Establishes the Medicare maximization and assistance program to assist eligible state retirees in obtaining certain Medicare benefits; provides for the investing of any net savings realized by the program back into the New York state health insurance program for the purpose of eliminating or limiting the impact of any premium rate or other cost increases that would be the responsibility of an employee or retiree.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A9759
SPONSOR: Pheffer Amato TITLE OF BILL:
An act to amend the civil service law, in relation to establishing the
Medicare maximization and assistance program to assist eligible state
retirees in obtaining certain Medicare benefits
PURPOSE:
This legislation would require the Department of Civil Service to design
a program to identify state retirees eligible for but not receiving
social security disability insurance (SSDI) and Medicare coverage.
SUMMARY OF PROVISIONS:
Section 1 of the bill would:
Require the Department of Civil Service to establish a Medicare Maximi-
zation and Assistance Program (the Program) to identify state retirees
eligible for but not receiving social security disability insurance and
medicare coverage;
Define a state retiree as an individual retired from state service
eligible for benefits pursuant to article XI of the civil service law;
Establish the elements of the Program, including requirements to assist
qualified retirees to apply for Medicare and SSDI benefits and to moni-
tor the Program through reporting requirements and other means to ensure
contract performance and quality delivery of services;
Ensure that the program will not result in any adverse change in health
or other benefits to any individual;
Require the Department of Civil Service to report annually to the Legis-
lature about the impact of the program; and
Require the State to invest any net savings realized from the program
back into the NYS Health Insurance Program for the purpose of reducing
or eliminating certain costs to employees or retirees.
Section two would set the effective date.
JUSTIFICATION:
Persons who are under age sixty-five and disabled are frequently eligi-
ble for, but not receiving, social security disability insurance (SSDI)
and medicare. As a consequence, they forego the supplemental income to
which disabled individuals are entitled through SSDI. By requiring New
York State to assist state retirees in qualifying for SSDI and Medicare,
this legislation will increase the disposable incomes of disabled reti-
rees and ensure that they receive the federal monetary benefits to which
they are entitled. Participation in the Program by retirees will be
completely voluntary.
Moreover, identification of retirees under the age of 65 who would qual-
ify for Medicare as their primary insurer will generate significant
savings for the state's health insurance plan. Disabled retirees under
the age of 65, like post-65 retirees, will have the benefit of Medicare
coverage while maintaining the full benefit of the State's health insur-
ance plan as their secondary source of insurance. Retirees will experi-
ence no diminution in coverage.
LEGISLATIVE HISTORY:
New Legislation
STATE AND LOCAL FISCAL IMPLICATIONS:
This legislation will generate an estimated $852,000 in savings for the
State Financial Plan in the first year of operation, growing to annual
savings of $42 million within 5 years of implementation. This legis-
lation also could generate savings for local governments if the Commis-
sioner elects to extend the program to local government retirees, as
authorized to do in the bill.
EFFECTIVE DATE:
This act shall take effect April 1, 2024.
STATE OF NEW YORK
________________________________________________________________________
9759
IN ASSEMBLY
April 3, 2024
___________
Introduced by M. of A. PHEFFER AMATO -- read once and referred to the
Committee on Governmental Employees
AN ACT to amend the civil service law, in relation to establishing the
Medicare maximization and assistance program to assist eligible state
retirees in obtaining certain Medicare benefits
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The civil service law is amended by adding a new article 15
2 to read as follows:
3 ARTICLE XV
4 MEDICARE MAXIMIZATION AND ASSISTANCE PROGRAM
5 Section 300. Definitions.
6 301. Purpose.
7 302. Establishment of the Medicare maximization and assistance
8 program.
9 303. Investment of savings.
10 § 300. Definitions. As used in this article, the following terms shall
11 have the following meanings:
12 1. "Eligible individual" means an individual retired from state
13 service eligible for benefits pursuant to article eleven of this chap-
14 ter.
15 2. "Program" means the Medicare maximization and assistance program
16 established pursuant to the provisions of this article.
17 § 301. Purpose. Persons who are under age sixty-five and disabled are
18 frequently eligible for, but not receiving social security disability
19 insurance and Medicare. The Medicare maximization and assistance program
20 is designed to ensure that eligible retirees are able to access all
21 benefits available to them. The benefits accrue not just to the retiree,
22 but to the state in ensuring that Medicare serves as the primary payer
23 for eligible persons.
24 § 302. Establishment of the Medicare maximization and assistance
25 program. 1. The commissioner shall establish within the department a
26 Medicare maximization and assistance program which shall be designed to
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD15000-01-4
A. 9759 2
1 identify state retirees eligible for but not receiving social security
2 disability insurance and Medicare coverage.
3 2. Elements of the program shall include:
4 (a) conducting an ongoing claims analysis of retirees for the purpose
5 of identifying individuals who may be eligible for social security disa-
6 bility insurance or Medicare benefits and are not yet receiving them;
7 (b) assisting any individual whose claims history and social security
8 eligibility qualify such individual to apply for and be awarded social
9 security disability and subsequently Medicare. Such assistance shall
10 include the following:
11 (i) developing communication materials to educate Medicaid recipients
12 about social security disability insurance benefits;
13 (ii) performing outreach to populations targeted by claims analysis;
14 (iii) analyzing responses to determine social security disability
15 insurance benefit or Medicare eligibility;
16 (iv) representing qualified individuals with their claim or claims to
17 qualify for social security disability insurance benefits and Medicare
18 enrollment;
19 (v) monitoring the program through reporting requirements and other
20 means to ensure contract performance and quality delivery of services;
21 and
22 (vi) monitoring the quality of services delivered to participants
23 through outcome measurements.
24 3. Under no circumstances shall an individual eligible for this
25 program experience any adverse change in health benefits or other bene-
26 fits as a result of participating in this program. No individual shall
27 be required to transfer to Medicare as a result of participating in this
28 program.
29 4. The commissioner shall provide the department and the legislature
30 with an annual report showing the number of Medicaid recipients who have
31 transitioned to social security disability insurance and Medicare and
32 the amount of savings realized by the program.
33 § 303. Investment of savings. The state shall invest any net savings
34 realized from the program back into the New York state health insurance
35 program for the purpose of eliminating or limiting the impact of any
36 premium rate or other cost increases that would be the responsibility of
37 an employee or retiree.
38 § 2. This act shall take effect April 1, 2024; provided, however, if
39 this act shall become a law after such date it shall take effect imme-
40 diately and shall be deemed to have been in full force and effect on and
41 after such date.
