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A09205 Summary:

BILL NO    A09205 

SAME AS    SAME AS UNI. S06914

SPONSOR    Budget

COSPNSR    

MLTSPNSR   

Amd Various Laws, generally

amends part C of chapter 58 of the laws of 2008, amending the social services
law and the public health law relating to adjustments of rates, in relation to
extending the utilization threshold exemption; amends chapter 19 of the laws of
1998, amending the social services law relating to limiting the method of
payment for prescription drugs under the medical assistance program, in
relation to extending provisions related to dispensing fees; relates to rates
of payment to residential health care facilities; amends chapter 731 of the
laws of 1993, amending the public health law and other laws relating to
reimbursement, delivery and capital cost of ambulatory health care services and
inpatient hospital services, in relation to the effectiveness thereof; amends
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; provides for the repeal of certain provisions
relating to the availability of funds upon expiration thereof; repeals certain
provisions of the social services law and the public health law relating
thereto (Part C); relates to the practice of pharmacy and the compounding of
drugs and establishes requirements for the registration of outsourcing
facilities in New York state (Part D); relates to establishing an integrated
employment plan (Part E); directs a report by the office for people with
developmental disabilities on the establishment of a direct support
professional credentialing pilot program (Part F); relates to community mental
health support and workforce reinvestment funds; amends chapter 62 of the laws
of 2003, amending the mental hygiene law and the state finance law relating to
the community mental health support and workforce reinvestment program, the
membership of subcommittees for mental health of community services boards and
the duties of such subcommittees and creating the community mental health and
workforce reinvestment account, in relation to extending such provisions
relating thereto (Part G); relates to establishing protections to prevent
surprise medical bills including network adequacy requirements, claim
submission requirements, access to out-of-network care and prohibition of
excessive emergency charges (Part H); amends chapter 57 of the laws of 2006,
relating to establishing a cost of living adjustment for designated human
services programs, in relation to forgoing such adjustment during the 2014-2015
state fiscal year (Part I).
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A09205 Text:

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

           S. 6914                                                  A. 9205

                             S E N A T E - A S S E M B L Y

                                    March 29, 2014
                                      ___________

       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 prenatal clinical
         health care services; to amend the public health law, in  relation  to
         simplifying  consent  for HIV testing; to amend the public health law,
         in relation to authorization  for  data  sharing  with  providers  for
         purposes of patient linkage and retention in care; to amend the public
         health  law, in relation to biennial reports for the control of malig-
         nant diseases; to amend the state finance  law,  in  relation  to  the
         breast  cancer research and education fund; to amend the public health
         law, and the state finance law, in relation to  the  cancer  detection
         and education program advisory counsel; to amend the vehicle and traf-
         fic  law,  in  relation  to a distinctive "drive for the cure" license
         plate; to amend the tax law, in relation to the gift for prostate  and
         testicular  research and education; to amend the public health law, in
         relation to the capital restructuring financing program; to amend  the
         public  health  law,  in  relation to delivery system reform incentive
         payments; to amend the public health  law,  in  relation  to  eligible
         applicants  for  the  Medicaid redesign team initiatives; to amend the
         state finance law, in relation to the Alzheimer's  disease  assistance
         fund;  to  amend  the  public health law, in relation to participating
         borrowers; to amend the elder law, in relation to program  eligibility
         for catastrophic coverage; to amend the public health law, in relation
         to the primary care service corps practitioner loan repayment program;
         to  amend the public health law, in relation to evaluating the state's
         health information technology infrastructure and systems; to amend the
         public health law, in relation to the establishment  of  certain  free
         standing  clinics,  outpatient  health  care facilities and ambulatory
         health care centers in the county of Bronx; in  relation  to  payments
         submitted  by  early  intervention  providers  to  certain third party
         payors; to amend the public health  law  and  the  insurance  law,  in
         relation  to safe patient handling; to amend the public health law and

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD12676-01-4
       S. 6914                             2                            A. 9205

         the social services law, in relation to  review  of  criminal  history
         information  concerning  prospective  employees;  to  amend the public
         health law, in relation to the provision of contact information relat-
         ing  to  long  term care; to amend the public health law and the state
         finance law, in relation to the operation of the New York State donate
         life registry; to amend the social services law and the public  health
         law,  in  relation  to  streamlining the application process for adult
         care facilities and assisted living residences; to  amend  the  public
         health  law, in relation to the long term home health care program; to
         amend the public health law, in relation to resident  working  audits;
         to  amend  chapter  58  of the laws of 2008 amending the elder law and
         other laws relating to reimbursement to particular provider pharmacies
         and prescription drug coverage, in relation to the effectiveness ther-
         eof; and to repeal certain provisions of the public health law and the
         state finance law relating thereto (Part A); to  amend  the  New  York
         Health  Care  Reform  Act  of  1996,  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  the  distrib-
         ution  of  pool  allocations  and graduate medical education; to amend
         chapter 62 of the laws of 2003 amending the general business  law  and
         other  laws  relating to enacting major components necessary to imple-
         ment the state fiscal plan for  the  2003-04  state  fiscal  year,  in
         relation  to  the deposit of certain funds; to amend the public health
         law, in relation to health  care  initiative  pool  distributions;  to
         amend  the  social  services  law,  in  relation  to extending payment
         provisions for general hospitals; 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 the effectiveness of such chapter; to amend chapter 520 of the laws
         of 1978 relating to providing for a  comprehensive  survey  of  health
         care financing, education and illness prevention and creating councils
         for the conduct thereof, in relation to extending the effectiveness of
         portions  thereof;  to  amend  the  public  health law, in relation to
         extending access to community health care services in rural areas;  to
         amend  the  public  health  law,  in  relation to rates of payment for
         personal care service providers; to amend the public  health  law,  in
         relation  to  the  assessment  on  covered  lives; to amend the public
         health law, in relation to the comprehensive diagnostic and  treatment
         centers  indigent  care  program;  to  amend the public health law, in
         relation to general hospital indigent pool and general hospital  inpa-
         tient  reimbursement  rates;  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; and to amend chapter
         63 of the laws of 2001 amending chapter 20 of the laws of 2001  amend-
         ing  the military law and other laws relating to making appropriations
         for the support of government, in relation to extending  the  applica-
         bility  of  certain  provisions  thereof (Part B); to amend the social
         services law, in relation to eliminating prescriber prevails for brand
         name drugs with  generic  equivalents;  directing  the  department  of
         health to develop new methodology for pharmacy reimbursement; to amend
         the public health law, in relation to minimum supplemental rebates for
         pharmaceutical  manufacturers;  to  amend  the social services law, in
         relation to  early  refill  of  prescriptions;  to  amend  the  social
         services  law,  in relation to emergency and non-emergency transporta-
       S. 6914                             3                            A. 9205

         tion; to amend section 45-c of part A of chapter 56  of  the  laws  of
         2013,  relating  to  the report on the transition of behavioral health
         services as a managed care benefit in the medical assistance  program,
         in  relation to reports on the transition of behavior health services;
         to amend the social services law, in relation to  the  integration  of
         behavioral  and  physical  health  clinic services; to amend part A of
         chapter 56 of the laws of 2013 amending chapter 59 of the laws of 2011
         amending the public health law and  other  laws  relating  to  general
         hospital  reimbursement  for annual rates relating to the cap on local
         Medicaid expenditures, in relation to  establishing  rate  protections
         for behavioral health essential providers and the effectiveness there-
         of;  to  amend section 1 of part H of chapter 111 of the laws of 2010,
         relating to increasing Medicaid payments to providers through  managed
         care organizations and providing equivalent fees through an ambulatory
         patient  group  methodology,  in relation to transfer of funds and the
         effectiveness thereof; to amend the social services law,  in  relation
         to spousal support for the costs of community-based long term care; to
         amend the social services law, in relation to fair hearings within the
         Fully  Integrated  Duals Advantage program; to amend the public health
         law, in relation to the establishment of a default  rate  for  nursing
         homes  under managed care; to amend the public health law, in relation
         to rates of payment for certified home health agencies and  long  term
         home health care programs; to amend social services law in relation to
         Community  First  Choice Option; to amend education law in relation to
         developing training curricula to educate certain home health aides; to
         amend public health law in relation to Development Disabilities  Indi-
         vidual  Care and Support Organization; to amend the public health law,
         in relation to rate setting methodologies for the ICD-10; to amend the
         public health law, in relation to inpatient psych base years; to amend
         the public health law, in relation to specialty inpatient base  years;
         to  amend  the  public health law, in relation to inpatient psych base
         years; to amend the public health law, in relation to  hospital  inpa-
         tient  base  years; to amend part H of chapter 59 of the laws of 2011,
         amending the public health law and other laws relating  to  known  and
         projected  department  of  health state fund medicaid expenditures, in
         relation to the determination of rates of payments  by  certain  state
         governmental agencies; to amend the social services law and the public
         health  law,  in relation to requiring the use of an enrollment broker
         for counties that are mandated Medicaid managed care and managed  long
         term care; to amend the public health law, in relation to establishing
         vital  access  pools for licensed home care service agencies; to amend
         the social services law, in relation to the expansion of the  Medicaid
         managed  care  advisory review panel; to amend part H of chapter 59 of
         the laws of 2011 amending the public health law  relating  to  general
         hospital  inpatient reimbursement for annual rates, in relation to the
         across the board reduction of 2011; to amend the social services  law,
         in  relation  to  establishing  a health homes criminal justice initi-
         ative; to amend the social services law, in relation to the transition
         of children in foster care  to  managed  care;  to  amend  the  social
         services  law and the state finance law, in relation to the establish-
         ment of a basic health plan; to amend  the  social  services  law,  in
         relation to hospital presumptive eligibility under the affordable care
         act;  to  amend  the  state finance law, in relation to a basic health
         program trust fund and a state  health  innovation  plan  account;  to
         amend the social services law, in relation to spending down procedures
         under  the  MAGI  system  of  eligibility  determination; to amend the
       S. 6914                             4                            A. 9205

         public health law, in relation to moving rate setting for child health
         plus to the department of health; to amend the public health  law,  in
         relation to eliminating the existing child health plus waiting period;
         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 allowing for the permanent expansion  of  child  health
         plus  income and benefit provisions; to amend the public health law in
         relation to potentially preventable negative outcomes;  to  amend  the
         public  health law, in relation to a rural dentistry pilot program; to
         amend chapter 779 of the laws of 1986, amending  the  social  services
         law relating to authorizing services for non-residents in adult homes,
         residences  for  adults  and enriched housing programs, in relation to
         extending the authorization  of  non-resident  services  within  adult
         homes; to amend part C of chapter 58 of the laws of 2008, amending the
         social  services law and the public health law relating to adjustments
         of  rates,  in  relation  to  extending  the   utilization   threshold
         exemption;  to  amend  chapter  19  of  the laws of 1998, amending the
         social services law relating to limiting the  method  of  payment  for
         prescription  drugs  under the medical assistance program, in relation
         to extending provisions related  to  dispensing  fees;  to  amend  the
         public  health  law,  in  relation  to rates of payment to residential
         health care facilities; to amend chapter 731  of  the  laws  of  1993,
         amending  the  public health law and other laws relating to reimburse-
         ment, delivery and capital cost of ambulatory health care services and
         inpatient hospital services, 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;  providing
         for  the  repeal of certain provisions relating to the availability of
         funds upon expiration thereof; providing for  the  repeal  of  certain
         provisions relating to the availability of funds upon expiration ther-
         eof;  and  to repeal certain provisions of the social services law and
         the public health law relating thereto (Part C); to amend  the  educa-
         tion  law  and  the  public health law, in relation to the practice of
         pharmacy and the compounding of drugs, and  establishing  requirements
         for the registration of outsourcing facilities in New York state (Part
         D);  to  amend  the mental hygiene law, in relation to establishing an
         integrated employment plan (Part E); directing a report by the  office
         for  people  with developmental disabilities on the establishment of a
         direct support professional credentialing pilot program (Part  F);  to
         amend the mental hygiene law and the state finance law, in relation to
         community  mental health support and workforce reinvestment funds; and
         to amend chapter 62 of the laws of 2003, amending the  mental  hygiene
         law  and the state finance law relating to the community mental health
         support and workforce reinvestment program, the membership of  subcom-
         mittees  for mental health of community services boards and the duties
         of such subcommittees and creating the  community  mental  health  and
         workforce   reinvestment   account,  in  relation  to  extending  such
         provisions relating thereto (Part G); to amend the insurance law,  the
         public  health  law  and  the  financial  services law, in relation to
         establishing protections to prevent surprise medical  bills  including
         network  adequacy  requirements, claim submission requirements, access
         to out-of-network care and prohibition of excessive emergency  charges
         (Part  H);  and  to  amend chapter 57 of the laws of 2006, relating to
         establishing a cost of living adjustment for designated human services
       S. 6914                             5                            A. 9205

         programs, in relation to forgoing such adjustment during the 2014-2015
         state fiscal year (Part I)

         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 2014-2015
    3  state  fiscal  year.  Each  component  is wholly contained within a Part
    4  identified as Parts A through I. The effective date for each  particular
    5  provision contained within such Part is set forth in the last section of
    6  such Part. Any provision in any section contained within a Part, includ-
    7  ing the effective date of the Part, which makes a reference to a section
    8  "of  this  act", when used in connection with that particular component,
    9  shall be deemed to mean and refer to the corresponding  section  of  the
   10  Part  in  which  it  is  found. Section three of this act sets forth the
   11  general effective date of this act.

   12                                   PART A

   13    Section 1. Paragraph (a) of subdivision 1 of section 602 of the public
   14  health law, as added by section 16 of part E of chapter 56 of  the  laws
   15  of 2013, is amended to read as follows:
   16    (a)  Family  health, which shall include activities designed to reduce
   17  perinatal, infant and maternal mortality and morbidity  and  to  promote
   18  the health of infants, children, adolescents, and people of childbearing
   19  age.  Such  activities  shall include family centered perinatal services
   20  and other services appropriate to promote the birth of a healthy baby to
   21  a healthy mother, and services to assure that infants,  young  children,
   22  and  school  age  children  are enrolled in appropriate health insurance
   23  programs and other health benefit programs for which they are  eligible,
   24  and  that  the  parents  or guardians of such children are provided with
   25  information concerning health care providers  in  their  area  that  are
   26  willing  and able to provide health services to such children. Provision
   27  of primary and preventive clinical health care services shall be  eligi-
   28  ble  for  state  aid  for uninsured persons under the age of twenty-one,
   29  provided that the municipality makes good faith efforts to  assist  such
   30  persons with insurance enrollment and only until such time as enrollment
   31  becomes  effective.  PROVISION OF PRENATAL CLINICAL HEALTH CARE SERVICES
   32  SHALL BE ELIGIBLE FOR STATE AID FOR UNINSURED WOMEN OF ANY AGE, PROVIDED
   33  THAT THE MUNICIPALITY MAKES GOOD FAITH EFFORTS TO ASSIST SUCH WOMEN WITH
   34  INSURANCE ENROLLMENT AND ONLY UNTIL  SUCH  TIME  AS  ENROLLMENT  BECOMES
   35  EFFECTIVE.
   36    S  2. Subdivisions 1, 2, 2-a, 2-b, 2-c, 3 and 4 of section 2781 of the
   37  public health law, subdivisions 1, 2, 3 and 4 as  amended  and  subdivi-
   38  sions  2-a, 2-b and 2-c as added by chapter 308 of the laws of 2010, are
   39  amended to read as follows:
   40    1. Except as provided in section three thousand one hundred twenty-one
   41  of the civil practice law and rules, or  unless  otherwise  specifically
   42  authorized  or required by a state or federal law, no person shall order
   43  the performance of an HIV related test  without  first  having  received
   44  [the  written  or, where authorized by this subdivision, oral,] informed
   45  consent of the subject of the test who has capacity to consent or,  when
   46  the  subject  lacks capacity to consent, of a person authorized pursuant
   47  to law to consent to health care for such individual.   [When  the  test
       S. 6914                             6                            A. 9205

    1  being ordered is a rapid HIV test, such informed consent may be obtained
    2  orally  and  shall  be  documented  in the subject of the test's medical
    3  record by the person ordering the performance of the test.] IN ORDER FOR
    4  THERE  TO BE INFORMED CONSENT, THE PERSON ORDERING THE TEST SHALL, PRIOR
    5  TO OBTAINING INFORMED CONSENT, AT A MINIMUM ADVISE THE  PROTECTED  INDI-
    6  VIDUAL THAT AN HIV-RELATED TEST IS BEING PERFORMED.
    7    2.  [Except  where  subdivision  one  of this section permits informed
    8  consent to be obtained orally, informed consent to HIV  related  testing
    9  shall consist of a statement consenting to HIV related testing signed by
   10  the subject of the test who has capacity to consent or, when the subject
   11  lacks  capacity  to  consent,  by a person authorized pursuant to law to
   12  consent to health care for the subject after the subject or  such  other
   13  person  has  received  the information described in subdivision three of
   14  this section.
   15    2-a. Where a written consent to HIV related testing is included  in  a
   16  signed general consent to medical care for the subject of the test or in
   17  a signed consent to any health care service for the subject of the test,
   18  the  consent  form  shall  have  a  clearly marked place adjacent to the
   19  signature where the subject of the test,  or,  when  the  subject  lacks
   20  capacity  to  consent, a person authorized pursuant to law to consent to
   21  health care for such  individual,  shall  be  given  an  opportunity  to
   22  specifically  decline  in  writing  HIV  related testing on such general
   23  consent.
   24    2-b. A written or oral informed]  INFORMED  consent  for  HIV  related
   25  testing  pursuant  to this section shall be valid for such testing until
   26  such consent is revoked [or expires by its terms]. Each time that an HIV
   27  related test is ordered pursuant to informed consent in accordance  with
   28  this  section,  the physician or other person authorized pursuant to law
   29  to order the performance of the  HIV  related  test,  or  such  person's
   30  representative, shall orally notify the subject of the test or, when the
   31  subject  lacks  capacity to consent, a person authorized pursuant to law
   32  to consent to health care for such individual, that an HIV related  test
   33  will  be  conducted at such time, and shall note the notification in the
   34  patient's record.
   35    [2-c.] 2-A. The provisions of this section regarding  [oral]  informed
   36  consent  [for  a rapid HIV test] shall not apply to tests performed in a
   37  facility operated under the correction law.   FOR TESTS CONDUCTED  IN  A
   38  FACILITY  UNDER  THE  CORRECTION LAW, INDIVIDUAL CONSENT FOR HIV RELATED
   39  TESTING MUST BE IN WRITING.
   40    3. [Prior to the execution of written, or  obtaining  and  documenting
   41  oral,  informed  consent, a] A person ordering the performance of an HIV
   42  related test shall provide either directly or through  a  representative
   43  to  the subject of an HIV related test or, if the subject lacks capacity
   44  to consent, to a person authorized pursuant to law to consent to  health
   45  care for the subject, an explanation that:
   46    (a)  HIV  causes AIDS and can be transmitted through sexual activities
   47  and needle-sharing, by pregnant women  to  their  fetuses,  and  through
   48  breastfeeding infants;
   49    (b)  there is treatment for HIV that can help an individual stay heal-
   50  thy;
   51    (c) individuals with HIV or AIDS can adopt safe practices  to  protect
   52  uninfected  and infected people in their lives from becoming infected or
   53  multiply infected with HIV;
   54    (d) testing is voluntary and can be done anonymously at a public test-
   55  ing center;
   56    (e) the law protects the confidentiality of HIV related test results;
       S. 6914                             7                            A. 9205

    1    (f) the law prohibits discrimination  based  on  an  individual's  HIV
    2  status and services are available to help with such consequences; and
    3    (g)  the  law  allows an individual's informed consent for HIV related
    4  testing to be valid for such testing until such consent  is  revoked  by
    5  the subject of the HIV RELATED test [or expires by its terms].
    6    Protocols shall be in place to ensure compliance with this section.
    7    4.  A person authorized pursuant to law to order the performance of an
    8  HIV related test shall provide directly or through a  representative  to
    9  the person seeking such test, an opportunity to remain anonymous [and to
   10  provide  written,  informed  consent  or authorize documentation of oral
   11  informed consent,] through use of a coded  system  with  no  linking  of
   12  individual  identity  to  the  test  request  or  results. A health care
   13  provider who is not  authorized  by  the  commissioner  to  provide  HIV
   14  related tests on an anonymous basis shall refer a person who requests an
   15  anonymous  test to a test site which does provide anonymous testing. The
   16  provisions of this subdivision shall not apply to a health care provider
   17  ordering the performance  of  an  HIV  related  test  on  an  individual
   18  proposed for insurance coverage.
   19    S  3. Section 2135 of the public health law, as amended by chapter 308
   20  of the laws of 2010, is amended to read as follows:
   21    S 2135. Confidentiality. All reports or  information  secured  by  the
   22  department,  municipal  health  commissioner  or district health officer
   23  under the provisions of this title shall be confidential except: (a)  in
   24  so  far  as  is necessary to carry out the provisions of this title; (b)
   25  when used in the aggregate, without patient specific identifying  infor-
   26  mation,  in programs approved by the commissioner for the improvement of
   27  the quality of medical care provided to persons with HIV/AIDS; [or]  (c)
   28  when  used  within the state or local health department by public health
   29  disease programs to assess co-morbidity or completeness of reporting and
   30  to direct program needs, in  which  case  patient  specific  identifying
   31  information  shall  not  be  disclosed outside the state or local health
   32  department; OR (D)  WHEN  USED  FOR  PURPOSES  OF  PATIENT  LINKAGE  AND
   33  RETENTION IN CARE, PATIENT SPECIFIC IDENTIFIED INFORMATION MAY BE SHARED
   34  BETWEEN  LOCAL  AND  STATE  HEALTH DEPARTMENTS AND HEALTH CARE PROVIDERS
   35  CURRENTLY TREATING THE PATIENT AS APPROVED BY THE COMMISSIONER.
   36    S 4. Intentionally omitted.
   37    S 5. Subdivision 1 of section  2411  of  the  public  health  law,  as
   38  amended  by chapter 219 of the laws of 1997, paragraph (e) as amended by
   39  chapter 106 of the laws of 2013, and paragraph (h) as amended by chapter
   40  638 of the laws of 2008, is amended to read as follows:
   41    1. The board shall:
   42    (a) Survey state agencies, boards, programs and  other  state  govern-
   43  mental  entities  to  assess  what, if any, relevant data has been or is
   44  being collected which may be of use to researchers engaged  in  breast[,
   45  prostate or testicular] cancer research;
   46    (b)  Consistent with the survey conducted pursuant to paragraph (a) of
   47  this subdivision, compile a list of data  collected  by  state  agencies
   48  which  may  be of assistance to researchers engaged in breast[, prostate
   49  or testicular] cancer research as  established  in  section  twenty-four
   50  hundred twelve of this title;
   51    (c)  Consult  with the Centers for Disease Control and Prevention, the
   52  National Institutes of Health, the Federal Agency For Health Care Policy
   53  and Research, the National Academy of Sciences and  other  organizations
   54  or  entities  which  may  be involved in cancer research to solicit both
   55  information regarding breast[, prostate and testicular] cancer  research
       S. 6914                             8                            A. 9205

    1  projects  that  are  currently  being  conducted and recommendations for
    2  future research projects;
    3    (d) Review requests made to the commissioner for access to information
    4  pursuant  to paragraph b of subdivision one of section 33-1203 and para-
    5  graph c of subdivision two  of  section  33-1205  of  the  environmental
    6  conservation law for use in human health related research projects. Such
    7  data  shall  only  be  provided  to  researchers engaged in human health
    8  related research. The request made by such researchers shall  include  a
    9  copy of the research proposal or the research protocol approved by their
   10  institution and copies of their institution's Institutional Review Board
   11  (IRB)  or equivalent review board approval of such proposal or protocol.
   12  In the case of research conducted outside the auspices of an institution
   13  by a researcher previously published in a peer-reviewed scientific jour-
   14  nal, the board shall request copies of the research proposal  and  shall
   15  deny  access to the site-specific and nine-digit zip code pesticide data
   16  if the board determines that such  proposal  does  not  follow  accepted
   17  scientific  practice  for  the  design  of a research project. The board
   18  shall establish guidelines to restrict the dissemination by  researchers
   19  of  the name, address or other information that would otherwise identify
   20  a commercial applicator or private applicator or any person who receives
   21  the services of a commercial applicator;
   22    (e) Solicit, receive, and review applications from public and  private
   23  agencies  and  organizations  and  qualified  research  institutions for
   24  grants from the breast  cancer  research  and  education  fund,  created
   25  pursuant to section ninety-seven-yy of the state finance law, to conduct
   26  research  or educational programs which focus on the causes, prevention,
   27  screening, treatment and cure of breast cancer and may include, but  are
   28  not  limited  to  mapping of breast cancer, and basic, behavioral, clin-
   29  ical,  demographic,  environmental,   epidemiologic   and   psychosocial
   30  research.  The board shall make recommendations to the commissioner, and
   31  the commissioner shall, in his or  her  discretion,  grant  approval  of
   32  applications  for  grants  from  those  applications  recommended by the
   33  board. The board shall consult with the Centers for Disease Control  and
   34  Prevention,  the  National  Institutes of Health, the Federal Agency For
   35  Health Care Policy and  Research,  the  National  Academy  of  Sciences,
   36  breast cancer advocacy groups, and other organizations or entities which
   37  may  be  involved  in breast cancer research to solicit both information
   38  regarding breast cancer  research  projects  that  are  currently  being
   39  conducted  and  recommendations for future research projects. As used in
   40  this section, "qualified  research  institution"  may  include  academic
   41  medical  institutions,  state  or  local  government agencies, public or
   42  private organizations within  this  state,  and  any  other  institution
   43  approved by the department, which is conducting a breast cancer research
   44  project or educational program. If a board member submits an application
   45  for  a  grant  from the breast cancer research and education fund, he or
   46  she shall be prohibited from reviewing and making  a  recommendation  on
   47  the application;
   48    (f)  Consider, based on evolving scientific evidence, whether a corre-
   49  lation exists between pesticide use and pesticide exposure. As  part  of
   50  such  consideration the board shall make recommendations as to methodol-
   51  ogies which may be utilized to establish such correlation;
   52    (g) After two years of implementation of pesticide reporting  pursuant
   53  to  section  33-1205  of  the  environmental conservation law, the board
   54  shall compare the percentage of agricultural crop production general use
   55  pesticides being reported to the total amount of such  pesticides  being
   56  used  in  this state as estimated by Cornell University, Cornell Cooper-
       S. 6914                             9                            A. 9205

    1  ative Extension, the department of environmental conservation,  and  the
    2  Environmental Protection Agency;
    3    (h)  Meet  at least six times in the first year, at the request of the
    4  chair and at any other time as the  chair  deems  necessary.  The  board
    5  shall  meet  at  least [four] TWO times a year AND AS NEEDED thereafter.
    6  Provided, however, that at least one such meeting  a  year  shall  be  a
    7  public  hearing,  at  which  the general public may question and present
    8  information and comments to the board with respect to the  operation  of
    9  the health research science board, the breast cancer research and educa-
   10  tion  fund[,  the  prostate and testicular cancer research and education
   11  fund], and pesticide reporting established pursuant to sections  33-1205
   12  and  33-1207 of the environmental conservation law. At such hearing, the
   13  commissioner of the department of environmental conservation or  his  or
   14  her  designee shall make a report to the board with respect to the effi-
   15  ciency and  utility  of  pesticide  reporting  established  pursuant  to
   16  sections  33-1205  and  33-1207  of  the environmental conservation law.
   17  SHOULD THE EXISTING BYLAWS BE AMENDED BY THE BOARD, ANY SUCH  AMENDMENTS
   18  SHALL BE CONSISTENT WITH THE REVISIONS OF THIS PARAGRAPH;
   19    S  5-a.  Section  2413 of the public health law, as amended by chapter
   20  219 of the laws of 1997, is amended to read as follows:
   21    S 2413. Biennial report.  The commissioner shall submit a report on or
   22  before January first commencing in  nineteen  hundred  ninety-nine,  and
   23  biennially  thereafter,  to the governor, the temporary president of the
   24  senate and the speaker of the assembly concerning the operation  of  the
   25  health research science board. Such report shall include recommendations
   26  from  the  health  research science board including, but not limited to,
   27  the types of data that would be useful for breast[, prostate or testicu-
   28  lar] cancer researchers and whether private citizen use  of  residential
   29  pesticides  should  be  added  to the reporting requirements. The report
   30  shall also include a summary of research requests granted or denied.  In
   31  addition, such report shall include an evaluation by  the  commissioner,
   32  the commissioner of the department of environmental conservation and the
   33  health  research  science  board of the basis, efficiency and scientific
   34  utility of the information derived from pesticide reporting pursuant  to
   35  sections  33-1205  and 33-1207 of the environmental conservation law and
   36  recommend whether such system  should  be  modified  or  continued.  The
   37  report  shall  include  a  summary  of  the comments and recommendations
   38  presented by the public at the board's public hearings.
   39    S 5-b. Section 97-yy of the state finance law is amended by  adding  a
   40  new subdivision 2-b to read as follows:
   41    2-B. ON OR BEFORE THE FIRST DAY OF FEBRUARY EACH YEAR, THE COMMISSION-
   42  ER  OF  HEALTH SHALL PROVIDE A WRITTEN REPORT TO THE TEMPORARY PRESIDENT
   43  OF THE SENATE, SPEAKER OF THE ASSEMBLY,  CHAIR  OF  THE  SENATE  FINANCE
   44  COMMITTEE,  CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, CHAIR OF THE
   45  SENATE COMMITTEE ON HEALTH, AND CHAIR OF THE ASSEMBLY HEALTH  COMMITTEE.
   46  SUCH  REPORT  SHALL  INCLUDE  HOW  THE  MONIES OF THE FUND WERE UTILIZED
   47  DURING THE PRECEDING CALENDAR YEAR, AND SHALL INCLUDE:
   48    (I) THE AMOUNT OF MONEY DISPERSED FROM THE FUND;
   49    (II) RECIPIENTS OF AWARDS FROM THE FUND;
   50    (III) THE AMOUNT AWARDED TO EACH; AND
   51    (IV) THE PURPOSES FOR WHICH SUCH AWARDS WERE GRANTED.
   52    S 6. Section 2409-a of the public health law, as added by  section  73
   53  of  part  D  of  chapter  60  of the laws of 2012, is amended to read as
   54  follows:
   55    S 2409-a. Advisory council. 1. There  is  hereby  established  in  the
   56  department  the  [breast,  cervical  and  ovarian]  cancer detection and
       S. 6914                            10                            A. 9205

    1  education program advisory council, for  the  purpose  of  advising  the
    2  commissioner   with  regards  to  providing  information  to  consumers,
    3  patients, and health  care  providers  relating,  but  not  limited  to,
    4  breast,  cervical,  PROSTATE,  TESTICULAR  and ovarian cancer, including
    5  signs and symptoms, risk factors, the benefits of prevention  and  early
    6  detection, guideline concordant cancer screening and disease management,
    7  options  for  diagnostic  testing  and  treatment, new technologies, and
    8  survivorship.
    9    2. The advisory council shall: (A) make recommendations to the depart-
   10  ment regarding  the  promotion  and  implementation  of  programs  under
   11  sections  twenty-four  hundred  six and twenty-four hundred nine of this
   12  title; AND (B) PRIOR TO THE DEPARTMENT PROVIDING  GRANTS  FROM  THE  NEW
   13  YORK  STATE  PROSTATE AND TESTICULAR CANCER RESEARCH AND EDUCATION FUND,
   14  CREATED PURSUANT TO SECTION NINETY-FIVE-E  OF  THE  STATE  FINANCE  LAW,
   15  ADVISE  THE  DEPARTMENT ON VARIOUS COMPONENTS OF THE DEPARTMENT'S SOLIC-
   16  ITATION TO DISTRIBUTE SUCH FUNDS, INCLUDING  BUT  NOT  LIMITED  TO,  THE
   17  POTENTIAL  USES OF THE FUNDS, THE ENTITIES THAT MAY BE ELIGIBLE TO APPLY
   18  FOR THE  FUNDS,  THE  RECOMMENDED  CONTRACT  DELIVERABLES  FOR  ENTITIES
   19  RECEIVING  THE  FUNDS,  THE  RECOMMENDED  GEOGRAPHIC DISTRIBUTION OF THE
   20  FUNDS, AND THE RECOMMENDED AWARD AMOUNTS.
   21    3. The commissioner shall appoint  twenty-one  voting  members,  which
   22  shall  include  representation  of health care professionals, consumers,
   23  patients, ONE VOTING MEMBER WHO SHALL BE A PERSON WHO  HAS  OR  HAS  HAD
   24  PROSTATE  OR  TESTICULAR CANCER, ONE VOTING MEMBER WHO SHALL BE A PERSON
   25  WHO HAS OR HAS HAD BREAST, CERVICAL OR OVARIAN CANCER and  other  appro-
   26  priate  [interest]  INTERESTS  reflective of the diversity of the state,
   27  with expertise in breast, cervical, PROSTATE, TESTICULAR and/or  ovarian
   28  cancer.  The commissioner shall appoint one member as a chairperson. The
   29  members of the council shall receive no compensation for their services,
   30  but shall be allowed their actual and  necessary  expenses  incurred  in
   31  performance of their duties.
   32    4.  A  majority  of the appointed voting membership of the board shall
   33  constitute quorum.
   34    5. The advisory council shall meet at  least  twice  a  year,  at  the
   35  request of the department.
   36    S 7. Section 95-e of the state finance law, as added by chapter 273 of
   37  the  laws  of  2004,  subdivision 2 as amended by section 1 of part A of
   38  chapter 58 of the laws of 2004, is amended to read as follows:
   39    S  95-e.  New  York  [state]  STATE  prostate  AND  TESTICULAR  cancer
   40  research[, detection] and education fund. 1. There is hereby established
   41  in the joint custody of the commissioner of taxation and finance and the
   42  comptroller,  a  special fund to be known as the "New York [state] STATE
   43  prostate AND  TESTICULAR  cancer  research[,  detection]  and  education
   44  fund".
   45    2.  Such  fund  shall consist of all revenues received pursuant to the
   46  provisions of SECTION FOUR HUNDRED FOUR-Q OF  THE  VEHICLE  AND  TRAFFIC
   47  LAW,  AS ADDED BY CHAPTER FIVE HUNDRED TWENTY-EIGHT OF THE LAWS OF NINE-
   48  TEEN HUNDRED NINETY-NINE,  AND  sections  two  hundred  nine-E  and  six
   49  hundred  thirty of the tax law, all revenues received pursuant to appro-
   50  priations by the legislature, and all moneys appropriated, credited,  or
   51  transferred  thereto  from any other fund or source pursuant to law. For
   52  each state fiscal year, there shall be appropriated to the fund  by  the
   53  state,  in  addition  to  all other moneys required to be deposited into
   54  such fund, an amount equal to the amounts of monies collected and depos-
   55  ited into the fund pursuant to SECTION FOUR HUNDRED FOUR-Q OF THE  VEHI-
   56  CLE  AND  TRAFFIC  LAW, AS ADDED BY CHAPTER FIVE HUNDRED TWENTY-EIGHT OF
       S. 6914                            11                            A. 9205

    1  THE LAWS OF NINETEEN  HUNDRED  NINETY-NINE,  AND  sections  two  hundred
    2  [nine-e] NINE-E and six hundred thirty of the tax law during the preced-
    3  ing  calendar  year,  as certified by the comptroller. Nothing contained
    4  herein  shall prevent the state from receiving grants, gifts or bequests
    5  for the purposes of the fund as defined in this section  and  depositing
    6  them  into the fund according to law. Any interest received by the comp-
    7  troller on moneys on deposit in such  fund  shall  be  retained  in  and
    8  become part of such fund.
    9    3. (A) Moneys of the fund [shall be expended only to provide grants to
   10  the  New  York State Coalition to Cure Prostate Cancer, a not-for-profit
   11  corporation established in this state which is incorporated],  FOLLOWING
   12  APPROPRIATION  BY  THE LEGISLATURE AND ALLOCATION BY THE DIRECTOR OF THE
   13  BUDGET, SHALL BE MADE AVAILABLE TO THE COMMISSIONER OF HEALTH TO PROVIDE
   14  GRANTS for the purpose of advancing and financing prostate AND  TESTICU-
   15  LAR   cancer   research,  [detection]  SUPPORT  PROGRAMS  and  education
   16  projects. [To the extent practicable, the New York  State  Coalition  to
   17  Cure Prostate Cancer shall cooperate and coordinate its efforts with the
   18  prostate  and testicular cancer detection and education advisory council
   19  established pursuant to  section  twenty-four  hundred  sixteen  of  the
   20  public health law.]
   21    (B)  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTION ONE HUNDRED
   22  SIXTY-THREE OF THE STATE FINANCE LAW,  THE  COMMISSIONER  OF  HEALTH  IS
   23  AUTHORIZED  TO ENTER INTO A CONTRACT OR CONTRACTS UNDER PARAGRAPH (A) OF
   24  THIS SUBDIVISION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROC-
   25  ESS, PROVIDED, HOWEVER, THAT:
   26    (I) THE DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR  A  PERIOD
   27  OF NO LESS THAN THIRTY DAYS:
   28    (1)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
   29  THE CONTRACT OR CONTRACTS;
   30    (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
   31    (3) THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY  SEEK
   32  SELECTION,  WHICH  SHALL BE NO LESS THAN THIRTY DAYS AFTER SUCH INFORMA-
   33  TION IS FIRST POSTED ON THE WEBSITE; AND
   34    (4) THE MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY  SEEK  SUCH
   35  SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
   36    (II)  ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM
   37  PROSPECTIVE CONTRACTORS IN TIMELY  FASHION  SHALL  BE  REVIEWED  BY  THE
   38  COMMISSIONER OF HEALTH; AND
   39    (III)  THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT SUCH CONTRACTOR OR
   40  CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
   41  PURPOSES OF THIS SECTION.
   42    4. (A) On or before the first day of February  each  year,  the  comp-
   43  troller  shall  certify  to  the  governor,  temporary  president of the
   44  senate, speaker of the assembly, chair of the senate  finance  committee
   45  and  chair of the assembly ways and means committee, the amount of money
   46  deposited by source in the New York [state] STATE prostate AND  TESTICU-
   47  LAR cancer research[, detection] and education fund during the preceding
   48  calendar  year as the result of revenue derived pursuant to SECTION FOUR
   49  HUNDRED FOUR-Q OF THE VEHICLE AND TRAFFIC LAW, AS ADDED BY CHAPTER  FIVE
   50  HUNDRED  TWENTY-EIGHT  OF  THE LAWS OF NINETEEN HUNDRED NINETY-NINE, AND
   51  sections two hundred nine-E and six hundred thirty of the  tax  law  and
   52  from all other sources.
   53    (B) ON OR BEFORE THE FIRST DAY OF FEBRUARY EACH YEAR, THE COMMISSIONER
   54  OF  HEALTH  SHALL PROVIDE A WRITTEN REPORT TO THE TEMPORARY PRESIDENT OF
   55  THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE SENATE FINANCE COMMIT-
   56  TEE, CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, CHAIR OF THE SENATE
       S. 6914                            12                            A. 9205

    1  COMMITTEE ON HEALTH, AND CHAIR OF THE ASSEMBLY  HEALTH  COMMITTEE.  SUCH
    2  REPORT  SHALL  INCLUDE  HOW  MONIES OF THE FUND WERE UTILIZED DURING THE
    3  PRECEDING CALENDAR YEAR AND SHALL INCLUDE:
    4    (I) THE AMOUNT OF MONEY DISBURSED FROM THE FUND;
    5    (II) RECIPIENTS OF AWARDS FROM THE FUND;
    6    (III) THE AMOUNT AWARDED TO EACH; AND
    7    (IV) THE PURPOSES FOR WHICH SUCH AWARDS WERE GRANTED.
    8    5.  [As  a  condition  of receiving grants from the fund, the New York
    9  State Coalition To Cure Prostate Cancer shall agree to issue  and  shall
   10  issue,  on  or  before  the  first  day  of February each year, a report
   11  including, but not limited to, financial statements,  financial  reports
   12  and  reports  on the issuance of grants. Such reports shall be delivered
   13  to the governor and the chairs of the senate finance committee  and  the
   14  assembly  ways  and  means committee and shall also be made available to
   15  the public.  Such financial statements and reports shall be audited by a
   16  nationally recognized accounting firm.
   17    6.] Moneys shall be payable from the  fund  [to  the  New  York  State
   18  Coalition to Cure Prostate Cancer] on the audit and warrant of the comp-
   19  troller on vouchers approved by the comptroller.
   20    S  7-a. Subdivision 2 of section 404-q of the vehicle and traffic law,
   21  as added by chapter 528 of the laws of  1999,  is  amended  to  read  as
   22  follows:
   23    2. A distinctive "drive for the cure" license plate issued pursuant to
   24  this  section  shall be issued in the same manner as other number plates
   25  upon the payment of the regular registration fee prescribed  by  section
   26  four  hundred one of this article, provided, however, that an additional
   27  annual service charge of twenty-five dollars shall be charged  for  such
   28  plate.  Twelve  dollars  and  fifty  cents from each twenty-five dollars
   29  received as annual service charges under this section shall be deposited
   30  to the credit of the breast cancer research and  education  fund  estab-
   31  lished  pursuant to section ninety-seven-yy of the state finance law and
   32  shall be used for research and education programs undertaken pursuant to
   33  section twenty-four hundred ten of the public health law. Twelve dollars
   34  and fifty cents from each twenty-five dollars received as annual service
   35  charges under this section shall be deposited to the credit of  the  NEW
   36  YORK  STATE  prostate  and testicular cancer research and education fund
   37  established pursuant to section [ninety-seven-ccc] NINETY-FIVE-E of  the
   38  state  finance law and shall be used for research and education programs
   39  undertaken pursuant to section [ninety-seven-ccc] NINETY-FIVE-E  of  the
   40  state  finance  law. Provided, however that one year after the effective
   41  date of this section funds in the amount of six thousand dollars, or  so
   42  much  thereof  as may be available, shall be allocated to the department
   43  to offset costs associated with the production of such license plates.
   44    S 7-b. Section 97-ccc of the state finance law is REPEALED.
   45    S 7-c. Section  209-E of the tax law, as added by chapter 273  of  the
   46  laws of 2004, is amended to read as follows:
   47    S 209-E. Gift for prostate AND TESTICULAR cancer research[, detection]
   48  and  education.  Effective for any tax year commencing on or after Janu-
   49  ary first, two thousand four, a taxpayer in any taxable year  may  elect
   50  to  contribute to the support of the New York [state] STATE prostate AND
   51  TESTICULAR  cancer  research[,  detection]  and  education  fund.   Such
   52  contribution  shall  be  in any whole dollar amount and shall not reduce
   53  the amount of the state tax owed  by  such  taxpayer.  The  commissioner
   54  shall  include  space  on  the  corporate  income tax return to enable a
   55  taxpayer to make such contribution.  Notwithstanding any other provision
   56  of law, all revenues collected pursuant to this section shall be credit-
       S. 6914                            13                            A. 9205

    1  ed to  the  New  York  [state]  STATE  prostate  AND  TESTICULAR  cancer
    2  research[,  detection]  and  education  fund  and shall be used only for
    3  those purposes enumerated in section ninety-five-e of the state  finance
    4  law.
    5    S 7-d. Section 630 of the tax law, as added by chapter 273 of the laws
    6  of 2004, is amended to read as follows:
    7    S  630.  Gift for prostate AND TESTICULAR cancer research[, detection]
    8  and education.  Effective for any tax year commencing on or after  Janu-
    9  ary  first,  two  thousand  four,  an individual in any taxable year may
   10  elect to contribute to the New York [state] STATE prostate AND  TESTICU-
   11  LAR  cancer  research[, detection] and education fund. Such contribution
   12  shall be in any whole dollar amount and shall not reduce the  amount  of
   13  state  tax owed by such individual. The commissioner shall include space
   14  on the personal income tax return to enable  a  taxpayer  to  make  such
   15  contribution.  Notwithstanding  any  other provision of law all revenues
   16  collected pursuant to this section shall be credited  to  the  New  York
   17  [state]  STATE  prostate AND TESTICULAR cancer research[, detection] and
   18  education fund and used only for those purposes  enumerated  in  section
   19  ninety-five-e of the state finance law.
   20    S  8. The public health law is amended by adding a new section 2825 to
   21  read as follows:
   22    S 2825. CAPITAL RESTRUCTURING FINANCING PROGRAM. 1. A CAPITAL RESTRUC-
   23  TURING FINANCING PROGRAM IS HEREBY ESTABLISHED UNDER THE JOINT  ADMINIS-
   24  TRATION OF THE COMMISSIONER AND THE PRESIDENT OF THE DORMITORY AUTHORITY
   25  OF  THE  STATE  OF  NEW  YORK  FOR THE PURPOSE OF ENHANCING THE QUALITY,
   26  FINANCIAL VIABILITY AND EFFICIENCY OF NEW YORK'S  HEALTH  CARE  DELIVERY
   27  SYSTEM  BY TRANSFORMING THE SYSTEM INTO A MORE RATIONAL PATIENT-CENTERED
   28  CARE SYSTEM THAT PROMOTES POPULATION HEALTH AND IMPROVED WELL-BEING  FOR
   29  ALL  NEW  YORKERS.  THE  ISSUANCE  OF ANY BONDS OR NOTES HEREUNDER SHALL
   30  FURTHER BE SUBJECT TO THE APPROVAL OF THE DIRECTOR OF  THE  DIVISION  OF
   31  THE  BUDGET,  AND  ANY  PROJECTS FUNDED THROUGH THE ISSUANCE OF BONDS OR
   32  NOTES HEREUNDER SHALL BE APPROVED BY THE NEW YORK STATE PUBLIC  AUTHORI-
   33  TIES  CONTROL  BOARD,  AS REQUIRED UNDER SECTION FIFTY-ONE OF THE PUBLIC
   34  AUTHORITIES LAW.
   35    2. FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH  MARCH
   36  THIRTY-FIRST, TWO THOUSAND TWENTY-ONE, FUNDS MADE AVAILABLE FOR EXPENDI-
   37  TURE PURSUANT TO THIS SECTION MAY BE DISTRIBUTED BY THE COMMISSIONER AND
   38  THE  PRESIDENT  OF THE AUTHORITY, IN CONSULTATION WITH THE COMMISSIONERS
   39  OF THE OFFICE OF MENTAL HEALTH, OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL
   40  DISABILITIES  AND OFFICE FOR ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, AS
   41  APPLICABLE, FOR:
   42    (A) CAPITAL GRANTS  TO  GENERAL  HOSPITALS,  RESIDENTIAL  HEALTH  CARE
   43  FACILITIES,  DIAGNOSTICS  AND  TREATMENT  CENTERS,  AND CLINICS LICENSED
   44  PURSUANT TO THIS CHAPTER OR THE  MENTAL  HYGIENE  LAW,  ASSISTED  LIVING
   45  PROGRAMS,  PRIMARY  CARE PROVIDERS, AND HOME CARE PROVIDERS CERTIFIED OR
   46  LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF  THIS  CHAPTER  (COLLECTIVELY
   47  "APPLICANTS") THAT QUALIFY FOR PAYMENTS UNDER THE DELIVERY SYSTEM REFORM
   48  INCENTIVE  PAYMENT  PROGRAM  (DSRIP),  IN  WHICH CASE FUNDING UNDER THIS
   49  PARAGRAPH SHALL BE REQUESTED IN SUCH APPLICANT'S DSRIP APPLICATION. SUCH
   50  CAPITAL GRANT PROJECTS INCLUDE, BUT ARE NOT LIMITED TO; CLOSURES,  MERG-
   51  ERS,  RESTRUCTURING,  IMPROVEMENTS  TO  INFRASTRUCTURE,  DEVELOPMENT  OF
   52  PRIMARY CARE SERVICE CAPACITY, DEVELOPMENT OF TELEHEALTH INFRASTRUCTURE,
   53  THE PROMOTION OF INTEGRATED DELIVERY SYSTEMS THAT STRENGTHEN AND PROTECT
   54  CONTINUED ACCESS TO ESSENTIAL HEALTH CARE SERVICES AND OTHER TRANSFORMA-
   55  TIONAL PROJECTS AS DETERMINED BY THE COMMISSIONER AND THE  PRESIDENT  OF
   56  THE AUTHORITY.
       S. 6914                            14                            A. 9205

    1    (B)  CAPITAL  GRANTS  TO  GENERAL  HOSPITALS,  RESIDENTIAL HEALTH CARE
    2  FACILITIES, DIAGNOSTIC  AND  TREATMENT  CENTERS,  AND  CLINICS  LICENSED
    3  PURSUANT  TO  THIS  CHAPTER  OR  THE MENTAL HYGIENE LAW, ASSISTED LIVING
    4  PROGRAMS, PRIMARY CARE PROVIDERS,  HOME  CARE  PROVIDERS,  CERTIFIED  OR
    5  LICENSED  PURSUANT  TO  ARTICLE THIRTY-SIX OF THIS CHAPTER (COLLECTIVELY
    6  "APPLICANTS") THAT ARE NON-QUALIFYING AND  NON-PARTICIPATING  APPLICANTS
    7  UNDER  PARAGRAPH  (A)  OF  THIS SUBDIVISION, FOR CAPITAL NON-OPERATIONAL
    8  WORKS OR PURPOSES THAT SUPPORT THE PURPOSES SET FORTH IN  THIS  SECTION.
    9  SUCH  CAPITAL  GRANT PROJECTS INCLUDE, BUT ARE NOT LIMITED TO; CLOSURES,
   10  MERGERS, RESTRUCTURING, IMPROVEMENTS TO INFRASTRUCTURE,  DEVELOPMENT  OF
   11  PRIMARY CARE SERVICE CAPACITY, DEVELOPMENT OF TELEHEALTH INFRASTRUCTURE,
   12  THE PROMOTION OF INTEGRATED DELIVERY SYSTEMS THAT STRENGTHEN AND PROTECT
   13  CONTINUED ACCESS TO ESSENTIAL HEALTH CARE SERVICES.
   14    3.  THE  COMMISSIONER  AND  THE PRESIDENT OF THE AUTHORITY SHALL ENTER
   15  INTO AN AGREEMENT, SUBJECT TO APPROVAL BY THE DIRECTOR OF THE BUDGET AND
   16  SUBJECT TO SECTION SIXTEEN HUNDRED EIGHTY-R OF  THE  PUBLIC  AUTHORITIES
   17  LAW, AS ADDED BY A CHAPTER OF THE LAWS OF TWO THOUSAND FOURTEEN, FOR THE
   18  PURPOSES  OF  AWARDING,  DISTRIBUTING,  AND ADMINISTERING THE FUNDS MADE
   19  AVAILABLE PURSUANT TO THIS SECTION.
   20    (A) FOR CAPITAL GRANT PROJECTS UNDER PARAGRAPH (A) OF SUBDIVISION  TWO
   21  OF  THIS  SECTION,  THE  EVALUATION  OF  APPLICATIONS SHALL BE SUBMITTED
   22  PURSUANT TO THE PROCESS DESCRIBED IN PARAGRAPH (B) OF SUBDIVISION TWENTY
   23  OF SECTION TWENTY-EIGHT HUNDRED SEVEN OF THIS ARTICLE; PROVIDED,  HOWEV-
   24  ER,  THAT  SUCH CAPITAL GRANT PROJECTS SHALL NOT BE SUBJECT TO REVIEW BY
   25  THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES.
   26    (B) FOR MONIES ALLOCATED UNDER PARAGRAPH (B)  OF  SUBDIVISION  TWO  OF
   27  THIS SECTION:
   28    (I)  THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO LESS
   29  THAN THIRTY DAYS:
   30    (A) THE PROCESS BY WHICH SUCH APPLICATIONS SHALL BE REVIEWED;
   31    (B) THE CRITERIA BY WHICH SUCH APPLICATIONS SHALL BE JUDGED; AND
   32    (C) A LIST OF APPROVED AND  DENIED  APPLICATIONS  SUBSEQUENT  TO  SUCH
   33  DETERMINATION.
   34    (II)  THE  EVALUATION OF APPLICATIONS SHALL BE REVIEWED BY THE DEPART-
   35  MENT, PURSUANT TO A PROCESS TO BE DETERMINED BY THE DEPARTMENT. APPLICA-
   36  TIONS SHALL THEN BE SUBJECT TO REVIEW BY THE PANEL ESTABLISHED  PURSUANT
   37  TO  PARAGRAPH  (B) OF SUBDIVISION TWENTY OF SECTION TWENTY-EIGHT HUNDRED
   38  SEVEN OF THIS ARTICLE, WHICH SHALL SUBMIT  ITS  RECOMMENDATIONS  TO  THE
   39  COMMISSIONER  FOR FINAL DETERMINATION. DETERMINATION OF AWARDS FOR FUNDS
   40  ALLOCATED UNDER PARAGRAPH (B) OF SUBDIVISION TWO OF THIS SECTION,  SHALL
   41  INCLUDE, BUT NOT BE LIMITED TO THE FOLLOWING CRITERIA:
   42    (A) ELIGIBILITY REQUIREMENTS FOR APPLICANTS;
   43    (B) STATEWIDE GEOGRAPHIC DISTRIBUTION OF FUNDS;
   44    (C)  MINIMUM  AND  MAXIMUM  AMOUNTS OF FUNDING TO BE AWARDED UNDER THE
   45  PROGRAM;
   46    (D) THE RELATIONSHIP BETWEEN THE PROJECT PROPOSED BY AN APPLICANT  AND
   47  IDENTIFIED COMMUNITY NEED;
   48    (E)  THE  EXTENT  TO  WHICH  THE  APPLICANT  HAS ACCESS TO ALTERNATIVE
   49  FINANCING;
   50    (F) THE EXTENT TO WHICH THE PROPOSED PROJECT FURTHERS THE PURPOSES SET
   51  FORTH IN THIS SECTION;
   52    (G) THE EXTENT THAT THE PROPOSED PROJECT FURTHERS THE  DEVELOPMENT  OF
   53  PRIMARY CARE;
   54    (H)  THE EXTENT TO WHICH THE PROPOSED PROJECT BENEFITS MEDICAID ENROL-
   55  LEES AND UNINSURED INDIVIDUALS;
       S. 6914                            15                            A. 9205

    1    (I) THE EXTENT TO WHICH THE PROPOSED PROJECT ADDRESSES POTENTIAL  RISK
    2  TO PATIENT SAFETY AND WELFARE;
    3    (J)  THE  EXTENT  THAT THE PROPOSED PROJECT INVOLVES AN APPLICANT THAT
    4  RECEIVES OR HAS APPLIED FOR A  TEMPORARY  RATE  ADJUSTMENT  PURSUANT  TO
    5  APPLICABLE REGULATIONS; AND
    6    (K)  THE  EXTENT  TO WHICH THE PROPOSED PROJECT WILL CONTRIBUTE TO THE
    7  LONG TERM SUSTAINABILITY OF THE APPLICANT.
    8    THE COMMISSIONER SHALL PROVIDE A REPORT ON A QUARTERLY  BASIS  TO  THE
    9  CHAIRS OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND
   10  ASSEMBLY  HEALTH  COMMITTEES.  SUCH  REPORTS SHALL BE SUBMITTED NO LATER
   11  THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND SHALL CONFORM TO THE
   12  REPORTING REQUIREMENTS OF SUBDIVISION  TWENTY  OF  SECTION  TWENTY-EIGHT
   13  HUNDRED SEVEN OF THIS ARTICLE, AS APPLICABLE.
   14    S  8-a.  Subdivision  20  of section 2807 of the public health law, as
   15  added by section 9 of part Q of chapter 56  of  the  laws  of  2013,  is
   16  amended to read as follows:
   17    20.  (A)  Notwithstanding any contrary provision of law and subject to
   18  the receipt of all necessary federal approvals and the  availability  of
   19  federal financial participation, the commissioner is authorized to enter
   20  into agreements with SUNY downstate medical center, other public general
   21  hospitals,  and/or  with  the sponsoring local governments of such other
   22  public general hospitals, under which such facilities and/or such  local
   23  government  shall,  by  intergovernmental transfer, fund the non-federal
   24  share of Medicaid funds made available for Delivery System Reform Incen-
   25  tive Payments ("[DSRIPS] DSRIP") to such  facilities.  Such  non-federal
   26  share  payments  shall  be  deemed voluntary and, further, such payments
   27  shall be excluded from computations made pursuant to section one of part
   28  C of chapter fifty-eight of the laws of two thousand five,  as  amended.
   29  In  addition, the facilities, and/or the sponsoring local governments of
   30  such facilities or the state may, by written notification to  the  other
   31  parties to the agreement, cancel such agreement at any time prior to the
   32  payment  of  the  DSRIP  funds.  THE  COMMISSIONER SHALL, TO THE MAXIMUM
   33  DEGREE PRACTICABLE, AND TO THE EXTENT PERMITTED BY THE  FEDERAL  CENTERS
   34  FOR  MEDICARE  AND  MEDICAID  SERVICES  ("CMS"),  ENSURE  THAT THE DSRIP
   35  PROGRAM IS IMPLEMENTED THROUGHOUT THE ENTIRE STATE.
   36    (B) THE COMMISSIONER SHALL ESTABLISH  AN  ADVISORY  PANEL  TO  PROVIDE
   37  ASSISTANCE  WITH REGARD TO THE DSRIP PROGRAM. THE PANEL SHALL BE CHARGED
   38  WITH REVIEWING RECOMMENDATIONS FOR DSRIP FUNDING  MADE  BY  THE  STATE'S
   39  CONTRACTED  DSRIP  ASSESSOR  AND ADVISING THE COMMISSIONER REGARDING THE
   40  RESULTS OF SUCH REVIEW. SUCH PANEL SHALL ALSO REVIEW APPLICATIONS  UNDER
   41  PARAGRAPH  (B)  OF SUBDIVISION TWO OF SECTION TWENTY-EIGHT HUNDRED TWEN-
   42  TY-FIVE OF THIS ARTICLE. PANEL MEMBERSHIP SHALL BE COMPRISED OF INDIVID-
   43  UALS WITH SIGNIFICANT HEALTH CARE SYSTEM EXPERIENCE. MEMBERS MAY NOT  BE
   44  ELECTED OFFICIALS OR EMPLOYED BY PROVIDERS THAT WOULD BENEFIT FROM DSRIP
   45  FUNDING,  AND  MUST NOT HAVE ANY CONFLICT OF INTEREST THAT WOULD PREVENT
   46  THEM FROM PROVIDING AN IMPARTIAL REVIEW OF  DSRIP  ASSESSOR  RECOMMENDA-
   47  TIONS.  THE PANEL SHALL CONSIST OF MEMBERS APPOINTED BY THE COMMISSIONER
   48  AND SHALL IN ADDITION CONSIST OF ONE MEMBER APPOINTED  BY  THE  MAJORITY
   49  LEADER  OF  THE  NEW  YORK STATE SENATE, AND ONE MEMBER APPOINTED BY THE
   50  SPEAKER OF THE NEW YORK STATE ASSEMBLY. THE PANEL SHALL  CARRY  OUT  THE
   51  REVIEW  OF  DSRIP RECOMMENDATIONS IN STRICT ACCORDANCE WITH ALL REQUIRE-
   52  MENTS SET FORTH IN THE STATE'S FEDERAL  1115  MEDICAID  WAIVER  STANDARD
   53  TERMS  AND CONDITIONS. THE PANEL SHALL SUBMIT ITS RECOMMENDATIONS TO THE
   54  COMMISSIONER FOR FINAL DETERMINATION, IN ACCORDANCE  WITH  ALL  REQUIRE-
   55  MENTS  SET  FORTH  IN  THE STATE'S FEDERAL 1115 MEDICAID WAIVER STANDARD
   56  TERMS AND CONDITIONS. THE COMMISSIONER MAY MODIFY  THE  REQUIREMENTS  OF
       S. 6914                            16                            A. 9205

    1  THIS  PARAGRAPH  AND PARAGRAPH (C) OF THIS SUBDIVISION IF SUCH MODIFICA-
    2  TIONS ARE REQUIRED BY THE FEDERAL CMS.
    3    (C)  FOR  PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND FOURTEEN, THE
    4  COMMISSIONER SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO  THE  CHAIRS
    5  OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND ASSEM-
    6  BLY  HEALTH  COMMITTEES  WITH REGARD TO THE STATUS OF THE DSRIP PROGRAM.
    7  SUCH REPORTS SHALL BE SUBMITTED NO LATER THAN SIXTY DAYS AFTER THE CLOSE
    8  OF THE QUARTER, AND SHALL INCLUDE THE MOST CURRENT INFORMATION SUBMITTED
    9  BY PROVIDERS TO THE  STATE  AND  THE  FEDERAL  CMS.  THE  REPORTS  SHALL
   10  INCLUDE:
   11    (I) ANALYSIS OF PROGRESS MADE TOWARD DSRIP GOALS;
   12    (II) THE IMPACT ON THE STATE'S HEALTH CARE DELIVERY SYSTEM;
   13    (III)  INFORMATION  ON  THE  NUMBER AND TYPES OF PROVIDERS WHO PARTIC-
   14  IPATE;
   15    (IV) PLANS  AND  PROGRESS  FOR  MONITORING  PROVIDER  COMPLIANCE  WITH
   16  REQUIREMENTS;
   17    (V) A STATUS UPDATE ON PROJECT MILESTONE PROGRESS;
   18    (VI) INFORMATION ON PROJECT SPENDING AND BUDGET;
   19    (VII) ANALYSIS OF IMPACT ON MEDICAID BENEFICIARIES SERVED;
   20    (VIII) A SUMMARY OF PUBLIC ENGAGEMENT AND PUBLIC COMMENTS RECEIVED;
   21    (IX) A DESCRIPTION OF DSRIP FUNDING APPLICATIONS THAT WERE DENIED;
   22    (X)  A  DESCRIPTION OF ALL REGULATION WAIVERS ISSUED PURSUANT TO PARA-
   23  GRAPH (E) OF THIS SUBDIVISION; AND
   24    (XI) A SUMMARY OF THE STATEWIDE GEOGRAPHIC DISTRIBUTION OF FUNDS.
   25    (D) FOR PERIODS ON AND AFTER APRIL FIRST, TWO  THOUSAND  FOURTEEN  THE
   26  COMMISSIONER  SHALL PROMPTLY MAKE ALL DSRIP GOVERNING DOCUMENTS, INCLUD-
   27  ING 1115 WAIVER STANDARD TERMS AND  CONDITIONS,  SUPPORTING  ATTACHMENTS
   28  AND  DETAILED  PROJECT DESCRIPTIONS, AND ALL MATERIALS MADE AVAILABLE TO
   29  THE LEGISLATURE PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION, AVAILABLE
   30  ON THE DEPARTMENT'S WEBSITE.  THE  COMMISSIONER  SHALL  ALSO  PROVIDE  A
   31  DETAILED  OVERVIEW  ON THE DEPARTMENT'S WEBSITE OF THE OPPORTUNITIES FOR
   32  PUBLIC COMMENT ON THE DSRIP PROGRAM.
   33    (E) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, THE  COMMIS-
   34  SIONERS  OF  THE  DEPARTMENT OF HEALTH, THE OFFICE OF MENTAL HEALTH, THE
   35  OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES,  AND  THE  OFFICE  OF
   36  ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES  ARE AUTHORIZED TO WAIVE ANY
   37  REGULATORY REQUIREMENTS AS ARE  NECESSARY,  CONSISTENT  WITH  APPLICABLE
   38  LAW,  TO  ALLOW  APPLICANTS  UNDER THIS SUBDIVISION AND PARAGRAPH (A) OF
   39  SUBDIVISION TWO OF SECTION  TWENTY-EIGHT  HUNDRED  TWENTY-FIVE  OF  THIS
   40  ARTICLE  TO AVOID DUPLICATION OF REQUIREMENTS AND TO ALLOW THE EFFICIENT
   41  IMPLEMENTATION OF THE PROPOSED PROJECT; PROVIDED,  HOWEVER,  THAT  REGU-
   42  LATIONS  PERTAINING  TO  PATIENT SAFETY MAY NOT BE WAIVED, NOR SHALL ANY
   43  REGULATIONS BE WAIVED IF SUCH WAIVER WOULD  RISK  PATIENT  SAFETY.  SUCH
   44  WAIVER  SHALL  NOT  EXCEED  THE LIFE OF THE PROJECT OR SUCH SHORTER TIME
   45  PERIODS AS THE AUTHORIZING COMMISSIONER MAY  DETERMINE.  ANY  REGULATORY
   46  RELIEF  GRANTED PURSUANT TO THIS SUBDIVISION SHALL BE DESCRIBED, INCLUD-
   47  ING EACH REGULATIONS WAIVED AND THE PROJECT IT RELATES TO, IN THE REPORT
   48  PROVIDED PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION.
   49    S 8-b. Subdivision 21 of section 2807 of the  public  health  law,  as
   50  added  by  section  10  of  part Q of chapter 56 of the laws of 2013, is
   51  amended to read as follows:
   52    21. (A) Notwithstanding any contrary provision of law and  subject  to
   53  the  receipt  of all necessary federal approvals and the availability of
   54  federal financial participation, the commissioner is authorized to enter
   55  into agreements with SUNY downstate medical center, other public general
   56  hospitals, and/or with the sponsoring local governments  of  such  other
       S. 6914                            17                            A. 9205

    1  public  general hospitals, under which such facilities and/or such local
    2  government shall, by intergovernmental transfer,  fund  the  non-federal
    3  share  of  Medicaid  funds made available for implementation of Medicaid
    4  Redesign  Team  initiatives.  Such  non-federal  share payments shall be
    5  deemed voluntary and, further, such  payments  shall  be  excluded  from
    6  computations  made  pursuant  to section one of part C of chapter fifty-
    7  eight of the laws of two thousand five, as  amended.  In  addition,  the
    8  facilities,  and/or  the sponsoring local governments of such facilities
    9  or the state may, by written notification to the other  parties  to  the
   10  agreement, cancel such agreement at any time prior to the payment of the
   11  Medicaid Redesign Team initiatives funds.
   12    (B)  APPLICATIONS  BY  ELIGIBLE  APPLICANTS FOR MEDICAID REDESIGN TEAM
   13  INITIATIVES FUNDED BY MONIES MADE AVAILABLE PURSUANT TO PARAGRAPH (A) OF
   14  THIS SUBDIVISION SHALL BE SUBMITTED FOR REVIEW  TO  THE  ADVISORY  PANEL
   15  ESTABLISHED  PURSUANT  TO  PARAGRAPH  (B)  OF SUBDIVISION TWENTY OF THIS
   16  SECTION AND SUCH PANEL SHALL SUBMIT THEIR RECOMMENDATIONS TO THE COMMIS-
   17  SIONER FOR FINAL DETERMINATION. FOR PERIODS ON AND  AFTER  APRIL  FIRST,
   18  TWO  THOUSAND  FOURTEEN,  THE  COMMISSIONER  SHALL PROVIDE A REPORT ON A
   19  QUARTERLY BASIS TO THE MAJORITY LEADER OF THE NEW YORK STATE SENATE  AND
   20  TO  THE SPEAKER OF THE NEW YORK STATE ASSEMBLY WITH REGARD TO THE STATUS
   21  OF SUCH APPLICATIONS  AND  APPROVED  PROJECTS.  SUCH  REPORTS  SHALL  BE
   22  SUBMITTED  NO  LATER THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND
   23  SHALL INCLUDE THE MOST CURRENT INFORMATION SUBMITTED  BY  APPLICANTS  TO
   24  THE  STATE.  THE REPORTS SHALL BE SUBMITTED IN CONJUNCTION WITH AND AS A
   25  PART OF THE REPORTS SUBMITTED PURSUANT TO PARAGRAPH (C)  OF  SUBDIVISION
   26  TWENTY OF THIS SECTION AND SHALL INCLUDE:
   27    (I) ANALYSIS OF PROGRESS MADE TOWARD PROJECT GOALS;
   28    (II) THE IMPACT ON THE STATE'S HEALTH CARE DELIVERY SYSTEM;
   29    (III)  INFORMATION  ON  THE  NUMBER AND TYPES OF PROVIDERS WHO PARTIC-
   30  IPATE;
   31    (IV) PLANS  AND  PROGRESS  FOR  MONITORING  PROVIDER  COMPLIANCE  WITH
   32  REQUIREMENTS;
   33    (V) A STATUS UPDATE ON PROJECT MILESTONE PROGRESS;
   34    (VI) INFORMATION ON PROJECT SPENDING AND BUDGET;
   35    (VII) ANALYSIS OF IMPACT ON MEDICAID BENEFICIARIES SERVED;
   36    (VIII) A SUMMARY OF PUBLIC ENGAGEMENT AND PUBLIC COMMENTS RECEIVED;
   37    (IX) A DESCRIPTION OF APPLICATIONS THAT WERE DENIED;
   38    (X)  A  DESCRIPTION OF ALL REGULATION WAIVERS ISSUED PURSUANT TO PARA-
   39  GRAPH (E) OF THIS SUBDIVISION; AND
   40    (XI) A SUMMARY OF THE STATEWIDE GEOGRAPHIC DISTRIBUTION OF FUNDS.
   41    (C) THE COMMISSIONER SHALL MAKE ALL REPORTS PREPARED PURSUANT TO PARA-
   42  GRAPH (B) OF THIS SUBDIVISION AND ALL SUPPORTING ATTACHMENTS AND MATERI-
   43  ALS AVAILABLE ON THE DEPARTMENT'S WEBSITE.
   44    (D) NOTWITHSTANDING ANY INCONSISTENT LAW TO THE CONTRARY, AND  SUBJECT
   45  TO  FEDERAL FINANCIAL PARTICIPATION, AND SUBJECT TO AMOUNTS APPROPRIATED
   46  FOR PURPOSES HEREIN, THE DEPARTMENT MAY DISTRIBUTE FUNDS  TO  MAKE  RATE
   47  ADJUSTMENTS  FOR  HEALTH  HOME  PROVIDERS  AS DESCRIBED IN SECTION THREE
   48  HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW FOR  MEMBER  ENGAGEMENT,
   49  STAFF TRAINING AND RETRAINING, HEALTH INFORMATION TECHNOLOGY IMPLEMENTA-
   50  TION,  JOINT GOVERNANCE TECHNICAL ASSISTANCE, AND OTHER SUCH PURPOSES AS
   51  THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONERS OF  THE  OFFICE
   52  OF  MENTAL  HEALTH  AND  THE  OFFICE  OF  ALCOHOLISM AND SUBSTANCE ABUSE
   53  SERVICES DETERMINES.
   54    (E) NOTWITHSTANDING ANY PROVISIONS OF LAW TO THE CONTRARY, THE COMMIS-
   55  SIONERS OF THE DEPARTMENT OF HEALTH, THE OFFICE OF  MENTAL  HEALTH,  THE
   56  OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL DISABILITIES, AND THE OFFICE OF
       S. 6914                            18                            A. 9205

    1  ALCOHOLISM AND SUBSTANCE ABUSE SERVICES  ARE  AUTHORIZED  TO  WAIVE  ANY
    2  REGULATORY  REQUIREMENTS  AS  ARE  NECESSARY, CONSISTENT WITH APPLICABLE
    3  LAW, TO ALLOW APPLICANTS UNDER THIS SUBDIVISION  AND  PARAGRAPH  (A)  OF
    4  SUBDIVISION  TWO  OF  SECTION  TWENTY-EIGHT  HUNDRED TWENTY-FIVE OF THIS
    5  ARTICLE TO AVOID DUPLICATION OF REQUIREMENTS AND TO ALLOW THE  EFFICIENT
    6  IMPLEMENTATION  OF  THE  PROPOSED PROJECT; PROVIDED, HOWEVER, THAT REGU-
    7  LATIONS PERTAINING TO PATIENT SAFETY MAY NOT BE WAIVED,  NOT  SHALL  ANY
    8  REGULATION  BE  WAIVED  IF  SUCH  WAIVER WOULD RISK PATIENT SAFETY. SUCH
    9  WAIVER SHALL NOT EXCEED THE LIFE OF THE PROJECT  OR  SUCH  SHORTER  TIME
   10  PERIOD  AS  THE  AUTHORIZING  COMMISSIONER ANY DETERMINE. ANY REGULATORY
   11  RELIEF GRANTED PURSUANT TO THIS SUBDIVISION SHALL BE DESCRIBED,  INCLUD-
   12  ING  EACH REGULATION WAIVED AND THE PROJECT IT RELATES TO, IN THE REPORT
   13  PROVIDED PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION.
   14    S 9. Section 89-e of the state finance law is amended by adding a  new
   15  subdivision 2-b to read as follows:
   16    (2-B)  ON  OR  BEFORE THE FIRST DAY OF FEBRUARY EACH YEAR, THE COMMIS-
   17  SIONER OF HEALTH SHALL PROVIDE A WRITTEN REPORT TO THE TEMPORARY  PRESI-
   18  DENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE SENATE FINANCE
   19  COMMITTEE,  CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, CHAIR OF THE
   20  SENATE COMMITTEE ON HEALTH, AND CHAIR OF THE ASSEMBLY HEALTH  COMMITTEE.
   21  SUCH  REPORT  SHALL  INCLUDE  HOW  THE  MONIES OF THE FUND WERE UTILIZED
   22  DURING THE PRECEDING CALENDAR YEAR AND SHALL INCLUDE:
   23    (I) THE AMOUNT OF MONEY DISPERSED FROM THE FUND;
   24    (II) RECIPIENTS OF AWARDS FROM THE FUND;
   25    (III) THE AMOUNT AWARDED TO EACH; AND
   26    (IV) THE PURPOSES FOR WHICH SUCH AWARDS WERE GRANTED.
   27    S 10. Paragraph (c) of subdivision 1 of section  2815  of  the  public
   28  health  law,  as added by chapter 639 of the laws of 1996, is amended to
   29  read as follows:
   30    (c) "Participating [general hospital] BORROWER" shall mean a  not-for-
   31  profit  general hospital, A NOT-FOR-PROFIT DIAGNOSTIC CENTER, A NOT-FOR-
   32  PROFIT TREATMENT CENTER, A NOT-FOR-PROFIT RESIDENTIAL HEALTH CARE FACIL-
   33  ITY OR  ANY  OTHER  NOT-FOR-PROFIT  ENTITY  IN  POSSESSION  OF  A  VALID
   34  OPERATING  CERTIFICATE  ISSUED  PURSUANT TO THIS ARTICLE, EACH organized
   35  under the laws of this state, which has been approved for  participation
   36  in this program by the commissioner.
   37    S  11.  Paragraphs (b), (c), and (d) of subdivision 3 and subdivisions
   38  3-a, 4, 5, and 6 of section 2815 of the public health law, as  added  by
   39  chapter  639  of the laws of 1996, subdivision 3-a as added by chapter 1
   40  of the laws of 1999, are amended to read as follows:
   41    (b) for the development  and  implementation  of  business  plans  for
   42  participating  [general hospitals] BORROWERS, addressing the development
   43  of service delivery strategies, including strategies for  the  formation
   44  or  strengthening  of  networks, affiliations or other business combina-
   45  tions, designed to provide  long-term  financial  stability  within  and
   46  among participating [general hospitals] BORROWERS;
   47    (c)  for  the  expenditure  or loan of funds by the authority from the
   48  restructuring pool to reimburse  the  authority  or  the  agency,  where
   49  appropriate,  for  the costs of engaging management, legal or accounting
   50  consultants to identify, develop and implement improved  strategies  for
   51  one or more participating [general hospitals] BORROWERS for implementing
   52  the  recommendations of such consultants, where appropriate, and for the
   53  payment of debt service on bonds, notes or other obligations  issued  or
   54  incurred  by  the  authority  or the agency to fund loans to one or more
   55  participating [general hospitals] BORROWERS;
       S. 6914                            19                            A. 9205

    1    (d) for assurances that participating  [general  hospitals]  BORROWERS
    2  will  address  the  recommendations  of such consultants and furnish the
    3  commissioner, the authority, and where applicable, the agency, with such
    4  additional financial, management, legal and operational  information  as
    5  each  may  deem  necessary to monitor the performance of a participating
    6  [general hospital] BORROWER; and
    7    3-a. Any participating  [general  hospital]  BORROWER  may  apply  for
    8  restructuring  pool  funds  to  the  extent  such funds are derived from
    9  deposits made pursuant to paragraph (d) of subdivision  one  of  section
   10  twenty-eight  hundred  seven-l of this article, provided, however, that,
   11  in reviewing such applications, the commissioner and the authority shall
   12  consider the extent to which  the  applicant  hospital  has  alternative
   13  available  sources of funds, including, but not limited to, funds avail-
   14  able through affiliation agreements with other hospitals OR ENTITIES.
   15    4. To the extent funds are available  from  a  participating  [general
   16  hospital]  BORROWER  therefor,  expenditures from the restructuring pool
   17  shall be repaid to the restructuring pool from  repayments  received  by
   18  the  authority,  or  the  agency  where applicable, from a participating
   19  [general hospital] BORROWER pursuant  to  the  terms  of  any  financing
   20  agreement,  mortgage  or  loan document permitting the recovery from the
   21  participating [general hospital]  BORROWER  of  such  expenditures.  The
   22  authority shall record and account for all such payments, which shall be
   23  deposited in the restructuring pool.
   24    5.  Loans  from  the  restructuring  pool shall be made pursuant to an
   25  agreement with the participating [general hospital] BORROWER  specifying
   26  the terms thereof, including repayment terms. The authority shall record
   27  and  account  for  all  such repayments, which shall be deposited in the
   28  restructuring pool. The authority shall notify the chair of  the  senate
   29  finance  committee, the director of the division of budget, the chair of
   30  the assembly ways and means committee, THE CHAIR OF THE SENATE COMMITTEE
   31  ON HEALTH, AND THE CHAIR OF THE ASSEMBLY  HEALTH  COMMITTEE,  five  days
   32  prior to the making of a loan from the restructuring pool. The authority
   33  shall  also report quarterly to such chairpersons on the transactions in
   34  the pool, including but not limited to RECEIPTS OR deposits to the pool,
   35  DISBURSEMENTS OR loans made from the pool, investment  income,  and  the
   36  balance on hand as of the end of the month for each such quarter.
   37    6. The commissioner is authorized, with the assistance and cooperation
   38  of  the  authority,  to  provide  a  program  of technical assistance to
   39  participating [general hospitals] BORROWERS.
   40    S 12. Subdivision 2 of section 242 of  the  elder  law,  as  added  by
   41  section  5  of  part  T of chapter 56 of the laws of 2012, is amended to
   42  read as follows:
   43    2. Persons  eligible  for  catastrophic  coverage  under  section  two
   44  hundred forty-eight of this title shall include:
   45    (a) any unmarried resident who is at least sixty-five years of age and
   46  whose  income  for the calendar year immediately preceding the effective
   47  date of the annual coverage period beginning on or after January  first,
   48  two thousand one, is more than twenty thousand and less than or equal to
   49  [thirty-five]  SEVENTY-FIVE thousand dollars. After the initial determi-
   50  nation of eligibility, each eligible  individual  must  be  redetermined
   51  eligible at least every twenty-four months; and
   52    (b)  any  married resident who is at least sixty-five years of age and
   53  whose income for the calendar year immediately preceding  the  effective
   54  date  of the annual coverage period when combined with the income in the
   55  same calendar year of such married person's spouse beginning on or after
   56  January first, two  thousand  one,  is  more  than  twenty-six  thousand
       S. 6914                            20                            A. 9205

    1  dollars  and less than or equal to [fifty] ONE HUNDRED thousand dollars.
    2  After the initial determination of eligibility, each eligible individual
    3  must be redetermined eligible at least every twenty-four months.
    4    S  13.  Paragraphs  (a) and (b) of subdivision 2 of section 248 of the
    5  elder law, as added by section 17 of part T of chapter 56 of the laws of
    6  2012, are amended to read as follows:
    7    (a) Annual personal covered drug expenditures for unmarried individual
    8  eligible program participants:
    9  individual income of $20,001 to $21,000                $530
   10  individual income of $21,001 to $22,000                $550
   11  individual income of $22,001 to $23,000                $580
   12  individual income of $23,001 to $24,000                $720
   13  individual income of $24,001 to $25,000                $750
   14  individual income of $25,001 to $26,000                $780
   15  individual income of $26,001 to $27,000                $810
   16  individual income of $27,001 to $28,000                $840
   17  individual income of $28,001 to $29,000                $870
   18  individual income of $29,001 to $30,000                $900
   19  individual income of $30,001 to $31,000                $930
   20  individual income of $31,001 to $32,000                $960
   21  individual income of $32,001 to $33,000                $1,160
   22  individual income of $33,001 to $34,000                $1,190
   23  individual income of $34,001 to $35,000                $1,230
   24  INDIVIDUAL INCOME OF $35,001 TO $36,000                $1,260
   25  INDIVIDUAL INCOME OF $36,001 TO $37,000                $1,290
   26  INDIVIDUAL INCOME OF $37,001 TO $38,000                $1,320
   27  INDIVIDUAL INCOME OF $38,001 TO $39,000                $1,350
   28  INDIVIDUAL INCOME OF $39,001 TO $40,000                $1,380
   29  INDIVIDUAL INCOME OF $40,001 TO $41,000                $1,410
   30  INDIVIDUAL INCOME OF $41,001 TO $42,000                $1,440
   31  INDIVIDUAL INCOME OF $42,001 TO $43,000                $1,470
   32  INDIVIDUAL INCOME OF $43,001 TO $44,000                $1,500
   33  INDIVIDUAL INCOME OF $44,001 TO $45,000                $1,530
   34  INDIVIDUAL INCOME OF $45,001 TO $46,000                $1,560
   35  INDIVIDUAL INCOME OF $46,001 TO $47,000                $1,590
   36  INDIVIDUAL INCOME OF $47,001 TO $48,000                $1,620
   37  INDIVIDUAL INCOME OF $48,001 TO $49,000                $1,650
   38  INDIVIDUAL INCOME OF $49,001 TO $50,000                $1,680
   39  INDIVIDUAL INCOME OF $50,001 TO $51,000                $1,710
   40  INDIVIDUAL INCOME OF $51,001 TO $52,000                $1,740
   41  INDIVIDUAL INCOME OF $52,001 TO $53,000                $1,770
   42  INDIVIDUAL INCOME OF $53,001 TO $54,000                $1,800
   43  INDIVIDUAL INCOME OF $54,001 TO $55,000                $1,830
   44  INDIVIDUAL INCOME OF $55,001 TO $56,000                $1,860
   45  INDIVIDUAL INCOME OF $56,001 TO $57,000                $1,890
   46  INDIVIDUAL INCOME OF $57,001 TO $58,000                $1,920
   47  INDIVIDUAL INCOME OF $58,001 TO $59,000                $1,950
   48  INDIVIDUAL INCOME OF $59,001 TO $60,000                $1,980
   49  INDIVIDUAL INCOME OF $60,001 TO $61,000                $2,010
   50  INDIVIDUAL INCOME OF $61,001 TO $62,000                $2,040
   51  INDIVIDUAL INCOME OF $62,001 TO $63,000                $2,070
   52  INDIVIDUAL INCOME OF $63,001 TO $64,000                $2,100
   53  INDIVIDUAL INCOME OF $64,001 TO $65,000                $2,130
   54  INDIVIDUAL INCOME OF $65,001 TO $66,000                $2,160
   55  INDIVIDUAL INCOME OF $66,001 TO $67,000                $2,190
   56  INDIVIDUAL INCOME OF $67,001 TO $68,000                $2,220
       S. 6914                            21                            A. 9205

    1  INDIVIDUAL INCOME OF $68,001 TO $69,000                $2,250
    2  INDIVIDUAL INCOME OF $69,001 TO $70,000                $2,280
    3  INDIVIDUAL INCOME OF $70,001 TO $71,000                $2,310
    4  INDIVIDUAL INCOME OF $71,001 TO $72,000                $2,340
    5  INDIVIDUAL INCOME OF $72,001 TO $73,000                $2,370
    6  INDIVIDUAL INCOME OF $73,001 TO $74,000                $2,400
    7  INDIVIDUAL INCOME OF $74,001 TO $75,000                $2,430
    8    (b) Annual personal covered drug expenditures for each married
    9  individual eligible program participant:
   10  joint income of $26,001 to $27,000                     $650
   11  joint income of $27,001 to $28,000                     $675
   12  joint income of $28,001 to $29,000                     $700
   13  joint income of $29,001 to $30,000                     $725
   14  joint income of $30,001 to $31,000                     $900
   15  joint income of $31,001 to $32,000                     $930
   16  joint income of $32,001 to $33,000                     $960
   17  joint income of $33,001 to $34,000                     $990
   18  joint income of $34,001 to $35,000                     $1,020
   19  joint income of $35,001 to $36,000                     $1,050
   20  joint income of $36,001 to $37,000                     $1,080
   21  joint income of $37,001 to $38,000                     $1,110
   22  joint income of $38,001 to $39,000                     $1,140
   23  joint income of $39,001 to $40,000                     $1,170
   24  joint income of $40,001 to $41,000                     $1,200
   25  joint income of $41,001 to $42,000                     $1,230
   26  joint income of $42,001 to $43,000                     $1,260
   27  joint income of $43,001 to $44,000                     $1,290
   28  joint income of $44,001 to $45,000                     $1,320
   29  joint income of $45,001 to $46,000                     $1,575
   30  joint income of $46,001 to $47,000                     $1,610
   31  joint income of $47,001 to $48,000                     $1,645
   32  joint income of $48,001 to $49,000                     $1,680
   33  joint income of $49,001 to $50,000                     $1,715
   34  JOINT INCOME OF $50,001 TO $51,000                     $1,745
   35  JOINT INCOME OF $51,001 TO $52,000                     $1,775
   36  JOINT INCOME OF $52,001 TO $53,000                     $1,805
   37  JOINT INCOME OF $53,001 TO $54,000                     $1,835
   38  JOINT INCOME OF $54,001 TO $55,000                     $1,865
   39  JOINT INCOME OF $55,001 TO $56,000                     $1,895
   40  JOINT INCOME OF $56,001 TO $57,000                     $1,925
   41  JOINT INCOME OF $57,001 TO $58,000                     $1,955
   42  JOINT INCOME OF $58,001 TO $59,000                     $1,985
   43  JOINT INCOME OF $59,001 TO $60,000                     $2,015
   44  JOINT INCOME OF $60,001 TO $61,000                     $2,045
   45  JOINT INCOME OF $61,001 TO $62,000                     $2,075
   46  JOINT INCOME OF $62,001 TO $63,000                     $2,105
   47  JOINT INCOME OF $63,001 TO $64,000                     $2,135
   48  JOINT INCOME OF $64,001 TO $65,000                     $2,165
   49  JOINT INCOME OF $65,001 TO $66,000                     $2,195
   50  JOINT INCOME OF $66,001 TO $67,000                     $2,225
   51  JOINT INCOME OF $67,001 TO $68,000                     $2,255
   52  JOINT INCOME OF $68,001 TO $69,000                     $2,285
   53  JOINT INCOME OF $69,001 TO $70,000                     $2,315
   54  JOINT INCOME OF $70,001 TO $71,000                     $2,345
   55  JOINT INCOME OF $71,001 TO $72,000                     $2,375
   56  JOINT INCOME OF $72,001 TO $73,000                     $2,405
       S. 6914                            22                            A. 9205

    1  JOINT INCOME OF $73,001 TO $74,000                     $2,435
    2  JOINT INCOME OF $74,001 TO $75,000                     $2,465
    3  JOINT INCOME OF $75,001 TO $76,000                     $2,495
    4  JOINT INCOME OF $76,001 TO $77,000                     $2,525
    5  JOINT INCOME OF $77,001 TO $78,000                     $2,555
    6  JOINT INCOME OF $78,001 TO $79,000                     $2,585
    7  JOINT INCOME OF $79,001 TO $80,000                     $2,615
    8  JOINT INCOME OF $80,001 TO $81,000                     $2,645
    9  JOINT INCOME OF $81,001 TO $82,000                     $2,675
   10  JOINT INCOME OF $82,001 TO $83,000                     $2,705
   11  JOINT INCOME OF $83,001 TO $84,000                     $2,735
   12  JOINT INCOME OF $84,001 TO $85,000                     $2,765
   13  JOINT INCOME OF $85,001 TO $86,000                     $2,795
   14  JOINT INCOME OF $86,001 TO $87,000                     $2,825
   15  JOINT INCOME OF $87,001 TO $88,000                     $2,855
   16  JOINT INCOME OF $88,001 TO $89,000                     $2,885
   17  JOINT INCOME OF $89,001 TO $90,000                     $2,915
   18  JOINT INCOME OF $90,001 TO $91,000                     $2,945
   19  JOINT INCOME OF $91,001 TO $92,000                     $2,975
   20  JOINT INCOME OF $92,001 TO $93,000                     $3,005
   21  JOINT INCOME OF $93,001 TO $94,000                     $3,035
   22  JOINT INCOME OF $94,001 TO $95,000                     $3,065
   23  JOINT INCOME OF $95,001 TO $96,000                     $3,095
   24  JOINT INCOME OF $96,001 TO $97,000                     $3,125
   25  JOINT INCOME OF $97,001 TO $98,000                     $3,155
   26  JOINT INCOME OF $98,001 TO $99,000                     $3,185
   27  JOINT INCOME OF $99,001 TO $100,000                    $3,215
   28    S  14.  Paragraphs  (a) and (b) of subdivision 4 of section 248 of the
   29  elder law, as added by section 17 of part T of chapter 56 of the laws of
   30  2012, are amended to read as follows:
   31    (a) Limits on co-payments by  unmarried  individual  eligible  program
   32  participants:
   33  individual income of $20,001 to $21,000           no more than $1,050
   34  individual income of $21,001 to $22,000           no more than $1,100
   35  individual income of $22,001 to $23,000           no more than $1,150
   36  individual income of $23,001 to $24,000           no more than $1,200
   37  individual income of $24,001 to $25,000           no more than $1,250
   38  individual income of $25,001 to $26,000           no more than $1,300
   39  individual income of $26,001 to $27,000           no more than $1,350
   40  individual income of $27,001 to $28,000           no more than $1,400
   41  individual income of $28,001 to $29,000           no more than $1,450
   42  individual income of $29,001 to $30,000           no more than $1,500
   43  individual income of $30,001 to $31,000           no more than $1,550
   44  individual income of $31,001 to $32,000           no more than $1,600
   45  individual income of $32,001 to $33,000           no more than $1,650
   46  individual income of $33,001 to $34,000           no more than $1,700
   47  individual income of $34,001 to                   no more than $1,750
   48    [$35,000] $75,000
   49    (b)  Limits on co-payments by each married individual eligible program
   50  participant:
   51  joint income of $26,001 to $27,000                no more than $1,080
   52  joint income of $27,001 to $28,000                no more than $1,120
   53  joint income of $28,001 to $29,000                no more than $1,160
   54  joint income of $29,001 to $30,000                no more than $1,200
   55  joint income of $30,001 to $31,000                no more than $1,240
   56  joint income of $31,001 to $32,000                no more than $1,280
       S. 6914                            23                            A. 9205

    1  joint income of $32,001 to $33,000                no more than $1,320
    2  joint income of $33,001 to $34,000                no more than $1,360
    3  joint income of $34,001 to $35,000                no more than $1,400
    4  joint income of $35,001 to $36,000                no more than $1,440
    5  joint income of $36,001 to $37,000                no more than $1,480
    6  joint income of $37,001 to $38,000                no more than $1,520
    7  joint income of $38,001 to $39,000                no more than $1,560
    8  joint income of $39,001 to $40,000                no more than $1,600
    9  joint income of $40,001 to $41,000                no more than $1,640
   10  joint income of $41,001 to $42,000                no more than $1,680
   11  joint income of $42,001 to $43,000                no more than $1,720
   12  joint income of $43,001 to $44,000                no more than $1,760
   13  joint income of $44,001 to $45,000                no more than $1,800
   14  joint income of $45,001 to $46,000                no more than $1,840
   15  joint income of $46,001 to $47,000                no more than $1,880
   16  joint income of $47,001 to $48,000                no more than $1,920
   17  joint income of $48,001 to $49,000                no more than $1,960
   18  joint income of $49,001 to                        no more than $2,000
   19    [$50,000] $100,000
   20    S  15. Subdivision 1 of section 924 of the public health law, as added
   21  by section 23 of part D of chapter 56 of the laws of 2012, is amended to
   22  read as follows:
   23    1. [The] NOTWITHSTANDING  ANY  CONTRARY  PROVISION  OF  THIS  SECTION,
   24  SECTIONS  ONE  HUNDRED  TWELVE  AND ONE HUNDRED SIXTY-THREE OF THE STATE
   25  FINANCE LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE commissioner is
   26  authorized, within amounts available therefor, to  make  loan  repayment
   27  awards to eligible primary care service corps practitioners who agree to
   28  practice  full-time in an underserved area in New York state, in amounts
   29  to be determined by the commissioner, but not to exceed thirty-two thou-
   30  sand dollars per year for any year in which such  practitioners  provide
   31  full-time eligible obligated service, WITHOUT COMPETITIVE BID OR REQUEST
   32  FOR PROPOSAL PROCESS.
   33    S  16.  Paragraph (b) of subdivision 18-a of section 206 of the public
   34  health law, as amended by section 38-a of part H of chapter  59  of  the
   35  laws of 2011, is amended and paragraph (c) is added to read as follows:
   36    (b) The commissioner shall:
   37    (I) CONVENE A WORKGROUP TO:
   38    (A)  EVALUATE THE STATE'S HEALTH INFORMATION TECHNOLOGY INFRASTRUCTURE
   39  AND SYSTEMS, AS WELL AS OTHER RELATED PLANS  AND  PROJECTS  DESIGNED  TO
   40  MAKE  IMPROVEMENTS  OR  MODIFICATIONS TO SUCH INFRASTRUCTURE AND SYSTEMS
   41  INCLUDING, BUT NOT LIMITED TO, THE ALL PAYOR DATABASE (APD),  THE  STATE
   42  PLANNING  AND  RESEARCH  COOPERATIVE  SYSTEM  (SPARCS),  REGIONAL HEALTH
   43  INFORMATION ORGANIZATIONS  (RHIOS),  THE  STATEWIDE  HEALTH  INFORMATION
   44  NETWORK  OF  NEW  YORK  (SHIN-NY)  AND  MEDICAL  ASSISTANCE  ELIGIBILITY
   45  SYSTEMS; AND
   46    (B) DEVELOP RECOMMENDATIONS FOR THE STATE TO MOVE TOWARD A  COMPREHEN-
   47  SIVE  HEALTH  CLAIMS AND CLINICAL DATABASE AIMED AT IMPROVING QUALITY OF
   48  CARE, EFFICIENCY, COST OF CARE AND PATIENT SATISFACTION AVAILABLE  IN  A
   49  SELF-SUSTAINABLE,  NON-DUPLICATIVE, INTERACTIVE AND INTEROPERABLE MANNER
   50  THAT ENSURES SAFEGUARDS FOR PRIVACY, CONFIDENTIALITY AND SECURITY;
   51    (II) SUBMIT A REPORT TO THE GOVERNOR AND THE  TEMPORARY  PRESIDENT  OF
   52  THE  SENATE  AND THE SPEAKER OF THE ASSEMBLY, WHICH SHALL FULLY CONSIDER
   53  THE EVALUATION AND RECOMMENDATIONS OF THE WORKGROUP, ON OR BEFORE DECEM-
   54  BER FIRST, TWO THOUSAND FOURTEEN.
   55    (C) THE MEMBERS OF THE WORKGROUP SHALL INCLUDE, AT  A  MINIMUM,  THREE
   56  MEMBERS  WHO REPRESENT RHIOS, TWO MEMBERS EMPLOYED BY THE DEPARTMENT WHO
       S. 6914                            24                            A. 9205

