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A08807 Summary:

BILL NOA08807C
 
SAME ASSAME AS UNI. S08307-C
 
SPONSORBudget
 
COSPNSR
 
MLTSPNSR
 
Amd Various Laws, generally
 
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2024-2025 state fiscal year; requires the commissioner of health to provide a quarterly report on known and expected department of health state funds Medicaid expenditures (Part A); extends various provisions related to health and mental hygiene (Part B); relates to the provision of certain early intervention services for children with handicapping conditions (Part C); reduces the hospital capital rate add-on; relates to the payment of certain funds for uncompensated care; extends provisions relating to certain Medicaid management; increases operating cost component of rates of payment for general hospital outpatient services; authorizes the department of health to make Medicaid payment increases for county operated free-standing clinics (Part D); freezes the operating component of the rates for skilled nursing facilities; reduces the capital component of the rates for skilled nursing facilities by an additional ten percent; expands admission eligibility to the NYS veteran's home for certain veterans of the Persian Gulf conflict (Part E); provides that the program for individuals living with Alzheimer's disease and dementia who are not eligible for medical assistance and reside in a special needs assisted living residence shall, subject to appropriations, authorize vouchers to individuals (Part F); eliminates the one percent Medicaid rate increase to managed care organizations (Part H); relates to coverage and reimbursement of certain drugs under the Medicaid drug cap program and pharmacy cost reporting (Part I); renames the basic health program to the essential plan; extends provisions related to providing long-term services and supports under the essential plan; adds references to the 1332 state innovation waiver; provides a new subsidy to assist low and moderate income New Yorkers; adds the 1332 state innovation program to the functions of the marketplace (Part J); extends certain provisions of law relating to malpractice and professional medical conduct (Part K); authorizes continuous coverage under medical assistance for needy persons and child health plus for eligible children up to age six (Part M); expands financial assistance for medical debt; provides additional consumer protection for medical debt; restricts the applications for and use of credit cards and medical financial products (Part O); extends authorization for pharmacists to order and administer certain tests and perform collaborative drug therapy management with physicians in certain settings (Part P); establishes the healthcare safety net transformation program for the purpose of supporting the transformation of safety net hospitals to improve access, equity, quality, and outcomes while increasing the financial sustainability of safety net hospitals (Part S); extends the effectiveness of certain provisions relating to membership of subcommittees for mental health of community service boards and the duties of such subcommittees and the community mental health and workforce reinvestment account (Part Y); extends certain provisions clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs (Part Z); provides for reimbursement insurance rates for the provision of outpatient, intensive outpatient, outpatient rehabilitation and opioid treatment (Part AA); extends certain provisions of law relating to psychiatric emergency programs (Part BB); extends provisions for the care and custody of funds belonging to patients in facilities operated by the office of mental health (Part DD); establishes a cost of living adjustment for certain human services programs (Part FF); provides contracting flexibility in relation to 1115 Medicaid waivers (Part GG); relates to statewide fiscal intermediaries; creates a registration process for statewide fiscal intermediaries (Part HH); establishes a New York managed care organization provider tax (Part II); provides that services provided in school-based health centers shall not be provided to medical assistance recipients through certain managed care programs before April 1, 2025 (Part JJ); establishes a community doula expansion grant program to support community-based doulas and community-based doula organizations; provides for the repeal of such program upon expiration thereof (Part KK); provides for Medicaid reimbursement rates for treatment of medically fragile children at pediatric diagnostic and treatment centers and repeals such provisions upon expiration thereof (Part LL); establishes the nine member community advisory board for the modernization and revitalization of SUNY downstate health sciences university; requires such advisory board to solicit recommendations from healthcare experts, county health departments, community-based organizations, state and regional health care industry associations, labor unions, experts in hospital operations, and other interested parties; requires recommendations and a report to the governor, the temporary president of the senate and the speaker of the assembly no later than April 1, 2025; makes related provisions (Part MM); extends certain provisions relating to certain Medicaid payments made for hospital services (Part NN).
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A08807 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
            S. 8307--C                                            A. 8807--C
 
                SENATE - ASSEMBLY
 
                                    January 17, 2024
                                       ___________
 
        IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
          cle seven of the Constitution -- read twice and ordered  printed,  and
          when  printed to be committed to the Committee on Finance -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee  --  committee  discharged,  bill  amended,  ordered
          reprinted  as  amended  and recommitted to said committee -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee
 
        IN ASSEMBLY -- A BUDGET BILL, submitted  by  the  Governor  pursuant  to
          article  seven  of  the  Constitution -- read once and referred to the
          Committee on Ways and Means --  committee  discharged,  bill  amended,
          ordered  reprinted  as  amended  and  recommitted to said committee --
          again reported from said committee with amendments, ordered  reprinted
          as  amended  and  recommitted to said committee -- again reported from
          said committee with  amendments,  ordered  reprinted  as  amended  and
          recommitted to said committee
 
        AN  ACT  to amend part H of chapter 59 of the laws of 2011, amending the
          public  health  law  and  other  laws  relating  to  general  hospital
          reimbursement  for  annual  rates,  in relation to known and projected
          department of health state fund medicaid  expenditures  (Part  A);  to
          amend  the  public  health  law,  in  relation  to  extending  certain
          provisions related to the issuance of  accountable  care  organization
          certifications  and  state oversight of antitrust provisions; to amend
          part D of chapter 56 of the laws of 2013 amending the social  services
          law  relating  to  eligibility  conditions, chapter 649 of the laws of
          1996 amending the public health law, the mental hygiene  law  and  the
          social  services  law  relating  to  authorizing  the establishment of
          special needs plans, part V of chapter 57 of the laws of 2022 amending
          the public health law and the insurance law relating to  reimbursement
          for  commercial and Medicaid services provided via telehealth, chapter
          659 of the laws of 1997 amending the public health law and other  laws
          relating  to  creation of continuing care retirement communities, part
          NN of chapter 57 of the laws of 2018 amending the  public  health  law
          and  the state finance law relating to enacting the opioid stewardship
          act, part II of chapter 54 of the laws of  2016  amending  part  C  of
          chapter  58 of the laws of 2005 relating to authorizing reimbursements
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD12671-05-4

        S. 8307--C                          2                         A. 8807--C
 
          for expenditures made by or on behalf of social services districts for
          medical assistance for needy persons and administration thereof,  part
          B  of  chapter 57 of the laws of 2015 amending the social services law
          and  other laws relating to energy audits and/or disaster preparedness
          reviews of residential healthcare facilities by the commissioner, part
          H of chapter 57 of the laws of 2019 amending  the  public  health  law
          relating to waiver of certain regulations, part Q of chapter 59 of the
          laws  of 2016, amending the mental hygiene law relating to the closure
          or transfer of a state-operated  individualized  residential  alterna-
          tive,  and chapter 769 of the laws of 2023, amending the public health
          law relating to the  adult  cystic  fibrosis  assistance  program,  in
          relation to the effectiveness thereof; and to amend chapter 670 of the
          laws of 2021, requiring the office for people with developmental disa-
          bilities  to  establish the care demonstration program, in relation to
          the establishment of a care demonstration program and  the  effective-
          ness  thereof  (Part  B);  to  amend the education law, in relation to
          removing the exemption for school psychologists to render early inter-
          vention services; and to amend chapter 217 of the laws of 2015, amend-
          ing the education law relating to certified school  psychologists  and
          special  education  services  and programs for preschool children with
          handicapping conditions, in  relation  to  the  effectiveness  thereof
          (Part  C); to amend the public health law, in relation to reducing the
          hospital capital rate add-on; to amend part ZZ of chapter  56  of  the
          laws  of 2020 amending the tax law and the  social services law relat-
          ing to certain Medicaid management, in relation to  the  effectiveness
          thereof;  to  amend part E of chapter 57 of the laws of 2015, amending
          the public health law relating to the payment  of  certain  funds  for
          uncompensated  care,  in  relation  to  certain payments being made as
          outpatient  upper  payment  limit  payments  for  outpatient  hospital
          services  during  certain  state  fiscal  years and calendar years; to
          amend part B of chapter 57 of the laws of 2015,  amending  the  social
          services  law relating to supplemental rebates, in relation to author-
          izing the department of health to increase operating cost component of
          rates of payment for general hospital outpatient services and  author-
          izing  the department of health to pay a public hospital adjustment to
          public general hospitals during certain state fiscal years and  calen-
          dar  years; to amend the public health law, in relation to authorizing
          the commissioner to make additional inpatient hospital payments during
          certain state fiscal years and calendar years; and to amend part B  of
          chapter  58  of the laws of 2010, amending the social services law and
          the public health law relating to prescription drug coverage for needy
          persons and health care initiatives pools, in relation to  authorizing
          the department of health to make Medicaid payment increases for county
          operated  free-standing  clinics during certain state fiscal years and
          calendar years (Part D); to amend the public health law,  in  relation
          to  freezing  the operating component of the rates for skilled nursing
          facilities, reducing the capital component of the  rates  for  skilled
          nursing  facilities  by an additional ten percent, and eligibility for
          admission to the New York state veterans' home (Part E); to amend  the
          social  services law, in relation to the special needs assisted living
          residence voucher program (Part F); intentionally omitted (Part G); to
          amend part I of chapter 57 of  the  laws  of  2022,  providing  a  one
          percent  across  the board payment increase to all qualifying fee-for-
          service Medicaid rates, in relation to  eliminating  the  one  percent
          rate  increase  to  managed  care organizations (Part H); to amend the
          social services law, in relation to copayments for drugs; to amend the

        S. 8307--C                          3                         A. 8807--C
 
          public health law, in relation to the preferred drug program; to amend
          the public health law, in relation to the Medicaid drug cap and  phar-
          macy cost reporting; and to amend the social services law, in relation
          to  coverage for drugs authorized by accelerated approval (Part I); to
          amend the social services law,  in  relation  to  renaming  the  basic
          health program to the essential plan; to amend part H of chapter 57 of
          the  laws of 2021, amending the social services law relating to elimi-
          nating consumer-paid premium payments in the basic health program,  in
          relation to the effectiveness thereof; to amend part BBB of chapter 56
          of  the  laws  of  2022, amending the public health law and other laws
          relating to permitting the commissioner of health to submit  a  waiver
          that  expands  eligibility  for  New  York's  basic health program and
          increases the federal poverty  limit  cap  for  basic  health  program
          eligibility  from    two  hundred  to  two  hundred  fifty percent, in
          relation to extending certain provisions related  to  providing  long-
          term  services and supports under the essential plan; and to amend the
          public health law, in relation to adding references to the 1332  state
          innovation  waiver,  providing  a new subsidy to assist low-income New
          Yorkers with the payment of premiums, cost-sharing or both through the
          marketplace, and adding the 1332 state innovation program to the func-
          tions of the marketplace (Part J); to amend chapter 266 of the laws of
          1986 amending the civil practice law and rules and other laws relating
          to malpractice and professional medical conduct, in relation to insur-
          ance coverage paid for by funds from  the  hospital  excess  liability
          pool and extending the effectiveness of certain provisions thereof; to
          amend part J of chapter 63 of the laws of 2001 amending chapter 266 of
          the  laws  of 1986 amending the civil practice law and rules and other
          laws relating to malpractice  and  professional  medical  conduct,  in
          relation  to  extending  certain  provisions  concerning  the hospital
          excess liability pool; and to amend part H of chapter 57 of  the  laws
          of 2017 amending the New York Health Care Reform Act of 1996 and other
          laws  relating  to  extending  certain provisions relating thereto, in
          relation to extending provisions relating to excess coverage (Part K);
          intentionally omitted (Part L); to amend the social services  law  and
          the  public health law, in relation to authorizing continuous coverage
          in Medicaid and child health plus, for eligible children ages zero  to
          six  (Part  M);  intentionally  omitted  (Part N); to amend the public
          health law, in relation to  expanding  financial  assistance;  and  to
          amend  the  general  business  law, in relation to additional consumer
          protection for medical debt and restricting the applications  for  and
          use  of credit cards and medical financial products (Part O); to amend
          part C of chapter 57 of the laws of 2022 amending  the  public  health
          law  and  the education law relating to allowing pharmacists to direct
          limited service laboratories and order  and  administer  COVID-19  and
          influenza tests and modernizing nurse practitioners, and chapter 21 of
          the  laws  of  2011 amending the education law relating to authorizing
          pharmacists to perform  collaborative  drug  therapy  management  with
          physicians in certain settings, in relation to the effectiveness ther-
          eof  (Part  P);  intentionally omitted (Part Q); intentionally omitted
          (Part R); to amend the public health law, in relation to  establishing
          the  healthcare  safety  net  transformation  program (Part S); inten-
          tionally omitted (Part T);  intentionally  omitted  (Part  U);  inten-
          tionally  omitted  (Part  V);  intentionally  omitted (Part W); inten-
          tionally omitted (Part X); to amend chapter 62 of the  laws  of  2003,
          amending  the mental hygiene law and the state finance law relating to
          the  community  mental  health  support  and  workforce   reinvestment

        S. 8307--C                          4                         A. 8807--C
 
          program, the membership of subcommittees for mental health of communi-
          ty  services  boards and the duties of such subcommittees and creating
          the community mental health and  workforce  reinvestment  account,  in
          relation  to  the  effectiveness thereof (Part Y); to amend part NN of
          chapter 58 of the laws of 2015, amending the mental hygiene law relat-
          ing to clarifying the authority of the commissioners in the department
          of mental hygiene to design and implement  time-limited  demonstration
          programs,  in relation to the effectiveness thereof (Part Z); to amend
          the insurance law, in relation to setting  minimal  reimbursement  for
          behavioral  health  treatment  (Part  AA); to amend chapter 723 of the
          laws of 1989 amending the mental hygiene law and other  laws  relating
          to  comprehensive  psychiatric emergency programs, in  relation to the
          effectiveness of certain provisions thereof (Part  BB);  intentionally
          omitted  (Part CC); to amend part A of chapter 111 of the laws of 2010
          amending the mental hygiene law relating to the receipt of federal and
          state benefits received by individuals receiving  care  in  facilities
          operated by an office of the department of mental hygiene, in relation
          to  the  effectiveness  thereof (Part DD); intentionally omitted (Part
          EE); to establish a cost of living  adjustment  for  designated  human
          services  programs  (Part  FF);  to  amend the social services law, in
          relation to providing contracting  flexibility  in  relation  to  1115
          medicaid  waivers  (Part  GG);  to  amend  the social services law, in
          relation to statewide fiscal intermediaries and a registration process
          for such intermediaries; to amend the social services law, in relation
          to the consumer directed personal assistance program;  and  to  repeal
          certain  provisions  of the social services law relating thereto (Part
          HH); to amend the public health law and  the  state  finance  law,  in
          relation to establishing a New York managed care organization provider
          tax (Part II); to amend the social services law, in relation to cover-
          age  for  services provided by school-based health centers for medical
          assistance recipients (Part JJ); to amend the public  health  law,  in
          relation to the creation of a community doula expansion grant program;
          and to repeal such program upon expiration thereof (Part KK); to amend
          the  public  health  law,  in  relation  to  reimbursement  rates  for
          medically fragile children  and  pediatric  diagnostic  and  treatment
          centers;  and  providing  for  the  repeal of such provisions upon the
          expiration thereof (Part LL); to amend the executive law, in  relation
          to establishing the community advisory board for the modernization and
          revitalization of SUNY downstate health sciences university (Part MM);
          and  to amend part I of chapter 57 of the laws of 2022 providing a one
          percent across the board payment increase to all  qualifying  fee-for-
          service  Medicaid rates, in relation to certain Medicaid payments made
          for hospital services (Part NN)
 
          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  necessary to implement the state health and mental  hygiene  budget  for
     3  the  2024-2025  state  fiscal  year.  Each component is wholly contained
     4  within a Part identified as Parts A through NN. The effective  date  for
     5  each particular provision contained within such Part is set forth in the
     6  last section of such Part. Any provision in any section contained within
     7  a  Part,  including the effective date of the Part, which makes a refer-
     8  ence to a section "of this act",  when  used  in  connection  with  that

        S. 8307--C                          5                         A. 8807--C
 
     1  particular  component,  shall  be deemed to mean and refer to the corre-
     2  sponding section of the Part in which it is found. Section three of this
     3  act sets forth the general effective date of this act.
 
     4                                   PART A
 
     5    Section  1.  Paragraph (a) of subdivision 1 of section 92 of part H of
     6  chapter 59 of the laws of 2011, amending the public health law and other
     7  laws relating to general hospital reimbursement  for  annual  rates,  as
     8  amended  by  section  1  of part A of chapter 57 of the laws of 2023, is
     9  amended to read as follows:
    10    (a) For state fiscal years  2011-12  through  [2024-25]  2025-26,  the
    11  director  of the budget, in consultation with the commissioner of health
    12  referenced as "commissioner" for purposes of this section, shall  assess
    13  on  a  quarterly  basis,  as  reflected in quarterly reports pursuant to
    14  subdivision five of this  section  known  and  projected  department  of
    15  health  state  funds medicaid expenditures by category of service and by
    16  geographic regions, as defined by the commissioner.
    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, 2024.
 
    19                                   PART B
 
    20    Section  1. Subdivision p of section 76 of part D of chapter 56 of the
    21  laws of 2013 amending the social services law  relating  to  eligibility
    22  conditions,  as amended by section 2 of part E of chapter 57 of the laws
    23  of 2019, is amended to read as follows:
    24    p. the amendments to subparagraph 7 of paragraph (b) of subdivision  1
    25  of  section  366  of the social services law made by section one of this
    26  act shall expire and be deemed repealed October 1, [2024] 2029.
    27    § 2. Section 10 of chapter 649 of the laws of 1996 amending the public
    28  health law, the mental hygiene law and the social services law  relating
    29  to  authorizing  the establishment of special needs plans, as amended by
    30  section 21 of part E of chapter 57 of the laws of 2019,  is  amended  to
    31  read as follows:
    32    §  10.  This  act shall take effect immediately and shall be deemed to
    33  have been in full force and effect on and after July 1, 1996;  provided,
    34  however,  that  sections one, two and three of this act shall expire and
    35  be deemed repealed [on] March 31, [2025] 2030 provided, however that the
    36  amendments to section 364-j of the social services law made  by  section
    37  four  of  this  act  shall not affect the expiration of such section and
    38  shall be deemed to expire therewith  and  provided,  further,  that  the
    39  provisions  of  subdivisions  8,  9 and 10 of section 4401 of the public
    40  health law, as added by section one of this act; section 4403-d  of  the
    41  public health law as added by section two of this act and the provisions
    42  of  section seven of this act, except for the provisions relating to the
    43  establishment of no more than twelve  comprehensive  HIV  special  needs
    44  plans, shall expire and be deemed repealed on July 1, 2000.
    45    §  3.  Subdivision  3  of  section 2999-p of the public health law, as
    46  amended by section 8 of part BB of chapter 56 of the laws  of  2020,  is
    47  amended to read as follows:
    48    3.  The commissioner may issue a certificate of authority to an entity
    49  that meets conditions for ACO certification as set forth in  regulations
    50  made  by  the commissioner pursuant to section twenty-nine hundred nine-
    51  ty-nine-q of this article. The commissioner  shall  not  issue  any  new

        S. 8307--C                          6                         A. 8807--C
 
     1  certificate under this article after December thirty-first, two thousand
     2  [twenty-four] twenty-eight.
     3    §  4.  Subdivision  1  of section 2999-aa of the public health law, as
     4  amended by section 9 of part S of chapter 57 of the  laws  of  2021,  is
     5  amended to read as follows:
     6    1.  In order to promote improved quality and efficiency of, and access
     7  to, health care services and to promote improved  clinical  outcomes  to
     8  the  residents  of  New  York,  it  shall  be the policy of the state to
     9  encourage, where appropriate, cooperative, collaborative and integrative
    10  arrangements including but not  limited  to,  mergers  and  acquisitions
    11  among  health  care  providers  or  among  others who might otherwise be
    12  competitors, under the active supervision of the  commissioner.  To  the
    13  extent  such arrangements, or the planning and negotiations that precede
    14  them, might be anti-competitive within the meaning  and  intent  of  the
    15  state and federal antitrust laws, the intent of the state is to supplant
    16  competition  with  such  arrangements  under  the active supervision and
    17  related administrative actions  of  the  commissioner  as  necessary  to
    18  accomplish  the  purposes  of  this article, and to provide state action
    19  immunity under the state and federal  antitrust  laws  with  respect  to
    20  activities  undertaken  by  health care providers and others pursuant to
    21  this article, where the benefits of such  active  supervision,  arrange-
    22  ments  and actions of the commissioner outweigh any disadvantages likely
    23  to result from a reduction of competition. The  commissioner  shall  not
    24  approve  an  arrangement for which state action immunity is sought under
    25  this article without first consulting with, and receiving a  recommenda-
    26  tion from, the public health and health planning council. No arrangement
    27  under  this  article  shall be approved after December thirty-first, two
    28  thousand [twenty-four] twenty-eight.
    29    § 5. Section 7 of part V of chapter 57 of the laws  of  2022  amending
    30  the  public  health  law and the insurance law relating to reimbursement
    31  for commercial and Medicaid services provided via telehealth, is amended
    32  to read as follows:
    33    § 7. This act shall take effect immediately and  shall  be  deemed  to
    34  have been in full force and effect on and after April 1, 2022; provided,
    35  however, this act shall expire and be deemed repealed on and after April
    36  1, [2024] 2026.
    37    § 6. Section 97 of chapter 659 of the laws of 1997 amending the public
    38  health  law  and  other  laws  relating  to  creation of continuing care
    39  retirement communities, as amended by section 11 of part Z of chapter 57
    40  of the laws of 2018, is amended to read as follows:
    41    § 97. This act shall take effect immediately, provided, however,  that
    42  the  amendments to subdivision 4 of section 854 of the general municipal
    43  law made by section seventy of this act shall not affect the  expiration
    44  of such subdivision and shall be deemed to expire therewith and provided
    45  further  that  sections  sixty-seven  and  sixty-eight of this act shall
    46  apply to taxable years  beginning  on  or  after  January  1,  1998  and
    47  provided  further  that sections eighty-one through eighty-seven of this
    48  act shall expire and be deemed repealed on December 31, [2024] 2029  and
    49  provided further, however, that the amendments to section ninety of this
    50  act  shall  take effect January 1, 1998 and shall apply to all policies,
    51  contracts, certificates, riders or other evidences of coverage  of  long
    52  term  care  insurance  issued,  renewed, altered or modified pursuant to
    53  section 3229 of the insurance law on or after such date.
    54    § 7. Section 5 of part NN of chapter 57 of the laws of  2018  amending
    55  the public health law and the state finance law relating to enacting the

        S. 8307--C                          7                         A. 8807--C
 
     1  opioid stewardship act, as amended by section 5 of part XX of chapter 59
     2  of the laws of 2019, is amended to read as follows:
     3    §  5.  This act shall take effect July 1, 2018 and shall expire and be
     4  deemed to be repealed on June 30, [2024] 2029, provided that,  effective
     5  immediately,  the addition, amendment and/or repeal of any rule or regu-
     6  lation necessary for the implementation of this  act  on  its  effective
     7  date are authorized to be made and completed on or before such effective
     8  date,  and,  provided  that  this  act  shall  only apply to the sale or
     9  distribution of opioids in the state of New York on or  before  December
    10  31, 2018.
    11    §  8.  Section 2 of part II of chapter 54 of the laws of 2016 amending
    12  part C of chapter 58  of  the  laws  of  2005  relating  to  authorizing
    13  reimbursements  for expenditures made by or on behalf of social services
    14  districts for medical assistance for needy  persons  and  administration
    15  thereof, as amended by section 6 of part CC of chapter 57 of the laws of
    16  2022, is amended to read as follows:
    17    §  2.  This  act shall take effect immediately and shall expire and be
    18  deemed repealed March 31, [2024] 2026.
    19    § 9. Subdivision 5 of section 60 of part B of chapter 57 of  the  laws
    20  of  2015  amending  the  social  services law and other laws relating to
    21  energy  audits  and/or  disaster  preparedness  reviews  of  residential
    22  healthcare  facilities by the commissioner, as amended by chapter 125 of
    23  the laws of 2021, is amended to read as follows:
    24    5. section thirty-eight  of  this  act  shall  expire  and  be  deemed
    25  repealed July 1, [2024] 2027;
    26    §  10. Section 7 of part H of chapter 57 of the laws of 2019, amending
    27  the public health law relating to  waiver  of  certain  regulations,  as
    28  amended  by  section  1 of part GG of chapter 57 of the laws of 2022, is
    29  amended to read as follows:
    30    § 7. This act shall take effect immediately and  shall  be  deemed  to
    31  have been in full force and effect on and after April 1, 2019, provided,
    32  however,  that  section  two of this act shall expire on April 1, [2024]
    33  2026.
    34    § 11. Section 2 of part Q of chapter 59 of the laws of 2016,  amending
    35  the  mental  hygiene law relating to the closure or transfer of a state-
    36  operated individualized residential alternative, as amended  by  chapter
    37  176 of the laws of 2022, is amended to read as follows:
    38    §  2.  This  act shall take effect immediately and shall expire and be
    39  deemed repealed March 31, [2024] 2026.
    40    § 12. Subdivision (a) of section 1 of chapter 670 of the laws of 2021,
    41  requiring the office  for  people  with  developmental  disabilities  to
    42  establish the care demonstration program, is amended to read as follows:
    43    (a) The commissioner of the office for people with developmental disa-
    44  bilities  [shall]  may,  at  their discretion, establish the care demon-
    45  stration program, to utilize the state workforce  to  provide  community
    46  based care to individuals with developmental disabilities.
    47    §  13.  Section  3  of  chapter 670 of the laws of 2021, requiring the
    48  office for people with developmental disabilities to establish the  care
    49  demonstration program, is amended to read as follows:
    50    §  3.  This  act shall take effect immediately and shall expire and be
    51  deemed repealed March 31, [2024] 2026.
    52    § 14. Section 2 of chapter 769 of  the  laws  of  2023,  amending  the
    53  public  health  law  relating  to  the  adult cystic fibrosis assistance
    54  program, as amended by chapter 31 of the laws of  2024,  is  amended  to
    55  read as follows:

        S. 8307--C                          8                         A. 8807--C
 
     1    § 2. This act shall take effect immediately and shall expire March 31,
     2  [2024]  2025  when  upon  such  date the provisions of this act shall be
     3  deemed repealed.
     4    §  15.  This  act shall take effect immediately and shall be deemed to
     5  have been in full force and effect on and after March 31, 2024.
 
     6                                   PART C
 
     7    Section 1. Paragraph d of subdivision 6 of section 4410 of the  educa-
     8  tion  law,  as amended by chapter 217 of the laws of 2015, is amended to
     9  read as follows:
    10    d. Notwithstanding any other provision of law  to  the  contrary,  the
    11  exemption in subdivision one of section seventy-six hundred five of this
    12  chapter  shall  apply  to  persons  employed on a full-time or part-time
    13  salary basis, which may include on an hourly, weekly, or monthly  basis,
    14  or  on  a fee for evaluation services basis provided that such person is
    15  employed by and under the dominion and control of a center-based program
    16  approved pursuant to subdivision nine of this  section  as  a  certified
    17  school psychologist to provide activities, services and use of the title
    18  psychologist to students enrolled in such approved center-based program;
    19  and  to  certified school psychologists employed on a full-time or part-
    20  time salary basis, which may include on an hourly,  weekly,  or  monthly
    21  basis,  or  on  a  fee  for  evaluation services basis provided that the
    22  school psychologist is employed by and under the dominion and control of
    23  a program that has been approved pursuant to paragraph b of  subdivision
    24  nine  of this section, or subdivision nine-a of this section, to conduct
    25  a multi-disciplinary evaluation of a preschool child having or suspected
    26  of having a disability where authorized by paragraph a [or b] of  subdi-
    27  vision  six  of section sixty-five hundred three-b of this chapter[; and
    28  to certified school psychologists employed on a full-time  or  part-time
    29  salary  basis, which may include on an hourly, weekly, or monthly basis,
    30  or on a fee for evaluation services basis provided  that  such  psychol-
    31  ogist  is  employed  by  and under the dominion and control of an agency
    32  approved in accordance with title two-A of article  twenty-five  of  the
    33  public  health  law to deliver early intervention program multidiscipli-
    34  nary evaluations, service coordination services and  early  intervention
    35  program  services,  where  authorized by paragraph a or b of subdivision
    36  six of section sixty-five hundred three-b of this chapter, each], in the
    37  course of their employment. Nothing in this section shall  be  construed
    38  to  authorize  a  certified  school psychologist or group of such school
    39  psychologists to engage in independent practice or practice  outside  of
    40  an employment relationship.
    41    § 2. Subdivision 1 of section 7605 of the education law, as amended by
    42  chapter 217 of the laws of 2015, is amended to read as follows:
    43    1.  The activities, services, and use of the title of psychologist, or
    44  any derivation thereof, on the part of a  person  in  the  employ  of  a
    45  federal,  state, county or municipal agency, or other political subdivi-
    46  sion, or a chartered elementary or secondary school  or  degree-granting
    47  educational  institution  insofar  as such activities and services are a
    48  part of the duties of [his] such salaried position; or on the part of  a
    49  person  in  the employ as a certified school psychologist on a full-time
    50  or part-time salary basis, which may include on an  hourly,  weekly,  or
    51  monthly  basis,  or on a fee for evaluation services basis provided that
    52  such person employed as a certified school psychologist is  employed  by
    53  and  under  the  dominion  and  control of a preschool special education
    54  program approved pursuant to paragraph b of subdivision nine or subdivi-

        S. 8307--C                          9                         A. 8807--C

     1  sion nine-a of section forty-four hundred ten of this chapter to provide
     2  activities, services and to use the  title  "certified  school  psychol-
     3  ogist",  so long as this shall not be construed to permit the use of the
     4  title  "licensed  psychologist",  to  students enrolled in such approved
     5  program or to conduct a  multidisciplinary  evaluation  of  a  preschool
     6  child  having  or suspected of having a disability[; or on the part of a
     7  person in the employ as a certified school psychologist on  a  full-time
     8  or  part-time  salary  basis,  which may include on an hourly, weekly or
     9  monthly basis, or on a fee for evaluation services basis  provided  that
    10  such  person  employed as a certified school psychologist is employed by
    11  and under the dominion and control of an agency approved  in  accordance
    12  with  title  two-A  of  article  twenty-five of the public health law to
    13  deliver  early  intervention  program   multidisciplinary   evaluations,
    14  service  coordination services and early intervention program services],
    15  where each such preschool special education  program  [or  early  inter-
    16  vention provider] is authorized by paragraph a [or b] of subdivision six
    17  of  section  sixty-five hundred [three] three-b of this title[, each] in
    18  the course of their employment. Nothing in  this  subdivision  shall  be
    19  construed  to authorize a certified school psychologist or group of such
    20  school psychologists to  engage  in  independent  practice  or  practice
    21  outside of an employment relationship.
    22    § 3. Section 3 of chapter 217 of the laws of 2015, amending the educa-
    23  tion  law  relating to certified school psychologists and special educa-
    24  tion services and programs  for  preschool  children  with  handicapping
    25  conditions, as amended by chapter 339 of the laws of 2022, is amended to
    26  read as follows:
    27    §  3.  This  act  shall take effect immediately and shall be deemed to
    28  have been in full force and effect on and after July 1, 2014,  provided,
    29  however  that  the  provisions  of  this  act shall expire and be deemed
    30  repealed June 30, [2024] 2026.
    31    § 4. This act shall take effect immediately and  shall  be  deemed  to
    32  have been in full force and effect on and after April 1, 2024; provided,
    33  however,  that  sections one and two of this act shall take effect April
    34  1, 2025; provided further, however, that the amendments to  paragraph  d
    35  of  subdivision  6  of section 4410 of the education law made by section
    36  one of this act shall not affect the expiration of  such  paragraph  and
    37  shall be deemed to expire therewith; and provided further, however, that
    38  the  amendments  to  subdivision  1 of section 7605 of the education law
    39  made by section two of this act shall not affect the expiration of  such
    40  subdivision and shall be deemed to expire therewith.
 
