[ ] is old law to be omitted.
LBD12671-02-4
S. 8307--A 2 A. 8807--A
lations, in relation to the effectiveness thereof (Part B); to amend
the education law, in relation to removing the exemption for school
psychologists to render early intervention services; and to amend
chapter 217 of the laws of 2015, amending 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 relating to certain Medicaid manage-
ment, in relation to the effectiveness thereof; to amend part E of
chapter 57 of the laws of 2015, amending the public health law relat-
ing 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 supple-
mental rebates, in relation to authorizing the department of health to
increase operating cost component of rates of payment for general
hospital outpatient services and authorizing the department of health
to pay a public hospital adjustment to public general hospitals during
certain state fiscal years and calendar years; to amend the public
health law, in relation to authorizing the commissioner to make addi-
tional 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 facil-
ities 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 making the special needs assisted living
residence voucher program permanent; and to amend the public health
law, in relation to assisted living quality improvement standards
(Part F); to amend the public health law, in relation to home care
worker wage parity; and to repeal certain provisions of the public
health law relating thereto (Part G); to amend the financial services
law, in relation to excluding managed care plans from the independent
resolution process; to amend the social services law and the public
health law, in relation to providing authority for the department of
health to competitively procure managed care organizations participat-
ing in medicaid managed care programs; 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 organiza-
tions; and to repeal certain provisions of the social services law
relating thereto (Part H); to amend the social services law, in
relation to copayments for drugs; to amend the public health law, in
relation to prescriber prevails; to amend the public health law, in
relation to the Medicaid drug cap and pharmacy cost reporting; and to
repeal certain provisions of the social services law relating to
coverage for certain prescription drugs (Part I); to amend the social
S. 8307--A 3 A. 8807--A
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 eliminating consumer-paid
premium payments in the basic health program, in relation to the
effectiveness thereof; and 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 functions of the
marketplace (Part J); to amend chapter 266 of the laws of 1986 amend-
ing the civil practice law and rules and other laws relating to malp-
ractice and professional medical conduct, in relation to insurance
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 liabil-
ity pool; and to amend part H of chapter 57 of the laws of 2017 amend-
ing the New York Health Care Reform Act of 1996 and other laws relat-
ing to extending certain provisions relating thereto, in relation to
extending provisions relating to excess coverage (Part K); to amend
the public health law and the state finance law, in relation to the
discontinuation of the empire clinical research investigator program;
to amend the public health law, in relation to the discontinuance of
participation and membership during a three year demonstration period
in a physician committee of the Medical Society of the State of New
York or the New York State Osteopathic Society; to repeal subdivision
9 of section 2803 of the public health law, relating to the hospital
audit program; to repeal section 461-s of the social services law,
relating to enhancing the quality of adult living program for adult
care facilities; to repeal paragraph (c) of subdivision 1 of section
461-b of the social services law, relating to an appropriation made
available for the purposes of funding the operating assistance sub-
program for enriched housing; to repeal article 27-H of the public
health law, relating to the tick-borne disease institute; and to
repeal paragraph (g) of subdivision 11 of section 230 of the public
health law, relating to reporting of professional misconduct (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); to amend
the public health law, in relation to authorizing the commissioner of
health to issue a statewide standing order for the provision of doula
services, providing medical services to pregnant minors, and to the
provision of contraception (Part N); to amend the public health law,
in relation to expanding financial assistance; and to amend the gener-
al 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
S. 8307--A 4 A. 8807--A
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 thereof (Part P);
to amend the education law and the public health law, in relation to
the scope of practice of physician assistants, certified nurse aides,
medical assistants, dentists and dental hygienists (Part Q); to amend
the education law, in relation to enacting the interstate medical
licensure compact; and to amend the education law, in relation to
enacting the nurse licensure compact (Part R); to amend the public
health law, in relation to establishing the healthcare safety net
transformation program (Part S); to amend the public health law and
the education law, in relation to making necessary changes to end the
HIV, HCV, HBV, syphilis and mpox epidemics; and to repeal certain
provisions the public health law relating thereto (Part T); to amend
the public health law, in relation to increasing prescription monitor-
ing program data retention periods and allowing enhanced data sharing
to combat the opioid crisis, updating controlled substance schedules
to conform with those of the federal drug enforcement administration,
permitting providers to distribute three-day supplies of buprenor-
phine, and updating the term "addict" to "person with a substance use
disorder" in certain provisions of such law; and to repeal section
3372 of such law relating to practitioner patient reporting (Part U);
to amend the public health law, in relation to expanding hospital
services and home care collaboration into the home and community; to
amend the public health law and the education law, in relation to
modernizing the state of New York's emergency medical system and work-
force; to amend the public health law, in relation to establishing the
paramedic urgent care program; and to amend chapter 137 of the laws of
2023 amending the public health law relating to establishing a commu-
nity-based paramedicine demonstration program, in relation to extend-
ing the effectiveness thereof (Part V); to amend the elder law, in
relation to establishing the interagency elder justice coordinating
council (Part W); intentionally 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 work-
force reinvestment program, the membership of subcommittees for mental
health of community services boards and the duties of such subcommit-
tees and creating the community mental health and workforce reinvest-
ment 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 relating to clarifying the authority of the commissioners
in the department of mental hygiene to design and implement time-lim-
ited demonstration programs, in relation to making such provisions
permanent (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); to amend the social services law, in relation to
clarifying the requirements related to referrals of substantiated
reports of abuse or neglect from the justice center to the office of
the Medicaid inspector general (Part CC); to amend part A of chapter
S. 8307--A 5 A. 8807--A
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);
to amend the education law, in relation to expanding the description
of certain services which are not prohibited by statutes governing the
practice of nursing (Part EE); to establish a cost of living adjust-
ment 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); and to amend the
social services law, in relation to the removal of the fiscal interme-
diary procurement and replacing it with an authorization process; to
amend the public health law, in relation to eliminating conflicts of
interest between consumer directed personal assistance program fiscal
intermediaries and licensed home care services agencies; 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)
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act enacts into law major components of legislation
necessary to implement the state health and mental hygiene budget for
the 2024-2025 state fiscal year. Each component is wholly contained
within a Part identified as Parts A through HH. The effective date for
each particular provision contained within such Part is set forth in the
last section of such Part. Any provision in any section contained within
a Part, including the effective date of the Part, which makes a refer-
ence to a section "of this act", when used in connection with that
particular component, shall be deemed to mean and refer to the corre-
sponding section of the Part in which it is found. Section three of this
act sets forth the general effective date of this act.
PART A
Section 1. Paragraph (a) of subdivision 1 of section 92 of 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, as
amended by section 1 of part A of chapter 57 of the laws of 2023, is
amended to read as follows:
(a) For state fiscal years 2011-12 through [2024-25] 2025-26, the
director of the budget, in consultation with the commissioner of health
referenced as "commissioner" for purposes of this section, shall assess
on a quarterly basis, as reflected in quarterly reports pursuant to
subdivision five of this section known and projected department of
health state funds medicaid expenditures by category of service and by
geographic regions, as defined by the commissioner.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART B
Section 1. Subdivision p of section 76 of part D of chapter 56 of the
laws of 2013 amending the social services law relating to eligibility
S. 8307--A 6 A. 8807--A
conditions, as amended by section 2 of part E of chapter 57 of the laws
of 2019, is amended to read as follows:
p. the amendments to subparagraph 7 of paragraph (b) of subdivision 1
of section 366 of the social services law made by section one of this
act shall expire and be deemed repealed October 1, [2024] 2029.
§ 2. Section 10 of 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, as amended by
section 21 of part E of chapter 57 of the laws of 2019, is amended to
read as follows:
§ 10. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after July 1, 1996; provided,
however, that sections one, two and three of this act shall expire and
be deemed repealed [on] March 31, [2025] 2030 provided, however that the
amendments to section 364-j of the social services law made by section
four of this act shall not affect the expiration of such section and
shall be deemed to expire therewith and provided, further, that the
provisions of subdivisions 8, 9 and 10 of section 4401 of the public
health law, as added by section one of this act; section 4403-d of the
public health law as added by section two of this act and the provisions
of section seven of this act, except for the provisions relating to the
establishment of no more than twelve comprehensive HIV special needs
plans, shall expire and be deemed repealed on July 1, 2000.
§ 3. Subdivision 3 of section 2999-p of the public health law, as
amended by section 8 of part BB of chapter 56 of the laws of 2020, is
amended to read as follows:
3. The commissioner may issue a certificate of authority to an entity
that meets conditions for ACO certification as set forth in regulations
made by the commissioner pursuant to section twenty-nine hundred nine-
ty-nine-q of this article. The commissioner shall not issue any new
certificate under this article after December thirty-first, two thousand
[twenty-four] TWENTY-EIGHT.