    1  ARE INVOLVED IN THE DEVELOPMENT OF THE SHIN-NY AND THE APD, TWO  MEMBERS
    2  WHO  REPRESENT  PHYSICIANS,  TWO  MEMBERS  WHO  REPRESENT HOSPITALS, ONE
    3  MEMBER WHO REPRESENTS FEDERALLY QUALIFIED HEALTH CENTERS, THE  CHAIR  OF
    4  THE  SENATE  HEALTH  COMMITTEE  OR HIS OR HER DESIGNEE, THE CHAIR OF THE
    5  ASSEMBLY HEALTH COMMITTEE OR HIS OR HER DESIGNEE, AND OTHER  INDIVIDUALS
    6  WITH EXPERTISE IN MATTERS RELEVANT TO THE CHARGE OF THE WORKGROUP.
    7    (D)  THE  COMMISSIONER  MAY  make such rules and regulations as may be
    8  necessary to implement federal policies and disburse funds  as  required
    9  by the American Recovery and Reinvestment Act of 2009 and to promote the
   10  development  of  a  [statewide health information network of New York (]
   11  SELF-SUFFICIENT SHIN-NY[)] to enable widespread, NON-DUPLICATIVE  inter-
   12  operability  among disparate health information systems, including elec-
   13  tronic health records, personal  health  records,  health  care  claims,
   14  PAYMENT  and  other  administrative  data, and public health information
   15  systems, while protecting privacy and security.  Such  rules  and  regu-
   16  lations shall include, but not be limited to, requirements for organiza-
   17  tions  covered  by  42  U.S.C.  17938  or  any  other organizations that
   18  exchange health information through the SHIN-NY OR ANY  OTHER  STATEWIDE
   19  HEALTH INFORMATION SYSTEM RECOMMENDED BY THE WORKGROUP. THE COMMISSIONER
   20  SHALL CONSIDER THE RECOMMENDATIONS OF THE WORKGROUP. IF THE COMMISSIONER
   21  ACTS IN A MANNER INCONSISTENT WITH THE RECOMMENDATIONS OF THE WORKGROUP,
   22  HE OR SHE SHALL PROVIDE THE REASONS THEREFOR.
   23    S  17.  Section  2818 of the public health law is amended to add a new
   24  subdivision 8 to read as follows:
   25    8. ON OR BEFORE DECEMBER FIRST, TWO THOUSAND FOURTEEN, THE  DEPARTMENT
   26  SHALL  ISSUE  A  REPORT  TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE
   27  SENATE AND THE SPEAKER OF THE ASSEMBLY REGARDING GRANTS MADE PURSUANT TO
   28  THIS SECTION TO SUPPORT HEALTH INFORMATION TECHNOLOGY.
   29    S 18. The public health law is amended by adding a new section  2801-h
   30  to read as follows:
   31    S  2801-H.  COMMUNITY  FORUM ON ESTABLISHMENT OF CERTAIN FACILITIES IN
   32  THE COUNTY OF BRONX. 1. FOR ANY PROPOSED FREE  STANDING  CLINIC,  OUTPA-
   33  TIENT  HEALTH  CARE FACILITY OR AMBULATORY HEALTH CARE CENTER THAT:  (I)
   34  IS TO BE OVER THREE STORIES IN HEIGHT OR TO CONTAIN OVER THIRTY THOUSAND
   35  SQUARE FEET, (II) IS PROPOSED TO BE LOCATED IN THE COUNTY OF BRONX,  AND
   36  (III)  IS  SPONSORED,  DIRECTLY  OR  INDIRECTLY, BY A HOSPITAL, THEN THE
   37  SPONSORING HOSPITAL SHALL, PRIOR TO THE ESTABLISHMENT  OF  SUCH  CLINIC,
   38  FACILITY  OR  CENTER,  FILE  A  NOTICE  THEREOF WITH THE DEPARTMENT, THE
   39  EDUCATION DEPARTMENT AND THE COMMUNITY BOARD OF THE  LOCALITY  IN  WHICH
   40  THE CLINIC, FACILITY OR CENTER IS TO BE ESTABLISHED.
   41    2.  NOT  LESS  THAN  ONE HUNDRED EIGHTY DAYS NOR MORE THAN TWO HUNDRED
   42  SEVENTY DAYS AFTER RECEIPT OF A SPONSORING HOSPITAL'S NOTICE PURSUANT TO
   43  SUBDIVISION ONE OF THIS SECTION, THE COMMISSIONER SHALL  HOLD  A  PUBLIC
   44  COMMUNITY  FORUM FOR THE PURPOSE OF OBTAINING PUBLIC AND COMMUNITY BOARD
   45  INPUT CONCERNING THE ANTICIPATED IMPACT OF THE ESTABLISHMENT OF  A  FREE
   46  STANDING  CLINIC,  OUTPATIENT  HEALTH CARE FACILITY OR AMBULATORY HEALTH
   47  CARE FACILITY. SUCH IMPACT MAY INCLUDE AND RELATE TO:  (I) THE APPROPRI-
   48  ATENESS OF THE SIZE, HEIGHT, BULK DIMENSIONS AND SCOPE OF  SUCH  CLINIC,
   49  FACILITY  OR CENTER WHEN COMPARED TO THE SURROUNDING PHYSICAL CHARACTER-
   50  ISTICS AND SOCIAL FABRIC  OF  SUCH  COMMUNITY,  (II)  THE  PROVISION  OF
   51  ADEQUATE  MOTOR  VEHICLE  PARKING TO ACCOMMODATE SUCH FACILITY NEEDS AND
   52  WHICH DOES NOT DIMINISH THE CURRENT SUPPLY OF PARKING FOR  NEARBY  RESI-
   53  DENTS  OR  INCREASE  TRAFFIC  CONGESTION  NEAR  SUCH FACILITY, (III) THE
   54  CURRENT ACCESS TO APPROPRIATE MEDICAL FACILITIES  OR  THE  PROVISION  OF
   55  ESSENTIAL MEDICAL SERVICES TO SUCH COMMUNITY, SERVICE AREA AND SURROUND-
   56  ING  COMMUNITIES,  AND (IV) OPTIONS AND PROPOSALS TO AMELIORATE OR MITI-
       S. 6914                            25                            A. 9205

    1  GATE ANTICIPATED ADVERSE IMPACTS TO THE LOCAL COMMUNITY.    THE  COMMIS-
    2  SIONER  SHALL  AFFORD  COMMUNITY  MEMBERS,  REPRESENTATIVES OF THE LOCAL
    3  COMMUNITY BOARD, LOCAL BUSINESSES AND CONSUMERS A REASONABLE OPPORTUNITY
    4  TO  SPEAK  ABOUT  RELEVANT  MATTERS AT SUCH COMMUNITY FORUM.  EVERY SUCH
    5  FORUM SHALL BE HELD UPON  NOT  LESS  THAN  THIRTY  DAYS  NOTICE  TO  THE
    6  AFFECTED COMMUNITY AND THE LOCAL COMMUNITY BOARD.
    7    3.  THE  COMMISSIONER  SHALL, PRIOR TO ESTABLISHING THE DATE, TIME AND
    8  LOCATION OF THE PUBLIC COMMUNITY FORUM, CONSULT  WITH,  AND  OBTAIN  THE
    9  ADVICE  AND CONSENT OF THE APPROPRIATE COMMUNITY BOARD, AS TO ESTABLISH-
   10  ING A CONVENIENT DATE, TIME AND LOCATION TO CONDUCT THE  FORUM  FOR  THE
   11  LOCALLY  IMPACTED  COMMUNITY.    SUCH  HEARING  LOCATION SHALL BE WITHIN
   12  REASONABLE PROXIMITY TO THE PROPOSED CLINIC, FACILITY OR CENTER, AND  IN
   13  SUITABLE FACILITIES THAT PROVIDE ADEQUATE ROOM AND ACCESS TO HEAR PUBLIC
   14  COMMENTS PRESENTED.
   15    4.  NOT  LATER  THAN  NINETY  DAYS AFTER HOLDING A COMMUNITY FORUM THE
   16  COMMISSIONER SHALL MAKE AVAILABLE TO  THE  PUBLIC  ON  THE  DEPARTMENT'S
   17  WEBSITE  THE  REASONS  WHY  SUCH  FACILITY IS, BY A PREPONDERANCE OF THE
   18  EVIDENCE, IN THE BEST INTERESTS OF  THOSE  WHO  LIVE  WITHIN  THE  LOCAL
   19  COMMUNITY  AND  WITHIN  THE LOCAL SERVICE AREA AS IT RELATES TO: (I) THE
   20  APPROPRIATENESS OF THE SIZE, HEIGHT, BULK DIMENSIONS AND SCOPE  OF  SUCH
   21  CLINIC,  FACILITY  OR  CENTER  WHEN COMPARED TO THE SURROUNDING PHYSICAL
   22  CHARACTERISTICS AND SOCIAL FABRIC OF SUCH COMMUNITY, (II) THE  PROVISION
   23  OF ADEQUATE MOTOR VEHICLE PARKING TO ACCOMMODATE SUCH FACILITY NEEDS AND
   24  WHICH  DOES  NOT DIMINISH THE CURRENT SUPPLY OF PARKING FOR NEARBY RESI-
   25  DENTS OR INCREASE TRAFFIC CONGESTION NEAR SUCH FACILITY, AND  (III)  THE
   26  CURRENT  ACCESS  TO  APPROPRIATE  MEDICAL FACILITIES OR THE PROVISION OF
   27  ESSENTIAL MEDICAL SERVICES TO SUCH COMMUNITY, SERVICE AREA AND SURROUND-
   28  ING COMMUNITIES.
   29    5. AFTER DUE CONSIDERATION OF THE COMMENTS AT THE COMMUNITY FORUM  AND
   30  CONSULTATION  WITH  THE  EDUCATION  DEPARTMENT,  THE  COMMISSIONER SHALL
   31  EITHER APPROVE, MODIFY OR DENY AUTHORIZATION FOR  THE  ESTABLISHMENT  OF
   32  ANY SUCH CLINIC, FACILITY OR CENTER.
   33    S 19. For claims for payment submitted by early intervention providers
   34  to  third  party  payors between the period April 1, 2013 until June 30,
   35  2013 in accordance with title 2-A of article 25  of  the  public  health
   36  law,  for  which the third party payor has not, on the effective date of
   37  this section, made payment of the claim in whole or in part or  rendered
   38  a  determination that it is not obligated to pay the claim, the provider
   39  shall be authorized to seek payment of such claim from the municipality,
   40  through the fiscal agent under contract with the department  of  health;
   41  provided,  however,  that  the  provider  shall  continue  to render any
   42  assistance  needed,  and  provide  any  information  and   documentation
   43  requested  by  the  third party payor to facilitate payment of the claim
   44  even if the provider has already received payment from the municipality.
   45  If such third party payor makes payment of the claim after the  provider
   46  has  received  payment  from  the  municipality, the third party payment
   47  shall be reconciled against future payments due the  provider  from  the
   48  municipality.  This  section  shall  only  apply  to claims submitted by
   49  approved early intervention providers to third party payors  during  the
   50  period  April 1, 2013 until June 30, 2013 for which no payment or deter-
   51  mination has been made, as specified in this section, on April 1,  2014.
   52  Payment  shall  be made on the forty-fifth day after this act shall take
   53  effect. The provisions in subdivision 2 of section 2557  of  the  public
   54  health  law  that  prohibit state reimbursement from being paid prior to
   55  April first of the year in which the approved  costs  are  paid  by  the
       S. 6914                            26                            A. 9205

    1  municipality  shall  not apply to the municipal payments made under this
    2  section.
    3    S 20. Article 29-D of the public health law is amended by adding a new
    4  title 1-A to read as follows:
    5                                  TITLE 1-A
    6                            SAFE PATIENT HANDLING
    7  SECTION 2997-G. LEGISLATIVE INTENT.
    8          2997-H. DEFINITIONS.
    9          2997-I. SAFE PATIENT HANDLING WORKGROUP.
   10          2997-J. DISSEMINATION OF BEST PRACTICES, EXAMPLES OF SAMPLE SAFE
   11                   PATIENT  HANDLING  POLICIES  AND  OTHER  RESOURCES  AND
   12                   TOOLS.
   13          2997-K. SAFE PATIENT HANDLING COMMITTEES; PROGRAMS.
   14          2997-L. ACTIVITIES.
   15    S  2997-G.  LEGISLATIVE  INTENT.  THE  LEGISLATURE  HEREBY  FINDS  AND
   16  DECLARES THAT IT IS IN THE PUBLIC INTEREST FOR HEALTH CARE FACILITIES TO
   17  IMPLEMENT  SAFE  PATIENT HANDLING POLICIES. THERE ARE MANY BENEFITS THAT
   18  CAN BE DERIVED FROM SAFE PATIENT  HANDLING  PROGRAMS.  PATIENTS  BENEFIT
   19  THROUGH  IMPROVED  QUALITY  OF  CARE AND QUALITY OF LIFE BY REDUCING THE
   20  RISK OF INJURY. CAREGIVERS ALSO BENEFIT FROM THE REDUCED RISK OF  CAREER
   21  ENDING  AND  DEBILITATING INJURIES LEADING TO INCREASED MORALE, IMPROVED
   22  JOB SATISFACTION, AND LONGEVITY IN THE PROFESSION. HEALTH  CARE  FACILI-
   23  TIES  MAY  REALIZE A RETURN ON THEIR INVESTMENT THROUGH REDUCED WORKERS'
   24  COMPENSATION MEDICAL AND INDEMNITY COSTS,  REDUCED  LOST  WORKDAYS,  AND
   25  IMPROVED RECRUITMENT AND RETENTION OF CAREGIVERS. ALL OF THIS COULD LEAD
   26  TO FISCAL IMPROVEMENT IN HEALTH CARE IN NEW YORK STATE.
   27    S 2997-H. DEFINITIONS. FOR THE PURPOSES OF THIS TITLE:
   28    1.  "HEALTH  CARE  FACILITY" SHALL MEAN GENERAL HOSPITALS, RESIDENTIAL
   29  HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT  CENTERS,  AND  CLINICS
   30  LICENSED  PURSUANT  TO  ARTICLE TWENTY-EIGHT OF THIS CHAPTER, FACILITIES
   31  WHICH PROVIDE HEALTH CARE SERVICES AND ARE LICENSED OR OPERATED PURSUANT
   32  TO ARTICLE EIGHT OF THE EDUCATION LAW, ARTICLE NINETEEN-G OF THE  EXECU-
   33  TIVE  LAW  OR  THE  CORRECTION LAW, AND HOSPITALS AND SCHOOLS DEFINED IN
   34  SECTION 1.03 OF THE MENTAL HYGIENE LAW.
   35    2. "NURSE" SHALL MEAN A REGISTERED PROFESSIONAL NURSE  OR  A  LICENSED
   36  PRACTICAL  NURSE  AS  DEFINED  BY ARTICLE ONE HUNDRED THIRTY-NINE OF THE
   37  EDUCATION LAW.
   38    3. "DIRECT CARE WORKER" SHALL MEAN  ANY  EMPLOYEE  OF  A  HEALTH  CARE
   39  FACILITY  WHO  IS RESPONSIBLE FOR PATIENT HANDLING OR PATIENT ASSESSMENT
   40  AS A REGULAR OR INCIDENTAL PART OF HIS OR HER EMPLOYMENT, INCLUDING  ANY
   41  LICENSED OR UNLICENSED HEALTH CARE WORKER.
   42    4.  "EMPLOYEE  REPRESENTATIVE"  SHALL MEAN THE RECOGNIZED OR CERTIFIED
   43  COLLECTIVE BARGAINING AGENT FOR NURSES  OR  DIRECT  CARE  WORKERS  OF  A
   44  HEALTH CARE FACILITY.
   45    5. "SAFE PATIENT HANDLING" SHALL MEAN THE USE OF ENGINEERING CONTROLS,
   46  LIFTING  AND TRANSFER AIDS, OR ASSISTIVE DEVICES BY STAFF TO PERFORM THE
   47  ACTS OF LIFTING, TRANSFERRING AND REPOSITIONING HEALTH CARE PATIENTS AND
   48  RESIDENTS.
   49    6. "MUSCULOSKELETAL DISORDERS" SHALL MEAN CONDITIONS THAT INVOLVE  THE
   50  NERVES, TENDONS, MUSCLES AND SUPPORTING STRUCTURES OF THE BODY.
   51    S  2997-I.  SAFE PATIENT HANDLING WORKGROUP. 1. THE COMMISSIONER SHALL
   52  ESTABLISH A SAFE PATIENT HANDLING WORKGROUP (REFERRED TO IN THIS SECTION
   53  AS THE "WORKGROUP") WITHIN THE DEPARTMENT. THE WORKGROUP  SHALL  CONSIST
   54  OF, AT THE MINIMUM, THE COMMISSIONER OR HIS OR HER DESIGNEE; THE COMMIS-
   55  SIONER  OF  LABOR OR HIS OR HER DESIGNEE; REPRESENTATIVES OF HEALTH CARE
   56  PROVIDER  ORGANIZATIONS;  REPRESENTATIVES  FROM  EMPLOYEE  ORGANIZATIONS
       S. 6914                            27                            A. 9205

    1  REPRESENTING  NURSES  AND  REPRESENTATIVES  FROM  EMPLOYEE ORGANIZATIONS
    2  REPRESENTING DIRECT CARE WORKERS; REPRESENTATIVES OF  NURSE  EXECUTIVES;
    3  REPRESENTATIVES WHO ARE CERTIFIED ERGONOMIST EVALUATION SPECIALISTS; AND
    4  REPRESENTATIVES  WHO  HAVE  EXPERTISE IN FIELDS OF DISCIPLINE RELATED TO
    5  HEALTH CARE OR OCCUPATIONAL SAFETY.
    6    2. WORKGROUP MEMBERS SHALL RECEIVE NO COMPENSATION FOR THEIR  SERVICES
    7  AS  MEMBERS  OF  THE  WORKGROUP,  BUT SHALL BE REIMBURSED FOR ACTUAL AND
    8  NECESSARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
    9    3. THE WORKGROUP SHALL BE ESTABLISHED NO LATER THAN JANUARY FIRST, TWO
   10  THOUSAND FIFTEEN.
   11    4. THE WORKGROUP SHALL:
   12    (A) REVIEW  EXISTING  SAFE  PATIENT  HANDLING  PROGRAMS  OR  POLICIES,
   13  INCLUDING  DEMONSTRATION PROGRAMS PREVIOUSLY AUTHORIZED BY CHAPTER SEVEN
   14  HUNDRED THIRTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE AND NATIONAL  DATA
   15  AND RESULTS;
   16    (B)  CONSULT  WITH  ANY  ORGANIZATION,  EDUCATIONAL INSTITUTION, OTHER
   17  GOVERNMENT ENTITY OR AGENCY OR PERSON THAT THE WORKGROUP DETERMINES  MAY
   18  BE  ABLE  TO  PROVIDE  INFORMATION  AND EXPERTISE ON THE DEVELOPMENT AND
   19  IMPLEMENTATION OF SAFE PATIENT HANDLING PROGRAMS;
   20    (C) IDENTIFY OR DEVELOP TRAINING MATERIALS FOR CONSIDERATION BY HEALTH
   21  CARE FACILITIES; AND
   22    (D) SUBMIT A REPORT TO THE COMMISSIONER BY JULY  FIRST,  TWO  THOUSAND
   23  FIFTEEN  IDENTIFYING  SAFE  PATIENT  HANDLING  PROGRAM  BEST  PRACTICES,
   24  PROVIDING EXAMPLES OF SAMPLE POLICIES,  AND  IDENTIFYING  RESOURCES  AND
   25  TOOLS  USEFUL  FOR  PROVIDERS TO MEET THE GOALS OF SAFE PATIENT HANDLING
   26  POLICIES.
   27    5. ALL STATE DEPARTMENTS, COMMISSIONS, AGENCIES, AND  PUBLIC  AUTHORI-
   28  TIES  SHALL  PROVIDE THE WORKGROUP WITH ANY REASONABLY REQUESTED ASSIST-
   29  ANCE OR ADVICE IN A TIMELY MANNER.
   30    S 2997-J. DISSEMINATION OF BEST PRACTICES,  EXAMPLES  OF  SAMPLE  SAFE
   31  PATIENT HANDLING POLICIES AND OTHER RESOURCES AND TOOLS. THE COMMISSION-
   32  ER  SHALL  DISSEMINATE  BEST  PRACTICES, EXAMPLES OF SAMPLE SAFE PATIENT
   33  HANDLING POLICIES, AND OTHER RESOURCES AND TOOLS TO HEALTH CARE  FACILI-
   34  TIES,  TAKING INTO CONSIDERATION THE RECOMMENDATIONS OF THE SAFE PATIENT
   35  HANDLING WORKGROUP. SUCH BEST PRACTICES, EXAMPLES OF SAMPLE SAFE PATIENT
   36  HANDLING POLICIES, AND OTHER RESOURCES AND TOOLS SHALL BE MADE AVAILABLE
   37  TO ALL FACILITIES COVERED BY THIS TITLE ON OR BEFORE JANUARY FIRST,  TWO
   38  THOUSAND SIXTEEN.
   39    S  2997-K. SAFE PATIENT HANDLING COMMITTEES; PROGRAMS. 1. ON OR BEFORE
   40  JANUARY FIRST, TWO THOUSAND SIXTEEN, EACH  HEALTH  CARE  FACILITY  SHALL
   41  ESTABLISH A SAFE PATIENT HANDLING COMMITTEE (REFERRED TO IN THIS SECTION
   42  AS  A  "COMMITTEE"  EXCEPT WHERE THE CONTEXT CLEARLY REQUIRES OTHERWISE)
   43  EITHER BY CREATING A NEW COMMITTEE OR ASSIGNING THE FUNCTIONS OF A  SAFE
   44  PATIENT  HANDLING  COMMITTEE TO AN EXISTING COMMITTEE, INCLUDING BUT NOT
   45  LIMITED TO A SAFETY COMMITTEE OR QUALITY ASSURANCE COMMITTEE, OR SUBCOM-
   46  MITTEE THEREOF. THE PURPOSE OF A COMMITTEE IS TO  DESIGN  AND  RECOMMEND
   47  THE  PROCESS  FOR  IMPLEMENTING  A SAFE PATIENT HANDLING PROGRAM FOR THE
   48  HEALTH CARE FACILITY.  THE  COMMITTEE  SHALL  INCLUDE  INDIVIDUALS  WITH
   49  EXPERTISE  OR  EXPERIENCE  THAT  IS  RELEVANT  TO SAFE PATIENT HANDLING,
   50  INCLUDING RISK MANAGEMENT, NURSING, PURCHASING, OR  OCCUPATIONAL  SAFETY
   51  AND  HEALTH, AND IN FACILITIES WHERE THERE ARE EMPLOYEE REPRESENTATIVES,
   52  AT LEAST ONE SHALL BE APPOINTED ON BEHALF OF NURSES  AND  AT  LEAST  ONE
   53  SHALL  BE  APPOINTED  ON  BEHALF OF DIRECT CARE WORKERS. ONE HALF OF THE
   54  MEMBERS OF THE COMMITTEE SHALL BE FRONTLINE NON-MANAGERIAL EMPLOYEES WHO
   55  PROVIDE DIRECT CARE TO PATIENTS. AT LEAST ONE NON-MANAGERIAL  NURSE  AND
   56  ONE  NON-MANAGERIAL  DIRECT  CARE  WORKER  SHALL  BE ON THE SAFE PATIENT
       S. 6914                            28                            A. 9205

    1  HANDLING COMMITTEE. IN HEALTH CARE FACILITIES WHERE A  RESIDENT  COUNCIL
    2  IS  ESTABLISHED,  AND  WHERE  FEASIBLE,  AT LEAST ONE MEMBER OF THE SAFE
    3  PATIENT HANDLING COMMITTEE SHALL BE A REPRESENTATIVE FROM  THE  RESIDENT
    4  COUNCIL.    THE COMMITTEE SHALL HAVE TWO CO-CHAIRS WITH ONE FROM MANAGE-
    5  MENT AND ONE FRONTLINE NON-MANAGERIAL NURSE OR DIRECT CARE WORKER.
    6    2. ON OR BEFORE JANUARY FIRST, TWO  THOUSAND  SEVENTEEN,  EACH  HEALTH
    7  CARE  FACILITY,  IN  CONSULTATION  WITH THE COMMITTEE, SHALL ESTABLISH A
    8  SAFE PATIENT HANDLING PROGRAM. AS PART OF THIS PROGRAM,  A  HEALTH  CARE
    9  FACILITY SHALL:
   10    (A) IMPLEMENT A SAFE PATIENT HANDLING POLICY, CONSIDERING THE ELEMENTS
   11  OF  THE SAMPLE SAFE PATIENT HANDLING POLICIES AND BEST PRACTICES DISSEM-
   12  INATED BY THE COMMISSIONER, AS WELL AS THE  TYPE  OF  FACILITY  AND  ITS
   13  SERVICES,  PATIENT  POPULATIONS AND CARE PLANS, TYPES OF CAREGIVERS, AND
   14  PHYSICAL ENVIRONMENT, FOR ALL SHIFTS AND UNITS OF THE HEALTH CARE FACIL-
   15  ITY.  IMPLEMENTATION OF THE SAFE PATIENT HANDLING POLICY MAY BE  PHASED-
   16  IN;
   17    (B)  CONDUCT  A  PATIENT  HANDLING  HAZARD ASSESSMENT. THIS ASSESSMENT
   18  SHOULD CONSIDER SUCH VARIABLES AS PATIENT-HANDLING TASKS, TYPES OF NURS-
   19  ING UNITS, PATIENT POPULATIONS AND THE PHYSICAL ENVIRONMENT  OF  PATIENT
   20  CARE AREAS;
   21    (C)  DEVELOP  A  PROCESS  TO  IDENTIFY THE APPROPRIATE USE OF THE SAFE
   22  PATIENT HANDLING POLICY BASED ON  THE  PATIENT'S  PHYSICAL  AND  MEDICAL
   23  CONDITION  AND  THE AVAILABILITY OF SAFE PATIENT HANDLING EQUIPMENT. THE
   24  POLICY SHALL INCLUDE A MEANS TO ADDRESS  CIRCUMSTANCES  UNDER  WHICH  IT
   25  WOULD  BE  CONTRAINDICATED  BASED  ON  A  PATIENT'S  PHYSICAL,  MEDICAL,
   26  WEIGHT-BEARING, COGNITIVE AND/OR REHABILITATIVE STATUS TO USE LIFTING OR
   27  TRANSFER AIDS OR ASSISTIVE DEVICES FOR PARTICULAR PATIENTS;
   28    (D) PROVIDE INITIAL AND ON-GOING YEARLY TRAINING AND EDUCATION ON SAFE
   29  PATIENT HANDLING FOR CURRENT EMPLOYEES  AND  NEW  HIRES,  AND  ESTABLISH
   30  PROCEDURES  TO ENSURE THAT RETRAINING FOR THOSE FOUND TO BE DEFICIENT IS
   31  PROVIDED AS NEEDED;
   32    (E) SET UP AND UTILIZE A PROCESS FOR INCIDENT INVESTIGATION AND  POST-
   33  INVESTIGATION  REVIEW  WHICH MAY INCLUDE A PLAN OF CORRECTION AND IMPLE-
   34  MENTATION OF CONTROLS;
   35    (F) CONDUCT AN ANNUAL PERFORMANCE EVALUATION OF THE PROGRAM TO  DETER-
   36  MINE  ITS  EFFECTIVENESS, WITH THE RESULTS OF THE EVALUATION REPORTED TO
   37  THE COMMITTEE. THE EVALUATION SHALL DETERMINE THE EXTENT TO WHICH IMPLE-
   38  MENTATION OF THE PROGRAM HAS RESULTED IN A  REDUCTION  IN  THE  RISK  OF
   39  INJURY  TO  PATIENTS,  MUSCULOSKELETAL  DISORDER CLAIMS AND DAYS OF LOST
   40  WORK ATTRIBUTABLE TO MUSCULOSKELETAL DISORDERS BY  EMPLOYEES  CAUSED  BY
   41  PATIENT  HANDLING, AND INCLUDE RECOMMENDATIONS TO INCREASE THE PROGRAM'S
   42  EFFECTIVENESS;
   43    (G) WHEN DEVELOPING ARCHITECTURAL PLANS FOR CONSTRUCTING OR REMODELING
   44  A HEALTH CARE FACILITY OR A UNIT OF A  HEALTH  CARE  FACILITY  IN  WHICH
   45  PATIENT HANDLING AND MOVEMENT OCCURS, CONSIDER THE FEASIBILITY OF INCOR-
   46  PORATING   PATIENT   HANDLING   EQUIPMENT  OR  THE  PHYSICAL  SPACE  AND
   47  CONSTRUCTION DESIGN NEEDED TO INCORPORATE  THAT  EQUIPMENT  AT  A  LATER
   48  DATE; AND
   49    (H)  DEVELOP  A PROCESS BY WHICH EMPLOYEES MAY REFUSE TO PERFORM OR BE
   50  INVOLVED IN PATIENT HANDLING OR MOVEMENT THAT  THE  EMPLOYEE  REASONABLY
   51  BELIEVES  IN  GOOD  FAITH  WILL EXPOSE A PATIENT OR HEALTH CARE FACILITY
   52  EMPLOYEE TO AN UNACCEPTABLE RISK OF INJURY. SUCH PROCESS  SHALL  REQUIRE
   53  THAT  THE NURSE OR DIRECT CARE WORKER MAKE A GOOD FAITH EFFORT TO ENSURE
   54  PATIENT SAFETY AND BRING THE MATTER TO THE ATTENTION OF THE FACILITY  IN
   55  A  TIMELY  MANNER. A HEALTH CARE FACILITY EMPLOYEE WHO REASONABLY AND IN
   56  GOOD FAITH FOLLOWS THE PROCESS DEVELOPED BY THE HEALTH CARE FACILITY  IN
       S. 6914                            29                            A. 9205

    1  ACCORDANCE  WITH  THIS SUBDIVISION SHALL NOT BE THE SUBJECT OF DISCIPLI-
    2  NARY ACTION BY THE HEALTH CARE FACILITY FOR THE REFUSAL TO PERFORM OR BE
    3  INVOLVED IN THE PATIENT HANDLING OR MOVEMENT.
    4    S 2997-L. ACTIVITIES. THE ACTIVITIES ENUMERATED IN SECTION TWENTY-NINE
    5  HUNDRED NINETY-SEVEN-K OF THIS TITLE SHALL BE UNDERTAKEN CONSISTENT WITH
    6  SECTION  TWENTY-EIGHT HUNDRED FIVE-J OF THIS CHAPTER BY A COVERED HEALTH
    7  CARE PROVIDER  AND  SHALL  BE  DEEMED  ACTIVITIES  OF  SUCH  PROGRAM  AS
    8  DESCRIBED  IN  SUCH  SECTION AND ANY AND ALL INFORMATION ATTRIBUTABLE TO
    9  SUCH ACTIVITIES SHALL BE SUBJECT TO PROVISIONS OF  SECTION  TWENTY-EIGHT
   10  HUNDRED   FIVE-M   OF   THIS  CHAPTER  AND  SECTION  SIXTY-FIVE  HUNDRED
   11  TWENTY-SEVEN OF THE EDUCATION LAW.
   12    S 21. Section 2304 of the insurance law is amended  by  adding  a  new
   13  subsection (j) to read as follows:
   14    (J)(1)  ON  OR BEFORE JULY FIRST, TWO THOUSAND SIXTEEN, THE DEPARTMENT
   15  SHALL MAKE RULES ESTABLISHING REQUIREMENTS FOR HEALTH CARE FACILITIES TO
   16  OBTAIN A REDUCED WORKER'S COMPENSATION RATE FOR  SAFE  PATIENT  HANDLING
   17  PROGRAMS IMPLEMENTED PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-NINE-A OF
   18  THE PUBLIC HEALTH LAW.
   19    (2)  THE DEPARTMENT SHALL COMPLETE AN EVALUATION OF THE RESULTS OF THE
   20  REDUCED RATE, INCLUDING CHANGES IN CLAIM FREQUENCY AND COSTS, AND  SHALL
   21  REPORT  TO  THE  APPROPRIATE  COMMITTEES OF THE LEGISLATURE ON OR BEFORE
   22  DECEMBER FIRST, TWO THOUSAND EIGHTEEN AND AGAIN ON  OR  BEFORE  DECEMBER
   23  FIRST, TWO THOUSAND TWENTY.
   24    S  22.  Subdivision  6  of  section  2899 of the public health law, as
   25  amended by chapter 331 of the laws  of  2006,  is  amended  to  read  as
   26  follows:
   27    6. "Provider" shall mean any residential health care facility licensed
   28  under article twenty-eight of this chapter; or any certified home health
   29  agency, licensed home care services agency or long term home health care
   30  program certified under article thirty-six of this chapter; OR ANY ADULT
   31  CARE FACILITY LICENSED UNDER ARTICLE SEVEN OF THE SOCIAL SERVICES LAW.
   32    S  23.  Paragraph (a) of subdivision 9 of section 2899-a of the public
   33  health law, as amended by chapter 331 of the laws of 2006, is amended to
   34  read as follows:
   35    (a) In the event that funds are appropriated in any given fiscal  year
   36  for  the  reimbursement for the costs of providing such criminal history
   37  information, reimbursement shall be made available in an  equitable  and
   38  direct  manner for the projected cost of the fee established pursuant to
   39  law by the division of criminal justice services for processing a crimi-
   40  nal history information check, the fee imposed by the federal bureau  of
   41  investigation  for  a national criminal history check, and costs associ-
   42  ated with obtaining the fingerprints to all providers licensed, but  not
   43  certified  under  article thirty-six of this chapter, AND ALL ADULT CARE
   44  FACILITIES LICENSED UNDER ARTICLE SEVEN  OF  THE  SOCIAL  SERVICES  LAW,
   45  including  those  that  are  subject  to  this article and are unable to
   46  access direct reimbursement from  state  and/or  federal  funded  health
   47  programs.
   48    S 24. The social services law is amended by adding a new section 461-t
   49  to read as follows:
   50    S 461-T. REVIEW OF CRIMINAL HISTORY INFORMATION CONCERNING PROSPECTIVE
   51  DIRECT  CARE EMPLOYEES. EVERY ADULT CARE FACILITY SHALL CONDUCT A CRIMI-
   52  NAL HISTORY RECORD CHECK OF PROSPECTIVE DIRECT CARE EMPLOYEES  UTILIZING
   53  THE  PROCEDURES AND STANDARDS SET FORTH IN ARTICLE TWENTY-EIGHT-E OF THE
   54  PUBLIC HEALTH LAW.
   55    S 25. The public health law is amended by adding a new section  2997-e
   56  to read as follows:
       S. 6914                            30                            A. 9205

    1    S 2997-E. PROVISION OF CONTACT INFORMATION RELATING TO LONG TERM CARE.
    2  WHENEVER  A  HEALTH CARE PROVIDER OR PRACTITIONER MAKES A RECOMMENDATION
    3  REGARDING THE NECESSITY OF LONG TERM CARE SERVICES OR A REFERRAL FOR THE
    4  RECEIPT OF LONG  TERM  CARE  SERVICES  TO  A  PATIENT,  THE  PATIENT  OR
    5  PATIENT'S DESIGNATED REPRESENTATIVE SHALL BE PROVIDED BY THE HEALTH CARE
    6  PROVIDER OR PRACTITIONER THE CONTACT INFORMATION FOR NY CONNECTS: CHOIC-
    7  ES  FOR  LONG  TERM  CARE,  ESTABLISHED PURSUANT TO SUBDIVISION EIGHT OF
    8  SECTION TWO HUNDRED THREE OF THE ELDER  LAW,  THAT  CORRESPONDS  TO  THE
    9  PATIENT'S  COUNTY  OF RESIDENCE OR PROSPECTIVE COUNTY OF RESIDENCE BASED
   10  ON THE PREFERENCE OF THE PATIENT.
   11    S 26. Intentionally omitted.
   12    S 27. Section 4310 of the public health law, as amended by chapter 639
   13  of the laws of 2006, the section heading as separately amended by  chap-
   14  ter  640 of the laws of 2006, subdivisions 1 and 3 as amended by chapter
   15  158 of the laws of 2012, subdivision 2 as separately amended by chapters
   16  158 and 465 of the laws of 2012, is amended to read as follows:
   17    S 4310. New York state donate life registry for organ, EYE and  tissue
   18  donations.  1.  The department shall establish an organ, EYE, and tissue
   19  donor registry, which shall be called and be referred to as the  "donate
   20  life  registry", WHICH SHALL PROVIDE A MEANS TO MAKE AND REGISTER A GIFT
   21  OF ORGANS, EYES AND TISSUES TO TAKE PLACE AFTER DEATH PURSUANT  TO  THIS
   22  ARTICLE.  [Such] THE DONATE LIFE registry shall contain a listing of all
   23  donors who have declared their consent to make an anatomical gift.
   24    2. THE COMMISSIONER MAY ENTER INTO A MULTI-YEAR CONTRACT FOR THE OPER-
   25  ATION AND PROMOTION OF THE DONATE LIFE REGISTRY SUBJECT  TO  SUCH  TERMS
   26  AND  CONDITIONS AS MAY BE CONTAINED WITHIN SUCH CONTRACT WITH A NOT-FOR-
   27  PROFIT ORGANIZATION THAT HAS EXPERIENCE  WORKING  WITH  ORGAN,  EYE  AND
   28  TISSUE PROCUREMENT ORGANIZATIONS, HAS EXPERTISE IN CONDUCTING ORGAN, EYE
   29  AND  TISSUE  DONOR  PROMOTIONAL  CAMPAIGNS,  AND  IS AFFILIATED WITH THE
   30  ORGAN, EYE AND TISSUE  DONATION  COMMUNITY  THROUGHOUT  THE  STATE.  THE
   31  CONTRACTOR  MAY  SUBCONTRACT  AS NEEDED FOR THE EFFECTIVE PERFORMANCE OF
   32  THE CONTRACT. ALL SUCH SUBCONTRACTORS AND THE TERMS OF SUCH SUBCONTRACTS
   33  SHALL BE SUBJECT TO APPROVAL BY THE COMMISSIONER. ANY  APPLICABLE  STATE
   34  AGENCY, INCLUDING, BUT NOT LIMITED TO, THE DEPARTMENT, THE DEPARTMENT OF
   35  MOTOR  VEHICLES  AND  THE  BOARD  OF  ELECTIONS,  SHALL COOPERATE IN THE
   36  COLLECTION AND TRANSFER OF REGISTRANT DATA TO THE DONATE LIFE REGISTRY.
   37    3. THE DUTIES OF THE CONTRACTOR SHALL INCLUDE, BUT NOT BE LIMITED  TO,
   38  THE FOLLOWING:
   39    (A) THE DEVELOPMENT, IMPLEMENTATION AND MAINTENANCE OF THE DONATE LIFE
   40  REGISTRY  THAT INCLUDES ONLINE, MAILED AND OTHER FORMS OF ORGAN, EYE AND
   41  TISSUE DONOR REGISTRATION, VERIFICATION, AMENDMENT AND REVOCATION;
   42    (B) PREPARATION AND SUBMISSION OF A PLAN TO ENCOURAGE ORGAN,  EYE  AND
   43  TISSUE DONATION THROUGH EDUCATION AND MARKETING EFFORTS AND OTHER RECOM-
   44  MENDATIONS  THAT  WOULD STREAMLINE AND ENHANCE THE COST-EFFECTIVE OPERA-
   45  TION OF THE DONATE LIFE REGISTRY;
   46    (C) PROVISION OF WRITTEN OR ELECTRONIC NOTIFICATION OF REGISTRATION IN
   47  THE DONATE LIFE REGISTRY TO AN INDIVIDUAL ENROLLING IN THE  DONATE  LIFE
   48  REGISTRY; AND
   49    (D)  PREPARATION  AND  SUBMISSION  OF  AN ANNUAL WRITTEN REPORT TO THE
   50  DEPARTMENT. SUCH REPORT SHALL INCLUDE:
   51    (I) A PERFORMANCE MATRIX INCLUDING THE NUMBER OF  REGISTRANTS  ON  THE
   52  DONATE  LIFE REGISTRY AND AN ANALYSIS OF THE REGISTRATION RATES, INCLUD-
   53  ING BUT NOT LIMITED TO, LOCATION, METHOD OF  REGISTRATION,  DEMOGRAPHIC,
   54  AND STATE COMPARISONS;
   55    (II)  THE CHARACTERISTICS OF REGISTRANTS AS DETERMINED FROM THE DONATE
   56  LIFE REGISTRY INFORMATION;
       S. 6914                            31                            A. 9205

    1    (III) THE ANNUAL DOLLAR AMOUNT OF VOLUNTARY CONTRIBUTIONS RECEIVED  BY
    2  THE  CONTRACTOR FOR THE PURPOSES OF MAINTAINING THE DONATE LIFE REGISTRY
    3  AND/OR EDUCATIONAL AND PROMOTIONAL CAMPAIGNS AND INITIATIVES;
    4    (IV) A DESCRIPTION OF THE PROMOTIONAL CAMPAIGNS AND INITIATIVES IMPLE-
    5  MENTED DURING THE YEAR; AND
    6    (V)  ACCOUNTING  STATEMENTS  OF EXPENDITURES FOR THE PURPOSES OF MAIN-
    7  TAINING THE DONATE LIFE REGISTRY AND PROMOTIONAL  CAMPAIGNS  AND  INITI-
    8  ATIVES.
    9    4.    (A)  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH
   10  MARCH THIRTY-FIRST, TWO THOUSAND FIFTEEN,  PAYMENTS  TO  THE  CONTRACTOR
   11  SHALL BE PAID BY THE DEPARTMENT.
   12    (B)  FOR  THE  PERIOD  BEGINNING APRIL FIRST, TWO THOUSAND FIFTEEN AND
   13  THEREAFTER, PAYMENTS TO THE CONTRACTOR SHALL BE PAID BY  THE  DEPARTMENT
   14  FROM  FUNDS AVAILABLE FOR THESE PURPOSES, INCLUDING, BUT NOT LIMITED TO,
   15  THE FUNDS DEPOSITED INTO THE LIFE PASS IT  ON  TRUST  FUND  PURSUANT  TO
   16  SECTION NINETY-FIVE-D OF THE STATE FINANCE LAW.
   17    (C) IN ADDITION, THE CONTRACTOR MAY RECEIVE AND USE VOLUNTARY CONTRIB-
   18  UTIONS.
   19    5.  (A)  Such ORGAN, EYE AND TISSUE registration of consent to make an
   20  anatomical gift can be made through [(a)]: (I) indication  made  on  the
   21  application or renewal form of a DRIVER'S license, [(b)] (II) indication
   22  made  on  a  non-driver identification card application or renewal form,
   23  [(c) enrolling in the registry website  maintained  by  the  department,
   24  which may include using an electronic signature subject to article three
   25  of  the  state  technology  law,  (d)]  (III) indication made on a voter
   26  registration form pursuant to subdivision five of section 5-210  of  the
   27  election  law, (IV) ENROLLMENT THROUGH THE DONATE LIFE REGISTRY WEBSITE,
   28  (V) PAPER ENROLLMENT SUBMITTED TO THE DONATE  LIFE  REGISTRY,  or  [(e)]
   29  (VI) through any other method identified by the commissioner.
   30    (B)(I)   Where  required  by  law  for  [consent]  REGISTRATION  forms
   31  described in [paragraphs (a) and (b)]  SUBPARAGRAPHS  (I)  AND  (II)  of
   32  PARAGRAPH  (A)  OF  this subdivision, the commissioner shall ensure that
   33  space is provided on any [consent] REGISTRATION form so that the  appli-
   34  cant  shall register or decline registration in the donate life registry
   35  for organ, EYE and tissue donations under  this  section  and  that  the
   36  following is stated on the form in clear and conspicuous type:
   37    "You  must  fill out the following section: Would you like to be added
   38  to the Donate Life Registry? Check box for 'yes'  or  'skip  this  ques-
   39  tion'."
   40    (II)  The  commissioner  shall  not maintain records of any person who
   41  checks "skip this question". Failure to check a box shall not impair the
   42  validity of an application, and failure to check "yes" or checking "skip
   43  this question" shall not be construed to imply a wish not to donate.  In
   44  the  case  of  an  applicant under eighteen years of age, checking "yes"
   45  shall not constitute consent to make an anatomical gift or  registration
   46  in the donate life registry. Where an applicant has previously consented
   47  to  make  an  anatomical gift or registered in the donate life registry,
   48  checking "skip this question" or failing to check a box shall not impair
   49  that consent or registration.
   50    (C) ENROLLMENT OR AMENDMENT OR  REVOCATION  THROUGH  THE  DONATE  LIFE
   51  REGISTRY WEBSITE THROUGH ANY OF THE MEANS LISTED IN THIS SUBDIVISION MAY
   52  BE  SIGNED BY ELECTRONIC SIGNATURE, IN ACCORDANCE WITH THE PROVISIONS OF
   53  ARTICLE THREE OF THE STATE TECHNOLOGY LAW, SUPPORTED BY THE USE OF SUIT-
   54  ABLE MECHANISMS INCLUDING UNIQUE IDENTIFIERS TO  PROVIDE  CONFIDENCE  IN
   55  THE  IDENTITY  OF  THE  PERSON  PROVIDING  THE ELECTRONIC SIGNATURE. The
   56  registration shall take effect upon the provision of  written  or  elec-
       S. 6914                            32                            A. 9205

    1  tronic  notice  of the registration to the [person] INDIVIDUAL enrolling
    2  in the DONATE LIFE registry.
    3    [3.  (a)  Information contained in the registry shall be accessible to
    4  (i) federally designated organ procurement organizations, (ii)  eye  and
    5  tissue   banks   licensed   by   the   department  pursuant  to  article
    6  forty-three-B of this chapter,  and  (iii)  any  other  entity  formally
    7  approved by the commissioner.
    8    (b) The information contained in the registry shall not be released to
    9  any person except as expressly authorized by this section solely for the
   10  purpose  of identifying potential organ and tissue donors at or near the
   11  time of death.
   12    4. If the department had an established registry prior to  the  effec-
   13  tive  date  of this section, it shall be deemed to meet the requirements
   14  of this section.
   15    5. The registry shall provide  persons  enrolled  the  opportunity  to
   16  specify which organs and tissues they want to donate and if the donation
   17  can be used for transplantation, research, or both.]
   18    (D)  AMENDMENTS  OR REVOCATIONS FROM THE DONATE LIFE REGISTRY SHALL BE
   19  MADE BY THE FOLLOWING, SUBJECT TO THE REQUIREMENTS OF THE COMMISSIONER:
   20    (I) REGISTRANTS SUBMITTING AN AMENDMENT OR REVOCATION  IN  WRITING  TO
   21  THE DONATE LIFE REGISTRY; OR
   22    (II)  REGISTRANTS SUBMITTING AN AMENDMENT OR REVOCATION ELECTRONICALLY
   23  THROUGH THE DONATE LIFE REGISTRY WEBSITE.
   24    (E) REMOVAL FROM THE DONATE  LIFE  REGISTRY  SHALL  NOT  BE  DEEMED  A
   25  REFUSAL OF ANY OTHER OR FUTURE ANATOMICAL GIFT.
   26    (F)  THE  DONATE  LIFE REGISTRY SHALL PROVIDE INDIVIDUALS ENROLLED THE
   27  OPPORTUNITY TO SPECIFY WHICH ORGANS,  EYES  AND  TISSUES  THEY  WANT  TO
   28  DONATE AND IF THE DONATION MAY BE USED FOR TRANSPLANTATION, RESEARCH, OR
   29  BOTH.
   30    6.  [A  person]  AN  INDIVIDUAL  registered  in the [organ and tissue]
   31  DONATE LIFE registry before [the effective  date  of  this  subdivision]
   32  JULY  TWENTY-THIRD, TWO THOUSAND EIGHT shall be deemed to have expressed
   33  intent to donate, until and unless he or she files an amendment  to  his
   34  or her registration or a new registration expressing consent to donate.
   35    7.  [The  commissioner shall contact each person registered before the
   36  effective date of this subdivision in the organ and tissue  registry  in
   37  writing  to inform him or her that at the time he or she registered, the
   38  registry was that of intent and that the registry is now one of consent,
   39  to explain in clear and  understandable  terms  the  difference  between
   40  intent  and consent, and to provide opportunity for the person to change
   41  his or her registration to  provide  consent  by  amending  his  or  her
   42  current  registration  or  executing a new registration.] (A) THE DONATE
   43  LIFE REGISTRY SHALL BE MAINTAINED IN  A  MANNER  THAT  ALLOWS  IMMEDIATE
   44  ACCESS  TO  ORGAN,  EYE  AND TISSUE DONATION RECORDS TWENTY-FOUR HOURS A
   45  DAY, SEVEN DAYS A WEEK TO  THE  CONTRACTOR,  THE  DEPARTMENT,  FEDERALLY
   46  DESIGNATED  ORGAN  PROCUREMENT  ORGANIZATIONS,  LICENSED  EYE AND TISSUE
   47  BANKS, AND SUCH OTHER ENTITIES WHICH MAY BE APPROVED BY  THE  DEPARTMENT
   48  FOR  ACCESS.  ACCESS  SHALL  BE  AVAILABLE TO REGISTRANTS TO CONFIRM THE
   49  ACCURACY AND VALIDITY OF THEIR REGISTRATION AND TO AMEND OR REVOKE THEIR
   50  REGISTRATION, SUBJECT TO REASONABLE PROCEDURES TO VERIFY IDENTITY.
   51    (B) ACCESS TO THE DONATE LIFE REGISTRY SHALL  HAVE  SECURITY  MEASURES
   52  SET  FORTH  IN THE CONTRACT TO PROTECT THE INTEGRITY OF THE IDENTIFIABLE
   53  DATA IN THE DONATE LIFE REGISTRY, WHICH MAY  ONLY  BE  ACCESSED  BY  THE
   54  PARTIES  DESCRIBED IN PARAGRAPH (A) OF THIS SUBDIVISION AND ONLY FOR THE
   55  PURPOSES OF DETERMINING DONOR STATUS AT OR NEAR THE TIME OF DEATH OF  AN
   56  INDIVIDUAL,  BY  THE  DEPARTMENT FOR ANY PURPOSE, BY THE CONTRACTOR ONLY
       S. 6914                            33                            A. 9205

    1  FOR PURPOSES OF QUALITY ASSESSMENT AND  IMPROVEMENT,  TECHNICAL  SUPPORT
    2  AND  DONOR  SERVICES,  OR  BY INDIVIDUAL REGISTRANTS FOR THE PURPOSES OF
    3  CONFIRMING THE ACCURACY AND VALIDITY OF THEIR  REGISTRATION  OR  MAKING,
    4  AMENDING OR REVOKING THEIR REGISTRATION.
    5    (C)  DE-IDENTIFIED  INFORMATION MAY BE ACCESSED BY THE ENTITIES LISTED
    6  IN PARAGRAPH (A) OF THIS SUBDIVISION OR THEIR DESIGNEES FOR PURPOSES  OF
    7  ANALYSIS,   PROMOTION,  EDUCATION,  QUALITY  IMPROVEMENT  AND  TECHNICAL
    8  SUPPORT FOR THE DONATE LIFE REGISTRY. THE INFORMATION CONTAINED  IN  THE
    9  REGISTRY SHALL NOT BE RELEASED TO ANY PERSON EXCEPT AS EXPRESSLY AUTHOR-
   10  IZED BY THIS SECTION, SOLELY FOR THE PURPOSES SO AUTHORIZED.
   11    8.  The commissioner is authorized to promulgate rules and regulations
   12  necessary to implement the provisions of this section.
   13    9. AN INTERAGENCY  WORK  GROUP,  COMPOSED  OF  THE  COMMISSIONER,  THE
   14  COMMISSIONER  OF  THE DEPARTMENT OF MOTOR VEHICLES, A CHAIR OF THE BOARD
   15  OF ELECTIONS, OR THEIR DESIGNEES, AND SUCH OTHER INDIVIDUALS AS  MAY  BE
   16  DESIGNATED  BY  THE  COMMISSIONER, SHALL BE ESTABLISHED TO MEET WITH THE
   17  CONTRACTOR ANNUALLY AND AS NEEDED TO REVIEW THE  STATUS  OF  THE  DONATE
   18  LIFE  REGISTRY,  TO EXAMINE THE STEPS THAT MIGHT BE TAKEN BY STATE AGEN-
   19  CIES TO ENHANCE ITS PERFORMANCE  AND  TO  MAKE  RECOMMENDATIONS  TO  THE
   20  CONTRACTOR.
   21    S 28. Intentionally omitted.
   22    S 29. Subdivision 3 of section 95-d of the state finance law, as added
   23  by chapter 415 of the laws of 2003, is amended to read as follows:
   24    3.  Monies  of  the  fund  shall be expended only for organ transplant
   25  research and education projects approved by the commissioner of  health,
   26  or  to provide grants to not-for-profit corporations in this state which
   27  are incorporated for the purpose of increasing and promoting  organ  and
   28  tissue  donation awareness PROVIDED, HOWEVER, BEGINNING APRIL FIRST, TWO
   29  THOUSAND FIFTEEN, ANY REVENUES  RECEIVED  OR  ANY  MONIES  APPROPRIATED,
   30  CREDITED OR TRANSFERRED TO THE FUND ON AND AFTER MAY FIRST, TWO THOUSAND
   31  FOURTEEN  MAY  ALSO BE EXPENDED TO SUPPORT THE MAINTENANCE AND OPERATION
   32  OF THE DONATE LIFE REGISTRY IN ACCORDANCE WITH THE PROVISIONS OF SECTION
   33  FORTY-THREE HUNDRED TEN OF THE PUBLIC HEALTH LAW.
   34    S 30. Section 461-b of the social services law is  amended  by  adding
   35  two new subdivisions 9 and 10 to read as follows:
   36    9.  (A)  THE PRIOR WRITTEN APPROVAL OF THE DEPARTMENT IS REQUIRED FOR:
   37  (I) ANY TRANSFER, ASSIGNMENT OR OTHER DISPOSITION OF TEN PERCENT OR MORE
   38  OF AN INTEREST OR VOTING RIGHTS IN A PARTNERSHIP,  BUSINESS  CORPORATION
   39  OR  LIMITED  LIABILITY  COMPANY  WHICH  IS THE OPERATOR OF AN ADULT CARE
   40  FACILITY TO A NEW PARTNER, SHAREHOLDER OR MEMBER; OR (II) ANY  TRANSFER,
   41  ASSIGNMENT  OR OTHER DISPOSITION OF INTEREST OR VOTING RIGHTS IN A PART-
   42  NERSHIP, BUSINESS CORPORATION OR LIMITED LIABILITY COMPANY WHICH IS  THE
   43  OPERATOR  OF  AN  ADULT  CARE FACILITY WHICH RESULTS IN THE OWNERSHIP OR
   44  CONTROL OF MORE THAN TEN PERCENT OF THE INTEREST OR VOTING RIGHTS THERE-
   45  UNDER BY ANY PERSON WHO HAS NOT BEEN PREVIOUSLY APPROVED BY THE  DEPART-
   46  MENT FOR THAT OPERATOR.
   47    (B)  WITH  RESPECT  TO A TRANSFER, ASSIGNMENT OR DISPOSITION INVOLVING
   48  LESS THAN TEN PERCENT OF AN INTEREST OR VOTING RIGHTS IN  SUCH  PARTNER-
   49  SHIP,  BUSINESS  CORPORATION OR LIMITED LIABILITY COMPANY TO A NEW PART-
   50  NER, SHAREHOLDER OR MEMBER, NO PRIOR APPROVAL OF THE DEPARTMENT SHALL BE
   51  REQUIRED EXCEPT WHERE REQUIRED BY PARAGRAPH  (A)  OF  THIS  SUBDIVISION.
   52  HOWEVER,  NO  SUCH TRANSACTION SHALL BE EFFECTIVE UNLESS AT LEAST NINETY
   53  DAYS PRIOR TO THE INTENDED  EFFECTIVE  DATE  THEREOF,  THE  PARTNERSHIP,
   54  BUSINESS  CORPORATION  OR  LIMITED LIABILITY COMPANY FULLY COMPLETES AND
   55  FILES WITH THE DEPARTMENT NOTICE ON A  FORM,  TO  BE  DEVELOPED  BY  THE
   56  DEPARTMENT,  WHICH  SHALL DISCLOSE SUCH INFORMATION AS MAY REASONABLY BE
       S. 6914                            34                            A. 9205

    1  NECESSARY FOR THE DEPARTMENT TO DETERMINE WHETHER IT SHOULD PROHIBIT THE
    2  TRANSACTION. WITHIN NINETY DAYS FROM THE DATE OF RECEIPT OF SUCH NOTICE,
    3  THE DEPARTMENT MAY PROHIBIT ANY SUCH TRANSACTION UNDER THIS SUBPARAGRAPH
    4  IF  IT FINDS:   (I) THERE ARE REASONABLE GROUNDS TO BELIEVE THE PROPOSED
    5  TRANSACTION DOES NOT SATISFY THE CHARACTER AND COMPETENCE REVIEW, AS MAY
    6  BE APPROPRIATE; OR (II) IF THE TRANSACTION, TOGETHER WITH ALL OTHER SUCH
    7  TRANSACTIONS DURING ANY  FIVE  YEAR  PERIOD,  WOULD  IN  THE  AGGREGATE,
    8  INVOLVE  TWENTY-FIVE  PERCENT OR MORE OF THE INTEREST IN THE ENTITY THAT
    9  CONSTITUTES THE  OPERATOR.  THE  DEPARTMENT  SHALL  STATE  THE  SPECIFIC
   10  REASONS  FOR  PROHIBITING  ANY  TRANSACTION  UNDER THIS SUBPARAGRAPH AND
   11  SHALL SO NOTIFY EACH PARTY TO THE PROPOSED TRANSACTION.
   12    (C) WITH RESPECT TO A TRANSFER, ASSIGNMENT OR DISPOSITION OF AN INTER-
   13  EST OR VOTING RIGHTS IN A PARTNERSHIP, BUSINESS CORPORATION  OR  LIMITED
   14  LIABILITY  COMPANY  TO  ANY  EXISTING PARTNER, SHAREHOLDER OR MEMBER, NO
   15  PRIOR APPROVAL OF THE DEPARTMENT SHALL  BE  REQUIRED.  HOWEVER,  IF  THE
   16  TRANSACTION  INVOLVES THE WITHDRAWAL OF THE TRANSFEROR FROM THE PARTNER-
   17  SHIP, BUSINESS CORPORATION OR LIMITED LIABILITY COMPANY, NO SUCH  TRANS-
   18  ACTION  SHALL  BE  EFFECTIVE  UNLESS  AT  LEAST NINETY DAYS PRIOR TO THE
   19  INTENDED EFFECTIVE DATE THEREOF, THE PARTNERSHIP,  BUSINESS  CORPORATION
   20  OR  LIMITED LIABILITY COMPANY FULLY COMPLETES AND FILES WITH THE DEPART-
   21  MENT NOTICE OF SUCH TRANSACTION.  WITHIN NINETY DAYS FROM  THE  DATE  OF
   22  RECEIPT OF SUCH NOTICE, THE DEPARTMENT MAY PROHIBIT ANY SUCH TRANSACTION
   23  UNDER THIS PARAGRAPH IF THE EQUITY POSITION OF THE PARTNERSHIP, BUSINESS
   24  CORPORATION  OR LIMITED LIABILITY COMPANY, DETERMINED IN ACCORDANCE WITH
   25  GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, WOULD BE REDUCED AS  A  RESULT
   26  OF  THE  TRANSFER, ASSIGNMENT OR DISPOSITION. THE DEPARTMENT SHALL STATE
   27  THE SPECIFIC REASON FOR PROHIBITING ANY TRANSACTION UNDER THIS PARAGRAPH
   28  AND SHALL SO NOTIFY EACH PARTY TO THE PROPOSED TRANSACTION.
   29    10. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, THE  DEPART-
   30  MENT IS AUTHORIZED TO APPROVE A CERTIFICATE OF INCORPORATION OR ARTICLES
   31  OF  ORGANIZATION FOR ESTABLISHMENT OF AN ADULT CARE FACILITY ON AN EXPE-
   32  DITED BASIS WHERE: (A) THE CERTIFICATE OF INCORPORATION OR  ARTICLES  OF
   33  ORGANIZATION REFLECTS SOLELY A CHANGE IN THE FORM OF THE BUSINESS ORGAN-
   34  IZATION  OF AN EXISTING ENTITY WHICH HAD BEEN APPROVED BY THE DEPARTMENT
   35  TO OPERATE AN ADULT CARE FACILITY; (B) EVERY INCORPORATOR,  STOCKHOLDER,
   36  MEMBER AND DIRECTOR OF THE NEW ENTITY SHALL HAVE BEEN AN OWNER, PARTNER,
   37  INCORPORATOR,  STOCKHOLDER,  MEMBER  OR DIRECTOR OF THE EXISTING ENTITY;
   38  (C) THE DISTRIBUTION OF OWNERSHIP INTERESTS AND VOTING RIGHTS IN THE NEW
   39  ENTITY SHALL BE THE SAME AS IN THE EXISTING ENTITY; AND (D) THERE  SHALL
   40  BE  NO  CHANGE IN THE OPERATOR OF THE ADULT CARE FACILITY OTHER THAN THE
   41  FORM OF ITS BUSINESS ORGANIZATION, AS A RESULT OF THE APPROVAL  OF  SUCH
   42  CERTIFICATE   OF   INCORPORATION   OR  ARTICLES  OF  ORGANIZATION.  UPON
   43  SUBMISSION, IF THE DEPARTMENT DOES NOT OBJECT  TO  THE  PROPOSAL  WITHIN
   44  NINETY  DAYS OF THE RECEIPT OF A COMPLETE APPLICATION, THE PROPOSAL WILL
   45  BE DEEMED ACCEPTABLE TO THE DEPARTMENT AND AN AMENDED OPERATING  CERTIF-
   46  ICATE SHALL BE ISSUED.
   47    S  31.  Subdivisions  1  and 2 of section 461-k of the social services
   48  law, as added by chapter 779 of the laws of 1986, are amended to read as
   49  follows:
   50    1. (a) "Services for non-residents  in  adult  homes,  residences  for
   51  adults and enriched housing programs" shall mean an organized program of
   52  services  which  the  facility  is authorized to provide to residents of
   53  such facility but which are provided to non-residents for the purpose of
   54  restoring, maintaining or developing the capacity of  aged  or  disabled
   55  persons  to  remain  in  or  return  to the community. Such services may
   56  include but shall not be limited to day programs and temporary  residen-
       S. 6914                            35                            A. 9205

    1  tial  care  as  defined  herein.  A person participating in a program of
    2  services for non-residents in an adult care facility shall be considered
    3  a resident of the facility and shall be  afforded  all  the  rights  and
    4  protections afforded residents of the facility under this chapter except
    5  that  the  provisions  of  sections  four  hundred  sixty-one-g and four
    6  hundred sixty-one-h of this title relating to termination  of  admission
    7  agreements  shall not apply and that persons receiving services pursuant
    8  to this section shall not be considered to be receiving residential care
    9  as defined in section two hundred nine of this chapter for  purposes  of
   10  determining  eligibility  for  and  the  amount of supplemental security
   11  income benefits and additional state payments.
   12    (b) "Day programs" shall mean an organized program  for  non-residents
   13  which  shall include personal care, supervision and other adult services
   14  which the facility is authorized to provide to residents of such facili-
   15  ty which may include but are not limited to, activities, meals, informa-
   16  tion and referral, and transportation services,  provided  in  an  adult
   17  home, residence for adults or enriched housing program.
   18    (c) "Temporary residential care" shall mean the provision of temporary
   19  residential  care  of  frail  or  disabled adults on behalf of or in the
   20  absence of the caregiver for up to [six weeks] ONE HUNDRED  TWENTY  DAYS
   21  in  any  twelve  month  period, provided in an adult home, residence for
   22  adults or enriched housing program.
   23    2. A program to provide services for non-residents in  an  adult  care
   24  facility may be established and operated in an adult home, residence for
   25  adults  or  enriched  housing  program provided that such facility has a
   26  current operating certificate issued in  accordance  with  section  four
   27  hundred sixty-one-b of this title. No operator may establish and operate
   28  a  DAY  program  to  provide  services  for non-residents, AS DEFINED IN
   29  SUBPARAGRAPH (B) OF SUBDIVISION ONE OF THIS SECTION, unless the operator
   30  has received the prior written approval of the department.  The  depart-
   31  ment  shall  grant  such approval TO OPERATE A DAY PROGRAM only to those
   32  operators that are operating in compliance with applicable law and regu-
   33  lations.  NO OPERATOR MAY PROVIDE TEMPORARY RESIDENTIAL CARE AS  DEFINED
   34  IN SUBPARAGRAPH (C) OF SUBDIVISION ONE OF THIS SECTION, UNLESS THE OPER-
   35  ATOR HAS NOTIFIED THE DEPARTMENT OF ITS INTENT TO DO SO.
   36    S 32. Intentionally omitted.
   37    S 33. Subdivision 4 of section 4656 of the public health law, as added
   38  by chapter 2 of the laws of 2004, is amended to read as follows:
   39    4. The department shall develop an expedited review and approval proc-
   40  ess  FOR  APPLICATIONS  FOR  UP  TO  NINE ADDITIONAL BEDS TO AN EXISTING
   41  ENHANCED OR SPECIAL NEEDS ASSISTED LIVING CERTIFICATE QUALIFIED AS BEING
   42  IN GOOD STANDING UNDER SECTION FORTY-SIX  HUNDRED  FIFTY-THREE  OF  THIS
   43  ARTICLE.
   44    S  34.  Paragraph  (b)  of subdivision 5 of section 3610 of the public
   45  health law is REPEALED.
   46    S 35. Subdivision 2 of section 3610  of  the  public  health  law,  as
   47  amended  by  section  65 of part A of chapter 58 of the laws of 2010, is
   48  amended to read as follows:
   49    2. A hospital, residential health care  facility,  or  certified  home
   50  health  agency  seeking authorization to provide a long term home health
   51  care program shall transmit to the commissioner an  application  setting
   52  forth  the scope of the proposed program. Such application shall be in a
   53  format and shall be submitted in a quantity determined  by  the  commis-
   54  sioner.  The  commissioner  shall transmit the application to the public
   55  health and health planning council and to the health systems agency,  if
   56  any,  having  geographic  jurisdiction  of  the  area where the proposed
       S. 6914                            36                            A. 9205

    1  program is to be located.  The  application  shall  include  a  detailed
    2  description  of  the proposed program including, but not limited to, the
    3  following:
    4    (a) an outline of the institution's or agency's plans for the program;
    5    (b) the need for the proposed program;
    6    (c) the number and types of personnel to be employed;
    7    (d)  the  ability  of the agency, hospital, or facility to provide the
    8  program;
    9    (e) the estimated number of visits to be provided;
   10    (f) the geographic  area  in  which  the  proposed  programs  will  be
   11  provided;
   12    (g)  any  special  or  unusual  services, programs, or equipment to be
   13  provided;
   14    (h) a demonstration that the proposed program is feasible and adequate
   15  in terms of both short range and long range goals;
   16    (i) such other information as the commissioner may require.
   17    The health systems agency and the public health  and  health  planning
   18  council shall review the application and submit their recommendations to
   19  the  commissioner.  At  the time members of the public health and health
   20  planning council are notified  that  an  application  is  scheduled  for
   21  consideration,  the  applicant and the health systems agency shall be so
   22  notified in writing. The health systems agency or the public health  and
   23  health  planning council shall not recommend approval of the application
   24  unless it is satisfied as to:
   25    (a) the public need for the program at the time and  place  and  under
   26  the circumstances proposed;
   27    (b)  the  financial  resources of the provider of the proposed program
   28  and its sources of future revenues;
   29    (c) the ability of the proposed program to meet those standards estab-
   30  lished for participation as a home health agency under  title  XVIII  of
   31  the federal Social Security Act; and
   32    (d) such other matters as it shall deem pertinent.
   33    After  receiving  and  considering  the  recommendations of the public
   34  health and health planning council and the health  systems  agency,  the
   35  commissioner shall make his or her determination. The commissioner shall
   36  act  upon  an  application  after  the public health and health planning
   37  council and the health systems agency have  had  a  reasonable  time  to
   38  submit their recommendations. The commissioner shall not take any action
   39  contrary  to  the  advice of either until he or she affords to either an
   40  opportunity to request a public hearing and, if so requested,  a  public
   41  hearing  shall  be held. The commissioner shall not approve the applica-
   42  tion unless he or she is satisfied as to the detailed description of the
   43  proposed program and
   44    (a) the public need for the existence of the program at the  time  and
   45  place and under the circumstances proposed;
   46    (b)  the  financial  resources of the provider of the proposed program
   47  and its sources of future revenues;
   48    (c) the ability of the proposed program to meet those standards estab-
   49  lished for participation as a home health agency under  title  XVIII  of
   50  the federal Social Security Act; and
   51    (d) such other matters as he or she shall deem pertinent.
   52    If  the application is approved, the applicant shall be so notified in
   53  writing. The commissioner's written approval of  the  application  shall
   54  constitute  authorization  to  provide  a  long  term  home  health care
   55  program. [In making his or her  authorization,  the  commissioner  shall
   56  stipulate  the maximum number of persons which a provider of a long term
       S. 6914                            37                            A. 9205

    1  home health care program may serve.] If  the  commissioner  proposes  to
    2  disapprove  the  application,  he  or  she shall notify the applicant in
    3  writing, stating his or her reasons  for  disapproval,  and  afford  the
    4  applicant an opportunity for a public hearing.
    5    S 36. Intentionally omitted.
    6    S 37. Section 32 of part A of chapter 58 of the laws of 2008, amending
    7  the  elder  law  and  other laws relating to reimbursement to particular
    8  provider pharmacies  and  prescription  drug  coverage,  as  amended  by
    9  section  26  of  part A of chapter 59 of the laws of 2011, is amended to
   10  read as follows:
   11    S 32. This act shall take effect immediately and shall  be  deemed  to
   12  have  been in full force and effect on and after April 1, 2008; provided
   13  however, that sections one, six-a, nineteen,  twenty,  twenty-four,  and
   14  twenty-five of this act shall take effect July 1, 2008; provided however
   15  that  sections  sixteen, seventeen and eighteen of this act shall expire
   16  April 1, [2014] 2017; provided, however, that  the  amendments  made  by
   17  section  twenty-eight  of this act shall take effect on the same date as
   18  section 1 of chapter 281 of the laws  of  2007  takes  effect;  provided
   19  further,  that  sections twenty-nine, thirty, and thirty-one of this act
   20  shall take effect October 1, 2008; provided further, that section  twen-
   21  ty-seven  of  this  act  shall take effect January 1, 2009; and provided
   22  further, that section twenty-seven of  this  act  shall  expire  and  be
   23  deemed  repealed  March 31, [2014] 2015; and provided, further, however,
   24  that the amendments to subdivision 1 of section 241 of the education law
   25  made by section twenty-nine of this act shall not affect the  expiration
   26  of such subdivision and shall be deemed to expire therewith and provided
   27  that  the  amendments  to  section  272 of the public health law made by
   28  section thirty of this act shall not affect the repeal of  such  section
   29  and shall be deemed repealed therewith.
   30    S  38.  This  act shall take effect immediately and shall be deemed to
   31  have been in full force and effect on and after April 1, 2014; provided,
   32  however, that the amendments to subdivisions 1 and 2 of section 461-k of
   33  the social services law made by section thirty-one of this act shall not
   34  affect the expiration of such section and  shall  be  deemed  to  expire
   35  therewith;  and provided, further, that the amendments made to paragraph
   36  (b) of subdivision 18-a of section 206 of the public health law made  by
   37  section  sixteen  of  this  act  shall not affect the expiration of such
   38  paragraph and shall be deemed to expire therewith.

   39                                   PART B

   40    Section 1. Subdivision 5 of section 168 of chapter 639 of the laws  of
   41  1996,  constituting  the  New  York  Health  Care Reform Act of 1996, as
   42  amended by section 1 of part C of chapter 59 of the  laws  of  2011,  is
   43  amended to read as follows:
   44    5.  sections  2807-c,  2807-j,  2807-s and 2807-t of the public health
   45  law, as amended or as added by this act, shall expire  on  December  31,
   46  [2014]  2017,  and  shall be thereafter effective only in respect to any
   47  act done on or before such date or action or proceeding arising  out  of
   48  such  act  including continued collections of funds from assessments and
   49  allowances and  surcharges  established  pursuant  to  sections  2807-c,
   50  2807-j,  2807-s  and 2807-t of the public health law, and administration
   51  and distributions of funds from pools established pursuant  to  sections
   52  2807-c,  2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public
   53  health law related to patient  services  provided  before  December  31,
       S. 6914                            38                            A. 9205

    1  [2014]  2017, and continued expenditure of funds authorized for programs
    2  and grants until the exhaustion of funds therefor;
    3    S  2.  Subdivision  1 of section 138 of chapter 1 of the laws of 1999,
    4  constituting the New York Health Care Reform Act of 2000, as amended  by
    5  section  2  of  part  C of chapter 59 of the laws of 2011, is amended to
    6  read as follows:
    7    1. sections 2807-c, 2807-j, 2807-s, and 2807-t of  the  public  health
    8  law,  as  amended by this act, shall expire on December 31, [2014] 2017,
    9  and shall be thereafter effective only in respect to any act done before
   10  such date or action or proceeding arising  out  of  such  act  including
   11  continued  collections  of  funds  from  assessments  and allowances and
   12  surcharges established pursuant to sections 2807-c, 2807-j,  2807-s  and
   13  2807-t of the public health law, and administration and distributions of
   14  funds  from  pools  established  pursuant  to  sections  2807-c, 2807-j,
   15  2807-k, 2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the  public
   16  health law, as amended or added by this act, related to patient services
   17  provided  before  December 31, [2014] 2017, and continued expenditure of
   18  funds authorized for programs and grants until the exhaustion  of  funds
   19  therefor;
   20    S  3.  The opening paragraph, subparagraph (xiv) and (xv) of paragraph
   21  (a), subparagraph (v) of paragraph (c) and paragraph (e) of  subdivision
   22  6  of  section 2807-s of the public health law, the opening paragraph as
   23  amended by section 4 of part A3 of chapter  62  of  the  laws  of  2003,
   24  subparagraphs (xiv) and (xv) of paragraph (a) as amended by section 5 of
   25  part  C of chapter 59 of the laws of 2011, subparagraph (v) of paragraph
   26  (c) as amended by section 5-a of part C of chapter 59  of  the  laws  of
   27  2011  and paragraph (e) as amended by section 6 of part A3 of chapter 62
   28  of the laws of 2003, subparagraphs (i) and  (ii)  of  paragraph  (e)  as
   29  amended  by section 5-b of part C of chapter 59 of the laws of 2011, are
   30  amended to read as follows:
   31    The amount allocated to each region for purposes  of  calculating  the
   32  regional  allowance  percentage  pursuant  to this section for each year
   33  during the period January first, nineteen hundred  ninety-seven  through
   34  December  thirty-first,  nineteen  hundred  ninety-nine and the regional
   35  assessments pursuant to section twenty-eight  hundred  seven-t  of  this
   36  article  for each year during the period January first, nineteen hundred
   37  ninety-seven through December thirty-first, nineteen hundred ninety-nine
   38  and for each year on and after January first, two thousand, shall be the
   39  sum of the factors computed in paragraphs  (b),  (d)  and  (f)  of  this
   40  subdivision, IF SUCH FACTORS ARE APPLICABLE TO A GIVEN YEAR, as follows:
   41    (xiv)  A  gross  annual statewide amount for the period January first,
   42  two thousand nine through December thirty-first, two thousand [thirteen]
   43  FOURTEEN, shall be nine hundred forty-four million dollars.
   44    (xv) A gross ANNUAL statewide amount for the period January first, two
   45  thousand [fourteen] FIFTEEN through [March] DECEMBER  thirty-first,  two
   46  thousand  [fourteen]  SEVENTEEN,  shall  be [two hundred thirty-six] ONE
   47  BILLION FORTY-FIVE million dollars.
   48    (v) A further gross ANNUAL statewide amount  for  the  period  January
   49  first,  two thousand fourteen through [March] DECEMBER thirty-first, two
   50  thousand  fourteen,  shall  be  [twenty-two]  EIGHTY-NINE  million  [two
   51  hundred fifty thousand] dollars.
   52    (e)  [(i)]  A  further  gross  annual statewide amount shall be twelve
   53  million dollars for each period prior to  January  first,  two  thousand
   54  [fourteen] FIFTEEN.
       S. 6914                            39                            A. 9205

    1    [(ii)  A  further gross statewide amount for the period January first,
    2  two thousand fourteen through March thirty-first, two thousand  fourteen
    3  shall be three million dollars.]
    4    S  4. Subparagraph (xiii) of paragraph (a) of subdivision 7 of section
    5  2807-s of the public health law, as added by section 30  of  part  H  of
    6  chapter 59 of the laws of 2011, is amended to read as follows:
    7    (xiii)  twenty-three million eight hundred thirty-six thousand dollars
    8  each state fiscal year for the period April first, two  thousand  twelve
    9  through March thirty-first, two thousand [fourteen] SEVENTEEN;
   10    S  5.  Subparagraphs (iv) and (v) of paragraph (a) of subdivision 9 of
   11  section 2807-j of the public health law, as amended by section 3 of part
   12  C of chapter 59 of the laws of 2011, are amended to read as follows:
   13    (iv) seven hundred sixty-five million dollars annually  of  the  funds
   14  accumulated for the periods January first, two thousand through December
   15  thirty-first, two thousand [thirteen] SIXTEEN, and
   16    (v)  one hundred ninety-one million two hundred fifty thousand dollars
   17  of the funds accumulated for the  period  January  first,  two  thousand
   18  [fourteen] SEVENTEEN through March thirty-first, two thousand [fourteen]
   19  SEVENTEEN.
   20    S  6. Section 34 of part A3 of chapter 62 of the laws of 2003 amending
   21  the general business law and  other  laws  relating  to  enacting  major
   22  components  necessary to implement the state fiscal plan for the 2003-04
   23  state fiscal year, as amended by section 4 of part C of  chapter  59  of
   24  the laws of 2011, is amended to read as follows:
   25    S  34.  (1) Notwithstanding any inconsistent provision of law, rule or
   26  regulation and effective April 1, 2008 through March  31,  [2014]  2017,
   27  the commissioner of health is authorized to transfer and the state comp-
   28  troller  is authorized and directed to receive for deposit to the credit
   29  of the department of health's special revenue fund - other, health  care
   30  reform  act  (HCRA) resources fund - 061, provider collection monitoring
   31  account, within amounts appropriated each year,  those  funds  collected
   32  and  accumulated  pursuant  to  section 2807-v of the public health law,
   33  including income from invested funds, for the  purpose  of  payment  for
   34  administrative  costs  of  the  department of health related to adminis-
   35  tration of  statutory  duties  for  the  collections  and  distributions
   36  authorized by section 2807-v of the public health law.
   37    (2)  Notwithstanding  any inconsistent provision of law, rule or regu-
   38  lation and effective April 1, 2008 through March 31,  [2014]  2017,  the
   39  commissioner  of  health  is  authorized to transfer and the state comp-
   40  troller is authorized and directed to receive for deposit to the  credit
   41  of  the department of health's special revenue fund - other, health care
   42  reform act (HCRA) resources fund - 061, provider  collection  monitoring
   43  account,  within  amounts  appropriated each year, those funds collected
   44  and accumulated and interest earned through surcharges on  payments  for
   45  health care services pursuant to section 2807-s of the public health law
   46  and from assessments pursuant to section 2807-t of the public health law
   47  for the purpose of payment for administrative costs of the department of
   48  health related to administration of statutory duties for the collections
   49  and  distributions  authorized by sections 2807-s, 2807-t, and 2807-m of
   50  the public health law.
   51    (3) Notwithstanding any inconsistent provision of law, rule  or  regu-
   52  lation  and  effective  April 1, 2008 through March 31, [2014] 2017, the
   53  commissioner of health is authorized to transfer and the comptroller  is
   54  authorized  to  deposit,  within  amounts  appropriated each year, those
   55  funds authorized for distribution in accordance with the  provisions  of
   56  paragraph  (a)  of  subdivision 1 of section 2807-l of the public health
       S. 6914                            40                            A. 9205

    1  law for the purposes of payment for administrative costs of the  depart-
    2  ment  of  health  related  to  the  child  health insurance plan program
    3  authorized pursuant to title 1-A of article 25 of the public health  law
    4  into  the  special  revenue funds - other, health care reform act (HCRA)
    5  resources fund - 061, child health insurance account, established within
    6  the department of health.
    7    (4) Notwithstanding any inconsistent provision of law, rule  or  regu-
    8  lation  and  effective  April 1, 2008 through March 31, [2014] 2017, the
    9  commissioner of health is authorized to transfer and the comptroller  is
   10  authorized  to  deposit,  within  amounts  appropriated each year, those
   11  funds authorized for distribution in accordance with the  provisions  of
   12  paragraph  (e)  of  subdivision 1 of section 2807-l of the public health
   13  law for the purpose of payment for administrative costs of  the  depart-
   14  ment  of  health  related to the health occupation development and work-
   15  place demonstration program established pursuant to section  2807-h  and
   16  the  health workforce retraining program established pursuant to section
   17  2807-g of the public health law into the special revenue funds -  other,
   18  health  care  reform  act (HCRA) resources fund - 061, health occupation
   19  development and workplace  demonstration  program  account,  established
   20  within the department of health.
   21    (5)  Notwithstanding  any inconsistent provision of law, rule or regu-
   22  lation and effective April 1, 2008 through March 31,  [2014]  2017,  the
   23  commissioner  of health is authorized to transfer and the comptroller is
   24  authorized to deposit, within  amounts  appropriated  each  year,  those
   25  funds  allocated  pursuant  to paragraph (j) of subdivision 1 of section
   26  2807-v of the public health law for the purpose of payment for  adminis-
   27  trative  costs  of the department of health related to administration of
   28  the state's tobacco control programs and cancer services provided pursu-
   29  ant to sections 2807-r and 1399-ii of the public health  law  into  such
   30  accounts established within the department of health for such purposes.
   31    (6)  Notwithstanding  any inconsistent provision of law, rule or regu-
   32  lation and effective April 1, 2008 through March 31,  [2014]  2017,  the
   33  commissioner  of health is authorized to transfer and the comptroller is
   34  authorized to deposit, within amounts appropriated each year, the  funds
   35  authorized for distribution in accordance with the provisions of section
   36  2807-l of the public health law for the purposes of payment for adminis-
   37  trative costs of the department of health related to the programs funded
   38  pursuant  to  section  2807-l  of the public health law into the special
   39  revenue funds - other, health care reform act (HCRA)  resources  fund  -
   40  061,  pilot  health insurance account, established within the department
   41  of health.
   42    (7) Notwithstanding any inconsistent provision of law, rule  or  regu-
   43  lation  and  effective  April 1, 2008 through March 31, [2014] 2017, the
   44  commissioner of health is authorized to transfer and the comptroller  is
   45  authorized  to  deposit,  within  amounts  appropriated each year, those
   46  funds authorized for distribution in accordance with the  provisions  of
   47  subparagraph  (ii)  of paragraph (f) of subdivision 19 of section 2807-c
   48  of the public health law from monies accumulated and interest earned  in
   49  the  bad  debt  and  charity care and capital statewide pools through an
   50  assessment charged to general hospitals pursuant to  the  provisions  of
   51  subdivision  18  of  section  2807-c  of the public health law and those
   52  funds authorized for distribution in accordance with the  provisions  of
   53  section  2807-l of the public health law for the purposes of payment for
   54  administrative costs of the department of  health  related  to  programs
   55  funded  under  section  2807-l of the public health law into the special
   56  revenue funds - other, health care reform act (HCRA)  resources  fund  -
       S. 6914                            41                            A. 9205

    1  061, primary care initiatives account, established within the department
    2  of health.
    3    (8)  Notwithstanding  any inconsistent provision of law, rule or regu-
    4  lation and effective April 1, 2008 through March 31,  [2014]  2017,  the
    5  commissioner  of health is authorized to transfer and the comptroller is
    6  authorized to deposit, within  amounts  appropriated  each  year,  those
    7  funds  authorized  for distribution in accordance with section 2807-l of
    8  the public health law for the purposes  of  payment  for  administrative
    9  costs  of  the  department  of  health  related to programs funded under
   10  section 2807-l of the public health law into the special revenue funds -
   11  other, health care reform act (HCRA) resources fund - 061,  health  care
   12  delivery  administration  account,  established within the department of
   13  health.
   14    (9) Notwithstanding any inconsistent provision of law, rule  or  regu-
   15  lation  and  effective  April 1, 2008 through March 31, [2014] 2017, the
   16  commissioner of health is authorized to transfer and the comptroller  is
   17  authorized  to  deposit,  within  amounts  appropriated each year, those
   18  funds authorized pursuant to sections 2807-d, 3614-a and 3614-b  of  the
   19  public  health  law and section 367-i of the social services law and for
   20  distribution in accordance with  the  provisions  of  subdivision  9  of
   21  section  2807-j  of the public health law for the purpose of payment for
   22  administration of statutory duties for the collections and distributions
   23  authorized by sections 2807-c, 2807-d, 2807-j,  2807-k,  2807-l,  3614-a
   24  and  3614-b  of  the  public  health law and section 367-i of the social
   25  services law into the special revenue funds - other, health care  reform
   26  act (HCRA) resources fund - 061, provider collection monitoring account,
   27  established within the department of health.
   28    S  7. Section 2807-l of the public health law, as amended by section 7
   29  of part C of chapter 59 of the laws of  2011,  is  amended  to  read  as
   30  follows:
   31    S 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
   32  lated  in the health care initiatives pools pursuant to paragraph (b) of
   33  subdivision nine of section twenty-eight hundred seven-j of  this  arti-
   34  cle,  or  the  health  care reform act (HCRA) resources fund established
   35  pursuant to section ninety-two-dd of the state finance law, whichever is
   36  applicable, including income from invested funds, shall  be  distributed
   37  or retained by the commissioner or by the state comptroller, as applica-
   38  ble, in accordance with the following.
   39    (a)  Funds  shall  be  reserved  and accumulated from year to year and
   40  shall be available, including income from invested funds,  for  purposes
   41  of  distributions  to programs to provide health care coverage for unin-
   42  sured or underinsured children pursuant to sections twenty-five  hundred
   43  ten  and  twenty-five hundred eleven of this chapter from the respective
   44  health care initiatives pools established for the following  periods  in
   45  the following amounts:
   46    (i) from the pool for the period January first, nineteen hundred nine-
   47  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
   48  up to one hundred twenty million six hundred thousand dollars;
   49    (ii) from the pool for the  period  January  first,  nineteen  hundred
   50  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
   51  eight, up to  one  hundred  sixty-four  million  five  hundred  thousand
   52  dollars;
   53    (iii)  from  the  pool  for the period January first, nineteen hundred
   54  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   55  up to one hundred eighty-one million dollars;
       S. 6914                            42                            A. 9205

    1    (iv) from the pool for the period January first, two thousand  through
    2  December thirty-first, two thousand, two hundred seven million dollars;
    3    (v)  from  the  pool  for  the  period January first, two thousand one
    4  through December thirty-first, two thousand one, two hundred thirty-five
    5  million dollars;
    6    (vi) from the pool for the period  January  first,  two  thousand  two
    7  through  December  thirty-first, two thousand two, three hundred twenty-
    8  four million dollars;
    9    (vii) from the pool for the period January first, two  thousand  three
   10  through  December  thirty-first,  two thousand three, up to four hundred
   11  fifty million three hundred thousand dollars;
   12    (viii) from the pool for the period January first, two  thousand  four
   13  through  December  thirty-first,  two  thousand four, up to four hundred
   14  sixty million nine hundred thousand dollars;
   15    (ix) from the pool or the health  care  reform  act  (HCRA)  resources
   16  fund,  whichever  is applicable, for the period January first, two thou-
   17  sand five through December thirty-first, two thousand five,  up  to  one
   18  hundred fifty-three million eight hundred thousand dollars;
   19    (x)  from  the  health  care  reform act (HCRA) resources fund for the
   20  period January first, two thousand six  through  December  thirty-first,
   21  two  thousand  six, up to three hundred twenty-five million four hundred
   22  thousand dollars;
   23    (xi) from the health care reform act (HCRA)  resources  fund  for  the
   24  period  January first, two thousand seven through December thirty-first,
   25  two thousand seven, up to four hundred twenty-eight  million  fifty-nine
   26  thousand dollars;
   27    (xii)  from  the  health care reform act (HCRA) resources fund for the
   28  period January first, two thousand eight through December  thirty-first,
   29  two  thousand  ten,  up  to four hundred fifty-three million six hundred
   30  seventy-four thousand dollars annually;
   31    (xiii) from the health care reform act (HCRA) resources fund  for  the
   32  period  January  first, two thousand eleven, through March thirty-first,
   33  two thousand eleven, up to one hundred  thirteen  million  four  hundred
   34  eighteen thousand dollars;
   35    (xiv)  from  the  health care reform act (HCRA) resources fund for the
   36  period April first, two thousand eleven, through March thirty-first, two
   37  thousand twelve, up to three hundred twenty-four million  seven  hundred
   38  forty-four thousand dollars;
   39    (xv)  from  the  health  care reform act (HCRA) resources fund for the
   40  period April first, two thousand twelve, through March thirty-first, two
   41  thousand thirteen, up to three hundred forty-six  million  four  hundred
   42  forty-four thousand dollars; [and]
   43    (xvi)  from  the  health care reform act (HCRA) resources fund for the
   44  period April first, two thousand thirteen, through  March  thirty-first,
   45  two  thousand  fourteen, up to three hundred seventy million six hundred
   46  ninety-five thousand dollars[.]; AND
   47    (XVII) FROM THE HEALTH CARE REFORM ACT (HCRA) RESOURCES FUND FOR  EACH
   48  STATE  FISCAL  YEAR  FOR  PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND
   49  FOURTEEN, WITHIN AMOUNTS APPROPRIATED.
   50    (b) Funds shall be reserved and accumulated  from  year  to  year  and
   51  shall  be  available, including income from invested funds, for purposes
   52  of distributions for health  insurance  programs  under  the  individual
   53  subsidy programs established pursuant to the expanded health care cover-
   54  age  act of nineteen hundred eighty-eight as amended, and for evaluation
   55  of such programs from the respective health care  initiatives  pools  or
       S. 6914                            43                            A. 9205

    1  the  health care reform act (HCRA) resources fund, whichever is applica-
    2  ble, established for the following periods in the following amounts:
    3    (i)  (A)  an amount not to exceed six million dollars on an annualized
    4  basis for the  periods  January  first,  nineteen  hundred  ninety-seven
    5  through  December  thirty-first, nineteen hundred ninety-nine; up to six
    6  million dollars for the  period  January  first,  two  thousand  through
    7  December  thirty-first, two thousand; up to five million dollars for the
    8  period January first, two thousand one  through  December  thirty-first,
    9  two  thousand  one;  up  to  four million dollars for the period January
   10  first, two thousand two through December thirty-first, two thousand two;
   11  up to two million six hundred thousand dollars for  the  period  January
   12  first,  two  thousand  three through December thirty-first, two thousand
   13  three; up to one million three hundred thousand dollars for  the  period
   14  January  first,  two  thousand  four  through December thirty-first, two
   15  thousand four; up to six hundred seventy thousand dollars for the period
   16  January first, two thousand five through June  thirtieth,  two  thousand
   17  five;  up  to  one million three hundred thousand dollars for the period
   18  April first, two thousand six through March thirty-first,  two  thousand
   19  seven; and up to one million three hundred thousand dollars annually for
   20  the  period  April first, two thousand seven through March thirty-first,
   21  two thousand nine, shall be allocated to  individual  subsidy  programs;
   22  and
   23    (B)  an  amount  not  to exceed seven million dollars on an annualized
   24  basis for the periods during the period January first, nineteen  hundred
   25  ninety-seven through December thirty-first, nineteen hundred ninety-nine
   26  and  four  million  dollars  annually for the periods January first, two
   27  thousand through December thirty-first,  two  thousand  two,  and  three
   28  million dollars for the period January first, two thousand three through
   29  December  thirty-first,  two thousand three, and two million dollars for
   30  the period January first, two thousand  four  through  December  thirty-
   31  first, two thousand four, and two million dollars for the period January
   32  first, two thousand five through June thirtieth, two thousand five shall
   33  be allocated to the catastrophic health care expense program.
   34    (ii) Notwithstanding any law to the contrary, the characterizations of
   35  the  New  York state small business health insurance partnership program
   36  as in effect prior  to  June  thirtieth,  two  thousand  three,  voucher
   37  program  as  in effect prior to December thirty-first, two thousand one,
   38  individual subsidy program as in effect prior  to  June  thirtieth,  two
   39  thousand  five,  and  catastrophic  health  care  expense program, as in
   40  effect prior to June thirtieth, two thousand five, may, for the purposes
   41  of identifying matching funds for the community health  care  conversion
   42  demonstration  project  described in a waiver of the provisions of title
   43  XIX of the federal social security act granted to the state of New  York
   44  and dated July fifteenth, nineteen hundred ninety-seven, may continue to
   45  be used to characterize the insurance programs in sections four thousand
   46  three  hundred  twenty-one-a,  four thousand three hundred twenty-two-a,
   47  four thousand three hundred twenty-six and four thousand  three  hundred
   48  twenty-seven of the insurance law, which are successor programs to these
   49  programs.
   50    (c)  Up to seventy-eight million dollars shall be reserved and accumu-
   51  lated from year to year from the pool  for  the  period  January  first,
   52  nineteen  hundred  ninety-seven  through December thirty-first, nineteen
   53  hundred ninety-seven, for purposes of  public  health  programs,  up  to
   54  seventy-six  million dollars shall be reserved and accumulated from year
   55  to year from the pools for the periods January first,  nineteen  hundred
   56  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
       S. 6914                            44                            A. 9205

    1  eight and January first, nineteen hundred ninety-nine  through  December
    2  thirty-first,  nineteen  hundred  ninety-nine, up to eighty-four million
    3  dollars shall be reserved and accumulated from year  to  year  from  the
    4  pools  for the period January first, two thousand through December thir-
    5  ty-first, two thousand, up  to  eighty-five  million  dollars  shall  be
    6  reserved and accumulated from year to year from the pools for the period
    7  January first, two thousand one through December thirty-first, two thou-
    8  sand one, up to eighty-six million dollars shall be reserved and accumu-
    9  lated from year to year from the pools for the period January first, two
   10  thousand  two  through  December  thirty-first,  two thousand two, up to
   11  eighty-six million one hundred fifty thousand dollars shall be  reserved
   12  and  accumulated from year to year from the pools for the period January
   13  first, two thousand three through December  thirty-first,  two  thousand
   14  three,  up  to fifty-eight million seven hundred eighty thousand dollars
   15  shall be reserved and accumulated from year to year from the  pools  for
   16  the  period  January  first,  two thousand four through December thirty-
   17  first, two thousand four, up to sixty-eight million seven hundred thirty
   18  thousand dollars shall be reserved and accumulated  from  year  to  year
   19  from  the  pools  or  the  health care reform act (HCRA) resources fund,
   20  whichever is applicable, for the period January first, two thousand five
   21  through December thirty-first, two  thousand  five,  up  to  ninety-four
   22  million three hundred fifty thousand dollars shall be reserved and accu-
   23  mulated  from  year  to  year  from  the  health  care reform act (HCRA)
   24  resources fund for the period January first, two  thousand  six  through
   25  December  thirty-first,  two  thousand  six,  up to seventy million nine
   26  hundred thirty-nine thousand dollars shall be reserved  and  accumulated
   27  from  year to year from the health care reform act (HCRA) resources fund
   28  for the period January first, two thousand seven through December  thir-
   29  ty-first,  two  thousand  seven,  up  to  fifty-five million six hundred
   30  eighty-nine thousand dollars annually shall be reserved and  accumulated
   31  from  year to year from the health care reform act (HCRA) resources fund
   32  for the period January first, two thousand eight through December  thir-
   33  ty-first,  two thousand ten, up to thirteen million nine hundred twenty-
   34  two thousand dollars shall be reserved and accumulated from year to year
   35  from the health care reform act (HCRA) resources  fund  for  the  period
   36  January first, two thousand eleven through March thirty-first, two thou-
   37  sand  eleven,  and  for  periods  on and after April first, two thousand
   38  eleven [through March thirty-first, two thousand fourteen], up to  fund-
   39  ing  amounts  specified  below  and shall be available, including income
   40  from invested funds, for:
   41    (i) deposit by the commissioner, within amounts appropriated, and  the
   42  state  comptroller  is  hereby  authorized  and  directed to receive for
   43  deposit to, to the credit of the department of health's special  revenue
   44  fund  -  other, hospital based grants program account or the health care
   45  reform act (HCRA) resources fund, whichever is applicable, for  purposes
   46  of  services  and  expenses  related  to  general  hospital  based grant
   47  programs, up to twenty-two million dollars annually  from  the  nineteen
   48  hundred  ninety-seven pool, nineteen hundred ninety-eight pool, nineteen
   49  hundred ninety-nine pool, two thousand pool, two thousand one  pool  and
   50  two  thousand  two  pool, respectively, up to twenty-two million dollars
   51  from the two thousand three pool, up to  ten  million  dollars  for  the
   52  period  January  first, two thousand four through December thirty-first,
   53  two thousand four, up to eleven million dollars for the  period  January
   54  first,  two  thousand  five  through December thirty-first, two thousand
   55  five, up to twenty-two million dollars for the period January first, two
   56  thousand six through December thirty-first,  two  thousand  six,  up  to
       S. 6914                            45                            A. 9205

