Directs the commissioner of health to provide authorizations to all fiscal intermediaries that timely submit a request for authorization prior to January 1, 2026; details information required for such authorizations; makes related provisions.
STATE OF NEW YORK
________________________________________________________________________
5703
2025-2026 Regular Sessions
IN ASSEMBLY
February 20, 2025
___________
Introduced by M. of A. SAYEGH, HEVESI, EICHENSTEIN, WEPRIN, RAMOS, DAVI-
LA, HYNDMAN -- read once and referred to the Committee on Health
AN ACT to amend the social services law, in relation to certain authori-
zations to fiscal intermediaries
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph (b) of subdivision 4-a of section 365-f of the
2 social services law, as amended by section 2 of part HH of chapter 57 of
3 the laws of 2024, is amended to read as follows:
4 (b) [Notwithstanding section one hundred sixty-three of the state
5 finance law, section one hundred twelve of the state finance law, or
6 section one hundred forty-two of the economic development law the
7 commissioner shall enter into a contract under this subdivision with an
8 eligible contractor that submits an offer for a contract, provided,
9 however, that:
10 (i) the department shall post on its website:
11 (A) a description of the proposed statewide fiscal intermediary
12 services to be provided pursuant to a contract in accordance with this
13 subdivision;
14 (B) the criteria for selection of the statewide fiscal intermediary,
15 which shall include at a minimum that the eligible contractor is capable
16 of performing statewide fiscal intermediary services with demonstrated
17 cultural and language competencies specific to the population of consum-
18 ers and those of the available workforce, has experience serving indi-
19 viduals with disabilities, and as of April first, two thousand twenty-
20 four is providing services as a fiscal intermediary on a statewide basis
21 with at least one other state;
22 (C) the manner by which prospective contractors may seek such
23 selection, which may include submission by electronic means;
24 (ii) all offers that are received from prospective contractors in a
25 timely fashion and that meet the criteria set forth in clause (B) of
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05945-01-5
A. 5703 2
1 subparagraph (i) of this paragraph shall be reviewed by the commission-
2 er; and
3 (iii) the commissioner shall award such contract to the contractor
4 that meets the criteria for selection and offers the best value for
5 providing the services required pursuant to this section and the needs
6 of consumers.] The commissioner shall provide authorizations under this
7 subdivision to all fiscal intermediaries that timely submit a request
8 for authorization prior to January first, two thousand twenty-six, and
9 meet the requirements of this section. No entity shall provide, direct-
10 ly or through contract, fiscal intermediary services without having
11 received an authorization as a fiscal intermediary issued by the commis-
12 sioner in accordance with this subdivision, or that has a pending
13 authorization timely submitted and currently in processing, review,
14 appeal, or legal challenge.
15 (i) An application for authorization as a fiscal intermediary shall be
16 filed with the commissioner, together with such other forms and informa-
17 tion as shall be prescribed by, or acceptable to the commissioner. Such
18 information shall consist of the following:
19 (A) the name and employer identification number, of the entity,
20 including any subsidiary corporations, if applicable, and any name
21 under which the entity does business;
22 (B) all addresses at which the organization operates;
23 (C) the names, titles and contact information of all officers and
24 directors in a not-for-profit company or business, or managers in a
25 limited liability company, as well as the name and employment history of
26 the individual ultimately accountable for operation of the fiscal inter-
27 mediary; and for a not-for-profit entity, the number of director posi-
28 tions set by the company's by-laws, and how many are currently filled;
29 (D) a history of the organization, along with an overview of the
30 organization and all services it offers, including any relationships
31 with outside agencies that may influence in any way the ability of the
32 organization to provide fiscal intermediary services consistent with the
33 manner described in its application;
34 (E) all policies and procedures of the fiscal intermediary, including
35 any contracts or other documents used in communications with consumers;
36 (F) plans to solicit and consider input from the fiscal intermediary's
37 consumers, staff, personal assistants and other interested parties which
38 may be charged with roles including, but not limited to, quality assur-
39 ance review, referral, program monitoring or development or establishing
40 and responding to community needs; such input may be in the form of a
41 board of directors, committee, survey, or other mechanism, provided that
42 the majority of input obtained as part of this process must be from
43 individual consumers and consumer advocates of the fiscal intermediary;
44 (G) the organization's plan to address the needs of consumers and
45 their personal assistants in a timely manner, regardless of where they
46 live, including, but not limited to, input from consumers, obtaining
47 physicals and other health information from personal assistants, obtain-
48 ing time records for payroll, and timely processing of payroll; and
49 (H) a written sworn statement by an officer of the entity disclosing
50 any pending litigation, unsatisfied judgments or penalties, convictions
51 for fraud or sanctions imposed by government authorities.