§ 4. Subdivision 1 of section 2999-aa of the public health law, as
amended by section 9 of part S of chapter 57 of the laws of 2021, is
amended to read as follows:
1. In order to promote improved quality and efficiency of, and access
to, health care services and to promote improved clinical outcomes to
the residents of New York, it shall be the policy of the state to
encourage, where appropriate, cooperative, collaborative and integrative
arrangements including but not limited to, mergers and acquisitions
among health care providers or among others who might otherwise be
competitors, under the active supervision of the commissioner. To the
extent such arrangements, or the planning and negotiations that precede
them, might be anti-competitive within the meaning and intent of the
state and federal antitrust laws, the intent of the state is to supplant
competition with such arrangements under the active supervision and
related administrative actions of the commissioner as necessary to
accomplish the purposes of this article, and to provide state action
immunity under the state and federal antitrust laws with respect to
activities undertaken by health care providers and others pursuant to
this article, where the benefits of such active supervision, arrange-
ments and actions of the commissioner outweigh any disadvantages likely
to result from a reduction of competition. The commissioner shall not
approve an arrangement for which state action immunity is sought under
this article without first consulting with, and receiving a recommenda-
tion from, the public health and health planning council. No arrangement
S. 8307--A 7 A. 8807--A
under this article shall be approved after December thirty-first, two
thousand [twenty-four] TWENTY-EIGHT.
§ 5. Section 7 of 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, is amended
to read as follows:
§ 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022; provided,
however, this act shall expire and be deemed repealed on and after April
1, [2024] 2025.
§ 6. Section 97 of chapter 659 of the laws of 1997 amending the public
health law and other laws relating to creation of continuing care
retirement communities, as amended by section 11 of part Z of chapter 57
of the laws of 2018, is amended to read as follows:
§ 97. This act shall take effect immediately, provided, however, that
the amendments to subdivision 4 of section 854 of the general municipal
law made by section seventy of this act shall not affect the expiration
of such subdivision and shall be deemed to expire therewith and provided
further that sections sixty-seven and sixty-eight of this act shall
apply to taxable years beginning on or after January 1, 1998 and
provided further that sections eighty-one through eighty-seven of this
act shall expire and be deemed repealed on December 31, [2024] 2029 and
provided further, however, that the amendments to section ninety of this
act shall take effect January 1, 1998 and shall apply to all policies,
contracts, certificates, riders or other evidences of coverage of long
term care insurance issued, renewed, altered or modified pursuant to
section 3229 of the insurance law on or after such date.
§ 7. Section 5 of 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, as amended by section 5 of part XX of chapter 59
of the laws of 2019, is amended to read as follows:
§ 5. This act shall take effect July 1, 2018 and shall expire and be
deemed to be repealed on June 30, [2024] 2027, provided that, effective
immediately, the addition, amendment and/or repeal of any rule or regu-
lation necessary for the implementation of this act on its effective
date are authorized to be made and completed on or before such effective
date, and, provided that this act shall only apply to the sale or
distribution of opioids in the state of New York on or before December
31, 2018.
§ 8. Section 2 of 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 for expenditures made by or on behalf of social services
districts for medical assistance for needy persons and administration
thereof, as amended by section 6 of part CC of chapter 57 of the laws of
2022, is amended to read as follows:
§ 2. This act shall take effect immediately and shall expire and be
deemed repealed March 31, [2024] 2026.
§ 9. Subdivision 5 of section 60 of 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, as amended by chapter 125 of
the laws of 2021, is amended to read as follows:
5. section thirty-eight of this act shall expire and be deemed
repealed July 1, [2024] 2027;
§ 10. Section 7 of part H of chapter 57 of the laws of 2019, amending
the public health law relating to waiver of certain regulations, as
S. 8307--A 8 A. 8807--A
amended by section 1 of part GG of chapter 57 of the laws of 2022, is
amended to read as follows:
§ 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2019, provided,
however, that section two of this act shall expire on April 1, [2024]
2026.
§ 11. This act shall take effect immediately.
PART C
Section 1. Paragraph d of subdivision 6 of section 4410 of the educa-
tion law, as amended by chapter 217 of the laws of 2015, is amended to
read as follows:
d. Notwithstanding any other provision of law to the contrary, the
exemption in subdivision one of section seventy-six hundred five of this
chapter shall apply to persons employed on a full-time or part-time
salary basis, which may include on an hourly, weekly, or monthly basis,
or on a fee for evaluation services basis provided that such person is
employed by and under the dominion and control of a center-based program
approved pursuant to subdivision nine of this section as a certified
school psychologist to provide activities, services and use of the title
psychologist to students enrolled in such approved center-based program;
and to certified school psychologists employed on a full-time or part-
time salary basis, which may include on an hourly, weekly, or monthly
basis, or on a fee for evaluation services basis provided that the
school psychologist is employed by and under the dominion and control of
a program that has been approved pursuant to paragraph b of subdivision
nine of this section, or subdivision nine-a of this section, to conduct
a multi-disciplinary evaluation of a preschool child having or suspected
of having a disability where authorized by paragraph a [or b] of subdi-
vision six of section sixty-five hundred three-b of this chapter[; and
to certified school psychologists employed on a full-time or part-time
salary basis, which may include on an hourly, weekly, or monthly basis,
or on a fee for evaluation services basis provided that such psychol-
ogist is employed by and under the dominion and control of an agency
approved in accordance with title two-A of article twenty-five of the
public health law to deliver early intervention program multidiscipli-
nary evaluations, service coordination services and early intervention
program services, where authorized by paragraph a or b of subdivision
six of section sixty-five hundred three-b of this chapter, each], in the
course of their employment. Nothing in this section shall be construed
to authorize a certified school psychologist or group of such school
psychologists to engage in independent practice or practice outside of
an employment relationship.
§ 2. Subdivision 1 of section 7605 of the education law, as amended by
chapter 217 of the laws of 2015, is amended to read as follows:
1. The activities, services, and use of the title of psychologist, or
any derivation thereof, on the part of a person in the employ of a
federal, state, county or municipal agency, or other political subdivi-
sion, or a chartered elementary or secondary school or degree-granting
educational institution insofar as such activities and services are a
part of the duties of his salaried position; or on the part of a person
in the employ as a certified school psychologist on a full-time or part-
time salary basis, which may include on an hourly, weekly, or monthly
basis, or on a fee for evaluation services basis provided that such
person employed as a certified school psychologist is employed by and
S. 8307--A 9 A. 8807--A
under the dominion and control of a preschool special education program
approved pursuant to paragraph b of subdivision nine or subdivision
nine-a of section forty-four hundred ten of this chapter to provide
activities, services and to use the title "certified school psychol-
ogist", so long as this shall not be construed to permit the use of the
title "licensed psychologist", to students enrolled in such approved
program or to conduct a multidisciplinary evaluation of a preschool
child having or suspected of having a disability[; or on the part of a
person in the employ as a certified school psychologist on a full-time
or part-time salary basis, which may include on an hourly, weekly or
monthly basis, or on a fee for evaluation services basis provided that
such person employed as a certified school psychologist is employed by
and under the dominion and control of an agency approved in accordance
with title two-A of article twenty-five of the public health law to
deliver early intervention program multidisciplinary evaluations,
service coordination services and early intervention program services],
where each such preschool special education program [or early inter-
vention provider] is authorized by paragraph a [or b] of subdivision six
of section sixty-five hundred [three] THREE-B of this title[, each] in
the course of their employment. Nothing in this subdivision shall be
construed to authorize a certified school psychologist or group of such
school psychologists to engage in independent practice or practice
outside of an employment relationship.
§ 3. Section 3 of chapter 217 of the laws of 2015, amending the educa-
tion law relating to certified school psychologists and special educa-
tion services and programs for preschool children with handicapping
conditions, as amended by chapter 339 of the laws of 2022, is amended to
read as follows:
§ 3. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after July 1, 2014, provided,
however that the provisions of this act shall expire and be deemed
repealed June 30, [2024] 2026.
§ 4. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024; provided,
however, that the amendments to paragraph d of subdivision 6 of section
4410 of the education law made by section one of this act shall not
affect the expiration of such paragraph and shall be deemed to expire
therewith; provided further, however, that the amendments to subdivision
1 of section 7605 of the education law made by section two of this act
shall not affect the expiration of such subdivision and shall be deemed
to expire therewith.
PART D
Section 1. Paragraph (c) of subdivision 8 of section 2807-c of the
public health law, as amended by section 1 of part D of chapter 57 of
the laws of 2021, is amended to read as follows:
(c) In order to reconcile capital related inpatient expenses included
in rates of payment based on a budget to actual expenses and statistics
for the rate period for a general hospital, rates of payment for a
general hospital shall be adjusted to reflect the dollar value of the
difference between capital related inpatient expenses included in the
computation of rates of payment for a prior rate period based on a budg-
et and actual capital related inpatient expenses for such prior rate
period, each as determined in accordance with paragraph (a) of this
subdivision, adjusted to reflect increases or decreases in volume of
S. 8307--A 10 A. 8807--A
service in such prior rate period compared to statistics applied in
determining the capital related inpatient expenses component of rates of
payment based on a budget for such prior rate period.