    1  twenty-two million ninety-seven thousand dollars annually for the period
    2  January  first,  two  thousand  seven through December thirty-first, two
    3  thousand ten, up to  five  million  five  hundred  twenty-four  thousand
    4  dollars  for the period January first, two thousand eleven through March
    5  thirty-first, two thousand eleven, up to thirteen million  four  hundred
    6  forty-five  thousand  dollars  for  the period April first, two thousand
    7  eleven through March thirty-first, two thousand twelve, and up to  thir-
    8  teen  million  three  hundred  seventy-five  thousand dollars each state
    9  fiscal year for the period April  first,  two  thousand  twelve  through
   10  March thirty-first, two thousand fourteen;
   11    (ii) deposit by the commissioner, within amounts appropriated, and the
   12  state  comptroller  is  hereby  authorized  and  directed to receive for
   13  deposit to, to the credit of the  emergency  medical  services  training
   14  account  established  in section ninety-seven-q of the state finance law
   15  or the health care reform act (HCRA) resources fund, whichever is appli-
   16  cable, up to sixteen million dollars on  an  annualized  basis  for  the
   17  periods  January  first,  nineteen hundred ninety-seven through December
   18  thirty-first, nineteen hundred ninety-nine, up to twenty million dollars
   19  for the period January first,  two  thousand  through  December  thirty-
   20  first,  two  thousand,  up  to twenty-one million dollars for the period
   21  January first, two thousand one through December thirty-first, two thou-
   22  sand one, up to twenty-two million dollars for the period January first,
   23  two thousand two through December thirty-first, two thousand two, up  to
   24  twenty-two  million  five  hundred fifty thousand dollars for the period
   25  January first, two thousand three  through  December  thirty-first,  two
   26  thousand  three,  up to nine million six hundred eighty thousand dollars
   27  for the period January first, two thousand four through  December  thir-
   28  ty-first,  two  thousand  four,  up to twelve million one hundred thirty
   29  thousand dollars for the period January first, two thousand five through
   30  December thirty-first, two thousand five, up to twenty-four million  two
   31  hundred  fifty  thousand dollars for the period January first, two thou-
   32  sand six through December thirty-first, two thousand six, up  to  twenty
   33  million four hundred ninety-two thousand dollars annually for the period
   34  January  first,  two  thousand  seven through December thirty-first, two
   35  thousand ten, up to  five  million  one  hundred  twenty-three  thousand
   36  dollars  for the period January first, two thousand eleven through March
   37  thirty-first, two thousand eleven, up to eighteen million three  hundred
   38  fifty  thousand  dollars for the period April first, two thousand eleven
   39  through March thirty-first, two thousand twelve, up to eighteen  million
   40  nine  hundred  fifty  thousand  dollars  for the period April first, two
   41  thousand twelve through March thirty-first, two thousand thirteen, [and]
   42  up to nineteen million four hundred nineteen thousand  dollars  for  the
   43  period  April  first,  two thousand thirteen through March thirty-first,
   44  two thousand fourteen, AND UP TO NINETEEN MILLION SIX HUNDRED FIFTY-NINE
   45  THOUSAND SEVEN HUNDRED DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD  OF
   46  APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
   47  SAND SEVENTEEN;
   48    (iii)  priority  distributions  by  the  commissioner up to thirty-two
   49  million dollars on an annualized basis for the period January first, two
   50  thousand through December thirty-first, two thousand four, up  to  thir-
   51  ty-eight  million  dollars on an annualized basis for the period January
   52  first, two thousand five through  December  thirty-first,  two  thousand
   53  six,  up  to eighteen million two hundred fifty thousand dollars for the
   54  period January first, two thousand seven through December  thirty-first,
   55  two  thousand seven, up to three million dollars annually for the period
   56  January first, two thousand eight  through  December  thirty-first,  two
       S. 6914                            46                            A. 9205

    1  thousand  ten, up to seven hundred fifty thousand dollars for the period
    2  January first, two thousand eleven through March thirty-first, two thou-
    3  sand eleven, [and] up to two million nine hundred thousand dollars  each
    4  state  fiscal  year  for  the  period  April  first, two thousand eleven
    5  through March thirty-first, two thousand fourteen, AND UP TO TWO MILLION
    6  NINE HUNDRED THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE  PERIOD
    7  APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
    8  SAND SEVENTEEN to be allocated (A) for the purposes established pursuant
    9  to subparagraph (ii) of paragraph (f) of subdivision nineteen of section
   10  twenty-eight  hundred  seven-c  of this article as in effect on December
   11  thirty-first, nineteen hundred  ninety-six  and  as  may  thereafter  be
   12  amended,  up to fifteen million dollars annually for the periods January
   13  first, two thousand through December thirty-first, two thousand four, up
   14  to twenty-one million dollars annually for the period January first, two
   15  thousand five through December thirty-first, two thousand six, and up to
   16  seven million five hundred  thousand  dollars  for  the  period  January
   17  first,  two  thousand  seven  through  March  thirty-first, two thousand
   18  seven;
   19    (B) pursuant to a memorandum of  understanding  entered  into  by  the
   20  commissioner,  the  majority leader of the senate and the speaker of the
   21  assembly, for the purposes outlined in such memorandum upon  the  recom-
   22  mendation  of  the  majority  leader  of the senate, up to eight million
   23  five hundred thousand dollars annually for the period January first, two
   24  thousand through December thirty-first, two thousand six, and up to four
   25  million two hundred fifty thousand dollars for the period January first,
   26  two thousand seven through June thirtieth, two thousand seven,  and  for
   27  the  purposes outlined in such memorandum upon the recommendation of the
   28  speaker of the assembly, up  to  eight  million  five  hundred  thousand
   29  dollars  annually  for  the  periods January first, two thousand through
   30  December thirty-first, two thousand six, and  up  to  four  million  two
   31  hundred  fifty  thousand dollars for the period January first, two thou-
   32  sand seven through June thirtieth, two thousand seven; and
   33    (C) for services and expenses, including grants, related to  emergency
   34  assistance  distributions  as  designated by the commissioner.  Notwith-
   35  standing section one hundred twelve or one hundred  sixty-three  of  the
   36  state  finance law or any other contrary provision of law, such distrib-
   37  utions shall be limited to providers or programs where, as determined by
   38  the commissioner, emergency assistance is vital to protect the  life  or
   39  safety  of  patients,  to ensure the retention of facility caregivers or
   40  other staff, or in instances where health facility operations are  jeop-
   41  ardized,  or  where  the public health is jeopardized or other emergency
   42  situations exist, up to three million dollars annually  for  the  period
   43  April first, two thousand seven through March thirty-first, two thousand
   44  eleven, [and] up to two million nine hundred thousand dollars each state
   45  fiscal  year  for  the  period  April first, two thousand eleven through
   46  March thirty-first, two thousand fourteen, AND UP TO  TWO  MILLION  NINE
   47  HUNDRED  THOUSAND  DOLLARS  EACH  STATE FISCAL YEAR FOR THE PERIOD APRIL
   48  FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND
   49  SEVENTEEN.   Upon any distribution of such funds, the commissioner shall
   50  immediately notify the chair and ranking minority member of  the  senate
   51  finance  committee,  the  assembly  ways and means committee, the senate
   52  committee on health, and the assembly committee on health;
   53    (iv) distributions by  the  commissioner  related  to  poison  control
   54  centers  pursuant  to subdivision seven of section twenty-five hundred-d
   55  of this chapter, up to five  million  dollars  for  the  period  January
   56  first,  nineteen  hundred  ninety-seven  through  December thirty-first,
       S. 6914                            47                            A. 9205

    1  nineteen hundred ninety-seven, up to three million dollars on an annual-
    2  ized basis for the periods during the  period  January  first,  nineteen
    3  hundred  ninety-eight  through  December  thirty-first, nineteen hundred
    4  ninety-nine, up to five million dollars annually for the periods January
    5  first,  two thousand through December thirty-first, two thousand two, up
    6  to four million six hundred thousand dollars annually  for  the  periods
    7  January  first,  two  thousand  three through December thirty-first, two
    8  thousand four, up to five million one hundred thousand dollars  for  the
    9  period  January  first, two thousand five through December thirty-first,
   10  two thousand six annually, up  to  five  million  one  hundred  thousand
   11  dollars  annually  for  the  period  January  first,  two thousand seven
   12  through December thirty-first, two thousand nine, up  to  three  million
   13  six  hundred thousand dollars for the period January first, two thousand
   14  ten through December thirty-first, two thousand ten, up to seven hundred
   15  seventy-five thousand dollars for the period January first, two thousand
   16  eleven through March thirty-first, two thousand eleven, [and] up to  two
   17  million  five  hundred  thousand  dollars each state fiscal year for the
   18  period April first, two thousand eleven through March thirty-first,  two
   19  thousand  fourteen,  AND  UP  TO THREE MILLION DOLLARS EACH STATE FISCAL
   20  YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH  MARCH
   21  THIRTY-FIRST, TWO THOUSAND SEVENTEEN; and
   22    (v)  deposit by the commissioner, within amounts appropriated, and the
   23  state comptroller is hereby  authorized  and  directed  to  receive  for
   24  deposit  to, to the credit of the department of health's special revenue
   25  fund - other, miscellaneous special revenue  fund  -  339  maternal  and
   26  child  HIV  services  account  or  the  health  care  reform  act (HCRA)
   27  resources fund, whichever is  applicable,  for  purposes  of  a  special
   28  program  for  HIV services for women and children, including adolescents
   29  pursuant to section twenty-five hundred-f-one of [the public health law]
   30  THIS CHAPTER, up to five million dollars annually for the periods  Janu-
   31  ary first, two thousand through December thirty-first, two thousand two,
   32  up  to  five  million dollars for the period January first, two thousand
   33  three through December thirty-first,  two  thousand  three,  up  to  two
   34  million  five hundred thousand dollars for the period January first, two
   35  thousand four through December thirty-first, two thousand  four,  up  to
   36  two  million five hundred thousand dollars for the period January first,
   37  two thousand five through December thirty-first, two thousand  five,  up
   38  to  five  million dollars for the period January first, two thousand six
   39  through December thirty-first, two thousand  six,  up  to  five  million
   40  dollars  annually  for  the  period  January  first,  two thousand seven
   41  through December thirty-first, two thousand ten, up to one  million  two
   42  hundred  fifty  thousand dollars for the period January first, two thou-
   43  sand eleven through March thirty-first, two thousand eleven, and  up  to
   44  five  million dollars each state fiscal year for the period April first,
   45  two thousand eleven through March thirty-first, two thousand fourteen;
   46    (d) (i) An amount of up to twenty million  dollars  annually  for  the
   47  period  January  first,  two thousand through December thirty-first, two
   48  thousand six, up to ten million dollars for the  period  January  first,
   49  two  thousand  seven  through  June thirtieth, two thousand seven, up to
   50  twenty million dollars annually for the period January first, two  thou-
   51  sand  eight  through December thirty-first, two thousand ten, up to five
   52  million dollars for  the  period  January  first,  two  thousand  eleven
   53  through  March  thirty-first,  two thousand eleven, [and] up to nineteen
   54  million six hundred thousand dollars each  state  fiscal  year  for  the
   55  period  April first, two thousand eleven through March thirty-first, two
   56  thousand fourteen, AND UP  TO  NINETEEN  MILLION  SIX  HUNDRED  THOUSAND
       S. 6914                            48                            A. 9205

    1  DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
    2  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND  SEVENTEEN,  shall  be
    3  transferred to the health facility restructuring pool established pursu-
    4  ant to section twenty-eight hundred fifteen of this article;
    5    (ii)  provided,  however, amounts transferred pursuant to subparagraph
    6  (i) of this paragraph may be reduced in an amount to be approved by  the
    7  director  of  the budget to reflect the amount received from the federal
    8  government under the state's 1115 waiver which  is  directed  under  its
    9  terms and conditions to the health facility restructuring program.
   10    (e)  Funds  shall  be  reserved  and accumulated from year to year and
   11  shall be available,  including income from invested funds, for  purposes
   12  of  distributions  to  organizations  to  support  the  health workforce
   13  retraining program established pursuant to section twenty-eight  hundred
   14  seven-g  of  this   article  from the respective health care initiatives
   15  pools established for the following periods  in  the  following  amounts
   16  from  the  pools  or  the  health care reform act (HCRA) resources fund,
   17  whichever is applicable,  during  the  period  January  first,  nineteen
   18  hundred  ninety-seven  through  December  thirty-first, nineteen hundred
   19  ninety-nine, up to fifty million dollars on an annualized basis,  up  to
   20  thirty  million  dollars  for  the  period  January  first, two thousand
   21  through December thirty-first, two thousand, up to forty million dollars
   22  for the period January first, two thousand one through December  thirty-
   23  first,  two  thousand  one,  up  to fifty million dollars for the period
   24  January first, two thousand two through December thirty-first, two thou-
   25  sand two, up to forty-one million one hundred fifty thousand dollars for
   26  the period January first, two thousand three  through  December  thirty-
   27  first,  two  thousand  three,  up to forty-one million one hundred fifty
   28  thousand dollars for the period January first, two thousand four through
   29  December thirty-first, two thousand  four,  up  to  fifty-eight  million
   30  three  hundred  sixty thousand dollars for the period January first, two
   31  thousand five through December thirty-first, two thousand  five,  up  to
   32  fifty-two  million  three  hundred sixty thousand dollars for the period
   33  January first, two thousand six through December thirty-first, two thou-
   34  sand six, up to thirty-five million four hundred thousand dollars  annu-
   35  ally  for  the period January first, two thousand seven through December
   36  thirty-first, two thousand ten, up to eight million eight hundred  fifty
   37  thousand  dollars  for  the  period  January  first, two thousand eleven
   38  through March thirty-first, two thousand eleven,  [and]  up  to  twenty-
   39  eight  million  four hundred thousand dollars each state fiscal year for
   40  the period April first, two thousand eleven through March  thirty-first,
   41  two thousand fourteen, AND UP TO TWENTY-SIX MILLION EIGHT HUNDRED SEVEN-
   42  TEEN THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST,
   43  TWO  THOUSAND  FOURTEEN  THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVEN-
   44  TEEN, less the amount  of  funds  available  for  allocations  for  rate
   45  adjustments  for  workforce  training  programs  for  payments  by state
   46  governmental agencies for inpatient hospital services.
   47    (f) Funds shall be accumulated and transferred from as follows:
   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  (A)  thirty-four  million   six hundred thousand dollars shall be trans-
   51  ferred to funds reserved and accumulated pursuant to  paragraph  (b)  of
   52  subdivision  nineteen  of  section  twenty-eight hundred seven-c of this
   53  article, and (B) eighty-two million dollars  shall  be  transferred  and
   54  deposited  and  credited to the credit of the state general fund medical
   55  assistance local assistance account;
       S. 6914                            49                            A. 9205

    1    (ii) from the pool for the  period  January  first,  nineteen  hundred
    2  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
    3  eight, eighty-two million dollars shall be transferred and deposited and
    4  credited to the credit of the  state  general  fund  medical  assistance
    5  local assistance account;
    6    (iii)  from  the  pool  for the period January first, nineteen hundred
    7  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
    8  eighty-two million dollars shall be transferred and deposited and  cred-
    9  ited  to  the  credit of the state general fund medical assistance local
   10  assistance account;
   11    (iv) from the pool or the health  care  reform  act  (HCRA)  resources
   12  fund,  whichever  is applicable, for the period January first, two thou-
   13  sand  through  December  thirty-first,  two  thousand  four,  eighty-two
   14  million dollars annually, and for the period January first, two thousand
   15  five  through  December  thirty-first,  two  thousand  five,  eighty-two
   16  million dollars, and for the period  January  first,  two  thousand  six
   17  through  December  thirty-first,  two  thousand  six, eighty-two million
   18  dollars, and for the period January first, two  thousand  seven  through
   19  December  thirty-first,  two thousand seven, eighty-two million dollars,
   20  and for the period January first, two thousand  eight  through  December
   21  thirty-first,  two thousand eight, ninety million seven hundred thousand
   22  dollars shall be deposited by the  commissioner,  and  the  state  comp-
   23  troller  is hereby authorized and directed to receive for deposit to the
   24  credit of the state special revenue fund - other,  HCRA  transfer  fund,
   25  medical assistance account;
   26    (v)  from  the  health  care  reform act (HCRA) resources fund for the
   27  period January first, two thousand nine through  December  thirty-first,
   28  two  thousand  nine, one hundred eight million nine hundred seventy-five
   29  thousand dollars, and for the period January  first,  two  thousand  ten
   30  through  December thirty-first, two thousand ten, one hundred twenty-six
   31  million one hundred thousand dollars, for the period January first,  two
   32  thousand  eleven through March thirty-first, two thousand eleven, twenty
   33  million five hundred thousand dollars, and for each  state  fiscal  year
   34  for  the  period  April first, two thousand eleven through March thirty-
   35  first, two thousand fourteen, one hundred forty-six million four hundred
   36  thousand dollars, shall be deposited by the commissioner, and the  state
   37  comptroller is hereby authorized and directed to receive for deposit, to
   38  the  credit  of  the  state  special revenue fund - other, HCRA transfer
   39  fund, medical assistance account.
   40    (g) Funds shall be transferred to primary health care  services  pools
   41  created  by  the  commissioner, and shall be available, including income
   42  from invested funds, for distributions in accordance with former section
   43  twenty-eight hundred seven-bb of this article from the respective health
   44  care initiatives pools  for  the  following  periods  in  the  following
   45  percentage  amounts  of  funds remaining after allocations in accordance
   46  with paragraphs (a) through (f) of this subdivision:
   47    (i) from the pool for the period January first, nineteen hundred nine-
   48  ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
   49  fifteen and eighty-seven-hundredths percent;
   50    (ii)  from  the  pool  for  the period January first, nineteen hundred
   51  ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
   52  eight, fifteen and eighty-seven-hundredths percent; and
   53    (iii)  from  the  pool  for the period January first, nineteen hundred
   54  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   55  sixteen and thirteen-hundredths percent.
       S. 6914                            50                            A. 9205

    1    (h) Funds shall be reserved and accumulated from year to year  by  the
    2  commissioner  and  shall  be  available,  including income from invested
    3  funds, for purposes of primary care education and training  pursuant  to
    4  article nine of this chapter from the respective health care initiatives
    5  pools  established for the following periods in the following percentage
    6  amounts of funds remaining after allocations in  accordance  with  para-
    7  graphs  (a)  through  (f) of this subdivision and shall be available for
    8  distributions as follows:
    9    (i) funds shall be reserved and accumulated:
   10    (A) from the pool for the period January first, nineteen hundred nine-
   11  ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
   12  six and thirty-five-hundredths percent;
   13    (B) from the pool for the period January first, nineteen hundred nine-
   14  ty-eight  through  December thirty-first, nineteen hundred ninety-eight,
   15  six and thirty-five-hundredths percent; and
   16    (C) from the pool for the period January first, nineteen hundred nine-
   17  ty-nine through December thirty-first, nineteen hundred ninety-nine, six
   18  and forty-five-hundredths percent;
   19    (ii) funds shall be available for distributions including income  from
   20  invested funds as follows:
   21    (A)  for purposes of the primary care physician loan repayment program
   22  in accordance with section nine hundred three of  this  chapter,  up  to
   23  five million dollars on an annualized basis;
   24    (B)  for purposes of the primary care practitioner scholarship program
   25  in accordance with section nine hundred four of this chapter, up to  two
   26  million dollars on an annualized basis;
   27    (C) for purposes of minority participation in medical education grants
   28  in  accordance  with section nine hundred six of this chapter, up to one
   29  million dollars on an annualized basis; and
   30    (D) provided, however, that the commissioner may reallocate any  funds
   31  remaining  or unallocated for distributions for the primary care practi-
   32  tioner scholarship program in accordance with section nine hundred  four
   33  of this chapter.
   34    (i)  Funds  shall  be  reserved  and accumulated from year to year and
   35  shall be available, including income from invested funds,  for  distrib-
   36  utions  in  accordance  with  section  twenty-nine hundred fifty-two and
   37  section twenty-nine hundred fifty-eight of this chapter for rural health
   38  care delivery development and  rural  health  care  access  development,
   39  respectively,  from  the respective health care initiatives pools or the
   40  health care reform act (HCRA) resources fund, whichever  is  applicable,
   41  for  the  following periods in the following percentage amounts of funds
   42  remaining after allocations in accordance with  paragraphs  (a)  through
   43  (f) of this subdivision, and for periods on and after January first, two
   44  thousand, in the following amounts:
   45    (i) from the pool for the period January first, nineteen hundred nine-
   46  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
   47  thirteen and forty-nine-hundredths percent;
   48    (ii) from the pool for the  period  January  first,  nineteen  hundred
   49  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
   50  eight, thirteen and forty-nine-hundredths percent;
   51    (iii) from the pool for the period  January  first,  nineteen  hundred
   52  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   53  thirteen and seventy-one-hundredths percent;
   54    (iv) from the pool for the periods January first, two thousand through
   55  December thirty-first, two thousand two, seventeen million dollars annu-
   56  ally,  and  for  the  period  January  first, two thousand three through
       S. 6914                            51                            A. 9205

    1  December thirty-first, two thousand three, up to fifteen  million  eight
    2  hundred fifty thousand dollars;
    3    (v) from the pool or the health care reform act (HCRA) resources fund,
    4  whichever is applicable, for the period January first, two thousand four
    5  through  December thirty-first, two thousand four, up to fifteen million
    6  eight hundred fifty thousand  dollars,  [and]  for  the  period  January
    7  first,  two  thousand  five  through December thirty-first, two thousand
    8  five, up to nineteen million two hundred thousand dollars, [and] for the
    9  period January first, two thousand six  through  December  thirty-first,
   10  two  thousand  six, up to nineteen million two hundred thousand dollars,
   11  for the period January first, two thousand seven through December  thir-
   12  ty-first,  two  thousand  ten,  up to eighteen million one hundred fifty
   13  thousand dollars annually, for the period January  first,  two  thousand
   14  eleven  through  March  thirty-first,  two  thousand  eleven, up to four
   15  million five hundred thirty-eight thousand dollars, [and] for each state
   16  fiscal year for the period April  first,  two  thousand  eleven  through
   17  March  thirty-first,  two  thousand  fourteen, up to sixteen million two
   18  hundred thousand dollars, AND UP TO SIXTEEN MILLION TWO HUNDRED THOUSAND
   19  DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
   20  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
   21    (j)  Funds  shall  be  reserved  and accumulated from year to year and
   22  shall be available, including income from invested funds,  for  purposes
   23  of  distributions  related to health information and health care quality
   24  improvement pursuant to former section twenty-eight hundred  seven-n  of
   25  this  article  from  the respective health care initiatives pools estab-
   26  lished for the following periods in the following percentage amounts  of
   27  funds  remaining  after  allocations  in  accordance with paragraphs (a)
   28  through (f) of this subdivision:
   29    (i) from the pool for the period January first, nineteen hundred nine-
   30  ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
   31  six and thirty-five-hundredths percent;
   32    (ii)  from  the  pool  for  the period January first, nineteen hundred
   33  ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
   34  eight, six and thirty-five-hundredths percent; and
   35    (iii)  from  the  pool  for the period January first, nineteen hundred
   36  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   37  six and forty-five-hundredths percent.
   38    (k) Funds shall be reserved and accumulated  from  year  to  year  and
   39  shall  be  available,  including  income  from invested funds, for allo-
   40  cations  and  distributions  in  accordance  with  section  twenty-eight
   41  hundred  seven-p  of  this  article  for diagnostic and treatment center
   42  uncompensated care from the respective health care initiatives pools  or
   43  the  health care reform act (HCRA) resources fund, whichever is applica-
   44  ble, for the following periods in the following percentage   amounts  of
   45  funds  remaining  after  allocations  in  accordance with paragraphs (a)
   46  through (f) of this subdivision, and for periods on  and  after  January
   47  first, two thousand, in the following amounts:
   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  thirty-eight and one-tenth 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, thirty-eight and one-tenth percent;
   54    (iii) from the pool for the period  January  first,  nineteen  hundred
   55  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   56  thirty-eight and seventy-one-hundredths percent;
       S. 6914                            52                            A. 9205

    1    (iv) from the pool for the periods January first, two thousand through
    2  December  thirty-first,  two  thousand  two, forty-eight million dollars
    3  annually, and for the period January first, two thousand  three  through
    4  June thirtieth, two thousand three, twenty-four million dollars;
    5    (v)  (A)  from the pool or the health care reform act (HCRA) resources
    6  fund, whichever is applicable, for the period July first,  two  thousand
    7  three  through  December  thirty-first,  two  thousand  three, up to six
    8  million dollars, for the period January first, two thousand four through
    9  December thirty-first, two thousand six, up to  twelve  million  dollars
   10  annually,  for  the  period  January  first,  two thousand seven through
   11  December thirty-first, two thousand thirteen, up to forty-eight  million
   12  dollars annually, [and] for the period January first, two thousand four-
   13  teen  through  March  thirty-first,  two thousand fourteen, up to twelve
   14  million dollars AND FOR THE PERIOD APRIL FIRST,  TWO  THOUSAND  FOURTEEN
   15  THROUGH  MARCH  THIRTY-FIRST,  TWO THOUSAND SEVENTEEN, UP TO FORTY-EIGHT
   16  MILLION DOLLARS ANNUALLY;
   17    (B) from the health care reform act  (HCRA)  resources  fund  for  the
   18  period  January  first,  two thousand six through December thirty-first,
   19  two thousand six, an additional  seven  million  five  hundred  thousand
   20  dollars, for the period January first, two thousand seven through Decem-
   21  ber  thirty-first,  two  thousand  thirteen, an additional seven million
   22  five hundred thousand dollars annually, [and]  for  the  period  January
   23  first,  two  thousand  fourteen through March thirty-first, two thousand
   24  fourteen, an additional one million eight hundred seventy-five  thousand
   25  dollars,  AND  FOR THE PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH
   26  MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN, AN ADDITIONAL SEVEN  MILLION
   27  FIVE HUNDRED THOUSAND DOLLARS ANNUALLY for voluntary non-profit diagnos-
   28  tic  and treatment center uncompensated care in accordance with subdivi-
   29  sion four-c of section twenty-eight hundred seven-p of this article; and
   30    (vi) funds reserved and accumulated pursuant  to  this  paragraph  for
   31  periods  on and after July first, two thousand three, shall be deposited
   32  by the commissioner, within amounts appropriated, and  the  state  comp-
   33  troller  is hereby authorized and directed to receive for deposit to the
   34  credit of the state special revenue funds - other, HCRA  transfer  fund,
   35  medical  assistance  account, for purposes of funding the state share of
   36  rate adjustments made pursuant to section twenty-eight  hundred  seven-p
   37  of  this article, provided, however, that in the event federal financial
   38  participation is not available for rate  adjustments  made  pursuant  to
   39  paragraph (b) of subdivision one of section twenty-eight hundred seven-p
   40  of this article, funds shall be distributed pursuant to paragraph (a) of
   41  subdivision  one of section twenty-eight hundred seven-p of this article
   42  from the respective health care initiatives pools  or  the  health  care
   43  reform act (HCRA) resources fund, whichever is applicable.
   44    (l)  Funds  shall be reserved and accumulated from year to year by the
   45  commissioner and shall be  available,  including  income  from  invested
   46  funds, for transfer to and allocation  for services and expenses for the
   47  payment  of benefits to recipients of  drugs under the AIDS drug assist-
   48  ance program (ADAP) - HIV uninsured  care  program  as  administered  by
   49  Health  Research  Incorporated  from  the respective  health care initi-
   50  atives pools or the health care reform act (HCRA) resources fund, which-
   51  ever is applicable, established for the following periods in the follow-
   52  ing  percentage  amounts  of  funds  remaining  after   allocations   in
   53  accordance  with paragraphs (a) through (f) of this subdivision, and for
   54  periods on and after January  first,  two  thousand,  in  the  following
   55  amounts:
       S. 6914                            53                            A. 9205

    1    (i) from the pool for the period January first, nineteen hundred nine-
    2  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
    3  nine and fifty-two-hundredths percent;
    4    (ii)  from  the  pool  for  the period January first, nineteen hundred
    5  ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
    6  eight, nine and fifty-two-hundredths percent;
    7    (iii)  from  the  pool  for the period January first, nineteen hundred
    8  ninety-nine and December  thirty-first,  nineteen  hundred  ninety-nine,
    9  nine and sixty-eight-hundredths percent;
   10    (iv) from the pool for the periods January first, two thousand through
   11  December  thirty-first,  two  thousand two, up to twelve million dollars
   12  annually, and for the period January first, two thousand  three  through
   13  December  thirty-first, two thousand three, up to forty million dollars;
   14  and
   15    (v) from the pool or the health care reform act (HCRA) resources fund,
   16  whichever is applicable, for the periods  January  first,  two  thousand
   17  four  through  December thirty-first, two thousand four, up to fifty-six
   18  million dollars, for the period January first, two thousand five through
   19  December thirty-first, two thousand six, up  to  sixty  million  dollars
   20  annually,  for  the  period  January  first,  two thousand seven through
   21  December thirty-first, two thousand ten, up  to  sixty  million  dollars
   22  annually,  for  the  period  January  first, two thousand eleven through
   23  March thirty-first, two thousand eleven, up to fifteen million  dollars,
   24  [and]  each  state  fiscal year for the period April first, two thousand
   25  eleven through March thirty-first, two thousand fourteen, up  to  forty-
   26  two  million  three hundred thousand dollars AND UP TO FORTY-ONE MILLION
   27  FIFTY THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE  PERIOD  APRIL
   28  FIRST,  TWO  THOUSAND  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
   29  SEVENTEEN.
   30    (m) Funds shall be reserved and accumulated  from  year  to  year  and
   31  shall  be  available, including income from invested funds, for purposes
   32  of distributions pursuant to section  twenty-eight  hundred  seven-r  of
   33  this article for cancer related services from the respective health care
   34  initiatives  pools  or the health care reform act (HCRA) resources fund,
   35  whichever is applicable, established for the following  periods  in  the
   36  following  percentage  amounts  of  funds remaining after allocations in
   37  accordance with paragraphs (a) through (f) of this subdivision, and  for
   38  periods  on  and  after  January  first,  two thousand, in the following
   39  amounts:
   40    (i) from the pool for the period January first, nineteen hundred nine-
   41  ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
   42  seven and ninety-four-hundredths percent;
   43    (ii)  from  the  pool  for  the period January first, nineteen hundred
   44  ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
   45  eight, seven and ninety-four-hundredths percent;
   46    (iii)  from  the  pool  for the period January first, nineteen hundred
   47  ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
   48  and forty-five-hundredths percent;
   49    (iv) from the pool for the period January first, two thousand  through
   50  December thirty-first, two thousand two, up to ten million dollars on an
   51  annual basis;
   52    (v)  from  the  pool  for the period January first, two thousand three
   53  through December thirty-first, two thousand four, up  to  eight  million
   54  nine hundred fifty thousand dollars on an annual basis;
   55    (vi)  from  the  pool  or  the health care reform act (HCRA) resources
   56  fund, whichever is applicable, for the period January first,  two  thou-
       S. 6914                            54                            A. 9205

    1  sand  five  through  December  thirty-first, two thousand six, up to ten
    2  million fifty thousand dollars on an annual basis, for the period  Janu-
    3  ary  first,  two thousand seven through December thirty-first, two thou-
    4  sand  ten,  up  to nineteen million dollars annually, and for the period
    5  January first, two thousand eleven through March thirty-first, two thou-
    6  sand eleven, up to four million seven hundred fifty thousand dollars.
    7    (n) Funds shall be accumulated and transferred from  the  health  care
    8  reform act (HCRA) resources fund as follows: for the period April first,
    9  two  thousand  seven through March thirty-first, two thousand eight, and
   10  on an annual basis for the  periods  April  first,  two  thousand  eight
   11  through  November  thirtieth,  two  thousand  nine, funds within amounts
   12  appropriated shall be transferred and  deposited  and  credited  to  the
   13  credit  of  the state special revenue funds - other, HCRA transfer fund,
   14  medical assistance account, for purposes of funding the state  share  of
   15  rate  adjustments  made  to public and voluntary hospitals in accordance
   16  with paragraphs (i) and (j) of subdivision one of  section  twenty-eight
   17  hundred seven-c of this article.
   18    2.  Notwithstanding  any  inconsistent provision of law, rule or regu-
   19  lation, any funds accumulated  in  the  health  care  initiatives  pools
   20  pursuant  to  paragraph  (b) of subdivision nine of section twenty-eight
   21  hundred seven-j of this article, as a result of surcharges,  assessments
   22  or  other obligations during the periods January first, nineteen hundred
   23  ninety-seven through December  thirty-first,  nineteen  hundred  ninety-
   24  nine, which are unused or uncommitted for distributions pursuant to this
   25  section  shall  be  reserved  and  accumulated  from year to year by the
   26  commissioner and, within amounts appropriated, transferred and deposited
   27  into the special revenue funds - other,  miscellaneous  special  revenue
   28  fund  -  339,  child  health  insurance account or any successor fund or
   29  account, for purposes of distributions to  implement  the  child  health
   30  insurance  program  established pursuant to sections twenty-five hundred
   31  ten and twenty-five hundred eleven of this chapter for  periods  on  and
   32  after January first, two thousand one; provided, however, funds reserved
   33  and  accumulated  for  priority  distributions  pursuant to subparagraph
   34  (iii) of paragraph (c) of subdivision one of this section shall  not  be
   35  transferred  and  deposited  into such account pursuant to this subdivi-
   36  sion; and provided further, however, that any unused or uncommitted pool
   37  funds accumulated and allocated pursuant to paragraph (j) of subdivision
   38  one of this section shall be distributed  for  purposes  of  the  health
   39  information and quality improvement act of 2000.
   40    3.  Revenue  from  distributions pursuant to this section shall not be
   41  included in gross revenue  received  for  purposes  of  the  assessments
   42  pursuant to subdivision eighteen of section twenty-eight hundred seven-c
   43  of  this article, subject to the provisions of paragraph (e) of subdivi-
   44  sion eighteen of section twenty-eight hundred seven-c of  this  article,
   45  and  shall not be included in gross revenue received for purposes of the
   46  assessments pursuant to section twenty-eight  hundred  seven-d  of  this
   47  article,  subject  to  the  provisions  of subdivision twelve of section
   48  twenty-eight hundred seven-d of this article.
   49    S 8. Section 2807-v of the public health law, as amended by section  5
   50  of part B of chapter 58 of the laws of 2008, subdivision 1 as amended by
   51  section  8  of  part  C of chapter 59 of the laws of 2011, clause (K) of
   52  subparagraph (i) of paragraph  (bb)  of  subdivision  1  as  amended  by
   53  section  35-a,  subparagraph  (xi) of paragraph (cc) of subdivision 1 as
   54  amended by section 35-b and subparagraph (vii)  of  paragraph  (ccc)  of
   55  subdivision  1 as amended by section 35-c of part D of chapter 56 of the
   56  laws of 2012, paragraph (fff) of subdivision 1 as separately amended  by
       S. 6914                            55                            A. 9205

    1  section  16  of  part A of chapter 59 of the laws of 2011, and paragraph
    2  (iii) of subdivision 1 as added by section 52-b of part H of chapter  59
    3  of the laws of 2011, is amended to read as follows:
    4    S  2807-v.  Tobacco  control  and  insurance initiatives pool distrib-
    5  utions.   1. Funds accumulated in  the  tobacco  control  and  insurance
    6  initiatives  pool or in the health care reform act (HCRA) resources fund
    7  established pursuant to section ninety-two-dd of the state finance  law,
    8  whichever  is applicable, including income from invested funds, shall be
    9  distributed or retained by the commissioner or by the state comptroller,
   10  as applicable, in accordance with the following:
   11    (a) Funds shall be  deposited  by  the  commissioner,  within  amounts
   12  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   13  directed to receive for deposit to  the  credit  of  the  state  special
   14  revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
   15  medicaid administration account, or any successor fund or  account,  for
   16  purposes  of  services  and  expenses  related to the toll-free medicaid
   17  fraud hotline established pursuant to section one hundred eight of chap-
   18  ter one of the laws of nineteen hundred  ninety-nine  from  the  tobacco
   19  control  and  insurance  initiatives  pool established for the following
   20  periods in the following amounts: four hundred thousand dollars annually
   21  for the periods January first, two  thousand  through  December  thirty-
   22  first,  two  thousand  two,  up to four hundred thousand dollars for the
   23  period January first, two thousand three through December  thirty-first,
   24  two  thousand  three, up to four hundred thousand dollars for the period
   25  January first, two thousand  four  through  December  thirty-first,  two
   26  thousand  four, up to four hundred thousand dollars for the period Janu-
   27  ary first, two thousand five through December thirty-first, two thousand
   28  five, up to four hundred thousand dollars for the period January  first,
   29  two  thousand six through December thirty-first, two thousand six, up to
   30  four hundred thousand dollars for the period January first, two thousand
   31  seven through December thirty-first, two  thousand  seven,  up  to  four
   32  hundred  thousand  dollars  for  the  period January first, two thousand
   33  eight through December thirty-first, two  thousand  eight,  up  to  four
   34  hundred thousand dollars for the period January first, two thousand nine
   35  through  December  thirty-first,  two  thousand nine, up to four hundred
   36  thousand dollars for the period January first, two thousand ten  through
   37  December  thirty-first,  two  thousand  ten,  up to one hundred thousand
   38  dollars for the period January first, two thousand eleven through  March
   39  thirty-first, two thousand eleven and within amounts appropriated on and
   40  after April first, two thousand eleven.
   41    (b)  Funds  shall  be  reserved  and accumulated from year to year and
   42  shall be available, including income from invested funds,  for  purposes
   43  of payment of audits or audit contracts necessary to determine payor and
   44  provider compliance with requirements set forth in sections twenty-eight
   45  hundred  seven-j,  twenty-eight hundred seven-s and twenty-eight hundred
   46  seven-t of this article from the tobacco control  and  insurance  initi-
   47  atives  pool  established  for  the  following  periods in the following
   48  amounts: five million six hundred  thousand  dollars  annually  for  the
   49  periods  January  first, two thousand through December thirty-first, two
   50  thousand two, up to five million dollars for the period  January  first,
   51  two thousand three through December thirty-first, two thousand three, up
   52  to  five million dollars for the period January first, two thousand four
   53  through December thirty-first, two thousand four,  up  to  five  million
   54  dollars for the period January first, two thousand five through December
   55  thirty  first,  two  thousand  five,  up to five million dollars for the
   56  period January first, two thousand six  through  December  thirty-first,
       S. 6914                            56                            A. 9205

    1  two thousand six, up to seven million eight hundred thousand dollars for
    2  the  period  January  first, two thousand seven through December thirty-
    3  first, two thousand seven, and up to eight million three  hundred  twen-
    4  ty-five  thousand  dollars  for  the  period January first, two thousand
    5  eight through December thirty-first, two thousand  eight,  up  to  eight
    6  million  five hundred thousand dollars for the period January first, two
    7  thousand nine through December thirty-first, two thousand  nine,  up  to
    8  eight  million  five  hundred  thousand  dollars  for the period January
    9  first, two thousand ten through December thirty-first, two thousand ten,
   10  up to two million one hundred twenty-five thousand dollars for the peri-
   11  od January first, two thousand eleven through  March  thirty-first,  two
   12  thousand  eleven,  [and]  up  to fourteen million seven hundred thousand
   13  dollars each state fiscal year for the period April first, two  thousand
   14  eleven  through  March  thirty-first,  two  thousand fourteen, AND UP TO
   15  ELEVEN MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL  YEAR  FOR
   16  THE   PERIOD   APRIL   FIRST,   TWO   THOUSAND  FOURTEEN  THROUGH  MARCH
   17  THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
   18    (c) Funds shall be  deposited  by  the  commissioner,  within  amounts
   19  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   20  directed to receive for deposit to  the  credit  of  the  state  special
   21  revenue  funds  - other, HCRA transfer fund, enhanced community services
   22  account, or any successor fund or account, for  mental  health  services
   23  programs for case management services for adults and children; supported
   24  housing;  home  and community based waiver services; family based treat-
   25  ment; family support services; mobile mental health teams;  transitional
   26  housing; and community oversight, established pursuant to articles seven
   27  and  forty-one of the mental hygiene law and subdivision nine of section
   28  three hundred sixty-six of the social services law; and  for  comprehen-
   29  sive  care  centers  for eating disorders pursuant to the former section
   30  twenty-seven hundred ninety-nine-l of  this  chapter,  provided  however
   31  that,  for  such  centers,  funds in the amount of five hundred thousand
   32  dollars on an annualized basis shall be transferred  from  the  enhanced
   33  community services account, or any successor fund or account, and depos-
   34  ited  into  the  fund  established by section ninety-five-e of the state
   35  finance law; from the tobacco control  and  insurance  initiatives  pool
   36  established for the following periods in the following amounts:
   37    (i)  forty-eight million dollars to be reserved, to be retained or for
   38  distribution pursuant to a chapter of the laws of two thousand, for  the
   39  period  January  first,  two thousand through December thirty-first, two
   40  thousand;
   41    (ii) eighty-seven million dollars to be reserved, to  be  retained  or
   42  for  distribution pursuant to a chapter of the laws of two thousand one,
   43  for the period January first, two thousand one through December  thirty-
   44  first, two thousand one;
   45    (iii)  eighty-seven  million dollars to be reserved, to be retained or
   46  for distribution pursuant to a chapter of the laws of two thousand  two,
   47  for  the period January first, two thousand two through December thirty-
   48  first, two thousand two;
   49    (iv) eighty-eight million dollars to be reserved, to  be  retained  or
   50  for  distribution  pursuant  to  a  chapter  of the laws of two thousand
   51  three, for the period January first, two thousand three through December
   52  thirty-first, two thousand three;
   53    (v) eighty-eight million dollars, plus five hundred thousand  dollars,
   54  to be reserved, to be retained or for distribution pursuant to a chapter
   55  of  the  laws  of  two thousand four, and pursuant to the former section
   56  twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
       S. 6914                            57                            A. 9205

    1  ary first, two thousand four through December thirty-first, two thousand
    2  four;
    3    (vi) eighty-eight million dollars, plus five hundred thousand dollars,
    4  to be reserved, to be retained or for distribution pursuant to a chapter
    5  of  the  laws  of  two thousand five, and pursuant to the former section
    6  twenty-seven hundred ninety-nine-l of this chapter, for the period Janu-
    7  ary first, two thousand five through December thirty-first, two thousand
    8  five;
    9    (vii)  eighty-eight  million  dollars,  plus  five  hundred   thousand
   10  dollars,  to be reserved, to be retained or for distribution pursuant to
   11  a chapter of the laws of  two  thousand  six,  and  pursuant  to  FORMER
   12  section  twenty-seven  hundred  ninety-nine-l  of  this chapter, for the
   13  period January first, two thousand six  through  December  thirty-first,
   14  two thousand six;
   15    (viii)  eighty-six  million  four  hundred thousand dollars, plus five
   16  hundred thousand dollars, to be reserved, to be retained or for distrib-
   17  ution pursuant to a chapter of the laws of two thousand seven and pursu-
   18  ant to the former section twenty-seven  hundred  ninety-nine-l  of  this
   19  chapter, for the period January first, two thousand seven through Decem-
   20  ber thirty-first, two thousand seven; and
   21    (ix)  twenty-two  million nine hundred thirteen thousand dollars, plus
   22  one hundred twenty-five thousand dollars, to be reserved, to be retained
   23  or for distribution pursuant to a chapter of the laws  of  two  thousand
   24  eight  and  pursuant  to the former section twenty-seven hundred ninety-
   25  nine-l of this chapter, for the period January first, two thousand eight
   26  through March thirty-first, two thousand eight.
   27    (d) 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  purposes  of  funding  the  state
   32  share of services and expenses related to the family health plus program
   33  including up to two and one-half million dollars annually for the period
   34  January  first, two thousand through December thirty-first, two thousand
   35  two, for administration and marketing costs associated with such program
   36  established pursuant to clause (A) of subparagraph (v) of paragraph  (a)
   37  of  subdivision two of section three hundred sixty-nine-ee of the social
   38  services law from the tobacco control  and  insurance  initiatives  pool
   39  established for the following periods in the following amounts:
   40    (i) three million five hundred thousand dollars for the period January
   41  first, two thousand through December thirty-first, two thousand;
   42    (ii)  twenty-seven  million  dollars for the period January first, two
   43  thousand one through December thirty-first, two thousand one; and
   44    (iii) fifty-seven million dollars for the period  January  first,  two
   45  thousand two through December thirty-first, two thousand two.
   46    (e)  Funds  shall  be  deposited  by  the commissioner, within amounts
   47  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   48  directed  to  receive  for  deposit  to  the credit of the state special
   49  revenue funds - other, HCRA transfer fund, medical  assistance  account,
   50  or  any  successor  fund  or  account, for purposes of funding the state
   51  share of services and expenses related to the family health plus program
   52  including up to two and one-half million dollars annually for the period
   53  January first, two thousand through December thirty-first, two  thousand
   54  two  for administration and marketing costs associated with such program
   55  established pursuant to clause (B) of subparagraph (v) of paragraph  (a)
   56  of  subdivision two of section three hundred sixty-nine-ee of the social
       S. 6914                            58                            A. 9205

    1  services law from the tobacco control  and  insurance  initiatives  pool
    2  established for the following periods in the following amounts:
    3    (i)  two  million five hundred thousand dollars for the period January
    4  first, two thousand through December thirty-first, two thousand;
    5    (ii) thirty million five hundred thousand dollars for the period Janu-
    6  ary first, two thousand one through December thirty-first, two  thousand
    7  one; and
    8    (iii)  sixty-six  million  dollars  for  the period January first, two
    9  thousand two through December thirty-first, two thousand two.
   10    (f) Funds shall be  deposited  by  the  commissioner,  within  amounts
   11  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   12  directed to receive for deposit to  the  credit  of  the  state  special
   13  revenue  funds  -  other, HCRA transfer fund, medicaid fraud hotline and
   14  medicaid administration account, or any successor fund or  account,  for
   15  purposes of payment of administrative expenses of the department related
   16  to  the family health plus program established pursuant to section three
   17  hundred sixty-nine-ee of  the  social  services  law  from  the  tobacco
   18  control  and  insurance  initiatives  pool established for the following
   19  periods in the following amounts: five hundred thousand  dollars  on  an
   20  annual  basis for the periods January first, two thousand through Decem-
   21  ber thirty-first, two thousand six, five hundred  thousand  dollars  for
   22  the  period  January  first, two thousand seven through December thirty-
   23  first, two thousand seven, and five hundred  thousand  dollars  for  the
   24  period  January first, two thousand eight through December thirty-first,
   25  two thousand eight, five hundred thousand dollars for the period January
   26  first, two thousand nine through  December  thirty-first,  two  thousand
   27  nine,  five  hundred  thousand dollars for the period January first, two
   28  thousand ten  through  December  thirty-first,  two  thousand  ten,  one
   29  hundred  twenty-five  thousand dollars for the period January first, two
   30  thousand eleven through March  thirty-first,  two  thousand  eleven  and
   31  within amounts appropriated on and after April first, two thousand elev-
   32  en.
   33    (g)  Funds  shall  be  reserved  and accumulated from year to year and
   34  shall be available, including income from invested funds,  for  purposes
   35  of  services and expenses related to the health maintenance organization
   36  direct pay market program established pursuant to  sections  forty-three
   37  hundred  twenty-one-a and forty-three hundred twenty-two-a of the insur-
   38  ance law from the tobacco control and insurance initiatives pool  estab-
   39  lished for the following periods in the following amounts:
   40    (i)  up  to  thirty-five million dollars for the period January first,
   41  two thousand through December thirty-first, two thousand of which  fifty
   42  percentum  shall  be  allocated  to the program pursuant to section four
   43  thousand three hundred twenty-one-a  of  the  insurance  law  and  fifty
   44  percentum to the program pursuant to section four thousand three hundred
   45  twenty-two-a of the insurance law;
   46    (ii)  up  to  thirty-six million dollars for the period January first,
   47  two thousand one through December  thirty-first,  two  thousand  one  of
   48  which  fifty  percentum  shall  be  allocated to the program pursuant to
   49  section four thousand three hundred twenty-one-a of  the  insurance  law
   50  and  fifty  percentum  to  the program pursuant to section four thousand
   51  three hundred twenty-two-a of the insurance law;
   52    (iii) up to thirty-nine million dollars for the period January  first,
   53  two  thousand  two  through  December  thirty-first, two thousand two of
   54  which fifty percentum shall be allocated  to  the  program  pursuant  to
   55  section  four  thousand  three hundred twenty-one-a of the insurance law
       S. 6914                            59                            A. 9205

    1  and fifty percentum to the program pursuant  to  section  four  thousand
    2  three hundred twenty-two-a of the insurance law;
    3    (iv)  up  to  forty  million dollars for the period January first, two
    4  thousand three through December  thirty-first,  two  thousand  three  of
    5  which  fifty  percentum  shall  be  allocated to the program pursuant to
    6  section four thousand three hundred twenty-one-a of  the  insurance  law
    7  and  fifty  percentum  to  the program pursuant to section four thousand
    8  three hundred twenty-two-a of the insurance law;
    9    (v) up to forty million dollars for  the  period  January  first,  two
   10  thousand  four through December thirty-first, two thousand four of which
   11  fifty percentum shall be allocated to the program  pursuant  to  section
   12  four  thousand three hundred twenty-one-a of the insurance law and fifty
   13  percentum to the program pursuant to section four thousand three hundred
   14  twenty-two-a of the insurance law;
   15    (vi) up to forty million dollars for the  period  January  first,  two
   16  thousand  five through December thirty-first, two thousand five of which
   17  fifty percentum shall be allocated to the program  pursuant  to  section
   18  four  thousand three hundred twenty-one-a of the insurance law and fifty
   19  percentum to the program pursuant to section four thousand three hundred
   20  twenty-two-a of the insurance law;
   21    (vii) up to forty million dollars for the period  January  first,  two
   22  thousand  six  through  December thirty-first, two thousand six of which
   23  fifty percentum shall be allocated to the program  pursuant  to  section
   24  four  thousand three hundred twenty-one-a of the insurance law and fifty
   25  percentum shall be allocated to the program  pursuant  to  section  four
   26  thousand three hundred twenty-two-a of the insurance law;
   27    (viii)  up  to forty million dollars for the period January first, two
   28  thousand seven through December  thirty-first,  two  thousand  seven  of
   29  which  fifty  percentum  shall  be  allocated to the program pursuant to
   30  section four thousand three hundred twenty-one-a of  the  insurance  law
   31  and  fifty  percentum  shall  be  allocated  to  the program pursuant to
   32  section four thousand three hundred twenty-two-a of the  insurance  law;
   33  and
   34    (ix)  up  to  forty  million dollars for the period January first, two
   35  thousand eight through December  thirty-first,  two  thousand  eight  of
   36  which  fifty  per  centum  shall be allocated to the program pursuant to
   37  section four thousand three hundred twenty-one-a of  the  insurance  law
   38  and  fifty  per  centum  shall  be  allocated to the program pursuant to
   39  section four thousand three hundred twenty-two-a of the insurance law.
   40    (h) Funds shall be reserved and accumulated  from  year  to  year  and
   41  shall  be  available, including income from invested funds, for purposes
   42  of services and expenses related to  the  healthy  New  York  individual
   43  program  established  pursuant  to  sections four thousand three hundred
   44  twenty-six and four thousand three hundred twenty-seven of the insurance
   45  law from the tobacco control and insurance initiatives pool  established
   46  for the following periods in the following 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 five million one hundred thousand dollars for the period
   52  January first, two thousand three  through  December  thirty-first,  two
   53  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;
       S. 6914                            60                            A. 9205

    1    (v)  up  to  thirty-four  million six hundred thousand dollars for the
    2  period January first, two thousand five through  December  thirty-first,
    3  two thousand five;
    4    (vi)  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;
    7    (vii)  up  to sixty-one million seven hundred thousand dollars for the
    8  period January first, two thousand seven through December  thirty-first,
    9  two thousand seven; and
   10    (viii)  up  to  one hundred three million seven hundred fifty thousand
   11  dollars for the period January first, two thousand eight through  Decem-
   12  ber thirty-first, two thousand eight.
   13    (i)  Funds  shall  be  reserved  and accumulated from year to year and
   14  shall be available, including income from invested funds,  for  purposes
   15  of  services  and expenses related to the healthy New York group program
   16  established pursuant to sections four thousand three hundred  twenty-six
   17  and  four  thousand three hundred twenty-seven of the insurance law from
   18  the tobacco control and insurance initiatives pool established  for  the
   19  following periods in the following amounts:
   20    (i)  up  to  thirty-four million dollars for the period January first,
   21  two thousand one through December thirty-first, two thousand one;
   22    (ii) up to seventy-seven million dollars for the period January first,
   23  two thousand two through December thirty-first, two thousand two;
   24    (iii) up to ten million five hundred thousand dollars for  the  period
   25  January  first,  two  thousand  three through December thirty-first, two
   26  thousand three;
   27    (iv) up to twenty-four million six hundred thousand  dollars  for  the
   28  period  January  first, two thousand four through December thirty-first,
   29  two thousand four;
   30    (v) up to thirty-four million six hundred  thousand  dollars  for  the
   31  period  January  first, two thousand five through December thirty-first,
   32  two thousand five;
   33    (vi) up to fifty-four million eight hundred thousand dollars  for  the
   34  period  January  first,  two thousand six through December thirty-first,
   35  two thousand six;
   36    (vii) up to sixty-one million seven hundred thousand dollars  for  the
   37  period  January first, two thousand seven through December thirty-first,
   38  two thousand seven; and
   39    (viii) up to one hundred three million seven  hundred  fifty  thousand
   40  dollars  for the period January first, two thousand eight through Decem-
   41  ber thirty-first, two thousand eight.
   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 periods January
   45  first, two thousand four through  December  thirty-first,  two  thousand
   46  six,  one  million  four hundred thousand dollars for the period January
   47  first, two thousand seven through December  thirty-first,  two  thousand
   48  seven,  two  million  dollars for the period January first, two thousand
   49  eight through December thirty-first,  two  thousand  eight,  from  funds
   50  otherwise  available  for  distribution  under  such  paragraphs for the
   51  services and expenses related to the  pilot  program  for  entertainment
   52  industry  employees  included  in subsection (b) of section one thousand
   53  one hundred twenty-two of the insurance law,  and  an  additional  seven
   54  hundred  thousand  dollars  annually  for the periods January first, two
   55  thousand four through December thirty-first, two thousand six, an  addi-
   56  tional  three hundred thousand dollars for the period January first, two
       S. 6914                            61                            A. 9205

    1  thousand seven through June thirtieth, two thousand seven  for  services
    2  and expenses related to the pilot program for displaced workers included
    3  in  subsection (c) of section one thousand one hundred twenty-two of the
    4  insurance law.
    5    (j)  Funds  shall  be  reserved  and accumulated from year to year and
    6  shall be available, including income from invested funds,  for  purposes
    7  of  services  and  expenses  related  to  the tobacco use prevention and
    8  control program established pursuant to sections thirteen hundred  nine-
    9  ty-nine-ii and thirteen hundred ninety-nine-jj of this chapter, from the
   10  tobacco  control  and  insurance  initiatives  pool  established for the
   11  following periods in the following amounts:
   12    (i) up to thirty million dollars for the  period  January  first,  two
   13  thousand through December thirty-first, two thousand;
   14    (ii)  up  to  forty  million dollars for the period January first, two
   15  thousand one through December thirty-first, two thousand one;
   16    (iii) up to forty million dollars for the period  January  first,  two
   17  thousand two through December thirty-first, two thousand two;
   18    (iv)  up to thirty-six million nine hundred fifty thousand dollars for
   19  the period January first, two thousand three  through  December  thirty-
   20  first, two thousand three;
   21    (v)  up  to thirty-six million nine hundred fifty thousand dollars for
   22  the period January first, two thousand  four  through  December  thirty-
   23  first, two thousand four;
   24    (vi)  up  to forty million six hundred thousand dollars for the period
   25  January first, two thousand  five  through  December  thirty-first,  two
   26  thousand five;
   27    (vii)  up  to eighty-one million nine hundred thousand dollars for the
   28  period January first, two thousand six  through  December  thirty-first,
   29  two thousand six, provided, however, that within amounts appropriated, a
   30  portion  of  such  funds  may  be transferred to the Roswell Park Cancer
   31  Institute Corporation to support costs associated with cancer research;
   32    (viii) up to ninety-four million one hundred  fifty  thousand  dollars
   33  for  the period January first, two thousand seven through December thir-
   34  ty-first, two thousand seven, provided,  however,  that  within  amounts
   35  appropriated,  a portion of such funds may be transferred to the Roswell
   36  Park Cancer Institute  Corporation  to  support  costs  associated  with
   37  cancer research;
   38    (ix)  up to ninety-four million one hundred fifty thousand dollars for
   39  the period January first, two thousand eight  through  December  thirty-
   40  first, two thousand eight;
   41    (x)  up  to ninety-four million one hundred fifty thousand dollars for
   42  the period January first, two thousand  nine  through  December  thirty-
   43  first, two thousand nine;
   44    (xi)  up  to  eighty-seven million seven hundred seventy-five thousand
   45  dollars for the period January first, two thousand ten through  December
   46  thirty-first, two thousand ten;
   47    (xii)  up  to  twenty-one million four hundred twelve thousand dollars
   48  for the period January first, two thousand eleven through March  thirty-
   49  first, two thousand eleven; [and]
   50    (xiii) up to fifty-two million one hundred thousand dollars each state
   51  fiscal  year  for  the  period  April first, two thousand eleven through
   52  March thirty-first, two thousand fourteen; AND
   53    (XIV) UP TO SIX MILLION DOLLARS EACH STATE FISCAL YEAR FOR THE  PERIOD
   54  APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
   55  SAND SEVENTEEN.
       S. 6914                            62                            A. 9205

    1    (k)  Funds  shall  be  deposited  by  the commissioner, within amounts
    2  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    3  directed  to  receive  for  deposit  to  the credit of the state special
    4  revenue fund - other, HCRA transfer fund, health care services  account,
    5  or  any successor fund or account, for purposes of services and expenses
    6  related to public health programs, including comprehensive care  centers
    7  for eating disorders pursuant to the former section twenty-seven hundred
    8  ninety-nine-l  of this chapter, provided however that, for such centers,
    9  funds in the amount of five hundred thousand dollars  on  an  annualized
   10  basis shall be transferred from the health care services account, or any
   11  successor  fund  or  account, and deposited into the fund established by
   12  section ninety-five-e of the state finance  law  for  periods  prior  to
   13  March  thirty-first,  two  thousand eleven, from the tobacco control and
   14  insurance initiatives pool established for the following periods in  the
   15  following amounts:
   16    (i) up to thirty-one million dollars for the period January first, two
   17  thousand through December thirty-first, two thousand;
   18    (ii) up to forty-one million dollars for the period January first, two
   19  thousand one through December thirty-first, two thousand one;
   20    (iii)  up  to eighty-one million dollars for the period January first,
   21  two thousand two through December thirty-first, two thousand two;
   22    (iv) one hundred twenty-two million five hundred thousand dollars  for
   23  the  period  January  first, two thousand three through December thirty-
   24  first, two thousand three;
   25    (v) one hundred  eight  million  five  hundred  seventy-five  thousand
   26  dollars, plus an additional five hundred thousand dollars, for the peri-
   27  od  January  first, two thousand four through December thirty-first, two
   28  thousand four;
   29    (vi) ninety-one million eight hundred thousand dollars, plus an  addi-
   30  tional  five hundred thousand dollars, for the period January first, two
   31  thousand five through December thirty-first, two thousand five;
   32    (vii) one hundred fifty-six million six hundred thousand dollars, plus
   33  an additional five hundred thousand  dollars,  for  the  period  January
   34  first, two thousand six through December thirty-first, two thousand six;
   35    (viii)  one  hundred  fifty-one million four hundred thousand dollars,
   36  plus an additional five hundred thousand dollars, for the period January
   37  first, two thousand seven through December  thirty-first,  two  thousand
   38  seven;
   39    (ix)  one  hundred  sixteen  million  nine hundred forty-nine thousand
   40  dollars, plus an additional five hundred thousand dollars, for the peri-
   41  od January first, two thousand eight through December thirty-first,  two
   42  thousand eight;
   43    (x)  one  hundred  sixteen  million  nine  hundred forty-nine thousand
   44  dollars, plus an additional five hundred thousand dollars, for the peri-
   45  od January first, two thousand nine through December  thirty-first,  two
   46  thousand nine;
   47    (xi)  one  hundred  sixteen  million  nine hundred forty-nine thousand
   48  dollars, plus an additional five hundred thousand dollars, for the peri-
   49  od January first, two thousand ten through  December  thirty-first,  two
   50  thousand ten;
   51    (xii)  twenty-nine  million  two  hundred  thirty-seven  thousand  two
   52  hundred fifty dollars, plus an additional one hundred twenty-five  thou-
   53  sand  dollars, for the period January first, two thousand eleven through
   54  March thirty-first, two thousand eleven;
       S. 6914                            63                            A. 9205

    1    (xiii) one hundred twenty million thirty-eight  thousand  dollars  for
    2  the  period April first, two thousand eleven through March thirty-first,
    3  two thousand twelve; and
    4    (xiv) one hundred nineteen million four hundred seven thousand dollars
    5  each  state  fiscal year for the period April first, two thousand twelve
    6  through March thirty-first, two thousand fourteen.
    7    (l) Funds shall be  deposited  by  the  commissioner,  within  amounts
    8  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    9  directed to receive for deposit to  the  credit  of  the  state  special
   10  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   11  or any successor fund or account, for  purposes  of  funding  the  state
   12  share  of the personal care and certified home health agency rate or fee
   13  increases established pursuant to subdivision  three  of  section  three
   14  hundred  sixty-seven-o  of  the  social  services  law  from the tobacco
   15  control and insurance initiatives pool  established  for  the  following
   16  periods in the following amounts:
   17    (i)  twenty-three  million two hundred thousand dollars for the period
   18  January first, two thousand through December thirty-first, two thousand;
   19    (ii) twenty-three million two hundred thousand dollars for the  period
   20  January first, two thousand one through December thirty-first, two thou-
   21  sand one;
   22    (iii) twenty-three million two hundred thousand dollars for the period
   23  January first, two thousand two through December thirty-first, two thou-
   24  sand two;
   25    (iv)  up  to  sixty-five  million two hundred thousand dollars for the
   26  period January first, two thousand three through December  thirty-first,
   27  two thousand three;
   28    (v)  up  to  sixty-five  million  two hundred thousand dollars for the
   29  period January first, two thousand four through  December  thirty-first,
   30  two thousand four;
   31    (vi)  up  to  sixty-five  million two hundred thousand dollars for the
   32  period January first, two thousand five through  December  thirty-first,
   33  two thousand five;
   34    (vii)  up  to  sixty-five million two hundred thousand dollars for the
   35  period January first, two thousand six  through  December  thirty-first,
   36  two thousand six;
   37    (viii)  up  to sixty-five million two hundred thousand dollars for the
   38  period January first, two thousand seven through December  thirty-first,
   39  two thousand seven; and
   40    (ix)  up  to  sixteen  million  three hundred thousand dollars for the
   41  period January first, two thousand eight through March thirty-first, two
   42  thousand eight.
   43    (m) Funds shall be  deposited  by  the  commissioner,  within  amounts
   44  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   45  directed to receive for deposit to  the  credit  of  the  state  special
   46  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   47  or any successor fund or account, for  purposes  of  funding  the  state
   48  share  of  services  and expenses related to home care workers insurance
   49  pilot demonstration programs established pursuant to subdivision two  of
   50  section  three hundred sixty-seven-o of the social services law from the
   51  tobacco control and  insurance  initiatives  pool  established  for  the
   52  following periods in the following amounts:
   53    (i)  three million eight hundred thousand dollars for the period Janu-
   54  ary first, two thousand through December thirty-first, two thousand;
       S. 6914                            64                            A. 9205

    1    (ii) three million eight hundred thousand dollars for the period Janu-
    2  ary first, two thousand one through December thirty-first, two  thousand
    3  one;
    4    (iii)  three  million  eight  hundred  thousand dollars for the period
    5  January first, two thousand two through December thirty-first, two thou-
    6  sand two;
    7    (iv) up to three million eight hundred thousand dollars for the period
    8  January first, two thousand three  through  December  thirty-first,  two
    9  thousand three;
   10    (v)  up to three million eight hundred thousand dollars for the period
   11  January first, two thousand  four  through  December  thirty-first,  two
   12  thousand four;
   13    (vi) up to three million eight hundred thousand dollars for the period
   14  January  first,  two  thousand  five  through December thirty-first, two
   15  thousand five;
   16    (vii) up to three million eight hundred thousand dollars for the peri-
   17  od January first, two thousand six through  December  thirty-first,  two
   18  thousand six;
   19    (viii)  up  to  three  million  eight hundred thousand dollars for the
   20  period January first, two thousand seven through December  thirty-first,
   21  two thousand seven; and
   22    (ix)  up to nine hundred fifty thousand dollars for the period January
   23  first, two thousand  eight  through  March  thirty-first,  two  thousand
   24  eight.
   25    (n) Funds shall be transferred by the commissioner and shall be depos-
   26  ited  to  the credit of the special revenue funds - other, miscellaneous
   27  special revenue fund - 339, elderly  pharmaceutical  insurance  coverage
   28  program  premium  account authorized pursuant to the provisions of title
   29  three of article two of the elder law, or any successor fund or account,
   30  for funding state expenses relating to  the  program  from  the  tobacco
   31  control  and  insurance  initiatives  pool established for the following
   32  periods in the following amounts:
   33    (i) one hundred seven million dollars for the  period  January  first,
   34  two thousand through December thirty-first, two thousand;
   35    (ii)  one  hundred  sixty-four  million dollars for the period January
   36  first, two thousand one through December thirty-first, two thousand one;
   37    (iii) three hundred twenty-two million seven hundred thousand  dollars
   38  for  the period January first, two thousand two through December thirty-
   39  first, two thousand two;
   40    (iv) four hundred thirty-three million three hundred thousand  dollars
   41  for  the period January first, two thousand three through December thir-
   42  ty-first, two thousand three;
   43    (v) five hundred four million one hundred fifty thousand  dollars  for
   44  the  period  January  first,  two thousand four through December thirty-
   45  first, two thousand four;
   46    (vi) five hundred sixty-six million eight hundred thousand dollars for
   47  the period January first, two thousand  five  through  December  thirty-
   48  first, two thousand five;
   49    (vii) six hundred three million one hundred fifty thousand dollars for
   50  the  period  January  first,  two  thousand six through December thirty-
   51  first, two thousand six;
   52    (viii) six hundred sixty million eight hundred  thousand  dollars  for
   53  the  period  January  first, two thousand seven through December thirty-
   54  first, two thousand seven;
       S. 6914                            65                            A. 9205

    1    (ix) three hundred sixty-seven million four hundred sixty-three  thou-
    2  sand  dollars  for  the period January first, two thousand eight through
    3  December thirty-first, two thousand eight;
    4    (x)  three hundred thirty-four million eight hundred twenty-five thou-
    5  sand dollars for the period January first,  two  thousand  nine  through
    6  December thirty-first, two thousand nine;
    7    (xi)  three  hundred  forty-four million nine hundred thousand dollars
    8  for the period January first, two thousand ten through December  thirty-
    9  first, two thousand ten;
   10    (xii) eighty-seven million seven hundred eighty-eight thousand dollars
   11  for  the period January first, two thousand eleven through March thirty-
   12  first, two thousand eleven;
   13    (xiii) one hundred forty-three  million  one  hundred  fifty  thousand
   14  dollars  for  the  period April first, two thousand eleven through March
   15  thirty-first, two thousand twelve;
   16    (xiv) one hundred twenty million nine hundred fifty  thousand  dollars
   17  for  the  period  April first, two thousand twelve through March thirty-
   18  first, two thousand thirteen; [and]
   19    (xv) one hundred twenty-eight million  eight  hundred  fifty  thousand
   20  dollars  for the period April first, two thousand thirteen through March
   21  thirty-first, two thousand fourteen[.]; AND
   22    (XVI) ONE HUNDRED TWENTY-SEVEN MILLION FOUR HUNDRED  SIXTEEN  THOUSAND
   23  DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
   24  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
   25    (o) Funds shall be reserved and accumulated and shall  be  transferred
   26  to  the  Roswell  Park  Cancer  Institute  Corporation, from the tobacco
   27  control and insurance initiatives pool  established  for  the  following
   28  periods in the following amounts:
   29    (i)  up  to  ninety  million dollars for the period January first, two
   30  thousand through December thirty-first, two thousand;
   31    (ii) up to sixty million dollars for the  period  January  first,  two
   32  thousand one through December thirty-first, two thousand one;
   33    (iii)  up to eighty-five million dollars for the period January first,
   34  two thousand two through December thirty-first, two thousand two;
   35    (iv) eighty-five million two hundred fifty thousand  dollars  for  the
   36  period  January first, two thousand three through December thirty-first,
   37  two thousand three;
   38    (v) seventy-eight million dollars for the period  January  first,  two
   39  thousand four through December thirty-first, two thousand four;
   40    (vi)  seventy-eight  million dollars for the period January first, two
   41  thousand five through December thirty-first, two thousand five;
   42    (vii) ninety-one million dollars for the  period  January  first,  two
   43  thousand six through December thirty-first, two thousand six;
   44    (viii) seventy-eight million dollars for the period January first, two
   45  thousand seven through December thirty-first, two thousand seven;
   46    (ix)  seventy-eight  million dollars for the period January first, two
   47  thousand eight through December thirty-first, two thousand eight;
   48    (x) seventy-eight million dollars for the period  January  first,  two
   49  thousand nine through December thirty-first, two thousand nine;
   50    (xi)  seventy-eight  million dollars for the period January first, two
   51  thousand ten through December thirty-first, two thousand ten;
   52    (xii) nineteen million five hundred thousand dollars  for  the  period
   53  January first, two thousand eleven through March thirty-first, two thou-
   54  sand eleven; [and]
       S. 6914                            66                            A. 9205

    1    (xiii)  sixty-nine  million  eight hundred forty thousand dollars each
    2  state fiscal year for  the  period  April  first,  two  thousand  eleven
    3  through March thirty-first, two thousand fourteen[.]; AND
    4    (XIV) UP TO NINETY-SIX MILLION SIX HUNDRED THOUSAND DOLLARS EACH STATE
    5  FISCAL  YEAR  FOR  THE PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH
    6  MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
    7    (p) Funds shall be  deposited  by  the  commissioner,  within  amounts
    8  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    9  directed to receive for deposit to  the  credit  of  the  state  special
   10  revenue  funds - other, indigent care fund - 068, indigent care account,
   11  or any successor fund or account, for purposes of providing  a  medicaid
   12  disproportionate  share payment from the high need indigent care adjust-
   13  ment pool established pursuant to section twenty-eight  hundred  seven-w
   14  of this article, from the tobacco control and insurance initiatives pool
   15  established for the following periods in the following amounts:
   16    (i) eighty-two million dollars annually for the periods January first,
   17  two thousand through December thirty-first, two thousand two;
   18    (ii)  up  to  eighty-two million dollars for the period January first,
   19  two thousand three through December thirty-first, two thousand three;
   20    (iii) up to eighty-two million dollars for the period  January  first,
   21  two thousand four through December thirty-first, two thousand four;
   22    (iv)  up  to  eighty-two million dollars for the period January first,
   23  two thousand five through December thirty-first, two thousand five;
   24    (v) up to eighty-two million dollars for the period January first, two
   25  thousand six through December thirty-first, two thousand six;
   26    (vi) up to eighty-two million dollars for the  period  January  first,
   27  two thousand seven through December thirty-first, two thousand seven;
   28    (vii)  up  to eighty-two million dollars for the period January first,
   29  two thousand eight through December thirty-first, two thousand eight;
   30    (viii) up to eighty-two million dollars for the period January  first,
   31  two thousand nine through December thirty-first, two thousand nine;
   32    (ix)  up  to  eighty-two million dollars for the period January first,
   33  two thousand ten through December thirty-first, two thousand ten;
   34    (x) up to twenty million five hundred thousand dollars for the  period
   35  January first, two thousand eleven through March thirty-first, two thou-
   36  sand eleven; and
   37    (xi)  up  to eighty-two million dollars each state fiscal year for the
   38  period April first, two thousand eleven through March thirty-first,  two
   39  thousand fourteen.
   40    (q)  Funds  shall  be  reserved  and accumulated from year to year and
   41  shall be available, including income from invested funds,  for  purposes
   42  of  providing  distributions  to  eligible  school  based health centers
   43  established pursuant to section eighty-eight of chapter one of the  laws
   44  of  nineteen hundred ninety-nine, from the tobacco control and insurance
   45  initiatives pool established for the following periods in the  following
   46  amounts:
   47    (i)  seven  million dollars annually for the period January first, two
   48  thousand through December thirty-first, two thousand two;
   49    (ii) up to seven million dollars for the  period  January  first,  two
   50  thousand three through December thirty-first, two thousand three;
   51    (iii)  up  to  seven million dollars for the period January first, two
   52  thousand four through December thirty-first, two thousand four;
   53    (iv) up to seven million dollars for the  period  January  first,  two
   54  thousand five through December thirty-first, two thousand five;
   55    (v)  up  to  seven  million  dollars for the period January first, two
   56  thousand six through December thirty-first, two thousand six;
       S. 6914                            67                            A. 9205

    1    (vi) up to seven million dollars for the  period  January  first,  two
    2  thousand seven through December thirty-first, two thousand seven;
    3    (vii)  up  to  seven million dollars for the period January first, two
    4  thousand eight through December thirty-first, two thousand eight;
    5    (viii) up to seven million dollars for the period January  first,  two
    6  thousand nine through December thirty-first, two thousand nine;
    7    (ix)  up  to  seven  million dollars for the period January first, two
    8  thousand ten through December thirty-first, two thousand ten;
    9    (x) up to one million seven hundred fifty  thousand  dollars  for  the
   10  period  January  first,  two thousand eleven through March thirty-first,
   11  two thousand eleven; [and]
   12    (xi) up to five million six hundred thousand dollars each state fiscal
   13  year for the period April first, two thousand eleven through March thir-
   14  ty-first, two thousand fourteen[.]; AND
   15    (XII) UP TO FIVE MILLION TWO HUNDRED  EIGHTY-EIGHTY  THOUSAND  DOLLARS
   16  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN
   17  THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
   18    (r) Funds shall be deposited by the commissioner within amounts appro-
   19  priated,  and the state comptroller is hereby authorized and directed to
   20  receive for deposit to the credit of the state special revenue  funds  -
   21  other,  HCRA transfer fund, medical assistance account, or any successor
   22  fund or account, for purposes of providing distributions for  supplemen-
   23  tary   medical  insurance  for  Medicare  part  B  premiums,  physicians
   24  services, outpatient services, medical  equipment,  supplies  and  other
   25  health services, from the tobacco control and insurance initiatives pool
   26  established for the following periods in the following amounts:
   27    (i)  forty-three  million  dollars  for  the period January first, two
   28  thousand through December thirty-first, two thousand;
   29    (ii) sixty-one million dollars for the period January first, two thou-
   30  sand one through December thirty-first, two thousand one;
   31    (iii) sixty-five million dollars for the  period  January  first,  two
   32  thousand two through December thirty-first, two thousand two;
   33    (iv)  sixty-seven million five hundred thousand dollars for the period
   34  January first, two thousand three  through  December  thirty-first,  two
   35  thousand three;
   36    (v)  sixty-eight  million  dollars  for  the period January first, two
   37  thousand four through December thirty-first, two thousand four;
   38    (vi) sixty-eight million dollars for the  period  January  first,  two
   39  thousand five through December thirty-first, two thousand five;
   40    (vii)  sixty-eight  million  dollars for the period January first, two
   41  thousand six through December thirty-first, two thousand six;
   42    (viii) seventeen million five hundred thousand dollars for the  period
   43  January  first,  two  thousand  seven through December thirty-first, two
   44  thousand seven;
   45    (ix) sixty-eight million dollars for the  period  January  first,  two
   46  thousand eight through December thirty-first, two thousand eight;
   47    (x)  sixty-eight  million  dollars  for  the period January first, two
   48  thousand nine through December thirty-first, two thousand nine;
   49    (xi) sixty-eight million dollars for the  period  January  first,  two
   50  thousand ten through December thirty-first, two thousand ten;
   51    (xii)  seventeen  million  dollars  for  the period January first, two
   52  thousand eleven through March thirty-first, two thousand eleven; and
   53    (xiii) sixty-eight million dollars each  state  fiscal  year  for  the
   54  period  April first, two thousand eleven through March thirty-first, two
   55  thousand fourteen.
       S. 6914                            68                            A. 9205

    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,  for  purposes of providing distributions pursuant to
    6  paragraphs (s-5), (s-6),  (s-7)  and  (s-8)  of  subdivision  eleven  of
    7  section  twenty-eight  hundred  seven-c of this article from the tobacco
    8  control and insurance initiatives pool  established  for  the  following
    9  periods in the following amounts:
   10    (i)  eighteen  million dollars for the period January first, two thou-
   11  sand through December thirty-first, two thousand;
   12    (ii) twenty-four million dollars  annually  for  the  periods  January
   13  first, two thousand one through December thirty-first, two thousand two;
   14    (iii)  up to twenty-four million dollars for the period January first,
   15  two thousand three through December thirty-first, two thousand three;
   16    (iv) up to twenty-four million dollars for the period  January  first,
   17  two thousand four through December thirty-first, two thousand four;
   18    (v)  up  to  twenty-four million dollars for the period January first,
   19  two thousand five through December thirty-first, two thousand five;
   20    (vi) up to twenty-four million dollars for the period  January  first,
   21  two thousand six through December thirty-first, two thousand six;
   22    (vii)  up to twenty-four million dollars for the period January first,
   23  two thousand seven through December thirty-first, two thousand seven;
   24    (viii) up to twenty-four million dollars for the period January first,
   25  two thousand eight through December thirty-first,  two  thousand  eight;
   26  and
   27    (ix)  up  to  twenty-two million dollars for the period January first,
   28  two thousand nine through November thirtieth, two thousand nine.
   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. 6914                            69                            A. 9205

    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;
   11    (ii) up to eighteen million seven hundred fifty thousand  dollars  for
   12  the  period  January  first,  two thousand five through December thirty-
   13  first, two thousand five; and
   14    (iii) up to fifty-six million five hundred thousand  dollars  for  the
   15  period  January  first,  two thousand six through December thirty-first,
   16  two thousand six.
   17    (v) Funds shall be transferred by the commissioner and shall be depos-
   18  ited to the credit of the hospital excess liability pool created  pursu-
   19  ant  to section eighteen of chapter two hundred sixty-six of the laws of
   20  nineteen hundred eighty-six, or  any  successor  fund  or  account,  for
   21  purposes  of expenses related to the purchase of excess medical malprac-
   22  tice insurance and the cost of administrating the pool, including  costs
   23  associated  with  the  risk  management  program established pursuant to
   24  section forty-two of part A of chapter one of the laws of  two  thousand
   25  two  required by paragraph (a) of subdivision one of section eighteen of
   26  chapter two hundred sixty-six of the laws of nineteen hundred eighty-six
   27  as may be amended from time to time, from the tobacco control and insur-
   28  ance initiatives pool established  for  the  following  periods  in  the
   29  following amounts:
   30    (i) up to fifty million dollars or so much as is needed for the period
   31  January first, two thousand two through December thirty-first, two thou-
   32  sand two;
   33    (ii)  up to seventy-six million seven hundred thousand dollars for the
   34  period January first, two thousand three through December  thirty-first,
   35  two thousand three;
   36    (iii)  up  to sixty-five million dollars for the period January first,
   37  two thousand four through December thirty-first, two thousand four;
   38    (iv) up to sixty-five million dollars for the  period  January  first,
   39  two thousand five through December thirty-first, two thousand five;
   40    (v)  up to one hundred thirteen million eight hundred thousand dollars
   41  for the period January first, two thousand six through December  thirty-
   42  first, two thousand six;
   43    (vi)  up  to one hundred thirty million dollars for the period January
   44  first, two thousand seven through December  thirty-first,  two  thousand
   45  seven;
   46    (vii)  up to one hundred thirty million dollars for the period January
   47  first, two thousand eight through December  thirty-first,  two  thousand
   48  eight;
   49    (viii) up to one hundred thirty million dollars for the period January
   50  first,  two  thousand  nine  through December thirty-first, two thousand
   51  nine;
   52    (ix) up to one hundred thirty million dollars for the  period  January
   53  first, two thousand ten through December thirty-first, two thousand ten;
   54    (x)  up  to  thirty-two  million five hundred thousand dollars for the
   55  period January first, two thousand eleven  through  March  thirty-first,
   56  two thousand eleven; [and]
       S. 6914                            70                            A. 9205

    1    (xi)  up  to  one  hundred  twenty-seven million four hundred thousand
    2  dollars each state fiscal year for the period April first, two  thousand
    3  eleven through March thirty-first, two thousand fourteen[.]; AND
    4    (XII)  UP  TO  ONE  HUNDRED TWENTY-SEVEN MILLION FOUR HUNDRED THOUSAND
    5  DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
    6  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
    7    (w)  Funds  shall  be  deposited  by  the commissioner, within amounts
    8  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    9  directed  to  receive  for  deposit  to  the credit of the state special
   10  revenue funds - other, HCRA transfer fund, medical  assistance  account,
   11  or  any  successor  fund  or  account, for purposes of funding the state
   12  share of the treatment of breast and cervical cancer pursuant  to  para-
   13  graph  (v) of subdivision four of section three hundred sixty-six of the
   14  social services law, from the tobacco control and insurance  initiatives
   15  pool established for the following periods in the following amounts:
   16    (i)  up  to four hundred fifty thousand dollars for the period January
   17  first, two thousand two through December thirty-first, two thousand two;
   18    (ii) up to two million one hundred thousand  dollars  for  the  period
   19  January  first,  two  thousand  three through December thirty-first, two
   20  thousand three;
   21    (iii) up to two million one hundred thousand dollars  for  the  period
   22  January  first,  two  thousand  four  through December thirty-first, two
   23  thousand four;
   24    (iv) up to two million one hundred thousand  dollars  for  the  period
   25  January  first,  two  thousand  five  through December thirty-first, two
   26  thousand five;
   27    (v) up to two million one hundred  thousand  dollars  for  the  period
   28  January first, two thousand six through December thirty-first, two thou-
   29  sand six;
   30    (vi)  up  to  two  million one hundred thousand dollars for the period
   31  January first, two thousand seven  through  December  thirty-first,  two
   32  thousand seven;
   33    (vii)  up  to  two million one hundred thousand dollars for the period
   34  January first, two thousand eight  through  December  thirty-first,  two
   35  thousand eight;
   36    (viii)  up  to two million one hundred thousand dollars for the period
   37  January first, two thousand  nine  through  December  thirty-first,  two
   38  thousand nine;
   39    (ix)  up  to  two  million one hundred thousand dollars for the period
   40  January first, two thousand ten through December thirty-first, two thou-
   41  sand ten;
   42    (x) up to five hundred twenty-five thousand  dollars  for  the  period
   43  January first, two thousand eleven through March thirty-first, two thou-
   44  sand eleven; [and]
   45    (xi)  up to two million one hundred thousand dollars each state fiscal
   46  year for the period April first, two thousand eleven through March thir-
   47  ty-first, two thousand fourteen[.]; AND
   48    (XII) UP TO TWO MILLION ONE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
   49  YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH  MARCH
   50  THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
   51    (x)  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 non-public general hospital rates increases for recruitment
       S. 6914                            71                            A. 9205

    1  and retention of health care workers from the tobacco control and insur-
    2  ance initiatives pool established  for  the  following  periods  in  the
    3  following amounts:
    4    (i) twenty-seven million one hundred thousand dollars on an annualized
    5  basis  for  the  period January first, two thousand two through December
    6  thirty-first, two thousand two;
    7    (ii) fifty million eight 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) sixty-nine million three hundred thousand dollars on an  annual-
   11  ized  basis  for  the  period  January  first, two thousand four through
   12  December thirty-first, two thousand four;
   13    (iv) sixty-nine million three hundred thousand dollars for the  period
   14  January  first,  two  thousand  five  through December thirty-first, two
   15  thousand five;
   16    (v) sixty-nine million three hundred thousand dollars for  the  period
   17  January first, two thousand six through December thirty-first, two thou-
   18  sand six;
   19    (vi)  sixty-five million three hundred thousand dollars for the period
   20  January first, two thousand seven  through  December  thirty-first,  two
   21  thousand seven;
   22    (vii)  sixty-one  million  one  hundred fifty thousand dollars for the
   23  period January first, two thousand eight through December  thirty-first,
   24  two thousand eight; and
   25    (viii)  forty-eight  million seven hundred twenty-one thousand dollars
   26  for the period January first, two thousand nine through November thirti-
   27  eth, two thousand nine.
   28    (y) Funds shall be reserved and accumulated  from  year  to  year  and
   29  shall  be  available, including income from invested funds, for purposes
   30  of grants to public general hospitals for recruitment and  retention  of
   31  health  care  workers pursuant to paragraph (b) of subdivision thirty of
   32  section twenty-eight hundred seven-c of this article  from  the  tobacco
   33  control  and  insurance  initiatives  pool established for the following
   34  periods in the following amounts:
   35    (i) eighteen 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-seven million four 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) fifty-two million two hundred thousand dollars on an  annualized
   42  basis  for  the period January first, two thousand four through December
   43  thirty-first, two thousand four;
   44    (iv) fifty-two million two hundred thousand  dollars  for  the  period
   45  January  first,  two  thousand  five  through December thirty-first, two
   46  thousand five;
   47    (v) fifty-two million two hundred  thousand  dollars  for  the  period
   48  January first, two thousand six through December thirty-first, two thou-
   49  sand six;
   50    (vi)  forty-nine  million  dollars  for  the period January first, two
   51  thousand seven through December thirty-first, two thousand seven;
   52    (vii) forty-nine million dollars for the  period  January  first,  two
   53  thousand eight through December thirty-first, two thousand eight; and
   54    (viii) twelve million two hundred fifty thousand dollars for the peri-
   55  od  January  first,  two  thousand  nine through March thirty-first, two
   56  thousand nine.
       S. 6914                            72                            A. 9205

    1    Provided, however, amounts pursuant to this paragraph may  be  reduced
    2  in  an  amount  to  be approved by the director of the budget to reflect
    3  amounts received from the federal  government  under  the  state's  1115
    4  waiver  which  are directed under its terms and conditions to the health
    5  workforce recruitment and retention program.
    6    (z)  Funds  shall  be  deposited  by  the commissioner, within amounts
    7  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    8  directed  to  receive  for  deposit  to  the credit of the state special
    9  revenue funds - other, HCRA transfer fund, medical  assistance  account,
   10  or  any  successor  fund  or  account, for purposes of funding the state
   11  share of the non-public residential health care facility rate  increases
   12  for  recruitment  and retention of health care workers pursuant to para-
   13  graph (a) of subdivision eighteen of section twenty-eight hundred  eight
   14  of  this article from the tobacco control and insurance initiatives pool
   15  established for the following periods in the following amounts:
   16    (i) twenty-one million five hundred thousand dollars on an  annualized
   17  basis  for  the  period January first, two thousand two through December
   18  thirty-first, two thousand two;
   19    (ii) thirty-three million three hundred thousand dollars on an annual-
   20  ized basis for the period January  first,  two  thousand  three  through
   21  December thirty-first, two thousand three;
   22    (iii)  forty-six  million three hundred thousand dollars on an annual-
   23  ized basis for the period  January  first,  two  thousand  four  through
   24  December thirty-first, two thousand four;
   25    (iv)  forty-six  million three hundred thousand dollars for the period
   26  January first, two thousand  five  through  December  thirty-first,  two
   27  thousand five;
   28    (v)  forty-six  million  three hundred thousand dollars for the period
   29  January first, two thousand six through December thirty-first, two thou-
   30  sand six;
   31    (vi) thirty million nine hundred thousand dollars for the period Janu-
   32  ary first, two thousand seven through December thirty-first,  two  thou-
   33  sand seven;
   34    (vii) twenty-four million seven hundred thousand dollars for the peri-
   35  od  January first, two thousand eight through December thirty-first, two
   36  thousand eight;
   37    (viii) twelve million three hundred seventy-five thousand dollars  for
   38  the  period  January  first,  two thousand nine through December thirty-
   39  first, two thousand nine;
   40    (ix) nine million three hundred thousand dollars for the period  Janu-
   41  ary  first, two thousand ten through December thirty-first, two thousand
   42  ten; and
   43    (x) two million three hundred twenty-five  thousand  dollars  for  the
   44  period  January  first,  two thousand eleven through March thirty-first,
   45  two thousand eleven.
   46    (aa) Funds shall be reserved and accumulated from  year  to  year  and
   47  shall  be  available, including income from invested funds, for purposes
   48  of grants to public residential health care facilities  for  recruitment
   49  and retention of health care workers pursuant to paragraph (b) of subdi-
   50  vision  eighteen  of  section twenty-eight hundred eight of this article
   51  from the tobacco control and insurance initiatives pool established  for
   52  the following periods in the following amounts:
   53    (i) seven million five hundred thousand dollars on an annualized basis
   54  for  the period January first, two thousand two through December thirty-
   55  first, two thousand two;
       S. 6914                            73                            A. 9205

    1    (ii) eleven million seven hundred thousand dollars  on  an  annualized
    2  basis  for the period January first, two thousand three through December
    3  thirty-first, two thousand three;
    4    (iii)  sixteen  million  two hundred thousand dollars on an annualized
    5  basis for the period January first, two thousand four  through  December
    6  thirty-first, two thousand four;
    7    (iv) sixteen million two hundred thousand dollars for the period Janu-
    8  ary first, two thousand five through December thirty-first, two thousand
    9  five;
   10    (v)  sixteen million two hundred thousand dollars for the period Janu-
   11  ary first, two thousand six through December thirty-first, two  thousand
   12  six;
   13    (vi) ten million eight hundred thousand dollars for the period January
   14  first,  two  thousand  seven through December thirty-first, two thousand
   15  seven;
   16    (vii) six million seven hundred fifty thousand dollars for the  period
   17  January  first,  two  thousand  eight through December thirty-first, two
   18  thousand eight; and
   19    (viii) one million three hundred fifty thousand dollars for the period
   20  January first, two thousand  nine  through  December  thirty-first,  two
   21  thousand nine.
   22    (bb)(i)  Funds  shall be deposited by the commissioner, within amounts
   23  appropriated, and subject  to  the  availability  of  federal  financial
   24  participation,  and  the  state  comptroller  is  hereby  authorized and
   25  directed to receive for deposit to  the  credit  of  the  state  special
   26  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   27  or any successor fund or account, for  the  purpose  of  supporting  the
   28  state  share  of  adjustments  to Medicaid rates of payment for personal
   29  care services provided pursuant to paragraph (e) of subdivision  two  of
   30  section three hundred sixty-five-a of the social services law, for local
   31  social  service districts which include a city with a population of over
   32  one million persons and computed  and  distributed  in  accordance  with
   33  memorandums of understanding to be entered into between the state of New
   34  York and such local social service districts for the purpose of support-
   35  ing  the  recruitment  and retention of personal care service workers or
   36  any worker with direct patient care  responsibility,  from  the  tobacco
   37  control  and  insurance  initiatives  pool established for the following
   38  periods and the following amounts:
   39    (A) forty-four million dollars, on an annualized basis, for the period
   40  April first, two thousand two through December thirty-first,  two  thou-
   41  sand two;
   42    (B)  seventy-four  million  dollars,  on  an annualized basis, for the
   43  period January first, two thousand three through December  thirty-first,
   44  two thousand three;
   45    (C)  one hundred four million dollars, on an annualized basis, for the
   46  period January first, two thousand four through  December  thirty-first,
   47  two thousand four;
   48    (D)  one  hundred  thirty-six million dollars, on an annualized basis,
   49  for the period January first, two thousand five through  December  thir-
   50  ty-first, two thousand five;
   51    (E)  one  hundred  thirty-six million dollars, on an annualized basis,
   52  for the period January first, two thousand six through December  thirty-
   53  first, two thousand six;
   54    (F)  one  hundred  thirty-six  million  dollars for the period January
   55  first, two thousand seven through December  thirty-first,  two  thousand
   56  seven;
       S. 6914                            74                            A. 9205

    1    (G)  one  hundred  thirty-six  million  dollars for the period January
    2  first, two thousand eight through December  thirty-first,  two  thousand
    3  eight;
    4    (H)  one  hundred  thirty-six  million  dollars for the period January
    5  first, two thousand nine through  December  thirty-first,  two  thousand
    6  nine;
    7    (I)  one  hundred  thirty-six  million  dollars for the period January
    8  first, two thousand ten through December thirty-first, two thousand ten;
    9    (J) thirty-four million dollars for  the  period  January  first,  two
   10  thousand eleven through March thirty-first, two thousand eleven; [and]
   11    (K)  up  to  one  hundred thirty-six million dollars each state fiscal
   12  year for the period April first, two thousand eleven through March thir-
   13  ty-first, two thousand fourteen[.]; AND
   14    (L) UP TO ONE HUNDRED THIRTY-SIX MILLION  DOLLARS  EACH  STATE  FISCAL
   15  YEAR  FOR  THE  PERIOD MARCH THIRTY-FIRST, TWO THOUSAND FOURTEEN THROUGH
   16  APRIL FIRST, TWO THOUSAND SEVENTEEN.
   17    (ii) Adjustments to Medicaid rates made  pursuant  to  this  paragraph
   18  shall  not, in aggregate, exceed the following amounts for the following
   19  periods:
   20    (A) for the period April first,  two  thousand  two  through  December
   21  thirty-first, two thousand two, one hundred ten million dollars;
   22    (B)  for the period January first, two thousand three through December
   23  thirty-first,  two  thousand  three,  one  hundred  eighty-five  million
   24  dollars;
   25    (C)  for  the period January first, two thousand four through December
   26  thirty-first, two thousand four, two hundred sixty million dollars;
   27    (D) for the period January first, two thousand five  through  December
   28  thirty-first, two thousand five, three hundred forty million dollars;
   29    (E)  for  the  period January first, two thousand six through December
   30  thirty-first, two thousand six, three hundred forty million dollars;
   31    (F) for the period January first, two thousand seven through  December
   32  thirty-first, two thousand seven, three hundred forty million dollars;
   33    (G)  for the period January first, two thousand eight through December
   34  thirty-first, two thousand eight, three hundred forty million dollars;
   35    (H) for the period January first, two thousand nine  through  December
   36  thirty-first, two thousand nine, three hundred forty million dollars;
   37    (I)  for  the  period January first, two thousand ten through December
   38  thirty-first, two thousand ten, three hundred forty million dollars;
   39    (J) for the period January first, two thousand  eleven  through  March
   40  thirty-first, two thousand eleven, eighty-five million dollars; [and]
   41    (K)  for  each  state  fiscal  year within the period April first, two
   42  thousand eleven through March thirty-first, two thousand fourteen, three
   43  hundred forty million dollars[.]; AND
   44    (L) FOR EACH STATE FISCAL YEAR WITHIN  THE  PERIOD  APRIL  FIRST,  TWO
   45  THOUSAND  FOURTEEN  THROUGH  MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN,
   46  THREE HUNDRED FORTY MILLION DOLLARS.
   47    (iii) Personal care service providers which have their rates  adjusted
   48  pursuant  to  this  paragraph  shall  use  such funds for the purpose of
   49  recruitment and retention  of  non-supervisory  personal  care  services
   50  workers  or  any worker with direct patient care responsibility only and
   51  are prohibited from using such funds for any other  purpose.  Each  such
   52  personal  care services provider shall submit, at a time and in a manner
   53  to be determined by the commissioner, a written certification  attesting
   54  that  such  funds will be used solely for the purpose of recruitment and
   55  retention of non-supervisory personal care services workers or any work-
   56  er with direct patient care responsibility. The commissioner is  author-
       S. 6914                            75                            A. 9205

