Provides for increasing the applicability of brand name and generic prescription drugs and other medical services, except diagnostic services, co-payments for medicaid recipients.
STATE OF NEW YORK
________________________________________________________________________
2783
2019-2020 Regular Sessions
IN ASSEMBLY
January 25, 2019
___________
Introduced by M. of A. SCHIMMINGER -- read once and referred to the
Committee on Health
AN ACT to amend the social services law, in relation to medicaid co-pay-
ments for prescription drugs and other services
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 6 of section 367-a of the
2 social services law, as amended by section 15 of part B of chapter 57 of
3 the laws of 2015, is amended to read as follows:
4 (b) Co-payments shall apply to all eligible persons for the services
5 defined in paragraph (d) of this subdivision with the exception of:
6 (i) [individuals under twenty-one years of age;
7 (ii) pregnant women;
8 (iii)] individuals who are inpatients in a medical facility who have
9 been required to spend all of their income for medical care, except
10 their personal needs allowance or residents of community based residen-
11 tial facilities licensed by the office of mental health or the office of
12 mental retardation and developmental disabilities who have been required
13 to spend all of their income, except their personal needs allowance;
14 [(iv) individuals enrolled in health maintenance organizations or
15 other entities which provide comprehensive health services, or other
16 managed care programs for services covered by such programs, except that
17 such persons, other than persons otherwise exempted from co-payments
18 pursuant to subparagraphs (i), (ii), (iii) and (v) of this paragraph,
19 and other than those persons enrolled in a managed long term care
20 program, shall be subject to co-payments as described in subparagraph
21 (v) of paragraph (d) of this subdivision;
22 (v)] (ii) individuals whose family income is less than one hundred
23 percent of the federal poverty line, as defined in subparagraph four of
24 paragraph (a) of subdivision one of section three hundred sixty-six of
25 this title, for a family of the same size; and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03827-01-9
A. 2783 2
1 [(vi)] (iii) any other individuals required to be excluded by federal
2 law or regulations.
3 § 2. The opening paragraph of paragraph (d) of subdivision 6 of
4 section 367-a of the social services law, as added by chapter 41 of the
5 laws of 1992, is amended to read as follows:
6 Co-payments shall apply to [the following] all services covered by
7 this title, except diagnostic services, and shall be pre-paid at the
8 time when such services are rendered, subject to such exceptions for
9 subcategories of these services as recognized by the commissioner of
10 health in regulations, provided in accordance with section three hundred
11 sixty-five-a of this [article] title and the regulations of the depart-
12 ment, to the extent permitted by title XIX of the federal social securi-
13 ty act:
14 § 3. The commissioner of health is authorized to promulgate or adopt
15 any rules or regulations necessary to implement the provisions of this
16 act and any co-payments, procedures, forms, or instructions necessary
17 for such implementation may be adopted and issued on or after the effec-
18 tive date of this act. Notwithstanding any inconsistent provision of the
19 state administrative procedure act or any other provision of law, rule
20 or regulation, the commissioner of health and the superintendent of
21 financial services and any appropriate council are authorized to adopt
22 or amend or promulgate on an emergency basis any regulation he or she or
23 such council determines necessary to implement any provision of this act
24 on its effective date.
25 § 4. This act shall take effect immediately.
