousand three hundred seventeen of this
13 chapter and its board shall not be considered and shall not constitute
14 the state, a state agency, department, board, officer, commission,
15 institution, employee, fund, bureau, division, council, office, commit-
16 tee, body, or agent of any kind.
17 § 49. Paragraph 1 of subsection (a) of section 7317 of the insurance
18 law, as added by section 10 of part A of chapter 1 of the laws of 2002,
19 is amended to read as follows:
20 (1) An article forty-three corporation [which was the subject of an
21 initial opinion and decision issued by the superintendent on or before
22 December thirty-first, nineteen hundred ninety-nine, as the same may be
23 amended,] and its not-for-profit subsidiaries (including, without limi-
24 tation, any such subsidiary licensed as a health service corporation
25 pursuant to this chapter or as a health maintenance organization organ-
26 ized pursuant to article forty-four of the public health law) which
27 seeks to convert into [a corporation or other entity] one or more corpo-
28 rations or other entities organized for pecuniary profit or into [a
29 for-profit organization] one or more for-profit organizations of any
30 kind shall submit a proposed plan of conversion to the superintendent
31 for approval pursuant to this section.
32 § 50. Paragraph 8 of subsection (k) of section 7317 of the insurance
33 law, as added by section 10 of part A of chapter 1 of the laws of 2002,
34 is amended to read as follows:
35 (8) (A) Neither the members of the board of directors of the charita-
36 ble organization nor any agent or other person or persons acting on its
37 behalf, while acting within the scope of their authority as members or
38 agents of the board, shall be subject to any personal liability result-
39 ing from the carrying out of the powers conferred hereunder; and (B) the
40 provisions of section seventeen of the public officers law shall apply
41 to members of the board and agents or other persons acting on its
42 behalf, in connection with any and all claims, demands, suits, actions
43 or proceedings which may be made or brought against any of them arising
44 out of any determination made or actions taken or omitted to be taken in
45 compliance with any obligations under or pursuant to the terms of this
46 section or section four thousand three hundred one of this chapter. The
47 provisions of this subparagraph shall be severable from and shall
48 survive any legal challenge to the legality, validity, or constitution-
49 ality of this section.
50 § 51. Section 59 of part J of chapter 82 of the laws of 2002 amending
51 the environmental conservation law and other laws relating to enacting
52 major components necessary to implement the state fiscal plan for the
53 2002-2003 state fiscal year, is amended to read as follows:
54 § 59. Notwithstanding any law, rule or regulation to the contrary, the
55 commissioner of health is authorized to [borrow] utilize any existing
56 cash balances in pools established or funded pursuant to sections
S. 992 72 A. 1922
1 2807-j, 2807-k, 2807-m, 2807-s, 2807-t and 2807-v of the public health
2 law for the purpose of meeting any funding obligations set forth in
3 sections 2807-k, 2807-l, 2807-m or 2807-v of the public health law[,
4 provided, however, that such authorization shall expire and be of no
5 further effect in the event the two hundred million dollars transferred
6 from pools established pursuant to sections 2807-j and 2807-v of the
7 public health law pursuant to section fifty-eight of this act are trans-
8 ferred back to said pools from the state general fund or otherwise; and
9 further provided that such authorization shall in no event extend beyond
10 December 31, 2005; and further provided that, commencing with the effec-
11 tive date of this section, reports of cash transfers made pursuant to
12 this section shall be submitted on a semi-annual basis to the director
13 of the budget, the temporary president of the senate and the speaker of
14 the assembly].
15 § 52. Paragraph (a) of subdivision 4 of section 2807-j of the public
16 health law, as amended by section 35 of part A3 of chapter 62 of the
17 laws of 2003, is amended to read as follows:
18 (a) [The] For periods prior to January first, two thousand five, the
19 commissioner is authorized to contract with the article forty-three
20 insurance law plans, or such other contractors as the commissioner shall
21 designate, to receive and distribute funds from the allowances estab-
22 lished pursuant to this section, and funds from the assessments estab-
23 lished pursuant to subdivision eighteen of section twenty-eight hundred
24 seven-c of this article. In the event contracts with the article forty-
25 three insurance law plans or other commissioner's designees are effectu-
26 ated, the commissioner shall conduct annual audits of the receipt and
27 distribution of the funds. The reasonable costs and expenses of an
28 administrator as approved by the commissioner, not to exceed for person-
29 nel services on an annual basis two million two hundred thousand dollars
30 for collection and distribution of allowances and assessments estab-
31 lished pursuant to this section and subdivision eighteen of section
32 twenty-eight hundred seven-c of this article, shall be paid from the
33 allowance and assessment funds.
34 § 53. Paragraph (a) of subdivision 4 of section 2807-s of the public
35 health law, as amended by section 36 of part A3 of chapter 62 of the
36 laws of 2003, is amended to read as follows:
37 (a) [The] For periods prior to January first, two thousand five, the
38 commissioner is authorized to contract with the article forty-three
39 insurance law plans, or such other contractors as the commissioner shall
40 designate, to receive and distribute funds from the allowances estab-
41 lished pursuant to this section and funds from the assessments estab-
42 lished pursuant to section twenty-eight hundred seven-t of this article.
43 In the event contracts with the article forty-three insurance law plans
44 or other commissioner's designees are effectuated, the commissioner
45 shall conduct annual audits of the receipt and distribution of the
46 funds. The reasonable costs and expenses of an administrator as approved
47 by the commissioner, not to exceed for personnel services on an annual
48 basis eight hundred fifty thousand dollars for collection and distrib-
49 ution of allowances established pursuant to this section and assessments
50 established pursuant to this section and assessments established pursu-
51 ant to section twenty-eight hundred seven-t of this article shall be
52 paid from the allowance and assessment funds.
53 § 54. Intentionally omitted.
54 § 55. Paragraph (c) of subdivision 16 of section 2807-c of the public
55 health law, as amended by chapter 731 of the laws of 1993, is amended to
56 read as follows:
S. 992 73 A. 1922
1 (c) [The] For periods prior to January first, two thousand five, the
2 commissioner and the commissioner of social services are authorized to
3 contract with the article forty-three insurance law plans, or if not
4 available such other administrators as the commissioner and the commis-
5 sioner of social services shall designate, to receive funds for the bad
6 debt and charity care regional pools and/or the bad debt and charity
7 care and capital statewide pool and distribute funds from such pools. In
8 the event contracts with the article forty-three insurance law plans or
9 other commissioners' designees are effectuated, the commissioner and the
10 commissioner of social services shall jointly conduct or cause to be
11 conducted annual audits of the receipt and distribution of the pooled
12 funds. The reasonable costs and expenses of a pool administrator as
13 approved by the commissioner and the commissioner of social services,
14 not to exceed for personnel services on an annual basis four hundred
15 thousand dollars for all pools, shall be paid from the pooled funds.
16 Such pool administrator or pool administrators shall be acting on behalf
17 of the state medical assistance program provided pursuant to title elev-
18 en of article five of the social services law in the distribution to
19 hospitals pursuant to subdivisions fourteen-c, seventeen and paragraphs
20 (c) and (d) of subdivision nineteen of this section of pooled funds.
21 § 56. Subdivision 4 of section 2807-d of the public health law, as
22 amended by chapter 41 of the laws of 1992, is amended to read as
23 follows:
24 4. [The] For periods prior to January first, two thousand five, the
25 commissioner is authorized to contract with the article forty-three
26 insurance law plans, or if not available such other administrators as
27 the commissioner shall designate, to receive and distribute hospital
28 assessment funds. In the event contracts with the article forty-three
29 insurance law plans or other commissioner's designees are effectuated,
30 the commissioner shall conduct annual audits of the receipt and distrib-
31 ution of the assessment funds. The reasonable costs and expenses of an
32 administrator as approved by the commissioner, not to exceed for person-
33 nel services on an annual basis four hundred thousand dollars for all
34 assessments established pursuant to this section, shall be paid from the
35 assessment funds.
36 § 57. Subdivision 4 of section 3614-a of the public health law, as
37 added by chapter 938 of the laws of 1990, is amended to read as follows:
38 4. [The] For periods prior to January first, two thousand five, the
39 commissioner is authorized to contract with the article forty-three
40 insurance law plans, or such other administrators as the commissioner
41 shall designate, to receive and distribute home care provider assessment
42 funds and personal care services provider assessment funds assessed
43 pursuant to section three hundred sixty-seven-i of the social services
44 law. In the event contracts with the article forty-three insurance law
45 plans or other commissioner's designees are effectuated, the commission-
46 er shall conduct annual audits of the receipt and distribution of the
47 assessment funds. The reasonable costs and expenses of an administrator
48 as approved by the commissioner, not to exceed for personnel services on
49 an annual basis two hundred thousand dollars for all assessments estab-
50 lished pursuant to this section and the personal care services provider
51 assessment established pursuant to section three hundred sixty-seven-i
52 of the social services law, shall be paid from the assessment funds.
53 § 58. The public health law is amended by adding a new section 2807-y
54 to read as follows:
55 § 2807-y. Pool administration. 1. For periods on and after January
56 first, two thousand five, the commissioner is authorized to contract
S. 992 74 A. 1922
1 with the article forty-three insurance law plans, or such other contrac-
2 tors as the commissioner shall designate, to receive and distribute
3 funds from the allowances and assessments established pursuant to:
4 (a) subdivision eighteen of section twenty-eight hundred seven-c of
5 this article;
6 (b) section twenty-eight hundred seven-j of this article;
7 (c) section twenty-eight hundred seven-s of this article;
8 (d) section twenty-eight hundred seven-t of this article;
9 (e) section twenty-eight hundred seven-v of this article;
10 (f) section twenty-eight hundred seven-d of this article;
11 (g) section thirty-six hundred fourteen-a of this chapter; and
12 (h) section three hundred sixty-seven-i of the social services law.
13 2. In the event contracts with the article forty-three insurance law
14 plans or other commissioner's designees are effectuated, the commission-
15 er shall conduct annual audits of the receipt and distribution of the
16 funds.
17 3. The reasonable costs and expenses of an administrator as approved
18 by the commissioner, not to exceed for personnel services on an annual
19 basis four million five hundred fifty thousand dollars, increased annu-
20 ally by the lower of the consumer price index or five percent, for
21 collection and distribution of allowances and assessments set forth in
22 subdivision one of this section, shall be paid from the allowance and
23 assessment funds.
24 4. Notwithstanding any inconsistent provision of section one hundred
25 twelve or one hundred sixty-three of the state finance law or any other
26 law, at the discretion of the commissioner without a competitive bid or
27 request for proposal process, contracts in effect for administration of
28 the allowances and assessments set forth in subdivision one of this
29 section for the period January first, two thousand four through December
30 thirty-first, two thousand four may be extended to provide for adminis-
31 tration of the allowances and assessments pursuant to this section and
32 amended as necessary.
33 § 59. Section 34 of part A3 of chapter 62 of the laws of 2003, amend-
34 ing the general business law and other laws relating to enacting major
35 components necessary to implement the state fiscal plan for the
36 2003-2004 state fiscal year, is amended to read as follows:
37 § 34. (1) Notwithstanding any inconsistent provision of law, rule or
38 regulation, the commissioner of health is authorized to transfer within
39 amounts appropriated and the state comptroller is authorized and
40 directed to receive for deposit to the credit of the department of
41 health's special revenue fund - other, miscellaneous special revenue
42 fund - 339, provider collection monitoring account, [five hundred thou-
43 sand dollars ($500,000), or so much thereof as may be necessary, annual-
44 ly of] within amounts appropriated, those funds collected and accumu-
45 lated pursuant to section 2807-v of the public health law, including
46 income from invested funds, for the purpose of payment for administra-
47 tive costs of the department of health related to administration of
48 statutory duties for the collections and distributions authorized by
49 section 2807-v of the public health law.
50 (2) Notwithstanding any inconsistent provision of law, rule or regu-
51 lation, the commissioner of health is authorized to transfer and the
52 comptroller is authorized to deposit [five hundred thousand dollars
53 ($500,000), or so much thereof as may be necessary, annually of], within
54 amounts appropriated, those funds collected and accumulated and interest
55 earned through surcharges on payments for health care services pursuant
56 to section 2807-s of the public health law and from assessments pursuant
S. 992 75 A. 1922
1 to section 2807-t of the public health law for the purpose of payment
2 for administrative costs of the department of health related to adminis-
3 tration of statutory duties for the collections and distributions
4 authorized by sections 2807-s, 2807-t, and 2807-m of the public health
5 law into such accounts established within the department of health for
6 such purposes.
7 (3) Notwithstanding any inconsistent provision of law, rule or regu-
8 lation, the commissioner of health is authorized to transfer and the
9 comptroller is authorized to deposit, within amounts appropriated, those
10 funds authorized for distribution in accordance with the provisions of
11 paragraph (a) of subdivision 1 of section 2807-l of the public health
12 law for the purposes of payment for administrative costs of the depart-
13 ment of health related to the child health insurance plan program
14 authorized pursuant to title 1-A of article 25 of the public health law
15 into the special revenue funds - other, miscellaneous special revenue
16 fund - 339, child health insurance account established within the
17 department of health.
18 (4) Notwithstanding any inconsistent provision of law, rule or regu-
19 lation, the commissioner of health is authorized to transfer and the
20 comptroller is authorized to deposit, within amounts appropriated, those
21 funds authorized for distribution in accordance with the provisions of
22 paragraph (e) of subdivision 1 of section 2807-1 of the public health
23 law for the purpose of payment for administrative costs of the depart-
24 ment of health related to the health occupation development and work-
25 place demonstration program established pursuant to section 2807-h and
26 the health workforce retraining program established pursuant to section
27 2807-g of the public health law into the special revenue funds - other,
28 miscellaneous special revenue fund - 339, health occupation development
29 and workplace demonstration program account established within the
30 department of health.
31 (5) Notwithstanding any inconsistent provision of law, rule or regu-
32 lation, the commissioner of health is authorized to transfer and the
33 comptroller is authorized to deposit two million six hundred thousand
34 dollars [($2,000,000)] ($2,600,000), or so much thereof as may be neces-
35 sary, annually of funds allocated pursuant to paragraph (j) of subdivi-
36 sion 1 of section 2807-v of the public health law for the purpose of
37 payment for administrative costs of the department of health related to
38 administration of the state's tobacco control programs and cancer
39 services provided pursuant to sections 2807-r and 1399-ii of the public
40 health law into such accounts established within the department of
41 health for such purposes.
42 (6) Notwithstanding any inconsistent provision of law, rule or regu-
43 lation, the commissioner of health is authorized to transfer and deposit
44 [six] seven hundred fifty thousand dollars [($650,000)] ($750,000), or
45 so much thereof as may be necessary, annually of funds authorized for
46 distribution in accordance with the provisions of section 2807-l of the
47 public health law from monies accumulated and interest earned through
48 funds authorized for distribution in accordance with the provisions of
49 section 2807-l of the public health law for the purpose of payment for
50 administrative costs of the department of health related to programs
51 funded pursuant to section 2807-l of the public health law into the
52 special revenue funds - other, miscellaneous special revenue fund - 339,
53 primary care initiatives monitoring account established within the
54 department of health.
55 (7) [Notwithstanding any inconsistent provision of law, rule or regu-
56 lation, the commissioner of health is authorized to transfer and deposit
S. 992 76 A. 1922
1 one hundred thousand dollars ($100,000), or so much thereof as may be
2 necessary, annually of funds authorized for distribution in accordance
3 with the provisions of section 2807-l of the public health law for the
4 purposes of payment for administrative costs of the department of health
5 related to the programs funded pursuant to section 2807-l of the public
6 health law into the special revenue funds - other, miscellaneous special
7 revenue fund - 339, primary care initiatives monitoring account estab-
8 lished within the department of health.
9 (8)] Notwithstanding any inconsistent provision of law, rule or regu-
10 lation, the commissioner of health is authorized to transfer and the
11 comptroller is authorized to deposit, within amounts appropriated, the
12 funds authorized for distribution in accordance with the provisions of
13 section 2807-l of the public health law for the purposes of payment for
14 administrative costs of the department of health related to the programs
15 funded pursuant to section 2807-l of the public health law into the
16 special revenue funds - other, miscellaneous special revenue fund - 339,
17 pilot health insurance account, or any successor fund or account, estab-
18 lished within the department of health.
19 [(9)] (8) Notwithstanding any inconsistent provision of law, rule or
20 regulation, the commissioner of health is authorized to transfer and the
21 comptroller is authorized to deposit, within amounts appropriated, those
22 funds authorized for distribution in accordance with the provisions of
23 subparagraph (ii) of paragraph (f) of subdivision 19 of section 2807-c
24 of the public health law from monies accumulated and interest earned in
25 the bad debt and charity care and capital statewide pools through an
26 assessment charged to general hospitals pursuant to the provisions of
27 subdivision 18 of section 2807-c of the public health law and those
28 funds authorized for distribution in accordance with the provisions of
29 section 2807-l of the public health law for the purposes of payment for
30 administrative costs of the department of health related to monitoring
31 the implementation and effectiveness of programs funded under section
32 2807-l of the public health law into the special revenue funds - other,
33 miscellaneous special revenue fund - 339, primary care initiatives moni-
34 toring account established within the department of health.
35 [(10)] (9) Notwithstanding any inconsistent provision of law, rule or
36 regulation, the commissioner of health is authorized to transfer and the
37 comptroller is authorized to deposit, within amounts appropriated, those
38 funds authorized for distribution in accordance with section 2807-l of
39 the public health law for the purposes of payment for administrative
40 costs of the department of health related to programs funded under
41 section 2807-l of the public health law into the special revenue funds -
42 other, miscellaneous special revenue fund - 339, health care delivery
43 improvement grant administration account established within the depart-
44 ment of health.
45 [(11)] (10) Notwithstanding any inconsistent provision of law, rule or
46 regulation, the commissioner of health is authorized to transfer and the
47 comptroller is authorized to deposit, within amounts appropriated, those
48 funds authorized pursuant to sections 2807-d, 3614-a and 3614-b of the
49 public health law and section 367-i of the social services law and for
50 distribution in accordance with the provisions of subdivision 9 of
51 section 2807-j of the public health law for the purpose of payment for
52 administration of statutory duties for the collections and distributions
53 authorized by sections 2807-c, 2807-d, 2807-j, 2807-k, 2807-l, 3614-a
54 and 3614-b of the public health law and section 367-i of the social
55 services law into the special revenue funds - other, miscellaneous
S. 992 77 A. 1922
1 special revenue fund - 339, provider collection monitoring account
2 established within the department of health.
3 § 60. Subdivision 6 of section 2510 of the public health law, as
4 amended by chapter 639 of the laws of 1996, is amended to read as
5 follows:
6 6. "Period of eligibility" means that period commencing on the first
7 day of the month during which a child is an eligible child [or on the
8 first day of the month of application, whichever is later,] and enrolled
9 or recertified for enrollment on an annual basis based on all required
10 information and documentation and ending on the last day of the twelfth
11 month [in which a child ceases to be an eligible child, or up to the
12 last day of the third month after an eligible child becomes eligible for
13 medical assistance, whichever is earlier.] following such date,
14 provided, however:
15 (a) the period of eligibility for a child who ceases to be eligible
16 because he or she no longer resides in New York state or has access to
17 or obtained other health insurance coverage, as defined by the commis-
18 sioner in consultation with the superintendent pursuant to paragraph (c)
19 of subdivision two of section twenty-five hundred eleven of this arti-
20 cle, shall end the last day of the month in which the child ceases to be
21 an eligible child; and
22 (b) the period of eligibility for a child who becomes eligible for
23 medical assistance shall end the last day of the third month after the
24 child becomes eligible for medical assistance; and
25 (c) the period of eligibility for a child for whom an applicable
26 premium payment has not been paid shall end in accordance with time
27 frames and procedures determined by the commissioner.
28 § 61. Subdivision 4 of section 2511 of the public health law, as
29 amended by chapter 2 of the laws of 1998, is amended to read as follows:
30 4. Households shall report to the approved organization, within thirty
31 days, any changes in New York state residency or health care coverage
32 under insurance that may make a child ineligible for subsidy payments
33 pursuant to this section. Any individual who, with the intent to obtain
34 benefits, willfully misstates income or residence to establish eligibil-
35 ity pursuant to subdivision two of this section or willfully fails to
36 notify an approved organization of [an increase in income or] a change
37 in residence or health care coverage pursuant to this subdivision [two
38 of this section] shall repay such subsidy to the commissioner. Individ-
39 uals seeking to enroll children for coverage shall be informed that such
40 willful misstatement or failure to notify shall result in such liabil-
41 ity.
42 § 62. Paragraph (b) of subdivision 5-a of section 2511 of the public
43 health law, as added by chapter 170 of the laws of 1994, is amended to
44 read as follows:
45 (b) An approved organization shall promptly review all information
46 relating to a potential change in eligibility [as set forth in subdivi-
47 sion two of this section] based on information provided pursuant to
48 subdivision four of this section. Within at least thirty days after
49 receipt of such information, the approved organization shall make a
50 determination whether the child is still eligible for a subsidy payment
51 and shall notify the household and the commissioner if it determines the
52 child is not eligible for a subsidy payment.
53 § 63. Subdivision 8 of section 2510 of the public health law, as
54 amended by chapter 2 of the laws of 1998, is amended to read as follows:
55 8. "Subsidy payment" means a payment made to an approved organization
56 for the cost of covered health care services coverage to an eligible
S. 992 78 A. 1922
1 child or children, the amount of which shall be determined solely by the
2 commissioner.
3 § 64. Subdivision 5 of section 2511 of the public health law, as
4 amended by chapter 2 of the laws of 1998, is amended to read as follows:
5 5. Notwithstanding any inconsistent provisions of subdivision two of
6 this section, an individual who meets the criteria of paragraphs (b) and
7 (c) of subdivision two of this section but not the criteria of paragraph
8 (a) of such subdivision may be enrolled for covered health care
9 services, provided however, that an approved organization shall not be
10 eligible to receive a subsidy payment for providing coverage to such
11 individuals. The cost of coverage shall be determined by the commission-
12 er[, in consultation with the superintendent] and shall be no more than
13 the cost of providing such coverage.
14 § 65. Paragraph (b) of subdivision 7 of section 2511 of the public
15 health law, as amended by chapter 923 of the laws of 1990, is amended to
16 read as follows:
17 (b) The commissioner, in consultation with the superintendent, shall
18 make a determination whether to approve, disapprove or recommend modifi-
19 cation of the proposal. In order for a proposal to be approved by the
20 commissioner, the proposal must also be approved by the superintendent
21 with respect to the provisions of subparagraphs (viii) through [(xii)]
22 (x) of paragraph (a) of this subdivision.
23 § 66. Subparagraph (i) of paragraph (f) of subdivision 2 of section
24 2511 of the public health law, as added by section 44 of part A of chap-
25 ter 1 of the laws of 2002, is amended to read as follows:
26 (i) In order to establish income eligibility under this subdivision at
27 initial application, a household shall provide such documentation speci-
28 fied in subparagraph (iii) of this paragraph, as necessary and suffi-
29 cient to determine a child's financial eligibility for a subsidy payment
30 under this title. The commissioner may verify the accuracy of such
31 income information provided by the household by matching it against
32 income information contained in databases to which the commissioner has
33 access, including the state's wage reporting system pursuant to subdivi-
34 sion five of section one hundred seventy-one-a of the tax law.
35 § 67. Paragraph (g) of subdivision 2 of section 2511 of the public
36 health law, as added by chapter 2 of the laws of 1998, subparagraph (i)
37 as amended by chapter 419 of the laws of 2000, is amended to read as
38 follows:
39 (g) (i) Notwithstanding any inconsistent provision of law to the
40 contrary and subject to the availability of federal financial partic-
41 ipation under title XIX of the federal social security act, a child
42 under the age of nineteen shall be presumed to be eligible for subsidy
43 payments under this title, once during a twelve month period, beginning
44 on the first day of the enrollment period following the date that an
45 approved organization determines, on the basis of preliminary informa-
46 tion, that a child whose family's net household income does not exceed
47 one hundred ninety-two percent or, effective July first, two thousand,
48 two hundred eight percent of the non-farm federal poverty level or the
49 gross equivalent of such net income. The presumptive eligibility period
50 shall continue until the earlier of the date an eligibility determi-
51 nation is made pursuant to this title or title eleven of article five of
52 the social services law, or two months after the date presumptive eligi-
53 bility begins; provided however, a presumptive eligibility period may be
54 extended in the event an eligibility determination under this title or
55 title eleven of article five of the social services law is not made
56 within such two month period through no fault of the applicant for
S. 992 79 A. 1922
1 insurance for medical assistance. The commissioner shall assure that
2 children who are enrolled pursuant to this paragraph receive the appro-
3 priate follow-up for a determination of eligibility for benefits under
4 this title or title eleven of article five of the social services law
5 prior to the termination of the presumptive eligibility period. The
6 commissioner shall assure that children and their families are informed
7 of all available enrollment sites in accordance with subdivision nine of
8 this section.
9 (ii) [This paragraph shall have no force and effect and presumptive
10 eligibility under this paragraph shall not be available on and after the
11 date presumptive eligibility in the medical assistance program becomes
12 effective and is available pursuant to subdivision four of section three
13 hundred sixty-four-i and paragraph (u) of subdivision four of section
14 three hundred sixty-six of the social services law.] Effective one
15 hundred twenty days after the chapter of the laws of two thousand five
16 that amended this paragraph shall have become a law, the presumptive
17 eligibility provisions set forth in this paragraph as they relate to
18 children who appear eligible for medical assistance pursuant to title
19 eleven of article five of the social services law shall be null and void
20 and have no further force and effect; provided however, approved organ-
21 izations which do not have a contract with the state to provide facili-
22 tated enrollment services pursuant to subdivision nine of this section
23 shall continue to enroll such children presumptively in accordance with
24 this paragraph.
25 § 68. Section 2807-k of the public health law is amended by adding a
26 new subdivision 9-a to read as follows:
27 9-a. (a) In order for a general hospital to participate in the
28 distribution of funds from the pool, the general hospital must have
29 financial aid policies and procedures, in accordance with the provisions
30 of this subdivision, for reducing charges otherwise applicable to low-
31 income individuals without health insurance, or who have exhausted their
32 health insurance benefits, and who can demonstrate an inability to pay
33 full charges, and also for reducing or discounting the collection of
34 co-pays and deductible payments from those individuals who can demon-
35 strate an inability to pay such amounts.
36 (b) Such policies and procedures shall be clear, understandable, in
37 writing and publicly available and each general hospital participating
38 in the pool shall ensure that every patient is made aware of the exist-
39 ence of such policies and procedures and is provided, in a timely
40 manner, with a written copy of such policies and procedures upon
41 request.
42 (c) Such financial aid policies and procedures shall include clear,
43 objective criteria for determining a patient's ability to pay and for
44 providing such adjustments to payment requirements as are necessary.
45 Such adjustment mechanisms may include sliding fee schedules, discounts
46 to fixed standards and flexible or extended payment plans. Such policies
47 and procedures shall be applied consistently to all eligible patients.
48 (d) General hospitals may require that patients seeking payment
49 adjustments provide appropriate financial information and documentation
50 in support of their application, provided, however, that such applica-
51 tion process shall not be unduly burdensome or complex. General hospi-
52 tals shall, upon request, assist patients in understanding the hospi-
53 tal's policies and procedures and in applying for payment adjustments.
54 Decisions regarding such applications shall be made in a timely manner.
55 (e) Patients with incomes below two hundred percent of the federal
56 poverty level shall be presumptively eligible for payment adjustments,
S. 992 80 A. 1922
1 provided, however, that nothing in this provision shall be interpreted
2 as precluding hospitals from extending such payment adjustments to other
3 patients, either generally or on a case by case basis.
4 (f) General hospitals participating in the pool shall not force the
5 sale or foreclosure of a patient's primary residence in order to collect
6 an outstanding medical bill.
7 (g) Reports required to be submitted to the department by each general
8 hospital participating in the pool and which contain, in accordance with
9 applicable regulations, a certification from an independent certified
10 public accountant or independent licensed public accountant that the
11 hospital is in compliance with conditions of participation in the pool
12 shall also contain a certification from such accountant that such hospi-
13 tal is in compliance with the provisions of this subdivision.
14 § 69. Article 29-D of the public health law is amended by adding a new
15 title III to read as follows:
16 TITLE 3 - PAY FOR PERFORMANCE
17 Section 2999-b. Legislative intent.
18 2999-c. Definition.
19 2999-d. Commissioner's workgroup.
20 2999-e. Demonstration projects.
21 2999-f. Authorizations.
22 § 2999-b. Legislative intent. It is the intent of the legislature to
23 promote patient safety and the quality of care, as well as the cost
24 effectiveness of such care, by convening providers and payers to develop
25 clinical measures, and the metrics on which to measure provider perform-
26 ance. Thereafter, it is the legislature's intent to encourage and
27 support regional demonstration projects involving multiple payors
28 utilizing such metrics as the basis for providing financial incentives
29 to providers to achieve increased quality and cost effectiveness.
30 § 2999-c. Definition. "Health care plan" shall have the same meaning
31 set forth in subdivision four-e of section forty-nine hundred of this
32 chapter.
33 § 2999-d. Commissioner's workgroup. 1. The commissioner shall, within
34 ninety days of the effective date of this title, convene and chair,
35 directly or through a designee or designees, a workgroup including but
36 not necessarily limited to representatives of statewide and regional
37 health care provider associations, health care plan associations, and
38 self-insured employers.
39 2. The workgroup shall seek consensus on clinical measures and meas-
40 urement criteria necessary and appropriate to achieve improvement in
41 quality performance by providers in delivering health care services;
42 further, it shall develop metrics to be utilized by demonstration
43 projects selected pursuant to the provisions of this title which will,
44 when implemented:
45 (a) promote the use of best practices through the development of
46 broadly agreed upon performance measures;
47 (b) improve care coordination through the participation of multiple
48 stakeholders;
49 (c) institute long-term quality improvement;
50 (d) encourage appropriate utilization of health care services and
51 improve health outcomes through the use of evidence-based medicine prac-
52 tice guidelines; and
53 (e) promote self-management by consumers through the implementation of
54 patient-specific metrics.
55 § 2999-e. Demonstration projects. 1. Notwithstanding any other
56 provision of law, the commissioner is authorized and shall select demon-
S. 992 81 A. 1922
1 stration projects throughout the state which have been determined by the
2 commissioner to encompass one or more of the following elements:
3 (a) use of the workgroup metrics to measure and reward physician,
4 clinic and hospital performance;
5 (b) involvement of multiple payers, including government programs,
6 multiple providers and multiple communities agreeing to employ the work-
7 group metrics to reward physician, clinic and hospital performance for
8 quality improvement;
9 (c) use of information technology to share patient information among
10 providers to improve coordination of patient care;
11 (d) targeted improvement in care coordination through the partic-
12 ipation of multiple stakeholders;
13 (e) collection, analysis and public reporting on the measures, incen-
14 tives and processes utilized, and outcomes; and
15 (f) programs to enhance patient self-management through adherence to
16 treatment plans.
17 2. In evaluating proposed demonstration projects, the commissioner
18 shall consider the degree to which a proposed project reflects the
19 elements listed above.
20 § 2999-f. Authorizations. 1. The commissioner may contract with
21 projects and provide grants to support projects to the extent funds are
22 appropriated for such purpose.
23 2. The commissioner may authorize the participation of the Medicaid,
24 Family Health Plus and Child Health Plus programs in one or more demon-
25 stration projects.
26 3. The commissioner may contract with entities possessing expertise
27 deemed necessary to assist in the evaluation of the metrics developed by
28 the workgroup and individual project designs to the extent funds are
29 appropriated for such purpose.
30 4. The commissioner shall report to the governor and the legislature
31 on or before March first, two thousand six, on the results of the
32 commissioner's workgroup, and shall report within three years of the
33 effective date of this title, and again six months prior to the expira-
34 tion date of this title, on the number of demonstration projects chosen
35 and on the operation and effectiveness of each demonstration undertaken,
36 together with any recommendations the commissioner deems appropriate.
37 5. This title shall expire five years after it shall have become a
38 law.
39 § 70. Paragraph (a) of subdivision 1 of section 18 of chapter 266 of
40 the laws of 1986, amending the civil practice law and rules and other
41 laws relating to malpractice and professional medical conduct, as
42 amended by section 1 of part G of chapter 120 of the laws of 2004, is
43 amended to read as follows:
44 (a) The superintendent of insurance and the commissioner of health or
45 their designee shall, from funds available in the hospital excess
46 liability pool created pursuant to subdivision (5) of this section,
47 purchase a policy or policies for excess insurance coverage, as author-
48 ized by paragraph (1) of subsection (e) of section 5502 of the insurance
49 law; or from an insurer, other than an insurer described in section 5502
50 of the insurance law, duly authorized to write such coverage and actual-
51 ly writing medical malpractice insurance in this state; or shall
52 purchase equivalent excess coverage in a form previously approved by the
53 superintendent of insurance for purposes of providing equivalent excess
54 coverage in accordance with section 19 of chapter 294 of the laws of
55 1985, for medical or dental malpractice occurrences between July 1, 1986
56 and June 30, 1987, between July 1, 1987 and June 30, 1988, between July
S. 992 82 A. 1922
1 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
2 between July 1, 1990 and June 30, 1991, between July 1, 1991 and June
3 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993
4 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July
5 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997,
6 between July 1, 1997 and June 30, 1998, between July 1, 1998 and June
7 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000
8 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July
9 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, [and]
10 between July 1, 2004 and June 30, 2005, between July 1, 2005 and June
11 30, 2006 and between July 1, 2006 and June 30, 2007 or reimburse the
12 hospital where the hospital purchases equivalent excess coverage as
13 defined in subparagraph (i) of paragraph (a) of subdivision (1-a) of
14 this section for medical or dental malpractice occurrences between July
15 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989,
16 between July 1, 1989 and June 30, 1990, between July 1, 1990 and June
17 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992
18 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July
19 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996,
20 between July 1, 1996 and June 30, 1997, between July 1, 1997 and June
21 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999
22 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July
23 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003,
24 between July 1, 2003 and June 30, 2004, [and] between July 1, 2004 and
25 June 30, 2005, between July 1, 2005 and June 30, 2006 and between July
26 1, 2006 and June 30, 2007 for physicians or dentists certified as eligi-
27 ble for each such period or periods pursuant to subdivision (2) of this
28 section by a general hospital licensed pursuant to article 28 of the
29 public health law; provided that no single insurer shall write more than
30 fifty percent of the total excess premium for a given policy year; and
31 provided, however, that such eligible physicians or dentists must have
32 in force an individual policy, from an insurer licensed in this state of
33 primary malpractice insurance coverage in amounts of no less than one
34 million three hundred thousand dollars for each claimant and three
35 million nine hundred thousand dollars for all claimants under that poli-
36 cy during the period of such excess coverage for such occurrences or be
37 endorsed as additional insureds under a hospital professional liability
38 policy which is offered through a voluntary attending physician ("chan-
39 neling") program previously permitted by the superintendent of insurance
40 during the period of such excess coverage for such occurrences. During
41 such period, such policy for excess coverage or such equivalent excess
42 coverage shall, when combined with the physician's or dentist's primary
43 malpractice insurance coverage or coverage provided through a voluntary
44 attending physician ("channeling") program, total an aggregate level of
45 two million three hundred thousand dollars for each claimant and six
46 million nine hundred thousand dollars for all claimants from all such
47 policies with respect to occurrences in each of such years provided,
48 however, if the cost of primary malpractice insurance coverage in excess
49 of one million dollars, but below the excess medical malpractice insur-
50 ance coverage provided pursuant to this act, exceeds the rate of nine
51 percent per annum, then the required level of primary malpractice insur-
52 ance coverage in excess of one million dollars for each claimant shall
53 be in an amount of not less than the dollar amount of such coverage
54 available at nine percent per annum; the required level of such coverage
55 for all claimants under that policy shall be in an amount not less than
56 three times the dollar amount of coverage for each claimant; and excess
S. 992 83 A. 1922
1 coverage, when combined with such primary malpractice insurance cover-
2 age, shall increase the aggregate level for each claimant by one million
3 dollars and three million dollars for all claimants; and provided
4 further, that, with respect to policies of primary medical malpractice
5 coverage that include occurrences between April 1, 2002 and June 30,
6 2002, such requirement that coverage be in amounts no less than one
7 million three hundred thousand dollars for each claimant and three
8 million nine hundred thousand dollars for all claimants for such occur-
9 rences shall be effective April 1, 2002.