    1  ized  to  audit each such provider to ensure compliance with the written
    2  certification required by this subdivision and shall  recoup  any  funds
    3  determined  to  have  been  used for purposes other than recruitment and
    4  retention of non-supervisory personal care services workers or any work-
    5  er  with direct patient care responsibility. Such recoupment shall be in
    6  addition to any other penalties provided by law.
    7    (cc) Funds shall be deposited  by  the  commissioner,  within  amounts
    8  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    9  directed to receive for deposit to  the  credit  of  the  state  special
   10  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   11  or any successor fund or account, for  the  purpose  of  supporting  the
   12  state  share  of  adjustments  to Medicaid rates of payment for personal
   13  care services provided pursuant to paragraph (e) of subdivision  two  of
   14  section three hundred sixty-five-a of the social services law, for local
   15  social  service  districts  which  shall not include a city with a popu-
   16  lation of over one million persons for the  purpose  of  supporting  the
   17  personal  care  services  worker  recruitment  and  retention program as
   18  established pursuant to  section  three  hundred  sixty-seven-q  of  the
   19  social  services law, from the tobacco control and insurance initiatives
   20  pool established for the following periods and the following amounts:
   21    (i) two million eight hundred thousand dollars for  the  period  April
   22  first, two thousand two through December thirty-first, two thousand two;
   23    (ii)  five  million  six  hundred  thousand  dollars, on an annualized
   24  basis, for the period January first, two thousand three through December
   25  thirty-first, two thousand three;
   26    (iii) eight million four hundred thousand dollars,  on  an  annualized
   27  basis,  for the period January first, two thousand four through December
   28  thirty-first, two thousand four;
   29    (iv) ten million eight hundred  thousand  dollars,  on  an  annualized
   30  basis,  for the period January first, two thousand five through December
   31  thirty-first, two thousand five;
   32    (v) ten million eight  hundred  thousand  dollars,  on  an  annualized
   33  basis,  for  the period January first, two thousand six through December
   34  thirty-first, two thousand six;
   35    (vi) eleven million two hundred thousand dollars for the period  Janu-
   36  ary  first,  two thousand seven through December thirty-first, two thou-
   37  sand seven;
   38    (vii) eleven million two hundred thousand dollars for the period Janu-
   39  ary first, two thousand eight through December thirty-first,  two  thou-
   40  sand eight;
   41    (viii)  eleven  million  two  hundred  thousand dollars for the period
   42  January first, two thousand  nine  through  December  thirty-first,  two
   43  thousand nine;
   44    (ix)  eleven million two hundred thousand dollars for the period Janu-
   45  ary first, two thousand ten through December thirty-first, two  thousand
   46  ten;
   47    (x)  two million eight hundred thousand dollars for the period January
   48  first, two thousand eleven  through  March  thirty-first,  two  thousand
   49  eleven; [and]
   50    (xi)  up  to  eleven  million  two hundred thousand dollars each state
   51  fiscal year for the period April  first,  two  thousand  eleven  through
   52  March thirty-first, two thousand fourteen[.]; AND
   53    (XII)  UP  TO  ELEVEN  MILLION TWO HUNDRED THOUSAND DOLLARS EACH STATE
   54  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH
   55  MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
       S. 6914                            76                            A. 9205

    1    (dd)  Funds  shall  be  deposited  by the commissioner, within amounts
    2  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    3  directed  to  receive  for  deposit  to  the credit of the state special
    4  revenue fund - other, HCRA transfer fund, medical assistance account, or
    5  any  successor  fund or account, for purposes of funding the state share
    6  of Medicaid expenditures for physician services from the tobacco control
    7  and insurance initiatives pool established for the following periods  in
    8  the following amounts:
    9    (i)  up to fifty-two million dollars for the period January first, two
   10  thousand two through December thirty-first, two thousand two;
   11    (ii) eighty-one million two hundred thousand dollars  for  the  period
   12  January  first,  two  thousand  three through December thirty-first, two
   13  thousand three;
   14    (iii) eighty-five million two hundred thousand dollars for the  period
   15  January  first,  two  thousand  four  through December thirty-first, two
   16  thousand four;
   17    (iv) eighty-five million two hundred thousand dollars for  the  period
   18  January  first,  two  thousand  five  through December thirty-first, two
   19  thousand five;
   20    (v) eighty-five million two hundred thousand dollars  for  the  period
   21  January first, two thousand six through December thirty-first, two thou-
   22  sand six;
   23    (vi)  eighty-five  million two hundred thousand dollars for the period
   24  January first, two thousand seven  through  December  thirty-first,  two
   25  thousand seven;
   26    (vii)  eighty-five million two hundred thousand dollars for the period
   27  January first, two thousand eight  through  December  thirty-first,  two
   28  thousand eight;
   29    (viii) eighty-five million two hundred thousand dollars for the period
   30  January  first,  two  thousand  nine  through December thirty-first, two
   31  thousand nine;
   32    (ix) eighty-five million two hundred thousand dollars for  the  period
   33  January first, two thousand ten through December thirty-first, two thou-
   34  sand ten;
   35    (x)  twenty-one  million three hundred thousand dollars for the period
   36  January first, two thousand eleven through March thirty-first, two thou-
   37  sand eleven; and
   38    (xi) eighty-five million  two  hundred  thousand  dollars  each  state
   39  fiscal  year  for  the  period  April first, two thousand eleven through
   40  March thirty-first, two thousand fourteen.
   41    (ee) 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 fund - other, HCRA transfer fund, medical assistance account, or
   45  any  successor  fund or account, for purposes of funding the state share
   46  of the free-standing diagnostic and treatment center rate increases  for
   47  recruitment and retention of health care workers pursuant to subdivision
   48  seventeen of section twenty-eight hundred seven of this article from the
   49  tobacco  control  and  insurance  initiatives  pool  established for the
   50  following periods in the following amounts:
   51    (i) three million two hundred fifty thousand dollars  for  the  period
   52  April  first,  two thousand two through December thirty-first, two thou-
   53  sand two;
   54    (ii) three million two hundred fifty thousand dollars on an annualized
   55  basis for the period January first, two thousand three through  December
   56  thirty-first, two thousand three;
       S. 6914                            77                            A. 9205

    1    (iii)  three  million two hundred fifty thousand dollars on an annual-
    2  ized basis for the period  January  first,  two  thousand  four  through
    3  December thirty-first, two thousand four;
    4    (iv)  three  million two hundred fifty thousand dollars for the period
    5  January first, two thousand  five  through  December  thirty-first,  two
    6  thousand five;
    7    (v)  three  million  two hundred fifty thousand dollars for the period
    8  January first, two thousand six through December thirty-first, two thou-
    9  sand six;
   10    (vi) three million two hundred fifty thousand dollars for  the  period
   11  January  first,  two  thousand  seven through December thirty-first, two
   12  thousand seven;
   13    (vii) three million four hundred thirty-eight thousand dollars for the
   14  period January first, two thousand eight through December  thirty-first,
   15  two thousand eight;
   16    (viii)  two million four hundred fifty thousand dollars for the period
   17  January first, two thousand  nine  through  December  thirty-first,  two
   18  thousand nine;
   19    (ix)  one million five hundred thousand dollars for the period January
   20  first, two thousand ten through December thirty-first, two thousand ten;
   21  and
   22    (x) three hundred twenty-five thousand dollars for the period  January
   23  first,  two  thousand  eleven  through  March thirty-first, two thousand
   24  eleven.
   25    (ff) 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 fund - other, HCRA transfer fund, medical assistance account, or
   29  any  successor  fund or account, for purposes of funding the state share
   30  of Medicaid expenditures for disabled persons as authorized pursuant  to
   31  FORMER subparagraphs twelve and thirteen of paragraph (a) of subdivision
   32  one  of  section three hundred sixty-six of the social services law from
   33  the tobacco control and insurance initiatives pool established  for  the
   34  following periods in the following amounts:
   35    (i)  one  million  eight hundred thousand dollars for the period April
   36  first, two thousand two through December thirty-first, two thousand two;
   37    (ii) sixteen million four hundred thousand dollars  on  an  annualized
   38  basis  for the period January first, two thousand three through December
   39  thirty-first, two thousand three;
   40    (iii) eighteen million seven hundred thousand dollars on an annualized
   41  basis for the period January first, two thousand four  through  December
   42  thirty-first, two thousand four;
   43    (iv)  thirty million six hundred thousand dollars for the period Janu-
   44  ary first, two thousand five through December thirty-first, two thousand
   45  five;
   46    (v) thirty million six hundred thousand dollars for the period January
   47  first, two thousand six through December thirty-first, two thousand six;
   48    (vi) thirty million six hundred thousand dollars for the period  Janu-
   49  ary  first,  two thousand seven through December thirty-first, two thou-
   50  sand seven;
   51    (vii) fifteen million dollars for the period January first, two  thou-
   52  sand eight through December thirty-first, two thousand eight;
   53    (viii) fifteen million dollars for the period January first, two thou-
   54  sand nine through December thirty-first, two thousand nine;
   55    (ix)  fifteen  million dollars for the period January first, two thou-
   56  sand ten through December thirty-first, two thousand ten;
       S. 6914                            78                            A. 9205

    1    (x) three million seven hundred fifty thousand dollars for the  period
    2  January first, two thousand eleven through March thirty-first, two thou-
    3  sand eleven; [and]
    4    (xi)  fifteen  million  dollars  each state fiscal year for the period
    5  April first, two thousand eleven through March thirty-first,  two  thou-
    6  sand fourteen[.]; AND
    7    (XII)  FIFTEEN  MILLION  DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD
    8  APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
    9  SAND SEVENTEEN.
   10    (gg) Funds shall be reserved and accumulated from  year  to  year  and
   11  shall  be  available, including income from invested funds, for purposes
   12  of grants to non-public general hospitals pursuant to paragraph  (c)  of
   13  subdivision thirty of section twenty-eight hundred seven-c of this arti-
   14  cle  from the tobacco control and insurance initiatives pool established
   15  for the following periods in the following amounts:
   16    (i) up to one million three hundred thousand dollars on an  annualized
   17  basis  for  the  period January first, two thousand two through December
   18  thirty-first, two thousand two;
   19    (ii) up to three million two 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) up to five million six hundred thousand dollars on an annualized
   23  basis  for  the period January first, two thousand four through December
   24  thirty-first, two thousand four;
   25    (iv) up to eight million six hundred thousand dollars for  the  period
   26  January  first,  two  thousand  five  through December thirty-first, two
   27  thousand five;
   28    (v) up to eight million six hundred thousand dollars on an  annualized
   29  basis  for  the  period January first, two thousand six through December
   30  thirty-first, two thousand six;
   31    (vi) up to two million six hundred thousand  dollars  for  the  period
   32  January  first,  two  thousand  seven through December thirty-first, two
   33  thousand seven;
   34    (vii) up to two million six hundred thousand dollars  for  the  period
   35  January  first,  two  thousand  eight through December thirty-first, two
   36  thousand eight;
   37    (viii) up to two million six hundred thousand dollars for  the  period
   38  January  first,  two  thousand  nine  through December thirty-first, two
   39  thousand nine;
   40    (ix) up to two million six hundred thousand  dollars  for  the  period
   41  January first, two thousand ten through December thirty-first, two thou-
   42  sand ten; and
   43    (x)  up  to  six hundred fifty thousand dollars for the period January
   44  first, two thousand eleven  through  March  thirty-first,  two  thousand
   45  eleven.
   46    (hh)  Funds  shall  be  deposited  by the commissioner, within amounts
   47  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   48  directed  to  receive  for  deposit to the credit of the special revenue
   49  fund -  other,  HCRA  transfer  fund,  medical  assistance  account  for
   50  purposes  of  providing  financial assistance to residential health care
   51  facilities pursuant to subdivisions nineteen and twenty-one  of  section
   52  twenty-eight hundred eight of this article, from the tobacco control and
   53  insurance  initiatives pool established for the following periods in the
   54  following amounts:
   55    (i) for the period April first,  two  thousand  two  through  December
   56  thirty-first, two thousand two, ten million dollars;
       S. 6914                            79                            A. 9205

    1    (ii) for the period January first, two thousand three through December
    2  thirty-first,  two thousand three, nine million four hundred fifty thou-
    3  sand dollars;
    4    (iii) for the period January first, two thousand four through December
    5  thirty-first,  two thousand four, nine million three hundred fifty thou-
    6  sand dollars;
    7    (iv) up to fifteen million dollars for the period January  first,  two
    8  thousand five through December thirty-first, two thousand five;
    9    (v)  up  to  fifteen million dollars for the period January first, two
   10  thousand six through December thirty-first, two thousand six;
   11    (vi) up to fifteen million dollars for the period January  first,  two
   12  thousand seven through December thirty-first, two thousand seven;
   13    (vii)  up to fifteen million dollars for the period January first, two
   14  thousand eight through December thirty-first, two thousand eight;
   15    (viii) up to fifteen million dollars for the period January first, two
   16  thousand nine through December thirty-first, two thousand nine;
   17    (ix) up to fifteen million dollars for the period January  first,  two
   18  thousand ten through December thirty-first, two thousand ten;
   19    (x)  up  to three million seven hundred fifty thousand dollars for the
   20  period January first, two thousand eleven  through  March  thirty-first,
   21  two thousand eleven; and
   22    (xi)  fifteen  million  dollars  each state fiscal year for the period
   23  April first, two thousand eleven through March thirty-first,  two  thou-
   24  sand fourteen.
   25    (ii)  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 the purpose of supporting the
   30  state share of Medicaid expenditures for disabled persons as  authorized
   31  by sections 1619 (a) and (b) of the federal social security act pursuant
   32  to  the  tobacco  control and insurance initiatives pool established for
   33  the following periods in the following amounts:
   34    (i) six million four hundred thousand dollars  for  the  period  April
   35  first, two thousand two through December thirty-first, two thousand two;
   36    (ii) eight million five hundred thousand dollars, for the period Janu-
   37  ary  first,  two thousand three through December thirty-first, two thou-
   38  sand three;
   39    (iii) eight million five hundred thousand dollars for the period Janu-
   40  ary first, two thousand four through December thirty-first, two thousand
   41  four;
   42    (iv) eight million five hundred thousand dollars for the period  Janu-
   43  ary first, two thousand five through December thirty-first, two thousand
   44  five;
   45    (v) eight million five hundred thousand dollars for the period January
   46  first, two thousand six through December thirty-first, two thousand six;
   47    (vi) eight million six hundred thousand dollars for the period January
   48  first,  two  thousand  seven through December thirty-first, two thousand
   49  seven;
   50    (vii) eight million five hundred thousand dollars for the period Janu-
   51  ary first, two thousand eight through December thirty-first,  two  thou-
   52  sand eight;
   53    (viii)  eight  million  five  hundred  thousand dollars for the period
   54  January first, two thousand  nine  through  December  thirty-first,  two
   55  thousand nine;
       S. 6914                            80                            A. 9205

    1    (ix)  eight million five hundred thousand dollars for the period Janu-
    2  ary first, two thousand ten through December thirty-first, two  thousand
    3  ten;
    4    (x) two million one hundred twenty-five thousand dollars for the peri-
    5  od  January  first,  two thousand eleven through March thirty-first, two
    6  thousand eleven; [and]
    7    (xi) eight million five hundred thousand  dollars  each  state  fiscal
    8  year for the period April first, two thousand eleven through March thir-
    9  ty-first, two thousand fourteen[.]; AND
   10    (XII)  EIGHT  MILLION  FIVE HUNDRED THOUSAND DOLLARS EACH STATE FISCAL
   11  YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH  MARCH
   12  THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
   13    (jj)  Funds  shall  be  reserved and accumulated from year to year and
   14  shall be available,  including  income  from  invested  funds,  for  the
   15  purposes  of  a grant program to improve access to infertility services,
   16  treatments and procedures, from the tobacco control and insurance initi-
   17  atives pool established for the period January first, two  thousand  two
   18  through  December  thirty-first,  two thousand two in the amount of nine
   19  million one hundred seventy-five thousand dollars, for the period  April
   20  first,  two  thousand six through March thirty-first, two thousand seven
   21  in the amount of five million dollars, for the period April  first,  two
   22  thousand  seven  through  March  thirty-first, two thousand eight in the
   23  amount of five million dollars, for the period April first, two thousand
   24  eight through March thirty-first, two thousand nine  in  the  amount  of
   25  five  million dollars, and for the period April first, two thousand nine
   26  through March thirty-first, two thousand  ten  in  the  amount  of  five
   27  million  dollars,  for  the period April first, two thousand ten through
   28  March thirty-first, two thousand eleven in the amount of two million two
   29  hundred thousand dollars, and for the period April first,  two  thousand
   30  eleven through March thirty-first, two thousand twelve up to one million
   31  one hundred thousand dollars.
   32    (kk)  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  Medical  Assistance  Program  expenditures  from  the  tobacco
   38  control  and  insurance  initiatives  pool established for the following
   39  periods in the following amounts:
   40    (i) thirty-eight million eight hundred thousand dollars for the period
   41  January first, two thousand two through December thirty-first, two thou-
   42  sand two;
   43    (ii) up to two hundred ninety-five  million  dollars  for  the  period
   44  January  first,  two  thousand  three through December thirty-first, two
   45  thousand three;
   46    (iii) up to four hundred seventy-two million dollars  for  the  period
   47  January  first,  two  thousand  four  through December thirty-first, two
   48  thousand four;
   49    (iv) up to nine hundred million dollars for the period January  first,
   50  two thousand five through December thirty-first, two thousand five;
   51    (v)  up  to  eight  hundred  sixty-six  million three hundred thousand
   52  dollars for the period January first, two thousand six through  December
   53  thirty-first, two thousand six;
   54    (vi)  up to six hundred sixteen million seven hundred thousand dollars
   55  for the period January first, two thousand seven through December  thir-
   56  ty-first, two thousand seven;
       S. 6914                            81                            A. 9205

    1    (vii)  up  to  five hundred seventy-eight million nine hundred twenty-
    2  five thousand dollars for the period January first, two  thousand  eight
    3  through December thirty-first, two thousand eight; and
    4    (viii)  within  amounts  appropriated  on and after January first, two
    5  thousand nine.
    6    (ll) Funds shall be deposited  by  the  commissioner,  within  amounts
    7  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    8  directed to receive for deposit to  the  credit  of  the  state  special
    9  revenue  funds -- other, HCRA transfer fund, medical assistance account,
   10  or any successor fund or account, for  purposes  of  funding  the  state
   11  share  of Medicaid expenditures related to the city of New York from the
   12  tobacco control and  insurance  initiatives  pool  established  for  the
   13  following periods in the following amounts:
   14    (i)  eighty-two  million seven hundred thousand dollars for the period
   15  January first, two thousand two through December thirty-first, two thou-
   16  sand two;
   17    (ii) one hundred twenty-four million six hundred thousand dollars  for
   18  the  period  January  first, two thousand three through December thirty-
   19  first, two thousand three;
   20    (iii) one hundred twenty-four million seven hundred  thousand  dollars
   21  for  the  period January first, two thousand four through December thir-
   22  ty-first, two thousand four;
   23    (iv) one hundred twenty-four million seven  hundred  thousand  dollars
   24  for  the  period January first, two thousand five through December thir-
   25  ty-first, two thousand five;
   26    (v) one hundred twenty-four million seven hundred thousand dollars for
   27  the period January first, two  thousand  six  through  December  thirty-
   28  first, two thousand six;
   29    (vi)  one  hundred  twenty-four million seven hundred thousand dollars
   30  for the period January first, two thousand seven through December  thir-
   31  ty-first, two thousand seven;
   32    (vii)  one  hundred twenty-four million seven hundred thousand dollars
   33  for the period January first, two thousand eight through December  thir-
   34  ty-first, two thousand eight;
   35    (viii)  one hundred twenty-four million seven hundred thousand dollars
   36  for the period January first, two thousand nine through  December  thir-
   37  ty-first, two thousand nine;
   38    (ix)  one  hundred  twenty-four million seven hundred thousand dollars
   39  for the period January first, two thousand ten through December  thirty-
   40  first, two thousand ten;
   41    (x)  thirty-one  million one hundred seventy-five thousand dollars for
   42  the period January first, two  thousand  eleven  through  March  thirty-
   43  first, two thousand eleven; and
   44    (xi)  one  hundred  twenty-four million seven hundred thousand dollars
   45  each state fiscal year for the period April first, two  thousand  eleven
   46  through March thirty-first, two thousand fourteen.
   47    (mm)  Funds  shall  be  deposited  by the commissioner, within amounts
   48  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   49  directed  to  receive  for  deposit  to  the credit of the state special
   50  revenue funds - other, HCRA transfer fund, medical  assistance  account,
   51  or  any  successor  fund  or  account, for purposes of funding specified
   52  percentages of the state share of services and expenses related  to  the
   53  family health plus program in accordance with the following schedule:
   54    (i)  (A)  for  the  period  January  first, two thousand three through
   55  December thirty-first, two thousand four, one  hundred  percent  of  the
   56  state share;
       S. 6914                            82                            A. 9205

    1    (B)  for  the period January first, two thousand five through December
    2  thirty-first, two thousand  five,  seventy-five  percent  of  the  state
    3  share; and,
    4    (C)  for  periods  beginning  on and after January first, two thousand
    5  six, fifty percent of the state share.
    6    (ii) Funding for the family health plus program  will  include  up  to
    7  five million dollars annually for the period January first, two thousand
    8  three  through  December  thirty-first,  two  thousand  six,  up to five
    9  million dollars for the period January first, two thousand seven through
   10  December thirty-first, two thousand  seven,  up  to  seven  million  two
   11  hundred  thousand  dollars  for  the  period January first, two thousand
   12  eight through December thirty-first, two thousand  eight,  up  to  seven
   13  million  two  hundred thousand dollars for the period January first, two
   14  thousand nine through December thirty-first, two thousand  nine,  up  to
   15  seven million two hundred thousand dollars for the period January first,
   16  two  thousand ten through December thirty-first, two thousand ten, up to
   17  one million eight hundred thousand dollars for the period January first,
   18  two thousand eleven through March thirty-first, two thousand eleven,  up
   19  to  six  million forty-nine thousand dollars for the period April first,
   20  two thousand eleven through March thirty-first, two thousand twelve,  up
   21  to  six  million two hundred eighty-nine thousand dollars for the period
   22  April first, two thousand twelve through March thirty-first,  two  thou-
   23  sand  thirteen,  and  up  to six million four hundred sixty-one thousand
   24  dollars for the period April first, two thousand thirteen through  March
   25  thirty-first,  two  thousand  fourteen, for administration and marketing
   26  costs associated with such program established pursuant to  clauses  (A)
   27  and  (B)  of  subparagraph  (v)  of  paragraph (a) of subdivision two of
   28  section three hundred sixty-nine-ee of the social services law from  the
   29  tobacco  control  and  insurance  initiatives  pool  established for the
   30  following periods in the following amounts:
   31    (A) one hundred ninety million six hundred thousand  dollars  for  the
   32  period  January first, two thousand three through December thirty-first,
   33  two thousand three;
   34    (B) three hundred seventy-four million dollars for the period  January
   35  first,  two  thousand  four  through December thirty-first, two thousand
   36  four;
   37    (C) five hundred thirty-eight million four  hundred  thousand  dollars
   38  for  the  period January first, two thousand five through December thir-
   39  ty-first, two thousand five;
   40    (D) three hundred eighteen million seven hundred seventy-five thousand
   41  dollars for the period January first, two thousand six through  December
   42  thirty-first, two thousand six;
   43    (E) four hundred eighty-two million eight hundred thousand dollars for
   44  the  period  January  first, two thousand seven through December thirty-
   45  first, two thousand seven;
   46    (F) five hundred seventy million twenty-five thousand dollars for  the
   47  period  January first, two thousand eight through December thirty-first,
   48  two thousand eight;
   49    (G) six hundred ten million seven hundred twenty-five thousand dollars
   50  for the period January first, two thousand nine through  December  thir-
   51  ty-first, two thousand nine;
   52    (H) six hundred twenty-seven million two hundred seventy-five thousand
   53  dollars  for the period January first, two thousand ten through December
   54  thirty-first, two thousand ten;
       S. 6914                            83                            A. 9205

    1    (I) one hundred fifty-seven million eight hundred  seventy-five  thou-
    2  sand  dollars  for the period January first, two thousand eleven through
    3  March thirty-first, two thousand eleven;
    4    (J) six hundred twenty-eight million four hundred thousand dollars for
    5  the  period April first, two thousand eleven through March thirty-first,
    6  two thousand twelve;
    7    (K) six hundred fifty million four hundred thousand  dollars  for  the
    8  period  April first, two thousand twelve through March thirty-first, two
    9  thousand thirteen; [and]
   10    (L) six hundred fifty million four hundred thousand  dollars  for  the
   11  period  April  first,  two thousand thirteen through March thirty-first,
   12  two thousand fourteen[.]; AND
   13    (M) UP TO THREE HUNDRED TEN MILLION FIVE HUNDRED NINETY-FIVE  THOUSAND
   14  DOLLARS  FOR THE PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH
   15  THIRTY-FIRST, TWO THOUSAND FIFTEEN.
   16    (nn) Funds shall be deposited  by  the  commissioner,  within  amounts
   17  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   18  directed to receive for deposit to  the  credit  of  the  state  special
   19  revenue  fund - other, HCRA transfer fund, health care services account,
   20  or any successor fund or account, for purposes  related  to  adult  home
   21  initiatives  for  medicaid  eligible residents of residential facilities
   22  licensed pursuant to section four hundred sixty-b of the social services
   23  law from the tobacco control and insurance initiatives pool  established
   24  for the following periods in the following amounts:
   25    (i) up to four million dollars for the period January first, two thou-
   26  sand three through December thirty-first, two thousand three;
   27    (ii) up to six million dollars for the period January first, two thou-
   28  sand four through December thirty-first, two thousand four;
   29    (iii)  up  to  eight million dollars for the period January first, two
   30  thousand  five  through  December  thirty-first,  two   thousand   five,
   31  provided,  however,  that  up to five million two hundred fifty thousand
   32  dollars of such funds shall be received by the comptroller and deposited
   33  to the credit of the special revenue fund - other / aid  to  localities,
   34  HCRA  transfer  fund - 061, enhanced community services account - 05, or
   35  any successor fund or account, for the purposes set forth in this  para-
   36  graph;
   37    (iv)  up  to  eight  million dollars for the period January first, two
   38  thousand six through December thirty-first, two thousand six,  provided,
   39  however,  that  up to five million two hundred fifty thousand dollars of
   40  such funds shall be received by the comptroller  and  deposited  to  the
   41  credit  of  the  special  revenue fund - other / aid to localities, HCRA
   42  transfer fund - 061, enhanced community services account -  05,  or  any
   43  successor fund or account, for the purposes set forth in this paragraph;
   44    (v)  up  to  eight  million  dollars for the period January first, two
   45  thousand  seven  through  December  thirty-first,  two  thousand  seven,
   46  provided,  however,  that  up to five million two hundred fifty thousand
   47  dollars of such funds shall be received by the comptroller and deposited
   48  to the credit of the special revenue fund - other / aid  to  localities,
   49  HCRA  transfer  fund - 061, enhanced community services account - 05, or
   50  any successor fund or account, for the purposes set forth in this  para-
   51  graph;
   52    (vi)  up  to  two million seven hundred fifty thousand dollars for the
   53  period January first, two thousand eight through December  thirty-first,
   54  two thousand eight;
       S. 6914                            84                            A. 9205

    1    (vii)  up  to two million seven hundred fifty thousand dollars for the
    2  period January first, two thousand nine through  December  thirty-first,
    3  two thousand nine;
    4    (viii)  up to two million seven hundred fifty thousand dollars for the
    5  period January first, two thousand ten  through  December  thirty-first,
    6  two thousand ten; and
    7    (ix)  up  to  six hundred eighty-eight thousand dollars for the period
    8  January first, two thousand eleven through March thirty-first, two thou-
    9  sand eleven.
   10    (oo) Funds shall be reserved and accumulated from  year  to  year  and
   11  shall  be  available, including income from invested funds, for purposes
   12  of grants to non-public general hospitals pursuant to paragraph  (e)  of
   13  subdivision  twenty-five of section twenty-eight hundred seven-c of this
   14  article from the tobacco control and insurance initiatives  pool  estab-
   15  lished for the following periods in the following amounts:
   16    (i)  up  to five million dollars on an annualized basis for the period
   17  January first, two thousand  four  through  December  thirty-first,  two
   18  thousand four;
   19    (ii)  up  to  five  million  dollars for the period January first, two
   20  thousand five through December thirty-first, two thousand five;
   21    (iii) up to five million dollars for the  period  January  first,  two
   22  thousand six through December thirty-first, two thousand six;
   23    (iv)  up  to  five  million  dollars for the period January first, two
   24  thousand seven through December thirty-first, two thousand seven; [and]
   25    (v) up to five million dollars for the period January first, two thou-
   26  sand eight through December thirty-first, two thousand eight;
   27    (vi) up to five million dollars for  the  period  January  first,  two
   28  thousand nine through December thirty-first, two thousand nine;
   29    (vii)  up  to  five  million dollars for the period January first, two
   30  thousand ten through December thirty-first, two thousand ten; and
   31    (viii) up to one million two hundred fifty thousand  dollars  for  the
   32  period  January  first,  two thousand eleven through March thirty-first,
   33  two thousand eleven.
   34    (pp) Funds shall be reserved and accumulated from  year  to  year  and
   35  shall  be  available,  including  income  from  invested  funds, for the
   36  purpose of supporting the provision of tax credits for  long  term  care
   37  insurance  pursuant  to subdivision one of section one hundred ninety of
   38  the tax law, paragraph (a) of subdivision twenty-five-a of  section  two
   39  hundred  ten  of such law, subsection (aa) of section six hundred six of
   40  such law, paragraph one of subsection (k) of  section  fourteen  hundred
   41  fifty-six  of  such  law and paragraph one of subdivision (m) of section
   42  fifteen hundred eleven of such law, in the following amounts:
   43    (i) ten million dollars for the period  January  first,  two  thousand
   44  four through December thirty-first, two thousand four;
   45    (ii)  ten  million  dollars for the period January first, two thousand
   46  five through December thirty-first, two thousand five;
   47    (iii) ten million dollars for the period January first,  two  thousand
   48  six through December thirty-first, two thousand six; and
   49    (iv)  five  million dollars for the period January first, two thousand
   50  seven through June thirtieth, two thousand seven.
   51    (qq) Funds shall be reserved and accumulated from  year  to  year  and
   52  shall  be  available,  including  income  from  invested  funds, for the
   53  purpose  of  supporting  the  long-term  care  insurance  education  and
   54  outreach program established pursuant to section two hundred seventeen-a
   55  of the elder law for the following periods in the following amounts:
       S. 6914                            85                            A. 9205

    1    (i) up to five million dollars for the period January first, two thou-
    2  sand  four  through  December  thirty-first,  two thousand four; of such
    3  funds one million nine hundred fifty  thousand  dollars  shall  be  made
    4  available  to the department for the purpose of developing, implementing
    5  and  administering  the  long-term care insurance education and outreach
    6  program and three million fifty thousand dollars shall be  deposited  by
    7  the  commissioner,  within  amounts appropriated, and the comptroller is
    8  hereby authorized and directed to receive for deposit to the  credit  of
    9  the  special  revenue  funds - other, HCRA transfer fund, long term care
   10  insurance resource center account of the state office for the  aging  or
   11  any  future  account designated for the purpose of implementing the long
   12  term care insurance education and outreach  program  and  providing  the
   13  long  term  care insurance resource centers with the necessary resources
   14  to carry out their operations;
   15    (ii) up to five million dollars for  the  period  January  first,  two
   16  thousand  five through December thirty-first, two thousand five; of such
   17  funds 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  three million fifty thousand dollars shall be deposited by
   21  the commissioner, within amounts appropriated, and  the  comptroller  is
   22  hereby  authorized  and directed to receive for deposit to the credit of
   23  the special revenue funds - other, HCRA transfer fund,  long  term  care
   24  insurance  resource  center account of the state office for the aging or
   25  any future account designated for the purpose of implementing  the  long
   26  term  care  insurance  education  and outreach program and providing the
   27  long term care insurance resource centers with the  necessary  resources
   28  to carry out their operations;
   29    (iii)  up  to  five  million dollars for the period January first, two
   30  thousand six through December thirty-first, two thousand  six;  of  such
   31  funds  one  million  nine  hundred  fifty thousand dollars shall be made
   32  available to the department for the purpose of developing,  implementing
   33  and  administering  the  long-term care insurance education and outreach
   34  program and three million fifty thousand dollars shall be made available
   35  to the office for the aging for the purpose of providing the  long  term
   36  care  insurance  resource  centers with the necessary resources to carry
   37  out their operations;
   38    (iv) up to five million dollars for  the  period  January  first,  two
   39  thousand  seven  through  December  thirty-first, two thousand seven; of
   40  such funds one million nine hundred fifty thousand dollars shall be made
   41  available to the department for the purpose of developing,  implementing
   42  and  administering  the  long-term care insurance education and outreach
   43  program and three million fifty thousand dollars shall be made available
   44  to the office for the aging for the purpose of providing the  long  term
   45  care  insurance  resource  centers with the necessary resources to carry
   46  out their operations;
   47    (v) up to five million dollars for the period January first, two thou-
   48  sand eight through December thirty-first, two thousand  eight;  of  such
   49  funds  one  million  nine  hundred  fifty thousand dollars shall be made
   50  available to the department for the purpose of developing,  implementing
   51  and  administering  the  long term care insurance education and outreach
   52  program and three million fifty thousand dollars shall be made available
   53  to the office for the aging for the purpose of providing the  long  term
   54  care  insurance  resource  centers with the necessary resources to carry
   55  out their operations;
       S. 6914                            86                            A. 9205

    1    (vi) up to five million dollars for  the  period  January  first,  two
    2  thousand  nine through December thirty-first, two thousand nine; of such
    3  funds one million nine hundred fifty  thousand  dollars  shall  be  made
    4  available  to the department for the purpose of developing, implementing
    5  and  administering  the  long-term care insurance education and outreach
    6  program and three million fifty thousand dollars shall be made available
    7  to the office for the aging for the purpose of providing  the  long-term
    8  care  insurance  resource  centers with the necessary resources to carry
    9  out their operations;
   10    (vii) up to four hundred eighty-eight thousand dollars for the  period
   11  January first, two thousand ten through March thirty-first, two thousand
   12  ten;  of  such funds four hundred eighty-eight thousand dollars shall be
   13  made available to the department for the purpose of  developing,  imple-
   14  menting  and  administering  the  long-term care insurance education and
   15  outreach program.
   16    (rr) Funds shall be reserved and accumulated from the tobacco  control
   17  and  insurance initiatives pool and shall be available, including income
   18  from invested funds, for the purpose of supporting expenses  related  to
   19  implementation  of  the provisions of title III of article twenty-nine-D
   20  of this chapter, for the following periods and in the following amounts:
   21    (i) up to ten million dollars for the period January first, two  thou-
   22  sand six through December thirty-first, two thousand six;
   23    (ii) up to ten million dollars for the period January first, two thou-
   24  sand seven through December thirty-first, two thousand seven;
   25    (iii)  up  to  ten  million  dollars for the period January first, two
   26  thousand eight through December thirty-first, two thousand eight;
   27    (iv) up to ten million dollars for the period January first, two thou-
   28  sand nine through December thirty-first, two thousand nine;
   29    (v) up to ten million dollars for the period January first, two  thou-
   30  sand ten through December thirty-first, two thousand ten; and
   31    (vi)  up  to  two million five hundred thousand dollars for the period
   32  January first, two thousand eleven through March thirty-first, two thou-
   33  sand eleven.
   34    (ss) Funds shall be reserved and accumulated from the tobacco  control
   35  and  insurance initiatives pool and used for a health care stabilization
   36  program established by the commissioner for the purposes of  stabilizing
   37  critical health care providers and health care programs whose ability to
   38  continue  to provide appropriate services are threatened by financial or
   39  other challenges, in the amount of up to  twenty-eight  million  dollars
   40  for the period July first, two thousand four through June thirtieth, two
   41  thousand  five.  Notwithstanding  the  provisions of section one hundred
   42  twelve of the state finance law or any other inconsistent  provision  of
   43  the state finance law or any other law, funds available for distribution
   44  pursuant  to  this  paragraph  may  be  allocated and distributed by the
   45  commissioner, or the state comptroller as applicable without  a  compet-
   46  itive bid or request for proposal process. Considerations relied upon by
   47  the commissioner in determining the allocation and distribution of these
   48  funds  shall  include,  but  not  be  limited to, the following: (i) the
   49  importance of the provider or program in meeting  critical  health  care
   50  needs  in  the  community  in  which  it  operates; (ii) the provider or
   51  program provision of care to under-served populations; (iii) the quality
   52  of the care or services the provider or program delivers; (iv) the abil-
   53  ity of the provider or program to continue  to  deliver  an  appropriate
   54  level  of  care or services if additional funding is made available; (v)
   55  the ability of the provider or program to access, in  a  timely  manner,
   56  alternative  sources  of  funding, including other sources of government
       S. 6914                            87                            A. 9205

    1  funding; (vi) the ability of other providers or programs in the communi-
    2  ty to meet the community health care needs; (vii) whether  the  provider
    3  or  program  has an appropriate plan to improve its financial condition;
    4  and  (viii)  whether  additional  funding  would  permit the provider or
    5  program to consolidate, relocate, or close programs  or  services  where
    6  such  actions  would  result  in greater stability and efficiency in the
    7  delivery of needed health care services or programs.
    8    (tt) Funds shall be reserved and accumulated from  year  to  year  and
    9  shall  be  available, including income from invested funds, for purposes
   10  of providing grants  for  two  long  term  care  demonstration  projects
   11  designed  to test new models for the delivery of long term care services
   12  established pursuant to section twenty-eight  hundred  seven-x  of  this
   13  chapter, for the following periods and in the following amounts:
   14    (i)  up to five hundred thousand dollars for the period January first,
   15  two thousand four through December thirty-first, two thousand four;
   16    (ii) up to five hundred thousand dollars for the period January first,
   17  two thousand five through December thirty-first, two thousand five;
   18    (iii) up to five hundred  thousand  dollars  for  the  period  January
   19  first, two thousand six through December thirty-first, two thousand six;
   20    (iv) up to one million dollars for the period January first, two thou-
   21  sand seven through December thirty-first, two thousand seven; and
   22    (v)  up  to  two hundred fifty thousand dollars for the period January
   23  first, two thousand  eight  through  March  thirty-first,  two  thousand
   24  eight.
   25    (uu)  Funds  shall  be  reserved and accumulated from year to year and
   26  shall be available,  including  income  from  invested  funds,  for  the
   27  purpose  of supporting disease management and telemedicine demonstration
   28  programs authorized pursuant to section  twenty-one  hundred  eleven  of
   29  this chapter for the following periods in the following amounts:
   30    (i)  five  million  dollars for the period January first, two thousand
   31  four through December thirty-first, two thousand four,  of  which  three
   32  million  dollars shall be available for disease management demonstration
   33  programs and two million dollars shall  be  available  for  telemedicine
   34  demonstration programs;
   35    (ii)  five  million dollars for the period January first, two thousand
   36  five through December thirty-first, two thousand five,  of  which  three
   37  million  dollars shall be available for disease management demonstration
   38  programs and two million dollars shall  be  available  for  telemedicine
   39  demonstration programs;
   40    (iii)  nine million five hundred thousand dollars for the period Janu-
   41  ary first, two thousand six through December thirty-first, two  thousand
   42  six,  of  which  seven  million  five  hundred thousand dollars shall be
   43  available for disease management demonstration programs and two  million
   44  dollars shall be available for telemedicine demonstration programs;
   45    (iv) nine million five hundred thousand dollars for the period January
   46  first,  two  thousand  seven through December thirty-first, two thousand
   47  seven, of which seven million five hundred  thousand  dollars  shall  be
   48  available  for disease management demonstration programs and one million
   49  dollars shall be available for telemedicine demonstration programs;
   50    (v) nine million five hundred thousand dollars for the period  January
   51  first,  two  thousand  eight through December thirty-first, two thousand
   52  eight, of which seven million five hundred  thousand  dollars  shall  be
   53  available  for disease management demonstration programs and two million
   54  dollars shall be available for telemedicine demonstration programs;
   55    (vi) seven million eight hundred thirty-three thousand  three  hundred
   56  thirty-three  dollars  for  the  period January first, two thousand nine
       S. 6914                            88                            A. 9205

    1  through December thirty-first, two thousand nine, of which seven million
    2  five hundred thousand dollars shall be available for disease  management
    3  demonstration  programs  and  three  hundred thirty-three thousand three
    4  hundred  thirty-three dollars shall be available for telemedicine demon-
    5  stration programs for  the  period  January  first,  two  thousand  nine
    6  through March first, two thousand nine;
    7    (vii)  one million eight hundred seventy-five thousand dollars for the
    8  period January first, two thousand ten through March  thirty-first,  two
    9  thousand  ten  shall  be  available for disease management demonstration
   10  programs.
   11    (ww) Funds shall be deposited  by  the  commissioner,  within  amounts
   12  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   13  directed to receive for the deposit to the credit of the  state  special
   14  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   15  or any successor fund or account, for  purposes  of  funding  the  state
   16  share  of  the  general  hospital  rates  increases  for recruitment and
   17  retention of health care workers pursuant to paragraph (e)  of  subdivi-
   18  sion thirty of section twenty-eight hundred seven-c of this article from
   19  the  tobacco  control and insurance initiatives pool established for the
   20  following periods in the following amounts:
   21    (i) sixty million five hundred thousand dollars for the period January
   22  first, two thousand five through  December  thirty-first,  two  thousand
   23  five; and
   24    (ii)  sixty million five hundred thousand dollars for the period Janu-
   25  ary first, two thousand six through December thirty-first, two  thousand
   26  six.
   27    (xx)  Funds  shall  be  deposited  by the commissioner, within amounts
   28  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   29  directed  to  receive for the 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 purposes of funding the state
   32  share of the general hospital rates increases for rural hospitals pursu-
   33  ant to subdivision thirty-two of section twenty-eight hundred seven-c of
   34  this article from the tobacco control  and  insurance  initiatives  pool
   35  established for the following periods in the following amounts:
   36    (i) three million five hundred thousand dollars for the period January
   37  first,  two  thousand  five  through December thirty-first, two thousand
   38  five;
   39    (ii) three million five hundred thousand dollars for the period  Janu-
   40  ary  first, two thousand six through December thirty-first, two thousand
   41  six;
   42    (iii) three million five hundred thousand dollars for the period Janu-
   43  ary first, two thousand seven through December thirty-first,  two  thou-
   44  sand seven;
   45    (iv)  three million five hundred thousand dollars for the period Janu-
   46  ary first, two thousand eight through December thirty-first,  two  thou-
   47  sand eight; and
   48    (v)  three  million  two hundred eight thousand dollars for the period
   49  January first, two thousand nine through November thirtieth,  two  thou-
   50  sand nine.
   51    (yy)  Funds  shall  be  reserved and accumulated from year to year and
   52  shall be available,  within  amounts  appropriated  and  notwithstanding
   53  section  one  hundred  twelve  of  the  state  finance law and any other
   54  contrary provision of law, for the purpose of supporting grants  not  to
   55  exceed  five  million  dollars  to be made by the commissioner without a
   56  competitive bid or request for  proposal  process,  in  support  of  the
       S. 6914                            89                            A. 9205

    1  delivery  of  critically  needed  health  care  services, to health care
    2  providers located in the counties of Erie and Niagara which  executed  a
    3  memorandum of closing and conducted a merger closing in escrow on Novem-
    4  ber  twenty-fourth, nineteen hundred ninety-seven and which entered into
    5  a settlement dated December thirtieth, two thousand four for a  loss  on
    6  disposal  of  assets  under the provisions of title XVIII of the federal
    7  social security act applicable to mergers occurring  prior  to  December
    8  first, nineteen hundred ninety-seven.
    9    (zz)  Funds  shall  be  reserved and accumulated from year to year and
   10  shall be available, within amounts  appropriated,  for  the  purpose  of
   11  supporting  expenditures  authorized  pursuant  to  section twenty-eight
   12  hundred eighteen of this article from the tobacco control and  insurance
   13  initiatives  pool established for the following periods in the following
   14  amounts:
   15    (i) six million five hundred thousand dollars for the  period  January
   16  first,  two  thousand  five  through December thirty-first, two thousand
   17  five;
   18    (ii) one hundred eight million three hundred thousand dollars for  the
   19  period  January  first,  two thousand six through December thirty-first,
   20  two thousand six, provided, however, that within amounts appropriated in
   21  the two thousand six through two thousand seven  state  fiscal  year,  a
   22  portion  of  such  funds  may  be transferred to the Roswell Park Cancer
   23  Institute Corporation to fund capital costs;
   24    (iii) one hundred seventy-one million dollars for the  period  January
   25  first,  two  thousand  seven through December thirty-first, two thousand
   26  seven, provided, however, that within amounts appropriated  in  the  two
   27  thousand  six through two thousand seven state fiscal year, a portion of
   28  such funds may be transferred  to  the  Roswell  Park  Cancer  Institute
   29  Corporation to fund capital costs;
   30    (iv) one hundred seventy-one million five hundred thousand dollars for
   31  the  period  January  first, two thousand eight through December thirty-
   32  first, two thousand eight;
   33    (v) one hundred twenty-eight  million  seven  hundred  fifty  thousand
   34  dollars for the period January first, two thousand nine through December
   35  thirty-first, two thousand nine;
   36    (vi)  one  hundred thirty-one million three hundred seventy-five thou-
   37  sand dollars for the period January  first,  two  thousand  ten  through
   38  December thirty-first, two thousand ten;
   39    (vii)  thirty-four  million two hundred fifty thousand dollars for the
   40  period January first, two thousand eleven  through  March  thirty-first,
   41  two thousand eleven;
   42    (viii) four hundred thirty-three million three hundred sixty-six thou-
   43  sand  dollars  for  the  period April first, two thousand eleven through
   44  March thirty-first, two thousand twelve;
   45    (ix) one hundred fifty million eight hundred six thousand dollars  for
   46  the  period April first, two thousand twelve through March thirty-first,
   47  two thousand thirteen; [and]
   48    (x) seventy-eight million seventy-one thousand dollars for the  period
   49  April first, two thousand thirteen through March thirty-first, two thou-
   50  sand fourteen.
   51    (aaa)  Funds  shall  be reserved and accumulated from year to year and
   52  shall be available, including income from invested funds,  for  services
   53  and  expenses related to school based health centers, in an amount up to
   54  three million five hundred thousand dollars for the period April  first,
   55  two  thousand  six through March thirty-first, two thousand seven, up to
   56  three million five hundred thousand dollars for the period April  first,
       S. 6914                            90                            A. 9205

    1  two thousand seven through March thirty-first, two thousand eight, up to
    2  three  million five hundred thousand dollars for the period April first,
    3  two thousand eight through March thirty-first, two thousand nine, up  to
    4  three  million five hundred thousand dollars for the period April first,
    5  two thousand nine through March thirty-first, two thousand  ten,  up  to
    6  three  million five hundred thousand dollars for the period April first,
    7  two thousand ten through March thirty-first, two thousand eleven,  [and]
    8  up  to two million eight hundred thousand dollars each state fiscal year
    9  for the period April first, two thousand eleven  through  March  thirty-
   10  first,  two  thousand  fourteen,  AND  UP  TO  TWO  MILLION  SIX HUNDRED
   11  FORTY-FOUR THOUSAND DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD  APRIL
   12  FIRST,  TWO  THOUSAND  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
   13  SEVENTEEN.  The total amount of funds provided herein shall be  distrib-
   14  uted  as  grants  based on the ratio of each provider's total enrollment
   15  for all sites to the total enrollment of  all  providers.  This  formula
   16  shall be applied to the total amount provided herein.
   17    (bbb)  Funds  shall  be reserved and accumulated from year to year and
   18  shall be available, including income from invested funds,  for  purposes
   19  of  awarding  grants  to  operators  of  adult  homes,  enriched housing
   20  programs and residences through the enhancing abilities and life experi-
   21  ence (EnAbLe) program to provide for  the  installation,  operation  and
   22  maintenance  of air conditioning in resident rooms, consistent with this
   23  paragraph, in an amount up to two million dollars for the  period  April
   24  first,  two thousand six through March thirty-first, two thousand seven,
   25  up to three million eight hundred thousand dollars for the period  April
   26  first,  two  thousand  seven  through  March  thirty-first, two thousand
   27  eight, up to three million eight hundred thousand dollars for the period
   28  April first, two thousand eight through March thirty-first, two thousand
   29  nine, up to three million eight hundred thousand dollars for the  period
   30  April  first, two thousand nine through March thirty-first, two thousand
   31  ten, and up to three million eight  hundred  thousand  dollars  for  the
   32  period  April  first,  two  thousand ten through March thirty-first, two
   33  thousand eleven. Residents shall not be charged utility cost for the use
   34  of air conditioners supplied under the  EnAbLe  program.  All  such  air
   35  conditioners must be operated in occupied resident rooms consistent with
   36  requirements applicable to common areas.
   37    (ccc)  Funds  shall  be  deposited by the commissioner, within amounts
   38  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   39  directed  to  receive for the deposit to the credit of the state special
   40  revenue funds - other, HCRA transfer fund, medical  assistance  account,
   41  or  any  successor  fund  or  account, for purposes of funding the state
   42  share of increases in the rates for certified home health agencies, long
   43  term home  health  care  programs,  AIDS  home  care  programs,  hospice
   44  programs and managed long term care plans and approved managed long term
   45  care  operating  demonstrations as defined in section forty-four hundred
   46  three-f of this chapter for recruitment and  retention  of  health  care
   47  workers  pursuant  to  subdivisions  nine  and ten of section thirty-six
   48  hundred fourteen of this chapter from the tobacco control and  insurance
   49  initiatives  pool established for the following periods in the following
   50  amounts:
   51    (i) twenty-five million dollars for the period June first,  two  thou-
   52  sand six through December thirty-first, two thousand six;
   53    (ii)  fifty million dollars for the period January first, two thousand
   54  seven through December thirty-first, two thousand seven;
   55    (iii) fifty million dollars for the period January first, two thousand
   56  eight through December thirty-first, two thousand eight;
       S. 6914                            91                            A. 9205

    1    (iv) fifty million dollars for the period January first, two  thousand
    2  nine through December thirty-first, two thousand nine;
    3    (v)  fifty  million dollars for the period January first, two thousand
    4  ten through December thirty-first, two thousand ten;
    5    (vi) twelve million five hundred thousand dollars for the period Janu-
    6  ary first, two thousand eleven through March thirty-first, two  thousand
    7  eleven; [and]
    8    (vii) up to fifty million dollars each state fiscal year for the peri-
    9  od  April  first,  two  thousand  eleven through March thirty-first, two
   10  thousand fourteen[.]; AND
   11    (VIII) UP TO FIFTY MILLION DOLLARS EACH  STATE  FISCAL  YEAR  FOR  THE
   12  PERIOD  APRIL  FIRST,  TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST,
   13  TWO THOUSAND SEVENTEEN.
   14    (ddd) Funds shall be deposited by  the  commissioner,  within  amounts
   15  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   16  directed to receive for the deposit to the credit of the  state  special
   17  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   18  or any successor fund or account, for  purposes  of  funding  the  state
   19  share  of  increases  in  the medical assistance rates for providers for
   20  purposes of enhancing the provision, quality and/or efficiency  of  home
   21  care  services  pursuant  to  subdivision  eleven  of section thirty-six
   22  hundred fourteen of this chapter from the tobacco control and  insurance
   23  initiatives  pool  established for the following period in the amount of
   24  eight million dollars for the  period  April  first,  two  thousand  six
   25  through December thirty-first, two thousand six.
   26    (eee)  Funds  shall  be reserved and accumulated from year to year and
   27  shall be available, including income from invested funds, to the  Center
   28  for  Functional  Genomics at the State University of New York at Albany,
   29  for the purposes of the Adirondack  network  for  cancer  education  and
   30  research  in rural communities grant program to improve access to health
   31  care and shall be made available from the tobacco control and  insurance
   32  initiatives  pool  established for the following period in the amount of
   33  up to five million dollars for the period January  first,  two  thousand
   34  six through December thirty-first, two thousand six.
   35    (fff) Funds shall be made available to the empire state stem cell fund
   36  established  by  section  ninety-nine-p  of the state finance law within
   37  amounts appropriated up to fifty million dollars annually and shall  not
   38  exceed five hundred million dollars in total.
   39    (ggg)  Funds  shall  be  deposited by the commissioner, within amounts
   40  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   41  directed  to  receive  for  deposit  to  the credit of the state special
   42  revenue fund - other, HCRA transfer fund, medical assistance account, or
   43  any successor fund or account, for the purpose of supporting  the  state
   44  share  of  Medicaid  expenditures  for  hospital translation services as
   45  authorized pursuant to paragraph (k) of subdivision one of section twen-
   46  ty-eight hundred seven-c of this article from the  tobacco  control  and
   47  initiatives  pool established for the following periods in the following
   48  amounts:
   49    (i) sixteen million dollars for the period July  first,  two  thousand
   50  eight through December thirty-first, two thousand eight; and
   51    (ii)  fourteen  million  seven hundred thousand dollars for the period
   52  January first, two thousand nine through November thirtieth,  two  thou-
   53  sand nine.
   54    (hhh)  Funds  shall  be  deposited by the commissioner, within amounts
   55  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   56  directed  to  receive  for  deposit  to  the credit of the state special
       S. 6914                            92                            A. 9205

    1  revenue fund - other, HCRA transfer fund, medical assistance account, or
    2  any successor fund or account, for the purpose of supporting  the  state
    3  share  of  Medicaid  expenditures  for adjustments to inpatient rates of
    4  payment  for  general  hospitals  located  in the counties of Nassau and
    5  Suffolk as authorized pursuant to paragraph (l) of  subdivision  one  of
    6  section  twenty-eight  hundred  seven-c of this article from the tobacco
    7  control and initiatives pool established for the  following  periods  in
    8  the following amounts:
    9    (i)  two  million  five  hundred thousand dollars for the period April
   10  first, two thousand eight through December  thirty-first,  two  thousand
   11  eight; and
   12    (ii) two million two hundred ninety-two thousand dollars for the peri-
   13  od  January  first,  two  thousand  nine through November thirtieth, two
   14  thousand nine.
   15    (iii) Funds shall be reserved and set aside and accumulated from  year
   16  to  year  and  shall be made available, including income from investment
   17  funds, for the purpose of supporting the New York state  medical  indem-
   18  nity  fund as authorized pursuant to title four of article twenty-nine-D
   19  of this chapter, for the following periods and in the following amounts,
   20  provided, however, that the commissioner is authorized  to  seek  waiver
   21  authority  from  the  federal  centers for medicare and Medicaid for the
   22  purpose of securing Medicaid federal financial  participation  for  such
   23  program, in which case the funding authorized pursuant to this paragraph
   24  shall be utilized as the non-federal share for such payments:
   25    Thirty million dollars for the period April first, two thousand eleven
   26  through March thirty-first, two thousand twelve.
   27    2.  (a)  For  periods  prior  to January first, two thousand five, the
   28  commissioner is authorized to  contract  with  the  article  forty-three
   29  insurance law plans, or such other contractors as the commissioner shall
   30  designate,  to receive and distribute funds from the tobacco control and
   31  insurance initiatives pool established pursuant to this section. In  the
   32  event  contracts  with  the  article  forty-three insurance law plans or
   33  other commissioner's designees are effectuated, the  commissioner  shall
   34  conduct annual audits of the receipt and distribution of such funds. The
   35  reasonable  costs  and  expenses  of an administrator as approved by the
   36  commissioner, not to exceed for personnel services on  an  annual  basis
   37  five  hundred thousand dollars, for collection and distribution of funds
   38  pursuant to this section shall be paid from such funds.
   39    (b) Notwithstanding any inconsistent provision of section one  hundred
   40  twelve  or one hundred sixty-three of the state finance law or any other
   41  law, at the discretion of the commissioner without a competitive bid  or
   42  request  for proposal process, contracts in effect for administration of
   43  pools established pursuant to  sections  twenty-eight  hundred  seven-k,
   44  twenty-eight  hundred  seven-l  and twenty-eight hundred seven-m of this
   45  article for the  period  January  first,  nineteen  hundred  ninety-nine
   46  through  December  thirty-first,  nineteen  hundred  ninety-nine  may be
   47  extended to provide for administration pursuant to this section and  may
   48  be amended as may be necessary.
   49    S  9.  Subdivisions  5-a  and 7 of section 2807-m of the public health
   50  law, as added by section 75-c of part C of chapter 58  of  the  laws  of
   51  2008, the paragraph heading of paragraph (b) and the second undesignated
   52  paragraph of paragraph (b) of subdivision 5-a as amended by section 4 of
   53  part  B  of  chapter  109  of the laws of 2010, the opening paragraph of
   54  paragraph (b), subparagraphs (C), (D) and  (G)  of  paragraph  (b),  and
   55  paragraphs  (c), (f) and (g) of subdivision 5-a as amended by section 26
   56  of part C of chapter 59 of the laws of 2011, subparagraph (H)  of  para-
       S. 6914                            93                            A. 9205

    1  graph (b) of subdivision 5-a as added by section 60 of part D of chapter
    2  56  of  the  laws  of 2012, paragraphs (d) and (e) of subdivision 5-a as
    3  amended by section 53 of part D of chapter 56 of the laws  of  2012  and
    4  paragraph  (e-1)  of subdivision 5-a as added by section 54 of part D of
    5  chapter 56 of the laws of 2012, and subdivision 7 as amended by  section
    6  26-a of part C of chapter 59 of the laws of 2011, are amended to read as
    7  follows:
    8    5-a.  Graduate  medical  education  innovations pool. (a) Supplemental
    9  distributions. (i) Thirty-one million dollars  for  the  period  January
   10  first,  two  thousand  eight through December thirty-first, two thousand
   11  eight, shall be set aside and reserved  by  the  commissioner  from  the
   12  regional  pools  established pursuant to subdivision two of this section
   13  and shall be available for distributions pursuant to subdivision five of
   14  this section and in accordance with section 86-1.89 of title 10  of  the
   15  codes,  rules  and  regulations of the state of New York as in effect on
   16  January first, two thousand eight; provided, however,  for  purposes  of
   17  funding  the  empire  clinical research investigation program (ECRIP) in
   18  accordance with paragraph eight of subdivision (e) and paragraph two  of
   19  subdivision  (f)  of section 86-1.89 of title 10 of the codes, rules and
   20  regulations of the state of New York, distributions shall be made  using
   21  two  regions  defined as New York city and the rest of the state and the
   22  dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
   23  sion (f) of section 86-1.89 of title 10 of the codes,  rules  and  regu-
   24  lations  of the state of New York shall be increased from sixty thousand
   25  dollars to seventy-five thousand dollars.
   26    (ii) For periods on  and  after  January  first,  two  thousand  nine,
   27  supplemental  distributions pursuant to subdivision five of this section
   28  and in accordance with section 86-1.89 of title 10 of the  codes,  rules
   29  and regulations of the state of New York shall no longer be made and the
   30  provisions  of section 86-1.89 of title 10 of the codes, rules and regu-
   31  lations of the state of New York shall be null and void.
   32    (b) Empire clinical  research  investigator  program  (ECRIP).    Nine
   33  million  one  hundred  twenty  thousand  dollars annually for the period
   34  January first, two thousand  nine  through  December  thirty-first,  two
   35  thousand  ten,  and  two million two hundred eighty thousand dollars for
   36  the period January first, two thousand eleven, [and] THROUGH MARCH THIR-
   37  TY-FIRST, TWO THOUSAND ELEVEN, nine million one hundred twenty  thousand
   38  dollars  each state fiscal year for the period April first, two thousand
   39  eleven through March thirty-first, two thousand fourteen, [through March
   40  thirty-first, two thousand eleven,] AND UP TO EIGHT MILLION SIX  HUNDRED
   41  TWELVE  THOUSAND  DOLLARS  EACH  STATE  FISCAL YEAR FOR THE PERIOD APRIL
   42  FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND
   43  SEVENTEEN,  shall be set aside and reserved by the commissioner from the
   44  regional pools established pursuant to subdivision two of  this  section
   45  to  be  allocated  regionally  with  two-thirds of the available funding
   46  going to New York city and one-third of the available funding  going  to
   47  the  rest  of  the  state  and  shall  be  available for distribution as
   48  follows:
   49    Distributions shall first be made to consortia  and  teaching  general
   50  hospitals  for the empire clinical research investigator program (ECRIP)
   51  to help secure federal funding for biomedical research,  train  clinical
   52  researchers,  recruit national leaders as faculty to act as mentors, and
   53  train residents and fellows  in  biomedical  research  skills  based  on
   54  hospital-specific  data  submitted  to the commissioner by consortia and
   55  teaching general hospitals in accordance with clause (G) of this subpar-
       S. 6914                            94                            A. 9205

    1  agraph. Such distributions shall be made in accordance with the  follow-
    2  ing methodology:
    3    (A)  The  greatest  number  of clinical research positions for which a
    4  consortium or teaching general hospital may be funded pursuant  to  this
    5  subparagraph  shall  be  one  percent  of  the total number of residents
    6  training at the consortium or teaching general hospital on  July  first,
    7  two  thousand  eight  for  the  period  January first, two thousand nine
    8  through December thirty-first, two thousand nine rounded up to the near-
    9  est one position.
   10    (B) Distributions made to a consortium or  teaching  general  hospital
   11  shall  equal  the product of the total number of clinical research posi-
   12  tions submitted  by  a  consortium  or  teaching  general  hospital  and
   13  accepted  by the commissioner as meeting the criteria set forth in para-
   14  graph (b) of subdivision one of this section, subject to  the  reduction
   15  calculation  set  forth  in  clause  (C) of this subparagraph, times one
   16  hundred ten thousand dollars.
   17    (C) If the dollar amount for the total  number  of  clinical  research
   18  positions  in  the  region  calculated  pursuant  to  clause (B) of this
   19  subparagraph exceeds the total amount appropriated for purposes of  this
   20  paragraph,  including clinical research positions that continue from and
   21  were funded in prior distribution periods, the commissioner shall elimi-
   22  nate one-half of the  clinical  research  positions  submitted  by  each
   23  consortium  or teaching general hospital rounded down to the nearest one
   24  position. Such reduction shall be repeated until the dollar  amount  for
   25  the  total  number of clinical research positions in the region does not
   26  exceed the total amount appropriated for purposes of this paragraph.  If
   27  the  repeated  reduction  of the total number of clinical research posi-
   28  tions in the region by one-half does not render a total  funding  amount
   29  that  is equal to or less than the total amount reserved for that region
   30  within the appropriation, the funding for each clinical  research  posi-
   31  tion  in  that  region  shall  be reduced proportionally in one thousand
   32  dollar increments until the total dollar amount for the total number  of
   33  clinical  research  positions  in  that region does not exceed the total
   34  amount reserved for that region within the appropriation. Any  reduction
   35  in  funding will be effective for the duration of the award. No clinical
   36  research positions that continue from and were funded in prior  distrib-
   37  ution periods shall be eliminated or reduced by such methodology.
   38    (D)  Each  consortium  or  teaching general hospital shall receive its
   39  annual distribution amount in accordance with the following:
   40    (I) Each consortium or teaching general hospital with a one-year ECRIP
   41  award  shall  receive  its  annual  distribution  amount  in  full  upon
   42  completion of the requirements set forth in items (I) and (II) of clause
   43  (G)  of  this subparagraph. The requirements set forth in items (IV) and
   44  (V) of clause (G) of this subparagraph must be completed by the  consor-
   45  tium  or teaching general hospital in order for the consortium or teach-
   46  ing general hospital to be eligible to apply for ECRIP  funding  in  any
   47  subsequent funding cycle.
   48    (II)  Each  consortium  or  teaching  general hospital with a two-year
   49  ECRIP award shall receive its first annual distribution amount  in  full
   50  upon  completion  of the requirements set forth in items (I) and (II) of
   51  clause (G) of this subparagraph. Each  consortium  or  teaching  general
   52  hospital will receive its second annual distribution amount in full upon
   53  completion  of the requirements set forth in item (III) of clause (G) of
   54  this subparagraph. The requirements set forth in items (IV) and  (V)  of
   55  clause  (G)  of this subparagraph must be completed by the consortium or
   56  teaching general hospital in order for the consortium or teaching gener-
       S. 6914                            95                            A. 9205

    1  al hospital to be eligible to apply for ECRIP funding in any  subsequent
    2  funding cycle.
    3    (E)  Each  consortium  or teaching general hospital receiving distrib-
    4  utions pursuant to this subparagraph shall reserve seventy-five thousand
    5  dollars to primarily fund salary and fringe  benefits  of  the  clinical
    6  research  position  with  the remainder going to fund the development of
    7  faculty who are involved in biomedical research, training  and  clinical
    8  care.
    9    (F)  Undistributed  or  returned  funds  available  to  fund  clinical
   10  research positions pursuant to this paragraph for a distribution  period
   11  shall  be  available to fund clinical research positions in a subsequent
   12  distribution period.
   13    (G) In order to be eligible for distributions pursuant to this subpar-
   14  agraph, each consortium and teaching general hospital shall  provide  to
   15  the  commissioner by July first of each distribution period, the follow-
   16  ing data and information on a hospital-specific  basis.  Such  data  and
   17  information  shall  be  certified as to accuracy and completeness by the
   18  chief executive officer, chief financial officer or chair of the consor-
   19  tium governing body of each consortium or teaching general hospital  and
   20  shall be maintained by each consortium and teaching general hospital for
   21  five years from the date of submission:
   22    (I)  For  each  clinical  research  position, information on the type,
   23  scope, training objectives,  institutional  support,  clinical  research
   24  experience of the sponsor-mentor, plans for submitting research outcomes
   25  to  peer reviewed journals and at scientific meetings, including a meet-
   26  ing sponsored by the department, the name of a principal contact  person
   27  responsible for tracking the career development of researchers placed in
   28  clinical  research positions, as defined in paragraph (c) of subdivision
   29  one of this section, and who is authorized to certify to the commission-
   30  er that all the requirements of the clinical  research  training  objec-
   31  tives  set  forth  in this subparagraph shall be met. Such certification
   32  shall be provided by July first of each distribution period;
   33    (II) For each clinical research position,  information  on  the  name,
   34  citizenship  status, medical education and training, and medical license
   35  number of the researcher, if applicable, shall be provided  by  December
   36  thirty-first of the calendar year following the distribution period;
   37    (III)  Information on the status of the clinical research plan, accom-
   38  plishments, changes in research activities, progress, and performance of
   39  the researcher shall be provided upon  completion  of  one-half  of  the
   40  award term;
   41    (IV)  A  final report detailing training experiences, accomplishments,
   42  activities and performance of the clinical researcher, and  data,  meth-
   43  ods,  results  and  analyses  of  the  clinical  research  plan shall be
   44  provided three months after the clinical research position ends; and
   45    (V) Tracking information concerning past  researchers,  including  but
   46  not  limited  to (A) background information, (B) employment history, (C)
   47  research status, (D) current research activities, (E)  publications  and
   48  presentations,  (F)  research  support,  and  (G)  any other information
   49  necessary to track the researcher; and
   50    (VI) Any other data or information required  by  the  commissioner  to
   51  implement this subparagraph.
   52    (H)  Notwithstanding  any  inconsistent provision of this subdivision,
   53  for periods on and after April first, two thousand thirteen, ECRIP grant
   54  awards shall be made in accordance with rules and regulations promulgat-
   55  ed by the commissioner. Such regulations shall, at a minimum:
       S. 6914                            96                            A. 9205

    1    (1) provide that ECRIP grant awards shall be made with  the  objective
    2  of  securing  federal funding for biomedical research, training clinical
    3  researchers, recruiting national leaders as faculty to act  as  mentors,
    4  and training residents and fellows in biomedical research skills;
    5    (2)  provide that ECRIP grant applicants may include interdisciplinary
    6  research teams comprised of teaching general hospitals acting in collab-
    7  oration with entities including but  not  limited  to  medical  centers,
    8  hospitals, universities and local health departments;
    9    (3) provide that applications for ECRIP grant awards shall be based on
   10  such  information requested by the commissioner, which shall include but
   11  not be limited to hospital-specific data;
   12    (4) establish the qualifications for  investigators  and  other  staff
   13  required for grant projects eligible for ECRIP grant awards; and
   14    (5)  establish a methodology for the distribution of funds under ECRIP
   15  grant awards.
   16    (c) Ambulatory care  training.  Four  million  nine  hundred  thousand
   17  dollars  for the period January first, two thousand eight through Decem-
   18  ber thirty-first, two thousand eight, four million nine hundred thousand
   19  dollars for the period January first, two thousand nine through December
   20  thirty-first, two thousand nine,  four  million  nine  hundred  thousand
   21  dollars  for the period January first, two thousand ten through December
   22  thirty-first, two thousand ten,  one  million  two  hundred  twenty-five
   23  thousand  dollars  for  the  period  January  first, two thousand eleven
   24  through March thirty-first, two  thousand  eleven,  [and]  four  million
   25  three  hundred  thousand  dollars  each state fiscal year for the period
   26  April first, two thousand eleven through March thirty-first,  two  thou-
   27  sand  fourteen, AND UP TO FOUR MILLION SIXTY THOUSAND DOLLARS EACH STATE
   28  FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  FOURTEEN  THROUGH
   29  MARCH  THIRTY-FIRST,  TWO  THOUSAND  SEVENTEEN,  shall  be set aside and
   30  reserved by the commissioner from the regional pools established  pursu-
   31  ant  to  subdivision  two  of  this  section  and shall be available for
   32  distributions to sponsoring institutions to be directed to support clin-
   33  ical training of medical students and residents in free-standing ambula-
   34  tory care settings, including community health centers and private prac-
   35  tices. Such funding shall be allocated regionally with two-thirds of the
   36  available funding going to New York city and one-third of the  available
   37  funding going to the rest of the state and shall be distributed to spon-
   38  soring institutions in each region pursuant to a request for application
   39  or  request for proposal process with preference being given to sponsor-
   40  ing institutions which provide training in sites located in  underserved
   41  rural  or  inner-city  areas  and those that include medical students in
   42  such training.
   43    (d) Physician loan repayment program. One million nine  hundred  sixty
   44  thousand  dollars  for  the  period  January  first,  two thousand eight
   45  through December thirty-first, two  thousand  eight,  one  million  nine
   46  hundred  sixty  thousand dollars for the period January first, two thou-
   47  sand nine through December thirty-first, two thousand nine, one  million
   48  nine  hundred  sixty  thousand dollars for the period January first, two
   49  thousand ten through  December  thirty-first,  two  thousand  ten,  four
   50  hundred  ninety thousand dollars for the period January first, two thou-
   51  sand eleven through March thirty-first, two thousand eleven,  [and]  one
   52  million  seven  hundred  thousand dollars each state fiscal year for the
   53  period April first, two thousand eleven through March thirty-first,  two
   54  thousand  fourteen,  AND  UP  TO ONE MILLION SEVEN HUNDRED FIVE THOUSAND
   55  DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
   56  FOURTEEN  THROUGH  MARCH  THIRTY-FIRST, TWO THOUSAND SEVENTEEN, shall be
       S. 6914                            97                            A. 9205

    1  set aside and reserved by  the  commissioner  from  the  regional  pools
    2  established  pursuant  to  subdivision  two of this section and shall be
    3  available for purposes of physician loan repayment  in  accordance  with
    4  subdivision  ten of this section. Notwithstanding any contrary provision
    5  of this section, sections one hundred twelve and one hundred sixty-three
    6  of the state finance law, or any other contrary provision of  law,  such
    7  funding  shall be allocated regionally with one-third of available funds
    8  going to New York city and two-thirds of available funds  going  to  the
    9  rest  of the state and shall be distributed in a manner to be determined
   10  by the commissioner without a competitive bid or  request  for  proposal
   11  process as follows:
   12    (i) Funding shall first be awarded to repay loans of up to twenty-five
   13  physicians  who  train  in  primary care or specialty tracks in teaching
   14  general hospitals, and who enter and remain in primary care or specialty
   15  practices in underserved communities, as determined by the commissioner.
   16    (ii) After distributions in accordance with subparagraph (i)  of  this
   17  paragraph, all remaining funds shall be awarded to repay loans of physi-
   18  cians  who  enter  and  remain in primary care or specialty practices in
   19  underserved communities, as determined by  the  commissioner,  including
   20  but  not  limited  to  physicians working in general hospitals, or other
   21  health care facilities.
   22    (iii) In no case shall less than fifty percent of the funds  available
   23  pursuant  to  this  paragraph be distributed in accordance with subpara-
   24  graphs (i) and (ii) of this paragraph to physicians identified by gener-
   25  al hospitals.
   26    (e) Physician practice support. Four  million  nine  hundred  thousand
   27  dollars  for the period January first, two thousand eight through Decem-
   28  ber thirty-first, two thousand eight, four million nine hundred thousand
   29  dollars annually for the period January first, two thousand nine through
   30  December thirty-first, two thousand ten, one million two  hundred  twen-
   31  ty-five  thousand  dollars  for  the  period January first, two thousand
   32  eleven through March  thirty-first,  two  thousand  eleven,  [and]  four
   33  million  three  hundred  thousand dollars each state fiscal year for the
   34  period April first, two thousand eleven through March thirty-first,  two
   35  thousand  fourteen,  AND UP TO FOUR MILLION THREE HUNDRED SIXTY THOUSAND
   36  DOLLARS EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO  THOUSAND
   37  FOURTEEN  THROUGH  MARCH  THIRTY-FIRST, TWO THOUSAND SEVENTEEN, shall be
   38  set aside and reserved by  the  commissioner  from  the  regional  pools
   39  established  pursuant  to  subdivision  two of this section and shall be
   40  available for purposes of physician  practice  support.  Notwithstanding
   41  any  contrary provision of this section, sections one hundred twelve and
   42  one hundred sixty-three of the state finance law, or any other  contrary
   43  provision  of  law, such funding shall be allocated regionally with one-
   44  third of available funds going to New York city and two-thirds of avail-
   45  able funds going to the rest of the state and shall be distributed in  a
   46  manner to be determined by the commissioner without a competitive bid or
   47  request for proposal process as follows:
   48    (i)  Preference in funding shall first be accorded to teaching general
   49  hospitals for up to twenty-five awards, to  support  costs  incurred  by
   50  physicians  trained in primary or specialty tracks who thereafter estab-
   51  lish or join practices in underserved communities, as determined by  the
   52  commissioner.
   53    (ii)  After  distributions in accordance with subparagraph (i) of this
   54  paragraph, all remaining funds shall be awarded to physicians to support
   55  the cost of establishing or joining practices  in  underserved  communi-
   56  ties,  as  determined  by  the  commissioner, and to hospitals and other
       S. 6914                            98                            A. 9205

    1  health care providers to recruit new physicians to provide  services  in
    2  underserved communities, as determined by the commissioner.
    3    (iii)  In no case shall less than fifty percent of the funds available
    4  pursuant to this  paragraph  be  distributed  to  general  hospitals  in
    5  accordance with subparagraphs (i) and (ii) of this paragraph.
    6    (e-1) Work group. For funding available pursuant to paragraphs (d) and
    7  (e) of this subdivision:
    8    (i)  The  department  shall  appoint a work group from recommendations
    9  made by associations  representing  physicians,  general  hospitals  and
   10  other  health care facilities to develop a streamlined application proc-
   11  ess by June first, two thousand twelve.
   12    (ii) Subject to available funding, applications shall be accepted on a
   13  continuous basis. The department shall provide technical  assistance  to
   14  applicants  to facilitate their completion of applications. An applicant
   15  shall be notified in writing  by  the  department  within  ten  days  of
   16  receipt  of an application as to whether the application is complete and
   17  if the application is incomplete, what information is  outstanding.  The
   18  department  shall act on an application within thirty days of receipt of
   19  a complete application.
   20    (f) Study on physician workforce. Five hundred ninety thousand dollars
   21  annually for the period January first, two thousand eight through Decem-
   22  ber thirty-first, two thousand ten,  one  hundred  forty-eight  thousand
   23  dollars  for the period January first, two thousand eleven through March
   24  thirty-first, two thousand eleven, [and] five hundred  sixteen  thousand
   25  dollars  each state fiscal year for the period April first, two thousand
   26  eleven through March thirty-first, two thousand fourteen, AND UP TO FOUR
   27  HUNDRED EIGHTY-SEVEN THOUSAND DOLLARS EACH STATE  FISCAL  YEAR  FOR  THE
   28  PERIOD  APRIL  FIRST,  TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST,
   29  TWO THOUSAND SEVENTEEN, shall be set aside and reserved by  the  commis-
   30  sioner  from  the regional pools established pursuant to subdivision two
   31  of this section and shall be available to  fund  a  study  of  physician
   32  workforce needs and solutions including, but not limited to, an analysis
   33  of  residency  programs  and projected physician workforce and community
   34  needs. The commissioner shall enter into agreements  with  one  or  more
   35  organizations  to  conduct  such  study  based on a request for proposal
   36  process.
   37    (g) Diversity in medicine/post-baccalaureate program.  Notwithstanding
   38  any  inconsistent provision of section one hundred twelve or one hundred
   39  sixty-three of the state finance law or any other law, one million  nine
   40  hundred  sixty  thousand  dollars annually for the period January first,
   41  two thousand eight through December thirty-first, two thousand ten, four
   42  hundred ninety thousand dollars for the period January first, two  thou-
   43  sand  eleven  through March thirty-first, two thousand eleven, [and] one
   44  million seven hundred thousand dollars each state fiscal  year  for  the
   45  period  April first, two thousand eleven through March thirty-first, two
   46  thousand fourteen, AND UP TO  ONE  MILLION  SIX  HUNDRED  FIVE  THOUSAND
   47  DOLLARS  EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND
   48  FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND  SEVENTEEN,  shall  be
   49  set  aside  and  reserved  by  the  commissioner from the regional pools
   50  established pursuant to subdivision two of this  section  and  shall  be
   51  available  for  distributions  to  the Associated Medical Schools of New
   52  York to fund its diversity program including existing and new  post-bac-
   53  calaureate programs for minority and economically disadvantaged students
   54  and  encourage  participation  from all medical schools in New York. The
   55  associated medical schools of New York shall report to the  commissioner
       S. 6914                            99                            A. 9205

    1  on  an  annual basis regarding the use of funds for such purpose in such
    2  form and manner as specified by the commissioner.
    3    (h)  In  the  event  there are undistributed funds within amounts made
    4  available for distributions pursuant to this subdivision, such funds may
    5  be reallocated and distributed in  current  or  subsequent  distribution
    6  periods  in  a manner determined by the commissioner for any purpose set
    7  forth in this subdivision.
    8    7. Notwithstanding any inconsistent provision of section  one  hundred
    9  twelve  or one hundred sixty-three of the state finance law or any other
   10  law, up to one million dollars for the period January first,  two  thou-
   11  sand  through  December  thirty-first,  two  thousand,  one  million six
   12  hundred thousand dollars annually for the  periods  January  first,  two
   13  thousand  one  through  December  thirty-first,  two thousand eight, one
   14  million five hundred thousand dollars annually for the  periods  January
   15  first,  two  thousand  nine  through December thirty-first, two thousand
   16  ten, three hundred seventy-five thousand dollars for the period  January
   17  first,  two  thousand  eleven  through  March thirty-first, two thousand
   18  eleven, [and] one million three hundred  twenty  thousand  dollars  each
   19  state  fiscal  year  for  the  period  April  first, two thousand eleven
   20  through March thirty-first, two thousand fourteen, AND UP TO TWO MILLION
   21  SEVENTY-SEVEN THOUSAND DOLLARS EACH STATE FISCAL  YEAR  FOR  THE  PERIOD
   22  APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
   23  SAND SEVENTEEN, shall be set aside and reserved by the commissioner from
   24  the  regional  pools  established  pursuant  to  subdivision two of this
   25  section and shall be available for distributions to the New  York  state
   26  area health education center program for the purpose of expanding commu-
   27  nity-based  training  of  medical  students.  In  addition,  one million
   28  dollars annually for  the  period  January  first,  two  thousand  eight
   29  through December thirty-first, two thousand ten, two hundred fifty thou-
   30  sand  dollars  for the period January first, two thousand eleven through
   31  March thirty-first, two thousand eleven, and eight hundred eighty  thou-
   32  sand  dollars  each  state  fiscal  year for the period April first, two
   33  thousand eleven through March thirty-first, two thousand fourteen, shall
   34  be set aside and reserved by the commissioner from  the  regional  pools
   35  established  pursuant  to  subdivision  two of this section and shall be
   36  available for distributions to the New York state area health  education
   37  center program for the purpose of post-secondary training of health care
   38  professionals  who will achieve specific program outcomes within the New
   39  York state area health education center program. The New York state area
   40  health education center program shall report to the commissioner  on  an
   41  annual  basis  regarding  the use of funds for each purpose in such form
   42  and manner as specified by the commissioner.
   43    S 10. Paragraph (a) of subdivision 12 of section 367-b of  the  social
   44  services  law,  as  amended by section 10 of part C of chapter 59 of the
   45  laws of 2011, is amended to read as follows:
   46    (a) For the purpose of regulating cash flow for general hospitals, the
   47  department shall develop and implement a payment methodology to  provide
   48  for  timely  payments  for inpatient hospital services eligible for case
   49  based payments per discharge based on diagnosis-related groups  provided
   50  during  the  period January first, nineteen hundred eighty-eight through
   51  March thirty-first two thousand [fourteen] SEVENTEEN, by such  hospitals
   52  which elect to participate in the system.
   53    S 11. Section 2 of chapter 600 of the laws of 1986 amending the public
   54  health  law  relating to the development of pilot reimbursement programs
   55  for ambulatory care services, as amended by section  11  of  part  C  of
   56  chapter 59 of the laws of 2011, is amended to read as follows:
       S. 6914                            100                           A. 9205

    1    S  2.  This  act  shall  take effect immediately, except that this act
    2  shall expire and be of no further force and effect on and after April 1,
    3  [2014] 2017; provided, however, that the commissioner  of  health  shall
    4  submit a report to the governor and the legislature detailing the objec-
    5  tive,  impact, design and computation of any pilot reimbursement program
    6  established pursuant to this act, on or before March 31, 1994 and  annu-
    7  ally  thereafter.  Such report shall include an assessment of the finan-
    8  cial impact of such payment system on providers, as well as  the  impact
    9  of such system on access to care.
   10    S  12. Paragraph (i) of subdivision (b) of section 1 of chapter 520 of
   11  the laws of 1978, relating to providing for a  comprehensive  survey  of
   12  health  care  financing,  education  and illness prevention and creating
   13  councils for the conduct thereof, as amended by section 12 of part C  of
   14  chapter 59 of the laws of 2011, is amended to read as follows:
   15    (i)  oversight  and  evaluation  of  the inpatient financing system in
   16  place for 1988 through March 31, [2014] 2017,  and  the  appropriateness
   17  and effectiveness of the bad debt and charity care financing provisions;
   18    S  13.    Paragraph (i) of subdivision 9 of section 3614 of the public
   19  health law, as added by section 23 of part C of chapter 59 of  the  laws
   20  of  2011, is amended and three new paragraphs (j), (k) and (l) are added
   21  to read as follows:
   22    (i) for the period April first, two thousand  thirteen  through  March
   23  thirty-first,   two   thousand  fourteen,  up  to  one  hundred  million
   24  dollars[.];
   25    (J) FOR THE PERIOD APRIL FIRST, TWO THOUSAND  FOURTEEN  THROUGH  MARCH
   26  THIRTY-FIRST, TWO THOUSAND FIFTEEN, UP TO ONE HUNDRED MILLION DOLLARS;
   27    (K)  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH
   28  THIRTY-FIRST, TWO THOUSAND SIXTEEN, UP TO ONE HUNDRED MILLION DOLLARS;
   29    (L) FOR THE PERIOD APRIL FIRST, TWO  THOUSAND  SIXTEEN  THROUGH  MARCH
   30  THIRTY-FIRST, TWO THOUSAND SEVENTEEN, UP TO ONE HUNDRED MILLION DOLLARS.
   31    S  14. Paragraphs (1) and (m) of subdivision 1 of section 367-q of the
   32  social services law, as amended by section 35 of part D of chapter 56 of
   33  the laws of 2012, are amended and three new paragraphs (n), (o) and  (p)
   34  are added to read as follows:
   35    (l)  for  the  period  April  first, two thousand twelve through March
   36  thirty-first, two thousand thirteen, up  to  twenty-eight  million  five
   37  hundred thousand dollars; [and]
   38    (m)  for  the  period April first, two thousand thirteen through March
   39  thirty-first, two thousand fourteen, up  to  twenty-eight  million  five
   40  hundred thousand dollars[.];
   41    (N)  FOR  THE  PERIOD APRIL FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH
   42  THIRTY-FIRST, TWO THOUSAND FIFTEEN,  UP  TO  TWENTY-EIGHT  MILLION  FIVE
   43  HUNDRED THOUSAND DOLLARS;
   44    (O)  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH
   45  THIRTY-FIRST, TWO THOUSAND SIXTEEN,  UP  TO  TWENTY-EIGHT  MILLION  FIVE
   46  HUNDRED THOUSAND DOLLARS; AND
   47    (P)  FOR  THE  PERIOD  APRIL FIRST, TWO THOUSAND SIXTEEN THROUGH MARCH
   48  THIRTY-FIRST, TWO THOUSAND SEVENTEEN, UP TO  TWENTY-EIGHT  MILLION  FIVE
   49  HUNDRED THOUSAND DOLLARS.
   50    S  15.  Subdivision  6  of section 2807-t of the public health law, as
   51  added by chapter 639 of the laws of 1996, is amended to read as follows:
   52    6. Prospective adjustments. (A) The commissioner shall annually recon-
   53  cile the sum of the actual payments made  to  the  commissioner  or  the
   54  commissioner's designee for each region pursuant to section twenty-eight
   55  hundred  seven-s  of  this  article and pursuant to this section for the
   56  prior year with the regional allocation of the  gross  annual  statewide
       S. 6914                            101                           A. 9205

    1  amount  specified  in  subdivision  six  of section twenty-eight hundred
    2  seven-s of this article for such prior year. The difference between  the
    3  actual  amount  raised  for  a region and the regional allocation of the
    4  specified  gross annual amount for such prior year shall be applied as a
    5  prospective adjustment to the regional allocation of the specified gross
    6  annual payment amount for such region for the year  next  following  the
    7  calculation  of  the  reconciliation. The authorized dollar value of the
    8  adjustments shall be the same as if calculated retrospectively.
    9    (B) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (A) OF  THIS  SUBDIVI-
   10  SION,  FOR  COVERED  LIVES  ASSESSMENT RATE PERIODS ON AND AFTER JANUARY
   11  FIRST, TWO THOUSAND FIFTEEN THROUGH DECEMBER THIRTY-FIRST, TWO  THOUSAND
   12  SEVENTEEN,  FOR  AMOUNTS  COLLECTED  IN  THE  AGGREGATE IN EXCESS OF ONE
   13  BILLION FORTY-FIVE MILLION  DOLLARS  ON  AN  ANNUAL  BASIS,  PROSPECTIVE
   14  ADJUSTMENTS  SHALL BE SUSPENDED IF THE ANNUAL RECONCILIATION CALCULATION
   15  FROM THE PRIOR YEAR WOULD OTHERWISE RESULT IN A DECREASE TO THE REGIONAL
   16  ALLOCATION OF THE SPECIFIED GROSS ANNUAL PAYMENT AMOUNT FOR THAT REGION,
   17  PROVIDED, HOWEVER, THAT SUCH SUSPENSION SHALL BE LIFTED UPON A  DETERMI-
   18  NATION  BY  THE  COMMISSIONER,  IN CONSULTATION WITH THE DIRECTOR OF THE
   19  BUDGET, THAT SIXTY-FIVE MILLION DOLLARS IN AGGREGATE COLLECTIONS  ON  AN
   20  ANNUAL BASIS OVER AND ABOVE ONE BILLION FORTY-FIVE MILLION DOLLARS ON AN
   21  ANNUAL  BASIS  HAVE  BEEN RESERVED AND SET ASIDE FOR DEPOSIT IN THE HCRA
   22  RESOURCES FUND. ANY AMOUNTS COLLECTED IN THE AGGREGATE AT OR  BELOW  ONE
   23  BILLION  FORTY-FIVE MILLION DOLLARS ON AN ANNUAL BASIS, SHALL BE SUBJECT
   24  TO REGIONAL ADJUSTMENTS RECONCILING ANY DECREASES OR  INCREASES  TO  THE
   25  REGIONAL  ALLOCATION  IN  ACCORDANCE WITH PARAGRAPH (A) OF THIS SUBDIVI-
   26  SION.
   27    S 16. Subdivision 4-c of section 2807-p of the public health  law,  as
   28  amended  by  section  27 of part C of chapter 59 of the laws of 2011, is
   29  amended to read as follows:
   30    4-c. Notwithstanding any provision of law to the contrary, the commis-
   31  sioner shall make additional payments for uncompensated care  to  volun-
   32  tary  non-profit  diagnostic and treatment centers that are eligible for
   33  distributions under subdivision four of this section  in  the  following
   34  amounts:  for  the  period June first, two thousand six through December
   35  thirty-first, two thousand six, in the  amount  of  seven  million  five
   36  hundred  thousand  dollars,  for  the period January first, two thousand
   37  seven through December thirty-first, two thousand seven,  seven  million
   38  five  hundred  thousand dollars, for the period January first, two thou-
   39  sand eight through December  thirty-first,  two  thousand  eight,  seven
   40  million five hundred thousand dollars, for the period January first, two
   41  thousand  nine through December thirty-first, two thousand nine, fifteen
   42  million five hundred thousand dollars, for the period January first, two
   43  thousand ten through December  thirty-first,  two  thousand  ten,  seven
   44  million five hundred thousand dollars, for the period January first, two
   45  thousand eleven though December thirty-first, two thousand eleven, seven
   46  million five hundred thousand dollars, for the period January first, two
   47  thousand  twelve  through  December  thirty-first,  two thousand twelve,
   48  seven million five hundred thousand  dollars,  for  the  period  January
   49  first, two thousand thirteen through December thirty-first, two thousand
   50  thirteen,  seven  million  five hundred thousand dollars, FOR THE PERIOD
   51  JANUARY FIRST, TWO THOUSAND FOURTEEN THROUGH DECEMBER THIRTY-FIRST,  TWO
   52  THOUSAND  FOURTEEN, SEVEN MILLION FIVE HUNDRED THOUSAND DOLLARS, FOR THE
   53  PERIOD  JANUARY   FIRST,   TWO   THOUSAND   FIFTEEN   THROUGH   DECEMBER
   54  THIRTY-FIRST,  TWO THOUSAND FIFTEEN, SEVEN MILLION FIVE HUNDRED THOUSAND
   55  DOLLARS, FOR THE PERIOD  JANUARY  FIRST  TWO  THOUSAND  SIXTEEN  THROUGH
   56  DECEMBER  THIRTY-FIRST, TWO THOUSAND SIXTEEN, SEVEN MILLION FIVE HUNDRED
       S. 6914                            102                           A. 9205

    1  THOUSAND DOLLARS, and for the period January first, two thousand  [four-
    2  teen]  SEVENTEEN  through  March  thirty-first,  two thousand [fourteen]
    3  SEVENTEEN, in the amount of one million [eight hundred seventy-five] SIX
    4  HUNDRED  thousand  dollars,  provided,  however, that for periods on and
    5  after January first, two thousand eight, such additional payments  shall
    6  be distributed to voluntary, non-profit diagnostic and treatment centers
    7  and  to public diagnostic and treatment centers in accordance with para-
    8  graph (g) of subdivision four of this section. In the event that federal
    9  financial participation is available for rate  adjustments  pursuant  to
   10  this  section,  the  commissioner shall make such payments as additional
   11  adjustments to rates of payment for voluntary non-profit diagnostic  and
   12  treatment  centers that are eligible for distributions under subdivision
   13  four-a of this section in the following amounts:  for  the  period  June
   14  first, two thousand six through December thirty-first, two thousand six,
   15  fifteen  million  dollars  in  the aggregate, and for the period January
   16  first, two thousand seven through June thirtieth,  two  thousand  seven,
   17  seven  million  five  hundred  thousand  dollars  in  the aggregate. The
   18  amounts allocated pursuant to this paragraph shall  be  aggregated  with
   19  and  distributed  pursuant  to  the  same  methodology applicable to the
   20  amounts allocated to such diagnostic  and  treatment  centers  for  such
   21  periods  pursuant  to subdivision four of this section if federal finan-
   22  cial participation is not available, or pursuant to  subdivision  four-a
   23  of  this  section  if  federal  financial  participation  is  available.
   24  Notwithstanding  section  three  hundred  sixty-eight-a  of  the  social
   25  services  law,  there  shall  be  no local share in a medical assistance
   26  payment adjustment under this subdivision.
   27    S 17. Subdivision 9 of section 2807-k of the  public  health  law,  as
   28  added by chapter 639 of the laws of 1996, is amended to read as follows:
   29    9.  In order for a general hospital to participate in the distribution
   30  of funds from the pool, the  general  hospital  must  implement  minimum
   31  collection  policies  and  procedures  approved by the commissioner [and
   32  must be in compliance with bad debt and charity care reporting  require-
   33  ments established pursuant to this article].
   34    S  17-a.  Paragraph  (d)  of  subdivision  16 of section 2807-c of the
   35  public health law, as amended by chapter 731 of the  laws  of  1993,  is
   36  amended to read as follows:
   37    (d) In order for a general hospital to participate in the distribution
   38  of  funds from the pools, the general hospital must implement collection
   39  policies and procedures approved by the commissioner  [and  must  be  in
   40  compliance  with bad debt and charity care reporting requirements estab-
   41  lished pursuant to this article].
   42    S 18. Paragraph (a) of subdivision 1 of section 18 of chapter  266  of
   43  the  laws  of  1986, amending the civil practice law and rules and other
   44  laws relating  to  malpractice  and  professional  medical  conduct,  as
   45  amended  by  section  15 of part C of chapter 59 of the laws of 2011, is
   46  amended to read as follows:
   47    (a) The superintendent of insurance and the commissioner of health  or
   48  their  designee  shall,  from  funds  available  in  the hospital excess
   49  liability pool created  pursuant  to  subdivision  5  of  this  section,
   50  purchase  a policy or policies for excess insurance coverage, as author-
   51  ized by paragraph 1 of subsection (e) of section 5502 of  the  insurance
   52  law; or from an insurer, other than an insurer described in section 5502
   53  of the insurance law, duly authorized to write such coverage and actual-
   54  ly  writing  medical  malpractice  insurance  in  this  state;  or shall
   55  purchase equivalent excess coverage in a form previously approved by the
   56  superintendent of insurance for purposes of providing equivalent  excess
       S. 6914                            103                           A. 9205

    1  coverage  in  accordance  with  section 19 of chapter 294 of the laws of
    2  1985, for medical or dental malpractice occurrences between July 1, 1986
    3  and June 30, 1987, between July 1, 1987 and June 30, 1988, between  July
    4  1,  1988  and  June  30,  1989,  between July 1, 1989 and June 30, 1990,
    5  between July 1, 1990 and June 30, 1991, between July 1,  1991  and  June
    6  30,  1992,  between July 1, 1992 and June 30, 1993, between July 1, 1993
    7  and June 30, 1994, between July 1, 1994 and June 30, 1995, between  July
    8  1,  1995  and  June  30,  1996,  between July 1, 1996 and June 30, 1997,
    9  between July 1, 1997 and June 30, 1998, between July 1,  1998  and  June
   10  30,  1999,  between July 1, 1999 and June 30, 2000, between July 1, 2000
   11  and June 30, 2001, between July 1, 2001 and June 30, 2002, between  July
   12  1,  2002  and  June  30,  2003,  between July 1, 2003 and June 30, 2004,
   13  between July 1, 2004 and June 30, 2005, between July 1,  2005  and  June
   14  30,  2006,  between July 1, 2006 and June 30, 2007, between July 1, 2007
   15  and June 30, 2008, between July 1, 2008 and June 30, 2009, between  July
   16  1,  2009  and  June  30,  2010,  between July 1, 2010 and June 30, 2011,
   17  between July 1, 2011 and June 30, 2012, between July 1,  2012  and  June
   18  30, 2013 [and], between July 1, 2013 and June 30, 2014, AND BETWEEN JULY
   19  1,  2014  AND JUNE 30, 2015 or reimburse the hospital where the hospital
   20  purchases equivalent excess coverage as defined in subparagraph  (i)  of
   21  paragraph  (a)  of subdivision 1-a of this section for medical or dental
   22  malpractice occurrences between July 1, 1987 and June 30, 1988,  between
   23  July  1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
   24  between July 1, 1990 and June 30, 1991, between July 1,  1991  and  June
   25  30,  1992,  between July 1, 1992 and June 30, 1993, between July 1, 1993
   26  and June 30, 1994, between July 1, 1994 and June 30, 1995, between  July
   27  1,  1995  and  June  30,  1996,  between July 1, 1996 and June 30, 1997,
   28  between July 1, 1997 and June 30, 1998, between July 1,  1998  and  June
   29  30,  1999,  between July 1, 1999 and June 30, 2000, between July 1, 2000
   30  and June 30, 2001, between July 1, 2001 and June 30, 2002, between  July
   31  1,  2002  and  June  30,  2003,  between July 1, 2003 and June 30, 2004,
   32  between July 1, 2004 and June 30, 2005, between July 1,  2005  and  June
   33  30,  2006,  between July 1, 2006 and June 30, 2007, between July 1, 2007
   34  and June 30, 2008, between July 1, 2008 and June 30, 2009, between  July
   35  1,  2009  and  June  30,  2010,  between July 1, 2010 and June 30, 2011,
   36  between July 1, 2011 and June 30, 2012, between July 1,  2012  and  June
   37  30, 2013 [and], between July 1, 2013 and June 30, 2014, AND BETWEEN JULY
   38  1, 2014 AND JUNE 30, 2015 for physicians or dentists certified as eligi-
   39  ble  for  each  such period or periods pursuant to subdivision 2 of this
   40  section by a general hospital licensed pursuant to  article  28  of  the
   41  public health law; provided that no single insurer shall write more than
   42  fifty  percent  of the total excess premium for a given policy year; and
   43  provided, however, that such eligible physicians or dentists  must  have
   44  in force an individual policy, from an insurer licensed in this state of
   45  primary  malpractice  insurance  coverage in amounts of no less than one
   46  million three hundred thousand  dollars  for  each  claimant  and  three
   47  million nine hundred thousand dollars for all claimants under that poli-
   48  cy  during the period of such excess coverage for such occurrences or be
   49  endorsed as additional insureds under a hospital professional  liability
   50  policy  which is offered through a voluntary attending physician ("chan-
   51  neling") program previously permitted by the superintendent of insurance
   52  during the period of such excess coverage for such  occurrences.  During
   53  such  period,  such policy for excess coverage or such equivalent excess
   54  coverage shall, when combined with the physician's or dentist's  primary
   55  malpractice  insurance coverage or coverage provided through a voluntary
   56  attending physician ("channeling") program, total an aggregate level  of
       S. 6914                            104                           A. 9205