    41                                   PART D
 
    42    Section  1.  Paragraph  (c)  of subdivision 8 of section 2807-c of the
    43  public health law, as amended by section 1 of part D of  chapter  57  of
    44  the laws of 2021, is amended to read as follows:
    45    (c)  In order to reconcile capital related inpatient expenses included
    46  in rates of payment based on a budget to actual expenses and  statistics
    47  for  the  rate  period  for  a  general hospital, rates of payment for a
    48  general hospital shall be adjusted to reflect the dollar  value  of  the
    49  difference  between  capital  related inpatient expenses included in the
    50  computation of rates of payment for a prior rate period based on a budg-
    51  et and actual capital related inpatient expenses  for  such  prior  rate
    52  period,  each  as  determined  in  accordance with paragraph (a) of this
    53  subdivision, adjusted to reflect increases or  decreases  in  volume  of
    54  service  in  such  prior  rate  period compared to statistics applied in

        S. 8307--C                         10                         A. 8807--C
 
     1  determining the capital related inpatient expenses component of rates of
     2  payment based on a budget for such prior rate period.
     3    For  rates  effective  April  first, two thousand twenty through March
     4  thirty-first, two  thousand  twenty-one,  the  budgeted  capital-related
     5  expenses add-on as described in paragraph (a) of this subdivision, based
     6  on  a  budget  submitted in accordance to paragraph (a) of this subdivi-
     7  sion, shall be reduced by five percent relative to the rate in effect on
     8  such date; and the actual capital expenses add-on as described in  para-
     9  graph  (a)  of this subdivision, based on actual expenses and statistics
    10  through appropriate audit procedures in accordance with paragraph (a) of
    11  this subdivision shall be reduced by five percent relative to  the  rate
    12  in effect on such date.
    13    For  rates  effective [on and after] April first, two thousand twenty-
    14  one through September thirtieth, two thousand twenty-four, the  budgeted
    15  capital-related  expenses  add-on  as described in paragraph (a) of this
    16  subdivision, based on a budget submitted in accordance to paragraph  (a)
    17  of  this  subdivision,  shall  be reduced by ten percent relative to the
    18  rate in effect on such date; and the actual capital expenses  add-on  as
    19  described in paragraph (a) of this subdivision, based on actual expenses
    20  and  statistics  through appropriate audit procedures in accordance with
    21  paragraph (a) of this subdivision shall be reduced by ten percent  rela-
    22  tive to the rate in effect on such date.
    23    For  rates  effective on and after October first, two thousand twenty-
    24  four, the budgeted capital-related expenses add-on as described in para-
    25  graph (a) of this subdivision, based on a budget submitted in accordance
    26  with paragraph (a) of this  subdivision,  shall  be  reduced  by  twenty
    27  percent  relative  to  the  rate  in effect on such date; and the actual
    28  capital expenses add-on as described in paragraph (a) of  this  subdivi-
    29  sion  shall  be reduced by twenty percent relative to the rate in effect
    30  on such date.
    31    For any rate year, all reconciliation add-on  amounts  calculated  [on
    32  and  after]  for  the period of April first, two thousand twenty through
    33  September thirtieth, two thousand twenty-four shall be  reduced  by  ten
    34  percent,  and  all  reconciliation  recoupment amounts calculated [on or
    35  after] for the period  of  April  first,  two  thousand  twenty  through
    36  September  thirtieth,  two  thousand  twenty-four  shall increase by ten
    37  percent.
    38    For any rate year, all reconciliation add-on amounts calculated on and
    39  after October first, two thousand twenty-four shall be reduced by twenty
    40  percent, and all reconciliation  recoupment  amounts  calculated  on  or
    41  after  October  first, two thousand twenty-four shall increase by twenty
    42  percent.
    43    Notwithstanding any inconsistent  provision  of  subparagraph  (i)  of
    44  paragraph (e) of subdivision nine of this section, capital related inpa-
    45  tient  expenses  of  a  general  hospital included in the computation of
    46  rates of payment based on a budget shall not be included in the computa-
    47  tion of a volume adjustment made in accordance with  such  subparagraph.
    48  Adjustments  to rates of payment for a general hospital made pursuant to
    49  this paragraph shall be made in accordance with paragraph (c) of  subdi-
    50  vision  eleven  of  this  section. Such adjustments shall not be carried
    51  forward except for such  volume  adjustment  as  may  be  authorized  in
    52  accordance with subparagraph (i) of paragraph (e) of subdivision nine of
    53  this section for such general hospital.
    54    §  2.  Section 5 of part ZZ of chapter 56 of the laws of 2020 amending
    55  the tax law and the social services law  relating  to  certain  Medicaid

        S. 8307--C                         11                         A. 8807--C
 
     1  management, as amended by section 3 of part RR of chapter 57 of the laws
     2  of 2022, is amended to read as follows:
     3    §  5.  This  act  shall  take  effect  immediately and shall be deemed
     4  repealed [five] eight years after such effective date.
     5    § 3. Section 2 of part E of chapter 57 of the laws of  2015,  amending
     6  the  public  health  law  relating  to  the payment of certain funds for
     7  uncompensated care, is amended to read as follows:
     8    § 2. Notwithstanding any inconsistent provision of law, rule or  regu-
     9  lation  to  the  contrary,  and  subject  to the availability of federal
    10  financial participation pursuant to title  XIX  of  the  federal  social
    11  security  act,  effective  for  [periods on and after] each state fiscal
    12  year from April 1, 2015, through December 31, 2024; and for the calendar
    13  year January 1, 2025 through December 31, 2025; and  for  each  calendar
    14  year thereafter, payments pursuant to paragraph (i) of subdivision 35 of
    15  section  2807-c of the public health law may be made as outpatient upper
    16  payment limit payments for outpatient hospital services, not  to  exceed
    17  an  amount of three hundred thirty-nine million dollars annually between
    18  payments authorized under this section and such section  of  the  public
    19  health  law.  Such payments shall be made as medical assistance payments
    20  for outpatient services pursuant to title 11 of article 5 of the  social
    21  services  law  for patients eligible for federal financial participation
    22  under title XIX of the federal social security act for general  hospital
    23  outpatient  services and general hospital emergency room services issued
    24  pursuant to paragraph (g) of subdivision 2 of section 2807 of the public
    25  health law to general hospitals, other than major public general  hospi-
    26  tals,  providing emergency room services and including safety net hospi-
    27  tals, which shall, for the purpose of  this  paragraph,  be  defined  as
    28  having  either:  a Medicaid share of total inpatient hospital discharges
    29  of at least thirty-five  percent,  including  both  fee-for-service  and
    30  managed  care  discharges  for  acute and exempt services; or a Medicaid
    31  share of total discharges of at least  thirty  percent,  including  both
    32  fee-for-service  and  managed  care  discharges  for  acute  and  exempt
    33  services, and also  providing  obstetrical  services.    Eligibility  to
    34  receive  such additional payments shall be based on data from the period
    35  two years prior to the rate year, as reported on the institutional  cost
    36  report submitted to the department as of October first of the prior rate
    37  year.  No  eligible general hospital's annual payment amount pursuant to
    38  this section shall exceed the lower of the sum of the annual amounts due
    39  that hospital pursuant  to  section  twenty-eight  hundred  seven-k  and
    40  section  twenty-eight  hundred  seven-w of the public health law; or the
    41  hospital's facility specific projected disproportionate  share  hospital
    42  payment  ceiling established pursuant to federal law, provided, however,
    43  that payment amounts to eligible hospitals in excess  of  the  lower  of
    44  such  sum  or payment ceiling shall be reallocated to eligible hospitals
    45  that do not have excess payment amounts.  Such  reallocations  shall  be
    46  proportional  to  each such hospital's aggregate payment amount pursuant
    47  to paragraph (i) of subdivision 35  of  section  2807-c  of  the  public
    48  health law and this section to the total of all payment amounts for such
    49  eligible  hospitals.  Such  adjustment  payment may be added to rates of
    50  payment or made as aggregate  payments  to  eligible  general  hospitals
    51  other  than  major  public general hospitals.   The distribution of such
    52  payments shall be pursuant to a methodology approved by the commissioner
    53  of health in regulation.
    54    § 4. Section 21 of part B of chapter 57 of the laws of 2015,  amending
    55  the  social services law relating to supplemental rebates, is amended to
    56  read as follows:

        S. 8307--C                         12                         A. 8807--C
 
     1    § 21. Notwithstanding any inconsistent provision of law, rule or regu-
     2  lation to the contrary, and  subject  to  the  availability  of  federal
     3  financial  participation  pursuant  to  title  XIX of the federal social
     4  security act, effective for [the period] each  state  fiscal  year  from
     5  April  1, 2011 through [March 31, 2012, and state fiscal years] December
     6  31, 2024; and for the calendar year January 1, 2025 through December 31,
     7  2025; and for each calendar year thereafter, the department of health is
     8  authorized to increase the operating cost component of rates of  payment
     9  for  general hospital outpatient services and general hospital emergency
    10  room services issued pursuant to  paragraph  (g)  of  subdivision  2  of
    11  section  2807  of the public health law for public general hospitals, as
    12  defined in subdivision 10 of section 2801  of  the  public  health  law,
    13  other  than those operated by the state of New York or the state univer-
    14  sity of New York, and located in a  city  with  a  population  over  one
    15  million,  up  to  two  hundred  eighty-seven million dollars annually as
    16  medical assistance payments for outpatient services pursuant to title 11
    17  of article 5 of the social services law for patients eligible for feder-
    18  al financial participation under title XIX of the federal social securi-
    19  ty act based on such criteria and methodologies as the commissioner  may
    20  from time to time set through a memorandum of understanding with the New
    21  York  city  health and hospitals corporation, and such adjustments shall
    22  be paid by means of one or more estimated payments, with such  estimated
    23  payments  to be reconciled to the commissioner of health's final adjust-
    24  ment determinations after the disproportionate  share  hospital  payment
    25  adjustment  caps  have  been  calculated  for such period under sections
    26  1923(f) and (g) of the federal  social  security  act.  Such  adjustment
    27  payment  may  be added to rates of payment or made as aggregate payments
    28  to eligible public general hospitals.
    29    § 5. The opening paragraph of subparagraph (i)  of  paragraph  (i)  of
    30  subdivision 35 of section 2807-c of the public health law, as amended by
    31  section  4  of  part  C of chapter 56 of the laws of 2013, is amended to
    32  read as follows:
    33    Notwithstanding any inconsistent provision of this subdivision or  any
    34  other  contrary  provision  of  law  and  subject to the availability of
    35  federal financial participation, for [the period] each state fiscal year
    36  from July first, two thousand ten through [March thirty-first, two thou-
    37  sand eleven,] December thirty-first, two thousand twenty-four; and [each
    38  state fiscal year period] for the calendar year January first, two thou-
    39  sand twenty-five through December  thirty-first,  two  thousand  twenty-
    40  five; and for each calendar year thereafter, the commissioner shall make
    41  additional inpatient hospital payments up to the aggregate upper payment
    42  limit for inpatient hospital services after all other medical assistance
    43  payments, but not to exceed two hundred thirty-five million five hundred
    44  thousand  dollars  for  the  period July first, two thousand ten through
    45  March thirty-first, two thousand eleven, three hundred fourteen  million
    46  dollars  for  each state fiscal year beginning April first, two thousand
    47  eleven, through March thirty-first, two thousand thirteen, and  no  less
    48  than  three  hundred  thirty-nine  million dollars for each state fiscal
    49  year [thereafter] until December thirty-first, two thousand twenty-four;
    50  and then from calendar year  January  first,  two  thousand  twenty-five
    51  through  December  thirty-first,  two thousand twenty-five; and for each
    52  calendar year thereafter, to general hospitals, other than major  public
    53  general hospitals, providing emergency room services and including safe-
    54  ty  net  hospitals,  which  shall, for the purpose of this paragraph, be
    55  defined as having either: a Medicaid share of total  inpatient  hospital
    56  discharges  of at least thirty-five percent, including both fee-for-ser-

        S. 8307--C                         13                         A. 8807--C
 
     1  vice and managed care discharges for acute and  exempt  services;  or  a
     2  Medicaid share of total discharges of at least thirty percent, including
     3  both  fee-for-service  and  managed care discharges for acute and exempt
     4  services,  and  also  providing  obstetrical  services.  Eligibility  to
     5  receive such additional payments shall be based on data from the  period
     6  two  years prior to the rate year, as reported on the institutional cost
     7  report submitted to the department as of October first of the prior rate
     8  year. Such payments shall be made as  medical  assistance  payments  for
     9  fee-for-service  inpatient hospital services pursuant to title eleven of
    10  article five of the social services law for patients eligible for feder-
    11  al financial participation under title XIX of the federal social securi-
    12  ty act and in accordance with the following:
    13    § 6. Section 18 of part B of chapter 57 of the laws of 2015,  amending
    14  the  social services law relating to supplemental rebates, is amended to
    15  read as follows:
    16    § 18. Notwithstanding any inconsistent provision of law or  regulation
    17  to  the  contrary,  and subject to the availability of federal financial
    18  participation pursuant to title XIX of the federal social security  act,
    19  effective  for  [the  period] each state fiscal year from April 1, 2012,
    20  through [March 31, 2013, and state fiscal years] December 31, 2024;  and
    21  for  the  calendar  year from January 1, 2025 through December 31, 2025;
    22  and for each calendar year  thereafter,  the  department  of  health  is
    23  authorized  to pay a public hospital adjustment to public general hospi-
    24  tals, as defined in subdivision 10 of section 2801 of the public  health
    25  law,  other  than  those  operated by the state of New York or the state
    26  university of New York, and located in a city with a population of  over
    27  1  million,  of  up  to  one  billion eighty million dollars annually as
    28  medical assistance payments for inpatient services pursuant to title  11
    29  of article 5 of the social services law for patients eligible for feder-
    30  al financial participation under title XIX of the federal social securi-
    31  ty  act based on such criteria and methodologies as the commissioner may
    32  from time to time set through a memorandum of understanding with the New
    33  York city health and hospitals corporation, and such  adjustments  shall
    34  be  paid by means of one or more estimated payments, with such estimated
    35  payments to be reconciled to the commissioner of health's final  adjust-
    36  ment  determinations  after  the disproportionate share hospital payment
    37  adjustment caps have been calculated  for  such  period  under  sections
    38  1923(f)  and  (g)  of  the  federal social security act. Such adjustment
    39  payment may be added to rates of payment or made as  aggregate  payments
    40  to eligible public general hospitals.
    41    §  7. Subdivision 1 of section 3-a of part B of chapter 58 of the laws
    42  of 2010, amending the social services law  and  the  public  health  law
    43  relating to prescription drug coverage for needy persons and health care
    44  initiatives pools, is amended to read as follows:
    45    1.  Notwithstanding  any  inconsistent provision of law, rule or regu-
    46  lation to the contrary, and  subject  to  the  availability  of  federal
    47  financial  participation,  effective  for [the period] each state fiscal
    48  year from August 1, 2010 through [March 31, 2011, and each state  fiscal
    49  year]  December 31, 2024; and for the calendar year from January 1, 2025
    50  through December 31, 2025; and for each calendar  year  thereafter,  the
    51  department  of  health  is authorized to make Medicaid payment increases
    52  for diagnostic and treatment centers (DTC) services issued  pursuant  to
    53  section  2807  of  the public health law for public DTCs operated by the
    54  New York City Health and Hospitals Corporation, at the election  of  the
    55  social services district in which an eligible DTC is physically located,
    56  of  up  to  twelve million six hundred thousand dollars on an annualized

        S. 8307--C                         14                         A. 8807--C
 
     1  basis for DTC services pursuant to title 11 of article 5 of  the  social
     2  services  law  for patients eligible for federal financial participation
     3  under title XIX of the federal social security act based  on  each  such
     4  DTC's proportionate share of the sum of all clinic visits for all facil-
     5  ities  eligible  for an adjustment pursuant to this section for the base
     6  year two years prior to the rate year. Such proportionate share payments
     7  may be added to rates of payment or made as aggregate payments to eligi-
     8  ble DTCs.
     9    § 8. Subdivision 1 of section 3-b of part B of chapter 58 of the  laws
    10  of  2010,  amending  the  social  services law and the public health law
    11  relating to prescription drug coverage for needy persons and health care
    12  initiatives pools, is amended to read as follows:
    13    1. Notwithstanding any inconsistent provision of law,  rule  or  regu-
    14  lation  to  the  contrary,  and  subject  to the availability of federal
    15  financial participation, effective for [the period]  each  state  fiscal
    16  year  from August 1, 2010 through [March 31, 2011, and each state fiscal
    17  year] December 31, 2024; and for the calendar year from January 1,  2025
    18  through  December  31,  2025; and for each calendar year thereafter, the
    19  department of health, is authorized to make Medicaid  payment  increases
    20  for  county  operated  diagnostic  and  treatment centers (DTC) services
    21  issued pursuant to section  2807  of  the  public  health  law  and  for
    22  services  provided  by  county  operated  free-standing clinics licensed
    23  pursuant to articles 31 and 32  of  the  mental  hygiene  law,  but  not
    24  including  facilities operated by the New York City Health and Hospitals
    25  Corporation, of up to five million four hundred thousand dollars  on  an
    26  annualized  basis for such services pursuant to title 11 of article 5 of
    27  the social services law for  patients  eligible  for  federal  financial
    28  participation  under title XIX of the federal social security act. Local
    29  social services districts may decline such increased payments  to  their
    30  sponsored  DTCs and free-standing clinics, provided they provide written
    31  notification to the commissioner of health, within thirty days following
    32  receipt of notification of a payment pursuant to this section.  Distrib-
    33  utions pursuant to this  section  shall  be  based  on  each  facility's
    34  proportionate  share  of  the  sum  of all DTC and clinic visits for all
    35  facilities receiving payments pursuant to this section for the base year
    36  two years prior to the rate year. Such proportionate share payments  may
    37  be  added  to rates or payment or made as aggregate payments to eligible
    38  facilities.
    39    § 9. Paragraph (e-1) of subdivision 12 of section 2808 of  the  public
    40  health law, as amended by section 15 of part B of chapter 57 of the laws
    41  of 2023, is amended to read as follows:
    42    (e-1) Notwithstanding any inconsistent provision of law or regulation,
    43  the  commissioner  shall  provide,  in  addition to payments established
    44  pursuant to this article prior to application  of  this  section,  addi-
    45  tional  payments  under the medical assistance program pursuant to title
    46  eleven of article five of the social services law for non-state operated
    47  public residential health care facilities, including public  residential
    48  health  care  facilities  located in the county of Nassau, the county of
    49  Westchester and the county of Erie,  but  excluding  public  residential
    50  health  care  facilities  operated by a town or city within a county, in
    51  aggregate annual amounts of up to one hundred fifty million  dollars  in
    52  additional payments for the state fiscal year beginning April first, two
    53  thousand  six  and  for the state fiscal year beginning April first, two
    54  thousand seven and for the state fiscal year beginning April first,  two
    55  thousand eight and of up to three hundred million dollars in such aggre-
    56  gate  annual  additional  payments  for  the state fiscal year beginning

        S. 8307--C                         15                         A. 8807--C
 
     1  April first, two thousand nine, and for the state fiscal year  beginning
     2  April  first,  two  thousand ten and for the state fiscal year beginning
     3  April first, two thousand eleven, and for the state fiscal years  begin-
     4  ning  April  first,  two  thousand  twelve and April first, two thousand
     5  thirteen, and of up to five hundred million dollars  in  such  aggregate
     6  annual  additional  payments  for the state fiscal years beginning April
     7  first, two thousand fourteen, April  first,  two  thousand  fifteen  and
     8  April  first,  two  thousand  sixteen  and of up to five hundred million
     9  dollars in such aggregate  annual  additional  payments  for  the  state
    10  fiscal years beginning April first, two thousand seventeen, April first,
    11  two thousand eighteen, and April first, two thousand nineteen, and of up
    12  to  five  hundred  million  dollars  in such aggregate annual additional
    13  payments for the state fiscal years beginning April first, two  thousand
    14  twenty, April first, two thousand twenty-one, and April first, two thou-
    15  sand  twenty-two,  and  of  up  to  five hundred million dollars in such
    16  aggregate annual additional payments for the state fiscal  years  begin-
    17  ning  April  first, two thousand twenty-three, and from April first, two
    18  thousand twenty-four until December thirty-first, two  thousand  twenty-
    19  four,  and [April first, two thousand twenty-five] for the calendar year
    20  January first, two thousand twenty-five through  December  thirty-first,
    21  two  thousand  twenty-five,  and for each calendar year thereafter.  The
    22  amount allocated to each eligible public residential health care facili-
    23  ty for this period shall be computed in accordance with  the  provisions
    24  of  paragraph  (f)  of this subdivision, provided, however, that patient
    25  days shall be utilized for such computation reflecting  actual  reported
    26  data  for  two thousand three and each representative succeeding year as
    27  applicable, and provided further, however, that,  in  consultation  with
    28  impacted providers, of the funds allocated for distribution in the state
    29  fiscal  year beginning April first, two thousand thirteen, up to thirty-
    30  two million dollars may be allocated in accordance with paragraph  (f-1)
    31  of this subdivision.
    32    §  10.  This  act  shall  take  effect immediately; provided, however,
    33  section one of this act shall take effect October 1, 2024; and provided,
    34  further, that sections three, four, five, six, seven, eight and nine  of
    35  this act shall take effect January 1, 2025.
 
    36                                   PART E
 
    37    Section  1.  Subparagraph  (ii) of paragraph (b) of subdivision 2-b of
    38  section 2808 of the public health law, as added by section 47 of part  C
    39  of chapter 109 of the laws of 2006, is amended to read as follows:
    40    (ii) (A) The operating component of rates shall be subject to case mix
    41  adjustment  through  application  of  the  relative resource utilization
    42  groups system of patient classification (RUG-III) employed by the feder-
    43  al government with regard to  payments  to  skilled  nursing  facilities
    44  pursuant  to  title XVIII of the federal social security act (Medicare),
    45  as revised by regulation to reflect New  York  state  wages  and  fringe
    46  benefits,  provided,  however,  that  such RUG-III classification system
    47  weights shall be increased in the following amounts  for  the  following
    48  categories  of  residents:  [(A)]  (1)  thirty  minutes for the impaired
    49  cognition A category, [(B)] (2) forty minutes for the impaired cognition
    50  B category, and [(C)] (3) twenty-five minutes for the  reduced  physical
    51  functions  B  category.    Such adjustments shall be made in January and
    52  July of each calendar year. Such adjustments and related patient classi-
    53  fications in each facility shall be subject to audit review  in  accord-
    54  ance with regulations promulgated by the commissioner.

        S. 8307--C                         16                         A. 8807--C
 
     1    (B)  Effective  April  first,  two  thousand twenty-four, the case mix
     2  adjustment from the operating component of the rates for skilled nursing
     3  facilities shall remain unchanged from the  July  two  thousand  twenty-
     4  three  rates  during  the development and until full implementation of a
     5  case mix methodology using the Patient Driven Payment Model.
     6    §  2. Subparagraph (iv) of paragraph (b) of subdivision 2-b of section
     7  2808 of the public health law, as amended by section 1  of  part  NN  of
     8  chapter 56 of the laws of 2020, is amended to read as follows:
     9    (iv)  The  capital cost component of rates on and after January first,
    10  two thousand nine shall: (A) fully reflect the cost  of  local  property
    11  taxes  and payments made in lieu of local property taxes, as reported in
    12  each facility's cost report submitted for the year two  years  prior  to
    13  the  rate  year; (B) provided, however, notwithstanding any inconsistent
    14  provision of this article, commencing April first, two  thousand  twenty
    15  for  rates  of  payment for patients eligible for payments made by state
    16  governmental agencies, the capital cost component determined in  accord-
    17  ance  with  this  subparagraph  and  inclusive of any shared savings for
    18  eligible facilities that elect to refinance their mortgage loans  pursu-
    19  ant  to  paragraph  (d)  of  subdivision two-a of this section, shall be
    20  reduced by the commissioner by five percent; and (C) provided,  however,
    21  notwithstanding  any  inconsistent provision of this article, commencing
    22  April first, two thousand twenty-four for rates of payment for  patients
    23  eligible  for  payments made by state governmental agencies, the capital
    24  cost component determined  in  accordance  with  this  subparagraph  and
    25  inclusive  of  any  shared savings for eligible facilities that elect to
    26  refinance their mortgage loans pursuant to paragraph (d) of  subdivision
    27  two-a  of this section, shall be reduced by the commissioner by an addi-
    28  tional ten percent, provided, however, that  such  reduction  shall  not
    29  apply  to  rates of payment for patients in pediatric residential health
    30  care facilities as defined  in  paragraph  (c)  of  subdivision  two  of
    31  section twenty-eight hundred eight-e of this article.
    32    §  3.  Paragraph  (h)  of  subdivision 1 of section 2632 of the public
    33  health law, as amended by chapter 414 of the laws of 2015, is amended to
    34  read as follows:
    35    (h) in the Persian Gulf conflict from the second day of August,  nine-
    36  teen  hundred  ninety  to  the  end  of such conflict including military
    37  service in Operation Enduring Freedom, Operation Iraqi  Freedom,  Opera-
    38  tion New Dawn or Operation Inherent Resolve and was the recipient of the
    39  global  war  on terrorism expeditionary medal or the Iraq campaign medal
    40  or the Afghanistan campaign medal; and who was a resident of  the  state
    41  of New York at the time of entry upon such active duty or who shall have
    42  been  a  resident of this state for [one year] six months next preceding
    43  the application for admission shall be entitled  to  admission  to  said
    44  home  after  the  approval  of the application by the board of visitors,
    45  subject to the provisions of this article and to the conditions, limita-
    46  tions and penalties prescribed by the regulations of the department. Any
    47  such veteran or dependent, who otherwise fulfills the  requirements  set
    48  forth  in  this section, may be admitted directly to the skilled nursing
    49  facility or the health related facility provided such veteran or depend-
    50  ent is certified by a physician designated or approved by the department
    51  to require the type of care provided by such facilities.
    52    § 4. This act shall take effect immediately and  shall  be  deemed  to
    53  have been in full force and effect on and after April 1, 2024.
 
    54                                   PART F

        S. 8307--C                         17                         A. 8807--C
 
     1    Section  1.  Paragraph  (n)  of  subdivision 3 of section 461-l of the
     2  social services law, as amended by section 2 of part B of chapter 57  of
     3  the laws of 2018, is amended to read as follows:
     4    (n)  The  commissioner  of health is authorized to create a program to
     5  subsidize the cost of assisted living for those individuals living  with
     6  Alzheimer's  disease  and  dementia  who  are  not  eligible for medical
     7  assistance pursuant to title eleven of article five of this chapter  and
     8  reside  in  a  special  needs  assisted living residence certified under
     9  section forty-six hundred fifty-five of the public health  law.    [The]
    10  Subject  to  appropriations,  the  program  shall  authorize  [up to two
    11  hundred] vouchers to individuals through an application process and  pay
    12  for  up  to  seventy-five percent of the average private pay rate in the
    13  respective region. The commissioner of  health  may  propose  rules  and
    14  regulations to effectuate this provision.
    15    §  2.    This act shall take effect immediately and shall be deemed to
    16  have been in full force and effect on and after April 1, 2024.
 
    17                                   PART G
 
    18                            Intentionally Omitted
 
    19                                   PART H

    20    Section 1. Section 1 of part I of chapter 57  of  the  laws  of  2022,
    21  providing  a one percent across the board payment increase to all quali-
    22  fying fee-for-service Medicaid rates,  is  amended  by  adding  two  new
    23  subdivisions 3 and 4 to read as follows:
    24    3. For the state fiscal years beginning April 1, 2024, and thereafter,
    25  all department of health Medicaid payments made to Medicaid managed care
    26  organizations  will no longer be subject to the uniform rate increase in
    27  subdivision 1 of this section.
    28    4. Rate adjustments made pursuant to subdivisions 1 through 3 of  this
    29  section  shall not be subject to the notification requirements set forth
    30  in subdivision 7 of section 2807 of the public health law.
    31    § 2. This act shall take effect immediately.