10 § 71. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
11 amending the civil practice law and rules and other laws relating to
12 malpractice and professional medical conduct, as amended by section 2 of
13 part G of chapter 120 of the laws of 2004, is amended to read as
14 follows:
15 (3)(a) The superintendent of insurance shall determine and certify to
16 each general hospital and to the commissioner of health the cost of
17 excess malpractice insurance for medical or dental malpractice occur-
18 rences between July 1, 1986 and June 30, 1987, between July 1, 1988 and
19 June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1,
20 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between
21 July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994,
22 between July 1, 1994 and June 30, 1995, between July 1, 1995 and June
23 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997
24 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July
25 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001,
26 between July 1, 2001 and June 30, 2002, between July 1, 2002 and June
27 30, 2003, between July 1, 2003 and June 30, 2004, [and] between July 1,
28 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006 and
29 between July 1, 2006 and June 30, 2007 allocable to each general hospi-
30 tal for physicians or dentists certified as eligible for purchase of a
31 policy for excess insurance coverage by such general hospital in accord-
32 ance with subdivision (2) of this section, and may amend such determi-
33 nation and certification as necessary.
34 (b) The superintendent of insurance shall determine and certify to
35 each general hospital and to the commissioner of health the cost of
36 excess malpractice insurance or equivalent excess coverage for medical
37 or dental malpractice occurrences between July 1, 1987 and June 30,
38 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 and
39 June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1,
40 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between
41 July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
42 between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
43 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
44 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
45 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
46 between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
47 30, 2004, [and] between July 1, 2004 and June 30, 2005, between July 1,
48 2005 and June 30, 2006 and between July 1, 2006 and June 30, 2007 allo-
49 cable to each general hospital for physicians or dentists certified as
50 eligible for purchase of a policy for excess insurance coverage or
51 equivalent excess coverage by such general hospital in accordance with
52 subdivision (2) of this section, and may amend such determination and
53 certification as necessary. The superintendent of insurance shall deter-
54 mine and certify to each general hospital and to the commissioner of
55 health the ratable share of such cost allocable to the period July 1,
56 1987 to December 31, 1987, to the period January 1, 1988 to June 30,
S. 992 84 A. 1922
1 1988, to the period July 1, 1988 to December 31, 1988, to the period
2 January 1, 1989 to June 30, 1989, to the period July 1, 1989 to December
3 31, 1989, to the period January 1, 1990 to June 30, 1990, to the period
4 July 1, 1990 to December 31, 1990, to the period January 1, 1991 to June
5 30, 1991, to the period July 1, 1991 to December 31, 1991, to the period
6 January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
7 31, 1992, to the period January 1, 1993 to June 30, 1993, to the period
8 July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
9 30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
10 January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
11 31, 1995, to the period January 1, 1996 to June 30, 1996, to the period
12 July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
13 30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
14 January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
15 31, 1998, to the period January 1, 1999 to June 30, 1999, to the period
16 July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
17 30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
18 January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
19 2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
20 2003 to June 30, 2004, [and] to the period July 1, 2004 to June 30,
21 2005, to the period July 1, 2005 and June 30, 2006 and to the period
22 July 1, 2006 and June 30, 2007.
23 § 72. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of
24 section 18 of chapter 266 of the laws of 1986, amending the civil prac-
25 tice law and rules and other laws relating to malpractice and profes-
26 sional medical conduct, as amended by section 3 of part G of chapter 120
27 of the laws of 2004, are amended to read as follows:
28 (a) To the extent funds available to the hospital excess liability
29 pool pursuant to subdivision (5) of this section as amended, and pursu-
30 ant to section 6 of part J of chapter 63 of the laws of 2001, as may
31 from time to time be amended, which amended this subdivision, are insuf-
32 ficient to meet the costs of excess insurance coverage or equivalent
33 excess coverage for coverage periods during the period July 1, 1992 to
34 June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
35 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
36 to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
37 during the period July 1, 1997 to June 30, 1998, during the period July
38 1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
39 2000, during the period July 1, 2000 to June 30, 2001, during the period
40 July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
41 June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
42 the period July 1, 2003 to June 30, 2004, [and] during the period July
43 1, 2004 to June 30, 2005, during the period July 1, 2005 to June 30,
44 2006 and during the period July 1, 2006 to June 30, 2007 allocated or
45 reallocated in accordance with paragraph (a) of subdivision (4-a) of
46 this section to rates of payment applicable to state governmental agen-
47 cies, each physician or dentist for whom a policy for excess insurance
48 coverage or equivalent excess coverage is purchased for such period
49 shall be responsible for payment to the provider of excess insurance
50 coverage or equivalent excess coverage of an allocable share of such
51 insufficiency, based on the ratio of the total cost of such coverage for
52 such physician to the sum of the total cost of such coverage for all
53 physicians applied to such insufficiency.
54 (b) Each provider of excess insurance coverage or equivalent excess
55 coverage covering the period July 1, 1992 to June 30, 1993, or covering
56 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
S. 992 85 A. 1922
1 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
2 1996, or covering the period July 1, 1996 to June 30, 1997, or covering
3 the period July 1, 1997 to June 30, 1998, or covering the period July 1,
4 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
5 2000, or covering the period July 1, 2000 to June 30, 2001, or covering
6 the period July 1, 2001 to October 29, 2001, or covering the period
7 April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
8 June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
9 covering the period July 1, 2004 to June 30, 2005, or covering the peri-
10 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
11 June 30, 2007 shall notify a covered physician or dentist by mail,
12 mailed to the address shown on the last application for excess insurance
13 coverage or equivalent excess coverage, of the amount due to such
14 provider from such physician or dentist for such coverage period deter-
15 mined in accordance with paragraph (a) of this subdivision. Such amount
16 shall be due from such physician or dentist to such provider of excess
17 insurance coverage or equivalent excess coverage in a time and manner
18 determined by the superintendent of insurance.
19 (c) If a physician or dentist liable for payment of a portion of the
20 costs of excess insurance coverage or equivalent excess coverage cover-
21 ing the period July 1, 1992 to June 30, 1993, or covering the period
22 July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
23 June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
24 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
25 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
26 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
27 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
28 od July 1, 2001 to October 29, 2001, or covering the period April 1,
29 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
30 2003, or covering the period July 1, 2003 to June 30, 2004, or covering
31 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
32 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
33 2007 determined in accordance with paragraph (a) of this subdivision
34 fails, refuses or neglects to make payment to the provider of excess
35 insurance coverage or equivalent excess coverage in such time and manner
36 as determined by the superintendent of insurance pursuant to paragraph
37 (b) of this subdivision, excess insurance coverage or equivalent excess
38 coverage purchased for such physician or dentist in accordance with this
39 section for such coverage period shall be cancelled and shall be null
40 and void as of the first day on or after the commencement of a policy
41 period where the liability for payment pursuant to this subdivision has
42 not been met.
43 (d) Each provider of excess insurance coverage or equivalent excess
44 coverage shall notify the superintendent of insurance and the commis-
45 sioner of health or their designee of each physician and dentist eligi-
46 ble for purchase of a policy for excess insurance coverage or equivalent
47 excess coverage covering the period July 1, 1992 to June 30, 1993, or
48 covering the period July 1, 1993 to June 30, 1994, or covering the peri-
49 od July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to
50 June 30, 1996, or covering the period July 1, 1996 to June 30, 1997, or
51 covering the period July 1, 1997 to June 30, 1998, or covering the peri-
52 od July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to
53 June 30, 2000, or covering the period July 1, 2000 to June 30, 2001, or
54 covering the period July 1, 2001 to October 29, 2001, or covering the
55 period April 1, 2002 to June 30, 2002, or covering the period July 1,
56 2002 to June 30, 2003, or covering the period July 1, 2003 to June 30,
S. 992 86 A. 1922
1 2004, or covering the period July 1, 2004 to June 30, 2005, or covering
2 the period July 1, 2005 to June 30, 2006, or covering the period July 1,
3 2006 to June 30, 2007 that has made payment to such provider of excess
4 insurance coverage or equivalent excess coverage in accordance with
5 paragraph (b) of this subdivision and of each physician and dentist who
6 has failed, refused or neglected to make such payment.
7 (e) A provider of excess insurance coverage or equivalent excess
8 coverage shall refund to the hospital excess liability pool any amount
9 allocable to the period July 1, 1992 to June 30, 1993, and to the period
10 July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
11 30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
12 period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
13 June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
14 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
15 to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
16 and to the period April 1, 2002 to June 30, 2002, and to the period July
17 1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
18 2004, and to the period July 1, 2004 to June 30, 2005, and to the period
19 July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
20 30, 2007 received from the hospital excess liability pool for purchase
21 of excess insurance coverage or equivalent excess coverage covering the
22 period July 1, 1992 to June 30, 1993, and covering the period July 1,
23 1993 to June 30, 1994, and covering the period July 1, 1994 to June 30,
24 1995, and covering the period July 1, 1995 to June 30, 1996, and cover-
25 ing the period July 1, 1996 to June 30, 1997, and covering the period
26 July 1, 1997 to June 30, 1998, and covering the period July 1, 1998 to
27 June 30, 1999, and covering the period July 1, 1999 to June 30, 2000,
28 and covering the period July 1, 2000 to June 30, 2001, and covering the
29 period July 1, 2001 to October 29, 2001, and covering the period April
30 1, 2002 to June 30, 2002, and covering the period July 1, 2002 to June
31 30, 2003, and covering the period July 1, 2003 to June 30, 2004, and
32 covering the period July 1, 2004 to June 30, 2005, and covering the
33 period July 1, 2005 to June 30, 2006, and covering the period July 1,
34 2006 to June 30, 2007 for a physician or dentist where such excess
35 insurance coverage or equivalent excess coverage is cancelled in accord-
36 ance with paragraph (c) of this subdivision.
37 § 73. Section 40 of chapter 266 of the laws of 1986, amending the
38 civil practice law and rules and other laws relating to malpractice and
39 professional medical conduct, as amended by section 4 of part G of chap-
40 ter 120 of the laws of 2004, is amended to read as follows:
41 § 40. The superintendent of insurance shall establish rates for poli-
42 cies providing coverage for physicians and surgeons medical malpractice
43 for the periods commencing July 1, 1985 and ending June 30, [2005] 2007.
44 The superintendent shall direct insurers to establish segregated
45 accounts for premiums, payments, reserves and investment income attrib-
46 utable to such premium periods and shall require periodic reports by the
47 insurers regarding claims and expenses attributable to such periods to
48 monitor whether such accounts will be sufficient to meet incurred claims
49 and expenses. On or after July 1, 1989, the superintendent shall impose
50 a surcharge on premiums to satisfy a projected deficiency that is
51 attributable to the premium levels established pursuant to this section
52 for such periods; provided, however, that such annual surcharge shall
53 not exceed eight percent of the established rate until July 1, [2005]
54 2007, at which time and thereafter such surcharge shall not exceed twen-
55 ty-five percent of the approved adequate rate, and that such annual
56 surcharges shall continue for such period of time as shall be sufficient
S. 992 87 A. 1922
1 to satisfy such deficiency. On and after July 1, 1989, the surcharge
2 prescribed by this section shall be retained by insurers to the extent
3 that they insured physicians and surgeons during the July 1, 1985
4 through June 30, [2005] 2007 policy periods; in the event and to the
5 extent physicians and surgeons were insured by another insurer during
6 such periods, all or a pro rata share of the surcharge, as the case may
7 be, shall be remitted to such other insurer in accordance with rules and
8 regulations to be promulgated by the superintendent. Surcharges
9 collected from physicians and surgeons who were not insured during such
10 policy periods shall be apportioned among all insurers in proportion to
11 the premium written by each insurer during such policy periods; if a
12 physician or surgeon was insured by an insurer subject to rates estab-
13 lished by the superintendent during such policy periods, and at any time
14 thereafter a hospital, health maintenance organization, employer or
15 institution is responsible for responding in damages for liability aris-
16 ing out of such physician's or surgeon's practice of medicine, such
17 responsible entity shall also remit to such prior insurer the equivalent
18 amount that would then be collected as a surcharge if the physician or
19 surgeon had continued to remain insured by such prior insurer. In the
20 event any insurer that provided coverage during such policy periods is
21 in liquidation, the property/casualty insurance security fund shall
22 receive the portion of surcharges to which the insurer in liquidation
23 would have been entitled. The surcharges authorized herein shall be
24 deemed to be income earned for the purposes of section 2303 of the
25 insurance law. The superintendent, in establishing adequate rates and
26 in determining any projected deficiency pursuant to the requirements of
27 this section and the insurance law, shall give substantial weight,
28 determined in his discretion and judgment, to the prospective antic-
29 ipated effect of any regulations promulgated and laws enacted and the
30 public benefit of stabilizing malpractice rates and minimizing rate
31 level fluctuation during the period of time necessary for the develop-
32 ment of more reliable statistical experience as to the efficacy of such
33 laws and regulations affecting medical, dental or podiatric malpractice
34 enacted or promulgated in 1985, 1986, by this act and at any other time.
35 Notwithstanding any provision of the insurance law, rates already estab-
36 lished and to be established by the superintendent pursuant to this
37 section are deemed adequate if such rates would be adequate when taken
38 together with the maximum authorized annual surcharges to be imposed for
39 a reasonable period of time whether or not any such annual surcharge has
40 been actually imposed as of the establishment of such rates.
41 § 74. Section 5 and subdivisions (a) and (e) of section 6 of part J of
42 chapter 63 of the laws of 2001, amending chapter 20 of the laws of 2001
43 amending the military law and other laws relating to making appropri-
44 ations for the support of government, as amended by section 5 of part G
45 of chapter 120 of the laws of 2004, are amended to read as follows:
46 § 5. The superintendent of insurance and the commissioner of health
47 shall determine, no later than June 15, 2002, June 15, 2003, June 15,
48 2004, [and] June 15, 2005, June 15, 2006 and June 15, 2007, the amount
49 of funds available in the hospital excess liability pool, created pursu-
50 ant to section 18 of chapter 266 of the laws of 1986, and whether such
51 funds are sufficient for purposes of purchasing excess insurance cover-
52 age for eligible participating physicians and dentists during the period
53 July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
54 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
55 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, as applicable.
S. 992 88 A. 1922
1 (a) This section shall be effective only upon a determination, pursu-
2 ant to section five of this act, by the superintendent of insurance and
3 the commissioner of health, and a certification of such determination to
4 the state director of the budget, the chair of the senate committee on
5 finance and the chair of the assembly committee on ways and means, that
6 the amount of funds in the hospital excess liability pool, created
7 pursuant to section 18 of chapter 266 of the laws of 1986, is insuffi-
8 cient for purposes of purchasing excess insurance coverage for eligible
9 participating physicians and dentists during the period July 1, 2001 to
10 June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June
11 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30,
12 2006, or July 1, 2006 to June 30, 2007, as applicable.
13 (e) The commissioner of health shall transfer for deposit to the
14 hospital excess liability pool created pursuant to section 18 of chapter
15 266 of the laws of 1986 such amounts as directed by the superintendent
16 of insurance for the purchase of excess liability insurance coverage for
17 eligible participating physicians and dentists for the policy year July
18 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1,
19 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005
20 to June 30, 2006, or July 1, 2006 to June 30, 2007, as applicable, and
21 the cost of administering the hospital excess liability pool for such
22 applicable policy year, pursuant to the program established in chapter
23 266 of the laws of 1986, as amended, no later than June 15, 2002, June
24 15, 2003, June 15, 2004, [and] June 15, 2005, June 15, 2006, and June
25 15, 2007, as applicable.
26 § 75. Subdivision 1 of section 2111 of the public health law, as added
27 by section 21 of part C of chapter 58 of the laws of 2004, is amended to
28 read as follows:
29 1. The department may establish [up to six] disease management demon-
30 stration programs through a request for proposals process to enhance the
31 quality and cost-effectiveness of care rendered to medicaid-eligible
32 persons with chronic health problems whose care and treatment, because
33 of one or more hospitalizations or other health care requirements,
34 results in high medicaid expenditures. In order to be eligible to spon-
35 sor and to undertake a disease management demonstration program, the
36 proposed sponsor may be a not-for-profit, for-profit or local government
37 organization that has demonstrated expertise in the management or coor-
38 dination of care to persons with chronic diseases or that has the expe-
39 rience of providing cost-effective community-based care to such
40 patients, or in the case of a local government organization, has
41 expressed a strong willingness to sponsor such a program. The department
42 may also approve disease management demonstration programs which
43 include, but are not limited to, the promotion of adherence to
44 evidence-based guidelines, improvement of provider and patient communi-
45 cation and provide information on provider and beneficiary utilization
46 of services. [The department shall grant no fewer than six demonstration
47 programs, no more than one-third of such programs shall be selected to
48 provide these services in any single social services district; provided
49 further, where the department grants less than six demonstration
50 programs, no more than one such program shall be selected to provide
51 these services in any single social services district.] The department
52 shall approve disease management demonstration programs which are
53 geographically diverse and representative of both urban and rural social
54 services districts. The program sponsor must establish, to the satisfac-
55 tion of the department, its capacity to enroll and serve sufficient
S. 992 89 A. 1922
1 numbers of enrollees to demonstrate the cost-effectiveness of the demon-
2 stration program.
3 § 76. Subdivision 5 of section 2111 of the public health law, as added
4 by section 21 of part C of chapter 58 of the laws of 2004, is amended to
5 read as follows:
6 5. The department shall be responsible for monitoring the quality,
7 appropriateness and cost-effectiveness of a demonstration program. The
8 department shall utilize, to the extent possible, all potential sources
9 of funding for demonstration programs, including, but not limited to,
10 private payments[,] and donations[, and any funding or shared savings
11 that may be available through federal waivers or otherwise under titles
12 18 and 19 of the federal social security act. Services provided as part
13 of a demonstration program and related administrative expenses not
14 otherwise eligible for coverage under these or other funding sources
15 shall be eligible for reimbursement under the medical assistance program
16 for the purposes of this section only if federal financial participation
17 is available]. All such funds shall be deposited by the commissioner
18 and credited to the disease management account which shall be estab-
19 lished by the comptroller in the special revenue-other fund. Addi-
20 tionally, to the extent of funds appropriated therefor, medical assist-
21 ance funds, including any funding or shared savings as may become
22 available through federal waivers or otherwise under titles 18 and 19 of
23 the federal social security act, may be used by the department for
24 expenditures in support of the disease management program.
25 § 77. Subdivision 2 of section 2816 of the public health law, as added
26 by chapter 225 of the laws of 2001, is amended to read as follows:
27 2. Regulations governing the statewide planning and research cooper-
28 ative system shall include, but not be limited to, the following:
29 (a) Specification of patient and other data elements and format to be
30 reported including data related to:
31 (i) inpatient hospitalization data from general hospitals;
32 (ii) ambulatory surgery data from hospital-based ambulatory surgery
33 services and all other ambulatory surgery facilities licensed under this
34 article;
35 (iii) emergency department data from general hospitals[.];
36 (iv) all other ambulatory care data from general hospitals and diag-
37 nostic and treatment centers licensed under this article.
38 (b) Standards to assure the protection of patient privacy in data
39 collected and released under this section.
40 (c) Standards for the publication and release of data reported in
41 accordance with this section.
42 § 78. Subparagraphs (ii) and (iii) of paragraph (a) of subdivision 6
43 of section 4403-f of the public health law, as added by chapter 659 of
44 the laws of 1997, are amended to read as follows:
45 (ii) [no more than five of the twenty-four certificates of authority,
46 inclusive of those certificates issued to entities initially authorized
47 to operate as an approved managed long term care demonstration pursuant
48 to paragraph (e) of this subdivision may be issued to eligible appli-
49 cants which are, or are owned or controlled by one or more entities that
50 have received a certificate of authority pursuant to either section
51 forty-four hundred three, forty-four hundred three-a or forty-four
52 hundred eight-a of this article (as added by chapter six hundred thir-
53 ty-nine of the laws of nineteen hundred ninety-six) or a health mainte-
54 nance organization organized under article forty-three of the insurance
55 law provided further, that no more than one such certificate may be
56 issued to an eligible applicant described in this subparagraph in the
S. 992 90 A. 1922
1 first twelve months following the effective date of this section, and no
2 more than two such certificates may be issued to eligible applicants
3 described in this subparagraph in the first twelve months commencing
4 with the selection, pursuant to a request for proposals, of eligible
5 applicants to operate managed long term care plans pursuant to this
6 paragraph. For purposes of this subparagraph, "control" shall exist if
7 an entity or entities designated in this subparagraph directly or indi-
8 rectly own, control, or hold the power to vote ten percent or more, in
9 the aggregate, of the voting securities or voting rights of such eligi-
10 ble applicant, or are corporate members of an eligible applicant organ-
11 ized as a not-for-profit corporation;
12 (iii)] absent federal approvals as may be necessary to achieve the
13 full capitation requirements of paragraph (g) of subdivision three of
14 this section, the commissioner shall approve no more than eight certif-
15 icates of authority pursuant to this paragraph to operate a managed long
16 term care plan which requires such federal approvals.
17 § 78-a. Paragraph (e) of subdivision 6 of section 4403-f of the public
18 health law, as amended by section 19 of part C of chapter 58 of the laws
19 of 2004, is amended to read as follows:
20 (e) The commissioner, the majority leader of the senate and the speak-
21 er of the assembly may each designate in writing up to four eligible
22 applicants as approved managed long term care demonstrations. Subsequent
23 to such designation, the commissioner and the superintendent of insur-
24 ance shall impose terms and conditions pursuant to a written agreement
25 with each such demonstration, not inconsistent with this section, under
26 which such demonstrations shall be authorized to operate. If any such
27 demonstration, that has been designated by the majority leader of the
28 senate or the speaker of the assembly, has not commenced operations by
29 January first, two thousand four, the majority leader of the senate or
30 the speaker of the assembly, as the case may be, may, consistent with
31 this paragraph, rescind its designation as an approved managed long term
32 care demonstration and its authorization to operate, and, consistent
33 with this paragraph, designate an alternate applicant as an approved
34 managed long term care demonstration.
35 § 79. Section 4 of chapter 495 of the laws of 2004, amending the
36 insurance law and the public health law relating to the New York state
37 health insurance continuation assistance demonstration project, is
38 amended to read as follows:
39 § 4. This act shall take effect on the sixtieth day after it shall
40 have become a law; provided, however, that this act shall remain in
41 effect until July 1, [2005] 2007 when upon such date the provisions of
42 this act shall expire and be deemed repealed; provided, further, that a
43 displaced worker shall be eligible for continuation assistance retroac-
44 tive to July 1, 2004.
45 § 80. The public health law is amended by adding a new section 2802-a
46 to read as follows:
47 § 2802-a. Transitional care unit program. 1. Notwithstanding any
48 other provision of law to the contrary, the commissioner is authorized
49 to approve general hospitals within the state to operate transitional
50 care units by and within such general hospitals. For purposes of this
51 section, "transitional care" shall mean sub acute care services provided
52 to patients of a general hospital who no longer require acute care
53 general hospital inpatient services, but continue to need specialized
54 medical, nursing and other hospital ancillary services and are not yet
55 appropriate for discharge.
S. 992 91 A. 1922
1 2. In order to receive approval from the commissioner to operate a
2 transitional care unit and to provide transitional care services, a
3 general hospital shall file an application on forms prescribed by or
4 acceptable to the commissioner.
5 (a) The commissioner may evaluate such applications in a manner
6 consistent with section twenty-eight hundred two of this article,
7 provided that the commissioner may waive review and recommendation by
8 the state hospital review and planning council. In conducting such
9 review, the commissioner shall give consideration to the geographic
10 distribution of applicants throughout the state, so that applications
11 may be approved from the various geographic regions of the state.
12 (b) The care provided in a transitional care unit shall be limited in
13 duration and designed to resolve a patient's sub acute care medical
14 problems and result in the timely and appropriate discharge of such a
15 patient to a home, residential health care facility or other appropriate
16 setting.
17 (c) In order to be approved to operate a transitional care unit and to
18 provide transitional care services, an applicant must comply with and
19 meet all applicable requirements of and conditions of participation
20 under title XVIII of the federal Social Security Act (Medicare).
21 3. The commissioner shall report to the governor and the legislature
22 concerning the implementation of this section and the operation of tran-
23 sitional care units within three years after the effective date of this
24 section.
25 § 81. Notwithstanding any contrary provision of law, the commissioner
26 of health is authorized, within amounts made available from funds allo-
27 cated pursuant to paragraph (ww) of subdivision one of section 2807-v of
28 the public health law, to make grants up to an aggregate amount not to
29 exceed one million five hundred thousand dollars to facilities licensed
30 under article 28 of the public health law for the purpose of the
31 purchase and operation of mobile dental clinic units for use in those
32 areas of the state which are underserved with regard to dental clinic
33 services. Notwithstanding the provisions of section one hundred twelve
34 of the state finance law or any other provision of the state finance law
35 or any other law, grants made pursuant to this section may be made by
36 the commissioner of health without a competitive bid or request for
37 proposal process.
38 § 82. Title VIII of article 25 of the public health law, as added by
39 chapter 604 of the laws of 2003, is amended to read as follows:
40 TITLE VIII
41 CHILDHOOD OBESITY PREVENTION PROGRAM
42 Section 2599-a. Childhood obesity prevention program; establishment.
43 2599-b. Program development.
44 2599-c. School-based childhood obesity prevention and physical
45 activity programs.
46 2599-d. Powers of commissioner.
47 § 2599-a. Childhood obesity prevention program; establishment. The
48 childhood obesity prevention program is established within the depart-
49 ment.
50 § 2599-b. Program development. 1. The program shall be designed to
51 prevent and reduce the incidence and prevalence of obesity in children
52 and adolescents, especially among populations with high rates of obesity
53 and obesity-related health complications including, but not limited to,
54 diabetes, heart disease, cancer, osteoarthritis, asthma and other condi-
55 tions. The program shall use recommendations and goals of the United
56 States departments of agriculture and health and human services, the
S. 992 92 A. 1922
1 surgeon general and centers for disease control in developing and imple-
2 menting guidelines for nutrition education and physical activity
3 projects as part of obesity prevention efforts. The content and imple-
4 mentation of the program shall stress the benefits of choosing a
5 balanced, healthful diet from the many options available to consumers,
6 without specifically targeting the elimination of any particular food
7 group, food product or food-related industry.
8 2. The childhood obesity prevention program [shall] may include, but
9 not be limited to:
10 (a) developing media health promotion campaigns targeted to children
11 and adolescents and their parents and caregivers that emphasize increas-
12 ing consumption of low-calorie, high-nutrient foods, decreasing consump-
13 tion of high-calorie, low-nutrient foods and increasing physical activ-
14 ity designed to prevent or reduce obesity;
15 (b) establishing school-based childhood obesity prevention nutrition
16 education and physical activity programs including programs described in
17 section twenty-five hundred ninety-nine of this article, as well as
18 other programs with linkages to physical and health education courses,
19 and which utilize the school health index of the National Center for
20 Chronic Disease Prevention and Health Promotion or other recognized
21 school health assessment;
22 (c) establishing community-based childhood obesity prevention nutri-
23 tion education and physical activity programs including programs which
24 involve parents and caregivers, and which encourage communities, fami-
25 lies, child care and other settings to provide safe and adequate space
26 and time for physical activity and encourage a healthy diet;
27 (d) coordinating with the state education department, department of
28 agriculture and markets, office of parks, recreation and historic pres-
29 ervation, office of temporary and disability assistance, office of chil-
30 dren and family services and other federal, state and local agencies to
31 incorporate strategies to prevent and reduce childhood obesity into
32 government food assistance, health, education and recreation programs;
33 (e) sponsoring periodic conferences or meetings to bring together
34 experts in nutrition, exercise, public health, mental health, education,
35 parenting, media, food marketing, food security, agriculture, community
36 planning and other disciplines to examine societal-based solutions to
37 the problem of childhood obesity and issue guidelines and recommenda-
38 tions for New York state policy and programs; [and]
39 (f) developing training programs for medical and other health profes-
40 sionals to teach practical skills in nutrition and exercise education to
41 children and their parents and caregivers; and
42 (g) screening for overweight and obesity for any children aged two
43 through eighteen years, using body mass index appropriate for age and
44 gender, and notification of parents of BMI status.
45 3. The department shall periodically collect and analyze information
46 from schools, health and nutrition programs and other sources to deter-
47 mine the prevalence of childhood obesity in New York state, and to eval-
48 uate, to the extent possible, the effectiveness of the childhood obesity
49 prevention program.
50 § 2599-c. School-based childhood obesity prevention and physical
51 activity programs. The commissioner shall encourage the establishment of
52 school-based childhood obesity prevention and physical activity programs
53 that promote:
54 1. A healthy school environment, including physical and aesthetic
55 surroundings and culture designed to prevent and reduce the incidence
56 and prevalence of obesity; and
S. 992 93 A. 1922
1 2. Parent/community involvement, including an integrated school,
2 parent, and community approach for enhancing the health and well-being
3 of students.
4 § 2599-d. Powers of commissioner. The commissioner may [directly]
5 administer directly or through contract, within the amount of funds
6 [available] allocated and within amounts appropriated pursuant to para-
7 graph (k) of subdivision one of section twenty-eight hundred seven-v of
8 this chapter, the childhood obesity prevention program. The commissioner
9 shall also make grants, within the amount of funds available therefor,
10 for community-based projects targeted to high-risk populations to imple-
11 ment the provisions of this title.
12 § 83. The state finance law is amended by adding a new section 92-dd
13 to read as follows:
14 § 92-dd. Health care reform act (HCRA) resources fund. Notwithstand-
15 ing any contrary provision of law, there is hereby established in the
16 joint custody of the comptroller and the department of health a fund to
17 be known as the health care reform act resources fund. Such fund shall
18 be composed of the HCRA program account and the HCRA transition account,
19 which are hereby established, and such other existing or other duly
20 authorized funds or accounts which the director of the budget, upon
21 recommendation of the commissioner of health, may direct to be trans-
22 ferred into the HCRA resources fund. Such fund shall be administered in
23 accordance with the following:
24 (a) On and after April first, two thousand five, such fund shall
25 consist of the revenues heretofore and hereafter collected or required
26 to be deposited pursuant to paragraph (a) of subdivision eighteen of
27 section twenty-eight hundred seven-c, and sections twenty-eight hundred
28 seven-j, twenty-eight hundred seven-s and twenty-eight hundred seven-t
29 of the public health law, section four hundred eighty-two of the tax
30 law, subparagraph (O) of paragraph four of subsection (j) of section
31 four thousand three hundred one of the insurance law, section twenty-
32 seven of part A of chapter one of the laws of two thousand two and all
33 other moneys credited or transferred thereto from any other fund or
34 source pursuant to law.
35 (b) The pool administrator under contract with the commissioner of
36 health pursuant to section twenty-eight hundred seven-y of the public
37 health law shall continue to collect moneys required to be collected or
38 deposited pursuant to paragraph (a) of subdivision eighteen of section
39 twenty-eight hundred seven-c, and sections twenty-eight hundred seven-j,
40 twenty-eight hundred seven-s and twenty-eight hundred seven-t of the
41 public health law, and shall deposit such moneys in the HCRA resources
42 fund. The comptroller shall deposit moneys collected or required to be
43 deposited pursuant to section four hundred eighty-two of the tax law,
44 subparagraph (O) of paragraph four of subsection (j) of section four
45 thousand three hundred one of the insurance law, section twenty-seven of
46 part A of chapter one of the laws of two thousand two and all other
47 moneys credited or transferred thereto from any other fund or source
48 pursuant to law in the HCRA resources fund.
49 (c) The pool administrator shall, from appropriated funds transferred
50 to the pool administrator from the comptroller, continue to make
51 payments as required pursuant to sections twenty-eight hundred seven-k,
52 twenty-eight hundred seven-m and twenty-eight hundred seven-w of the
53 public health law, paragraph (e) of subdivision twenty-five of section
54 twenty-eight hundred seven-c of the public health law, paragraphs (b)
55 and (c) of subdivision thirty of section twenty-five hundred seven-c of
56 the public health law, paragraph (b) of subdivision eighteen of section
S. 992 94 A. 1922
1 twenty-eight hundred eight of the public health law, subdivision seven
2 of section twenty-five hundred-d of the public health law and section
3 eighty-eight of chapter one of the laws of nineteen hundred ninety-nine.
4 (d) Moneys in the health care reform act resources fund shall be kept
5 separate from and shall not be commingled with any other moneys in the
6 joint or sole custody of the comptroller and the department of health.
7 (e) Moneys of the fund, following appropriation by the legislature,
8 shall be expended in accordance with sections twenty-eight hundred
9 seven-k, twenty-eight hundred seven-l, twenty-eight hundred seven-m, and
10 twenty-eight hundred seven-v of the public health law, pursuant to a
11 certificate of approval of availability issued by the director of the
12 budget, upon the recommendation of the commissioner of health, or where
13 appropriate, the superintendent of insurance, the commissioner of mental
14 health and the director of the state office for the aging, and a copy of
15 such certificate filed with the state comptroller, the chairperson of
16 the senate finance committee and the chairperson of the assembly ways
17 and means committee.
18 (f) The moneys, following allocation, shall be paid out of the fund on
19 the audit and warrant of the comptroller on vouchers certified or
20 approved by the commissioner of health, or by an officer or employee of
21 the department of health designated by the commissioner.
22 (g) Upon the direction of the director of the budget, the state comp-
23 troller shall transfer amounts up to the undisbursed balance of existing
24 funds and accounts supported by revenues collected pursuant to HCRA to
25 the HCRA resources fund.
26 (h) The comptroller shall provide the pool administrator with any
27 information needed, in a form or format prescribed by the pool adminis-
28 trator, to meet health care reform act reporting requirements as set
29 forth in article twenty-eight of the public health law or as otherwise
30 provided by law.
31 (i) The commissioner of health and the comptroller are directed to
32 develop an expedited process to make immediate payments to any provider
33 or an immediate transfer of funds to the pool administrator for the
34 purposes of making necessary distributions, within available appropri-
35 ations therefor, in accordance with sections twenty-eight hundred
36 seven-k, twenty-eight hundred seven-l, twenty-eight hundred seven-m, and
37 twenty-eight hundred seven-v of the public health law to address emer-
38 gency provider cash needs, as determined by the commissioner of health.
39 § 84. Notwithstanding sections 2807-k, 2807-w and subdivision four-
40 teen-f of section 2807-c of the public health law and any other contrary
41 provision of law, rule or regulation, the commissioner of health may
42 issue regulations, with the approval of the director of the budget,
43 providing for the distribution to general hospitals, within amounts
44 appropriated therefor and subject to the receipt of all necessary
45 approvals to secure federal financial participation of funds allocated
46 for periods on and after January 1, 2006, pursuant to paragraph (a) of
47 subdivision 9 of section 2807-j of the public health law, and paragraph
48 (p) of subdivision one of section 2807-v of the public health law, and
49 rate adjustments for periods on and after January 1, 2006 made pursuant
50 to subdivision fourteen-f of section 2807-c of the public health law.
