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S08090 Summary:

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S08090 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
            S. 8090                                                 A. 11372
 
                SENATE - ASSEMBLY
 
                                      June 7, 2010
                                       ___________
 
        IN  SENATE  --  Introduced  by  COMMITTEE ON RULES -- (at request of the
          Governor) -- read twice and ordered printed, and when  printed  to  be
          committed to the Committee on Finance
 
        IN  ASSEMBLY  --  Introduced by COMMITTEE ON RULES -- (at request of the
          Governor) -- read once and referred to the Committee on Ways and Means
 
        AN ACT

          to amend the public health law, the state finance law, and  the  elder
        law,  in  relation to various public health programs; to amend the elder
        law, in relation to the elderly pharmaceutical insurance program; and to
        repeal certain provisions of the public health law and the state finance
        law relating thereto (Part A); in relation to general hospital  indigent
        care pools, and preferred drug programs; to amend the public health law,
        in  relation to reimbursements; to amend the social services law and the
        public health law, in relation to prescription drug coverage  for  needy
        persons;  to amend the general business law and the social services law,
        in relation to authorizing moneys paid in advance for  funeral  merchan-
        dise  or  services for family members; to amend the social services law,
        in relation to authorizing the commissioner of health to assume  respon-

        sibility  for  transportation  costs; to amend the public health law, in
        relation to covering  medically  necessary  orthodontia;  to  amend  the
        social  services law, in relation to eligibility for medical assistance;
        to amend  the  public  health  law,  in  relation  to  general  hospital
        reimbursement rate periods; to amend part C of chapter 58 of the laws of
        2005 amending the public health law and other laws relating to authoriz-
        ing  reimbursements  for  expenditures made by social services districts
        for medical assistance, in relation to medicaid services; to amend  part
        A  of  chapter  57  of the laws of 2006 amending the social services law
        relating to medically fragile children, in relation to the effectiveness
        of provisions; to amend the social services law, in relation to  partic-
        ipation in certain federal medical assistance programs; to amend chapter

        33  of  the  laws  of  1998 amending the social services law relating to
        authorizing payment of Medicare part B  premiums  for  certain  Medicaid
        recipients,  in relation to making the provisions of such chapter perma-
        nent; to amend the public health law, in relation to residential  health
        care  facilities;  to  amend  part  D  of chapter 58 of the laws of 2009
        amending the public health law and other laws  relating  to  residential
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD12272-04-0
        S. 8090                             2                           A. 11372
 
        health   care   facilities,   in   relation  to  hospital  reimbursement

        provisions; and providing for the  repeal  of  certain  provisions  upon
        expiration  thereof  (Part  B; to authorize funding for the Consolidated
        Local  Street  and  Highway  Improvement Program (CHIPS) and Marchiselli
        program for state fiscal year 2010-2011; and to amend chapter 329 of the
        laws of 1991, amending the state finance law and other laws relating  to
        the  establishment  of  the  dedicated highway and bridge trust fund, in
        relation to funding therefor (Part C); to amend the navigation  law,  in
        relation to the authorized reimbursement rate paid to governmental enti-
        ties  (Part D); to amend the executive law, in relation to reimbursement
        for expenditures made by the office of children and family services  and
        providing  for  the  repeal  of  such provisions upon expiration thereof
        (Part E); and to amend the state finance law, in relation to the  school

        tax relief fund (Part F)
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. This act enacts into law major  components  of  legislation
     2  which are necessary to implement the state fiscal plan for the 2010-2011
     3  state  fiscal  year.  Each  component  is wholly contained within a Part
     4  identified as Parts A through F. The effective date for each  particular
     5  provision contained within such Part is set forth in the last section of
     6  such Part. Any provision in any section contained within a Part, includ-
     7  ing  the  effective date of the Part, which makes reference to a section
     8  "of this act", when used in connection with that  particular  component,
     9  shall  be  deemed  to mean and refer to the corresponding section of the
    10  Part in which it is found. Section three of  this  act  sets  forth  the

    11  general effective date of this act.
 
    12                                   PART A
 
    13    Section 1.  The title heading of title 1-A of article 24 of the public
    14  health law, as amended by chapter 300 of the laws of 1995, is amended to
    15  read as follows:
    16       [BREAST] CANCER DETECTION AND EDUCATION PROGRAM[; OVARIAN CANCER
    17                            INFORMATION PROGRAM]
    18    § 2. Section 2405 of the public health law, as added by chapter 328 of
    19  the laws of 1989, subdivision 1 as amended by chapter 554 of the laws of
    20  2002  and  paragraphs (a) and (d) of subdivision 2 as amended by chapter
    21  515 of the laws of 2003, is amended to read as follows:
    22    § 2405. [Breast cancer] Cancer detection and education program; estab-
    23  lishment.  1. There is hereby created within the department the [breast]

    24  cancer detection and education program, also known as the [healthy women
    25  partnership] cancer services program.   This program is  established  to
    26  promote  screening  and  detection  of [breast] cancer among unserved or
    27  underserved populations, to educate the public regarding [breast] cancer
    28  and the benefits of early  detection,  and  to  provide  counseling  and
    29  referral  services.  For  purposes  of this section, "unserved or under-
    30  served populations" shall mean  persons  having  inadequate  access  and
    31  financial  resources  to  obtain [breast] cancer screening and detection
    32  services, including persons who lack health insurance  or  whose  health
    33  insurance  coverage  is  inadequate  or who cannot meet their deductible
    34  obligations for purposes of accessing coverage under their health insur-
    35  ance.

        S. 8090                             3                           A. 11372
 
     1    2. The program shall include:
     2    (a)  establishment  of  a  statewide  public  education  and  outreach
     3  campaign to publicize  [breast]  evidence  based  cancer  detection  and
     4  education  services,  such  campaign  shall  include:  general community
     5  education, outreach to specific underserved populations, evidence  based
     6  clinical  [breast] cancer screening services [and follow-up care, infor-
     7  mation on the extent of coverage for such services by health  insurance,
     8  the  medical  assistance program and other public and private programs],
     9  and an informational summary that shall include an  explanation  of  the

    10  importance  of clinical [breast] examinations[, breast-self-examinations
    11  and mammography,] and what to expect during [a] clinical  [breast  exam-
    12  ination]  examinations and [mammography, and how to perform breast-self-
    13  examinations] cancer screening services;
    14    (b) provision of grants to approved organizations under section  twen-
    15  ty-four hundred six of this title;
    16    (c)  compilation  of data concerning the [breast] cancer detection and
    17  education program and dissemination of the data to the public; and
    18    (d) development of professional education programs including the bene-
    19  fits of early detection of  [breast]  cancer[,]  and  clinical  [breast]

    20  examinations  [and  breast-self-examinations], the recommended frequency
    21  of  clinical  [breast]  examinations[,  breast-self-examinations,]   and
    22  [mammography]  cancer  screening services, and professionally recognized
    23  best practices guidelines.
    24    § 3. Subdivisions 2 and 3 of section 2406 of the public health law are
    25  REPEALED.
    26    § 4. Section 2409 of the public health law, as added by chapter 275 of
    27  the laws of 1995, is REPEALED.
    28    § 5. Subdivisions 2 and 3 of section 95-a of the state finance law, as
    29  added by chapter 275 of the  laws  of  1995,  are  amended  to  read  as
    30  follows:
    31    2. Such fund shall consist of all monies appropriated [for the purpose
    32  of]  to  such  fund  and  any grant, gift or bequest made to the [breast

    33  cancer detection and education program advisory council] fund.
    34    3. Monies of the  fund  shall  be  available  [to  the  breast  cancer
    35  detection  and  education  program advisory council] for the purposes of
    36  the [New York state innovation in breast] cancer [early]  detection  and
    37  [research  awards]  education  program,  pursuant to section twenty-four
    38  hundred [nine] five of the public health law.
    39    § 6. Subdivision 3-a of section 2407  of  the  public  health  law  is
    40  REPEALED.
    41    §  7.  Subdivisions 1, 4, 5 and 6 of section 2406 of the public health
    42  law, subdivision 1 as amended by chapter 176 of the laws of 2006, subdi-
    43  vision 4 as amended and subdivision 5 as renumbered by  chapter  334  of

    44  the  laws  of 1990, subdivision 5 as added by chapter 328 of the laws of
    45  1989, and subdivision 6 as added by chapter 323 of the laws of 1995, are
    46  amended to read as follows:
    47    1. The commissioner[, in consultation with the breast cancer detection
    48  and education program advisory council established pursuant  to  section
    49  twenty-four  hundred  seven of this title,] shall make grants within the
    50  amounts appropriated to approved organizations[, as defined in  subdivi-
    51  sion  three  of this section,] for the provision of services relating to
    52  the evidence based screening and detection of [breast] cancer as part of
    53  this program. Such services shall include but not be limited to:
    54    (a) promotion and provision of early  detection  of  [breast]  cancer,

    55  including [mammography,] clinical [examination, and breast self-examina-
    56  tion] examinations and cancer screening services;
        S. 8090                             4                           A. 11372
 
     1    (b)  provision  of counseling and information on treatment options and
     2  referral for appropriate medical treatment;
     3    (c)  dissemination  of  information  to unserved and underserved popu-
     4  lations, to the general public and to health care professionals concern-
     5  ing [breast] cancer, the benefits of early detection and treatment,  and
     6  the availability of [breast] cancer screening services;
     7    (d)  identification of local [breast] cancer screening services within
     8  the approved organization's region;

     9    (e) provision of information,  counseling  and  referral  services  to
    10  individuals diagnosed with [breast] cancer; and
    11    (f)  provision  of  information  regarding the availability of medical
    12  assistance, including medical assistance under paragraph (v) of subdivi-
    13  sion four of section three hundred sixty-six of the social services law,
    14  to an individual who requires treatment for [breast, cervical, colon  or
    15  prostate] cancer.
    16    [4.]  2.  The  commissioner[,  in  consultation with the breast cancer
    17  detection and education program advisory council,] shall give notice and
    18  provide opportunity [for organizations described in subdivision three of
    19  this  section]  to  submit  applications  to  provide  [breast]   cancer

    20  detection  and education programs. In order to be considered for a grant
    21  to provide [breast] cancer detection and education programs,  applicants
    22  must show evidence of the following:
    23    (a)  ability  to provide and to ensure consistent and quality [breast]
    24  cancer detection services;
    25    (b) expertise in [breast] cancer detection and treatment;
    26    (c) capacity to coordinate services  with  physicians,  hospitals  and
    27  other appropriate local institutions or agencies;
    28    (d)  ability  to  provide  [breast]  cancer  detection  and  education
    29  services to unserved or underserved populations; and
    30    (e) ability to implement a [breast]  cancer  detection  and  education
    31  program in accordance with the standards specified in subdivision [five]
    32  three of this section.

    33    Applications shall be made on forms provided by the commissioner. [The
    34  breast  cancer  detection  and  education program advisory council shall
    35  review and evaluate applications and make recommendations to the commis-
    36  sioner for approval of grants to organizations to provide breast  cancer
    37  detection and education programs.]
    38    [5.]  3.  The  commissioner[,  in  consultation with the breast cancer
    39  detection and education program advisory council,] shall develop  stand-
    40  ards  for  the implementation of [breast] cancer detection and education
    41  programs by approved organizations which shall ensure the following:
    42    (a) integration of the approved organization with existing health care
    43  providers;
    44    (b) maximizing third party reimbursement;

    45    (c) provision of services to unserved or underserved populations.
    46    [6.] 4. Within the amounts of state or federal funds appropriated  for
    47  [cervical]  cancer early detection and diagnosis, approved organizations
    48  may be authorized by the department to provide such services  for  popu-
    49  lations  served  pursuant  to this title. Early detection services shall
    50  include, but not be limited to,  complete  [pelvic]  examinations,  [pap
    51  smears,]   evidence  based  screening,  patient  education,  counseling,
    52  follow-up and referral.
    53    § 8.  Section 2406-a of the public health law, as added by chapter 623
    54  of the laws of 2007, is amended to read as follows:
    55    § 2406-a. Grants to community-based organizations. 1. The  commission-

    56  er[,  in  consultation with the breast and cervical cancer detection and
        S. 8090                             5                           A. 11372

     1  education program advisory council established pursuant to section twen-
     2  ty-four hundred seven of this title,] shall make grants within any  such
     3  amount as may be appropriated specifically for community-based organiza-
     4  tions  for  the provision of counseling, education and outreach programs
     5  for persons diagnosed with breast cancer.
     6    2. For the purposes of this section,  "community-based  organizations"
     7  shall  mean  grass  roots,  free-standing  organizations in which breast
     8  cancer survivors hold significant  decision-making  responsibility,  and
     9  which  offer  a  broad  range  of  breast  cancer  education and support
    10  services free of charge.

    11    3. The commissioner[, in consultations with the  breast  and  cervical
    12  cancer  detection and education program advisory council,] shall provide
    13  notice and  opportunity  for  community-based  organizations  to  submit
    14  applications  to provide post-diagnosis breast cancer counseling, educa-
    15  tion and outreach programs. Such applications shall be on  forms  estab-
    16  lished  by  the  commissioner. [The breast and cervical cancer detection
    17  and education program advisory council shall review and evaluate  appli-
    18  cations  submitted pursuant to this subdivision and shall make recommen-
    19  dations thereon to the commissioner for approval of grants  to  communi-
    20  ty-based organizations for the provision of post-diagnosis breast cancer
    21  counseling, education and outreach programs.]