    1  two  million  three  hundred  thousand dollars for each claimant and six
    2  million nine hundred thousand dollars for all claimants  from  all  such
    3  policies  with  respect  to  occurrences in each of such years provided,
    4  however, if the cost of primary malpractice insurance coverage in excess
    5  of  one million dollars, but below the excess medical malpractice insur-
    6  ance coverage provided pursuant to this act, exceeds the  rate  of  nine
    7  percent per annum, then the required level of primary malpractice insur-
    8  ance  coverage  in excess of one million dollars for each claimant shall
    9  be in an amount of not less than the  dollar  amount  of  such  coverage
   10  available at nine percent per annum; the required level of such coverage
   11  for  all claimants under that policy shall be in an amount not less than
   12  three times the dollar amount of coverage for each claimant; and  excess
   13  coverage,  when  combined with such primary malpractice insurance cover-
   14  age, shall increase the aggregate level for each claimant by one million
   15  dollars and three  million  dollars  for  all  claimants;  and  provided
   16  further,  that,  with respect to policies of primary medical malpractice
   17  coverage that include occurrences between April 1,  2002  and  June  30,
   18  2002,  such  requirement  that  coverage  be in amounts no less than one
   19  million three hundred thousand  dollars  for  each  claimant  and  three
   20  million  nine hundred thousand dollars for all claimants for such occur-
   21  rences shall be effective April 1, 2002.
   22    S 19. Subdivision 3 of section 18 of chapter 266 of the laws of  1986,
   23  amending  the  civil  practice  law and rules and other laws relating to
   24  malpractice and professional medical conduct, as amended by  section  16
   25  of  part  C  of  chapter  59  of the laws of 2011, is amended to read as
   26  follows:
   27    (3)(a) The superintendent of insurance shall determine and certify  to
   28  each  general  hospital  and  to  the commissioner of health the cost of
   29  excess malpractice insurance for medical or  dental  malpractice  occur-
   30  rences  between July 1, 1986 and June 30, 1987, between July 1, 1988 and
   31  June 30, 1989, between July 1, 1989 and June 30, 1990, between  July  1,
   32  1990  and June 30, 1991, between July 1, 1991 and June 30, 1992, between
   33  July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30,  1994,
   34  between  July  1,  1994 and June 30, 1995, between July 1, 1995 and June
   35  30, 1996, between July 1, 1996 and June 30, 1997, between July  1,  1997
   36  and  June 30, 1998, between July 1, 1998 and June 30, 1999, between July
   37  1, 1999 and June 30, 2000, between July  1,  2000  and  June  30,  2001,
   38  between  July  1,  2001 and June 30, 2002, between July 1, 2002 and June
   39  30, 2003, between July 1, 2003 and June 30, 2004, between July  1,  2004
   40  and  June 30, 2005, between July 1, 2005 and June 30, 2006, between July
   41  1, 2006 and June 30, 2007, between July  1,  2007  and  June  30,  2008,
   42  between  July  1,  2008 and June 30, 2009, between July 1, 2009 and June
   43  30, 2010, between July 1, 2010 and June 30, 2011, between July  1,  2011
   44  and  June  30, 2012, between July 1, 2012 and June 30, 2013, and between
   45  July 1, 2013 and June 30, 2014, AND BETWEEN JULY 1, 2014  AND  JUNE  30,
   46  2015  allocable  to  each  general  hospital  for physicians or dentists
   47  certified as eligible for purchase of  a  policy  for  excess  insurance
   48  coverage  by  such  general hospital in accordance with subdivision 2 of
   49  this section, and may amend  such  determination  and  certification  as
   50  necessary.
   51    (b)  The  superintendent  of  insurance shall determine and certify to
   52  each general hospital and to the commissioner  of  health  the  cost  of
   53  excess  malpractice  insurance or equivalent excess coverage for medical
   54  or dental malpractice occurrences between July  1,  1987  and  June  30,
   55  1988,  between  July 1, 1988 and June 30, 1989, between July 1, 1989 and
   56  June 30, 1990, between July 1, 1990 and June 30, 1991, between  July  1,
       S. 6914                            105                           A. 9205

    1  1991  and June 30, 1992, between July 1, 1992 and June 30, 1993, between
    2  July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30,  1995,
    3  between  July  1,  1995 and June 30, 1996, between July 1, 1996 and June
    4  30,  1997,  between July 1, 1997 and June 30, 1998, between July 1, 1998
    5  and June 30, 1999, between July 1, 1999 and June 30, 2000, between  July
    6  1,  2000  and  June  30,  2001,  between July 1, 2001 and June 30, 2002,
    7  between July 1, 2002 and June 30, 2003, between July 1,  2003  and  June
    8  30,  2004,  between July 1, 2004 and June 30, 2005, between July 1, 2005
    9  and June 30, 2006, between July 1, 2006 and June 30, 2007, between  July
   10  1,  2007  and  June  30,  2008,  between July 1, 2008 and June 30, 2009,
   11  between July 1, 2009 and June 30, 2010, between July 1,  2010  and  June
   12  30,  2011,  between July 1, 2011 and June 30, 2012, between July 1, 2012
   13  and June 30, 2013, [and] between July 1, 2013 and  June  30,  2014,  AND
   14  BETWEEN  JULY 1, 2014 AND JUNE 30, 2015 allocable to each general hospi-
   15  tal for physicians or dentists certified as eligible for purchase  of  a
   16  policy  for  excess  insurance coverage or equivalent excess coverage by
   17  such general hospital in accordance with subdivision 2 of this  section,
   18  and  may  amend  such  determination and certification as necessary. The
   19  superintendent of insurance shall determine and certify to each  general
   20  hospital  and  to  the  commissioner of health the ratable share of such
   21  cost allocable to the period July 1, 1987 to December 31, 1987,  to  the
   22  period  January  1, 1988 to June 30, 1988, to the period July 1, 1988 to
   23  December 31, 1988, to the period January 1, 1989 to June  30,  1989,  to
   24  the  period  July 1, 1989 to December 31, 1989, to the period January 1,
   25  1990 to June 30, 1990, to the period July 1, 1990 to December 31,  1990,
   26  to  the  period  January 1, 1991 to June 30, 1991, to the period July 1,
   27  1991 to December 31, 1991, to the period January 1,  1992  to  June  30,
   28  1992,  to  the  period  July 1, 1992 to December 31, 1992, to the period
   29  January 1, 1993 to June 30, 1993, to the period July 1, 1993 to December
   30  31, 1993, to the period January 1, 1994 to June 30, 1994, to the  period
   31  July 1, 1994 to December 31, 1994, to the period January 1, 1995 to June
   32  30, 1995, to the period July 1, 1995 to December 31, 1995, to the period
   33  January 1, 1996 to June 30, 1996, to the period July 1, 1996 to December
   34  31,  1996, to the period January 1, 1997 to June 30, 1997, to the period
   35  July 1, 1997 to December 31, 1997, to the period January 1, 1998 to June
   36  30, 1998, to the period July 1, 1998 to December 31, 1998, to the period
   37  January 1, 1999 to June 30, 1999, to the period July 1, 1999 to December
   38  31, 1999, to the period January 1, 2000 to June 30, 2000, to the  period
   39  July 1, 2000 to December 31, 2000, to the period January 1, 2001 to June
   40  30,  2001,  to  the  period July 1, 2001 to June 30, 2002, to the period
   41  July 1, 2002 to June 30, 2003, to the period July 1, 2003  to  June  30,
   42  2004, to the period July 1, 2004 to June 30, 2005, to the period July 1,
   43  2005 and June 30, 2006, to the period July 1, 2006 and June 30, 2007, to
   44  the  period  July  1, 2007 and June 30, 2008, to the period July 1, 2008
   45  and June 30, 2009, to the period July 1, 2009 and June 30, 2010, to  the
   46  period  July  1,  2010 and June 30, 2011, to the period July 1, 2011 and
   47  June 30, 2012, to the period July 1, 2012 and June 30,  2013,  [and]  to
   48  the  period  July  1,  2013 and June 30, 2014, AND TO THE PERIOD JULY 1,
   49  2014 AND JUNE 30, 2015.
   50    S 20. Paragraphs (a), (b), (c),  (d)  and  (e)  of  subdivision  8  of
   51  section  18 of chapter 266 of the laws of 1986, amending the civil prac-
   52  tice law and rules and other laws relating to  malpractice  and  profes-
   53  sional medical conduct, as amended by section 17 of part C of chapter 59
   54  of the laws of 2011, are amended to read as follows:
   55    (a)  To  the  extent  funds available to the hospital excess liability
   56  pool pursuant to subdivision 5 of this section as amended, and  pursuant
       S. 6914                            106                           A. 9205

    1  to  section  6  of part J of chapter 63 of the laws of 2001, as may from
    2  time to time be amended, which amended this  subdivision,  are  insuffi-
    3  cient  to  meet  the  costs  of  excess insurance coverage or equivalent
    4  excess  coverage  for coverage periods during the period July 1, 1992 to
    5  June 30, 1993, during the period July 1, 1993 to June 30,  1994,  during
    6  the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
    7  to  June  30,  1996,  during  the  period July 1, 1996 to June 30, 1997,
    8  during the period July 1, 1997 to June 30, 1998, during the period  July
    9  1,  1998  to  June  30, 1999, during the period July 1, 1999 to June 30,
   10  2000, during the period July 1, 2000 to June 30, 2001, during the period
   11  July 1, 2001 to October 29, 2001, during the period  April  1,  2002  to
   12  June  30,  2002, during the period July 1, 2002 to June 30, 2003, during
   13  the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
   14  to June 30, 2005, during the period July  1,  2005  to  June  30,  2006,
   15  during  the period July 1, 2006 to June 30, 2007, during the period July
   16  1, 2007 to June 30, 2008, during the period July 1,  2008  to  June  30,
   17  2009, during the period July 1, 2009 to June 30, 2010, during the period
   18  July  1,  2010  to June 30, 2011, during the period July 1, 2011 to June
   19  30, 2012, during the period July 1, 2012 to June 30, 2013, [and]  during
   20  the  period July 1, 2013 to June 30, 2014, AND DURING THE PERIOD JULY 1,
   21  2014 TO JUNE 30, 2015 allocated or reallocated in accordance with  para-
   22  graph  (a) of subdivision 4-a of this section to rates of payment appli-
   23  cable to state governmental agencies, each physician or dentist for whom
   24  a policy for excess insurance coverage or equivalent excess coverage  is
   25  purchased  for  such  period  shall  be  responsible  for payment to the
   26  provider of excess insurance coverage or equivalent excess  coverage  of
   27  an  allocable  share  of  such  insufficiency, based on the ratio of the
   28  total cost of such coverage for such physician to the sum of  the  total
   29  cost of such coverage for all physicians applied to such insufficiency.
   30    (b)  Each  provider  of excess insurance coverage or equivalent excess
   31  coverage covering the period July 1, 1992 to June 30, 1993, or  covering
   32  the period July 1, 1993 to June 30, 1994, or covering the period July 1,
   33  1994  to  June 30, 1995, or covering the period July 1, 1995 to June 30,
   34  1996, or covering the period July 1, 1996 to June 30, 1997, or  covering
   35  the period July 1, 1997 to June 30, 1998, or covering the period July 1,
   36  1998  to  June 30, 1999, or covering the period July 1, 1999 to June 30,
   37  2000, or covering the period July 1, 2000 to June 30, 2001, or  covering
   38  the  period  July  1,  2001  to October 29, 2001, or covering the period
   39  April 1, 2002 to June 30, 2002, or covering the period July 1,  2002  to
   40  June  30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
   41  covering the period July 1, 2004 to June 30, 2005, or covering the peri-
   42  od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
   43  June 30, 2007, or covering the period July 1, 2007 to June 30, 2008,  or
   44  covering the period July 1, 2008 to June 30, 2009, or covering the peri-
   45  od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
   46  June  30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
   47  covering the period July 1, 2012 to June 30, 2013, or covering the peri-
   48  od July 1, 2013 to June 30, 2014, OR COVERING THE PERIOD JULY 1, 2014 TO
   49  JUNE 30, 2015 shall notify a  covered  physician  or  dentist  by  mail,
   50  mailed to the address shown on the last application for excess insurance
   51  coverage  or  equivalent  excess  coverage,  of  the  amount due to such
   52  provider from such physician or dentist for such coverage period  deter-
   53  mined  in accordance with paragraph (a) of this subdivision. Such amount
   54  shall be due from such physician or dentist to such provider  of  excess
   55  insurance  coverage  or  equivalent excess coverage in a time and manner
   56  determined by the superintendent of insurance.
       S. 6914                            107                           A. 9205

    1    (c) If a physician or dentist liable for payment of a portion  of  the
    2  costs  of excess insurance coverage or equivalent excess coverage cover-
    3  ing the period July 1, 1992 to June 30, 1993,  or  covering  the  period
    4  July  1,  1993  to June 30, 1994, or covering the period July 1, 1994 to
    5  June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
    6  covering the period July 1, 1996 to June 30, 1997, or covering the peri-
    7  od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
    8  June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
    9  covering the period July 1, 2000 to June 30, 2001, or covering the peri-
   10  od  July  1,  2001  to October 29, 2001, or covering the period April 1,
   11  2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
   12  2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
   13  the period July 1, 2004 to June 30, 2005, or covering the period July 1,
   14  2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
   15  2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
   16  the period July 1, 2008 to June 30, 2009, or covering the period July 1,
   17  2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
   18  2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
   19  the period July 1, 2012 to June 30, 2013, or covering the period July 1,
   20  2013 to June 30, 2014, OR COVERING THE PERIOD JULY 1, 2014 TO  JUNE  30,
   21  2015  determined  in  accordance  with paragraph (a) of this subdivision
   22  fails, refuses or neglects to make payment to  the  provider  of  excess
   23  insurance coverage or equivalent excess coverage in such time and manner
   24  as  determined  by the superintendent of insurance pursuant to paragraph
   25  (b) of this subdivision, excess insurance coverage or equivalent  excess
   26  coverage purchased for such physician or dentist in accordance with this
   27  section  for  such  coverage period shall be cancelled and shall be null
   28  and void as of the first day on or after the commencement  of  a  policy
   29  period  where the liability for payment pursuant to this subdivision has
   30  not been met.
   31    (d) Each provider of excess insurance coverage  or  equivalent  excess
   32  coverage  shall  notify  the superintendent of insurance and the commis-
   33  sioner of health or their designee of each physician and dentist  eligi-
   34  ble for purchase of a policy for excess insurance coverage or equivalent
   35  excess  coverage  covering  the period July 1, 1992 to June 30, 1993, or
   36  covering the period July 1, 1993 to June 30, 1994, or covering the peri-
   37  od July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to
   38  June 30, 1996, or covering the period July 1, 1996 to June 30, 1997,  or
   39  covering the period July 1, 1997 to June 30, 1998, or covering the peri-
   40  od July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to
   41  June  30, 2000, or covering the period July 1, 2000 to June 30, 2001, or
   42  covering the period July 1, 2001 to October 29, 2001,  or  covering  the
   43  period  April  1,  2002 to June 30, 2002, or covering the period July 1,
   44  2002 to June 30, 2003, or covering the period July 1, 2003 to  June  30,
   45  2004,  or covering the period July 1, 2004 to June 30, 2005, or covering
   46  the period July 1, 2005 to June 30, 2006, or covering the period July 1,
   47  2006 to June 30, 2007, or covering the period July 1, 2007 to  June  30,
   48  2008,  or covering the period July 1, 2008 to June 30, 2009, or covering
   49  the period July 1, 2009 to June 30, 2010, or covering the period July 1,
   50  2010 to June 30, 2011, or covering the period July 1, 2011 to  June  30,
   51  2012,  or covering the period July 1, 2012 to June 30, 2013, or covering
   52  the period July 1, 2013 to June 30, 2014, OR COVERING THE PERIOD JULY 1,
   53  2014 TO JUNE 30, 2015 that has made payment to such provider  of  excess
   54  insurance  coverage  or  equivalent  excess  coverage in accordance with
   55  paragraph (b) of this subdivision and of each physician and dentist  who
   56  has failed, refused or neglected to make such payment.
       S. 6914                            108                           A. 9205

    1    (e)  A  provider  of  excess  insurance  coverage or equivalent excess
    2  coverage shall refund to the hospital excess liability pool  any  amount
    3  allocable to the period July 1, 1992 to June 30, 1993, and to the period
    4  July  1,  1993  to June 30, 1994, and to the period July 1, 1994 to June
    5  30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
    6  period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
    7  June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
    8  the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
    9  to June 30, 2001, and to the period July 1, 2001 to  October  29,  2001,
   10  and to the period April 1, 2002 to June 30, 2002, and to the period July
   11  1,  2002  to  June  30, 2003, and to the period July 1, 2003 to June 30,
   12  2004, and to the period July 1, 2004 to June 30, 2005, and to the period
   13  July 1, 2005 to June 30, 2006, and to the period July 1,  2006  to  June
   14  30,  2007,  and  to the period July 1, 2007 to June 30, 2008, and to the
   15  period July 1, 2008 to June 30, 2009, and to the period July 1, 2009  to
   16  June  30,  2010, and to the period July 1, 2010 to June 30, 2011, and to
   17  the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
   18  to June 30, 2013, and to the period July 1, 2013 to June 30,  2014,  AND
   19  TO  THE  PERIOD JULY 1, 2014 TO JUNE 30, 2015 received from the hospital
   20  excess liability pool for  purchase  of  excess  insurance  coverage  or
   21  equivalent  excess coverage covering the period July 1, 1992 to June 30,
   22  1993, and covering the period July 1, 1993 to June 30, 1994, and  cover-
   23  ing  the  period  July 1, 1994 to June 30, 1995, and covering the period
   24  July 1, 1995 to June 30, 1996, and covering the period July 1,  1996  to
   25  June  30,  1997,  and covering the period July 1, 1997 to June 30, 1998,
   26  and covering the period July 1, 1998 to June 30, 1999, and covering  the
   27  period  July  1,  1999 to June 30, 2000, and covering the period July 1,
   28  2000 to June 30, 2001, and covering the period July 1, 2001  to  October
   29  29,  2001,  and  covering the period April 1, 2002 to June 30, 2002, and
   30  covering the period July 1, 2002 to June  30,  2003,  and  covering  the
   31  period  July  1,  2003 to June 30, 2004, and covering the period July 1,
   32  2004 to June 30, 2005, and covering the period July 1, 2005 to June  30,
   33  2006,  and covering the period July 1, 2006 to June 30, 2007, and cover-
   34  ing the period July 1, 2007 to June 30, 2008, and  covering  the  period
   35  July  1,  2008 to June 30, 2009, and covering the period July 1, 2009 to
   36  June 30, 2010, and covering the period July 1, 2010 to  June  30,  2011,
   37  and  covering the period July 1, 2011 to June 30, 2012, and covering the
   38  period July 1, 2012 to June 30, 2013, and covering the  period  July  1,
   39  2013  to June 30, 2014, AND COVERING THE PERIOD JULY 1, 2014 TO JUNE 30,
   40  2015 for a physician or dentist where such excess insurance coverage  or
   41  equivalent excess coverage is cancelled in accordance with paragraph (c)
   42  of this subdivision.
   43    S  21.  Section  40  of  chapter 266 of the laws of 1986, amending the
   44  civil practice law and rules and other laws relating to malpractice  and
   45  professional  medical  conduct,  as  amended  by section 18 of part C of
   46  chapter 59 of the laws of 2011, is amended to read as follows:
   47    S 40. The superintendent of insurance shall establish rates for  poli-
   48  cies  providing coverage for physicians and surgeons medical malpractice
   49  for the periods commencing July 1, 1985 and ending June 30, [2014] 2015;
   50  provided, however, that notwithstanding any other provision of law,  the
   51  superintendent  shall not establish or approve any increase in rates for
   52  the period commencing July 1, 2009 and ending June 30, 2010. The  super-
   53  intendent  shall  direct  insurers  to establish segregated accounts for
   54  premiums, payments, reserves and investment income attributable to  such
   55  premium  periods  and  shall  require  periodic  reports by the insurers
   56  regarding claims and expenses attributable to such  periods  to  monitor
       S. 6914                            109                           A. 9205

    1  whether  such  accounts  will  be sufficient to meet incurred claims and
    2  expenses. On or after July 1, 1989, the superintendent  shall  impose  a
    3  surcharge  on premiums to satisfy a projected deficiency that is attrib-
    4  utable  to  the  premium levels established pursuant to this section for
    5  such periods; provided, however, that such annual  surcharge  shall  not
    6  exceed  eight percent of the established rate until July 1, [2014] 2015,
    7  at which time and thereafter such surcharge shall not exceed twenty-five
    8  percent of the approved adequate rate, and that such  annual  surcharges
    9  shall continue for such period of time as shall be sufficient to satisfy
   10  such  deficiency.  The  superintendent  shall  not impose such surcharge
   11  during the period commencing July 1, 2009 and ending June 30, 2010.   On
   12  and  after  July 1, 1989, the surcharge prescribed by this section shall
   13  be retained by insurers to the extent that they insured  physicians  and
   14  surgeons  during  the  July  1, 1985 through June 30, [2014] 2015 policy
   15  periods; in the event and to the extent  physicians  and  surgeons  were
   16  insured  by another insurer during such periods, all or a pro rata share
   17  of the surcharge, as the case may be, shall be remitted  to  such  other
   18  insurer  in  accordance  with rules and regulations to be promulgated by
   19  the superintendent.  Surcharges collected from physicians  and  surgeons
   20  who  were  not  insured  during such policy periods shall be apportioned
   21  among all insurers in proportion to the premium written by each  insurer
   22  during  such policy periods; if a physician or surgeon was insured by an
   23  insurer subject to rates established by the superintendent  during  such
   24  policy  periods,  and  at any time thereafter a hospital, health mainte-
   25  nance organization, employer or institution is responsible for  respond-
   26  ing  in  damages  for  liability  arising  out  of  such  physician's or
   27  surgeon's practice of medicine, such responsible entity shall also remit
   28  to such prior insurer the equivalent amount that would then be collected
   29  as a surcharge if the physician  or  surgeon  had  continued  to  remain
   30  insured  by  such  prior insurer. In the event any insurer that provided
   31  coverage  during  such   policy   periods   is   in   liquidation,   the
   32  property/casualty  insurance  security fund shall receive the portion of
   33  surcharges to which the insurer in liquidation would have been entitled.
   34  The surcharges authorized herein shall be deemed to be income earned for
   35  the purposes of section 2303 of the insurance law.  The  superintendent,
   36  in  establishing  adequate  rates and in determining any projected defi-
   37  ciency pursuant to the requirements of this section  and  the  insurance
   38  law,  shall  give  substantial  weight, determined in his discretion and
   39  judgment, to the  prospective  anticipated  effect  of  any  regulations
   40  promulgated  and  laws  enacted  and the public benefit of   stabilizing
   41  malpractice rates and minimizing rate level fluctuation during the peri-
   42  od of time necessary for the development of  more  reliable  statistical
   43  experience  as  to  the  efficacy of such laws and regulations affecting
   44  medical, dental or podiatric malpractice enacted or promulgated in 1985,
   45  1986, by this act and at any other time.  Notwithstanding any  provision
   46  of the insurance law, rates already established and to be established by
   47  the  superintendent pursuant to this section are deemed adequate if such
   48  rates would be adequate when taken together with the maximum  authorized
   49  annual  surcharges to be imposed for a reasonable period of time whether
   50  or not any such annual surcharge has been actually  imposed  as  of  the
   51  establishment of such rates.
   52    S 22. Section 5 and subdivisions (a) and (e) of section 6 of part J of
   53  chapter  63 of the laws of 2001, amending chapter 20 of the laws of 2001
   54  amending the military law and other laws relating  to  making  appropri-
   55  ations for the support of government, as amended by section 20 of part C
   56  of chapter 59 of the laws of 2011, are amended to read as follows:
       S. 6914                            110                           A. 9205

    1    S  5.  The  superintendent of insurance and the commissioner of health
    2  shall determine, no later than June 15, 2002, June 15,  2003,  June  15,
    3  2004,  June  15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, June
    4  15, 2009, June 15, 2010, June 15, 2011, June 15, 2012,  June  15,  2013,
    5  [and]  June 15, 2014, AND JUNE 15, 2015 the amount of funds available in
    6  the hospital excess liability pool, created pursuant to  section  18  of
    7  chapter  266  of the laws of 1986, and whether such funds are sufficient
    8  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, or July 1, 2007 to June 30,
   13  2008, or July 1, 2008 to June 30, 2009, or July  1,  2009  to  June  30,
   14  2010,  or  July  1,  2010  to June 30, 2011, or July 1, 2011 to June 30,
   15  2012, or July 1, 2012 to June 30, 2013, or July  1,  2013  to  June  30,
   16  2014, OR JULY 1, 2014 TO JUNE 30, 2015, as applicable.
   17    (a)  This section shall be effective only upon a determination, pursu-
   18  ant to section five of this act, by the superintendent of insurance  and
   19  the commissioner of health, and a certification of such determination to
   20  the  state  director of the budget, the chair of the senate committee on
   21  finance and the chair of the assembly committee on ways and means,  that
   22  the  amount  of  funds  in  the  hospital excess liability pool, created
   23  pursuant to section 18 of chapter 266 of the laws of 1986,  is  insuffi-
   24  cient  for purposes of purchasing excess insurance coverage for eligible
   25  participating physicians and dentists during the period July 1, 2001  to
   26  June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June
   27  30,  2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30,
   28  2006, or July 1, 2006 to June 30, 2007, or July  1,  2007  to  June  30,
   29  2008,  or  July  1,  2008  to June 30, 2009, or July 1, 2009 to June 30,
   30  2010, or July 1, 2010 to June 30, 2011, or July  1,  2011  to  June  30,
   31  2012,  or  July  1,  2012  to June 30, 2013, or July 1, 2013 to June 30,
   32  2014, OR JULY 1, 2014 TO JUNE 30, 2015, as applicable.
   33    (e) The commissioner of health  shall  transfer  for  deposit  to  the
   34  hospital excess liability pool created pursuant to section 18 of chapter
   35  266  of  the laws of 1986 such amounts as directed by the superintendent
   36  of insurance for the purchase of excess liability insurance coverage for
   37  eligible participating physicians and dentists for the policy year  July
   38  1,  2001  to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1,
   39  2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005
   40  to June 30, 2006, or July 1, 2006 to June 30, 2007, as  applicable,  and
   41  the  cost  of  administering the hospital excess liability pool for such
   42  applicable policy year,  pursuant to the program established in  chapter
   43  266  of  the laws of 1986, as amended, no later than June 15, 2002, June
   44  15, 2003, June 15, 2004, June 15, 2005, June 15, 2006,  June  15,  2007,
   45  June  15,  2008,  June  15, 2009, June 15, 2010, June 15, 2011, June 15,
   46  2012, June 15, 2013, [and] June 15, 2014, AND JUNE 15, 2015, as applica-
   47  ble.
   48    S 23. Notwithstanding any law, rule or  regulation  to  the  contrary,
   49  only  physicians  or dentists who were eligible, and for whom the super-
   50  intendent of financial services and the commissioner of health, or their
   51  designee, purchased, with funds available in the hospital excess liabil-
   52  ity pool, a full or partial policy for  excess  coverage  or  equivalent
   53  excess  coverage  for  the coverage period ending the thirtieth of June,
   54  two thousand fourteen, shall be eligible to apply for such coverage  for
   55  the  coverage period beginning the first of July, two thousand fourteen;
   56  provided, however, if the total number of  physicians  or  dentists  for
       S. 6914                            111                           A. 9205

    1  whom  such  excess  coverage or equivalent excess coverage was purchased
    2  for the policy year ending the thirtieth of June, two thousand  fourteen
    3  exceeds the total number of physicians or dentists certified as eligible
    4  for  the coverage period beginning the first of July, two thousand four-
    5  teen, then the general hospitals may certify additional eligible  physi-
    6  cians  or  dentists in a number equal to such general hospital's propor-
    7  tional share of the total number of  physicians  or  dentists  for  whom
    8  excess  coverage  or equivalent excess coverage was purchased with funds
    9  available in the hospital excess liability pool as of the  thirtieth  of
   10  June,  two  thousand  fourteen, as applied to the difference between the
   11  number of eligible physicians or dentists for whom a policy  for  excess
   12  coverage  or  equivalent  excess coverage was purchased for the coverage
   13  period ending the thirtieth of  June,  two  thousand  fourteen  and  the
   14  number  of  such  eligible  physicians  or dentists who have applied for
   15  excess coverage or equivalent excess coverage for  the  coverage  period
   16  beginning the first of July, two thousand fourteen.
   17    S 24. Notwithstanding any inconsistent provision of law, rule or regu-
   18  lation, for purposes of implementing the provisions of the public health
   19  law and the social services law, references to titles XIX and XXI of the
   20  federal  social  security  act  in  the public health law and the social
   21  services law shall be deemed to include and also to mean  any  successor
   22  titles thereto under the federal social security act.
   23    S 25. Notwithstanding any inconsistent provision of law, rule or regu-
   24  lation, the effectiveness of the provisions of sections 2807 and 3614 of
   25  the  public health law, section 18 of chapter 2 of the laws of 1988, and
   26  18 NYCRR 505.14(h), as they relate to time frames for  notice,  approval
   27  or  certification  of rates of payment, are hereby suspended and without
   28  force or effect for purposes of implementing the provisions of this act.
   29    S 26. Severability clause. If any clause, sentence, paragraph,  subdi-
   30  vision,  section  or  part of this act shall be adjudged by any court of
   31  competent jurisdiction to be invalid, such judgment  shall  not  affect,
   32  impair or invalidate the remainder thereof, but shall be confined in its
   33  operation  to  the  clause, sentence, paragraph, subdivision, section or
   34  part thereof directly involved in the controversy in which such judgment
   35  shall have been rendered. It is hereby declared to be the intent of  the
   36  legislature  that  this act would have been enacted even if such invalid
   37  provisions had not been included herein.
   38    S 27. This act shall take effect immediately and shall  be  deemed  to
   39  have  been in full force and effect on and after April 1, 2014, provided
   40  that:
   41    (a) any rules or regulations necessary to implement the provisions  of
   42  this  act  may be promulgated and any procedures, forms, or instructions
   43  necessary for such implementation may be adopted and issued on or  after
   44  the date this act shall have become a law;
   45    (b)  this  act shall not be construed to alter, change, affect, impair
   46  or defeat any right, obligations, duties or interests accrued,  incurred
   47  or conferred prior to the effective date of this act;
   48    (c)  the  commissioner  of  health and the superintendent of financial
   49  services and any appropriate council may take  any  steps  necessary  to
   50  implement this act prior to its effective date;
   51    (d)  notwithstanding  any inconsistent provision of the state adminis-
   52  trative procedure act or any other provision of law, rule or regulation,
   53  the commissioner of health and the superintendent of financial  services
   54  and  any  appropriate council is authorized to adopt or amend or promul-
   55  gate on an emergency basis any regulation he  or  she  or  such  council
       S. 6914                            112                           A. 9205

    1  determines  necessary  to  implement  any  provision  of this act on its
    2  effective date;
    3    (e)  the provisions of this act shall become effective notwithstanding
    4  the failure of the commissioner  of  health  or  the  superintendent  of
    5  financial  services or any council to adopt or amend or promulgate regu-
    6  lations implementing this act;
    7    (f) the amendments to sections 2807-s and 2807-j of the public  health
    8  law  made  by  sections  three, four and five, respectively, of this act
    9  shall not affect the expiration of such sections and shall expire there-
   10  with;
   11    (g) the amendments to paragraph (i-l)  of  subdivision  1  of  section
   12  2807-v  of the public health law made by section eight of this act shall
   13  not affect the repeal of such paragraph and  shall  be  deemed  repealed
   14  therewith; and
   15    (h)  the  amendments  to subdivision 6 of section 2807-t of the public
   16  health law made by section fifteen of this  act  shall  not  affect  the
   17  expiration of such section and shall be deemed to expire therewith.

   18                                   PART C

   19    Section  1.  Notwithstanding any provision of law to the contrary, the
   20  department of health is directed to consult with all  interested  stake-
   21  holders,  for  the purpose of developing a new methodology of reimburse-
   22  ment for pharmacies.  The department of health shall develop a transpar-
   23  ent methodology that provides an adequate  level  of  reimbursement  for
   24  pharmacies.
   25    S  2.  Subparagraphs (i) and (ii) of paragraph (b) of subdivision 9 of
   26  section 367-a of the social services law, as amended by  section  10  of
   27  part H of chapter 59 of the laws of 2011, is amended to read as follows:
   28    (i)  if  the drug dispensed is a multiple source prescription drug for
   29  which an upper limit has been set by the federal  centers  for  medicare
   30  and medicaid services, the lower of: (A) an amount equal to the specific
   31  upper  limit  set  by  such  federal  agency  for  the  multiple  source
   32  prescription drug; (B) the estimated acquisition cost of  such  drug  to
   33  pharmacies  which,  for  purposes  of  this subparagraph, shall mean the
   34  average wholesale price of a prescription drug based on the package size
   35  dispensed from, as reported by the  prescription  drug  pricing  service
   36  used  by the department, less twenty-five percent thereof; (C) the maxi-
   37  mum acquisition cost, if any, established pursuant to paragraph  (e)  of
   38  this  subdivision,  PROVIDED THAT THE METHODOLOGY USED BY THE DEPARTMENT
   39  TO ESTABLISH A MAXIMUM ACQUISITION COST SHALL NOT INCLUDE AVERAGE ACQUI-
   40  SITION COST AS DETERMINED BY DEPARTMENT SURVEYS; OR (D)  the  dispensing
   41  pharmacy's  usual and customary price charged to the general public; [or
   42  (E) the average acquisition cost if available;] and
   43    (ii) if the drug dispensed is a multiple source prescription drug or a
   44  brand-name prescription drug for which no specific upper limit has  been
   45  set  by such federal agency, the lower of the estimated acquisition cost
   46  of such drug to pharmacies[, the average acquisition cost if  available]
   47  or  the  dispensing  pharmacy's usual and customary price charged to the
   48  general public. For sole and multiple source brand name drugs, estimated
   49  acquisition cost means the average wholesale  price  of  a  prescription
   50  drug  based  upon  the  package  size dispensed from, as reported by the
   51  prescription drug pricing service used by the department, less seventeen
   52  percent thereof or the wholesale acquisition cost of a prescription drug
   53  based upon package size dispensed from, as reported by the  prescription
   54  drug  pricing  service  used by the department, minus zero and forty-one
       S. 6914                            113                           A. 9205

    1  hundredths percent thereof, and updated monthly by the  department.  For
    2  multiple  source  generic  drugs,  estimated  acquisition cost means the
    3  lower of [the average acquisition cost,] the average wholesale price  of
    4  a  prescription  drug  based  on  the  package  size  dispensed from, as
    5  reported by the prescription drug pricing service used  by  the  depart-
    6  ment, less twenty-five percent thereof, or the maximum acquisition cost,
    7  if  any,  established  pursuant  to  paragraph  (e) of this subdivision,
    8  PROVIDED THAT THE METHODOLOGY USED BY  THE  DEPARTMENT  TO  ESTABLISH  A
    9  MAXIMUM  ACQUISITION  COST SHALL NOT INCLUDE AVERAGE ACQUISITION COST AS
   10  DETERMINED BY DEPARTMENT SURVEYS.
   11    S 3. Paragraph (f) of subdivision 9 of section  367-a  of  the  social
   12  services  law,  as  added by section 10-b of part H of chapter 59 of the
   13  laws of 2011, is amended to read as follows:
   14    [(f) Notwithstanding any inconsistent provision of law  or  regulation
   15  to  the contrary, the commissioner shall have the authority to establish
   16  the amount of payments and dispensing fees under this  title  for  those
   17  drugs  which  may not be dispensed without a prescription as required by
   18  section sixty-eight hundred ten of  the  education  law  and  for  which
   19  payment  is  authorized  pursuant to paragraph (g) of subdivision two of
   20  section three hundred sixty-five-a of this title. The commissioner shall
   21  not change the amounts of or method for such payments or dispensing fees
   22  on or after April first, two thousand  eleven  unless  notice  is  given
   23  sixty  days in advance of such change to the chairs of the committees on
   24  senate finance, assembly ways and means,  senate  health,  and  assembly
   25  health.]
   26    S 4. Intentionally omitted.
   27    S  5.  Paragraph (g-1) of subdivision 2 of section 365-a of the social
   28  services law, as amended by section 23 of part H of chapter  59  of  the
   29  laws of 2011, is amended to read as follows:
   30    (g-1)  drugs provided on an in-patient basis, those drugs contained on
   31  the list established by regulation of the commissioner of health  pursu-
   32  ant  to  subdivision four of this section, and those drugs which may not
   33  be dispensed without a prescription as required by  section  sixty-eight
   34  hundred  ten  of  the education law and which the commissioner of health
   35  shall determine to be reimbursable based upon such factors as the avail-
   36  ability of such drugs or alternatives at low  cost  if  purchased  by  a
   37  medicaid  recipient,  or the essential nature of such drugs as described
   38  by such commissioner in regulations, provided, however, that such drugs,
   39  exclusive of long-term maintenance drugs, shall be dispensed in  quanti-
   40  ties no greater than a thirty day supply or one hundred doses, whichever
   41  is  greater; provided further that the commissioner of health is author-
   42  ized to require prior authorization for any  refill  of  a  prescription
   43  when  [less than seventy-five percent of the previously dispensed amount
   44  per fill should have been used] MORE THAN A TEN DAY SUPPLY OF THE PREVI-
   45  OUSLY DISPENSED AMOUNT SHOULD REMAIN were the product used  as  normally
   46  indicated;  provided  further that the commissioner of health is author-
   47  ized to require prior authorization of prescriptions of opioid  analges-
   48  ics in excess of four prescriptions in a thirty-day period in accordance
   49  with section two hundred seventy-three of the public health law; medical
   50  assistance  shall  not include any drug provided on other than an in-pa-
   51  tient basis for which a recipient is charged or a claim is made  in  the
   52  case  of  a  prescription  drug,  in  excess of the maximum reimbursable
   53  amounts to be established by department regulations in  accordance  with
   54  standards  established  by the secretary of the United States department
   55  of health and human services, or, in the case of a drug not requiring  a
   56  prescription,  in  excess of the maximum reimbursable amount established
       S. 6914                            114                           A. 9205

    1  by the commissioner of health pursuant to paragraph (a)  of  subdivision
    2  four of this section;
    3    S  6.  Paragraph  (i)  of subdivision 9 of section 367-a of the social
    4  services law is REPEALED.
    5    S 7. Section 365-h of the social services law is amended by  adding  a
    6  new subdivision 5 to read as follows:
    7    5.  NOTWITHSTANDING  ANY  CONTRARY  PROVISION  OF  LAW, AND SUBJECT TO
    8  FEDERAL FINANCIAL PARTICIPATION, THE COMMISSIONER OF HEALTH  SHALL  MAKE
    9  ADJUSTMENTS  TO PAYMENTS UNDER THIS SECTION, FOR THE PURPOSES OF PROVID-
   10  ING INCREASED ACCESS TO MEDICAID NON-EMERGENCY TRANSPORTATION  IN  RURAL
   11  COMMUNITIES.  UP  TO  TWO  MILLION  DOLLARS  SHALL BE AVAILABLE FOR SUCH
   12  PURPOSES.
   13    S 8. The opening paragraph of  subdivision  1  and  subdivision  3  of
   14  section  367-s  of  the social services law, as amended by section 38 of
   15  part C of chapter 58 of the  laws  of  2008,  are  amended  to  read  as
   16  follows:
   17    Notwithstanding  any  provision of law to the contrary, a supplemental
   18  medical assistance payment shall be made on an annual basis to providers
   19  of emergency medical transportation services in an aggregate amount  not
   20  to exceed four million dollars for two thousand six, six million dollars
   21  for  two  thousand  seven  [and],  six  million dollars for two thousand
   22  eight, AND SIX MILLION DOLLARS FOR THE PERIOD MAY  FIRST,  TWO  THOUSAND
   23  FOURTEEN  THROUGH  MARCH  THIRTY-FIRST, TWO THOUSAND FIFTEEN pursuant to
   24  the following methodology:
   25    3. If all necessary approvals under federal law and regulation are not
   26  obtained to receive federal  financial  participation  in  the  payments
   27  authorized by this section, payments under this section shall be made in
   28  an  aggregate  amount not to exceed two million dollars for two thousand
   29  six, three million dollars for two thousand seven [and],  three  million
   30  dollars  for two thousand eight AND THREE MILLION DOLLARS FOR THE PERIOD
   31  MAY FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH THIRTY-FIRST,  TWO  THOU-
   32  SAND  FIFTEEN.   In such case, the multiplier set forth in paragraph (b)
   33  of subdivision one of this section shall be deemed  to  be  two  million
   34  dollars or three million dollars as applicable to the annual period.
   35    S  9.  Subparagraph (iii) of paragraph (c) of subdivision 6 of section
   36  367-a of the social services law, as amended by section 47 of part C  of
   37  chapter 58 of the laws of 2009, is amended to read as follows:
   38    (iii)  Notwithstanding  any  other  provision  of  this paragraph, co-
   39  payments charged for each generic prescription drug dispensed  shall  be
   40  one  dollar and for each brand name prescription drug dispensed shall be
   41  three dollars; provided, however, that the co-payments charged for  each
   42  brand  name  prescription  drug  on  the preferred drug list established
   43  pursuant to section two hundred seventy-two of the public health law OR,
   44  FOR MANAGED CARE PROVIDERS OPERATING PURSUANT TO SECTION  THREE  HUNDRED
   45  SIXTY-FOUR-J  OF  THIS TITLE, FOR EACH BRAND NAME PRESCRIPTION DRUG ON A
   46  MANAGED CARE PROVIDER'S FORMULARY THAT SUCH PROVIDER HAS DESIGNATED AS A
   47  PREFERRED  DRUG,  and  the  co-payments  charged  for  each  brand  name
   48  prescription  drug reimbursed pursuant to subparagraph (ii) of paragraph
   49  (a-1) of subdivision four of section three hundred sixty-five-a of  this
   50  title shall be one dollar.
   51    S 10. Notwithstanding any inconsistent provision of law to the contra-
   52  ry,  funds  shall be made available to the commissioner of the office of
   53  mental health and the commissioner  of  the  office  of  alcoholism  and
   54  substance  abuse  services,  in  consultation  with  the commissioner of
   55  health and approved by the director  of  the  budget,  and  pursuant  to
   56  appropriations  made therefor in an amount equal to the savings achieved
       S. 6914                            115                           A. 9205

    1  by the reductions described herein, to implement allocation plans devel-
    2  oped by such commissioners, in consultation with the voluntary  agencies
    3  providing  behavioral  health  services and local governmental units, as
    4  defined  in  section  41.03  of  the  mental  hygiene  law, of the areas
    5  impacted by reductions of  inpatient  behavioral  health  services,  and
    6  which shall describe behavioral health services, including mental health
    7  and  substance use disorder services, that are designed to amend service
    8  needs resulting  from  the  reduction  of  inpatient  behavioral  health
    9  services provided under the Medicaid program by programs licensed pursu-
   10  ant  to  article  31  or 32 of the mental hygiene law. Such programs may
   11  include programs that are licensed pursuant to both article  31  of  the
   12  mental hygiene law and article 28 of the public health law, or certified
   13  under  both  article  32 of the mental hygiene law and article 28 of the
   14  public health law. The commissioner  of  health  shall  include  details
   15  regarding  the  implementation of reinvestment allocation plans pursuant
   16  to reductions of inpatient behavioral  health  services  in  the  annual
   17  report  required  under section 45-c of part A of chapter 56 of the laws
   18  of 2013.
   19    S 11. Section 365-m of the social services law is amended by adding  a
   20  new subdivision 5 to read as follows:
   21    5. PURSUANT TO APPROPRIATIONS, THE DEPARTMENT OF HEALTH SHALL REINVEST
   22  FUNDS  ALLOCATED  FOR BEHAVIORAL HEALTH SERVICES, WHICH ARE GENERAL FUND
   23  SAVINGS DIRECTLY RELATED TO SAVINGS REALIZED THROUGH THE  TRANSITION  OF
   24  POPULATIONS  COVERED  BY  THIS  SECTION  FROM  THE  APPLICABLE  MEDICAID
   25  FEE-FOR-SERVICE SYSTEM  TO  A  MANAGED  CARE  MODEL,  INCLUDING  SAVINGS
   26  RESULTING  FROM  THE  REDUCTION  OF  INPATIENT AND OUTPATIENT BEHAVIORAL
   27  HEALTH SERVICES PROVIDED UNDER THE MEDICAID PROGRAMS LICENSED OR  CERTI-
   28  FIED  PURSUANT TO ARTICLE THIRTY-ONE OR THIRTY-TWO OF THE MENTAL HYGIENE
   29  LAW, OR PROGRAMS THAT ARE LICENSED PURSUANT TO BOTH  ARTICLE  THIRTY-ONE
   30  OF  THE MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH
   31  LAW, OR CERTIFIED UNDER BOTH ARTICLE THIRTY-TWO OF  THE  MENTAL  HYGIENE
   32  LAW  AND  ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, FOR THE PURPOSE
   33  OF INCREASING INVESTMENT IN COMMUNITY BASED BEHAVIORAL HEALTH  SERVICES,
   34  INCLUDING RESIDENTIAL SERVICES CERTIFIED BY THE OFFICE OF ALCOHOLISM AND
   35  SUBSTANCE  ABUSE  SERVICES.  THE  METHODOLOGIES  USED  TO  CALCULATE THE
   36  SAVINGS SHALL BE DEVELOPED BY THE COMMISSIONER OF HEALTH AND THE  DIREC-
   37  TOR  OF  THE BUDGET IN CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE
   38  OF MENTAL HEALTH AND  THE  OFFICE  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
   39  SERVICES. IN NO EVENT SHALL THE FULL ANNUAL VALUE OF THE COMMUNITY BASED
   40  BEHAVIORAL HEALTH SERVICE REINVESTMENT SAVINGS ATTRIBUTABLE TO THE TRAN-
   41  SITION  TO  MANAGED CARE EXCEED THE TWELVE MONTH VALUE OF THE DEPARTMENT
   42  OF HEALTH GENERAL FUND REDUCTIONS RESULTING FROM SUCH TRANSITION. WITHIN
   43  ANY FISCAL YEAR WHERE APPROPRIATION INCREASES ARE RECOMMENDED FOR  REIN-
   44  VESTMENT,  INSOFAR  AS  MANAGED  CARE TRANSITION SAVINGS DO NOT OCCUR AS
   45  ESTIMATED, AND GENERAL FUND SAVINGS DO NOT  RESULT,  THEN  SPENDING  FOR
   46  SUCH REINVESTMENT MAY BE REDUCED IN THE NEXT YEAR'S ANNUAL BUDGET ITEMI-
   47  ZATION.  THE  COMMISSIONER  OF  HEALTH SHALL PROMULGATE REGULATIONS, AND
   48  PRIOR TO OCTOBER FIRST, TWO THOUSAND FIFTEEN, MAY  PROMULGATE  EMERGENCY
   49  REGULATIONS  AS  REQUIRED  TO DISTRIBUTE FUNDS PURSUANT TO THIS SUBDIVI-
   50  SION; PROVIDED, HOWEVER,  THAT  ANY  EMERGENCY  REGULATIONS  PROMULGATED
   51  PURSUANT   TO   THIS   SECTION  SHALL  EXPIRE  NO  LATER  THAN  DECEMBER
   52  THIRTY-FIRST, TWO  THOUSAND  FIFTEEN.  THE  COMMISSIONER  SHALL  INCLUDE
   53  DETAILED  DESCRIPTIONS  OF THE METHODOLOGY USED TO CALCULATE SAVINGS FOR
   54  REINVESTMENT, THE RESULTS OF APPLYING SUCH  METHODOLOGIES,  THE  DETAILS
   55  REGARDING  IMPLEMENTATION OF SUCH REINVESTMENT PURSUANT TO THIS SECTION,
   56  AND ANY REGULATIONS PROMULGATED UNDER THIS SUBDIVISION,  IN  THE  ANNUAL
       S. 6914                            116                           A. 9205

    1  REPORT  REQUIRED  UNDER  SECTION  FORTY-FIVE-C  OF  PART  A  OF  CHAPTER
    2  FIFTY-SIX OF THE LAWS OF TWO THOUSAND THIRTEEN.
    3    S  12.  Notwithstanding  any law, rule, or regulation to the contrary,
    4  the commissioner of health, in consultation with the commissioner of the
    5  office of mental health and the commissioner of the office of alcoholism
    6  and substance abuse services, is authorized to  establish  an  evidence-
    7  based,  collaborative  care  clinical delivery model in clinics licensed
    8  under article 28 of the public health law, for the purpose of  improving
    9  the  detection of depression and other diagnosed mental or substance use
   10  disorders and the treatment of individuals with such  conditions  in  an
   11  integrated  manner.    Such  commissioner shall be authorized to develop
   12  criteria for the designation of clinics to be providers of collaborative
   13  care services.   At a minimum, such  designated  clinics  shall  provide
   14  screening  for depression and substance use disorders, medical diagnosis
   15  of patients who screen  positive,  evidence-based  depression  care  and
   16  substance  use disorder referrals, ongoing tracking of patient progress,
   17  care management, and a designated  behavioral  health  practitioner  who
   18  consults  with the care manager and primary care physician. The rates of
   19  payment and billing rules for this service  will  be  developed  by  the
   20  commissioner  of  health,  in  consultation with the commissioner of the
   21  office of mental health and the commissioner of the office of alcoholism
   22  and substance abuse services, and with the approval of the  director  of
   23  the  budget.  Such commissioners are authorized to waive any duplicative
   24  regulatory requirements as may be necessary to  allow  this  service  to
   25  function  in  an effective and efficient manner; provided, however, that
   26  regulations pertaining to patient safety may not be  waived,  nor  shall
   27  any  regulation be waived if such waiver would risk patient safety. Such
   28  waiver shall not exceed the life of the project, or  such  shorter  time
   29  period  as  the authorizing commissioner may determine. The commissioner
   30  of health shall include details  regarding  the  implementation  of  the
   31  collaborative  care  clinical  delivery model, including any regulations
   32  waived and the frequency and rationale for such waivers, in  the  annual
   33  report under section 45-c of part A of chapter 56 of the laws of 2013.
   34    S  12-a. Paragraph (c) of subdivision 2 of section 365-a of the social
   35  services law, as amended by section 24 of part A of chapter  56  of  the
   36  laws of 2013, is amended to read as follows:
   37    (c)  out-patient hospital or clinic services in facilities operated in
   38  compliance with applicable provisions of this chapter, the public health
   39  law, the mental hygiene law and other  laws,  including  any  provisions
   40  thereof requiring an operating certificate or license, including facili-
   41  ties  authorized by the appropriate licensing authority to provide inte-
   42  grated mental health services, and/or  alcoholism  and  substance  abuse
   43  services,  and/or  physical  health services, and/or services to persons
   44  with developmental disabilities, when such services are  provided  at  a
   45  single  location  or  service  site,  or  where  such facilities are not
   46  conveniently accessible, in any hospital located  [without]  WITHIN  the
   47  state  and  care and services in a day treatment program operated by the
   48  department of mental hygiene or by a voluntary agency under an agreement
   49  with such department in that part of a public institution  operated  and
   50  approved  pursuant  to  law as an intermediate care facility for persons
   51  with developmental disabilities; AND PROVIDED, THAT THE COMMISSIONERS OF
   52  HEALTH, MENTAL HEALTH, ALCOHOLISM AND SUBSTANCE ABUSE SERVICES  AND  THE
   53  OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES MAY ISSUE REGULATIONS,
   54  INCLUDING  EMERGENCY REGULATIONS PROMULGATED PRIOR TO OCTOBER FIRST, TWO
   55  THOUSAND FIFTEEN THAT ARE REQUIRED TO FACILITATE  THE  ESTABLISHMENT  OF
   56  INTEGRATED SERVICES CLINICS. ANY SUCH REGULATIONS PROMULGATED UNDER THIS
       S. 6914                            117                           A. 9205

    1  PARAGRAPH  SHALL  BE DESCRIBED IN THE ANNUAL REPORT REQUIRED PURSUANT TO
    2  SECTION FORTY-FIVE-C OF PART A OF CHAPTER FIFTY-SIX OF THE LAWS  OF  TWO
    3  THOUSAND THIRTEEN;
    4    S  13. Section 48-a of part A of chapter 56 of the laws of 2013 amend-
    5  ing chapter 59 of the laws of 2011 amending the public  health  law  and
    6  other  laws  relating to general hospital reimbursement for annual rates
    7  relating to the cap on local Medicaid expenditures, is amended  to  read
    8  as follows:
    9    S  48-a.  Notwithstanding  any contrary provision of law, the [commis-
   10  sioner] COMMISSIONERS OF THE OFFICE of alcoholism  and  substance  abuse
   11  services [is] AND THE OFFICE OF MENTAL HEALTH ARE authorized, subject to
   12  the  approval  of the director of the budget, to transfer to the commis-
   13  sioner of health state funds to be utilized as the state share  for  the
   14  purpose  of  increasing  payments  under the medicaid program to managed
   15  care organizations licensed under article 44 of the public health law or
   16  under article 43 of the insurance law. Such managed  care  organizations
   17  shall  utilize such funds for the purpose of reimbursing [hospital-based
   18  and free-standing chemical dependence outpatient  and  opioid  treatment
   19  clinics]  PROVIDERS licensed pursuant to article 28 of the public health
   20  law or article 31 OR 32 of the mental hygiene law for [chemical  depend-
   21  ency]  AMBULATORY  BEHAVIORAL  HEALTH  services,  as  determined  by the
   22  commissioner of health, in consultation with the commissioner  of  alco-
   23  holism  and  substance abuse services AND THE COMMISSIONER OF THE OFFICE
   24  OF MENTAL  HEALTH,  provided  to  medicaid  eligible  outpatients.  Such
   25  reimbursement  shall  be in the form of fees for such services which are
   26  equivalent to the payments established for such services under the ambu-
   27  latory patient group (APG) rate-setting methodology as utilized  by  the
   28  department  of  health  [or  by], the office of alcoholism and substance
   29  abuse  services,  OR  THE  OFFICE  OF  MENTAL  HEALTH  for  rate-setting
   30  purposes;  provided,  however, that the increase to such fees that shall
   31  result from the provisions of this section shall not, in  the  aggregate
   32  and  as  determined  by the commissioner of health, in consultation with
   33  the commissioner of alcoholism and  substance  abuse  services  AND  THE
   34  COMMISSIONER  OF  THE  OFFICE  OF  MENTAL  HEALTH,  be  greater than the
   35  increased funds made available pursuant to this section.   THE  INCREASE
   36  OF  SUCH  AMBULATORY BEHAVIORAL HEALTH FEES TO PROVIDERS AVAILABLE UNDER
   37  THIS SECTION SHALL BE FOR ALL RATE PERIODS ON AND  AFTER  THE  EFFECTIVE
   38  DATE  OF  THE  CHAPTER  OF  THE  LAWS OF 2014 WHICH AMENDED THIS SECTION
   39  THROUGH DECEMBER 31, 2016 FOR PATIENTS IN THE CITY OF NEW YORK, FOR  ALL
   40  RATE  PERIODS ON AND AFTER THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS
   41  OF 2014 WHICH AMENDED THIS SECTION THROUGH JUNE 30,  2017  FOR  PATIENTS
   42  OUTSIDE  THE CITY OF NEW YORK, AND FOR ALL RATE PERIODS ON AND AFTER THE
   43  EFFECTIVE DATE OF SUCH CHAPTER OF THE LAWS OF 2014  WHICH  AMENDED  THIS
   44  SECTION  THROUGH  DECEMBER 31, 2017 FOR ALL SERVICES PROVIDED TO PERSONS
   45  UNDER THE AGE OF TWENTY-ONE; PROVIDED, HOWEVER, THAT MANAGED CARE ORGAN-
   46  IZATIONS AND PROVIDERS MAY NEGOTIATE  DIFFERENT  RATES  AND  METHODS  OF
   47  PAYMENT  DURING SUCH PERIODS DESCRIBED ABOVE, SUBJECT TO THE APPROVAL OF
   48  THE DEPARTMENT OF HEALTH. THE DEPARTMENT OF HEALTH  SHALL  CONSULT  WITH
   49  THE  OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES AND THE OFFICE OF
   50  MENTAL HEALTH IN DETERMINING WHETHER SUCH  ALTERNATIVE  RATES  SHALL  BE
   51  APPROVED.  The  commissioner  of  health  may,  in consultation with the
   52  commissioner of alcoholism and substance abuse services AND THE  COMMIS-
   53  SIONER OF THE OFFICE OF MENTAL HEALTH, promulgate regulations, including
   54  emergency  regulations PROMULGATED PRIOR TO OCTOBER 1, 2015 TO ESTABLISH
   55  RATES FOR AMBULATORY BEHAVIORAL HEALTH SERVICES,  as  are  necessary  to
   56  implement  the  provisions of this section. RATES PROMULGATED UNDER THIS
       S. 6914                            118                           A. 9205

    1  SECTION SHALL BE INCLUDED IN THE REPORT REQUIRED UNDER SECTION  45-C  OF
    2  PART A OF THIS CHAPTER.
    3    S  14. Subdivision 8 of section 84 of part A of chapter 56 of the laws
    4  of 2013, amending chapter 59 of the laws of  2011  amending  the  public
    5  health law and other laws relating to general hospital reimbursement for
    6  annual  rates  relating  to  the  cap on local Medicaid expenditures, is
    7  amended to read as follows:
    8    8. section forty-eight-a of  this  act  shall  expire  and  be  deemed
    9  repealed [March 31, 2016] JANUARY 1, 2018;
   10    S  15. Section 1 of part H of chapter 111 of the laws of 2010 relating
   11  to increasing Medicaid payments to providers through managed care organ-
   12  izations and providing equivalent fees  through  an  ambulatory  patient
   13  group methodology, is amended to read as follows:
   14    Section  1.    Notwithstanding  any  contrary  provision  of  law, the
   15  [commissioner] COMMISSIONERS of mental health [is]  AND  ALCOHOLISM  AND
   16  SUBSTANCE  ABUSE SERVICES ARE authorized, subject to the approval of the
   17  director of the budget, to transfer to the commissioner of health  state
   18  funds  to  be  utilized as the state share for the purpose of increasing
   19  payments under  the  medicaid  program  to  managed  care  organizations
   20  licensed  under  article 44 of the public health law or under article 43
   21  of the insurance law. Such managed care organizations shall utilize such
   22  funds for the purpose of reimbursing [hospital-based  and  free-standing
   23  clinics]  PROVIDERS licensed pursuant to article 28 of the public health
   24  law, OR pursuant to article 31 OR ARTICLE 32 of the mental  hygiene  law
   25  [or pursuant to both such provisions of law for outpatient mental health
   26  services]  FOR  AMBULATORY  BEHAVIORAL HEALTH SERVICES, as determined by
   27  the commissioner of health in  consultation  with  the  commissioner  of
   28  mental  health  AND  COMMISSIONER  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
   29  SERVICES, provided to medicaid eligible outpatients. Such  reimbursement
   30  shall  be  in the form of fees for such services which are equivalent to
   31  the payments established for such services under the ambulatory  patient
   32  group  (APG)  rate-setting  methodology as utilized by the department of
   33  health or by the office of mental health OR  OFFICE  OF  ALCOHOLISM  AND
   34  SUBSTANCE  ABUSE  SERVICES for rate-setting purposes; provided, however,
   35  that the increase to such fees that shall result from the provisions  of
   36  this  section  shall  not,  in  the  aggregate  and as determined by the
   37  commissioner of health in consultation with the  [commissioner]  COMMIS-
   38  SIONERS of mental health AND ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, be
   39  greater  than  the  increased  funds  made  available  pursuant  to this
   40  section. THE INCREASE OF SUCH BEHAVIORAL HEALTH FEES TO PROVIDERS AVAIL-
   41  ABLE UNDER THIS SECTION SHALL BE FOR ALL RATE PERIODS ON AND  AFTER  THE
   42  EFFECTIVE  DATE  OF  THE  CHAPTER OF THE LAWS OF 2014 WHICH AMENDED THIS
   43  SECTION THROUGH DECEMBER 31, 2016 FOR PATIENTS IN THE CITY OF NEW  YORK,
   44  FOR  ALL  RATE PERIODS ON AND AFTER THE EFFECTIVE DATE OF THE CHAPTER OF
   45  THE LAWS OF 2014 WHICH AMENDED THIS SECTION THROUGH JUNE  30,  2017  FOR
   46  PATIENTS  OUTSIDE  THE CITY OF NEW YORK, AND FOR ALL RATE PERIODS ON AND
   47  AFTER THE EFFECTIVE DATE OF THE  CHAPTER  OF  THE  LAWS  OF  2014  WHICH
   48  AMENDED THIS SECTION THROUGH DECEMBER 31, 2017 FOR ALL SERVICES PROVIDED
   49  TO  PERSONS UNDER THE AGE OF TWENTY-ONE; PROVIDED, HOWEVER, THAT MANAGED
   50  CARE ORGANIZATIONS AND PROVIDERS MAY NEGOTIATE DIFFERENT RATES AND METH-
   51  ODS OF PAYMENT DURING SUCH PERIODS DESCRIBED, SUBJECT TO THE APPROVAL OF
   52  THE DEPARTMENT OF HEALTH. THE DEPARTMENT OF HEALTH  SHALL  CONSULT  WITH
   53  THE  OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES AND THE OFFICE OF
   54  MENTAL HEALTH IN DETERMINING WHETHER SUCH  ALTERNATIVE  RATES  SHALL  BE
   55  APPROVED.  The  commissioner  of  health  may,  in consultation with the
   56  [commissioner]  COMMISSIONERS  of  mental  health  AND  ALCOHOLISM   AND
       S. 6914                            119                           A. 9205

    1  SUBSTANCE  ABUSE  SERVICES,  promulgate regulations, including emergency
    2  regulations PROMULGATED PRIOR TO OCTOBER 1, 2013  THAT  ESTABLISH  RATES
    3  FOR  BEHAVIORAL  HEALTH  SERVICES,  as  are  necessary  to implement the
    4  provisions  of  this section. RATES PROMULGATED UNDER THIS SECTION SHALL
    5  BE INCLUDED IN THE REPORT REQUIRED UNDER SECTION 45-C OF PART A OF CHAP-
    6  TER 56 OF THE LAWS OF 2013.
    7    S 16. Section 2 of part H of chapter 111 of the laws of 2010, relating
    8  to increasing Medicaid payments to providers through managed care organ-
    9  izations and providing equivalent fees  through  an  ambulatory  patient
   10  group  methodology,  as amended by section 49 of part A of chapter 56 of
   11  the laws of 2013, is amended to read as follows:
   12    S 2. This act shall take effect immediately and  shall  be  deemed  to
   13  have been in full force and effect on and after April 1, 2010, and shall
   14  expire on [March 31, 2016] JANUARY 1, 2018.
   15    S  16-a.  Section  45-c  of  part A of chapter 56 of the laws of 2013,
   16  relating to the report on the transition of behavioral  health  services
   17  as  a managed care benefit in the medical assistance program, is amended
   18  to read as follows:
   19    S 45-c. The commissioner of health in consultation  with  the  commis-
   20  sioners  of the office of mental health and the office of alcoholism and
   21  substance abuse SERVICES shall prepare a report  on  the  transition  of
   22  behavioral  health  services  as  a  managed care benefit in the medical
   23  assistance program.   Such report shall  examine  (i)  the  adequacy  of
   24  rates;  (ii)  the  ability  of  managed care plans to arrange and manage
   25  covered services for eligible enrollees; (iii) the  ability  of  managed
   26  care plans to provide an adequate network of providers to meet the needs
   27  of  enrollees;  (iv)  the  use  of evidence based tools or guidelines by
   28  managed care plans when determining the appropriate  level  of  care  or
   29  coverage for enrollees; (v) the ability of managed care plans to provide
   30  eligible  enrollees  with  both  the  appropriate  amount  and  type  of
   31  services; (vi) the quality assurance mechanisms  used  by  managed  care
   32  plans,  including  processes  to ensure enrollee satisfaction; (vii) the
   33  manner in which managed care plans address the cultural  and  linguistic
   34  needs  of  enrollees;  [and]  (viii)  any other quality of care criteria
   35  deemed appropriate by the commissioners to ensure the adequacy of rates,
   36  continuity of care and the quality of life, health, and safety of enrol-
   37  lees during the  transition  of  the  behavioral  health  benefit;  (IX)
   38  DETAILS  REGARDING  THE  IMPLEMENTATION OF REINVESTMENT ALLOCATION PLANS
   39  PURSUANT TO REDUCTIONS OF INPATIENT BEHAVIORAL HEALTH  SERVICES  INCLUD-
   40  ING,  BUT  NOT  LIMITED, TO THE LOCATION AND SCOPE OF SERVICE REDUCTIONS
   41  RESULTING FROM THE REDUCTION OR CLOSURE OF PROGRAMS LICENSED PURSUANT TO
   42  ARTICLE 31 OR 32 OF THE MENTAL HYGIENE LAW AND A DESCRIPTION OF SERVICES
   43  TO BE FUNDED PURSUANT TO ALLOCATION PLANS; (X) DETAILED DESCRIPTIONS  OF
   44  THE  METHODOLOGY  USED TO CALCULATE THE AMOUNT OF SAVINGS RESULTING FROM
   45  THE TRANSITION OF INDIVIDUALS INTO MANAGED CARE REALIZED UNDER  SUBDIVI-
   46  SION  5  OF  SECTION 365-M OF THE SOCIAL SERVICES LAW, AND THE MANNER IN
   47  WHICH THE REINVESTMENT WILL ADDRESS  THE  SERVICE  NEEDS;  (XI)  DETAILS
   48  REGARDING THE IMPLEMENTATION OF THE COLLABORATIVE CARE CLINICAL DELIVERY
   49  MODEL; (XII) A DESCRIPTION OF, AND RATIONALE FOR, ANY WAIVER OF EXISTING
   50  REGULATIONS OR ANY PROMULGATION OF EMERGENCY REGULATIONS PURSUANT TO THE
   51  BEHAVIORAL  HEALTH SERVICES TRANSITION AUTHORIZED BY SECTIONS 10 THROUGH
   52  17 OF PART C OF A CHAPTER  OF  THE  LAWS  OF  2014  WHICH  AMENDED  THIS
   53  SECTION, RELATING TO THE IMPLEMENTATION OF THE HEALTH AND MENTAL HYGIENE
   54  BUDGET;  (XIII)  IMPLEMENTATION  OF  INFRASTRUCTURE  AND  ORGANIZATIONAL
   55  MODIFICATIONS AND  INVESTMENTS  IN  HEALTH  INFORMATION  TECHNOLOGY  AND
   56  TRAINING  AND  TECHNICAL  ASSISTANCE;  AND  (XIV)  DETAILS REGARDING THE
       S. 6914                            120                           A. 9205

    1  IMPLEMENTATION OF THE PLAN TO TRANSITION ADULT AND CHILDREN'S BEHAVIORAL
    2  HEALTH PROVIDERS AND SERVICES INTO MANAGED CARE. [The  report  shall  be
    3  submitted  no later than April first, two thousand sixteen to the gover-
    4  nor, the temporary president of the senate, the speaker of the assembly,
    5  the minority leader of the senate, and the minority leader of the assem-
    6  bly.]  THE REPORT SHALL BE SUBMITTED ON AN ANNUAL BASIS TO THE GOVERNOR,
    7  THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEMBLY,  THE
    8  MINORITY  LEADER OF THE SENATE, THE MINORITY LEADER OF THE ASSEMBLY, AND
    9  THE BEHAVIORAL HEALTH SUBCOMMITTEE OF THE  MEDICAID  REDESIGN  TEAM,  NO
   10  LATER THAN JANUARY FIRST OF EACH YEAR.
   11    S 16-b. Section 84 of part A of chapter 56 of the laws of 2013, amend-
   12  ing the public health law and other laws relating to state health mental
   13  hygiene budget for the 2013-14 state fiscal year, is amended by adding a
   14  new subdivision 7-a to read as follows:
   15    7-A.  SECTION  FORTY-FIVE-C  OF  THIS  ACT  SHALL EXPIRE AND BE DEEMED
   16  REPEALED JANUARY 1, 2018;
   17    S 17. Subject to the availability of federal financial  participation,
   18  the  commissioner  of health is authorized, within amounts appropriated,
   19  to distribute funds to local governmental units, as defined  in  section
   20  41.03  of  the mental hygiene law, to Medicaid managed care plans certi-
   21  fied by the department  of  health,  health  homes  designated  by  such
   22  department,  and  individual behavioral health providers and consortiums
   23  of such providers licensed or certified by the office of  mental  health
   24  or  the office of alcoholism and substance abuse services to prepare for
   25  the transition of adult and children's behavioral health  providers  and
   26  services  into  managed care. The use of such funds may include, but not
   27  be limited  to,  infrastructure  and  organizational  modifications  and
   28  investments  in health information technology and training and technical
   29  assistance. Such funds shall be distributed pursuant to  a  plan  to  be
   30  developed  by  the  commissioner  of  health,  in  consultation with the
   31  commissioners of the office of mental health and the office of  alcohol-
   32  ism  and substance abuse services. In developing such plan, such commis-
   33  sioners may take into account the size and scope of  a  grantee's  oper-
   34  ations  as a factor relevant to eligibility for, and the amount of, such
   35  funds. The commissioner of health is authorized to audit  recipients  of
   36  funds  under  this  section to ensure compliance and to recoup any funds
   37  determined to have been used for purposes other than as described herein
   38  or otherwise approved by such commissioners.   The  commissioners  shall
   39  include  details  regarding the implementation of the plan to transition
   40  adult and children's  behavioral  health  providers  and  services  into
   41  managed  care in the annual report required under section 45-c of part A
   42  of chapter 56 of the laws of 2013.
   43    S 18. The commissioner of health is authorized to establish a disabil-
   44  ity clinician advisory group of experienced clinicians and clinic admin-
   45  istrators who have an understanding of the comprehensive needs of people
   46  with disabilities. Such group shall provide  the  commissioner  and  the
   47  department  of  health  with information and data on the effect of poli-
   48  cies,  including  proposed  regulations  or  statutes,  and  of   fiscal
   49  proposals, including rate setting and appropriations, on the delivery of
   50  supports  and  services  for individuals with disabilities including but
   51  not limited to the role of specialty services.
   52    S 19. Paragraph (i) of subdivision 38  of  section  2  of  the  social
   53  services law, as added by section 63 of part H of chapter 59 of the laws
   54  of 2011, is amended to read as follows:
   55    (i)  "Participating  provider"  means  a certified home health agency,
   56  long term home health agency or personal care provider with total  medi-
       S. 6914                            121                           A. 9205

    1  caid  reimbursements,  INCLUDING REIMBURSEMENTS THROUGH THE MANAGED CARE
    2  PROGRAM ESTABLISHED PURSUANT TO SECTION THREE  HUNDRED  SIXTY-FOUR-J  OF
    3  THIS CHAPTER, exceeding fifteen million dollars per calendar year.
    4    S  20.  The  opening paragraph of section 363-e of the social services
    5  law, as added by section 64 of part H of chapter 59 of the laws of 2011,
    6  is amended to read as follows:
    7    THE DEPARTMENT OF HEALTH AND THE  OFFICE  OF  THE  MEDICAID  INSPECTOR
    8  GENERAL  SHALL  JOINTLY  DEVELOP REQUIREMENTS FOR PRECLAIM REVIEW. Every
    9  service or item within a claim OR ENCOUNTER submitted by a participating
   10  provider shall be reviewed and verified by a  verification  organization
   11  prior  to submission of a claim OR ENCOUNTER to the department of health
   12  OR TO A MANAGED CARE PROVIDER AS DEFINED IN PARAGRAPH (B) OF SUBDIVISION
   13  ONE OF SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE.  The  verifica-
   14  tion  organization  shall declare each service or item to be verified or
   15  unverified. Each  participating  provider  shall  receive  and  maintain
   16  reports from the verification organization which shall contain data on:
   17    S  21.  The  opening paragraph of subdivision 1 of section 20-c of the
   18  social services law, as added by section 151 of part B of chapter 436 of
   19  the laws of 1997, is amended to read as follows:
   20    (A) Except as otherwise specified  in  the  appropriation  for  system
   21  support  and  information  services  program  in the office of temporary
   22  disability assistance within the department of family assistance, OR  AS
   23  AUTHORIZED  BY  SUBDIVISION TWO-A OF SECTION TWENTY-TWO OF THIS ARTICLE,
   24  the department shall not enter into any contract with a  private  entity
   25  under  which  that entity would perform any of the public assistance and
   26  care eligibility determination functions, duties or obligations  of  the
   27  department as set forth in this chapter.
   28    S 22. Section 22 of the social services law is amended by adding a new
   29  subdivision 2-a to read as follows:
   30    2-A.  WITH  REGARD  TO  FAIR  HEARINGS HELD IN CONNECTION WITH APPEALS
   31  UNDER THE FULLY INTEGRATED DUALS ADVANTAGE  DEMONSTRATION  PROGRAM,  THE
   32  COMMISSIONER MAY CONTRACT FOR THE SOLE PURPOSE OF ASSISTING STAFF OF THE
   33  OFFICE FOR SUCH PURPOSE.
   34    S  23.  Subdivision  2-c  of  section 2808 of the public health law is
   35  amended by adding a new paragraph (e) to read as follows:
   36    (E) WITH THE EXCEPTION OF THOSE ENROLLEES COVERED UNDER A PAYMENT RATE
   37  METHODOLOGY AGREEMENT NEGOTIATED WITH A RESIDENTIAL HEALTH CARE  FACILI-
   38  TY,  PAYMENTS  FOR  INPATIENT  RESIDENTIAL HEALTH CARE FACILITY SERVICES
   39  PROVIDED TO PATIENTS ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT  TO  TITLE
   40  ELEVEN  OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW MADE BY ORGANIZATIONS
   41  OPERATING IN ACCORDANCE WITH THE PROVISIONS  OF  ARTICLE  FORTY-FOUR  OF
   42  THIS  CHAPTER OR BY HEALTH MAINTENANCE ORGANIZATIONS ORGANIZED AND OPER-
   43  ATING IN ACCORDANCE WITH ARTICLE FORTY-THREE OF THE INSURANCE LAW, SHALL
   44  BE THE RATES OF PAYMENT THAT WOULD BE PAID FOR SUCH PATIENTS  UNDER  THE
   45  MEDICAL  ASSISTANCE  PROGRAM  AS DETERMINED PURSUANT TO THIS SECTION AND
   46  SUBDIVISION TEN OF SECTION TWENTY-EIGHT HUNDRED SEVEN-D OF THIS  ARTICLE
   47  AND AS IN EFFECT AT THE TIME SUCH SERVICES WERE PROVIDED. THE PROVISIONS
   48  OF  THIS PARAGRAPH SHALL NOT APPLY TO PAYMENTS FOR PATIENTS WHOSE PLACE-
   49  MENT IN A RESIDENTIAL HEALTH CARE FACILITY IS FOR THE PURPOSE OF RECEIV-
   50  ING TIME-LIMITED REHABILITATION, TO BE FOLLOWED BY  DISCHARGE  FROM  THE
   51  FACILITY, DURING THE PERIOD SUCH TIME-LIMITED SERVICES ARE PROVIDED.
   52    S  24. Section 365-f of the social services law is amended by adding a
   53  new subdivision 9 to read as follows:
   54    9. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND  SUBJECT  TO  THE
   55  AVAILABILITY  OF  FEDERAL  FINANCIAL  PARTICIPATION,  FOR PERIODS ON AND
   56  AFTER APRIL FIRST, TWO THOUSAND FOURTEEN, THE COMMISSIONER IS AUTHORIZED
       S. 6914                            122                           A. 9205

    1  TO MAKE TEMPORARY PERIODIC LUMP-SUM MEDICAID PAYMENTS TO FISCAL INTERME-
    2  DIARIES PRINCIPALLY ENGAGED  IN  PROVIDING  CONSUMER  DIRECTED  PERSONAL
    3  ASSISTANCE SERVICES TO MEDICAID PATIENTS, IN ACCORDANCE WITH THE FOLLOW-
    4  ING:
    5    (A) ELIGIBLE FISCAL INTERMEDIARIES SHALL INCLUDE:
    6    (I)  PROVIDERS  UNDERGOING  CLOSURE  OR  SUBSTANTIAL  REDUCTION IN THE
    7  VOLUME OF CARE;
    8    (II) PROVIDERS IMPACTED BY THE CLOSURE OF OTHER HEALTH CARE PROVIDERS;
    9    (III) PROVIDERS SUBJECT TO MERGERS,  ACQUISITIONS,  CONSOLIDATIONS  OR
   10  RESTRUCTURING;
   11    (IV)  PROVIDERS  IMPACTED BY THE MERGER, ACQUISITION, CONSOLIDATION OR
   12  RESTRUCTURING OF OTHER HEALTH CARE PROVIDERS;
   13    (V) PROVIDERS SEEKING TO ENSURE THAT ACCESS TO CARE IS  MAINTAINED  OR
   14  INCREASED; OR
   15    (VI)  ON  OR  AFTER  JANUARY  FIRST,  TWO  THOUSAND FIFTEEN, PROVIDERS
   16  IMPACTED BY CHANGES TO THE FAIR LABOR STANDARDS ACT  REQUIRING  OVERTIME
   17  PAY FOR PERSONAL ASSISTANTS WORKING IN EXCESS OF FORTY HOURS PER WEEK.
   18    (B)  PROVIDERS  SEEKING MEDICAID PAYMENTS UNDER THIS SUBDIVISION SHALL
   19  DEMONSTRATE THROUGH SUBMISSION OF A WRITTEN PROPOSAL TO THE COMMISSIONER
   20  THAT THE ADDITIONAL RESOURCES PROVIDED BY SUCH  MEDICAID  PAYMENTS  WILL
   21  ACHIEVE ONE OR MORE OF THE FOLLOWING:
   22    (I) PROTECT OR ENHANCE ACCESS TO CARE;
   23    (II) PROTECT OR ENHANCE QUALITY OF CARE;
   24    (III)  IMPROVE  THE  COST EFFECTIVENESS OF THE DELIVERY OF HEALTH CARE
   25  SERVICES; OR
   26    (IV) OTHERWISE PROTECT OR ENHANCE THE HEALTH CARE DELIVERY SYSTEM,  AS
   27  DETERMINED BY THE COMMISSIONER.
   28    (C)(I) SUCH WRITTEN PROPOSAL SHALL BE SUBMITTED TO THE COMMISSIONER AT
   29  LEAST  SIXTY  DAYS  PRIOR TO THE REQUESTED COMMENCEMENT OF SUCH MEDICAID
   30  PAYMENTS AND SHALL INCLUDE A PROPOSED BUDGET TO ACHIEVE THE GOALS OF THE
   31  PROPOSAL. ANY MEDICAID PAYMENTS  ISSUED  PURSUANT  TO  THIS  SUBDIVISION
   32  SHALL  BE  MADE  OVER  A  SPECIFIED PERIOD OF TIME, AS DETERMINED BY THE
   33  COMMISSIONER, OF UP  TO  THREE  YEARS.  AT  THE  END  OF  THE  SPECIFIED
   34  TIME-FRAME SUCH PAYMENTS SHALL CEASE. THE COMMISSIONER MAY ESTABLISH, AS
   35  A CONDITION OF RECEIVING SUCH MEDICAID PAYMENTS, BENCHMARKS AND GOALS TO
   36  BE  ACHIEVED  IN  CONFORMITY  WITH  THE  PROVIDER'S  WRITTEN PROPOSAL AS
   37  APPROVED BY THE COMMISSIONER AND MAY  ALSO  REQUIRE  THAT  THE  PROVIDER
   38  SUBMIT  SUCH  PERIODIC REPORTS CONCERNING THE ACHIEVEMENT OF SUCH BENCH-
   39  MARKS AND GOALS AS THE COMMISSIONER DEEMS NECESSARY. FAILURE TO  ACHIEVE
   40  SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMISSIONER, IN ACCOMPLISH-
   41  ING SUCH BENCHMARKS AND GOALS SHALL BE A BASIS FOR ENDING THE PROVIDER'S
   42  MEDICAID PAYMENTS PRIOR TO THE END OF THE SPECIFIED TIMEFRAME.
   43    (II) THE COMMISSIONER MAY REQUIRE THAT APPLICATIONS SUBMITTED PURSUANT
   44  TO THIS SUBDIVISION BE SUBMITTED IN RESPONSE TO AND IN ACCORDANCE WITH A
   45  REQUEST  FOR  APPLICATIONS  OR  A  REQUEST  FOR  PROPOSALS ISSUED BY THE
   46  COMMISSIONER.
   47    S 25. Section 3605 of the public health law is amended by adding a new
   48  subdivision 14 to read as follows:
   49    14. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND SUBJECT  TO  THE
   50  AVAILABILITY  OF  FEDERAL  FINANCIAL  PARTICIPATION,  FOR PERIODS ON AND
   51  AFTER APRIL FIRST, TWO THOUSAND FOURTEEN, THE COMMISSIONER IS AUTHORIZED
   52  TO MAKE TEMPORARY PERIODIC LUMP-SUM MEDICAID PAYMENTS TO  LICENSED  HOME
   53  CARE  SERVICE  AGENCIES  ("LHCSA") PRINCIPALLY ENGAGED IN PROVIDING HOME
   54  HEALTH SERVICES TO MEDICAID PATIENTS, IN ACCORDANCE WITH THE FOLLOWING:
   55    (A) ELIGIBLE LHCSA PROVIDERS SHALL INCLUDE:
   56    (I) PROVIDERS UNDERGOING CLOSURE;
       S. 6914                            123                           A. 9205

    1    (II) PROVIDERS IMPACTED BY THE CLOSURE OF OTHER HEALTH CARE PROVIDERS;
    2    (III)  PROVIDERS  SUBJECT  TO MERGERS, ACQUISITIONS, CONSOLIDATIONS OR
    3  RESTRUCTURING;
    4    (IV) PROVIDERS IMPACTED BY THE MERGER, ACQUISITION,  CONSOLIDATION  OR
    5  RESTRUCTURING OF OTHER HEALTH CARE PROVIDERS; OR
    6    (V) PROVIDERS SEEKING TO ENSURE THAT ACCESS TO CARE IS MAINTAINED.
    7    (B)  PROVIDERS  SEEKING MEDICAID PAYMENTS UNDER THIS SUBDIVISION SHALL
    8  DEMONSTRATE THROUGH SUBMISSION OF A WRITTEN PROPOSAL TO THE COMMISSIONER
    9  THAT THE ADDITIONAL RESOURCES PROVIDED BY SUCH  MEDICAID  PAYMENTS  WILL
   10  ACHIEVE ONE OR MORE OF THE FOLLOWING:
   11    (I) PROTECT OR ENHANCE ACCESS TO CARE;
   12    (II) PROTECT OR ENHANCE QUALITY OF CARE;
   13    (III)  IMPROVE  THE  COST EFFECTIVENESS OF THE DELIVERY OF HEALTH CARE
   14  SERVICES; OR
   15    (IV) OTHERWISE PROTECT OR ENHANCE THE HEALTH CARE DELIVERY SYSTEM,  AS
   16  DETERMINED BY THE COMMISSIONER.
   17    (C)  (I)  SUCH WRITTEN PROPOSAL SHALL BE SUBMITTED TO THE COMMISSIONER
   18  AT LEAST SIXTY DAYS PRIOR TO THE REQUESTED COMMENCEMENT OF SUCH MEDICAID
   19  PAYMENTS AND SHALL INCLUDE A PROPOSED BUDGET TO ACHIEVE THE GOALS OF THE
   20  PROPOSAL. ANY MEDICAID PAYMENTS  ISSUED  PURSUANT  TO  THIS  SUBDIVISION
   21  SHALL  BE  MADE  OVER  A  SPECIFIED PERIOD OF TIME, AS DETERMINED BY THE
   22  COMMISSIONER, OF UP TO THREE YEARS. AT THE END OF  THE  SPECIFIED  TIME-
   23  FRAME  SUCH  PAYMENTS SHALL CEASE.  THE COMMISSIONER MAY ESTABLISH, AS A
   24  CONDITION OF RECEIVING SUCH MEDICAID PAYMENTS, BENCHMARKS AND  GOALS  TO
   25  BE  ACHIEVED  IN  CONFORMITY  WITH  THE  PROVIDER'S  WRITTEN PROPOSAL AS
   26  APPROVED BY THE COMMISSIONER AND MAY  ALSO  REQUIRE  THAT  THE  PROVIDER
   27  SUBMIT  SUCH  PERIODIC REPORTS CONCERNING THE ACHIEVEMENT OF SUCH BENCH-
   28  MARKS AND GOALS AS THE COMMISSIONER DEEMS NECESSARY. FAILURE TO  ACHIEVE
   29  SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMISSIONER, IN ACCOMPLISH-
   30  ING SUCH BENCHMARKS AND GOALS SHALL BE A BASIS FOR ENDING THE PROVIDER'S
   31  MEDICAID PAYMENTS PRIOR TO THE END OF THE SPECIFIED TIMEFRAME.
   32    (II) THE COMMISSIONER MAY REQUIRE THAT APPLICATIONS SUBMITTED PURSUANT
   33  TO THIS SUBDIVISION BE SUBMITTED IN RESPONSE TO AND IN ACCORDANCE WITH A
   34  REQUEST  FOR  APPLICATIONS  OR  A  REQUEST  FOR  PROPOSALS ISSUED BY THE
   35  COMMISSIONER.
   36    S 26. Section 3614 of the public health law is amended by adding a new
   37  subdivision 14 to read as follows:
   38    14. (A) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND  SUBJECT  TO
   39  THE  AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, FOR PERIODS ON AND
   40  AFTER MARCH FIRST, TWO THOUSAND FOURTEEN THE COMMISSIONER  SHALL  ADJUST
   41  MEDICAID RATES OF PAYMENT FOR SERVICES PROVIDED BY CERTIFIED HOME HEALTH
   42  AGENCIES  TO  ADDRESS  COST  INCREASES  STEMMING FROM THE WAGE INCREASES
   43  REQUIRED BY IMPLEMENTATION  OF  THE  PROVISIONS  OF  SECTION  THIRTY-SIX
   44  HUNDRED FOURTEEN-C OF THIS ARTICLE. SUCH RATE ADJUSTMENTS SHALL BE BASED
   45  ON  A  COMPARISON,  AS  DETERMINED  BY  THE  COMMISSIONER, OF THE HOURLY
   46  COMPENSATION LEVELS FOR HOME HEALTH AIDES AND  PERSONAL  CARE  AIDES  AS
   47  REFLECTED IN THE EXISTING MEDICAID RATES FOR CERTIFIED HOME HEALTH AGEN-
   48  CIES TO THE HOURLY COMPENSATION LEVELS INCURRED AS A RESULT OF COMPLYING
   49  WITH  THE  PROVISIONS  OF  SECTION THIRTY-SIX HUNDRED FOURTEEN-C OF THIS
   50  ARTICLE.
   51    (B) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND SUBJECT  TO  THE
   52  AVAILABILITY  OF  FEDERAL  FINANCIAL  PARTICIPATION,  FOR PERIODS ON AND
   53  AFTER MARCH FIRST, TWO THOUSAND FOURTEEN THE COMMISSIONER  SHALL  ADJUST
   54  MEDICAID RATES OF PAYMENT FOR SERVICES PROVIDED BY LONG TERM HOME HEALTH
   55  CARE PROGRAMS TO ADDRESS COST INCREASES STEMMING FROM THE WAGE INCREASES
   56  REQUIRED  BY  IMPLEMENTATION  OF  THE  PROVISIONS  OF SECTION THIRTY-SIX
       S. 6914                            124                           A. 9205

    1  HUNDRED FOURTEEN-C OF THIS ARTICLE. SUCH RATE ADJUSTMENTS SHALL BE BASED
    2  ON A COMPARISON, AS  DETERMINED  BY  THE  COMMISSIONER,  OF  THE  HOURLY
    3  COMPENSATION  LEVELS  FOR  HOME  HEALTH AIDES AND PERSONAL CARE AIDES AS
    4  REFLECTED  IN THE EXISTING MEDICAID RATES FOR LONG TERM HOME HEALTH CARE
    5  PROGRAMS TO THE HOURLY COMPENSATION  LEVELS  INCURRED  AS  A  RESULT  OF
    6  COMPLYING  WITH  THE PROVISIONS OF SECTION THIRTY-SIX HUNDRED FOURTEEN-C
    7  OF THIS ARTICLE.
    8    S 26-a. Paragraph (d) of subdivision 2-c of section 2808 of the public
    9  health law, as added by section 95 of part H of chapter 59 of  the  laws
   10  of 2011, is amended to read as follows:
   11    (d)  The commissioner shall promulgate regulations, and may promulgate
   12  emergency regulations, to implement the provisions of this  subdivision.
   13  Such  regulations  shall  be  developed in consultation with the nursing
   14  home industry and advocates for residential health care  facility  resi-
   15  dents and, further, the commissioner shall provide notification concern-
   16  ing  such  regulations  to  the chairs of the senate and assembly health
   17  committees, the chair of the senate finance committee and the  chair  of
   18  the  assembly  ways  and means committee. Such regulations shall include
   19  provisions for rate adjustments or payment enhancements to facilitate  a
   20  minimum four-year transition of facilities to the rate-setting methodol-
   21  ogy  established  by  this  subdivision and may also include, but not be
   22  limited to, provisions for facilitating quality improvements in residen-
   23  tial health care facilities.    FOR  PURPOSES  OF  FACILITATING  QUALITY
   24  IMPROVEMENTS  THROUGH  THE ESTABLISHMENT OF A NURSING HOME QUALITY POOL,
   25  THOSE FACILITIES THAT CONTRIBUTE TO THE QUALITY  POOL,  BUT  ARE  DEEMED
   26  INELIGIBLE  FOR QUALITY POOL PAYMENTS DUE EXCLUSIVELY TO A SPECIFIC CASE
   27  OF EMPLOYEE MISCONDUCT, SHALL NEVERTHELESS BE  ELIGIBLE  FOR  A  QUALITY
   28  POOL  PAYMENT  IF  THE  FACILITY PROPERLY REPORTED THE INCIDENT, DID NOT
   29  RECEIVE A SURVEY CITATION FROM THE COMMISSIONER OR THE CENTERS FOR MEDI-
   30  CARE AND MEDICAID SERVICES ESTABLISHING THE FACILITY'S CULPABILITY  WITH
   31  REGARD  TO  SUCH  MISCONDUCT  AND, BUT FOR THE SPECIFIC CASE OF EMPLOYEE
   32  MISCONDUCT, THE FACILITY WOULD HAVE OTHERWISE RECEIVED  A  QUALITY  POOL
   33  PAYMENT.  REGULATIONS PERTAINING TO THE FACILITATION OF QUALITY IMPROVE-
   34  MENT  MAY  BE MADE EFFECTIVE FOR PERIODS ON AND AFTER JANUARY FIRST, TWO
   35  THOUSAND THIRTEEN.
   36    S 27. The public health law is amended by adding a new section 2826 to
   37  read as follows:
   38    S 2826. TEMPORARY ADJUSTMENT TO REIMBURSEMENT  RATES.    (A)  NOTWITH-
   39  STANDING ANY PROVISION OF LAW TO THE CONTRARY, WITHIN FUNDS APPROPRIATED
   40  AND  SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, THE
   41  COMMISSIONER MAY GRANT APPROVAL OF A TEMPORARY ADJUSTMENT TO THE NON-CA-
   42  PITAL COMPONENTS OF RATES, OR MAKE TEMPORARY LUMP-SUM MEDICAID PAYMENTS,
   43  TO ELIGIBLE GENERAL HOSPITALS, SKILLED NURSING FACILITIES,  CLINICS  AND
   44  HOME  CARE  PROVIDERS,  PROVIDED  HOWEVER, THAT SHOULD FEDERAL FINANCIAL
   45  PARTICIPATION NOT BE AVAILABLE FOR ANY ELIGIBLE PROVIDER, THEN  PAYMENTS
   46  PURSUANT  TO  THIS  SUBDIVISION  MAY  BE MADE AS GRANTS AND SHALL NOT BE
   47  DEEMED TO BE MEDICAL ASSISTANCE PAYMENTS.
   48    (B) ELIGIBLE PROVIDERS SHALL INCLUDE:
   49    (I) PROVIDERS UNDERGOING CLOSURE;
   50    (II) PROVIDERS IMPACTED BY THE CLOSURE OF OTHER HEALTH CARE PROVIDERS;
   51    (III) PROVIDERS SUBJECT TO MERGERS,  ACQUISITIONS,  CONSOLIDATIONS  OR
   52  RESTRUCTURING; OR
   53    (IV)  PROVIDERS  IMPACTED BY THE MERGER, ACQUISITION, CONSOLIDATION OR
   54  RESTRUCTURING OF OTHER HEALTH CARE PROVIDERS.
   55    (C) PROVIDERS SEEKING TEMPORARY RATE ADJUSTMENTS  UNDER  THIS  SECTION
   56  SHALL  DEMONSTRATE  THROUGH  SUBMISSION  OF  A  WRITTEN  PROPOSAL TO THE
       S. 6914                            125                           A. 9205