    32                                   PART I
 
    33    Section 1. Paragraph (a) of subdivision 4  of  section  365-a  of  the
    34  social  services  law, as amended by chapter 493 of the laws of 2010, is
    35  amended to read as follows:
    36    (a) drugs which may be dispensed without a prescription as required by
    37  section sixty-eight hundred ten of the education law; provided, however,
    38  that the state commissioner of health may by regulation specify  certain
    39  of  such  drugs which may be reimbursed as an item of medical assistance
    40  in accordance with the price schedule established by such  commissioner.
    41  Notwithstanding any other provision of law, [additions] modifications to
    42  the  list  of  drugs  reimbursable  under this paragraph may be filed as
    43  regulations by the commissioner  of  health  without  prior  notice  and
    44  comment; provided, however, that the department will notify enrollees of
    45  any  eliminations to the list of drugs reimbursable under this paragraph
    46  at least sixty days prior to the removal of such drug. Such eliminations
    47  shall be referred to  the  drug  utilization  review  board  established
    48  pursuant  to  section  three  hundred  sixty-nine-bb of this article for
    49  recommendation prior to elimination from the list;

        S. 8307--C                         18                         A. 8807--C
 
     1    § 1-a. Subdivision 7 of section 272  of  the  public  health  law,  as
     2  amended  by  section  16 of part A of chapter 56 of the laws of 2013, is
     3  amended to read as follows:
     4    7.  The  commissioner  shall  provide thirty days public notice on the
     5  department's website prior to any meeting of the board to develop recom-
     6  mendations concerning the preferred drug program and any proposed elimi-
     7  nations to the list of drugs  reimbursable  under  subdivision  four  of
     8  section  three  hundred  sixty-five-a  of the social services law.  Such
     9  notice regarding meetings of the board shall include  a  description  of
    10  the  proposed  therapeutic  class  to  be  reviewed,  a  listing of drug
    11  products in the therapeutic class, and the proposals to be considered by
    12  the board.  The board shall allow interested parties a reasonable oppor-
    13  tunity to make an oral presentation to the board related  to  the  prior
    14  authorization  of  the therapeutic class to be reviewed. The board shall
    15  consider any information provided by any  interested  party,  including,
    16  but  not  limited  to,  prescribers, dispensers, patients, consumers and
    17  manufacturers of the drug in developing their recommendations.
    18    § 2. Subdivision 8 of section 272 of the public health law, as amended
    19  by section 16 of part A of chapter 56 of the laws of 2013, is amended to
    20  read as follows:
    21    8. The commissioner shall provide notice of any recommendations devel-
    22  oped by the board regarding the preferred drug program or elimination to
    23  the list of drugs reimbursable under subdivision four of  section  three
    24  hundred  sixty-five-a  of  the  social  services law, at least five days
    25  before any final determination  by  the  commissioner,  by  making  such
    26  information  available  on  the department's website. Such public notice
    27  may include: a summary of the deliberations of the board; a  summary  of
    28  the  positions of those making public comments at meetings of the board;
    29  the response of the board to those comments, if any;  and  the  findings
    30  and recommendations of the board.
    31    § 3. Subdivision 9 of section 272 of the public health law, as amended
    32  by section 16 of part A of chapter 56 of the laws of 2013, is amended to
    33  read as follows:
    34    9.  Within  ten  days of a final determination regarding the preferred
    35  drug program or elimination to the  list  of  drugs  reimbursable  under
    36  subdivision  four  of  section  three hundred sixty-five-a of the social
    37  services law, the  commissioner  shall  provide  public  notice  on  the
    38  department's  website  of  such determinations, including: the nature of
    39  the determination; and analysis of  the  impact  of  the  commissioner's
    40  determination on state public health plan populations and providers; and
    41  the  projected fiscal impact to the state public health plan programs of
    42  the commissioner's determination.
    43    § 4. Section 280 of the public health law, as amended by section 8  of
    44  part D of chapter 57 of the laws of 2018, paragraph (b) of subdivision 2
    45  as  amended  by  section 5, subdivision 3 as amended by section 6, para-
    46  graph (a) of subdivision 5 as amended by section 7,  subparagraph  (iii)
    47  of paragraph (e) of subdivision 5 as amended by section 6-a and subdivi-
    48  sion  8  as  amended by section 9 of part B of chapter 57 of the laws of
    49  2019,  paragraphs (c) and (d) of subdivision 2 as amended and  paragraph
    50  (e)  of subdivision 2 as added by section 2 of part FFF of chapter 56 of
    51  the laws of 2020, the opening paragraph of paragraph (a) of  subdivision
    52  6  and  paragraph  (a)  of subdivision 7 as amended by sections 3 and 4,
    53  respectively, of part GG of chapter 56 of the laws of 2020,  is  amended
    54  to read as follows:
    55    § 280. Medicaid drug cap. 1. The legislature hereby finds and declares
    56  that  there is a significant public interest for the Medicaid program to

        S. 8307--C                         19                         A. 8807--C
 
     1  manage drug costs in a manner that ensures patient access while  provid-
     2  ing  financial  stability  for  the  state  and participating providers.
     3  Since two thousand eleven, the state  has  taken  significant  steps  to
     4  contain  costs  in the Medicaid program by imposing a statutory limit on
     5  annual growth. Drug expenditures,  however,  continually  outpace  other
     6  cost  components  causing  significant pressure on the state, providers,
     7  and patient access operating under the Medicaid global cap. It is there-
     8  fore intended that the department establish a [Medicaid drug  cap  as  a
     9  separate  component  within the Medicaid global cap] supplemental rebate
    10  program as part of a focused and sustained effort to balance the  growth
    11  of drug expenditures with the growth of total Medicaid expenditures.
    12    2.  The  commissioner shall [establish a year to year] review at least
    13  annually the department of health state funds Medicaid drug [expenditure
    14  growth target as follows:
    15    (a) for state fiscal year two thousand seventeen--two  thousand  eigh-
    16  teen,  be  limited to the ten-year rolling average of the medical compo-
    17  nent of the consumer price index plus five percent and minus a  pharmacy
    18  savings target of fifty-five million dollars; and
    19    (b)  for  state  fiscal year two thousand eighteen--two thousand nine-
    20  teen, be limited to the ten-year rolling average of the  medical  compo-
    21  nent  of the consumer price index plus four percent and minus a pharmacy
    22  savings target of eighty-five million dollars;
    23    (c) for state fiscal year two thousand nineteen--two thousand  twenty,
    24  be  limited  to the ten-year rolling average of the medical component of
    25  the consumer price index plus four percent and minus a pharmacy  savings
    26  target of eighty-five million dollars;
    27    (d)  for  state  fiscal year two thousand twenty--two thousand twenty-
    28  one, be limited to the ten-year rolling average of the medical component
    29  of the consumer price index plus two percent; and
    30    (e) for state fiscal year two thousand twenty-one--two thousand  twen-
    31  ty-two and fiscal years thereafter, be limited in accordance with subdi-
    32  vision  one of section ninety-one of part H of chapter fifty-nine of the
    33  laws of two thousand eleven, as amended] expenditures to identify  drugs
    34  in  the  eightieth percentile or higher of total spend, net of rebate or
    35  in the eightieth percentile or higher based on cost per  claim,  net  of
    36  rebate.
    37    3.  (a) The [department and the division of the budget shall assess on
    38  a quarterly basis the projected total amount to be expended in the  year
    39  on a cash basis by the Medicaid program for each drug, and the projected
    40  annual  amount of state funds Medicaid drug expenditures on a cash basis
    41  for all drugs, which shall be a component of the projected department of
    42  health state funds Medicaid  expenditures  calculated  for  purposes  of
    43  sections  ninety-one  and  ninety-two of part H of chapter fifty-nine of
    44  the laws of two thousand eleven. For purposes  of  this  section,  state
    45  funds  Medicaid  drug expenditures include amounts expended for drugs in
    46  both the Medicaid fee-for-service  program  and  Medicaid  managed  care
    47  programs,  minus  the  amount  of  any drug rebates or supplemental drug
    48  rebates received by the department, including rebates pursuant to subdi-
    49  vision five of this section with respect to rebate targets. The  depart-
    50  ment  and  the  division  of the budget shall report in December of each
    51  year, for the prior April  through  October,  to  the  drug  utilization
    52  review  board  the  projected  state  funds  Medicaid  drug expenditures
    53  including the amounts, in aggregate thereof,  attributable  to  the  net
    54  cost  of:  changes  in  the utilization of drugs by Medicaid recipients;
    55  changes in the number of Medicaid recipients; changes  to  the  cost  of
    56  brand  name drugs and changes to the cost of generic drugs. The informa-

        S. 8307--C                         20                         A. 8807--C

     1  tion contained in the report shall not be publicly released in a  manner
     2  that allows for the identification of an individual drug or manufacturer
     3  or  that  is likely to compromise the financial competitive, or proprie-
     4  tary nature of the information.
     5    (a) In the event the director of the budget determines, based on Medi-
     6  caid drug expenditures for the previous quarter or other relevant infor-
     7  mation,  that  the  total department of health state funds Medicaid drug
     8  expenditure is projected to exceed the annual growth limitation  imposed
     9  by  subdivision  two of this section, the] commissioner may identify and
    10  refer drugs in the eightieth percentile or higher of total spend, net of
    11  rebate or in the eightieth percentile or higher based on cost per claim,
    12  net of rebate, to the  drug  utilization  review  board  established  by
    13  section  three  hundred  sixty-nine-bb  of the social services law for a
    14  recommendation as to  whether  a  target  supplemental  Medicaid  rebate
    15  should be paid by the manufacturer of the drug to the department and the
    16  target amount of the rebate.
    17    (b)  If the department intends to refer a drug to the drug utilization
    18  review board pursuant to paragraph (a) of this subdivision, the  depart-
    19  ment  shall  notify  the  manufacturer of such drug and shall attempt to
    20  reach agreement with the manufacturer on a rebate for the drug prior  to
    21  referring  the  drug  to  the  drug utilization review board for review.
    22  Such rebate may be based on evidence-based research, including, but  not
    23  limited  to,  such  research operated or conducted by or for other state
    24  governments, the federal government, the governments of  other  nations,
    25  and  third party payers or multi-state coalitions, provided however that
    26  the department shall account for the effectiveness of the drug in treat-
    27  ing the conditions  for  which  it  is  prescribed  or  in  improving  a
    28  patient's  health,  quality of life, or overall health outcomes, and the
    29  likelihood that use of the drug will reduce the need for  other  medical
    30  care, including hospitalization.
    31    (c)  In  the  event  that  the  commissioner and the manufacturer have
    32  previously agreed to a supplemental rebate for a drug pursuant to  para-
    33  graph  (b)  of this subdivision or paragraph (e) of subdivision seven of
    34  section three hundred sixty-seven-a of the social services law, the drug
    35  shall not be referred to the  drug  utilization  review  board  for  any
    36  further  supplemental  rebate  for  the  duration of the previous rebate
    37  agreement, provided however, the commissioner may refer a  drug  to  the
    38  drug  utilization  review board if the commissioner determines there are
    39  significant  and  substantiated  utilization  or  market  changes,   new
    40  evidence-based research, or statutory or federal regulatory changes that
    41  warrant  additional  rebates. In such cases, the department shall notify
    42  the manufacturer and provide evidence of the changes  or  research  that
    43  would  warrant  additional rebates, and shall attempt to reach agreement
    44  with the manufacturer on a rebate for the drug prior  to  referring  the
    45  drug to the drug utilization review board for review.
    46    (d)  The  department shall consider a drug's actual cost to the state,
    47  including current rebate amounts, prior to seeking an additional  rebate
    48  pursuant to paragraph (b) or (c) of this subdivision.
    49    (e)  [The  commissioner  shall  be  authorized  to  take  the  actions
    50  described in this section only so long as total Medicaid  drug  expendi-
    51  tures  are  projected  to exceed the annual growth limitation imposed by
    52  subdivision two of this section.] If the commissioner is unsuccessful in
    53  entering into a rebate arrangement with the  manufacturer  of  the  drug
    54  satisfactory  to  the  department,  the drug manufacturer shall, in that
    55  event be required to provide to the department, on a standard  reporting
    56  form developed by the department, the following information:

        S. 8307--C                         21                         A. 8807--C

     1    (i) the actual cost of developing, manufacturing, producing (including
     2  the cost per dose of production), and distributing the drug;
     3    (ii) research and development costs of the drug, including payments to
     4  predecessor  entities  conducting  research  and  development,  such  as
     5  biotechnology companies, universities and medical schools,  and  private
     6  research institutions;
     7    (iii)  administrative,  marketing, and advertising costs for the drug,
     8  apportioned by marketing activities  that  are  directed  to  consumers,
     9  marketing  activities  that  are  directed to prescribers, and the total
    10  cost of all marketing and advertising  that  is  directed  primarily  to
    11  consumers  and  prescribers  in  New  York, including but not limited to
    12  prescriber detailing, copayment discount programs, and direct-to-consum-
    13  er marketing;
    14    (iv) the extent of utilization of the drug;
    15    (v) prices for the drug that are charged  to  purchasers  outside  the
    16  United States;
    17    (vi)  prices charged to typical purchasers in the state, including but
    18  not limited to pharmacies, pharmacy  chains,  pharmacy  wholesalers,  or
    19  other direct purchasers;
    20    (vii) the average rebates and discounts provided per payer type in the
    21  state; and
    22    (viii) the average profit margin of each drug over the prior five-year
    23  period and the projected profit margin anticipated for such drug.
    24    (f) All information disclosed pursuant to paragraph (e) of this subdi-
    25  vision  shall  be  considered confidential and shall not be disclosed by
    26  the department in a form that  identifies  a  specific  manufacturer  or
    27  prices charged for drugs by such manufacturer.
    28    4.  In  determining  whether to recommend a target supplemental rebate
    29  for a drug, the drug utilization review board shall consider the  actual
    30  cost  of  the  drug to the Medicaid program, including federal and state
    31  rebates, and may consider, among other things:
    32    (a) the drug's impact on [the] Medicaid drug spending [growth target],
    33  and the adequacy of capitation rates of participating  Medicaid  managed
    34  care  plans,  and  the  drug's  affordability  and value to the Medicaid
    35  program; or
    36    (b) significant and unjustified increases in the price of the drug; or
    37    (c) whether the drug may be priced disproportionately to its therapeu-
    38  tic benefits.
    39    5. (a) If the drug utilization review board recommends a target rebate
    40  amount on a drug referred by  the  commissioner,  the  department  shall
    41  negotiate  with  the drug's manufacturer for a supplemental rebate to be
    42  paid by the manufacturer in an amount not to exceed such  target  rebate
    43  amount.  [A  rebate requirement shall apply beginning with the first day
    44  of the state fiscal year during which the rebate  was  required  without
    45  regard  to the date the department enters into the rebate agreement with
    46  the manufacturer.]
    47    (b) The supplemental rebate required by paragraph (a) of this subdivi-
    48  sion shall apply to drugs dispensed to enrollees of managed care provid-
    49  ers pursuant  to  section  three  hundred  sixty-four-j  of  the  social
    50  services  law  and to drugs dispensed to Medicaid recipients who are not
    51  enrollees of such providers.
    52    (c) [If the drug utilization review board recommends a  target  rebate
    53  amount  for  a  drug  and the department is unable to negotiate a rebate
    54  from the manufacturer in an amount that is at least seventy-five percent
    55  of the target rebate amount, the commissioner is authorized to waive the
    56  provisions of paragraph (b) of subdivision three of section two  hundred

        S. 8307--C                         22                         A. 8807--C

     1  seventy-three  of  this article and the provisions of subdivisions twen-
     2  ty-five and twenty-five-a of section three hundred sixty-four-j  of  the
     3  social  services  law  with  respect  to such drug; however, this waiver
     4  shall  not be implemented in situations where it would prevent access by
     5  a Medicaid recipient to a drug which is the only treatment for a partic-
     6  ular disease or condition. Under no circumstances shall the commissioner
     7  be authorized to waive such provisions with respect  to  more  than  two
     8  drugs in a given time.
     9    (d)]  Where  the  department  and  a  manufacturer enter into a rebate
    10  agreement pursuant to this section, which may be in addition to existing
    11  rebate agreements entered into by the manufacturer with respect  to  the
    12  same  drug,  no  additional  rebates shall be required to be paid by the
    13  manufacturer to a managed care provider or any of a managed care provid-
    14  er's agents, including but not limited to any pharmacy benefit  manager,
    15  while the department is collecting the rebate pursuant to this section.
    16    [(e)]  (d)  In formulating a recommendation concerning a target rebate
    17  amount for a drug, the drug utilization review board may consider:
    18    (i) publicly available information relevant  to  the  pricing  of  the
    19  drug;
    20    (ii) information supplied by the department relevant to the pricing of
    21  the drug;
    22    (iii)  information  relating to value-based pricing provided, however,
    23  if the department directly invites any third party to  provide  cost-ef-
    24  fectiveness analysis or research related to value-based pricing, and the
    25  department  receives  and considers such analysis or research for use by
    26  the board, such third party shall disclose any  funding  sources.    The
    27  department  shall,  if  reasonably possible, make publicly available the
    28  following documents in its possession that it  relies  upon  to  provide
    29  cost  effectiveness analyses or research related to value-based pricing:
    30  (A) descriptions of underlying methodologies; (B) assumptions and  limi-
    31  tations  of  research findings; and (C) if available, data that presents
    32  results in a way that reflects different outcomes for affected  subpopu-
    33  lations;
    34    (iv)  the  seriousness and prevalence of the disease or condition that
    35  is treated by the drug;
    36    (v) the extent of utilization of the drug;
    37    (vi) the effectiveness of the drug  in  treating  the  conditions  for
    38  which  it  is prescribed, or in improving a patient's health, quality of
    39  life, or overall health outcomes;
    40    (vii) the likelihood that use of the drug will  reduce  the  need  for
    41  other medical care, including hospitalization;
    42    (viii) the average wholesale price, wholesale acquisition cost, retail
    43  price  of  the  drug,  and  the cost of the drug to the Medicaid program
    44  minus rebates received by the state;
    45    (ix) in the case  of  generic  drugs,  the  number  of  pharmaceutical
    46  manufacturers that produce the drug;
    47    (x) whether there are pharmaceutical equivalents to the drug; and
    48    (xi)  information supplied by the manufacturer, if any, explaining the
    49  relationship between the pricing of the drug and the cost of development
    50  of the drug and/or the therapeutic benefit  of  the  drug,  or  that  is
    51  otherwise  pertinent  to  the  manufacturer's pricing decision; any such
    52  information, including the information on the  standard  reporting  form
    53  requirement  in  paragraph  (e)  of  subdivision  three of this section,
    54  provided shall be considered confidential and shall not be disclosed  by
    55  the  drug  utilization review board in a form that identifies a specific
    56  manufacturer or prices charged for drugs by such manufacturer.

        S. 8307--C                         23                         A. 8807--C
 
     1    6. [(a) If the drug  utilization  review  board  recommends  a  target
     2  rebate  amount  or  if the commissioner identifies a drug as a high cost
     3  drug pursuant to subparagraph (vii) of paragraph (e) of subdivision 7 of
     4  section three hundred sixty-seven-a of the social services law  and  the
     5  department  is  unsuccessful  in entering into a rebate arrangement with
     6  the manufacturer of the drug satisfactory to the  department,  the  drug
     7  manufacturer  shall  in that event be required to provide to the depart-
     8  ment, on a standard reporting form  developed  by  the  department,  the
     9  following information:
    10    (i) the actual cost of developing, manufacturing, producing (including
    11  the cost per dose of production), and distributing the drug;
    12    (ii) research and development costs of the drug, including payments to
    13  predecessor  entities  conducting  research  and  development,  such  as
    14  biotechnology companies, universities and medical schools,  and  private
    15  research institutions;
    16    (iii)  administrative,  marketing, and advertising costs for the drug,
    17  apportioned by marketing activities  that  are  directed  to  consumers,
    18  marketing  activities  that  are  directed to prescribers, and the total
    19  cost of all marketing and advertising  that  is  directed  primarily  to
    20  consumers  and  prescribers  in  New  York, including but not limited to
    21  prescriber detailing, copayment discount programs, and direct-to-consum-
    22  er marketing;
    23    (iv) the extent of utilization of the drug;
    24    (v) prices for the drug that are charged  to  purchasers  outside  the
    25  United States;
    26    (vi)  prices charged to typical purchasers in the state, including but
    27  not limited to pharmacies, pharmacy  chains,  pharmacy  wholesalers,  or
    28  other direct purchasers;
    29    (vii) the average rebates and discounts provided per payer type in the
    30  State; and
    31    (viii) the average profit margin of each drug over the prior five-year
    32  period and the projected profit margin anticipated for such drug.
    33    (b) All information disclosed pursuant to paragraph (a) of this subdi-
    34  vision  shall  be  considered confidential and shall not be disclosed by
    35  the department in a form that  identifies  a  specific  manufacturer  or
    36  prices charged for drugs by such manufacturer.
    37    7.]  (a) [If, after] After taking into account all rebates and supple-
    38  mental rebates received by the department, including rebates received to
    39  date pursuant to this section[, total  Medicaid  drug  expenditures  are
    40  still projected to exceed the annual growth limitation imposed by subdi-
    41  vision two of this section], the commissioner may: subject any drug of a
    42  manufacturer  referred  to  the drug utilization review board under this
    43  section to prior approval in  accordance  with  existing  processes  and
    44  procedures  when  such  manufacturer has not entered into a supplemental
    45  rebate arrangement as required by this section; direct  a  managed  care
    46  plan  to  limit or reduce reimbursement for a drug provided by a medical
    47  practitioner if the drug utilization review board  recommends  a  target
    48  rebate  amount  for  such  drug and the manufacturer has failed to enter
    49  into a rebate arrangement required by this section; direct managed  care
    50  plans  to remove from their Medicaid formularies any drugs of a manufac-
    51  turer who has a drug that the drug utilization review board recommends a
    52  target rebate amount for and the manufacturer has failed to enter into a
    53  rebate arrangement required by this section; promote  the  use  of  cost
    54  effective  and  clinically  appropriate  drugs  other  than  those  of a
    55  manufacturer who has a drug  that  the  drug  utilization  review  board
    56  recommends  a  target  rebate  amount and the manufacturer has failed to

        S. 8307--C                         24                         A. 8807--C
 
     1  enter into a rebate arrangement required by this section; allow manufac-
     2  turers to accelerate rebate payments under  existing  rebate  contracts;
     3  and  such  other  actions  as  authorized by law. The commissioner shall
     4  provide  written notice to the legislature at least thirty days prior to
     5  taking action pursuant to this paragraph[, unless action is necessary in
     6  the fourth quarter of a fiscal  year  to  prevent  total  Medicaid  drug
     7  expenditures from exceeding the limitation imposed by subdivision two of
     8  this  section,  in which case such notice to the legislature may be less
     9  than thirty days].
    10    (b) The commissioner shall be authorized to take the actions described
    11  in paragraph (a) of this subdivision [only so  long  as  total  Medicaid
    12  drug  expenditures  are projected to exceed the annual growth limitation
    13  imposed by subdivision two  of  this  section].  In  addition,  no  such
    14  actions  shall be deemed to supersede the provisions of paragraph (b) of
    15  subdivision three of section two hundred seventy-three of  this  article
    16  or  the  provisions  of  subdivisions  twenty-five  and twenty-five-a of
    17  section three hundred sixty-four-j of the social services  law[,  except
    18  as  allowed  by  paragraph  (c)  of  subdivision  five of this section];
    19  provided further that nothing in this section shall prevent access by  a
    20  Medicaid  recipient  to a drug which is the only treatment for a partic-
    21  ular disease or condition.
    22    [8.] 7. The commissioner shall provide a report by July first annually
    23  to the drug utilization review board, the governor, the speaker  of  the
    24  assembly,  and the temporary president of the senate on savings achieved
    25  through the [drug cap] supplemental rebate programs in the  last  fiscal
    26  year.  Such  report  shall  provide  data  on what savings were achieved
    27  through actions pursuant to subdivisions three, five and [seven] six  of
    28  this section, respectively, and what savings were achieved through other
    29  means and how such savings were calculated and implemented.
    30    §  5.  The  opening  paragraph  of  paragraph  (e) of subdivision 7 of
    31  section 367-a of the social services law, as amended by  section  24  of
    32  part B of chapter 57 of the laws of 2023, is amended to read as follows:
    33    During the period from April first, two thousand fifteen through March
    34  thirty-first,  two thousand twenty-six, the commissioner may, in lieu of
    35  a managed care provider or pharmacy benefit manager, negotiate  directly
    36  and enter into an arrangement with a pharmaceutical manufacturer for the
    37  provision of supplemental rebates relating to pharmaceutical utilization
    38  by enrollees of managed care providers pursuant to section three hundred
    39  sixty-four-j  of  this  title  and may also negotiate directly and enter
    40  into such an agreement relating to pharmaceutical utilization by medical
    41  assistance recipients not so enrolled. Such rebate arrangements shall be
    42  limited to the following: antiretrovirals approved by the  FDA  for  the
    43  treatment  of  HIV/AIDS, accelerated approval drugs established pursuant
    44  to this paragraph, opioid dependence agents and opioid antagonists list-
    45  ed in a statewide formulary established pursuant to  subparagraph  (vii)
    46  of  this  paragraph, hepatitis C agents, high cost drugs as provided for
    47  in subparagraph (viii) of this paragraph, gene therapies as provided for
    48  in subparagraph (ix) of this paragraph, and  any  other  class  or  drug
    49  designated by the commissioner for which the pharmaceutical manufacturer
    50  has  in effect a rebate arrangement with the federal secretary of health
    51  and human services pursuant to 42 U.S.C. § 1396r-8, and  for  which  the
    52  state  has  established standard clinical criteria. No agreement entered
    53  into pursuant to this  paragraph  shall  have  an  initial  term  or  be
    54  extended  beyond  the  expiration  or  repeal  of  this paragraph.   For
    55  purposes of this paragraph, an  "accelerated  approval"  is  a  drug  or
    56  labeled  indication  of  a drug authorized by the Federal Food, Drug and

        S. 8307--C                         25                         A. 8807--C
 
     1  Cosmetic Act for drugs approved under Subpart H of 21 CFR Part  314  and
     2  Subpart  E  of 21 CFR Part 601 for serious conditions that fill an unmet
     3  medical need based on whether the drug has  an  effect  on  a  surrogate
     4  clinical  endpoint,  and  is pending verification of clinical benefit in
     5  confirmatory trials.
     6    § 6. Paragraphs (a), (b) and (c) of subdivision 9 of section 367-a  of
     7  the social services law, paragraphs (a) and (c) as amended by chapter 19
     8  of  the laws of 1998, paragraph (b) as amended by section 3 of part C of
     9  chapter 58 of the laws of 2004, subparagraphs (i) and (ii) of  paragraph
    10  (b) as amended by section 7 of part D of chapter 57 of the laws of 2017,
    11  and subparagraph (iii) of paragraph (b) as added by section 29 of part E
    12  of chapter 63 of the laws of 2005, are amended to read as follows:
    13    (a) for drugs provided by medical practitioners and claimed separately
    14  by  the  practitioners[, the actual cost of the drugs to the practition-
    15  ers; and] the lower of:
    16    (i) (1) an amount equal to the national average drug acquisition  cost
    17  set  by  the  federal centers for medicare and medicaid services for the
    18  drug, if any, or if such amount is not available, the wholesale acquisi-
    19  tion cost of the drug based on  the  package  size  dispensed  from,  as
    20  reported  by  the  prescription drug pricing service used by the depart-
    21  ment, (2) the federal upper limit, if any, established  by  the  federal
    22  centers for medicare and medicaid services; (3) the state maximum acqui-
    23  sition  cost,  if  any,  established  pursuant  to paragraph (e) of this
    24  subdivision; or (4) the actual cost of the drug to the practitioner.
    25    (ii) Notwithstanding subparagraph (i) of this paragraph and  paragraph
    26  (e)  of this subdivision, for the Medicaid fee-for-service program, if a
    27  drug has been purchased from a manufacturer by a covered entity pursuant
    28  to section 340B of the federal public health  service  act  (42  USCA  §
    29  256b),  the  actual  amount paid by such covered entity. For purposes of
    30  this subparagraph, a "covered  entity"  is  an  entity  that  meets  the
    31  requirements  of  paragraph four of subdivision (a) of such section that
    32  elects to participate in the program established by  such  section,  and
    33  that causes claims for payment for drugs covered by this subparagraph to
    34  be  submitted  to  the  medical  assistance  program, either directly or
    35  through an authorized contract pharmacy. No medical assistance  payments
    36  may be made to a covered entity or to an authorized contract pharmacy of
    37  a  covered  entity  for  drugs  that are eligible for purchase under the
    38  section 340B program  and  are  dispensed  on  an  outpatient  basis  to
    39  patients  of the covered entity, other than under the provisions of this
    40  subparagraph.  Medical practitioners submitting claims for reimbursement
    41  of drugs purchased pursuant to section 340B of the public health service
    42  act shall notify the department that the claim is eligible for  purchase
    43  under  the 340B program, consistent with claiming instructions issued by
    44  the department to identify such claims.
    45    (iii) In no event shall a medical practitioner  be  reimbursed  at  an
    46  amount  that  is  lower  than the state maximum acquisition cost, or for
    47  drugs that do not have a state maximum acquisition cost,  the  wholesale
    48  acquisition cost of the drug based on the package size.
    49    (b) for drugs dispensed by pharmacies:
    50    (i)  (A)  if  the  drug  dispensed is a generic prescription drug, the
    51  lower of: (1) an amount equal to the national average  drug  acquisition
    52  cost  set  by the federal centers for medicare and medicaid services for
    53  the drug, if any, or if such amount  if  not  available,  the  wholesale
    54  acquisition  cost  of the drug based on the package size dispensed from,
    55  as reported by the prescription drug pricing service used by the depart-
    56  ment, less seventeen and one-half percent thereof; (2) the federal upper

        S. 8307--C                         26                         A. 8807--C
 
     1  limit, if any, established by the federal centers for medicare and medi-
     2  caid services; (3) the state maximum acquisition cost,  if  any,  estab-
     3  lished  pursuant  to  paragraph  (e)  of  this  subdivision;  or (4) the
     4  dispensing  pharmacy's  usual and customary price charged to the general
     5  public; (B) if the drug dispensed is available without a prescription as
     6  required by section sixty-eight hundred ten of the education law but  is
     7  reimbursed as an item of medical assistance pursuant to paragraph (a) of
     8  subdivision  four  of  section three hundred sixty-five-a of this title,
     9  the lower of (1) an amount equal to the national average  drug  acquisi-
    10  tion  cost set by the federal centers for medicare and medicaid services
    11  for the drug, if any, or if such amount is not available, the  wholesale
    12  acquisition  cost  of the drug based on the package size dispensed from,
    13  as reported by the prescription drug pricing service used by the depart-
    14  ment, (2) the federal upper limit, if any, established  by  the  federal
    15  centers for medicare and medicaid services; (3) the state maximum acqui-
    16  sition cost if any, established pursuant to paragraph (e) of this subdi-
    17  vision;  or  (4)  the  dispensing  pharmacy's  usual and customary price
    18  charged to the general public;
    19    (ii) if the drug dispensed is  a  brand-name  prescription  drug,  the
    20  lower of:
    21    (A)  an amount equal to the national average drug acquisition cost set
    22  by the federal centers for medicare and medicaid services for the  drug,
    23  if  any,  or  if such amount is not available, the wholesale acquisition
    24  cost of the drug based on the package size dispensed from,  as  reported
    25  by  the  prescription drug pricing service used by the department[, less
    26  three and three-tenths percent thereof]; or (B) the  dispensing  pharma-
    27  cy's usual and customary price charged to the general public; and
    28    (iii) notwithstanding subparagraphs (i) and (ii) of this paragraph and
    29  paragraphs  (d)  and (e) of this subdivision, if the drug dispensed is a
    30  drug that has been purchased from a manufacturer  by  a  covered  entity
    31  pursuant  to  section  340B of the federal public health service act (42
    32  USCA § 256b), the actual amount paid by such covered entity pursuant  to
    33  such section, plus the reasonable administrative costs, as determined by
    34  the  commissioner,  incurred  by  the covered entity or by an authorized
    35  contract pharmacy in connection with the purchase and dispensing of such
    36  drug and the tracking of such transactions. For purposes of this subpar-
    37  agraph, a "covered entity" is an entity that meets the  requirements  of
    38  paragraph four of subsection (a) of such section, that elects to partic-
    39  ipate in the program established by such section, and that causes claims
    40  for  payment  for  drugs covered by this subparagraph to be submitted to
    41  the medical assistance program, either directly or through an authorized
    42  contract pharmacy. No medical assistance  payments  may  be  made  to  a
    43  covered entity or to an authorized contract pharmacy of a covered entity
    44  for  drugs that are eligible for purchase under the section 340B program
    45  and are dispensed on an outpatient basis  to  patients  of  the  covered
    46  entity, other than under the provisions of this subparagraph. Pharmacies
    47  submitting  claims  for  reimbursement  of  drugs  purchased pursuant to
    48  section 340B of the public health service act shall notify  the  depart-
    49  ment  that  the  claim  is eligible for purchase under the 340B program,
    50  consistent with claiming instructions issued by the department to  iden-
    51  tify such claims.
    52    (c) Notwithstanding subparagraph (i) of paragraph (b) of this subdivi-
    53  sion, if a qualified prescriber certifies "brand medically necessary" or
    54  "brand  necessary" in his or her own handwriting directly on the face of
    55  a prescription, or in the case of electronic prescriptions,  inserts  an
    56  electronic  direction  to  clarify "brand medically necessary" or "brand

        S. 8307--C                         27                         A. 8807--C
 
     1  necessary", for a multiple source drug for which a specific upper  limit
     2  of reimbursement has been established by the federal agency, in addition
     3  to  writing  "d  a  w"  in  the  box  provided  for  such purpose on the
     4  prescription  form,  payment under this title for such drug must be made
     5  under the provisions of subparagraph (ii) of such paragraph.
     6    § 7. This act  shall  take  effect  October  1,  2024;  provided  that
     7  the amendments to paragraph (e) of subdivision 7 of section 367-a of the
     8  social services law made by section five of this act  shall  not  affect
     9  the repeal of such paragraph and shall be deemed repealed therewith; and
    10  provided  further, that the amendments to subdivision 9 of section 367-a
    11  of the social services law made by section six of  this  act  shall  not
    12  affect the expiration of such subdivision pursuant to section 4 of chap-
    13  ter 19 of the laws of 1998, as amended, and shall expire therewith.
 