52 (ii) The entity shall reasonably promptly notify the department of any
53 change in the information submitted to the department for authorization
54 under this subdivision.
55 (iii) The commissioner shall not withhold approval of any application
56 for authorization that demonstrates the fiscal intermediary's ability to
A. 5703 3
1 provide fiscal intermediary services, in accordance with the manner
2 required by this subdivision and the rules and regulations hereunder.
3 All such applications shall be approved by the commissioner.
4 (iv) If the commissioner denies an application for authorization, he
5 or she shall include a narrative explanation of the reason or reasons
6 for its denial and provide the fiscal intermediary with sixty days to
7 submit additional information for reconsideration by the commissioner.
8 (v) The commissioner shall consider and evaluate any response received
9 by the fiscal intermediary before reaching a final determination, which
10 likewise shall be accompanied by a narrative explanation, if the appli-
11 cation is still denied.
12 (vi) All orders or determinations under this subdivision shall be
13 subject to review as provided in article seventy-eight of the civil
14 practice law and rules.
15 § 2. Subparagraphs (i) and (ii) of paragraph (a) of subdivision 4-a of
16 section 365-f of the social services law, as amended by section 1 of
17 part HH of chapter 57 of the laws of 2024, are amended to read as
18 follows:
19 (i) "Statewide fiscal intermediary" means an entity that provides
20 fiscal intermediary services and has a contract for providing such
21 services with [the department of health and is selected through the
22 procurement process described in paragraph (b) of this subdivision.]:
23 (A) a local department of social services; an organization licensed
24 under article forty-four of the public health law; or
25 (B) an accountable care organization certified under article twenty-
26 nine-E of the public health law or an integrated delivery system
27 composed primarily of health care providers recognized by the department
28 as a performing provider system under the delivery system reform incen-
29 tive payment program.
30 (ii) Fiscal intermediary services shall include the following
31 services, performed on behalf of the consumer to facilitate the consum-
32 er's role as the employer:
33 (A) wage and benefit processing for consumer directed personal assist-
34 ants;
35 (B) processing all income tax and other required wage withholdings;
36 (C) complying with workers' compensation, disability and unemployment
37 requirements;
38 (D) maintaining personnel records for each consumer directed personal
39 assistant, including time records and other documentation needed for
40 wages and benefit processing and a copy of the medical documentation
41 required pursuant to regulations established by the commissioner;
42 (E) ensuring that the health status of each consumer directed personal
43 assistant is assessed prior to service delivery pursuant to regulations
44 issued by the commissioner;
45 (F) maintaining records of service authorizations or reauthorizations;
46 (G) monitoring the consumer's or, if applicable, the designated repre-
47 sentative's continuing ability to fulfill the consumer's responsibil-
48 ities under the program and promptly notifying the authorizing entity of
49 any circumstance that may affect the consumer's or, if applicable, the
50 designated representative's ability to fulfill such responsibilities;
51 (H) complying with regulations established by the commissioner speci-
52 fying the responsibilities of fiscal intermediaries providing services
53 under this title;
54 (I) entering into a department approved memorandum of understanding
55 with the consumer that describes the parties' responsibilities under
56 this program[; and
A. 5703 4
1 (J) other related responsibilities which may include, as determined by
2 the commissioner, assisting consumers to perform the consumers' respon-
3 sibilities under this section and department regulations in a manner
4 that does not infringe upon the consumer's responsibilities and self-di-
5 rection].
6 § 3. Paragraph (c) of subdivision 4-d of section 365-f of the social
7 services law, as added by section 7 of part G of chapter 57 of the laws
8 of 2019, is amended to read as follows:
9 (c) Where a fiscal intermediary is suspending or ceasing operation
10 pursuant to an order under subdivision four-b of this section, [or has
11 failed to submit an offer for a contract, or has been denied a contract
12 under this section,] all the provisions of this subdivision shall apply
13 except subparagraph (i) of paragraph (a) of this subdivision, notice of
14 which to all parties shall be provided by the department as appropriate.
15 § 4. This act shall take effect immediately and shall be deemed to
16 have been in full force and effect on and after April 1, 2025.