51 § 85. Notwithstanding any contrary provision of law, the commissioner
52 of health is authorized to:
53 (i) submit amendments to the state plan for medical assistance;
54 (ii) submit applications for waivers, or applications for amendment of
55 existing waivers, of provisions of the federal social security act; and
S. 992 95 A. 1922
1 (iii) promulgate or adopt any rules or regulations necessary to imple-
2 ment the provisions of this act and to obtain any federal approvals
3 necessary to obtain federal financial participation for care and
4 services provided pursuant to the provisions of this act. Notwithstand-
5 ing any inconsistent provision of the state administrative procedure act
6 or any other provision of law, rule or regulation, the commissioner of
7 health and any appropriate council are authorized to adopt, amend or
8 promulgate on an emergency basis any regulation such commissioner or
9 such council determines to be necessary to implement any provision of
10 this act on its effective date.
11 § 86. Notwithstanding any inconsistent provision of law, rule or regu-
12 lation, for purposes of implementing the provisions of the public health
13 law and the social services law, references to titles XIX and XXI of the
14 federal social security act in the public health law and the social
15 services law shall be deemed to include and also to mean any successor
16 titles thereto under the federal social security act.
17 § 87. Notwithstanding any inconsistent provision of law, rule or regu-
18 lation, the effectiveness of subdivisions 4, 7, 7-a and 7-b of section
19 2807 of the public health law and section 18 of chapter 2 of the laws of
20 1988, as they relate to time frames for notice, approval or certif-
21 ication of rates of payment, are hereby suspended and shall, for
22 purposes of implementing the provisions of this act, be deemed to have
23 been without any force or effect from and after November 1, 2004 for
24 such rates effective for the period January 1, 2005 through December 31,
25 2005.
26 § 88. Severability clause. If any clause, sentence, paragraph, subdi-
27 vision, section or part of this act shall be adjudged by any court of
28 competent jurisdiction to be invalid, such judgment shall not affect,
29 impair or invalidate the remainder thereof, but shall be confined in its
30 operation to the clause, sentence, paragraph, subdivision, section or
31 part thereof directly involved in the controversy in which such judgment
32 shall have been rendered. It is hereby declared to be the intent of the
33 legislature that this act would have been enacted even if such invalid
34 provisions had not been included herein.
35 § 89. This act shall take effect immediately provided, however, that:
36 1. The amendment to subdivision six of section 47 of chapter 2 of the
37 laws of 1998 made by section fourteen of this act shall be deemed to
38 have been in full force and effect on and after October 1, 2004;
39 2. Section twenty of this act shall be deemed to have been in full
40 force and effect on and after July 1, 2005;
41 3. Sections forty-six through fifty of this act shall be deemed to
42 have been in full force and effect on and after January 25, 2002;
43 4. Section eighty of this act shall expire and be deemed repealed five
44 years from the date on which it shall become law;
45 5. Any rules or regulations necessary to implement the provisions of
46 this act may be promulgated and any procedures, forms, or instructions
47 necessary for such implementation may be adopted and issued on or after
48 the date this act shall have become a law;
49 6. This act shall not be construed to alter, change, affect, impair or
50 defeat any rights, obligations, duties or interests accrued, incurred or
51 conferred prior to the enactment of this act;
52 7. The commissioner of health and the superintendent of insurance and
53 any appropriate council may take any steps necessary to implement
54 provisions of this act prior to its effective date;
55 8. Notwithstanding any inconsistent provision of the state administra-
56 tive procedure act or any other provision of law, rule or regulation,
S. 992 96 A. 1922
1 the commissioner of health and the superintendent of insurance and any
2 appropriate council is authorized to adopt or amend or promulgate on an
3 emergency basis any regulation he or she or such council determines
4 necessary to implement any provision of this act on its effective date;
5 9. The provisions of this act shall become effective notwithstanding
6 the failure of the commissioner of health or the superintendent of
7 insurance or any council to adopt or amend or promulgate regulations
8 implementing this act;
9 10. The amendments to subdivisions 4 and 5 and paragraph (g) of subdi-
10 vision 2 of section 2511 of the public health law made by sections
11 sixty-one, sixty-four and sixty-seven of this act shall not affect the
12 expiration of such subdivisions and shall be deemed to expire therewith;
13 11. The amendments to section 2807-j of the public health law made by
14 sections thirty-four, thirty-six, thirty-seven, forty-four and fifty-two
15 of this act shall not affect the expiration of such section and shall be
16 deemed to expire therewith;
17 12. The amendments to section 2807-s of the public health law made by
18 sections twenty-nine, thirty, thirty-one, thirty-two, thirty-three and
19 fifty-three of this act shall not affect the expiration of such section
20 and shall be deemed to expire therewith;
21 13. The amendments to section 2807-t of the public health law made by
22 section thirty-eight of this act shall not affect the expiration of such
23 section and shall be deemed to expire therewith;
24 14. The amendments to paragraph (i-1) of subdivision 1 of section
25 2807-v of the public health law made by section three of this act shall
26 not affect the repeal of such paragraph and shall be deemed to be
27 repealed therewith; and
28 15. The amendments to section 4403-f of the public health law made by
29 sections seventy-eight and seventy-eight-a of this act shall not affect
30 the repeal of such section and shall be deemed to be repealed therewith.
31 PART C
32 Section 1. (a) Notwithstanding the provisions of section 368-a of the
33 social services law, or any other provision of law, the department of
34 health shall provide reimbursement for expenditures made by or on behalf
35 of social services districts for medical assistance for needy persons,
36 and the administration thereof, in accordance with the provisions of
37 this section; provided, however, that this section shall not apply to
38 amounts expended for health care services under section 369-ee of the
39 social services law, which amounts shall be reimbursed in accordance
40 with paragraph (t) of subdivision 1 of section 368-a of such law and
41 shall be excluded from all calculations made pursuant to this section.
42 (b) Commencing with the period April 1, 2005 though March 31, 2006, a
43 social services district's yearly net share of medical assistance
44 expenditures shall be calculated in relation to a reimbursement base
45 year which, for purposes of this section, is defined as January 1, 2005
46 through December 31, 2005. The final base year expenditure calculation
47 for each social services district shall be made by the commissioner of
48 health, and approved by the director of the division of the budget, no
49 later than June 30, 2006. Such calculations shall be based on actual
50 expenditures made by or on behalf of social services districts, and
51 revenues received by social services districts, during the base year and
52 shall be made without regard to expenditures made, and revenues
53 received, outside the base year that are related to services provided
54 during, or prior to, the base year. Such base year calculations shall be
S. 992 97 A. 1922
1 based on the social services district medical assistance shares
2 provisions in effect on January 1, 2005.
3 (c) Commencing with the calendar year beginning January 1, 2006,
4 calendar year social services district medical assistance expenditure
5 amounts for each social services district shall be calculated by multi-
6 plying the results of the calculations performed pursuant to paragraph
7 (b) of this section by a non-compounded trend factor, as follows:
8 (i) 2006 (January 1, 2006 through December 31, 2006): 3.5%;
9 (ii) 2007 (January 1, 2007 through December 31, 2007): 6.75% (3.25%
10 plus the prior year's 3.5%);
11 (iii) 2008 (January 1, 2008 through December 31, 2008): 9.75% (3%
12 plus the prior year's 6.75%);
13 (iv) 2009 (January 1, 2009 through December 31, 2009), and each
14 succeeding calendar year: prior year's trend factor percentage plus 3%.
15 (d) The base year expenditure amounts calculated pursuant to paragraph
16 (b) of this section and the calendar year social services district
17 expenditure amounts calculated pursuant to paragraph (c) of this section
18 shall be converted into state fiscal year social services district
19 expenditure cap amounts for each social services district such that each
20 such state fiscal year amount is proportional to the portions of the two
21 calendar years within each fiscal year, as follows:
22 (i) fiscal year 2005-2006 (April 1, 2005 through March 31, 2006): 75%
23 of the base year amount plus 25% of the 2006 calendar year amount;
24 (ii) fiscal year 2006-2007 (April 1, 2006 through March 31, 2007): 75%
25 of the 2006 year calendar amount plus 25% of the 2007 calendar year
26 amount;
27 (iii) each succeeding fiscal year: 75% of the first calendar year
28 within that fiscal year's amount plus 25% of the second calendar year
29 within that fiscal year's amount.
30 (e) No later than April 1, 2007, the commissioner of health shall
31 certify the 2006-2007 fiscal year social services district expenditure
32 cap amounts for each social services district calculated pursuant to
33 subparagraph (ii) of paragraph (d) of this section and shall communicate
34 such amounts to the commissioner of taxation and finance.
35 (f) Subject to paragraph (g) of this section, the state fiscal year
36 social services district expenditure cap amount calculated for each
37 social services district pursuant to paragraph (d) of this section shall
38 be allotted to each district during that fiscal year and paid to the
39 department in equal weekly amounts in a manner to be determined by the
40 commissioner and communicated to such districts and shall represent each
41 district's maximum responsibility for medical assistance expenditures
42 governed by this section. Commencing January 1, 2008, all such amounts
43 shall be deposited into the general fund of the state treasury to the
44 credit of the state purposes account therein.
45 (g) (i) No allotment pursuant to paragraph (f) of this section shall
46 be applied against a social services district during the period April 1,
47 2005 through December 31, 2005. Social services district medical
48 assistance shares shall be determined for such period pursuant to shares
49 provisions in effect on January 1, 2005.
50 (ii) For the period January 1, 2006 through June 30, 2006, the commis-
51 sioner is authorized to allot against each district an amount based on
52 the commissioner's best estimate of the final base year expenditure
53 calculation required by paragraph (b) of this section. Upon completion
54 of such calculation, the commissioner shall, no later than December 31,
55 2006, reconcile such estimated allotments with the fiscal year social
S. 992 98 A. 1922
1 services district expenditure cap amounts calculated pursuant to subpar-
2 agraphs (i) and (ii) of paragraph (d) of this section.
3 (iii) During each state fiscal year subject to the provisions of this
4 section, the commissioner shall maintain an accounting, for each social
5 services district, of the net amounts that would have been expended by,
6 or on behalf of, such district had the social services district medical
7 assistance shares provisions in effect on January 1, 2005 been applied
8 to such district. As soon as practicable after the conclusion of each
9 such fiscal year, but in no event later than six months after the
10 conclusion of each such fiscal year, the commissioner shall reconcile
11 such net amounts with such fiscal year's social services district
12 expenditure cap amount. Such reconciliation shall be based on actual
13 expenditures made by or on behalf of social services districts, and
14 revenues received by social services districts, during such fiscal year
15 and shall be made without regard to expenditures made, and revenues
16 received, outside such fiscal year that are related to services provided
17 during, or prior to, such fiscal year. The commissioner shall pay to
18 each social services district the amount, if any, by which such
19 district's expenditure cap amount exceeds such net amount.
20 § 2. (a) Commencing January 1, 2008, at the option of a social
21 services district, such option to be exercised as described in paragraph
22 (b) of this section, and notwithstanding any other provision of law, the
23 department of health shall provide reimbursement for the full amount of
24 expenditures made by such district for medical assistance for needy
25 persons, and the administration thereof, in accordance with the
26 provisions of this section.
27 (b) Notwithstanding any provisions of state or local law, ordinance or
28 resolution to the contrary:
29 (i) A social services district shall exercise the option described in
30 this section through the adoption of a resolution by its local legisla-
31 tive body, in the form set forth in subparagraph (ii) of this paragraph,
32 to elect the medical assistance reimbursement methodology set forth in
33 paragraph (a) of this section and to elect the tax intercept methodology
34 set forth in subdivision (f) of section 1261 of the tax law or subdivi-
35 sion (g) of section 1261 and subdivision (h) of section 1313 of the tax
36 law, as applicable. A social services district, acting through its local
37 legislative body, is hereby authorized to adopt such a resolution. Such
38 a resolution shall be effective only if it is adopted exactly as set
39 forth in subparagraph (ii) of this paragraph no later than September 30,
40 2007, and a certified copy of such resolution is mailed to the commis-
41 sioner of health by certified mail by such date. The commissioner of
42 health shall, no later than October 31, 2007, certify to the commission-
43 er of taxation and finance a list of those social services districts
44 which have elected the option described in this section. A social
45 services district shall have no authority to rescind the exercise of the
46 option described in this section.
47 (ii) Form of resolution.
48 Be it enacted by the (county or city) of (insert locality's name) as
49 follows:
50 Section one. The (county or city) of (insert locality's name) hereby
51 elects the medical assistance reimbursement option and revenue intercept
52 for Medicaid purposes described in section 2 of chapter (fill in chapter
53 number) of the laws of 2005.
54 Section 2. This resolution shall take effect immediately.
55 § 3. The commissioner of health shall examine social services district
56 expenditures during calendar year 2005 for the purpose of assuring that
S. 992 99 A. 1922
1 local administrative or other actions were not taken for the purpose of
2 artificially diminishing medical assistance expenditures during the base
3 year established under paragraph (b) of section one of this act. The
4 commissioner shall examine patterns of such expenditures that appear to
5 be atypical when compared with historical expenditure patterns and
6 trends within the district. If the commissioner determines that such
7 actions were taken, the commissioner is authorized to adjust the base
8 year medical assistance calculation in the amount necessary to account
9 for the impact of such actions.
10 § 4. Notwithstanding the provisions of sections one and two of this
11 act, the director of the division of the budget may, at his or her sole
12 discretion, decrease a fiscal year social services district expenditure
13 cap amount calculated pursuant to paragraph (d) of section one of this
14 act or a tax revenue intercept amount calculated pursuant to subdivision
15 (f) or (g) of section 1261 of the tax law to account for any increases
16 in the New York state federal medical assistance percentage amount
17 established pursuant to the federal social security act.
18 § 5. Notwithstanding the provisions of any law to the contrary, the
19 commissioner of health is authorized to approve social services district
20 demonstration programs for the purposes of demonstrating innovative
21 methods of improving the delivery of quality health care services in a
22 cost effective manner. The commissioner should evaluate the results of
23 any such programs, including any savings, resulting therefrom. Any such
24 savings, after certification by the director of the division of the
25 budget, shall be shared equally with the applicable social services
26 district in a manner to be determined jointly by the commissioner of
27 health and the director of the division of the budget.
28 § 6. Section 1261 of the tax law is amended by adding two new subdivi-
29 sions (f) and (g) to read as follows:
30 (f) Notwithstanding any provision of state or local law, ordinance or
31 resolution to the contrary, if the commissioner of health timely certi-
32 fies to the commissioner that a county which imposes sales and compen-
33 sating use taxes pursuant to the authority of section twelve hundred
34 ten, twelve hundred ten-A, twelve hundred ten-B or twelve hundred ten-C
35 of this article properly exercised its option by September thirtieth,
36 two thousand seven, pursuant to section two of the chapter of the laws
37 of two thousand five which added this subdivision, that such county be
38 reimbursed for medical assistance expenditures as provided in such
39 section two of such chapter, then the commissioner shall calculate the
40 Medicaid amount of each such county. The amount due each month to each
41 such county provided for in subdivision (c) of this section shall be
42 reduced by the monthly Medicaid amount; and such monthly Medicaid amount
43 of each such county shall instead be paid into the general fund of the
44 state treasury to the credit of the state purposes account therein. The
45 calculation of each such county's Medicaid amount and monthly Medicaid
46 amounts and the procedures governing the payment of such amounts shall
47 be as follows:
48 (1) The commissioner of health shall furnish the commissioner with the
49 amount of every county's "two thousand six-two thousand seven fiscal
50 year social services district expenditure cap amount," as provided in
51 paragraph (e) of section one of a chapter of the laws of two thousand
52 five which added this subdivision, as soon as practicable but no later
53 than April first, two thousand seven.
54 (2) The commissioner shall calculate the "Medicaid factor" for every
55 county as follows and shall notify each county's chief fiscal officer of
S. 992 100 A. 1922
1 the results of such calculation by April thirtieth, two thousand seven,
2 to help each county determine whether to exercise such option:
3 (A) for a county in which no city exercises any prior right to impose
4 sales or compensating use taxes authorized by section twelve hundred ten
5 of this article, first, divide the total amount of sales and compensat-
6 ing use tax distributions to such county during state fiscal year two
7 thousand six-two thousand seven by the county's general rate of such
8 taxes during such period, and then divide the county's "two thousand
9 six-two thousand seven fiscal year social services district expenditure
10 cap amount" by the quotient of the first division;
11 (B) for a county in which one or more cities exercise any prior right
12 to impose sales or compensating use taxes authorized by section twelve
13 hundred ten of this article and the combined rate of the county's and
14 city's taxes in each such city equals the general rate of the county's
15 taxes on similar transactions in the area of the county outside such
16 city or cities, first, add the total amounts of sales and compensating
17 use tax distributions to such county and to each such city during state
18 fiscal year two thousand six-two thousand seven and divide such sum by
19 the county's general rate of such taxes during such period, and then
20 divide the county's "two thousand six-two thousand seven fiscal year
21 social services district expenditure cap amount" by the quotient of the
22 first division; and
23 (C) for a county in which one or more cities exercise any prior right
24 to impose sales or compensating use taxes authorized by section twelve
25 hundred ten of this article and the combined rate of the county's and
26 city's taxes in any such city does not equal the general rate of the
27 county's taxes on similar transactions in the area of the county outside
28 such city or cities:
29 (i) for each such city, add the total amount of sales and compensating
30 use tax distributions to such city during state fiscal year two thousand
31 six-two thousand seven and divide such sum by the city's effective
32 general rate of such taxes during such period, then multiply such
33 quotient by the amount by which the city's rate forced a reduction in
34 the county's rate of such taxes in such city during such period, and
35 then
36 (ii) add the amount derived in clause (i) of this subparagraph for
37 each such city to the total amount of sales and compensating use tax
38 distributions to such county during state fiscal year two thousand six-
39 two thousand seven;
40 (iii) divide the total of the addition in clause (ii) of this subpara-
41 graph by the county's general rate of such taxes during such period; and
42 (iv) divide the county's "two thousand six-two thousand seven fiscal
43 year social services district expenditure cap amount" by the quotient of
44 the division in clause (iii) of this subparagraph.
45 (D) The commissioner shall consider any change in a county's or city's
46 general rate of sales and compensating use taxes which takes effect
47 during state fiscal year two thousand six-two thousand seven and the
48 number of months such rates are in effect during such state fiscal year
49 in order to perform accurately the calculations provided for in this
50 paragraph.
51 (3) By the twelfth day of each month, commencing in January, two thou-
52 sand eight, the commissioner shall calculate the "monthly Medicaid
53 amount" of each such county which has made the election described in the
54 opening paragraph of this subdivision and certify such amounts to the
55 comptroller. The comptroller shall reduce the amount due each month to
56 each such county provided for in subdivision (c) of this section by such
S. 992 101 A. 1922
1 monthly Medicaid amount; and the comptroller shall instead each month
2 pay the monthly Medicaid amount of each such county into the general
3 fund of the state treasury to the credit of the state purposes account
4 therein, provided, however, that the comptroller, subject to the limita-
5 tions provided in paragraphs five and six of this subdivision, shall
6 each month collect the amount of Nassau county's reduction from amounts
7 payable to such county by the Nassau county interim finance authority
8 while such authority exists.
9 (4) "Monthly Medicaid amount" shall mean the result of the following
10 calculations:
11 (A) for a county described in subparagraph (A) of paragraph two of
12 this subdivision, first, the amount of the comptroller's payment due
13 such a county in the immediately preceding month, as described in subdi-
14 vision (c) of this section and as described in sections twelve hundred
15 ten-A, twelve hundred ten-B and twelve hundred ten-C of this article,
16 but without regard to whether the comptroller is to pay all or a portion
17 of such amount to another entity described in subdivision (c) of this
18 section and without regard to the revenue disposition provisions of such
19 section twelve hundred ten-A, twelve hundred ten-B or twelve hundred
20 ten-C, and considered without regard to any Medicaid amount, shall be
21 divided by the county's general rate of sales and compensating use taxes
22 in such month; and the quotient of that division shall be multiplied by
23 the Medicaid factor calculated as provided in subparagraph (A) of para-
24 graph two of this subdivision.
25 (B) for a county described in subparagraph (B) of paragraph two of
26 this subdivision, first, add the amount of the comptroller's payment due
27 any city in such a county in the immediately preceding month, as
28 described in subdivision (c) of this section to the amount of the comp-
29 troller's payment due such a county in the immediately preceding month,
30 as described in subdivision (c) of this section and as described in
31 sections twelve hundred ten-A, twelve hundred ten-B and twelve hundred
32 ten-C of this article, but without regard to whether the comptroller is
33 to pay all or a portion of such amount to another entity described in
34 subdivision (c) of this section and without regard to the revenue dispo-
35 sition provisions of such section twelve hundred ten-A, twelve hundred
36 ten-B or twelve hundred ten-C, and considered without regard to any
37 Medicaid amount, then divide the total of such amounts by the county's
38 general rate of sales and compensating use taxes in such month; and the
39 quotient of that division shall be multiplied by the Medicaid factor
40 calculated as provided in subparagraph (B) of paragraph two of this
41 subdivision.
42 (C) For a county described in subparagraph (C) of paragraph two of
43 this subdivision:
44 (i) with respect to each such city described in subparagraph (C),
45 divide the amount of the comptroller's payment due each such city in the
46 immediately preceding month, as described in subdivision (c) of this
47 section, by the effective general rate of such city's taxes during such
48 month and multiply such quotient by the amount by which the city's rate
49 forced a reduction in the county's rate of such taxes in such city
50 during such month;
51 (ii) add the amount or amounts derived in clause (i) of this subpara-
52 graph to the amount of the comptroller's payment due such county in the
53 immediately preceding month, as described in subdivision (c) of this
54 section and as described in sections twelve hundred ten-A, twelve
55 hundred ten-B and twelve hundred ten-C of this article, but without
56 regard to whether the comptroller is to pay all or a portion of such
S. 992 102 A. 1922
1 amount to another entity described in subdivision (c) of this section
2 and without regard to the revenue disposition provisions of such section
3 twelve hundred ten-A, twelve hundred ten-B or twelve hundred ten-C, and
4 considered without regard to any Medicaid amount; and
5 (iii) divide the total of the addition in clause (ii) of this subpara-
6 graph by the county's general rate of such taxes during such month, and
7 the quotient of that division shall be multiplied by the Medicaid factor
8 calculated as provided in subparagraph (C) of paragraph two of this
9 subdivision.
10 (5) If for any reason a county's monthly Medicaid amount is greater
11 than the amount of the comptroller's net payment to the county for that
12 month under subdivision (c) of this section and under sections twelve
13 hundred ten-A, twelve hundred ten-B and twelve hundred ten-C of this
14 article, after the comptroller has made any payments to other entities
15 required by subdivision (c) of this section or by any other law and
16 after any payment, deposit, appropriation, transfer or expenditure
17 required or authorized by such section twelve hundred ten-A, twelve
18 hundred ten-B or twelve hundred ten-C, the comptroller shall, at the
19 same time that the comptroller makes the payment and reduction described
20 in paragraph three of this subdivision, bill such county an amount equal
21 to the difference and such county shall pay in full the amount of such
22 bill to the comptroller by the twenty-fifth day of such month. Such
23 county shall use any funds available to it to pay such bill. The comp-
24 troller shall deposit any such amounts received into the general fund of
25 the state treasury to the credit of the state purposes account therein.
26 (6) If a county does not remit the required monies or pay in full a
27 bill described in paragraph five of this subdivision by the twenty-fifth
28 day of the month in accordance with paragraph five of this subdivision,
29 the comptroller shall, as soon as any other moneys payable to the county
30 are available, either deduct any amount not paid from the amount of the
31 next payment or payments due such county pursuant to subdivision (c) of
32 this section until such amount not paid has been recovered or, in the
33 alternative and at the comptroller's discretion, deduct any amount not
34 paid from the amount of any other moneys payable to such county from the
35 comptroller and not subject to any lien or pledge for the benefit of
36 bondholders of the Nassau county interim finance authority or of any
37 public benefit corporation, as defined in section sixty-six of the
38 general construction law, created by interstate compact or at least half
39 of whose members are appointed by the governor, until such amount not
40 paid has been recovered. The comptroller shall deposit any amounts so
41 deducted and recovered into the general fund of the state treasury to
42 the credit of the state purposes account therein.
43 (7) This subdivision shall apply to payments required in respect of a
44 county to be made on January twelfth, two thousand eight, and thereaft-
45 er.
46 (8) Nothing in this subdivision shall be construed to relieve a county
47 of any obligation or commitment to distribute and pay or allocate net
48 collections pursuant to this part, regardless whether such obligation or
49 commitment arises before or after the date this subdivision shall have
50 taken effect, or to preclude a city in a county from exercising its
51 prior rights under section twelve hundred twenty-four of this article.
52 To the extent that a county's net collections have been diminished below
53 a level sufficient to meet any such obligation or commitment as a result
54 of the reductions or bills provided for in this subdivision, such county
55 shall hereby be authorized to use any other funds available to it to
S. 992 103 A. 1922
1 meet such obligation or commitment, notwithstanding any law to the
2 contrary.
3 (9) If a county adopts or amends a local law, ordinance or resolution
4 to repeal its sales and compensating use taxes, then, effective on the
5 first day of the first month on which such repeal takes effect, such
6 county's resolution electing to be reimbursed for certain medical
7 assistance expenditures pursuant to section two of the chapter of the
8 laws of two thousand five which added this subdivision shall also be
9 repealed automatically as of such date; and the commissioner shall noti-
10 fy the commissioner of health of such county's repeal of such taxes. In
11 that event, as of such date, such county shall be treated as if it had
12 never made such election for purposes of such expenditures and such
13 commissioner of health shall thenceforth compute the amount due monthly
14 from such county for such expenditures pursuant to section one of the
15 chapter of the laws of two thousand five which added this subdivision.
16 (g) Notwithstanding any provision of state or local law, ordinance or
17 resolution to the contrary, if the commissioner of health timely certi-
18 fies to the commissioner that a city having a population of one million
19 or more in which the taxes imposed by section eleven hundred seven of
20 this chapter are in effect or which imposes sales and compensating use
21 taxes pursuant to the authority of section twelve hundred ten of this
22 article properly exercised its option by September thirtieth, two thou-
23 sand seven, pursuant to section two of the chapter of the laws of two
24 thousand five which added this subdivision, that such city be reimbursed
25 for medical assistance expenditures as provided in such section two of
26 such chapter, then the commissioner shall calculate the Medicaid amount
27 of such a city. The amount due each month to such a city with respect to
28 such taxes and certain other taxes shall be reduced; and the amount of
29 each such reduction shall instead be paid into the general fund of the
30 state treasury to the credit of the state purposes account therein. The
31 calculation of such a city's Medicaid amount and reductions and the
32 procedure governing the payment of such amounts are as follows:
33 (1) The commissioner of health shall furnish the commissioner with the
34 amount of such a city's "two thousand six-two thousand seven fiscal year
35 social services district expenditure cap amount," as provided in para-
36 graph (e) of section one of the chapter of the laws of two thousand five
37 which added this subdivision, as soon as practicable but no later than
38 April first, two thousand seven.
39 (2) The commissioner shall use or calculate the following amounts in
40 respect of such a city, which amounts shall be designated by the follow-
41 ing symbols, in order to determine the components of the monthly amount
42 described in paragraph three of this subdivision and shall notify the
43 chief fiscal officer of such city of the calculated value of "D" as
44 described in this paragraph and such other information available relat-
45 ing to D, by April thirtieth, two thousand seven, to help such city
46 determine whether to exercise such option:
47 (A) "A" shall equal the amount of such a city's "two thousand six-two
48 thousand seven fiscal year social services district expenditure cap
49 amount," as furnished by the commissioner of health pursuant to para-
50 graph one of this subdivision;
51 (B)(i) "B1" shall equal the total amount of sales and compensating use
52 tax distributions during state fiscal year two thousand six-two thousand
53 seven to such city or to a municipal assistance corporation on such
54 city's behalf from taxes imposed in such city by section eleven hundred
55 seven of this chapter, other than taxes imposed by subdivision (c) of
56 this section, at the rate of three percent;
S. 992 104 A. 1922
1 (ii) "B2" shall equal the total amount of sales tax distributions
2 during state fiscal year two thousand six-two thousand seven to such
3 city or to a municipal assistance corporation on such city's behalf from
4 taxes imposed in such city by subdivision (c) of section eleven hundred
5 seven of this chapter, at the rate of three percent;
6 (C) "C" shall equal the total amount of sales and compensating use tax
7 distributions during state fiscal year two thousand six-two thousand
8 seven to such city from its taxes imposed pursuant to the authority of
9 section twelve hundred twelve-A of this article; and
10 (D) "D" shall be the "Base Year PIT intercept amount" and shall equal
11 A less the sum of B1, B2 and C.
12 (3) (A) Commencing in January, two thousand eight, the commissioner
13 shall calculate the monthly Medicaid amount ("MA") for such city accord-
14 ing to the following formula: MA equals {((En/Fn) + (Ep/Fp)) X (.03)} +
15 (C/12) X (G) + (D/12) X (G); where C and D equal the amounts described
16 in paragraph two of this subdivision; "En" equals the current month's
17 portion of revenues from taxes imposed by section eleven hundred seven
18 of this chapter, excluding revenues from the tax on parking imposed by
19 subdivision (c) of such section eleven hundred seven; "Ep" equals the
20 current month's revenues from such tax on parking; "Fn" equals the
21 current month's general rate of sales and use taxes imposed by such
22 section eleven hundred seven or pursuant to the authority of such
23 section twelve hundred ten, other than on parking; "Fp" equals the
24 current month's rate of sales tax on parking under or pursuant to the
25 authority of such section eleven hundred seven or twelve hundred ten, as
26 the case may be; "G" equals a growth factor according to the formula G
27 equals {((En/Fn) + (Ep/Fp))} divided by {(MB1/.04) + (MB2/.06)}; "MB1"
28 equals the revenues from taxes imposed by section eleven hundred seven
29 of this chapter, excluding revenues from such tax on parking imposed by
30 subdivision (c) of such section eleven hundred seven, during the same
31 month of state fiscal year two thousand six-two thousand seven corre-
32 sponding to the current month described above; and "MB2" equals the
33 revenues from such tax on parking during the same month of state fiscal
34 year two thousand six-two thousand seven corresponding to the current
35 month described above.
36 (B) Using the amount of MA calculated each month in subparagraph (A)
37 of this paragraph, the commissioner shall then calculate the amounts of
38 sales and use tax revenues (E + H, where E and H equal the amounts
39 described in subparagraph (C) of this paragraph) and personal income tax
40 revenues (PIT) of such city which are to be intercepted or billed for as
41 described in this subdivision, according to the formula MA equals E + H
42 + PIT, as PIT is defined in subparagraph (D) of this paragraph. By the
43 twelfth day of each month, commencing in January, two thousand eight,
44 the commissioner shall establish the amount of E and H and certify such
45 amounts to the comptroller and by the fifteenth day of each month,
46 commencing in January, two thousand eight, the commissioner shall estab-
47 lish the amount of PIT and certify such amount and the amount of MA to
48 the comptroller, in the manner set forth in this paragraph.
49 (C) (i) For the period commencing January first, two thousand eight,
50 and ending on the last day of the month in which the taxes imposed in
51 such a city by section eleven hundred seven of this chapter shall
52 expire, the sales and use tax component "E" shall equal the amount of
53 revenues from such taxes imposed at the rate of three percent or the
54 amount of revenues from such taxes imposed at the rate of four percent
55 after payments to the municipal assistance corporation for such a city
56 required under section ninety-two-d of the state finance law have been
S. 992 105 A. 1922
1 made, whichever amount is less, and "H" shall equal net collections from
2 taxes imposed by such a city pursuant to the authority of section twelve
3 hundred twelve-A of this article, due such a city in the immediately
4 preceding month.
5 (ii) For the period commencing on the first day of the first month
6 following the period described in clause (i) of this subparagraph, the
7 sales and use tax component "E" shall equal net collections from sales
8 and compensating use taxes imposed by such city pursuant to the authori-
9 ty of subdivision (a) of section twelve hundred ten of this article up
10 to the rate of three percent and "H" shall equal net collections from
11 taxes imposed by such city pursuant to the authority of section twelve
12 hundred twelve-A of this article, due such a city in the immediately
13 preceding month.
14 (D) For the period commencing January first, two thousand eight, the
15 PIT component for each month shall be designated "PIT" and shall equal
16 the portion of the revenues from taxes imposed by such city pursuant to
17 the authority of article thirty of this chapter due such a city in the
18 immediately preceding month, calculated according to the formula: PIT
19 equals MA - E - H.
20 (E)(i) During the period that the taxes imposed in such a city by
21 section eleven hundred seven of this chapter are in effect, the comp-
22 troller shall each month, after paying amounts certified to by the
23 chairperson of the municipal assistance corporation created in aid of
24 such city, as provided for in section ninety-two-d of the state finance
25 law, pay the relevant portion of the sales and use tax component relat-
26 ing to such taxes imposed by such section eleven hundred seven for such
27 month equal to E into the general fund of the state treasury to the
28 credit of the state purposes account therein.
29 (ii) During the period that the taxes imposed by such a city pursuant
30 to the authority of section twelve hundred ten of this article are in
31 effect, the comptroller shall reduce the amount due each month to such
32 city from such taxes provided for in subdivision (c) of this section by
33 the relevant portion of the sales and use tax component for such month
34 equal to E; and the comptroller shall instead each month pay such
35 portion into the general fund of the state treasury to the credit of the
36 state purposes account therein.
37 (iii) The comptroller shall reduce the amount due each month to such
38 city from taxes imposed pursuant to the authority of section twelve
39 hundred twelve-A provided for in subdivision (c) of this section by the
40 relevant portion of the sales and use tax component for such month equal
41 to H; and the comptroller shall instead each month pay such portion into
42 the general fund of the state treasury to the credit of the state
43 purposes account therein.
44 (iv) The comptroller shall each month certify to the New York city
45 transitional finance authority the monthly amount of PIT and such
46 authority shall, after applying amounts described in section thirteen
47 hundred thirteen of this chapter, immediately pay such monthly amount,
48 or so much of which is available after applying such amounts, directly
49 and immediately to the comptroller; and the comptroller shall upon
50 receipt of such moneys, subject to the exceptions in such section thir-
51 teen hundred thirteen, pay them into the general fund of the state trea-
52 sury to the credit of the state purposes account therein.
53 (4) If for any reason such a city's Medicaid amount in a month (MA) is
54 greater than the sum of the amounts of the comptroller's net payments to
55 such city for that month under subdivision (c) of this section, under
56 section twelve hundred twelve-A of this article and under section thir-
S. 992 106 A. 1922
1 teen hundred thirteen of this chapter, after the comptroller has made
2 any payments to other entities required by any law and after any
3 payment, deposit, appropriation, transfer or expenditure required or
4 authorized by any of such sections, the comptroller shall, at the same
5 time that the comptroller makes the payments and reductions described in
6 paragraph three of this subdivision, bill such city an amount equal to
7 the difference and such city shall pay in full the amount of such bill
8 to the comptroller by the twenty-fifth day of such month. Such city
9 shall use any funds available to it to pay such bill. The comptroller
10 shall deposit any such amounts received into the general fund of the
11 state treasury to the credit of the state purposes account therein.
12 (5) If such a city does not pay in full a bill described in paragraph
13 four of this subdivision by the twenty-fifth day of the month in accord-
14 ance with such paragraph four, the comptroller shall, as soon as any
15 other moneys payable to the city are available, either deduct any amount
16 not paid from the amount of the next payment or payments due such city
17 pursuant to subdivision (c) of this section, section twelve hundred
18 twelve-A of this article or section thirteen hundred thirteen of this
19 chapter, until such amount not paid has been recovered or, in the alter-
20 native and at the comptroller's discretion, deduct any amount not paid
21 from the amount of any other moneys payable to such city from the comp-
22 troller and not subject to any lien or pledge for the benefit of bond-
23 holders of the transitional finance authority or of the municipal
24 assistance corporation, until such amount not paid has been recovered.