    14                                   PART J
 
    15    Section  1. The title heading of title 11-D of article 5 of the social
    16  services law, as amended by section 1 of part H of  chapter  57  of  the
    17  laws of 2021, is amended to read as follows:
    18                     [BASIC HEALTH PROGRAM] ESSENTIAL PLAN
    19    §  2.  Section 3 of part H of chapter 57 of the laws of 2021, amending
    20  the social services law relating to  eliminating  consumer-paid  premium
    21  payments in the basic health program, is amended to read as follows:
    22    § 3. This act shall take effect June 1, 2021 [and]; provided, however,
    23  section  two  of  this  act  shall  expire and be deemed repealed should
    24  federal approval be withdrawn or 42 U.S.C. 18051 be  repealed;  provided
    25  that the commissioner of health shall notify the legislative bill draft-
    26  ing  commission upon the withdrawal of federal approval or the repeal of
    27  42 U.S.C. 18051 in order that the commission may  maintain  an  accurate
    28  and  timely  effective data base of the official text of the laws of the
    29  state of New York in  furtherance  of  effectuating  the  provisions  of
    30  section  44  of the legislative law and section 70-b of the public offi-
    31  cers law.
    32    § 3. Subdivisions (b) and (c) of section 8 of part BBB of  chapter  56
    33  of  the  laws  of  2022,  amending  the public health law and other laws
    34  relating to permitting the commissioner of health  to  submit  a  waiver
    35  that  expands  eligibility  for  New  York's  basic  health  program and
    36  increases the federal poverty limit cap for basic health  program eligi-
    37  bility from  two hundred to two hundred  fifty percent, are  amended  to
    38  read as follows:
    39    (b)  section  four  of  this  act  shall expire and be deemed repealed
    40  December 31, [2024] 2025; provided, however, the amendments to paragraph
    41  (c) of subdivision 1 of section 369-gg of the social services  law  made
    42  by  such  section  of  this  act  shall be subject to the expiration and
    43  reversion of such paragraph pursuant to section 2 of part H  of  chapter
    44  57  of  the  laws of 2021 when upon such date, the provisions of section
    45  five of this act shall take effect; provided, however, the amendments to
    46  such paragraph made by section five of this  act  shall  expire  and  be
    47  deemed repealed December 31, [2024] 2025;
    48    (c)  section six of this act shall take effect January 1, [2025] 2026;
    49  provided, however, the amendments to paragraph (c) of subdivision  1  of
    50  section  369-gg  of the social services law made by such section of this
    51  act shall be subject to the expiration and reversion of  such  paragraph
    52  pursuant  to  section 2 of part H of chapter 57 of the laws of 2021 when
    53  upon such date, the provisions of section seven of this act  shall  take
    54  effect; and

        S. 8307--C                         28                         A. 8807--C

     1    §  4.  Paragraph  (a)  of subdivision 1 of section 268-c of the public
     2  health law, as added by section 2 of part T of chapter 57 of the laws of
     3  2019, is amended to read as follows:
     4    (a) Perform eligibility determinations for federal and state insurance
     5  affordability  programs  including medical assistance in accordance with
     6  section three hundred sixty-six of the social services law, child health
     7  plus in accordance with section twenty-five hundred eleven of this chap-
     8  ter, the basic health program in accordance with section  three  hundred
     9  sixty-nine-gg  of  the  social  services  law, the 1332 state innovation
    10  program in accordance with section three hundred  sixty-nine-ii  of  the
    11  social services law, premium tax credits and cost-sharing reductions and
    12  qualified  health  plans  in  accordance  with  applicable law and other
    13  health insurance programs as determined by the commissioner;
    14    § 5. Subdivision 16 of section 268-c of  the  public  health  law,  as
    15  added  by  section  2  of  part  T of chapter 57 of the laws of 2019, is
    16  amended to read as follows:
    17    16. In accordance with applicable federal and state law, inform  indi-
    18  viduals of eligibility requirements for the Medicaid program under title
    19  XIX  of  the  social security act and the social services law, the chil-
    20  dren's health insurance program (CHIP) under title  XXI  of  the  social
    21  security  act  and  this chapter, the basic health program under section
    22  three hundred sixty-nine-gg of the social services law, the  1332  state
    23  innovation  program in accordance with section three hundred sixty-nine-
    24  ii of the social services law, or any applicable state or  local  public
    25  health insurance program and if, through screening of the application by
    26  the  Marketplace,  the  Marketplace determines that such individuals are
    27  eligible for any such program, enroll such individuals in such program.
    28    § 6. Section 268-c of the public health law is amended by adding a new
    29  subdivision 26 to read as follows:
    30    26. Subject to federal approval if required, the use  of  state  funds
    31  and  the availability of funds in the 1332 state innovation program fund
    32  established pursuant to section ninety-eight-d of the state finance law,
    33  the commissioner shall have the authority  to  establish  a  program  to
    34  provide  subsidies for the payment of premium or cost sharing or both to
    35  assist individuals who are eligible to purchase qualified  health  plans
    36  through  the  marketplace,  or  take such other action as appropriate to
    37  reduce or eliminate qualified health plan premiums  or  cost-sharing  or
    38  both.
    39    §  7.  Subparagraph  (i)  of paragraph (a) of subdivision 4 of section
    40  268-e of the public health law, as added by section 2 of part T of chap-
    41  ter 57 of the laws of 2019, is amended to read as follows:
    42    (i) An initial determination of eligibility, including:
    43    (A) eligibility to enroll in a qualified health plan;
    44    (B) eligibility for Medicaid;
    45    (C) eligibility for Child Health Plus;
    46    (D) eligibility for the Basic Health Program;
    47    (E) eligibility for the 1332 state innovation program;
    48    (F) the amount of advance payments of the premium tax credit and level
    49  of cost-sharing reductions;
    50    [(F)] (G) the amount of any other subsidy that may be available  under
    51  law; and
    52    [(G)]  (H)  eligibility  for  such  other health insurance programs as
    53  determined by the commissioner; and
    54    § 8. Section 268 of the public health law, as added by  section  2  of
    55  part T of chapter 57 of the laws of 2019, is amended to read as follows:

        S. 8307--C                         29                         A. 8807--C
 
     1    § 268. Statement of policy and purposes.  The purpose of this title is
     2  to  codify the establishment of the health benefit exchange in New York,
     3  known as NY State  of  Health,  The  Official  Health  Plan  Marketplace
     4  (Marketplace),  in  conformance  with  Executive Order 42 (Cuomo) issued
     5  April  12,  2012.  The Marketplace shall continue to perform eligibility
     6  determinations for federal and state  insurance  affordability  programs
     7  including  medical  assistance  in accordance with section three hundred
     8  sixty-six of the social services law, child health  plus  in  accordance
     9  with  section  twenty-five  hundred  eleven  of  this chapter, the basic
    10  health program in accordance with section three hundred sixty-nine-gg of
    11  the social services law, the 1332 state innovation program in accordance
    12  with section three hundred sixty-nine-ii of the social service law,  and
    13  premium  tax credits and cost-sharing reductions, together with perform-
    14  ing eligibility determinations for qualified health plans and such other
    15  health insurance programs as determined by the commissioner. The Market-
    16  place  shall  also  facilitate  enrollment  in  insurance  affordability
    17  programs,  qualified health plans and other health insurance programs as
    18  determined by the commissioner,  the  purchase  and  sale  of  qualified
    19  health  plans  and/or  other or additional health plans certified by the
    20  Marketplace pursuant to this title,  and  shall  continue  to  have  the
    21  authority to operate a small business health options program ("SHOP") to
    22  assist  eligible  small  employers  in  selecting qualified health plans
    23  and/or other or additional health plans certified by the Marketplace and
    24  to determine small employer eligibility for purposes of  small  employer
    25  tax  credits.  It  is  the  intent  of the legislature, by codifying the
    26  Marketplace in state statute, to continue to promote quality and afford-
    27  able health coverage and care, reduce the number of  uninsured  persons,
    28  provide a transparent marketplace, educate consumers and assist individ-
    29  uals  with  access to coverage, premium assistance tax credits and cost-
    30  sharing reductions. In addition, the  legislature  declares  the  intent
    31  that  the  Marketplace continue to be properly integrated with insurance
    32  affordability programs, including Medicaid, child health  plus  and  the
    33  basic  health program, the 1332 state innovation program, and such other
    34  health insurance programs as determined by the commissioner.
    35    § 9. Subdivision 8 of section 268-a of the public health law, as added
    36  by section 1 of part PP of chapter 57 of the laws of 2021, is amended to
    37  read as follows:
    38    8. "Insurance affordability  program"  means  Medicaid,  child  health
    39  plus, the basic health program, the 1332 state innovation program, post-
    40  partum  extended coverage and any other health insurance subsidy program
    41  designated as such by the commissioner.
    42    § 10. This act shall take effect immediately and shall  be  deemed  to
    43  have been in full force and effect on and after April 1, 2024; provided,
    44  however,  that  section  six of this act shall only take effect upon the
    45  commissioner of health obtaining and maintaining all necessary approvals
    46  from the secretary of health and human services and the secretary of the
    47  treasury based on an amended application for a waiver  for  state  inno-
    48  vation pursuant to section 1332 of the patient protection and affordable
    49  care  act  (P.L.  111-148)  and  subdivision  25 of section 268-c of the
    50  public health law; and  provided,  further,  that  the  commissioner  of
    51  health  shall  notify  the legislative bill drafting commission upon the
    52  occurrence of the enactment of the legislation provided for  in  section
    53  six  of  this  act in order that the commission may maintain an accurate
    54  and timely effective data base of the official text of the laws  of  the
    55  state  of  New  York  in  furtherance  of effectuating the provisions of

        S. 8307--C                         30                         A. 8807--C
 
     1  section 44 of the legislative law and section 70-b of the  public  offi-
     2  cers law.
 
     3                                   PART K
 
     4    Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
     5  of the laws of 1986, amending the civil practice law and rules and other
     6  laws  relating  to  malpractice  and  professional  medical  conduct, as
     7  amended by section 1 of part F of chapter 57 of the  laws  of  2023,  is
     8  amended to read as follows:
     9    (a)  The  superintendent of financial services and the commissioner of
    10  health or their designee shall, from funds  available  in  the  hospital
    11  excess liability pool created pursuant to subdivision 5 of this section,
    12  purchase  a policy or policies for excess insurance coverage, as author-
    13  ized by paragraph 1 of subsection (e) of section 5502 of  the  insurance
    14  law; or from an insurer, other than an insurer described in section 5502
    15  of the insurance law, duly authorized to write such coverage and actual-
    16  ly  writing  medical  malpractice  insurance  in  this  state;  or shall
    17  purchase equivalent excess coverage in a form previously approved by the
    18  superintendent of financial services for purposes  of  providing  equiv-
    19  alent  excess  coverage  in accordance with section 19 of chapter 294 of
    20  the laws of 1985, for medical or dental malpractice occurrences  between
    21  July  1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
    22  between July 1, 1988 and June 30, 1989, between July 1,  1989  and  June
    23  30,  1990,  between July 1, 1990 and June 30, 1991, between July 1, 1991
    24  and June 30, 1992, between July 1, 1992 and June 30, 1993, between  July
    25  1,  1993  and  June  30,  1994,  between July 1, 1994 and June 30, 1995,
    26  between July 1, 1995 and June 30, 1996, between July 1,  1996  and  June
    27  30,  1997,  between July 1, 1997 and June 30, 1998, between July 1, 1998
    28  and June 30, 1999, between July 1, 1999 and June 30, 2000, between  July
    29  1,  2000  and  June  30,  2001,  between July 1, 2001 and June 30, 2002,
    30  between July 1, 2002 and June 30, 2003, between July 1,  2003  and  June
    31  30,  2004,  between July 1, 2004 and June 30, 2005, between July 1, 2005
    32  and June 30, 2006, between July 1, 2006 and June 30, 2007, between  July
    33  1,  2007  and  June  30,  2008,  between July 1, 2008 and June 30, 2009,
    34  between July 1, 2009 and June 30, 2010, between July 1,  2010  and  June
    35  30,  2011,  between July 1, 2011 and June 30, 2012, between July 1, 2012
    36  and June 30, 2013, between July 1, 2013 and June 30, 2014, between  July
    37  1,  2014  and  June  30,  2015,  between July 1, 2015 and June 30, 2016,
    38  between July 1, 2016 and June 30, 2017, between July 1,  2017  and  June
    39  30,  2018,  between July 1, 2018 and June 30, 2019, between July 1, 2019
    40  and June 30, 2020, between July 1, 2020 and June 30, 2021, between  July
    41  1, 2021 and June 30, 2022, between July 1, 2022 and June 30, 2023, [and]
    42  between  July  1,  2023  and June 30, 2024, and between July 1, 2024 and
    43  June 30, 2025 or reimburse the hospital  where  the  hospital  purchases
    44  equivalent  excess  coverage as defined in subparagraph (i) of paragraph
    45  (a) of subdivision 1-a of this section for medical or dental malpractice
    46  occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988
    47  and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
    48  1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
    49  between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
    50  30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
    51  and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
    52  1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
    53  between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
    54  30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002

        S. 8307--C                         31                         A. 8807--C
 
     1  and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
     2  1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
     3  between July 1, 2006 and June 30, 2007, between July 1,  2007  and  June
     4  30,  2008,  between July 1, 2008 and June 30, 2009, between July 1, 2009
     5  and June 30, 2010, between July 1, 2010 and June 30, 2011, between  July
     6  1,  2011  and  June  30,  2012,  between July 1, 2012 and June 30, 2013,
     7  between July 1, 2013 and June 30, 2014, between July 1,  2014  and  June
     8  30,  2015,  between July 1, 2015 and June 30, 2016, between July 1, 2016
     9  and June 30, 2017, between July 1, 2017 and June 30, 2018, between  July
    10  1,  2018  and  June  30,  2019,  between July 1, 2019 and June 30, 2020,
    11  between July 1, 2020 and June 30, 2021, between July 1,  2021  and  June
    12  30,  2022, between July 1, 2022 and June 30, 2023, [and] between July 1,
    13  2023 and June 30, 2024, and between July 1, 2024 and June 30,  2025  for
    14  physicians  or  dentists  certified  as eligible for each such period or
    15  periods pursuant to subdivision 2 of this section by a general  hospital
    16  licensed  pursuant to article 28 of the public health law; provided that
    17  no single insurer shall write more  than  fifty  percent  of  the  total
    18  excess premium for a given policy year; and provided, however, that such
    19  eligible physicians or dentists must have in force an individual policy,
    20  from  an insurer licensed in this state of primary malpractice insurance
    21  coverage in amounts of no less than one million three  hundred  thousand
    22  dollars  for  each  claimant  and  three  million  nine hundred thousand
    23  dollars for all claimants under that policy during the  period  of  such
    24  excess  coverage  for  such  occurrences  or  be  endorsed as additional
    25  insureds under a hospital professional liability policy which is offered
    26  through a voluntary attending physician ("channeling") program previous-
    27  ly permitted by the superintendent  of  financial  services  during  the
    28  period of such excess coverage for such occurrences. During such period,
    29  such  policy  for  excess  coverage  or  such equivalent excess coverage
    30  shall, when combined with the physician's or dentist's primary  malprac-
    31  tice insurance coverage or coverage provided through a voluntary attend-
    32  ing  physician  ("channeling")  program, total an aggregate level of two
    33  million three hundred thousand dollars for each claimant and six million
    34  nine hundred thousand dollars for all claimants from all  such  policies
    35  with  respect to occurrences in each of such years provided, however, if
    36  the cost of primary malpractice insurance  coverage  in  excess  of  one
    37  million  dollars,  but  below  the  excess medical malpractice insurance
    38  coverage provided pursuant to this act, exceeds the rate of nine percent
    39  per annum, then the required  level  of  primary  malpractice  insurance
    40  coverage  in excess of one million dollars for each claimant shall be in
    41  an amount of not less than the dollar amount of such coverage  available
    42  at  nine  percent per annum; the required level of such coverage for all
    43  claimants under that policy shall be in an amount not  less  than  three
    44  times the dollar amount of coverage for each claimant; and excess cover-
    45  age,  when  combined  with  such primary malpractice insurance coverage,
    46  shall increase the aggregate level for  each  claimant  by  one  million
    47  dollars  and  three  million  dollars  for  all  claimants; and provided
    48  further, that, with respect to policies of primary  medical  malpractice
    49  coverage  that  include  occurrences  between April 1, 2002 and June 30,
    50  2002, such requirement that coverage be in  amounts  no  less  than  one
    51  million  three  hundred  thousand  dollars  for  each claimant and three
    52  million nine hundred thousand dollars for all claimants for such  occur-
    53  rences shall be effective April 1, 2002.
    54    §  2.  Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
    55  amending the civil practice law and rules and  other  laws  relating  to

        S. 8307--C                         32                         A. 8807--C
 
     1  malpractice and professional medical conduct, as amended by section 2 of
     2  part F of chapter 57 of the laws of 2023, is amended to read as follows:
     3    (3)(a)  The  superintendent  of financial services shall determine and
     4  certify to each general hospital and to the commissioner of  health  the
     5  cost  of  excess malpractice insurance for medical or dental malpractice
     6  occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
     7  and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
     8  1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
     9  between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
    10  30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
    11  and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
    12  1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
    13  between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
    14  30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002
    15  and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
    16  1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
    17  between July 1, 2006 and June 30, 2007, between July 1,  2007  and  June
    18  30,  2008,  between July 1, 2008 and June 30, 2009, between July 1, 2009
    19  and June 30, 2010, between July 1, 2010 and June 30, 2011, between  July
    20  1,  2011  and  June  30,  2012,  between July 1, 2012 and June 30, 2013,
    21  between July 1, 2013 and June 30, 2014, between July 1,  2014  and  June
    22  30,  2015,  between July 1, 2015 and June 30, 2016, between July 1, 2016
    23  and June 30, 2017, between July 1, 2017 and June 30, 2018, between  July
    24  1,  2018  and  June  30,  2019,  between July 1, 2019 and June 30, 2020,
    25  between July 1, 2020 and June 30, 2021, between July 1,  2021  and  June
    26  30,  2022, between July 1, 2022 and June 30, 2023, [and] between July 1,
    27  2023 and June 30, 2024, and between July 1, 2024 and June 30, 2025 allo-
    28  cable to each general hospital for physicians or dentists  certified  as
    29  eligible  for purchase of a policy for excess insurance coverage by such
    30  general hospital in accordance with subdivision 2 of this  section,  and
    31  may amend such determination and certification as necessary.
    32    (b)  The  superintendent  of  financial  services  shall determine and
    33  certify to each general hospital and to the commissioner of  health  the
    34  cost  of  excess malpractice insurance or equivalent excess coverage for
    35  medical or dental malpractice occurrences between July 1, 1987 and  June
    36  30,  1988,  between July 1, 1988 and June 30, 1989, between July 1, 1989
    37  and June 30, 1990, between July 1, 1990 and June 30, 1991, between  July
    38  1,  1991  and  June  30,  1992,  between July 1, 1992 and June 30, 1993,
    39  between July 1, 1993 and June 30, 1994, between July 1,  1994  and  June
    40  30,  1995,  between July 1, 1995 and June 30, 1996, between July 1, 1996
    41  and June 30, 1997, between July 1, 1997 and June 30, 1998, between  July
    42  1,  1998  and  June  30,  1999,  between July 1, 1999 and June 30, 2000,
    43  between July 1, 2000 and June 30, 2001, between July 1,  2001  and  June
    44  30,  2002,  between July 1, 2002 and June 30, 2003, between July 1, 2003
    45  and June 30, 2004, between July 1, 2004 and June 30, 2005, between  July
    46  1,  2005  and  June  30,  2006,  between July 1, 2006 and June 30, 2007,
    47  between July 1, 2007 and June 30, 2008, between July 1,  2008  and  June
    48  30,  2009,  between July 1, 2009 and June 30, 2010, between July 1, 2010
    49  and June 30, 2011, between July 1, 2011 and June 30, 2012, between  July
    50  1,  2012  and  June  30,  2013,  between July 1, 2013 and June 30, 2014,
    51  between July 1, 2014 and June 30, 2015, between July 1,  2015  and  June
    52  30,  2016,  between July 1, 2016 and June 30, 2017, between July 1, 2017
    53  and June 30, 2018, between July 1, 2018 and June 30, 2019, between  July
    54  1,  2019  and  June  30,  2020,  between July 1, 2020 and June 30, 2021,
    55  between July 1, 2021 and June 30, 2022, between July 1,  2022  and  June
    56  30, 2023, [and] between July 1, 2023 and June 30, 2024, and between July

        S. 8307--C                         33                         A. 8807--C
 
     1  1,  2024 and June 30, 2025 allocable to each general hospital for physi-
     2  cians or dentists certified as eligible for purchase  of  a  policy  for
     3  excess  insurance coverage or equivalent excess coverage by such general
     4  hospital in accordance with subdivision 2 of this section, and may amend
     5  such determination and certification as necessary. The superintendent of
     6  financial  services shall determine and certify to each general hospital
     7  and to the commissioner of health the ratable share of such cost alloca-
     8  ble to the period July 1, 1987 to December 31, 1987, to the period Janu-
     9  ary 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31,
    10  1988, to the period January 1, 1989 to June 30, 1989, to the period July
    11  1, 1989 to December 31, 1989, to the period January 1, 1990 to June  30,
    12  1990,  to  the  period  July 1, 1990 to December 31, 1990, to the period
    13  January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December
    14  31, 1991, to the period January 1, 1992 to June 30, 1992, to the  period
    15  July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June
    16  30, 1993, to the period July 1, 1993 to December 31, 1993, to the period
    17  January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December
    18  31,  1994, to the period January 1, 1995 to June 30, 1995, to the period
    19  July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June
    20  30, 1996, to the period July 1, 1996 to December 31, 1996, to the period
    21  January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December
    22  31, 1997, to the period January 1, 1998 to June 30, 1998, to the  period
    23  July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June
    24  30, 1999, to the period July 1, 1999 to December 31, 1999, to the period
    25  January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December
    26  31,  2000, to the period January 1, 2001 to June 30, 2001, to the period
    27  July 1, 2001 to June 30, 2002, to the period July 1, 2002  to  June  30,
    28  2003, to the period July 1, 2003 to June 30, 2004, to the period July 1,
    29  2004  to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to
    30  the period July 1, 2006 and June 30, 2007, to the period  July  1,  2007
    31  and  June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the
    32  period July 1, 2009 and June 30, 2010, to the period July  1,  2010  and
    33  June  30,  2011,  to  the  period July 1, 2011 and June 30, 2012, to the
    34  period July 1, 2012 and June 30, 2013, to the period July  1,  2013  and
    35  June  30,  2014,  to  the  period July 1, 2014 and June 30, 2015, to the
    36  period July 1, 2015 and June 30, 2016, to the period July  1,  2016  and
    37  June 30, 2017, to the period July 1, 2017 to June 30, 2018, to the peri-
    38  od July 1, 2018 to June 30, 2019, to the period July 1, 2019 to June 30,
    39  2020, to the period July 1, 2020 to June 30, 2021, to the period July 1,
    40  2021  to  June  30,  2022,  to the period July 1, 2022 to June 30, 2023,
    41  [and] to the period July 1, 2023 to June 30, 2024,  and  to  the  period
    42  July 1, 2024 to June 30, 2025.
    43    § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
    44  18  of  chapter 266 of the laws of 1986, amending the civil practice law
    45  and rules and  other  laws  relating  to  malpractice  and  professional
    46  medical  conduct, as amended by section 3 of part F of chapter 57 of the
    47  laws of 2023, are amended to read as follows:
    48    (a) To the extent funds available to  the  hospital  excess  liability
    49  pool  pursuant to subdivision 5 of this section as amended, and pursuant
    50  to section 6 of part J of chapter 63 of the laws of 2001,  as  may  from
    51  time  to  time  be amended, which amended this subdivision, are insuffi-
    52  cient to meet the costs  of  excess  insurance  coverage  or  equivalent
    53  excess  coverage  for coverage periods during the period July 1, 1992 to
    54  June 30, 1993, during the period July 1, 1993 to June 30,  1994,  during
    55  the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
    56  to  June  30,  1996,  during  the  period July 1, 1996 to June 30, 1997,

        S. 8307--C                         34                         A. 8807--C
 
     1  during the period July 1, 1997 to June 30, 1998, during the period  July
     2  1,  1998  to  June  30, 1999, during the period July 1, 1999 to June 30,
     3  2000, during the period July 1, 2000 to June 30, 2001, during the period
     4  July  1,  2001  to  October 29, 2001, during the period April 1, 2002 to
     5  June 30, 2002, during the period July 1, 2002 to June 30,  2003,  during
     6  the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
     7  to  June  30,  2005,  during  the  period July 1, 2005 to June 30, 2006,
     8  during the period July 1, 2006 to June 30, 2007, during the period  July
     9  1,  2007  to  June  30, 2008, during the period July 1, 2008 to June 30,
    10  2009, during the period July 1, 2009 to June 30, 2010, during the period
    11  July 1, 2010 to June 30, 2011, during the period July 1,  2011  to  June
    12  30,  2012,  during  the period July 1, 2012 to June 30, 2013, during the
    13  period July 1, 2013 to June 30, 2014, during the period July 1, 2014  to
    14  June  30,  2015, during the period July 1, 2015 to June 30, 2016, during
    15  the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
    16  to June 30, 2018, during the period July  1,  2018  to  June  30,  2019,
    17  during  the period July 1, 2019 to June 30, 2020, during the period July
    18  1, 2020 to June 30, 2021, during the period July 1,  2021  to  June  30,
    19  2022,  during the period July 1, 2022 to June 30, 2023, [and] during the
    20  period July 1, 2023 to June 30, 2024, and during the period July 1, 2024
    21  to June 30, 2025 allocated or reallocated in accordance  with  paragraph
    22  (a) of subdivision 4-a of this section to rates of payment applicable to
    23  state governmental agencies, each physician or dentist for whom a policy
    24  for excess insurance coverage or equivalent excess coverage is purchased
    25  for  such  period  shall  be  responsible for payment to the provider of
    26  excess insurance coverage or equivalent excess coverage of an  allocable
    27  share  of  such  insufficiency,  based on the ratio of the total cost of
    28  such coverage for such physician to the sum of the total  cost  of  such
    29  coverage for all physicians applied to such insufficiency.
    30    (b)  Each  provider  of excess insurance coverage or equivalent excess
    31  coverage covering the period July 1, 1992 to June 30, 1993, or  covering
    32  the period July 1, 1993 to June 30, 1994, or covering the period July 1,
    33  1994  to  June 30, 1995, or covering the period July 1, 1995 to June 30,
    34  1996, or covering the period July 1, 1996 to June 30, 1997, or  covering
    35  the period July 1, 1997 to June 30, 1998, or covering the period July 1,
    36  1998  to  June 30, 1999, or covering the period July 1, 1999 to June 30,
    37  2000, or covering the period July 1, 2000 to June 30, 2001, or  covering
    38  the  period  July  1,  2001  to October 29, 2001, or covering the period
    39  April 1, 2002 to June 30, 2002, or covering the period July 1,  2002  to
    40  June  30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
    41  covering the period July 1, 2004 to June 30, 2005, or covering the peri-
    42  od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
    43  June 30, 2007, or covering the period July 1, 2007 to June 30, 2008,  or
    44  covering the period July 1, 2008 to June 30, 2009, or covering the peri-
    45  od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
    46  June  30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
    47  covering the period July 1, 2012 to June 30, 2013, or covering the peri-
    48  od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
    49  June 30, 2015, or covering the period July 1, 2015 to June 30, 2016,  or
    50  covering the period July 1, 2016 to June 30, 2017, or covering the peri-
    51  od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
    52  June  30, 2019, or covering the period July 1, 2019 to June 30, 2020, or
    53  covering the period July 1, 2020 to June 30, 2021, or covering the peri-
    54  od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to
    55  June 30, 2023, or covering the period July 1, 2023 to June 30, 2024,  or
    56  covering the period July 1, 2024 to June 30, 2025 shall notify a covered