    1  COMMISSIONER THAT THE ADDITIONAL RESOURCES PROVIDED BY A TEMPORARY  RATE
    2  ADJUSTMENT WILL ACHIEVE ONE OR MORE OF THE FOLLOWING:
    3    (I) PROTECT OR ENHANCE ACCESS TO CARE;
    4    (II) PROTECT OR ENHANCE QUALITY OF CARE;
    5    (III)  IMPROVE  THE  COST EFFECTIVENESS OF THE DELIVERY OF HEALTH CARE
    6  SERVICES; OR
    7    (IV) OTHERWISE PROTECT OR ENHANCE THE HEALTH CARE DELIVERY SYSTEM,  AS
    8  DETERMINED BY THE COMMISSIONER.
    9    (D) (I) SUCH  WRITTEN  PROPOSAL SHALL BE SUBMITTED TO THE COMMISSIONER
   10  AT LEAST SIXTY DAYS PRIOR TO THE REQUESTED EFFECTIVE DATE OF THE  TEMPO-
   11  RARY RATE ADJUSTMENT, AND SHALL INCLUDE A PROPOSED BUDGET TO ACHIEVE THE
   12  GOALS  OF  THE  PROPOSAL.  ANY  MEDICAID PAYMENT ISSUED PURSUANT TO THIS
   13  SECTION SHALL BE IN EFFECT FOR A SPECIFIED PERIOD OF TIME AS  DETERMINED
   14  BY  THE  COMMISSIONER, OF UP TO THREE YEARS. AT THE END OF THE SPECIFIED
   15  TIMEFRAME SUCH PAYMENTS OR ADJUSTMENTS TO THE NON-CAPITAL  COMPONENT  OF
   16  RATES  SHALL  CEASE,  AND THE PROVIDER SHALL BE REIMBURSED IN ACCORDANCE
   17  WITH THE OTHERWISE APPLICABLE RATE-SETTING METHODOLOGY AS SET  FORTH  IN
   18  APPLICABLE  STATUTES AND REGULATIONS. THE COMMISSIONER MAY ESTABLISH, AS
   19  A CONDITION OF RECEIVING SUCH  TEMPORARY  RATE  ADJUSTMENTS  OR  GRANTS,
   20  BENCHMARKS  AND  GOALS  TO BE ACHIEVED IN CONFORMITY WITH THE PROVIDER'S
   21  WRITTEN PROPOSAL AS APPROVED BY THE COMMISSIONER AND  MAY  ALSO  REQUIRE
   22  THAT  THE  FACILITY SUBMIT SUCH PERIODIC REPORTS CONCERNING THE ACHIEVE-
   23  MENT OF SUCH BENCHMARKS AND GOALS AS THE COMMISSIONER  DEEMS  NECESSARY.
   24  FAILURE  TO  ACHIEVE SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMIS-
   25  SIONER, IN ACCOMPLISHING SUCH BENCHMARKS AND GOALS SHALL BE A BASIS  FOR
   26  ENDING  THE  FACILITY'S  TEMPORARY RATE ADJUSTMENT OR GRANT PRIOR TO THE
   27  END OF THE SPECIFIED TIMEFRAME. (II) THE COMMISSIONER MAY  REQUIRE  THAT
   28  APPLICATIONS SUBMITTED PURSUANT TO THIS SECTION BE SUBMITTED IN RESPONSE
   29  TO  AND  IN  ACCORDANCE WITH A REQUEST FOR APPLICATIONS OR A REQUEST FOR
   30  PROPOSALS ISSUED BY THE COMMISSIONER.
   31    (E) NOTWITHSTANDING ANY LAW TO THE CONTRARY, GENERAL HOSPITALS DEFINED
   32  AS CRITICAL ACCESS HOSPITALS PURSUANT TO  TITLE  XVIII  OF  THE  FEDERAL
   33  SOCIAL SECURITY ACT SHALL BE ALLOCATED NO LESS THAN FIVE MILLION DOLLARS
   34  ANNUALLY  PURSUANT  TO  THIS  SECTION.  THE  DEPARTMENT  OF HEALTH SHALL
   35  PROVIDE A REPORT TO THE GOVERNOR AND LEGISLATURE NO LATER THAN  DECEMBER
   36  FIRST,  TWO THOUSAND FOURTEEN PROVIDING RECOMMENDATIONS ON HOW TO ENSURE
   37  THE FINANCIAL STABILITY OF, AND PRESERVE  PATIENT  ACCESS  TO,  CRITICAL
   38  ACCESS HOSPITALS.
   39    S  27-a.  Subdivision 2 of section 365-a of the social services law is
   40  amended by adding a new paragraph (bb) to read as follows:
   41    (BB) SUBJECT TO THE AVAILABILITY OF FEDERAL  FINANCIAL  PARTICIPATION,
   42  SERVICES  AND  SUPPORTS  AUTHORIZED BY THE FEDERAL REGULATIONS GOVERNING
   43  THE HOME AND COMMUNITY-BASED ATTENDANT SERVICES AND SUPPORTS STATE  PLAN
   44  OPTION (COMMUNITY FIRST CHOICE) PURSUANT TO 42 U.S.C. S 1396N(K).
   45    S  27-b. Section 365-f of the social services law is amended by adding
   46  a new subdivision 8 to read as follows:
   47    8. SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, THE
   48  PROVISIONS OF THIS SECTION GOVERNING CONSUMER DIRECTED PERSONAL  ASSIST-
   49  ANCE  SERVICES  SHALL ALSO APPLY TO SUCH SERVICES WHEN OFFERED UNDER THE
   50  HOME AND COMMUNITY-BASED ATTENDANT  SERVICES  AND  SUPPORTS  STATE  PLAN
   51  OPTION (COMMUNITY FIRST CHOICE) PURSUANT TO 42 U.S.C. S 1396N(K).
   52    S  27-c. Subparagraph (iii) of paragraph a of subdivision 1 of section
   53  6908 of the education law, as amended by chapter  160  of  the  laws  of
   54  2003, is amended to read as follows:
   55    (iii)  the  providing  of  care  by  a person acting in the place of a
   56  person exempt under clause (i) of this  paragraph,  but  who  does  hold
       S. 6914                            126                           A. 9205

    1  himself or herself out as one who accepts employment for performing such
    2  care,  where  nursing  services  are under the instruction of a licensed
    3  nurse, or under the instruction of a  patient  or  family  or  household
    4  member  determined by a registered professional nurse to be self-direct-
    5  ing and capable of providing such instruction, and [any remuneration is]
    6  SERVICES ARE provided under section three hundred  sixty-five-f  of  the
    7  social services law; or
    8    S 27-d. Intentionally omitted.
    9    S 27-e. Intentionally omitted.
   10    S 27-f. Intentionally omitted.
   11    S  27-h.  Section  57-c  of  part A of chapter 56 of the laws of 2013,
   12  relating to establishing the home and community-based care  work  group,
   13  is amended to read as follows:
   14    S  57-c.  Home and community based care workgroup. The commissioner of
   15  health shall convene a home and community based care workgroup to  exam-
   16  ine and make recommendations on issues which include, but are not limit-
   17  ed to:
   18    a. State and federal regulatory requirements and related policy guide-
   19  lines  (including the applicability of the federal conditions of partic-
   20  ipation);
   21    b. Efficient home and community based care delivery,  including  tele-
   22  health and hospice services; [and]
   23    c.  Alignment  of functions between managed care entities and home and
   24  community based providers[.]; AND
   25    D. BEST PRACTICE FOR CLEAN CLAIMS AND RELATED DISPUTE RESOLUTION.
   26    The workgroup shall be 11 members. The members of the workgroup  shall
   27  including  providers,  plans and representatives of consumers and direct
   28  caregivers with relevant expertise.
   29    The commissioner of health, or his or her  designee  shall  chair  the
   30  workgroup  and  department  of  health  and other executive agencies and
   31  offices shall provide relevant data and other information as  is  neces-
   32  sary for the group to perform its duties.
   33    The  commissioner  of  health  shall convene this workgroup by May 15,
   34  [2013] 2014 and the group shall issue [a report] PERIODIC  REPORTS  with
   35  recommendations  by  March  1,  2014, SEPTEMBER 1, 2014 AND FEBRUARY 28,
   36  2015.
   37    S 28. Subdivision 35 of section 2807-c of the  public  health  law  is
   38  amended by adding a new paragraph (j) to read as follows:
   39    (J)  NOTWITHSTANDING  ANY  CONTRARY  PROVISION  OF LAW, WITH REGARD TO
   40  INPATIENT AND OUTPATIENT MEDICAID RATES OF PAYMENT FOR GENERAL  HOSPITAL
   41  SERVICES,  THE  COMMISSIONER MAY MAKE SUCH ADJUSTMENTS TO SUCH RATES AND
   42  TO THE METHODOLOGY FOR COMPUTING SUCH RATES AS IS NECESSARY  TO  ACHIEVE
   43  NO  AGGREGATE, NET INCREASE OR DECREASE IN OVERALL MEDICAID EXPENDITURES
   44  RELATED TO THE IMPLEMENTATION OF  THE  INTERNATIONAL  CLASSIFICATION  OF
   45  DISEASES  VERSION  10  (ICD-10) CODING SYSTEM ON OR ABOUT OCTOBER FIRST,
   46  TWO THOUSAND FOURTEEN, AS COMPARED TO SUCH AGGREGATE  EXPENDITURES  FROM
   47  THE TWELVE-MONTH PERIOD IMMEDIATELY PRIOR TO SUCH IMPLEMENTATION.
   48    S  29. Subparagraph (i) of paragraph (e-1) of subdivision 4 of section
   49  2807-c of the public health law, as amended by section 41 of part  B  of
   50  chapter 58 of the laws of 2010, is amended to read as follows:
   51    (i)  For  rate periods on and after April first, two thousand ten, the
   52  commissioner, in consultation with the commissioner  of  the  office  of
   53  mental health, shall promulgate regulations, and may promulgate emergen-
   54  cy regulations, establishing methodologies for determining the operating
   55  cost  components  of  rates  of  payments for services described in this
   56  paragraph. Such regulations shall utilize two  thousand  five  operating
       S. 6914                            127                           A. 9205

    1  costs  as  submitted to the department prior to July first, two thousand
    2  nine and shall provide for methodologies establishing per diem inpatient
    3  rates that utilize case  mix  adjustment  mechanisms.  Such  regulations
    4  shall  contain  criteria for adjustments based on length of stay AND MAY
    5  ALSO PROVIDE FOR A BASE YEAR UPDATE, PROVIDED, HOWEVER, THAT  SUCH  BASE
    6  YEAR  UPDATE SHALL TAKE EFFECT NO EARLIER THAN APRIL FIRST, TWO THOUSAND
    7  FIFTEEN, AND PROVIDED FURTHER, HOWEVER, THAT THE COMMISSIONER  MAY  MAKE
    8  SUCH  ADJUSTMENTS TO SUCH UTILIZATION AND TO THE METHODOLOGY FOR COMPUT-
    9  ING SUCH RATES AS IS NECESSARY TO ACHIEVE NO AGGREGATE,  NET  GROWTH  IN
   10  OVERALL MEDICAID EXPENDITURES RELATED TO SUCH RATES, AS COMPARED TO SUCH
   11  AGGREGATE  EXPENDITURES  FROM THE PRIOR YEAR. IN DETERMINING THE UPDATED
   12  BASE YEAR TO BE UTILIZED PURSUANT TO THIS SUBPARAGRAPH, THE COMMISSIONER
   13  SHALL TAKE INTO ACCOUNT THE BASE  YEAR  DETERMINED  IN  ACCORDANCE  WITH
   14  PARAGRAPH (C) OF SUBDIVISION THIRTY-FIVE OF THIS SECTION.
   15    S  30.  Subparagraph  (vii)  of  paragraph  (e-2)  of subdivision 4 of
   16  section 2807-c of the public health law, as added by section 13 of  part
   17  C of chapter 58 of the laws of 2009, is amended to read as follows:
   18    (vii) The commissioner may promulgate regulations, including emergency
   19  regulations,   implementing  the  provisions  of  this  paragraph,  AND,
   20  FURTHER, SUCH REGULATIONS MAY PROVIDE FOR AN UPDATE  OF  THE  BASE  YEAR
   21  COSTS AND STATISTICS USED TO COMPUTE SUCH RATES, PROVIDED, HOWEVER, THAT
   22  SUCH BASE YEAR UPDATE SHALL TAKE EFFECT NO EARLIER THAN APRIL FIRST, TWO
   23  THOUSAND  FIFTEEN,  AND PROVIDED FURTHER, HOWEVER, THAT THE COMMISSIONER
   24  MAY MAKE SUCH ADJUSTMENTS TO SUCH UTILIZATION AND TO THE METHODOLOGY FOR
   25  COMPUTING SUCH RATES AS IS NECESSARY TO ACHIEVE NO AGGREGATE, NET GROWTH
   26  IN OVERALL MEDICAID EXPENDITURES RELATED TO SUCH RATES, AS  COMPARED  TO
   27  SUCH  AGGREGATE  EXPENDITURES  FROM  THE  PRIOR YEAR. IN DETERMINING THE
   28  UPDATED BASE YEAR TO BE UTILIZED  PURSUANT  TO  THIS  SUBPARAGRAPH,  THE
   29  COMMISSIONER SHALL TAKE INTO ACCOUNT THE BASE YEAR DETERMINED IN ACCORD-
   30  ANCE WITH PARAGRAPH (C) OF SUBDIVISION THIRTY-FIVE OF THIS SECTION.
   31    S  31.  Paragraph (l) of subdivision 4 of section 2807-c of the public
   32  health law is amended by adding  a  new  subparagraph  (v)  to  read  as
   33  follows:
   34    (V)  THE  COMMISSIONER MAY PROMULGATE REGULATIONS, INCLUDING EMERGENCY
   35  REGULATIONS, PROVIDING FOR AN UPDATE OF THE BASE YEAR COSTS AND  STATIS-
   36  TICS  USED  TO  COMPUTE  RATES  OF  PAYMENT  PURSUANT TO THIS PARAGRAPH,
   37  PROVIDED, HOWEVER, THAT SUCH BASE  YEAR  UPDATE  SHALL  TAKE  EFFECT  NO
   38  EARLIER  THAN  APRIL  FIRST, TWO THOUSAND FIFTEEN, AND PROVIDED FURTHER,
   39  HOWEVER, THAT THE COMMISSIONER MAY MAKE SUCH ADJUSTMENTS TO SUCH  UTILI-
   40  ZATION  AND  TO THE METHODOLOGY FOR COMPUTING SUCH RATES AS IS NECESSARY
   41  TO ACHIEVE NO AGGREGATE, NET GROWTH  IN  OVERALL  MEDICAID  EXPENDITURES
   42  RELATED  TO  SUCH RATES, AS COMPARED TO SUCH AGGREGATE EXPENDITURES FROM
   43  THE PRIOR YEAR. IN DETERMINING THE UPDATED  BASE  YEAR  TO  BE  UTILIZED
   44  PURSUANT  TO THIS SUBPARAGRAPH, THE COMMISSIONER SHALL TAKE INTO ACCOUNT
   45  THE BASE YEAR DETERMINED IN ACCORDANCE WITH PARAGRAPH (C) OF SUBDIVISION
   46  THIRTY-FIVE OF THIS SECTION.
   47    S 32.  Paragraph (c) of subdivision 35 of section 2807-c of the public
   48  health law, as amended by section 26 of part A of chapter 56 of the laws
   49  of 2013, is amended to read as follows:
   50    (c) The base period reported costs and statistics used  for  rate-set-
   51  ting  for  operating  cost components, including the weights assigned to
   52  diagnostic related groups, shall be  updated  no  less  frequently  than
   53  every  four  years  and  the  new base period shall be no more than four
   54  years prior to the first applicable rate period that utilizes  such  new
   55  base  period provided, however, that the first updated base period shall
       S. 6914                            128                           A. 9205

    1  begin on [January] OR AFTER APRIL first, two thousand fourteen,  BUT  NO
    2  LATER THAN JULY FIRST, TWO THOUSAND FOURTEEN.
    3    S 32-a. Notwithstanding any contrary provision of law, the commission-
    4  er of health shall establish a workgroup to review and investigate Medi-
    5  caid inpatient rate-setting methodologies with regard to hospitals whose
    6  rates  are  governed by paragraphs (e-1), (e-2) and (l) of subdivision 4
    7  of section 2807-c of the public health law and with particular regard to
    8  the impact of the utilization of updated base years in  the  computation
    9  of  such  rates.  The  workgroup  shall  contain designated staff of the
   10  department of health, representatives of hospital associations and  such
   11  other  interested  stakeholders  as  determined by the commissioner. The
   12  commissioner shall consider the recommendations  of  such  workgroup  in
   13  determining  proposed  revised  rates reflecting the utilization of such
   14  updated base years and shall make such proposed revised rates  available
   15  to  the chairs of the senate and assembly health committees no less than
   16  thirty days prior to the effective date for  such  rates.  Such  updated
   17  base  years  shall be implemented for rate periods commending no earlier
   18  than April 1, 2015.
   19    S 33. Subdivision 1 of section 92 of part H of chapter 59 of the  laws
   20  of 2011, amending the public health law and other laws relating to known
   21  and  projected department of health state fund medicaid expenditures, as
   22  amended by section 3 of part A of chapter 56 of the  laws  of  2013,  is
   23  amended to read as follows:
   24    1.  For  state  fiscal  years  2011-12  through [2014-15] 2015-16, the
   25  director of the budget, in consultation with the commissioner of  health
   26  referenced  as "commissioner" for purposes of this section, shall assess
   27  on a monthly basis, as reflected in monthly reports pursuant to subdivi-
   28  sion five of this section known and projected department of health state
   29  funds medicaid expenditures by category of  service  and  by  geographic
   30  regions,  as  defined  by  the  commissioner, and if the director of the
   31  budget determines that such expenditures are expected to cause  medicaid
   32  disbursements  for  such  period  to  exceed the projected department of
   33  health medicaid state funds disbursements in the enacted  budget  finan-
   34  cial  plan  pursuant to subdivision 3 of section 23 of the state finance
   35  law, the commissioner of health, in consultation with  the  director  of
   36  the  budget,  shall  develop a medicaid savings allocation plan to limit
   37  such spending to the aggregate limit  level  specified  in  the  enacted
   38  budget  financial  plan,  provided,  however,  such  projections  may be
   39  adjusted by the director of the budget to account for any changes in the
   40  New York state federal medical assistance percentage amount  established
   41  pursuant  to the federal social security act, changes in provider reven-
   42  ues, reductions to local social  services  district  medical  assistance
   43  administration, and beginning April 1, 2012 the operational costs of the
   44  New York state medical indemnity fund.  Such projections may be adjusted
   45  by  the  director  of  the  budget to account for increased or expedited
   46  department of health state funds medicaid expenditures as a result of  a
   47  natural  or other type of disaster, including a governmental declaration
   48  of emergency.
   49    S 33-a. Subdivision 5 of section 92 of part H of  chapter  59  of  the
   50  laws  of 2011, amending the public health law and other laws relating to
   51  known and projected department of health state  fund  medicaid  expendi-
   52  tures,  as  amended  by section 3 of part A of chapter 56 of the laws of
   53  2013, is amended and three new subdivisions 6, 7, and  8  are  added  to
   54  read as follows:
       S. 6914                            129                           A. 9205

    1    5.  The [department of health] COMMISSIONER OF HEALTH, IN CONSULTATION
    2  WITH  THE  DIRECTOR  OF BUDGET, shall prepare a monthly report that sets
    3  forth:
    4    (a)  known and projected department of health medicaid expenditures as
    5  described in subdivision one of this section,  and  factors  that  could
    6  result  in  medicaid disbursements for the relevant state fiscal year to
    7  exceed the projected department of health state funds  disbursements  in
    8  the  enacted  budget financial plan pursuant to subdivision 3 of section
    9  23 of the state finance law, including spending increases  or  decreases
   10  due  to: enrollment fluctuations, rate changes, utilization changes, MRT
   11  investments, and shift of beneficiaries to managed care; and  variations
   12  in offline medicaid payments; [and]
   13    (b)  the  actions  taken  to implement any medicaid savings allocation
   14  plan implemented pursuant to subdivision four of this section, including
   15  information concerning the impact of such actions on  each  category  of
   16  service  and  each  geographic  region  of the state. [Each such monthly
   17  report shall be provided to the chairs of the  senate  finance  and  the
   18  assembly ways and means committees and shall be posted on the department
   19  of health's website in a timely manner.]
   20    (C) THE PRICE, TO INCLUDE THE BASE RATE PLUS ANY UPCOMING RATE ADJUST-
   21  MENT;  UTILIZATION,  TO INCLUDE CURRENT ENROLLMENT, PROJECTED ENROLLMENT
   22  CHANGES AND ACUITY; AND MEDICAID  REDESIGN  TEAM  INITIATIVES,  ONE-TIME
   23  INITIATIVES  AND OTHER INITIATIVES DESCRIBING THE PROPOSED BUDGET ACTION
   24  IMPACT, ANY PRIOR YEAR INITIATIVE WITH CURRENT AND FUTURE  YEAR  IMPACTS
   25  FOR THE FOLLOWING CATEGORIES OF SPENDING:
   26    (I) INPATIENT;
   27    (II) OUTPATIENT;
   28    (III) EMERGENCY ROOM;
   29    (IV) CLINIC;
   30    (V) NURSING HOMES;
   31    (VI) OTHER LONG TERM CARE;
   32    (VII) MEDICAID MANAGED CARE;
   33    (VIII) FAMILY HEALTH PLUS;
   34    (IX) PHARMACY;
   35    (X) TRANSPORTATION;
   36    (XI) DENTAL;
   37    (XII) NON-INSTITUTIONAL AND ALL OTHER CATEGORIES;
   38    (XIII) AFFORDABLE HOUSING;
   39    (XIV) VITAL ACCESS PROVIDER SERVICES;
   40    (XV) BEHAVIORAL HEALTH VITAL ACCESS PROVIDER SERVICES;
   41    (XVI) HEALTH HOME ESTABLISHMENT GRANTS;
   42    (XVII) GRANTS FOR FACILITATING TRANSITION OF BEHAVIORAL HEALTH SERVICE
   43  TO MANAGED CARE;
   44    (XVIII) FINGER LAKES HEALTH SERVICES AGENCY;
   45    (XIX) THE TRANSITION OF VULNERABLE POPULATIONS TO MANAGED CARE;
   46    (XX) AUDIT RECOVERIES AND SETTLEMENTS; AND
   47    (D)  WHERE  PRICE  AND UTILIZATION ARE NOT APPLICABLE, DETAIL SHALL BE
   48  PROVIDED ON SPENDING, TO INCLUDE BUT NOT BE LIMITED TO:
   49    (I) DEMOGRAPHIC INFORMATION OF TARGETED RECIPIENTS;
   50    (II) NUMBER OF RECIPIENTS;
   51    (III) AWARD AMOUNTS;
   52    (IV) TIMING OF AWARDS; AND
   53    (V) THE IMPACT OF MEDICAID REDESIGN TEAM AND/OR ONE-TIME INITIATIVES.
   54    INFORMATION REQUIRED BY PARAGRAPHS (A) AND  (B)  OF  THIS  SUBDIVISION
   55  SHALL  BE  PROVIDED TO THE CHAIRS OF THE SENATE FINANCE AND THE ASSEMBLY
       S. 6914                            130                           A. 9205

    1  WAYS AND MEANS COMMITTEES, AND SHALL BE  POSTED  ON  THE  DEPARTMENT  OF
    2  HEALTH'S WEBSITE IN THE TIMELY MANNER.
    3    (E)  BEGINNING  ON  JULY  1,  2014, ADDITIONAL INFORMATION REQUIRED BY
    4  PARAGRAPHS (C) AND (D) OF THIS SUBDIVISION  SHALL  BE  PROVIDED  TO  THE
    5  GOVERNOR,  THE  TEMPORARY  PRESIDENT  OF  THE SENATE, THE SPEAKER OF THE
    6  ASSEMBLY, THE CHAIR OF THE SENATE FINANCE COMMITTEE, THE  CHAIR  OF  THE
    7  ASSEMBLY  WAYS  AND  MEANS  COMMITTEE,  AND THE CHAIRS OF THE SENATE AND
    8  ASSEMBLY HEALTH COMMITTEES.
    9    (F) ANY PROJECTED MEDICAID SAVINGS DETERMINED BY THE  COMMISSIONER  OF
   10  HEALTH  PURSUANT  TO  SECTION  34  OF PART C OF A CHAPTER OF THE LAWS OF
   11  2014, RELATING TO THE IMPLEMENTATION OF THE HEALTH  AND  MENTAL  HYGIENE
   12  BUDGET, AND THE PROPOSED ALLOCATION PLAN WITH REGARD TO SUCH SAVINGS.
   13    6.  THE  COMMISSIONER  OF  HEALTH AND THE DIRECTOR OF THE BUDGET SHALL
   14  MAKE APPROPRIATE STAFF AVAILABLE TO MEET WITH THE CHAIRS OF  THE  HEALTH
   15  COMMITTEES OF THE NEW YORK STATE SENATE AND THE NEW YORK STATE ASSEMBLY,
   16  OR  THEIR  DESIGNEES,  UPON THEIR REQUEST AND WITH REASONABLE NOTICE, TO
   17  REVIEW EACH MONTHLY REPORT, AS DESCRIBED IN THIS SUBDIVISION.
   18    7. THE COMMISSIONER OF HEALTH SHALL MAKE TRAINING AVAILABLE TO  DESIG-
   19  NATED  LEGISLATIVE STAFF WITH REGARD TO THE SKILLS AND TECHNIQUES NEEDED
   20  TO EFFECTIVELY ACCESS AND REVIEW RELEVANT MEDICAID DATA BASES UNDER  THE
   21  CONTROL OF THE DEPARTMENT OF HEALTH, UPON THEIR REQUEST AND WITH REASON-
   22  ABLE NOTICE.
   23    8.  THE  MONTHLY  REPORTS  AS  DESCRIBED  IN  SUBDIVISION FIVE OF THIS
   24  SECTION AND RELATED DOCUMENTS PROVIDED TO THE NEW YORK STATE LEGISLATURE
   25  SHALL BE POSTED ON THE WEBSITE MAINTAINED BY THE DEPARTMENT OF HEALTH.
   26    S 34. Notwithstanding any contrary provision of law and subject to the
   27  availability of federal financial participation, for state fiscal  years
   28  beginning  on  and  after  April 1, 2014, the commissioner of health, in
   29  consultation with the director of the budget, shall,  prior  to  January
   30  first  of  each  year,  determine  the  extent of savings that have been
   31  achieved as a result of the application of the provisions of sections 91
   32  and 92 of part H of chapter 59 of the laws  of  2011,  as  amended,  and
   33  shall  further  determine  the availability of such savings for distrib-
   34  ution during the last quarter of such state fiscal year. In  determining
   35  such savings the commissioner of health, in consultation with the direc-
   36  tor  of  the  budget,  may  exempt the medical assistance administration
   37  program from distributions  under  this  section.  The  commissioner  of
   38  health,  in consultation with the director of the budget, may distribute
   39  funds up to an amount equal to such available savings in accordance with
   40  an allocation plan that utilizes a  methodology  that  distributes  such
   41  funds  proportionately  among providers and plans in New York's Medicaid
   42  program. In developing such allocation plan the commissioner  of  health
   43  shall  seek  the  input  of  the  legislature,  as well as organizations
   44  representing health  care  providers,  consumers,  businesses,  workers,
   45  health care insurers and others with relevant expertise. Such allocation
   46  plan  shall  utilize  three years of the most recently available system-
   47  wide expenditure data reflecting both MMIS and managed care  encounters.
   48  Distributions to managed care plans shall be based on the administrative
   49  outlays stemming from participation in the Medicaid program. The commis-
   50  sioner  of  health  may  impose minimum threshold amounts in determining
   51  provider eligibility for distributions pursuant to this section. No less
   52  than fifty percent of the amount available  for  distribution  shall  be
   53  made available for the purpose of assisting eligible providers utilizing
   54  the  methodology  outlined  above.  The  remainder  of the distributions
   55  pursuant to this section shall be made available  for  the  purposes  of
   56  ensuring  a  minimum  level  of assistance to financially distressed and
       S. 6914                            131                           A. 9205

    1  critically needed providers  as  identified  by  the  commissioner.  The
    2  commissioner  of  health shall post the Medicaid savings allocation plan
    3  on the department of health's website and shall provide  written  copies
    4  of  such  plan to the chairs of the senate finance and the assembly ways
    5  and means committees at least 30 days before the date on which implemen-
    6  tation is expected to begin. The commissioner of health is authorized to
    7  seek such federal  approvals  as  may  be  required  to  effectuate  the
    8  provisions  of  this  section,  including, but not limited to, to permit
    9  payment of such distributions as lumps sums and to secure  waivers  from
   10  otherwise  applicable  federal  upper payment limit restrictions on such
   11  payments.  The provisions of this section are subject to  the  reporting
   12  requirements  set  forth in paragraph (e) of subdivision 5 of section 92
   13  of part H of chapter 59 of the laws of 2011, as amended by section  33-a
   14  of  part  C of a chapter of the laws of 2014, relating to implementation
   15  of the health and mental hygiene budget.
   16    S 34-a. Subdivision 1 of section 206  of  the  public  health  law  is
   17  amended by adding a new paragraph (u) to read as follows:
   18    (U) THE COMMISSIONER SHALL PROVIDE A WRITTEN OR ELECTRONIC COPY OF ANY
   19  STATE  PLAN AMENDMENT SUBMITTED TO THE CENTERS FOR MEDICARE AND MEDICAID
   20  SERVICES TO THE CHAIR OF THE SENATE STANDING COMMITTEE ON HEALTH AND THE
   21  CHAIR OF THE ASSEMBLY HEALTH COMMITTEE, NO LATER THAN FIVE BUSINESS DAYS
   22  FROM THE DATE OF MAILING OR SUBMISSION.
   23    S 35. Subdivision 9 of section 365-l of the social  services  law,  as
   24  added  by  section  6  of  part  A of chapter 56 of the laws of 2013, is
   25  amended to read as follows:
   26    9. [Any] THE contract [or contracts] entered into by the  commissioner
   27  of  health  prior  to  January  first, two thousand thirteen pursuant to
   28  subdivision eight of this section may be amended or modified without the
   29  need for a competitive bid or request for proposal process, and  without
   30  regard  to the provisions of sections one hundred twelve and one hundred
   31  sixty-three of the state finance law, section one hundred  forty-two  of
   32  the  economic  development  law, or any other provision of law, to allow
   33  the purchase of additional personnel and services, subject to  available
   34  funding,  for  the limited purpose of assisting the department of health
   35  with implementing the Balancing Incentive Program, the Fully  Integrated
   36  Duals Advantage Program, the Vital Access Provider Program, the Medicaid
   37  waiver amendment associated with the public hospital transformation, the
   38  addition  of  behavioral health services as a managed care plan benefit,
   39  THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PLAN, ACTIVITIES TO FACILI-
   40  TATE THE TRANSITION OF VULNERABLE POPULATIONS TO MANAGED CARE and/or any
   41  workgroups required to be established by the chapter of the laws of  two
   42  thousand thirteen that added this subdivision.
   43    S 36. Section 92 of part H of chapter 59 of the laws of 2011, amending
   44  the  public  health  law  and other laws relating to known and projected
   45  department of health state fund medicaid  expenditures,  is  amended  by
   46  adding a new subdivision 6 to read as follows:
   47    6.  THE  COMMISSIONER  OF HEALTH, IN CONSULTATION WITH THE DIVISION OF
   48  THE BUDGET SHALL, UPON SUBMISSION OF THE EXECUTIVE BUDGET TO THE  LEGIS-
   49  LATURE,  PROVIDE  A DETAILED ACCOUNTING OF THE STATE MEDICAID GLOBAL CAP
   50  ON THE CLOSE OUT OF THE PRIOR YEAR,  A  CURRENT  YEAR  RE-ESTIMATE,  THE
   51  PROSPECTIVE TWO-YEAR ESTIMATE AND ANY OTHER INFORMATION DEEMED NECESSARY
   52  AND APPROPRIATE.
   53    S  37.  Notwithstanding  any  provision  of  law  to the contrary, the
   54  department of health and its designees, in consultation with the  assem-
   55  bly  and the senate health committees and their designees, and the divi-
   56  sion of budget and its designees,  shall  explore  the  feasibility  and
       S. 6914                            132                           A. 9205

    1  efficacy  of  codifying in consolidated law the provisions of section 92
    2  of part H of chapter 59 of the laws of 2011, and other such related laws
    3  and shall make such recommendations regarding codification by  no  later
    4  than June 1, 2014.
    5    S  38.  Subdivision  (a)  of section 90 of part H of chapter 59 of the
    6  laws of 2011, amending the public health law and other laws, relating to
    7  general hospital inpatient reimbursement for annual rates, as amended by
    8  section 1 of part A of chapter 56 of the laws of  2013,  is  amended  to
    9  read as follows:
   10    (a)  (1)  Notwithstanding  any other provision of law to the contrary,
   11  for the state fiscal years beginning April 1, 2011 and ending  on  March
   12  31, [2015] 2014, all Medicaid payments made for services provided on and
   13  after  April  1, 2011, shall, except as hereinafter provided, be subject
   14  to a uniform two percent reduction and such reduction shall be  applied,
   15  to  the  extent  practicable,  in  equal amounts during the fiscal year,
   16  provided, however, that an alternative method may be considered  at  the
   17  discretion  of the commissioner of health and the director of the budget
   18  based upon consultation with the health care industry including but  not
   19  limited  to,  a uniform reduction in Medicaid rates of payments or other
   20  reductions provided that any method selected achieves up to $345,000,000
   21  in Medicaid state share savings in state fiscal year 2011-12 and  up  to
   22  $357,000,000  annually in state fiscal years 2012-13[,] AND 2013-14 [and
   23  2014-15] except as hereinafter provided, for services  provided  on  and
   24  after April 1, 2011 through March 31, [2015] 2014. Any alternative meth-
   25  ods  to  achieve  the reduction must be provided in writing and shall be
   26  filed with the senate finance committee and the assembly ways and  means
   27  committee not less than thirty days before the date on which implementa-
   28  tion  is  expected  to begin. Nothing in this section shall be deemed to
   29  prevent all or part of  such  alternative  reduction  plan  from  taking
   30  effect retroactively, to the extent permitted by the federal centers for
   31  medicare and medicaid services.
   32    (2)  ALTERNATIVE  METHODS OF COST CONTAINMENT AS AUTHORIZED AND IMPLE-
   33  MENTED PURSUANT TO PARAGRAPH ONE OF THIS SUBDIVISION SHALL  CONTINUE  TO
   34  BE  APPLIED  AND  MAINTAINED  FOR  PERIODS  ON  AND AFTER APRIL 1, 2014,
   35  PROVIDED, HOWEVER, THAT THE COMMISSIONER OF HEALTH, IN CONSULTATION WITH
   36  THE DIRECTOR OF THE BUDGET, IS AUTHORIZED TO TERMINATE SUCH  ALTERNATIVE
   37  METHODS  UPON  A  FINDING  THAT THEY ARE NO LONGER NECESSARY TO MAINTAIN
   38  ESSENTIAL COST SAVINGS.
   39    S 39. Subdivisions (a)  and  (b)  of  section  364-jj  of  the  social
   40  services  law, as amended by section 80-a of part A of chapter 56 of the
   41  laws of 2013, are amended to read as follows:
   42    (a) There is hereby established a special  advisory  review  panel  on
   43  Medicaid  managed  care.  The  panel  shall  consist of [twelve] SIXTEEN
   44  members who shall be appointed as follows: [four] SIX by  the  governor,
   45  one  of  which shall serve as the chair; [three] FOUR each by the tempo-
   46  rary president of the senate and the speaker of the  assembly;  and  one
   47  each by the minority leader of the senate and the minority leader of the
   48  assembly.  At  least three members of such panel shall be members of the
   49  joint advisory panel established  under  section  13.40  of  the  mental
   50  hygiene law. THE PANEL SHALL INCLUDE A CONSUMER REPRESENTATIVE FOR INDI-
   51  VIDUALS  WITH  BEHAVIORAL  HEALTH  NEEDS,  A CONSUMER REPRESENTATIVE FOR
   52  INDIVIDUALS WHO ARE DUALLY ELIGIBLE FOR MEDICARE AND MEDICAID, A  REPRE-
   53  SENTATIVE  OF  ENTITIES  THAT  PROVIDE  OR  ARRANGE FOR THE PROVISION OF
   54  SERVICES TO INDIVIDUALS WITH BEHAVIORAL HEALTH NEEDS,  AND  A  REPRESEN-
   55  TATIVE OF ENTITIES THAT PROVIDE OR ARRANGE FOR THE PROVISION OF SERVICES
   56  TO  INDIVIDUALS  WHO  ARE  DUALLY  ELIGIBLE  FOR  MEDICARE AND MEDICAID.
       S. 6914                            133                           A. 9205

    1  Members shall serve without compensation but  shall  be  reimbursed  for
    2  appropriate expenses.  The department shall provide technical assistance
    3  and  access  to  data  as  is  required  for the panel to effectuate the
    4  mission and purposes established herein.
    5    (b) The panel shall:
    6    (i)  determine  whether  there  is  sufficient  managed  care provider
    7  participation in the Medicaid managed care program;
    8    (ii) determine whether managed care providers meet  proper  enrollment
    9  targets  that  permit  as  many  Medicaid recipients as possible to make
   10  their own health plan decisions, thus minimizing the number of automatic
   11  assignments;
   12    (iii) review the phase-in schedule for  enrollment,  of  managed  care
   13  providers under both the voluntary and mandatory programs;
   14    (iv)  assess the impact of managed care provider marketing and enroll-
   15  ment strategies, and the public education campaign conducted in New York
   16  city, on enrollees participation in Medicaid managed care plans;
   17    (v) evaluate the adequacy of managed care provider capacity by review-
   18  ing established capacity measurements and monitoring  actual  access  to
   19  plan practitioners;
   20    (vi)  examine  the  cost  implications  of  populations  excluded  and
   21  exempted from Medicaid managed care;
   22    (vii) EVALUATE THE ADEQUACY AND APPROPRIATENESS OF PROGRAM MATERIALS;
   23    (VIII) EXAMINE TRENDS IN SERVICE DENIALS;
   24    (IX) ASSESS THE ACCESS TO CARE FOR PEOPLE WITH DISABILITIES;
   25    (X) in accordance with the recommendations of the joint advisory coun-
   26  cil established pursuant to section 13.40 of  the  mental  hygiene  law,
   27  advise  the  commissioners of health and developmental disabilities with
   28  respect to the oversight of DISCOs and of health  maintenance  organiza-
   29  tions  and  managed  long term care plans providing services authorized,
   30  funded, approved or certified by the office  for  people  with  develop-
   31  mental  disabilities,  and  review  all managed care options provided to
   32  persons with developmental  disabilities,  including:  the  adequacy  of
   33  support  for  habilitation  services;  the  record  of  compliance  with
   34  requirements for person-centered planning, person-centered services  and
   35  community  integration;  the  adequacy  of  rates  paid  to providers in
   36  accordance with the provisions of paragraph 1  of  subdivision  four  of
   37  section  forty-four  hundred  three  of the public health law, paragraph
   38  (a-2) of subdivision eight of section forty-four hundred  three  of  the
   39  public  health  law  or paragraph (a-2) of subdivision twelve of section
   40  forty-four hundred three-f of the public health law; and the quality  of
   41  life,  health, safety and community integration of persons with develop-
   42  mental disabilities enrolled in managed care; and
   43    [(viii)] (XI) examine other issues as it deems appropriate.
   44    S 40. Subdivision 6 of section 368-d of the social  services  law,  as
   45  amended  by  section  37 of part D of chapter 56 of the laws of 2012, is
   46  amended to read as follows:
   47    6. The commissioner shall evaluate the results of the study  conducted
   48  pursuant  to  subdivision four of this section to determine, after iden-
   49  tification of actual direct and indirect costs incurred by public school
   50  districts [and state operated and state supported schools for blind  and
   51  deaf  students],  whether it is advisable to claim federal reimbursement
   52  for expenditures under this section as certified public expenditures. In
   53  the event such claims are submitted, if federal  reimbursement  received
   54  for certified public expenditures on behalf of medical assistance recip-
   55  ients  whose  assistance  and  care  are  the responsibility of a social
   56  services district results in a decrease in the  state  share  of  annual
       S. 6914                            134                           A. 9205

    1  expenditures  pursuant  to this section for such recipients, then to the
    2  extent that the amount of any  such  decrease  when  combined  with  any
    3  decrease in the state share of annual expenditures described in subdivi-
    4  sion  five  of section three hundred sixty-eight-e of this title exceeds
    5  one hundred fifty million dollars for the period April 1,  2011  through
    6  March  31,  2013, or exceeds one hundred million dollars in state fiscal
    7  [year 2012-13 or any fiscal year thereafter] YEARS 2013-14 AND  2014-15,
    8  the  excess  amount shall be transferred to such public school districts
    9  [and state operated and state  supported  schools  for  blind  and  deaf
   10  students]  in  amounts  proportional to their percentage contribution to
   11  the statewide savings; AN AMOUNT EQUAL TO THIRTEEN AND  FIVE  HUNDREDTHS
   12  PERCENT OF ANY DECREASE IN THE STATE SHARE OF ANNUAL EXPENDITURES PURSU-
   13  ANT TO THIS SECTION FOR SUCH RECIPIENTS IN STATE FISCAL YEAR 2015-16 AND
   14  ANY  FISCAL  YEAR  THEREAFTER SHALL BE TRANSFERRED TO SUCH PUBLIC SCHOOL
   15  DISTRICTS IN AMOUNTS PROPORTIONAL TO THEIR  PERCENTAGE  CONTRIBUTION  TO
   16  THE  STATEWIDE SAVINGS. Any [such excess] amount transferred PURSUANT TO
   17  THIS SECTION shall not be considered a revenue received by  such  social
   18  services  district  in determining the district's actual medical assist-
   19  ance expenditures for purposes of paragraph (b) of section one of part C
   20  of chapter fifty-eight of the laws of two thousand five.
   21    S 41. Subdivision 5 of section 368-e of the social  services  law,  as
   22  amended  by  section  38 of part D of chapter 56 of the laws of 2012, is
   23  amended to read as follows:
   24    5. The commissioner shall evaluate the results of the study  conducted
   25  pursuant  to subdivision three of this section to determine, after iden-
   26  tification of actual direct and indirect costs incurred by counties  for
   27  medical  care,  services,  and supplies furnished to pre-school children
   28  with handicapping conditions, whether it is advisable to  claim  federal
   29  reimbursement  for  expenditures  under this section as certified public
   30  expenditures. In  the  event  such  claims  are  submitted,  if  federal
   31  reimbursement  received  for  certified public expenditures on behalf of
   32  medical assistance recipients whose assistance and care are the  respon-
   33  sibility  of  a  social  services district, results in a decrease in the
   34  state share of annual expenditures pursuant to  this  section  for  such
   35  recipients, then to the extent that the amount of any such decrease when
   36  combined  with  any  decrease  in the state share of annual expenditures
   37  described in subdivision six of section three hundred  sixty-eight-d  of
   38  this  title  exceeds  one  hundred  fifty million dollars for the period
   39  April 1, 2011 through March 31, 2013, or  exceeds  one  hundred  million
   40  dollars  in  state  fiscal  [year 2012-13 or any fiscal year thereafter]
   41  YEARS 2013-14 AND 2014-15, the excess amount  shall  be  transferred  to
   42  such  counties  in amounts proportional to their percentage contribution
   43  to  the  statewide  savings;  AN  AMOUNT  EQUAL  TO  THIRTEEN  AND  FIVE
   44  HUNDREDTHS PERCENT OF ANY DECREASE IN THE STATE SHARE OF ANNUAL EXPENDI-
   45  TURES  PURSUANT TO THIS SECTION FOR SUCH RECIPIENTS IN STATE FISCAL YEAR
   46  2015-16 AND ANY FISCAL YEAR THEREAFTER  SHALL  BE  TRANSFERRED  TO  SUCH
   47  COUNTIES IN AMOUNTS PROPORTIONAL TO THEIR PERCENTAGE CONTRIBUTION TO THE
   48  STATEWIDE  SAVINGS.    Any  [such excess] amount transferred PURSUANT TO
   49  THIS SECTION shall not be considered a revenue received by  such  social
   50  services  district  in determining the district's actual medical assist-
   51  ance expenditures for purposes of paragraph (b) of section one of part C
   52  of chapter fifty-eight of the laws of two thousand five.
   53    S 42.  Subdivision 8 of section 365-a of the social services  law,  as
   54  added  by  section  46-a of part B of chapter 58 of the laws of 2009, is
   55  amended to read as follows:
       S. 6914                            135                           A. 9205

    1    8. When a non-governmental entity  is  authorized  by  the  department
    2  pursuant to contract or subcontract to make prior authorization or prior
    3  approval  determinations  that  may  be required for any item of medical
    4  assistance, a recipient may challenge any action taken or failure to act
    5  in connection with a prior authorization or prior approval determination
    6  as  if such determination were made by a government entity, and shall be
    7  entitled to the same medical assistance benefits and  standards  and  to
    8  the  same notice and procedural due process rights, including a right to
    9  a fair hearing and aid continuing pursuant to section twenty-two of this
   10  chapter, as if the prior authorization or prior  approval  determination
   11  were  made  by  a government entity, WITHOUT REGARD TO EXPIRATION OF THE
   12  PRIOR SERVICE AUTHORIZATION.
   13    S 43. Subparagraph (ii) of paragraph (a) of subdivision 7  of  section
   14  4403-f of the public health law, as amended by section 41-b of part H of
   15  chapter 59 of the laws of 2011, is amended to read as follows:
   16    (ii) Notwithstanding any inconsistent provision of the social services
   17  law  to  the  contrary,  the commissioner shall, pursuant to regulation,
   18  determine whether and the extent to which the applicable  provisions  of
   19  the social services law or regulations relating to approvals and author-
   20  izations  of,  and utilization limitations on, health and long term care
   21  services reimbursed pursuant to title XIX of the federal social security
   22  act, including, but not limited to, fiscal assessment requirements,  are
   23  inconsistent  with  the flexibility necessary for the efficient adminis-
   24  tration of managed long term  care  plans  and  such  regulations  shall
   25  provide  that  such  provisions  shall not be applicable to enrollees or
   26  managed long term care plans,  provided  that  such  determinations  are
   27  consistent  with  applicable  federal law and regulation, AND SUBJECT TO
   28  THE  PROVISIONS  OF  SUBDIVISION  EIGHT   OF   SECTION   THREE   HUNDRED
   29  SIXTY-FIVE-A OF THE SOCIAL SERVICES LAW.
   30    S 44. The social services law is amended by adding a new section 398-b
   31  to read as follows:
   32    S 398-B. TRANSITION TO MANAGED CARE. 1. NOTWITHSTANDING ANY INCONSIST-
   33  ENT  PROVISION OF LAW TO THE CONTRARY AND SUBJECT TO THE AVAILABILITY OF
   34  FEDERAL FINANCIAL PARTICIPATION, THE COMMISSIONER IS AUTHORIZED TO  MAKE
   35  GRANTS  FROM  A  GROSS  AMOUNT OF FIVE MILLION DOLLARS TO FACILITATE THE
   36  TRANSITION OF FOSTER CARE CHILDREN PLACED  WITH  VOLUNTARY  FOSTER  CARE
   37  AGENCIES  TO  MANAGED  CARE. THE USE OF SUCH FUNDS MAY INCLUDE PROVIDING
   38  TRAINING AND CONSULTING SERVICES TO VOLUNTARY AGENCIES TO  ACCESS  READ-
   39  INESS  AND  MAKE  NECESSARY  INFRASTRUCTURE AND ORGANIZATIONAL MODIFICA-
   40  TIONS, COLLECTING SERVICE UTILIZATION  AND  OTHER  DATA  FROM  VOLUNTARY
   41  AGENCIES  AND  OTHER ENTITIES, AND MAKING INVESTMENTS IN HEALTH INFORMA-
   42  TION TECHNOLOGY, INCLUDING THE INFRASTRUCTURE NECESSARY TO ESTABLISH AND
   43  MAINTAIN ELECTRONIC HEALTH RECORDS.  SUCH  FUNDS  SHALL  BE  DISTRIBUTED
   44  PURSUANT  TO A FORMULA TO BE DEVELOPED BY THE COMMISSIONER OF HEALTH, IN
   45  CONSULTATION WITH THE COMMISSIONER OF THE OFFICE  OF  FAMILY  AND  CHILD
   46  SERVICES.  IN  DEVELOPING  SUCH  FORMULA THE COMMISSIONERS MAY TAKE INTO
   47  ACCOUNT SIZE AND SCOPE OF PROVIDER OPERATIONS AS A  FACTOR  RELEVANT  TO
   48  ELIGIBILITY  FOR  SUCH  FUNDS.  EACH  RECIPIENT  OF  SUCH FUNDS SHALL BE
   49  REQUIRED TO DOCUMENT AND DEMONSTRATE THE EFFECTIVE USE OF FUNDS DISTRIB-
   50  UTED HEREIN.
   51    2. DATA PROVIDED BY VOLUNTARY FOSTER CARE AGENCIES SHALL BE  COMPLIANT
   52  WITH  THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT, AND SHALL
   53  BE TRANSMITTED SECURELY USING EMEDS OR OTHER MECHANISM TO BE  DETERMINED
   54  BY  THE DEPARTMENT OF HEALTH. SUCH DATA MAY BE USED BY THE DEPARTMENT OF
   55  HEALTH TO ESTABLISH RATES OF PAYMENT FOR MANAGED CARE ORGANIZATIONS  FOR
   56  SERVICES PROVIDED TO CHILDREN IN FOSTER CARE. IN ESTABLISHING SUCH RATES
       S. 6914                            136                           A. 9205

    1  THE  COMMISSIONER  OF  HEALTH  SHALL ALSO TAKE INTO ACCOUNT CARE COORDI-
    2  NATION SERVICES THAT WILL CONTINUE  TO  BE  PROVIDED  BY  THE  VOLUNTARY
    3  FOSTER CARE AGENCIES.
    4    3.  THE  COMMISSIONER OF HEALTH SHALL ISSUE A REPORT TO BE MADE PUBLIC
    5  ON THE DEPARTMENT OF HEALTH'S WEBSITE. SUCH REPORT SHALL CONFORM TO  THE
    6  REQUIREMENTS  OF  SUBDIVISION  FIVE  OF  SECTION NINETY-TWO OF PART H OF
    7  CHAPTER FIFTY-NINE OF THE LAWS OF TWO THOUSAND ELEVEN.
    8    S 45. Subdivision 3 of section 365-n of the social  services  law,  as
    9  added  by  section  6  of  part  F of chapter 56 of the laws of 2012, is
   10  amended to read as follows:
   11    3. Notwithstanding sections sixty-one, sixty-three, seventy,  seventy-
   12  eight,  seventy-nine,  eighty-one  and [eight-one-a] EIGHTY-ONE-A of the
   13  civil service law or any provisions to the  contrary  contained  in  any
   14  general,  special,  or  local  laws,  all  lawful appointees of a county
   15  performing the functions established in subdivision two of this  section
   16  as of the effective date of this section OR ANY SUCH APPOINTEES WHO MEET
   17  THE OPEN COMPETITIVE QUALIFICATIONS FOR POSITIONS ESTABLISHED TO PERFORM
   18  THESE  FUNCTIONS  will be eligible for voluntary transfer to appropriate
   19  positions, in the department, that are classified to perform such  func-
   20  tions  without further examination, qualification, or probationary peri-
   21  od; and, upon such transfer, will have all the rights and privileges  of
   22  the  jurisdictional classification to which such positions are allocated
   23  in the classified service of the state.
   24    S 46.  Section 365-n of the social services law is amended by adding a
   25  new subdivision 5-a to read as follows:
   26    5-A. (A) THE COMMISSIONER MAY TAKE  NECESSARY  ACTION  TO  REVIEW  THE
   27  ACCURACY  OF DETERMINATIONS OF INITIAL AND ONGOING ELIGIBILITY UNDER THE
   28  MEDICAL ASSISTANCE PROGRAM, AND TO IDENTIFY AND ELIMINATE  INAPPROPRIATE
   29  INSTANCES  OF  CONCURRENT  OR DUPLICATE BENEFITS AND AUTHORIZATIONS. THE
   30  COMMISSIONER IS AUTHORIZED TO CONTRACT WITH  ONE  OR  MORE  ENTITIES  TO
   31  ASSIST THE STATE IN IMPLEMENTING THE PROVISIONS OF THIS SUBDIVISION.
   32    (B)  NOTWITHSTANDING THE PROVISIONS OF SECTIONS ONE HUNDRED TWELVE AND
   33  ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTION ONE HUNDRED
   34  FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY CONTRARY PROVISION  OF
   35  LAW,  THE  COMMISSIONER  IS  AUTHORIZED  TO  ENTER  INTO  A  CONTRACT OR
   36  CONTRACTS UNDER PARAGRAPH (A) OF THIS SUBDIVISION WITHOUT A  COMPETITIVE
   37  BID OR REQUEST FOR PROPOSAL PROCESS, PROVIDED, HOWEVER, THAT:
   38    (I)  THE  DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR A PERIOD
   39  OF NO LESS THAN THIRTY DAYS:
   40    (1) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
   41  THE CONTRACT OR CONTRACTS;
   42    (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
   43    (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
   44  SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
   45  TION IS FIRST POSTED ON THE WEBSITE; AND
   46    (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
   47  SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
   48    (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
   49  PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
   50  COMMISSIONER; AND
   51    (III) THE COMMISSIONER SHALL SELECT  SUCH  CONTRACTOR  OR  CONTRACTORS
   52  THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
   53  THIS SECTION; AND
   54    (IV)  NO CONTRACT ENTERED PURSUANT TO THIS PARAGRAPH SHALL HAVE A TERM
   55  THAT ENDS LATER THAN MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN.
       S. 6914                            137                           A. 9205

    1    S 47.   Subparagraph (iv) of  paragraph  (e-2)  of  subdivision  4  of
    2  section  2807-c  of  the  public  health  law is amended by adding a new
    3  clause (E) to read as follows:
    4    (E) FOR FACILITIES SUBJECT TO THE PROVISIONS OF THIS SUBPARAGRAPH, THE
    5  DEPARTMENT  SHALL EXAMINE THE FEASIBILITY OF REIMBURSING SUCH FACILITIES
    6  FOR SERVICES PROVIDED TO CHILDREN ELIGIBLE FOR MEDICAL ASSISTANCE  ON  A
    7  NON-FEE-FOR-SERVICE    BASIS.    FOR    PURPOSES    OF    THIS   CLAUSE,
    8  "NON-FEE-FOR-SERVICE" SHALL BE DEFINED AS AN ALTERNATIVE PAYMENT  METHOD
    9  TO  BUNDLE  CERTAIN  SERVICES RENDERED BY SUCH FACILITY, INCLUDING INPA-
   10  TIENT, OUTPATIENT,  SPECIALTY  OUTPATIENT  AND  PHYSICIAN  SERVICES,  IN
   11  AMOUNTS DETERMINED BY THE COMMISSIONER. THE DEPARTMENT SHALL EXAMINE:
   12    (A)  WHAT  SERVICES COULD BE PROVIDED PURSUANT TO THE NON-FEE-FOR-SER-
   13  VICE BASIS;
   14    (B) HOW TO ENSURE, FOR CHILDREN ENROLLED  IN  MEDICAID  MANAGED  CARE,
   15  THAT  THEIR  HEALTH  PLANS CAN CONTINUE TO ASSIST IN THE COORDINATION OF
   16  THEIR CARE, PARTICULARLY UPON DISCHARGE FROM  INPATIENT,  OUTPATIENT  OR
   17  SPECIALTY OUTPATIENT SERVICES; AND
   18    (C)  WHETHER  INCENTIVES  SHOULD  BE  INCORPORATED FOR MEETING QUALITY
   19  BENCHMARKS OR ACHIEVING EFFICIENCIES IN THE DELIVERY AND COORDINATION OF
   20  CARE OR WHETHER OTHER MEANS SHOULD BE CONSIDERED TO ACHIEVE THESE OBJEC-
   21  TIVES.
   22    THE DEPARTMENT SHALL PROVIDE A REPORT OF ITS FINDINGS AND  RECOMMENDA-
   23  TIONS  TO  THE  GOVERNOR  AND LEGISLATURE NO LATER THAN MARCH FIRST, TWO
   24  THOUSAND FIFTEEN.
   25    S 48. Notwithstanding sections 112 and 163 of the state  finance  law,
   26  or  any  other  contrary provision of law, the commissioner of health is
   27  authorized to negotiate an  extension  of  the  terms  of  the  contract
   28  executed  by  the  department  of  health  for  actuarial and consulting
   29  services, on September 18, 2009, without a competitive  bid  or  request
   30  for proposal process; provided, however, such extension shall not extend
   31  beyond December 31, 2016.
   32    S 49.  Section 364-j of the social services law is amended by adding a
   33  new subdivision 29 to read as follows:
   34    29.    IN  THE  EVENT  THAT  THE DEPARTMENT RECEIVES APPROVAL FROM THE
   35  CENTERS FOR MEDICARE AND MEDICAID SERVICES  TO  AMEND  ITS  1115  WAIVER
   36  KNOWN AS THE PARTNERSHIP PLAN OR RECEIVES APPROVAL FOR A NEW 1115 WAIVER
   37  FOR  THE  PURPOSE  OF REINVESTING SAVINGS RESULTING FROM THE REDESIGN OF
   38  THE MEDICAL ASSISTANCE PROGRAM, THE COMMISSIONER IS AUTHORIZED TO  ENTER
   39  INTO  CONTRACTS, AND/OR TO AMEND THE TERMS OF CONTRACTS AWARDED PRIOR TO
   40  THE EFFECTIVE DATE OF THIS SUBDIVISION, FOR THE PURPOSE OF ASSISTING THE
   41  DEPARTMENT OF HEALTH WITH IMPLEMENTING PROJECTS  AUTHORIZED  UNDER  SUCH
   42  WAIVER  APPROVAL. NOTWITHSTANDING THE PROVISIONS OF SECTIONS ONE HUNDRED
   43  TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
   44  ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
   45  OPMENT LAW, OR ANY CONTRARY PROVISION OF LAW, CONTRACTS MAY  BE  ENTERED
   46  OR  CONTRACT AMENDMENTS MAY BE MADE PURSUANT TO THIS SUBDIVISION WITHOUT
   47  A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS IF  THE  TERM  OF  ANY
   48  SUCH  CONTRACT  OR CONTRACT AMENDMENT DOES NOT EXTEND BEYOND MARCH THIR-
   49  TY-FIRST, TWO THOUSAND NINETEEN; PROVIDED, HOWEVER, IN  THE  CASE  OF  A
   50  CONTRACT  ENTERED  INTO  AFTER  THE  EFFECTIVE DATE OF THIS SUBDIVISION,
   51  THAT:
   52    (A) THE DEPARTMENT OF HEALTH SHALL POST ON ITS WEBSITE, FOR  A  PERIOD
   53  OF NO LESS THAN THIRTY DAYS:
   54    (I)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
   55  THE CONTRACT OR CONTRACTS;
   56    (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
       S. 6914                            138                           A. 9205

    1    (III) THE PERIOD OF TIME DURING WHICH  A  PROSPECTIVE  CONTRACTOR  MAY
    2  SEEK  SELECTION,  WHICH  SHALL  BE  NO  LESS THAN THIRTY DAYS AFTER SUCH
    3  INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
    4    (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
    5  SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
    6    (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
    7  PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
    8  COMMISSIONER OF HEALTH; AND
    9    (C) THE  COMMISSIONER  OF  HEALTH  SHALL  SELECT  SUCH  CONTRACTOR  OR
   10  CONTRACTORS THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE
   11  PURPOSES OF THIS SECTION.
   12    S  50.  Subdivision  1  of  section  366 of the social services law is
   13  amended by adding a new paragraph (g) to read as follows:
   14    (G) COVERAGE OF CERTAIN NONCITIZENS. (1) APPLICANTS AND RECIPIENTS WHO
   15  ARE LAWFULLY ADMITTED FOR PERMANENT RESIDENCE, OR  WHO  ARE  PERMANENTLY
   16  RESIDING  IN THE UNITED STATES UNDER COLOR OF LAW; WHO ARE MAGI ELIGIBLE
   17  PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION; AND WHO WOULD BE INELIGI-
   18  BLE FOR MEDICAL ASSISTANCE COVERAGE UNDER SUBDIVISIONS ONE  AND  TWO  OF
   19  SECTION  THREE  HUNDRED  SIXTY-FIVE-A  OF THIS TITLE SOLELY DUE TO THEIR
   20  IMMIGRATION STATUS IF THE PROVISIONS OF SECTION ONE  HUNDRED  TWENTY-TWO
   21  OF  THIS  CHAPTER  WERE  APPLIED,  SHALL ONLY BE ELIGIBLE FOR ASSISTANCE
   22  UNDER THIS TITLE IF ENROLLED IN A STANDARD  HEALTH  PLAN  OFFERED  BY  A
   23  BASIC  HEALTH  PROGRAM  ESTABLISHED  PURSUANT  TO  SECTION THREE HUNDRED
   24  SIXTY-NINE-GG OF THIS ARTICLE IF SUCH PROGRAM IS ESTABLISHED AND OPERAT-
   25  ING.
   26    (2) WITH RESPECT TO A PERSON DESCRIBED IN  SUBPARAGRAPH  ONE  OF  THIS
   27  PARAGRAPH  WHO IS ENROLLED IN A STANDARD HEALTH PLAN, MEDICAL ASSISTANCE
   28  COVERAGE SHALL MEAN:
   29    (I) PAYMENT OF REQUIRED PREMIUMS AND  OTHER  COST-SHARING  OBLIGATIONS
   30  UNDER THE STANDARD HEALTH PLAN THAT EXCEED THE PERSON'S CO-PAYMENT OBLI-
   31  GATION  UNDER  SUBDIVISION SIX OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF
   32  THIS TITLE; AND
   33    (II) PAYMENT FOR SERVICES AND SUPPLIES DESCRIBED IN SUBDIVISION ONE OR
   34  TWO OF SECTION THREE HUNDRED SIXTY-FIVE-A OF THIS TITLE, AS  APPLICABLE,
   35  BUT  ONLY  TO THE EXTENT THAT SUCH SERVICES AND SUPPLIES ARE NOT COVERED
   36  BY THE STANDARD HEALTH PLAN.
   37    (3) NOTHING IN THIS SUBDIVISION SHALL PREVENT A  PERSON  DESCRIBED  IN
   38  SUBPARAGRAPH  ONE  OF  THIS  PARAGRAPH  FROM QUALIFYING FOR OR RECEIVING
   39  MEDICAL ASSISTANCE WHILE HIS OR HER ENROLLMENT IN A STANDARD HEALTH PLAN
   40  IS PENDING, IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THIS TITLE.
   41    S 51. The social services law is amended by adding a new section  369-
   42  gg to read as follows:
   43    S  369-GG. BASIC HEALTH PROGRAM. 1. DEFINITIONS.  FOR PURPOSES OF THIS
   44  SECTION:
   45    (A) "ELIGIBLE ORGANIZATION" MEANS  AN  INSURER  LICENSED  PURSUANT  TO
   46  ARTICLE  THIRTY-TWO  OR FORTY-TWO OF THE INSURANCE LAW, A CORPORATION OR
   47  AN ORGANIZATION UNDER ARTICLE FORTY-THREE OF THE INSURANCE  LAW,  OR  AN
   48  ORGANIZATION  CERTIFIED  UNDER  ARTICLE  FORTY-FOUR OF THE PUBLIC HEALTH
   49  LAW, INCLUDING PROVIDERS  CERTIFIED  UNDER  SECTION  FORTY-FOUR  HUNDRED
   50  THREE-E OF THE PUBLIC HEALTH LAW;
   51    (B) "APPROVED ORGANIZATION" MEANS AN ELIGIBLE ORGANIZATION APPROVED BY
   52  THE COMMISSIONER TO UNDERWRITE A BASIC HEALTH INSURANCE PLAN PURSUANT TO
   53  THIS TITLE;
   54    (C)  "HEALTH CARE SERVICES" MEANS THE SERVICES AND SUPPLIES AS DEFINED
   55  BY THE COMMISSIONER IN CONSULTATION WITH THE SUPERINTENDENT OF FINANCIAL
   56  SERVICES, AND SHALL BE CONSISTENT WITH  AND  SUBJECT  TO  THE  ESSENTIAL
       S. 6914                            139                           A. 9205

    1  HEALTH  BENEFITS  AS  DEFINED BY THE COMMISSIONER IN ACCORDANCE WITH THE
    2  PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (P.L.  111-
    3  148)  AND  CONSISTENT  WITH  THE BENEFITS PROVIDED BY THE REFERENCE PLAN
    4  SELECTED BY THE COMMISSIONER FOR THE PURPOSES OF DEFINING SUCH BENEFITS;
    5    (D)  "QUALIFIED HEALTH PLAN" MEANS A HEALTH PLAN THAT MEETS THE CRITE-
    6  RIA FOR CERTIFICATION DESCRIBED IN S 1311(C) OF THE  PATIENT  PROTECTION
    7  AND  AFFORDABLE  CARE  ACT (P.L. 111-148), AND IS OFFERED TO INDIVIDUALS
    8  THROUGH THE HEALTH INSURANCE EXCHANGE MARKETPLACE; AND
    9    (E) "BASIC HEALTH INSURANCE PLAN" MEANS A STANDARD HEALTH PLAN,  SEPA-
   10  RATE  AND  APART  FROM  QUALIFIED  HEALTH  PLANS,  THAT  IS ISSUED BY AN
   11  APPROVED ORGANIZATION AND CERTIFIED IN ACCORDANCE WITH THIS SECTION.
   12    2. AUTHORIZATION. IF IT IS IN THE FINANCIAL INTEREST OF THE  STATE  TO
   13  DO  SO,  THE  COMMISSIONER OF HEALTH IS AUTHORIZED, WITH THE APPROVAL OF
   14  THE DIRECTOR OF THE BUDGET, TO ESTABLISH A  BASIC  HEALTH  PROGRAM.  THE
   15  COMMISSIONER'S  AUTHORITY  PURSUANT  TO  THIS SECTION IS CONTINGENT UPON
   16  OBTAINING AND MAINTAINING ALL NECESSARY APPROVALS FROM THE SECRETARY  OF
   17  HEALTH  AND HUMAN SERVICES TO OFFER A BASIC HEALTH PROGRAM IN ACCORDANCE
   18  WITH 42 U.S.C. 18051. THE COMMISSIONER MAY  TAKE  ANY  AND  ALL  ACTIONS
   19  NECESSARY TO OBTAIN SUCH APPROVALS.
   20    3.  ELIGIBILITY.  A  PERSON IS ELIGIBLE TO RECEIVE COVERAGE FOR HEALTH
   21  CARE SERVICES PURSUANT TO THIS TITLE IF HE OR SHE:
   22    (A) RESIDES IN NEW YORK STATE AND IS UNDER SIXTY-FIVE YEARS OF AGE;
   23    (B) IS NOT ELIGIBLE FOR MEDICAL ASSISTANCE UNDER TITLE ELEVEN OF  THIS
   24  ARTICLE  OR FOR THE CHILD HEALTH INSURANCE PLAN DESCRIBED IN TITLE ONE-A
   25  OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW;
   26    (C) IS NOT ELIGIBLE FOR MINIMUM  ESSENTIAL  COVERAGE,  AS  DEFINED  IN
   27  SECTION  5000A(F)  OF  THE  INTERNAL REVENUE SERVICE CODE OF 1986, OR IS
   28  ELIGIBLE FOR AN EMPLOYER-SPONSORED  PLAN  THAT  IS  NOT  AFFORDABLE,  IN
   29  ACCORDANCE WITH SECTION 5000A OF SUCH CODE; AND
   30    (D)  (I)  HAS  HOUSEHOLD INCOME AT OR BELOW TWO HUNDRED PERCENT OF THE
   31  FEDERAL POVERTY LINE DEFINED AND ANNUALLY REVISED BY THE  UNITED  STATES
   32  DEPARTMENT  OF  HEALTH  AND  HUMAN  SERVICES FOR A HOUSEHOLD OF THE SAME
   33  SIZE;  AND  (II)  HAS  HOUSEHOLD  INCOME  THAT   EXCEEDS   ONE   HUNDRED
   34  THIRTY-THREE  PERCENT  OF  THE FEDERAL POVERTY LINE DEFINED AND ANNUALLY
   35  REVISED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR
   36  A HOUSEHOLD OF THE SAME SIZE; HOWEVER,  MAGI  ELIGIBLE  ALIENS  LAWFULLY
   37  PRESENT  IN  THE  UNITED  STATES  WITH HOUSEHOLD INCOMES AT OR BELOW ONE
   38  HUNDRED THIRTY-THREE PERCENT OF THE FEDERAL POVERTY LINE SHALL BE ELIGI-
   39  BLE TO RECEIVE  COVERAGE  FOR  HEALTH  CARE  SERVICES  PURSUANT  TO  THE
   40  PROVISIONS  OF  THIS TITLE IF SUCH ALIEN WOULD BE INELIGIBLE FOR MEDICAL
   41  ASSISTANCE UNDER TITLE ELEVEN OF THIS ARTICLE DUE TO HIS  OR  HER  IMMI-
   42  GRATION STATUS.
   43    AN  APPLICANT  WHO  FAILS  TO MAKE AN APPLICABLE PREMIUM PAYMENT SHALL
   44  LOSE ELIGIBILITY TO RECEIVE COVERAGE FOR HEALTH CARE SERVICES IN ACCORD-
   45  ANCE WITH TIME FRAMES AND PROCEDURES DETERMINED BY THE COMMISSIONER.
   46    4. ENROLLMENT. (A) SUBJECT TO FEDERAL APPROVAL,  THE  COMMISSIONER  IS
   47  AUTHORIZED  TO  ESTABLISH  AN  APPLICATION  AND ENROLLMENT PROCEDURE FOR
   48  PROSPECTIVE ENROLLEES.  SUCH  PROCEDURE  SHALL  INCLUDE  A  VERIFICATION
   49  SYSTEM FOR APPLICANTS, WHICH SHALL BE CONSISTENT WITH 42 USC S 1320B-7.
   50    (B) SUCH PROCEDURE SHALL ALLOW FOR CONTINUOUS ENROLLMENT FOR ENROLLEES
   51  TO THE BASIC HEALTH PROGRAM WHERE AN INDIVIDUAL MAY APPLY AND ENROLL FOR
   52  COVERAGE AT ANY POINT.
   53    (C)  UPON  AN APPLICANT'S ENROLLMENT IN A BASIC HEALTH INSURANCE PLAN,
   54  COVERAGE FOR HEALTH CARE SERVICES PURSUANT TO  THE  PROVISIONS  OF  THIS
   55  TITLE  SHALL BE PROSPECTIVE. COVERAGE SHALL BEGIN IN A MANNER CONSISTENT
   56  WITH THE REQUIREMENTS FOR QUALIFIED HEALTH  PLANS  OFFERED  THROUGH  THE
       S. 6914                            140                           A. 9205

    1  HEALTH  INSURANCE  EXCHANGE  MARKETPLACE, AS DELINEATED IN FEDERAL REGU-
    2  LATION AT 42 CFR 155.420(B)(1) OR ANY SUCCESSOR REGULATION THEREOF.
    3    (D) A PERSON WHO HAS ENROLLED FOR COVERAGE PURSUANT TO THIS TITLE, AND
    4  WHO LOSES ELIGIBILITY TO ENROLL IN THE BASIC HEALTH PROGRAM FOR A REASON
    5  OTHER  THAN  CITIZENSHIP  STATUS,  LACK  OF  STATE RESIDENCE, FAILURE TO
    6  PROVIDE A VALID SOCIAL SECURITY NUMBER, PROVIDING INACCURATE INFORMATION
    7  THAT WOULD AFFECT ELIGIBILITY WHEN REQUESTING OR RENEWING HEALTH  COVER-
    8  AGE  PURSUANT  TO  THIS  TITLE, OR FAILURE TO MAKE AN APPLICABLE PREMIUM
    9  PAYMENT, BEFORE THE END OF A TWELVE MONTH PERIOD BEGINNING ON THE EFFEC-
   10  TIVE DATE OF THE PERSON'S INITIAL ELIGIBILITY FOR  COVERAGE,  OR  BEFORE
   11  THE END OF A TWELVE MONTH PERIOD BEGINNING ON THE DATE OF ANY SUBSEQUENT
   12  DETERMINATION  OF  ELIGIBILITY,  SHALL  HAVE  HIS OR HER ELIGIBILITY FOR
   13  COVERAGE CONTINUED UNTIL THE END OF SUCH TWELVE MONTH  PERIOD,  PROVIDED
   14  THAT  THE STATE RECEIVES FEDERAL APPROVAL FOR USING FUNDS FROM THE BASIC
   15  HEALTH PROGRAM TRUST FUND, ESTABLISHED  UNDER  SECTION  97-OOOO  OF  THE
   16  STATE FINANCE LAW, FOR THE COSTS ASSOCIATED WITH SUCH ASSISTANCE.
   17    5.  PREMIUMS  AND  COST  SHARING. (A) SUBJECT TO FEDERAL APPROVAL, THE
   18  COMMISSIONER SHALL ESTABLISH PREMIUM PAYMENTS  ENROLLEES  SHALL  PAY  TO
   19  APPROVED  ORGANIZATIONS FOR COVERAGE OF HEALTH CARE SERVICES PURSUANT TO
   20  THIS TITLE. SUCH PREMIUM PAYMENTS SHALL BE ESTABLISHED IN THE  FOLLOWING
   21  MANNER:
   22    (I)  UP  TO  TWENTY DOLLARS MONTHLY FOR AN INDIVIDUAL WITH A HOUSEHOLD
   23  INCOME ABOVE ONE HUNDRED AND FIFTY PERCENT OF THE FEDERAL  POVERTY  LINE
   24  BUT  AT OR BELOW TWO HUNDRED PERCENT OF THE FEDERAL POVERTY LINE DEFINED
   25  AND ANNUALLY REVISED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN
   26  SERVICES FOR A HOUSEHOLD OF THE SAME SIZE; AND
   27    (II) NO PAYMENT IS REQUIRED FOR INDIVIDUALS WITH A HOUSEHOLD INCOME AT
   28  OR BELOW ONE HUNDRED AND FIFTY  PERCENT  OF  THE  FEDERAL  POVERTY  LINE
   29  DEFINED  AND  ANNUALLY REVISED BY THE UNITED STATES DEPARTMENT OF HEALTH
   30  AND HUMAN SERVICES FOR A HOUSEHOLD OF THE SAME SIZE.
   31    (B) THE COMMISSIONER SHALL  ESTABLISH  COST  SHARING  OBLIGATIONS  FOR
   32  ENROLLEES, SUBJECT TO FEDERAL APPROVAL.
   33    6. ANY FUNDS TRANSFERRED BY THE SECRETARY OF HEALTH AND HUMAN SERVICES
   34  TO THE STATE PURSUANT TO 42 U.S.C. 18051(D) SHALL BE DEPOSITED IN TRUST.
   35  FUNDS FROM THE TRUST SHALL BE USED FOR PROVIDING HEALTH BENEFITS THROUGH
   36  AN  APPROVED  ORGANIZATION, WHICH, AT A MINIMUM, SHALL INCLUDE ESSENTIAL
   37  HEALTH BENEFITS AS DEFINED IN 42 U.S.C. 18022(B); TO REDUCE THE PREMIUMS
   38  AND COST SHARING OF PARTICIPANTS IN THE BASIC  HEALTH  PROGRAM;  OR  FOR
   39  SUCH  OTHER  PURPOSES  AS  MAY BE ALLOWED BY THE SECRETARY OF HEALTH AND
   40  HUMAN SERVICES. HEALTH  BENEFITS  AVAILABLE  THROUGH  THE  BASIC  HEALTH
   41  PROGRAM SHALL BE PROVIDED BY ONE OR MORE APPROVED ORGANIZATIONS PURSUANT
   42  TO  AN  AGREEMENT  WITH  THE  DEPARTMENT  OF  HEALTH  AND SHALL MEET THE
   43  REQUIREMENTS OF APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.
   44    7. AN INDIVIDUAL WHO IS LAWFULLY ADMITTED FOR PERMANENT  RESIDENCE  OR
   45  PERMANENTLY  RESIDING  IN  THE UNITED STATES UNDER COLOR OF LAW, AND WHO
   46  WOULD BE INELIGIBLE FOR MEDICAL ASSISTANCE UNDER TITLE  ELEVEN  OF  THIS
   47  ARTICLE  DUE  TO  HIS  OR  HER  IMMIGRATION  STATUS IF THE PROVISIONS OF
   48  SECTION ONE HUNDRED TWENTY-TWO OF THIS CHAPTER WERE  APPLIED,  SHALL  BE
   49  CONSIDERED TO BE INELIGIBLE FOR MEDICAL ASSISTANCE FOR PURPOSES OF PARA-
   50  GRAPHS (B) AND (C) OF SUBDIVISION THREE OF THIS SECTION.
   51    S  52.  Subparagraph  2  of  paragraph (e) of subdivision 3 of section
   52  367-a of the social services law, as added by section 16 of  part  D  of
   53  chapter 56 of the laws of 2013, is amended to read as follows:
   54    (2)  Payment  pursuant  to  this  paragraph shall be for premium obli-
   55  gations of the individual under the  qualified  health  plan  and  shall
   56  continue  only  if  and  for  so long as the individual's MAGI household
       S. 6914                            141                           A. 9205

    1  income exceeds one hundred thirty-three percent, but does not exceed one
    2  hundred fifty percent, of the federal poverty line  for  the  applicable
    3  family  size,  OR,  IF  EARLIER,  UNTIL  THE  INDIVIDUAL IS ELIGIBLE FOR
    4  ENROLLMENT  IN  A STANDARD HEALTH PLAN PURSUANT TO SECTION THREE HUNDRED
    5  SIXTY-NINE-GG OF THIS ARTICLE.
    6    S 53. The state finance law is amended by adding a new section 97-oooo
    7  to read as follows:
    8    S 97-OOOO. BASIC HEALTH PROGRAM TRUST FUND. 1. THERE IS HEREBY  ESTAB-
    9  LISHED  IN  THE JOINT CUSTODY OF THE COMPTROLLER AND THE COMMISSIONER OF
   10  TAXATION AND FINANCE A FUND, TO BE KNOWN AS THE  "BASIC  HEALTH  PROGRAM
   11  TRUST FUND".
   12    2.  SUCH  FUND  SHALL  CONSIST  OF MONEYS TRANSFERRED FROM THE FEDERAL
   13  GOVERNMENT PURSUANT TO 42 U.S.C. S 18051(D) FOR THE PURPOSE OF  REDUCING
   14  THE  PREMIUMS  AND  COST-SHARING OF, OR PROVIDING BENEFITS FOR, ELIGIBLE
   15  INDIVIDUALS ENROLLED IN THE BASIC HEALTH PROGRAM,  ESTABLISHED  PURSUANT
   16  TO SECTION THREE HUNDRED SIXTY-NINE-GG OF THE SOCIAL SERVICES LAW.
   17    3.  UPON  FEDERAL  APPROVAL,  ALL MONIES IN SUCH FUND SHALL BE USED TO
   18  IMPLEMENT AND OPERATE THE BASIC HEALTH PLAN, PURSUANT TO  SECTION  THREE
   19  HUNDRED  SIXTY-NINE-GG  OF THE SOCIAL SERVICES LAW, EXCEPT TO THE EXTENT
   20  THAT THE PROVISIONS OF SUCH SECTION CONFLICT OR  ARE  INCONSISTENT  WITH
   21  FEDERAL  LAW,  IN  WHICH  CASE  THE PROVISIONS OF SUCH FEDERAL LAW SHALL
   22  SUPERSEDE SUCH STATE LAW PROVISIONS.
   23    S 54. The state finance law is amended by adding a new section 97-xxxx
   24  to read as follows:
   25    S 97-XXXX. STATE HEALTH INNOVATION PLAN ACCOUNT. 1.  THERE  IS  HEREBY
   26  ESTABLISHED  IN  THE  JOINT  CUSTODY  OF  THE  STATE COMPTROLLER AND THE
   27  COMMISSIONER OF THE DEPARTMENT OF HEALTH AN ACCOUNT OF THE MISCELLANEOUS
   28  SPECIAL REVENUE FUND TO BE KNOWN AS THE  STATE  HEALTH  INNOVATION  PLAN
   29  ACCOUNT.
   30    2.  NOTWITHSTANDING ANY OTHER LAW, RULE OR REGULATION TO THE CONTRARY,
   31  THE STATE COMPTROLLER IS HEREBY AUTHORIZED AND DIRECTED TO  RECEIVE  FOR
   32  DEPOSIT  TO  THE  CREDIT  OF  THE  STATE HEALTH INNOVATION PLAN ACCOUNT,
   33  MONIES RECEIVED PURSUANT TO THE STATE INNOVATION MODEL  INITIATIVE  FROM
   34  THE CENTERS FOR MEDICARE AND MEDICAID INNOVATION.
   35    3. MONEYS OF THIS ACCOUNT, FOLLOWING APPROPRIATION BY THE LEGISLATURE,
   36  SHALL BE AVAILABLE TO THE DEPARTMENT OF HEALTH FOR SERVICES AND EXPENSES
   37  OF THE STATE HEALTH INNOVATION PLAN.
   38    S  55. Section 364-i of the social services law is amended by adding a
   39  new subdivision 8 to read as follows:
   40    8. (A) THE FOLLOWING INDIVIDUALS SHALL BE PRESUMED TO BE ELIGIBLE  FOR
   41  MEDICAL  ASSISTANCE UNDER THIS TITLE BEGINNING ON THE DATE THAT A QUALI-
   42  FIED HOSPITAL, AS DEFINED IN PARAGRAPH (B) OF THIS  SUBDIVISION,  DETER-
   43  MINES, ON THE BASIS OF PRELIMINARY INFORMATION, THAT:
   44    (1)  A CHILD HAS MAGI HOUSEHOLD INCOME THAT DOES NOT EXCEED THE APPLI-
   45  CABLE LEVEL FOR ELIGIBILITY AS PROVIDED FOR PURSUANT TO SUBPARAGRAPH TWO
   46  OR THREE OF PARAGRAPH (B) OF SUBDIVISION ONE OF  SECTION  THREE  HUNDRED
   47  SIXTY-SIX OF THIS TITLE;
   48    (2)  A  PREGNANT  WOMAN HAS MAGI HOUSEHOLD INCOME THAT DOES NOT EXCEED
   49  THE MAGI-EQUIVALENT OF TWO HUNDRED PERCENT OF THE FEDERAL  POVERTY  LINE
   50  FOR THE APPLICABLE FAMILY SIZE;
   51    (3) A PARENT OR CARETAKER RELATIVE HAS MAGI HOUSEHOLD INCOME THAT DOES
   52  NOT  EXCEED  THE  MAGI-EQUIVALENT  OF  ONE HUNDRED THIRTY PERCENT OF THE
   53  HIGHEST AMOUNT THAT ORDINARILY WOULD HAVE BEEN PAID TO A PERSON  WITHOUT
   54  ANY  INCOME  OR  RESOURCES  UNDER  THE  FAMILY  ASSISTANCE PROGRAM AS IT
   55  EXISTED ON THE FIRST DAY OF NOVEMBER, NINETEEN HUNDRED NINETY-SEVEN,  OR
   56  HAS  NET  AVAILABLE INCOME, INCLUDING AVAILABLE SUPPORT FROM RESPONSIBLE
       S. 6914                            142                           A. 9205

    1  RELATIVES, THAT DOES NOT EXCEED THE AMOUNTS SET FORTH IN  PARAGRAPH  (A)
    2  OF SUBDIVISION TWO OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
    3    (4)  AN INDIVIDUAL IN NEED OF TREATMENT OF BREAST, CERVICAL, COLON, OR
    4  PROSTATE CANCER MEETS THE REQUIREMENTS OF PARAGRAPH (D) OR (E) OF SUBDI-
    5  VISION FOUR OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
    6    (5) AN INDIVIDUAL AGE NINETEEN OR OLDER AND UNDER AGE SIXTY-FIVE MEETS
    7  THE REQUIREMENTS OF SUBPARAGRAPH ONE OF PARAGRAPH (B) OF SUBDIVISION ONE
    8  OF SECTION THREE HUNDRED SIXTY-SIX OF THIS TITLE;
    9    (6) AN INDIVIDUAL UNDER TWENTY-SIX YEARS OF AGE MEETS THE REQUIREMENTS
   10  OF SUBPARAGRAPH NINE OF PARAGRAPH (C)  OF  SUBDIVISION  ONE  OF  SECTION
   11  THREE HUNDRED SIXTY-SIX OF THIS TITLE; AND
   12    (7)  AN INDIVIDUAL HAS INCOME THAT DOES NOT EXCEED THE MAGI-EQUIVALENT
   13  OF TWO HUNDRED PERCENT OF THE FEDERAL POVERTY LINE  FOR  THE  APPLICABLE
   14  FAMILY  SIZE,  AND THE INDIVIDUAL MEETS THE REQUIREMENTS OF SUBPARAGRAPH
   15  SIX OF PARAGRAPH (B) OF SUBDIVISION ONE OF SECTION THREE HUNDRED  SIXTY-
   16  SIX  OF  THIS  TITLE;  COVERAGE  PURSUANT  TO THIS SUBPARAGRAPH SHALL BE
   17  LIMITED TO FAMILY PLANNING SERVICES REIMBURSED BY THE FEDERAL GOVERNMENT
   18  AT A RATE OF NINETY PERCENT.
   19    (B) FOR THE PURPOSES OF THIS SUBDIVISION, "QUALIFIED HOSPITAL" MEANS A
   20  HOSPITAL THAT:
   21    (1) IS LICENSED AS A GENERAL HOSPITAL UNDER  ARTICLE  TWENTY-EIGHT  OF
   22  THE PUBLIC HEALTH LAW;
   23    (2)  IS  ENROLLED  AS  A PROVIDER IN THE PROGRAM OF MEDICAL ASSISTANCE
   24  UNDER THIS TITLE;
   25    (3) HAS NOTIFIED THE DEPARTMENT OF HEALTH  OF  ITS  ELECTION  TO  MAKE
   26  PRESUMPTIVE  ELIGIBILITY  DETERMINATIONS  UNDER  THIS  SUBDIVISION,  AND
   27  AGREES TO MAKE SUCH  DETERMINATIONS  IN  ACCORDANCE  WITH  POLICIES  AND
   28  PROCEDURES ESTABLISHED BY THE DEPARTMENT;
   29    (4)  HAS  BEEN  DESIGNATED  BY THE DEPARTMENT OF HEALTH AS A CERTIFIED
   30  APPLICATION COUNSELOR TO PROVIDE INFORMATION TO  INDIVIDUALS  CONCERNING
   31  QUALIFIED  HEALTH  PLANS OFFERED THROUGH A HEALTH INSURANCE EXCHANGE AND
   32  OTHER INSURANCE AFFORDABILITY PROGRAMS, ASSIST INDIVIDUALS TO APPLY  FOR
   33  COVERAGE  THROUGH  A  QUALIFIED  HEALTH  PLAN OR INSURANCE AFFORDABILITY
   34  PROGRAM, AND HELP FACILITATE THE ENROLLMENT OF ELIGIBLE  INDIVIDUALS  IN
   35  SUCH PLANS OR PROGRAMS; AND
   36    (5)  HAS NOT BEEN DISQUALIFIED BY THE DEPARTMENT OF HEALTH PURSUANT TO
   37  PARAGRAPH (C) OF THIS SUBDIVISION.
   38    (C) THE DEPARTMENT OF HEALTH MAY DISQUALIFY A HOSPITAL AS A  QUALIFIED
   39  HOSPITAL IF THE DEPARTMENT DETERMINES THAT THE HOSPITAL IS NOT:
   40    (1)  MAKING,  OR  IS  NOT  CAPABLE  OF MAKING, PRESUMPTIVE ELIGIBILITY
   41  DETERMINATIONS IN ACCORDANCE WITH THE  POLICIES  AND  PROCEDURES  ESTAB-
   42  LISHED BY THE DEPARTMENT; OR
   43    (2)  MEETING  SUCH  STANDARDS  AS MAY BE ESTABLISHED BY THE DEPARTMENT
   44  WITH RESPECT TO THE PROPORTION OF INDIVIDUALS  DETERMINED  PRESUMPTIVELY
   45  ELIGIBLE BY THE HOSPITAL WHO ARE FOUND BY THE MEDICAL ASSISTANCE PROGRAM
   46  TO  BE  ELIGIBLE  FOR  ONGOING  MEDICAL  ASSISTANCE AFTER THE END OF THE
   47  PRESUMPTIVE ELIGIBILITY PERIOD.
   48    (D) CARE, SERVICES AND SUPPLIES, AS SET FORTH IN SECTION THREE HUNDRED
   49  SIXTY-FIVE-A OF THIS TITLE, THAT ARE FURNISHED TO AN INDIVIDUAL DURING A
   50  PRESUMPTIVE ELIGIBILITY PERIOD UNDER THIS SUBDIVISION BY AN ENTITY  THAT
   51  IS  ELIGIBLE FOR PAYMENTS UNDER THIS TITLE SHALL BE DEEMED TO BE MEDICAL
   52  ASSISTANCE FOR PURPOSES OF PAYMENT AND STATE REIMBURSEMENT.
   53    S 56. Subdivision 1 of section 366  of  the  social  services  law  is
   54  amended by adding a new paragraph (f) to read as follows:
   55    (F)  NOTWITHSTANDING  ANY INCONSISTENT PROVISION OF THIS TITLE, FOR AN
   56  INDIVIDUAL WHO HAS INCOME IN EXCESS OF AN APPLICABLE INCOME  ELIGIBILITY
       S. 6914                            143                           A. 9205

    1  STANDARD  AND  IS  ALLOWED TO ACHIEVE ELIGIBILITY FOR MEDICAL ASSISTANCE
    2  UNDER THIS TITLE BY INCURRING MEDICAL EXPENSES EQUAL TO  THE  AMOUNT  OF
    3  SUCH  EXCESS  INCOME,  THE  AMOUNT OF EXCESS INCOME MAY BE CALCULATED BY
    4  COMPARING  THE INDIVIDUAL'S MAGI HOUSEHOLD INCOME TO THE MAGI-EQUIVALENT
    5  OF THE APPLICABLE INCOME ELIGIBILITY STANDARD; PROVIDED,  HOWEVER,  THAT
    6  MEDICAL  ASSISTANCE  SHALL  BE FURNISHED PURSUANT TO THIS PARAGRAPH ONLY
    7  IF, FOR SO LONG AS, AND TO THE EXTENT  THAT  FEDERAL  FINANCIAL  PARTIC-
    8  IPATION IS AVAILABLE THEREFOR. THE COMMISSIONER OF HEALTH SHALL MAKE ANY
    9  AMENDMENTS  TO  THE  STATE PLAN FOR MEDICAL ASSISTANCE, OR APPLY FOR ANY
   10  WAIVER OR APPROVAL UNDER THE FEDERAL SOCIAL SECURITY ACT THAT ARE NECES-
   11  SARY TO CARRY OUT THE PROVISIONS OF THIS PARAGRAPH.
   12    S 56-a. Section 364-j of the social services law is amended by  adding
   13  a new subdivision 30 to read as follows:
   14    30.  NOTWITHSTANDING THE PROVISIONS OF SECTION ONE HUNDRED SIXTY-THREE
   15  OF THE STATE FINANCE LAW, OR SECTIONS  ONE  HUNDRED  FORTY-TWO  AND  ONE
   16  HUNDRED  FORTY-THREE  OF  THE  ECONOMIC DEVELOPMENT LAW, OR ANY CONTRARY
   17  PROVISION OF LAW, IN THE EVENT THAT THE STATE  RECEIVES  PRIOR  APPROVAL
   18  AND  ENHANCED  FINANCIAL PARTICIPATION FROM THE CENTERS FOR MEDICAID AND
   19  MEDICARE SERVICES, ADMINISTRATION FOR  CHILDREN  AND  FAMILIES  AND  THE
   20  FEDERAL  FOOD  AND  NUTRITION  SERVICES FOR REIMBURSEMENT PURSUANT TO AN
   21  A-87 COST ALLOCATION WAIVER FOR ENHANCED FUNDING FOR  INTEGRATED  ELIGI-
   22  BILITY  SYSTEMS, THE STATE IS AUTHORIZED TO ENTER INTO CONTRACTS, AND/OR
   23  TO AMEND THE TERMS OF CONTRACTS AWARDED PRIOR TO THE EFFECTIVE  DATE  OF
   24  THIS  SUBDIVISION,  WITHOUT  A  COMPETITIVE  BID OR REQUEST FOR PROPOSAL
   25  PROCESS, CONSISTENT WITH FEDERAL REQUIREMENTS, FOR THE PURPOSE OF IMPLE-
   26  MENTING PROJECTS  AUTHORIZED  UNDER  SUCH  WAIVER  AMENDMENT;  PROVIDED,
   27  HOWEVER, IN THE CASE OF A CONTRACT ENTERED INTO AFTER THE EFFECTIVE DATE
   28  OF THIS SUBDIVISION, THAT:
   29    (A)  THE  OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE AND THE OFFICE
   30  OF GENERAL SERVICES, OR ANOTHER STATE AGENCY, SHALL POST ON ITS  WEBSITE
   31  AND CONCURRENTLY PROVIDE TO THE CHAIR OF THE SENATE HEALTH COMMITTEE AND
   32  THE CHAIR OF THE ASSEMBLY HEALTH COMMITTEE, FOR A PERIOD OF NO LESS THAN
   33  THIRTY DAYS:
   34    (I)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
   35  THE CONTRACT OR CONTRACTS;
   36    (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
   37    (III) THE PERIOD OF TIME DURING WHICH  A  PROSPECTIVE  CONTRACTOR  MAY
   38  SUBMIT  AN  OFFER,  WHICH  SHALL  BE NO LESS THAN THIRTY DAYS AFTER SUCH
   39  INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
   40    (IV) THE MANNER BY WHICH A PROSPECTIVE CONTRACTOR MAY SUBMIT AN OFFER,
   41  WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
   42    (B) ALL RESPONSIVE  AND  REASONABLE  OFFERS  THAT  ARE  RECEIVED  FROM
   43  PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
   44  COMMISSIONER OF TEMPORARY AND DISABILITY ASSISTANCE OR OTHER STATE AGEN-
   45  CY; AND
   46    (C) THE COMMISSIONERS OF THE  DEPARTMENT  OF  HEALTH,  THE  OFFICE  OF
   47  TEMPORARY AND DISABILITY ASSISTANCE AND THE OFFICE OF CHILDREN AND FAMI-
   48  LY  SERVICES,  WORKING  IN  COOPERATION WITH THE STATE CHIEF INFORMATION
   49  OFFICER AND THE OFFICE OF GENERAL SERVICES, SHALL AWARD SUCH CONTRACT TO
   50  THE CONTRACTOR OR CONTRACTORS OFFER THAT PROVIDES THE BEST VALUE AS SUCH
   51  TERM IS DEFINED IN SECTION ONE HUNDRED SIXTY-THREE OF THE STATE  FINANCE
   52  LAW,  TO  THE  STATE.  AT  NOTIFICATION THE COMMISSIONER OF HEALTH SHALL
   53  PROVIDE THIS INFORMATION TO THE CHAIR  OF  THE  SENATE  STANDING  HEALTH
   54  COMMITTEE AND THE CHAIR OF THE ASSEMBLY HEALTH COMMITTEE.
       S. 6914                            144                           A. 9205