25 The comptroller shall deposit any amounts so deducted and recovered into
26 the general fund of the state treasury to the credit of the state
27 purposes account therein.
28 (6) This subdivision shall apply to payments required in respect of a
29 city to be made on January twelfth, two thousand eight, and thereafter.
30 (7)(A) If such a city adopts or amends a local law, ordinance or
31 resolution to repeal its sales and compensating use taxes imposed pursu-
32 ant to the authority of subdivision (a) of section twelve hundred ten of
33 this article, then, effective on the first day of the first month on
34 which such repeal takes effect, such city's resolution electing to be
35 reimbursed for certain medical assistance expenditures pursuant to
36 section two of the chapter of the laws of two thousand five which added
37 this subdivision shall also be repealed automatically as of such date;
38 and the commissioner shall notify the commissioner of health of such
39 city's repeal of such taxes. In that event, as of such date, such city
40 shall be treated as if it had never made such election for purposes of
41 such expenditures and such commissioner of health shall thenceforth
42 compute the amount due monthly from such city for such expenditures
43 pursuant to section one of such chapter of the laws of two thousand
44 five.
45 (B) If such city adopts or amends a local law to repeal its taxes on
46 personal income authorized by article thirty of this chapter, the comp-
47 troller shall bill such city monthly in the manner provided in paragraph
48 four of this subdivision for any amounts due under this subdivision
49 which otherwise would have been paid out of revenues from such taxes
50 into the general fund of the state treasury pursuant to this subdivi-
51 sion, and such bills shall be paid as provided in paragraph four of this
52 subdivision and any bill not paid shall be treated as provided in para-
53 graph five of this subdivision.
54 § 7. Section 1313 of the tax law, as amended by section 15 of part R
55 of chapter 60 of the laws of 2004, is amended to read as follows:
S. 992 107 A. 1922
1 § 1313. Deposit and disposition of revenues. (a) All revenue collected
2 by the commissioner from the taxes imposed pursuant to the authority of
3 this article or former article two-E of the general city law shall be
4 deposited daily with such responsible banks, banking houses or trust
5 companies, as may be designated by the state comptroller, to the credit
6 of the comptroller, in trust for the city of New York or the New York
7 city transitional finance authority, as their interests may appear
8 pursuant to this section. Such deposits shall be kept in trust and sepa-
9 rate and apart from all other moneys in the possession of the comp-
10 troller. The comptroller shall require adequate security from all such
11 depositories of such revenue collected by the commissioner.
12 (b) The comptroller shall retain in [his] the comptroller's hands such
13 amount as the commissioner may determine to be necessary for refunds in
14 respect to the taxes imposed pursuant to the authority of this article
15 or former article two-E of the general city law and for reasonable costs
16 of the commissioner in administering, collecting and distributing such
17 taxes, out of which the comptroller shall pay any refunds of such taxes
18 to which taxpayers shall be entitled under any law enacted pursuant to
19 the authority of this article or former article two-E of the general
20 city law.
21 [The] (c) Subject to the provisions of subsection (g) of this section,
22 the comptroller, after reserving such refund fund and such costs shall,
23 commencing on or before the fifteenth day of each month, pay to the New
24 York city transitional finance authority on a daily basis the balance of
25 taxes imposed pursuant to the authority of this article or former arti-
26 cle two-E of the general city law to be applied by the authority, in the
27 following order of priority: first pursuant to the authority's contracts
28 with bondholders, then to pay the authority's operating expenses not
29 otherwise provided for, and then pursuant to the authority's agreements
30 with the city, which agreements shall require the authority to transfer
31 the balance of such taxes not required to meet contractual or other
32 obligations of the authority to the city as frequently as practicable;
33 except that [he] the comptroller shall:
34 (1) pay to the state department of social services that amount of
35 overpayments of the taxes imposed pursuant to the authority of this
36 article or former article two-E of the general city law and the interest
37 on such amount which is certified to [him] the comptroller by the
38 commissioner as the amount to be credited against past-due support
39 pursuant to subdivision six of section one hundred seventy-one-c of this
40 chapter [and except that he shall];
41 (2) pay to the New York state higher education services corporation
42 that amount of overpayments of the taxes imposed pursuant to the author-
43 ity of this article or former article two-E of the general city law and
44 the interest on such amount which is certified to [him] the comptroller
45 by the commissioner as the amount to be credited against the amount of
46 defaults in repayment of guaranteed student loans pursuant to subdivi-
47 sion five of section one hundred seventy-one-d of this chapter [and
48 except that he shall];
49 (3) pay to the state university of New York or the city university of
50 New York respectively that amount of overpayments of the taxes imposed
51 pursuant to the authority of this article or former article two-E of the
52 general city law and the interest on such amount which is certified to
53 [him] the comptroller by the commissioner as the amount to be credited
54 against the amount of defaults in repayment of state or city university
55 loans pursuant to subdivision six of section one hundred seventy-one-e
56 of this chapter [and except that,];
S. 992 108 A. 1922
1 (4) notwithstanding any provision of law, [he shall] credit to the
2 revenue arrearage account, pursuant to section ninety-one-a of the state
3 finance law, that amount of overpayments of the taxes imposed pursuant
4 to the authority of this article or former article two-E of the general
5 city law and the interest on such amount which is certified to [him] the
6 comptroller by the commissioner as the amount to be credited against a
7 past-due legally enforceable debt owed to a state agency pursuant to
8 paragraph (a) of subdivision six of section one hundred seventy-one-f of
9 this chapter, provided, however, [he] the comptroller shall credit to
10 the special offset fiduciary account, pursuant to section ninety-one-c
11 of the state finance law, any such amount creditable as a liability as
12 set forth in paragraph (b) of subdivision six of section one hundred
13 seventy-one-f of this chapter[, and except that he shall];
14 (5) pay to the city of New York that amount of overpayments of tax
15 imposed pursuant to the authority of this article and the interest on
16 such amount which is certified to [him] the comptroller by the commis-
17 sioner as the amount to be credited against city of New York tax warrant
18 judgment debt pursuant to section one hundred seventy-one-l of this
19 chapter[, and except further that he shall]; and
20 (6) pay to a non-obligated spouse that amount of overpayment of tax
21 imposed pursuant to the authority of this article or former article
22 two-E of the general city law and the interest on such amount which has
23 been credited pursuant to section one hundred seventy-one-c, one hundred
24 seventy-one-d, one hundred seventy-one-e, one hundred seventy-one-f or
25 one hundred seventy-one-l of this chapter and which is certified to
26 [him] the comptroller by the commissioner as the amount due such non-o-
27 bligated spouse pursuant to paragraph six of subsection (b) of section
28 six hundred fifty-one of this chapter, and [he] the comptroller shall
29 deduct a like amount which [he], the comptroller shall pay into the
30 treasury to the credit of the general fund, from amounts subsequently
31 payable to the office of temporary and disability assistance, the state
32 university of New York, the city university of New York, the higher
33 education services corporation, or the revenue arrearage account or
34 special offset fiduciary account pursuant to section ninety-one-a or
35 ninety-one-c of the state finance law, as the case may be, whichever had
36 been credited the amount originally withheld from such overpayment.
37 (d) The amount deducted under subsection (b) of this section for
38 administering, collecting and distributing such taxes during such month-
39 ly period shall be paid by the comptroller into the general fund of the
40 state treasury to the credit of the state purposes account therein.
41 (e) The first payment to such chief fiscal officer shall be made on or
42 before March fifteenth, nineteen hundred seventy-six, which payment
43 shall represent the balance of revenue after provision for refund and
44 such reasonable costs, with respect to taxes collected from January
45 first, nineteen hundred seventy-six through February twenty-ninth, nine-
46 teen hundred seventy-six. Subsequent payments shall be made on or before
47 April fifteenth, nineteen hundred seventy-six, and on or before the
48 fifteenth day of each succeeding month thereafter, and shall represent
49 the balance of revenue with respect to taxes collected the preceding
50 calendar months.
51 (f) The amounts so payable under this section shall be certified to
52 the comptroller by the commissioner or [his] the commissioner's dele-
53 gate, either of whom shall not be held liable for any inaccuracy in such
54 certificate. Where the amount so paid over to such chief fiscal officer
55 is more or less than the amount then due such city, the amount of over-
56 payment or underpayment shall be certified to the comptroller by the
S. 992 109 A. 1922
1 commissioner or [his] the commissioner's delegate, either of whom shall
2 not be held liable for any inaccuracy in such certificate. The amount of
3 overpayment or underpayment shall be so certified to the comptroller as
4 soon after the discovery of the overpayment or underpayment as reason-
5 ably possible and subsequent payments by the comptroller to such chief
6 fiscal officer shall be adjusted by subtracting the amount of any such
7 overpayment from, or by adding the amount of any such underpayment to
8 such number of subsequent payments and distributions as the comptroller
9 and the commissioner shall consider reasonable in view of the amount of
10 the overpayment or underpayment and all other facts and circumstances.
11 (g) The balance payable to the New York city transitional finance
12 authority pursuant to this section shall instead be paid to the chief
13 fiscal officer of the city of New York unless and until the comptroller
14 has received from such authority a notice, which shall be conclusive and
15 upon which the comptroller may rely without further inquiry, that such
16 authority has incurred obligations payable by it, whether for borrowed
17 money, operating expenses or otherwise. On and after the date of such
18 notice and until such date as the authority shall have no obligations
19 outstanding, the city shall have no right, title or interest in or to
20 the taxes, except as provided in the authority's agreements with the
21 city.
22 (h) Notwithstanding any provision of state or local law, ordinance or
23 resolution to the contrary, if the commissioner of health timely certi-
24 fies to the commissioner that a city having a population of one million
25 or more which imposes tax pursuant to the authority of this article
26 properly exercised its option pursuant to section two of the chapter of
27 the laws of two thousand five which added this subdivision that such
28 city be reimbursed for medical assistance expenditures as provided in
29 such section two of such chapter, the commissioner shall make and certi-
30 fy the calculations and the comptroller shall, on the fifteenth day of
31 each month, starting in January, two thousand eight, intercept and pay
32 monthly amounts of revenue from taxes imposed in such a city pursuant to
33 the authority of this article, as provided in subdivision (g) of section
34 twelve hundred sixty-one of this chapter.
35 § 8. Paragraph (t) of subdivision 1 of section 368-a of the social
36 services law, as amended by section 2 of part C of chapter 58 of the
37 laws of 2004, is amended to read as follows:
38 (t) (i) for services provided on or after January first, two thousand
39 three through December thirty-first, two thousand four, fifty percent of
40 the amount expended for health care services under section three hundred
41 sixty-nine-ee of this article, after first deducting therefrom any
42 federal funds properly received or to be received on account thereof;
43 (ii) for services provided on or after January first, two thousand
44 five, through [December thirty-first] September thirtieth, two thousand
45 five, seventy-five percent of the amount expended for health care
46 services under section three hundred sixty-nine-ee of this article,
47 after first deducting therefrom any federal funds properly received or
48 to be received on account thereof; [and]
49 (iii) for services provided on or after October first, two thousand
50 five, through December thirty-first, two thousand five, seventy-five
51 percent of the amount expended by the social services district consist-
52 ing of the city of New York, and one hundred percent of the amount
53 expended by all other social services districts, for health care
54 services under section three hundred sixty-nine-ee of this article,
55 after first deducting therefrom any federal funds properly received or
56 to be received on account thereof; and
S. 992 110 A. 1922
1 (iv) for services provided on or after January first, two thousand six
2 through December thirty-first, two thousand six, and thereafter, one
3 hundred percent of the amount expended for health care services under
4 section three hundred sixty-nine-ee of this article, after first deduct-
5 ing therefrom any federal funds properly received or to be received on
6 account thereof.
7 § 9. Transitional funding. (a) For the purposes of assisting social
8 services districts in making necessary adjustments to the medical
9 assistance shares provisions set forth in section one of this act, the
10 commissioner of health shall make transitional payments to such
11 districts in the amount of $20,000,000 during the period April 1, 2005
12 through March 31, 2006, and in the amount of $10,000,000 during the
13 period April 1, 2006 through March 31, 2007 in accordance with the
14 provisions of paragraph (b) of this section. Such payments shall not be
15 subject to the provisions of section one of this act.
16 (b) Funds appropriated for transitional funding pursuant to this
17 section shall be distributed to social services districts pursuant to a
18 methodology or methodologies which consider county need as measured by
19 its per capita full property valuation and any such other factors as
20 developed by the commissioner of health and approved by the director of
21 the division of the budget. Such methodology may be implemented notwith-
22 standing the provisions of the state administrative procedure act.
23 § 10. The public health law is amended by adding a new article 2-A to
24 read as follows:
25 ARTICLE 2-A
26 PREFERRED DRUG PROGRAM
27 Section 270. Definitions.
28 271. Pharmacy and therapeutics committee.
29 272. Preferred drug program.
30 273. Preferred drug program prior authorization.
31 274. Clinical drug review program.
32 275. Applicability of prior authorization to EPIC.
33 276. Education and outreach.
34 277. Review and reports.
35 § 270. Definitions. As used in this article, unless the context clear-
36 ly requires otherwise:
37 1. "Administrator" means an entity with which the commissioner
38 contracts for the purpose of administering elements of the preferred
39 drug program, as established under section two hundred seventy-two of
40 this article or the clinical drug review program established under
41 section two hundred seventy-four of this article.
42 2. "Clinical drug review program" means the clinical drug review
43 program created by section two hundred seventy-four of this article.
44 3. "Committee" or "pharmacy and therapeutics committee" means the
45 pharmacy and therapeutics committee created by section two hundred
46 seventy-one of this article.
47 4. "Emergency condition" means a medical or behavioral condition as
48 determined by the prescriber or pharmacist, the onset of which is
49 sudden, that manifests itself by symptoms of sufficient severity,
50 including severe pain, and for which delay in beginning treatment
51 prescribed by the patient's health care practitioner would result in:
52 (a) placing the health or safety of the person afflicted with such
53 condition or other person or persons in serious jeopardy;
54 (b) serious impairment to such person's bodily functions;
55 (c) serious dysfunction of any bodily organ or part of such person;
S. 992 111 A. 1922
1 (d) serious disfigurement of such person; or
2 (e) severe discomfort.
3 5. "Panel" means the elderly pharmaceutical insurance coverage panel
4 established pursuant to section two hundred forty-four of the elder law.
5 6. "Preferred drug program" means the preferred drug program estab-
6 lished under section two hundred seventy-two of this article.
7 7. "Prescription drug" or "drug" means a drug defined in subdivision
8 seven of section sixty-eight hundred two of the education law, for which
9 a prescription is required under the federal food, drug and cosmetic
10 act. Any drug that does not require a prescription under such act, but
11 which would otherwise meet the criteria under this article for inclusion
12 on the preferred drug list may be added to the preferred drug list under
13 this article; and, if so included, shall be considered to be a
14 prescription drug for purposes of this article; provided that it shall
15 be eligible for reimbursement under a state public health plan when
16 ordered by a prescriber authorized to prescribe under the state public
17 health plan and the prescription is subject to the applicable provisions
18 of this article and paragraph (a) of subdivision four of section three
19 hundred sixty-five-a of the social services law.
20 8. "Prior authorization" means a process requiring the prescriber or
21 the dispenser to verify with the applicable state public health plan or
22 its authorized agent that the drug is appropriate for the needs of the
23 specific patient.
24 9. "State public health plan" means the medical assistance program
25 established by title eleven of article five of the social services law
26 (referred to in this article as "Medicaid") and the elderly pharmaceu-
27 tical insurance coverage program established by title three of article
28 two of the elder law (referred to in this article as "EPIC").
29 10. "Supplemental rebate" means a supplemental rebate under subdivi-
30 sion ten of section two hundred seventy-two of this article.
31 11. "Therapeutic class" means a group of prescription drugs that
32 produce a particular intended clinical outcome and are grouped together
33 as a therapeutic class by the pharmacy and therapeutics committee.
34 § 271. Pharmacy and therapeutics committee. 1. There is hereby estab-
35 lished in the department a pharmacy and therapeutics committee. The
36 committee shall consist of thirteen members, who shall be appointed by
37 the commissioner and who shall serve three year terms; except that for
38 the initial appointments to the committee, four members shall serve one
39 year terms, five shall serve two year terms, and four shall serve three
40 year terms. Committee members may be reappointed upon the completion of
41 their terms. No member of the committee shall be an employee of the
42 state or any subdivision of the state, other than for his or her member-
43 ship on the committee, except for employees of health care facilities or
44 universities operated by the state, a public benefit corporation, the
45 State University of New York or municipalities.
46 2. The membership shall be composed as follows:
47 (a) five persons licensed and actively engaged in the practice of
48 medicine in the state;
49 (b) one person licensed and actively engaged in the practice of nurs-
50 ing as a nurse practitioner, or in the practice of midwifery in the
51 state;
52 (c) five persons licensed and actively engaged in the practice of
53 pharmacy in the state;
54 (d) one person with expertise in drug utilization review who is either
55 a health care professional licensed under title eight of the education
56 law, is a pharmacologist or has a doctorate in pharmacology; and
S. 992 112 A. 1922
1 (e) one person who shall be a consumer or representative of an organ-
2 ization with a regional or statewide constituency and who has been
3 involved in activities related to health care consumer advocacy, includ-
4 ing issues affecting Medicaid or EPIC recipients.
5 3. The committee shall, at the request of the commissioner or the
6 panel, consider any matter relating to the preferred drug program estab-
7 lished pursuant to section two hundred seventy-two of this article, and
8 may advise the commissioner or the panel thereon. The committee may,
9 from time to time, submit to the commissioner or the panel recommenda-
10 tions relating to such preferred drug program. The committee may also
11 evaluate and provide recommendations to the commissioner or the panel on
12 other issues relating to pharmacy services under Medicaid or EPIC,
13 including, but not limited to: therapeutic comparisons; enhanced use of
14 generic drug products; enhanced targeting of physician prescribing
15 patterns; prior authorization of drugs subject to the clinical drug
16 review program established pursuant to section two hundred seventy-four
17 of this article; fraud, waste and abuse prevention; negotiations for
18 rebates; pharmacy benefit management activity by an administrator; and
19 negotiation of lower initial drug pricing.
20 4. The committee shall elect a chairperson from among its members, who
21 shall serve a one year term as chairperson. The chairperson may serve
22 consecutive terms.
23 5. The members of the committee shall receive no compensation for
24 their services but shall be reimbursed for expenses actually and neces-
25 sarily incurred in the performance of their duties.
26 6. The committee shall be a public body under article seven of the
27 public officers law and subject to article six of the public officers
28 law. In addition to the matters listed in section one hundred five of
29 the public officers law, the committee may conduct an executive session
30 for the purpose of receiving and evaluating drug pricing information
31 related to supplemental rebates, or receiving and evaluating trade
32 secrets, marketing plans or other information which, if disclosed, would
33 cause substantial injury to the competitive position of the manufactur-
34 er.
35 7. Committee members shall be deemed to be employees of the department
36 for the purposes of section seventeen of the public officers law, and
37 shall not participate in any matter for which a conflict of interest
38 exists.
39 8. The department shall provide administrative support to the commit-
40 tee.
41 § 272. Preferred drug program. 1. There is hereby established a
42 preferred drug program to promote access to the most effective
43 prescription drugs while reducing the cost of prescription drugs for
44 persons in state public health plans.
45 2. When a prescriber prescribes a non-preferred drug, state public
46 health plan reimbursement shall be denied unless prior authorization is
47 obtained, unless no prior authorization is required under this article.
48 3. The commissioner or the panel shall establish performance standards
49 for the program that, at a minimum, ensure that the preferred drug
50 program and the clinical drug review program provide sufficient techni-
51 cal support and timely responses to consumers, prescribers and pharma-
52 cists.
53 4. The pharmacy and therapeutics committee shall consider and make
54 recommendations to the commissioner or the panel for the adoption of a
55 preferred drug program. (a) In developing the preferred drug program,
56 the committee shall, without limitation: (i) identify therapeutic
S. 992 113 A. 1922
1 classes of drugs to be included in the preferred drug program; (ii)
2 identify preferred drugs in each of the chosen therapeutic classes;
3 (iii) evaluate the clinical effectiveness and safety of drugs consider-
4 ing the latest peer-reviewed research and may consider studies submitted
5 to the federal food and drug administration in connection with its drug
6 approval system; (iv) consider the potential impact on patient care and
7 the potential fiscal impact that may result from making such a drug
8 therapeutic class subject to prior authorization; and (v) consider the
9 potential impact of the preferred drug program on the health of special
10 populations such as children, the elderly, the chronically ill, persons
11 with HIV/AIDS and persons with mental health conditions.
12 (b) In developing the preferred drug program, the committee may
13 consider preferred drug programs or evidence based research operated or
14 conducted by or for other state governments, the federal government, or
15 multi-state coalitions. Notwithstanding any inconsistent provision of
16 section one hundred twelve or article eleven of the state finance law or
17 section one hundred forty-two of the economic development law or any
18 other law, the department or the panel may enter into contractual agree-
19 ments with the Oregon Health and Science University Drug Effectiveness
20 Review Project to provide technical and clinical support to the commit-
21 tee and the department or the panel in researching and recommending
22 drugs to be placed on the preferred drug list.
23 (c) The committee shall from time to time review all therapeutic
24 classes included in the preferred drug program, and may recommend that
25 the commissioner or the panel add or delete drugs or classes of drugs to
26 or from the preferred drug program, subject to this subdivision.
27 (d) The committee shall establish procedures to promptly review
28 prescription drugs newly approved by the federal food and drug adminis-
29 tration.
30 5. The committee shall recommend a procedure and criteria for the
31 approval of non-preferred drugs as part of the prior authorization proc-
32 ess. In developing these criteria, the committee shall include consider-
33 ation of the following:
34 (a) the preferred drug has been tried by the patient and has failed to
35 produce the desired health outcomes;
36 (b) the patient has tried the preferred drug and has experienced unac-
37 ceptable side effects;
38 (c) the patient has been stabilized on a non-preferred drug and tran-
39 sition to the preferred drug would be medically contraindicated; and
40 (d) other clinical indications for the use of the non-preferred drug,
41 including the medical needs of special populations including children,
42 the elderly, the chronically ill, persons with mental health conditions,
43 and persons affected by HIV/AIDS.
44 6. The commissioner or the panel shall provide thirty days public
45 notice on the department's website prior to any meeting of the committee
46 to develop recommendations concerning the preferred drug program. Such
47 notice regarding meetings of the committee shall include a description
48 of the proposed therapeutic class to be reviewed, a listing of drug
49 products in the therapeutic class, and the proposals to be considered by
50 the committee. The committee shall allow interested parties a reasonable
51 opportunity to make an oral presentation to the committee related to the
52 prior authorization of the drug therapeutic class to be reviewed. The
53 committee shall consider any information provided by any interested
54 party, including, but not limited to, prescribers, dispensers, patients,
55 consumers and manufacturers of the drug in developing their recommenda-
56 tions.
S. 992 114 A. 1922
1 7. The commissioner or the panel shall provide notice of any recommen-
2 dations developed by the committee regarding the preferred drug program,
3 at least thirty days before any final determination by the commissioner
4 or the panel, by making such information available on the department's
5 website. Such public notice shall include: a summary of the deliber-
6 ations of the committee; a summary of the positions of those making
7 public comments at meetings of the committee; the response of the
8 committee to those comments, if any; and the findings and recommenda-
9 tions of the committee.
10 8. Within ten days of a final determination regarding the preferred
11 drug program, the commissioner or the panel shall provide public notice
12 on the department's website of such determinations, including: the
13 nature of the determination; an analysis of the impact of the commis-
14 sioner's or the panel's determination on state public health plan popu-
15 lations and providers; and the projected fiscal impact to the state
16 public health plan programs of the commissioner's or the panel's deter-
17 mination.
18 9. The commissioner or the panel shall adopt a preferred drug program
19 and amendments after considering the recommendations from the committee
20 and any comments received from prescribers, dispensers, patients,
21 consumers and manufacturers of the drug.
22 (a) Any therapeutic class included in the preferred drug program shall
23 be developed based initially on an evaluation of the clinical effective-
24 ness, safety and patient outcomes, followed by consideration of the
25 cost-effectiveness of the drugs.
26 (b) In each therapeutic class included in the preferred drug program,
27 if the committee determines there is one drug which is significantly
28 more clinically effective and safe, that drug shall be included on the
29 preferred drug list without consideration of cost. If, among two or more
30 drugs in a therapeutic class, the difference in clinical effectiveness
31 and safety is not clinically significant, then cost effectiveness
32 (including price and supplemental rebates) may also be considered in
33 determining which drug or drugs shall be included on the preferred drug
34 list.
35 (c) In addition to drugs selected under paragraph (b) of this subdivi-
36 sion, any prescription drug in the therapeutic class, whose cost to the
37 state public health plans (including net price and supplemental rebates)
38 is equal to or less than the cost of another drug in the therapeutic
39 class that is on the preferred drug list under paragraph (b) of this
40 subdivision, may be selected to be on the preferred drug list, based on
41 clinical effectiveness, safety and cost-effectiveness.
42 10. The commissioner or the panel shall provide an opportunity for
43 pharmaceutical manufacturers to provide supplemental rebates to the
44 department or EPIC; such supplemental rebates shall be taken into
45 consideration by the committee and the commissioner or the panel in
46 determining the cost-effectiveness of drugs within a therapeutic class
47 under the state public health plans. Such supplemental rebates shall be
48 in addition to those required by applicable federal law and subdivision
49 seven of section three hundred sixty-seven-a of the social services law.
50 In order to be considered in connection with the preferred drug program,
51 such supplemental rebates shall apply to the drug products dispensed
52 under the Medicaid program and the EPIC program. The commissioner is
53 prohibited from approving alternative rebate demonstrations, value added
54 programs or guaranteed savings from other program benefits as a substi-
55 tution for supplemental rebates.
S. 992 115 A. 1922
1 11. No prior authorization shall be required under the preferred drug
2 program for: (a) atypical anti-psychotics; (b) anti-depressants; (c)
3 anti-retrovirals used in the treatment of HIV/AIDS; and (d) anti-rejec-
4 tion drugs used for the treatment of organ and tissue transplants.
5 12. The commissioner or the panel may implement all or a portion of
6 the preferred drug program through contracts with administrators with
7 expertise in management of pharmacy services, subject to applicable
8 laws.
9 § 273. Preferred drug program prior authorization. 1. For the purposes
10 of this section, a prescription drug shall be considered to be not on
11 the preferred drug list if it is in a therapeutic class that is included
12 on the preferred drug list and is not one of the drugs on the preferred
13 list in that class.
14 2. The preferred drug program shall make available a twenty-four hour
15 per day, seven days per week telephone call center that includes a toll-
16 free telephone line and dedicated facsimile line to respond to requests
17 for prior authorization. The call center shall include qualified health
18 care professionals who shall be available to consult with prescribers
19 concerning prescription drugs that are not on the preferred drug list. A
20 prescriber seeking prior authorization shall consult with the program
21 call line to reasonably present his or her justification for the
22 prescription and give the program's qualified health care professional a
23 reasonable opportunity to respond.
24 3. (a) When a patient's health care provider prescribes a prescription
25 drug that is not on the preferred drug list, the prescriber shall
26 consult with the program to confirm that in his or her reasonable
27 professional judgment, the patient's clinical condition is consistent
28 with the criteria for approval of the non-preferred drug. Such criteria
29 shall include requirements that:
30 (i) the preferred drug has been tried by the patient and has failed to
31 produce the desired health outcomes;
32 (ii) the patient has tried the preferred drug and has experienced
33 unacceptable side effects;
34 (iii) the patient has been stabilized on a non-preferred drug and
35 transition to the preferred drug would be medically contraindicated; or
36 (iv) other clinical indications identified by the committee for the
37 patient's use of the non-preferred drug, based on consideration of the
38 medical needs of patients including those who are children, elderly,
39 chronically ill, persons with mental health conditions, and persons
40 affected by HIV/AIDS.
41 (b) In the event that the patient does not meet the criteria described
42 in paragraph (a) of this subdivision, the program shall provide a
43 reasonable opportunity for a prescriber to present his or her justifica-
44 tion for prior authorization.
45 (c) If a patient is determined by the department to not meet the
46 requirements of paragraphs (a) or (b) of this subdivision, prior author-
47 ization under this section shall be denied.
48 (d) In the instance where a prior authorization determination cannot
49 be completed within twenty-four hours of the original request, a seven-
50 ty-two hour supply of the medication will be approved by the program and
51 the prescriber shall be notified of this determination.
52 4. When, in the judgment of the prescriber or the pharmacist, an emer-
53 gency condition exists, and the prescriber or pharmacist confirms with
54 the program that an emergency condition exists, a seventy-two hour emer-
55 gency supply of the drug prescribed shall be immediately authorized by
56 the program.
S. 992 116 A. 1922
1 5. In the event that a patient presents a prescription to a pharmacist
2 for a prescription drug that is not on the preferred drug list and for
3 which the prescriber has not obtained a prior authorization, the pharma-
4 cist shall, within a reasonable period based on professional judgment,
5 notify the prescriber. The prescriber shall, within a reasonable period
6 based on professional judgment, either seek prior authorization or shall
7 contact the pharmacist and amend or cancel the prescription.
8 6. No prior authorization under the program shall be required when a
9 prescriber prescribes a drug on the preferred drug list.
10 7. The department shall monitor the prior authorization process for
11 prescribing patterns which are suspected of endangering the health and
12 safety of the patient or which demonstrate a likelihood of fraud or
13 abuse. The department shall take any and all actions otherwise permitted
14 by law to investigate such prescribing patterns, to take remedial action
15 and to enforce applicable federal and state laws.
16 8. No prior authorization under the preferred drug program shall be
17 required for any prescription under EPIC until the panel has made prior
18 authorization applicable to EPIC under section two hundred seventy-five
19 of this article.
20 § 274. Clinical drug review program. 1. In addition to the preferred
21 drug program established by this article, the commissioner or the panel
22 may establish a clinical drug review program. The commissioner or the
23 panel may, from time to time, require prior authorization under such
24 program for prescription drugs or patterns of utilization under state
25 public health plans. When a prescriber prescribes a drug which requires
26 prior authorization under this section, state public health plan
27 reimbursement shall be denied unless such prior authorization is
28 obtained.
29 2. The clinical drug review program shall make available a twenty-four
30 hour per day, seven days per week response system.
31 3. In establishing a prior authorization requirement for a drug under
32 the clinical drug review program, the commissioner or the panel shall
33 consider the following:
34 (a) whether the drug requires monitoring of prescribing protocols to
35 protect both the long-term efficacy of the drug and the public health;
36 (b) the potential for, or a history of, overuse, abuse, drug diversion
37 or illegal utilization;
38 (c) the potential for, or a history of utilization inconsistent with
39 approved indications;
40 (d) whether similarly effective alternatives are available for the
41 same disease state;
42 (e) the cost of the drug compared to other drug therapies for the same
43 disease state; and
44 (f) the availability of an over-the-counter version of a drug product
45 with similar or equivalent clinical effectiveness.
46 4. The commissioner or the panel shall obtain an evaluation of the
47 factors set forth in subdivision three of this section and a recommenda-
48 tion as to the establishment of a prior authorization requirement for a
49 drug under the clinical drug review program from the pharmacy and thera-
50 peutics committee established pursuant to section two hundred seventy-
51 one of this article. For this purpose, the commissioner or the panel and
52 the committee, as applicable, shall comply with the following meeting
53 and notice processes established by this article:
54 (a) the open meetings law and freedom of information law provisions of
55 subdivision six of section two hundred seventy-one of this article; and
S. 992 117 A. 1922
1 (b) the public notice and interested party provisions of subdivisions
2 six, seven and eight of section two hundred seventy-two of this article.
3 5. The committee shall recommend a procedure and criteria for the
4 approval of drugs subject to prior authorization under the clinical drug
5 review program. Such criteria shall include the specific approved clin-
6 ical indications for use of the drug.
7 6. The commissioner or the panel shall identify a drug for which prior
8 authorization is required, as well as the procedures and criteria for
9 approval of use of the drug, under the clinical drug review program
10 after considering the recommendations from the committee and any
11 comments received from prescribers, dispensers, consumers and manufac-
12 turers of the drug. In no case shall the prior authorization criteria
13 for approval pursuant to this subdivision result in denial of the prior
14 authorization request based on the relative cost of the drug subject to
15 prior authorization.
16 7. In the event that the patient does not meet the criteria for
17 approval established by the commissioner in subdivision six of this
18 section, the clinical drug review program shall provide a reasonable
19 opportunity for a prescriber to reasonably present his or her justifica-
20 tion for prior authorization. If the patient is determined not to meet
21 the criteria for approval, prior authorization under this section shall
22 be denied.
23 8. In the instance where a prior authorization determination cannot be
24 completed within twenty-four hours of the original request, a seventy-
25 two hour supply of the medication will be approved by the program and
26 the prescriber shall be notified of the determination.
27 9. When, in the judgment of the prescriber or the pharmacist, an emer-
28 gency condition exists, and the prescriber or pharmacist consults with
29 the program to confirm that such an emergency condition exists, a seven-
30 ty-two hour emergency supply of the drug prescribed shall be immediately
31 authorized by the program.
32 10. The department or the panel shall monitor the prior authorization
33 process for prescribing patterns which are suspected of endangering the
34 health and safety of the patient or which demonstrate a likelihood of
35 fraud or abuse. The department or the panel shall take any and all
36 actions otherwise permitted by law to investigate such prescribing
37 patterns, to take remedial action and to enforce applicable federal and
38 state laws.
39 11. The commissioner or the panel may implement all or a portion of
40 the clinical drug review program through contracts with administrators
41 with expertise in management of pharmacy services, subject to applicable
42 laws.
43 12. No prior authorization under the clinical drug review program
44 shall be required for any prescription under EPIC until the commissioner
45 has made prior authorization applicable to EPIC under section two
46 hundred seventy-five of this article.
47 § 275. Applicability of prior authorization to EPIC. The panel shall,
48 no later than April first, two thousand eight, proceed to make prior
49 authorization under the preferred drug program and the clinical review
50 drug program, under this article, applicable to prescriptions under
51 EPIC. Upon determining that the necessary steps have been taken to apply
52 prior authorization under this article to EPIC, the panel shall, with
53 reasonable prior public notice, make prescriptions under EPIC subject to
54 prior authorization under this article as of a specified date. If neces-
55 sary, the panel may provide that such applicability take effect on sepa-
S. 992 118 A. 1922
1 rate dates for the preferred drug program and the clinical drug review
2 program.
3 § 276. Education and outreach. The department or the panel may conduct
4 education and outreach programs for consumers and health care providers
5 relating to the safe, therapeutic and cost-effective use of prescription
6 drugs and appropriate treatment practices for containing prescription
7 drug costs. The department or the panel shall provide information as to
8 how prescribers, pharmacists, patients and other interested parties can
9 obtain information regarding drugs included on the preferred drug list,
10 whether any change has been made to the preferred drug list since it was
11 last issued, and the process by which prior authorization may be
12 obtained.
13 § 277. Review and reports. 1. The commissioner, in consultation with
14 the pharmacy and therapeutics committee, shall undertake periodic
15 reviews, at least annually, of the preferred drug program which shall
16 include consideration of:
17 (a) the volume of prior authorizations being handled, including data
18 on the number of prior authorization requests for particular
19 prescription drugs;
20 (b) the quality of the program's responsiveness, including the quality
21 of the administrator's responsiveness;
22 (c) complaints received from patients and providers;
23 (d) the savings attributable to the state, and to each county and the
24 city of New York, due to the provisions of this article;
25 (e) the aggregate amount of supplemental rebates received in the
26 previous fiscal year and in the current fiscal year, to date; and such
27 amounts are to be broken out by fiscal year and by month;
28 (f) the education and outreach program established by section two
29 hundred seventy-six of this article.