        S. 8307--C                         35                         A. 8807--C

     1  physician  or  dentist  by mail, mailed to the address shown on the last
     2  application for excess insurance coverage or equivalent excess coverage,
     3  of the amount due to such provider from such physician  or  dentist  for
     4  such coverage period determined in accordance with paragraph (a) of this
     5  subdivision.  Such amount shall be due from such physician or dentist to
     6  such provider of excess insurance coverage or equivalent excess coverage
     7  in a time and manner  determined  by  the  superintendent  of  financial
     8  services.
     9    (c)  If  a physician or dentist liable for payment of a portion of the
    10  costs of excess insurance coverage or equivalent excess coverage  cover-
    11  ing  the  period  July  1, 1992 to June 30, 1993, or covering the period
    12  July 1, 1993 to June 30, 1994, or covering the period July  1,  1994  to
    13  June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
    14  covering the period July 1, 1996 to June 30, 1997, or covering the peri-
    15  od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
    16  June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
    17  covering the period July 1, 2000 to June 30, 2001, or covering the peri-
    18  od  July  1,  2001  to October 29, 2001, or covering the period April 1,
    19  2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
    20  2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
    21  the period July 1, 2004 to June 30, 2005, or covering the period July 1,
    22  2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
    23  2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
    24  the period July 1, 2008 to June 30, 2009, or covering the period July 1,
    25  2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
    26  2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
    27  the period July 1, 2012 to June 30, 2013, or covering the period July 1,
    28  2013 to June 30, 2014, or covering the period July 1, 2014 to  June  30,
    29  2015,  or covering the period July 1, 2015 to June 30, 2016, or covering
    30  the period July 1, 2016 to June 30, 2017, or covering the period July 1,
    31  2017 to June 30, 2018, or covering the period July 1, 2018 to  June  30,
    32  2019,  or covering the period July 1, 2019 to June 30, 2020, or covering
    33  the period July 1, 2020 to June 30, 2021, or covering the period July 1,
    34  2021 to June 30, 2022, or covering the period July 1, 2022 to  June  30,
    35  2023,  or covering the period July 1, 2023 to June 30, 2024, or covering
    36  the period July 1, 2024 to June 30, 2025 determined in  accordance  with
    37  paragraph  (a)  of  this  subdivision fails, refuses or neglects to make
    38  payment to the provider  of  excess  insurance  coverage  or  equivalent
    39  excess coverage in such time and manner as determined by the superinten-
    40  dent  of  financial  services pursuant to paragraph (b) of this subdivi-
    41  sion, excess insurance coverage or equivalent excess coverage  purchased
    42  for  such  physician or dentist in accordance with this section for such
    43  coverage period shall be cancelled and shall be null and void as of  the
    44  first  day  on  or  after  the commencement of a policy period where the
    45  liability for payment pursuant to this subdivision has not been met.
    46    (d) Each provider of excess insurance coverage  or  equivalent  excess
    47  coverage  shall  notify the superintendent of financial services and the
    48  commissioner of health or their designee of each physician  and  dentist
    49  eligible  for  purchase  of  a  policy  for excess insurance coverage or
    50  equivalent excess coverage covering the period July 1, 1992 to June  30,
    51  1993,  or covering the period July 1, 1993 to June 30, 1994, or covering
    52  the period July 1, 1994 to June 30, 1995, or covering the period July 1,
    53  1995 to June 30, 1996, or covering the period July 1, 1996 to  June  30,
    54  1997,  or covering the period July 1, 1997 to June 30, 1998, or covering
    55  the period July 1, 1998 to June 30, 1999, or covering the period July 1,
    56  1999 to June 30, 2000, or covering the period July 1, 2000 to  June  30,

        S. 8307--C                         36                         A. 8807--C
 
     1  2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
     2  ing  the  period  April 1, 2002 to June 30, 2002, or covering the period
     3  July 1, 2002 to June 30, 2003, or covering the period July  1,  2003  to
     4  June  30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
     5  covering the period July 1, 2005 to June 30, 2006, or covering the peri-
     6  od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
     7  June 30, 2008, or covering the period July 1, 2008 to June 30, 2009,  or
     8  covering the period July 1, 2009 to June 30, 2010, or covering the peri-
     9  od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
    10  June  30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
    11  covering the period July 1, 2013 to June 30, 2014, or covering the peri-
    12  od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
    13  June 30, 2016, or covering the period July 1, 2016 to June 30, 2017,  or
    14  covering the period July 1, 2017 to June 30, 2018, or covering the peri-
    15  od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
    16  June  30, 2020, or covering the period July 1, 2020 to June 30, 2021, or
    17  covering the period July 1, 2021 to June 30, 2022, or covering the peri-
    18  od July 1, 2022 to June 30, 2023, or covering the period July 1, 2023 to
    19  June 30, 2024, or covering the period July 1, 2024 to June 30, 2025 that
    20  has made payment to such provider of excess insurance coverage or equiv-
    21  alent excess coverage in accordance with paragraph (b) of this  subdivi-
    22  sion  and  of  each  physician  and  dentist  who has failed, refused or
    23  neglected to make such payment.
    24    (e) A provider of  excess  insurance  coverage  or  equivalent  excess
    25  coverage  shall  refund to the hospital excess liability pool any amount
    26  allocable to the period July 1, 1992 to June 30, 1993, and to the period
    27  July 1, 1993 to June 30, 1994, and to the period July 1,  1994  to  June
    28  30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
    29  period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
    30  June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
    31  the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
    32  to June 30, 2001, and to the period July 1, 2001 to  October  29,  2001,
    33  and to the period April 1, 2002 to June 30, 2002, and to the period July
    34  1,  2002  to  June  30, 2003, and to the period July 1, 2003 to June 30,
    35  2004, and to the period July 1, 2004 to June 30, 2005, and to the period
    36  July 1, 2005 to June 30, 2006, and to the period July 1,  2006  to  June
    37  30,  2007,  and  to the period July 1, 2007 to June 30, 2008, and to the
    38  period July 1, 2008 to June 30, 2009, and to the period July 1, 2009  to
    39  June  30,  2010, and to the period July 1, 2010 to June 30, 2011, and to
    40  the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
    41  to June 30, 2013, and to the period July 1, 2013 to June 30,  2014,  and
    42  to  the  period July 1, 2014 to June 30, 2015, and to the period July 1,
    43  2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017,  and
    44  to  the  period July 1, 2017 to June 30, 2018, and to the period July 1,
    45  2018 to June 30, 2019, and to the period July 1, 2019 to June 30,  2020,
    46  and  to the period July 1, 2020 to June 30, 2021, and to the period July
    47  1, 2021 to June 30, 2022, and to the period July 1,  2022  to  June  30,
    48  2023, and to the period July 1, 2023 to June 30, 2024, and to the period
    49  July  1, 2024 to June 30, 2025 received from the hospital excess liabil-
    50  ity pool for purchase of excess insurance coverage or equivalent  excess
    51  coverage covering the period July 1, 1992 to June 30, 1993, and covering
    52  the  period  July 1, 1993 to June 30, 1994, and covering the period July
    53  1, 1994 to June 30, 1995, and covering the period July 1, 1995  to  June
    54  30,  1996,  and  covering  the period July 1, 1996 to June 30, 1997, and
    55  covering the period July 1, 1997 to June  30,  1998,  and  covering  the
    56  period  July  1,  1998 to June 30, 1999, and covering the period July 1,

        S. 8307--C                         37                         A. 8807--C
 
     1  1999 to June 30, 2000, and covering the period July 1, 2000 to June  30,
     2  2001,  and  covering  the  period  July 1, 2001 to October 29, 2001, and
     3  covering the period April 1, 2002 to June 30,  2002,  and  covering  the
     4  period  July  1,  2002 to June 30, 2003, and covering the period July 1,
     5  2003 to June 30, 2004, and covering the period July 1, 2004 to June  30,
     6  2005,  and covering the period July 1, 2005 to June 30, 2006, and cover-
     7  ing the period July 1, 2006 to June 30, 2007, and  covering  the  period
     8  July  1,  2007 to June 30, 2008, and covering the period July 1, 2008 to
     9  June 30, 2009, and covering the period July 1, 2009 to  June  30,  2010,
    10  and  covering the period July 1, 2010 to June 30, 2011, and covering the
    11  period July 1, 2011 to June 30, 2012, and covering the  period  July  1,
    12  2012  to June 30, 2013, and covering the period July 1, 2013 to June 30,
    13  2014, and covering the period July 1, 2014 to June 30, 2015, and  cover-
    14  ing  the  period  July 1, 2015 to June 30, 2016, and covering the period
    15  July 1, 2016 to June 30, 2017, and covering the period July 1,  2017  to
    16  June  30,  2018,  and covering the period July 1, 2018 to June 30, 2019,
    17  and covering the period July 1, 2019 to June 30, 2020, and covering  the
    18  period  July  1,  2020 to June 30, 2021, and covering the period July 1,
    19  2021 to June 30, 2022, and covering the period July 1, 2022 to June  30,
    20  2023  for,  and  covering  the period July 1, 2023 to June 30, 2024, and
    21  covering the period July 1, 2024 to June 30, 2025 a physician or dentist
    22  where such excess insurance coverage or equivalent  excess  coverage  is
    23  cancelled in accordance with paragraph (c) of this subdivision.
    24    § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
    25  practice  law  and  rules  and  other  laws  relating to malpractice and
    26  professional medical conduct, as amended by section 4 of part F of chap-
    27  ter 57 of the laws of 2023, is amended to read as follows:
    28    § 40. The superintendent of financial services shall  establish  rates
    29  for  policies  providing  coverage  for  physicians and surgeons medical
    30  malpractice for the periods commencing July 1, 1985 and ending June  30,
    31  [2024] 2025; provided, however, that notwithstanding any other provision
    32  of  law,  the superintendent shall not establish or approve any increase
    33  in rates for the period commencing July 1,  2009  and  ending  June  30,
    34  2010.  The  superintendent shall direct insurers to establish segregated
    35  accounts for premiums, payments, reserves and investment income  attrib-
    36  utable to such premium periods and shall require periodic reports by the
    37  insurers  regarding  claims and expenses attributable to such periods to
    38  monitor whether such accounts will be sufficient to meet incurred claims
    39  and expenses. On or after July 1, 1989, the superintendent shall  impose
    40  a  surcharge  on  premiums  to  satisfy  a  projected deficiency that is
    41  attributable to the premium levels established pursuant to this  section
    42  for  such  periods;  provided, however, that such annual surcharge shall
    43  not exceed eight percent of the established rate until  July  1,  [2024]
    44  2025, at which time and thereafter such surcharge shall not exceed twen-
    45  ty-five  percent  of  the  approved  adequate rate, and that such annual
    46  surcharges shall continue for such period of time as shall be sufficient
    47  to satisfy such deficiency. The superintendent  shall  not  impose  such
    48  surcharge  during the period commencing July 1, 2009 and ending June 30,
    49  2010. On and after July  1,  1989,  the  surcharge  prescribed  by  this
    50  section  shall  be  retained by insurers to the extent that they insured
    51  physicians and surgeons during the July 1, 1985 through June 30,  [2024]
    52  2025  policy  periods;  in  the  event  and to the extent physicians and
    53  surgeons were insured by another insurer during such periods, all  or  a
    54  pro  rata  share of the surcharge, as the case may be, shall be remitted
    55  to such other insurer in accordance with rules  and  regulations  to  be
    56  promulgated by the superintendent.  Surcharges collected from physicians

        S. 8307--C                         38                         A. 8807--C
 
     1  and  surgeons  who  were not insured during such policy periods shall be
     2  apportioned among all insurers in proportion to the premium  written  by
     3  each  insurer  during such policy periods; if a physician or surgeon was
     4  insured by an insurer subject to rates established by the superintendent
     5  during  such  policy  periods,  and  at  any time thereafter a hospital,
     6  health maintenance organization, employer or institution is  responsible
     7  for  responding in damages for liability arising out of such physician's
     8  or surgeon's practice of medicine, such responsible  entity  shall  also
     9  remit  to  such  prior  insurer the equivalent amount that would then be
    10  collected as a surcharge if the physician or surgeon  had  continued  to
    11  remain  insured  by  such  prior  insurer. In the event any insurer that
    12  provided coverage during such policy  periods  is  in  liquidation,  the
    13  property/casualty  insurance  security fund shall receive the portion of
    14  surcharges to which the insurer in liquidation would have been entitled.
    15  The surcharges authorized herein shall be deemed to be income earned for
    16  the purposes of section 2303 of the insurance law.  The  superintendent,
    17  in  establishing  adequate  rates and in determining any projected defi-
    18  ciency pursuant to the requirements of this section  and  the  insurance
    19  law,  shall  give  substantial  weight, determined in his discretion and
    20  judgment, to the  prospective  anticipated  effect  of  any  regulations
    21  promulgated  and  laws  enacted  and the public benefit of   stabilizing
    22  malpractice rates and minimizing rate level fluctuation during the peri-
    23  od of time necessary for the development of  more  reliable  statistical
    24  experience  as  to  the  efficacy of such laws and regulations affecting
    25  medical, dental or podiatric malpractice enacted or promulgated in 1985,
    26  1986, by this act and at any other time.  Notwithstanding any  provision
    27  of the insurance law, rates already established and to be established by
    28  the  superintendent pursuant to this section are deemed adequate if such
    29  rates would be adequate when taken together with the maximum  authorized
    30  annual  surcharges to be imposed for a reasonable period of time whether
    31  or not any such annual surcharge has been actually  imposed  as  of  the
    32  establishment of such rates.
    33    §  5. Section 5 and subdivisions (a) and (e) of section 6 of part J of
    34  chapter 63 of the laws of 2001, amending chapter  266  of  the  laws  of
    35  1986,  amending the civil practice law and rules and other laws relating
    36  to malpractice and professional medical conduct, as amended by section 5
    37  of part F of chapter 57 of the laws of 2023,  are  amended  to  read  as
    38  follows:
    39    §  5. The superintendent of financial services and the commissioner of
    40  health shall determine, no later than June 15, 2002, June 15, 2003, June
    41  15, 2004, June 15, 2005, June 15, 2006, June 15, 2007,  June  15,  2008,
    42  June  15,  2009,  June  15, 2010, June 15, 2011, June 15, 2012, June 15,
    43  2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15,  2017,  June
    44  15,  2018,  June  15, 2019, June 15, 2020, June 15, 2021, June 15, 2022,
    45  June 15, 2023, [and] June 15, 2024, and June  15,  2025  the  amount  of
    46  funds  available in the hospital excess liability pool, created pursuant
    47  to section 18 of chapter 266 of the laws of 1986, and whether such funds
    48  are sufficient for purposes of purchasing excess insurance coverage  for
    49  eligible participating physicians and dentists during the period July 1,
    50  2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003
    51  to  June  30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to
    52  June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June
    53  30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June  30,
    54  2010,  or  July  1,  2010  to June 30, 2011, or July 1, 2011 to June 30,
    55  2012, or July 1, 2012 to June 30, 2013, or July  1,  2013  to  June  30,
    56  2014,  or  July  1,  2014  to June 30, 2015, or July 1, 2015 to June 30,

        S. 8307--C                         39                         A. 8807--C
 
     1  2016, or July 1, 2016 to June 30, 2017, or July  1,  2017  to  June  30,
     2  2018,  or  July  1,  2018  to June 30, 2019, or July 1, 2019 to June 30,
     3  2020, or July 1, 2020 to June 30, 2021, or July  1,  2021  to  June  30,
     4  2022,  or  July  1,  2022  to June 30, 2023, or July 1, 2023 to June 30,
     5  2024, or July 1, 2024 to June 30, 2025 as applicable.
     6    (a) This section shall be effective only upon a determination,  pursu-
     7  ant  to  section  five  of  this act, by the superintendent of financial
     8  services and the commissioner of health, and  a  certification  of  such
     9  determination  to  the  state  director  of the budget, the chair of the
    10  senate committee on finance and the chair of the assembly  committee  on
    11  ways  and means, that the amount of funds in the hospital excess liabil-
    12  ity pool, created pursuant to section 18 of chapter 266 of the  laws  of
    13  1986, is insufficient for purposes of purchasing excess insurance cover-
    14  age for eligible participating physicians and dentists during the period
    15  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
    16  1,  2003  to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
    17  2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
    18  to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1,  2009  to
    19  June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
    20  30,  2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
    21  2014, or July 1, 2014 to June 30, 2015, or July  1,  2015  to  June  30,
    22  2016,  or  July  1,  2016  to June 30, 2017, or July 1, 2017 to June 30,
    23  2018, or July 1, 2018 to June 30, 2019, or July  1,  2019  to  June  30,
    24  2020,  or  July  1,  2020  to June 30, 2021, or July 1, 2021 to June 30,
    25  2022, or July 1, 2022 to June 30, 2023, or July  1,  2023  to  June  30,
    26  2024, or July 1, 2024 to June 30, 2025 as applicable.
    27    (e)  The  commissioner  of  health  shall  transfer for deposit to the
    28  hospital excess liability pool created pursuant to section 18 of chapter
    29  266 of the laws of 1986 such amounts as directed by  the  superintendent
    30  of  financial  services  for  the purchase of excess liability insurance
    31  coverage for eligible participating  physicians  and  dentists  for  the
    32  policy  year  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
    33  2003, or July 1, 2003 to June 30, 2004, or July  1,  2004  to  June  30,
    34  2005,  or  July  1,  2005  to June 30, 2006, or July 1, 2006 to June 30,
    35  2007, as applicable, and the cost of administering the  hospital  excess
    36  liability pool for such applicable policy year,  pursuant to the program
    37  established  in  chapter  266  of the laws of 1986, as amended, no later
    38  than June 15, 2002, June 15, 2003, June 15, 2004, June  15,  2005,  June
    39  15,  2006,  June  15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
    40  June 15, 2011, June 15, 2012, June 15, 2013, June  15,  2014,  June  15,
    41  2015,  June  15, 2016, June 15, 2017, June 15, 2018, June 15, 2019, June
    42  15, 2020, June 15, 2021, June 15, 2022, June 15, 2023,  [and]  June  15,
    43  2024, and June 15, 2025 as applicable.
    44    §  6. Section 20 of part H of chapter 57 of the laws of 2017, amending
    45  the New York Health Care Reform Act of 1996 and other laws  relating  to
    46  extending  certain provisions thereto, as amended by section 6 of part F
    47  of chapter 57 of the laws of 2023, is amended to read as follows:
    48    § 20. Notwithstanding any law, rule or  regulation  to  the  contrary,
    49  only  physicians  or dentists who were eligible, and for whom the super-
    50  intendent of financial services and the commissioner of health, or their
    51  designee, purchased, with funds available in the hospital excess liabil-
    52  ity pool, a full or partial policy for  excess  coverage  or  equivalent
    53  excess  coverage  for  the coverage period ending the thirtieth of June,
    54  two thousand [twenty-three] twenty-four, shall be eligible to apply  for
    55  such  coverage  for the coverage period beginning the first of July, two
    56  thousand [twenty-three] twenty-four; provided,  however,  if  the  total

        S. 8307--C                         40                         A. 8807--C
 
     1  number of physicians or dentists for whom such excess coverage or equiv-
     2  alent excess coverage was purchased for the policy year ending the thir-
     3  tieth of June, two thousand [twenty-three] twenty-four exceeds the total
     4  number  of physicians or dentists certified as eligible for the coverage
     5  period beginning the first of July, two thousand [twenty-three]  twenty-
     6  four,  then the general hospitals may certify additional eligible physi-
     7  cians or dentists in a number equal to such general  hospital's  propor-
     8  tional  share  of  the  total  number of physicians or dentists for whom
     9  excess coverage or equivalent excess coverage was purchased  with  funds
    10  available  in  the hospital excess liability pool as of the thirtieth of
    11  June, two thousand [twenty-three] twenty-four, as applied to the differ-
    12  ence between the number of eligible physicians or dentists  for  whom  a
    13  policy  for  excess coverage or equivalent excess coverage was purchased
    14  for the coverage period ending  the  thirtieth  of  June,  two  thousand
    15  [twenty-three] twenty-four and the number of such eligible physicians or
    16  dentists  who  have  applied  for  excess  coverage or equivalent excess
    17  coverage for the coverage period beginning the first of July, two  thou-
    18  sand [twenty-three] twenty-four.
    19    §  7.  This  act  shall take effect immediately and shall be deemed to
    20  have been in full force and effect on and after April 1, 2024.
 
    21                                   PART L
 
    22                            Intentionally Omitted

    23                                   PART M
 
    24    Section 1. Subparagraph 3 of paragraph (b) of subdivision 4 of section
    25  366 of the social services law, as added by section 2 of part D of chap-
    26  ter 56 of the laws of 2013, is amended to read as follows:
    27    (3) (A) A child [under] between the [age] ages of six and nineteen who
    28  is determined eligible for medical assistance under  the  provisions  of
    29  this  section,  shall,  consistent with applicable federal requirements,
    30  remain eligible for such assistance until [the earlier of:
    31    (i)] the last day of the month which is twelve  months  following  the
    32  determination  [or  redetermination]  or renewal of eligibility for such
    33  assistance[; or
    34    (ii) the last day of the month in which the child reaches the  age  of
    35  nineteen].
    36    (B)  A  child  under  the  age  of  six who is determined eligible for
    37  medical assistance under the provisions of this section, shall, consist-
    38  ent with applicable federal requirements, remain  continuously  eligible
    39  for medical assistance coverage until the later of:
    40    (i)  the  last day of the twelfth month following the determination or
    41  renewal of eligibility for such assistance; or
    42    (ii) the last day of the month in which the child reaches the  age  of
    43  six.
    44    § 2. Subdivision 6 of section 2510 of the public health law is amended
    45  by adding a new paragraph (e) to read as follows:
    46    (e)  an  eligible  child under six years of age shall, consistent with
    47  applicable federal requirements, remain continuously enrolled until  the
    48  later of:
    49    (i) the last day of the twelfth month following the date of enrollment
    50  or recertification in the child health insurance plan; or

        S. 8307--C                         41                         A. 8807--C
 
     1    (ii)  the  last day of the month in which the child reaches the age of
     2  six.
     3    § 3. This act shall take effect January 1, 2025.
 
     4                                   PART N
 
     5                            Intentionally Omitted
 
     6                                   PART O
 
     7    Section 1. Subdivision 1 of section 2807-k of the public health law is
     8  amended by adding a new paragraph (h) to read as follows:
     9    (h) "Underinsured" shall mean an individual with out of pocket medical
    10  costs accumulated in the past twelve months that amount to more than ten
    11  percent of such individual's gross annual income.
    12    §  2.  Subdivision  9  of  section 2807-k of the public health law, as
    13  amended by section 1 of subpart C of part Y of chapter 57 of the laws of
    14  2023, is amended to read as follows:
    15    9. In order for a general hospital to participate in the  distribution
    16  of  funds  from  the  pool,  the general hospital must implement minimum
    17  collection policies and procedures approved by the commissioner, utiliz-
    18  ing only a uniform financial assistance form developed and  provided  by
    19  the  department.  All  general  hospitals that do not participate in the
    20  indigent care pool shall also utilize only the uniform financial assist-
    21  ance form and otherwise comply with subdivision nine-a of  this  section
    22  governing  the provision of financial assistance and hospital collection
    23  procedures.
    24    § 3. Subdivision 9-a of section 2807-k of the public  health  law,  as
    25  added  by  section  39-a of part A of chapter 57 of the laws of 2006 and
    26  paragraph (k) as added by section 43 of part B of chapter 58 of the laws
    27  of 2008, is amended to read as follows:
    28    9-a. (a) [As a  condition  for  participation  in  pool  distributions
    29  authorized  pursuant  to  this  section and section twenty-eight hundred
    30  seven-w of this article for] For periods on and after January first, two
    31  thousand nine, general hospitals shall, effective  for  periods  on  and
    32  after  January  first, two thousand seven, establish financial aid poli-
    33  cies and procedures, in accordance with the provisions of this  subdivi-
    34  sion,  for  reducing charges otherwise applicable to low-income individ-
    35  uals without health insurance or underinsured individuals, or  who  have
    36  exhausted  their  health  insurance benefits, and who can demonstrate an
    37  inability to pay full charges, and also, at the  hospital's  discretion,
    38  for  reducing  or  discounting  the collection of co-pays and deductible
    39  payments from those individuals who can demonstrate an inability to  pay
    40  such  amounts.  Immigration status shall not be an eligibility criterion
    41  for the purpose of determining financial assistance under this section.
    42    (b) Such reductions from charges for [uninsured] patients with incomes
    43  below at least [three] four hundred percent of the federal poverty level
    44  shall result in a charge to such individuals that does not  exceed  [the
    45  greater  of]  the amount that would have been paid for the same services
    46  [by the "highest volume payor" for such general hospital as  defined  in
    47  subparagraph (v) of this paragraph, or for services provided pursuant to
    48  title  XVIII  of  the  federal  social  security  act (medicare), or for
    49  services] provided pursuant to title XIX of the federal social  security
    50  act (medicaid), and provided further that such amounts shall be adjusted
    51  according to income level as follows:

        S. 8307--C                         42                         A. 8807--C

     1    (i) For patients with incomes [at or] below at least [one] two hundred
     2  percent  of  the  federal  poverty level, the hospital shall [collect no
     3  more than a nominal payment amount, consistent  with  guidelines  estab-
     4  lished  by the commissioner] waive all charges. No nominal payment shall
     5  be collected;
     6    (ii)  For  patients  with  incomes  between at least [one] two hundred
     7  [one] percent and [one] up to  three  hundred  [fifty]  percent  of  the
     8  federal  poverty  level,  the  hospital  shall  collect no more than the
     9  amount identified after application of a proportional sliding fee sched-
    10  ule under which patients with lower incomes shall pay the lowest amount.
    11  Such schedule shall provide that the amount the hospital may collect for
    12  such patients increases [from the nominal amount described  in  subpara-
    13  graph  (i)  of  this paragraph] in equal increments as the income of the
    14  patient increases, up to a  maximum  of  [twenty]  ten  percent  of  the
    15  [greater  of the] amount that would have been paid for the same services
    16  [by the "highest volume payor" for such general hospital, as defined  in
    17  subparagraph (v) of this paragraph, or for services provided pursuant to
    18  title  XVIII  of  the  federal  social  security  act  (medicare) or for
    19  services] provided pursuant to title XIX of the federal social  security
    20  act  (medicaid),  or  for  underinsured patients, up to a maximum of ten
    21  percent of the amount  that  would  have  been  paid  pursuant  to  such
    22  patient's insurance cost sharing;
    23    (iii)  For  patients with incomes between at least [one] three hundred
    24  [fifty-one] one percent and [two] four hundred [fifty]  percent  of  the
    25  federal  poverty  level,  the  hospital  shall  collect no more than the
    26  amount identified after application of a proportional sliding fee sched-
    27  ule under which patients with lower income shall pay the lowest amounts.
    28  Such schedule shall provide that the amount the hospital may collect for
    29  such patients increases from the [twenty] ten percent  figure  described
    30  in subparagraph (ii) of this paragraph in equal increments as the income
    31  of  the  patient  increases,  up  to  a  maximum of [the greater] twenty
    32  percent of the amount that would have been paid for  the  same  services
    33  [by  the "highest volume payor" for such general hospital, as defined in
    34  subparagraph (v) of this paragraph, or for services provided pursuant to
    35  title XVIII of  the  federal  social  security  act  (medicare)  or  for
    36  services]  provided pursuant to title XIX of the federal social security
    37  act (medicaid), or for underinsured patients, up to a maximum of  twenty
    38  percent  of  the  amount  that  would  have  been  paid pursuant to such
    39  patient's insurance cost sharing; [and
    40    (iv) For patients with incomes between at least two hundred  fifty-one
    41  percent  and  three  hundred  percent  of the federal poverty level, the
    42  hospital shall collect no more than the greater of the amount that would
    43  have been paid for the same services by the "highest volume  payor"  for
    44  such  general hospital as defined in subparagraph (v) of this paragraph,
    45  or for services provided pursuant to title XVIII of the  federal  social
    46  security  act (medicare), or for services provided pursuant to title XIX
    47  of the federal social security act (medicaid).
    48    (v) For the purposes of this paragraph, "highest volume  payor"  shall
    49  mean  the  insurer,  corporation  or organization licensed, organized or
    50  certified pursuant to article thirty-two, forty-two  or  forty-three  of
    51  the insurance law or article forty-four of this chapter, or other third-
    52  party  payor,  which  has  a  contract  or  agreement  to pay claims for
    53  services provided by the  general  hospital  and  incurred  the  highest
    54  volume of claims in the previous calendar year.
    55    (vi)  A  hospital may implement policies and procedures to permit, but
    56  not require, consideration on a case-by-case basis of exceptions to  the

        S. 8307--C                         43                         A. 8807--C

     1  requirements  described  in subparagraphs (i) and (ii) of this paragraph
     2  based upon the existence of significant assets owned by the patient that
     3  should be taken into account  in  determining  the  appropriate  payment
     4  amount  for  that  patient's care, provided, however, that such proposed
     5  policies and procedures  shall  be  subject  to  the  prior  review  and
     6  approval  of the commissioner and, if approved, shall be included in the
     7  hospital's financial assistance  policy  established  pursuant  to  this
     8  section,  and  provided  further  that, if such approval is granted, the
     9  maximum amount that may be collected shall not exceed the greater of the
    10  amount that would have been paid for the same services by  the  "highest
    11  volume  payor"  for such general hospital as defined in subparagraph (v)
    12  of this paragraph, or for services provided pursuant to title  XVIII  of
    13  the  federal  social  security  act (medicare), or for services provided
    14  pursuant to title XIX of the federal social security act (medicaid).  In
    15  the  event  that a general hospital reviews a patient's assets in deter-
    16  mining payment  adjustments  such  policies  and  procedures  shall  not
    17  consider  as assets a patient's primary residence, assets held in a tax-
    18  deferred or  comparable  retirement  savings  account,  college  savings
    19  accounts,  or  cars  used  regularly  by  a  patient or immediate family
    20  members.
    21    (vii)] (iv) Nothing in this paragraph shall be construed  to  limit  a
    22  hospital's   ability   to  establish  patient  eligibility  for  payment
    23  discounts at income levels higher than those specified herein and/or  to
    24  provide  greater  payment  discounts  for  eligible  patients than those
    25  required by this paragraph.
    26    (c) Such policies and procedures shall be  clear,  understandable,  in
    27  writing and publicly available in summary form and each general hospital
    28  participating  in the pool shall ensure that every patient is made aware
    29  of the existence of such policies and procedures and is provided,  in  a
    30  timely  manner,  with  a  summary  of such policies and procedures [upon
    31  request]. Any summary provided to patients shall, at a minimum,  include
    32  specific  information  as to income levels used to determine eligibility
    33  for assistance, a description of the primary service area of the  hospi-
    34  tal and the means of applying for assistance. For general hospitals with
    35  twenty-four  hour  emergency  departments,  such policies and procedures
    36  shall require the written notification of patients during the intake and
    37  registration process, and during discharge of the patient,  and  through
    38  the  conspicuous  posting  of  language-appropriate  information  in the
    39  general hospital, and  information  on  bills  and  statements  sent  to
    40  patients,  that financial aid may be available to qualified patients and
    41  how to obtain further information. For specialty hospitals without twen-
    42  ty-four hour emergency departments, such notification shall  take  place
    43  through  written  materials  provided  to patients during the intake and
    44  registration process prior to the provision of any health care  services
    45  or procedures, and during discharge of the patient, and through informa-
    46  tion on bills and statements sent to patients, that financial aid may be
    47  available  to  qualified patients and how to obtain further information.
    48  Application materials shall include  a  notice  to  patients  that  upon
    49  submission  of  a  completed  application,  including any information or
    50  documentation needed to determine the patient's eligibility pursuant  to
    51  the  hospital's  financial  assistance policy, the patient may disregard
    52  any bills until the hospital has rendered a decision on the  application
    53  in accordance with this paragraph.
    54    (d) Such policies and procedures shall include clear, objective crite-
    55  ria  for  determining  a patient's ability to pay and for providing such
    56  adjustments to payment requirements as are  necessary.  In  addition  to