    1    (D)  ALL DECISIONS MADE AND APPROACHES TAKEN PURSUANT TO THIS SUBDIVI-
    2  SION SHALL BE DOCUMENTED IN A PROCUREMENT RECORD AS DEFINED  IN  SECTION
    3  ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW.
    4    (E)  IN ACCORDANCE WITH ALL FEDERAL ADVANCE PLANNING DOCUMENT GUIDANCE
    5  AND WITHIN THE PARAMETERS ESTABLISHED BY THE ENHANCED FINANCIAL  PARTIC-
    6  IPATION  FROM  THE  CENTERS FOR MEDICAID AND MEDICARE SERVICES, ADMINIS-
    7  TRATION FOR CHILDREN AND FAMILIES AND THE  FEDERAL  FOOD  AND  NUTRITION
    8  SERVICES  FOR  REIMBURSEMENT  TO  AN  A-87  COST  ALLOCATION  WAIVER FOR
    9  ENHANCED FUNDING  FOR  INTEGRATED  ELIGIBILITY  SYSTEMS,  PHASE  1  WILL
   10  INCLUDE  FOUNDATIONAL  ALLOWABLE  SHARED  SERVICE COMPONENTS REQUIRED TO
   11  SUCCESSFULLY MEET THE REQUIREMENTS  FOR  NON-MAGI  MEDICAID  SUCH  AS  A
   12  COMMON  CLIENT  PORTAL,  DOCUMENT  MANAGEMENT,  RULES  ENGINES, WORKFLOW
   13  MANAGEMENT TOOLS, CASE MANAGEMENT, NOTICES AND TRAINING.
   14    (F) THE CONTRACT WILL REQUIRE TRAINING TO BE PROVIDED AT  NO  COST  TO
   15  THE SOCIAL SERVICES DISTRICTS.
   16    (G) THE CONTRACT SHALL REQUIRE THE COMPLETION OF SHARED SERVICE COMPO-
   17  NENTS  BY  THE  TIMELINES  NECESSARY  TO  RECEIVE THE ENHANCED FINANCIAL
   18  PARTICIPATION FROM THE  CENTERS  FOR  MEDICAID  AND  MEDICARE  SERVICES,
   19  ADMINISTRATION FOR CHILDREN AND FAMILIES AND THE FEDERAL FOOD AND NUTRI-
   20  TION SERVICES FOR REIMBURSEMENT TO AN A-87 COST ALLOCATION WAIVER.
   21    (H)  THE  COMMISSIONER  SHALL  PROVIDE, WITHIN THIRTY DAYS OF AWARD OF
   22  SUCH CONTRACT OR CONTRACTS, THE CHAIR OF THE SENATE  STANDING  COMMITTEE
   23  ON  HEALTH  AND THE CHAIR OF THE ASSEMBLY HEALTH COMMITTEE WITH A REPORT
   24  OUTLINING THE PROCUREMENT AND AWARDS.
   25    S 57. Subdivision 8 of section  2511  of  the  public  health  law  is
   26  amended by adding a new paragraph (h) to read as follows:
   27    (H) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS TITLE, ARTICLES
   28  THIRTY-TWO  AND  FORTY-THREE  OF THE INSURANCE LAW AND SUBSECTION (E) OF
   29  SECTION ELEVEN HUNDRED TWENTY OF THE INSURANCE LAW, FOR THE PERIOD APRIL
   30  FIRST, TWO THOUSAND FOURTEEN THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND
   31  FIFTEEN,  SUBSIDY  PAYMENTS  MADE  TO APPROVED ORGANIZATIONS SHALL BE AT
   32  AMOUNTS APPROVED PRIOR TO APRIL FIRST, TWO THOUSAND FOURTEEN.
   33    S 58. Article 29-A of the public health law is amended by adding a new
   34  title 1-A to read as follows:
   35                                  TITLE 1-A
   36                        RURAL DENTISTRY PILOT PROGRAM
   37  SECTION 2958-A. RURAL DENTISTRY PILOT PROGRAM.
   38    S 2958-A. RURAL DENTISTRY PILOT PROGRAM. 1.  THE  COMMISSIONER  SHALL,
   39  WITHIN  MONIES APPROPRIATED THEREFORE, ESTABLISH A RURAL DENTISTRY PILOT
   40  PROGRAM IN CHAUTAUQUA, ALLEGANY, AND CATTARAUGUS COUNTIES.  THE  COMMIS-
   41  SIONER  SHALL,  IN COORDINATION WITH THE UNIVERSITY OF BUFFALO SCHOOL OF
   42  DENTISTRY STUDY COST SAVINGS ACHIEVED THROUGH THE  PROVISION  OF  DENTAL
   43  SERVICES  IN GEOGRAPHICALLY ISOLATED AND UNDERSERVED AREAS. SUCH A STUDY
   44  SHALL DETERMINE:
   45    (I) THE QUALITY OF CARE  PROVIDED  THROUGH  A  MOBILE  DENTAL  SYSTEM,
   46  INCLUDING  MINIMIZING  ANY  ADVERSE  EFFECTS ON DENTAL PRACTICES ALREADY
   47  SERVING OR SEEKING  TO  ENTER  RURAL  OR  UNDERSERVED  COMMUNITIES,  THE
   48  INVOLVEMENT OF DENTAL PRACTICES SERVING RURAL OR UNDERSERVED COMMUNITIES
   49  IN  SUCH  A  MOBILE  DENTAL  SYSTEM,  AND  THE ESTABLISHMENT OF REFERRAL
   50  SYSTEMS AND NETWORKS TO  EXISTING  DENTAL  PRACTICES  SERVING  RURAL  OR
   51  UNDERSERVED COMMUNITIES FOR REGULAR ONGOING CARE OF PATIENTS;
   52    (II) COST SAVINGS ACHIEVED THROUGH TARGETED ORAL HEALTH INITIATIVES IN
   53  RURAL AREAS;
   54    (III)  COROLLARIES  BETWEEN  PREVENTATIVE  DENTAL  CARE  AND  IMPROVED
   55  PATIENT OUTCOMES IN RURAL AREAS;
       S. 6914                            145                           A. 9205

    1    (IV) KNOWLEDGE, ATTITUDE, AND BEHAVIOR OUTCOMES AMONG DENTAL  STUDENTS
    2  AND RECOMMENDATIONS FOR RURAL DENTAL HEALTH EDUCATION CURRICULUM;
    3    (V)  A  PROFILE OF THE PARTICIPANTS, THE NUMBER OF PERSONS SERVED, AND
    4  HEALTH CARE DISPARITIES;
    5    (VI) A DESCRIPTION OF THE ACTIVITIES OF THE PROGRAM;
    6    (VII) GUIDANCE ON FACILITATED PARTICIPATION IN RURAL AREAS;
    7    (VIII) PROVIDER SHORTAGES IN RURAL AREAS;
    8    (IX) A DESCRIPTION OF THE IMPACT OF THE PROGRAMS ON THE COMMUNITY  AND
    9  RECOMMENDATIONS FOR REPLICATION/IMPROVEMENT IN OTHER RURAL AREAS; AND
   10    (X)  SUCH  OTHER ACTIVITIES AS THE COMMISSIONER MAY DEEM NECESSARY AND
   11  APPROPRIATE TO THIS SECTION.
   12    2. TWELVE MONTHS AFTER THE  APPROVAL  OF  THE  RURAL  DENTISTRY  PILOT
   13  PROGRAM,  AND  ANNUALLY  THEREAFTER,  THE  PROGRAM  SHALL  REPORT TO THE
   14  COMMISSIONER ON THE PROGRESS OF  THE  PROGRAM.  THE  COMMISSIONER  SHALL
   15  EVALUATE  THE  FINDINGS  OF  THE  STUDY  AND REPORT TO THE GOVERNOR, THE
   16  TEMPORARY PRESIDENT OF THE SENATE, THE  SPEAKER  OF  THE  ASSEMBLY,  THE
   17  CHAIR  OF  THE  SENATE  STANDING  COMMITTEE  ON HEALTH, THE CHAIR OF THE
   18  ASSEMBLY HEALTH COMMITTEE AND THE CHAIR OF THE LEGISLATIVE COMMISSION ON
   19  RURAL RESOURCES ON ITS FINDINGS.
   20    3. ADDITIONALLY,  TO  THE  EXTENT  OF  FUNDS  APPROPRIATED  THEREFORE,
   21  MEDICAL ASSISTANCE FUNDS, INCLUDING ANY FUNDING OR SHARED SAVINGS AS MAY
   22  BECOME AVAILABLE THROUGH FEDERAL WAIVERS OR OTHERWISE UNDER TITLES EIGH-
   23  TEEN  AND  NINETEEN  OF THE FEDERAL SOCIAL SECURITY ACT, MAY BE USED FOR
   24  EXPENDITURES IN SUPPORT OF THE DEMONSTRATION PROGRAM.
   25    4. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW TO THE  CONTRARY,
   26  THE   COMMISSIONER  IS  AUTHORIZED  TO  WAIVE,  MODIFY  OR  SUSPEND  THE
   27  PROVISIONS OF RULES AND  REGULATIONS  PROMULGATED  PURSUANT  TO  ARTICLE
   28  TWENTY-EIGHT  OF  THIS  CHAPTER IF THE COMMISSIONER DETERMINES THAT SUCH
   29  WAIVER, MODIFICATION OR  SUSPENSION  IS  NECESSARY  FOR  THE  SUCCESSFUL
   30  IMPLEMENTING OF THE RURAL DENTISTRY PILOT PROGRAM AUTHORIZED PURSUANT TO
   31  THIS  SECTION  AND  PROVIDED  THAT  THE COMMISSIONER DETERMINES THAT THE
   32  HEALTH, SAFETY AND GENERAL WELFARE OF PEOPLE RECEIVING HEALTH CARE UNDER
   33  SUCH RURAL DENTISTRY PILOT PROGRAM WILL NOT BE IMPAIRED AS A  RESULT  OF
   34  SUCH WAIVER, MODIFICATION, OR SUSPENSION.
   35    S  59.  Paragraph  (d)  of subdivision 2 of section 2511 of the public
   36  health law is REPEALED.
   37    S 60.  Subparagraphs (iv) and (v) of paragraph (b) of subdivision 9 of
   38  section 2511 of the public health law, subparagraph (iv) as  amended  by
   39  section  33 of part D of chapter 56 of the laws of 2013 and subparagraph
   40  (v) as amended by chapter 2 of the laws of 1998, are amended to read  as
   41  follows:
   42    (iv) outstationing of persons who are authorized to provide assistance
   43  to  families in completing the enrollment application process under this
   44  title and title eleven of article five of the social  services  law,  in
   45  locations, such as community settings, which are geographically accessi-
   46  ble  to large numbers of children who may be eligible for benefits under
   47  such titles, and at times, including evenings and weekends,  when  large
   48  numbers  of  children who may be eligible for benefits under such titles
   49  are likely to be encountered. Persons outstationed  in  accordance  with
   50  this subparagraph shall be authorized to make determinations of presump-
   51  tive  eligibility  in accordance with paragraph [(g)] (F) of subdivision
   52  two of THIS section [two  thousand  five  hundred  and  eleven  of  this
   53  title]; and
   54    (v)  notice  by  local social services districts to medical assistance
   55  applicants of the availability of benefits under paragraph [(g)] (F)  of
       S. 6914                            146                           A. 9205

    1  subdivision two of THIS section [two thousand five hundred and eleven of
    2  this title].
    3    S  61.  Subdivisions 3, 4 and 5 of section 47 of chapter 2 of the laws
    4  of 1998, amending the public health  law  and  other  laws  relating  to
    5  expanding  the  child health insurance plan, as amended by section 19 of
    6  part D of chapter 59 of the  laws  of  2011,  are  amended  to  read  as
    7  follows:
    8    3.  section  six  of  this  act  shall  take  effect  January 1, 1999;
    9  provided, however, that subparagraph (iii) of paragraph (c) of  subdivi-
   10  sion  9  of section 2510 of the public health law, as added by this act,
   11  shall expire on July 1, [2014] 2017;
   12    4. sections two, three, four, seven, eight, nine,  fourteen,  fifteen,
   13  sixteen,  eighteen, eighteen-a, [twenty-three,] twenty-four, and twenty-
   14  nine of this act shall take effect January 1,  1999  and  SECTION  EIGH-
   15  TEEN-A  shall  expire  on  July 1, 2014; section twenty-five of this act
   16  shall take effect on January 1, 1999 and shall expire on April 1, 2005;
   17    5. section twelve of this act  shall  take  effect  January  1,  1999;
   18  provided,  however,  paragraphs  (g) and (h) of subdivision 2 of section
   19  2511 of the public health law, as added by such section, shall expire on
   20  July 1, [2014] 2017;
   21    S 62. The opening paragraph of subparagraph (ii) of paragraph  (a)  of
   22  subdivision  2  of section 369 of the social services law, as amended by
   23  chapter 41 of the laws of 1992, is amended to read as follows:
   24    with respect to the real property of an individual who is an inpatient
   25  in a nursing facility,  intermediate  care  facility  for  the  mentally
   26  retarded,  or  other  medical  institution,  [and] who is not reasonably
   27  expected to be discharged from the medical  institution  and  to  return
   28  home,  AND WHO IS REQUIRED, AS A CONDITION OF RECEIVING SERVICES IN SUCH
   29  INSTITUTION UNDER THE STATE PLAN FOR MEDICAL ASSISTANCE,  TO  SPEND  FOR
   30  COSTS  OF  MEDICAL  CARE  ALL  BUT A MINIMAL AMOUNT OF HIS OR HER INCOME
   31  REQUIRED FOR PERSONAL NEEDS;  provided,  however,  any  such  lien  will
   32  dissolve  upon  the  individual's discharge from the medical institution
   33  and return home; in addition, no such lien may be imposed on  the  indi-
   34  vidual's  home  if  one of the following persons is lawfully residing in
   35  the home:
   36    S 62-a. Subparagraph (i) of paragraph (b) of subdivision 2 of  section
   37  369 of the social services law, as amended by chapter 170 of the laws of
   38  1994, is amended to read as follows:
   39    (i)  Notwithstanding  any  inconsistent  provision  of this chapter or
   40  other law, no adjustment or recovery may be made against the property of
   41  any individual on account of any medical assistance correctly paid to or
   42  on behalf of an individual under this title, except that recoveries must
   43  be pursued:
   44    (A) upon the sale of the property subject to a lien imposed on account
   45  of medical assistance paid to an individual described in clause (ii)  of
   46  paragraph  (a)  of this subdivision, or from the estate of such individ-
   47  ual; and
   48    (B) from the estate of an individual who was fifty-five years  of  age
   49  or  older  when  he  or  she received such assistance, PROVIDED THAT FOR
   50  INDIVIDUALS WHOSE ELIGIBILITY FOR MEDICAL ASSISTANCE WAS BASED ON  PARA-
   51  GRAPH  (B) OF SUBDIVISION ONE OF SECTION THREE HUNDRED SIXTY-SIX OF THIS
   52  TITLE, RECOVERY SHALL BE LIMITED TO  MEDICAL  ASSISTANCE  CONSISTING  OF
   53  NURSING  FACILITY  SERVICES,  HOME  AND  COMMUNITY-BASED  SERVICES,  AND
   54  RELATED HOSPITAL AND PRESCRIPTION DRUG SERVICES.
   55    S 63. Section 4 of chapter 779 of  the  laws  of  1986,  amending  the
   56  social  services  law relating to authorizing services for non-residents
       S. 6914                            147                           A. 9205

    1  in adult homes, residences for adults and enriched housing programs,  as
    2  amended  by  chapter  108  of  the  laws  of 2011, is amended to read as
    3  follows:
    4    S 4. This act shall take effect on the one hundred twentieth day after
    5  it  shall  have  become  a law and shall remain in full force and effect
    6  until July 1, [2014] 2017, provided however, that effective immediately,
    7  the addition, amendment and/or repeal of any rules or regulations neces-
    8  sary for the implementation of the foregoing sections of this act on its
    9  effective date are authorized and directed to be made and  completed  on
   10  or before such effective date.
   11    S  64.  Subdivision (i-1) of section 79 of part C of chapter 58 of the
   12  laws of 2008, amending the social services law and the public health law
   13  relating to adjustments of rates, as amended by section 21 of part D  of
   14  chapter 59 of the laws of 2011, is amended to read as follows:
   15    (i-1)  section  thirty-one-a of this act shall be deemed repealed July
   16  1, [2014] 2017;
   17    S 65. Section 4 of chapter 19 of the laws of 1998, amending the social
   18  services law relating to limiting the method of payment for prescription
   19  drugs under the medical assistance program, as amended by section 107 of
   20  part H of chapter 59 of the laws of 2011, is amended to read as follows:
   21    S 4. This act shall take effect 120 days after it shall have become  a
   22  law and shall expire and be deemed repealed March 31, [2014] 2017.
   23    S  66. Paragraph (e-1) of subdivision 12 of section 2808 of the public
   24  health law, as amended by section 63 of part A of chapter 56 of the laws
   25  of 2013, is amended to read as follows:
   26    (e-1) Notwithstanding any inconsistent provision of law or regulation,
   27  the commissioner shall provide,  in  addition  to  payments  established
   28  pursuant  to  this  article  prior to application of this section, addi-
   29  tional payments under the medical assistance program pursuant  to  title
   30  eleven of article five of the social services law for non-state operated
   31  public  residential health care facilities, including public residential
   32  health care facilities located in the county of Nassau,  the  county  of
   33  Westchester  and  the  county  of Erie, but excluding public residential
   34  health care facilities operated by a town or city within  a  county,  in
   35  aggregate  annual  amounts of up to one hundred fifty million dollars in
   36  additional payments for the state fiscal year beginning April first, two
   37  thousand six and for the state fiscal year beginning  April  first,  two
   38  thousand  seven and for the state fiscal year beginning April first, two
   39  thousand eight and of up to three hundred million dollars in such aggre-
   40  gate annual additional payments for  the  state  fiscal  year  beginning
   41  April  first, two thousand nine, and for the state fiscal year beginning
   42  April first, two thousand ten and for the state  fiscal  year  beginning
   43  April  first, two thousand eleven, and for the state fiscal years begin-
   44  ning April first, two thousand twelve  and  April  first,  two  thousand
   45  thirteen,  AND  OF  UP TO FIVE HUNDRED MILLION DOLLARS IN SUCH AGGREGATE
   46  ANNUAL ADDITIONAL PAYMENTS FOR THE STATE FISCAL  YEARS  BEGINNING  APRIL
   47  FIRST,  TWO  THOUSAND  FOURTEEN,  APRIL  FIRST, TWO THOUSAND FIFTEEN AND
   48  APRIL FIRST, TWO THOUSAND SIXTEEN. The amount allocated to each eligible
   49  public residential  health  care  facility  for  this  period  shall  be
   50  computed  in  accordance  with  the  provisions of paragraph (f) of this
   51  subdivision, provided, however, that patient days shall be utilized  for
   52  such  computation reflecting actual reported data for two thousand three
   53  and each representative succeeding  year  as  applicable,  and  provided
   54  further,  however, that, in consultation with impacted providers, of the
   55  funds allocated for distribution in  the  state  fiscal  year  beginning
       S. 6914                            148                           A. 9205

    1  April first, two thousand thirteen, up to thirty-two million dollars may
    2  be allocated in accordance with paragraph (f-1) of this subdivision.
    3    S  67.  Paragraph  (i) of subdivision 3 of section 461-1 of the social
    4  services law, as amended by section 4 of part D of  chapter  56  of  the
    5  laws of 2012, is amended to read as follows:
    6    (i)  (A)  The  commissioner  of  health is authorized to add up to six
    7  thousand assisted living program beds to the gross  number  of  assisted
    8  living  program  beds having been determined to be available as of April
    9  first, two thousand nine. Nothing herein shall be interpreted as prohib-
   10  iting any eligible applicant from  submitting  an  application  for  any
   11  assisted  living  program bed so added. The commissioner of health shall
   12  not be required to review on a comparative basis applications  submitted
   13  for  assisted  living  program beds made available under this paragraph.
   14  The commissioner of health shall only  authorize  the  addition  of  six
   15  thousand beds pursuant to a [five] SEVEN year plan ENDING PRIOR TO JANU-
   16  ARY FIRST, TWO THOUSAND SEVENTEEN.
   17    (B)  THE COMMISSIONER OF HEALTH SHALL PROVIDE AN ANNUAL WRITTEN REPORT
   18  TO THE CHAIR OF THE SENATE STANDING COMMITTEE ON HEALTH AND THE CHAIR OF
   19  THE ASSEMBLY HEALTH COMMITTEE NO LATER THAN JANUARY FIRST OF EACH  YEAR.
   20  SUCH REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO, THE NUMBER OF ASSISTED
   21  LIVING  PROGRAM  BEDS MADE AVAILABLE PURSUANT TO THIS SECTION BY COUNTY,
   22  THE TOTAL NUMBER OF ASSISTED LIVING PROGRAM BEDS BY COUNTY,  THE  NUMBER
   23  OF VACANT ASSISTED LIVING PROGRAM BEDS BY COUNTY, AND ANY OTHER INFORMA-
   24  TION DEEMED NECESSARY AND APPROPRIATE.
   25    S 67-a. Subparagraph (v) of paragraph (b) of subdivision 35 of section
   26  2807-c  of  the  public health law, as amended by section 7 of part B of
   27  chapter 56 of the laws of 2013, is amended to read as follows:
   28    (v) such  regulations  shall  incorporate  quality  related  measures,
   29  including,  but  not  limited  to, potentially preventable re-admissions
   30  (PPRs) and provide for rate adjustments or payment disallowances related
   31  to PPRs and other potentially  preventable  negative  outcomes  (PPNOs),
   32  which shall be calculated in accordance with methodologies as determined
   33  by the commissioner, provided, however, that such methodologies shall be
   34  based on a comparison of the actual and risk adjusted expected number of
   35  PPRs and other PPNOs in a given hospital and with benchmarks established
   36  by  the  commissioner and provided further that such rate adjustments or
   37  payment disallowances shall result in an aggregate reduction in Medicaid
   38  payments of no less than thirty-five million dollars for the period July
   39  first, two thousand ten through March thirty-first, two thousand  eleven
   40  and  no less than fifty-one million dollars for annual periods beginning
   41  April first, two thousand eleven through March thirty-first,  two  thou-
   42  sand [fourteen] FIFTEEN, provided further that such aggregate reductions
   43  shall  be offset by Medicaid payment reductions occurring as a result of
   44  decreased PPRs during the period July first, two  thousand  ten  through
   45  March  thirty-first, two thousand eleven and the period April first, two
   46  thousand eleven through  March  thirty-first,  two  thousand  [fourteen]
   47  FIFTEEN  and  as  a  result  of  decreased PPNOs during the period April
   48  first, two thousand eleven  through  March  thirty-first,  two  thousand
   49  [fourteen] FIFTEEN; and provided further that for the period July first,
   50  two  thousand  ten  through  March thirty-first, two thousand [fourteen]
   51  FIFTEEN, such rate adjustments or payment disallowances shall not  apply
   52  to  behavioral  health  PPRs;  or to readmissions that occur on or after
   53  fifteen days following an initial  admission.  By  no  later  than  July
   54  first,  two  thousand eleven the commissioner shall enter into consulta-
   55  tions with representatives of the health care facilities subject to this
   56  section regarding potential prospective revisions to applicable  method-
       S. 6914                            149                           A. 9205

    1  ologies  and benchmarks set forth in regulations issued pursuant to this
    2  subparagraph;
    3    S 67-b. Paragraph (b) of subdivision 1 of section 76 of chapter 731 of
    4  the laws of 1993, amending the public health law and other laws relating
    5  to  reimbursement,  delivery  and capital cost of ambulatory health care
    6  services and inpatient hospital services, as amended by  section  28  of
    7  part A of chapter 59 of the laws of 2011, is amended to read as follows:
    8    (b)  sections  fifteen  through  nineteen and subdivision 3 of section
    9  2807-e of the public health law as added by section twenty of  this  act
   10  shall  expire  on  July 1, [2014] 2017, and section seventy-four of this
   11  act shall expire on July 1, 2007;
   12    S 67-c. Section 18 of chapter 904  the  laws  of  1984,  amending  the
   13  public  health  law  and the social services law relating to encouraging
   14  comprehensive health services, as amended by section 21  of  part  C  of
   15  chapter 59 of the laws of 2011, is amended to read as follows:
   16    S  18.  This  act  shall take effect immediately, except that sections
   17  six, nine, ten and eleven of this act shall take effect on the  sixtieth
   18  day after it shall have become a law, sections two, three, four and nine
   19  of  this  act  shall  expire  and be of no further force or effect on or
   20  after March 31, [2014] 2017, section two of this act shall  take  effect
   21  on  April  1,  1985 or seventy-five days following the submission of the
   22  report required by section one of this  act,  whichever  is  later,  and
   23  sections  eleven  and  thirteen  of  this  act shall expire and be of no
   24  further force or effect on or after March 31, 1988.
   25    S 68. Notwithstanding any inconsistent provision of law, rule or regu-
   26  lation, for purposes of implementing the provisions of the public health
   27  law and the social services law, references to titles XIX and XXI of the
   28  federal social security act in the public  health  law  and  the  social
   29  services  law  shall be deemed to include and also to mean any successor
   30  titles thereto under the federal social security act.
   31    S 69. Notwithstanding any inconsistent provision of law, rule or regu-
   32  lation, the effectiveness of the provisions of sections 2807 and 3614 of
   33  the public health law, section 18 of chapter 2 of the laws of 1988,  and
   34  18  NYCRR  505.14(h), as they relate to time frames for notice, approval
   35  or certification of rates of payment, are hereby suspended  and  without
   36  force or effect for purposes of implementing the provisions of this act.
   37    S  70. Severability clause. If any clause, sentence, paragraph, subdi-
   38  vision, section or part of this act shall be adjudged by  any  court  of
   39  competent  jurisdiction  to  be invalid, such judgment shall not affect,
   40  impair or invalidate the remainder thereof, but shall be confined in its
   41  operation to the clause, sentence, paragraph,  subdivision,  section  or
   42  part thereof directly involved in the controversy in which such judgment
   43  shall  have been rendered. It is hereby declared to be the intent of the
   44  legislature that this act would have been enacted even if  such  invalid
   45  provisions had not been included herein.
   46    S  71.  This  act shall take effect immediately and shall be deemed to
   47  have been in full force and effect on and after April 1,  2014  provided
   48  that:
   49    1.  sections  five, fifty-nine and sixty of this act shall take effect
   50  July 1, 2014;
   51    2. section twenty-six of this act shall take effect immediately and be
   52  deemed to have been in full force and effect on and after March 1, 2014;
   53    3. section nine of this act shall take effect May 1,  2014;  provided,
   54  however,  that  the amendments to subparagraph (iii) of paragraph (c) of
   55  subdivision 6 of section 367-a  of  the  social  services  law  made  by
       S. 6914                            150                           A. 9205

    1  section  nine  of this act shall not affect the repeal of such paragraph
    2  and shall be deemed repealed therewith;
    3    3-a.  amendments made to section 365-h of the social services law made
    4  by section seven of this act,  shall  not  affect  the  repeal  of  such
    5  section and shall be deemed repealed therewith.
    6    3-b.  section  twenty-six-a  of  this act shall take effect October 1,
    7  2014;
    8    3-c. sections fifty, fifty-one, fifty-two and fifty-three  shall  take
    9  effect April 1, 2015;
   10    3-d. section fifty-five of this act shall take effect January 1, 2015;
   11    4.  the  amendments  to  subdivision  9  of section 2511 of the public
   12  health law made by section sixty of this act shall not affect the  expi-
   13  ration of such subdivision and shall expire therewith;
   14    4-a.  section  twenty-two of this act shall take effect April 1, 2014,
   15  and shall be deemed expired January 1, 2017;
   16    4-b. the amendments to subdivisions (a) and (b) of section  364-jj  of
   17  the  social  services  law made by section thirty-nine of this act shall
   18  not affect the expiration of such section and shall be deemed to  expire
   19  therewith;
   20    4-c.  the  amendments to section 364-j of the social services law made
   21  by section forty-nine of this act shall not affect the  repeal  of  such
   22  section and shall be deemed to repeal therewith;
   23    4-d.  the  amendments  to  section 48-a of part A of chapter 56 of the
   24  laws of 2013 made by section thirteen of this act shall not  affect  the
   25  expiration of such section and shall expire therewith;
   26    4-e.  the amendments to section 1 of part H of chapter 111 of the laws
   27  of 2010 made by section fifteen of this act shall not affect the expira-
   28  tion of such section and shall expire therewith;
   29    5. any rules or regulations necessary to implement the  provisions  of
   30  this  act  may be promulgated and any procedures, forms, or instructions
   31  necessary for such implementation may be adopted and issued on or  after
   32  the date this act shall have become a law;
   33    6. this act shall not be construed to alter, change, affect, impair or
   34  defeat any rights, obligations, duties or interests accrued, incurred or
   35  conferred prior to the effective date of this act;
   36    7. the commissioner of health and the superintendent of the department
   37  of  financial  services  and  any appropriate council may take any steps
   38  necessary to implement this act prior to its effective date;
   39    8. notwithstanding any inconsistent provision of the state administra-
   40  tive procedure act or any other provision of law,  rule  or  regulation,
   41  the  commissioner  of health and the superintendent of the department of
   42  financial services and any appropriate council is authorized to adopt or
   43  amend or promulgate on an emergency basis any regulation he  or  she  or
   44  such council determines necessary to implement any provision of this act
   45  on its effective date; and
   46    9.  the  provisions of this act shall become effective notwithstanding
   47  the failure of the commissioner of health or the superintendent  of  the
   48  department  of  financial  services  or any council to adopt or amend or
   49  promulgate regulations implementing this act.

   50                                   PART D

   51    Section 1. Section 6802 of the education  law  is  amended  by  adding
   52  three new subdivisions 24, 25 and 26 to read as follows:
   53    24.  "COMPOUNDING"  MEANS  THE  COMBINING, ADMIXING, MIXING, DILUTING,
   54  POOLING, RECONSTITUTING, OR OTHERWISE ALTERING OF A DRUG  OR  BULK  DRUG
       S. 6914                            151                           A. 9205

    1  SUBSTANCE TO CREATE A DRUG WITH RESPECT TO AN OUTSOURCING FACILITY UNDER
    2  SECTION  503B  OF  THE  FEDERAL  FOOD, DRUG AND COSMETIC ACT AND FURTHER
    3  DEFINED IN THIS SECTION.
    4    25. "OUTSOURCING FACILITY" MEANS A FACILITY THAT:
    5    (A) IS ENGAGED IN THE COMPOUNDING OF STERILE DRUGS;
    6    (B) IS CURRENTLY REGISTERED AS AN OUTSOURCING FACILITY WITH THE SECRE-
    7  TARY OF HEALTH AND HUMAN SERVICES; AND
    8    (C)  COMPLIES  WITH  ALL  APPLICABLE REQUIREMENTS OF FEDERAL AND STATE
    9  LAW, INCLUDING THE FEDERAL FOOD, DRUG AND COSMETIC ACT.
   10    26. "STERILE DRUG" MEANS A DRUG THAT IS INTENDED FOR PARENTERAL ADMIN-
   11  ISTRATION, AN OPHTHALMIC OR ORAL INHALATION DRUG IN AQUEOUS FORMAT, OR A
   12  DRUG THAT IS REQUIRED TO BE STERILE UNDER FEDERAL OR STATE LAW.
   13    S 2. Subdivision 1 of section 6808 of the education law, as  added  by
   14  chapter 987 of the laws of 1971, is amended to read as follows:
   15    1.  No  person,  firm, corporation or association shall possess drugs,
   16  prescriptions or poisons for the  purpose  of  compounding,  dispensing,
   17  retailing,   wholesaling,   or  manufacturing,  or  shall  offer  drugs,
   18  prescriptions or poisons for sale at retail or wholesale  unless  regis-
   19  tered  by  the  department  as  a  pharmacy,  [store,]  wholesaler, [or]
   20  manufacturer OR OUTSOURCING FACILITY.
   21    S 3. Subdivisions 5, 6 and 7 of section 6808 of the education law  are
   22  renumbered  subdivisions  6, 7 and 8 and a new subdivision 5 is added to
   23  read as follows:
   24    5. OUTSOURCING FACILITY'S REGISTRATION.
   25    A. OBTAINING A REGISTRATION. AN OUTSOURCING FACILITY SHALL  BE  REGIS-
   26  TERED AS FOLLOWS:
   27    (1) AN APPLICATION FOR INITIAL REGISTRATION OR RENEWAL OF REGISTRATION
   28  SHALL BE MADE ON A FORM PRESCRIBED BY THE DEPARTMENT.
   29    (2)  AN APPLICATION FOR INITIAL REGISTRATION SHALL BE ACCOMPANIED BY A
   30  FEE OF EIGHT HUNDRED TWENTY-FIVE DOLLARS.
   31    B. RENEWAL OF REGISTRATION. ALL OUTSOURCING FACILITIES'  REGISTRATIONS
   32  SHALL  BE  RENEWED ON A DATE SET BY THE DEPARTMENT. THE TRIENNIAL REGIS-
   33  TRATION FEE SHALL BE FIVE HUNDRED TWENTY DOLLARS OR A PRO RATED  PORTION
   34  THEREOF AS DETERMINED BY THE DEPARTMENT.
   35    C.  DISPLAY  OF  REGISTRATION.  THE  REGISTRATION  SHALL  BE DISPLAYED
   36  CONSPICUOUSLY IN THE PLACE OF BUSINESS.
   37    D. CHANGE OF LOCATION. IN THE EVENT THAT THE LOCATION OF SUCH PLACE OF
   38  BUSINESS SHALL BE CHANGED, THE OWNER SHALL APPLY TO THE  DEPARTMENT  FOR
   39  INSPECTION  OF  THE NEW LOCATION AND ENDORSEMENT OF THE REGISTRATION FOR
   40  THE NEW LOCATION. THE FEE FOR INSPECTION AND ENDORSEMENT  SHALL  BE  ONE
   41  HUNDRED  SEVENTY-FIVE  DOLLARS, UNLESS IT APPEARS TO THE SATISFACTION OF
   42  THE DEPARTMENT THAT THE CHANGE IN LOCATION IS OF A TEMPORARY NATURE  DUE
   43  TO FIRE, FLOOD OR OTHER DISASTER.
   44    E.  REPORT.  UPON INITIALLY REGISTERING AS AN OUTSOURCING FACILITY AND
   45  EVERY SIX MONTHS THEREAFTER, EACH OUTSOURCING FACILITY SHALL  SUBMIT  TO
   46  THE EXECUTIVE SECRETARY OF THE STATE BOARD OF PHARMACY A REPORT:
   47    (1)  IDENTIFYING  THE  DRUGS  COMPOUNDED  BY SUCH OUTSOURCING FACILITY
   48  DURING THE PREVIOUS 6-MONTH PERIOD; AND
   49    (2) WITH RESPECT TO EACH DRUG IDENTIFIED  UNDER  SUBPARAGRAPH  ONE  OF
   50  THIS  PARAGRAPH,  PROVIDING  THE  ACTIVE  INGREDIENT; THE SOURCE OF SUCH
   51  ACTIVE INGREDIENT; THE NATIONAL DRUG CODE NUMBER OF THE SOURCE  DRUG  OR
   52  BULK  ACTIVE INGREDIENT, IF AVAILABLE; THE STRENGTH OF THE ACTIVE INGRE-
   53  DIENT PER UNIT; THE DOSAGE FORM AND ROUTE OF ADMINISTRATION; THE PACKAGE
   54  DESCRIPTION; THE NUMBER OF INDIVIDUAL UNITS PRODUCED; AND  THE  NATIONAL
   55  DRUG CODE NUMBER OF THE FINAL PRODUCT, IF ASSIGNED.
       S. 6914                            152                           A. 9205

    1    F.  CONDUCT  OF  OUTSOURCING  FACILITY.  EVERY OWNER OF AN OUTSOURCING
    2  FACILITY IS RESPONSIBLE FOR THE STRENGTH, QUALITY, PURITY  AND  LABELING
    3  THEREOF  OF  ALL COMPOUNDED DRUGS, SUBJECT TO THE GUARANTY PROVISIONS OF
    4  THIS ARTICLE AND THE PUBLIC HEALTH LAW. EVERY OUTSOURCING FACILITY SHALL
    5  BE  UNDER  THE  IMMEDIATE  SUPERVISION  AND  MANAGEMENT  OF A PHARMACIST
    6  LICENSED TO PRACTICE IN NEW YORK STATE.
    7    G. APPLICANT FOR REGISTRATION.  AN APPLICANT FOR  REGISTRATION  OF  AN
    8  OUTSOURCING  FACILITY SHALL BE OF GOOD MORAL CHARACTER, AS DETERMINED BY
    9  THE DEPARTMENT. IN THE CASE OF A CORPORATE  APPLICANT,  THE  REQUIREMENT
   10  SHALL EXTEND TO ALL OFFICERS AND DIRECTORS AND STAKEHOLDERS HAVING A TEN
   11  PERCENT OR GREATER INTEREST IN THE CORPORATION.
   12    S  4.  Subdivisions  6  and 7 of section 6808 of the education law, as
   13  added by chapter 987 of the laws of 1971, such  subdivisions  as  renum-
   14  bered by section three of this act, are amended to read as follows:
   15    6.  Inspection.  The  state  board  of  pharmacy and the department of
   16  education, and their employees designated  by  the  commissioner,  shall
   17  have  the  right  to  enter  any pharmacy, wholesaler, manufacturer, [or
   18  registered store,] OUTSOURCING FACILITY or vehicle and  to  inspect,  at
   19  reasonable  times, such factory, warehouse, establishment or vehicle and
   20  all records required by this article, pertinent equipment, finished  and
   21  unfinished materials, containers, and labels.
   22    7.  [Revocation or suspension] PENALTIES.  A pharmacy, [store,] whole-
   23  saler [or], manufacturer [registration may be revoked  or  suspended  by
   24  the  committee on professional conduct of the state board of pharmacy in
   25  accordance with  the  provisions  of  article  one  hundred  thirty]  OR
   26  OUTSOURCING  FACILITY  REGISTERED  UNDER THIS SECTION SHALL BE UNDER THE
   27  SUPERVISION OF THE BOARD OF REGENTS AND SHALL BE SUBJECT TO DISCIPLINARY
   28  PROCEEDINGS AND PENALTIES IN ACCORDANCE WITH ARTICLE ONE HUNDRED  THIRTY
   29  OF THIS CHAPTER IN THE SAME MANNER AND TO THE SAME EXTENT AS INDIVIDUALS
   30  AND PROFESSIONAL SERVICE CORPORATIONS WITH RESPECT TO THEIR LICENSES AND
   31  REGISTRATIONS,  PROVIDED THAT FAILURE TO COMPLY WITH THE REQUIREMENTS OF
   32  THIS SECTION SHALL CONSTITUTE PROFESSIONAL MISCONDUCT.
   33    S 5. Subdivision 1 of section 6808-b of the education law, as  amended
   34  by chapter 567 of the laws of 2002, is amended to read as follows:
   35    1.  Definition.    The term "nonresident establishment" shall mean any
   36  pharmacy, manufacturer [or], wholesaler, OR OUTSOURCING FACILITY located
   37  outside of the state that ships, mails or delivers prescription drugs or
   38  devices to other establishments, authorized prescribers and/or  patients
   39  residing  in  this  state. Such establishments shall include, but not be
   40  limited to, pharmacies that transact business through  the  use  of  the
   41  internet.
   42    S  6.  Paragraph f of subdivision 4 of section 6808-b of the education
   43  law, as amended by chapter 567 of the laws of 2002, is amended  to  read
   44  as follows:
   45    f. The application of establishments to be registered as a manufactur-
   46  er  [or],  wholesaler  OR  OUTSOURCING  FACILITY of drugs and/or devices
   47  shall be accompanied by a fee as provided in section sixty-eight hundred
   48  eight of this article; and
   49    S 7. Section 6810 of the education law is  amended  by  adding  a  new
   50  subdivision 14 to read as follows:
   51    14.  NOTWITHSTANDING  ANY  OTHER  PROVISION OF LAW TO THE CONTRARY, NO
   52  OUTSOURCING FACILITY MAY DISTRIBUTE OR DISPENSE ANY DRUG TO  ANY  PERSON
   53  PURSUANT TO A PRESCRIPTION UNLESS IT IS ALSO REGISTERED AS A PHARMACY IN
   54  THIS  STATE  AND  MEETS ALL OTHER APPLICABLE REQUIREMENTS OF FEDERAL AND
   55  STATE LAW.
       S. 6914                            153                           A. 9205

    1    S 8. Section 6811 of the education law is  amended  by  adding  a  new
    2  subdivision 26 to read as follows:
    3    26. ANY OUTSOURCING FACILITY TO SELL OR OFFER TO SELL ANY DRUG THAT IS
    4  NOT BOTH COMPOUNDED UNDER THE PERSONAL SUPERVISION OF A LICENSED PHARMA-
    5  CIST AND LABELED WITH THE FULL NAME OF THE OUTSOURCING FACILITY.
    6    S  9.  Subdivisions 1 and 2 of section 6811-a of the education law, as
    7  added by chapter 729 of the  laws  of  1981,  are  amended  to  read  as
    8  follows:
    9    1.  [No]  EXCEPT AS OTHERWISE AUTHORIZED IN THE FEDERAL FOOD, DRUG AND
   10  COSMETIC ACT, NO drug for  which  a  prescription  is  required  by  the
   11  provisions  of the Federal Food, Drug and Cosmetic Act or by the commis-
   12  sioner of health may be manufactured or commercially distributed  within
   13  this  state  in  tablet  or capsule form unless it has clearly marked or
   14  imprinted on each such tablet or capsule in conformance with the  appli-
   15  cable plan required by subdivision three of this section:
   16    (a)  an individual symbol, number, company name, words, letters, mark-
   17  ing or National Drug Code (hereinafter referred to as N. D. C.)   number
   18  identifying the manufacturer or distributor of the drug; and
   19    (b)  an  N.  D.  C.  number, symbol, number, letters, words or marking
   20  identifying such drug or combination of drugs.
   21    2. [No] EXCEPT AS OTHERWISE AUTHORIZED IN THE FEDERAL FOOD,  DRUG  AND
   22  COSMETIC  ACT,  NO  drug  for  which any prescription is required by the
   23  provisions of the Federal Food, Drug and Cosmetic Act or by the  commis-
   24  sioner  of  health  contained  within  a  bottle,  vial, carton or other
   25  container, or in any way affixed or appended to  or  enclosed  within  a
   26  package  of  any  kind,  and  designed  or intended for delivery in such
   27  container or package to an ultimate consumer, shall be  manufactured  or
   28  distributed  within  this  state  unless  such  container or package has
   29  clearly and permanently marked or imprinted upon it in conformance  with
   30  the applicable plan required by subdivision three of this section:
   31    (a)  an  individual  symbol,  N.  D.  C. number, company name, number,
   32  letters, words or marking identifying the manufacturer or distributor of
   33  the drug;
   34    (b) an N. D. C. number, symbol,  number,  letters,  words  or  marking
   35  identifying such drug or combination of drugs; and
   36    (c) whenever the distributor of the prescription drug product does not
   37  also  manufacture  the  product the names and places of business of both
   38  shall appear on the label in words clearly distinguishing each.
   39    S 10. Subdivision 1 of section 6812 of the education law, as added  by
   40  chapter 987 of the laws of 1971, is amended to read as follows:
   41    1. Where any pharmacy, MANUFACTURER, WHOLESALER OR OUTSOURCING FACILI-
   42  TY  registered  by  the department is damaged by fire the board shall be
   43  notified within a period of forty-eight hours, and the board shall  have
   44  power to impound all drugs for analysis and condemnation, if found unfit
   45  for   use.    Where  a  pharmacy  is  discontinued,  the  owner  of  its
   46  prescription records shall notify the department as to  the  disposition
   47  of  said  prescription  records, and in no case shall records be sold or
   48  given away to a person who does not currently possess a registration  to
   49  operate a pharmacy.
   50    S  11. Subdivision 1 of section 6817 of the education law, as added by
   51  chapter 987 of the laws of 1971, is amended to read as follows:
   52    1. [No] EXCEPT AS OTHERWISE PROVIDED IN THE  FEDERAL  FOOD,  DRUG  AND
   53  COSMETIC  ACT,  NO  person shall sell, deliver, offer for sale, hold for
   54  sale, or give away any new drug, unless:
   55    a. an application with respect thereto has become effective, or in the
   56  case of an investigational drug the sponsor has complied with the appli-
       S. 6914                            154                           A. 9205

    1  cable requirements, under the [federal food,  drug,  and  cosmetic  act]
    2  FEDERAL FOOD, DRUG, AND COSMETIC ACT, or
    3    b. when not subject to such act, such drug has been tested and has not
    4  been  found  to  be  unsafe  or ineffective for use under the conditions
    5  prescribed, recommended or suggested in the labeling thereof, and, prior
    6  to selling or offering for sale such drug, there has been filed with the
    7  department an application setting forth
    8    (1) full reports of investigations which have been made to show wheth-
    9  er or not such drug is safe and effective for use;
   10    (2) a full list of the ingredients used as components of such drug;
   11    (3) a full statement of the composition of such drug;
   12    (4) a full description of the methods used in, and the facilities  and
   13  controls  used  for,  the  manufacture,  processing  and packing of such
   14  drugs;
   15    (5) such samples of such drug and of the ingredients  used  as  compo-
   16  nents thereof as the board or secretary may require; and
   17    (6) specimens of the labeling proposed to be used for such drug.
   18    S  12.  The  education  law is amended by adding a new section 6831 to
   19  read as follows:
   20    S 6831. SPECIAL PROVISIONS RELATING TO  OUTSOURCING  FACILITIES.    1.
   21  REGISTRATION.  ANY OUTSOURCING FACILITY THAT IS ENGAGED IN THE COMPOUND-
   22  ING OF STERILE DRUGS IN THIS STATE SHALL BE REGISTERED AS AN OUTSOURCING
   23  FACILITY UNDER THE FEDERAL FOOD, DRUG AND COSMETIC ACT AND BE REGISTERED
   24  AS AN OUTSOURCING FACILITY PURSUANT TO THIS ARTICLE.
   25    2. NEW DRUGS. SECTIONS 502(F)(1), 505 AND 582  OF  THE  FEDERAL  FOOD,
   26  DRUG  AND  COSMETIC  ACT  SHALL  NOT  APPLY  TO  A DRUG COMPOUNDED IN AN
   27  OUTSOURCING FACILITY REGISTERED UNDER THE FEDERAL FOOD, DRUG AND COSMET-
   28  IC ACT.
   29    3. PRESCRIPTIONS. NOTWITHSTANDING ANY OTHER PROVISION OF  LAW  TO  THE
   30  CONTRARY, NO OUTSOURCING FACILITY MAY DISTRIBUTE OR DISPENSE ANY DRUG TO
   31  ANY  PERSON PURSUANT TO A PRESCRIPTION UNLESS IT IS ALSO REGISTERED AS A
   32  PHARMACY IN THIS STATE AND MEETS ALL OTHER  APPLICABLE  REQUIREMENTS  OF
   33  FEDERAL AND STATE LAW.
   34    4.  RESTRICTIONS.  ANY  DRUGS  COMPOUNDED  IN  AN OUTSOURCING FACILITY
   35  REGISTERED PURSUANT TO THIS ARTICLE SHALL BE  COMPOUNDED  IN  ACCORDANCE
   36  WITH ALL APPLICABLE FEDERAL AND STATE LAWS.
   37    5. LABELING. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRA-
   38  RY,  THE  LABEL  OF ANY DRUG COMPOUNDED BY AN OUTSOURCING FACILITY SHALL
   39  INCLUDE, BUT NOT BE LIMITED TO THE FOLLOWING:
   40    (A) A STATEMENT THAT THE DRUG IS A COMPOUNDED  DRUG  OR  A  REASONABLE
   41  COMPARABLE ALTERNATIVE STATEMENT THAT PROMINENTLY IDENTIFIES THE DRUG AS
   42  A COMPOUNDED DRUG;
   43    (B)  THE NAME, ADDRESS, AND PHONE NUMBER OF THE APPLICABLE OUTSOURCING
   44  FACILITY; AND
   45    (C) WITH RESPECT TO THE DRUG:
   46    (I) THE LOT OR BATCH NUMBER;
   47    (II) THE ESTABLISHED NAME OF THE DRUG;
   48    (III) THE DOSAGE FORM AND STRENGTH;
   49    (IV) THE STATEMENT OF QUANTITY OR VOLUME, AS APPROPRIATE;
   50    (V) THE DATE THAT THE DRUG WAS COMPOUNDED;
   51    (VI) THE EXPIRATION DATE;
   52    (VII) STORAGE AND HANDLING INSTRUCTIONS;
   53    (VIII) THE NATIONAL DRUG CODE NUMBER, IF AVAILABLE;
   54    (IX) THE STATEMENT THAT THE DRUG IS NOT FOR RESALE, AND THE  STATEMENT
   55  "OFFICE USE ONLY"; AND
       S. 6914                            155                           A. 9205

    1    (X)  A  LIST  OF  THE  ACTIVE  AND INACTIVE INGREDIENTS, IDENTIFIED BY
    2  ESTABLISHED NAME, AND THE QUANTITY OR PROPORTION OF EACH INGREDIENT.
    3    6.  CONTAINER.  THE  CONTAINER  FROM WHICH THE INDIVIDUAL UNITS OF THE
    4  DRUG ARE REMOVED FOR DISPENSING OR FOR ADMINISTRATION (SUCH AS A PLASTIC
    5  BAG CONTAINING INDIVIDUAL PRODUCT SYRINGES) SHALL INCLUDE:
    6    (A) A LIST OF ACTIVE AND INACTIVE INGREDIENTS,  IDENTIFIED  BY  ESTAB-
    7  LISHED NAME, AND THE QUANTITY OR PROPORTION OF EACH INGREDIENT; AND
    8    (B)  ANY  OTHER INFORMATION REQUIRED BY REGULATIONS PROMULGATED BY THE
    9  COMMISSIONER TO FACILITATE ADVERSE EVENT REPORTING  IN  ACCORDANCE  WITH
   10  THE  REQUIREMENTS ESTABLISHED IN SECTION 310.305 OF TITLE 21 OF THE CODE
   11  OF FEDERAL REGULATIONS.
   12    7. BULK DRUGS. A DRUG MAY ONLY BE COMPOUNDED IN AN OUTSOURCING FACILI-
   13  TY THAT DOES NOT COMPOUND USING  BULK  DRUG  SUBSTANCES  AS  DEFINED  IN
   14  SECTION  207.3(A)(4)  OF  TITLE 21 OF THE CODE OF FEDERAL REGULATIONS OR
   15  ANY SUCCESSOR REGULATION UNLESS:
   16    (A) THE BULK DRUG SUBSTANCE APPEARS  ON  A  LIST  ESTABLISHED  BY  THE
   17  SECRETARY  OF HEALTH AND HUMAN SERVICES IDENTIFYING BULK DRUG SUBSTANCES
   18  FOR WHICH THERE IS A CLINICAL NEED;
   19    (B) THE DRUG IS COMPOUNDED FROM A BULK DRUG SUBSTANCE THAT APPEARS  ON
   20  THE  FEDERAL  DRUG  SHORTAGE  LIST IN EFFECT AT THE TIME OF COMPOUNDING,
   21  DISTRIBUTING, AND DISPENSING;
   22    (C) IF AN APPLICABLE MONOGRAPH EXISTS UNDER THE UNITED STATES  PHARMA-
   23  COPEIA,  THE  NATIONAL  FORMULARY, OR ANOTHER COMPENDIUM OR PHARMACOPEIA
   24  RECOGNIZED BY THE SECRETARY OF HEALTH AND HUMAN SERVICES  AND  THE  BULK
   25  DRUG SUBSTANCES EACH COMPLY WITH THE MONOGRAPH;
   26    (D) THE BULK DRUG SUBSTANCES ARE EACH MANUFACTURED BY AN ESTABLISHMENT
   27  THAT IS REGISTERED WITH THE FEDERAL GOVERNMENT.
   28    8.  INGREDIENTS.  IF  AN  OUTSOURCING FACILITY USES INGREDIENTS, OTHER
   29  THAN BULK DRUG SUBSTANCES, SUCH INGREDIENTS MUST COMPLY WITH THE  STAND-
   30  ARDS  OF THE APPLICABLE UNITED STATES PHARMACOPEIA OR NATIONAL FORMULARY
   31  MONOGRAPH, IF SUCH MONOGRAPH EXISTS, OR OF ANOTHER COMPENDIUM OR PHARMA-
   32  COPEIA RECOGNIZED BY THE SECRETARY OF  HEALTH  AND  HUMAN  SERVICES  FOR
   33  PURPOSES OF THIS SUBDIVISION, IF ANY.
   34    9. UNSAFE OR INEFFECTIVE DRUGS. NO OUTSOURCING FACILITY MAY COMPOUND A
   35  DRUG  THAT  APPEARS  ON  A LIST PUBLISHED BY THE SECRETARY OF HEALTH AND
   36  HUMAN SERVICES THAT HAS  BEEN  WITHDRAWN  OR  REMOVED  FROM  THE  MARKET
   37  BECAUSE  SUCH  DRUGS  OR  COMPONENTS OF SUCH DRUGS HAVE BEEN FOUND TO BE
   38  UNSAFE OR NOT EFFECTIVE.
   39    10. PROHIBITION ON WHOLESALING. NO COMPOUNDED DRUG  WILL  BE  SOLD  OR
   40  TRANSFERRED  BY  ANY  ENTITY  OTHER  THAN  THE OUTSOURCING FACILITY THAT
   41  COMPOUNDED SUCH DRUG. THIS DOES NOT PROHIBIT  THE  ADMINISTRATION  OF  A
   42  DRUG IN A HEALTH CARE SETTING OR DISPENSING A DRUG PURSUANT TO A PROPER-
   43  LY EXECUTED PRESCRIPTION.
   44    11.  PROHIBITION  AGAINST  COPYING  AN  APPROVED  DRUG. NO OUTSOURCING
   45  FACILITY MAY COMPOUND A DRUG THAT IS ESSENTIALLY A COPY OF ONE  OR  MORE
   46  APPROVED DRUGS.
   47    12.  PROHIBITION  AGAINST  COMPOUNDING  DRUGS  PRESENTING DEMONSTRABLE
   48  DIFFICULTIES. NO OUTSOURCING FACILITY MAY COMPOUND A DRUG:
   49    I. THAT IS IDENTIFIED, DIRECTLY OR AS PART OF A CATEGORY OF DRUGS,  ON
   50  A  LIST  PUBLISHED  BY  THE  SECRETARY OF HEALTH AND HUMAN SERVICES THAT
   51  PRESENT DEMONSTRABLE DIFFICULTIES FOR COMPOUNDING  THAT  ARE  REASONABLY
   52  LIKELY  TO  LEAD  TO AN ADVERSE EFFECT ON THE SAFETY OR EFFECTIVENESS OF
   53  THE DRUG OR CATEGORY OF DRUGS, TAKING INTO ACCOUNT THE RISKS  AND  BENE-
   54  FITS TO PATIENTS; OR
       S. 6914                            156                           A. 9205

    1    II.  THAT  IS  COMPOUNDED IN ACCORDANCE WITH ALL APPLICABLE CONDITIONS
    2  IDENTIFIED ON THE DRUG LIST AS CONDITIONS THAT ARE NECESSARY TO  PREVENT
    3  THE DRUG OR CATEGORY OF DRUGS FROM PRESENTING DEMONSTRABLE DIFFICULTIES.
    4    13.  ADVERSE EVENT REPORTS. OUTSOURCING FACILITIES SHALL SUBMIT A COPY
    5  OF ALL ADVERSE EVENT REPORTS SUBMITTED TO THE SECRETARY  OF  HEALTH  AND
    6  HUMAN  SERVICES  IN  ACCORDANCE WITH THE CONTENT AND FORMAT REQUIREMENTS
    7  ESTABLISHED IN SECTION 310.305 OF TITLE 21 OF THE CODE OF FEDERAL  REGU-
    8  LATIONS, OR ANY SUCCESSOR REGULATION, TO THE EXECUTIVE SECRETARY FOR THE
    9  STATE BOARD OF PHARMACY.
   10    14.  REPORTS.  THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER
   11  OF HEALTH, SHALL PREPARE AND SUBMIT A REPORT TO  THE  GOVERNOR  AND  THE
   12  LEGISLATURE,  DUE  EIGHTEEN  MONTHS  FROM  THE  EFFECTIVE  DATE  OF THIS
   13  SECTION, EVALUATING THE EFFECTIVENESS OF THE REGISTRATION AND  OVERSIGHT
   14  OF OUTSOURCING FACILITIES RELATED TO COMPOUNDING.
   15    S  13.  Section 3302 of the public health law is amended by adding two
   16  new subdivisions 42 and 43 to read as follows:
   17    42. "COMPOUNDING" MEANS THE  COMBINING,  ADMIXING,  MIXING,  DILUTING,
   18  POOLING,  RECONSTITUTING,  OR  OTHERWISE ALTERING OF A DRUG OR BULK DRUG
   19  SUBSTANCE TO CREATE A DRUG WITH RESPECT TO AN OUTSOURCING FACILITY UNDER
   20  SECTION 503B OF THE FEDERAL FOOD, DRUG  AND  COSMETIC  ACT  AND  FURTHER
   21  DEFINED IN THIS SECTION.
   22    43. "OUTSOURCING FACILITY" MEANS A FACILITY THAT:
   23    (A)  IS  ENGAGED  IN  THE  COMPOUNDING  OF STERILE DRUGS AS DEFINED IN
   24  SECTION SIXTY-EIGHT HUNDRED TWO OF THE EDUCATION LAW;
   25    (B) IS CURRENTLY REGISTERED AS AN  OUTSOURCING  FACILITY  PURSUANT  TO
   26  ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION LAW; AND
   27    (C)  COMPLIES  WITH  ALL  APPLICABLE REQUIREMENTS OF FEDERAL AND STATE
   28  LAW, INCLUDING THE FEDERAL FOOD, DRUG AND COSMETIC ACT.
   29    NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE  CONTRARY,  WHEN  AN
   30  OUTSOURCING  FACILITY  DISTRIBUTES  OR  DISPENSES ANY DRUG TO ANY PERSON
   31  PURSUANT TO A PRESCRIPTION, SUCH OUTSOURCING FACILITY SHALL BE DEEMED TO
   32  BE PROVIDING PHARMACY SERVICES AND SHALL BE SUBJECT TO ALL  LAWS,  RULES
   33  AND REGULATIONS GOVERNING PHARMACIES AND PHARMACY SERVICES.
   34    S  14.  The  opening paragraph of subdivision 2 of section 3318 of the
   35  public health law, as added by chapter 878  of  the  laws  of  1972,  is
   36  amended to read as follows:
   37    No  controlled  substance  contained  within a bottle, vial, carton or
   38  other container, or in any way affixed or appended to or enclosed within
   39  a package of any kind, and designed or intended  for  delivery  in  such
   40  container  or  package  to  an ultimate consumer, shall be manufactured,
   41  DELIVERED or distributed within this  state  unless  such  container  or
   42  package has clearly and permanently marked or imprinted upon it:
   43    S 15. Subdivision 1 of section 3320 of the public health law, as added
   44  by chapter 878 of the laws of 1972, is amended to read as follows:
   45    1. Controlled substances may be lawfully distributed within this state
   46  only  to  licensed distributors or manufacturers, practitioners, pharma-
   47  cists,  pharmacies,  institutional  dispensers,  REGISTERED  OUTSOURCING
   48  FACILITIES, and laboratory, research or instructional facilities author-
   49  ized by law to possess the particular substance distributed.
   50    S  16.  Paragraph  (a)  of subdivision 1 of section 3321 of the public
   51  health law, as added by chapter 878 of the laws of 1972, is  amended  to
   52  read as follows:
   53    (a)  the return of controlled substances to a manufacturer, REGISTERED
   54  OUTSOURCING FACILITY or distributor by a practitioner or pharmacy;
       S. 6914                            157                           A. 9205

    1    S 17. Section 3322 of the public health law, as added by  chapter  878
    2  of the laws of 1972, subdivision 2 as amended by chapter 108 of the laws
    3  of 1975, is amended to read as follows:
    4    S  3322.  Reports and records. 1. Persons licensed under this title OR
    5  OPERATING A REGISTERED OUTSOURCING FACILITY shall  maintain  records  of
    6  all  controlled  substances manufactured, COMPOUNDED, received, disposed
    7  of, DELIVERED or distributed by them. The record shall show the date  of
    8  receipt  or  delivery,  the name and address, and registration number of
    9  the person from whom received or to whom DELIVERED OR  distributed,  the
   10  kind  and  quantity  of substance received and DELIVERED OR distributed,
   11  the kind and quantity of substance produced or removed from the  process
   12  of manufacture and the date thereof.
   13    2.  Any  person  licensed  under  this title OR OPERATING A REGISTERED
   14  OUTSOURCING FACILITY  shall  prepare  and  maintain  a  biennial  report
   15  setting  forth the current inventory of controlled substances, the quan-
   16  tities of controlled substances manufactured, COMPOUNDED,  DELIVERED  or
   17  distributed within the state during the period covered by the report and
   18  such  other  information  as  the  commissioner shall [be] BY regulation
   19  prescribe. Maintaining for inspection a biennial inventory of controlled
   20  substances prepared and maintained in compliance with  federal  statutes
   21  and regulations shall be deemed in compliance with this section.
   22    3.  Any  person  licensed  under  this title OR OPERATING A REGISTERED
   23  OUTSOURCING FACILITY shall forthwith notify the department of any  inci-
   24  dent  involving  the  theft,  loss  or  possible diversion of controlled
   25  substances manufactured, COMPOUNDED, DELIVERED  or  distributed  by  the
   26  licensee OR OPERATOR.
   27    4. The records and reports required by this section shall be prepared,
   28  preserved,  or filed in such manner and detail as the commissioner shall
   29  by regulation prescribe.
   30    S 18. Paragraph (c) of subdivision 1 of section  3397  of  the  public
   31  health law, as amended by chapter 547 of the laws of 1981, is amended to
   32  read as follows:
   33    (c) falsely assume the title of, or represent himself to be a licensed
   34  manufacturer, distributor, pharmacy, pharmacist, practitioner, research-
   35  er,  approved institutional dispenser, OWNER OR EMPLOYEE OF A REGISTERED
   36  OUTSOURCING FACILITY or other authorized  person,  for  the  purpose  of
   37  obtaining a controlled substance;
   38    S  19.  This act shall take effect on the ninetieth day after it shall
   39  have become a law.

   40                                   PART E

   41    Section 1. The mental hygiene law is amended by adding a  new  section
   42  13.41 to read as follows:
   43  S 13.41 INTEGRATED EMPLOYMENT PLAN.
   44    (A) THE COMMISSIONER, IN CONSULTATION WITH THE DEVELOPMENTAL DISABILI-
   45  TIES  ADVISORY  COUNCIL,  SHALL  ESTABLISH A PLAN TO INCREASE EMPLOYMENT
   46  OPPORTUNITIES FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES. THE PLAN SHALL
   47  INCLUDE, BUT NOT BE LIMITED TO:
   48    (1) IDENTIFICATION OF STRATEGIES TO  INCREASE  COMPETITIVE  EMPLOYMENT
   49  OPPORTUNITIES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, INCLUDING
   50  STUDENTS TRANSITIONING FROM EDUCATIONAL PROGRAMS;
   51    (2) DATA CONCERNING JOB RETENTION AMONG INDIVIDUALS WITH DEVELOPMENTAL
   52  DISABILITIES  AND  THE  IDENTIFICATION  OF  STRATEGIES  TO  INCREASE JOB
   53  RETENTION;
       S. 6914                            158                           A. 9205

    1    (3) IDENTIFICATION OF MODELS OF INTEGRATED  EMPLOYMENT  PROMOTING,  TO
    2  THE  GREATEST  EXTENT POSSIBLE, INDIVIDUALS WITH DEVELOPMENTAL DISABILI-
    3  TIES  WORKING  ALONGSIDE  INDIVIDUALS  WITHOUT  DISABILITIES,  INCLUDING
    4  CONSIDERATIONS  OF  ABILITY LEVELS, CRITICAL LIFE TRANSITIONS AND APPRO-
    5  PRIATE OPTIONS;
    6    (4)  STRATEGIES  FOR ASSISTING INDIVIDUALS IN TRANSITIONING FROM SHEL-
    7  TERED WORKSHOP PROGRAMS TO COMPETITIVE EMPLOYMENT;
    8    (5) PARTNERSHIPS WITH BUSINESS  COMMUNITIES  AND  SENIOR  SERVICES  TO
    9  ASSIST  IN  INCREASING  THE  AVAILABILITY  OF COMPETITIVE EMPLOYMENT FOR
   10  OLDER ADULTS;
   11    (6) IDENTIFICATION OF MEANS TO  ASSIST  INDIVIDUALS  WITH  SIGNIFICANT
   12  BEHAVIORAL  OR  MEDICAL  NEEDS IN PREPARING FOR AND MOVING TOWARDS INTE-
   13  GRATED EMPLOYMENT;
   14    (7) TECHNICAL ASSISTANCE, COMPLIANCE AND TRANSITION ASSISTANCE  PROCE-
   15  DURES  FOR  EXISTING  PROVIDERS  WHO  SEEK  TO TRANSITION TO COMPETITIVE
   16  AND/OR INTEGRATED EMPLOYMENT MODELS; AND
   17    (8) ASSESSMENTS OF FUNDING AND NECESSARY SUPPORTS FOR INDIVIDUALS  AND
   18  PROVIDERS.
   19    (B) THE COMMISSIONER, IN CONSULTATION WITH THE DEVELOPMENTAL DISABILI-
   20  TIES ADVISORY COUNCIL, SHALL DEVELOP THE PLAN WITH INPUT FROM STAKEHOLD-
   21  ERS,  INCLUDING INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, PARENTS AND
   22  GUARDIANS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, ADVOCATES  AND
   23  PROVIDERS OF SERVICES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES.
   24    (C)  THE PLAN REQUIRED PURSUANT TO THIS SECTION SHALL BE DEVELOPED AND
   25  SUBMITTED TO THE TEMPORARY PRESIDENT OF THE SENATE AND  SPEAKER  OF  THE
   26  ASSEMBLY  AND POSTED ON THE WEBSITE OF THE OFFICE FOR PEOPLE WITH DEVEL-
   27  OPMENTAL DISABILITIES WITHIN ONE HUNDRED EIGHTY DAYS OF THE CENTERS  FOR
   28  MEDICARE AND MEDICAID SERVICES' APPROVAL OF THE PLAN TO INCREASE COMPET-
   29  ITIVE  EMPLOYMENT  OPPORTUNITIES FOR PEOPLE WITH DEVELOPMENTAL DISABILI-
   30  TIES.
   31    S 2. This act shall take effect immediately.

   32                                   PART F

   33    Section 1. No later than January 1, 2016, the office for  people  with
   34  developmental  disabilities  shall  issue  a report to the governor, the
   35  temporary president of the  senate  and  the  speaker  of  the  assembly
   36  setting  forth recommendations for the establishment of a direct support
   37  professional  credentialing  pilot  program.  Recommendations  for   the
   38  program  shall  be  based  on  a study to be conducted by the office for
   39  people with developmental disabilities and shall  include  consideration
   40  of:  (1) national and international models of direct support credential-
   41  ing; (2) career ladders for direct support  professionals  and  supervi-
   42  sors;  (3)  current  direct  support  professional salaries and training
   43  requirements; (4) classroom and  on-the-job  training  requirements  for
   44  existing  direct  support credentialing programs and the impact of these
   45  requirements on operations of providers of  services;  (5)  ongoing  and
   46  continuing  professional  education requirements for credentialed direct
   47  support of professionals; (6) the fiscal impact of a credentialing pilot
   48  program;  and  (7)  financial  incentives  for  those  who  successfully
   49  complete the credentialing program.
   50    S 2. This act shall take effect immediately.

   51                                   PART G
       S. 6914                            159                           A. 9205

    1    Section 1. Subdivision (e) of section 41.55 of the mental hygiene law,
    2  as amended by section 3 of part C of chapter 111 of the laws of 2010, is
    3  amended to read as follows:
    4    (e)  The amount of community mental health support and workforce rein-
    5  vestment funds for the office of mental health shall  be  determined  in
    6  the  annual  budget  and  shall include the amount of actual state oper-
    7  ations general fund appropriation reductions, including personal service
    8  savings and other than personal service savings directly  attributed  to
    9  each  child  and  adult  non-geriatric  inpatient bed closure.   For the
   10  purposes of this section a bed shall be considered to be closed upon the
   11  elimination of funding for such beds  in  the  executive  budget.    The
   12  appropriation  reductions as a result of inpatient bed closures shall be
   13  no less than [seventy] ONE HUNDRED TEN thousand dollars  per  bed  on  a
   14  full  annual basis, as annually recommended by the commissioner, subject
   15  to the approval of the director of the budget, in the  executive  budget
   16  request prior to the fiscal year for which the executive budget is being
   17  submitted.  The  methodologies  used  to  calculate  the per bed closure
   18  savings shall be developed by the commissioner and the director  of  the
   19  budget.  In  no  event  shall  the full annual value of community mental
   20  health support and workforce reinvestment programs attributable to  beds
   21  closed  as  a  result  of net inpatient census decline exceed the twelve
   22  month value of the office of mental health state operations general fund
   23  reductions resulting from such census decline. Such reinvestment  amount
   24  shall  be  made  available in the same proportion by which the office of
   25  mental health's state operations general fund appropriations are reduced
   26  each year as a result of child and  adult  non-geriatric  inpatient  bed
   27  closures due to census decline.
   28    S  2.  Subdivision  2  of section 97-dddd of the state finance law, as
   29  added by section 6 of part R2 of chapter 62 of  the  laws  of  2003,  is
   30  amended to read as follows:
   31    2.  The  commissioner  of the office of mental health shall notify the
   32  director of the budget when the number of children's psychiatric  center
   33  beds  or  adult, non-geriatric psychiatric center beds closed in any one
   34  year exceeds the number of beds projected to be closed by the office  of
   35  mental  health  in  the  executive  budget request submitted in the year
   36  prior to the fiscal year for which the executive budget is being submit-
   37  ted. Notwithstanding any other law, rule or regulation to  the  contrary
   38  the  director  of  the  budget  shall then transfer the amount of actual
   39  state  operations  general  fund  appropriation  reductions,   including
   40  personal  service  and  nonpersonal  service, directly attributed to the
   41  closure of such beds, to the state comptroller  who  shall  then  credit
   42  such appropriation reductions to the community mental health support and
   43  workforce  reinvestment  account.  The  per  bed appropriation reduction
   44  shall be no less than [seventy] ONE HUNDRED TEN thousand  dollars  on  a
   45  full annual basis.
   46    S  3. Section 7 of part R2 of chapter 62 of the laws of 2003, amending
   47  the mental hygiene law and the state finance law relating to the  commu-
   48  nity  mental  health  support  and  workforce  reinvestment program, the
   49  membership of subcommittees for  mental  health  of  community  services
   50  boards  and  the duties of such subcommittees and creating the community
   51  mental health and workforce reinvestment account, as amended by  section
   52  3  of  part  H  of chapter 56 of the laws of 2013, is amended to read as
   53  follows:
   54    S 7. This act shall take effect immediately and shall expire March 31,
   55  [2015] 2018 when upon such date the provisions  of  this  act  shall  be
   56  deemed repealed.
       S. 6914                            160                           A. 9205

    1    S 4. This act shall take effect immediately; provided that:
    2    1.  the  amendments  to subdivision (e) of section 41.55 of the mental
    3  hygiene law made by section one of this act shall not affect the  repeal
    4  of such section and shall be deemed repealed therewith; and
    5    2.  the  amendments  to  subdivision 2 of section 97-dddd of the state
    6  finance law made by section two of this act shall not affect the  repeal
    7  of such section and shall be deemed repealed therewith.

    8                                   PART H

    9    Section  1.  Paragraphs 11, 12, 13, 14, 16 and 17 of subsection (a) of
   10  section 3217-a of the insurance law, as added by chapter 705 of the laws
   11  of 1996, are amended and four new paragraphs 16-a, 18,  19  and  20  are
   12  added to read as follows:
   13    (11)  where  applicable,  notice that an insured enrolled in a managed
   14  care product OR IN A COMPREHENSIVE POLICY THAT  UTILIZES  A  NETWORK  OF
   15  PROVIDERS  offered  by  the insurer may obtain a referral [to] OR PREAU-
   16  THORIZATION FOR a health care provider outside of the insurer's  network
   17  or  panel  when  the insurer does not have a health care provider [with]
   18  WHO IS GEOGRAPHICALLY ACCESSIBLE TO THE INSURED AND WHO HAS  THE  appro-
   19  priate  training  and  experience  in  the  network or panel to meet the
   20  particular health care needs of the insured and the procedure  by  which
   21  the insured can obtain such referral OR PREAUTHORIZATION;
   22    (12)  where  applicable,  notice that an insured enrolled in a managed
   23  care product OR A  COMPREHENSIVE  POLICY  THAT  UTILIZES  A  NETWORK  OF
   24  PROVIDERS offered by the insurer with a condition which requires ongoing
   25  care  from  a  specialist  may  request  a  standing  referral to such a
   26  specialist and the procedure for requesting and obtaining such a  stand-
   27  ing referral;
   28    (13)    where applicable, notice that an insured enrolled in a managed
   29  care product OR A  COMPREHENSIVE  POLICY  THAT  UTILIZES  A  NETWORK  OF
   30  PROVIDERS  offered  by  the  insurer  with  [(i)] (A) a life-threatening
   31  condition or disease, or [(ii)] (B) a degenerative and disabling  condi-
   32  tion  or disease, either of which requires specialized medical care over
   33  a prolonged period of time may  request  a  specialist  responsible  for
   34  providing  or  coordinating the insured's medical care and the procedure
   35  for requesting and obtaining such a specialist;
   36    (14) where applicable, notice that an insured enrolled  in  a  managed
   37  care  product  OR  A  COMPREHENSIVE  POLICY  THAT  UTILIZES A NETWORK OF
   38  PROVIDERS offered by the  insurer  with  [(i)]  (A)  a  life-threatening
   39  condition  or disease, or [(ii)] (B) a degenerative and disabling condi-
   40  tion or disease, either of which requires specialized medical care  over
   41  a  prolonged  period  of  time,  may  request access to a specialty care
   42  center and the procedure by which such access may be obtained;
   43    (16) notice of all appropriate mailing addresses and telephone numbers
   44  to be utilized by insureds seeking information or authorization; [and]
   45    (16-A) WHERE APPLICABLE, NOTICE THAT  AN  INSURED  SHALL  HAVE  DIRECT
   46  ACCESS  TO  PRIMARY  AND  PREVENTIVE OBSTETRIC AND GYNECOLOGIC SERVICES,
   47  INCLUDING ANNUAL EXAMINATIONS, CARE RESULTING FROM SUCH ANNUAL  EXAMINA-
   48  TIONS,  AND  TREATMENT OF ACUTE GYNECOLOGIC CONDITIONS, FROM A QUALIFIED
   49  PROVIDER OF SUCH SERVICES OF HER CHOICE FROM WITHIN THE PLAN OR FOR  ANY
   50  CARE RELATED TO A PREGNANCY;
   51    (17) where applicable, a listing by specialty, which may be in a sepa-
   52  rate  document that is updated annually, of the name, address, and tele-
   53  phone number of all participating providers, including  facilities,  and
   54  in   addition,  in  the  case  of  physicians,  board  certification[.],
       S. 6914                            161                           A. 9205

    1  LANGUAGES SPOKEN AND ANY AFFILIATIONS WITH PARTICIPATING HOSPITALS.  THE
    2  LISTING  SHALL  ALSO  BE POSTED ON THE INSURER'S WEBSITE AND THE INSURER
    3  SHALL UPDATE THE WEBSITE WITHIN FIFTEEN DAYS OF THE ADDITION  OR  TERMI-
    4  NATION  OF A PROVIDER FROM THE INSURER'S NETWORK OR A CHANGE IN A PHYSI-
    5  CIAN'S HOSPITAL AFFILIATION;
    6    (18) A DESCRIPTION OF THE METHOD BY WHICH  AN  INSURED  MAY  SUBMIT  A
    7  CLAIM FOR HEALTH CARE SERVICES;
    8    (19) WITH RESPECT TO OUT-OF-NETWORK COVERAGE:
    9    (A)  A  CLEAR  DESCRIPTION  OF  THE METHODOLOGY USED BY THE INSURER TO
   10  DETERMINE REIMBURSEMENT FOR OUT-OF-NETWORK HEALTH CARE SERVICES;
   11    (B) THE AMOUNT THAT THE INSURER WILL REIMBURSE UNDER  THE  METHODOLOGY
   12  FOR OUT-OF-NETWORK HEALTH CARE SERVICES SET FORTH AS A PERCENTAGE OF THE
   13  USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK HEALTH CARE SERVICES; AND
   14    (C)  EXAMPLES OF ANTICIPATED OUT-OF-POCKET COSTS FOR FREQUENTLY BILLED
   15  OUT-OF-NETWORK HEALTH CARE SERVICES; AND
   16    (20) INFORMATION IN WRITING  AND  THROUGH  AN  INTERNET  WEBSITE  THAT
   17  REASONABLY  PERMITS  AN  INSURED  OR PROSPECTIVE INSURED TO ESTIMATE THE
   18  ANTICIPATED OUT-OF-POCKET COST FOR OUT-OF-NETWORK HEALTH  CARE  SERVICES
   19  IN  A  GEOGRAPHICAL  AREA  OR ZIP CODE BASED UPON THE DIFFERENCE BETWEEN
   20  WHAT THE INSURER WILL REIMBURSE FOR OUT-OF-NETWORK HEALTH CARE  SERVICES
   21  AND  THE  USUAL  AND  CUSTOMARY  COST  FOR  OUT-OF-NETWORK  HEALTH  CARE
   22  SERVICES.
   23    S 2. Paragraphs 11 and 12 of subsection (b) of section 3217-a  of  the
   24  insurance  law, as added by chapter 705 of the laws of 1996, are amended
   25  and two new paragraphs 13 and 14 are added to read as follows:
   26    (11) where applicable, provide the written application procedures  and
   27  minimum  qualification  requirements  for  health  care  providers to be
   28  considered by the insurer for participation in the insurer's network for
   29  a managed care product; [and]
   30    (12) disclose such other information as required  by  the  superinten-
   31  dent,  provided  that  such requirements are promulgated pursuant to the
   32  state administrative procedure act[.];
   33    (13) DISCLOSE WHETHER A HEALTH CARE PROVIDER SCHEDULED  TO  PROVIDE  A
   34  HEALTH CARE SERVICE IS AN IN-NETWORK PROVIDER; AND
   35    (14) WITH RESPECT TO OUT-OF-NETWORK COVERAGE, DISCLOSE THE APPROXIMATE
   36  DOLLAR  AMOUNT  THAT  THE INSURER WILL PAY FOR A SPECIFIC OUT-OF-NETWORK
   37  HEALTH CARE SERVICE.  THE INSURER SHALL ALSO INFORM THE INSURED  THROUGH
   38  SUCH  DISCLOSURE  THAT  SUCH APPROXIMATION IS NOT BINDING ON THE INSURER
   39  AND THAT THE APPROXIMATE DOLLAR AMOUNT THAT THE INSURER WILL PAY  FOR  A
   40  SPECIFIC OUT-OF-NETWORK HEALTH CARE SERVICE MAY CHANGE.
   41    S  3.  Section  3217-a of the insurance law is amended by adding a new
   42  subsection (f) to read as follows:
   43    (F) FOR PURPOSES OF THIS SECTION, "USUAL  AND  CUSTOMARY  COST"  SHALL
   44  MEAN  THE  EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE PARTICULAR HEALTH
   45  CARE SERVICE PERFORMED BY A PROVIDER IN THE SAME  OR  SIMILAR  SPECIALTY
   46  AND PROVIDED IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING
   47  DATABASE  MAINTAINED BY A NONPROFIT ORGANIZATION SPECIFIED BY THE SUPER-
   48  INTENDENT. THE NONPROFIT ORGANIZATION SHALL NOT BE  AFFILIATED  WITH  AN
   49  INSURER, A CORPORATION SUBJECT TO ARTICLE FORTY-THREE OF THIS CHAPTER, A
   50  MUNICIPAL  COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE
   51  FORTY-SEVEN OF THIS CHAPTER, OR A HEALTH MAINTENANCE ORGANIZATION CERTI-
   52  FIED PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW.
   53    S 4. Section 3217-d of the insurance law is amended by  adding  a  new
   54  subsection (d) to read as follows:
   55    (D)  AN  INSURER  THAT  ISSUES  A COMPREHENSIVE POLICY THAT UTILIZES A
   56  NETWORK OF PROVIDERS AND IS NOT A MANAGED CARE HEALTH INSURANCE CONTRACT
       S. 6914                            162                           A. 9205

    1  AS DEFINED IN SUBSECTION (C) OF SECTION FOUR THOUSAND EIGHT HUNDRED  ONE
    2  OF  THIS  CHAPTER,  SHALL  PROVIDE  ACCESS  TO  OUT-OF-NETWORK  SERVICES
    3  CONSISTENT WITH THE REQUIREMENTS OF SUBSECTION (A) OF SECTION FOUR THOU-
    4  SAND  EIGHT HUNDRED FOUR OF THIS CHAPTER, SUBSECTIONS (G-6) AND (G-7) OF
    5  SECTION FOUR THOUSAND NINE HUNDRED OF THIS  CHAPTER,  SUBSECTIONS  (A-1)
    6  AND  (A-2)  OF  SECTION FOUR THOUSAND NINE HUNDRED FOUR OF THIS CHAPTER,
    7  PARAGRAPHS THREE AND FOUR OF SUBSECTION (B)  OF  SECTION  FOUR  THOUSAND
    8  NINE HUNDRED TEN OF THIS CHAPTER, AND SUBPARAGRAPHS (C) AND (D) OF PARA-
    9  GRAPH FOUR OF SUBSECTION (B) OF SECTION FOUR THOUSAND NINE HUNDRED FOUR-
   10  TEEN OF THIS CHAPTER.
   11    S  5.  Section  3224-a of the insurance law is amended by adding a new
   12  subsection (j) to read as follows:
   13    (J) AN INSURER OR AN ORGANIZATION OR CORPORATION LICENSED OR CERTIFIED
   14  PURSUANT TO ARTICLE FORTY-THREE OR FORTY-SEVEN OF THIS CHAPTER OR  ARTI-
   15  CLE  FORTY-FOUR OF THE PUBLIC HEALTH LAW OR A STUDENT HEALTH PLAN ESTAB-
   16  LISHED OR MAINTAINED PURSUANT TO SECTION ONE THOUSAND ONE HUNDRED  TWEN-
   17  TY-FOUR  OF THIS CHAPTER SHALL ACCEPT CLAIMS SUBMITTED BY A POLICYHOLDER
   18  OR COVERED PERSON, IN WRITING, INCLUDING THROUGH THE INTERNET, BY  ELEC-
   19  TRONIC MAIL OR BY FACSIMILE.
   20    S 6. The insurance law is amended by adding a new section 3241 to read
   21  as follows:
   22    S  3241.    NETWORK  COVERAGE. (A) AN INSURER, A CORPORATION ORGANIZED
   23  PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER, A MUNICIPAL COOPERATIVE
   24  HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE  FORTY-SEVEN  OF  THIS
   25  CHAPTER,  OR A STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT TO
   26  SECTION ONE THOUSAND ONE  HUNDRED  TWENTY-FOUR  OF  THIS  CHAPTER,  THAT
   27  ISSUES  A  HEALTH  INSURANCE POLICY OR CONTRACT WITH A NETWORK OF HEALTH
   28  CARE PROVIDERS SHALL ENSURE THAT THE NETWORK IS  ADEQUATE  TO  MEET  THE
   29  HEALTH  NEEDS OF INSUREDS AND PROVIDE AN APPROPRIATE CHOICE OF PROVIDERS
   30  SUFFICIENT TO RENDER THE SERVICES COVERED UNDER THE POLICY OR  CONTRACT.
   31  THE SUPERINTENDENT SHALL REVIEW THE NETWORK OF HEALTH CARE PROVIDERS FOR
   32  ADEQUACY  AT  THE  TIME  OF  THE  SUPERINTENDENT'S INITIAL APPROVAL OF A
   33  HEALTH INSURANCE POLICY OR CONTRACT; AT LEAST EVERY THREE  YEARS  THERE-
   34  AFTER; AND UPON APPLICATION FOR EXPANSION OF ANY SERVICE AREA ASSOCIATED
   35  WITH  THE POLICY OR CONTRACT IN CONFORMANCE WITH THE STANDARDS SET FORTH
   36  IN SUBDIVISION FIVE OF SECTION FOUR THOUSAND FOUR HUNDRED THREE  OF  THE
   37  PUBLIC  HEALTH LAW.   TO THE EXTENT THAT THE NETWORK HAS BEEN DETERMINED
   38  BY THE COMMISSIONER OF HEALTH TO MEET THE STANDARDS SET FORTH IN  SUBDI-
   39  VISION  FIVE  OF  SECTION FOUR THOUSAND FOUR HUNDRED THREE OF THE PUBLIC
   40  HEALTH LAW, SUCH NETWORK SHALL BE DEEMED ADEQUATE BY THE SUPERINTENDENT.
   41    (B)(1)(A) AN INSURER, A  CORPORATION  ORGANIZED  PURSUANT  TO  ARTICLE
   42  FORTY-THREE OF THIS CHAPTER, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN
   43  CERTIFIED  PURSUANT  TO  ARTICLE  FORTY-SEVEN  OF THIS CHAPTER, A HEALTH
   44  MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR OF THE
   45  PUBLIC HEALTH LAW OR A STUDENT HEALTH  PLAN  ESTABLISHED  OR  MAINTAINED
   46  PURSUANT  TO  SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAP-
   47  TER, THAT ISSUES A COMPREHENSIVE GROUP OR GROUP REMITTANCE HEALTH INSUR-
   48  ANCE POLICY OR CONTRACT THAT COVERS OUT-OF-NETWORK HEALTH CARE  SERVICES
   49  SHALL  MAKE AVAILABLE AND, IF REQUESTED BY THE POLICYHOLDER OR CONTRACT-
   50  HOLDER, PROVIDE AT LEAST ONE OPTION FOR COVERAGE  FOR  AT  LEAST  EIGHTY
   51  PERCENT  OF  THE  USUAL AND CUSTOMARY COST OF EACH OUT-OF-NETWORK HEALTH
   52  CARE SERVICE AFTER IMPOSITION OF A DEDUCTIBLE OR ANY PERMISSIBLE BENEFIT
   53  MAXIMUM.
   54    (B) IF THERE IS NO COVERAGE AVAILABLE PURSUANT TO SUBPARAGRAPH (A)  OF
   55  THIS  PARAGRAPH  IN A RATING REGION, THEN THE SUPERINTENDENT MAY REQUIRE
   56  AN INSURER, A CORPORATION ORGANIZED PURSUANT TO ARTICLE  FORTY-THREE  OF
       S. 6914                            163                           A. 9205

    1  THIS  CHAPTER,  A  MUNICIPAL  COOPERATIVE  HEALTH BENEFIT PLAN CERTIFIED
    2  PURSUANT TO ARTICLE FORTY-SEVEN OF THIS CHAPTER,  A  HEALTH  MAINTENANCE
    3  ORGANIZATION  CERTIFIED  PURSUANT  TO  ARTICLE  FORTY-FOUR OF THE PUBLIC
    4  HEALTH  LAW, OR A STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT
    5  TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER  ISSUING
    6  A  COMPREHENSIVE  GROUP  OR  GROUP REMITTANCE HEALTH INSURANCE POLICY OR
    7  CONTRACT IN THE RATING REGION, TO MAKE AVAILABLE AND,  IF  REQUESTED  BY
    8  THE  POLICYHOLDER  OR  CONTRACTHOLDER,  PROVIDE  AT LEAST ONE OPTION FOR
    9  COVERAGE OF EIGHTY PERCENT OF THE USUAL AND CUSTOMARY COST OF EACH  OUT-
   10  OF-NETWORK  HEALTH  CARE  SERVICE  AFTER  IMPOSITION  OF ANY PERMISSIBLE
   11  DEDUCTIBLE OR BENEFIT MAXIMUM.  THE  SUPERINTENDENT  MAY,  AFTER  GIVING
   12  CONSIDERATION  TO THE PUBLIC INTEREST, PERMIT AN INSURER, A CORPORATION,
   13  OR A HEALTH MAINTENANCE ORGANIZATION TO SATISFY THE REQUIREMENTS OF THIS
   14  PARAGRAPH ON BEHALF OF ANOTHER INSURER, CORPORATION, OR  HEALTH  MAINTE-
   15  NANCE ORGANIZATION WITHIN THE SAME HOLDING COMPANY SYSTEM, AS DEFINED IN
   16  ARTICLE  FIFTEEN  OF THIS CHAPTER, INCLUDING A HEALTH MAINTENANCE ORGAN-
   17  IZATION OPERATED AS A LINE OF BUSINESS OF A HEALTH  SERVICE  CORPORATION
   18  ORGANIZED  PURSUANT  TO  ARTICLE FORTY-THREE OF THIS CHAPTER. THE SUPER-
   19  INTENDENT MAY, UPON WRITTEN REQUEST, WAIVE THE REQUIREMENT FOR  COVERAGE
   20  OF  OUT-OF-NETWORK HEALTH CARE SERVICES TO BE MADE AVAILABLE PURSUANT TO
   21  THIS SUBPARAGRAPH IF THE SUPERINTENDENT DETERMINES THAT IT WOULD POSE AN
   22  UNDUE HARDSHIP UPON AN INSURER,  A  CORPORATION  ORGANIZED  PURSUANT  TO
   23  ARTICLE  FORTY-THREE  OF  THIS  CHAPTER,  A MUNICIPAL COOPERATIVE HEALTH
   24  BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF THIS  CHAPTER,
   25  A   HEALTH   MAINTENANCE  ORGANIZATION  CERTIFIED  PURSUANT  TO  ARTICLE
   26  FORTY-FOUR OF THE PUBLIC HEALTH LAW, OR A  STUDENT  HEALTH  PLAN  ESTAB-
   27  LISHED  OR MAINTAINED PURSUANT TO SECTION ONE THOUSAND ONE HUNDRED TWEN-
   28  TY-FOUR OF THIS CHAPTER.
   29    (2) FOR THE PURPOSES OF THIS SUBSECTION, "USUAL  AND  CUSTOMARY  COST"
   30  SHALL  MEAN  THE  EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE PARTICULAR
   31  HEALTH CARE SERVICE PERFORMED BY A  PROVIDER  IN  THE  SAME  OR  SIMILAR
   32  SPECIALTY  AND  PROVIDED  IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A
   33  BENCHMARKING DATABASE MAINTAINED BY A NONPROFIT  ORGANIZATION  SPECIFIED
   34  BY  THE  SUPERINTENDENT.  THE NONPROFIT ORGANIZATION SHALL NOT BE AFFIL-
   35  IATED WITH AN INSURER, A CORPORATION SUBJECT TO ARTICLE  FORTY-THREE  OF
   36  THIS  CHAPTER,  A  MUNICIPAL  COOPERATIVE  HEALTH BENEFIT PLAN CERTIFIED
   37  PURSUANT TO ARTICLE FORTY-SEVEN OF THIS CHAPTER,  A  HEALTH  MAINTENANCE
   38  ORGANIZATION  CERTIFIED  PURSUANT  TO  ARTICLE  FORTY-FOUR OF THE PUBLIC
   39  HEALTH LAW OR A STUDENT HEALTH PLAN ESTABLISHED OR  MAINTAINED  PURSUANT
   40  TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER.
   41    (3)  THIS  SUBSECTION  SHALL  NOT  APPLY TO EMERGENCY CARE SERVICES IN
   42  HOSPITAL FACILITIES OR PREHOSPITAL EMERGENCY MEDICAL SERVICES AS DEFINED
   43  IN CLAUSE (I) OF SUBPARAGRAPH (E) OF PARAGRAPH TWENTY-FOUR OF SUBSECTION
   44  (I) OF SECTION THREE THOUSAND TWO HUNDRED SIXTEEN OF  THIS  ARTICLE,  OR
   45  CLAUSE (I) OF SUBPARAGRAPH (E) OF PARAGRAPH FIFTEEN OF SUBSECTION (L) OF
   46  SECTION  THREE  THOUSAND  TWO  HUNDRED  TWENTY-ONE  OF  THIS CHAPTER, OR
   47  SUBPARAGRAPH (A) OF PARAGRAPH FIVE OF SUBSECTION (AA)  OF  SECTION  FOUR
   48  THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
   49    (4)  NOTHING  IN  THIS  SUBSECTION  SHALL  LIMIT  THE SUPERINTENDENT'S
   50  AUTHORITY PURSUANT TO SECTION THREE THOUSAND TWO  HUNDRED  SEVENTEEN  OF
   51  THIS  ARTICLE  TO  ESTABLISH MINIMUM STANDARDS FOR THE FORM, CONTENT AND
   52  SALE OF ACCIDENT AND HEALTH INSURANCE POLICIES AND SUBSCRIBER CONTRACTS,
   53  TO REQUIRE ADDITIONAL COVERAGE OPTIONS FOR OUT-OF-NETWORK  SERVICES,  OR
   54  TO PROVIDE FOR STANDARDIZATION AND SIMPLIFICATION OF COVERAGE.
   55    (C)  WHEN  AN  INSURED  OR  ENROLLEE  UNDER  A CONTRACT OR POLICY THAT
   56  PROVIDES COVERAGE FOR EMERGENCY SERVICES RECEIVES THE  SERVICES  FROM  A
       S. 6914                            164                           A. 9205

    1  HEALTH  CARE  PROVIDER THAT DOES NOT PARTICIPATE IN THE PROVIDER NETWORK
    2  OF AN INSURER, A CORPORATION ORGANIZED PURSUANT TO  ARTICLE  FORTY-THREE
    3  OF  THIS  CHAPTER, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED
    4  PURSUANT  TO  ARTICLE  FORTY-SEVEN OF THIS CHAPTER, A HEALTH MAINTENANCE
    5  ORGANIZATION CERTIFIED PURSUANT TO  ARTICLE  FORTY-FOUR  OF  THE  PUBLIC
    6  HEALTH  LAW, OR A STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT
    7  TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER ("HEALTH
    8  CARE PLAN"), THE HEALTH CARE PLAN  SHALL  ENSURE  THAT  THE  INSURED  OR
    9  ENROLLEE  SHALL  INCUR  NO GREATER OUT-OF-POCKET COSTS FOR THE EMERGENCY
   10  SERVICES THAN THE INSURED OR ENROLLEE WOULD HAVE INCURRED WITH A  HEALTH
   11  CARE  PROVIDER  THAT  PARTICIPATES  IN  THE  HEALTH CARE PLAN'S PROVIDER
   12  NETWORK. FOR THE PURPOSE OF THIS  SECTION,  "EMERGENCY  SERVICES"  SHALL
   13  HAVE  THE  MEANING  SET  FORTH  IN SUBPARAGRAPH (D) OF PARAGRAPH NINE OF
   14  SUBSECTION (I) OF SECTION THREE THOUSAND TWO  HUNDRED  SIXTEEN  OF  THIS
   15  ARTICLE, SUBPARAGRAPH (D) OF PARAGRAPH FOUR OF SUBSECTION (K) OF SECTION
   16  THREE  THOUSAND TWO HUNDRED TWENTY-ONE OF THIS ARTICLE, AND SUBPARAGRAPH
   17  (D) OF PARAGRAPH TWO OF SUBSECTION (A) OF SECTION  FOUR  THOUSAND  THREE
   18  HUNDRED THREE OF THIS CHAPTER.
   19    S  7.  Section  4306-c of the insurance law is amended by adding a new
   20  subsection (d) to read as follows:
   21    (D) A CORPORATION, INCLUDING A MUNICIPAL  COOPERATIVE  HEALTH  BENEFIT
   22  PLAN  CERTIFIED  PURSUANT  TO  ARTICLE FORTY-SEVEN OF THIS CHAPTER AND A
   23  STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT  TO  SECTION  ONE
   24  THOUSAND  ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER, THAT ISSUES A COMPRE-
   25  HENSIVE POLICY THAT UTILIZES A NETWORK OF PROVIDERS AND IS NOT A MANAGED
   26  CARE HEALTH INSURANCE CONTRACT AS DEFINED IN SUBSECTION (C)  OF  SECTION
   27  FOUR THOUSAND EIGHT HUNDRED ONE OF THIS CHAPTER, SHALL PROVIDE ACCESS TO
   28  OUT-OF-NETWORK  SERVICES  CONSISTENT WITH THE REQUIREMENTS OF SUBSECTION
   29  (A) OF SECTION  FOUR  THOUSAND  EIGHT  HUNDRED  FOUR  OF  THIS  CHAPTER,
   30  SUBSECTIONS  (G-6)  AND  (G-7)  OF SECTION FOUR THOUSAND NINE HUNDRED OF
   31  THIS CHAPTER, SUBSECTIONS (A-1) AND (A-2) OF SECTION FOUR THOUSAND  NINE
   32  HUNDRED  FOUR  OF  THIS CHAPTER, PARAGRAPHS THREE AND FOUR OF SUBSECTION
   33  (B) OF SECTION FOUR THOUSAND NINE  HUNDRED  TEN  OF  THIS  CHAPTER,  AND
   34  SUBPARAGRAPHS (C) AND (D) OF PARAGRAPH FOUR OF SUBSECTION (B) OF SECTION
   35  FOUR THOUSAND NINE HUNDRED FOURTEEN OF THIS CHAPTER.
   36    S  8. Paragraphs 11, 12, 13, 14, 16-a, 17, and 18 of subsection (a) of
   37  section 4324 of the insurance law, paragraphs 11, 12, 13, 14, 17 and  18
   38  as  added by chapter 705 of the laws of 1996, paragraph 16-a as added by
   39  chapter 554 of the laws of 2002, are amended and  three  new  paragraphs
   40  19, 20 and 21 are added to read as follows:
   41    (11)  where applicable, notice that a subscriber enrolled in a managed
   42  care  product  OR IN A COMPREHENSIVE CONTRACT THAT UTILIZES A NETWORK OF
   43  PROVIDERS offered by the corporation  may  obtain  a  referral  [to]  OR
   44  PREAUTHORIZATION FOR a health care provider outside of the corporation's
   45  network  or  panel  when  the  corporation  does  not have a health care
   46  provider [with] WHO IS GEOGRAPHICALLY ACCESSIBLE TO THE INSURED AND  WHO
   47  HAS  THE  appropriate training and experience in the network or panel to
   48  meet the particular health care needs of the subscriber and  the  proce-
   49  dure  by  which  the  subscriber can obtain such referral OR PREAUTHORI-
   50  ZATION;
   51    (12) where applicable, notice that a subscriber enrolled in a  managed
   52  care  product  OR  A  COMPREHENSIVE  CONTRACT THAT UTILIZES A NETWORK OF
   53  PROVIDERS offered by the corporation with  a  condition  which  requires
   54  ongoing care from a specialist may request a standing referral to such a
   55  specialist  and the procedure for requesting and obtaining such a stand-
   56  ing referral;
       S. 6914                            165                           A. 9205