30 2. The commissioner and the panel shall, beginning March thirty-first,
31 two thousand six and annually thereafter, submit a report to the gover-
32 nor and the legislature concerning each of the items subject to periodic
33 review under subdivision one of this section.
34 3. The commissioner and the panel shall, beginning with the commence-
35 ment of the preferred drug program and monthly thereafter, submit a
36 report to the governor and the legislature concerning the amount of
37 supplemental rebates received.
38 § 11. Paragraph (a-1) of subdivision 4 of section 365-a of the social
39 services law, as added by section 5 of part B of chapter 1 of the laws
40 of 2002, is amended to read as follows:
41 (a-1) [A] a brand name drug for which a multi-source therapeutically
42 and generically equivalent drug, as determined by the federal food and
43 drug administration, is available, unless previously authorized by the
44 department of health. The commissioner of health is authorized to
45 exempt, for good cause shown, any brand name drug from the restrictions
46 imposed by this paragraph. This paragraph shall not apply to any drug
47 that is in a therapeutic class included on the preferred drug list under
48 section two hundred seventy-two of the public health law or is in the
49 clinical drug review program under section two hundred seventy-four of
50 the public health law;
51 § 12. Subdivision 4 of section 365-a of the social services law is
52 amended by adding a new paragraph (a-2) to read as follows:
53 (a-2) drugs which may not be dispensed without a prescription as
54 required by section sixty-eight hundred ten of the education law, and
55 which are non-preferred drugs in a therapeutic class subject to the
56 preferred drug program pursuant to section two hundred seventy-two of
S. 992 119 A. 1922
1 the public health law, or the clinical drug review program under section
2 two hundred seventy-four of the public health law, unless prior authori-
3 zation is granted or not required;
4 § 13. Subdivision 5 of section 244 of the elder law is amended by
5 adding a new paragraph (l) to read as follows:
6 (l) implement a preferred drug program and clinical drug review
7 program in accordance with the provisions of article two-A of the public
8 health law.
9 § 14. Section 3-a of part Z2 of chapter 62 of the laws of 2003 amend-
10 ing the social services law and other laws relating to implementing the
11 state fiscal plan for the 2003-2004 state fiscal year is REPEALED.
12 § 15. Notwithstanding any inconsistent provision of section 271 of the
13 public health law, as added by section ten of this act, any pharmacy and
14 therapeutics committee appointed by the commissioner of health in exist-
15 ence on the effective date of this act shall continue to function and
16 shall be authorized to carry out the same duties and powers as
17 prescribed pursuant to article 2-A of the public health law, as added by
18 section ten of this act, until such committee is duly appointed pursuant
19 to such section 271 of the public health law.
20 § 16. Paragraph (g) of subdivision 2 of section 365-a of the social
21 services law, as amended by chapter 710 of the laws of 1988, is amended
22 to read as follows:
23 (g) sickroom supplies, eyeglasses, and prosthetic appliances [and
24 dental prosthetic appliances] furnished in accordance with the regu-
25 lations of the department; drugs provided on an in-patient basis, those
26 drugs contained on the list established by regulation of the commission-
27 er of health pursuant to subdivision four of this section, and those
28 drugs which may not be dispensed without a prescription as required by
29 section sixty-eight hundred ten of the education law and which the
30 commissioner of health shall determine to be reimbursable based upon
31 such factors as the availability of such drugs or alternatives at low
32 cost if purchased by a medicaid recipient, or the essential nature of
33 such drugs as described by such commissioner in regulations, provided,
34 however, that such drugs, exclusive of long-term maintenance drugs,
35 shall be dispensed in quantities no greater than a thirty day supply or
36 one hundred doses, whichever is greater; provided further that the
37 commissioner of health is authorized to require prior authorization for
38 any refill of a prescription when less than seventy-five percent of the
39 previously dispensed amount per fill should have been used were the
40 product used as normally indicated; medical assistance shall not include
41 any drug provided on other than an in-patient basis for which a recipi-
42 ent is charged or a claim is made in the case of a prescription drug, in
43 excess of the maximum reimbursable amounts to be established by depart-
44 ment regulations in accordance with standards established by the secre-
45 tary of the United States department of health and human services, or,
46 in the case of a drug not requiring a prescription, in excess of the
47 maximum reimbursable amount established by the commissioner of health
48 pursuant to paragraph (a) of subdivision four of this section;
49 § 17. Subparagraphs (i) and (ii) of paragraph (d) of subdivision 25
50 of section 2807-c of the public health law, as added by section 7 of
51 part B of chapter 58 of the laws of 2004, are amended to read as
52 follows:
53 (i) For periods on and after April first, two thousand four, the
54 commissioner shall adjust inpatient medical assistance rates of payment
55 established pursuant to this section, including discrete rates of
56 payment calculated pursuant to paragraph a-three of subdivision one of
S. 992 120 A. 1922
1 this section, for non-public general hospitals, and for periods on and
2 after April first, two thousand five, for public and non-public general
3 hospitals, in accordance with subparagraph (ii) of this paragraph, for
4 purposes of reimbursing graduate medical education costs based on the
5 following methodology:
6 (ii) Rate adjustments for each [non-public] general hospital shall be
7 based on the difference between the graduate medical education compo-
8 nent, direct and indirect, of the two thousand three medical assistance
9 inpatient rates of payment, including exempt unit per diem rates, and an
10 estimate of what the graduate medical education component, direct and
11 indirect, of such medical assistance inpatient rates of payment, includ-
12 ing exempt unit per diem rates would be, stated at two thousand three
13 levels and calculated as follows:
14 (A) Each [non-public] general hospital's total direct medical educa-
15 tion costs as reported in the two thousand one institutional cost report
16 submitted as of December thirty-first, two thousand three, and
17 (B) An estimate of the total indirect medical education costs for two
18 thousand one calculated in accordance with the methodology applicable
19 for purposes of determining an estimate of indirect medical education
20 costs pursuant to subparagraph (ii) of paragraph (c) of subdivision
21 seven of this section. The indirect medical education costs shall equal
22 the product of two thousand one hospital specific inpatient operating
23 costs, including exempt unit costs, and the indirect teaching cost
24 percentage determined by the following formula:
25 1-(1/(1+1.89(((1+r)^.405)-1)))
26 where r equals the ratio of residents and fellows to beds for two thou-
27 sand one adjusted to reflect the projected two thousand three resident
28 counts.
29 (C) Each hospital's rate adjustment shall be limited to seventy-five
30 percent of the graduate medical education component included in its two
31 thousand three medical assistance inpatient rates of payment, including
32 exempt unit rates. For periods on and after April first, two thousand
33 five, the seventy-five percent limit shall not apply to rate decreases
34 calculated pursuant to this paragraph.
35 (D) [No] For the period April first, two thousand four through March
36 thirty-first, two thousand five, no hospital shall receive a rate
37 adjustment pursuant to this paragraph if such rate adjustment would be a
38 negative amount. For periods on and after April first, two thousand
39 five, no public general hospital shall receive a rate increase calcu-
40 lated pursuant to this paragraph.
41 § 18. 1. Notwithstanding any inconsistent provision of law, rule or
42 regulation, for payments made by a state governmental agency to a gener-
43 al hospital for specialty inpatient hospital services provided to
44 patients eligible for payments pursuant to title 11 of article 5 of the
45 social services law discharged or for visits made on or after April
46 first, two thousand five, the commissioner of health, subject to the
47 approval of the director of the budget, may:
48 (a) establish rates of payment or special payment rate methodologies
49 for specialty inpatient hospital services selected in accordance with
50 paragraph (c) of this subdivision provided to patients eligible for
51 payments pursuant to title 11 of article 5 of the social services law
52 through negotiations with hospitals in any area of the state, and,
53 notwithstanding section 112 of the state finance law, award contracts to
54 hospitals that participate in such negotiations and agree to receive the
55 negotiated payment rates in lieu of rates of payment otherwise applica-
S. 992 121 A. 1922
1 ble pursuant to section 2807-c of the public health law without a
2 competitive bid or request for proposal process; and/or
3 (b) select among hospitals in any area of the state those eligible for
4 reimbursement for specialty inpatient hospital services selected in
5 accordance with paragraph (c) of this subdivision and establish payments
6 for such services based on a competitive bidding process.
7 (c) The commissioner of health shall select specialty inpatient hospi-
8 tal services for which reimbursement may be negotiated with hospitals
9 based on the following criteria:
10 (i) such services may be provided more efficiently and economically;
11 and
12 (ii) such services have low utilization or are provided in units with
13 low occupancy; and
14 (iii) any other criteria determined by the commissioner of health to
15 promote the cost effective delivery of specialty inpatient hospital
16 services.
17 (d) Inpatient hospital services not selected by the commissioner of
18 health pursuant to this section provided to patients eligible for
19 payments pursuant to title 11 of article 5 of the social services law
20 shall be reimbursed pursuant to section 2807-c of the public health law.
21 2. Notwithstanding any inconsistent provisions of law, rule or regu-
22 lation no payments shall be made for specialty inpatient hospital
23 services selected by the commissioner of health in accordance with para-
24 graph (c) of subdivision one of this section for which there is a
25 contract with a hospital pursuant to paragraphs (a) or (b) of subdivi-
26 sion one of this section when such services are provided to patients
27 eligible for payments pursuant to title 11 of article 5 of the social
28 services law by a hospital which has not contracted with the commission-
29 er of health pursuant to paragraphs (a) or (b) of subdivision one of
30 this section; provided, however, payments may be made to such hospital
31 in accordance with section 2807-c of the public health law if the
32 provision of such services has been prior approved by the commissioner
33 of health, or if the inpatient admission is a result of emergency admis-
34 sion.
35 3. Payment of rates established pursuant to this section shall be
36 contingent upon federal approval of a waiver application submitted by
37 the commissioner of health in order to receive federal financial partic-
38 ipation for services provided under this section; provided, however, the
39 commissioner of health may take any steps necessary to implement this
40 section prior to receiving federal approval of such waiver application.
41 § 19. Subparagraph (i) of paragraph (g) of subdivision 2 of section
42 2807 of the public health law, as amended by chapter 170 of the laws of
43 1994, is amended to read as follows:
44 (i) During the period April first, nineteen hundred ninety-four
45 through December thirty-first, nineteen hundred ninety-four and for each
46 calendar year rate period commencing on January first thereafter, rates
47 of payment by governmental agencies for the operating cost component of
48 general hospital outpatient services shall be based on the operating
49 costs reported in the base year cost report adjusted by the trend factor
50 applicable to the general hospital in which the services were provided;
51 provided, however, that the maximum payment for the operating cost
52 component of outpatient services shall be sixty-seven dollars and fifty
53 cents plus the addition of the capital cost per visit. The capital cost
54 per visit shall be based on the base year cost report except that the
55 capital cost per visit may be adjusted for major outpatient capital
56 expenditures incurred subsequent to the reporting year, when such
S. 992 122 A. 1922
1 expenditures have received the requisite approvals and the facility has
2 provided the commissioner with a certified statement of the expendi-
3 tures. The base year for the period April first, nineteen hundred nine-
4 ty-four through December thirty-first, nineteen hundred ninety-four
5 shall be nineteen hundred ninety-two and shall be advanced one year
6 thereafter for each subsequent calendar year rate period. Further, the
7 provisions of subdivision seven of this section shall not apply. The
8 commissioner may waive the maximum allowable payment and limitations on
9 the rate of payment as prescribed herein to provide for the reimburse-
10 ment of offering and arranging services eligible for ninety percent
11 federal funds as set forth in section nineteen hundred three of the
12 federal social security act, and to provide for the reimbursement of
13 specialized services having separately identifiable costs and statis-
14 tics, including but not limited to hemodialysis services and surgical
15 services provided on an outpatient basis, provided, however, that during
16 the period April first, two thousand five through December thirty-first,
17 two thousand five and for each calendar year rate period commencing
18 thereafter, such specialized services shall not include services for
19 which the rate of payment is established by the office of mental health
20 pursuant to section 43.02 of the mental hygiene law. Such waiver shall
21 be granted only when the commissioner finds that the services are being
22 provided efficiently and at minimum cost. The commissioner shall prompt-
23 ly promulgate rules and regulations necessary to identify such services.
24 Among the criteria which the commissioner shall consider in the case of
25 specialized services are whether the services require highly specialized
26 staff, equipment or facilities, thereby generating a cost that substan-
27 tially exceeds that of more routine diagnostic or treatment services;
28 whether the facility in which the services are provided is presently
29 providing the services to the population in need; and, whether the
30 services may be provided safely and effectively on an outpatient basis
31 at a lower cost than through inpatient admission. In addition the
32 commissioner shall provide for a waiver of the maximum allowable payment
33 for those outpatient services medically necessary which include surgical
34 procedures where delay in surgical intervention would substantially
35 increase the medical risk associated with such surgical intervention.
36 Where the commissioner waives the maximum allowable payment for any
37 specified service he or she may, in accordance with the foregoing crite-
38 ria and such other criteria as he or she deems appropriate, establish a
39 maximum allowable payment for such specified service.
40 § 20. Subdivision 4 of section 2807-c of the public health law is
41 amended by adding a new paragraph (l) to read as follows:
42 (l) Notwithstanding any law or regulation to the contrary, payments to
43 general hospitals for inpatient services provided to patients discharged
44 on and after April first, two thousand five, who are eligible for
45 payments made by state governmental agencies and who are determined to
46 be in diagnosis-related groups numbered seven hundred forty-three, seven
47 hundred forty-five, seven hundred forty-six, seven hundred forty-eight,
48 seven hundred forty-nine or seven hundred fifty-one shall be made on a
49 per diem basis in an amount equal to the fees paid in the same locality
50 pursuant to section 43.02 of the mental hygiene law for community based
51 detoxification services provided in facilities licensed pursuant to
52 article thirty-two of the mental hygiene law.
53 § 21. 1. Notwithstanding paragraph (c) of subdivision 10 of section
54 2807-c of the public health law and section 21 of chapter 1 of the laws
55 of 1999 and any other inconsistent provision of law or regulation to the
56 contrary, in determining rates of payment by state governmental agencies
S. 992 123 A. 1922
1 effective for services provided beginning April 1, 2005, and thereafter
2 for inpatient and outpatient services provided by general hospitals and
3 for inpatient services and outpatient adult day health care services
4 provided by residential health care facilities pursuant to article 28 of
5 the public health law, the commissioner of health shall apply no trend
6 factor projections attributable to the period January 1, 2005 through
7 December 31, 2005.
8 2. The commissioner of health shall adjust rates of payment to reflect
9 the exclusion pursuant to this section of such specified trend factor
10 projections or adjustments.
11 § 22. Paragraph (a) of subdivision 2 of section 2807-d of the public
12 health law is amended by adding a new subparagraph (v) to read as
13 follows:
14 (v) Notwithstanding any contrary provisions of this paragraph or any
15 other provision of law or regulation, for general hospitals the assess-
16 ment shall be seven-tenths of one percent of each general hospital's
17 gross receipts received from all patient care services and other operat-
18 ing income on a cash basis beginning April first, two thousand five for
19 hospital or health-related services, including, but not limited to inpa-
20 tient service, outpatient service, emergency service, referred ambulato-
21 ry service and ambulatory surgical services, but not including residen-
22 tial health care facilities services or home health care services.
23 § 23. Paragraph (b) of subdivision 12 of section 2807-d of the public
24 health law, as amended by section 57 of part J of chapter 82 of the laws
25 of 2002, is amended to read as follows:
26 (b) The exclusion of the hospitals described in paragraph (b) of
27 subdivision one of this section and the exclusion of revenue described
28 in [subparagraph (vi) of paragraph (b) of] subdivision two of this
29 section from the assessments set forth in [subparagraph (vi) of para-
30 graph (b) of] subdivision two of this section for periods on and after
31 April first, two thousand two shall be contingent upon either: (i) qual-
32 ification of the assessments for waiver pursuant to federal law and
33 regulation; or (ii) consistent with federal law and regulation, not
34 requiring a waiver by the secretary of the department of health and
35 human services related to such exclusion; in order for the assessments
36 under this section to be qualified as a broad-based health care related
37 tax for purposes of the revenues received by the state pursuant to the
38 assessments not reducing the amount expended by the state as medical
39 assistance for purposes of federal financial participation. The commis-
40 sioner shall collect such assessments relying on such exclusion, pending
41 any contrary action by the secretary of the department of health and
42 human services. In the event the secretary of the department of health
43 and human services determines that such assessments do not so qualify
44 based on such exclusion, then the commissioner shall, to the extent
45 necessary to achieve such qualification for federal financial partic-
46 ipation, deem such exclusions null and void as of [April first, two
47 thousand two] the first day of the period for which such assessments
48 apply, and the commissioner shall collect any retroactive amount due as
49 a result, without interest or penalty provided the hospital pays the
50 retroactive amount due within ninety days of notice from the commission-
51 er to the hospital that such exclusion is null and void.
52 § 24. Subparagraph (vi) of paragraph (b) of subdivision 2 of section
53 2807-d of the public health law, as amended by section 6 of part C of
54 chapter 58 of the laws of 2004, is amended to read as follows:
55 (vi) Notwithstanding any contrary provision of this paragraph or any
56 other provision of law or regulation to the contrary, for residential
S. 992 124 A. 1922
1 health care facilities the assessment shall be six percent of each resi-
2 dential health care facility's gross receipts received from all patient
3 care services and other operating income on a cash basis for the period
4 April first, two thousand two through March thirty-first, two thousand
5 three for hospital or health-related services, including adult day
6 services; provided, however, that residential health care facilities'
7 gross receipts attributable to payments received pursuant to title XVIII
8 of the federal social security act (medicare) shall be excluded from the
9 assessment; provided, however, that for all such gross receipts received
10 on or after April first, two thousand three through March thirty-first,
11 two thousand [six] five, such assessment shall be five percent, [and
12 further provided that such assessment shall expire and be of no further
13 effect for all such gross receipts received on or after April first, two
14 thousand six] and further provided that for all such gross receipts
15 received on or after April first, two thousand five such assessment
16 shall be six percent.
17 § 25. Paragraph (b) of subdivision 9 of section 2807-d of the public
18 health law, as amended by section 25 of part J of chapter 82 of the laws
19 of 2002, is amended to read as follows:
20 (b) provided, however, that funds accumulated, including income from
21 invested funds, from the [further additional assessment] assessments
22 provided in accordance with subparagraph (v) of paragraph (a) and
23 subparagraphs (iii), (iv), (v) and (vi) of paragraph (b) of subdivision
24 two of this section, including interest and penalties, shall be deposit-
25 ed by the commissioner and credited to [a] the special [revenue-other]
26 revenue fund-other, miscellaneous special revenue fund (339), medical
27 assistance account [to be established by the comptroller]. To the extent
28 of funds appropriated therefor, funds shall be made available for
29 payments under the medical assistance program provided pursuant to title
30 eleven of article five of the social services law;
31 § 26. Subsection (c) of section 612 of the tax law is amended by
32 adding a new paragraph 38 to read as follows:
33 (38) Nursing home assessment deduction. The amount that directly
34 relates to the assessment imposed on a residential health care facility
35 pursuant to paragraph (b) of subdivision two of section twenty-eight
36 hundred seven-d of the public health law which is separately stated and
37 accounted for on the billing statement of a resident of a residential
38 health care facility and is paid directly by an individual taxpayer.
39 § 26-a. Subdivision (c) of section 11-1712 of the administrative code
40 of the city of New York is amended by adding a new paragraph 35 to read
41 as follows:
42 (35) Nursing home assessment deduction. The amount that directly
43 relates to the assessment imposed on a residential health care facility
44 pursuant to paragraph (b) of subdivision two of section twenty-eight
45 hundred seven-d of the public health law which is separately stated and
46 accounted for on the billing statement of a resident of a residential
47 health care facility and is paid directly by an individual taxpayer.
48 § 27. Section 2808 of the public health law is amended by adding a new
49 subdivision 22 to read as follows:
50 22. Notwithstanding any inconsistent provision of law or regulation to
51 the contrary:
52 (a) (i) For services provided by residential health care facilities
53 beginning April first, two thousand five, except for services identified
54 in subparagraph (ii) of this paragraph, and for facilities described in
55 paragraph (d) of this subdivision, for purposes of establishing the
56 operating component of rates of payment by governmental agencies, the
S. 992 125 A. 1922
1 commissioner shall utilize the regional average of facility specific
2 allowable costs as reported by residential health care facilities in the
3 two thousand three calendar year cost report, trended pursuant to law to
4 the applicable rate period and adjusted for case mix. Such regional
5 average shall also be adjusted by a corridor percentage to be determined
6 by the commissioner to arrive at a final average operating component of
7 rates of payment for each region. Region shall mean those regions as
8 listed in paragraph (c) of this subdivision.
9 (ii) This subdivision shall not apply to rates paid for residential
10 health care facility services provided to:
11 (A) residents residing in a residential health care facility desig-
12 nated as an AIDS residential health care facility or residing in a
13 discrete AIDS unit approved by the commissioner;
14 (B) residents residing in discrete units for the care of patients
15 under the long-term inpatient rehabilitation program for traumatic brain
16 injured patients established pursuant to department regulations;
17 (C) residents residing in department approved discrete units for the
18 care of long-term ventilator dependent residents;
19 (D) residents residing in department approved discrete units specif-
20 ically designated for the purpose of providing specialized programs for
21 residents requiring behavioral interventions; or
22 (E) residents in residential health care facilities or discrete units
23 which provide extensive nursing, medical, psychological and counseling
24 support services solely to children, as determined by the department.
25 (b) The operating component of the rate of payment shall mean all
26 components of the rate except for the capital component.
27 (c) The regions are established as follows:
28 (i) Albany: Albany, Columbia, Greene, Montgomery, Rensselaer, Sarato-
29 ga, Schenectady, Schoharie, and Fulton counties;
30 (ii) Binghamton: Broome, and Tioga counties;
31 (iii) Erie: Cattaraugus, Chautauqua, Erie, Niagara, and Orleans coun-
32 ties;
33 (iv) Elmira: Chemung, Steuben, and Schuyler counties;
34 (v) Glens Falls: Essex, Warren, and Washington counties;
35 (vi) Long Island: Nassau, and Suffolk counties;
36 (vii) Orange: Chenango, Delaware, Orange, Otsego, Sullivan, and Ulster
37 counties;
38 (viii) New York City: Bronx, Kings, Queens, Richmond, and New York
39 counties;
40 (ix) Poughkeepsie: Dutchess, and Putnam counties;
41 (x) Rochester: Livingston, Monroe, Ontario, and Wayne counties;
42 (xi) Central Rural: Cayuga, Cortland, Seneca, Tompkins, and Yates
43 counties;
44 (xii) Syracuse: Madison, and Onondaga counties;
45 (xiii) Utica: Herkimer, Jefferson, Lewis, Oneida, and Oswego counties;
46 (xiv) Westchester: Rockland, and Westchester counties;
47 (xv) Northern Rural: Clinton, Franklin, Hamilton, and St. Lawrence
48 counties; and
49 (xvi) Western Rural: Allegany, Genesee, and Wyoming counties.
50 (d) For any newly constructed residential health care facility which
51 receives establishment approval by the public health council in accord-
52 ance with section twenty eight hundred one-a of this article on or after
53 April first, two thousand five; any new operator of an ongoing residen-
54 tial health care facility established pursuant to section twenty eight
55 hundred one-a of this article on or after April first, two thousand
56 five; or any facility in receivership on and after April first, two
S. 992 126 A. 1922
1 thousand five, the operating component of the rate of payment shall
2 equal the regional average operating component of facilities within its
3 region as determined pursuant to this subdivision provided however, such
4 regional average operating component shall not be adjusted by a corridor
5 percentage.
6 (e) Notwithstanding any inconsistent provision of the state adminis-
7 trative procedure act or any other provision of law or regulation to the
8 contrary, the commissioner shall adopt or amend on an emergency basis
9 any regulation the commissioner determines necessary to implement any
10 provision of this subdivision.
11 § 28. Notwithstanding any inconsistent provision of law, rule or regu-
12 lation to the contrary, the provisions of section 1 of chapter 41 of the
13 laws of 1992, as amended, shall remain and be in full force and effect
14 on and after April 1, 2000 through March 31, 2003 and on and after April
15 1, 2003 through March 31, 2005 and annually thereafter provided however,
16 for periods beginning April 1, 2005 and thereafter, such adult day
17 services maximum daily rate of payment shall not exceed sixty-five
18 percent of the residential health care facility per diem rate estab-
19 lished on a regional basis pursuant to a chapter of the laws of 2005.
20 § 29. Notwithstanding any inconsistent provision of law or regulation
21 to the contrary, residential health care facility rates of payment
22 determined pursuant to article 28 of the public health law for services
23 provided on and after April 1, 2005, except for the establishment of any
24 statewide or any peer group base, mean, or ceiling prices per day, shall
25 be calculated utilizing only the number of residents properly assessed
26 and reported in each patient classification group and eligible for
27 medical assistance pursuant to title 11 of article 5 of the social
28 services law.
29 § 30. Notwithstanding any inconsistent provision of law or regulation,
30 residential health care facility rates of payment determined pursuant to
31 article 28 of the public health law for services provided on and after
32 January 1, 2006, shall not include an amount for prescription drugs for
33 residents eligible for medical assistance pursuant to title 11 of arti-
34 cle 5 of the social services law and eligible for part D of title XVIII
35 of the federal social security act contingent upon implementation of
36 such provision of the federal social security act in this State.
37 § 31. The opening paragraph of subdivision 7 of section 3614 of the
38 public health law, as amended by chapter 81 of the laws of 1995, is
39 amended to read as follows:
40 Notwithstanding any inconsistent provision of law or regulation, for
41 purposes of establishing rates of payment by governmental agencies for
42 certified home health agencies for the period April first, nineteen
43 hundred ninety-five through December thirty-first, nineteen hundred
44 ninety-five and for rate periods beginning on or after January first,
45 nineteen hundred ninety-six, the reimbursable base year administrative
46 and general costs of a provider of services shall not exceed the state-
47 wide average of total reimbursable base year administrative and general
48 costs of such providers of services. The amount of such reduction in
49 certified home health agency rates of payments made during the period
50 April first, nineteen hundred ninety-five through March thirty-first,
51 nineteen hundred ninety-six shall be adjusted in the nineteen hundred
52 ninety-six rate period on a pro-rata basis, if it is determined upon
53 post-audit review by June fifteenth, nineteen hundred ninety-six and
54 reconciliation that the savings for the state share, excluding the
55 federal and local government shares, of medical assistance payments
56 pursuant to title eleven of article five of the social services law
S. 992 127 A. 1922
1 based on the limitation of such payment pursuant to this subdivision is
2 in excess of one million five hundred thousand dollars or is less than
3 one million five hundred thousand dollars for payments made on or before
4 March thirty-first, nineteen hundred ninety-six to reflect the amount by
5 which such savings are in excess of or lower than one million five
6 hundred thousand dollars. For rate periods on and after January first,
7 two thousand five, there shall be no such reconciliation of the amount
8 of savings in excess of or lower than one million five hundred thousand
9 dollars; provided, however, that if the provisions of this paragraph are
10 extended pursuant to a chapter of the laws of two thousand five, this
11 amendment shall be of no force or effect.
12 § 32. Section 3614 of the public health law is amended by adding a new
13 subdivision 7-a to read as follows:
14 7-a. Notwithstanding any inconsistent provision of law or regulation,
15 for the purposes of establishing rates of payment by governmental agen-
16 cies for long term home health care programs for the period April first,
17 two thousand five, through December thirty-first, two thousand five, and
18 for rate periods beginning on and after January first, two thousand six,
19 the reimbursable base year administrative and general costs of a provid-
20 er of services shall not exceed the statewide average of total reimburs-
21 able base year administrative and general costs of such providers of
22 services.
23 No such limit shall be applied to a provider of services reimbursed on
24 an initial budget basis, or a new provider, excluding changes in owner-
25 ship or changes in name, who begins operations in the year prior to the
26 year which is used as a base year in determining rates of payment.
27 For the purposes of this subdivision, reimbursable base year opera-
28 tional costs shall mean those base year operational costs remaining
29 after application of all other efficiency standards, including, but not
30 limited to, cost guidelines.
31 The limitation on reimbursement for provider administrative and gener-
32 al expenses provided by this subdivision shall be expressed as a
33 percentage reduction for the rate promulgated by the commissioner to
34 each long term home health care program provider.
35 § 33. The social services law is amended by adding a new section 367-s
36 to read as follows:
37 § 367-s. Long term care demonstration program. 1. Notwithstanding any
38 inconsistent provision of law, the commissioner of health is authorized
39 to establish a long term care demonstration program for persons eligible
40 to receive services under this title, to operate in up to four social
41 services districts, for the purposes of creating incentives for provid-
42 ers to care for individuals with more complex medical needs, supporting
43 relatives and other caregivers to assist patients needing care at home
44 and reducing the need for institutionalization.
45 2. The provisions of this section shall not take effect unless all
46 necessary approvals under federal law and regulation have been obtained
47 to receive federal financial participation in the costs of the health
48 care services provided pursuant to this section.
49 3. (a) The demonstration program established pursuant to this section
50 may include a program to improve the availability of care for persons
51 with clinically complex care needs who are being discharged from hospi-
52 tals or residential health care facilities. In this regard, and in
53 accordance with paragraph (d) of this subdivision, the commissioner
54 shall adjust the rates of payment to selected home health agencies
55 certified under article thirty-six of the public health law that provide
56 services to such persons.
S. 992 128 A. 1922
1 (b) Eligible certified home health agencies shall:
2 (i) demonstrate they have the experience and resources to provide
3 services to individuals who are discharged from hospitals or residential
4 health care facilities with clinically complex care needs, as determined
5 in accordance with criteria established by the commissioner.
6 (ii) demonstrate that they are capable of meeting such other condi-
7 tions as may be established by the commissioner.
8 (c) In selecting eligible certified home health agencies, the commis-
9 sioner shall consider the likelihood that the agency will provide
10 improved availability of care and may consider such other matters as the
11 commissioner deems appropriate.
12 (d) The adjusted Medicaid rate pursuant to this subdivision shall be
13 available for eligible certified home health agencies for services
14 provided to individuals, eligible for medical assistance pursuant to
15 this title, who are discharged from a hospital or residential health
16 care facility and have clinically complex care needs, as determined in
17 accordance with criteria established by the commissioner. Such rate
18 shall be payable for services provided up to the first sixty days after
19 discharge from a hospital or residential health care facility.
20 4. One or more demonstration sites established pursuant to this
21 section may include the provision of respite care through innovative
22 models. Subject to the approval of the director of the division of the
23 budget, the commissioner is authorized to establish payment rates or
24 fees for services provided pursuant to this subdivision.
25 5. One or more of the demonstration sites established pursuant to this
26 section may include a program with authority to make payments for
27 personal care services that are provided by a consumer's family members.
28 6. The demonstration program established pursuant to this section may
29 be established without regard to the provisions of the state administra-
30 tive procedure act. Notwithstanding any inconsistent provision of
31 section one hundred twelve or article eleven of the state finance law or
32 section one hundred forty-two of the economic development law or any
33 other law, the department of health is authorized to enter into any
34 agreements required to implement the provision of this section without a
35 competitive bid or request for proposals process.
36 § 34. Paragraph (e) of subdivision 1 of section 369-ee of the social
37 services law, as added by chapter 1 of the laws of 1999, subparagraph
38 (v) as amended by chapter 419 of the laws of 2000, subparagraphs (xiv)
39 and (xv) as amended and subparagraph (xvi) as added by chapter 526 of
40 the laws of 2002, is amended to read as follows:
41 (e) "Health care services" means the following services and supplies
42 as defined by the commissioner in consultation with the superintendent
43 of insurance:
44 (i) the services of physicians, nurse practitioners, and other related
45 personnel which are provided on an outpatient or inpatient basis;
46 (ii) inpatient hospital services provided by a general hospital[, a
47 facility operated by the office of mental health under section 7.17 of
48 the mental hygiene law, a facility issued an operating certificate
49 pursuant to the provisions of article twenty-three or thirty-one of the
50 mental hygiene law];
51 (iii) laboratory tests;
52 (iv) diagnostic x-rays;
53 (v) prescription drugs and non-prescription smoking cessation products
54 or devices;
55 (vi) [durable medical equipment;
56 (vii)] radiation therapy, chemotherapy, and hemodialysis;
S. 992 129 A. 1922
1 [(viii)] (vii) emergency room services;
2 [(ix) inpatient and outpatient mental health and alcohol and substance
3 abuse services, as defined by the commissioner;
4 (x) prehospital emergency medical services for the treatment of an
5 emergency medical condition when such services are provided by an ambu-
6 lance service;
7 (xi) emergency, preventive and routine dental care, to the extent
8 offered by a family health insurance plan described in this section,
9 except orthodontia and cosmetic surgery;
10 (xii) emergency, preventive and routine vision care;
11 (xiii) speech and hearing services;
12 (xiv)] (viii) diabetic supplies and equipment; and
13 [(xv)] (ix) services provided to meet the requirements of 42 U.S.C.
14 1396d(r)[; and
15 (xvi) hospice services].
16 § 35. Subdivision 2-a of section 369-ee of the social services law is
17 REPEALED and a new subdivision 2-a is added to read as follows:
18 2-a. Co-payments. (a) Subject to federal approval pursuant to subdivi-
19 sion six of this section, persons receiving family health plus coverage
20 under this section shall be responsible to make co-payments in accord-
21 ance with the following schedule:
22 (i) inpatient hospital services shall have a two hundred fifty dollar
23 co-payment for each continuous hospital confinement;
24 (ii) outpatient surgical services shall have a seventy-five dollar
25 co-payment per occurrence;
26 (iii) emergency room services shall have a fifty dollar co-payment
27 which shall be waived if hospital admission results from the emergency
28 room visit;
29 (iv) generic prescription drugs shall have a ten dollar co-payment and
30 brand name prescription drugs shall have a twenty dollar co-payment;
31 (v) all other services shall have a twenty dollar co-payment;
32 (b) The following services shall not be subject to co-payments under
33 this subdivision:
34 (i) family planning services; and
35 (ii) prenatal care services provided to pregnant women, labor, deliv-
36 ery and services related to the sixty-day post-partum period.
37 § 36. Paragraph (i) of subdivision 1 of section 369-ee of the social
38 services law, as added by section 2 of part B of chapter 58 of the laws
39 of 2004, is amended to read as follows:
40 (i) "Resources" for purposes of this title shall have the same meaning
41 as determined in accordance with paragraph (a) of subdivision two of
42 section three hundred sixty-six of this title except that the term
43 savings referred to in subparagraph four of such paragraph shall mean
44 household savings in an amount [equal to at least one hundred fifty
45 percent of the applicable allowable income amount permitted under
46 subparagraph seven of such paragraph] not to exceed ten thousand
47 dollars.
48 § 37. Subparagraph (iii) of paragraph (a) of subdivision 2 of section
49 369-ee of the social services law, as added by chapter 1 of the laws of
50 1999, is amended to read as follows:
51 (iii) does not have [equivalent] health care coverage under insurance
52 or equivalent mechanisms, as defined by the commissioner in consultation
53 with the superintendent of insurance, is not a federal, state, county,
54 municipal or school district employee, and is not employed by an employ-
55 er with more than fifty employees;
S. 992 130 A. 1922
1 § 38. Subparagraph (iv) of paragraph (a) of subdivision 2 of section
2 369-ee of the social services law, as added by chapter 1 of the laws of
3 1999, is amended to read as follows:
4 (iv) [(A)] was not covered by a group health plan based upon his or
5 her employment or a family member's employment, as defined by the
6 commissioner in consultation with the superintendent of insurance,
7 during the [six month] twelve-month period prior to the date of the
8 application under this title, except in the case of:
9 (I) loss of employment due to factors other than voluntary separation;
10 (II) death of a family member which results in termination of the
11 applicant's coverage under the group health plan;
12 (III) change to a new employer that does not provide an option for
13 comprehensive health benefits coverage;
14 (IV) change of residence so that no employer-based comprehensive
15 health benefits coverage is available;
16 (V) [discontinuation of comprehensive health benefits coverage to all
17 employees of the applicant's employer;
18 (VI)] expiration of the coverage periods established by COBRA or the
19 provisions of subsection (m) of section three thousand two hundred twen-
20 ty-one, subsection (k) of section four thousand three hundred four and
21 subsection (e) of section four thousand three hundred five of the insur-
22 ance law;
23 [(VII)] (VI) termination of comprehensive health benefits coverage due
24 to long-term disability; or
25 [(VIII)] (VII) loss of employment due to need to care for a child or
26 disabled household member or relative[; or
27 (IX) reduction in wages or hours or an increase in the cost of cover-
28 age so that coverage is no longer affordable or available.