For rates effective April first, two thousand twenty through March
thirty-first, two thousand twenty-one, the budgeted capital-related
expenses add-on as described in paragraph (a) of this subdivision, based
on a budget submitted in accordance to paragraph (a) of this subdivi-
sion, shall be reduced by five percent relative to the rate in effect on
such date; and the actual capital expenses add-on as described in para-
graph (a) of this subdivision, based on actual expenses and statistics
through appropriate audit procedures in accordance with paragraph (a) of
this subdivision shall be reduced by five percent relative to the rate
in effect on such date.
For rates effective [on and after] April first, two thousand twenty-
one THROUGH SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR, the budgeted
capital-related expenses add-on as described in paragraph (a) of this
subdivision, based on a budget submitted in accordance to paragraph (a)
of this subdivision, shall be reduced by ten percent relative to the
rate in effect on such date; and the actual capital expenses add-on as
described in paragraph (a) of this subdivision, based on actual expenses
and statistics through appropriate audit procedures in accordance with
paragraph (a) of this subdivision shall be reduced by ten percent rela-
tive to the rate in effect on such date.
FOR RATES EFFECTIVE ON AND AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-
FOUR, THE BUDGETED CAPITAL-RELATED EXPENSES ADD-ON AS DESCRIBED IN PARA-
GRAPH (A) OF THIS SUBDIVISION, BASED ON A BUDGET SUBMITTED IN ACCORDANCE
WITH PARAGRAPH (A) OF THIS SUBDIVISION, SHALL BE REDUCED BY TWENTY
PERCENT RELATIVE TO THE RATE IN EFFECT ON SUCH DATE; AND THE ACTUAL
CAPITAL EXPENSES ADD-ON AS DESCRIBED IN PARAGRAPH (A) OF THIS SUBDIVI-
SION SHALL BE REDUCED BY TWENTY PERCENT RELATIVE TO THE RATE IN EFFECT
ON SUCH DATE.
For any rate year, all reconciliation add-on amounts calculated [on
and after] FOR THE PERIOD OF April first, two thousand twenty THROUGH
SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR shall be reduced by ten
percent, and all reconciliation recoupment amounts calculated [on or
after] FOR THE PERIOD OF April first, two thousand twenty THROUGH
SEPTEMBER THIRTIETH, TWO THOUSAND TWENTY-FOUR shall increase by ten
percent.
FOR ANY RATE YEAR, ALL RECONCILIATION ADD-ON AMOUNTS CALCULATED ON AND
AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-FOUR SHALL BE REDUCED BY TWENTY
PERCENT, AND ALL RECONCILIATION RECOUPMENT AMOUNTS CALCULATED ON OR
AFTER OCTOBER FIRST, TWO THOUSAND TWENTY-FOUR SHALL INCREASE BY TWENTY
PERCENT.
Notwithstanding any inconsistent provision of subparagraph (i) of
paragraph (e) of subdivision nine of this section, capital related inpa-
tient expenses of a general hospital included in the computation of
rates of payment based on a budget shall not be included in the computa-
tion of a volume adjustment made in accordance with such subparagraph.
Adjustments to rates of payment for a general hospital made pursuant to
this paragraph shall be made in accordance with paragraph (c) of subdi-
vision eleven of this section. Such adjustments shall not be carried
forward except for such volume adjustment as may be authorized in
accordance with subparagraph (i) of paragraph (e) of subdivision nine of
this section for such general hospital.
§ 2. Section 5 of part ZZ of chapter 56 of the laws of 2020 amending
the tax law and the social services law relating to certain Medicaid
S. 8307--A 11 A. 8807--A
management, as amended by section 3 of part RR of chapter 57 of the laws
of 2022, is amended to read as follows:
§ 5. This act shall take effect immediately and shall be deemed
repealed [five] EIGHT years after such effective date.
§ 3. Section 2 of 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, is amended to read as follows:
§ 2. Notwithstanding any inconsistent provision of law, rule or regu-
lation to the contrary, and subject to the availability of federal
financial participation pursuant to title XIX of the federal social
security act, effective for [periods on and after] EACH STATE FISCAL
YEAR FROM April 1, 2015, THROUGH DECEMBER 31, 2024; AND FOR THE CALENDAR
YEAR JANUARY 1, 2025 THROUGH DECEMBER 31, 2025; AND FOR EACH CALENDAR
YEAR THEREAFTER, payments pursuant to paragraph (i) of subdivision 35 of
section 2807-c of the public health law may be made as outpatient upper
payment limit payments for outpatient hospital services, not to exceed
an amount of three hundred thirty-nine million dollars annually between
payments authorized under this section and such section of the public
health law. Such payments shall be made as medical assistance payments
for outpatient services pursuant to title 11 of article 5 of the social
services law for patients eligible for federal financial participation
under title XIX of the federal social security act for general hospital
outpatient services and general hospital emergency room services issued
pursuant to paragraph (g) of subdivision 2 of section 2807 of the public
health law to general hospitals, other than major public general hospi-
tals, providing emergency room services and including safety net hospi-
tals, which shall, for the purpose of this paragraph, be defined as
having either: a Medicaid share of total inpatient hospital discharges
of at least thirty-five percent, including both fee-for-service and
managed care discharges for acute and exempt services; or a Medicaid
share of total discharges of at least thirty percent, including both
fee-for-service and managed care discharges for acute and exempt
services, and also providing obstetrical services. Eligibility to
receive such additional payments shall be based on data from the period
two years prior to the rate year, as reported on the institutional cost
report submitted to the department as of October first of the prior rate
year. No eligible general hospital's annual payment amount pursuant to
this section shall exceed the lower of the sum of the annual amounts due
that hospital pursuant to section twenty-eight hundred seven-k and
section twenty-eight hundred seven-w of the public health law; or the
hospital's facility specific projected disproportionate share hospital
payment ceiling established pursuant to federal law, provided, however,
that payment amounts to eligible hospitals in excess of the lower of
such sum or payment ceiling shall be reallocated to eligible hospitals
that do not have excess payment amounts. Such reallocations shall be
proportional to each such hospital's aggregate payment amount pursuant
to paragraph (i) of subdivision 35 of section 2807-c of the public
health law and this section to the total of all payment amounts for such
eligible hospitals. Such adjustment payment may be added to rates of
payment or made as aggregate payments to eligible general hospitals
other than major public general hospitals. The distribution of such
payments shall be pursuant to a methodology approved by the commissioner
of health in regulation.
§ 4. Section 21 of part B of chapter 57 of the laws of 2015, amending
the social services law relating to supplemental rebates, is amended to
read as follows:
S. 8307--A 12 A. 8807--A
§ 21. Notwithstanding any inconsistent provision of law, rule or regu-
lation to the contrary, and subject to the availability of federal
financial participation pursuant to title XIX of the federal social
security act, effective for [the period] EACH STATE FISCAL YEAR FROM
April 1, 2011 through [March 31, 2012, and state fiscal years] DECEMBER
31, 2024; AND FOR THE CALENDAR YEAR JANUARY 1, 2025 THROUGH DECEMBER 31,
2025; AND FOR EACH CALENDAR YEAR thereafter, the department of health is
authorized to increase the operating cost component of rates of payment
for general hospital outpatient services and general hospital emergency
room services issued pursuant to paragraph (g) of subdivision 2 of
section 2807 of the public health law for public general hospitals, as
defined in subdivision 10 of section 2801 of the public health law,
other than those operated by the state of New York or the state univer-
sity of New York, and located in a city with a population over one
million, up to two hundred eighty-seven million dollars annually as
medical assistance payments for outpatient services pursuant to title 11
of article 5 of the social services law for patients eligible for feder-
al financial participation under title XIX of the federal social securi-
ty act based on such criteria and methodologies as the commissioner may
from time to time set through a memorandum of understanding with the New
York city health and hospitals corporation, and such adjustments shall
be paid by means of one or more estimated payments, with such estimated
payments to be reconciled to the commissioner of health's final adjust-
ment determinations after the disproportionate share hospital payment
adjustment caps have been calculated for such period under sections
1923(f) and (g) of the federal social security act. Such adjustment
payment may be added to rates of payment or made as aggregate payments
to eligible public general hospitals.
