A06527 Summary:

BILL NO    A06527A

SAME AS    SAME AS S04196-A

SPONSOR    Rodriguez

COSPNSR    Rivera, Colton, Weprin, Raia, Duprey, Montesano, Heastie, Crespo

MLTSPNSR   Brook-Krasny, Camara, Crouch, Johns, Magee, Malliotakis, McDonough,
           Moya, Tenney

Add Art 2-B SS290 - 293, Pub Health L; amd S367-b, Soc Serv L

Establishes the Medicaid identification and anti-fraud biometric technology
pilot program.
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A06527 Actions:

BILL NO    A06527A

04/04/2013 referred to health
01/08/2014 referred to health
01/23/2014 amend and recommit to health
01/23/2014 print number 6527a
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A06527 Text:

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________

                                        6527--A

                              2013-2014 Regular Sessions

                                 I N  A S S E M B L Y

                                     April 4, 2013
                                      ___________

       Introduced  by M. of A. RODRIGUEZ, RIVERA, COLTON, WEPRIN, RAIA, DUPREY,
         MONTESANO, HEASTIE, CRESPO -- Multi-Sponsored by -- M. of A.  BOYLAND,
         BROOK-KRASNY,  CAMARA,  CROUCH,  JOHNS, MAGEE, MALLIOTAKIS, McDONOUGH,
         MOYA, TENNEY -- read once and referred to the Committee on  Health  --
         recommitted  to  the  Committee  on Health in accordance with Assembly
         Rule  3,  sec.  2  --  committee  discharged,  bill  amended,  ordered
         reprinted as amended and recommitted to said committee

       AN  ACT  to amend the public health law, in relation to establishing the
         Medicaid identification  and  anti-fraud  biometric  technology  pilot
         program; and to amend the social services law, in relation to conform-
         ing medical assistance identification with the Medicaid identification
         and  anti-fraud  biometric technology program; and making an appropri-
         ation therefor

         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:

    1    Section  1.  The  public health law is amended by adding a new article
    2  2-B to read as follows:
    3                                  ARTICLE 2-B
    4              MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
    5                          TECHNOLOGY PILOT PROGRAM
    6  SECTION 290. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
    7                 PILOT PROGRAM.
    8          291. DEFINITIONS.
    9          292. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
   10          293. RULES AND REGULATIONS.
   11    S 290. MEDICAID IDENTIFICATION  AND  ANTI-FRAUD  BIOMETRIC  TECHNOLOGY
   12  PILOT  PROGRAM.  THERE IS HEREBY ESTABLISHED THE MEDICAID IDENTIFICATION
   13  AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PILOT PROGRAM.
   14    S 291. DEFINITIONS. AS USED IN THIS ARTICLE:
   15    1. "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND  ANALYZES
   16  BIOLOGICAL  DATA,  INCLUDING  BUT  NOT  LIMITED  TO DNA, FINGER IMAGING,

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD09632-03-4
       A. 6527--A                          2