    22    § 9. Intentionally omitted.
    23    § 10. Intentionally omitted.
    24    § 11. Section 2799-f of the public health law, as added by chapter 114
    25  of the laws of 2004, is amended to read as follows:
    26    §  2799-f.  Comprehensive  care  centers  for eating disorders; estab-
    27  lished.  [1.] The commissioner shall [facilitate the  development,  and]
    28  provide  for  the public identification[,] of comprehensive care centers
    29  for persons with eating disorders[. The development  and  identification
    30  of such centers shall be] for the purposes of:
    31    [(a)]  1.  Promoting the [development and] operation of a continuum of
    32  comprehensive, coordinated care for persons with eating disorders;
    33    [(b)] 2. Promoting ready access to information, referral and treatment

    34  services  on  eating  disorders  for  consumers,  health  practitioners,
    35  providers and insurers, with access in every region of the state;
    36    [(c)]  3.  Promoting community education, prevention and patient entry
    37  into care; and
    38    [(d)] 4. Promoting and coordinating regional  and  statewide  research
    39  efforts  into  effective methods of education, prevention and treatment,
    40  including research on the various models of care.
    41    [2. In order to identify such comprehensive care centers, the  commis-
    42  sioner  shall issue a request for applications ("hereinafter referred to
    43  in this section as RFA"). The form and content  of  such  RFA  shall  be
    44  prepared  with input from individuals and organizations who at a minimum

    45  are representative of  health  care  practitioners  and  providers  with
    46  expertise  in  the care of persons with eating disorders as well as from
    47  persons and families with experience in the diagnosis and  treatment  of
    48  these  disorders.  Such  RFA  shall be issued not later than one hundred
    49  twenty days following the effective date of this article.]
    50    § 12. Paragraph (d) of subdivision 1 of section 2799-g of  the  public
    51  health  law,  as added by chapter 114 of the laws of 2004, is amended to
    52  read as follows:
    53    (d) The applicant meets such additional criteria as [is  specified  in
    54  the RFA] are established by the commissioner.
    55    §  13.  Subdivision  2  of section 2799-h of the public health law, as
    56  added by chapter 114 of the laws of 2004, is amended to read as follows:

        S. 8090                             6                           A. 11372
 
     1    2. The commissioner's [written notice to applicants,  which  shall  be
     2  provided  no later than ninety days following the receipt of a satisfac-
     3  tory application, shall identify the applicant  as  a  state-identified]
     4  identification of a comprehensive care center for eating disorders under
     5  this article[, provided however that such notice] shall be valid for not
     6  more  than a two year period from the date of issuance. The commissioner
     7  may reissue such [written notices] identifications for subsequent  peri-
     8  ods  of up to two years, provided that the comprehensive care center has
     9  notified the commissioner of any material changes in structure or opera-

    10  tion based on its original [RFA submission] application,  or  since  its
    11  last  written  notice  by the commissioner, and that the commissioner is
    12  satisfied that the center continues to meet the criteria required pursu-
    13  ant to this article.
    14    § 14. Sections  2799-j  and  2799-l  of  the  public  health  law  are
    15  REPEALED.
    16    §  15.  Section 95-e of the state finance law, as added by chapter 114
    17  of the laws of 2004, is REPEALED.
    18    § 16. Section 207 of the public health law, as added by chapter 414 of
    19  the laws of 2005, subdivision 1 as amended by chapter 471 of the laws of
    20  2007, paragraph (f) of subdivision 1 as added by chapter 570 of the laws
    21  of 2008 and paragraph (f) of subdivision 1 as added by  chapter  573  of
    22  the laws of 2008, is amended to read as follows:

    23    §  207.  Health  care  and wellness education and outreach program. 1.
    24  There is hereby created within the department the health care and  well-
    25  ness  education and outreach program. The department [shall] may conduct
    26  education and outreach programs for consumers, patients, and health care
    27  providers relating to any health care  matters  the  commissioner  deems
    28  appropriate and:
    29    (a) Various health conditions, diseases and health care procedures and
    30  treatment options, including but not limited to those for breast, cervi-
    31  cal,  colorectal, prostate, testicular, skin, and ovarian cancer, shaken
    32  baby syndrome, reflex  sympathetic  dystrophy  syndrome  and  post-polio
    33  sequelae.
    34    (b)  Recommended  preventative  and  wellness  practices and services,

    35  including evidence based age and gender appropriate testing and  screen-
    36  ing exams and immunization schedules.
    37    (c)  Lymphedema, an abnormal swelling of the extremities including the
    38  causes and symptoms of lymphedema, the value of early detection,  possi-
    39  ble  options for treatment including their benefits and risks, and other
    40  relevant information and  the  recommendation  that  hospitals  treating
    41  breast cancer patients implement a lymphedema alert program by placing a
    42  bright pink wristband on the patient's affected arm.
    43    (d)  The  need  and importance of organ and tissue donation, including
    44  information about being registered as an  organ  and  tissue  donor  and
    45  executing documents of gift under article forty-three of this chapter.
    46    (e)  The  need  and  importance  for consumers and patients to have an

    47  advance directive, particularly a health care proxy, and  the  need  and
    48  importance  for  health  care  providers  to  play  a leadership role in
    49  discussing end-of-life care preferences and values with patients and  to
    50  provide patients with health care proxy forms.
    51    (f)  Uterine  fibroids,  an abnormal growth that occurs in the uterus,
    52  including the causes and symptoms of  uterine  fibroids,  the  value  of
    53  early detection, possible options for treatment including their benefits
    54  and risks, information on the elevated risk for minority women and other
    55  relevant information.
        S. 8090                             7                           A. 11372
 
     1    [(f)]  (g)  Improving  birth  outcomes,  including  the  importance of
     2  preconceptional care, early  prenatal  care,  considerations  of  health

     3  risks  during  pregnancy,  considerations of benefits and risks of labor
     4  and delivery options including, but not limited to, vaginal and cesarean
     5  section  delivery, elective or repeat cesarean sections, and appropriate
     6  use of drugs during delivery.
     7    2. Programs under this section, dealing with one or more subjects, may
     8  include but not be limited to any of the following elements:
     9    (a) educational and informational materials in print,  audio,  visual,
    10  electronic or other media;
    11    (b) public service announcements and advertisements; and
    12    (c)  establishment  of  toll-free  telephone  hotlines  and electronic
    13  services to provide information.
    14    3. The department [shall] may produce, make available  to  others  for
    15  reproduction,   or  contract  with  others  to  develop  such  materials

    16  mentioned in this section as the commissioner deems  appropriate.  These
    17  materials shall be made available to the public free of charge as appro-
    18  priate  or  for  a fee under certain circumstances. The commissioner may
    19  require where appropriate any health care provider to make these materi-
    20  als available to patients.
    21    4. In exercising any of his or her  powers  under  this  section,  the
    22  commissioner  [shall]  may  consult with appropriate health care profes-
    23  sionals, providers, consumers, and patients or organizations  represent-
    24  ing them.
    25    5.  The  commissioner  shall ensure that all information and materials
    26  produced pursuant to this section are maintained and updated to  reflect
    27  best practice recommendations.
    28    6.  The  commissioner  may  appoint  as  appropriate advisory councils

    29  relating to various matters that are or are proposed to be the  subjects
    30  of  programs  under this section. All such councils shall include repre-
    31  sentation of health care professionals, providers,  consumers,  patients
    32  and  other  appropriate  interests.  The  members  of the councils shall
    33  receive no compensation for their services, but shall be  allowed  their
    34  actual and necessary expenses incurred in performance of their duties.
    35    7.  In  addition  to  state funds appropriated for programs under this
    36  section, the commissioner may  accept  grants  from  public  or  private
    37  sources  for  these  programs.  The  commissioner, in administering this
    38  section, shall seek to coordinate the department's programs  with  other
    39  public  and  private  programs,  and  may undertake joint or cooperative
    40  programs with other public or private entities.

    41    8. The commissioner may  make  rules  and  regulations  necessary  and
    42  appropriate for implementation of this section.
    43    § 17. Article 43-C of the public health law is REPEALED.
    44    § 18. Section 2745 of the public health law is REPEALED.
    45    §  19. Paragraph (c) of subdivision 3 of section 242 of the elder law,
    46  as amended by section 4 of part A of chapter 58 of the laws of 2005,  is
    47  amended to read as follows:
    48    (c)  (1)  The  fact  that  some  of  an individual's prescription drug
    49  expenses are paid or reimbursable under the provisions of  the  medicare
    50  program  shall  not  disqualify an individual, if he or she is otherwise
    51  eligible, from receiving assistance under this title. In such cases, the
    52  state shall pay the portion of the cost of those prescriptions for qual-
    53  ified drugs for which no payment or reimbursement is made by  the  medi-

    54  care program or any federally funded prescription drug benefit, less the
    55  participant's co-payment required on the amount not paid by the medicare
    56  program.    [In  addition,  the  participant registration fee charged to
        S. 8090                             8                           A. 11372

     1  eligible program participants for  comprehensive  coverage  pursuant  to
     2  section  two  hundred  forty-seven of this title shall be waived for the
     3  portion of the annual coverage  period  that  the  participant  is  also
     4  enrolled  as  a  transitional  assistance  beneficiary  in  the medicare
     5  prescription drug discount card program, authorized  pursuant  to  title
     6  XVIII of the federal social security act, provided that: (i) any sponsor

     7  of  such  drug discount card program has signed an agreement to complete
     8  coordination of benefit functions with EPIC, and has  been  endorsed  by
     9  the EPIC panel; or (ii) any exclusive sponsor of such drug discount card
    10  program authorized pursuant to title XVIII of the federal social securi-
    11  ty  act  that  limits the participants to the medicare prescription drug
    12  discount card program sponsored by such exclusive sponsor, shall coordi-
    13  nate benefits available under such discount card program with EPIC.]
    14    (2) Coverage under this paragraph shall be available  only  after  the
    15  participant has first exhausted the first two levels of appeal available
    16  under  Part  D of title XVIII of the federal social security act and the

    17  appeal has been denied. During the  coverage  determination  and  appeal
    18  period,  the  elderly  pharmaceutical  insurance  coverage program shall
    19  provide up to a ninety day supply of the prescribed medication, or  such
    20  lesser  supply  as specified on the prescription, if: (i) the pharmacist
    21  notifies the prescriber that the participant's Medicare Part D plan  and
    22  the  elderly  pharmaceutical  insurance  coverage  program  have  denied
    23  payment for the prescribed medication and that if  the  prescriber  does
    24  not  choose  to change the prescription to a drug that is covered by the
    25  participant's Medicare Part D plan, a Medicare Part  D  appeal  must  be
    26  pursued;  and  (ii)  the  prescriber notifies the elderly pharmaceutical

    27  insurance coverage program of the prescriber's intent to provide  neces-
    28  sary  information  and cooperation in the pursuit of the Medicare Part D
    29  appeal. In instances where the pharmacist is unable to immediately reach
    30  the prescriber, the elderly pharmaceutical  insurance  coverage  program
    31  shall,  upon  the request of the pharmacist, authorize a three day emer-
    32  gency supply of the prescribed medication.  The  elderly  pharmaceutical
    33  insurance  coverage  program  shall authorize such additional ninety day
    34  supplies of the prescribed medication, or such lesser supply  as  speci-
    35  fied  on  the  prescription,  and  such  additional  three day emergency
    36  supplies as required to ensure coverage  of  the  prescribed  medication

    37  during the pendency of the Medicare Part D appeal.
    38    (3)  The  participant  registration  fee  charged  to eligible program
    39  participants for comprehensive coverage pursuant to section two  hundred
    40  forty-seven  of this title shall be waived for the portion of the annual
    41  coverage period that the participant is also enrolled as a full  subsidy
    42  individual  in  a  prescription drug or MA-PD plan under Part D of title
    43  XVIII of the federal social security act.
    44    § 19-a.  Subdivision 6 of section 250 of the elder law,  as  added  by
    45  section  31  of  part A of chapter 58 of the laws of 2008, is amended to
    46  read as follows:
    47    6. (a) The EPIC program shall be the payor of last resort for individ-
    48  uals qualified in both the EPIC program and title XVIII of  the  federal
    49  social  security  act (Medicare). For such individuals, no reimbursement

    50  shall be available under EPIC for covered drug expenses except:
    51    (i) where a prescription drug plan authorized by Part D of the federal
    52  social security act (referred to in this subdivision as a Medicare  Part
    53  D  plan)  has  approved  coverage  and EPIC has an obligation under this
    54  title to pay a portion of the participant's cost-sharing  responsibility
    55  under Medicare Part D; or
        S. 8090                             9                           A. 11372
 
     1    (ii)  where the provider pharmacy has certified that[: (1)] a Medicare
     2  Part D plan has denied coverage[, and  (2)  either,  after  consultation
     3  with   the  prescriber,  the  prescriber  has  declined  to  revise  the
     4  prescription to a drug that would be covered  by  the  Medicare  Part  D

     5  plan,  or  the provider pharmacy has been unable to contact the prescri-
     6  ber].
     7    (b) If the provider pharmacy certifies as set  forth  in  subparagraph
     8  (ii)  of  paragraph  (a) of this subdivision, the EPIC program shall pay
     9  for the drug as the primary payor[. If determined by the EPIC program to
    10  be practical and cost-effective, the program, or its  contractor,  shall
    11  attempt  to  obtain Medicare Part D coverage of the drug by initiating a
    12  Medicare Part D appeal. If the initial appeal is denied by the  Medicare
    13  Part D plan, the EPIC program shall pursue additional levels of Medicare
    14  Part  D  appeals  when  practical  and cost-effective] upon a showing of
    15  compliance with the notification and appeal provisions  of  subparagraph

    16  two  of paragraph (c) of subdivision three of section two hundred forty-
    17  two of this title.
    18    § 20. Article 27-I of the public health law is REPEALED.
    19    § 21.  This act shall take effect immediately and shall be  deemed  to
    20  have  been in full force and effect on and after April 1, 2010; provided
    21  however, that sections nineteen and nineteen-a of this  act  shall  take
    22  effect October 1, 2010.
 
    23                                   PART B
 
    24    Section 1.  Notwithstanding paragraph (c) of subdivision 10 of section
    25  2807-c  of the public health law, subdivision 2-b of section 2808 of the
    26  public health law, section 21 of chapter 1 of the laws of 1999, and  any
    27  other  contrary  provision  of  law, in determining rates of payments by
    28  state governmental agencies effective for services provided on and after

    29  April 1, 2010, for inpatient and outpatient services provided by general
    30  hospitals, for inpatient services and adult day health  care  outpatient
    31  services  provided  by  residential  health  care facilities pursuant to
    32  article 28 of the public health law, except for residential health  care
    33  facilities  that  provide  extensive nursing, medical, psychological and
    34  counseling support services to children, for home health  care  services
    35  provided  pursuant  to  article 36 of the public health law by certified
    36  home health agencies, long term home health care programs and AIDS  home
    37  care  programs,  and  for  personal  care  services provided pursuant to
    38  section 365-a of the social services law,  the  commissioner  of  health
    39  shall  apply  zero  trend  factor  projections  attributable to the 2010
    40  calendar year in accordance with paragraph  (c)  of  subdivision  10  of

    41  section  2807-c  of  the public health law, provided, however, that such
    42  zero trend factor projections for such 2010 calendar year shall also  be
    43  applied to rates of payment for personal care services provided in those
    44  local social services districts, including New York city, whose rates of
    45  payment  for such services are established by such local social services
    46  districts pursuant to a rate-setting exemption issued by the commission-
    47  er of health to such local social services districts in accordance  with
    48  applicable regulations, and provided further, however, that for rates of
    49  payment for assisted living program services provided on and after April
    50  1, 2010, trend factor projections attributable to the 2010 calendar year
    51  shall be established at zero percent.
    52    §  2.  Subparagraph  (v) of paragraph (b) of subdivision 35 of section

    53  2807-c of the public health law, as added by section  2  of  part  C  of
    54  chapter 58 of the laws of 2009, is amended to read as follows:
        S. 8090                            10                           A. 11372
 
     1    (v)  Such regulations [may] shall incorporate quality related measures
     2  pertaining to potentially preventable  complications  and  re-admissions
     3  (PPRs) and provide for rate adjustments or payment disallowances related
     4  to  PPRs,  which shall be calculated in accordance with methodologies as
     5  determined  by  the commissioner, provided, however, that such methodol-
     6  ogies shall be based on a risk adjusted comparison of the actual and the
     7  expected number of PPRs in a given hospital and with  benchmarks  estab-