        S. 8307--C                         44                         A. 8807--C
 
     1  adjustment  mechanisms  such  as  sliding fee schedules and discounts to
     2  fixed standards, such policies and procedures shall also provide for the
     3  use of installment plans for the  payment  of  outstanding  balances  by
     4  patients  pursuant  to  the  provisions  of  the  [hospital's] financial
     5  assistance policy. The monthly payment  under  such  a  plan  shall  not
     6  exceed  [ten]  five percent of the gross monthly income of the patient[,
     7  provided, however, that if patient assets are considered  under  such  a
     8  policy,  then  patient  assets which are not excluded assets pursuant to
     9  subparagraph (vi) of paragraph (b) of this subdivision may be considered
    10  in addition to the limit on monthly  payments].  The  rate  of  interest
    11  charged  to  the patient on the unpaid balance, if any, shall not exceed
    12  [the rate for a ninety-day security issued by the United States  Depart-
    13  ment  of  Treasury,  plus  .5]  two percent and no plan shall include an
    14  accelerator or similar clause under which a higher rate of  interest  is
    15  triggered upon a missed payment. If such policies and procedures include
    16  a  requirement  of  a deposit prior to non-emergent, medically-necessary
    17  care, such deposit must be included as part of any financial aid consid-
    18  eration. Such policies and procedures shall be applied  consistently  to
    19  all eligible patients.
    20    (e)  Such  policies  and procedures shall permit patients to apply for
    21  assistance [within at least ninety days of the date of discharge or date
    22  of service and provide at least twenty days for  patients  to  submit  a
    23  completed  application] at any time during the collection process.  Such
    24  policies and  procedures  may  require  that  patients  seeking  payment
    25  adjustments  provide appropriate financial information and documentation
    26  in support of their application, provided, however, that  such  applica-
    27  tion  process  shall not be unduly burdensome or complex. General hospi-
    28  tals shall, upon request, assist patients in  understanding  the  hospi-
    29  tal's  policies  and procedures and in applying for payment adjustments.
    30  Application forms  shall  be  printed  in  the  "primary  languages"  of
    31  patients  served by the general hospital. For the purposes of this para-
    32  graph, "primary languages" shall include any language that is either (i)
    33  used to communicate, during at least five percent of patient visits in a
    34  year, by patients who  cannot  speak,  read,  write  or  understand  the
    35  English  language  at  the  level of proficiency necessary for effective
    36  communication with health care providers, or (ii) spoken by  non-English
    37  speaking  individuals  comprising  more  than one percent of the primary
    38  hospital service area population, as calculated using demographic infor-
    39  mation available from the United States Bureau of  the  Census,  supple-
    40  mented  by  data  from school systems. Decisions regarding such applica-
    41  tions shall be made  within  thirty  days  of  receipt  of  a  completed
    42  application.  Such policies and procedures shall require that the hospi-
    43  tal issue any denial/approval of such application in writing with infor-
    44  mation on how to appeal the denial and shall  require  the  hospital  to
    45  establish  an appeals process under which it will evaluate the denial of
    46  an application. Nothing in this  subdivision  shall  be  interpreted  as
    47  prohibiting a hospital from making the availability of financial assist-
    48  ance contingent upon the patient first applying for coverage under title
    49  XIX of the social security act (medicaid) or another publicly subsidized
    50  insurance  program  if, in the judgment of the hospital, the patient may
    51  be eligible  for  medicaid  or  another  publicly  subsidized  insurance
    52  program,  and  upon  the  patient's cooperation in following the [hospi-
    53  tal's] financial  assistance  application  requirements,  including  the
    54  provision of information needed to make a determination on the patient's
    55  application in accordance with the hospital's financial assistance poli-
    56  cy,  provided,  however,  that  this  requirement shall not apply to any

        S. 8307--C                         45                         A. 8807--C
 
     1  patient that would otherwise not qualify for  coverage  based  on  their
     2  immigration status.
     3    (f)  Such  policies  and  procedures  shall provide that patients with
     4  incomes below [three] four hundred percent of the federal poverty  level
     5  are  deemed  presumptively  eligible  for  payment adjustments and shall
     6  conform to the requirements set forth in paragraph (b) of this  subdivi-
     7  sion,  provided,  however,  that  nothing  in  this subdivision shall be
     8  interpreted as precluding hospitals from extending such payment  adjust-
     9  ments  to  other  patients, either generally or on a case-by-case basis.
    10  Such policies and procedures shall provide financial aid  for  emergency
    11  hospital services, including emergency transfers pursuant to the federal
    12  emergency  medical  treatment  and  active labor act (42 USC 1395dd), to
    13  patients who reside in New York state and for medically necessary hospi-
    14  tal services for patients who reside in the hospital's  primary  service
    15  area  as determined according to criteria established by the commission-
    16  er. In developing such criteria, the  commissioner  shall  consult  with
    17  representatives of the hospital industry, health care consumer advocates
    18  and local public health officials. Such criteria shall be made available
    19  to  the public no less than thirty days prior to the date of implementa-
    20  tion and shall, at a minimum:
    21    (i) prohibit a  hospital  from  developing  or  altering  its  primary
    22  service  area in a manner designed to avoid medically underserved commu-
    23  nities or communities with high percentages of uninsured residents;
    24    (ii) ensure that every geographic area of the state is included in  at
    25  least  one  general  hospital's  primary  service  area so that eligible
    26  patients may access care and financial assistance; and
    27    (iii) require the hospital to notify the commissioner upon making  any
    28  change  to its primary service area, and to include a description of its
    29  primary service area in  the  hospital's  annual  implementation  report
    30  filed  pursuant  to  subdivision  three  of section twenty-eight hundred
    31  three-l of this article.
    32    (g) Nothing in this subdivision shall  be  interpreted  as  precluding
    33  hospitals  from  extending  payment  adjustments for medically necessary
    34  non-emergency hospital services to patients outside  of  the  hospital's
    35  primary  service area. For patients determined to be eligible for finan-
    36  cial aid under the terms of a  hospital's  financial  aid  policy,  such
    37  policies  and procedures shall prohibit any limitations on financial aid
    38  for services based on the medical condition of the applicant, other than
    39  typical limitations or exclusions based  on  medical  necessity  or  the
    40  clinical or therapeutic benefit of a procedure or treatment.
    41    (h)  Such  policies and procedures shall prohibit the denial of admis-
    42  sion or denial of treatment for services that are reasonably anticipated
    43  to be medically necessary because the  patient  has  an  unpaid  medical
    44  bill.  Such  policies  and  procedures  shall  [not permit] prohibit the
    45  forced sale or foreclosure of a patient's primary residence in order  to
    46  collect  an  outstanding  medical bill and shall require the hospital to
    47  refrain from sending an account to collection if the patient has submit-
    48  ted a completed application for financial aid,  including  any  required
    49  supporting  documentation,  while  the hospital determines the patient's
    50  eligibility for such aid. Such policies and  procedures  shall  prohibit
    51  the sale of medical debt accumulated pursuant to this section to a third
    52  party,  unless the third party explicitly purchases such medical debt in
    53  order to relieve the debt of the patient. Such policies  and  procedures
    54  shall provide for written notification, which shall include notification
    55  on  a  patient bill, to a patient not less than thirty days prior to the
    56  referral of debts for collection and shall require that  the  collection

        S. 8307--C                         46                         A. 8807--C
 
     1  agency obtain the hospital's written consent prior to commencing a legal
     2  action.  Such  policies  and  procedures  shall prohibit a hospital from
     3  commencing a legal action related to the recovery  of  medical  debt  or
     4  unpaid bills against patients with incomes below four hundred percent of
     5  the  federal  poverty level. In any legal action related to the recovery
     6  of medical debt or unpaid bills by or  on  behalf  of  a  hospital,  the
     7  complaint  shall  be accompanied by an affidavit by the hospital's chief
     8  financial officer stating that  based  upon  the  hospital's  reasonable
     9  effort  to  determine  the  patient's  income, the patient whom they are
    10  taking legal action against does not have an income below  four  hundred
    11  percent of the federal poverty level. Such policies and procedures shall
    12  require  all  general  hospital staff who interact with patients or have
    13  responsibility for billing and collections to be trained in  such  poli-
    14  cies  and  procedures, and require the implementation of a mechanism for
    15  the general hospital to measure its compliance with  such  policies  and
    16  procedures.   Such  policies  and  procedures  shall  require  that  any
    17  collection agency  under  contract  with  a  general  hospital  for  the
    18  collection  of  debts follow the hospital's financial assistance policy,
    19  including providing information to patients on how to apply  for  finan-
    20  cial  assistance  where  appropriate. Such policies and procedures shall
    21  prohibit collections from a patient who is determined to be eligible for
    22  medical assistance pursuant to title XIX of the federal social  security
    23  act  at  the time services were rendered and for which services medicaid
    24  payment is available.
    25    (i) Reports required to be submitted to the department by each general
    26  hospital as a condition  for  participation  in  the  pools,  and  which
    27  contain, in accordance with applicable regulations, a certification from
    28  an  independent  certified  public  accountant  or  independent licensed
    29  public accountant or an attestation from a senior official of the hospi-
    30  tal that the hospital is in compliance with conditions of  participation
    31  in  the  pools,  shall  also contain, for reporting periods on and after
    32  January first, two thousand seven:
    33    (i) a report on hospital costs incurred  and  uncollected  amounts  in
    34  providing  services  to  eligible patients without insurance[, including
    35  the amount of care provided for a nominal payment  amount,]  during  the
    36  period covered by the report;
    37    (ii)  hospital  costs incurred and uncollected amounts for deductibles
    38  and coinsurance for eligible patients with insurance or other third-par-
    39  ty payor coverage;
    40    (iii) the number of patients, organized  according  to  United  States
    41  postal  service  zip code, who applied for financial assistance pursuant
    42  to the hospital's financial assistance policy, and the number, organized
    43  according to United States postal service zip code,  whose  applications
    44  were approved and whose applications were denied;
    45    (iv)  the  number  of  patients, including their age, race, ethnicity,
    46  gender and insurance status, who applied for financial assistance  under
    47  the  hospital's financial assistance policy, and the number of patients,
    48  including their age, race, ethnicity, gender and insurance status, whose
    49  applications were approved and denied;
    50    (v) the reimbursement received for indigent care from the pool  estab-
    51  lished pursuant to this section;
    52    [(v)] (vi) the amount of funds that have been expended on charity care
    53  from  charitable  bequests made or trusts established for the purpose of
    54  providing financial assistance to patients who are eligible  in  accord-
    55  ance with the terms of such bequests or trusts;

        S. 8307--C                         47                         A. 8807--C
 
     1    [(vi)]  (vii)  for  hospitals  located in social services districts in
     2  which the district allows hospitals to assist patients with such  appli-
     3  cations,  the  number of applications for eligibility under title XIX of
     4  the social security act (medicaid) that the hospital  assisted  patients
     5  in completing and the number denied and approved; and
     6    [(vii)] (viii) the hospital's financial losses resulting from services
     7  provided under medicaid[; and
     8    (viii)  the  number  of  liens  placed  on  the  primary residences of
     9  patients through the collection process used by a hospital].
    10    (j) Within ninety days of the effective date of this subdivision  each
    11  hospital  shall submit to the commissioner a written report on its poli-
    12  cies and procedures for financial assistance to patients which are  used
    13  by  the  hospital on the effective date of this subdivision. Such report
    14  shall include copies of its policies and procedures, including  material
    15  which  is  distributed  to patients, and a description of the hospital's
    16  financial aid policies and procedures. Such  description  shall  include
    17  the  income levels of patients on which eligibility is based, the finan-
    18  cial aid eligible patients receive and the  means  of  calculating  such
    19  aid,  and  the  service  area, if any, used by the hospital to determine
    20  eligibility.
    21    (k) [In the event it is determined by the commissioner that the  state
    22  will  be unable to secure all necessary federal approvals to include, as
    23  part of the state's approved state plan  under  title  nineteen  of  the
    24  federal  social  security  act, a requirement, as set forth in paragraph
    25  one of this subdivision, that compliance  with  this  subdivision  is  a
    26  condition  of participation in pool distributions authorized pursuant to
    27  this section and section twenty-eight hundred seven-w of  this  article,
    28  then  such condition of participation shall be deemed null and void and,
    29  notwithstanding] Notwithstanding section twelve of this chapter, failure
    30  to comply with the provisions of this subdivision by a hospital  on  and
    31  after the date of such determination shall make such hospital liable for
    32  a  civil  penalty  not  to  exceed  ten  thousand  dollars for each such
    33  violation. The imposition of such civil penalties shall  be  subject  to
    34  the provisions of section twelve-a of this chapter.
    35    (l)  A  hospital  or  its  collection agent shall not commence a civil
    36  action against a patient or delegate a collection  activity  to  a  debt
    37  collector  for nonpayment for at least one hundred eighty days after the
    38  first post-service bill is issued and until a hospital has made  reason-
    39  able  efforts  to  determine  whether  a patient qualifies for financial
    40  assistance.
    41    § 4. The public health law is amended by adding a new section 18-c  to
    42  read as follows:
    43    §  18-c. Separate patient consent for treatment and payment for health
    44  care services. Informed consent from a patient to provide any treatment,
    45  procedure, examination or other direct health  care  services  shall  be
    46  obtained separately from such patient's consent to pay for the services.
    47  Consent  to  pay  for any health care services by a patient shall not be
    48  given prior to the patient receiving such services and discussing treat-
    49  ment costs. For purposes of this  section,  "consent"  means  an  action
    50  which:  (a)  clearly  and  conspicuously  communicates  the individual's
    51  authorization of an act or practice; (b) is made in the absence  of  any
    52  mechanism  in  the  user  interface  that has the purpose or substantial
    53  effect of obscuring, subverting, or impairing decision-making or  choice
    54  to obtain consent; and (c) cannot be inferred from inaction.
    55    §  5.  The  general business law is amended by adding two new sections
    56  349-g and 519-a to read as follows:

        S. 8307--C                         48                         A. 8807--C
 
     1    § 349-g.  Restrictions on applications for and use of credit cards and
     2  medical financial products. 1. For purposes of this section, the follow-
     3  ing terms shall have the following meanings:
     4    (a)  "Medical  financial products" shall mean medical credit cards and
     5  third-party medical installment loans.
     6    (b) "Health care provider"  shall  mean  a  health  care  professional
     7  licensed,  registered or certified pursuant to title eight of the educa-
     8  tion law.
     9    (c) "Medical credit card" shall mean a credit  card  issued  under  an
    10  open-end  or  closed-end  plan  offered  specifically for the payment of
    11  health care services, products, or devices provided to a person.
    12    2. It shall be prohibited for any hospital or health care provider, or
    13  employee or agent of a hospital or health care provider, to complete any
    14  portion of an application for medical financial products for the patient
    15  or otherwise arrange  for  or  establish  an  application  that  is  not
    16  completely filled out by the patient.
    17    §  519-a.  Credit  cards  and payment for health care services. 1. For
    18  purposes of this section, the term "credit card"  shall  have  the  same
    19  meaning as in section five hundred eleven of this article.
    20    2.  No hospital or health care provider shall require credit card pre-
    21  authorization nor require the patient to have  a  credit  card  on  file
    22  prior  to providing emergency or medically necessary medical services to
    23  such patient.
    24    3. Hospitals and health care providers shall notify all patients about
    25  the risks of paying for  medical  services  with  a  credit  card.  Such
    26  notification shall highlight the fact that by using a credit card to pay
    27  for  medical  services,  the  patient  is  forgoing  state  and  federal
    28  protections that regard medical debt.  The commissioner of health  shall
    29  have  the  authority  and  sole  discretion  to set requirements for the
    30  contents of such notices.
    31    § 6. This act shall take effect six months after it shall have  become
    32  a  law;  provided,  however, that if section 1 of subpart C of part Y of
    33  chapter 57 of the laws of 2023 shall not have taken effect on or  before
    34  such  date  then  section  two of this act shall take effect on the same
    35  date and in the same manner as such chapter of the laws  of  2023  takes
    36  effect.  Effective immediately, the addition, amendment and/or repeal of
    37  any  rule  or regulation necessary for the implementation of this act on
    38  its effective date are authorized to be made and completed on or  before
    39  such effective date.
 
    40                                   PART P
 
    41    Section  1.  Section  8  of  part  C of chapter 57 of the laws of 2022
    42  amending the public health law and the education law relating to  allow-
    43  ing  pharmacists  to  direct  limited service laboratories and order and
    44  administer COVID-19 and influenza tests and  modernizing  nurse  practi-
    45  tioners, is amended to read as follows:
    46    §  8.  This  act  shall take effect immediately and shall be deemed to
    47  have been in full force and effect on and after April 1, 2022; provided,
    48  however, that sections one, two, three, four, six and seven of this  act
    49  shall  expire  and  be  deemed  repealed  [two years after it shall have
    50  become a law] July 1, 2026.
    51    § 2. Section 5 of chapter 21 of the laws of 2011 amending  the  educa-
    52  tion  law  relating  to authorizing pharmacists to perform collaborative
    53  drug therapy management with physicians in certain settings, as  amended

        S. 8307--C                         49                         A. 8807--C
 
     1  by section 5 of part CC of chapter 57 of the laws of 2022, is amended to
     2  read as follows:
     3    § 5. This act shall take effect on the one hundred twentieth day after
     4  it  shall  have  become a law, provided, however, that the provisions of
     5  sections two, three, and four of this act shall  expire  and  be  deemed
     6  repealed  July 1, [2024] 2026; provided, however, that the amendments to
     7  subdivision 1 of section 6801 of the education law made by  section  one
     8  of  this  act  shall  be subject to the expiration and reversion of such
     9  subdivision pursuant to section 8 of chapter 563 of the  laws  of  2008,
    10  when  upon  such  date the provisions of section one-a of this act shall
    11  take effect; provided, further, that effective  immediately,  the  addi-
    12  tion,  amendment  and/or  repeal of any rule or regulation necessary for
    13  the implementation of this act on its effective date are authorized  and
    14  directed to be made and completed on or before such effective date.
    15    §  3.  This  act  shall take effect immediately and shall be deemed to
    16  have been in full force and effect on and after April 1, 2024.
 
    17                                   PART Q
 
    18                            Intentionally Omitted
 
    19                                   PART R
 
    20                            Intentionally Omitted
 
    21                                   PART S
 
    22    Section 1. (a) The public health  law  is  amended  by  adding  a  new
    23  section 2825-i to read as follows:
    24    §  2825-i.  Healthcare  safety  net  transformation  program. 1. (a) A
    25  statewide healthcare safety net transformation program shall  be  estab-
    26  lished within the department for the purpose of supporting the transfor-
    27  mation  of  safety net hospitals to improve access, equity, quality, and
    28  outcomes while increasing the financial  sustainability  of  safety  net
    29  hospitals.  Such  program may provide or utilize new or existing capital
    30  funding, or operating subsidies,  or  both.  Any  application  for  this
    31  program  must be jointly submitted by a safety net hospital and at least
    32  one partner organization.
    33    (b) All applications shall demonstrate how the requested  funding  and
    34  regulatory  flexibilities  are necessary to achieve the program goals of
    35  improving the safety net  hospital's  financial  outlook  and  improving
    36  health  outcomes  for  the communities it serves. The commissioner shall
    37  develop an application for this program that includes but is not limited
    38  to the following information:
    39    (i)  key  organizational  information,  including  the  organizational
    40  structure of the safety net hospital and partner organization (including
    41  any  parent  or  subsidiary,  and the interrelationship between all such
    42  organizations) and the name, business address,  and  biography  of  each
    43  director  and officer of the safety net hospital, the partner, and other
    44  organizations within either the safety net hospital's or  the  partner's
    45  organizational structure;
    46    (ii)  the  type  of  collaborative  model  proposed, including but not
    47  limited to a merger, acquisition, management services contract, or clin-
    48  ical integration;

        S. 8307--C                         50                         A. 8807--C
 
     1    (iii) a detailed description of the proposed transformation plan  that
     2  includes,  at  a  minimum,  a  five-year  strategic and operational plan
     3  outlining the roles and responsibilities of the safety net hospital  and
     4  partner organization;
     5    (iv) a timeline of key metrics and goals;
     6    (v)  any  regulatory  flexibilities  required  to implement such plan,
     7  including the justification for why such flexibilities are necessary for
     8  the transformation plan to achieve an improved financial outlook for the
     9  safety net hospital and improved health outcomes for the communities  it
    10  serves;
    11    (vi)  the  amount  of  funding  requested for the first five years and
    12  projected needs thereafter, including the rationale for why such funding
    13  is necessary for the transformation plan to achieve an  improved  finan-
    14  cial  outlook  for  the safety net hospital and improved health outcomes
    15  for the communities it serves; and
    16    (vii) detailed plans for any operational surplus after reaching finan-
    17  cial sustainability.
    18    2. The commissioner shall enter an agreement with the president of the
    19  dormitory authority of the state of New York pursuant to section sixteen
    20  hundred eighty-r of the public authorities law, as required, which shall
    21  apply to this agreement, subject to the approval of the director of  the
    22  division  of the budget, for the purposes of the distribution and admin-
    23  istration of available funds pursuant to such agreement and made  avail-
    24  able  pursuant  to this section and subject to appropriation. Such funds
    25  may be awarded and distributed by the department to  safety  net  hospi-
    26  tals,  or a partner organization, in the form of grants. To qualify as a
    27  safety net hospital for purposes of this section, a hospital shall:
    28    (a) be either a public hospital, a rural emergency hospital,  critical
    29  access hospital or sole community hospital;
    30    (b)  have  at least thirty percent of its inpatient discharges made up
    31  of medical assistance program eligible individuals,  uninsured  individ-
    32  uals  or  medical  assistance program dually eligible individuals and at
    33  least thirty-five percent of its outpatient visits made  up  of  medical
    34  assistance   program  eligible  individuals,  uninsured  individuals  or
    35  medical assistance program dually-eligible individuals;
    36    (c) serve at least thirty percent of the residents of a  county  or  a
    37  multi-county  area  who are medical assistance program eligible individ-
    38  uals, uninsured individuals or medical assistance program  dually-eligi-
    39  ble individuals; or
    40    (d)  in  the discretion of the commissioner, serve a significant popu-
    41  lation of medical assistance  program  eligible  individuals,  uninsured
    42  individuals or medical assistance program dually-eligible individuals.
    43    3.  Partner  organizations may include, but are not limited to, health
    44  systems, hospitals, health plans, residential  health  care  facilities,
    45  physician  groups,  community-based  organization,  or  other healthcare
    46  entities who can serve as partners in the transformation of  the  safety
    47  net hospital.
    48    4.    Notwithstanding  section  one  hundred  sixty-three of the state
    49  finance law, sections one hundred forty-two and one hundred  forty-three
    50  of the economic development law or any inconsistent provisions of law to
    51  the  contrary,  awards  may  be  provided  without  a competitive bid or
    52  request for proposal process to safety net hospitals or  partner  organ-
    53  izations  for  purposes of increasing access, equity, quality, outcomes,
    54  and long-term financial sustainability of such safety net hospitals.
    55    5. Notwithstanding any provision of law to the contrary,  the  commis-
    56  sioner  may  waive  regulatory  requirements to allow applicants to more

        S. 8307--C                         51                         A. 8807--C
 
     1  effectively  or  efficiently  implement  projects  awarded  through  the
     2  healthcare  safety  net  transformation program, provided, however, that
     3  regulations pertaining to minimum standards for  hospitals  for  patient
     4  safety,  patient  autonomy,  patient privacy, patient rights, quality of
     5  care, safe staffing, adverse event  reporting,  due  process,  scope  of
     6  practice,  professional  licensure, environmental protections, infection
     7  control, provider reimbursement methodologies, character and competence,
     8  or occupational standards and employee rights shall not be  waived,  nor
     9  shall  any regulations be waived if such waiver would risk patient safe-
    10  ty. Such waiver shall not exceed the life of the project or such shorter
    11  time periods as the commissioner may determine.  Any  regulatory  relief
    12  granted pursuant to this subdivision shall be specifically described and
    13  requested within each project application and be reviewed by the commis-
    14  sioner.
    15    6.  Continued  support  under the program shall be contingent upon the
    16  implementation of the approved plan and key milestones.
    17    7. The release of any funding will be contingent upon compliance  with
    18  the transformation plan and a determination that acceptable progress has
    19  been made with such plan. If key milestones and goals are not met, addi-
    20  tional  financial  resources  may  be  withheld and redirected, upon the
    21  recommendation of the commissioner and approval by the director of budg-
    22  et.
    23    8. The commissioner shall provide a report on an annual basis  to  the
    24  speaker  of  the  assembly,  the  temporary president of the senate, the
    25  chair of the assembly ways and means committee, the chair of the  senate
    26  finance  committee,  and  the director of the division of budget, on any
    27  transformation plan approved under this section,  including  information
    28  on  partnership agreements, and any amendments thereto. The report shall
    29  also include for each award, the name of the hospital and  partner,  the
    30  corporate  structure  of  any partner organization, a description of the
    31  project and its purpose, the amount of the award  and  the  disbursement
    32  date,  the regulations waived for each project and the justification for
    33  such waiver, and the status of achievement of  performance  metrics  and
    34  milestones. Such report shall be provided until such time as the depart-
    35  ment  determines that the projects that receive funding pursuant to this
    36  section are substantially complete.
    37    § 2. This act shall take effect immediately and  shall  be  deemed  to
    38  have been in full force and effect on and after April 1, 2024.
 
    39                                   PART T
 
    40                            Intentionally Omitted

    41                                   PART U
 
    42                            Intentionally Omitted
 
    43                                   PART V
 
    44                            Intentionally Omitted
 
    45                                   PART W

        S. 8307--C                         52                         A. 8807--C
 
     1                            Intentionally Omitted
 
     2                                   PART X
 
     3                           Intentionally Omitted.
 
     4                                   PART Y
 
     5    Section  1.  Section  7  of part R2 of chapter 62 of the laws of 2003,
     6  amending the mental hygiene law and the state finance  law  relating  to
     7  the  community mental health support and workforce reinvestment program,
     8  the membership of subcommittees for mental health of community  services
     9  boards  and  the duties of such subcommittees and creating the community
    10  mental health and workforce reinvestment account, as amended by  section
    11  1  of  part  W  of chapter 57 of the laws of 2021, is amended to read as
    12  follows:
    13    § 7. This act shall take effect immediately and shall expire March 31,
    14  [2024] 2027 when upon such date the provisions  of  this  act  shall  be
    15  deemed repealed.
    16    §  2.  This  act  shall take effect immediately and shall be deemed to
    17  have been in full force and effect on and after April 1, 2024.
 
    18                                   PART Z
 
    19    Section 1. Section 2 of part NN of chapter 58 of  the  laws  of  2015,
    20  amending  the mental hygiene law relating to clarifying the authority of
    21  the commissioners in the department of  mental  hygiene  to  design  and
    22  implement  time-limited  demonstration programs, as amended by section 1
    23  of part V of chapter 57 of the laws of  2021,  is  amended  to  read  as
    24  follows:
    25    §  2.  This  act shall take effect immediately and shall expire and be
    26  deemed repealed March 31, [2024] 2025.
    27    § 2. This act shall take effect immediately.
 