    1  VASCULAR PATTERNS,  EYE  RETINAS  AND  IRISES,  VOICE  PATTERNS,  FACIAL
    2  PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.
    3    2.    "BIOMETRIC  VERIFICATION DEVICE" MEANS A DEVICE CAPABLE OF USING
    4  BIOMETRIC VERIFICATION TECHNOLOGY TO VERIFY THE IDENTITY OF  A  MEDICAID
    5  RECIPIENT OR PROVIDER.
    6    S  292.  BIOMETRIC  TECHNOLOGY  USE REQUIREMENT. 1. THE DEPARTMENT, IN
    7  CONSULTATION WITH THE OFFICE OF THE MEDICAID INSPECTOR GENERAL  AND  THE
    8  OFFICE OF THE ATTORNEY GENERAL, SHALL DEVELOP A REQUEST FOR PROPOSALS TO
    9  IMPLEMENT  A PROGRAM AUTHORIZING THE USE OF BIOMETRIC TECHNOLOGY FOR THE
   10  PURPOSES OF PATIENT AND PROVIDER IDENTIFICATION AND FOR USE AS AN  ANTI-
   11  FRAUD APPLICATION IN THE MEDICAID PROGRAM.
   12    2.  SUCH  REQUEST  FOR  PROPOSALS  SHALL INCLUDE AT A MINIMUM THAT (A)
   13  MEDICAID RECIPIENTS AND PROVIDERS SHALL PROVIDE BIOMETRIC PROOF OF THEIR
   14  IDENTITY ALONG WITH OTHER INFORMATION DEEMED NECESSARY  BY  THE  COMMIS-
   15  SIONER.
   16    (B)  SUCH  PROGRAM  WILL BE CAPABLE OF STORING BIOMETRIC MARKERS AND A
   17  LOG OF DOCTOR AND PHARMACY VISITS FOR EACH SERVICE BILLED TO  THE  MEDI-
   18  CAID PROGRAM.
   19    (C)  MEDICAID  IDENTIFICATION  SHALL  BE ISSUED TO AND ACCEPTED BY THE
   20  ADMITTING STAFF OF THE HEALTH CARE FACILITY.
   21    (D) MEDICAID RECIPIENTS SHALL BE REQUIRED TO PROVIDE  BIOMETRIC  PROOF
   22  OF  IDENTITY  AT THE TIME OF EACH VISIT TO A DOCTORS OFFICE OR CLINIC AT
   23  THE POINT OF ACTUALLY BEING SEEN BY THE DOCTOR OR  CLINICAL  STAFF,  AND
   24  SHALL  AGAIN  PROVIDE  PROOF  OF  IDENTITY  UPON  COMPLETION  OF CARE OR
   25  SERVICES.
   26    (E)  PROVISIONS  SHALL  BE  INCLUDED   FOR   EMERGENCY   SERVICES   OR
   27  PRESCRIPTIONS  AND ALTERNATE IDENTIFICATION METHODS FOR MEDICAID RECIPI-
   28  ENTS PHYSICALLY OR MENTALLY UNABLE TO PROVIDE BIOMETRIC IDENTIFICATION.
   29    (F) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
   30  USED TO OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC TECHNOLOGY SHALL
   31  PREVENT AND/OR REJECT THE PAYMENT BY THE MEDICAID PROGRAM AND ALERT  THE
   32  SERVICE  PROVIDER  AT  POINT  OF  SERVICE IF FRAUD OR POTENTIAL FRAUD IS
   33  IDENTIFIED BY THE BIOMETRIC TECHNOLOGY SYSTEM.
   34    (G) PROVISIONS SHALL BE INCLUDED TO ENSURE  THAT  MEDICAID  RECIPIENTS
   35  HAVE  ACCESS  TO  EMERGENCY  HEALTH  SERVICES IN THE CASE OF A BIOMETRIC
   36  TECHNOLOGY SYSTEM MALFUNCTION OR FRAUD DETECTION ALARM.
   37    (H) EVALUATION AND SELECTION OF AN IDENTITY CREDENTIALING SYSTEM  THAT
   38  ADDRESSES THE REQUIREMENTS OF MEDICAID BENEFICIARIES AND PROVIDERS SHALL
   39  BE  BASED  ON  THE  FOLLOWING  CRITERIA:  SECURITY,  PRIVACY, USABILITY,
   40  PERFORMANCE, HYGIENE, BIOMETRIC CAPTURE AND  STORAGE  REQUIREMENTS,  AND
   41  INTEROPERABILITY.
   42    (I)  SUCH PROGRAM SHALL BE OPERATIONAL WITHIN TWELVE MONTHS OF PROGRAM
   43  APPROVAL AND WILL OPERATE FOR THREE YEARS.
   44    3. SUCH REQUEST FOR PROPOSALS SHALL SET FORTH REQUIREMENTS AS  TO  THE
   45  RESULTS AND GOALS TO BE ACHIEVED, RATHER THAN SPECIFIC TECHNICAL METHODS
   46  OR  SYSTEMS,  TO  ALLOW  CONSIDERATION  OF THE WIDEST POSSIBLE CHOICE OF
   47  AVAILABLE TECHNOLOGY.
   48    4. SUCH REQUEST FOR PROPOSALS SHALL  REQUIRE:  (A)  THAT  THE  PROGRAM
   49  SHALL  BE  REVENUE NEUTRAL FROM INCEPTION, WHEREBY ANY PROGRAM COSTS ARE
   50  AT LEAST OFFSET BY STATE MEDICAID SAVINGS, AND SHALL HAVE AS  A  PRIMARY
   51  GOAL REDUCTION OF MEDICAID EXPENDITURES THROUGH ELIMINATION OF FRAUD AND
   52  ABUSE;  AND (B) THAT THE PROGRAM SHALL BE COST NEUTRAL TO PROVIDERS FROM
   53  INCEPTION, WHEREBY ANY PROVIDER COSTS ARE AT LEAST  OFFSET  BY  PROVIDER
   54  SAVINGS,  AND  SHALL  HAVE  AS  A  PRIMARY GOAL PROVIDER SAVINGS THROUGH
   55  INCREASED EFFICIENCIES.
       A. 6527--A                          3