     8  lished  by  the commissioner and provided further that such rate adjust-
     9  ments or payment disallowances shall result in an aggregate reduction in
    10  Medicaid payments of no less than thirty-five million  dollars  for  the
    11  period  July  first,  two  thousand  ten through March thirty-first, two
    12  thousand eleven and no less than forty-seven  million  dollars  for  the
    13  period  April first, two thousand eleven through March thirty-first, two
    14  thousand twelve; and provided further that the  regulations  promulgated
    15  pursuant  to  this  subparagraph  shall  be  effective on and after July
    16  first, two thousand ten, and provided further,  however,  that  for  the
    17  period  July  first,  two  thousand  ten through March thirty-first, two

    18  thousand twelve, such rate adjustments or  payment  disallowances  shall
    19  not apply to behavioral health PPRs; or to readmissions that occur on or
    20  after  fifteen  days  following an initial admission.   By no later than
    21  April first, two thousand  eleven  the  commissioner  shall  enter  into
    22  consultations with representatives of the health care facilities subject
    23  to  this section regarding potential prospective revisions to applicable
    24  methodologies and benchmarks set forth in regulations issued pursuant to
    25  this subparagraph;
    26    § 3. Section 2807-k of the public health law is amended  by  adding  a
    27  new subdivision 5-c to read as follows:
    28    5-c.  (a) Notwithstanding any contrary provision of law and subject to

    29  the availability of federal  financial  participation,  for  the  period
    30  July first, two thousand ten through December thirty-first, two thousand
    31  ten,  distributions  pursuant  to  this section and section twenty-eight
    32  hundred seven-w of this article, shall reflect an aggregate reduction of
    33  sixty-nine million  four hundred thousand dollars, based on the  propor-
    34  tion  of  each  hospital's  indigent care allocations to the total allo-
    35  cations of all hospitals' indigent care allocations prior to application
    36  of this reduction, provided, however, that such reductions shall not  be
    37  applied  to  distributions  to  major  public hospitals, including major
    38  public hospitals operated by public benefit corporations, and also shall

    39  not be applied to distributions  made  pursuant  to  subparagraph  (ii),
    40  (iii) or (iv) of paragraph (b) of subdivision five-b of this section.
    41    (b)  Notwithstanding  any contrary provision of law and subject to the
    42  availability of federal financial participation, for the period  January
    43  first,  two  thousand eleven through December thirty-first, two thousand
    44  eleven and each calendar year thereafter, distributions pursuant to this
    45  section and section twenty-eight hundred seven-w of this  article  shall
    46  reflect  an  aggregate  reduction  of  seventy-three million two hundred
    47  thousand dollars, based on the proportion of  each  hospital's  indigent
    48  care allocation to the total allocations of all hospitals' indigent care

    49  allocations  prior  to application of this reduction, provided, however,
    50  that such reductions shall not be  applied  to  distributions  to  major
    51  public  hospitals,  including  major public hospitals operated by public
    52  benefit corporations, and shall also not  be  applied  to  distributions
    53  made  pursuant  to  subparagraph (ii), (iii) or (iv) of paragraph (b) of
    54  subdivision five-b of this section.
    55    § 3-a.  Subdivision 35 of section 2807-c of the public health  law  is
    56  amended by adding a new paragraph (i) to read as follows:
        S. 8090                            11                           A. 11372
 
     1    (i) (i) Notwithstanding any inconsistent provision of this subdivision
     2  or  any  other contrary provision of law and subject to the availability

     3  of federal financial participation,   for the period   July  first,  two
     4  thousand  ten through March thirty-first, two thousand eleven, and  each
     5  state  fiscal  year period thereafter, the commissioner shall make addi-
     6  tional inpatient hospital payments up to  the  aggregate  upper  payment
     7  limit for inpatient hospital services after all other medical assistance
     8  payments, but not to exceed two hundred thirty-five million five hundred
     9  thousand  dollars  for  the  period July first, two thousand ten through
    10  March thirty-first, two  thousand  eleven  and  three  hundred  fourteen
    11  million dollars for each state fiscal year thereafter, to general hospi-
    12  tals,  other  than  major  public general hospitals, providing emergency

    13  room services and including safety net hospitals, which shall,  for  the
    14  purpose of this paragraph, be defined as having either: a Medicaid share
    15  of  total inpatient hospital discharges of at least thirty-five percent,
    16  including both fee-for-service and managed care discharges for acute and
    17  exempt services; or a Medicaid share of total  discharges  of  at  least
    18  thirty   percent,   including  both  fee-for-service  and  managed  care
    19  discharges for acute and exempt services, and also providing obstetrical
    20  services. Eligibility to receive such additional payments shall be based
    21  on data from the period two years prior to the rate year, as reported on
    22  the institutional cost report submitted to the department as of  October

    23  first  of  the  prior  rate year. Such payments shall be made as medical
    24  assistance payments  for  fee-for-service  inpatient  hospital  services
    25  pursuant  to title eleven of article five of the social services law for
    26  patients eligible for federal financial participation under title XIX of
    27  the federal social security act and in accordance with the following:
    28    (A) Thirty percent of such payments shall be allocated to  safety  net
    29  hospitals  based  on each eligible hospital's proportionate share of all
    30  eligible safety net hospitals' Medicaid discharges for inpatient  hospi-
    31  tal  services,  including both Medicaid fee-for-service and managed care
    32  discharges for acute and exempt services, based on data from the  period

    33  two  years prior to the rate year, as reported on the institutional cost
    34  report submitted to the department as of   October first  of  the  prior
    35  rate year;
    36    (B)  Seventy  percent  of such payments shall be allocated to eligible
    37  general hospitals based on each such hospital's proportionate  share  of
    38  all  eligible  hospitals'  Medicaid  discharges  for  inpatient hospital
    39  services, including  both  Medicaid  fee-for-service  and  managed  care
    40  discharges  for acute and exempt services, based on data from the period
    41  two years prior to the rate year, as  reported on the institutional cost
    42  report submitted to the department as of   October first  of  the  prior
    43  rate year;

    44    (C)  No  eligible general hospital's annual payment amount pursuant to
    45  this paragraph shall exceed the lower of  the sum of the annual  amounts
    46  due  that  hospital pursuant to section twenty-eight hundred seven-k and
    47  section twenty-eight hundred seven-w of this article;  or the hospital's
    48  facility specific  projected  disproportionate  share  hospital  payment
    49  ceiling  established  pursuant  to  federal law, provided, however, that
    50  payment amounts to eligible hospitals pursuant to  clauses (A)  and  (B)
    51  of  this  subparagraph  in excess of the lower of    such sum or payment
    52  ceiling shall be reallocated to eligible  hospitals  that  do  not  have
    53  excess  payment  amounts.   Such reallocations shall be  proportional to

    54  each such hospital's aggregate payment amount pursuant to   clauses  (A)
    55  and  (B)  of  this  subparagraph to the total of all payment amounts for
    56  such eligible hospitals;
        S. 8090                            12                           A. 11372
 
     1    (D) Subject to the availability of  federal  financial  participation,
     2  the  payment methodology  set forth in this subparagraph  may be further
     3  revised by the commissioner on an annual basis pursuant  to  regulations
     4  issued  pursuant  to  this  subdivision  for  periods on and after April
     5  first, two thousand eleven; and
     6    (E) Subject to the availability of federal financial participation and
     7  in  conformance  with  all  applicable federal statutes and regulations,

     8  such payments shall  be  made  as  upper  payment  limit  payments  and,
     9  further,  such  payments shall be  made as aggregate monthly payments to
    10  eligible general hospitals and provided further, however, that  payments
    11  made pursuant to this paragraph shall not be available for periods after
    12  the last day of the calendar year during which enhanced federal medicaid
    13  assistance percentages (FMAP) payments to general hospitals in the state
    14  of  New York pursuant to section five thousand one of the federal Ameri-
    15  can Recovery and Reinvestment Act of 2009, or pursuant to  an  otherwise
    16  applicable  federal  law, cease to be available, provided, however, that
    17  the department will in conjunction with hospital representatives  review

    18  the  impact  associated with the expiration of such funding availability
    19  no later than sixty days prior to such expiration.
    20    (ii) In the event that  the  commissioner  determines  that    federal
    21  financial  participation    will not be available for aggregate payments
    22  made in accordance with  clause  (E) of subparagraph (i) of  this  para-
    23  graph,  payments  pursuant  to  this paragraph shall be included as rate
    24  add-ons to medical assistance inpatient  rates  of  payment  established
    25  pursuant  to  this  subdivision  based on data from the period two years
    26  prior to the rate year, as reported on  the  institutional  cost  report
    27  submitted to the department as of  October first of the prior rate year,

    28  provided,  however,  that if such payments are made as rate add-ons, the
    29  commissioner shall establish a procedure to reconcile payment amounts to
    30  reflect changes in medical assistance utilization from  the  period  two
    31  years  prior  to the rate year and the actual rate year based on data as
    32  reported on each hospital's annual institutional  cost  report  for  the
    33  respective rate year, as submitted to the department as of October first
    34  of the year following the rate year.
    35    (iii) Notwithstanding any other law, rule or regulation to the contra-
    36  ry,  projections of each general hospital's disproportionate share limi-
    37  tations as computed by the commissioner  pursuant  to  applicable  regu-

    38  lations  shall be adjusted to reflect any additional revenue received or
    39  anticipated to be received by each such  general  hospital  pursuant  to
    40  this paragraph.
    41    §  3-b. Section 2807-k of the public health law is amended by adding a
    42  new subdivision 17 to read as follows:
    43    17. Indigent care reductions. For  each  hospital  receiving  payments
    44  pursuant  to paragraph (i) of subdivision thirty-five of section twenty-
    45  eight hundred seven-c of this article, the commissioner shall reduce the
    46  sum of any amounts paid pursuant  to  this  section  and    pursuant  to
    47  section  twenty-eight hundred seven-w of this article, as computed based
    48  on projected facility specific disproportionate share hospital ceilings,

    49  by an amount equal to the lower of such  sum  or  each  such  hospital's
    50  payments pursuant to paragraph (i) of subdivision thirty-five of section
    51  twenty-eight  hundred  seven-c  of this article, provided, however, that
    52  any additional aggregate reductions enacted in a chapter of the laws  of
    53  two  thousand  ten  to  the  aggregate  amounts payable pursuant to this
    54  section and  pursuant to section twenty-eight hundred  seven-w  of  this
    55  article  shall  be  applied  subsequent  to  the  adjustments  otherwise
    56  provided for in this subdivision.
        S. 8090                            13                           A. 11372
 
     1    § 3-c. Section 2807-w of the public health law is amended by adding  a
     2  new subdivision 5 to read as follows:

     3    5.  For  each hospital receiving payments pursuant to paragraph (i) of
     4  subdivision thirty-five of section twenty-eight hundred seven-c  of this
     5  article, the commissioner shall reduce  the  sum  of  any  amounts  paid
     6  pursuant  to  this section and  pursuant to section twenty-eight hundred
     7  seven-k of this article,  as  computed  based    on  projected  facility
     8  specific  disproportionate  share hospital ceilings,  by an amount equal
     9  to the lower of such sum or each such hospital's  payments  pursuant  to
    10  paragraph (i) of subdivision thirty-five of section twenty-eight hundred
    11  seven-c   of this article, provided, however, that any additional aggre-
    12  gate reductions enacted in a chapter of the laws of two thousand ten  to

    13  the  aggregate amounts payable pursuant to this section and  pursuant to
    14  section twenty-eight hundred seven-k of this article  shall  be  applied
    15  subsequent  to  the  adjustments otherwise provided for in this subdivi-
    16  sion.
    17    § 3-d. Paragraph (d) of subdivision 18 of section 2807-c of the public
    18  health law, as amended by section 12 of part A of chapter 58 of the laws
    19  of 2007, is amended to read as follows:
    20    (d) Gross revenue received shall mean all moneys received  for  or  on
    21  account  of  inpatient hospital service, provided, however, that subject
    22  to the provisions of paragraph (e) of  this  subdivision  gross  revenue
    23  received  shall not include distributions from bad debt and charity care
    24  regional pools, health care services pools, bad debt  and  charity  care

    25  for  financially  distressed  hospitals statewide pools and bad debt and
    26  charity care and capital statewide pools created in accordance with this
    27  section or distributions from funds allocated in accordance with section
    28  twenty-eight hundred seven-l, twenty-eight hundred seven-k, twenty-eight
    29  hundred seven-v or twenty-eight hundred  seven-w  of  this  article  and
    30  shall  not include the components of rates of payment or charges related
    31  to the allowances provided in  accordance  with  subdivisions  fourteen,
    32  fourteen-b  and  fourteen-c  of this section, the adjustment provided in
    33  accordance with subdivision fourteen-a of this section,  the  adjustment
    34  provided  in accordance with subdivision fourteen-d of this section, the
    35  adjustment  for  health  maintenance  organization  reimbursement  rates
    36  provided  in  accordance  with former subdivision two-a of this section,

    37  payments made pursuant to paragraph (i) of  subdivision  thirty-five  of
    38  this  section  or,  if  effective, the adjustment provided in accordance
    39  with subdivision fifteen of this section,  the  adjustment  provided  in
    40  accordance with section eighteen of chapter two hundred sixty-six of the
    41  laws  of  nineteen  hundred eighty-six as amended, revenue received from
    42  physician practice  or  faculty  practice  plan  discrete  billings  for
    43  private  practicing  physician services, revenue from affiliation agree-
    44  ments or contracts with public hospitals for the delivery of health care
    45  services at such public hospitals, revenue received as  disproportionate
    46  share hospital payments in accordance with title nineteen of the federal
    47  social  security  act,  or  revenue  from  government deficit financing,
    48  provided, however, that funds received as  medical  assistance  payments

    49  which  include  state share amounts authorized pursuant to section twen-
    50  ty-eight hundred seven-v of this article that are  not  disproportionate
    51  share  hospital  payments  shall be included within the meaning of gross
    52  revenue for purposes of this subdivision.
    53    § 3-e. Paragraph (a) of subdivision 3 of section 2807-d of the  public
    54  health law, as amended by section 13 of part D of chapter 57 of the laws
    55  of 2006, is amended to read as follows:
        S. 8090                            14                           A. 11372
 
     1    (a)  for  general  hospitals, all monies received for or on account of
     2  inpatient  hospital  service,  outpatient  service,  emergency  service,
     3  referred  ambulatory  service  and ambulatory surgical service, or other
     4  hospital  or  health-related  services,  excluding,   subject   to   the