§ 5. The opening paragraph of subparagraph (i) of paragraph (i) of
subdivision 35 of section 2807-c of the public health law, as amended by
section 4 of part C of chapter 56 of the laws of 2013, is amended to
read as follows:
Notwithstanding any inconsistent provision of this subdivision or any
other contrary provision of law and subject to the availability of
federal financial participation, for [the period] EACH STATE FISCAL YEAR
FROM July first, two thousand ten through [March thirty-first, two thou-
sand eleven,] DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR; and [each
state fiscal year period] FOR THE CALENDAR YEAR JANUARY FIRST, TWO THOU-
SAND TWENTY-FIVE THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-
FIVE; AND FOR EACH CALENDAR YEAR thereafter, the commissioner shall make
additional inpatient hospital payments up to the aggregate upper payment
limit for inpatient hospital services after all other medical assistance
payments, but not to exceed two hundred thirty-five million five hundred
thousand dollars for the period July first, two thousand ten through
March thirty-first, two thousand eleven, three hundred fourteen million
dollars for each state fiscal year beginning April first, two thousand
eleven, through March thirty-first, two thousand thirteen, and no less
than three hundred thirty-nine million dollars for each state fiscal
year [thereafter] UNTIL DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR;
AND THEN FROM CALENDAR YEAR JANUARY FIRST, TWO THOUSAND TWENTY-FIVE
THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE; AND FOR EACH
CALENDAR YEAR THEREAFTER, to general hospitals, other than major public
general hospitals, providing emergency room services and including safe-
ty net hospitals, which shall, for the purpose of this paragraph, be
defined as having either: a Medicaid share of total inpatient hospital
discharges of at least thirty-five percent, including both fee-for-ser-
S. 8307--A 13 A. 8807--A
vice and managed care discharges for acute and exempt services; or a
Medicaid share of total discharges of at least thirty percent, including
both fee-for-service and managed care discharges for acute and exempt
services, and also providing obstetrical services. Eligibility to
receive such additional payments shall be based on data from the period
two years prior to the rate year, as reported on the institutional cost
report submitted to the department as of October first of the prior rate
year. Such payments shall be made as medical assistance payments for
fee-for-service inpatient hospital services pursuant to title eleven of
article five of the social services law for patients eligible for feder-
al financial participation under title XIX of the federal social securi-
ty act and in accordance with the following:
§ 6. Section 18 of part B of chapter 57 of the laws of 2015, amending
the social services law relating to supplemental rebates, is amended to
read as follows:
§ 18. Notwithstanding any inconsistent provision of law or regulation
to the contrary, and subject to the availability of federal financial
participation pursuant to title XIX of the federal social security act,
effective for [the period] EACH STATE FISCAL YEAR FROM April 1, 2012,
through [March 31, 2013, and state fiscal years] DECEMBER 31, 2024; AND
FOR THE CALENDAR YEAR FROM JANUARY 1, 2025 THROUGH DECEMBER 31, 2025;
AND FOR EACH CALENDAR YEAR thereafter, the department of health is
authorized to pay a public hospital adjustment to public general hospi-
tals, as defined in subdivision 10 of section 2801 of the public health
law, other than those operated by the state of New York or the state
university of New York, and located in a city with a population of over
1 million, of up to one billion eighty million dollars annually as
medical assistance payments for inpatient services pursuant to title 11
of article 5 of the social services law for patients eligible for feder-
al financial participation under title XIX of the federal social securi-
ty act based on such criteria and methodologies as the commissioner may
from time to time set through a memorandum of understanding with the New
York city health and hospitals corporation, and such adjustments shall
be paid by means of one or more estimated payments, with such estimated
payments to be reconciled to the commissioner of health's final adjust-
ment determinations after the disproportionate share hospital payment
adjustment caps have been calculated for such period under sections
1923(f) and (g) of the federal social security act. Such adjustment
payment may be added to rates of payment or made as aggregate payments
to eligible public general hospitals.
§ 7. Subdivision 1 of section 3-a of 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, is amended to read as follows:
1. Notwithstanding any inconsistent provision of law, rule or regu-
lation to the contrary, and subject to the availability of federal
financial participation, effective for [the period] EACH STATE FISCAL
YEAR FROM August 1, 2010 through [March 31, 2011, and each state fiscal
year] DECEMBER 31, 2024; AND FOR THE CALENDAR YEAR FROM JANUARY 1, 2025
THROUGH DECEMBER 31, 2025; AND FOR EACH CALENDAR YEAR thereafter, the
department of health is authorized to make Medicaid payment increases
for diagnostic and treatment centers (DTC) services issued pursuant to
section 2807 of the public health law for public DTCs operated by the
New York City Health and Hospitals Corporation, at the election of the
social services district in which an eligible DTC is physically located,
of up to twelve million six hundred thousand dollars on an annualized
S. 8307--A 14 A. 8807--A
basis for DTC services pursuant to title 11 of article 5 of the social
services law for patients eligible for federal financial participation
under title XIX of the federal social security act based on each such
DTC's proportionate share of the sum of all clinic visits for all facil-
ities eligible for an adjustment pursuant to this section for the base
year two years prior to the rate year. Such proportionate share payments
may be added to rates of payment or made as aggregate payments to eligi-
ble DTCs.
§ 8. Subdivision 1 of section 3-b of 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, is amended to read as follows:
1. Notwithstanding any inconsistent provision of law, rule or regu-
lation to the contrary, and subject to the availability of federal
financial participation, effective for [the period] EACH STATE FISCAL
YEAR FROM August 1, 2010 through [March 31, 2011, and each state fiscal
year] DECEMBER 31, 2024; AND FOR THE CALENDAR YEAR FROM JANUARY 1, 2025
THROUGH DECEMBER 31, 2025; AND FOR EACH CALENDAR YEAR thereafter, the
department of health, is authorized to make Medicaid payment increases
for county operated diagnostic and treatment centers (DTC) services
issued pursuant to section 2807 of the public health law and for
services provided by county operated free-standing clinics licensed
pursuant to articles 31 and 32 of the mental hygiene law, but not
including facilities operated by the New York City Health and Hospitals
Corporation, of up to five million four hundred thousand dollars on an
annualized basis for such services pursuant to title 11 of article 5 of
the social services law for patients eligible for federal financial
participation under title XIX of the federal social security act. Local
social services districts may decline such increased payments to their
sponsored DTCs and free-standing clinics, provided they provide written
notification to the commissioner of health, within thirty days following
receipt of notification of a payment pursuant to this section. Distrib-
utions pursuant to this section shall be based on each facility's
proportionate share of the sum of all DTC and clinic visits for all
facilities receiving payments pursuant to this section for the base year
two years prior to the rate year. Such proportionate share payments may
be added to rates or payment or made as aggregate payments to eligible
facilities.
§ 9. Paragraph (e-1) of subdivision 12 of section 2808 of the public
health law, as amended by section 15 of part B of chapter 57 of the laws
of 2023, is amended to read as follows:
(e-1) Notwithstanding any inconsistent provision of law or regulation,
the commissioner shall provide, in addition to payments established
pursuant to this article prior to application of this section, addi-
tional payments under the medical assistance program pursuant to title
eleven of article five of the social services law for non-state operated
public residential health care facilities, including public residential
health care facilities located in the county of Nassau, the county of
Westchester and the county of Erie, but excluding public residential
health care facilities operated by a town or city within a county, in
aggregate annual amounts of up to one hundred fifty million dollars in
additional payments for the state fiscal year beginning April first, two
thousand six and for the state fiscal year beginning April first, two
thousand seven and for the state fiscal year beginning April first, two
thousand eight and of up to three hundred million dollars in such aggre-
gate annual additional payments for the state fiscal year beginning
S. 8307--A 15 A. 8807--A
April first, two thousand nine, and for the state fiscal year beginning
April first, two thousand ten and for the state fiscal year beginning
April first, two thousand eleven, and for the state fiscal years begin-
ning April first, two thousand twelve and April first, two thousand
thirteen, and of up to five hundred million dollars in such aggregate
annual additional payments for the state fiscal years beginning April
first, two thousand fourteen, April first, two thousand fifteen and
April first, two thousand sixteen and of up to five hundred million
dollars in such aggregate annual additional payments for the state
fiscal years beginning April first, two thousand seventeen, April first,
two thousand eighteen, and April first, two thousand nineteen, and of up
to five hundred million dollars in such aggregate annual additional
payments for the state fiscal years beginning April first, two thousand
twenty, April first, two thousand twenty-one, and April first, two thou-
sand twenty-two, and of up to five hundred million dollars in such
aggregate annual additional payments for the state fiscal years begin-
ning April first, two thousand twenty-three, AND FROM April first, two
thousand twenty-four UNTIL DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-
FOUR, and [April first, two thousand twenty-five] FOR THE CALENDAR YEAR
JANUARY FIRST, TWO THOUSAND TWENTY-FIVE THROUGH DECEMBER THIRTY-FIRST,
TWO THOUSAND TWENTY-FIVE, AND FOR EACH CALENDAR YEAR THEREAFTER. The
amount allocated to each eligible public residential health care facili-
ty for this period shall be computed in accordance with the provisions
of paragraph (f) of this subdivision, provided, however, that patient
days shall be utilized for such computation reflecting actual reported
data for two thousand three and each representative succeeding year as
applicable, and provided further, however, that, in consultation with
impacted providers, of the funds allocated for distribution in the state
fiscal year beginning April first, two thousand thirteen, up to thirty-
two million dollars may be allocated in accordance with paragraph (f-1)
of this subdivision.
§ 10. This act shall take effect immediately; provided, however,
section one of this act shall take effect October 1, 2024; and provided,
further, that sections three, four, five, six, seven, eight and nine of
this act shall take effect January 1, 2025.
PART E
Section 1. Subparagraph (ii) of paragraph (b) of subdivision 2-b of
section 2808 of the public health law, as added by section 47 of part C
of chapter 109 of the laws of 2006, is amended to read as follows:
(ii) (A) The operating component of rates shall be subject to case mix
adjustment through application of the relative resource utilization
groups system of patient classification (RUG-III) employed by the feder-
al government with regard to payments to skilled nursing facilities
pursuant to title XVIII of the federal social security act (Medicare),
as revised by regulation to reflect New York state wages and fringe
benefits, provided, however, that such RUG-III classification system
weights shall be increased in the following amounts for the following
categories of residents: [(A)] (1) thirty minutes for the impaired
cognition A category, [(B)] (2) forty minutes for the impaired cognition
B category, and [(C)] (3) twenty-five minutes for the reduced physical
functions B category. Such adjustments shall be made in January and
July of each calendar year. Such adjustments and related patient classi-
fications in each facility shall be subject to audit review in accord-
ance with regulations promulgated by the commissioner.