29 (B) the implementation of this subparagraph shall take effect only
30 upon the commissioner's finding that insurance provided under this title
31 is substituting for coverage under group health plans in excess of a
32 percentage specified pursuant to subparagraph (ii) of paragraph (d) of
33 subdivision two of section twenty-five hundred eleven of the public
34 health law].
35 § 39. Subparagraph (i) of paragraph (d) of subdivision 3 of section
36 369-ee of the social services law, as added by chapter 1 of the laws of
37 1999, is amended to read as follows:
38 (i) approved organizations shall adhere to marketing [and enrollment]
39 guidelines established by the commissioner, which shall include but not
40 be limited to marketing [and enrollment] encounters between approved
41 organizations and prospective enrollees, locations for such encounters,
42 and prohibitions against telephone cold-calling and door-to-door solic-
43 itation at the homes of prospective enrollees. [Approved organizations
44 shall be permitted to assist prospective enrollees in completion of
45 enrollment forms at approved health care provider sites and other
46 approved locations. In no case may an emergency room be deemed an
47 approved location. Approved organizations shall submit enrollment forms
48 to the local department of social services.]
49 § 40. Subdivision 4 of section 369-ee of the social services law is
50 REPEALED.
51 § 41. Paragraph (a) of subdivision 5 of section 369-ee of the social
52 services law, as added by chapter 1 of the laws of 1999, is amended to
53 read as follows:
54 (a) Personal interviews, pursuant to section three hundred sixty-six-a
55 of this [chapter] article, may be required upon initial application only
56 [and may be conducted in community settings]. Recertification of eligi-
S. 992 131 A. 1922
1 bility shall take place on no more than an annual basis and shall not
2 require a personal interview. Nothing herein shall abridge the partic-
3 ipant's obligation to report changes in residency, financial circum-
4 stances or household composition.
5 § 42. Paragraph (a) of subdivision 1 of section 212 of chapter 474 of
6 the laws of 1996, amending the education law and other laws relating to
7 rates for residential health care facilities, as amended by section 9 of
8 part Z2 of chapter 62 of the laws of 2003, is amended to read as
9 follows:
10 (a) Notwithstanding any inconsistent provision of law or regulation to
11 the contrary, effective beginning August 1, 1996, for the period April
12 1, 1997 through March 31, 1998, April 1, 1998 for the period April 1,
13 1998 through March 31, 1999, August 1, 1999, for the period April 1,
14 1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
15 through March 31, 2001, April 1, 2001, for the period April 1, 2001
16 through March 31, 2002, April 1, 2002, for the period April 1, 2002
17 through March 31, 2003, and for the state fiscal year beginning April 1,
18 2005, and each state fiscal year thereafter, the department of health is
19 authorized to pay public general hospitals, as defined in subdivision 10
20 of section 2801 of the public health law, operated by the state of New
21 York or by the state university of New York or by a county, which shall
22 not include a city with a population of over one million, of the state
23 of New York, and those public general hospitals located in the county of
24 Westchester, the county of Erie or the county of Nassau, additional
25 payments for inpatient hospital services as medical assistance payments
26 pursuant to title 11 of article 5 of the social services law for
27 patients eligible for federal financial participation under title XIX of
28 the federal social security act in medical assistance pursuant to the
29 federal laws and regulations governing disproportionate share payments
30 to hospitals based on each such public general hospital's medical
31 assistance and uninsured patient losses after all other medical assist-
32 ance, including disproportionate share payments to such public general
33 hospital for 1996, 1997, 1998, and 1999, based initially for 1996 on
34 reported 1994 reconciled data as further reconciled to actual reported
35 1996 reconciled data, and for 1997 based initially on reported 1995
36 reconciled data as further reconciled to actual reported 1997 reconciled
37 data, for 1998 based initially on reported 1995 reconciled data as
38 further reconciled to actual reported 1998 reconciled data, for 1999
39 based initially on reported 1995 reconciled data as further reconciled
40 to actual reported 1999 reconciled data, for 2000 based initially on
41 reported 1995 reconciled data as further reconciled to actual reported
42 2000 data, for 2001 based initially on reported 1995 reconciled data as
43 further reconciled to actual reported 2001 data, for 2002 based initial-
44 ly on reported 2000 reconciled data as further reconciled to actual
45 reported 2002 data, and for state fiscal years beginning on and after
46 April 1, 2005, based initially on reported 2000 reconciled data as
47 further reconciled to actual reported data for 2005 and to actual
48 reported data for each respective succeeding year. The payments may be
49 added to rates of payment or made as aggregate payments to an eligible
50 public general hospital.
51 § 43. Paragraph (b) of subdivision 1 of section 211 of chapter 474 of
52 the laws of 1996, amending the education law and other laws relating to
53 rates for residential health care facilities, as amended by section 7 of
54 part B of chapter 1 of the laws of 2002, is amended to read as follows:
55 (b) Notwithstanding any inconsistent provision of law or regulation to
56 the contrary, effective beginning April 1, 2000, the department of
S. 992 132 A. 1922
1 health is authorized to pay public general hospitals, other than those
2 operated by the state of New York or the state university of New York,
3 as defined in subdivision 10 of section 2801 of the public health law,
4 located in a city with a population of over 1 million, additional
5 initial payments for inpatient hospital services of $120 million during
6 each state fiscal year until March 31, 2003, and during the state fiscal
7 year beginning April 1, 2005 and each state fiscal year thereafter, as
8 medical assistance payments pursuant to title 11 of article 5 of the
9 social services law for patients eligible for federal financial partic-
10 ipation under title XIX of the federal social security act in medical
11 assistance pursuant to the federal laws and regulations governing
12 disproportionate share payments to hospitals based on the relative share
13 of each such non-state operated public general hospital of medical
14 assistance and uninsured patient losses after all other medical assist-
15 ance, including disproportionate share payments to such public general
16 hospitals for payments made during the state fiscal year ending March
17 31, 2001, based initially on reported 1995 reconciled data as further
18 reconciled to actual reported 2000 or 2001 data, for payments made
19 during the state fiscal year ending March 31, 2002, based initially on
20 reported 1995 reconciled data as further reconciled to actual reported
21 2001 or 2002 data, for payments made during the state fiscal year ending
22 March 31, 2003, based initially on reported 2000 reconciled data as
23 further reconciled to actual reported 2002 or 2003 data, for payments
24 made during state fiscal years ending on and after March 31, 2006, based
25 initially on reported 2000 reconciled data as further reconciled to
26 actual reported data for 2005 and to actual reported data for each
27 respective succeeding year. The payments may be added to rates of
28 payment or made as aggregate payments to an eligible public general
29 hospital.
30 § 44. Notwithstanding any contrary provision of law, no local govern-
31 mental entity shall require any general hospital or residential health
32 care facility licensed under article 28 of the public health law to
33 transfer to such local governmental entity any funds attributable to
34 payments received on an after April 1, 2005 pursuant to section 211 or
35 212 of chapter 474 of the laws of 1996, as amended, or pursuant to
36 sections 12 and 14 of part A of chapter 1 of the laws of 2002, or
37 section 13 or 14 of part B of chapter 1 of the laws of 2002, or pursuant
38 to subdivision 12 of section 2808 of the public health law.
39 § 45. Paragraphs (e) and (f) of subdivision 12 of section 2808 of the
40 public health law, paragraph (e) as amended by section 7 and paragraph
41 (f) as amended by section 8 of part Z2 of chapter 62 of the laws of
42 2003, are amended to read as follows:
43 (e) Notwithstanding any inconsistent provision of law or regulation,
44 the commissioner shall provide, in addition to payments established
45 pursuant to this article prior to application of this section, addi-
46 tional payments under the medical assistance program pursuant to title
47 eleven of article five of the social services law for non-state operated
48 public residential health care facilities, including public residential
49 health care facilities located in the county of Nassau and the county of
50 Westchester, but excluding public residential health care facilities
51 operated by a town or city within a county, in an aggregate amount of up
52 to $991.5 million in additional payments each state fiscal year for the
53 period beginning April first, two thousand through March thirty-first,
54 two thousand [four] five.
55 (f) The amount allocated to each eligible public residential health
56 care facility for each period shall be calculated as the result of (A)
S. 992 133 A. 1922
1 the total payment for each period multiplied by (B) the ratio of patient
2 days for patients eligible for medical assistance pursuant to title
3 eleven of article five of the social services law provided by the public
4 residential health care facility, divided by the total of such patient
5 days summed for all eligible public residential health care facilities.
6 For the period August first, nineteen hundred ninety-six through March
7 thirty-first, nineteen hundred ninety-seven, nineteen hundred ninety-
8 four patient days shall be utilized; for the period April first, nine-
9 teen hundred ninety-seven through March thirty-first, nineteen hundred
10 ninety-eight, nineteen hundred ninety-five patient days shall be
11 utilized; for the period April first, nineteen hundred ninety-eight
12 through March thirty-first, nineteen hundred ninety-nine, nineteen
13 hundred ninety-six patient days shall be utilized; for the period April
14 first, nineteen hundred ninety-nine through March thirty-first, two
15 thousand, nineteen hundred ninety-seven patient days shall be utilized;
16 for the period April first, two thousand through March thirty-first, two
17 thousand one, nineteen hundred ninety-eight patient days shall be
18 utilized; for the period April first, two thousand one through March
19 thirty-first, two thousand two, nineteen hundred ninety-nine patient
20 days shall be utilized; for the period April first, two thousand two
21 through March thirty-first, two thousand three, two thousand patient
22 days shall be utilized; for the period April first, two thousand three
23 through March thirty-first, two thousand four, two thousand one patient
24 days shall be utilized; for the period April first, two thousand four
25 through March thirty-first, two thousand five, two thousand two patient
26 days shall be utilized.
27 § 46. Subdivision 12 of section 2808 of the public health law is
28 amended by adding a new paragraph (e-1) to read as follows:
29 (e-1) Notwithstanding any inconsistent provision of law or regulation,
30 the commissioner shall provide, in addition to payments established
31 pursuant to this article prior to application of this section, addi-
32 tional payments under the medical assistance program pursuant to title
33 eleven of article five of the social services law for non-state operated
34 public residential health care facilities, including public residential
35 health care facilities located in the county of Nassau, the county of
36 Westchester and the county of Erie, but excluding public residential
37 health care facilities operated by a town or city within a county, in an
38 aggregate amount of up to one hundred fifty million dollars in addi-
39 tional payments for state fiscal year beginning April first, two thou-
40 sand five. The amount allocated to each eligible public residential
41 health care facility for this period shall be computed in accordance
42 with the provisions of paragraph (f) of this subdivision, provided,
43 however, that patient days shall be utilized for such computation
44 reflecting actual reported data for two thousand three and each repre-
45 sentative succeeding year as applicable.
46 § 47. Subparagraph (iv) of paragraph (b) of subdivision 6 of section
47 367-a of the social services law, as amended by section 11 of part C of
48 chapter 58 of the laws of 2004, is amended to read as follows:
49 (iv) individuals enrolled in health maintenance organizations or other
50 entities which provide comprehensive health services, or other managed
51 care programs for services covered by such programs, except that such
52 persons, other than persons otherwise exempted from co-payments pursuant
53 to subparagraphs (i), (ii), (iii) and (v) of this paragraph, and other
54 than those persons enrolled in a managed long term care program, shall
55 be subject to co-payments as described in subparagraph (v) of paragraph
56 (d) of this subdivision; and
S. 992 134 A. 1922
1 § 48. Paragraph (c) of subdivision 6 of section 367-a of the social
2 services law is amended by adding a new subparagraph (iii) to read as
3 follows:
4 (iii) Notwithstanding any other provision of this paragraph, co-
5 payments charged for each generic prescription drug dispensed shall be
6 one dollar and for each brand name prescription drug dispensed shall be
7 three dollars.
8 § 49. Paragraph (f) of subdivision 6 of section 367-a of the social
9 services law, as added by chapter 41 of the laws of 1992, is amended to
10 read as follows:
11 (f) (i) In the year commencing April first, nineteen hundred ninety-
12 three and for each year thereafter, and ending in the year concluding on
13 March thirty-first, two thousand five, no recipient shall be required to
14 pay more than a total of one hundred dollars in co-payments required by
15 this subdivision, nor shall reductions in payments as a result of such
16 co-payments exceed one hundred dollars for any recipient.
17 (ii) In the year commencing April first, two thousand five and for
18 each year thereafter, no recipient shall be required to pay more than a
19 total of two hundred dollars in co-payments required by this subdivi-
20 sion, nor shall reductions in payments as a result of such co-payments
21 exceed two hundred dollars for any recipient.
22 § 50. Paragraph (j) of subdivision 2 of section 365-a of the social
23 services law is REPEALED.
24 § 51. Subparagraph (i) of paragraph (a) of subdivision 4 of section
25 365-g of the social services law, as amended by chapter 59 of the laws
26 of 1993, is amended to read as follows:
27 (i) mental health continuing treatment [and continuing day treatment],
28 day treatment, partial hospitalization, and intensive psychiatric reha-
29 bilitative treatment services provided pursuant to paragraph (c) of
30 subdivision two of section three hundred sixty-five-a of this chapter,
31 alcoholism services, substance abuse services, mental retardation and
32 developmental disabilities services provided in clinics certified under
33 article twenty-eight of the public health law, or article [twenty-three]
34 twenty-two or article thirty-one of the mental hygiene law; and
35 § 52. Paragraph (a) of subdivision 3 of section 366 of the social
36 services law, as amended by chapter 110 of the laws of 1971, is amended
37 to read as follows:
38 (a) Medical assistance shall be furnished to applicants in cases
39 where, although such applicant has a responsible relative with suffi-
40 cient income and resources to provide medical assistance as determined
41 by the regulations of the department, the income and resources of the
42 responsible relative are not available to such applicant because of the
43 absence of such relative [or] and the refusal or failure of such absent
44 relative to provide the necessary care and assistance. In such cases,
45 however, the furnishing of such assistance shall create an implied
46 contract with such relative, and the cost thereof may be recovered from
47 such relative in accordance with title six of article three of this
48 chapter and other applicable provisions of law.
49 § 53. Section 369 of the social services law is amended by adding a
50 new subdivision 7 to read as follows:
51 7. Notwithstanding any provision of law to the contrary, the office of
52 the attorney general shall, at the request of the department of health,
53 commence actions or proceedings in accordance with the provisions of
54 this section and sections one hundred one, one hundred four, and one
55 hundred four-b, paragraph (a) of subdivision three of section three
56 hundred sixty-six, subparagraph one of paragraph (h) of subdivision four
S. 992 135 A. 1922
1 of section three hundred sixty-six and paragraph (b) of subdivision two
2 of section three hundred sixty-seven-a of this chapter, to recover the
3 cost of medical assistance furnished pursuant to title eleven-d of this
4 article. Funds recovered pursuant to this subdivision, net of collection
5 fees authorized by law, shall be distributed to the department of health
6 for deposit in the medical assistance restitution account and shall be
7 allocated by the department pursuant to law.
8 § 54. Clause (vi) of subparagraph l, the opening paragraph and clause
9 (i) of subparagraph 3 and subparagraph 4 of paragraph (d) of subdivision
10 5 of section 366 of the social services law, as added by chapter 170 of
11 the laws of 1994, are amended to read as follows:
12 (vi) "look-back period" means the thirty-six month period, or, in the
13 case of payments from a trust or portions of a trust which are treated
14 as assets disposed of by the individual pursuant to department regu-
15 lations, the sixty-month period, immediately preceding the date that an
16 institutionalized individual is both institutionalized and has applied
17 for medical assistance, or in the case of a non-institutionalized indi-
18 vidual, the date that such non-institutionalized individual applies for
19 medical assistance coverage of long term care services; provided, howev-
20 er, that the look-back period for all types of transfers shall be sixty
21 months if the commissioner obtains all necessary approvals under federal
22 law and regulation to implement such a look-back period; provided
23 further that the use of a sixty-month look-back period for all types of
24 transfers shall continue only if and for so long as the use of such a
25 look-back period does not prevent the receipt of federal financial
26 participation under the medical assistance program; provided further
27 that the commissioner shall submit such waiver applications and/or state
28 plan amendments as may be necessary to obtain approval to implement a
29 sixty-month look-back period for all types of transfers and to ensure
30 continued federal financial participation.
31 In determining the medical assistance eligibility of an institutional-
32 ized individual, any transfer of an asset by the individual or the indi-
33 vidual's spouse for less than fair market value made within or after the
34 look-back period shall render the individual ineligible for nursing
35 facility services for the period of time specified in subparagraph four
36 of this paragraph. In determining the medical assistance eligibility of
37 a non-institutionalized individual, any transfer of an asset by the
38 individual or the individual's spouse for less than fair market value
39 made within or after the look-back period shall render the individual
40 ineligible for long term care services for the period of time specified
41 in subparagraph four of this paragraph. Notwithstanding the provisions
42 of this subparagraph, an individual shall not be ineligible for services
43 solely by reason of any such transfer to the extent that:
44 (i) [in the case of an institutionalized individual,] the asset trans-
45 ferred was a home and title to the home as transferred to: (A) the
46 spouse of the individual; or (B) a child of the individual who is under
47 the age of twenty-one years or blind or disabled; or (C) in the case of
48 an institutionalized individual, a sibling of the individual who has an
49 equity interest in such home and who resided in such home for a period
50 of at least one year immediately before the date the individual became
51 an institutionalized individual; or (D) in the case of an institutional-
52 ized individual, a child of the individual who was residing in such home
53 for a period of at least two years immediately before the date the indi-
54 vidual became an institutionalized individual, and who provided care to
55 the individual which permitted the individual to reside at home rather
56 than in an institution or facility; or
S. 992 136 A. 1922
1 (4) (i) Any transfer made by an individual or the individual's spouse
2 under subparagraph three of this paragraph shall cause the person to be
3 ineligible for services for a period equal to the total, cumulative
4 uncompensated value of all assets transferred during or after the look-
5 back period, divided by the average monthly costs of nursing facility
6 services provided to a private patient for a given period of time at the
7 time of application, as determined pursuant to the regulations of the
8 department. The period of ineligibility shall begin with the first day
9 of the first month during or after which assets have been transferred
10 for less than fair market value, and which does not occur in any other
11 periods of ineligibility under this paragraph. For purposes of this
12 subparagraph, the average monthly costs of nursing facility services to
13 a private patient for a given period of time at the time of application
14 shall be presumed to be one hundred twenty percent of the average
15 medical assistance rate of payment as of the first day of January of
16 each year for nursing facilities within the region wherein the applicant
17 resides, as established pursuant to paragraph (b) of subdivision sixteen
18 of section twenty-eight hundred seven-c of the public health law.
19 (ii) Notwithstanding any provision of clause (i) of this subparagraph
20 to the contrary, the period of ineligibility described therein shall
21 begin on the first day the individual is receiving services for which
22 medical assistance coverage would be available but for the provisions of
23 subparagraph three of this paragraph, and which does not occur in any
24 other periods of ineligibility under this paragraph, if the commissioner
25 obtains all necessary approvals under federal law and regulation to
26 implement such a period of ineligibility. The use of such a period of
27 ineligibility shall continue only if and for so long as it does not
28 prevent the receipt of federal financial participation under the medical
29 assistance program. The commissioner shall submit such waiver applica-
30 tions and/or state plan amendments as may be necessary to obtain
31 approval to implement the period of ineligibility described in this
32 clause and to ensure continued federal financial participation.
33 § 55. Subparagraph 1 of paragraph (d) of subdivision 5 of section 366
34 of the social services law is amended by adding two new clauses (xi) and
35 (xii) to read as follows:
36 (xi) "non-institutionalized individual" means an individual who is not
37 an institutionalized individual, as defined in clause (vii) of this
38 subparagraph.
39 (xii) "long term care services" means home health care services,
40 personal care services, assisted living program services and such other
41 services for which medical assistance is otherwise available under this
42 chapter which are designated as long term care services in the regu-
43 lations of the department.
44 § 56. Paragraph (d) of subdivision 5 of section 366 of the social
45 services law is amended by adding a new subparagraph 7 to read as
46 follows:
47 (7) In the case of a transfer by an individual which results in a
48 period of ineligibility for such individual or his or her spouse, such
49 period of ineligibility will continue without regard to the individual's
50 becoming an institutionalized individual if the transfer was made while
51 the individual was a non-institutionalized individual and without regard
52 to the individual's becoming a non-institutionalized individual if the
53 transfer was made while the individual was an institutionalized individ-
54 ual. In no event shall the total period of ineligibility for long term
55 care services and nursing facility services resulting from the same
S. 992 137 A. 1922
1 transfer of assets exceed the period calculated pursuant to subparagraph
2 four of this paragraph.
3 § 57. Paragraph (b) of subdivision 5 of section 366-c of the social
4 services law, as added by chapter 558 of the laws of 1989, is amended to
5 read as follows:
6 (b) An institutionalized spouse shall not be ineligible for medical
7 assistance by reason of excess resources determined under paragraph (a)
8 of this subdivision, if (i) the institutionalized spouse executes an
9 assignment of support from the community spouse in favor of the local
10 social services district and the department, or the institutionalized
11 spouse is unable to execute such assignment due to physical or mental
12 impairment, [or] and (ii) to deny assistance would create an undue hard-
13 ship, as defined by the commissioner.
14 § 58. Paragraph (a) of subdivision 2 of section 365-a of the social
15 services law, as amended by chapter 47 of the laws of 1996, is amended
16 to read as follows:
17 (a) services of qualified physicians, [dentists, nurses, and private
18 duty nursing services shall be further subject to the provisions of
19 section three hundred sixty-seven-o of this chapter,] optometrists,
20 nurse midwives, nurse practitioners, and other related professional
21 personnel;
22 § 59. Paragraph (f) of subdivision 2 of section 365-a of the social
23 services law is REPEALED.
24 § 60. Paragraph (l) of subdivision 2 of section 365-a of the social
25 services law, as amended by chapter 81 of the laws of 1995, is amended
26 to read as follows:
27 (l) care and services of podiatrists, clinical psychologists, nurses
28 and audiologists, including such care and services provided in a hospi-
29 tal out-patient or clinic facility operated in compliance with applica-
30 ble provisions of article twenty-eight of the public health law, and
31 dentists, which care and services shall only be provided upon referral
32 by a physician, nurse practitioner or certified nurse midwife in accord-
33 ance with the program of early and periodic screening and diagnosis
34 established pursuant to subdivision three of this section or to persons
35 eligible for benefits under title XVIII of the federal social security
36 act as qualified medicare beneficiaries in accordance with federal
37 requirements therefor [and private duty nurses which care and services
38 shall only be provided in accordance with regulations of the department
39 of health; provided, however, that private duty nursing services shall
40 not be restricted when such services are more appropriate and cost-ef-
41 fective than nursing services provided by a home health agency pursuant
42 to section three hundred sixty-seven-l]; provided, however, that nothing
43 in this paragraph shall be construed as limiting the care and services
44 of clinical psychologists or audiologists provided in a federally quali-
45 fied health center, in a clinic facility that is organized to provide as
46 its principal mission ongoing and long-term rehabilitation therapy to
47 individuals with developmental disabilities, or in an outpatient program
48 licensed by the office of mental retardation and developmental disabili-
49 ties under article sixteen, the office of mental health under article
50 thirty-one, and the office of alcoholism and substance abuse services
51 under article thirty-two of the mental hygiene law;
52 § 61. Paragraph (n) of subdivision 2 of section 365-a of the social
53 services law, as added by chapter 556 of the laws of 1986, is REPEALED.
54 § 62. Subdivision 19 of section 854 of the general municipal law, as
55 amended by chapter 659 of the laws of 1997, is amended to read as
56 follows:
S. 992 138 A. 1922
1 (19) "Continuing care retirement community" - shall mean any facility
2 that has been granted a certificate of authority pursuant to article
3 forty-six or forty-six-A of the public health law and is established to
4 provide, pursuant to continuing care retirement contracts approved
5 pursuant to article forty-six of the public health law, or fee-for-ser-
6 vice continuing care contracts approved pursuant to article forty-six-A
7 of the public health law, a comprehensive, cohesive living arrangement
8 for the elderly, and certified by the commissioner of health, that (i)
9 has been approved for the issuance of industrial development agency
10 bonds by the continuing care retirement community council pursuant to
11 section forty-six hundred four-a of the public health law except that
12 paragraphs b and g of subdivision two of section forty-six hundred
13 four-a of the public health law shall not apply to a continuing care
14 retirement community granted a certificate of authority pursuant to
15 article forty-six-A of the public health law and (ii) is a not-for-pro-
16 fit corporation as defined in section one hundred two of the not-for-
17 profit corporation law that is (a) eligible for tax-exempt financing
18 under section [four thousand six] forty-six hundred four-a of the public
19 health law and [the general municipal law] this chapter and (b) is
20 exempt from taxation pursuant to section 501(c)(3) of the federal inter-
21 nal revenue code; except that "continuing care retirement community"
22 shall not include a facility granted a certificate of authority upon
23 application of a state or local government applicant.
24 § 63. Section 4676 of the public health law, as added by chapter 519
25 of the laws of 2004, is amended to read as follows:
26 § 4676. Industrial development agency financing. Fee-for-service
27 continuing care retirement communities developed pursuant to this arti-
28 cle shall be eligible for industrial development financing in accordance
29 with section forty-six hundred four-a of this chapter except for para-
30 graphs b and g of subdivision two of such section and financing by any
31 public benefit corporation authorized to make loans to continuing care
32 retirement communities under the laws of this state provided, however,
33 the operator of such fee-for-service continuing care retirement communi-
34 ty has demonstrated capability to comply fully with the requirements for
35 a certificate of authority and has obtained a contingent certificate of
36 authority pursuant to section forty-six hundred fifty-five of this arti-
37 cle and the operator has agreed to meet the requirements of article
38 eighteen-A of the general municipal law.
39 § 64. Paragraph (a) of subdivision 1 of section 367-f of the social
40 services law, as amended by section 28 of part B of chapter 58 of the
41 laws of 2004, is amended to read as follows:
42 (a) "Medicaid extended coverage" shall mean eligibility for medical
43 assistance (i) without regard to the resource requirements of section
44 three hundred sixty-six of this [article] title, or in the case of an
45 individual covered under an insurance policy or certificate described in
46 subdivision two of this section that provided a residential health care
47 facility benefit less than three years in duration, without consider-
48 ation of an amount of resources equivalent to the value of benefits
49 received by the individual under such policy or certificate, as deter-
50 mined under the rules of the partnership for long term care program, and
51 (ii) without regard to the recovery of medical assistance from the
52 estates of individuals and the imposition of liens on the homes of
53 persons pursuant to section three hundred sixty-nine of this [article]
54 title, with respect to resources exempt from consideration pursuant to
55 subparagraph (i) of this paragraph; provided, however, that nothing
S. 992 139 A. 1922
1 herein shall prevent the imposition of a lien or recovery against prop-
2 erty of an individual on account of medical assistance incorrectly paid.
3 § 65. Subdivisions 2 and 4 of section 246 of chapter 81 of the laws of
4 1995, amending the public health law and other laws relating to medical
5 reimbursement and welfare reform, as amended by section 10 of part Z2 of
6 chapter 62 of the laws of 2003, are amended to read as follows:
7 2. Sections five, seven through nine, twelve through fourteen, and
8 eighteen of this act shall be deemed to have been in full force and
9 effect on and after April 1, 1995 through March 31, 1999 and on and
10 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
11 through March 31, 2003 and on and after April 1, 2003 through March 31,
12 2005 and annually thereafter;
13 4. Section one of this act shall be deemed to have been in full force
14 and effect on and after April 1, 1995 through March 31, 1999 and on and
15 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
16 through March 31, 2003 and on and after April 1, 2003 through March 31,
17 2005 and annually thereafter.
18 § 66. Section 4 of chapter 81 of the laws of 1995, amending the public
19 health law and other laws relating to medical reimbursement and welfare
20 reform, as amended by section 15 of part Z2 of chapter 62 of the laws of
21 2003, is amended to read as follows:
22 § 4. Notwithstanding any inconsistent provision of law, except subdi-
23 vision 15 of section 2807 of the public health law and section 364-j-2
24 of the social services law and section 32-g of part F of chapter 412 of
25 the laws of 1999, rates of payment for diagnostic and treatment centers
26 established in accordance with paragraphs (b) and (h) of subdivision 2
27 of section 2807 of the public health law for the period ending September
28 30, 1995 shall continue in effect through September 30, 2000 and for the
29 periods October 1, 2000 through September 30, 2003 and October 1, 2003
30 through September 30, 2005 and annually thereafter, and further provided
31 that rates in effect on March 31, 2003 as established in accordance with
32 paragraph (e) of subdivision 2 of section 2807 of the public health law
33 shall continue in effect for the period April 1, 2003 through September
34 30, 2005 and annually thereafter.
35 § 67. Subdivision 5 of section 246 of chapter 81 of the laws of 1995,
36 amending the public health law and other laws relating to medical
37 reimbursement and welfare reform, as amended by section 16 of part Z2 of
38 chapter 62 of the laws of 2003, is amended to read as follows:
39 5. Section three of this act shall be deemed to have been in full
40 force and effect on and after April 1, 1995 through March 31, 1999 and
41 on and after July 1, 1999 through March 31, 2000 and on and after April
42 1, 2000 through March 31, 2003 and on and after April 1, 2003 through
43 March 31, 2005 and annually thereafter;
44 § 68. Section 194 of chapter 474 of the laws of 1996, amending the
45 education law and other laws relating to rates for residential health
46 care facilities, as amended by section 11 of part Z2 of chapter 62 of
47 the laws of 2003, is amended to read as follows:
48 § 194. 1. Notwithstanding any inconsistent provision of law or regu-
49 lation, the trend factors used to project reimbursable operating costs
50 to the rate period for purposes of determining rates of payment pursuant
51 to article 28 of the public health law for residential health care
52 facilities for reimbursement of inpatient services provided to patients
53 eligible for payments made by state governmental agencies on and after
54 April 1, 1996 through March 31, 1999 and for payments made on and after
55 July 1, 1999 through March 31, 2000 and on and after April 1, 2000
56 through March 31, 2003 and on and after April 1, 2003 through March 31,
S. 992 140 A. 1922
1 2005 and annually thereafter shall reflect no trend factor projections
2 or adjustments for the period April 1, 1996, through March 31, 1997.
3 2. The commissioner of health shall adjust such rates of payment to
4 reflect the exclusion pursuant to this section of such specified trend
5 factor projections or adjustments.
6 § 69. The opening paragraph and paragraph (a) of subdivision 16 of
7 section 2808 of the public health law, as amended by section 17 of part
8 Z2 of chapter 62 of the laws of 2003, are amended to read as follows:
9 Notwithstanding any inconsistent provision of law or regulation to the
10 contrary, residential health care facility rates of payment determined
11 pursuant to this article for governmental agencies for services provided
12 on or after April first, nineteen hundred ninety-six through March thir-
13 ty-first, nineteen hundred ninety-nine and on or after July first, nine-
14 teen hundred ninety-nine through March thirty-first, two thousand and on
15 and after April first, two thousand through March thirty-first, two
16 thousand three and on and after April first, two thousand three through
17 March thirty-first, two thousand five and annually thereafter, shall be
18 further reduced by the commissioner to encourage improved productivity
19 and efficiency by providers by a factor determined as follows:
20 (a) an aggregate reduction shall be calculated for each residential
21 health care facility commencing April first, nineteen hundred ninety-six
22 through March thirty-first, nineteen hundred ninety-nine and on or after
23 July first, nineteen hundred ninety-nine through March thirty-first, two
24 thousand and on and after April first, two thousand through March thir-
25 ty-first, two thousand three and on and after April first, two thousand
26 three through March thirty-first, two thousand five and annually there-
27 after as the result of (i) fifty-six million dollars on an annualized
28 basis multiplied by (ii) the ratio of patient days for patients eligible
29 for payments made by governmental agencies provided in a base year two
30 years prior to the rate year by a residential health care facility, or
31 for residential health care facility beds not fully in operation in such
32 base year by an estimate of projected utilization for the rate year,
33 divided by the total of such patient days summed for all residential
34 health care facilities; and
35 § 70. Paragraph (a) of subdivision 14 of section 2808 of the public
36 health law, as amended by section 18 of part Z2 of chapter 62 of the
37 laws of 2003, is amended to read as follows:
38 (a) Notwithstanding any inconsistent provision of law or regulation to
39 the contrary, for purposes of establishing rates of payment by govern-
40 mental agencies for residential health care facilities for services
41 provided on or after April first, nineteen hundred ninety-five through
42 March thirty-first, nineteen hundred ninety-nine and for services
43 provided on or after July first, nineteen hundred ninety-nine through
44 March thirty-first, two thousand and on and after April first, two thou-
45 sand through March thirty-first, two thousand three and on and after
46 April first, two thousand three through March thirty-first, two thousand
47 five and annually thereafter, the reimbursable base year administrative
48 services and fiscal services costs, as defined in the New York state
49 residential health care facility accounting and reporting manual, of a
50 residential health care facility, excluding a provider of services reim-
51 bursed on an initial budget basis, shall, except as otherwise provided
52 in this subdivision, not exceed the statewide average of total reimburs-
53 able base year administrative and fiscal services costs of residential
54 health care facilities. For the purposes of this subdivision, reimbursa-
55 ble base year administrative and fiscal services costs shall mean those
56 base year administrative and fiscal services costs remaining after
S. 992 141 A. 1922
1 application of all other efficiency standards, including but not limited
2 to, peer group cost ceilings or guidelines.
3 § 71. Paragraph (b) of subdivision 14 of section 2808 of the public
4 health law, as amended by section 19 of part Z2 of chapter 62 of the
5 laws of 2003, is amended to read as follows:
6 (b) A separate statewide average of total reimbursable base year
7 administrative and fiscal services costs shall be determined for each of
8 those facilities wherein eighty percent or more of its patients are
9 classified with a patient acuity equal to or less than .83 which is
10 used as the basis for a facility's case mix adjustment. For the period
11 July first, two thousand through March thirty-first, two thousand one,
12 the total reimbursable base year administrative and fiscal services
13 costs of such facilities shall not exceed such separate statewide aver-
14 age plus one and one-half percentage points. For annual periods there-
15 after [through March thirty-first, two thousand five], the total reim-
16 bursable base year administrative and fiscal services costs of such
17 facilities shall not exceed such separate statewide average. In no event
18 shall the calculation of such separate statewide average result in a
19 change in the statewide average determined under paragraph (a) of this
20 subdivision.
21 § 72. Paragraph (f) of subdivision 1 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 section 20 of
24 part Z2 of chapter 62 of the laws of 2003, is amended to read as
25 follows:
26 (f) Prior to February 1, 2001, February 1, 2002, February 1, 2003,
27 February 1, 2004, February 1, 2005 [and], February 1, 2006, and February
28 1 of each year thereafter, the commissioner of health shall calculate
29 the result of the statewide total of residential health care facility
30 days of care provided to beneficiaries of title XVIII of the federal
31 social security act (medicare), divided by the sum of such days of care
32 plus days of care provided to residents eligible for payments pursuant
33 to title 11 of article 5 of the social services law minus the number of
34 days provided to residents receiving hospice care, expressed as a
35 percentage, for the period commencing January 1, through November 30, of
36 the prior year respectively, based on such data for such period. This
37 value shall be called the 2000, 2001, 2002, 2003, 2004 [and], 2005 and
38 each year thereafter statewide target percentage respectively.