     5  provisions of subdivision twelve of this section: distributions from bad
     6  debt  and  charity  care  regional  pools,  primary health care services
     7  regional pools, bad debt and charity  care  for  financially  distressed
     8  hospitals  statewide  pools  and  bad  debt and charity care and capital
     9  statewide pools created in accordance with section twenty-eight  hundred
    10  seven-c of this article and the components of rates of payment or charg-
    11  es  related  to  the allowances provided in accordance with subdivisions
    12  fourteen, fourteen-b and fourteen-c, the adjustment provided in  accord-
    13  ance  with subdivision fourteen-a, the adjustment provided in accordance
    14  with subdivision  fourteen-d,  the  adjustment  for  health  maintenance
    15  organization  reimbursement  rates  provided  in accordance with section
    16  twenty-eight hundred seven-f of this article, the adjustment for commer-

    17  cial insurer reimbursement rates provided in accordance  with  paragraph
    18  (i)  of  subdivision  eleven  of section twenty-eight hundred seven-c of
    19  this article or, if effective, the  adjustment  provided  in  accordance
    20  with subdivision fifteen of section twenty-eight hundred seven-c of this
    21  article  or  the adjustment provided in accordance with section eighteen
    22  of chapter two hundred sixty-six of the laws of nineteen hundred  eight-
    23  y-six as amended and physician practice or faculty practice plan revenue
    24  received  by  a  general hospital based on discrete billings for private
    25  practicing physician services, revenue received by  a  general  hospital
    26  from a public hospital pursuant to an affiliation agreement contract for
    27  the  delivery  of  health care services to such public hospital, revenue
    28  received pursuant to paragraph (i) of subdivision thirty-five of section

    29  twenty-eight hundred seven-c of this article, revenue received  pursuant
    30  to  section  twenty-eight  hundred  seven-w of this article, all revenue
    31  received as disproportionate share hospital payments, in accordance with
    32  title nineteen of the federal  Social  Security  Act,  revenue  received
    33  pursuant  to sections eleven, twelve, thirteen and fourteen of part A of
    34  chapter one of the laws of two thousand two, revenue  received  pursuant
    35  to  sections  thirteen and fourteen of part B of chapter one of the laws
    36  of two thousand two, revenue  from  patient  personal  fund  allowances,
    37  revenue  from  income  earned  on  patient funds, investment income from
    38  externally restricted funds,  revenue  from  investment  sinking  funds,
    39  revenue  from  investment  operating  escrow accounts, investment income
    40  from funded depreciation,  investment  income  from  mortgage  repayment

    41  escrow  accounts,  revenue derived from the operation of schools leading
    42  to licensure, and revenue from the collection of sales and excise taxes;
    43    § 4. The opening paragraph and subparagraph (i) of  paragraph  (b)  of
    44  subdivision  5-a of section 2807-m of the public health law, the opening
    45  paragraph as amended by section 98 of part C of chapter 58 of  the  laws
    46  of  2009,  and  subparagraph  (i)  as added by section 75-c of part C of
    47  chapter 58 of the laws of 2008, are amended  and  subparagraph  (ii)  of
    48  paragraph  (b)  of  subdivision  5-a  is  renumbered subdivision 5-b and
    49  amended to read as follows:
    50    Empire clinical research investigator program (ECRIP) [and other grad-
    51  uate medical education reforms. Thirty]. Nine million [four] one hundred

    52  twenty thousand dollars annually for the period January first, two thou-
    53  sand nine through December thirty-first, two thousand ten,  and  [seven]
    54  two  million  [six]  two  hundred eighty thousand dollars for the period
    55  January first, two thousand eleven through March thirty-first, two thou-
    56  sand eleven, shall be set aside and reserved by  the  commissioner  from
        S. 8090                            15                           A. 11372
 
     1  the  regional  pools  established  pursuant  to  subdivision two of this
     2  section to be allocated regionally  with  two-thirds  of  the  available
     3  funding  going  to  New York city and one-third of the available funding
     4  going  to  the rest of the state and shall be available for distribution
     5  as follows:

     6    [(i)] Distributions shall first be  made  to  consortia  and  teaching
     7  general  hospitals for the empire clinical research investigator program
     8  (ECRIP) to help secure federal funding for  biomedical  research,  train
     9  clinical  researchers,  recruit  national  leaders  as faculty to act as
    10  mentors, and train residents and fellows in biomedical  research  skills
    11  based on hospital-specific data submitted to the commissioner by consor-
    12  tia and teaching general hospitals in accordance with clause (G) of this
    13  subparagraph.  Such  distributions  shall be made in accordance with the
    14  following methodology:
    15    (A) The greatest number of clinical research  positions  for  which  a
    16  consortium  or  teaching general hospital may be funded pursuant to this
    17  subparagraph shall be one percent  of  the  total  number  of  residents

    18  training  at  the consortium or teaching general hospital on July first,
    19  two thousand eight for the  period  January  first,  two  thousand  nine
    20  through December thirty-first, two thousand nine rounded up to the near-
    21  est one position.
    22    (B)  Distributions  made  to a consortium or teaching general hospital
    23  shall equal the product of the total number of clinical  research  posi-
    24  tions  submitted  by  a  consortium  or  teaching  general  hospital and
    25  accepted by the commissioner as meeting the criteria set forth in  para-
    26  graph  (b)  of subdivision one of this section, subject to the reduction
    27  calculation set forth in clause (C)  of  this  subparagraph,  times  one
    28  hundred ten thousand dollars.
    29    (C)  If  the  dollar  amount for the total number of clinical research
    30  positions in the region  calculated  pursuant  to  clause  (B)  of  this

    31  subparagraph exceeds thirty percent of the funding available pursuant to
    32  this  paragraph,  or an amount equal to the sum of one clinical research
    33  position per teaching general  hospital  in  the  region,  whichever  is
    34  greater,  including  clinical  research positions that continue from and
    35  were funded in prior distribution periods, the commissioner shall elimi-
    36  nate one-half of the  clinical  research  positions  submitted  by  each
    37  consortium  or teaching general hospital rounded down to the nearest one
    38  position. Such reduction shall be repeated until the dollar  amount  for
    39  the  total  number of clinical research positions in the region does not
    40  exceed thirty percent of the regional pool, or an amount  equal  to  the
    41  sum  of  one clinical research position per teaching general hospital in
    42  the region, whichever is greater. No clinical  research  positions  that

    43  continue  from  and  were  funded in prior distribution periods shall be
    44  eliminated by such reduction.
    45    (D) Each consortium or teaching general hospital shall  receive  fifty
    46  percent  of  its  annual distribution amount calculated pursuant to this
    47  subparagraph once the requirements set  forth  in  clause  (G)  of  this
    48  subparagraph  have  been met. The remaining distribution amount shall be
    49  disbursed subsequent to the submission of information required  pursuant
    50  to clause (G) of this subparagraph.
    51    (E)  Each  consortium  or teaching general hospital receiving distrib-
    52  utions pursuant to this subparagraph shall reserve seventy-five thousand
    53  dollars to primarily fund salary and fringe  benefits  of  the  clinical
    54  research  position  with  the remainder going to fund the development of
    55  faculty who are involved in biomedical research, training  and  clinical
    56  care.

        S. 8090                            16                           A. 11372
 
     1    (F)  Undistributed  or  returned  funds  available  to  fund  clinical
     2  research positions pursuant to this paragraph for a distribution  period
     3  shall  be  available to fund clinical research positions in a subsequent
     4  distribution period.
     5    (G) In order to be eligible for distributions pursuant to this subpar-
     6  agraph,  each  consortium and teaching general hospital shall provide to
     7  the commissioner by July first of each distribution period, the  follow-
     8  ing  data  and  information  on a hospital-specific basis. Such data and
     9  information shall be certified as to accuracy and  completeness  by  the
    10  chief executive officer, chief financial officer or chair of the consor-
    11  tium  governing body of each consortium or teaching general hospital and

    12  shall be maintained by each consortium and teaching general hospital for
    13  five years from the date of submission:
    14    (I) For each clinical research  position,  information  on  the  type,
    15  scope,  training  objectives,  institutional  support, clinical research
    16  experience of the sponsor-mentor, plans for submitting research outcomes
    17  to peer reviewed journals and at scientific meetings, including a  meet-
    18  ing  sponsored by the department, the name of a principal contact person
    19  responsible for tracking the career development of researchers placed in
    20  clinical research positions, as defined in paragraph (c) of  subdivision
    21  one of this section, and who is authorized to certify to the commission-
    22  er  that  all  the requirements of the clinical research training objec-
    23  tives set forth in this subparagraph shall be  met.  Such  certification

    24  shall be provided by July first of each distribution period;
    25    (II)  For  each  clinical  research position, information on the name,
    26  citizenship status, medical education and training, and medical  license
    27  number  of  the researcher, if applicable, shall be provided by December
    28  thirty-first of the calendar year following the distribution period;
    29    (III) Information on the status of the clinical research plan,  accom-
    30  plishments, changes in research activities, progress, and performance of
    31  the  researcher shall be provided six months after the clinical research
    32  position has commenced and every six months thereafter for  a  full-time
    33  position  and  for  a  half-time  position,  one year after the clinical
    34  research position has commenced and every year thereafter;
    35    (IV) A final report detailing training  experiences,  accomplishments,

    36  activities  and  performance of the clinical researcher, and data, meth-
    37  ods, results and  analyses  of  the  clinical  research  plan  shall  be
    38  provided three months after the clinical research position ends; and
    39    (V)  Any  other  data  or  information required by the commissioner to
    40  implement this subparagraph.
    41    [(ii)] 5-b.  Other  graduate  medical  education  reforms.  Any  funds
    42  [remaining  after  distributions  in  accordance  with subparagraph (i)]
    43  specifically appropriated for the purposes of this [paragraph]  subdivi-
    44  sion shall be used to fund innovative graduate medical education reforms
    45  to  be  determined by the commissioner in consultation with the council,
    46  including, but not limited to, [(A)] (a)  development  of  primary  care

    47  residency  and specialty position training tracks for graduates to serve
    48  rural or inner-city communities, [(B)] (b) development of regional pilot
    49  network programs to affiliate  major  academic  centers  with  community
    50  teaching  general  hospitals,  [(C)] (c) support for faculty development
    51  programs, including designating faculty to mentor students and residents
    52  in primary care, [(D)] (d) support training in fields  which  serve  the
    53  geriatric  population;  [(E)]  (e)  increase training in cultural compe-
    54  tence, [(F)] (f) promote training of physicians who will  serve  persons
    55  with  developmental disabilities, and [(G)] (g) any other reforms neces-
    56  sary to improve patient care management, interdisciplinary training,  or

        S. 8090                            17                           A. 11372
 
     1  quality  in  graduate  medical education programs. Such funding shall be
     2  distributed to consortia and teaching general hospitals in  each  region
     3  on a competitive basis pursuant to a request for proposal process.
     4    §  5.  Subdivision 8 of section 272 of the public health law, as added
     5  by section 10 of part C of chapter 58 of the laws of 2005, is amended to
     6  read as follows:
     7    8. The commissioner shall provide notice of any recommendations devel-
     8  oped by the committee regarding the preferred  drug  program,  at  least
     9  [thirty]  five  days before any final determination by the commissioner,
    10  by making such information available on the department's  website.  Such
    11  public  notice  shall  include:  a  summary  of the deliberations of the

    12  committee; a summary of the positions of those making public comments at
    13  meetings of the committee;  the  response  of  the  committee  to  those
    14  comments, if any; and the findings and recommendations of the committee.
    15    § 6.  Intentionally Omitted.
    16    § 7.  Intentionally Omitted.
    17    § 8.  Intentionally Omitted.
    18    § 9. Subparagraphs (vii) and (viii) of paragraph (uu) of subdivision 1
    19  of section 2807-v of the public health law, as amended by section 120 of
    20  part  C  of  chapter  58  of  the  laws  of 2009, are amended to read as
    21  follows:
    22    (vii) [seven] one million [five] eight hundred  seventy-five  thousand
    23  dollars  for  the period January first, two thousand ten through [Decem-
    24  ber] March thirty-first, two thousand ten shall be available for disease

    25  management demonstration programs[; and
    26    (viii) one million eight hundred seventy-five thousand dollars for the
    27  period January first, two thousand eleven  through  March  thirty-first,
    28  two  thousand  eleven  shall  be available for disease management demon-
    29  stration programs].
    30    § 10. Paragraph (jj) of subdivision 1 of section 2807-v of the  public
    31  health  law, as amended by section 5 of part B of chapter 58 of the laws
    32  of 2008, is amended to read as follows:
    33    (jj) Funds shall be reserved and accumulated from  year  to  year  and
    34  shall  be  available,  including  income  from  invested  funds, for the
    35  purposes of a grant program to improve access to  infertility  services,
    36  treatments and procedures, from the tobacco control and insurance initi-

    37  atives  pool  established for the period January first, two thousand two
    38  through December thirty-first, two thousand two in the  amount  of  nine
    39  million  one hundred seventy-five thousand dollars, for the period April
    40  first, two thousand six through March thirty-first, two  thousand  seven
    41  in  the  amount of five million dollars, for the period April first, two
    42  thousand seven through March thirty-first, two  thousand  eight  in  the
    43  amount of five million dollars, for the period April first, two thousand
    44  eight  through  March  thirty-first,  two thousand nine in the amount of
    45  five million dollars, and for the period April first, two thousand  nine
    46  through  March  thirty-first,  two  thousand  ten  in the amount of five
    47  million dollars, and for  the  period  April  first,  two  thousand  ten
    48  through  March thirty-first, two thousand eleven in the amount of [five]

    49  two million two hundred thousand dollars.
    50    § 11. Subparagraphs (vii) and (viii) of paragraph (qq) of  subdivision
    51  1 of section 2807-v of the public health law, as amended by section 5 of
    52  part  B  of  chapter  58  of  the  laws  of 2008, are amended to read as
    53  follows:
    54    (vii) up to [five million] four hundred eighty-eight thousand  dollars
    55  for  the period January first, two thousand ten through [December] March
    56  thirty-first, two thousand ten; of such funds [one  million  nine]  four
        S. 8090                            18                           A. 11372
 
     1  hundred [fifty] eighty-eight thousand dollars shall be made available to
     2  the  department for the purpose of developing, implementing and adminis-

     3  tering the long-term care insurance education and outreach program  [and
     4  three  million  fifty  thousand  dollars  shall be made available to the
     5  office for the aging for the purpose of  providing  the  long-term  care
     6  insurance  resource  centers  with  the necessary resources to carry out
     7  their operations; and
     8    (viii) up to one million two hundred fifty thousand  dollars  for  the
     9  period  January  first,  two thousand eleven through March thirty-first,
    10  two thousand eleven; of such funds four  hundred  eighty-seven  thousand
    11  five  hundred  dollars shall be made available to the department for the
    12  purpose of developing, implementing and administering the long-term care
    13  insurance education and outreach program  and  seven  hundred  sixty-two

    14  thousand  five hundred dollars shall be made available to the office for
    15  the aging for the purpose of  providing  the  long-term  care  insurance
    16  resource  centers  with the necessary resources to carry out their oper-
    17  ations].
    18    § 12. Subparagraphs (xi) and (xii) of paragraph (j) of  subdivision  1
    19  of  section  2807-v of the public health law, as amended by section 5 of
    20  part B of chapter 58 of the  laws  of  2008,  are  amended  to  read  as
    21  follows:
    22    (xi)  up  to  [ninety-four]  eighty-seven  million [one] seven hundred
    23  [fifty] seventy-five thousand dollars for the period January first,  two
    24  thousand ten through December thirty-first, two thousand ten; and