    1    (13) where applicable, notice that a subscriber enrolled in a  managed
    2  care  product  OR  A  COMPREHENSIVE  CONTRACT THAT UTILIZES A NETWORK OF
    3  PROVIDERS offered by the corporation with (i) a life-threatening  condi-
    4  tion  or  disease,  or  (ii)  a  degenerative and disabling condition or
    5  disease,  either  of  which  requires  specialized  medical  care over a
    6  prolonged period of  time  may  request  a  specialist  responsible  for
    7  providing  or  coordinating the subscriber's medical care and the proce-
    8  dure for requesting and obtaining such a specialist;
    9    (14) where applicable, notice that a subscriber enrolled in a  managed
   10  care  product  OR  A  COMPREHENSIVE  CONTRACT THAT UTILIZES A NETWORK OF
   11  PROVIDERS offered by the corporation with [(i)] (A)  a  life-threatening
   12  condition  or disease, or [(ii)] (B) a degenerative and disabling condi-
   13  tion or disease, either of which requires specialized medical care  over
   14  a prolonged period of time may request access to a specialty care center
   15  and the procedure by which such access may be obtained;
   16    (16-a)  where  applicable,  notice  that an enrollee shall have direct
   17  access to primary and preventive  obstetric  and  gynecologic  services,
   18  INCLUDING  ANNUAL EXAMINATIONS, CARE RESULTING FROM SUCH ANNUAL EXAMINA-
   19  TIONS, AND TREATMENT OF ACUTE GYNECOLOGIC CONDITIONS, from  a  qualified
   20  provider  of  such  services  of her choice from within the plan [for no
   21  fewer than two examinations annually for such services] or [to] FOR  any
   22  care  related  to A pregnancy [and that additionally, the enrollee shall
   23  have direct access to primary and preventive obstetric  and  gynecologic
   24  services required as a result of such annual examinations or as a result
   25  of an acute gynecologic condition];
   26    (17) where applicable, a listing by specialty, which may be in a sepa-
   27  rate  document that is updated annually, of the name, address, and tele-
   28  phone number of all participating providers, including  facilities,  and
   29  in  addition,  in  the  case  of physicians, board certification[; and],
   30  LANGUAGES SPOKEN AND ANY AFFILIATIONS WITH PARTICIPATING HOSPITALS.  THE
   31  LISTING SHALL ALSO BE POSTED ON THE CORPORATION'S WEBSITE AND THE CORPO-
   32  RATION SHALL UPDATE THE WEBSITE WITHIN FIFTEEN DAYS OF THE  ADDITION  OR
   33  TERMINATION  OF A PROVIDER FROM THE CORPORATION'S NETWORK OR A CHANGE IN
   34  A PHYSICIAN'S HOSPITAL AFFILIATION;
   35    (18) a description of the mechanisms by which subscribers may  partic-
   36  ipate in the development of the policies of the corporation[.];
   37    (19)  THE  METHOD  BY WHICH A SUBSCRIBER MAY SUBMIT A CLAIM FOR HEALTH
   38  CARE SERVICES;
   39    (20) WITH RESPECT TO OUT-OF-NETWORK COVERAGE:
   40    (A) A CLEAR DESCRIPTION OF THE METHODOLOGY USED BY THE CORPORATION  TO
   41  DETERMINE REIMBURSEMENT FOR OUT-OF-NETWORK HEALTH CARE SERVICES;
   42    (B)  A  DESCRIPTION  OF THE AMOUNT THAT THE CORPORATION WILL REIMBURSE
   43  UNDER THE METHODOLOGY FOR OUT-OF-NETWORK HEALTH CARE SERVICES SET  FORTH
   44  AS  A  PERCENTAGE  OF  THE  USUAL  AND CUSTOMARY COST FOR OUT-OF-NETWORK
   45  HEALTH CARE SERVICES; AND
   46    (C) EXAMPLES OF ANTICIPATED OUT-OF-POCKET COSTS FOR FREQUENTLY  BILLED
   47  OUT-OF-NETWORK HEALTH CARE SERVICES; AND
   48    (21)  INFORMATION  IN  WRITING  AND  THROUGH  AN INTERNET WEBSITE THAT
   49  REASONABLY PERMITS A SUBSCRIBER OR PROSPECTIVE  SUBSCRIBER  TO  ESTIMATE
   50  THE  ANTICIPATED  OUT-OF-POCKET  COST  FOR  OUT-OF-NETWORK  HEALTH  CARE
   51  SERVICES IN A GEOGRAPHICAL AREA OR ZIP CODE BASED  UPON  THE  DIFFERENCE
   52  BETWEEN  WHAT  THE  CORPORATION WILL REIMBURSE FOR OUT-OF-NETWORK HEALTH
   53  CARE SERVICES AND THE USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK HEALTH
   54  CARE SERVICES.
       S. 6914                            166                           A. 9205

    1    S 9. Paragraphs 11 and 12 of subsection (b) of  section  4324  of  the
    2  insurance  law, as added by chapter 705 of the laws of 1996, are amended
    3  and two new paragraphs 13 and 14 are added to read as follows:
    4    (11)  where applicable, provide the written application procedures and
    5  minimum qualification requirements  for  health  care  providers  to  be
    6  considered  by  the  corporation  for participation in the corporation's
    7  network for a managed care product; [and]
    8    (12) disclose such other information as required  by  the  superinten-
    9  dent,  provided  that  such requirements are promulgated pursuant to the
   10  state administrative procedure act[.];
   11    (13) DISCLOSE WHETHER A HEALTH CARE PROVIDER SCHEDULED  TO  PROVIDE  A
   12  HEALTH CARE SERVICE IS AN IN-NETWORK PROVIDER; AND
   13    (14) WITH RESPECT TO OUT-OF-NETWORK COVERAGE, DISCLOSE THE APPROXIMATE
   14  DOLLAR  AMOUNT  THAT THE CORPORATION WILL PAY FOR A SPECIFIC OUT-OF-NET-
   15  WORK HEALTH CARE SERVICE.  THE CORPORATION SHALL ALSO INFORM THE INSURED
   16  THROUGH SUCH DISCLOSURE THAT SUCH APPROXIMATION IS NOT  BINDING  ON  THE
   17  CORPORATION  AND THAT THE APPROXIMATE DOLLAR AMOUNT THAT THE CORPORATION
   18  WILL PAY FOR A SPECIFIC OUT-OF-NETWORK HEALTH CARE SERVICE MAY CHANGE.
   19    S 10. Section 4324 of the insurance law is amended  by  adding  a  new
   20  subsection (f) to read as follows:
   21    (F)  FOR  PURPOSES  OF  THIS SECTION, "USUAL AND CUSTOMARY COST" SHALL
   22  MEAN THE EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE  PARTICULAR  HEALTH
   23  CARE  SERVICE  PERFORMED  BY A PROVIDER IN THE SAME OR SIMILAR SPECIALTY
   24  AND PROVIDED IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING
   25  DATABASE MAINTAINED BY A NONPROFIT ORGANIZATION SPECIFIED BY THE  SUPER-
   26  INTENDENT.  THE  NONPROFIT  ORGANIZATION SHALL NOT BE AFFILIATED WITH AN
   27  INSURER, A CORPORATION SUBJECT TO THIS ARTICLE, A MUNICIPAL  COOPERATIVE
   28  HEALTH  BENEFIT  PLAN  CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF THIS
   29  CHAPTER, OR A HEALTH  MAINTENANCE  ORGANIZATION  CERTIFIED  PURSUANT  TO
   30  ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW.
   31    S  11.  Section  4900  of the insurance law is amended by adding a new
   32  subsection (g-6-a) to read as follows:
   33    (G-6-A) "OUT-OF-NETWORK  REFERRAL  DENIAL"  MEANS  A  DENIAL  UNDER  A
   34  MANAGED  CARE PRODUCT AS DEFINED IN SUBSECTION (C) OF SECTION FOUR THOU-
   35  SAND EIGHT HUNDRED ONE OF THIS CHAPTER OF A REQUEST FOR AN AUTHORIZATION
   36  OR REFERRAL TO AN OUT-OF-NETWORK PROVIDER ON THE BASIS THAT  THE  HEALTH
   37  CARE  PLAN HAS A HEALTH CARE PROVIDER IN THE IN-NETWORK BENEFITS PORTION
   38  OF ITS NETWORK WITH APPROPRIATE TRAINING  AND  EXPERIENCE  TO  MEET  THE
   39  PARTICULAR  HEALTH  CARE NEEDS OF AN INSURED, AND WHO IS ABLE TO PROVIDE
   40  THE REQUESTED HEALTH SERVICE. THE NOTICE OF AN  OUT-OF-NETWORK  REFERRAL
   41  DENIAL  PROVIDED TO AN INSURED SHALL INCLUDE INFORMATION EXPLAINING WHAT
   42  INFORMATION THE INSURED MUST SUBMIT IN ORDER TO APPEAL  THE  OUT-OF-NET-
   43  WORK  REFERRAL DENIAL PURSUANT TO SUBSECTION (A-2) OF SECTION FOUR THOU-
   44  SAND NINE HUNDRED FOUR  OF  THIS  ARTICLE.  AN  OUT-OF-NETWORK  REFERRAL
   45  DENIAL  UNDER  THIS  SUBSECTION  DOES NOT CONSTITUTE AN ADVERSE DETERMI-
   46  NATION AS DEFINED IN THIS ARTICLE.   AN OUT-OF-NETWORK  REFERRAL  DENIAL
   47  SHALL NOT BE CONSTRUED TO INCLUDE AN OUT-OF-NETWORK DENIAL AS DEFINED IN
   48  SUBSECTION (G-6) OF THIS SECTION.
   49    S  12. Subsection (b) of section 4903 of the insurance law, as amended
   50  by chapter 514 of the laws of 2013, is amended to read as follows:
   51    (b) A utilization review agent shall make a utilization review  deter-
   52  mination  involving health care services which require pre-authorization
   53  and provide notice of a determination to the insured or insured's desig-
   54  nee and the insured's health care provider by telephone and  in  writing
   55  within  three  business days of receipt of the necessary information. To
   56  the extent practicable, such  written  notification  to  the  enrollee's
       S. 6914                            167                           A. 9205

    1  health  care  provider  shall be transmitted electronically, in a manner
    2  and in a form agreed upon by the parties.  THE NOTIFICATION SHALL  IDEN-
    3  TIFY:  (1) WHETHER THE SERVICES ARE CONSIDERED IN-NETWORK OR OUT-OF-NET-
    4  WORK; (2) WHETHER THE INSURED WILL BE HELD HARMLESS FOR THE SERVICES AND
    5  NOT  BE  RESPONSIBLE  FOR ANY PAYMENT, OTHER THAN ANY APPLICABLE CO-PAY-
    6  MENT, CO-INSURANCE OR DEDUCTIBLE; (3) AS APPLICABLE, THE  DOLLAR  AMOUNT
    7  THE  HEALTH CARE PLAN WILL PAY IF THE SERVICE IS OUT-OF-NETWORK; AND (4)
    8  AS APPLICABLE, INFORMATION EXPLAINING HOW AN INSURED MAY  DETERMINE  THE
    9  ANTICIPATED  OUT-OF-POCKET  COST FOR OUT-OF-NETWORK HEALTH CARE SERVICES
   10  IN A GEOGRAPHICAL AREA OR ZIP CODE BASED  UPON  THE  DIFFERENCE  BETWEEN
   11  WHAT  THE HEALTH CARE PLAN WILL REIMBURSE FOR OUT-OF-NETWORK HEALTH CARE
   12  SERVICES AND THE USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK HEALTH CARE
   13  SERVICES.
   14    S 13. Section 4904 of the insurance law is amended  by  adding  a  new
   15  subsection (a-2) to read as follows:
   16    (A-2)  AN  INSURED OR THE INSURED'S DESIGNEE MAY APPEAL AN OUT-OF-NET-
   17  WORK REFERRAL DENIAL BY A HEALTH  CARE  PLAN  BY  SUBMITTING  A  WRITTEN
   18  STATEMENT  FROM  THE  INSURED'S  ATTENDING  PHYSICIAN,  WHO  MUST  BE  A
   19  LICENSED, BOARD CERTIFIED OR BOARD ELIGIBLE PHYSICIAN QUALIFIED TO PRAC-
   20  TICE IN THE SPECIALTY AREA OF PRACTICE APPROPRIATE TO TREAT THE  INSURED
   21  FOR  THE HEALTH SERVICE SOUGHT, PROVIDED THAT: (1) THE IN-NETWORK HEALTH
   22  CARE PROVIDER OR PROVIDERS RECOMMENDED BY THE HEALTH CARE  PLAN  DO  NOT
   23  HAVE  THE  APPROPRIATE  TRAINING  AND  EXPERIENCE TO MEET THE PARTICULAR
   24  HEALTH CARE NEEDS OF THE INSURED FOR THE HEALTH SERVICE; AND (2)  RECOM-
   25  MENDS AN OUT-OF-NETWORK PROVIDER WITH THE APPROPRIATE TRAINING AND EXPE-
   26  RIENCE  TO MEET THE PARTICULAR HEALTH CARE NEEDS OF THE INSURED, AND WHO
   27  IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE.
   28    S 14. Subsection (b) of section 4910 of the insurance law  is  amended
   29  by adding a new paragraph 4 to read as follows:
   30    (4)(A)  THE  INSURED  HAS HAD AN OUT-OF-NETWORK REFERRAL DENIED ON THE
   31  GROUNDS THAT THE HEALTH CARE PLAN HAS A  HEALTH  CARE  PROVIDER  IN  THE
   32  IN-NETWORK BENEFITS PORTION OF ITS NETWORK WITH APPROPRIATE TRAINING AND
   33  EXPERIENCE  TO  MEET THE PARTICULAR HEALTH CARE NEEDS OF AN INSURED, AND
   34  WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE.
   35    (B) THE INSURED'S ATTENDING PHYSICIAN, WHO SHALL BE A LICENSED,  BOARD
   36  CERTIFIED  OR  BOARD  ELIGIBLE  PHYSICIAN  QUALIFIED  TO PRACTICE IN THE
   37  SPECIALTY AREA OF PRACTICE APPROPRIATE TO  TREAT  THE  INSURED  FOR  THE
   38  HEALTH SERVICE SOUGHT, CERTIFIES THAT THE IN-NETWORK HEALTH CARE PROVID-
   39  ER  OR  PROVIDERS  RECOMMENDED  BY  THE HEALTH CARE PLAN DO NOT HAVE THE
   40  APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTICULAR  HEALTH  CARE
   41  NEEDS  OF AN INSURED, AND RECOMMENDS AN OUT-OF-NETWORK PROVIDER WITH THE
   42  APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTICULAR  HEALTH  CARE
   43  NEEDS  OF  AN  INSURED,  AND WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH
   44  SERVICE.
   45    S 15. Paragraph 4 of subsection (b) of section 4914 of  the  insurance
   46  law is amended by adding a new subparagraph (D) to read as follows:
   47    (D)  FOR  EXTERNAL  APPEALS  REQUESTED  PURSUANT  TO PARAGRAPH FOUR OF
   48  SUBSECTION (B) OF SECTION FOUR THOUSAND NINE HUNDRED TEN OF  THIS  TITLE
   49  RELATING TO AN OUT-OF-NETWORK REFERRAL DENIAL, THE EXTERNAL APPEAL AGENT
   50  SHALL  REVIEW THE UTILIZATION REVIEW AGENT'S FINAL ADVERSE DETERMINATION
   51  AND, IN ACCORDANCE WITH THE PROVISIONS  OF  THIS  TITLE,  SHALL  MAKE  A
   52  DETERMINATION AS TO WHETHER THE OUT-OF-NETWORK REFERRAL SHALL BE COVERED
   53  BY THE HEALTH PLAN; PROVIDED THAT SUCH DETERMINATION SHALL:
   54    (I)  BE CONDUCTED ONLY BY ONE OR A GREATER ODD NUMBER OF CLINICAL PEER
   55  REVIEWERS;
   56    (II) BE ACCOMPANIED BY A WRITTEN STATEMENT:
       S. 6914                            168                           A. 9205

    1    (I) THAT THE OUT-OF-NETWORK REFERRAL SHALL BE COVERED  BY  THE  HEALTH
    2  CARE PLAN EITHER WHEN THE REVIEWER OR A MAJORITY OF THE PANEL OF REVIEW-
    3  ERS  DETERMINES,  UPON  REVIEW  OF  THE  TRAINING  AND EXPERIENCE OF THE
    4  IN-NETWORK HEALTH CARE PROVIDER OR PROVIDERS PROPOSED BY THE  PLAN,  THE
    5  TRAINING  AND  EXPERIENCE  OF THE REQUESTED OUT-OF-NETWORK PROVIDER, THE
    6  CLINICAL STANDARDS OF THE PLAN, THE INFORMATION PROVIDED CONCERNING  THE
    7  INSURED, THE ATTENDING PHYSICIAN'S RECOMMENDATION, THE INSURED'S MEDICAL
    8  RECORD,  AND  ANY OTHER PERTINENT INFORMATION, THAT THE HEALTH PLAN DOES
    9  NOT HAVE A PROVIDER WITH THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET
   10  THE PARTICULAR HEALTH CARE NEEDS OF AN INSURED WHO IS  ABLE  TO  PROVIDE
   11  THE  REQUESTED  HEALTH SERVICE, AND THAT THE OUT-OF-NETWORK PROVIDER HAS
   12  THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET  THE  PARTICULAR  HEALTH
   13  CARE  NEEDS  OF  AN  INSURED,  IS  ABLE  TO PROVIDE THE REQUESTED HEALTH
   14  SERVICE, AND IS LIKELY TO PRODUCE A MORE CLINICALLY BENEFICIAL  OUTCOME;
   15  OR
   16    (II) UPHOLDING THE HEALTH PLAN'S DENIAL OF COVERAGE;
   17    (III)  BE  SUBJECT TO THE TERMS AND CONDITIONS GENERALLY APPLICABLE TO
   18  BENEFITS UNDER THE EVIDENCE OF COVERAGE UNDER THE HEALTH CARE PLAN;
   19    (IV) BE BINDING ON THE PLAN AND THE INSURED; AND
   20    (V) BE ADMISSIBLE IN ANY COURT PROCEEDING.
   21    S 16. The public health law is amended by adding a new section  23  to
   22  read as follows:
   23    S  23.  CLAIM  FORMS.    A NON-PARTICIPATING PHYSICIAN SHALL INCLUDE A
   24  CLAIM FORM FOR A THIRD-PARTY PAYOR WITH A PATIENT BILL FOR  HEALTH  CARE
   25  SERVICES, OTHER THAN A BILL FOR THE PATIENT'S CO-PAYMENT, COINSURANCE OR
   26  DEDUCTIBLE.
   27    S  17.  The public health law is amended by adding a new section 24 to
   28  read as follows:
   29    S 24. DISCLOSURE.  1. A HEALTH CARE PROFESSIONAL, OR A GROUP  PRACTICE
   30  OF  HEALTH  CARE  PROFESSIONALS,  A DIAGNOSTIC AND TREATMENT CENTER OR A
   31  HEALTH CENTER DEFINED UNDER 42 U.S.C. S 254B ON BEHALF  OF  HEALTH  CARE
   32  PROFESSIONALS  RENDERING  SERVICES AT THE GROUP PRACTICE, DIAGNOSTIC AND
   33  TREATMENT CENTER  OR  HEALTH  CENTER,  SHALL  DISCLOSE  TO  PATIENTS  OR
   34  PROSPECTIVE  PATIENTS  IN  WRITING  OR  THROUGH  AN INTERNET WEBSITE THE
   35  HEALTH CARE PLANS IN WHICH THE HEALTH CARE PROFESSIONAL, GROUP PRACTICE,
   36  DIAGNOSTIC AND TREATMENT CENTER OR HEALTH  CENTER,  IS  A  PARTICIPATING
   37  PROVIDER  AND  THE  HOSPITALS WITH WHICH THE HEALTH CARE PROFESSIONAL IS
   38  AFFILIATED PRIOR TO THE PROVISION OF NON-EMERGENCY SERVICES AND VERBALLY
   39  AT THE TIME AN APPOINTMENT IS SCHEDULED.
   40    2. IF A HEALTH CARE PROFESSIONAL, OR A GROUP PRACTICE OF  HEALTH  CARE
   41  PROFESSIONALS,  A  DIAGNOSTIC  AND  TREATMENT  CENTER OR A HEALTH CENTER
   42  DEFINED UNDER 42 U.S.C. S 254B ON BEHALF OF  HEALTH  CARE  PROFESSIONALS
   43  RENDERING  SERVICES  AT  THE  GROUP  PRACTICE,  DIAGNOSTIC AND TREATMENT
   44  CENTER OR HEALTH CENTER, DOES  NOT  PARTICIPATE  IN  THE  NETWORK  OF  A
   45  PATIENT'S  OR  PROSPECTIVE  PATIENT'S  HEALTH CARE PLAN, THE HEALTH CARE
   46  PROFESSIONAL, GROUP PRACTICE, DIAGNOSTIC AND TREATMENT CENTER OR  HEALTH
   47  CENTER,  SHALL:    (A) PRIOR TO THE PROVISION OF NON-EMERGENCY SERVICES,
   48  INFORM A PATIENT OR PROSPECTIVE PATIENT THAT  THE  AMOUNT  OR  ESTIMATED
   49  AMOUNT  THE  HEALTH  CARE  PROFESSIONAL WILL BILL THE PATIENT FOR HEALTH
   50  CARE SERVICES IS AVAILABLE UPON REQUEST;  AND  (B)  UPON  RECEIPT  OF  A
   51  REQUEST  FROM  A PATIENT OR PROSPECTIVE PATIENT, DISCLOSE TO THE PATIENT
   52  OR PROSPECTIVE PATIENT IN WRITING THE AMOUNT  OR  ESTIMATED  AMOUNT  OR,
   53  WITH  RESPECT  TO  A HEALTH CENTER, A SCHEDULE OF FEES PROVIDED UNDER 42
   54  U.S.C. S 254B(K)(3)(G)(I), THAT  THE  HEALTH  CARE  PROFESSIONAL,  GROUP
   55  PRACTICE,  DIAGNOSTIC  AND  TREATMENT CENTER OR HEALTH CENTER, WILL BILL
   56  THE PATIENT OR PROSPECTIVE PATIENT FOR HEALTH CARE SERVICES PROVIDED  OR
       S. 6914                            169                           A. 9205

    1  ANTICIPATED  TO BE PROVIDED TO THE PATIENT OR PROSPECTIVE PATIENT ABSENT
    2  UNFORESEEN MEDICAL CIRCUMSTANCES THAT MAY ARISE  WHEN  THE  HEALTH  CARE
    3  SERVICES ARE PROVIDED.
    4    3.  A  HEALTH  CARE  PROFESSIONAL  WHO  IS A PHYSICIAN SHALL PROVIDE A
    5  PATIENT OR PROSPECTIVE PATIENT WITH THE  NAME,  PRACTICE  NAME,  MAILING
    6  ADDRESS,  AND  TELEPHONE NUMBER OF ANY HEALTH CARE PROVIDER SCHEDULED TO
    7  PERFORM ANESTHESIOLOGY, LABORATORY, PATHOLOGY,  RADIOLOGY  OR  ASSISTANT
    8  SURGEON  SERVICES  IN  CONNECTION WITH CARE TO BE PROVIDED IN THE PHYSI-
    9  CIAN'S OFFICE FOR THE PATIENT OR COORDINATED OR REFERRED BY  THE  PHYSI-
   10  CIAN  FOR  THE  PATIENT  AT  THE  TIME OF REFERRAL TO OR COORDINATION OF
   11  SERVICES WITH SUCH PROVIDER.
   12    4.   A HEALTH CARE PROFESSIONAL  WHO  IS  A  PHYSICIAN  SHALL,  FOR  A
   13  PATIENT'S  SCHEDULED HOSPITAL ADMISSION OR SCHEDULED OUTPATIENT HOSPITAL
   14  SERVICES, PROVIDE A PATIENT AND THE HOSPITAL  WITH  THE  NAME,  PRACTICE
   15  NAME,  MAILING ADDRESS AND TELEPHONE NUMBER OF ANY OTHER PHYSICIAN WHOSE
   16  SERVICES WILL BE ARRANGED BY THE PHYSICIAN AND ARE SCHEDULED AT THE TIME
   17  OF THE PRE-ADMISSION TESTING, REGISTRATION   OR ADMISSION  AT  THE  TIME
   18  NON-EMERGENCY  SERVICES  ARE  SCHEDULED;  AND  INFORMATION  AS TO HOW TO
   19  DETERMINE THE HEALTHCARE PLANS IN WHICH THE PHYSICIAN PARTICIPATES.
   20    5. A HOSPITAL SHALL ESTABLISH, UPDATE AND MAKE PUBLIC THROUGH  POSTING
   21  ON THE HOSPITAL'S WEBSITE, TO THE EXTENT REQUIRED BY FEDERAL GUIDELINES,
   22  A  LIST  OF  THE  HOSPITAL'S  STANDARD  CHARGES  FOR  ITEMS AND SERVICES
   23  PROVIDED BY THE HOSPITAL, INCLUDING FOR DIAGNOSIS-RELATED GROUPS  ESTAB-
   24  LISHED UNDER SECTION 1886(D)(4) OF THE FEDERAL SOCIAL SECURITY ACT.
   25    6.  A  HOSPITAL  SHALL POST ON THE HOSPITAL'S WEBSITE:  (A) THE HEALTH
   26  CARE PLANS IN WHICH THE HOSPITAL IS  A  PARTICIPATING  PROVIDER;  (B)  A
   27  STATEMENT  THAT  (I) PHYSICIAN SERVICES PROVIDED IN THE HOSPITAL ARE NOT
   28  INCLUDED IN THE HOSPITAL'S CHARGES; (II) PHYSICIANS WHO PROVIDE SERVICES
   29  IN THE HOSPITAL MAY OR MAY NOT PARTICIPATE WITH  THE  SAME  HEALTH  CARE
   30  PLANS  AS  THE HOSPITAL, AND; (III) THE PROSPECTIVE PATIENT SHOULD CHECK
   31  WITH THE PHYSICIAN ARRANGING FOR THE HOSPITAL SERVICES TO DETERMINE  THE
   32  HEALTH  CARE  PLANS IN WHICH THE PHYSICIAN PARTICIPATES; (C) AS APPLICA-
   33  BLE, THE NAME, MAILING ADDRESS AND TELEPHONE  NUMBER  OF  THE  PHYSICIAN
   34  GROUPS THAT THE HOSPITAL HAS CONTRACTED WITH TO PROVIDE SERVICES INCLUD-
   35  ING  ANESTHESIOLOGY,  PATHOLOGY  OR  RADIOLOGY,  AND INSTRUCTIONS HOW TO
   36  CONTACT THESE GROUPS TO DETERMINE THE HEALTH CARE PLAN PARTICIPATION  OF
   37  THE PHYSICIANS IN THESE GROUPS; AND (D) AS APPLICABLE, THE NAME, MAILING
   38  ADDRESS, AND TELEPHONE NUMBER OF PHYSICIANS EMPLOYED BY THE HOSPITAL AND
   39  WHOSE  SERVICES  MAY  BE  PROVIDED  AT THE HOSPITAL, AND THE HEALTH CARE
   40  PLANS IN WHICH THEY PARTICIPATE.
   41    7. IN REGISTRATION OR ADMISSION MATERIALS PROVIDED IN ADVANCE OF  NON-
   42  EMERGENCY HOSPITAL SERVICES, A HOSPITAL SHALL: (A) ADVISE THE PATIENT OR
   43  PROSPECTIVE  PATIENT  TO CHECK WITH THE PHYSICIAN ARRANGING THE HOSPITAL
   44  SERVICES TO DETERMINE: (I) THE NAME, PRACTICE NAME, MAILING ADDRESS  AND
   45  TELEPHONE  NUMBER OF ANY OTHER PHYSICIAN WHOSE SERVICES WILL BE ARRANGED
   46  BY THE PHYSICIAN; AND (II) WHETHER THE SERVICES OF  PHYSICIANS  WHO  ARE
   47  EMPLOYED  OR  CONTRACTED  BY  THE HOSPITAL TO PROVIDE SERVICES INCLUDING
   48  ANESTHESIOLOGY, PATHOLOGY AND/OR RADIOLOGY ARE REASONABLY ANTICIPATED TO
   49  BE PROVIDED TO THE PATIENT; AND  (B)  PROVIDE  PATIENTS  OR  PROSPECTIVE
   50  PATIENTS  WITH INFORMATION AS TO HOW TO TIMELY DETERMINE THE HEALTH CARE
   51  PLANS PARTICIPATED IN BY PHYSICIANS WHO ARE  REASONABLY  ANTICIPATED  TO
   52  PROVIDE  SERVICES  TO  THE PATIENT AT THE HOSPITAL, AS DETERMINED BY THE
   53  PHYSICIAN ARRANGING THE PATIENT'S HOSPITAL SERVICES, AND WHO ARE EMPLOY-
   54  EES OF THE HOSPITAL OR CONTRACTED BY THE HOSPITAL  TO  PROVIDE  SERVICES
   55  INCLUDING ANESTHESIOLOGY, RADIOLOGY AND/OR PATHOLOGY.
   56    8. FOR PURPOSES OF THIS SECTION:
       S. 6914                            170                           A. 9205

    1    (A)  "HEALTH  CARE  PLAN"  MEANS A HEALTH INSURER INCLUDING AN INSURER
    2  LICENSED TO WRITE ACCIDENT AND HEALTH INSURANCE SUBJECT TO ARTICLE THIR-
    3  TY-TWO OF THE INSURANCE LAW; A CORPORATION ORGANIZED PURSUANT TO ARTICLE
    4  FORTY-THREE OF THE INSURANCE LAW; A MUNICIPAL COOPERATIVE HEALTH BENEFIT
    5  PLAN  CERTIFIED  PURSUANT TO ARTICLE FORTY-SEVEN OF THE INSURANCE LAW; A
    6  HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR
    7  OF THIS CHAPTER; A STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED  PURSU-
    8  ANT TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THE INSURANCE LAW
    9  OR A SELF-FUNDED EMPLOYEE WELFARE BENEFIT PLAN.
   10    (B) "HEALTH CARE PROFESSIONAL" MEANS AN APPROPRIATELY LICENSED, REGIS-
   11  TERED  OR  CERTIFIED HEALTH CARE PROFESSIONAL PURSUANT TO TITLE EIGHT OF
   12  THE EDUCATION LAW.
   13    (C) "HOSPITAL" MEANS A GENERAL HOSPITAL AS DEFINED IN SUBDIVISION  TEN
   14  OF SECTION TWO THOUSAND EIGHT HUNDRED ONE OF THIS CHAPTER.
   15    S  18.  Paragraphs (k), (p-1), (q) and (r) of subdivision 1 of section
   16  4408 of the public health law, paragraphs (k), (q) and (r) as  added  by
   17  chapter 705 of the laws of 1996, and paragraph (p-1) as added by chapter
   18  554  of  the laws of 2002, are amended and three new paragraphs (s), (t)
   19  and (u) are added to read as follows:
   20    (k) notice that an enrollee may obtain a referral  to  a  health  care
   21  provider  outside  of  the  health maintenance organization's network or
   22  panel when the health maintenance organization does not  have  a  health
   23  care  provider  [with]  WHO IS GEOGRAPHICALLY ACCESSIBLE TO THE ENROLLEE
   24  AND WHO HAS appropriate training and experience in the network or  panel
   25  to  meet the particular health care needs of the enrollee and the proce-
   26  dure by which the enrollee can obtain such referral;
   27    (p-1) notice that an enrollee shall have direct access to primary  and
   28  preventive obstetric and gynecologic services, INCLUDING ANNUAL EXAMINA-
   29  TIONS,  CARE  RESULTING  FROM SUCH ANNUAL EXAMINATIONS, AND TREATMENT OF
   30  ACUTE GYNECOLOGIC CONDITIONS, from a qualified provider of such services
   31  of her choice from within the plan [for no fewer than  two  examinations
   32  annually  for such services] or [to] FOR any care related to A pregnancy
   33  [and that additionally, the enrollee shall have direct access to primary
   34  and preventive obstetric and gynecologic services required as  a  result
   35  of  such  annual  examinations  or  as  a result of an acute gynecologic
   36  condition];
   37    (q) notice of all appropriate mailing addresses and telephone  numbers
   38  to be utilized by enrollees seeking information or authorization; [and]
   39    (r)  a  listing by specialty, which may be in a separate document that
   40  is updated annually, of the name, address and telephone  number  of  all
   41  participating  providers, including facilities, and, in addition, in the
   42  case of physicians, board certification[.],  LANGUAGES  SPOKEN  AND  ANY
   43  AFFILIATIONS  WITH  PARTICIPATING  HOSPITALS.  THE LISTING SHALL ALSO BE
   44  POSTED ON THE HEALTH MAINTENANCE ORGANIZATION'S WEBSITE AND  THE  HEALTH
   45  MAINTENANCE ORGANIZATION SHALL UPDATE THE WEBSITE WITHIN FIFTEEN DAYS OF
   46  THE  ADDITION  OR  TERMINATION OF A PROVIDER FROM THE HEALTH MAINTENANCE
   47  ORGANIZATION'S NETWORK OR A CHANGE  IN  A  PHYSICIAN'S  HOSPITAL  AFFIL-
   48  IATION;
   49    (S) WHERE APPLICABLE, A DESCRIPTION OF THE METHOD BY WHICH AN ENROLLEE
   50  MAY SUBMIT A CLAIM FOR HEALTH CARE SERVICES;
   51    (T) WITH RESPECT TO OUT-OF-NETWORK COVERAGE:
   52    (I)  A CLEAR DESCRIPTION OF THE METHODOLOGY USED BY THE HEALTH MAINTE-
   53  NANCE ORGANIZATION TO DETERMINE REIMBURSEMENT FOR OUT-OF-NETWORK  HEALTH
   54  CARE SERVICES;
   55    (II)  THE  AMOUNT  THAT THE HEALTH MAINTENANCE ORGANIZATION WILL REIM-
   56  BURSE UNDER THE METHODOLOGY FOR OUT-OF-NETWORK HEALTH CARE SERVICES  SET
       S. 6914                            171                           A. 9205

    1  FORTH AS A PERCENTAGE OF THE USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK
    2  HEALTH CARE SERVICES;
    3    (III)  EXAMPLES  OF  ANTICIPATED  OUT-OF-POCKET  COSTS  FOR FREQUENTLY
    4  BILLED OUT-OF-NETWORK HEALTH CARE SERVICES; AND
    5    (U) INFORMATION IN  WRITING  AND  THROUGH  AN  INTERNET  WEBSITE  THAT
    6  REASONABLY  PERMITS  AN ENROLLEE OR PROSPECTIVE ENROLLEE TO ESTIMATE THE
    7  ANTICIPATED OUT-OF-POCKET COST FOR OUT-OF-NETWORK HEALTH  CARE  SERVICES
    8  IN  A  GEOGRAPHICAL  AREA  OR ZIP CODE BASED UPON THE DIFFERENCE BETWEEN
    9  WHAT THE HEALTH MAINTENANCE ORGANIZATION WILL REIMBURSE FOR  OUT-OF-NET-
   10  WORK  HEALTH  CARE  SERVICES  AND  THE  USUAL  AND  CUSTOMARY  COST  FOR
   11  OUT-OF-NETWORK HEALTH CARE SERVICES.
   12    S 19. Paragraphs (k) and (l) of subdivision 2 of section 4408  of  the
   13  public  health  law,  as  added  by chapter 705 of the laws of 1996, are
   14  amended and two new paragraphs (m) and (n) are added to read as follows:
   15    (k) provide the written application procedures and minimum  qualifica-
   16  tion  requirements  for  health  care  providers to be considered by the
   17  health maintenance organization; [and]
   18    (1) disclose  other  information  as  required  by  the  commissioner,
   19  provided  that  such  requirements are promulgated pursuant to the state
   20  administrative procedure act[.];
   21    (M) DISCLOSE WHETHER A HEALTH CARE PROVIDER  SCHEDULED  TO  PROVIDE  A
   22  HEALTH CARE SERVICE IS AN IN-NETWORK PROVIDER; AND
   23    (N)  WITH RESPECT TO OUT-OF-NETWORK COVERAGE, DISCLOSE THE APPROXIMATE
   24  DOLLAR AMOUNT THAT THE HEALTH MAINTENANCE ORGANIZATION WILL  PAY  FOR  A
   25  SPECIFIC  OUT-OF-NETWORK  HEALTH  CARE  SERVICE.  THE HEALTH MAINTENANCE
   26  ORGANIZATION SHALL ALSO INFORM AN ENROLLEE THROUGH SUCH DISCLOSURE  THAT
   27  SUCH APPROXIMATION IS NOT BINDING ON THE HEALTH MAINTENANCE ORGANIZATION
   28  AND  THAT  THE  APPROXIMATE  DOLLAR  AMOUNT  THAT THE HEALTH MAINTENANCE
   29  ORGANIZATION WILL PAY FOR A SPECIFIC OUT-OF-NETWORK HEALTH CARE  SERVICE
   30  MAY CHANGE.
   31    S 20. Section 4408 of the public health law is amended by adding a new
   32  subdivision 7 to read as follows:
   33    7.    FOR  PURPOSES  OF THIS SECTION, "USUAL AND CUSTOMARY COST" SHALL
   34  MEAN THE EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE  PARTICULAR  HEALTH
   35  CARE  SERVICE  PERFORMED  BY A PROVIDER IN THE SAME OR SIMILAR SPECIALTY
   36  AND PROVIDED IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING
   37  DATABASE MAINTAINED BY A NONPROFIT ORGANIZATION SPECIFIED BY THE  SUPER-
   38  INTENDENT OF FINANCIAL SERVICES. THE NONPROFIT ORGANIZATION SHALL NOT BE
   39  AFFILIATED WITH AN INSURER, A CORPORATION SUBJECT TO ARTICLE FORTY-THREE
   40  OF THE INSURANCE LAW, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN CERTI-
   41  FIED  PURSUANT  TO ARTICLE FORTY-SEVEN OF THE INSURANCE LAW, OR A HEALTH
   42  MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO THIS ARTICLE.
   43    S 21. Section 4900 of the public health law is amended by adding a new
   44  subdivision 7-f-1 to read as follows:
   45    7-F-1. "OUT-OF-NETWORK REFERRAL DENIAL" MEANS A DENIAL  OF  A  REQUEST
   46  FOR  AN  AUTHORIZATION  OR REFERRAL TO AN OUT-OF-NETWORK PROVIDER ON THE
   47  BASIS THAT THE HEALTH CARE PLAN  HAS  A  HEALTH  CARE  PROVIDER  IN  THE
   48  IN-NETWORK BENEFITS PORTION OF ITS NETWORK WITH APPROPRIATE TRAINING AND
   49  EXPERIENCE  TO MEET THE PARTICULAR HEALTH CARE NEEDS OF AN ENROLLEE, AND
   50  WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE. THE  NOTICE  OF  AN
   51  OUT-OF-NETWORK  REFERRAL  DENIAL  PROVIDED  TO AN ENROLLEE SHALL INCLUDE
   52  INFORMATION EXPLAINING WHAT INFORMATION  THE  ENROLLEE  MUST  SUBMIT  IN
   53  ORDER  TO APPEAL THE OUT-OF-NETWORK REFERRAL DENIAL PURSUANT TO SUBDIVI-
   54  SION ONE-B OF SECTION FOUR THOUSAND NINE HUNDRED FOUR OF  THIS  ARTICLE.
   55  AN  OUT-OF-NETWORK  REFERRAL  DENIAL  UNDER  THIS  SUBDIVISION  DOES NOT
   56  CONSTITUTE AN ADVERSE DETERMINATION AS DEFINED IN THIS ARTICLE. AN  OUT-
       S. 6914                            172                           A. 9205

    1  OF-NETWORK  REFERRAL DENIAL SHALL NOT BE CONSTRUED TO INCLUDE AN OUT-OF-
    2  NETWORK DENIAL AS DEFINED IN SUBDIVISION SEVEN-F OF THIS SECTION.
    3    S  22.  Subdivision  2  of  section  4903 of the public health law, as
    4  amended by chapter 514 of the laws  of  2013,  is  amended  to  read  as
    5  follows:
    6    2. A utilization review agent shall make a utilization review determi-
    7  nation  involving  health  care services which require pre-authorization
    8  and provide notice of a determination  to  the  enrollee  or  enrollee's
    9  designee  and  the  enrollee's  health care provider by telephone and in
   10  writing within three business days of receipt of the necessary  informa-
   11  tion.  To  the  extent  practicable,  such  written  notification to the
   12  enrollee's health care provider shall be transmitted electronically,  in
   13  a  manner  and  in  a  form agreed upon by the parties. THE NOTIFICATION
   14  SHALL IDENTIFY; (A) WHETHER THE SERVICES ARE  CONSIDERED  IN-NETWORK  OR
   15  OUT-OF-NETWORK;  (B)  AND WHETHER THE ENROLLEE WILL BE HELD HARMLESS FOR
   16  THE SERVICES AND NOT BE RESPONSIBLE FOR  ANY  PAYMENT,  OTHER  THAN  ANY
   17  APPLICABLE  CO-PAYMENT  OR  CO-INSURANCE;  (C) AS APPLICABLE, THE DOLLAR
   18  AMOUNT THE HEALTH CARE PLAN WILL PAY IF THE SERVICE  IS  OUT-OF-NETWORK;
   19  AND (D) AS APPLICABLE, INFORMATION EXPLAINING HOW AN ENROLLEE MAY DETER-
   20  MINE  THE  ANTICIPATED OUT-OF-POCKET COST FOR OUT-OF-NETWORK HEALTH CARE
   21  SERVICES IN A GEOGRAPHICAL AREA OR ZIP CODE BASED  UPON  THE  DIFFERENCE
   22  BETWEEN  WHAT  THE  HEALTH  CARE  PLAN WILL REIMBURSE FOR OUT-OF-NETWORK
   23  HEALTH CARE SERVICES AND THE USUAL AND CUSTOMARY COST FOR OUT-OF-NETWORK
   24  HEALTH CARE SERVICES.
   25    S 23. Section 4904 of the public health law is amended by adding a new
   26  subdivision 1-b to read as follows:
   27    1-B. AN ENROLLEE OR THE ENROLLEE'S DESIGNEE MAY APPEAL A DENIAL OF  AN
   28  OUT-OF-NETWORK  REFERRAL  BY  A HEALTH CARE PLAN BY SUBMITTING A WRITTEN
   29  STATEMENT FROM  THE  ENROLLEE'S  ATTENDING  PHYSICIAN,  WHO  MUST  BE  A
   30  LICENSED, BOARD CERTIFIED OR BOARD ELIGIBLE PHYSICIAN QUALIFIED TO PRAC-
   31  TICE IN THE SPECIALTY AREA OF PRACTICE APPROPRIATE TO TREAT THE ENROLLEE
   32  FOR  THE HEALTH SERVICE SOUGHT, PROVIDED THAT: (A) THE IN-NETWORK HEALTH
   33  CARE PROVIDER OR PROVIDERS RECOMMENDED BY THE HEALTH CARE  PLAN  DO  NOT
   34  HAVE  THE  APPROPRIATE  TRAINING  AND  EXPERIENCE TO MEET THE PARTICULAR
   35  HEALTH CARE NEEDS OF THE ENROLLEE FOR THE HEALTH SERVICE; AND (B) RECOM-
   36  MENDS AN OUT-OF-NETWORK PROVIDER WITH THE APPROPRIATE TRAINING AND EXPE-
   37  RIENCE TO MEET THE PARTICULAR HEALTH CARE NEEDS OF THE ENROLLEE, AND WHO
   38  IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE.
   39    S 24. Subdivision 2 of section  4910  of  the  public  health  law  is
   40  amended by adding a new paragraph (d) to read as follows:
   41    (D)(I)  THE  ENROLLEE HAS HAD AN OUT-OF-NETWORK REFERRAL DENIED ON THE
   42  GROUNDS THAT THE HEALTH CARE PLAN HAS A  HEALTH  CARE  PROVIDER  IN  THE
   43  IN-NETWORK BENEFITS PORTION OF ITS NETWORK WITH APPROPRIATE TRAINING AND
   44  EXPERIENCE  TO MEET THE PARTICULAR HEALTH CARE NEEDS OF AN ENROLLEE, AND
   45  WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH SERVICE.
   46    (II) THE ENROLLEE'S ATTENDING PHYSICIAN,  WHO  SHALL  BE  A  LICENSED,
   47  BOARD CERTIFIED OR BOARD ELIGIBLE PHYSICIAN QUALIFIED TO PRACTICE IN THE
   48  SPECIALTY  AREA  OF  PRACTICE  APPROPRIATE TO TREAT THE ENROLLEE FOR THE
   49  HEALTH SERVICE SOUGHT, CERTIFIES THAT THE IN-NETWORK HEALTH CARE PROVID-
   50  ER OR PROVIDERS RECOMMENDED BY THE HEALTH CARE  PLAN  DO  NOT  HAVE  THE
   51  APPROPRIATE  TRAINING  AND EXPERIENCE TO MEET THE PARTICULAR HEALTH CARE
   52  NEEDS OF AN ENROLLEE, AND RECOMMENDS AN OUT-OF-NETWORK PROVIDER WITH THE
   53  APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTICULAR  HEALTH  CARE
   54  NEEDS  OF  AN  ENROLLEE, AND WHO IS ABLE TO PROVIDE THE REQUESTED HEALTH
   55  SERVICE.
       S. 6914                            173                           A. 9205

    1    S 25. Paragraph (d) of subdivision 2 of section  4914  of  the  public
    2  health  law  is  amended  by  adding  a  new subparagraph (D) to read as
    3  follows:
    4    (D) FOR EXTERNAL APPEALS REQUESTED PURSUANT TO PARAGRAPH (D) OF SUBDI-
    5  VISION  TWO  OF  SECTION  FOUR  THOUSAND  NINE HUNDRED TEN OF THIS TITLE
    6  RELATING TO AN OUT-OF-NETWORK REFERRAL DENIAL, THE EXTERNAL APPEAL AGENT
    7  SHALL REVIEW THE UTILIZATION REVIEW AGENT'S FINAL ADVERSE  DETERMINATION
    8  AND,  IN  ACCORDANCE  WITH  THE  PROVISIONS  OF THIS TITLE, SHALL MAKE A
    9  DETERMINATION AS TO WHETHER THE OUT-OF-NETWORK REFERRAL SHALL BE COVERED
   10  BY THE HEALTH PLAN; PROVIDED THAT SUCH DETERMINATION SHALL:
   11    (I) BE CONDUCTED ONLY BY ONE OR A GREATER ODD NUMBER OF CLINICAL  PEER
   12  REVIEWERS;
   13    (II) BE ACCOMPANIED BY A WRITTEN STATEMENT:
   14    (1)  THAT  THE  OUT-OF-NETWORK REFERRAL SHALL BE COVERED BY THE HEALTH
   15  CARE PLAN EITHER WHEN THE REVIEWER OR A MAJORITY OF THE PANEL OF REVIEW-
   16  ERS DETERMINES, UPON REVIEW  OF  THE  TRAINING  AND  EXPERIENCE  OF  THE
   17  IN-NETWORK  HEALTH  CARE PROVIDER OR PROVIDERS PROPOSED BY THE PLAN, THE
   18  TRAINING AND EXPERIENCE OF THE REQUESTED  OUT-OF-NETWORK  PROVIDER,  THE
   19  CLINICAL  STANDARDS OF THE PLAN, THE INFORMATION PROVIDED CONCERNING THE
   20  ENROLLEE,  THE  ATTENDING  PHYSICIAN'S  RECOMMENDATION,  THE  ENROLLEE'S
   21  MEDICAL  RECORD,  AND  ANY  OTHER PERTINENT INFORMATION, THAT THE HEALTH
   22  PLAN DOES NOT HAVE A PROVIDER WITH THE APPROPRIATE TRAINING AND  EXPERI-
   23  ENCE TO MEET THE PARTICULAR HEALTH CARE NEEDS OF AN ENROLLEE WHO IS ABLE
   24  TO  PROVIDE  THE  REQUESTED  HEALTH SERVICE, AND THAT THE OUT-OF-NETWORK
   25  PROVIDER HAS THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTIC-
   26  ULAR HEALTH CARE NEEDS OF AN ENROLLEE, IS ABLE TO PROVIDE THE  REQUESTED
   27  HEALTH  SERVICE,  AND  IS LIKELY TO PRODUCE A MORE CLINICALLY BENEFICIAL
   28  OUTCOME; OR
   29    (2) UPHOLDING THE HEALTH PLAN'S DENIAL OF COVERAGE;
   30    (III) BE SUBJECT TO THE TERMS AND CONDITIONS GENERALLY  APPLICABLE  TO
   31  BENEFITS UNDER THE EVIDENCE OF COVERAGE UNDER THE HEALTH CARE PLAN;
   32    (IV) BE BINDING ON THE PLAN AND THE ENROLLEE; AND
   33    (V) BE ADMISSIBLE IN ANY COURT PROCEEDING.
   34    S  26. The financial services law is amended by adding a new article 6
   35  to read as follows:
   36                                   ARTICLE 6
   37                EMERGENCY MEDICAL SERVICES AND SURPRISE BILLS
   38  SECTION 601. DISPUTE RESOLUTION PROCESS ESTABLISHED.
   39          602. APPLICABILITY.
   40          603. DEFINITIONS.
   41          604. CRITERIA FOR DETERMINING A REASONABLE FEE.
   42          605. DISPUTE RESOLUTION FOR EMERGENCY SERVICES.
   43          606. HOLD HARMLESS AND ASSIGNMENT OF BENEFITS FOR SURPRISE BILLS
   44                 FOR INSUREDS.
   45          607. DISPUTE RESOLUTION FOR SURPRISE BILLS.
   46          608. PAYMENT FOR INDEPENDENT DISPUTE RESOLUTION ENTITY.
   47    S 601. DISPUTE  RESOLUTION  PROCESS  ESTABLISHED.  THE  SUPERINTENDENT
   48  SHALL  ESTABLISH  A  DISPUTE RESOLUTION PROCESS BY WHICH A DISPUTE FOR A
   49  BILL FOR EMERGENCY SERVICES OR A SURPRISE  BILL  MAY  BE  RESOLVED.  THE
   50  SUPERINTENDENT  SHALL  HAVE THE POWER TO GRANT AND REVOKE CERTIFICATIONS
   51  OF INDEPENDENT DISPUTE RESOLUTION ENTITIES TO CONDUCT THE DISPUTE RESOL-
   52  UTION PROCESS. THE SUPERINTENDENT SHALL  PROMULGATE  REGULATIONS  ESTAB-
   53  LISHING  STANDARDS FOR THE DISPUTE RESOLUTION PROCESS, INCLUDING A PROC-
   54  ESS  FOR  CERTIFYING  AND  SELECTING  INDEPENDENT   DISPUTE   RESOLUTION
   55  ENTITIES.  AN  INDEPENDENT  DISPUTE RESOLUTION ENTITY SHALL USE LICENSED
   56  PHYSICIANS IN ACTIVE PRACTICE IN THE SAME OR SIMILAR  SPECIALTY  AS  THE
       S. 6914                            174                           A. 9205

    1  PHYSICIAN  PROVIDING  THE  SERVICE THAT IS SUBJECT TO THE DISPUTE RESOL-
    2  UTION PROCESS OF THIS ARTICLE. TO THE EXTENT PRACTICABLE, THE  PHYSICIAN
    3  SHALL BE LICENSED IN THIS STATE.
    4    S  602. APPLICABILITY. (A) THIS ARTICLE SHALL NOT APPLY TO HEALTH CARE
    5  SERVICES, INCLUDING EMERGENCY SERVICES, WHERE PHYSICIAN FEES ARE SUBJECT
    6  TO SCHEDULES OR OTHER MONETARY LIMITATIONS UNDER ANY OTHER LAW,  INCLUD-
    7  ING THE WORKERS' COMPENSATION LAW AND ARTICLE FIFTY-ONE OF THE INSURANCE
    8  LAW, AND SHALL NOT PREEMPT ANY SUCH LAW.
    9    (B)(1) WITH REGARD TO EMERGENCY SERVICES BILLED UNDER AMERICAN MEDICAL
   10  ASSOCIATION  CURRENT  PROCEDURAL  TERMINOLOGY  (CPT) CODES 99281 THROUGH
   11  99285, 99288, 99291 THROUGH 99292, 99217 THROUGH  99220,  99224  THROUGH
   12  99226,  AND  99234  THROUGH 99236, THE DISPUTE RESOLUTION PROCESS ESTAB-
   13  LISHED IN THIS ARTICLE SHALL NOT APPLY WHEN:
   14    (A) THE AMOUNT BILLED FOR ANY SUCH CPT CODE MEETS THE REQUIREMENTS SET
   15  FORTH IN PARAGRAPH THREE OF THIS SUBSECTION, AFTER ANY APPLICABLE CO-IN-
   16  SURANCE, CO-PAYMENT AND DEDUCTIBLE; AND
   17    (B) THE AMOUNT BILLED FOR ANY  SUCH  CPT  CODE  DOES  NOT  EXCEED  ONE
   18  HUNDRED  TWENTY  PERCENT  OF  THE  USUAL AND CUSTOMARY COST FOR SUCH CPT
   19  CODE.
   20    (2) THE HEALTH CARE PLAN SHALL ENSURE THAT AN INSURED SHALL NOT  INCUR
   21  ANY  GREATER  OUT-OF-POCKET  COSTS FOR EMERGENCY SERVICES BILLED UNDER A
   22  CPT CODE AS SET FORTH IN THIS SUBSECTION THAN  THE  INSURED  WOULD  HAVE
   23  INCURRED  IF  SUCH  EMERGENCY  SERVICES WERE PROVIDED BY A PARTICIPATING
   24  PHYSICIAN.
   25    (3) BEGINNING JANUARY FIRST, TWO THOUSAND  FIFTEEN  AND  EACH  JANUARY
   26  FIRST  THEREAFTER,  THE  SUPERINTENDENT SHALL PUBLISH ON A WEBSITE MAIN-
   27  TAINED BY THE DEPARTMENT OF FINANCIAL SERVICES, AND PROVIDE  IN  WRITING
   28  TO EACH HEALTH CARE PLAN, A DOLLAR AMOUNT FOR WHICH BILLS FOR THE PROCE-
   29  DURE  CODES  IDENTIFIED  IN  THIS  SUBSECTION  SHALL  BE EXEMPT FROM THE
   30  DISPUTE RESOLUTION PROCESS ESTABLISHED  IN  THIS  ARTICLE.  SUCH  AMOUNT
   31  SHALL  EQUAL  THE AMOUNT FROM THE PRIOR YEAR, BEGINNING WITH SIX HUNDRED
   32  DOLLARS IN TWO THOUSAND FOURTEEN, ADJUSTED BY THE AVERAGE OF THE  ANNUAL
   33  AVERAGE  INFLATION  RATES  FOR  THE MEDICAL CARE COMMODITIES AND MEDICAL
   34  CARE SERVICES COMPONENTS OF THE CONSUMER PRICE INDEX. IN NO EVENT  SHALL
   35  AN  AMOUNT EXCEEDING ONE THOUSAND TWO HUNDRED DOLLARS FOR A SPECIFIC CPT
   36  CODE BILLED BE EXEMPT FROM THE DISPUTE RESOLUTION PROCESS ESTABLISHED IN
   37  THIS ARTICLE.
   38    S 603. DEFINITIONS. FOR THE PURPOSES OF THIS ARTICLE:
   39    (A) "EMERGENCY CONDITION" MEANS A MEDICAL OR BEHAVIORAL CONDITION THAT
   40  MANIFESTS ITSELF BY ACUTE SYMPTOMS  OF  SUFFICIENT  SEVERITY,  INCLUDING
   41  SEVERE  PAIN, SUCH THAT A PRUDENT LAYPERSON, POSSESSING AN AVERAGE KNOW-
   42  LEDGE OF MEDICINE AND HEALTH, COULD REASONABLY  EXPECT  THE  ABSENCE  OF
   43  IMMEDIATE MEDICAL ATTENTION TO RESULT IN : (1) PLACING THE HEALTH OF THE
   44  PERSON AFFLICTED WITH SUCH CONDITION IN SERIOUS JEOPARDY, OR IN THE CASE
   45  OF A BEHAVIORAL CONDITION PLACING THE HEALTH OF SUCH PERSON OR OTHERS IN
   46  SERIOUS  JEOPARDY;  (2) SERIOUS IMPAIRMENT TO SUCH PERSON'S BODILY FUNC-
   47  TIONS; (3) SERIOUS DYSFUNCTION OF ANY  BODILY  ORGAN  OR  PART  OF  SUCH
   48  PERSON;  (4)  SERIOUS  DISFIGUREMENT  OF SUCH PERSON; OR (5) A CONDITION
   49  DESCRIBED IN CLAUSE (I), (II) OR (III) OF SECTION 1867(E)(1)(A)  OF  THE
   50  SOCIAL SECURITY ACT 42 U.S.C. S 1395DD.
   51    (B)  "EMERGENCY  SERVICES"  MEANS, WITH RESPECT TO AN EMERGENCY CONDI-
   52  TION: (1) A MEDICAL SCREENING EXAMINATION AS REQUIRED UNDER SECTION 1867
   53  OF THE SOCIAL SECURITY ACT, 42 U.S.C. S  1395DD,  WHICH  IS  WITHIN  THE
   54  CAPABILITY  OF  THE EMERGENCY DEPARTMENT OF A HOSPITAL, INCLUDING ANCIL-
   55  LARY SERVICES ROUTINELY AVAILABLE TO THE EMERGENCY DEPARTMENT TO  EVALU-
   56  ATE SUCH EMERGENCY MEDICAL CONDITION; AND (2) WITHIN THE CAPABILITIES OF
       S. 6914                            175                           A. 9205

    1  THE STAFF AND FACILITIES AVAILABLE AT THE HOSPITAL, SUCH FURTHER MEDICAL
    2  EXAMINATION  AND  TREATMENT  AS  ARE  REQUIRED UNDER SECTION 1867 OF THE
    3  SOCIAL SECURITY ACT, 42 U.S.C.  S 1395DD, TO STABILIZE THE PATIENT.
    4    (C) "HEALTH CARE PLAN" MEANS AN INSURER LICENSED TO WRITE ACCIDENT AND
    5  HEALTH  INSURANCE PURSUANT TO ARTICLE THIRTY-TWO OF THE INSURANCE LAW; A
    6  CORPORATION ORGANIZED PURSUANT TO ARTICLE FORTY-THREE OF  THE  INSURANCE
    7  LAW;  A  MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO
    8  ARTICLE FORTY-SEVEN OF THE INSURANCE LAW; A HEALTH MAINTENANCE ORGANIZA-
    9  TION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH  LAW;
   10  OR  A  STUDENT HEALTH PLAN ESTABLISHED OR MAINTAINED PURSUANT TO SECTION
   11  ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF THE INSURANCE LAW.
   12    (D) "INSURED" MEANS A PATIENT COVERED UNDER A HEALTH CARE PLAN'S POLI-
   13  CY OR CONTRACT.
   14    (E) "NON-PARTICIPATING" MEANS NOT HAVING A CONTRACT WITH A HEALTH CARE
   15  PLAN TO PROVIDE HEALTH CARE SERVICES TO AN INSURED.
   16    (F) "PARTICIPATING" MEANS HAVING A CONTRACT WITH A HEALTH CARE PLAN TO
   17  PROVIDE HEALTH CARE SERVICES TO AN INSURED.
   18    (G) "PATIENT" MEANS  A  PERSON  WHO  RECEIVES  HEALTH  CARE  SERVICES,
   19  INCLUDING EMERGENCY SERVICES, IN THIS STATE.
   20    (H)  "SURPRISE BILL" MEANS A BILL FOR HEALTH CARE SERVICES, OTHER THAN
   21  EMERGENCY SERVICES, RECEIVED BY:
   22    (1) AN INSURED FOR SERVICES RENDERED BY A NON-PARTICIPATING  PHYSICIAN
   23  AT  A  PARTICIPATING  HOSPITAL  OR  AMBULATORY  SURGICAL CENTER, WHERE A
   24  PARTICIPATING PHYSICIAN IS UNAVAILABLE OR A NON-PARTICIPATING  PHYSICIAN
   25  RENDERS  SERVICES WITHOUT THE INSURED'S KNOWLEDGE, OR UNFORESEEN MEDICAL
   26  SERVICES ARISE AT THE  TIME  THE  HEALTH  CARE  SERVICES  ARE  RENDERED;
   27  PROVIDED,  HOWEVER,  THAT A SURPRISE BILL SHALL NOT MEAN A BILL RECEIVED
   28  FOR HEALTH CARE SERVICES WHEN A PARTICIPATING PHYSICIAN IS AVAILABLE AND
   29  THE INSURED HAS ELECTED TO  OBTAIN  SERVICES  FROM  A  NON-PARTICIPATING
   30  PHYSICIAN;
   31    (2)  AN INSURED FOR SERVICES RENDERED BY A NON-PARTICIPATING PROVIDER,
   32  WHERE THE SERVICES WERE REFERRED BY A PARTICIPATING PHYSICIAN TO A  NON-
   33  PARTICIPATING  PROVIDER  WITHOUT EXPLICIT WRITTEN CONSENT OF THE INSURED
   34  ACKNOWLEDGING THAT THE PARTICIPATING PHYSICIAN IS REFERRING THE  INSURED
   35  TO  A  NON-PARTICIPATING  PROVIDER  AND  THAT THE REFERRAL MAY RESULT IN
   36  COSTS NOT COVERED BY THE HEALTH CARE PLAN; OR
   37    (3) A PATIENT WHO IS NOT AN INSURED FOR SERVICES RENDERED BY A  PHYSI-
   38  CIAN  AT A HOSPITAL OR AMBULATORY SURGICAL CENTER, WHERE THE PATIENT HAS
   39  NOT TIMELY RECEIVED ALL OF THE DISCLOSURES REQUIRED PURSUANT TO  SECTION
   40  TWENTY-FOUR OF THE PUBLIC HEALTH LAW.
   41    (I)  "USUAL  AND CUSTOMARY COST" MEANS THE EIGHTIETH PERCENTILE OF ALL
   42  CHARGES FOR THE PARTICULAR HEALTH CARE SERVICE PERFORMED BY  A  PROVIDER
   43  IN  THE  SAME OR SIMILAR SPECIALTY AND PROVIDED IN THE SAME GEOGRAPHICAL
   44  AREA AS REPORTED IN A BENCHMARKING DATABASE MAINTAINED  BY  A  NONPROFIT
   45  ORGANIZATION SPECIFIED BY THE SUPERINTENDENT. THE NONPROFIT ORGANIZATION
   46  SHALL  NOT BE AFFILIATED WITH AN INSURER, A CORPORATION SUBJECT TO ARTI-
   47  CLE FORTY-THREE OF THE INSURANCE LAW,  A  MUNICIPAL  COOPERATIVE  HEALTH
   48  BENEFIT  PLAN CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF THE INSURANCE
   49  LAW, OR A HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO  ARTICLE
   50  FORTY-FOUR OF THE PUBLIC HEALTH LAW.
   51    S  604.  CRITERIA FOR DETERMINING A REASONABLE FEE. IN DETERMINING THE
   52  APPROPRIATE AMOUNT TO PAY FOR A  HEALTH  CARE  SERVICE,  AN  INDEPENDENT
   53  DISPUTE  RESOLUTION  ENTITY SHALL CONSIDER ALL RELEVANT FACTORS, INCLUD-
   54  ING:
   55    (A) WHETHER THERE IS A GROSS DISPARITY BETWEEN THE FEE CHARGED BY  THE
   56  PHYSICIAN FOR SERVICES RENDERED AS COMPARED TO:
       S. 6914                            176                           A. 9205

    1    (1) FEES PAID TO THE INVOLVED PHYSICIAN FOR THE SAME SERVICES RENDERED
    2  BY  THE  PHYSICIAN  TO  OTHER PATIENTS IN HEALTH CARE PLANS IN WHICH THE
    3  PHYSICIAN IS NOT PARTICIPATING, AND
    4    (2)  IN  THE CASE OF A DISPUTE INVOLVING A HEALTH CARE PLAN, FEES PAID
    5  BY THE HEALTH CARE PLAN TO REIMBURSE SIMILARLY QUALIFIED PHYSICIANS  FOR
    6  THE  SAME SERVICES IN THE SAME REGION WHO ARE NOT PARTICIPATING WITH THE
    7  HEALTH CARE PLAN;
    8    (B) THE LEVEL OF TRAINING, EDUCATION AND EXPERIENCE OF THE PHYSICIAN;
    9    (C) THE PHYSICIAN'S USUAL CHARGE FOR COMPARABLE SERVICES  WITH  REGARD
   10  TO  PATIENTS  IN HEALTH CARE PLANS IN WHICH THE PHYSICIAN IS NOT PARTIC-
   11  IPATING;
   12    (D) THE CIRCUMSTANCES AND COMPLEXITY OF THE PARTICULAR CASE, INCLUDING
   13  TIME AND PLACE OF THE SERVICE;
   14    (E) INDIVIDUAL PATIENT CHARACTERISTICS; AND
   15    (F) THE USUAL AND CUSTOMARY COST OF THE SERVICE.
   16    S 605.  DISPUTE  RESOLUTION  FOR  EMERGENCY  SERVICES.  (A)  EMERGENCY
   17  SERVICES FOR AN INSURED. (1) WHEN A HEALTH CARE PLAN RECEIVES A BILL FOR
   18  EMERGENCY  SERVICES  FROM A NON-PARTICIPATING PHYSICIAN, THE HEALTH CARE
   19  PLAN SHALL PAY AN AMOUNT THAT IT DETERMINES IS REASONABLE FOR THE  EMER-
   20  GENCY  SERVICES  RENDERED BY THE NON-PARTICIPATING PHYSICIAN, IN ACCORD-
   21  ANCE WITH SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THE INSUR-
   22  ANCE  LAW,  EXCEPT  FOR  THE  INSURED'S   CO-PAYMENT,   COINSURANCE   OR
   23  DEDUCTIBLE,  IF  ANY,  AND  SHALL ENSURE THAT THE INSURED SHALL INCUR NO
   24  GREATER OUT-OF-POCKET COSTS FOR THE EMERGENCY SERVICES THAN THE  INSURED
   25  WOULD   HAVE   INCURRED  WITH  A  PARTICIPATING  PHYSICIAN  PURSUANT  TO
   26  SUBSECTION (C) OF SECTION THREE THOUSAND TWO HUNDRED  FORTY-ONE  OF  THE
   27  INSURANCE LAW.
   28    (2)  A  NON-PARTICIPATING PHYSICIAN OR A HEALTH CARE PLAN MAY SUBMIT A
   29  DISPUTE REGARDING A FEE OR PAYMENT FOR EMERGENCY SERVICES FOR REVIEW  TO
   30  AN INDEPENDENT DISPUTE RESOLUTION ENTITY.
   31    (3)  THE  INDEPENDENT  DISPUTE RESOLUTION ENTITY SHALL MAKE A DETERMI-
   32  NATION WITHIN THIRTY DAYS OF RECEIPT OF THE DISPUTE FOR REVIEW.
   33    (4) IN DETERMINING A REASONABLE FEE  FOR  THE  SERVICES  RENDERED,  AN
   34  INDEPENDENT  DISPUTE  RESOLUTION  ENTITY  SHALL SELECT EITHER THE HEALTH
   35  CARE PLAN'S PAYMENT OR THE NON-PARTICIPATING PHYSICIAN'S FEE. THE  INDE-
   36  PENDENT DISPUTE RESOLUTION ENTITY SHALL DETERMINE WHICH AMOUNT TO SELECT
   37  BASED  UPON  THE CONDITIONS AND FACTORS SET FORTH IN SECTION SIX HUNDRED
   38  FOUR OF THIS ARTICLE.   IF  AN  INDEPENDENT  DISPUTE  RESOLUTION  ENTITY
   39  DETERMINES, BASED ON THE HEALTH CARE PLAN'S PAYMENT AND THE NON-PARTICI-
   40  PATING  PHYSICIAN'S  FEE, THAT A SETTLEMENT BETWEEN THE HEALTH CARE PLAN
   41  AND NON-PARTICIPATING PHYSICIAN IS REASONABLY LIKELY, OR THAT  BOTH  THE
   42  HEALTH  CARE  PLAN'S  PAYMENT  AND THE NON-PARTICIPATING PHYSICIAN'S FEE
   43  REPRESENT UNREASONABLE EXTREMES, THEN THE INDEPENDENT DISPUTE RESOLUTION
   44  ENTITY MAY DIRECT BOTH PARTIES TO ATTEMPT A GOOD FAITH  NEGOTIATION  FOR
   45  SETTLEMENT.  THE HEALTH CARE PLAN AND NON-PARTICIPATING PHYSICIAN MAY BE
   46  GRANTED UP TO TEN BUSINESS DAYS FOR THIS NEGOTIATION,  WHICH  SHALL  RUN
   47  CONCURRENTLY WITH THE THIRTY DAY PERIOD FOR DISPUTE RESOLUTION.
   48    (B)  EMERGENCY  SERVICES  FOR  A PATIENT THAT IS NOT AN INSURED. (1) A
   49  PATIENT THAT IS NOT AN INSURED OR THE PATIENT'S PHYSICIAN MAY  SUBMIT  A
   50  DISPUTE  REGARDING  A  FEE FOR EMERGENCY SERVICES FOR REVIEW TO AN INDE-
   51  PENDENT DISPUTE RESOLUTION ENTITY UPON APPROVAL OF THE SUPERINTENDENT.
   52    (2) AN INDEPENDENT DISPUTE RESOLUTION ENTITY SHALL DETERMINE A REASON-
   53  ABLE FEE FOR THE SERVICES BASED UPON THE SAME CONDITIONS AND FACTORS SET
   54  FORTH IN SECTION SIX HUNDRED FOUR OF THIS ARTICLE.
       S. 6914                            177                           A. 9205

    1    (3) A PATIENT THAT IS NOT AN INSURED SHALL NOT BE REQUIRED TO PAY  THE
    2  PHYSICIAN'S FEE IN ORDER TO BE ELIGIBLE TO SUBMIT THE DISPUTE FOR REVIEW
    3  TO AN INDEPENDENT DISPUTE RESOLUTION ENTITY.
    4    (C)  THE  DETERMINATION  OF  AN  INDEPENDENT DISPUTE RESOLUTION ENTITY
    5  SHALL BE BINDING ON THE HEALTH CARE PLAN,  PHYSICIAN  AND  PATIENT,  AND
    6  SHALL  BE  ADMISSIBLE  IN  ANY  COURT PROCEEDING BETWEEN THE HEALTH CARE
    7  PLAN, PHYSICIAN OR PATIENT, OR IN ANY ADMINISTRATIVE PROCEEDING  BETWEEN
    8  THIS STATE AND THE PHYSICIAN.
    9    S 606. HOLD HARMLESS AND ASSIGNMENT OF BENEFITS FOR SURPRISE BILLS FOR
   10  INSUREDS.  WHEN AN INSURED ASSIGNS BENEFITS FOR A SURPRISE BILL IN WRIT-
   11  ING TO A NON-PARTICIPATING PHYSICIAN THAT KNOWS THE INSURED  IS  INSURED
   12  UNDER A HEALTH CARE PLAN, THE NON-PARTICIPATING PHYSICIAN SHALL NOT BILL
   13  THE  INSURED EXCEPT FOR ANY APPLICABLE COPAYMENT, COINSURANCE OR DEDUCT-
   14  IBLE THAT WOULD BE OWED IF THE INSURED UTILIZED A  PARTICIPATING  PHYSI-
   15  CIAN.
   16    S  607.  DISPUTE  RESOLUTION  FOR  SURPRISE BILLS.   (A) SURPRISE BILL
   17  RECEIVED BY AN INSURED WHO ASSIGNS BENEFITS.  (1) IF AN INSURED  ASSIGNS
   18  BENEFITS  TO  A  NON-PARTICIPATING PHYSICIAN, THE HEALTH CARE PLAN SHALL
   19  PAY THE NON-PARTICIPATING PHYSICIAN IN ACCORDANCE  WITH  PARAGRAPHS  TWO
   20  AND THREE OF THIS SUBSECTION.
   21    (2)  THE NON-PARTICIPATING PHYSICIAN MAY BILL THE HEALTH CARE PLAN FOR
   22  THE HEALTH CARE SERVICES RENDERED, AND THE HEALTH CARE  PLAN  SHALL  PAY
   23  THE  NON-PARTICIPATING PHYSICIAN THE BILLED AMOUNT OR ATTEMPT TO NEGOTI-
   24  ATE REIMBURSEMENT WITH THE NON-PARTICIPATING PHYSICIAN.
   25    (3) IF THE HEALTH CARE PLAN'S ATTEMPTS TO NEGOTIATE REIMBURSEMENT  FOR
   26  HEALTH  CARE SERVICES PROVIDED BY A NON-PARTICIPATING PHYSICIAN DOES NOT
   27  RESULT IN A RESOLUTION OF THE PAYMENT DISPUTE BETWEEN  THE  NON-PARTICI-
   28  PATING  PHYSICIAN  AND  THE HEALTH CARE PLAN, THE HEALTH CARE PLAN SHALL
   29  PAY THE NON-PARTICIPATING PHYSICIAN  AN  AMOUNT  THE  HEALTH  CARE  PLAN
   30  DETERMINES  IS  REASONABLE FOR THE HEALTH CARE SERVICES RENDERED, EXCEPT
   31  FOR THE INSURED'S COPAYMENT, COINSURANCE OR  DEDUCTIBLE,  IN  ACCORDANCE
   32  WITH  SECTION  THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THE INSURANCE
   33  LAW.
   34    (4) EITHER THE HEALTH CARE PLAN OR THE NON-PARTICIPATING PHYSICIAN MAY
   35  SUBMIT THE DISPUTE REGARDING THE SURPRISE BILL FOR REVIEW  TO  AN  INDE-
   36  PENDENT  DISPUTE  RESOLUTION  ENTITY,  PROVIDED HOWEVER, THE HEALTH CARE
   37  PLAN MAY NOT SUBMIT THE DISPUTE UNLESS IT HAS COMPLIED WITH THE REQUIRE-
   38  MENTS OF PARAGRAPHS ONE, TWO AND THREE OF THIS SUBSECTION.
   39    (5) THE INDEPENDENT DISPUTE RESOLUTION ENTITY SHALL  MAKE  A  DETERMI-
   40  NATION WITHIN THIRTY DAYS OF RECEIPT OF THE DISPUTE FOR REVIEW.
   41    (6)  WHEN  DETERMINING A REASONABLE FEE FOR THE SERVICES RENDERED, THE
   42  INDEPENDENT DISPUTE RESOLUTION ENTITY SHALL  SELECT  EITHER  THE  HEALTH
   43  CARE  PLAN'S  PAYMENT OR THE NON-PARTICIPATING PHYSICIAN'S FEE. AN INDE-
   44  PENDENT DISPUTE RESOLUTION ENTITY SHALL DETERMINE WHICH AMOUNT TO SELECT
   45  BASED UPON THE CONDITIONS AND FACTORS SET FORTH IN SECTION  SIX  HUNDRED
   46  FOUR  OF  THIS  ARTICLE.    IF  AN INDEPENDENT DISPUTE RESOLUTION ENTITY
   47  DETERMINES, BASED ON THE HEALTH CARE PLAN'S PAYMENT AND THE NON-PARTICI-
   48  PATING PHYSICIAN'S FEE, THAT A SETTLEMENT BETWEEN THE HEALTH  CARE  PLAN
   49  AND  NON-PARTICIPATING  PHYSICIAN IS REASONABLY LIKELY, OR THAT BOTH THE
   50  HEALTH CARE PLAN'S PAYMENT AND  THE  NON-PARTICIPATING  PHYSICIAN'S  FEE
   51  REPRESENT UNREASONABLE EXTREMES, THEN THE INDEPENDENT DISPUTE RESOLUTION
   52  ENTITY  MAY  DIRECT BOTH PARTIES TO ATTEMPT A GOOD FAITH NEGOTIATION FOR
   53  SETTLEMENT. THE HEALTH CARE PLAN AND NON-PARTICIPATING PHYSICIAN MAY  BE
   54  GRANTED  UP  TO  TEN BUSINESS DAYS FOR THIS NEGOTIATION, WHICH SHALL RUN
   55  CONCURRENTLY WITH THE THIRTY DAY PERIOD FOR DISPUTE RESOLUTION.
       S. 6914                            178                           A. 9205

    1    (B) SURPRISE BILL RECEIVED BY AN INSURED WHO DOES NOT ASSIGN  BENEFITS
    2  OR  BY  A  PATIENT  WHO IS NOT AN INSURED.   (1) AN INSURED WHO DOES NOT
    3  ASSIGN BENEFITS IN ACCORDANCE WITH SUBSECTION (A) OF THIS SECTION  OR  A
    4  PATIENT  WHO  IS  NOT  AN  INSURED  AND WHO RECEIVES A SURPRISE BILL MAY
    5  SUBMIT  A DISPUTE REGARDING THE SURPRISE BILL FOR REVIEW TO AN INDEPEND-
    6  ENT DISPUTE RESOLUTION ENTITY.
    7    (2) THE  INDEPENDENT  DISPUTE  RESOLUTION  ENTITY  SHALL  DETERMINE  A
    8  REASONABLE  FEE  FOR THE SERVICES RENDERED BASED UPON THE CONDITIONS AND
    9  FACTORS SET FORTH IN SECTION SIX HUNDRED FOUR OF THIS ARTICLE.
   10    (3) A PATIENT OR INSURED WHO DOES NOT ASSIGN  BENEFITS  IN  ACCORDANCE
   11  WITH  SUBSECTION  (A)  OF  THIS SECTION SHALL NOT BE REQUIRED TO PAY THE
   12  PHYSICIAN'S FEE TO BE ELIGIBLE TO SUBMIT THE DISPUTE FOR REVIEW  TO  THE
   13  INDEPENDENT DISPUTE ENTITY.
   14    (C)  THE  DETERMINATION  OF  AN  INDEPENDENT DISPUTE RESOLUTION ENTITY
   15  SHALL BE BINDING ON THE PATIENT, PHYSICIAN AND  HEALTH  CARE  PLAN,  AND
   16  SHALL  BE  ADMISSIBLE  IN  ANY  COURT  PROCEEDING BETWEEN THE PATIENT OR
   17  INSURED, PHYSICIAN  OR  HEALTH  CARE  PLAN,  OR  IN  ANY  ADMINISTRATIVE
   18  PROCEEDING BETWEEN THIS STATE AND THE PHYSICIAN.
   19    S  608.  PAYMENT  FOR  INDEPENDENT  DISPUTE RESOLUTION ENTITY. (A) FOR
   20  DISPUTES INVOLVING AN INSURED, WHEN THE INDEPENDENT  DISPUTE  RESOLUTION
   21  ENTITY  DETERMINES THE HEALTH CARE PLAN'S PAYMENT IS REASONABLE, PAYMENT
   22  FOR THE DISPUTE RESOLUTION PROCESS SHALL BE THE  RESPONSIBILITY  OF  THE
   23  NON-PARTICIPATING  PHYSICIAN.  WHEN  THE  INDEPENDENT DISPUTE RESOLUTION
   24  ENTITY DETERMINES THE NON-PARTICIPATING PHYSICIAN'S FEE  IS  REASONABLE,
   25  PAYMENT  FOR  THE DISPUTE RESOLUTION PROCESS SHALL BE THE RESPONSIBILITY
   26  OF THE HEALTH CARE PLAN.  WHEN A GOOD FAITH NEGOTIATION DIRECTED BY  THE
   27  INDEPENDENT  DISPUTE  RESOLUTION  ENTITY  PURSUANT  TO PARAGRAPH FOUR OF
   28  SUBSECTION (A) OF SECTION SIX HUNDRED FIVE OF THIS ARTICLE, OR PARAGRAPH
   29  SIX OF SUBSECTION (A) OF SECTION  SIX  HUNDRED  SEVEN  OF  THIS  ARTICLE
   30  RESULTS IN A SETTLEMENT BETWEEN THE HEALTH CARE PLAN AND NON-PARTICIPAT-
   31  ING  PHYSICIAN, THE HEALTH CARE PLAN AND THE NON-PARTICIPATING PHYSICIAN
   32  SHALL EVENLY DIVIDE AND SHARE THE PRORATED COST FOR DISPUTE RESOLUTION.
   33    (B) FOR DISPUTES INVOLVING A PATIENT THAT IS NOT AN INSURED, WHEN  THE
   34  INDEPENDENT  DISPUTE RESOLUTION ENTITY DETERMINES THE PHYSICIAN'S FEE IS
   35  REASONABLE, PAYMENT FOR THE DISPUTE  RESOLUTION  PROCESS  SHALL  BE  THE
   36  RESPONSIBILITY  OF THE PATIENT UNLESS PAYMENT FOR THE DISPUTE RESOLUTION
   37  PROCESS WOULD POSE A HARDSHIP TO THE PATIENT. THE  SUPERINTENDENT  SHALL
   38  PROMULGATE  A REGULATION TO DETERMINE PAYMENT FOR THE DISPUTE RESOLUTION
   39  PROCESS IN CASES OF HARDSHIP. WHEN THE  INDEPENDENT  DISPUTE  RESOLUTION
   40  ENTITY  DETERMINES  THE PHYSICIAN'S FEE IS UNREASONABLE, PAYMENT FOR THE
   41  DISPUTE RESOLUTION PROCESS SHALL BE THE RESPONSIBILITY OF THE PHYSICIAN.
   42    S 27. Paragraphs 5 and 6 of subsection (a)  of  section  2601  of  the
   43  insurance law, paragraph 5 as amended by chapter 547 of the laws of 1997
   44  and  paragraph  6  as  amended  by  chapter 388 of the laws of 2008, are
   45  amended and a new paragraph 7 is added to read as follows:
   46    (5) compelling policyholders to institute suits to recover amounts due
   47  under its policies by offering substantially less than the amounts ulti-
   48  mately recovered in suits brought by them; [or]
   49    (6) failing to promptly disclose coverage pursuant to  subsection  (d)
   50  or  subparagraph (A) of paragraph two of subsection (f) of section three
   51  thousand four hundred twenty of this chapter[.]; OR
   52    (7) SUBMITTING REASONABLY RENDERED CLAIMS TO THE  INDEPENDENT  DISPUTE
   53  RESOLUTION  PROCESS  ESTABLISHED  UNDER  ARTICLE  SIX  OF  THE FINANCIAL
   54  SERVICES LAW.
   55    S 28. 1. An  out-of-network  reimbursement  rate  workgroup  shall  be
   56  convened  and  shall consist of 9 members appointed by the governor. Two
       S. 6914                            179                           A. 9205

    1  members shall be appointed on the recommendation of the speaker  of  the
    2  assembly and two members shall be appointed on the recommendation of the
    3  temporary  president  of the senate and shall consist of two physicians,
    4  two  representatives  of  health plans, and three consumers and shall be
    5  co-chaired by the superintendent of the department of financial services
    6  and the commissioner of the department of health.  Such  representatives
    7  of  the  workgroup  must  represent  different regions of the state. The
    8  members shall receive no compensation for their services, but  shall  be
    9  allowed  their actual and necessary expenses incurred in the performance
   10  of their duties.
   11    2. The workgroup shall review the current out-of-network reimbursement
   12  rates used by health insurers  licensed  under  the  insurance  law  and
   13  health  maintenance  organizations certified under the public health law
   14  and the rate methodology as required under the laws  of  2014  and  make
   15  recommendations  regarding  an  alternative rate methodology taking into
   16  consideration the following factors:
   17    a. current physician charges for out-of-network services;
   18    b. trends in medical care and the actual costs of medical care;
   19    c. regional differences regarding medical costs and trends;
   20    d. the current methodologies and levels of reimbursement  for  out-of-
   21  network  services  currently  paid  by health plans, including insurers,
   22  HMOs, Medicare, and Medicaid;
   23    e. the current in-network rates paid by health plans, including insur-
   24  ers, HMOs, Medicare and Medicaid for the same service and  by  the  same
   25  provider;
   26    f. the impact different rate methodologies would have on out-of-pocket
   27  costs for consumers who access out-of-network services;
   28    g. the impact different rate methodologies would have on premium costs
   29  in different regions of the state;
   30    h. reimbursement data from all health plans both public and private as
   31  well  as  charge data from medical professionals and hospitals available
   32  through the All Payer  Database  as  developed  and  maintained  by  the
   33  department  of  health  including  data  provided  in  the annual report
   34  published pursuant to section 2816 of the public health law; and
   35    i. other issues deemed appropriate by either the superintendent of the
   36  department of financial services or the commissioner of  the  department
   37  of health.
   38    3.  The workgroup shall review out-of-network coverage in the individ-
   39  ual and small group  markets  and  make  recommendations  regarding  the
   40  availability and adequacy of the coverage, taking into consideration the
   41  following factors:
   42    a.  the  extent  to which out-of-network coverage is available in each
   43  rating region in this state;
   44    b. the extent to which a significant level of out-of-network  benefits
   45  is  available in every rating region in this state, including the preva-
   46  lence of coverage based on the usual  and  customary  cost  as  well  as
   47  coverage  based  on other set reimbursement methodologies, such as Medi-
   48  care; and
   49    c. other issues deemed appropriate by either the superintendent of the
   50  department of financial services or the commissioner of  the  department
   51  of health.
   52    4.  The  workgroup  shall report its findings and make recommendations
   53  for legislation and regulations to the  governor,  the  speaker  of  the
   54  assembly,  the  senate  majority leader, the chairs of the insurance and
   55  health committees in both the assembly and the senate,  and  the  super-
       S. 6914                            180                           A. 9205

    1  intendent  of the department of financial services no later than January
    2  1, 2016.
    3    S 29. This act shall take effect one year after it shall have become a
    4  law, provided, however, that:
    5    1.  if  the  amendments  by  chapter  514  of the laws of 2013 made to
    6  subsection (b) of section 4903 of the insurance law and subdivision 2 of
    7  section 4903 of the public health law, as amended by sections twelve and
    8  twenty-two of this act, respectively, take effect after such date,  then
    9  sections twelve and twenty-two of this act shall take effect on the same
   10  date as chapter 514 of the laws of 2013 takes effect;
   11    2.  for  policies  renewed  on and after such date this act shall take
   12  effect on the renewal date;
   13    3. sections twelve, sixteen, seventeen, twenty-two and  twenty-six  of
   14  this  act shall apply to health care services provided on and after such
   15  date;
   16    4. sections eleven, thirteen, fourteen, fifteen,  twenty-one,  twenty-
   17  three,  twenty-four  and  twenty-five of this act shall apply to denials
   18  issued on and after such date; and
   19    5. effective immediately, the superintendent of financial services may
   20  promulgate any regulations  necessary  for  the  implementation  of  the
   21  provisions  of  this  act  on its effective date, and may certify one or
   22  more independent dispute resolution entities.

   23                                   PART I

   24    Section 1. Subdivisions 3-b and 3-c of section 1 and section 4 of part
   25  C of chapter 57 of the laws of 2006, relating to establishing a cost  of
   26  living  adjustment for designated human services programs, as amended by
   27  section 1 of part N of chapter 56 of the laws of 2013,  are  amended  to
   28  read as follows:
   29    3-b.  Notwithstanding  any  inconsistent  provision  of law, beginning
   30  April 1, 2009 and ending March 31, [2014] 2016, the commissioners  shall
   31  not  include  a  COLA for the purpose of establishing rates of payments,
   32  contracts or any other form of reimbursement.
   33    3-c. Notwithstanding any  inconsistent  provision  of  law,  beginning
   34  April 1, [2014] 2016 and ending March 31, [2017] 2019, the commissioners
   35  shall develop the COLA under this section using the actual U.S. consumer
   36  price  index  for  all  urban  consumers (CPI-U) published by the United
   37  States department of labor, bureau of labor statistics  for  the  twelve
   38  month  period  ending  in  July  of  the budget year prior to such state
   39  fiscal  year,  for  the  purpose  of  establishing  rates  of  payments,
   40  contracts or any other form of reimbursement.
   41    S  4.  This  act  shall take effect immediately and shall be deemed to
   42  have been in full force and effect on and after April 1, 2006;  provided
   43  section  one  of  this  act shall expire and be deemed repealed April 1,
   44  [2017] 2019; provided, further, that sections two and three of this  act
   45  shall expire and be deemed repealed December 31, 2009.
   46    S  2.  Section 1 of part C of chapter 57 of the laws of 2006, relating
   47  to establishing  a  cost  of  living  adjustment  for  designated  human
   48  services programs, is amended by adding a new subdivision 3-d to read as
   49  follows:
   50    3-D.  (I)  NOTWITHSTANDING  THE  PROVISIONS OF SUBDIVISION 3-B OF THIS
   51  SECTION, AS AMENDED BY SECTION ONE OF A CHAPTER  OF  THE  LAWS  OF  2014
   52  WHICH  ADDED  THIS  SUBDIVISION,  OR ANY OTHER INCONSISTENT PROVISION OF
   53  LAW, AND SUBJECT TO THE AVAILABILITY OF THE APPROPRIATION THEREFOR,  FOR
   54  THE  PROGRAMS  LISTED IN PARAGRAPHS (I), (II), (III), (IV), (V) AND (VI)
       S. 6914                            181                           A. 9205

    1  OF SUBDIVISION 4 OF THIS SECTION, THE COMMISSIONERS SHALL PROVIDE  FUND-
    2  ING  TO  SUPPORT  (1)  A  TWO PERCENT (2%) INCREASE IN ANNUAL SALARY AND
    3  SALARY-RELATED FRINGE BENEFITS FOR DIRECT CARE STAFF AND DIRECT  SUPPORT
    4  PROFESSIONALS, AND IN PAYMENT TO FOSTER PARENTS AND ADOPTIVE PARENTS, AS
    5  DEFINED  BY  THE  COMMISSIONER OF THE APPLICABLE STATE AGENCY SUBJECT TO
    6  THE APPROVAL OF THE DIRECTOR OF THE BUDGET BEGINNING  JANUARY  1,  2015,
    7  AND  (2) A TWO PERCENT (2%) INCREASE IN ANNUAL SALARY AND SALARY-RELATED
    8  FRINGE BENEFITS FOR DIRECT CARE STAFF, DIRECT SUPPORT PROFESSIONALS  AND
    9  CLINICAL  STAFF,  AND IN PAYMENT TO FOSTER PARENTS AND ADOPTIVE PARENTS,
   10  AS DEFINED BY THE COMMISSIONER OF THE APPLICABLE STATE AGENCY SUBJECT TO
   11  THE APPROVAL OF THE DIRECTOR OF THE BUDGET BEGINNING APRIL 1, 2015. SUCH
   12  COMMISSIONERS SHALL USE THE CONSOLIDATED FISCAL REPORTING  MANUAL  AS  A
   13  REFERENCE,  TO THE EXTENT THAT APPLICABLE JOB TITLES ARE LISTED THEREIN.
   14  WHERE APPLICABLE, THE FUNDING PROVIDED UNDER THIS SUBDIVISION  SHALL  BE
   15  APPLIED  TO  REIMBURSABLE  COSTS  OR  CONTRACT AMOUNTS TO SUPPORT SALARY
   16  INCREASES AND SALARY-RELATED FRINGE BENEFITS OF ELIGIBLE  PERSONS,  THAT
   17  TOOK EFFECT ON OR AFTER JANUARY 1, 2014. THE COMMISSIONERS SHALL PROVIDE
   18  FUNDING  FOR  SUCH  SALARY  AND ASSOCIATED FRINGE BENEFIT INCREASES IN A
   19  MANNER WHICH WILL RESULT IN A CONSISTENT METHODOLOGY AMONG PROGRAMS  AND
   20  PROVIDER TYPES.
   21    (II)  THE  COMMISSIONERS  SHALL  DEVELOP  STANDARDS, INCLUDING BUT NOT
   22  LIMITED TO, REQUIRING THAT A LOCAL GOVERNMENT UNIT  OR  PROVIDER  AGENCY
   23  DEVELOP  A  PLAN OF IMPLEMENTATION TO ENSURE THAT SUCH FUNDING INCREASES
   24  SHALL BE DIRECTED TO DIRECT CARE STAFF,  DIRECT  SUPPORT  PROFESSIONALS,
   25  CLINICAL  STAFF,  FOSTER  PARENTS  AND ADOPTIVE PARENTS, AS APPROPRIATE,
   26  PURSUANT TO PARAGRAPH (I) OF THIS  SUBDIVISION.  EACH  LOCAL  GOVERNMENT
   27  UNIT  OR  DIRECT CONTRACT PROVIDER RECEIVING SUCH FUNDING SHALL SUBMIT A
   28  WRITTEN CERTIFICATION, IN SUCH FORM AND AT SUCH TIME AS EACH COMMISSION-
   29  ER SHALL PRESCRIBE, ATTESTING TO HOW SUCH FUNDING WILL BE  OR  WAS  USED
   30  FOR  PURPOSES  ELIGIBLE  UNDER  THIS  SECTION.  FURTHER, PROVIDERS SHALL
   31  SUBMIT A RESOLUTION FROM THEIR GOVERNING BODY TO THE APPROPRIATE COMMIS-
   32  SIONER, ATTESTING THAT THE FUNDING  RECEIVED  WILL  BE  USED  SOLELY  TO
   33  SUPPORT  SALARY  AND  SALARY-RELATED FRINGE BENEFIT INCREASES FOR DIRECT
   34  CARE STAFF, DIRECT SUPPORT PROFESSIONALS, CLINICAL STAFF, FOSTER PARENTS
   35  AND ADOPTIVE PARENTS, PURSUANT TO PARAGRAPH (I) OF THIS SUBDIVISION  AND
   36  THE APPLICABLE STANDARDS ISSUED BY THE APPROPRIATE COMMISSIONER PURSUANT
   37  TO THIS PARAGRAPH.  SUCH COMMISSIONERS SHALL BE AUTHORIZED TO RECOUP ANY
   38  FUNDS  AS  APPROPRIATED  HEREIN DETERMINED TO HAVE BEEN USED IN A MANNER
   39  INCONSISTENT WITH SUCH STANDARDS OR INCONSISTENT WITH THE PROVISIONS  OF
   40  THIS  SUBDIVISION,  AND SUCH COMMISSIONERS SHALL BE AUTHORIZED TO EMPLOY
   41  ANY LEGAL MECHANISM TO RECOUP SUCH FUNDS, INCLUDING AN OFFSET  OF  OTHER
   42  FUNDS THAT ARE OWED TO SUCH LOCAL GOVERNMENTAL UNIT OR PROVIDER.
   43    (III)  WHERE  APPROPRIATE, TRANSFERS TO THE DEPARTMENT OF HEALTH SHALL
   44  BE MADE AS REIMBURSEMENT FOR THE STATE SHARE OF MEDICAL ASSISTANCE.
   45    S 3. This act shall take effect immediately and  shall  be  deemed  to
   46  have been in full force and effect on and after April 1, 2014; provided,
   47  however, that the amendments to subdivisions 3-b and 3-c of section 1 of
   48  part  C  of  chapter  57 of the laws of 2006, relating to establishing a
   49  cost of living adjustment for designated human services programs made by
   50  section one of this act shall not affect the repeal of such subdivisions
   51  and shall be deemed repealed therewith.
   52    S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
   53  sion, section or part of this act shall be  adjudged  by  any  court  of
   54  competent  jurisdiction  to  be invalid, such judgment shall not affect,
   55  impair, or invalidate the remainder thereof, but shall  be  confined  in
   56  its  operation  to the clause, sentence, paragraph, subdivision, section
       S. 6914                            182                           A. 9205

    1  or part thereof directly involved in the controversy in which such judg-
    2  ment shall have been rendered. It is hereby declared to be the intent of
    3  the legislature that this act would  have  been  enacted  even  if  such
    4  invalid provisions had not been included herein.
    5    S  3.  This  act shall take effect immediately provided, however, that
    6  the applicable effective date of Parts A through I of this act shall  be
    7  as specifically set forth in the last section of such Parts.
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