A02784 Summary:

BILL NOA02784
 
SAME ASNo Same As
 
SPONSORSchimminger (MS)
 
COSPNSR
 
MLTSPNSRRivera
 
Amd §365-a, rpld sub 2 ¶(n), Soc Serv L
 
Modifies availability of medicaid services to bring them more in line with those of private health insurance coverage.
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A02784 Actions:

BILL NOA02784
 
01/25/2019referred to health
01/08/2020referred to health
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A02784 Committee Votes:

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A02784 Floor Votes:

There are no votes for this bill in this legislative session.
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A02784 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2784
 
                               2019-2020 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 25, 2019
                                       ___________
 
        Introduced  by  M.  of  A. SCHIMMINGER -- Multi-Sponsored by -- M. of A.
          RIVERA -- read once and referred to the Committee on Health
 
        AN ACT to amend the social services law, in relation  to  the  character
          and  adequacy  of  Medicaid  assistance and to repeal paragraph (n) of
          subdivision 2 of section 365-a of the social services law relating  to
          the care and services of audiologists
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraph (a) of subdivision 2  of  section  365-a  of  the
     2  social  services  law,  as amended by chapter 47 of the laws of 1996, is
     3  amended to read as follows:
     4    (a) services of qualified physicians, [dentists, nurses,  and  private
     5  duty  nursing  services  shall  be  further subject to the provisions of
     6  section three hundred  sixty-seven-o  of  this  chapter,]  optometrists,
     7  nurse  midwives,  nurse  practitioners,  and  other related professional
     8  personnel;
     9    § 2. Paragraph (f) of subdivision 2 of section  365-a  of  the  social
    10  services  law, as added by chapter 184 of the laws of 1969 and as relet-
    11  tered by chapter 478 of the laws of 1980, is amended to read as follows:
    12    (f) preventive, prophylactic and other routine dental  care,  services
    13  and  supplies  only  when  provided  in  a hospital outpatient or clinic
    14  facility referred to in paragraph (c) of this subdivision;
    15    § 3. Paragraph (g) of subdivision 2 of section  365-a  of  the  social
    16  services  law,  as  amended by section 21 of part A of chapter 56 of the
    17  laws of 2013, is amended to read as follows:
    18    (g) sickroom supplies,  eyeglasses,  and  prosthetic  appliances  [and
    19  dental  prosthetic  appliances]  furnished  in accordance with the regu-
    20  lations of the department; provided further that: (i)  the  commissioner
    21  of health is authorized to implement a preferred diabetic supply program
    22  wherein  the  department  of  health  will receive enhanced rebates from
    23  preferred manufacturers of glucometers and test strips, and may  subject
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD03834-01-9

        A. 2784                             2
 
     1  non-preferred  manufacturers'  glucometers  and  test  strips  to  prior
     2  authorization under section two  hundred  seventy-three  of  the  public
     3  health law; (ii) enteral formula therapy and nutritional supplements are
     4  limited  to  coverage  only for nasogastric, jejunostomy, or gastrostomy
     5  tube feeding, for treatment of  an  inborn  metabolic  disorder,  or  to
     6  address  growth  and  development  problems  in children, or, subject to
     7  standards established by the commissioner, for persons with a  diagnosis
     8  of  HIV  infection,  AIDS  or  HIV-related illness or other diseases and
     9  conditions; (iii) prescription  footwear  and  inserts  are  limited  to
    10  coverage  only  when  used  as an integral part of a lower limb orthotic
    11  appliance, as part of a diabetic treatment plan, or  to  address  growth
    12  and  development  problems  in  children;  (iv)  compression and support
    13  stockings are limited to coverage only for  pregnancy  or  treatment  of
    14  venous stasis ulcers; [and] (v) the commissioner of health is authorized
    15  to  implement  an  incontinence supply utilization management program to
    16  reduce costs without  limiting  access  through  the  existing  provider
    17  network,  including  but  not  limited  to  single  or  multiple  source
    18  contracts or,  a  preferred  incontinence  supply  program  wherein  the
    19  department  of  health  will  receive  enhanced  rebates  from preferred
    20  manufacturers of incontinence supplies, and  may  subject  non-preferred
    21  manufacturers' incontinence supplies to prior approval pursuant to regu-
    22  lations of the department, provided any necessary approvals under feder-
    23  al  law have been obtained to receive federal financial participation in
    24  the costs of incontinence supplies provided pursuant  to  this  subpara-
    25  graph;  and  (vi)  the  commissioner  of health is authorized to require
    26  prior approval of any prescription drug that is prescribed for  a  resi-
    27  dent of a nursing home and that is not reimbursed as part of the nursing
    28  home's medicaid rate;
    29    §  4.  Paragraph  (l)  of subdivision 2 of section 365-a of the social
    30  services law, as amended by chapter 81 of the laws of 1995,  is  amended
    31  to read as follows:
    32    (l)  care  and services of podiatrists, clinical psychologists, nurses
    33  and audiologists, including such care and services provided in a  hospi-
    34  tal  out-patient or clinic facility referred to in paragraph (c) of this
    35  subdivision, and  dentists,  which  care  and  services  shall  only  be
    36  provided  upon  referral by a physician, nurse practitioner or certified
    37  nurse midwife in accordance with  the  program  of  early  and  periodic
    38  screening  and  diagnosis  established  pursuant to subdivision three of
    39  this section or to persons eligible for benefits under  title  XVIII  of
    40  the  federal  social security act as qualified medicare beneficiaries in
    41  accordance with federal requirements therefor [and private  duty  nurses
    42  which  care and services shall only be provided in accordance with regu-
    43  lations of the department of health;  provided,  however,  that  private
    44  duty  nursing  services  shall  not be restricted when such services are
    45  more appropriate and cost-effective than nursing services provided by  a
    46  home health agency pursuant to section three hundred sixty-seven-l];
    47    §  5.  Paragraph  (n)  of subdivision 2 of section 365-a of the social
    48  services law, as added by chapter 556 of the laws of 1986, is REPEALED.
    49    § 6. The commissioner of health is authorized to promulgate  or  adopt
    50  any  rules  or regulations necessary to implement the provisions of this
    51  act and any procedures, forms, or instructions necessary for such imple-
    52  mentation may be adopted and issued on or after the  effective  date  of
    53  this act. Notwithstanding any inconsistent provision of the state admin-
    54  istrative  procedure  act  or  any other provision of law, rule or regu-
    55  lation, the commissioner of health and the superintendent  of  financial
    56  services  and any appropriate council is authorized to adopt or amend or

        A. 2784                             3
 
     1  promulgate on an emergency basis any regulation he or she or such  coun-
     2  cil  determines  necessary to implement any provision of this act on its
     3  effective date.
     4    § 7. This act shall take effect on the one hundred eightieth day after
     5  it shall have become a law.
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