    25    (xii)  up  to  [twenty-three]  twenty-one  million [five] four hundred
    26  [thirty-seven] twelve thousand dollars for the period January first, two
    27  thousand eleven through March thirty-first, two thousand eleven.
    28    § 13. Subparagraph (iv) of paragraph (c) of subdivision 1  of  section
    29  2807-l  of  the  public health law, as amended by section 4 of part B of
    30  chapter 58 of the laws of 2008, is amended to read as follows:
    31    (iv) distributions by  the  commissioner  related  to  poison  control
    32  centers  pursuant  to subdivision seven of section twenty-five hundred-d
    33  of this chapter, up to five  million  dollars  for  the  period  January
    34  first,  nineteen  hundred  ninety-seven  through  December thirty-first,
    35  nineteen hundred ninety-seven, up to three million dollars on an annual-

    36  ized basis for the periods during the  period  January  first,  nineteen
    37  hundred  ninety-eight  through  December  thirty-first, nineteen hundred
    38  ninety-nine, up to five million dollars annually for the periods January
    39  first, two thousand through December thirty-first, two thousand two,  up
    40  to  four  million  six hundred thousand dollars annually for the periods
    41  January first, two thousand three  through  December  thirty-first,  two
    42  thousand  four,  up to five million one hundred thousand dollars for the
    43  period January first, two thousand five through  December  thirty-first,
    44  two  thousand  six  annually,  up  to  five million one hundred thousand
    45  dollars annually for  the  period  January  first,  two  thousand  seven
    46  through  December  thirty-first,  two  thousand [ten,] nine, up to three

    47  million six hundred thousand dollars for the period January  first,  two
    48  thousand  ten through December thirty-first, two thousand ten, and up to
    49  [one million two] seven hundred seventy-five thousand  dollars  for  the
    50  period  January  first,  two thousand eleven through March thirty-first,
    51  two thousand eleven; and
    52    § 14. Section 365-a of the social services law is amended by adding  a
    53  new subdivision 9 to read as follows:
    54    9. (a) Notwithstanding any inconsistent provision of law, any utiliza-
    55  tion controls on occupational therapy or physical therapy, including but
    56  not  limited  to,  prior approval of services, utilization thresholds or
        S. 8090                            19                           A. 11372
 

     1  other limitations imposed on such therapy  services  in  relation  to  a
     2  chronic condition in clinics certified under article twenty-eight of the
     3  public health law or article sixteen of the mental hygiene law shall be:
     4  (i) developed by the department of health in concurrence with the office
     5  of mental retardation and developmental disabilities; and (ii) in accord
     6  with  nationally  recognized  professional  standards. In the event that
     7  nationally recognized professional standards do not exist, such  thresh-
     8  olds  shall  be based upon the reasonably recognized professional stand-
     9  ards of those with a specific expertise in treating  individuals  served
    10  by clinics certified under article twenty-eight of the public health law

    11  or article sixteen of the mental hygiene law.
    12    (b)  Prior  approval by the department of health of a physical therapy
    13  evaluation or an occupational therapy evaluation by a qualified  practi-
    14  tioner  practicing  within  the  scope  of such practitioner's licensure
    15  shall not be required. The department may  require  prior  approval  for
    16  treatment  as recommended by such an evaluation. In the event that prior
    17  approval is required, and the department fails to make  a  determination
    18  within eight days of presentation of a treatment request for physical or
    19  occupational   therapy  services,  the  department  shall  automatically
    20  approve four therapy visits. In the  case  of  any  denial  of  a  prior

    21  approval  request  for  physical  therapy  or  occupational therapy, the
    22  department shall provide a  reasonable  opportunity  for  the  qualified
    23  practitioner to provide his or her assessment of the beneficiary's phys-
    24  ical  and  functional  status  as  documented  in  a treatment plan with
    25  reasonable and obtainable goals.  If, upon completion of such four ther-
    26  apy visits, the department has not yet rendered a determination  on  the
    27  request  for  physical  or occupational therapy services, the department
    28  shall automatically approve an additional four therapy visits.    Subse-
    29  quent  automatic approvals shall be issued in the same manner until such
    30  time as the department issues a determination, but  in  no  event  shall

    31  such  approvals  exceed  the  number  of  services or the period of time
    32  recommended by the evaluation.  If the qualified  practitioner  provides
    33  documentation  that is in accord with reasonably recognized professional
    34  standards, the recommended treatment plan shall be final, and the  prior
    35  approval request shall be approved.
    36    §  15.  Paragraph  (d)  of subdivision 1 of section 453 of the general
    37  business law, as amended by chapter 557 of the laws of 2001, is  amended
    38  to read as follows:
    39    (d) Moneys paid for such an agreement for an applicant or recipient of
    40  supplemental  security income benefits under section two hundred nine of
    41  the social services law or of medical  assistance  under  section  three
    42  hundred  sixty-six  of  such law, or moneys paid by such an applicant or

    43  recipient for such an agreement for his or her family member,  shall  be
    44  placed  into  a  trust  which  shall be irrevocable but under which such
    45  applicant/recipient reserves the  right  to  select  any  funeral  firm,
    46  funeral  director,  undertaker,  cemetery  or  any other person, firm or
    47  corporation to whom such payment is made and to  change  such  selection
    48  any  time  to any type of funeral or any funeral firm, funeral director,
    49  cemetery or any other person, firm or corporation to whom  such  payment
    50  is  made,  located in the state of New York or any other state. Any such
    51  change must be carried out within ten business days following receipt of
    52  a request by the purchaser to the funeral firm, funeral director,  ceme-
    53  tery  or  any  other person, firm or corporation to whom such payment is
    54  made, with which such trust was established. This requirement is subject

    55  to any limits set forth in  federal  law  or  regulation  pertaining  to
    56  disregarded resources or income.
        S. 8090                            20                           A. 11372
 
     1    §  16.  Paragraph  (f)  of subdivision 3 of section 453 of the general
     2  business law, as added by chapter 660 of the laws of 1996, is amended to
     3  read as follows:
     4    (f)  With respect to an agreement for an irrevocable trust fund pursu-
     5  ant to section two hundred nine of the social services law or  paragraph
     6  (d)  of subdivision one of this section, include the following statement
     7  in the agreement in conspicuous print of at least twelve point type:
     8                                 DISCLOSURE
     9    NEW YORK LAW REQUIRES THIS AGREEMENT TO BE IRREVOCABLE FOR  APPLICANTS

    10  FOR  [RECEIPT]  AND  RECIPIENTS  OF SUPPLEMENTAL SECURITY BENEFITS UNDER
    11  SECTION TWO HUNDRED NINE OF  THE  SOCIAL  SERVICES  LAW  OR  OF  MEDICAL
    12  ASSISTANCE  UNDER SECTION THREE HUNDRED SIXTY-SIX OF THE SOCIAL SERVICES
    13  LAW, AND FOR THE MONEYS PUT INTO A TRUST UNDER THIS AGREEMENT TO BE USED
    14  ONLY FOR FUNERAL AND BURIAL EXPENSES. WHETHER THE AGREEMENT IS FOR  YOUR
    15  FUNERAL  AND  BURIAL  EXPENSES  OR  FOR THOSE OF A FAMILY MEMBER, IF ANY
    16  MONEY IS LEFT OVER AFTER YOUR FUNERAL  AND  BURIAL  EXPENSES  HAVE  BEEN
    17  PAID,  IT  WILL  GO TO THE COUNTY. YOU MAY CHANGE YOUR CHOICE OF FUNERAL
    18  HOME AT ANY TIME. IF THIS  AGREEMENT  IS  FOR  THE  FUNERAL  AND  BURIAL
    19  EXPENSES  OF  A  FAMILY  MEMBER, AFTER YOUR DEATH SUCH FAMILY MEMBER MAY
    20  CHANGE THE CHOICE OF FUNERAL HOME AT ANY TIME.

    21    § 17. Subdivision 6 of section 209 of  the  social  services  law,  as
    22  amended  by  chapter  660 of the laws of 1996, paragraphs (a) and (b) as
    23  amended by chapter 317 of the laws  of  2002,  is  amended  to  read  as
    24  follows:
    25    6.  (a) As applicable federal law, rules and regulations so provide, a
    26  recipient of supplemental security income benefits or medical assistance
    27  in the state of New York or any other state may establish an irrevocable
    28  trust fund for the exclusive purpose  of  their  or  a  family  member's
    29  funeral  and  burial.  Such  trust fund and any accumulated interest not
    30  withdrawn by the recipient shall remain the responsibility of the funer-
    31  al firm, funeral director, undertaker, cemetery  or  any  other  person,
    32  firm  or  corporation  to  whom  such  payment is made to administer for

    33  funeral and burial expenses of the recipient. Those persons  who  estab-
    34  lish  such  a  trust  fund  shall be given the opportunity to select the
    35  funeral firm,  funeral  director,  undertaker,  cemetery  or  any  other
    36  person, firm or corporation to whom such payment is made of their choice
    37  to  provide  for  their  or a family member's burial arrangements and to
    38  change such selection at any time to any funeral firm, funeral director,
    39  undertaker, cemetery or any other person, firm or  corporation  to  whom
    40  such  payment  is  made,  located either in the state of New York or any
    41  other state. Any such change of funeral firm, funeral  director,  under-
    42  taker,  cemetery,  or any other person, firm or corporation to whom such
    43  payment is made, must be carried out within ten business days  following
    44  receipt  of  a  request  by  the  purchaser to the funeral firm, funeral

    45  director, undertaker, cemetery, or any other person, firm or corporation
    46  to whom such payment is made with  which  the  current  trust  fund  was
    47  established.  Funds  in  such  trust fund shall be placed in an interest
    48  bearing account pursuant to section  four  hundred  fifty-three  of  the
    49  general  business  law. Accumulated interest from such account shall not
    50  be reported as "countable income" pursuant to section two hundred  eight
    51  of this title.
    52    (b) An applicant for or a recipient of medical assistance in the state
    53  of  New York or any other state who enters into an agreement pursuant to
    54  section four hundred fifty-three of the general business law  for  their
    55  own  benefit  or  for  the  benefit of a family member shall establish a
        S. 8090                            21                           A. 11372
 

     1  single irrevocable trust fund for  each  such  beneficiary  pursuant  to
     2  paragraph (a) of this subdivision.
     3    (c)  A  funeral  firm,  funeral director, undertaker, cemetery, or any
     4  other person, firm or corporation  which  makes  an  agreement  for  and
     5  accepts  payment  for  such an irrevocable trust fund, shall comply with
     6  the provisions of section four hundred fifty-three of the general  busi-
     7  ness  law,  and shall include the following statement in any such agree-
     8  ment in conspicuous print of at least twelve point type:
     9                                 DISCLOSURE
    10    NEW YORK LAW REQUIRES THIS AGREEMENT TO BE IRREVOCABLE FOR  APPLICANTS
    11  FOR  [RECEIPT]  AND  RECIPIENTS  OF SUPPLEMENTAL SECURITY BENEFITS UNDER
    12  SECTION TWO HUNDRED NINE OF  THE  SOCIAL  SERVICES  LAW  OR  OF  MEDICAL

    13  ASSISTANCE  UNDER SECTION THREE HUNDRED SIXTY-SIX OF THE SOCIAL SERVICES
    14  LAW, AND FOR THE MONEYS PUT INTO A TRUST UNDER THIS AGREEMENT TO BE USED
    15  ONLY FOR FUNERAL AND BURIAL EXPENSES. WHETHER THIS AGREEMENT IS FOR YOUR
    16  FUNERAL AND BURIAL EXPENSES OR FOR THOSE OF  A  FAMILY  MEMBER,  IF  ANY
    17  MONEY  IS  LEFT  OVER  AFTER  YOUR FUNERAL AND BURIAL EXPENSES HAVE BEEN
    18  PAID, IT WILL GO TO THE COUNTY. YOU MAY CHANGE YOUR  CHOICE  OF  FUNERAL
    19  HOME  AT  ANY  TIME.  IF  THIS  AGREEMENT  IS FOR THE FUNERAL AND BURIAL
    20  EXPENSES OF A FAMILY MEMBER, AFTER YOUR DEATH  SUCH  FAMILY  MEMBER  MAY
    21  CHANGE THE CHOICE OF FUNERAL HOME AT ANY TIME.
    22    (d)  Any promotional literature prepared after January first, nineteen
    23  hundred ninety-seven by a funeral firm,  funeral  director,  undertaker,

    24  cemetery,  or  any  other  person,  firm  or corporation for prearranged
    25  funeral and burial services must contain language disclosing the  irrev-
    26  ocable  nature  of  burial  trusts established by or for an applicant or
    27  recipient of supplemental security income benefits  or  medical  assist-
    28  ance.
    29    §  18.    Paragraph (g) of subdivision 3 of section 453 of the general
    30  business law, as added by chapter 660 of the laws of 1996, is amended to
    31  read as follows:
    32    (g) Any promotional literature prepared after January first,  nineteen
    33  hundred  ninety-seven  by  a funeral firm, funeral director, undertaker,
    34  cemetery, or any other  person,  firm  or  corporation  for  prearranged
    35  funeral  and burial services must contain language disclosing the irrev-
    36  ocable nature of burial trusts established by or  for  an  applicant  or

    37  recipient  of  supplemental  security income benefits or medical assist-
    38  ance.
    39    § 19.  Subdivision 6 of section 141 of the  social  services  law,  as
    40  added by chapter 660 of the laws of 1996, is amended to read as follows:
    41    6.  If an applicant for or a recipient of public assistance or care or
    42  of medical assistance under section two hundred nine  or  three  hundred
    43  sixty-six of this chapter [dies having established] establishes an irre-
    44  vocable  trust  for the payment of his or her funeral expenses, or those
    45  of a family member, under section four hundred fifty-three of the gener-
    46  al business law, any funds remaining in such trust after the payment  of
    47  all  funeral  expenses must be paid over to the social services official
    48  responsible for arranging for burials under this section  in  the  local

    49  government subdivision where the decedent resided.
    50    § 20. Section 365-h of the social services law, as added by chapter 81
    51  of the laws of 1995 and subdivision 3 as amended by section 26 of part B
    52  of chapter 1 of the laws of 2002, is amended to read as follows:
    53    §  365-h.  Provision and reimbursement of transportation costs. 1. The
    54  local social services official and, subject to the provisions of  subdi-
    55  vision  four  of  this  section,  the  commissioner of health shall have
    56  responsibility for prior authorizing transportation of eligible  persons
        S. 8090                            22                           A. 11372
 
     1  and  for  limiting the provision of such transportation to those recipi-
     2  ents and circumstances where such transportation is essential, medically

     3  necessary and appropriate to obtain medical care, services  or  supplies
     4  otherwise available under this title.
     5    2.  In exercising this responsibility, the local social services offi-
     6  cial and, as appropriate, the commissioner of health shall:
     7    (a) make appropriate and economical use  of  transportation  resources
     8  available  in  the district in meeting the anticipated demand for trans-
     9  portation within the district, including, but not limited to:  transpor-
    10  tation generally available  free-of-charge  to  the  general  public  or
    11  specific   segments   of  the  general  public,  public  transportation,
    12  promotion of group rides, county vehicles,  coordinated  transportation,
    13  and direct purchase of services; and
    14    (b)  maintain quality assurance mechanisms in order to ensure that (i)
    15  only such transportation as is essential, medically necessary and appro-

    16  priate to obtain medical care, services or supplies otherwise  available
    17  under  this  title  is  provided [and]; (ii) no expenditures for taxi or
    18  livery transportation are made when public transportation or lower  cost
    19  transportation  is  reasonably  available to eligible persons; and (iii)
    20  transportation services are provided in a  safe,  timely,  and  reliable
    21  manner by providers that comply with state and local regulatory require-
    22  ments  and  meet  consumer satisfaction criteria approved by the commis-
    23  sioner of health.
    24    3. In the event that coordination or other such cost savings  measures
    25  are  implemented, the commissioner shall assure compliance with applica-
    26  ble standards governing the safety and quality of transportation of  the
    27  population served.

