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S05485 Summary:

S05485 Actions:

S05485 Committee Votes:

S05485 Floor Votes:

S05485 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5485--A
            Cal. No. 1107
 
                               2019-2020 Regular Sessions
 
                    IN SENATE
 
                                       May 2, 2019
                                       ___________
 
        Introduced  by  Sen.  RIVERA -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health -- reported favora-
          bly from said committee, ordered to first and second  report,  ordered
          to a third reading, amended and ordered reprinted, retaining its place
          in the order of third reading

        AN  ACT  to  amend the public health law and the social services law, in
          relation to automatic enrollment  and  recertification  simplification
          for Medicaid eligible recipients
 
          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 7 of  section  4403-f  of  the
     2  public  health law is amended by adding a new subparagraph (iii) to read
     3  as follows:
     4    (iii) Where a  person  determined  eligible  for  Medicaid  ("Medicaid
     5  recipient") has been determined by the commissioner or his or her desig-
     6  nee  to  require community-based long term care services for more than a
     7  continuous period of one hundred twenty days, and the Medicaid recipient
     8  has not selected and enrolled in a managed long term care plan prior  to
     9  any  expiration  date  of such determination of need for long term care,
    10  after being provided with information to make an  informed  choice,  the
    11  commissioner  shall  assign  the  recipient  to a managed long term care
    12  plan, taking into account consistency  with  any  prior  community-based
    13  direct  care  workers  having  recently  served  the  recipient, quality
    14  performance criteria,  capacity,  and  geographic  accessibility.    The
    15  commissioner  may  assign  participants  pursuant  to such criteria on a
    16  weighted basis.  A recipient assigned to a managed long term  care  plan
    17  under this subparagraph shall be deemed to have been determined to be in
    18  need of long term care services for more than a continuous period of one
    19  hundred  twenty  days and eligible to be enrolled in a managed long term
    20  care plan.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11182-04-9
        S. 5485--A                          2
 
     1    § 2. Paragraph (b) of subdivision 2 of section  366-a  of  the  social
     2  services  law, as added by section 51 of part A of chapter 1 of the laws
     3  of 2002, is amended to read as follows:
     4    (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
     5  sion, an applicant or recipient may attest to the amount of his  or  her
     6  accumulated  resources,  unless  such  applicant or recipient is seeking
     7  medical assistance payment for long term care  services  for  the  first
     8  time.  A  recipient  who has already provided documentation of resources
     9  may attest to the amount of accumulated resources if it has remained the
    10  same or is less than the amount originally documented.  For purposes  of
    11  this  paragraph,  long  term  care  services shall mean care, treatment,
    12  maintenance, and services described in paragraph (b) of subdivision  [1]
    13  one  of  section  three  hundred  sixty-seven-f  of this title, with the
    14  exception of short term rehabilitation, as defined by  the  commissioner
    15  of health.
    16    §  3.  Paragraph  (d)  of subdivision 5 of section 366-a of the social
    17  services law, as amended by section 12 of part D of chapter  56  of  the
    18  laws  of 2013, is relettered paragraph (e) and three new paragraphs (f),
    19  (g) and (h) are added to read as follows:
    20    (f) Notwithstanding paragraph (b) of subdivision two of  this  section
    21  and  paragraphs (a), (b), (c) and (d) of this subdivision, the following
    22  recipients will be recertified automatically, unless there  has  been  a
    23  finding of lack of eligibility for Medicaid:
    24    (i)  enrollees  in Medicaid managed long term care plans as defined in
    25  section forty-four hundred three-f of the public health law;
    26    (ii) enrollees in Medicaid managed care plans as  defined  in  section
    27  three  hundred  sixty-four-j  of  this  title  who receive personal care
    28  services pursuant to paragraph (e) of subdivision two of  section  three
    29  hundred sixty-five-a of this title or consumer directed personal assist-
    30  ance  services  pursuant  to  section three hundred sixty-five-f of this
    31  title;
    32    (iii) enrollees receiving Medicaid in the  Aged,  Blind  and  Disabled
    33  category  who  receive  fixed  income  from the Social Security Adminis-
    34  tration (SSA); and
    35    (iv) Medicare Savings Program (MSP) recipients who have a fixed income
    36  from the Social Security Administration (SSA).
    37    (g) Nothing in paragraph (e) of this subdivision should  be  construed
    38  to  alter a Medicaid recipient's obligation to inform the public welfare
    39  district of changes in income or other factors that might impact  eligi-
    40  bility pursuant to subdivision four of this section.
    41    (h)  Upon  a  finding of lack of eligibility, recipients identified in
    42  paragraph (e) of this subdivision will be entitled to notice and hearing
    43  rights as provided in section twenty-two of this chapter.
    44    § 4. This act shall take effect on the one hundred eightieth day after
    45  it shall have become a law; provided that the  amendments  to  paragraph
    46  (b)  of subdivision 7 of section 4403-f of the public health law made by
    47  section one of this act shall be subject to the expiration and reversion
    48  of such paragraph and shall expire and be deemed repealed therewith  and
    49  provided  further  that  such  amendments shall not affect the repeal of
    50  such section and shall expire and be deemed repealed  therewith.  Effec-
    51  tive  immediately, the commissioner of health shall make regulations and
    52  take other actions reasonably necessary to implement this  act  on  that
    53  date.