    28                                   PART AA
 
    29    Section 1. Paragraph 31 of subsection  (i)  of  section  3216  of  the
    30  insurance  law  is  amended  by adding a new subparagraph (J) to read as
    31  follows:
    32    (J) This subparagraph shall apply to facilities in this state that are
    33  licensed, certified, or otherwise authorized by the office of  addiction
    34  services  and supports for the provision of outpatient, intensive outpa-
    35  tient, outpatient rehabilitation and opioid treatment that  are  partic-
    36  ipating  in  the  insurer's  provider network. Reimbursement for covered
    37  outpatient treatment provided by such facilities shall be at rates nego-
    38  tiated between the insurer and the participating facility, provided that
    39  such rates are not less than the rates  that  would  be  paid  for  such
    40  treatment  pursuant to the medical assistance program under title eleven
    41  of article five of the social services law. For  the  purposes  of  this
    42  subparagraph,  the  rates that would be paid for such treatment pursuant
    43  to the medical assistance program under title eleven of article five  of
    44  the  social  services  law  shall be the rates with an effective date of
    45  April first of the preceding year, which shall be established  prior  to
    46  October first of the preceding calendar year. Prior to the submission of

        S. 8307--C                         53                         A. 8807--C
 
     1  premium rate filings and applications, the superintendent shall  provide
     2  insurers with  guidance on factors to consider in calculating the impact
     3  of  rate changes for the purposes of submitting premium rate filings and
     4  applications  to  the  superintendent for the subsequent policy year. To
     5  the extent that the rates with an effective date of April  first  differ
     6  from  the  estimated  rates  incorporated  in   premium rate filings and
     7  applications, insurers may account  for  such  differences    in  future
     8  premium  rate  filings  and applications submitted to the superintendent
     9  for approval.
    10    § 2. Paragraph 35 of subsection (i) of section 3216 of  the  insurance
    11  law is amended by adding a new subparagraph (K) to read as follows:
    12    (K)  This subparagraph shall apply to outpatient treatment provided in
    13  a facility issued an operating certificate by the commissioner of mental
    14  health pursuant to the provisions of article thirty-one  of  the  mental
    15  hygiene  law,  or in a facility operated by the office of mental health,
    16  or in a crisis stabilization center licensed pursuant to  section  36.01
    17  of  the  mental  hygiene  law,  that  is  participating in the insurer's
    18  provider  network.  Reimbursement  for  covered   outpatient   treatment
    19  provided  by  such  a  facility shall be at rates negotiated between the
    20  insurer and the participating facility, provided that such rates are not
    21  less than the rates that would be paid for such  treatment  pursuant  to
    22  the medical assistance program under title eleven of article five of the
    23  social  services  law.  For the purposes of this subparagraph, the rates
    24  that would be paid for such treatment pursuant to the medical assistance
    25  program under title eleven of article five of the  social  services  law
    26  shall be the rates with an effective date of  April first of the preced-
    27  ing  year,  which  shall  be  established  prior to October first of the
    28  preceding calendar year. Prior to the submission of premium rate filings
    29  and applications, the superintendent shall  provide insurers with  guid-
    30  ance on  factors to consider in calculating the impact of  rate  changes
    31  for  the purposes of submitting premium rate filings and applications to
    32  the superintendent for the subsequent policy year. To  the  extent  that
    33  the  rates  with  an effective date of April first differ from the esti-
    34  mated rates incorporated in   premium  rate  filings  and  applications,
    35  insurers  may  account  for  such  differences    in future premium rate
    36  filings and applications  submitted to the superintendent for approval.
    37    § 3. Paragraph 5 of subsection (l) of section 3221  of  the  insurance
    38  law is amended by adding a new subparagraph (K) to read as follows:
    39    (K)  This subparagraph shall apply to outpatient treatment provided in
    40  a facility issued an operating certificate by the commissioner of mental
    41  health pursuant to the provisions of article thirty-one  of  the  mental
    42  hygiene  law,  or in a facility operated by the office of mental health,
    43  or in a crisis stabilization center licensed pursuant to  section  36.01
    44  of  the  mental  hygiene  law,  that  is  participating in the insurer's
    45  provider  network.  Reimbursement  for  covered   outpatient   treatment
    46  provided  by  such  a  facility shall be at rates negotiated between the
    47  insurer and the participating facility, provided that such rates are not
    48  less than the rates that would be paid for such  treatment  pursuant  to
    49  the medical assistance program under title eleven of article five of the
    50  social  services  law.  For the purposes of this subparagraph, the rates
    51  that would be paid for such treatment pursuant to the medical assistance
    52  program under title eleven of article five of the  social  services  law
    53  shall be the rates with an effective date of  April first of the preced-
    54  ing  year,  which  shall  be  established  prior to October first of the
    55  preceding calendar year. Prior to the submission of premium rate filings
    56  and applications, the superintendent shall  provide insurers with  guid-

        S. 8307--C                         54                         A. 8807--C
 
     1  ance  on  factors  to consider in calculating the impact of rate changes
     2  for the purposes of submitting premium rate filings and applications  to
     3  the  superintendent  for  the subsequent policy year. To the extent that
     4  the  rates  with  an effective date of April first differ from the esti-
     5  mated rates incorporated in   premium  rate  filings  and  applications,
     6  insurers  may  account  for  such  differences    in future premium rate
     7  filings and applications  submitted to the superintendent for approval.
     8    § 4. Paragraph 7 of subsection (l) of section 3221  of  the  insurance
     9  law is amended by adding a new subparagraph (J) to read as follows:
    10    (J) This subparagraph shall apply to facilities in this state that are
    11  licensed,  certified, or otherwise authorized by the office of addiction
    12  services and supports for the provision of outpatient, intensive  outpa-
    13  tient,  outpatient  rehabilitation and opioid treatment that are partic-
    14  ipating in the insurer's provider  network.  Reimbursement  for  covered
    15  outpatient treatment provided by such facilities shall be at rates nego-
    16  tiated between the insurer and the participating facility, provided that
    17  such  rates  are  not  less  than  the rates that would be paid for such
    18  treatment pursuant to the medical assistance program under title  eleven
    19  of  article  five  of  the social services law. For the purposes of this
    20  subparagraph, the rates that would be paid for such  treatment  pursuant
    21  to  the medical assistance program under title eleven of article five of
    22  the social services law shall be the rates with  an  effective  date  of
    23  April  first  of the preceding year, which shall be established prior to
    24  October first of the preceding calendar year. Prior to the submission of
    25  premium rate filings and applications, the superintendent shall  provide
    26  insurers with  guidance on factors to consider in calculating the impact
    27  of rate changes for the purposes of submitting premium rate filings  and
    28  applications  to  the  superintendent for the subsequent policy year. To
    29  the extent that the rates with an effective date of April  first  differ
    30  from  the  estimated  rates  incorporated  in   premium rate filings and
    31  applications, insurers may account  for  such  differences    in  future
    32  premium  rate  filings  and applications submitted to the superintendent
    33  for approval.
    34    § 5. Subsection (g) of section 4303 of the insurance law is amended by
    35  adding a new paragraph 12 to read as follows:
    36    (12) This paragraph shall apply to outpatient treatment provided in  a
    37  facility  issued  an operating certificate by the commissioner of mental
    38  health pursuant to the provisions of article thirty-one  of  the  mental
    39  hygiene  law,  or in a facility operated by the office of mental health,
    40  or in a crisis stabilization center licensed pursuant to  section  36.01
    41  of  the  mental  hygiene law, that is participating in the corporation's
    42  provider  network.  Reimbursement  for  covered   outpatient   treatment
    43  provided  by  such  facility  shall  be  at rates negotiated between the
    44  corporation  and the participating facility, provided  that  such  rates
    45  are not less than the rates that would be paid for such treatment pursu-
    46  ant to the medical assistance program under title eleven of article five
    47  of  the  social  services  law.  For the purposes of this paragraph, the
    48  rates that would be paid for such  treatment  pursuant  to  the  medical
    49  assistance  program  under  title  eleven  of article five of the social
    50  services law shall be the rates with an effective date of April first of
    51  the preceding year, which shall be established prior to October first of
    52  the preceding calendar year. Prior to the  submission  of  premium  rate
    53  filings and applications, the superintendent shall  provide corporations
    54  with  guidance on  factors to consider in calculating the impact of rate
    55  changes for the purposes of submitting premium rate filings and applica-
    56  tions to the superintendent for  the  subsequent  policy  year.  To  the

        S. 8307--C                         55                         A. 8807--C
 
     1  extent  that the rates with an effective date of April first differ from
     2  the estimated rates incorporated in  premium rate filings  and  applica-
     3  tions,  corporations may account for such differences  in future premium
     4  rate  filings  and  applications    submitted  to the superintendent for
     5  approval.
     6    § 6. Subsection (l) of section 4303 of the insurance law is amended by
     7  adding a new paragraph 10 to read as follows:
     8    (10) This paragraph shall apply to facilities in this state  that  are
     9  licensed,  certified, or otherwise authorized by the office of addiction
    10  services and supports for the provision of outpatient, intensive  outpa-
    11  tient,  outpatient  rehabilitation and opioid treatment that are partic-
    12  ipating in the corporation's provider network. Reimbursement for covered
    13  outpatient treatment provided by such facilities shall be at rates nego-
    14  tiated between the corporation and the participating facility,  provided
    15  that  such rates are not less than the rates that would be paid for such
    16  treatment pursuant to the medical assistance program under title  eleven
    17  of  article  five  of  the social services law. For the purposes of this
    18  paragraph, the rates that would be paid for such treatment  pursuant  to
    19  the medical assistance program under title eleven of article five of the
    20  social  services  law shall be the rates with an effective date of April
    21  first of the preceding year, which shall be established prior to October
    22  first of the preceding calendar year. Prior to the submission of premium
    23  rate filings and applications, the superintendent shall  provide  corpo-
    24  rations  with  guidance on factors to consider in calculating the impact
    25  of rate changes for the purposes of submitting premium rate filings  and
    26  applications  to  the superintendent for the subsequent policy year.  To
    27  the extent that the rates with an effective date of April  first  differ
    28  from  the  estimated  rates  incorporated  in   premium rate filings and
    29  applications, corporations may account for such differences   in  future
    30  premium  rate  filings and applications  submitted to the superintendent
    31  for approval.
    32    § 7. This act shall take effect January 1, 2025  and  shall  apply  to
    33  policies and contracts issued, renewed, modified, altered, or amended on
    34  and after such date.
 
    35                                   PART BB
 
    36    Section  1.  Sections  19  and  21  of chapter 723 of the laws of 1989
    37  amending the mental hygiene law and other laws relating to comprehensive
    38  psychiatric emergency programs, as amended by section 1 of part  PPP  of
    39  chapter 58 of the laws of 2020, are amended to read as follows:
    40    §  19. Notwithstanding any other provision of law, the commissioner of
    41  mental health shall, until July 1, [2024] 2027, be solely authorized, in
    42  [his or her] such commissioner's discretion, to designate those  general
    43  hospitals,  local  governmental  units  and voluntary agencies which may
    44  apply and be considered for the approval and issuance  of  an  operating
    45  certificate  pursuant  to  article  31 of the mental hygiene law for the
    46  operation of a comprehensive psychiatric emergency program.
    47    § 21. This act shall take effect immediately, and  sections  one,  two
    48  and  four  through  twenty  of  this  act shall remain in full force and
    49  effect, until July 1, [2024] 2027, at  which  time  the  amendments  and
    50  additions  made  by  such  sections  of  this  act shall be deemed to be
    51  repealed, and any provision of law amended by any of  such  sections  of
    52  this  act  shall revert to its text as it existed prior to the effective
    53  date of this act.
    54    § 2. This act shall take effect immediately.

        S. 8307--C                         56                         A. 8807--C
 
     1                                   PART CC
 
     2                            Intentionally Omitted
 
     3                                   PART DD
 
     4    Section  1.  Section  3  of  part A of chapter 111 of the laws of 2010
     5  amending the mental hygiene law relating to the receipt of  federal  and
     6  state  benefits  received  by  individuals  receiving care in facilities
     7  operated by an office of the department of mental hygiene, as amended by
     8  section 1 of part T of chapter 57 of the laws of  2021,  is  amended  to
     9  read as follows:
    10    §  3.  This act shall take effect immediately; and shall expire and be
    11  deemed repealed June 30, [2024] 2027.
    12    § 2. This act shall take effect immediately.
 
    13                                   PART EE
 
    14                            Intentionally Omitted
 
    15                                   PART FF
 
    16    Section 1. 1. Subject to available appropriations and approval of  the
    17  director  of  the  budget,  the  commissioners  of  the office of mental
    18  health, office for people with  developmental  disabilities,  office  of
    19  addiction  services  and  supports,  office  of temporary and disability
    20  assistance, office of children and family services, and the state office
    21  for the aging (hereinafter "the commissioners") shall establish a  state
    22  fiscal  year 2024-2025 cost of living adjustment (COLA), effective April
    23  1, 2024, for projecting for the  effects  of  inflation  upon  rates  of
    24  payments, contracts, or any other form of reimbursement for the programs
    25  and services listed in subdivision five of this section. The COLA estab-
    26  lished  herein shall be applied to the appropriate portion of reimbursa-
    27  ble costs or contract  amounts.  Where  appropriate,  transfers  to  the
    28  department  of health (DOH) shall be made as reimbursement for the state
    29  share of medical assistance.
    30    2. Notwithstanding any inconsistent provision of law, subject  to  the
    31  approval  of  the  director  of  the budget and available appropriations
    32  therefore, for the period of April 1, 2024 through March 31,  2025,  the
    33  commissioners  shall  provide  funding to support a two and eight-tenths
    34  and four-hundredths percent (2.84%) cost of living adjustment under this
    35  section for all eligible programs and services as determined pursuant to
    36  subdivision five of this section.
    37    3. Notwithstanding any inconsistent provision of law, and as  approved
    38  by  the  director of the budget, the 2.84 percent cost of living adjust-
    39  ment (COLA) established herein shall be inclusive of all other  cost  of
    40  living  type  increases,  inflation  factors,  or trend factors that are
    41  newly applied effective April 1, 2024. Except for the 2.84 percent  cost
    42  of  living adjustment (COLA) established herein, for the period commenc-
    43  ing on April 1, 2024 and ending March 31, 2025 the  commissioners  shall
    44  not  apply  any  other new cost of living adjustments for the purpose of
    45  establishing  rates  of  payments,  contracts  or  any  other  form   of
    46  reimbursement.  The  phrase  "all  other  cost of living type increases,
    47  inflation factors, or trend factors"  as  defined  in  this  subdivision

        S. 8307--C                         57                         A. 8807--C
 
     1  shall not include payments made pursuant to the American Rescue Plan Act
     2  or other federal relief programs related to the Coronavirus Disease 2019
     3  (COVID-19)  pandemic public health emergency. This subdivision shall not
     4  prevent  the  office of children and family services from applying addi-
     5  tional trend factors or staff retention factors to eligible programs and
     6  services under paragraph (v) of subdivision five of this section.
     7    4. Each local government unit or direct  contract  provider  receiving
     8  the  cost of living adjustment established herein shall use such funding
     9  to provide a targeted salary increase of at least one  and  seven-tenths
    10  percent  (1.7%)  to  eligible individuals in accordance with subdivision
    11  six of this section.  Notwithstanding any inconsistent provision of law,
    12  the commissioners shall develop guidelines for  local  government  units
    13  and  direct contract providers on implementation of such targeted salary
    14  increase.
    15    5. Eligible programs and services. (i) Programs and  services  funded,
    16  licensed, or certified by the office of mental health (OMH) eligible for
    17  the  cost  of  living  adjustment  established  herein,  pending federal
    18  approval where applicable, include: office  of  mental  health  licensed
    19  outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of
    20  the office of mental health regulations including clinic, continuing day
    21  treatment,  day  treatment,  intensive  outpatient  programs and partial
    22  hospitalization;  outreach;  crisis  residence;  crisis   stabilization,
    23  crisis/respite  beds;  mobile crisis, part 590 comprehensive psychiatric
    24  emergency program  services;  crisis  intervention;  home  based  crisis
    25  intervention;  family  care;  supported single room occupancy; supported
    26  housing; supported housing  community  services;  treatment  congregate;
    27  supported   congregate;   community  residence  -  children  and  youth;
    28  treatment/apartment; supported  apartment;  community  residence  single
    29  room occupancy; on-site rehabilitation; employment programs; recreation;
    30  respite  care;  transportation;  psychosocial  club; assertive community
    31  treatment; case management; care  coordination,  including  health  home
    32  plus  services;  local  government  unit  administration; monitoring and
    33  evaluation; children and youth  vocational  services;  single  point  of
    34  access;  school-based mental health program; family support children and
    35  youth; advocacy/support services; drop  in  centers;  recovery  centers;
    36  transition management services; bridger; home and community based waiver
    37  services;  behavioral  health waiver services authorized pursuant to the
    38  section 1115 MRT waiver; self-help programs; consumer  service  dollars;
    39  conference  of local mental hygiene directors; multicultural initiative;
    40  ongoing integrated supported employment services;  supported  education;
    41  mentally   ill/chemical  abuse  (MICA)  network;  personalized  recovery
    42  oriented services; children and family treatment and  support  services;
    43  residential treatment facilities operating pursuant to part 584 of title
    44  14-NYCRR;   geriatric  demonstration  programs;  community-based  mental
    45  health family treatment  and  support;  coordinated  children's  service
    46  initiative; homeless services; and promises zone.
    47    (ii)  Programs  and  services  funded,  licensed,  or certified by the
    48  office for people with developmental disabilities (OPWDD)  eligible  for
    49  the  cost  of  living  adjustment  established  herein,  pending federal
    50  approval where applicable, include: local/unified services; chapter  620
    51  services;  voluntary operated community residential services; article 16
    52  clinics; day treatment  services;  family  support  services;  100%  day
    53  training;  epilepsy services; traumatic brain injury services; hepatitis
    54  B services;  independent  practitioner  services  for  individuals  with
    55  intellectual  and/or  developmental  disabilities;  crisis  services for
    56  individuals with intellectual and/or developmental disabilities;  family

        S. 8307--C                         58                         A. 8807--C

     1  care  residential  habilitation;  supervised  residential  habilitation;
     2  supportive residential habilitation; respite; day habilitation; prevoca-
     3  tional services; supported employment; community habilitation;  interme-
     4  diate  care  facility  day and residential services; specialty hospital;
     5  pathways to employment; intensive behavioral services; community transi-
     6  tion services;  family  education  and  training;  fiscal  intermediary;
     7  support broker; and personal resource accounts.
     8    (iii)  Programs  and  services  funded,  licensed, or certified by the
     9  office of addiction services and supports (OASAS) eligible for the  cost
    10  of  living adjustment established herein, pending federal approval where
    11  applicable, include: medically supervised withdrawal services - residen-
    12  tial; medically supervised withdrawal services -  outpatient;  medically
    13  managed  detoxification; medically monitored withdrawal; inpatient reha-
    14  bilitation services; outpatient  opioid  treatment;  residential  opioid
    15  treatment; KEEP units outpatient; residential opioid treatment to absti-
    16  nence;  problem  gambling  treatment;  medically  supervised outpatient;
    17  outpatient  rehabilitation;   specialized   services   substance   abuse
    18  programs;  home and community based waiver services pursuant to subdivi-
    19  sion 9 of section 366 of the social services law;  children  and  family
    20  treatment and support services; continuum of care rental assistance case
    21  management;  NY/NY  III  post-treatment  housing;  NY/NY III housing for
    22  persons at risk for homelessness;  permanent  supported  housing;  youth
    23  clubhouse;  recovery  community  centers;  recovery community organizing
    24  initiative; residential rehabilitation services for youth (RRSY); inten-
    25  sive residential; community residential; supportive living;  residential
    26  services;  job  placement  initiative;  case  management; family support
    27  navigator; local government unit administration; peer engagement;  voca-
    28  tional   rehabilitation;   support   services;  HIV  early  intervention
    29  services; dual diagnosis coordinator; problem gambling resource centers;
    30  problem  gambling  prevention;  prevention  resource  centers;   primary
    31  prevention services; other prevention services; and community services.
    32    (iv)  Programs  and  services  funded,  licensed,  or certified by the
    33  office of temporary and disability assistance (OTDA)  eligible  for  the
    34  cost  of  living adjustment established herein, pending federal approval
    35  where applicable, include:  nutrition  outreach  and  education  program
    36  (NOEP).
    37    (v) Programs and services funded, licensed, or certified by the office
    38  of  children  and family services (OCFS) eligible for the cost of living
    39  adjustment established herein, pending federal approval  where  applica-
    40  ble,  include:  programs  for  which  the  office of children and family
    41  services establishes maximum state aid rates pursuant to  section  398-a
    42  of  the social services law and section 4003 of the education law; emer-
    43  gency foster homes; foster family boarding homes and therapeutic  foster
    44  homes;  supervised  settings  as  defined  by  subdivision twenty-two of
    45  section 371 of the  social  services  law;  adoptive  parents  receiving
    46  adoption subsidy pursuant to section 453 of the social services law; and
    47  congregate  and  scattered  supportive  housing  programs and supportive
    48  services provided under the NY/NY III supportive  housing  agreement  to
    49  young adults leaving or having recently left foster care.
    50    (vi) Programs and services funded, licensed, or certified by the state
    51  office  for  the aging (SOFA) eligible for the cost of living adjustment
    52  established herein, pending federal approval where applicable,  include:
    53  community  services  for  the elderly; expanded in-home services for the
    54  elderly; and wellness in nutrition program.
    55    6. Eligible individuals.  Support staff, direct care  staff,  clinical
    56  staff,  and  non-executive administrative staff in programs and services

        S. 8307--C                         59                         A. 8807--C
 
     1  listed in subdivision five of this section shall  be  eligible  for  the
     2  1.7%  targeted  salary increase established pursuant to subdivision four
     3  of this section.
     4    (a)  For  the office of mental health, office for people with develop-
     5  mental disabilities, and office  of  addiction  services  and  supports,
     6  support  staff  shall  mean  individuals employed in consolidated fiscal
     7  report position title codes ranging from 100 to 199; direct  care  staff
     8  shall  mean  individuals employed in consolidated fiscal report position
     9  title codes ranging from 200 to 299; clinical staff shall mean  individ-
    10  uals employed in consolidated fiscal report position title codes ranging
    11  from 300 to 399; and non-executive administrative staff shall mean indi-
    12  viduals employed in consolidated fiscal report position title codes 400,
    13  500  to 599, 605 to 699, and 703 to 799. Individuals employed in consol-
    14  idated fiscal report position title codes 601 to 604, 701 and 702  shall
    15  be ineligible for the 1.7% targeted salary increase established herein.
    16    (b)  For  the office of temporary and disability assistance, office of
    17  children and family services, and the state office for the aging, eligi-
    18  ble support staff, direct care staff, clinical staff, and  non-executive
    19  administrative staff titles shall be determined by each agency's commis-
    20  sioner.
    21    7.  Each  local  government unit or direct contract provider receiving
    22  funding for the cost  of  living  adjustment  established  herein  shall
    23  submit  a  written  certification, in such form and at such time as each
    24  commissioner shall prescribe, attesting how such funding will be or  was
    25  used  to  first  promote the recruitment and retention of support staff,
    26  direct care staff, clinical staff, non-executive  administrative  staff,
    27  or  respond  to  other  critical  non-personal  service  costs  prior to
    28  supporting any salary increases  or  other  compensation  for  executive
    29  level job titles.
    30    8.  Notwithstanding any inconsistent provision of law to the contrary,
    31  agency commissioners shall be authorized to recoup funding from a  local
    32  governmental  unit  or  direct  contract provider for the cost of living
    33  adjustment established herein determined to have been used in  a  manner
    34  inconsistent  with  the  appropriation,  or  any other provision of this
    35  section. Such agency commissioners shall be  authorized  to  employ  any
    36  legal mechanism to recoup such funds, including an offset of other funds
    37  that are owed to such local governmental unit or direct contract provid-
    38  er.
    39    §  2.  This  act  shall take effect immediately and shall be deemed to
    40  have been in full force and effect on and after April 1, 2024.
 
    41                                   PART GG
 
    42    Section 1. Subdivision 29 of section 364-j of the social services law,
    43  as added by section 49 of part C of chapter 60 of the laws of  2014,  is
    44  amended to read as follows:
    45    29.  In  the  event  that  the  department  receives approval from the
    46  Centers for Medicare and Medicaid Services  to  amend  its  1115  waiver
    47  [known  as  the  Partnership  Plan]  or receives approval for a new 1115
    48  waiver [for the purpose of reinvesting savings resulting from the  rede-
    49  sign of the medical assistance program] prior to or following the effec-
    50  tive  date  of  the chapter of the laws of two thousand twenty-four that
    51  amended this subdivision, the commissioner is authorized to  enter  into
    52  contracts[, and/or] and to amend the terms of contracts awarded prior to
    53  the  effective  date  of the chapter of the laws of two thousand twenty-
    54  four that amended this subdivision, for the  purpose  of  assisting  the

        S. 8307--C                         60                         A. 8807--C
 
     1  department  of  health  with implementing projects authorized under such
     2  waiver approval. Notwithstanding the provisions of sections one  hundred
     3  twelve and one hundred sixty-three of the state finance law, or sections
     4  one hundred forty-two and one hundred forty-three of the economic devel-
     5  opment  law,  or any contrary provision of law, contracts may be entered
     6  or contract amendments may be made pursuant to  this  subdivision  until
     7  March  thirty-first, two thousand twenty-seven without a competitive bid
     8  or request for proposal process [if the term of  any  such  contract  or
     9  contract  amendment does not extend beyond March thirty-first, two thou-
    10  sand nineteen]; provided, however, in the case  of  a  contract  entered
    11  into after the effective date of this subdivision, that:
    12    (a)  The  department of health shall post on its website, for a period
    13  of no less than thirty days:
    14    (i) A description of the proposed services to be provided pursuant  to
    15  the contract or contracts;
    16    (ii) The criteria for selection of a contractor or contractors;
    17    (iii)  The  period  of  time during which a prospective contractor may
    18  seek selection, which shall be no  less  than  thirty  days  after  such
    19  information is first posted on the website; and
    20    (iv)  The  manner  by  which  a  prospective  contractor may seek such
    21  selection, which may include submission by electronic means;
    22    (b) All reasonable and responsive submissions that are  received  from
    23  prospective  contractors  in  timely  fashion  shall  be reviewed by the
    24  commissioner of health; and
    25    (c) The  commissioner  of  health  shall  select  such  contractor  or
    26  contractors  that,  in  [his or her] such commissioner's discretion, are
    27  best suited to serve the purposes of this section.
    28    § 2. This act shall take effect immediately; provided,  however,  that
    29  the  amendments  to  section  364-j  of  the social services law made by
    30  section one of this act shall not affect the repeal of such section  and
    31  shall be deemed repealed therewith.
 
    32                                   PART HH
 
    33    Section  1. Subparagraphs (i) and (ii) of paragraph (a) of subdivision
    34  4-a of section 365-f of the social services law, as amended by section 3
    35  of part G of chapter 57 of the laws of 2019, the  opening  paragraph  of
    36  subparagraph (i) as amended by section 2 of part PP of chapter 57 of the
    37  laws  of  2022,  are amended, and three new subparagraphs (ii-a), (ii-b)
    38  and (ii-c) are added to read as follows:
    39    (i) "[Fiscal] Statewide fiscal  intermediary"  means  an  entity  that
    40  provides  fiscal  intermediary services and has a contract for providing
    41  such services with the department of health and is selected through  the
    42  procurement  process  described  in  [paragraphs] paragraph (b)[, (b-1),
    43  (b-2) and (b-3)] of this subdivision. [Eligible applicants for contracts
    44  shall be entities that are capable  of  appropriately  providing  fiscal
    45  intermediary  services,  performing  the  responsibilities  of  a fiscal
    46  intermediary, and complying with this section, including but not limited
    47  to entities that:
    48    (A) are a service center for  independent  living  under  section  one
    49  thousand one hundred twenty-one of the education law; or
    50    (B)  have  been  established as fiscal intermediaries prior to January
    51  first, two thousand twelve and have  been  continuously  providing  such
    52  services for eligible individuals under this section.]