    28    4.  The  commissioner of health is authorized to assume responsibility
    29  from a local social services official for the provision  and  reimburse-
    30  ment  of  transportation  costs  under this section. If the commissioner
    31  elects to assume such responsibility, the commissioner shall notify  the
    32  local  social  services official in writing as to the election, the date
    33  upon which the election shall be effective and such  information  as  to
    34  transition  of  responsibilities  as the commissioner deems prudent. The
    35  commissioner is authorized to contract with a transportation manager  or
    36  managers  to manage transportation services in any local social services
    37  district. Any transportation manager or managers selected by the commis-

    38  sioner to manage transportation services shall have proven experience in
    39  coordinating transportation services in  a  geographic  and  demographic
    40  area  similar  to the area in New York state within which the contractor
    41  would manage the provision  of  services  under  this  section.  Such  a
    42  contract  or  contracts may include responsibility for: review, approval
    43  and processing of transportation orders; management of  the  appropriate
    44  level  of  transportation  based on documented patient medical need; and
    45  development of new  technologies  leading  to  efficient  transportation
    46  services.  If the commissioner elects to assume such responsibility from
    47  a local social services district, the commissioner shall examine and, if

    48  appropriate,  adopt quality assurance measures that may include, but are
    49  not limited to, global positioning tracking  system  reporting  require-
    50  ments  and  service  verification  mechanisms. Any and all reimbursement
    51  rates developed by transportation managers under this subdivision  shall
    52  be  subject  to  the  review and approval of the commissioner.  Notwith-
    53  standing any inconsistent provision of sections one hundred  twelve  and
    54  one hundred sixty-three of the state finance law, or section one hundred
    55  forty-two of the economic development law, or any other law, the commis-
    56  sioner  is  authorized  to enter into a contract or contracts under this
        S. 8090                            23                           A. 11372
 

     1  subdivision without a competitive bid or request for  proposal  process,
     2  provided, however, that:
     3    (a)  the department shall post on its website, for a period of no less
     4  than thirty days:
     5    (i) a description of the proposed services to be provided pursuant  to
     6  the contract or contracts;
     7    (ii) the criteria for selection of a contractor or contractors;
     8    (iii)  the  period  of  time during which a prospective contractor may
     9  seek selection, which shall be no  less  than  thirty  days  after  such
    10  information is first posted on the website; and
    11    (iv)  the  manner  by  which  a  prospective  contractor may seek such
    12  selection, which may include submission by electronic means;

    13    (b) all reasonable and responsive submissions that are  received  from
    14  prospective  contractors  in  timely  fashion  shall  be reviewed by the
    15  commissioner; and
    16    (c) the commissioner shall select such contractor or contractors that,
    17  in his or her discretion, are best suited to serve the purposes of  this
    18  section.
    19    §  21.  Subdivision  7  of  section  2510 of the public health law, as
    20  amended by chapter 645 of the laws  of  2005,  is  amended  to  read  as
    21  follows:
    22    7.  "Covered  health care services" means: the services of physicians,
    23  optometrists, nurses, nurse practitioners, midwives  and  other  related
    24  professional  personnel  which  are  provided  on  an  outpatient basis,
    25  including routine well-child visits; diagnosis and treatment of  illness

    26  and injury; inpatient health care services; laboratory tests; diagnostic
    27  x-rays;  prescription  and  non-prescription  drugs  and durable medical
    28  equipment; radiation therapy; chemotherapy; hemodialysis; emergency room
    29  services; hospice services; emergency,  preventive  and  routine  dental
    30  care, [except orthodontia and] including medically necessary orthodontia
    31  but excluding cosmetic surgery; emergency, preventive and routine vision
    32  care,  including eyeglasses; speech and hearing services; and, inpatient
    33  and outpatient mental health, alcohol and substance  abuse  services  as
    34  defined  by  the  commissioner  in consultation with the superintendent.
    35  "Covered health care services" shall not include drugs,  procedures  and
    36  supplies  for the treatment of erectile dysfunction when provided to, or

    37  prescribed for use by, a person who is required to  register  as  a  sex
    38  offender  pursuant to article six-C of the correction law, provided that
    39  any denial of coverage of  such  drugs,  procedures  or  supplies  shall
    40  provide  the  patient with the means of obtaining additional information
    41  concerning both the denial and the means of challenging such denial.
    42    § 21-a. Subdivision 8 of section 2511 of  the  public  health  law  is
    43  amended by adding a new paragraph (e) to read as follows:
    44    (e)  The commissioner shall adjust subsidy payments to approved organ-
    45  izations made on and after April first, two thousand ten,  so  that  the
    46  amount  of  each  such payment, as otherwise calculated pursuant to this
    47  subdivision, is reduced by twenty-eight percent of the amount  by  which

    48  such  calculated  payment  exceeds the statewide average subsidy payment
    49  for all approved organizations in effect on April  first,  two  thousand
    50  ten.  Such  statewide average subsidy payment shall be calculated by the
    51  commissioner and shall not reflect adjustments  made  pursuant  to  this
    52  paragraph.
    53    §  22.  Subdivision 4 of section 6 of part C of chapter 58 of the laws
    54  of 2005, amending the public health  law  and  other  laws  relating  to
    55  authorizing  reimbursements  for  expenditures  made  by social services
    56  districts for medical assistance, is amended to read as follows:
        S. 8090                            24                           A. 11372
 
     1    4. If the commissioner of health finds  that  a  district  has  either

     2  substantially  failed  to demonstrate due diligence, including due dili-
     3  gence with respect to the identification  and  reporting  of  fraud  and
     4  abuse,  according  to  the  prescribed  requirements  and  guidelines or
     5  continues to fail to comply with such requirements then such commission-
     6  er  may  impose  such sanctions and penalties as are permitted under the
     7  public health law and the social  services  law.  In  addition,  if  the
     8  federal Centers for Medicare and Medicaid Services, or a successor agen-
     9  cy, disallows claims for federal financial participation submitted to it
    10  by  the  department  of  health,  or if any federal agency determines to
    11  recover federal Medicaid funds previously  paid  to  the  department  of
    12  health,  the  department  may recover from a district the amount of such

    13  disallowance or recovery that the commissioner determines was caused  by
    14  a  district's  failure  to properly administer, supervise or operate the
    15  Medicaid program.  Any such recovery may be made by  the  department  of
    16  health  only  after  a  finding  by  the commissioner of health that the
    17  district has violated a statute, regulation or clearly articulated writ-
    18  ten policy and that such violation was a direct  cause  of  the  federal
    19  disallowance or recovery. A district subject to such findings shall have
    20  the opportunity to submit to the commissioner written objections to such
    21  findings  within thirty days after notice of the findings is transmitted
    22  to the district. The time to make such submission may be extended at the

    23  discretion of the commissioner. The commissioner shall issue  a  written
    24  determination in response to any such objections, prior to initiation of
    25  recovery  by  the  department.  The district may challenge such determi-
    26  nation in a proceeding commenced  under  article  seventy-eight  of  the
    27  civil  practice law and rules.  Any recovery from a district pursuant to
    28  this subdivision shall be made notwithstanding, and in addition to,  any
    29  district  Medicaid  share  amounts calculated pursuant to section one of
    30  this part.
    31    § 23. Subdivision (f) of section 1 of part C of chapter 58 of the laws
    32  of 2005, amending the public health  law  and  other  laws  relating  to
    33  authorizing  reimbursements  for  expenditures  made  by social services

    34  districts for medical assistance, as amended by section 62 of part C  of
    35  chapter 58 of the laws of 2007, is amended to read as follows:
    36    (f)  Subject  to  paragraph (g) of this section, the state fiscal year
    37  social services district expenditure  cap  amount  calculated  for  each
    38  social services district pursuant to paragraph (d) of this section shall
    39  be  allotted  to  each  district during that fiscal year and paid to the
    40  department in equal weekly amounts in a manner to be determined  by  the
    41  commissioner  and  communicated  to  such  districts and, subject to the
    42  provisions of subdivision four of section six of this part, shall repre-
    43  sent each  district's  maximum  responsibility  for  medical  assistance
    44  expenditures governed by this section.
    45    § 24. Subdivision (b) of section 1 of part C of chapter 58 of the laws

    46  of  2005,  amending  the  public  health  law and other laws relating to
    47  authorizing reimbursements for  expenditures  made  by  social  services
    48  districts for medical assistance, is amended to read as follows:
    49    (b)  Commencing with the period April 1, 2005 though March 31, 2006, a
    50  social services  district's  yearly  net  share  of  medical  assistance
    51  expenditures  shall  be  calculated  in relation to a reimbursement base
    52  year which, for purposes of this section, is defined as January 1,  2005
    53  through  December  31, 2005. The final base year expenditure calculation
    54  for each social services district shall be made by the  commissioner  of
    55  health,  and  approved by the director of the division of the budget, no
    56  later than June 30, 2006.  Such calculations shall be  based  on  actual

        S. 8090                            25                           A. 11372
 
     1  expenditures  made  by  or  on  behalf of social services districts, and
     2  revenues received by social services districts, during the base year and
     3  shall  be  made  without  regard  to  expenditures  made,  and  revenues
     4  received,  outside  the  base year that are related to services provided
     5  during, or prior to, the base year. Such base year calculations shall be
     6  based  on  the  social  services  district  medical  assistance   shares
     7  provisions  in  effect on January 1, 2005.  Subject to the provisions of
     8  subdivision four of section six of this  part,  the  state/local  social
     9  services  district  relative  percentages  of  the  non-federal share of
    10  medical assistance expenditures incurred prior to January 1, 2006  shall

    11  not be subject to adjustment on and after July 1, 2006.
    12    § 25. Notwithstanding any inconsistent provision of section 112 or 163
    13  of  the  state  finance law or any other contrary provision of the state
    14  finance law or any other contrary provision of law, the commissioner  of
    15  health  may,  without a competitive bid or request for proposal process,
    16  enter into contracts with one or more certified public accounting  firms
    17  for  the purpose of conducting audits of disproportionate share hospital
    18  payments made by the state of New York to general hospitals and for  the
    19  purpose  of  conducting  audits of hospital cost reports as submitted to
    20  the state of New York in accordance with article 28 of the public health
    21  law.
    22    § 26.  Subdivision 7-a of section 101 of part A of chapter 57  of  the
    23  laws  of  2006,  amending  the social services law relating to medically

    24  fragile children, as amended by section 65 of part C of  chapter  58  of
    25  the laws of 2008, is amended to read as follows:
    26    7-a.  Sections fifty-eight, fifty-eight-a and fifty-eight-b shall take
    27  effect January 1, 2007 [and shall expire and be deemed repealed  January
    28  1, 2011].
    29    §  27.  Paragraph  (d) of subdivision 3 of section 367-a of the social
    30  services law, as added by chapter 33 of the laws of 1998,  subparagraphs
    31  1  and  2 as amended by section 2 of part G of chapter 23 of the laws of
    32  2002, is amended to read as follows:
    33    (d) (1) Beginning April first, two thousand two and to the extent that
    34  federal financial participation is available at a  one  hundred  percent
    35  federal  Medical  assistance percentage and subject to sections 1933 and
    36  1902(a)(10)(E)(iv) of the federal social security act,  medical  assist-

    37  ance shall be available for full payment of medicare part B premiums for
    38  individuals (referred to as qualified individuals 1) who are entitled to
    39  hospital  insurance  benefits under part A of title XVIII of the federal
    40  social security act and whose income exceeds  the  income  level  estab-
    41  lished by the state and is at least one hundred twenty percent, but less
    42  than  one hundred thirty-five percent, of the federal poverty level, for
    43  a family of the size involved and who are  not  otherwise  eligible  for
    44  medical assistance under the state plan;
    45    (2)  [Beginning  April  first, two thousand two and to the extent that
    46  federal financial participation is available at a  one  hundred  percent
    47  federal  Medical  assistance percentage and subject to sections 1933 and
    48  1902(a)(10)(E)(iv) of the federal social security act,  medical  assist-

    49  ance shall be available for payment of that portion of the medicare part
    50  B  premium  increase that is attributable to the operation of the amend-
    51  ments made by section 4611(e)(3) of the balanced budget act of 1997, for
    52  individuals (referred to as qualified individuals 2) who are entitled to
    53  hospital insurance benefits under part A of title XVIII of  the  federal
    54  social  security  act  and  whose income exceeds the income level estab-
    55  lished by the state and is at least one hundred thirty-five percent, but
    56  less than one hundred  seventy-five  percent,  of  the  federal  poverty
        S. 8090                            26                           A. 11372

     1  level,  for  a  family  of  the  size involved and who are not otherwise

     2  eligible for medical assistance under the state plan;
     3    (3)] Premium payments for the individuals described in [subparagraphs]
     4  subparagraph one [and two] of this paragraph will be one hundred percent
     5  federally  funded up to the amount of the federal allotment. The depart-
     6  ment shall discontinue enrollment into  the  program  when  the  part  B
     7  premium  payments made pursuant to [such paragraphs] subparagraph one of
     8  this paragraph meet the yearly federal allotment.
     9    [(4)] (3) The commissioner of health shall develop a simplified appli-
    10  cation form, consistent with federal law, for payments pursuant to  this
    11  section.  The commissioner of health, in cooperation with the office for
    12  the aging, shall publicize the availability of such payments to medicare