S. 8307--A 16 A. 8807--A
(B) EFFECTIVE APRIL FIRST, TWO THOUSAND TWENTY-FOUR, THE CASE MIX
ADJUSTMENT FROM THE OPERATING COMPONENT OF THE RATES FOR SKILLED NURSING
FACILITIES SHALL REMAIN UNCHANGED FROM THE JULY TWO THOUSAND TWENTY-
THREE RATES DURING THE DEVELOPMENT AND UNTIL FULL IMPLEMENTATION OF A
CASE MIX METHODOLOGY USING THE PATIENT DRIVEN PAYMENT MODEL.
§ 2. Subparagraph (iv) of paragraph (b) of subdivision 2-b of section
2808 of the public health law, as amended by section 1 of part NN of
chapter 56 of the laws of 2020, is amended to read as follows:
(iv) The capital cost component of rates on and after January first,
two thousand nine shall: (A) fully reflect the cost of local property
taxes and payments made in lieu of local property taxes, as reported in
each facility's cost report submitted for the year two years prior to
the rate year; (B) provided, however, notwithstanding any inconsistent
provision of this article, commencing April first, two thousand twenty
for rates of payment for patients eligible for payments made by state
governmental agencies, the capital cost component determined in accord-
ance with this subparagraph and inclusive of any shared savings for
eligible facilities that elect to refinance their mortgage loans pursu-
ant to paragraph (d) of subdivision two-a of this section, shall be
reduced by the commissioner by five percent; AND (C) PROVIDED, HOWEVER,
NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS ARTICLE, COMMENCING
APRIL FIRST, TWO THOUSAND TWENTY-FOUR FOR RATES OF PAYMENT FOR PATIENTS
ELIGIBLE FOR PAYMENTS MADE BY STATE GOVERNMENTAL AGENCIES, THE CAPITAL
COST COMPONENT DETERMINED IN ACCORDANCE WITH THIS SUBPARAGRAPH AND
INCLUSIVE OF ANY SHARED SAVINGS FOR ELIGIBLE FACILITIES THAT ELECT TO
REFINANCE THEIR MORTGAGE LOANS PURSUANT TO PARAGRAPH (D) OF SUBDIVISION
TWO-A OF THIS SECTION, SHALL BE REDUCED BY THE COMMISSIONER BY AN ADDI-
TIONAL TEN PERCENT.
§ 3. Paragraph (h) of subdivision 1 of section 2632 of the public
health law, as amended by chapter 414 of the laws of 2015, is amended to
read as follows:
(h) in the Persian Gulf conflict from the second day of August, nine-
teen hundred ninety to the end of such conflict including military
service in Operation Enduring Freedom, Operation Iraqi Freedom, Opera-
tion New Dawn or Operation Inherent Resolve and was the recipient of the
global war on terrorism expeditionary medal or the Iraq campaign medal
or the Afghanistan campaign medal; and who was a resident of the state
of New York at the time of entry upon such active duty or who shall have
been a resident of this state for [one year] SIX MONTHS next preceding
the application for admission shall be entitled to admission to said
home after the approval of the application by the board of visitors,
subject to the provisions of this article and to the conditions, limita-
tions and penalties prescribed by the regulations of the department. Any
such veteran or dependent, who otherwise fulfills the requirements set
forth in this section, may be admitted directly to the skilled nursing
facility or the health related facility provided such veteran or depend-
ent is certified by a physician designated or approved by the department
to require the type of care provided by such facilities.
§ 4. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART F
Section 1. Paragraph (n) of subdivision 3 of section 461-l of the
social services law, as amended by section 2 of part B of chapter 57 of
the laws of 2018, is amended to read as follows:
S. 8307--A 17 A. 8807--A
(n) The commissioner of health is authorized to create a program to
subsidize the cost of assisted living for those individuals living with
Alzheimer's disease and dementia who are not eligible for medical
assistance pursuant to title eleven of article five of this chapter AND
RESIDE IN A SPECIAL NEEDS ASSISTED LIVING RESIDENCE CERTIFIED UNDER
SECTION FORTY-SIX HUNDRED FIFTY-FIVE OF THE PUBLIC HEALTH LAW. The
program shall authorize up to two hundred vouchers to individuals
through an application process and pay for up to seventy-five percent of
the average private pay rate in the respective region. The commissioner
of health may propose rules and regulations to effectuate this
provision.
§ 2. Subdivisions 7 and 8 of section 4656 of the public health law, as
added by chapter 2 of the laws of 2004, are renumbered subdivisions 8
and 9 and a new subdivision 7 is added to read as follows:
7. (A) ALL ASSISTED LIVING RESIDENCES, AS DEFINED IN SUBDIVISION ONE
OF SECTION FORTY-SIX HUNDRED FIFTY-ONE OF THIS ARTICLE, INCLUDING THOSE
LICENSED AND CERTIFIED AS AN ASSISTED LIVING RESIDENCE, SPECIAL NEEDS
ASSISTED LIVING RESIDENCE, OR ENHANCED ASSISTED LIVING RESIDENCE, SHALL:
(I) REPORT ANNUALLY ON QUALITY MEASURES TO BE ESTABLISHED BY THE
DEPARTMENT, IN THE FORM AND FORMAT PRESCRIBED BY THE DEPARTMENT, WITH
THE FIRST REPORT DUE NO LATER THAN JANUARY THIRTY-FIRST, TWO THOUSAND
TWENTY-FIVE; AND
(II) POST THE MONTHLY SERVICE RATE, STAFFING COMPLEMENT, APPROVED
ADMISSION OR RESIDENCY AGREEMENT, AND A CONSUMER-FRIENDLY SUMMARY OF ALL
SERVICE FEES IN A CONSPICUOUS PLACE ON THE FACILITY'S WEBSITE AND IN A
PUBLIC SPACE WITHIN THE FACILITY. SUCH INFORMATION SHALL BE MADE AVAIL-
ABLE TO THE PUBLIC ON FORMS DEVELOPED BY THE DEPARTMENT. BEGINNING ON
JANUARY FIRST, TWO THOUSAND TWENTY-FIVE, THIS INFORMATION SHALL ALSO BE
REPORTED TO THE DEPARTMENT.
(B) THE DEPARTMENT SHALL SCORE THE RESULTS OF THE ASSISTED LIVING
QUALITY REPORTING OBTAINED PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVI-
SION. TOP SCORING FACILITIES SHALL BE GRANTED THE CLASSIFICATION OF
ADVANCED STANDING ON THEIR ANNUAL SURVEILLANCE SCHEDULES.
(I) NOTWITHSTANDING SUBPARAGRAPH ONE OF PARAGRAPH (A) OF SUBDIVISION
TWO OF SECTION FOUR HUNDRED SIXTY-ONE-A OF THE SOCIAL SERVICES LAW,
FACILITIES ACHIEVING AN ADVANCED STANDING CLASSIFICATION SHALL BE
SURVEYED EVERY TWELVE TO EIGHTEEN MONTHS. ALL OTHER FACILITIES SHALL BE
SURVEYED ON AN UNANNOUNCED BASIS NO LESS THAN ANNUALLY; PROVIDED, HOWEV-
ER, THAT THIS SHALL NOT APPLY TO SURVEYS, INSPECTIONS OR INVESTIGATIONS
BASED ON COMPLAINTS RECEIVED BY THE DEPARTMENT UNDER ANY OTHER PROVISION
OF LAW.
(II) FACILITIES MAY REMAIN ON ADVANCED STANDING CLASSIFICATION
PROVIDED THEY MEET THE SCORING REQUIREMENTS IN THE ASSISTED LIVING QUAL-
ITY REPORTING.
(C) EFFECTIVE JANUARY THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE, THE
DEPARTMENT MAY POST ON ITS WEBSITE THE RESULTS OF THE ASSISTED LIVING
QUALITY REPORTING COLLECTED PURSUANT TO SUBPARAGRAPH (I) OF PARAGRAPH
(A) OF THIS SUBDIVISION.
§ 3. Subparagraph 1 of paragraph (a) of subdivision 2 of section 461-a
of the social services law, as amended by chapter 735 of the laws of
1994, is amended and a new subparagraph 1-a is added to read as follows:
(1) Such facilities receiving the department's highest rating shall be
inspected at least once every eighteen months on an unannounced basis.
SUCH RATING DETERMINATION SHALL BE MADE PURSUANT TO AN EVALUATION OF
QUALITY INDICATORS AS DEVELOPED BY THE DEPARTMENT AND PUBLISHED ON THE
DEPARTMENT'S WEBSITE.