39 § 73. Subparagraph (ii) of paragraph (b) of subdivision 3 of section
40 64 of chapter 81 of the laws of 1995, amending the public health law and
41 other laws relating to medical reimbursement and welfare reform, as
42 amended by section 21 of part Z2 of chapter 62 of the laws of 2003, is
43 amended to read as follows:
44 (ii) If the 1997, 1998, 2000, 2001, 2002, 2003, 2004 [and], 2005, and
45 each year thereafter statewide target percentages are not for each year
46 at least three percentage points higher than the statewide base percent-
47 age, the commissioner of health shall determine the percentage by which
48 the statewide target percentage for each year is not at least three
49 percentage points higher than the statewide base percentage. The
50 percentage calculated pursuant to this paragraph shall be called the
51 1997, 1998, 2000, 2001, 2002, 2003, 2004 [or], 2005, and each year ther-
52 eafter statewide reduction percentage respectively. If the 1997, 1998,
53 2000, 2001, 2002, 2003, 2004 [or], 2005, and each year thereafter state-
54 wide target percentage for the respective year is at least three
55 percentage points higher than the statewide base percentage, the state-
56 wide reduction percentage for the respective year shall be zero.
S. 992 142 A. 1922
1 § 74. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
2 64 of chapter 81 of the laws of 1995, amending the public health law and
3 other laws relating to medical reimbursement and welfare reform, as
4 amended by section 22 of part Z2 of chapter 62 of the laws of 2003, is
5 amended to read as follows:
6 (iii) The 1998, 2000, 2001, 2002, 2003, 2004 [and], 2005, and each
7 year thereafter statewide reduction percentage shall be multiplied by
8 one hundred two million dollars respectively to determine the 1998,
9 2000, 2001, 2002, 2003, 2004 [or], 2005, and each year thereafter state-
10 wide aggregate reduction amount. If the 1998 and the 2000, 2001, 2002,
11 2003, 2004 [and], 2005, and each year thereafter statewide reduction
12 percentage shall be zero respectively, there shall be no 1998, 2000,
13 2001, 2002, 2003, 2004 [or], 2005, and each year thereafter reduction
14 amount.
15 § 75. Paragraph (b) of subdivision 5 of section 64 of chapter 81 of
16 the laws of 1995, amending the public health law and other laws relating
17 to medical reimbursement and welfare reform, as amended by section 23 of
18 part Z2 of chapter 62 of the laws of 2003, is amended to read as
19 follows:
20 (b) The 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004 [and],
21 2005, and each year thereafter statewide aggregate reduction amounts
22 shall for each year be allocated by the commissioner of health among
23 residential health care facilities that are eligible to provide services
24 to beneficiaries of title XVIII of the federal social security act
25 (medicare) and residents eligible for payments pursuant to title 11 of
26 article 5 of the social services law on the basis of the extent of each
27 facility's failure to achieve a two percentage points increase in the
28 1996 target percentage, a three percentage point increase in the 1997,
29 1998, 2000, 2001, 2002, 2003, 2004 [and], 2005, and each year thereafter
30 target percentage and a two and one-quarter percentage point increase in
31 the 1999 target percentage for each year, compared to the base percent-
32 age, calculated on a facility specific basis for this purpose, compared
33 to the statewide total of the extent of each facility's failure to
34 achieve a two percentage points increase in the 1996 and a three
35 percentage point increase in the 1997 and a three percentage point
36 increase in the 1998 and a two and one-quarter percentage point increase
37 in the 1999 target percentage and a three percentage point increase in
38 the 2000, 2001, 2002, 2003, 2004 [and], 2005, and each year thereafter
39 target percentage compared to the base percentage. These amounts shall
40 be called the 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004
41 [and], 2005, and each year thereafter facility specific reduction
42 amounts respectively.
43 § 76. Subdivision 5-a of section 246 of chapter 81 of the laws of
44 1995, amending the public health law and other laws relating to medical
45 reimbursement and welfare reform, as amended by section 13 of part Z2 of
46 chapter 62 of the laws of 2003, is amended to read as follows:
47 [5-a. Section sixty-four-a of this act shall be deemed to have been in
48 full force and effect on and after April 1, 1995 through March 31, 1999
49 and on and after July 1, 1999 through March 31, 2000 and on and after
50 April 1, 2000 through March 31, 2003 and on and after April 1, 2003
51 through March 31, 2005;]
52 § 77. Section 64-b of chapter 81 of the laws of 1995, amending the
53 public health law and other laws relating to medical reimbursement and
54 welfare reform, as amended by section 14 of part Z2 of chapter 62 of the
55 laws of 2003, is amended to read as follows:
S. 992 143 A. 1922
1 [§ 64-b. Notwithstanding any inconsistent provision of law, the
2 provisions of subdivision 7 of section 3614 of the public health law, as
3 amended, shall remain and be in full force and effect on April 1, 1995
4 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
5 and after April 1, 2000 through March 31, 2003 and on and after April 1,
6 2003 through March 31, 2005.]
7 § 78. Section 228 of chapter 474 of the laws of 1996, amending the
8 education law and other laws relating to rates for residential health
9 care facilities, as amended by section 24 of part Z2 of chapter 62 of
10 the laws of 2003, is amended to read as follows:
11 § 228. 1. Definitions. (a) Regions, for purposes of this section,
12 shall mean a downstate region to consist of Kings, New York, Richmond,
13 Queens, Bronx, Nassau and Suffolk counties and an upstate region to
14 consist of all other New York state counties. A certified home health
15 agency or long term home health care program shall be located in the
16 same county utilized by the commissioner of health for the establishment
17 of rates pursuant to article 36 of the public health law.
18 (b) Certified home health agency (CHHA) shall mean such term as
19 defined in section 3602 of the public health law.
20 (c) Long term home health care program (LTHHCP) shall mean such term
21 as defined in subdivision 8 of section 3602 of the public health law.
22 (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
23 ly, located within a region.
24 (e) Medicaid revenue percentage, for purposes of this section, shall
25 mean CHHA and LTHHCP revenues attributable to services provided to
26 persons eligible for payments pursuant to title 11 of article 5 of the
27 social services law divided by such revenues plus CHHA and LTHHCP reven-
28 ues attributable to services provided to beneficiaries of Title XVIII of
29 the federal social security act (medicare).
30 (f) Base period, for purposes of this section, shall mean calendar
31 year 1995.
32 (g) Target period. For purposes of this section, the 1996 target peri-
33 od shall mean August 1, 1996 through March 31, 1997, the 1997 target
34 period shall mean January 1, 1997 through November 30, 1997, the 1998
35 target period shall mean January 1, 1998 through November 30, 1998, the
36 1999 target period shall mean January 1, 1999 through November 30, 1999,
37 the 2000 target period shall mean January 1, 2000 through November 30,
38 2000, the 2001 target period shall mean January 1, 2001 through November
39 30, 2001, the 2002 target period shall mean January 1, 2002 through
40 November 30, 2002, the 2003 target period shall mean January 1, 2003
41 through November 30, 2003, the 2004 target period shall mean January 1,
42 2004 through November 30, 2004, [and] the 2005 target period shall mean
43 January 1, 2005 through November 30, 2005, and each year thereafter the
44 target period shall be January 1 through November 30 for that respective
45 year.
46 2. (a) Prior to February 1, 1997, for each regional group the commis-
47 sioner of health shall calculate the 1996 medicaid revenue percentages
48 for the period commencing August 1, 1996 to the last date for which such
49 data is available and reasonably accurate.
50 (b) Prior to February 1, 1998, prior to February 1, 1999, prior to
51 February 1, 2000, prior to February 1, 2001, prior to February 1, 2002,
52 prior to February 1, 2003, prior to February 1, 2004, prior to February
53 1, 2005, [and] prior to February 1, 2006, and prior to February 1 of
54 each year thereafter for each regional group the commissioner of health
55 shall calculate the prior year's medicaid revenue percentages for the
56 period commencing January 1 through November 30 of such prior year.
S. 992 144 A. 1922
1 3. By September 15, 1996, for each regional group the commissioner of
2 health shall calculate the base period medicaid revenue percentage.
3 4. (a) For each regional group, the 1996 target medicaid revenue
4 percentage shall be calculated by subtracting the 1996 medicaid revenue
5 reduction percentages from the base period medicaid revenue percentages.
6 The 1996 medicaid revenue reduction percentage, taking into account
7 regional and program differences in utilization of medicaid and medicare
8 services, for the following regional groups shall be equal to:
9 (i) one and one-tenth percentage points for CHHAs located within the
10 downstate region;
11 (ii) six-tenths of one percentage point for CHHAs located within the
12 upstate region;
13 (iii) one and eight-tenths percentage points for LTHHCPs located with-
14 in the downstate region; and
15 (iv) one and seven-tenths percentage points for LTHHCPs located within
16 the upstate region.
17 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, [and] 2005, and each
18 year thereafter for each regional group, the target medicaid revenue
19 percentage for the respective year shall be calculated by subtracting
20 the respective year's medicaid revenue reduction percentage from the
21 base period medicaid revenue percentage. The medicaid revenue reduction
22 percentages for 1997, 1998, 2000, 2001, 2002, 2003, 2004, [and] 2005,
23 and each year thereafter taking into account regional and program
24 differences in utilization of medicaid and medicare services, for the
25 following regional groups shall be equal to for each such year:
26 (i) one and one-tenth percentage points for CHHAs located within the
27 downstate region;
28 (ii) six-tenths of one percentage point for CHHAs located within the
29 upstate region;
30 (iii) one and eight-tenths percentage points for LTHHCPs located with-
31 in the downstate region; and
32 (iv) one and seven-tenths percentage points for LTHHCPs located within
33 the upstate region.
34 (c) For each regional group, the 1999 target medicaid revenue percent-
35 age shall be calculated by subtracting the 1999 medicaid revenue
36 reduction percentage from the base period medicaid revenue percentage.
37 The 1999 medicaid revenue reduction percentages, taking into account
38 regional and program differences in utilization of medicaid and medicare
39 services, for the following regional groups shall be equal to:
40 (i) eight hundred twenty-five thousandths (.825) of one percentage
41 point for CHHAs located within the downstate region;
42 (ii) forty-five hundredths (.45) of one percentage point for CHHAs
43 located within the upstate region;
44 (iii) one and thirty-five hundredths percentage points (1.35) for
45 [LTHHPs] LTHHCPs located within the downstate region; and
46 (iv) one and two hundred seventy-five thousandths percentage points
47 (1.275) for LTHHCPs located within the upstate region.
48 5. (a) For each regional group, if the 1996 medicaid revenue percent-
49 age is not equal to or less than the 1996 target medicaid revenue
50 percentage, the commissioner of health shall compare the 1996 medicaid
51 revenue percentage to the 1996 target medicaid revenue percentage to
52 determine the amount of the shortfall which, when divided by the 1996
53 medicaid revenue reduction percentage, shall be called the 1996
54 reduction factor. These amounts, expressed as a percentage, shall not
55 exceed one hundred percent. If the 1996 medicaid revenue percentage is
S. 992 145 A. 1922
1 equal to or less than the 1996 target medicaid revenue percentage, the
2 1996 reduction factor shall be zero.
3 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, [and] 2005,
4 and each year thereafter for each regional group, if the medicaid reven-
5 ue percentage for the respective year is not equal to or less than the
6 target medicaid revenue percentage for such respective year, the commis-
7 sioner of health shall compare such respective year's medicaid revenue
8 percentage to such respective year's target medicaid revenue percentage
9 to determine the amount of the shortfall which, when divided by the
10 respective year's medicaid revenue reduction percentage, shall be called
11 the reduction factor for such respective year. These amounts, expressed
12 as a percentage, shall not exceed one hundred percent. If the medicaid
13 revenue percentage for a particular year is equal to or less than the
14 target medicaid revenue percentage for that year, the reduction factor
15 for that year shall be zero.
16 6. (a) For each regional group, the 1996 reduction factor shall be
17 multiplied by the following amounts to determine each regional group's
18 applicable 1996 state share reduction amount:
19 (i) two million three hundred ninety thousand dollars ($2,390,000) for
20 CHHAs located within the downstate region;
21 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
22 within the upstate region;
23 (iii) one million two hundred seventy thousand dollars ($1,270,000)
24 for LTHHCPs located within the downstate region; and
25 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
26 located within the upstate region.
27 For each regional group reduction, if the 1996 reduction factor shall
28 be zero, there shall be no 1996 state share reduction amount.
29 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004 [and] 2005, and each
30 year thereafter for each regional group, the reduction factor for the
31 respective year shall be multiplied by the following amounts to deter-
32 mine each regional group's applicable state share reduction amount for
33 such respective year:
34 (i) two million three hundred ninety thousand dollars ($2,390,000) for
35 CHHAs located within the downstate region;
36 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
37 within the upstate region;
38 (iii) one million two hundred seventy thousand dollars ($1,270,000)
39 for LTHHCPs located within the downstate region; and
40 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
41 located within the upstate region.
42 For each regional group reduction, if the reduction factor for a
43 particular year shall be zero, there shall be no state share reduction
44 amount for such year.
45 (c) For each regional group, the 1999 reduction factor shall be multi-
46 plied by the following amounts to determine each regional group's appli-
47 cable 1999 state share reduction amount:
48 (i) one million seven hundred ninety-two thousand five hundred dollars
49 ($1,792,500) for CHHAs located within the downstate region;
50 (ii) five hundred sixty-two thousand five hundred dollars ($562,500)
51 for CHHAs located within the upstate region;
52 (iii) nine hundred fifty-two thousand five hundred dollars ($952,500)
53 for LTHHCPs located within the downstate region; and
54 (iv) four hundred forty-two thousand five hundred dollars ($442,500)
55 for LTHHCPs located within the upstate region.
S. 992 146 A. 1922
1 For each regional group reduction, if the 1999 reduction factor shall
2 be zero, there shall be no 1999 state share reduction amount.
3 7. (a) For each regional group, the 1996 state share reduction amount
4 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
5 on the basis of the extent of each CHHA's and LTHHCP's failure to
6 achieve the 1996 target medicaid revenue percentage, calculated on a
7 provider specific basis utilizing revenues for this purpose, expressed
8 as a proportion of the total of each CHHA's and LTHHCP's failure to
9 achieve the 1996 target medicaid revenue percentage within the applica-
10 ble regional group. This proportion shall be multiplied by the applica-
11 ble 1996 state share reduction amount calculation pursuant to paragraph
12 (a) of subdivision 6 of this section. This amount shall be called the
13 1996 provider specific state share reduction amount.
14 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004 [and] 2005, and
15 each year thereafter for each regional group, the state share reduction
16 amount for the respective year shall be allocated by the commissioner of
17 health among CHHAs and LTHHCPs on the basis of the extent of each CHHA's
18 and LTHHCP's failure to achieve the target medicaid revenue percentage
19 for the applicable year, calculated on a provider specific basis utiliz-
20 ing revenues for this purpose, expressed as a proportion of the total of
21 each CHHA's and LTHHCP's failure to achieve the target medicaid revenue
22 percentage for the applicable year within the applicable regional group.
23 This proportion shall be multiplied by the applicable year's state share
24 reduction amount calculation pursuant to paragraph (b) or (c) of subdi-
25 vision 6 of this section. This amount shall be called the provider
26 specific state share reduction amount for the applicable year.
27 8. (a) The 1996 provider specific state share reduction amount shall
28 be due to the state from each CHHA and LTHHCP and may be recouped by the
29 state by March 31, 1997 in a lump sum amount or amounts from payments
30 due to the CHHA and LTHHCP pursuant to title 11 of article 5 of the
31 social services law.
32 (b) The provider specific state share reduction amount for 1997, 1998,
33 1999, 2000, 2001, 2002, 2003, 2004 [and] 2005, and each year thereafter
34 respectively, shall be due to the state from each CHHA and LTHHCP and
35 each year the amount due for such year may be recouped by the state by
36 March 31 of the following year in a lump sum amount or amounts from
37 payments due to the CHHA and LTHHCP pursuant to title 11 of article 5 of
38 the social services law.
39 9. CHHAs and LTHHCPs shall submit such data and information at such
40 times as the commissioner of health may require for purposes of this
41 section. The commissioner of health may use data available from third-
42 party payors.
43 10. On or about June 1, 1997, for each regional group the commissioner
44 of health shall calculate for the period August 1, 1996 through March
45 31, 1997 a medicaid revenue percentage, a reduction factor, a state
46 share reduction amount, and a provider specific state share reduction
47 amount in accordance with the methodology provided in paragraph (a) of
48 subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
49 sion 6 and paragraph (a) of subdivision 7 of this section. The provider
50 specific state share reduction amount calculated in accordance with this
51 subdivision shall be compared to the 1996 provider specific state share
52 reduction amount calculated in accordance with paragraph (a) of subdivi-
53 sion 7 of this section. Any amount in excess of the amount determined in
54 accordance with paragraph (a) of subdivision 7 of this section shall be
55 due to the state from each CHHA and LTHHCP and may be recouped in
56 accordance with paragraph (a) of subdivision 8 of this section. If the
S. 992 147 A. 1922
1 amount is less than the amount determined in accordance with paragraph
2 (a) of subdivision 7 of this section, the difference shall be refunded
3 to the CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
4 and LTHHCPs shall submit data for the period August 1, 1996 through
5 March 31, 1997 to the commissioner of health by April 15, 1997.
6 11. If a CHHA or LTHHCP fails to submit data and information as
7 required for purposes of this section:
8 (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
9 caid revenue percentage between the applicable base period and the
10 applicable target period for purposes of the calculations pursuant to
11 this section; and
12 (b) the commissioner of health shall reduce the current rate paid to
13 such CHHA and such LTHHCP by state governmental agencies pursuant to
14 article 36 of the public health law by one percent for a period begin-
15 ning on the first day of the calendar month following the applicable due
16 date as established by the commissioner of health and continuing until
17 the last day of the calendar month in which the required data and infor-
18 mation are submitted.
19 12. The commissioner of health shall inform in writing the director of
20 the budget and the chair of the senate finance committee and the chair
21 of the assembly ways and means committee of the results of the calcu-
22 lations pursuant to this section.
23 § 79. Notwithstanding any inconsistent provision of law, rule or regu-
24 lation, the annual percentage reductions set forth in sections 72
25 through 78 of this act shall be prorated by the commissioner of health
26 for the period April 1, 2005 through March 31, 2006 and each respective
27 year thereafter.
28 § 80. Subdivision (x) of section 165 of chapter 41 of the laws of
29 1992, amending the public health law and other laws relating to assess-
30 ing certain health care providers, is REPEALED.
31 § 81. Subdivision 11 of section 2807-c of the public health law is
32 amended by adding a new paragraph (s-7) to read as follows:
33 (s-7) To the extent funds are available otherwise notwithstanding any
34 inconsistent provision of law to the contrary, for rate periods April
35 first, two thousand five through March thirty-first, two thousand seven,
36 the commissioner shall increase rates of payment for patients eligible
37 for payments made by state governmental agencies by an amount not to
38 exceed forty-eight million dollars annually in the aggregate. Such
39 amount shall be allocated among those voluntary non-profit and private
40 proprietary general hospitals which continue to provide inpatient
41 services as of April first, two thousand five under a previous or new
42 name and which qualified for rate adjustments pursuant to paragraph (s)
43 of this subdivision as in effect for the period July first, nineteen
44 hundred ninety-five through June thirtieth, nineteen hundred ninety-six
45 proportionally based on each such general hospital's proportional share
46 of total funds allocated pursuant to paragraph (s) of this subdivision
47 as in effect for the period of July first, nineteen hundred ninety-five
48 through June thirtieth, nineteen hundred ninety-six, provided however,
49 that amounts allocable to previously but no longer qualified hospitals
50 shall be proportionally reallocated to the remaining qualified hospi-
51 tals. The rate adjustments calculated in accordance with this paragraph
52 shall be subject to retrospective reconciliation to ensure that each
53 hospital receives in the aggregate its proportionate share of the full
54 allocation, to the extent allowable under federal law, provided however
55 that the department shall not be required to reconcile payments made
S. 992 148 A. 1922
1 pursuant to paragraph (s) of this subdivision applicable to periods
2 prior to September first, nineteen hundred ninety-seven.
3 § 82. Subparagraph (iii) of paragraph (f) of subdivision 4 of section
4 2807-c of the public health law, as amended by section 28 of part Z2 of
5 chapter 62 of the laws of 2003, is amended to read as follows:
6 (iii) commencing April first, nineteen hundred ninety-seven through
7 March thirty-first, nineteen hundred ninety-nine and commencing July
8 first, nineteen hundred ninety-nine through March thirty-first, two
9 thousand and April first, two thousand through March thirty-first, two
10 thousand five and for periods on and after April first, two thousand
11 five, the reimbursable inpatient operating cost component of case based
12 rates of payment per diagnosis-related group, excluding any operating
13 cost components related to direct and indirect expenses of graduate
14 medical education, for patients eligible for payments made by state
15 governmental agencies shall be reduced by three and thirty-three
16 hundredths percent to encourage improved productivity and efficiency.
17 Such election shall not alter the calculation of the group price compo-
18 nent calculated pursuant to subparagraph (i) of paragraph (a) of subdi-
19 vision seven of this section;
20 § 83. Subparagraph (iii) of paragraph (k) of subdivision 4 of section
21 2807-c of the public health law, as amended by section 29 of part Z2 of
22 chapter 62 of the laws of 2003, is amended to read as follows:
23 (iii) commencing April first, nineteen hundred ninety-seven through
24 March thirty-first, nineteen hundred ninety-nine and commencing July
25 first, nineteen hundred ninety-nine through March thirty-first, two
26 thousand and April first, two thousand through March thirty-first, two
27 thousand five and for periods on and after April first, two thousand
28 five, the operating cost component of rates of payment, excluding any
29 operating cost components related to direct and indirect expenses of
30 graduate medical education, for patients eligible for payments made by a
31 state governmental agency shall be reduced by three and thirty-three
32 hundredths percent to encourage improved productivity and efficiency.
33 The facility will be eligible to receive the financial incentives for
34 the physician specialty weighting incentive towards primary care pursu-
35 ant to subparagraph (ii) of paragraph (a) of subdivision twenty-five of
36 this section.
37 § 84. The opening paragraph of subparagraph (vi) of paragraph (b) of
38 subdivision 5 of section 2807-c of the public health law, as amended by
39 section 30 of part Z2 of chapter 62 of the laws of 2003, is amended to
40 read as follows:
41 for discharges on or after April first, nineteen hundred ninety-seven
42 through March thirty-first, nineteen hundred ninety-nine and for
43 discharges on or after July first, nineteen hundred ninety-nine through
44 March thirty-first, two thousand and for discharges on or after April
45 first, two thousand through March thirty-first, two thousand five and
46 for discharges on or after April first, two thousand five, for purposes
47 of reimbursement of inpatient hospital services for patients eligible
48 for payments made by state governmental agencies, the average reimbursa-
49 ble inpatient operating cost per discharge of a general hospital shall,
50 to encourage improved productivity and efficiency, be the sum of:
51 § 85. The opening paragraph and subparagraph (i) of paragraph (c) of
52 subdivision 5 of section 2807-c of the public health law, as amended by
53 section 31 of part Z2 of chapter 62 of the laws of 2003, are amended to
54 read as follows:
55 Notwithstanding any inconsistent provision of this section, commencing
56 July first, nineteen hundred ninety-six through March thirty-first,
S. 992 149 A. 1922
1 nineteen hundred ninety-nine and July first, nineteen hundred ninety-
2 nine through March thirty-first, two thousand and April first, two thou-
3 sand through March thirty-first, two thousand five and for periods on
4 and after April first, two thousand five, rates of payment for a general
5 hospital for patients eligible for payments made by state governmental
6 agencies shall be further reduced by the commissioner to encourage
7 improved productivity and efficiency by providers by a factor determined
8 as follows:
9 (i) an aggregate reduction shall be calculated for each general hospi-
10 tal commencing July first, nineteen hundred ninety-six through March
11 thirty-first, nineteen hundred ninety-nine and July first, nineteen
12 hundred ninety-nine through March thirty-first, two thousand and April
13 first, two thousand through March thirty-first, two thousand five and
14 for periods on and after April first, two thousand five, as the result
15 of (A) eighty-nine million dollars on an annualized basis for each year,
16 multiplied by (B) the ratio of patient days for patients eligible for
17 payments made by state governmental agencies provided in a base year two
18 years prior to the rate year by a general hospital, divided by the total
19 of such patient days summed for all general hospitals; and
20 § 86. Clause (B-1) of subparagraph (i) of paragraph (f) of subdivision
21 11 of section 2807-c of the public health law, as amended by section 32
22 of part Z2 of chapter 62 of the laws of 2003, is amended to read as
23 follows:
24 (B-1) The increase in the statewide average case mix in the periods
25 January first, nineteen hundred ninety-seven through March thirty-first,
26 two thousand and on and after April first, two thousand through March
27 thirty-first, two thousand five and on and after April first, two thou-
28 sand five, from the statewide average case mix for the period January
29 first, nineteen hundred ninety-six through December thirty-first, nine-
30 teen hundred ninety-six shall not exceed one percent for nineteen
31 hundred ninety-seven, two percent for nineteen hundred ninety-eight,
32 three percent for the period January first, nineteen hundred ninety-nine
33 through September thirtieth, nineteen hundred ninety-nine, four percent
34 for the period October first, nineteen hundred ninety-nine through
35 December thirty-first, nineteen hundred ninety-nine [and], four percent
36 for two thousand plus an additional one percent per year thereafter
37 through March thirty-first, two thousand five, and eight percent for
38 periods beginning on and after April two thousand five, based on compar-
39 ison of data only for patients that are eligible for medical assistance
40 pursuant to title eleven of article five of the social services law,
41 including such patients enrolled in health maintenance organizations.
42 § 87. Subdivision 1 of section 46 of chapter 639 of the laws of 1996,
43 amending the public health law and other laws relating to welfare
44 reform, as amended by section 33 of part Z2 of chapter 62 of the laws of
45 2003, is amended to read as follows:
46 1. Notwithstanding any inconsistent provision of law or regulation to
47 the contrary, the trend factors used to project reimbursable operating
48 costs to the rate period for purposes of determining rates of payment
49 pursuant to article 28 of the public health law for general hospitals
50 for reimbursement of inpatient hospital services provided to patients
51 eligible for payments made by state governmental agencies on and after
52 April 1, 1996 through June 30, 1996 and on or after July 1, 1996 through
53 March 31, 1999 and on and after July 1, 1999 through March 31, 2000 and
54 on and after April 1, 2000 through March 31, 2005 and on and after April
55 1, 2005, shall reflect no trend factor projections or adjustments for
56 the period April 1, 1996, through March 31, 1997.
S. 992 150 A. 1922
1 § 88. Section 3 of chapter 483 of the laws of 1978, amending the
2 public health law relating to rate of payment for each residential
3 health care facility to real property costs, as amended by section 34 of
4 part Z2 of chapter 62 of the laws of 2003, is amended to read as
5 follows:
6 § 3. This act shall take effect immediately provided, however, that
7 the provisions of subdivision 2-a of section 2808 of the public health
8 law, as added by section one of this act, shall remain in full force and
9 effect until December 31, 2005 and on and after January 1, 2006.
10 § 89. Section 97 of chapter 659 of the laws of 1997, amending the
11 public health law and other laws relating to the creating of continuing
12 care retirement communities, is amended to read as follows:
13 § 97. This act shall take effect immediately, provided, however, that
14 the amendments to subdivision 4 of section 854 of the general municipal
15 law made by section seventy of this act shall not affect the expiration
16 of such subdivision and shall be deemed to expire therewith and provided
17 further that sections sixty-seven and sixty-eight of this act shall
18 apply to taxable years beginning on or after January 1, 1998 and
19 provided further that sections eighty-one [through], eighty-two, eight-
20 y-four, eighty-five, eighty-six and eighty-seven of this act shall
21 expire and be deemed repealed on December 31, 2006 and provided further
22 that section eighty-three of this act shall expire and be deemed
23 repealed on April 1, 2005 and provided further, however, that the amend-
24 ments to section ninety of this act shall take effect January 1, 1998
25 and shall apply to all policies, contracts, certificates, riders or
26 other evidences of coverage of long term care insurance issued, renewed,
27 altered or modified pursuant to section 3229 of the insurance law on or
28 after such date.
29 § 90. Section 10 of chapter 649 of the laws of 1996, amending the
30 public health law, the mental hygiene law and the social services law
31 relating to authorizing the establishment of special needs plans, as
32 amended by section 41 of part Z2 of chapter 62 of the laws of 2003, is
33 amended to read as follows:
34 § 10. This act shall take effect immediately and shall be deemed to
35 have been in full force and effect on and after July 1, 1996; [provided,
36 however, that sections one, two and three of this act shall expire and
37 be deemed repealed on March 31, 2006 provided, however that the amend-
38 ments to section 364-j of the social services law made by section four
39 of this act shall not affect the expiration of such section and shall be
40 deemed to expire therewith and] provided, further, that the provisions
41 of subdivisions 8, 9 and 10 of section 4401 of the public health law, as
42 added by section one of this act; section 4403-d of the public health
43 law as added by section two of this act and the provisions of section
44 seven of this act, except for the provisions relating to the establish-
45 ment of no more than twelve comprehensive HIV special needs plans, shall
46 expire and be deemed repealed on July 1, 2000.
47 § 91. Section 11 of chapter 710 of the laws of 1988, amending the
48 social services law and the education law relating to medical assistance
49 eligibility of certain persons and providing for managed medical care
50 demonstration programs, as amended by section 42 of part Z2 of chapter
51 62 of the laws of 2003, is amended to read as follows:
52 § 11. This act shall take effect immediately; except that the
53 provisions of sections one, two, three, four, eight and ten of this act
54 shall take effect on the ninetieth day after it shall have become a law;
55 and except that the provisions of sections five, six and seven of this
56 act shall take effect January 1, 1989; and except that effective imme-
S. 992 151 A. 1922
1 diately, the addition, amendment and/or repeal of any rule or regulation
2 necessary for the implementation of this act on its effective date are
3 authorized and directed to be made and completed on or before such
4 effective date; [provided, however, that the provisions of section 364-j
5 of the social services law, as added by section one of this act shall
6 expire and be deemed repealed on and after March 31, 2006,] the
7 provisions of section 364-k of the social services law, as added by
8 section two of this act, except subdivision 10 of such section, shall
9 expire and be deemed repealed on and after January 1, 1994, and the
10 provisions of subdivision 10 of section 364-k of the social services
11 law, as added by section two of this act, shall expire and be deemed
12 repealed on January 1, 1995.
13 § 92. Subdivision (c) of section 62 of chapter 165 of the laws of
14 1991, amending the public health law and other laws relating to estab-
15 lishing payments for medical assistance, as amended by section 43 of
16 part Z2 of chapter 62 of the laws of 2003, is amended to read as
17 follows:
18 (c) [section 364-j of the social services law, as amended by section
19 eight of this act and subdivision 6 of section 367-a of the social
20 services law as added by section twelve of this act shall expire and be
21 deemed repealed on March 31 2006 and provided further, that] the amend-
22 ments to the provisions of [such] section 364-j of the social services
23 law, as amended by section eight of this act, shall only apply to
24 managed care programs approved on or after the effective date of this
25 act;
26 § 93. Section 18 of chapter 904 of the laws of 1984, amending the
27 public health law and the social services law relating to encouraging
28 comprehensive health services, as amended by chapter 69 of the laws of
29 2004, is amended to read as follows:
30 § 18. This act shall take effect immediately, except that sections
31 six, nine, ten and eleven of this act shall take effect on the sixtieth
32 day after it shall have become a law, [sections two, three, four and
33 nine of this act shall expire and be of no further force or effect on or
34 after March 31, 2006,] section two of this act shall take effect on
35 April 1, 1985 or seventy-five days following the submission of the
36 report required by section one of this act, whichever is later, and
37 sections eleven and thirteen of this act shall expire and be of no
38 further force or effect on or after March 31, 1988.
39 § 94. Section 2 of chapter 535 of the laws of 1983, amending the
40 social services law relating to eligibility of certain enrollees for
41 medical assistance, as amended by section 45 of part Z2 of chapter 62 of
42 the laws of 2003, is amended to read as follows:
43 § 2. This act shall take effect immediately [and shall remain in full
44 force and effect through March 31, 2006].
45 § 95. The commissioner of health is authorized to:
46 (i) submit amendments to the state plan for medical assistance;
47 (ii) submit applications for waivers, or applications for amendment of
48 existing waivers, of provisions of the federal social security act; and
49 (iii) promulgate or adopt any rules or regulations; necessary to
50 implement the provisions of this act and to obtain any federal approvals
51 necessary to obtain federal financial participation for care and
52 services provided pursuant to the provisions of this act. Notwithstand-
53 ing any inconsistent provision of the state administrative procedure act
54 or any other provision of law, rule or regulation, the commissioner of
55 health and any appropriate council is authorized to adopt, amend or
56 promulgate on an emergency basis any regulation such commissioner or
S. 992 152 A. 1922
1 such council determines necessary to implement any provision of this act
2 on its effective date.
3 § 96. The commissioner of health is authorized to promulgate or adopt
4 any rules or regulations necessary to implement the provisions of this
5 act and any procedures, forms, or instructions necessary for such imple-
6 mentation may be adopted and issued on or after the effective date of
7 this act. Notwithstanding any inconsistent provision of the state admin-
8 istrative procedure act or any other provision of law, rule or regu-
9 lation the commissioner of health and the superintendent of insurance
10 and any appropriate council is authorized to adopt or amend or promul-
11 gate on an emergency basis any regulation he or she or such council
12 determines necessary to implement any provision of this act on its
13 effective date.
14 § 97. Notwithstanding any inconsistent provision of law, rule or regu-
15 lation, the effectiveness of subdivisions 4, 7 and 7-a of section 2807
16 of the public health law and section 18 of chapter 2 of the laws of
17 1998, as such provisions relate to time frames of notice, approval or
18 certification of rates of payment, and to the requirement of prior
19 notice of rates of payment, are hereby suspended and shall, for purposes
20 of implementing the provisions of this act, be deemed to have been with-
21 out any force or effect from and after November 1, 2004 for such rates
22 effective for any period January 1, 2005 through December 31, 2005.
23 § 98. Severability. If any clause, sentence, paragraph, section or
24 part of this act shall be adjudged by any court of competent jurisdic-
25 tion to be invalid, such judgment shall not affect, impair, or invali-
26 date the remainder thereof, but shall be confined in its operation to
27 the clause, sentence, paragraph, subdivision, section or part thereof
28 directly involved in the controversy in which such judgment shall have
29 been rendered. It is hereby declared to be the intent of the legislature
30 that this act would have been enacted even if such invalid provisions
31 had not been included therein.
32 § 99. This act shall take effect immediately and shall be deemed to
33 have been in full force and effect on and after April 1, 2005; provided
34 however, that:
35 1. in the event any provision of law relating to cost containment set
36 forth in sections ten through ninety-eight of this act is repealed or
37 amended in such a manner as is deemed by the director of the budget to
38 negate the efficacy of such provisions set forth therein, the provisions
39 of sections one through nine of this act shall be deemed repealed; upon
40 the occurrence of the contingency set forth above, the director of the
41 budget shall notify the legislative bill drafting commission upon the
42 occurrence of the enactment of the legislation provided for in sections
43 ten through ninety-eight of this act in order that the commission may
44 maintain an accurate and timely effective data base of the official text
45 of the laws of the state of New York in furtherance of effecting the
46 provisions of section 44 of the legislative law and section 70-b of the
47 public officers law.
