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).
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A9205
SPONSOR: Budget TITLE OF BILL: 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
malignant 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 traffic
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 Medi-
caid 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 the social services law, in relation to review of crimi-
nal history information concerning prospective employees; to amend the
public health law, in relation to the provision of contact information
relating 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 thereof;
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 distribution of pool allo-
cations 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 implement 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 initi-
ative 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 comprehen-
sive 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 amending the
military law and other laws relating to making appropriations for the
support of government, in relation to extending the applicability of
certain provisions 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 manufac-
turers; to amend the social services law, in relation to early refill of
prescriptions; to amend the social services law, in relation to emergen-
cy and non-emergency transportation; 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 gener-
al 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 thereof; 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 organ-
izations and providing equivalent fees through an ambulatory patient
group methodology, in relation to transfer of funds and the effective-
ness 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 Inte-
grated 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 Individual 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 inpatient 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 determi-
nation 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 initiative; 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 establishment 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 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 peri-
od; 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 relat-
ing 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 reimbursement, 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, amend-
ing the public health law and the social services law relating to
encouraging comprehensive health services, in relation to the effective-
ness 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 thereof; and to repeal certain provisions of the social
services law and the public health law relating thereto (Part C); to
amend the education 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 estab-
lishing an integrated employment plan (Part E); directing a report by
the office for people with developmental disabilities on the establish-
ment 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
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); to amend the insurance law, the
public health law and the financial services law, in relation to estab-
lishing 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 programs, in
relation to forgoing such adjustment during the 2014-2015 state fiscal
year (Part I)
SPONSOR:
BUDGET
This bill would enact into law major components of legislation that are
necessary to implement the Health and Mental Hygiene budgets for State
Fiscal Year (SFY) 2014-15. Among its provisions are the following
proposals:
A Makes changes to various public health programs, related to capital
grants, safe patient handling, organ donation, tax check-off programs,
and the Elderly Pharmaceutical Insurance Program.
B Extends the Health Care Reinvestment Act (HCRA) for three years,
from March 31, 2014 to March 31, 2017.
C Makes various changes to the Medical Assistance program to implement
the recommendation of the Medicaid Redesign Team.
D Authorizes drug compounding by regulated outsourcing facilities.
E Requires the Office for People with Developmental Disabilities
(OPWDD) to develop an integrated employment plan for increasing employ-
ment opportunities for people with development disabilities.
F Requires OPWDD to report in the viability of establishing a direct
support professional credentialing pilot program.
G Extends the Community Mental Health Support and Workforce Reinvest-
ment Act and increases the required reinvestment amount from $70,000 to
$100,000 per bed.
H Provides for improved patient protections for individuals seeing an
out-of-network provider.
I Provides for a two-percent cost_ of living adjustment for various
human services programs, effective January 1, 2015, to support costs
associated with for direct care staff, direct support staff, foster
parents and adoptive parents.
JUSTIFICATION:
This bill is necessary for the enactment of portions of the SFY 2014-15
Health and Mental Hygiene budget, as contained in the State Operations,
Capital Projects and Aid to Localities appropriations bills.
FISCAL IMPACT:
The provisions contained in this legislation are related to appropri-
ations proposed for SFY 2014-15.
EFFECTIVE DATE:
Effective April 1, 2014, with exceptions.