S. 8307--A 18 A. 8807--A
(1-A) (I) ADULT CARE FACILITIES DUALLY LICENSED TO PROVIDE ASSISTED
LIVING PURSUANT TO THE REQUIREMENTS SPECIFIED IN SECTION FORTY-SIX
HUNDRED FIFTY-THREE OF THE PUBLIC HEALTH LAW MAY SEEK ACCREDITATION BY
ONE OR MORE NATIONALLY RECOGNIZED ACCREDITING AGENCIES DETERMINED BY THE
COMMISSIONER.
(II) SUCH ACCREDITATION AGENCIES SHALL REPORT DATA AND INFORMATION, IN
A MANNER AND FORM AS DETERMINED BY THE DEPARTMENT, PERTAINING TO THOSE
ASSISTED LIVING RESIDENCES ACCREDITED BY SUCH AGENCIES, THOSE ASSISTED
LIVING RESIDENCES THAT SEEK BUT DO NOT RECEIVE SUCH ACCREDITATION, AND
THOSE ASSISTED LIVING RESIDENCES WHICH OBTAIN BUT LOSE SUCH ACCREDI-
TATION.
(III) NOTWITHSTANDING THE PROVISIONS OF SUBPARAGRAPH ONE OF THIS PARA-
GRAPH, OR ANY OTHER PROVISION OF LAW, ASSISTED LIVING RESIDENCES WHICH
HAVE OBTAINED ACCREDITATION FROM A NATIONALLY RECOGNIZED ACCREDITATION
ORGANIZATION APPROVED BY THE DEPARTMENT AND WHICH MEET ELIGIBILITY
CRITERIA, AS DETERMINED BY THE DEPARTMENT, MAY, AT THE DISCRETION OF THE
COMMISSIONER, BE EXEMPT FROM THE DEPARTMENT INSPECTION REQUIRED IN THIS
SUBDIVISION FOR THE DURATION THEY MAINTAIN THEIR ACCREDITATION IN GOOD
STANDING. THE OPERATOR OF AN ADULT CARE FACILITY THAT OBTAINS BUT SUBSE-
QUENTLY LOSES ACCREDITATION SHALL REPORT SUCH LOSS TO THE DEPARTMENT
WITHIN TEN BUSINESS DAYS IN A MANNER AND FORM DETERMINED BY THE DEPART-
MENT AND WILL NO LONGER BE EXEMPT FROM THE DEPARTMENT INSPECTION
REQUIRED IN THIS SUBDIVISION. THE DEPARTMENT SHALL POST ON ITS WEBSITE A
LIST OF ALL ACCREDITED ASSISTED LIVING RESIDENCES.
§ 4. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024; provided,
however, the provisions of sections two and three of this act shall take
effect on the one hundred twentieth day after it shall have become a
law.
PART G
Section 1. Paragraph (i) of subdivision 1 of section 3614-c of the
public health law is REPEALED.
§ 2. Paragraph (d) of subdivision 1, and subdivisions 2, 4, 5, 5-a, 6,
6-a, 7, 7-a, 9 and 10 of section 3614-c of the public health law, subdi-
visions 2, 4, 5, 6, 7, 9 and 10 as amended and subdivisions 6-a and 7-a
as added by section 1 and subdivision 5-a as added by section 1-a of
part OO of chapter 56 of the laws of 2020, are amended to read as
follows:
(d) "Home care aide" means a home health aide, personal care aide,
home attendant, [personal assistant performing consumer directed
personal assistance services pursuant to section three hundred sixty-
five-f of the social services law,] or other licensed or unlicensed
person whose primary responsibility includes the provision of in-home
assistance with activities of daily living, instrumental activities of
daily living or health-related tasks; provided, however, that home care
aide does not include any individual (i) working on a casual basis, or
(ii) [(except for a person employed under the consumer directed personal
assistance program under section three hundred sixty-five-f of the
social services law)] who is a relative through blood, marriage or
adoption of: (1) the employer; or (2) the person for whom the worker is
delivering services, under a program funded or administered by federal,
state or local government.
2. Notwithstanding any inconsistent provision of law, rule or regu-
lation, no payments by government agencies shall be made to certified
S. 8307--A 19 A. 8807--A
home health agencies, long term home health care programs, managed care
plans, [fiscal intermediaries,] the nursing home transition and diver-
sion waiver program under section three hundred sixty-six of the social
services law, or the traumatic brain injury waiver program under section
twenty-seven hundred forty of this chapter for any episode of care
furnished, in whole or in part, by any home care aide who is compensated
at amounts less than the applicable minimum rate of home care aide total
compensation established pursuant to this section.
4. The terms of this section shall apply equally to services provided
by home care aides who work on episodes of care as direct employees of
certified home health agencies, long term home health care programs, or
managed care plans, or as employees of licensed home care services agen-
cies, limited licensed home care services agencies, [or fiscal interme-
diaries,] or under any other arrangement.
5. No payments by government agencies shall be made to certified home
health agencies, licensed home care services agencies, long term home
health care programs, managed care plans[, fiscal intermediaries] for
any episode of care without the certified home health agency, licensed
home care services agency, long term home health care program, OR
managed care plan [or the fiscal intermediary], having delivered prior
written certification to the commissioner annually, at a time prescribed
by the commissioner, on forms prepared by the department in consultation
with the department of labor, that all services provided under each
episode of care during the period covered by the certification are in
full compliance with the terms of this section and any regulations
promulgated pursuant to this section and that no portion of the dollars
spent or to be spent to satisfy the wage or benefit portion under this
section shall be returned to the certified home health agency, licensed
home care services agency, long term home health care program, OR
managed care plan, [or fiscal intermediary,] related persons or enti-
ties, other than to a home care aide as defined in this section to whom
the wage or benefits are due, as a refund, dividend, profit, or in any
other manner. Such written certification shall also verify that the
certified home health agency, long term home health care program, or
managed care plan has received from the licensed home care services
agency, [fiscal intermediary,] or other third party an annual statement
of wage parity hours and expenses on a form provided by the department
of labor accompanied by an independently-audited financial statement
verifying such expenses.
5-a. No portion of the dollars spent or to be spent to satisfy the
wage or benefit portion under this section shall be returned to the
certified home health agency, licensed home care services agency, long
term home health care program, OR managed care plan, [or fiscal interme-
diary,] related persons or entities, other than to a home care aide as
defined in this section to whom the wage or benefits are due, as a
refund, dividend, profit, or in any other manner.
6. If a certified home health agency, long term home health care
program or managed care plan elects to provide home care aide services
through contracts with licensed home care services agencies, [fiscal
intermediaries,] or through other third parties, provided that the
episode of care on which the home care aide works is covered under the
terms of this section, the certified home health agency, long term home
health care program, or managed care plan shall include in its
contracts, a requirement that it be provided with a written certif-
ication, verified by oath, from the licensed home care services agency,
[fiscal intermediary,] or other third party, on forms prepared by the
S. 8307--A 20 A. 8807--A
department in consultation with the department of labor, which attests
to the licensed home care services agency's, [fiscal intermediary's,] or
other third party's compliance with the terms of this section. Such
contracts shall also obligate the licensed home care services agency,
[fiscal intermediary,] or other third party to provide the certified
home health agency, long term home health care program, or managed care
plan all information from the licensed home care services agency,
[fiscal intermediary] or other third party necessary to verify compli-
ance with the terms of this section, which shall include an annual
compliance statement of wage parity hours and expenses on a form
provided by the department of labor accompanied by an independently-au-
dited financial statement verifying such expenses. Such annual state-
ments shall be available no less than annually for the previous calendar
year, at a time as prescribed by the commissioner. Such certifications,
the information necessary to verify compliance, and the annual compli-
ance statement and financial statements shall be retained by all certi-
fied home health agencies, long term home health care programs, or
managed care plans, and all licensed home care services agencies,
[fiscal intermediaries,] or other third parties for a period of no less
than ten years, and made available to the department upon request. Any
licensed home care services agency, [fiscal intermediary,] or other
third party who shall upon oath verify any statement required to be
transmitted under this section and any regulations promulgated pursuant
to this section which is known by such party to be false shall be guilty
of perjury and punishable as provided by the penal law.
6-a. The certified home health agency, long term home health care
program, or managed care plan shall review and assess the annual compli-
ance statement of wage parity hours and expenses and make a written
referral to the department of labor for any reasonably suspected fail-
ures of licensed home care services agencies, [fiscal intermediaries,]
or third parties to conform to the wage parity requirements of this
section.
7. The commissioner shall distribute to all certified home health
agencies, long term home health care programs, managed care plans, AND
licensed home care services agencies[, and fiscal intermediaries] offi-
cial notice of the minimum rates of home care aide compensation at least
one hundred twenty days prior to the effective date of each minimum rate
for each social services district covered by the terms of this section.