    13  beneficiaries.
    14    § 28. Section 2 of chapter 33 of the laws of 1998, amending the social
    15  services law relating to authorizing payment of medicare part B premiums
    16  to certain medicaid recipients, as amended by chapter 415 of the laws of
    17  2008, is amended to read as follows:
    18    § 2. This act shall take effect immediately and shall be  deemed    to
    19  have  been  in  full  force  and  effect  on and after January 1, 1998[,
    20  provided, however that  such  provisions  shall  expire  and  be  deemed
    21  repealed December 31, 2010].
    22    §  29. Section 45 of part D of chapter 58 of the laws of 2009 amending
    23  the public health law and other laws relating to residential health care
    24  facilities is amended to read as follows:
    25    § 45. Notwithstanding any inconsistent provision of law, rule or regu-

    26  lation, the effectiveness of subdivisions 4, 7, 7-a and 7-b  of  section
    27  2807 of the public health law and section 18 of chapter 2 of the laws of
    28  1988,  as  they  relate  to  time frames for notice, approval or certif-
    29  ication of rates  of  payment,  are  hereby  suspended  and  shall,  for
    30  purposes  of  implementing the provisions of this act and the provisions
    31  of parts B and C of this chapter, be deemed to  have  been  without  any
    32  force  or  effect from and after [November 1, 2007 for such rates effec-
    33  tive for the period January 1, 2008 through December 31, 2008] March  1,
    34  2009.
    35    §  30.  Subdivision  17  of  section 2808 of the public health law, as
    36  added by chapter 433 of the laws of 1997, is amended to read as follows:

    37    17. (a) Notwithstanding any inconsistent provision  of  law  or  regu-
    38  lation  to  the  contrary,  for the period April first, nineteen hundred
    39  ninety-seven through March thirty-first, nineteen hundred  ninety-eight,
    40  the  commissioner  shall  not  be required to revise a certified rate of
    41  payment established pursuant to this article based on  consideration  of
    42  rate  appeals  filed by a residential health care facility or based upon
    43  adjustments to capital cost reimbursement as a result of approval by the
    44  commissioner of an application for construction  under  section  twenty-
    45  eight  hundred two of this article. For the period April first, nineteen
    46  hundred ninety-eight, through March thirty-first, nineteen hundred nine-
    47  ty-nine, the commissioner shall revise certified rates of payment in  an
    48  aggregate  amount  not  to  exceed  twenty  million dollars, state share

    49  medical assistance. In cases where the commissioner  determines  that  a
    50  significant  financial  hardship  exists,  he or she may, subject to the
    51  approval of the director of the budget, consider an  exemption  to  this
    52  subdivision.  Beginning  April  first,  nineteen hundred ninety-nine and
    53  thereafter, the commissioner shall consider such rate appeals  within  a
    54  reasonable period.
    55    (b) Notwithstanding any inconsistent provision of law or regulation to
    56  the contrary, for the state fiscal year beginning April first, two thou-
        S. 8090                            27                           A. 11372
 
     1  sand ten and ending March thirty-first, two thousand eleven, the commis-
     2  sioner shall not be required to revise certified rates of payment estab-

     3  lished  pursuant  to this article for rate periods prior to April first,
     4  two  thousand  eleven,  based  on consideration of rate appeals filed by
     5  residential health care facilities or based upon adjustments to  capital
     6  cost  reimbursement  as  a  result of approval by the commissioner of an
     7  application for construction under section twenty-eight hundred  two  of
     8  this  article, in excess of an aggregate annual amount of eighty million
     9  dollars for such state fiscal year. In revising such rates  within  such
    10  fiscal  limit,    the  commissioner  shall,  in  prioritizing  such rate
    11  appeals, include consideration  of  which  facilities  the  commissioner
    12  determines  are  facing  significant  financial hardship as well as such

    13  other considerations as the commissioner deems appropriate and, further,
    14  the commissioner is authorized to enter into agreements with such facil-
    15  ities or any other facility to resolve  multiple  pending  rate  appeals
    16  based  upon a negotiated aggregate amount and may offset such negotiated
    17  aggregate amounts against any  amounts  owed  by  the  facility  to  the
    18  department,  including,  but  not  limited  to, amounts owed pursuant to
    19  section twenty-eight hundred seven-d of this article.  Rate  adjustments
    20  made  pursuant to this paragraph remain fully subject to approval by the
    21  director of the budget in accordance with the provisions of  subdivision
    22  two of section twenty-eight hundred seven of this article.

    23    § 31. Section 2808 of the public health law is amended by adding a new
    24  subdivision 25 to read as follows:
    25    25.  Reserved  bed  days.  (a)  For  purposes  of  this subdivision, a
    26  "reserved bed day" is a day for which a governmental agency pays a resi-
    27  dential health care facility to reserve a bed for a person eligible  for
    28  medical  assistance  pursuant  to  title  eleven  of article five of the
    29  social services law while he or she is temporarily  hospitalized  or  on
    30  leave of absence from the facility.
    31    (b)  Notwithstanding any other provisions of this section or any other
    32  law or regulation to the contrary, for reserved  bed  days  provided  on
    33  behalf of persons twenty-one years of age or older:

    34    (i)  payments  for  reserved  bed  days  shall  be made at ninety-five
    35  percent of the Medicaid rate  otherwise  payable  to  the  facility  for
    36  services provided on behalf of such person;
    37    (ii) payment to a facility for reserved bed days provided on behalf of
    38  such  person for temporary hospitalizations may not exceed fourteen days
    39  in any twelve month period;
    40    (iii) payment to a facility for reserved bed days provided  on  behalf
    41  of  such person for non-hospitalization leaves of absence may not exceed
    42  ten days in any twelve month period.
    43    § 32. Section 2808 of the public health law is amended by adding a new
    44  subdivision 26 to read as follows:
    45    26. Notwithstanding any inconsistent provision of law, for rate  peri-

    46  ods  on and after April first, two thousand ten, residential health care
    47  facility Medicaid rates of payment shall not include  reimbursement  for
    48  the  cost  of prescription drugs. Such reimbursement shall be in accord-
    49  ance with otherwise  applicable  provisions  of  section  three  hundred
    50  sixty-seven-a of the social services law.
    51    §  33.  Subdivision  2  of  section  3616 of the public health law, as
    52  amended by chapter 622 of the laws  of  1988,  is  amended  to  read  as
    53  follows:
    54    2.  Continued  provision of a long term home health care program, AIDS
    55  home care program or certified home health agency services paid  for  by
    56  government  funds  shall be based upon a comprehensive assessment of the
        S. 8090                            28                           A. 11372
 

     1  medical,  social  and  environmental  needs  of  the  recipient  of  the
     2  services.  Such assessment shall be performed at least every one hundred
     3  [twenty] eighty days by the provider of a long  term  home  health  care
     4  program,  AIDS  home  care  program  or the certified home health agency
     5  providing services for the patient and the local  department  of  social
     6  services,  and shall be reviewed by a physician charged with the respon-
     7  sibility by the commissioner. The commissioner shall prescribe the forms
     8  on which the assessment will be made.
     9    § 34. Notwithstanding any  provision  of  law  or  regulation  to  the
    10  contrary,  and  subject to the availability of federal financial partic-
    11  ipation, the commissioner of health shall establish procedures to permit
    12  long-term home health care programs  and  providers  of  other  services

    13  covered  pursuant  to  federal waivers, or which provide case management
    14  services, to collaborate to jointly serve individuals when the  services
    15  of  both  entities  are  necessary  to  meet such an individual's needs;
    16  provided, however, that such entities shall maintain distinct yet  coor-
    17  dinated  service  and  case  management  responsibilities  and shall not
    18  duplicate benefits.
    19    § 35.  Federal-state  Medicare  shared  savings  partnership  program.
    20  Notwithstanding  any  provision of law to the contrary, the commissioner
    21  of health shall seek federal approval for the establishment of a  feder-
    22  al-state  Medicare  shared savings partnership program. Such program may
    23  include, among others, the following features: (a) an incentive  through
    24  shared savings to the state for achieving federal cost-savings and effi-

    25  ciencies  to  Medicare,  such as from reduced expenditures for hospital,
    26  long-term care and other medical care provided to beneficiaries eligible
    27  for both Medicare and Medicaid, which result from state  initiatives  in
    28  the  care  and  management  of  such beneficiaries; such incentive shall
    29  provide for a reinvestment of a portion of such federal savings into the
    30  state's health care system; (b) acceptance of risk by the state for  the
    31  delivery  and  financing of Medicare-covered services; and (c) an incen-
    32  tive to permit providers of medical services to  share  in  demonstrated
    33  Medicare savings.
    34    §  36.  Paragraphs (b) and (c) of subdivision 5 of section 2808 of the
    35  public health law, paragraph (b) as added by section 12 of  part  OO  of
    36  chapter 57 of the laws of 2008, and paragraph (c) as added by section 11

    37  of  part  D  of  chapter  58 of the laws of 2009, are amended to read as
    38  follows:
    39    (b) On and after April first, two thousand [eight] ten, no  non-public
    40  residential  health care facility may withdraw equity or transfer assets
    41  which in the aggregate exceed three percent  of  such  facility's  total
    42  [Medicaid]  reported  annual  revenue [in any calendar year] for patient
    43  care services, based on the facility's most recently available  reported
    44  data,  without prior written notification to the commissioner. Notifica-
    45  tion shall be made in a form acceptable to the department  by  certified
    46  or registered mail.
    47    (c) Notwithstanding any inconsistent provision of this subdivision, on

    48  and  after  April first, two thousand [nine] ten, no non-public residen-
    49  tial health care facility, whether operated as a for-profit facility  or
    50  as  a  not-for-profit  facility,  may withdraw equity or transfer assets
    51  which in the aggregate exceed three percent  of  such  facility's  total
    52  [Medicaid]  reported  annual  revenue  [in  the prior calendar year] for
    53  patient care services, based on the facility's most  recently  available
    54  reported  data,  without the prior written approval of the commissioner.
    55  The commissioner shall make a determination to approve or  disapprove  a
    56  request for withdrawal of equity or assets under this subdivision within
        S. 8090                            29                           A. 11372
 

     1  sixty  days  of  the  date  of the receipt of a written request from the
     2  facility. Requests shall be made in a form acceptable to the  department
     3  by  certified or registered mail. In reviewing such requests the commis-
     4  sioner  shall  consider  the facility's overall financial condition, any
     5  indications of financial distress, whether the facility is delinquent in
     6  any payment owed to the department, whether the facility has been  cited
     7  for  immediate  jeopardy  or substandard quality of care, and such other
     8  factors as the commissioner deems appropriate. In addition to any  other
     9  remedy  or  penalty  available under this chapter, and after opportunity
    10  for a hearing, the commissioner may require replacement of the withdrawn
    11  equity or  assets  and  may  impose  a  penalty  for  violation  of  the
    12  provisions of this subdivision in an amount not to exceed ten percent of

    13  any amount withdrawn without prior approval.
    14    §  36-a.  Subdivision 1 of section 367-w of the social services law as
    15  added by section 29 of part D of chapter 58 of  the  laws  of  2009,  is
    16  amended to read as follows:
    17    1.  Notwithstanding  any provision of law to the contrary, the depart-
    18  ment of health is authorized to establish a demonstration program, which
    19  shall be three years in  duration,  under  which  the  department  shall
    20  designate  [two]  one  or  more  long-term care assessment centers[, the
    21  first of which shall] to be established in [a]  and  together  serve  an
    22  entire county within the city of New York and [the second of which will]
    23  shall  designate a long term care assessment center to be established in

    24  another region consisting of one or more contiguous  counties  elsewhere
    25  in  the state. Such centers shall serve the purpose of transferring from
    26  the social services district to the regional long-term  care  assessment
    27  centers  responsibility  for  activities  related to the assessment of a
    28  person's need for, and the authorization of, long-term care services and
    29  programs identified in subdivisions two, three and four of this section.
    30  The department is authorized to contract with one or more entities with-
    31  in each county to operate regional long-term care assessment centers.
    32    § 37. Notwithstanding any inconsistent provision of law, rule or regu-
    33  lation, for purposes of implementing the provisions of the public health
    34  law and the social services law, references to titles XIX and XXI of the

    35  federal social security act in the public  health  law  and  the  social
    36  services  law  shall be deemed to include and also to mean any successor
    37  titles thereto under the federal social security act.
    38    § 38. Notwithstanding any inconsistent provision of law, rule or regu-
    39  lation, the effectiveness of the provisions of sections 2807 and 3614 of
    40  the public health law, section 18 of chapter 2 of the laws of 1988,  and
    41  18  NYCRR  505.14(h), as they relate to time frames for notice, approval
    42  or certification of rates of payment, are hereby suspended  and  without
    43  force or effect for purposes of implementing the provisions of this act.
    44    §  39. Severability clause. If any clause, sentence, paragraph, subdi-
    45  vision, section or part of this act shall be adjudged by  any  court  of
    46  competent  jurisdiction  to  be invalid, such judgment shall not affect,

    47  impair or invalidate the remainder thereof, but shall be confined in its
    48  operation to the clause, sentence, paragraph,  subdivision,  section  or
    49  part thereof directly involved in the controversy in which such judgment
    50  shall  have been rendered. It is hereby declared to be the intent of the
    51  legislature that this act would have been enacted even if  such  invalid
    52  provisions had not been included herein.
    53    §  40.  This  act shall take effect immediately and shall be deemed to
    54  have been in full force and effect on and after April 1, 2010,  provided
    55  that:
        S. 8090                            30                           A. 11372
 
     1    (a)  sections  two, three, three-a, three-b, three-c, three-d, three-e
     2  and twenty-one of this act shall take  effect  July  1,  2010;  sections
     3  fifteen,  sixteen,  seventeen,  eighteen  and nineteen of this act shall

     4  take effect January 1, 2011; and provided further that section twenty of
     5  this act shall be deemed repealed four years after the date the contract
     6  entered  into  pursuant  to section 365-h of the social services law, as
     7  amended by section twenty of this act, is executed;  provided  that  the
     8  commissioner  of  health  shall  notify  the  legislative  bill drafting
     9  commission upon the execution of the contract entered into  pursuant  to
    10  section  367-h  of  the social services law in order that the commission
    11  may maintain an accurate and timely effective data base of the  official
    12  text of the laws of the state of New York in furtherance of effectuating
    13  the  provisions of section 44 of the legislative law and section 70-b of
    14  the public officers law;
    15    (b) any rules or regulations necessary to implement the provisions  of

    16  this  act  may be promulgated and any procedures, forms, or instructions
    17  necessary for such implementation may be adopted and issued on or  after
    18  the date this act shall have become a law;
    19    (c)  this  act shall not be construed to alter, change, affect, impair
    20  or defeat any rights, obligations, duties or interests accrued, incurred
    21  or conferred prior to the effective date of this act;
    22    (d) the commissioner of health and the superintendent of insurance and
    23  any appropriate council may take any steps necessary to  implement  this
    24  act prior to its effective date;
    25    (e)  notwithstanding  any inconsistent provision of the state adminis-
    26  trative procedure act or any other provision of law, rule or regulation,
    27  the commissioner of health and the superintendent of insurance  and  any
    28  appropriate  council is authorized to adopt or amend or promulgate on an

    29  emergency basis any regulation he or  she  or  such  council  determines
    30  necessary to implement any provision of this act on its effective date;
    31    (f)  the provisions of this act shall become effective notwithstanding
    32  the failure of the commissioner  of  health  or  the  superintendent  of
    33  insurance  or  any  council  to adopt or amend or promulgate regulations
    34  implementing this act;
    35    (g) the amendments to subdivision 8  of  section  272  of  the  public
    36  health  law made by section five of this act shall not affect the repeal
    37  of such section and shall be deemed repealed therewith;
    38    (h) the amendments to subparagraph (ii) of paragraph (b)  of  subdivi-
    39  sion 9 of section 367-a of the social services law made by section seven
    40  of  this  act  shall  not  affect the expiration of such subdivision and
    41  shall be deemed to expire therewith;

    42    (i) the amendments to subdivision 7 of  section  2510  of  the  public
    43  health  law  made by section twenty-one of this act shall not affect the
    44  expiration of such subdivision and shall be deemed to expire  therewith;
    45  and
    46    (j)  the amendments made to paragraph (d) of subdivision 18 of section
    47  2807-c of the public health law by section three-d of this act shall not
    48  affect the expiration of such paragraph and shall be  deemed  to  expire
    49  therewith.
 