        S. 8307--C                         61                         A. 8807--C
 
     1    (ii)   Fiscal   intermediary  services  shall  include  the  following
     2  services, performed on behalf of the consumer to facilitate [his or her]
     3  the consumer's role as the employer:
     4    (A) wage and benefit processing for consumer directed personal assist-
     5  ants;
     6    (B) processing all income tax and other required wage withholdings;
     7    (C)  complying with workers' compensation, disability and unemployment
     8  requirements;
     9    (D) maintaining personnel records for each consumer directed  personal
    10  assistant,  including  time  records  and other documentation needed for
    11  wages and benefit processing and a copy  of  the  medical  documentation
    12  required pursuant to regulations established by the commissioner;
    13    (E) ensuring that the health status of each consumer directed personal
    14  assistant  is assessed prior to service delivery pursuant to regulations
    15  issued by the commissioner;
    16    (F) maintaining records of service authorizations or reauthorizations;
    17    (G) monitoring the consumer's or, if applicable, the designated repre-
    18  sentative's continuing ability to fulfill  the  consumer's  responsibil-
    19  ities under the program and promptly notifying the authorizing entity of
    20  any  circumstance  that may affect the consumer's or, if applicable, the
    21  designated representative's ability to fulfill such responsibilities;
    22    (H) complying with regulations established by the commissioner  speci-
    23  fying  the  responsibilities of fiscal intermediaries providing services
    24  under this title;
    25    (I) entering into a department approved  memorandum  of  understanding
    26  with  the  consumer  that  describes the parties' responsibilities under
    27  this program; and
    28    (J) other related responsibilities which may include, as determined by
    29  the commissioner, assisting consumers to perform the consumers'  respon-
    30  sibilities  under  this  section  and department regulations in a manner
    31  that does not infringe upon the consumer's responsibilities and self-di-
    32  rection.
    33    (ii-a) The commissioner shall require any managed care plans,  managed
    34  long-term  care  plans, local social service districts, and other appro-
    35  priate long-term service programs offering  consumer  directed  personal
    36  assistance  services  to contract with the statewide fiscal intermediary
    37  set forth in subparagraph (i) of this paragraph to  provide  all  fiscal
    38  intermediary services to consumers.
    39    (ii-b)  The statewide fiscal intermediary shall subcontract to facili-
    40  tate the delivery of fiscal intermediary services to an entity that is a
    41  service center for independent living under  section  one  thousand  one
    42  hundred  twenty-one  of the education law that has been providing fiscal
    43  intermediary services since January first, two thousand  twenty-four  or
    44  earlier.  The statewide fiscal intermediary shall further subcontract to
    45  facilitate the delivery of fiscal intermediary services  with  at  least
    46  one  entity per rate setting region that has a proven record of deliver-
    47  ing services to individuals with disabilities and the senior population,
    48  and has been providing fiscal intermediary services since January first,
    49  two thousand twelve; provided that such subcontractor shall be  required
    50  to  provide any delegated fiscal intermediary services with cultural and
    51  linguistic competency specific to the population of consumers and  those
    52  of  the  available workforce, and shall comply with the requirements for
    53  registration as a fiscal intermediary set forth in  subdivision  four-a-
    54  one  of  this  section.  For purposes of this section, "delegated fiscal
    55  intermediary services" are defined as fiscal  intermediary  services  as
    56  set forth in subparagraph (ii) of paragraph (a) of this subdivision that

        S. 8307--C                         62                         A. 8807--C
 
     1  the  statewide  fiscal  intermediary includes in a subcontract and which
     2  shall include services designed to meet the needs of  consumers  of  the
     3  program,  which  may  include assisting consumers with navigation of the
     4  program by providing individual consumer assistance and support as need-
     5  ed,  consumer  peer  support, and education and training to consumers on
     6  their duties under the program.
     7    (ii-c) The statewide fiscal  intermediary  shall  be  responsible  for
     8  payment  to  subcontractors  for delegated fiscal intermediary services.
     9  The payment shall not require a certification  by  the  commissioner  if
    10  payments  are  reasonably  related to the costs of efficient delivery of
    11  such services.
    12    § 2. Paragraph (b) of subdivision 4-a of section 365-f of  the  social
    13  services  law,  as  amended  by section 4 of part G of chapter 57 of the
    14  laws of 2019 and subparagraph (vi) as amended by section 1 of part LL of
    15  chapter 57 of the laws of 2021, is amended to read as follows:
    16    (b)  Notwithstanding  [any  inconsistent  provision  of]  section  one
    17  hundred sixty-three of the state finance law, section one hundred twelve
    18  of  the  state  finance  law,  or  section  one hundred forty-two of the
    19  economic development law the commissioner shall enter into [contracts] a
    20  contract under this subdivision with an eligible [contractors]  contrac-
    21  tor  that  [submit]  submits an offer for a contract, provided, however,
    22  that:
    23    (i) the department shall post on its website:
    24    (A) a  description  of  the  proposed  statewide  fiscal  intermediary
    25  services to be provided pursuant to [contracts] a contract in accordance
    26  with this subdivision;
    27    (B)  [that  the  selection  of  contractors shall be based on criteria
    28  reasonably related to the contractors' ability to provide fiscal  inter-
    29  mediary  services including but not limited to: ability to appropriately
    30  serve individuals participating in the program, geographic  distribution
    31  that  would  ensure  access in rural and underserved areas, demonstrated
    32  cultural and language competencies specific to the population of consum-
    33  ers and those of the available  workforce,  ability  to  provide  timely
    34  consumer  assistance,  experience serving individuals with disabilities,
    35  the availability of consumer peer support, and  demonstrated  compliance
    36  with  all  applicable  federal and state laws and regulations, including
    37  but not limited to those relating to wages and labor] the  criteria  for
    38  selection of the statewide fiscal intermediary, which shall include at a
    39  minimum  that the eligible contractor is capable of performing statewide
    40  fiscal intermediary services with  demonstrated  cultural  and  language
    41  competencies  specific  to  the population of consumers and those of the
    42  available workforce, has experience serving individuals  with  disabili-
    43  ties,  and  as  of  April  first,  two thousand twenty-four is providing
    44  services as a fiscal intermediary on a statewide basis with at least one
    45  other state;
    46    (C)  the  manner  by  which  prospective  contractors  may  seek  such
    47  selection, which may include submission by electronic means;
    48    (ii)  all  [reasonable  and  responsive] offers that are received from
    49  prospective contractors in a timely fashion and that meet  the  criteria
    50  set  forth  in clause (B) of subparagraph (i) of this paragraph shall be
    51  reviewed by the commissioner; and
    52    (iii) the commissioner shall award such [contracts]  contract  to  the
    53  [contractors]  contractor  that  [best  meet]  meets  the  criteria  for
    54  selection and [are best suited to serve the purposes of] offers the best
    55  value for providing the services required pursuant to this  section  and
    56  the needs of consumers[;

        S. 8307--C                         63                         A. 8807--C

     1    (iv)  all entities providing fiscal intermediary services on or before
     2  April first, two thousand nineteen, shall submit an offer for a contract
     3  under this section within sixty days after  the  commissioner  publishes
     4  the  initial  offer  on the department's website. Such entities shall be
     5  deemed  authorized to provide such services unless: (A) the entity fails
     6  to submit an offer for a contract under this section  within  the  sixty
     7  days;  or  (B)  the  entity's offer for a contract under this section is
     8  denied;
     9    (v) all decisions made and approaches taken pursuant to this paragraph
    10  shall be documented in a procurement record as defined  in  section  one
    11  hundred sixty-three of the state finance law; and
    12    (vi)  the  commissioner  is  authorized to either reoffer contracts or
    13  utilize the previous offer,  to  ensure  that  all  provisions  of  this
    14  section are met].
    15    §  3.  Section 365-f of the social services law is amended by adding a
    16  new subdivision 4-a-1 to read as follows:
    17    4-a-1.  (a) Fiscal intermediary registration. Except for the statewide
    18  fiscal intermediary and its subcontractors, as of April first, two thou-
    19  sand twenty-five, no entity shall provide, directly or through contract,
    20  fiscal intermediary services.    All  subcontractors  of  the  statewide
    21  fiscal  intermediary,  shall  register with the department within thirty
    22  days of being selected as a subcontractor.
    23    (b) In selecting its subcontractors, the statewide fiscal intermediary
    24  shall consider demonstrated compliance with all applicable  federal  and
    25  state  laws and regulations, including but not limited to, marketing and
    26  labor practices,  cost  reporting,  and  electronic  visit  verification
    27  requirements.
    28    §  4.  Paragraphs (b-1), (b-2) and (b-3) of subdivision 4-a of section
    29  365-f of the social services law are REPEALED.
    30    § 5. Subdivision 4-b of section 365-f of the social services  law,  as
    31  amended  by  section  8  of part G of chapter 57 of the laws of 2019, is
    32  amended to read as follows:
    33    4-b. Actions involving the [authorization] registration  of  a  fiscal
    34  intermediary.
    35    (a)  [The  department  may  terminate a fiscal intermediary's contract
    36  under this section or suspend or limit the fiscal intermediary's  rights
    37  and  privileges  under  the contract upon thirty day's written notice to
    38  the fiscal intermediary, if  the  commissioner  finds  that  the  fiscal
    39  intermediary has failed to comply with the provisions of this section or
    40  regulations promulgated hereunder. The written notice shall include:
    41    (i)  A  description of the conduct and the issues related thereto that
    42  have been identified as failure of compliance; and
    43    (ii) the time frame of the conduct that  fails  compliance]  A  fiscal
    44  intermediary's  registration  may  be  revoked,  suspended,  limited, or
    45  annulled by the commissioner upon thirty days'  written  notice  to  the
    46  fiscal  intermediary, if the commissioner finds that the fiscal interme-
    47  diary has failed to comply with the provisions of this section or  regu-
    48  lations promulgated hereunder.
    49    (b)  [Notwithstanding  the foregoing, upon determining that the public
    50  health or safety would be imminently endangered by the continued  opera-
    51  tion  or actions of the fiscal intermediary, the commissioner may termi-
    52  nate the fiscal intermediary's contract or suspend or limit  the  fiscal
    53  intermediary's rights and privileges under the contract immediately upon
    54  written  notice.]  The  commissioner  may  issue  orders  and take other
    55  actions as  necessary  and  appropriate  to  prohibit  and  prevent  the
    56  provision of fiscal intermediary services by an unregistered entity.

        S. 8307--C                         64                         A. 8807--C
 
     1    (c)  All  orders  or  determinations  under  this subdivision shall be
     2  subject to review as provided in  article  seventy-eight  of  the  civil
     3  practice law and rules.
     4    §  6.  Paragraph (d) of subdivision 4-d of section 365-f of the social
     5  services law is REPEALED.
     6    § 7. Paragraph (b) of subdivision 5 of section  365-f  of  the  social
     7  services  law, as added by chapter 81 of the laws of 1995, is amended to
     8  read as follows:
     9    (b) Notwithstanding any other provision of law,  the  commissioner  is
    10  authorized to waive any provision of section three hundred sixty-seven-b
    11  of  this  title related to payment and may promulgate regulations neces-
    12  sary to carry out the objectives of the program including minimum  safe-
    13  ty,  and  health and immunization criteria and training requirements for
    14  personal assistants, and which  describe  the  responsibilities  of  the
    15  eligible  individuals  in  arranging  and  paying  for  services and the
    16  protections assured such individuals if they are  unable  or  no  longer
    17  desire  to continue in the program, the fiscal intermediary registration
    18  process, standards, and time frames, and those regulations necessary  to
    19  ensure adequate access to services.
    20    §  8.  This  act  shall take effect immediately and shall be deemed to
    21  have been in full force and effect on and after April 1, 2024.
 
    22                                   PART II
 
    23    Section 1. The public health law is amended by adding  a  new  section
    24  2807-ff to read as follows:
    25    §  2807-ff.  New  York managed care organization provider tax.  1. The
    26  commissioner, subject to the approval of the  director  of  the  budget,
    27  shall:  apply  for a waiver or waivers of the broad-based and uniformity
    28  requirements related to the establishment of a  New  York  managed  care
    29  organization  provider  tax  (the "MCO provider tax") in order to secure
    30  federal financial participation for the costs of the medical  assistance
    31  program;  issue  regulations  to  implement  the  MCO provider tax; and,
    32  subject to approval by the centers for medicare and  medicaid  services,
    33  impose the MCO provider tax as an assessment upon insurers, health main-
    34  tenance  organizations,  and  managed  care  organizations  offering the
    35  following plans or products:
    36    (a) Medical assistance  program  coverage  provided  by  managed  care
    37  providers  pursuant  to section three hundred sixty-four-j of the social
    38  services law;
    39    (b) A child health insurance plan certified pursuant to section  twen-
    40  ty-five hundred eleven of this chapter;
    41    (c)  Essential  plan  coverage  certified  pursuant  to  section three
    42  hundred sixty-nine-gg of the social services law;
    43    (d) Coverage purchased on the New York insurance exchange  established
    44  pursuant to section two hundred sixty-eight-b of this chapter; or
    45    (e)  Any  other comprehensive coverage subject to articles thirty-two,
    46  forty-two and forty-three of the insurance law, or article forty-four of
    47  this chapter.
    48    2. The MCO provider tax shall comply with all relevant  provisions  of
    49  federal laws, rules and regulations.
    50    § 2. The state finance law is amended by adding a new section 99-rr to
    51  read as follows:
    52    §  99-rr. Healthcare stability fund. 1. There is hereby established in
    53  the joint custody of the state comptroller and the commissioner of taxa-

        S. 8307--C                         65                         A. 8807--C
 
     1  tion and finance a special fund to be known as the "healthcare stability
     2  fund" ("fund").
     3    2.  The  fund  shall consist of monies received from the imposition of
     4  the centers for medicare and medicaid services-approved MCO provider tax
     5  established pursuant to section twenty-eight  hundred  seven-ff  of  the
     6  public  health  law,  and  all  other  monies appropriated, credited, or
     7  transferred thereto from any other fund or source pursuant to law.
     8    3. Notwithstanding any provision of law to the contrary and subject to
     9  available legislative appropriation and approval of the director of  the
    10  budget, monies of the fund may be available for:
    11    (a)  funding the non-federal share of increased capitation payments to
    12  managed care providers, as defined in section three hundred sixty-four-j
    13  of the social services law, for the medical assistance program, pursuant
    14  to a plan developed and approved by the director of the budget;
    15    (b) funding the non-federal share of the medical  assistance  program,
    16  including  supplemental support for the delivery of health care services
    17  to medical assistance program enrollees and quality incentive programs;
    18    (c) reimbursement to the general fund for expenditures incurred in the
    19  medical assistance program, including, but not limited to, reimbursement
    20  pursuant to a savings allocation plan  established  in  accordance  with
    21  section  ninety-two  of  part H of chapter fifty-nine of the laws of two
    22  thousand eleven, as amended; and
    23    (d) transfer to the  capital  projects  fund,  or  any  other  capital
    24  projects  fund  of  the  state  to  support  the delivery of health care
    25  services.
    26    4. Monies disbursed from the fund shall be exempt from the calculation
    27  of department of health state funds medicaid expenditures under subdivi-
    28  sion one of section ninety-two of part H of chapter  fifty-nine  of  the
    29  laws of two thousand eleven, as amended.
    30    5.  Monies  in  such fund shall be kept separate from and shall not be
    31  commingled with any other monies in the custody of  the  comptroller  or
    32  the  commissioner  of  taxation  and finance. Any monies of the fund not
    33  required for immediate use may, at the discretion of the comptroller, in
    34  consultation with the director of the budget, be invested by  the  comp-
    35  troller  in  obligations  of  the United States or the state. Any income
    36  earned by the investment of such monies shall be added to and  become  a
    37  part of and shall be used for the purposes of such fund.
    38    6.  The  director of the budget shall provide quarterly reports to the
    39  speaker of the assembly, the temporary  president  of  the  senate,  the
    40  chair of the senate finance committee and the chair of the assembly ways
    41  and means committee, on the receipts and distributions of the healthcare
    42  stability  fund, including an itemization of such receipts and disburse-
    43  ments, the historical and projected expenditures, and the projected fund
    44  balance.
    45    § 3. Paragraphs (g) and (h) of subdivision 1 of section 2807-y of  the
    46  public health law, as added by section 67 of part B of chapter 58 of the
    47  laws  of  2005,  are amended and a new paragraph (i) is added to read as
    48  follows:
    49    (g) section thirty-six hundred fourteen-a of this chapter; [and]
    50    (h) section three hundred sixty-seven-i of the social services law[.];
    51  and
    52    (i) section twenty-eight hundred seven-ff of this article.
    53    § 4. This act shall take effect immediately and  shall  be  deemed  to
    54  have been in full force and effect on and after April 1, 2024.
 
    55                                   PART JJ

        S. 8307--C                         66                         A. 8807--C
 
     1    Section  1.  Subdivision 3 of section 364-j of the social services law
     2  is amended by adding a new paragraph (d-3) to read as follows:
     3    (d-3)  Services  provided  in school-based health centers shall not be
     4  provided to medical assistance recipients through managed care  programs
     5  established  pursuant  to  this  section until at least April first, two
     6  thousand twenty-five.
     7    § 2. This act shall take effect immediately; provided,  however,  that
     8  the  amendments to section 364-j of the social services law made by this
     9  act shall not affect the repeal of such  section  and  shall  be  deemed
    10  repealed therewith.
 
    11                                   PART KK
 
    12    Section  1.    Paragraph  (d)  of  subdivision 4 of section 206 of the
    13  public health law, as added by chapter 602  of  the  laws  of  2007,  is
    14  amended and a new paragraph (e) is added to read as follows:
    15    (d)  assess  civil  penalties  against  a  public  water  system which
    16  provides water to the public for  human  consumption  through  pipes  or
    17  other  constructed conveyances, as further defined in the state sanitary
    18  code or, in the case  of  mass  gatherings,  the  person  who  holds  or
    19  promotes  the  mass  gathering as defined in subdivision five of section
    20  two hundred twenty-five of this article not to exceed twenty-five  thou-
    21  sand  dollars  per  day, for each violation of or failure to comply with
    22  any term or provision of the state sanitary code as it relates to public
    23  water systems that serve a population of five thousand or  more  persons
    24  or any mass gatherings, which penalty may be assessed after a hearing or
    25  an opportunity to be heard[.];
    26    (e)  issue  a  non-patient  specific  statewide standing order for the
    27  provision of doula services for pregnant, birthing, and postpartum indi-
    28  viduals through twelve months postpartum.
    29    § 2. Article 25 of the public health law is amended by  adding  a  new
    30  title 3-A to read as follows:
    31                                 TITLE III-A
    32                      COMMUNITY DOULA EXPANSION PROGRAM
    33  Section 2560. Community doula expansion grant program.
    34          2561. Definitions.
    35          2562. Rules.
    36          2563. Report.
    37    § 2560. Community  doula  expansion grant program. The community doula
    38  expansion grant program is established within the department.
    39    § 2561. Definitions. As used in this title:
    40    1.  "Eligible  providers"  shall  mean  community-based  organizations
    41  providing  for  the  recruitment,  training,  certification, supporting,
    42  and/or mentoring of community-based doulas.
    43    2. "Community-based doula" shall mean a certified doula that  provides
    44  culturally  sensitive  pregnancy and childbirth education, early linkage
    45  to health care, and aids birthing persons in navigating  other  services
    46  and supports that they may need to be healthy.
    47    §  2562.  Rules. 1. The commissioner shall establish a community doula
    48  expansion grant program for eligible providers to receive funding in the
    49  performance of recruitment, training, certification, supporting,  and/or
    50  mentoring  of community-based doulas. Such eligible providers shall meet
    51  professionally recognized training  standards,  comply  with  applicable
    52  state  law and regulations, and shall be capable of providing culturally
    53  congruent care.

        S. 8307--C                         67                         A. 8807--C
 
     1    2. The commissioner is authorized,  within  amounts  appropriated  for
     2  such  purpose,  to make grants in accordance with this subdivision. Such
     3  grants may be used for but not limited to  the  administration,  faculty
     4  recruitment and development, start-up costs and other costs incurred for
     5  providing   recruitment,  training,  certification,  supporting,  and/or
     6  mentoring of community-based doulas.
     7    3. There shall be an emphasis  of  appropriating  grants  to  eligible
     8  providers  that  specifically  train,  recruit,  and  employ doulas from
     9  historically vulnerable communities, and bilingual  doulas.    This  may
    10  include grants for doula apprentice programs.
    11    4. Information about the community doula expansion grant program shall
    12  be posted on the department's website.
    13    §  2563.  Report.    Upon  expiration of the program, the commissioner
    14  shall post a final report on  the  department's  website  outlining  the
    15  total  number of grants awarded, the names of eligible providers awarded
    16  funds pursuant to the program, and the amount  of  funding  received  by
    17  each.
    18    §  3.  This  act  shall take effect immediately and shall be deemed to
    19  have been in full force and effect on and after April 1, 2024; provided,
    20  however, that the provisions of section two of  this  act  shall  expire
    21  March  31, 2025 when upon such date the provisions of such section shall
    22  be deemed repealed.
 
    23                                   PART LL
 
    24    Section 1. Paragraph (g) of subdivision  2  of  section  2807  of  the
    25  public  health law is amended by adding a new subparagraph (iii) to read
    26  as follows:
    27    (iii) (A) For purposes of this subparagraph:
    28    (1) "Children with medical fragility" shall mean an individual who  is
    29  under  twenty-one  years of age and has a chronic debilitating condition
    30  or conditions, who may or may not be hospitalized or  institutionalized,
    31  and  who meets one or more of the following criteria: (I) is technology-
    32  dependent for life or health sustaining functions; (II) requires complex
    33  medication regimens or medical interventions to maintain or  to  improve
    34  their health status; or (III) is in need of ongoing assessment or inter-
    35  vention  to  prevent  serious  deterioration  of  their health status or
    36  medical complications that place their life, health  or  development  at
    37  risk.
    38    (2)  "Pediatric  residential  health care facility" shall mean a free-
    39  standing facility or discrete unit within a facility authorized  by  the
    40  commissioner  to  provide extensive nursing, medical, psychological, and
    41  counseling support services solely to children under the age of  twenty-
    42  one.
    43    (3)  "Pediatric diagnostic and treatment center" shall mean a diagnos-
    44  tic and treatment center established pursuant to this article, which  as
    45  of  April first, two thousand twenty-four, has been participating in the
    46  demonstration program authorized under subdivision one of section  twen-
    47  ty-eight  hundred  eight-e  of  this  article, for which at least eighty
    48  percent of its total Medicaid fee-for-service reimbursements derive from
    49  the provision of services to children under the age of  twenty-one  with
    50  medical  fragility and is affiliated with a pediatric residential health
    51  care facility.
    52    (B) (1) Notwithstanding any law, rule, or regulation to the  contrary,
    53  the  commissioner  shall  establish rates of reimbursement for pediatric
    54  diagnostic and treatment centers for all services provided on  or  after

        S. 8307--C                         68                         A. 8807--C
 
     1  April  first, two thousand twenty-four, to children eligible for medical
     2  assistance that reflect the costs necessary to provide care and services
     3  to children with medical fragility being treated at such pediatric diag-
     4  nostic and treatment center.
     5    (2)  For the period April first, two thousand twenty-four, to December
     6  thirty-first, two thousand twenty-four, and until such time as a  certi-
     7  fied  annual cost report for such period is received and verified by the
     8  department, the operating component of such rate shall reflect  budgeted
     9  costs  for  the  period January first, two thousand twenty-four, through
    10  December thirty-first, two thousand twenty-four,  as  submitted  to  the
    11  department  and  adjusted  as  the  commissioner deems appropriate. Upon
    12  submission and subsequent verification of the cost report, the operating
    13  component of the rate shall be reflective of actual costs for the period
    14  January first, two thousand twenty-four, through December  thirty-first,
    15  two  thousand twenty-four, subject to further adjustments as the commis-
    16  sioner deems appropriate. Thereafter, the base period reported operating
    17  costs used to establish rates pursuant to  this  subparagraph  shall  be
    18  updated no less frequently than every two years. In addition to required
    19  annual  cost  reports,  pediatric  diagnostic  and treatment centers, as
    20  defined by this  subparagraph,  shall  submit  additional  data  as  the
    21  commissioner requires.
    22    (3)  Notwithstanding  any  law,  rule,  or regulation to the contrary,
    23  pediatric diagnostic and  treatment  centers  shall  be  reimbursed  for
    24  services provided to children enrolled in Medicaid managed care plans at
    25  the rates of reimbursement promulgated pursuant to this subparagraph.
    26    (4)  The  capital component of the rate shall reflect actual base year
    27  costs.
    28    (5) All rates established under this subparagraph shall be subject  to
    29  the availability of federal financial participation.
    30    (6)  The  commissioner  may  promulgate  or  amend  regulations as the
    31  commissioner determines appropriate and necessary to establish the rates
    32  provided for in this subparagraph and/or exempt pediatric diagnostic and
    33  treatment centers from the ambulatory payment group reimbursement  meth-
    34  odology applicable to diagnostic and treatment centers.
    35    §  2.  This  act  shall take effect immediately and shall be deemed to
    36  have been in full force and effect on and after April 1, 2024; provided,
    37  however, that the provisions of this act  shall  expire  and  be  deemed
    38  repealed April 1, 2027.
 
    39                                   PART MM

    40    Section  1.  The executive law is amended by adding a new article 49-C
    41  to read as follows:
    42                                ARTICLE 49-C
    43    COMMUNITY ADVISORY BOARD FOR THE MODERNIZATION AND REVITALIZATION OF
    44                  SUNY DOWNSTATE HEALTH SCIENCES UNIVERSITY
    45  § 996. Community advisory board for the modernization and revitalization
    46           of SUNY Downstate health sciences university.
    47    § 996. Community advisory board for the modernization and  revitaliza-
    48  tion  of  SUNY  Downstate  health sciences university. 1. Advisory board
    49  established. (a) There shall be established the advisory board  for  the
    50  modernization and revitalization of SUNY Downstate (hereinafter referred
    51  to as "the advisory board"). The advisory board shall review and examine
    52  a  variety  of  options  to strengthen SUNY Downstate and promote longer
    53  term viability  for  its  dual  education  and  healthcare  mission.  In

        S. 8307--C                         69                         A. 8807--C
 
     1  conducting  its  study,  the  advisory board will consider the following
     2  factors:
     3    (i) Overall healthcare service delivery trends and models;
     4     (ii)  Historic  and  projected  financials  for  the hospital and the
     5  campus;
     6    (iii) Current state of building infrastructure and capital needs;
     7    (iv) Community healthcare needs, outcomes, and health disparities;
     8    (v) Existing inpatient and outpatient  service  offerings  and  health
     9  outcomes;
    10    (vi) Capacity and availability of inpatient and outpatient services in
    11  the broader primary and secondary service areas;
    12    (vii)  Efficiency  of  operations  and  quality of healthcare services
    13  benchmarking; and
    14    (viii) Training needs for students and employment outcomes.
    15    2. Advisory board members. The advisory board  shall  consist  of  the
    16  following members: (a) the commissioner of the department of health; (b)
    17  one  representative  of  organized  labor  representing employees at the
    18  state university of New York pursuant to article fourteen of  the  civil
    19  service  law, who shall be appointed by the governor upon recommendation
    20  of the president of  the  union  representing  the  greatest  number  of
    21  employees  at  SUNY Downstate; (c) one member appointed by the temporary
    22  president of the senate; (d) one member appointed by the speaker of  the
    23  assembly;  (e)  three  members appointed by the governor; (f) one member
    24  appointed by the governor upon  the  joint  recommendation  of  Brooklyn
    25  community boards 9 and 17; and (g) the chancellor of the state universi-
    26  ty of New York.
    27    3.  Outreach.  The  advisory  board shall solicit recommendations from
    28  healthcare experts, county health departments, community-based organiza-
    29  tions,  state  and  regional  healthcare  industry  associations,  labor
    30  unions,  experts  in  hospital operations, and other interested parties.
    31  The advisory board shall hold no less than three  public  hearings  with
    32  requisite  public  notice  to solicit input and recommendations from any
    33  interested party.
    34    4. Compensation. The members of the advisory board  shall  receive  no
    35  compensation  for  their  service as members, but shall be allowed their
    36  actual and necessary expenses  incurred  in  the  performance  of  their
    37  duties.
    38    5. Recommendations and report. (a) The advisory board shall complete a
    39  study  and  provide  written  recommendations  to  prioritize healthcare
    40  services provided in the SUNY  Downstate  service  area.    The  written
    41  recommendations  shall  include  a  reasonable,  scalable  and  fiscally
    42  responsible plan for the financial health, viability and  sustainability
    43  of  SUNY  Downstate; provided, however, that such plan shall incorporate
    44  utilization of all available state and federally available  appropriated
    45  amounts,  and  shall  not  exceed more than two hundred fifty percent of
    46  such amounts.
    47    (b) A report of the advisory board's recommendations shall be provided
    48  to the governor, the temporary president of the senate, and the  speaker
    49  of the assembly no later than April first, two thousand twenty-five.
    50    6.  Certificate of need. The public health and health planning council
    51  and the commissioner of health are prohibited from reviewing or  approv-
    52  ing  any certificate of need application related to a reduction in inpa-
    53  tient services pursuant to any article of law  or  regulation  that  may
    54  affect  a change to inpatient services at SUNY Downstate health sciences
    55  university until at least April first, two thousand twenty-five.
    56    § 2. This act shall take effect immediately.

        S. 8307--C                         70                         A. 8807--C
 
     1                                   PART NN
 
     2    Section  1.  Section  1-a  of part I of chapter 57 of the laws of 2022
     3  providing a one percent across the board payment increase to all  quali-
     4  fying fee-for-service Medicaid rates, as added by section 8 of part E of
     5  chapter 57 of the laws of 2023, is amended to read as follows:
     6    §  1-a.  Notwithstanding any provision of law to the contrary, for the
     7  state fiscal years beginning April 1,  2023,  and  thereafter,  Medicaid
     8  payments made for the operating component of hospital inpatient services
     9  shall  be  subject  to  a  uniform  rate  increase of seven and one-half
    10  percent in addition to the increase contained in  section  one  of  this
    11  act,  subject  to  the  approval  of  the commissioner of health and the
    12  director of the budget.   Notwithstanding any provision of  law  to  the
    13  contrary, for the state fiscal years beginning April 1, 2023, and there-
    14  after,  Medicaid  payments  made for the operating component of hospital
    15  outpatient services shall be subject to a uniform rate increase  of  six
    16  and  one-half  percent  in addition to the increase contained in section
    17  one of this act, subject to the approval of the commissioner  of  health
    18  and the director of the budget.  Notwithstanding any provision of law to
    19  the  contrary, for the period April 1, 2024 through March 31, 2025 Medi-
    20  caid payments made for hospital services shall be increased by an aggre-
    21  gate amount of up to $525,000,000 in addition to the increase  contained
    22  in  sections  one  and  one-b of this act subject to the approval of the
    23  commissioner of health  and  the  director  of  the  budget.  Such  rate
    24  [increase]  increases  shall  be  subject  to  federal financial partic-
    25  ipation.
    26    § 2. Section 1-a of part I of chapter 57 of the laws of 2022 providing
    27  a one percent across the board payment increase to all  qualifying  fee-
    28  for-service  Medicaid  rates, as added by section 7 of part I of chapter
    29  57 of the laws of 2023, is amended to read as follows:
    30    § [1-a] 1-b.  Notwithstanding any provision of law  to  the  contrary,
    31  for  the  state  fiscal  years  beginning April 1, 2023, and thereafter,
    32  Medicaid payments made for the operating component of residential health
    33  care facilities services shall be subject to a uniform rate increase  of
    34  6.5  percent  in  addition to the increase contained in subdivision 1 of
    35  section 1 of this part, subject to the approval of the  commissioner  of
    36  the department of health and the director of the division of the budget;
    37  provided,  however,  that  such  Medicaid payments shall be subject to a
    38  uniform rate increase of up to 7.5 percent in addition to  the  increase
    39  contained  in  subdivision  1  of section 1 of this part contingent upon
    40  approval of the commissioner of the department of health,  the  director
    41  of the division of the budget, and the Centers for Medicare and Medicaid
    42  Services.  Notwithstanding any provision of law to the contrary, for the
    43  period  April  1, 2024 through March 31, 2025 Medicaid payments made for
    44  nursing home services shall be increased by an aggregate amount of up to
    45  $285,000,000 in addition to the increase contained in sections  one  and
    46  one-c  of this act subject to the approval of the commissioner of health
    47  and the director of the budget. Such rate [increase] increases shall  be
    48  subject to federal financial participation.
    49    § 3. Section 1-b of part I of chapter 57 of the laws of 2022 providing
    50  a  one  percent across the board payment increase to all qualifying fee-
    51  for-service Medicaid rates, as added by section 7 of part I  of  chapter
    52  57 of the laws of 2023, is amended to read as follows:
    53    § [1-b] 1-c. Notwithstanding any provision of law to the contrary, for
    54  the state fiscal years beginning April 1, 2023, and thereafter, Medicaid
    55  payments made for the operating component of assisted living programs as

        S. 8307--C                         71                         A. 8807--C
 
     1  defined  by  paragraph  (a)  of  subdivision one of section 461-l of the
     2  social services law shall be subject to a uniform rate increase  of  6.5
     3  percent  in  addition  to  the increase contained in section one of this
     4  part,  subject  to the approval of the commissioner of the department of
     5  health and the director of division of the budget.  Notwithstanding  any
     6  provision  of  law to the contrary, for the period April 1, 2024 through
     7  March 31, 2025, Medicaid payments for assisted living programs shall  be
     8  increased  by up to $15,000,000 in addition to the increase contained in
     9  this section subject to the approval of the commissioner of  health  and
    10  the  director  of  the  budget.  Such rate [increase] increases shall be
    11  subject to federal financial participation.
    12    § 4. Part I of chapter 57 of the laws of 2022 providing a one  percent
    13  across  the  board  payment  increase  to all qualifying fee-for-service
    14  Medicaid rates, is amended by adding  a  new  section  1-d  to  read  as
    15  follows:
    16    § 1-d. Such increases as added by the chapter of the laws of 2024 that
    17  added  this  section  may take the form of increased rates of payment in
    18  Medicaid  fee-for-service  and/or  Medicaid  managed  care,   lump   sum
    19  payments,  or  state  directed payments under 42 CFR 438.6(c). Such rate
    20  increases shall be subject to federal financial participation.
    21    § 5. This act shall take effect immediately and  shall  be  deemed  to
    22  have been in full force and effect on and after April 1, 2024.
    23    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
    24  sion,  section  or  part  of  this act shall be adjudged by any court of
    25  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    26  impair,  or  invalidate  the remainder thereof, but shall be confined in
    27  its operation to the clause, sentence, paragraph,  subdivision,  section
    28  or part thereof directly involved in the controversy in which such judg-
    29  ment shall have been rendered. It is hereby declared to be the intent of
    30  the  legislature  that  this  act  would  have been enacted even if such
    31  invalid provisions had not been included herein.
    32    § 3. This act shall take effect immediately  provided,  however,  that
    33  the applicable effective date of Parts A through NN of this act shall be
    34  as specifically set forth in the last section of such Parts.
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