7-a. Any certified home health agency, licensed home care services
agency, long term home health care program, managed care plan, [or
fiscal intermediary,] or other third party that willfully pays less than
such stipulated minimums regarding wages and supplements, as established
in this section, shall be guilty of a misdemeanor and upon conviction
shall be punished, for a first offense by a fine of five hundred dollars
or by imprisonment for not more than thirty days, or by both fine and
imprisonment; for a second offense by a fine of one thousand dollars,
and in addition thereto the contract on which the violation has occurred
shall be forfeited; and no such person or corporation shall be entitled
to receive any sum nor shall any officer, agent or employee of the state
pay the same or authorize its payment from the funds under his or her
charge or control to any person or corporation for work done upon any
contract, on which the certified home health agency, licensed home care
services agency, long term home health care program, managed care plan,
[or fiscal intermediary,] or other third party has been convicted of a
second offense in violation of the provisions of this section.
S. 8307--A 21 A. 8807--A
9. Nothing in this section should be construed as applicable to any
service provided by certified home health agencies, licensed home care
services agencies, long term home health care programs[,] OR managed
care plans[, or fiscal intermediaries] except for all episodes of care
reimbursed in whole or in part by the New York Medicaid program.
10. No certified home health agency, managed care plan, or long term
home health care program shall be liable for recoupment of payments or
any other penalty under this section for services provided through a
licensed home care services agency, [fiscal intermediary,] or other
third party with which the certified home health agency, long term home
health care program, or managed care plan has a contract because the
licensed agency, [fiscal intermediary,] or other third party failed to
comply with the provisions of this section if the certified home health
agency, long term home health care program, or managed care plan has
reasonably and in good faith collected certifications and all informa-
tion required pursuant to this section and conducts the monitoring and
reporting required by this section.
§ 3. Paragraph (a) of subdivision 1 of section 3614-f of the public
health law, as added by section 3 of part NN of chapter 57 of the laws
of 2023, is amended to read as follows:
(a) "Home care aide" [shall have the same meaning as defined in
section thirty-six hundred fourteen-c of this article] means, for the
purpose of this section, a home health aide, personal care aide, home
attendant, personal assistant performing consumer directed personal
assistance services pursuant to section three hundred sixty-five-f of
the social services law, or other licensed or unlicensed person whose
primary responsibility includes the provision of in-home assistance with
activities of daily living, instrumental activities of daily living or
health-related tasks; provided, however, that home care aide does not
include any individual (i)working on a casual basis, or (ii) (except for
a person employed under the consumer directed personal assistance
program under section three hundred sixty-five-f of the social services
law) who is a relative through blood, marriage or adoption of: (1) the
employer; or (2) the person for whom the worker is delivering services,
under a program funded or administered by federal, state or local
government.
§ 4. This act shall take effect October 1, 2024.
PART H
Section 1. Section 602 of the financial services law, as added by
section 26 of part H of chapter 60 of the laws of 2014, is amended to
read as follows:
§ 602. Applicability. [(a)] This article shall not apply to health
care services, including emergency services, where physician fees are
subject to schedules or other monetary limitations under any other law,
including the workers' compensation law and article fifty-one of the
insurance law, and shall not preempt any such law. THIS ARTICLE ALSO
SHALL NOT APPLY TO HEALTH CARE SERVICES, INCLUDING EMERGENCY SERVICES,
SUBJECT TO MEDICAL ASSISTANCE PROGRAM COVERAGE PROVIDED PURSUANT TO
SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW.
§ 2. Subdivision 2 of section 364-j of the social services law is
amended by adding a new paragraph (e) to read as follows:
(E) EFFECTIVE APRIL FIRST, TWO THOUSAND TWENTY-FOUR AND EXPIRING ON
THE DATE THE COMMISSIONER PUBLISHES ON THE DEPARTMENT'S WEBSITE A
REQUEST FOR PROPOSALS IN ACCORDANCE WITH PARAGRAPH (A) OF SUBDIVISION
S. 8307--A 22 A. 8807--A
FIVE OF THIS SECTION, THE COMMISSIONER SHALL PLACE A MORATORIUM ON THE
PROCESSING AND APPROVAL OF APPLICATIONS SEEKING AUTHORITY TO ESTABLISH A
MANAGED CARE PROVIDER, INCLUDING APPLICATIONS SEEKING AUTHORIZATION TO
EXPAND THE SCOPE OF ELIGIBLE ENROLLEE POPULATIONS. SUCH MORATORIUM SHALL
NOT APPLY TO:
(I) APPLICATIONS SUBMITTED TO THE DEPARTMENT PRIOR TO JANUARY FIRST,
TWO THOUSAND TWENTY-FOUR;
(II) APPLICATIONS SEEKING APPROVAL TO TRANSFER OWNERSHIP OR CONTROL OF
AN EXISTING MANAGED CARE PROVIDER;
(III) APPLICATIONS SEEKING AUTHORIZATION TO EXPAND AN EXISTING MANAGED
CARE PROVIDER'S APPROVED SERVICE AREA;
(IV) APPLICATIONS SEEKING AUTHORIZATION TO FORM OR OPERATE A MANAGED
CARE PROVIDER THROUGH AN ENTITY CERTIFIED UNDER SECTION FORTY-FOUR
HUNDRED THREE-C OR FORTY-FOUR HUNDRED THREE-G OF THE PUBLIC HEALTH LAW;
(V) APPLICATIONS DEMONSTRATING TO THE COMMISSIONER'S SATISFACTION THAT
SUBMISSION OF THE APPLICATION FOR CONSIDERATION WOULD BE APPROPRIATE TO
ADDRESS A SERIOUS CONCERN WITH CARE DELIVERY, SUCH AS A LACK OF ADEQUATE
ACCESS TO MANAGED CARE PROVIDERS IN A GEOGRAPHIC AREA OR A LACK OF
ADEQUATE AND APPROPRIATE CARE, LANGUAGE AND CULTURAL COMPETENCE, OR
SPECIAL NEEDS SERVICES.
§ 3. Subdivision 5 of section 364-j of the social services law, as
amended by section 15 of part C of chapter 58 of the laws of 2004, para-
graph (a) as amended by section 40 of part A of chapter 56 of the laws
of 2013, and paragraphs (d), (e) and (f) as amended by section 80 of
part H of chapter 59 of the laws of 2011, is amended to read as follows:
5. Managed care programs shall be conducted in accordance with the
requirements of this section and, to the extent practicable, encourage
the provision of comprehensive medical services, pursuant to this arti-
cle.
(a) NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED
SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND ANY OTHER
INCONSISTENT PROVISION OF LAW, [The] THE [managed care program] COMMIS-
SIONER OF HEALTH shall, THROUGH A COMPETITIVE BID PROCESS BASED ON
PROPOSALS SUBMITTED TO THE DEPARTMENT, provide for the selection of
qualified managed care providers [by the commissioner of health] to
participate in the MANAGED CARE program PURSUANT TO A CONTRACT WITH THE
DEPARTMENT, including [comprehensive HIV special needs plans and]
special needs managed care plans in accordance with the provisions of
section three hundred sixty-five-m of this title; provided, however,
[that] NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED
SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND ANY OTHER
INCONSISTENT PROVISION OF LAW, the commissioner of health may contract
directly with comprehensive HIV special needs plans [consistent with
standards set forth in this section] WITHOUT A COMPETITIVE BID PROCESS,
and assure that such providers are accessible taking into account the
needs of persons with disabilities and the differences between rural,
suburban, and urban settings, and in sufficient numbers to meet the
health care needs of participants, and shall consider the extent to
which major public hospitals are included within such providers'
networks[.]; AND PROVIDED FURTHER THAT:
[(b) A proposal] (I) PROPOSALS submitted by a managed care provider to
participate in the managed care program shall:
[(i)] (A) designate the geographic [area] AREAS, AS DEFINED BY THE
COMMISSIONER IN THE REQUEST FOR PROPOSALS, to be served [by the provid-
S. 8307--A 23 A. 8807--A
er], and estimate the number of eligible participants and actual partic-
ipants in such designated area;
[(ii)] (B) include a network of health care providers in sufficient
numbers and geographically accessible to service program participants;
[(iii)] (C) describe the procedures for marketing in the program
location, including the designation of other entities which may perform
such functions under contract with the organization;
[(iv)] (D) describe the quality assurance, utilization review and case
management mechanisms to be implemented;
[(v)] (E) demonstrate the applicant's ability to meet the data analy-
sis and reporting requirements of the program;
[(vi)] (F) demonstrate financial feasibility of the program; and
[(vii)] (G) include such other information as the commissioner of
health may deem appropriate.
[(c) The commissioner of health shall make a determination whether to
approve, disapprove or recommend modification of the proposal.
(d) Notwithstanding any inconsistent provision of this title and
section one hundred sixty-three of the state finance law, the commis-
sioner of health may contract with managed care providers approved under
paragraph (b) of this subdivision, without a competitive bid or request
for proposal process, to provide coverage for participants pursuant to
this title.
(e) Notwithstanding any inconsistent provision of this title and
section one hundred forty-three of the economic development law, no
notice in the procurement opportunities newsletter shall be required for
contracts awarded by the commissioner of health, to qualified managed
care providers pursuant to this section.