    50                                   PART C
 
    51    Section  1.  The sum of four hundred two million seven hundred ninety-
    52  seven thousand dollars ($402,797,000), or so much thereof  as  shall  be
    53  necessary, and in addition to amounts previously appropriated by law, is
    54  hereby  made  available, in accordance with subdivision 1 of section 380

        S. 8090                            31                           A. 11372
 
     1  of the public authorities law as amended,  according  to  the  following
     2  schedule.  Payments pursuant to subdivision (a) of this section shall be
     3  made  available  as  moneys become available for such payments. Payments
     4  pursuant  to  subdivisions  (b)  and  (c)  of this section shall be made
     5  available on the fifteenth day of June, September, December and March or
     6  as soon thereafter as moneys become  available  for  such  payments.  No
     7  moneys  of  the state in the state treasury or any of its funds shall be
     8  available for payments pursuant to this section:
     9                                  SCHEDULE
    10    (a) Thirty-nine million seven hundred thousand  dollars  ($39,700,000)
    11  to municipalities for repayment of eligible costs of federal aid munici-
    12  pal street and highway projects pursuant to section 15 of chapter 329 of

    13  the  laws  of  1991, as added by section 9 of chapter 330 of the laws of
    14  1991, as amended. The department of transportation  shall  provide  such
    15  information  to  the  municipalities as may be necessary to maintain the
    16  federal tax exempt status of any  bonds,  notes,  or  other  obligations
    17  issued  by  such  municipalities to provide for the non-federal share of
    18  the cost of projects pursuant to chapter 330 of  the  laws  of  1991  or
    19  section 80-b of the highway law.
    20    The  program  authorized  pursuant to section 15 of chapter 329 of the
    21  laws of 1991, as added by section 9 of chapter 330 of the laws of  1991,
    22  as amended, shall additionally make payments for reimbursement according
    23  to the following schedule:
    24                      State Fiscal Year        Amount
    25                      2010-11                  $39,700,000

    26    (b)   Three  hundred  four  million  three  hundred  thousand  dollars
    27  ($304,300,000) to counties, cities, towns and villages for reimbursement
    28  of eligible costs of local  highway  and  bridge  projects  pursuant  to
    29  sections  16  and  16-a  of chapter 329 of the laws of 1991, as added by
    30  section 9 of chapter 330 of the  laws  of  1991,  as  amended.  For  the
    31  purposes of computing allocations to municipalities, the amount distrib-
    32  uted  pursuant to section 16 of chapter 329 of the laws of 1991 shall be
    33  deemed to be $121,520,000.  The amount distributed pursuant  to  section
    34  16-a  of  chapter  329  of  the  laws  of  1991  shall  be  deemed to be
    35  $182,780,000.  Notwithstanding the provisions of any general or  special
    36  law,  the  amounts  deemed  distributed in accordance with section 16 of
    37  chapter 329 of the laws of 1991 shall be adjusted so that  such  amounts

    38  will  not  be less than 83.807 percent of the "funding level" as defined
    39  in subdivision 5 of section 10-c of the highway law for each such  muni-
    40  cipality.  In  order  to achieve the objectives of section 16 of chapter
    41  329 of the laws of 1991, to the extent necessary, the amounts in  excess
    42  of  83.807 percent of the funding level to be deemed distributed to each
    43  municipality under this subdivision shall be reduced  in  equal  propor-
    44  tion.
    45    (c)  Fifty-eight  million  seven hundred ninety-seven thousand dollars
    46  ($58,797,000) to municipalities for reimbursement of eligible  costs  of
    47  local  highway  and  bridge projects pursuant to sections 16 and 16-a of
    48  chapter 329 of the laws of 1991, as added by section 9 of chapter 330 of
    49  the laws of 1991, as amended. For the purposes of computing  allocations
    50  to  municipalities,  the  amount  distributed  pursuant to section 16 of

    51  chapter 329 of the laws of 1991 shall be deemed to be  $23,480,000.  The
    52  amount  distributed  pursuant to section 16-a of chapter 329 of the laws
    53  of  1991  shall  be  deemed  to  be  $35,317,000.  Notwithstanding   the
    54  provisions of any general or special law, the amounts deemed distributed
    55  in  accordance  with section 16 of chapter 329 of the laws of 1991 shall
    56  be adjusted so that such amounts will not be less than 16.193 percent of
        S. 8090                            32                           A. 11372
 
     1  the "funding level" as defined in subdivision 5 of section 10-c  of  the
     2  highway  law  for each such municipality. In order to achieve the objec-
     3  tives of section 16 of chapter 329 of the laws of 1991,  to  the  extent
     4  necessary,  the amounts in excess of 16.193 percent of the funding level

     5  to be deemed distributed to each  municipality  under  this  subdivision
     6  shall  be  reduced  in equal proportion. To the extent that the total of
     7  remaining payment allocations calculated herein varies from $58,797,000,
     8  the payment amounts to each locality shall  be  adjusted  by  a  uniform
     9  percentage so that the total payments equal $58,797,000.
    10    The program authorized pursuant to sections 16 and 16-a of chapter 329
    11  of the laws of 1991, as added by section 9 of chapter 330 of the laws of
    12  1991,  as  amended,  shall  additionally make payments for reimbursement
    13  according to the following schedule:
    14                      State Fiscal Year        Amount
    15                      2010-11                  $363,097,000
    16    § 2. Subdivision (b) of section 11 of chapter 329 of the laws of 1991,
    17  amending the state finance law and other laws relating to the establish-

    18  ment of the dedicated highway and  bridge  trust  fund,  as  amended  by
    19  section  49  of part PP of chapter 56 of the laws of 2009, is amended to
    20  read as follows:
    21    (b) Any service contract or contracts for projects authorized pursuant
    22  to sections 10-c, 10-f, 10-g and 80-b of the  highway  law  and  section
    23  14-k of the transportation law, and entered into pursuant to subdivision
    24  (a)  of  this  section,  shall  provide for state commitments to provide
    25  annually to the thruway authority a sum or sums,  upon  such  terms  and
    26  conditions as shall be deemed appropriate by the director of the budget,
    27  to fund, or fund the debt service requirements of any bonds or any obli-
    28  gations  of  the thruway authority issued to fund such projects having a
    29  cost not in excess of [$5,860,800,000]  $6,286,660,000  cumulatively  by

    30  the end of fiscal year [2009-10] 2010-2011.
    31    §  3.  This  act  shall take effect immediately and shall be deemed to
    32  have been in full force and effect on and after April 1, 2010.
 
    33                                   PART D
 
    34    Section 1. Subdivision 3 of section 79-b of  the  navigation  law,  as
    35  separately  amended  by  chapters  768  and  805 of the laws of 1992, is
    36  amended to read as follows:
    37    3. The amount of state aid to be allocated  to  eligible  governmental
    38  entities pursuant to this article shall be determined by the commission-
    39  er  as  hereinafter provided.  [He] The commissioner shall determine the
    40  percentage proportion which the authorized expenditures of each individ-
    41  ual entity, not exceeding four hundred thousand dollars for each  county

    42  including  municipalities  therein,  shall  bear to the total authorized
    43  expenditures of all entities. Such percentage proportion shall  then  be
    44  applied  against  an  amount  equal  to [three-quarters] one-half of the
    45  total of the amount received by the state in each preceding program year
    46  in [fees] vessel registration fees as  provided  in  section  twenty-two
    47  hundred  fifty-one  of  the  vehicle  and traffic law, less no more than
    48  thirty percent, subject to appropriation,  which  may  be  used  by  the
    49  commissioner  and  the commissioner of motor vehicles for administrative
    50  costs of the program, including  training  and  equipment,  and  by  the
    51  department  of  environmental conservation, the division of state police
    52  and other state agencies, subject to the approval of  the  commissioner,

    53  for the purposes of this article [for the registration of vessels], plus
    54  the  entire  amount  received  pursuant  to  subdivision nine of section
        S. 8090                            33                           A. 11372
 
     1  forty-four of this chapter. The amount thus determined shall  constitute
     2  the maximum amount of state aid to which each such entity shall be enti-
     3  tled;  provided,  however,  that no entity shall receive state aid in an
     4  amount  in  excess  of  [seventy-five]  fifty  percent of its authorized
     5  expenditures as approved by the commissioner for such program year.  The
     6  commissioner shall certify to the comptroller the amount thus determined
     7  for  each  eligible local governmental entity as the amount of state aid
     8  to be apportioned to such eligible local governmental entity. The  allo-

     9  cation  of  state  aid  to  any  county, town or village within the Lake
    10  George park shall not be reduced because of the allocation of state  aid
    11  to  the  Lake George park commission. Of the remaining funds received by
    12  the state for the registration of vessels as provided in  section  twen-
    13  ty-two  hundred  fifty-one  of the vehicle and traffic law, no less than
    14  six percent shall be made available to the commissioner for the expenses
    15  of the office in  providing  navigation  law  enforcement  training  and
    16  administering the provisions of this section.
    17    §  2.  This  act  shall take effect immediately and shall be deemed to
    18  have been in full force and effect on and after April 1, 2010.
 
    19                                   PART E
 
    20    Section 1. Paragraph (c) of subdivision 6 of section 529 of the execu-

    21  tive law, as added by chapter 906 of the laws of  1973,  is  amended  to
    22  read as follows:
    23    (c) The [director] commissioner of the [division for youth]  office of
    24  children and family services, subject to the approval of the director of
    25  the  budget  and  certification  to  the [chairmen] chairs of the senate
    26  finance and assembly ways and means committees, may establish  a  single
    27  per  diem  rate  for  all  [division] office facilities or may establish
    28  separate rates as may be appropriate to  reflect  the  differentials  in
    29  cost of specific [division] office programs including making any adjust-
    30  ments  to  the  costs  included in determining such rates to reflect any

    31  changes in federal funding made available to the  office  or  to  social
    32  services districts for such costs.
    33    §  2.  Subdivision  9 of section 529 of the executive law, as added by
    34  section 2 of part G of chapter 57 of the laws of  2007,  is  amended  to
    35  read as follows:
    36    9. All reimbursement made by social services districts for care, main-
    37  tenance and supervision under this section shall be paid directly to the
    38  state  through  the  office  of children and family services for deposit
    39  into a miscellaneous special revenue fund known as  the  youth  facility
    40  per  diem  account.    Notwithstanding  any other provision of law, if a
    41  social services district fails to provide reimbursement to  such  office
    42  within  sixty  days of receiving a bill for such services or by the date

    43  certain set by the office for providing such reimbursement, whichever is
    44  later, the offices of the department of family assistance are authorized
    45  to exercise the state's set-off rights by withholding  any  amounts  due
    46  and  owing  to  such district from such office under this article or the
    47  social services law up to the amounts due and owing to the  state  under
    48  this  section  and  transferring  such funds to the youth facilities per
    49  diem account.
    50    § 3. Notwithstanding any law to the contrary, and in  accordance  with
    51  section 4 of the state finance law, the comptroller is hereby authorized
    52  and directed to transfer, upon request of the director of the budget, on
    53  or  before  March  31,  2011,  up  to $27,000,000 from the miscellaneous

        S. 8090                            34                           A. 11372
 
     1  special revenue fund (339), youth facility per diem account (YF), to the
     2  general fund.
     3    §  4.  This  act  shall take effect immediately and shall be deemed to
     4  have been in full force and effect on and after April 1, 2010; provided,
     5  however, that the provisions of section one of this act shall  apply  to
     6  all  per diems established by the office of children and family services
     7  for office programs for the 2002 calendar year and thereafter;  provided
     8  further,  however,  that the provisions of section two of this act shall
     9  apply to all outstanding reimbursements due by social services districts
    10  to the office of children and family services on or before April 1, 2010
    11  and thereafter; and provided further that this act shall expire  and  be
    12  deemed repealed April 1, 2013.
 

    13                                   PART F
 
    14    Section  1.  Subdivision 5 of section 97-rrr of the state finance law,
    15  as amended by section 13 of part PP of chapter 56 of the laws  of  2009,
    16  is amended to read as follows:
    17     5.   Notwithstanding   the   provisions   of   section   one  hundred
    18  seventy-one-a of the tax law, as separately  amended  by  chapters  four
    19  hundred  eighty-one and four hundred eighty-four of the laws of nineteen
    20  hundred eighty-one, or any other provisions  of  law  to  the  contrary,
    21  during  the  fiscal year beginning April first, two thousand [nine] ten,
    22  the state comptroller is hereby authorized and directed  to  deposit  to
    23  the  fund created pursuant to this section from amounts collected pursu-
    24  ant to article twenty-two of the tax law  and  pursuant  to  a  schedule

    25  submitted  by  the  director  of  the  budget,  up  to  [$3,524,450,000]
    26  $496,624,180, as may be certified in such schedule as necessary to  meet
    27  the purposes of such fund for the fiscal year beginning April first, two
    28  thousand [nine] ten.
    29    §  2.  This act shall take effect immediately; provided, however, that
    30  the amendments to subdivision 5 of section 97-rrr of the  state  finance
    31  law made by this act shall not affect the expiration of such subdivision
    32  and shall be deemed to expire therewith.
    33    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
    34  sion,  section  or  part  of  this act shall be adjudged by any court of
    35  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    36  impair,  or  invalidate  the remainder thereof, but shall be confined in

    37  its operation to the clause, sentence, paragraph,  subdivision,  section
    38  or part thereof directly involved in the controversy in which such judg-
    39  ment shall have been rendered. It is hereby declared to be the intent of
    40  the  legislature  that  this  act  would  have been enacted even if such
    41  invalid provisions had not been included herein.
    42    § 3. This act shall take effect immediately  provided,  however,  that
    43  the  applicable effective date of Parts A through F of this act shall be
    44  as specifically set forth in the last section of such Parts.