    1    5. (A) SUCH REQUEST FOR PROPOSALS FOR THE IMPLEMENTATION OF A  PROGRAM
    2  FOR  BIOMETRIC  TECHNOLOGY  USE  SHALL BE PUBLISHED ON OR BEFORE JANUARY
    3  FIFTEENTH, TWO THOUSAND SIXTEEN, AND SHALL PROVIDE THAT PROPOSALS  SHALL
    4  BE OPENED ON OR BEFORE MARCH FIRST, TWO THOUSAND SIXTEEN.
    5    (B) THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRES-
    6  IDENT  OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, AND THE CHAIRS OF THE
    7  SENATE AND ASSEMBLY HEALTH COMMITTEES ON OR BEFORE MARCH THIRTIETH,  TWO
    8  THOUSAND  SIXTEEN WITH REGARD TO THE PROGRESS MADE IN THE DEVELOPMENT OF
    9  CRITERIA FOR A PROGRAM OF BIOMETRIC IDENTIFICATION AND OF THE  IMPLEMEN-
   10  TATION OF SUCH PROGRAM.
   11    6.    THE COMMISSIONER SHALL, UPON SUBMISSION OF SATISFACTORY EVIDENCE
   12  OF COMPLIANCE WITH THE PROVISIONS OF THIS TITLE,  APPROVE  TWO  MEDICAID
   13  IDENTIFICATION  AND  ANTI-FRAUD BIOMETRIC TECHNOLOGY PILOT PROGRAMS, ONE
   14  TO BE LOCATED IN AN UPSTATE HOSPITAL AND ONE TO BE LOCATED  IN  A  DOWN-
   15  STATE HOSPITAL.
   16    7.  EACH  HOSPITAL WILL BE APPROPRIATED THREE HUNDRED THOUSAND DOLLARS
   17  TO ASSIST IN ENABLING THE MEDICAID IDENTIFICATION AND ANTI-FRAUD  BIOME-
   18  TRIC TECHNOLOGY PILOT PROGRAM.
   19    S  293.  RULES  AND  REGULATIONS.  THE  COMMISSIONER IS AUTHORIZED AND
   20  DIRECTED TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY  DEEM
   21  NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
   22    S  2.    Subdivision 1 of section 367-b of the social services law, as
   23  added by chapter 639 of the laws of 1976, is amended to read as follows:
   24    1. The department, IN CONSULTATION WITH THE  COMMISSIONER  OF  HEALTH,
   25  shall  design  and  implement a statewide medical assistance information
   26  and payments system for the purpose of providing individual  and  aggre-
   27  gate  data  to  social services districts to assist them in making basic
   28  management decisions, to the department  and  other  state  agencies  to
   29  assist  in  the administration of the medical assistance program, and to
   30  the governor and the legislature as may be necessary to assist in making
   31  major administrative and policy decisions affecting such program.   Such
   32  system shall be designed so as to be capable of the following:
   33    a. receiving and processing information relating to the eligibility of
   34  each  person  applying  for  medical assistance and of issuing a medical
   35  assistance identification card, AND WHEN AVAILABLE UTILIZING THE  BIOME-
   36  TRIC  IDENTIFICATION  ISSUED  BY THE DEPARTMENT OF HEALTH, CONFORMING TO
   37  THE REQUIREMENTS SET FORTH IN THE MEDICAID IDENTIFICATION AND ANTI-FRAUD
   38  BIOMETRIC TECHNOLOGY PILOT PROGRAM ESTABLISHED PURSUANT TO ARTICLE TWO-B
   39  OF THE PUBLIC HEALTH LAW to persons  determined  by  a  social  services
   40  official to be eligible for such assistance;
   41    b.    ACTIVATING  MEDICAL  ASSISTANCE  IDENTIFICATION  BY REQUIRING AN
   42  APPLICANT RECEIVING SUCH IDENTIFICATION FROM THE DEPARTMENT TO  HAVE  IT
   43  VERIFIED  AT  A  SOCIAL  SERVICES DISTRICT OFFICE IN THE SOCIAL SERVICES
   44  DISTRICT IN WHICH THE APPLICANT RESIDES;
   45    C. receiving and processing information  relating  to  each  qualified
   46  provider of medical assistance furnishing care, services or supplies for
   47  which claims for payment are made pursuant to this title;
   48    [c.]  D.  receiving and processing, in a form and manner prescribed by
   49  the department, all claims for medical care, services and supplies,  and
   50  making  payments for valid claims to providers of medical care, services
   51  and supplies on behalf of social services districts; AND
   52    [d.] E. maintaining information necessary  to  allow  the  department,
   53  consistent  with  the  powers and duties of the department of health, to
   54  review the appropriateness, scope and duration of medical care, services
   55  and supplies provided to any eligible person pursuant to  this  chapter;
   56  and
       A. 6527--A                          4

    1    [e.]  F.  initiating  implementation of such a system for the district
    2  comprising the city of New York, in a manner compatible  with  expansion
    3  of  such system to districts other than the district comprising the city
    4  of New York.
    5    S  3.   The sum of six hundred thousand dollars ($600,000), or so much
    6  thereof as may be necessary, is hereby appropriated to the department of
    7  health out of any moneys in the state treasury in the  general  fund  to
    8  the credit of the Medicaid identification and anti-fraud biometric tech-
    9  nology  pilot  program, not otherwise appropriated, and made immediately
   10  available, for the purpose of carrying out the provisions of  this  act.
   11  Such moneys shall be payable on the audit and warrant of the comptroller
   12  on  vouchers  certified  or  approved by the department of health in the
   13  manner prescribed by law.
   14    S 4.  This act shall take effect immediately.
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