48 2. sections twenty-six and twenty-six-a of this act shall apply to
49 taxable years beginning on and after January 1, 2005;
50 3. sections forty-eight through fifty and sections fifty-four through
51 sixty of this act shall take effect July 1, 2005;
52 4. section forty-five of this act shall be deemed to have been in full
53 force and effect on and after April 1, 2004;
54 5. sections thirty-six through thirty-eight of this act shall not take
55 effect unless and until the commissioner of health receives all neces-
56 sary approvals under federal law and regulation to implement such
S. 992 153 A. 1922
1 provisions, and provided that such provisions do not prevent the receipt
2 of federal financial participation under the medical assistance program;
3 6. no section of this act shall be required to be implemented sooner
4 than sixty days following the receipt of all waivers and approvals
5 necessary under federal law and regulation to implement the provisions
6 of this act with federal financial participation; The commissioner of
7 health shall submit such waiver applications and/or state plan amend-
8 ments as may be necessary to obtain such approvals and to ensure contin-
9 ued federal financial participation; and
10 7. the amendments made to paragraphs (f) and (k) of subdivision 4 and
11 subparagraph (vi) of paragraph (b) and paragraph (c) of subdivision 5 of
12 section 2807-c of the public health law by sections eighty-two, eighty-
13 three, eighty-four and eighty-five of this act, notwithstanding the
14 expiration provided for in subdivision 5 of section 168 of chapter 639
15 of the laws of 1996 and subdivision 1 of section 138 of chapter 1 of the
16 laws of 1999, shall no longer expire and shall be made permanent.
17 PART D
18 Section 1. Subdivision (b) of section 7.17 of the mental hygiene law,
19 as amended by chapter 564 of the laws of 2003, 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 Greater Binghamton Health 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. 992 154 A. 1922
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. One hundred percent of the community mental health support and
5 workforce reinvestment funds made available for appropriation, pursuant
6 to section 41.55 of the mental hygiene law, as a result of the closure
7 of Middletown Psychiatric Center, pursuant to section one of this act,
8 shall be allocated for state-operated community services located within
9 such facility catchment area, and such allocation shall be deemed to
10 satisfy the seven percent allocation pursuant to subdivision (i) of
11 section 41.55 of the mental hygiene law.
12 § 3. This act shall take effect immediately; and notwithstanding any
13 other law to the contrary, the closure of Middletown Psychiatric Center,
14 pursuant to section one of this act, shall take effect April 1, 2006.
15 PART E
16 Section 1. Section 14 of chapter 642 of the laws of 2004, constituting
17 chapter 35-A of the consolidated laws relating to the elderly and amend-
18 ing the elder law and other laws relating to the elderly, is amended to
19 read as follows:
20 § 14. This act shall take effect immediately; provided, however, that
21 section 209 of the elder law, as added by section one of this act, shall
22 expire and be deemed repealed December 31, [2005] 2007; provided
23 further, however, that paragraph (b) of subdivision 1 and paragraph (g)
24 of subdivision 3 of section 218 of the elder law, as added by section
25 one of this act, shall expire and be deemed repealed December 31, 2006;
26 and provided further, however, that section two of this act shall take
27 effect December 31, 2006.
28 § 2. This act shall take effect immediately and shall be deemed to
29 have been in full force and effect on and after April 1, 2005.
30 PART F
31 Section 1. Article 43 of the executive law is REPEALED.
32 § 2. The article heading of article 45 of the mental hygiene law, as
33 added by chapter 655 of the laws of 1977, is amended to read as follows:
34 STATE COMMISSION ON QUALITY OF CARE [FOR THE MENTALLY DISABLED]
35 AND ADVOCACY FOR PERSONS WITH DISABILITIES
36 § 3. Section 45.01 of the mental hygiene law, as added by chapter 655
37 of the laws of 1977, subdivisions 2 and 3 as amended by chapter 80 of
38 the laws of 1986 and subdivision 5 as amended by chapter 299 of the laws
39 of 1984, is amended to read as follows:
40 § 45.01 Definitions.
41 When used in this article:
42 1. "Commission" means the state commission on quality of care [for the
43 mentally disabled] and advocacy for persons with disabilities.
44 2. "Council" means the advisory council to the commission.
45 3. "Boards of visitors" means the boards of visitors as used in arti-
46 cle seven and article thirteen of this chapter.
47 4. "Board" means the mental hygiene medical review board.
48 5. "Mental hygiene facility" means a facility as defined in subdivi-
49 sion six of section 1.03 of this chapter and facilities for the opera-
50 tion of which an operating certificate is required pursuant to article
51 sixteen or thirty-one of this chapter and including family care homes.
S. 992 155 A. 1922
1 6. "Disability" means disability as defined in subdivision twenty-one
2 of section two hundred ninety-two of the executive law.
3 § 4. Section 45.03 of the mental hygiene law, as added by chapter 655
4 of the laws of 1977, subdivision (a) as amended by chapter 437 of the
5 laws of 1995, is amended to read as follows:
6 § 45.03 State commission on quality of care [for the mentally disabled]
7 and advocacy for persons with disabilities; organization.
8 (a) There shall be within the executive department a state commission
9 on quality of care [for the mentally disabled] and advocacy for persons
10 with disabilities. It shall consist of three persons to be appointed by
11 the governor, by and with the consent of the senate. The persons so
12 appointed shall have expressed an active interest in or obtained profes-
13 sional knowledge in the care of [the mentally disabled or in mental
14 hygiene] and in the provision of services, supports, and advocacy for
15 persons with disabilities and in disability endeavors generally. The
16 governor shall designate one of the members as [chairman] chair to serve
17 as such at the pleasure of the governor. The members of the commission,
18 except for the [chairman] chair who shall devote full time to his or her
19 duties, shall receive no compensation for their services but shall be
20 reimbursed for expenses actually and necessarily incurred in the
21 performance of their duties within appropriations made therefor.
22 (b) The members shall hold office for terms of five years; provided
23 that of the members first appointed, one shall serve for a term of one
24 year, one shall serve for a term of three years and one shall serve for
25 a term of five years from January first next succeeding his or her
26 appointment. Any member of the commission may be removed by the governor
27 for cause.
28 (c) Any member chosen to fill a vacancy created other than by expira-
29 tion of a term shall be appointed for the unexpired term of the member
30 whom he or she is to succeed. Vacancies caused by expiration of term or
31 otherwise shall be filled in the same manner as original appointments.
32 § 5. Section 45.05 of the mental hygiene law, as added by chapter 655
33 of the laws of 1977, subdivision (e) as added by chapter 477 of the laws
34 of 1979, is amended to read as follows:
35 § 45.05 [Chairman] Chair of commission.
36 (a) The [chairman] chair shall be the chief executive officer of the
37 commission.
38 (b) The [chairman] chair may appoint such assistants, officers and
39 employees, committees and consultants for the commission as may be
40 determined to be necessary, prescribe their powers and duties, fix their
41 compensation and provide for reimbursement of their expenses within
42 amounts appropriated therefor.
43 (c) The [chairman] chair may, from time to time, create, abolish,
44 transfer and consolidate bureaus and other units within the commission
45 not expressly established by law as may be determined necessary for the
46 efficient operation of the commission subject to the approval of the
47 director of the budget.
48 (d) The [chairman] chair may request, and shall receive upon request
49 from any department, division, board, bureau, commission or other agency
50 of the state or any political subdivision thereof or any public authori-
51 ty such assistance, information and data as will enable the commission
52 properly to carry out its functions, powers and duties.
53 (e) The [chairman] chair may request and upon such request the coron-
54 er, coroner's physician or medical examiner shall provide to the [chair-
55 man] chair or to the mental hygiene medical review board, as designated,
56 access to original autopsy slides, tissue materials and specimens
S. 992 156 A. 1922
1 derived from any autopsy or inquiry with respect to the death of a
2 patient or resident in a mental hygiene facility. Such original materi-
3 als shall be preserved intact, except for unavoidable changes due to
4 necessary scientific testing by the mental hygiene medical review board
5 and shall be returned to the coroner, coroner's physician or medical
6 examiner.
7 § 6. Section 45.07 of the mental hygiene law, as added by chapter 655
8 of the laws of 1977, subdivision (c) as amended by chapter 719 of the
9 laws of 1986, paragraphs 2, 3 and 4 as amended and paragraph 5 of subdi-
10 vision (c) as added by chapter 32 of the laws of 1992, subparagraph e of
11 paragraph 2 of subdivision (c) as amended by chapter 12 of the laws of
12 1996, subdivision (d) as amended by chapter 376 of the laws of 1994,
13 paragraph 2 of subdivision (f) as amended by chapter 157 of the laws of
14 1985, subdivision (k) as added by chapter 734 of the laws of 1994 and
15 subdivision (l) as relettered by chapter 890 of the laws of 1990, is
16 amended to read as follows:
17 § 45.07 Functions, powers and duties of the commission.
18 The commission shall have the following functions, powers and duties:
19 (a) Review the organization and operations of the department of mental
20 hygiene and advise and assist the governor in developing policies, plans
21 and programs for improving the administration of mental hygiene facili-
22 ties and the delivery of services therein and for ensuring that the
23 quality of care provided to [the mentally disabled] persons with mental
24 disabilities in the state is of a uniformly high standard.
25 (b) Review the cost [effect] effectiveness of mental hygiene programs
26 and procedures provided for by law with particular attention to effi-
27 ciency, effectiveness and economy in the management, supervision and
28 delivery of such programs. Such review may include but is not limited
29 to: (i) determining reasons for rising costs and possible means of
30 controlling them; (ii) analyzing and comparing expenditures in mental
31 hygiene to determine the factors associated with variations in costs;
32 and (iii) analyzing and comparing achievements in selected samples to
33 determine the factors associated with variations in program success and
34 their relationship to mental hygiene costs.
35 (c) 1. Establish procedures to assure effective investigation of
36 complaints of patients, residents and employees of mental hygiene facil-
37 ities affecting such patients and residents including allegations of
38 patient abuse or mistreatment, including all reports of abuse or
39 maltreatment of children in residential care as defined in paragraph (g)
40 of subdivision seven of section four hundred twelve of the social
41 services law and made pursuant to title six of article six of such law.
42 Such procedures shall include but not be limited to receipt of written
43 complaints, interviews of persons, patients, residents and of employees
44 and on-site monitoring of conditions. In addition, the commission shall
45 establish procedures for the speedy and impartial review of patient and
46 resident abuse and mistreatment allegations called to its attention in
47 writing.
48 2. With respect to reports of abuse or maltreatment of children in
49 residential care as defined in paragraph (g) of subdivision seven of
50 section four hundred twelve of the social services law and made pursuant
51 to title six of article six of such law except such facilities or
52 programs enumerated in paragraph (h) of subdivision seven of section
53 four hundred twelve of the social services law, in addition to complying
54 with requirements of applicable provisions of the social services law
55 and this subdivision, the commission shall:
S. 992 157 A. 1922
1 a. receive from the state central register of child abuse and
2 maltreatment on a twenty-four hour, seven day a week basis all reports
3 of suspected child abuse or maltreatment;
4 b. maintain and keep up-to-date a child abuse and maltreatment record
5 of all cases reported together with any additional information obtained
6 and a record of the final disposition of the report, including recommen-
7 dations by the commission and action taken with respect to the residen-
8 tial care facility or the subject of a report of child abuse or
9 maltreatment pursuant to section 16.29 or 29.29 of this chapter;
10 c. not later than seven days after receipt of such report, send a
11 preliminary written report of the initial investigation, including,
12 whenever practicable, an evaluation of whether or not such report
13 constitutes an allegation of child abuse or neglect and actions taken or
14 contemplated, to the state central register. If such initial investi-
15 gation results in a determination that the report does not constitute an
16 allegation of abuse or neglect, the commission shall refer such report
17 to the appropriate office of the department [of mental hygiene],
18 provided, however, that the name and other personally identifiable
19 information of the person making the report shall not be provided by the
20 commission unless such person authorizes such disclosure;
21 d. give telephone notice and forward immediately a copy of reports
22 made which involve the death of a child to the appropriate district
23 attorney. In addition, telephone notice shall be given and a copy of
24 all reports made shall be forwarded immediately by the commission to the
25 appropriate district attorney if a prior request in writing for such
26 notice and copies has been made to the commission by the district attor-
27 ney. Such request shall specify the kinds of allegations concerning
28 which the district attorney requires such notice and copies;
29 e. upon receipt of such report of child abuse or maltreatment,
30 commence within twenty-four hours, an appropriate investigation which
31 shall include but not be limited to an evaluation of the residential
32 care facility in which the child resides who is named in the report and
33 a determination of the risk to such child if he or she continues to
34 remain in the existing residential care facility as well as a determi-
35 nation of the nature, extent and cause of any condition enumerated in
36 such report and, after seeing to the safety of the child and, to the
37 maximum extent feasible, the other children in the facility forthwith:
38 (i) notify the subject of the report and other persons named in the
39 report in writing of the existence of the report and their respective
40 rights pursuant to title six of article six of the social services law
41 in regard to amendment; and (ii) notify the director or operator of the
42 residential facility and the office of mental health or the office of
43 mental retardation and developmental disabilities of the existence of
44 such report including the name of any child alleged to be abused or
45 maltreated, the name of the subject of the report of child abuse or
46 maltreatment, and any other information which may be necessary to assure
47 the health and safety of the children in the residential care facility;
48 f. comply with the terms and conditions for maintenance of confiden-
49 tial records and due process rights of the subject of the report of
50 child abuse or maltreatment pursuant to sections four hundred twenty-two
51 and four hundred twenty-four-a of the social services law;
52 g. determine within sixty days, whether the report is "indicated" or
53 "unfounded"; and
54 h. assist the criminal court during all stages of the court proceeding
55 in accordance with the purposes of title six of article six of the
56 social services law and other applicable provisions of law.
S. 992 158 A. 1922
1 3. Where the [department of social services] office of children and
2 family services determines that some credible evidence of the alleged
3 abuse or maltreatment exists, the commission shall recommend to the
4 office of mental health or the office of mental retardation and develop-
5 mental disabilities, as the case may be, that appropriate preventive and
6 remedial actions including legal actions, consistent with appropriate
7 collective bargaining agreements and applicable provisions of the civil
8 service law, and pursuant to standards of such offices, promulgated
9 pursuant to section 16.29 or 29.29 of this chapter and other applicable
10 provisions of law, be undertaken with respect to a residential care
11 facility and/or the subject of the report of child abuse or maltreat-
12 ment. However, nothing in this paragraph shall prevent the commission
13 from making recommendations, as provided for by this paragraph, even
14 though the investigation may fail to result in a determination that
15 there is some credible evidence of the alleged abuse or maltreatment.
16 4. In order to assure effective investigation of reports of child
17 abuse and maltreatment made pursuant to title six of article six of the
18 social services law, the commission shall establish standards for the
19 provision of training to its employees charged with the investigation of
20 such reports, in at least the following: (a) basic training in the prin-
21 ciples and techniques of investigation, including relationships with
22 other investigative bodies, (b) legal issues in child protection includ-
23 ing the legal rights of children, employees and volunteers, (c) methods
24 of identification, remediation, treatment and prevention, (d) safety and
25 security procedures, and (e) the principles of child development, the
26 characteristics of children in care, and techniques of group and child
27 management including crisis intervention. The commission shall take all
28 reasonable and necessary actions to assure that its employees are kept
29 apprised on a current basis of all department of mental hygiene policies
30 and procedures relating to the protection of children from abuse and
31 maltreatment.
32 5. The commission shall prepare an annual report to the governor and
33 legislature on the protection of children in residential care from abuse
34 and maltreatment, including the implementation of the provisions of this
35 paragraph and other applicable provisions of law, including reports
36 received, results of investigations by types of facilities, remedial
37 actions taken, and efforts undertaken by the office of mental health and
38 the office of mental retardation and developmental disabilities to
39 provide training pursuant to standards established by such offices
40 pursuant to section 16.29 or 29.29 of this chapter.
41 (d) Conduct periodic orientation, training and informational programs
42 upon appointment or reappointment, and as otherwise needed, to assist
43 the members of the boards of visitors to fulfill their responsibilities
44 pursuant to law.
45 (e) 1. Visit, inspect and appraise the management of mental hygiene
46 facilities with specific attention to the safety, security and quality
47 of care provided to patients and residents.
48 2. Provide staff and other necessary assistance upon request to boards
49 of visitors of department facilities in performing their duties pursuant
50 to law.
51 3. Receive and review periodic and annual reports of the boards of
52 visitors of each department facility.
53 4. Place such members of its staff as it deems appropriate as monitors
54 in any mental hygiene facility which, in the judgment of the commission,
55 presents an imminent danger to the health or safety of the patients,
56 residents or employees of such facility.
S. 992 159 A. 1922
1 (f) 1. Make a preliminary determination whether matters referred to
2 its attention warrant investigation and, if so, conduct an investigation
3 of such scope and duration as it deems necessary and proper.
4 2. Make findings concerning matters referred to its attention and,
5 where it deems appropriate, make a report and recommendations. Such
6 report shall be delivered to the commissioner and to the director of the
7 facility involved. Such commissioner and director shall each make a
8 written report of actions taken regarding each of the recommendations
9 within ninety days of receipt of the report. If such response indicates
10 that any of the recommendations have not been fully implemented, the
11 commission may require further periodic progress reports as it deems
12 appropriate. If it appears that a crime may have been committed, the
13 commission shall give notice thereof to the district attorney or other
14 appropriate law enforcement official.
15 (g) Make an annual report to the governor and legislature concerning
16 its work during the preceding year, and such further interim reports to
17 the governor, or to the governor and legislature, as it shall deem
18 advisable, or as shall be required by the governor.
19 (h) Accept, with the approval of the governor, as agent of the state
20 any grant, including federal grants, or any gift for any of the purposes
21 of this article. Any moneys so received may be expended by the commis-
22 sion to effectuate any purpose of this article, subject to the same
23 limitations as to approval of expenditures and audit as are prescribed
24 for state moneys appropriated for the purposes of this article.
25 (i) Enter into contracts with any person, firm, corporation, munici-
26 pality or governmental agency for the performance of functions author-
27 ized by law.
28 (j) Adopt, amend or rescind such rules and regulations as may be
29 necessary or convenient to the performance of the functions, powers and
30 duties of the commission.
31 (k) 1. Establish an adult home and residence for adults resident advo-
32 cacy program to assist residents, who have at any time received or are
33 receiving services from a mental hygiene provider, of adult homes and
34 residences for adults, as defined in section two of the social services
35 law, where at least twenty-five percent or [more] twenty-five residents,
36 whichever is less, have at any time received or are receiving services
37 from a mental hygiene provider which is licensed, operated or funded by
38 the office of mental health or office of mental retardation and develop-
39 mental disabilities, in understanding their legal rights, and to promote
40 and protect the rights of such residents. Based on the level of appro-
41 priations made available therefor, the [chairperson] chair of the
42 commission shall determine the feasibility of establishing such program
43 on a statewide basis or, if not so feasible, the [chairperson] chair,
44 after consultation with the commissioner of the department of [social
45 services] health, shall designate those regions in which such program
46 may be established.
47 2. In establishing such program, the commission shall provide grants
48 to non-profit organizations with expertise in providing advocacy
49 services to the persons with disabilities. Entities which are eligible
50 for funding pursuant to this subdivision must be independent of any
51 agency which provides treatment or care to residents of adult care
52 facilities and must have the capacity to protect and advocate for the
53 rights of residents of such facilities. Such grants shall be used to
54 expand the capacity of organizations to assist residents in understand-
55 ing their rights and to pursue administrative, legal or other remedies
56 on behalf of residents to assure the protection of their rights. Any
S. 992 160 A. 1922
1 organization receiving funding pursuant to this subdivision shall be
2 granted access to adult homes and residences for adults as defined in
3 section two of the social services law.
4 3. The commission shall, prior to making any grant pursuant to this
5 subdivision, receive assurances that such funds will be used to supple-
6 ment existing resources available to any such organization and that the
7 staff of such organization are trained or will be trained in matters
8 related to the rights of residents of adult homes and residences for
9 adults as defined in section two of the social services law and the
10 standards governing the operation of such facilities.
11 (l) Advise and assist persons with disabilities, family members, advo-
12 cates, service providers and community organizations in the formation of
13 strategies to identify and meet the needs of individuals with disabili-
14 ties for services, supports, and advocacy.
15 (m) Advise and assist the governor, the legislature and public and
16 private entities in the development and implementation of state policies
17 which meet the needs of persons with disabilities for services,
18 supports, and advocacy in a manner which is cost-effective and respect-
19 ful of the rights of persons with disabilities.
20 (n) Serve as a clearinghouse for information relating to services,
21 supports, and advocacy for persons with disabilities and provide a
22 statewide system of information and referral to link persons seeking
23 information and assistance with public and private sector services,
24 supports, and advocacy which may be appropriate to meet their needs.
25 (o) Advise and assist the governor, the legislature, state agencies,
26 persons with disabilities and public and private sector entities in the
27 design and implementation of initiatives to increase access to technolo-
28 gy related assistance for individuals with disabilities.
29 (p) Administer such protection and advocacy and client assistance
30 programs as may be established by federal law, pursuant to such authori-
31 zation or designation as may be required.
32 (q) Administer the surrogate decision-making committee program, as
33 authorized pursuant to article eighty of this chapter.
34 (r) Do all other things necessary or convenient to carry out its func-
35 tions, powers and duties set forth in this article.
36 § 7. Section 45.09 of the mental hygiene law, as added by chapter 655
37 of the laws of 1977, subdivision (a) as amended by chapter 734 of the
38 laws of 1994, subdivision (b) as added and subdivisions (c) and (d) as
39 relettered by chapter 184 of the laws of 1986, is amended to read as
40 follows:
41 § 45.09 Procedures of the commission.
42 (a) The commission, any member or any employee designated by the
43 [commission] chair, must be granted access at any and all times to any
44 mental hygiene facility, or adult home or residence for adults in which
45 at least twenty-five percent or [more] twenty-five residents, whichever
46 is less, have at any time received or are receiving services from a
47 mental hygiene provider which is licensed, operated or funded by the
48 office of mental health, or the office of mental retardation and devel-
49 opmental disabilities in order to carry out the functions of the commis-
50 sion as provided for by section 45.10 of this article, or part thereof,
51 and to all books, records, and data pertaining to any such facility
52 deemed necessary for carrying out the commission's functions, powers and
53 duties. The commission, any members or any employee designated by the
54 [chairman] chair may require from the officers or employees of such
55 facility or from the commissioners of the offices of the department of
56 mental hygiene or in the case of an adult home or residence for adults,
S. 992 161 A. 1922
1 from the officers or employees of an adult home or residence for adults
2 or from the department of [social services] health any information
3 deemed necessary for the purpose of carrying out the commission's func-
4 tions, powers and duties. The commission, [or] any member, or any
5 employee designated by the chair may require from any hospital, as
6 defined under article twenty-eight of the public health law, any infor-
7 mation, report or record necessary for the purpose of carrying out the
8 functions, powers and duties of the commission related to the investi-
9 gation of deaths and complaints of abuse or mistreatment concerning
10 patients or former patients of mental hygiene facilities who have been
11 treated at such hospitals, and from any adult care facility as defined
12 in paragraph twenty-one of section two of the social services law, such
13 information, report or record, including access to such facility neces-
14 sary for the purpose of carrying out the functions, powers and duties of
15 the commission related to the investigation of deaths, as provided for
16 by section 45.17 of this [chapter] article, concerning patients of
17 mental hygiene facilities who resided at such residential care facili-
18 ties at the time of their death or were former residents of such resi-
19 dential care facilities and the commission determines that such informa-
20 tion, report or record is necessary for the completion of its
21 investigation. The results of investigations involving such residents
22 of adult care facilities shall be provided promptly to the commissioner
23 of the department of [social services] health and shall be treated as a
24 record or personal information within the meaning of section ninety-six
25 of the public officers law and shall not be disclosed except in accord-
26 ance with such section ninety-six. Information, books, records or data
27 which are confidential as provided by law shall be kept confidential by
28 the commission and by non-profit organizations receiving contracts
29 pursuant to subdivision (k) of section 45.07 of this article and any
30 limitations on the release thereof imposed by law upon the party
31 furnishing the information, books, records or data shall apply to the
32 commission and such non-profit organizations receiving contracts pursu-
33 ant to subdivision (k) of section 45.07 of this article.
34 (b) Pursuant to the authorization of the commission to administer the
35 protection and advocacy system as provided for by federal law, any agen-
36 cy or person within or under contract with the commission which provides
37 protection and advocacy services must be granted access at any and all
38 times to any [residential] facility, or part thereof, serving a person
39 with a [mental] disability operated or licensed by any office or agency
40 of the state, and to all books, records, and data pertaining to any such
41 facility upon receipt of a complaint by or on behalf of a person with a
42 [mental] disability. Information, books, records or data which are
43 confidential as provided by law shall be kept confidential by the person
44 or agency within the protection and advocacy system and any limitations
45 on the release thereof imposed by law upon the party furnishing the
46 information, books, records or data shall apply to the person or agency
47 within the protection and advocacy system.
48 (c) In the exercise of its functions, powers and duties, the commis-
49 sion and any member is authorized to issue and enforce a subpoena and a
50 subpoena duces tecum, conduct hearings, administer oaths and examine
51 persons under oath, in accordance with and pursuant to civil practice
52 law and rules.
53 (d) In any case where a person in charge or control of such facility
54 or an officer or employee thereof shall fail to comply with the
55 provisions of subdivision (a) of this section, the commission may apply
56 to the supreme court for an order directed to such person requiring
S. 992 162 A. 1922
1 compliance therewith. Upon such application the court may issue such
2 order as may be just and a failure to comply with the order of the court
3 shall be a contempt of court and punishable as such.
4 § 8. Section 45.10 of the mental hygiene law, as amended by chapter 83
5 of the laws of 1995, is amended to read as follows:
6 § 45.10 Adult home and residence for adults special oversight authority.
7 (a) The commission shall have the following authority with respect to
8 adult homes or residences for adults, as defined by section two of the
9 social services law, where at least twenty-five percent or [more] twen-
10 ty-five of the residents, whichever is less, are persons who have at any
11 time received or are receiving services from a mental hygiene provider
12 which is licensed, operated or funded by the office of mental health or
13 the office of mental retardation and developmental disabilities.
14 (1) investigation of complaints regarding the quality of care, includ-
15 ing mental hygiene services, provided to such residents who had at any
16 time received or are receiving services from such mental hygiene provid-
17 er;
18 (2) examination of the programmatic and financial operations of such
19 adult homes or residences for adults; and
20 (3) examination of the programmatic and financial operations of
21 providers of mental hygiene services to residents of such homes or resi-
22 dences. Such financial audit shall only be conducted upon the approval
23 of the [chairperson] chair of the commission.
24 (b) Upon completion of any review or investigation conducted under
25 this section, the commission may make findings concerning such matters
26 referred to its attention and make a report and recommendations thereon
27 to the operator of such home and any appropriate commissioner of a state
28 agency. Such commissioner and operator shall make a written report of
29 actions taken regarding the recommendations of the commission within
30 ninety days of receipt of such report. The commission may require
31 further periodic reports as it deems appropriate.
32 § 9. Section 45.11 of the mental hygiene law, as added by chapter 349
33 of the laws of 1985, is amended to read as follows:
34 § 45.11 Advisory council to the commission.
35 (a) There shall be within the commission an advisory council consist-
36 ing of no less than fifteen members to be appointed by the governor,
37 with the advice and consent of the senate. Members shall be appointed on
38 the basis of their professional knowledge in the care and treatment of
39 [the mentally disabled] and in the provision of services, supports, and
40 advocacy to persons with disabilities or their active interest in the
41 system of services for [the mentally disabled] persons with
42 disabilities. In making such appointments, the governor shall endeavor
43 to insure the overall membership of the council adequately reflects the
44 programs and services within the commission's jurisdiction and that at
45 least one-half of the members are [patients, former patients, and
46 parents or relatives of patients or former patients] individuals or
47 parents or relatives of individuals who are or have participated in or
48 are or have been recipients of programs and services within the commis-
49 sion's jurisdiction. The council shall include but shall not be limited
50 to:
51 (i) members of boards of visitors appointed pursuant to articles seven
52 and thirteen of this chapter;
53 (ii) consumer representatives including patients, former patients, and
54 parents or relatives of patients or former patients who have received
55 services [for the mentally disabled] from a mental hygiene facility;
S. 992 163 A. 1922
1 (iii) providers of services to [the mentally disabled] persons with
2 mental or physical disabilities;
3 (iv) directors of psychiatric centers and developmental centers; and
4 (v) directors of community services or members of community services
5 boards.
6 (b) Members shall be appointed for terms of three years provided,
7 however, that of the members first appointed, one-third shall be
8 appointed for one-year terms and one-third shall be appointed for two-
9 year terms. A member may be removed by the governor for good cause after
10 notice and an opportunity to be heard on the charges. Vacancies shall be
11 filled in the same manner as original appointments for the remainder of
12 any unexpired term.
13 (c) The governor shall designate one member of the council as its
14 [chairman] chair to serve as such at the pleasure of the governor.
15 (d) Council members shall not receive compensation, but each member
16 shall be entitled to receive his or her reasonable and necessary
17 expenses incurred in connection with his or her services as a member
18 within the amounts appropriated therefor.
19 (e) The council shall have an executive secretary designated by the
20 [chairman] chair of the commission. The [chairman] chair of the commis-
21 sion may also assign such other commission officers and employees as the
22 council may from time to time require to assist it in the performance of
23 its duties.
24 (f) The council shall advise and assist the commission in developing
25 policies, plans and programs to carry out its functions, powers and
26 duties pursuant to this section. The council may consider any matter
27 related to improving the quality of [care provided to mentally disabled]
28 life of citizens of the state who have disabilities and shall advise the
29 commission on any such matter.
30 (g) The council shall meet at least four times a year. The council
31 shall meet at the request of its [chairman] chair or the [chairman]
32 chair of the commission.
33 § 10. Section 45.15 of the mental hygiene law, as amended by chapter
34 300 of the laws of 1989, is amended to read as follows:
35 § 45.15 Mental hygiene medical review board; organization.
36 (a) There shall be within the commission a mental hygiene medical
37 review board. The board shall be composed of up to fifteen members,
38 including specialists in forensic pathology, psychiatry and internal
39 medicine to be appointed by the governor. The governor shall designate
40 one of the members to serve as [chairman] chair of the board. Members
41 [currently appointed shall serve for terms expiring on July thirty-
42 first, nineteen hundred ninety. Upon the expiration of such terms,
43 members] shall be appointed for terms of three years [commencing on
44 August first, nineteen hundred ninety], provided, however, that one-
45 third of the members first appointed shall be appointed for a one year
46 term and one-third for two year terms. Vacancies shall be filled in the
47 same manner as original appointments for the remainder of any unexpired
48 term. Members shall continue in office after the expiration of their
49 terms until their successors have been appointed and qualified. The
50 governor may remove any member of the board whenever in his judgment the
51 public interest may require such removal. In case of such removal, the
52 governor shall file with the department of state a statement indicating
53 the cause for such removal. Notwithstanding any provision of law to the
54 contrary, the [chairman] chair of the board may appoint committees of
55 five or more members of the board and delegate in writing to any such
S. 992 164 A. 1922
1 committee the authority to perform the functions, powers and duties of
2 the board pursuant to section 45.17 of this [chapter] article.
3 (b) The members of the board shall receive no compensation for their
4 services but shall be reimbursed for their actual and necessary expenses
5 incurred in the performance of their duties.
6 (c) The board shall have an executive secretary and such officers and
7 employees as the [chairman] chair of the commission shall assign upon
8 request of the [chairman] chair of the board, to assist it in the
9 performance of its duties.
10 (d) All records of the proceedings, the deliberations of the mental
11 hygiene medical review board and any testimony given before the board
12 shall not be subject to disclosure under article thirty-one of the civil
13 practice law and rules.
14 (e) The board or any committee appointed by the [chairman] chair of
15 the board shall meet at the request of its [chairman] chair or the
16 [chairman] chair of the commission. Any member of the board who fails to
17 attend three consecutive meetings of the board or the committee to which
18 such member is assigned by the [chairman] chair of the board, unless
19 excused by the [chairman] chair of the board, shall be considered to
20 have vacated his or her office unless otherwise ordered by the governor.
21 The term of any such person appointed by the governor to fill such
22 vacancy shall be governed by the provisions of this section.
23 § 11. Subdivision (g) of section 80.03 of the mental hygiene law, as
24 added by chapter 354 of the laws of 1985, is amended to read as follows:
25 (g) "Commission" means the commission on quality of care [for the
26 mentally disabled] and advocacy for persons with disabilities.
27 § 12. Terms occurring in laws, contract and other documents. Whenever
28 the functions, powers, obligations, duties and officials relating to the
29 state commission on quality of care for the mentally disabled, the chair
30 of the state commission on quality of care for the mentally disabled,
31 the office of advocate for persons with disabilities or the state advo-
32 cate for persons with disabilities are referred to or designated in any
33 law, contract or document, such reference or designation shall be deemed
34 to refer to the appropriate functions, powers, obligations, duties and
35 the chair and officials of the state commission on quality of care and
36 advocacy for persons with disabilities as redesignated by this act, as
37 applicable.
38 § 13. Existing rights and remedies preserved. No existing right or
39 remedy of any character shall be lost, impaired or affected by reason of
40 this act.
41 § 14. Transfer of authority, administration and appropriations.
42 1. The state advocate for persons with disabilities shall provide for
43 the orderly transfer of all matters, records and things relating to the
44 office.
45 2. The director of the budget is hereby authorized to transfer to the
46 state commission on quality of care and advocacy for persons with disa-
47 bilities, for use by the commission, funds otherwise appropriated or
48 reappropriated to the office of advocate for persons with disabilities
49 consistent with the purposes of this act.
50 § 15. Transfer of employees. Upon the repeal of article 43 of the
51 executive law pursuant to section one of this act, employees of the
52 office of advocate for persons with disabilities shall be transferred to
53 the state commission on quality of care and advocacy for persons with
54 disabilities in accordance with section 70 of the civil service law.
55 § 16. Federal laws. Notwithstanding any other law, rule or regulation
56 to the contrary, effective April 1, 2005, the chair of the state commis-
S. 992 165 A. 1922
1 sion on quality of care and advocacy for persons with disabilities shall
2 be the designee of the state of New York for the purpose of carrying
3 into effect any provisions of federal laws relating to the functions,
4 powers, duties and obligations of the office of advocate for persons
5 with disabilities hereby assigned to the state commission on quality of
6 care and advocacy for persons with disabilities and any federal funds
7 applicable to appropriations to the office of advocate for persons with
8 disabilities for such functions, powers, duties and obligations may be
9 made available to the state commission on quality of care and advocacy
10 for persons with disabilities subject to the approval of the director of
11 the budget.
12 § 17. Continuation of rules and regulations. All rules, regulations,
13 acts, determinations, and decisions of the state advocate for persons
14 with disabilities with respect to the functions, powers, duties and
15 obligations of the office of advocate for persons with disabilities in
16 force and effect on March 31, 2005 shall continue in force and effect as
17 rules, regulations, acts, determinations and decisions of the chair of
18 the state commission on quality of care and advocacy for persons with
19 disabilities until amended or revised by said chair.
20 § 18. Completion of unfinished business. Any business or other matter
21 undertaken or commenced by the office of advocate for persons with disa-
22 bilities relating to the functions, powers, duties, and obligations of
23 the office pending on April 1, 2005 shall be continued by the state
24 commission on quality of care and advocacy for persons with disabili-
25 ties.
26 § 19. This act shall take effect immediately and shall be deemed to
27 have been in full force and effect on and after April 1, 2005.
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 F of this act shall be
39 as specifically set forth in the last section of such Parts.