(f)] (II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF
THIS PARAGRAPH, THE COMMISSIONER SHALL ALSO CONSIDER:
(A) ACCESSIBILITY AND GEOGRAPHIC DISTRIBUTION OF NETWORK PROVIDERS,
TAKING INTO ACCOUNT THE NEEDS OF PERSONS WITH DISABILITIES AND THE
DIFFERENCES BETWEEN RURAL, SUBURBAN, AND URBAN SETTINGS;
(B) THE EXTENT TO WHICH MAJOR PUBLIC HOSPITALS ARE INCLUDED IN THE
SUBMITTED PROVIDER NETWORK;
(C) DEMONSTRATED CULTURAL AND LANGUAGE COMPETENCIES SPECIFIC TO THE
POPULATION OF PARTICIPANTS;
(D) THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A CHARITA-
BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
(E) THE ABILITY OF A BIDDER TO OFFER PLANS IN MULTIPLE REGIONS;
(F) THE TYPE AND NUMBER OF PRODUCTS THE BIDDER PROPOSES TO OPERATE,
INCLUDING PRODUCTS BID FOR IN ACCORDANCE WITH THE PROVISIONS OF SUBDIVI-
SION SIX OF SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW,
AND OTHER PRODUCTS DETERMINED BY THE COMMISSIONER, INCLUDING BUT NOT
NECESSARILY LIMITED TO THOSE OPERATED UNDER TITLE ONE-A OF ARTICLE TWEN-
TY-FIVE OF THE PUBLIC HEALTH LAW AND SECTION THREE HUNDRED SIXTY-NINE-GG
OF THIS ARTICLE;
(G) WHETHER THE BIDDER PARTICIPATES IN PRODUCTS FOR INTEGRATED CARE
FOR PARTICIPANTS WHO ARE DUALLY ELIGIBLE FOR MEDICAID AND MEDICARE;
(H) WHETHER THE BIDDER PARTICIPATES IN VALUE BASED PAYMENT ARRANGE-
MENTS AS DEFINED BY THE DEPARTMENT, INCLUDING THE DELEGATION OF SIGNIF-
ICANT FINANCIAL RISK TO CLINICALLY INTEGRATED PROVIDER NETWORKS;
(I) THE BIDDER'S COMMITMENT TO PARTICIPATION IN MANAGED CARE IN THE
STATE;
(J) THE BIDDER'S COMMITMENT TO QUALITY IMPROVEMENT;
(K) THE BIDDER'S COMMITMENT TO COMMUNITY REINVESTMENT SPENDING, AS
SHALL BE DEFINED IN THE PROCUREMENT;
S. 8307--A 24 A. 8807--A
(L) FOR CURRENT OR PREVIOUSLY AUTHORIZED MANAGED CARE PROVIDERS, PAST
PERFORMANCE IN MEETING MANAGED CARE CONTRACT OR FEDERAL OR STATE
REQUIREMENTS, AND IF THE COMMISSIONER ISSUED ANY STATEMENTS OF FINDINGS,
STATEMENTS OF DEFICIENCY, INTERMEDIATE SANCTIONS OR ENFORCEMENT ACTIONS
TO A BIDDER FOR NON-COMPLIANCE WITH SUCH REQUIREMENTS, WHETHER THE
BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER; AND
(M) ANY OTHER CRITERIA DEEMED APPROPRIATE BY THE COMMISSIONER.
(III) SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH DESCRIBING PROPOSAL
CONTENT AND SELECTION CRITERIA REQUIREMENTS SHALL NOT BE CONSTRUED AS
LIMITING OR REQUIRING THE COMMISSIONER TO EVALUATE SUCH CONTENT OR
CRITERIA ON A PASS/FAIL SCALE, OR OTHER METHODOLOGICAL BASIS; PROVIDED
HOWEVER, THAT THE COMMISSIONER MUST CONSIDER ALL SUCH CONTENT AND CRITE-
RIA USING METHODS DETERMINED BY THE COMMISSIONER IN THEIR DISCRETION
AND, AS APPLICABLE, IN CONSULTATION WITH THE COMMISSIONERS OF THE OFFICE
OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES,
THE OFFICE OF ADDICTION SERVICES AND SUPPORTS, AND THE OFFICE OF CHIL-
DREN AND FAMILY SERVICES.
(IV) THE DEPARTMENT SHALL POST ON ITS WEBSITE:
(A) THE REQUEST FOR PROPOSALS AND A DESCRIPTION OF THE PROPOSED
SERVICES TO BE PROVIDED PURSUANT TO CONTRACTS IN ACCORDANCE WITH THIS
SUBDIVISION;
(B) THE CRITERIA ON WHICH THE DEPARTMENT SHALL DETERMINE QUALIFIED
BIDDERS AND EVALUATE THEIR PROPOSALS, INCLUDING ALL CRITERIA IDENTIFIED
IN THIS SUBDIVISION;
(C) THE MANNER BY WHICH A PROPOSAL MAY BE SUBMITTED, WHICH MAY INCLUDE
SUBMISSION BY ELECTRONIC MEANS;
(D) THE MANNER BY WHICH A MANAGED CARE PROVIDER MAY CONTINUE TO
PARTICIPATE IN THE MANAGED CARE PROGRAM PENDING AWARD OF MANAGED CARE
PROVIDERS THROUGH A COMPETITIVE BID PROCESS PURSUANT TO THIS SUBDIVI-
SION; AND
(E) UPON AWARD, THE MANAGED CARE PROVIDERS THAT THE COMMISSIONER
INTENDS TO CONTRACT WITH PURSUANT TO THIS SUBDIVISION, PROVIDED THAT THE
COMMISSIONER SHALL UPDATE SUCH LIST TO INDICATE THE FINAL SLATE OF
CONTRACTED MANAGED CARE PROVIDERS.
(V) AWARDS AND CONTRACTING. (A) ALL RESPONSIBLE AND RESPONSIVE
SUBMISSIONS THAT ARE RECEIVED FROM BIDDERS IN A TIMELY FASHION SHALL BE
REVIEWED BY THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMIS-
SIONERS OF THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH
DEVELOPMENTAL DISABILITIES, THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS, AND THE OFFICE OF CHILDREN AND FAMILY SERVICES, AS APPLICABLE.
THE COMMISSIONER SHALL CONSIDER COMMENTS RESULTING FROM THE REVIEW OF
PROPOSALS AND MAKE AWARDS IN CONSULTATION WITH SUCH AGENCIES.
(B) THE COMMISSIONER MAY MAKE AWARDS UNDER THIS SUBDIVISION FOR EACH
PRODUCT, FOR WHICH PROPOSALS WERE REQUESTED, TO TWO OR MORE MANAGED CARE
PROVIDERS IN EACH GEOGRAPHIC REGION DEFINED BY THE COMMISSIONER IN THE
REQUEST FOR PROPOSALS FOR WHICH AT LEAST TWO MANAGED CARE PROVIDERS HAVE
SUBMITTED A PROPOSAL, AND SHALL HAVE DISCRETION TO OFFER MORE CONTRACTS
BASED ON NEED FOR ACCESS.
(C) MANAGED CARE PROVIDERS AWARDED UNDER THIS SUBDIVISION SHALL BE
ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE OF
PARTICIPATING IN THE MANAGED CARE PROGRAM. SUCH CONTRACTS SHALL RUN FOR
A TERM TO BE DETERMINED BY THE COMMISSIONER, WHICH MAY BE RENEWED OR
MODIFIED FROM TIME TO TIME WITHOUT A NEW REQUEST FOR PROPOSALS, TO
ENSURE CONSISTENCY WITH CHANGES IN FEDERAL AND STATE LAWS, REGULATIONS
AND POLICIES, INCLUDING BUT NOT LIMITED TO THE EXPANSION OR REDUCTION OF
S. 8307--A 25 A. 8807--A
MEDICAL ASSISTANCE SERVICES AVAILABLE TO THE PARTICIPANTS THROUGH A
MANAGED CARE PROVIDER.
(D) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO TERMI-
NATE AWARDED CONTRACTS FOR CAUSE, WHICH SHALL INCLUDE BUT NOT BE LIMITED
TO ANY VIOLATION OF THE TERMS OF SUCH CONTRACTS OR VIOLATIONS OF STATE
OR FEDERAL LAWS AND REGULATIONS AND ANY LOSS OF NECESSARY STATE OR
FEDERAL FUNDING.
(E) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO ISSUE
A NEW REQUEST FOR PROPOSALS FOR A TERM FOLLOWING AN EXISTING TERM OF AN
AWARD.
(B) TRANSITIONING THE MANAGED CARE PROGRAM. (I) WITHIN SIXTY-DAYS OF
THE DEPARTMENT ISSUING THE REQUEST FOR PROPOSALS UNDER PARAGRAPH (A) OF
THIS SUBDIVISION, A MANAGED CARE PROVIDER THAT WAS APPROVED TO PARTIC-
IPATE IN THE MANAGED CARE PROGRAM PRIOR TO THE ISSUANCE OF THE REQUEST
FOR PROPOSALS, SHALL SUBMIT ITS INTENTION TO COMPLETE SUCH PROPOSAL TO
THE DEPARTMENT. (II) A MANAGED CARE PROVIDER THAT: (A) FAILS TO SUBMIT
ITS INTENT TIMELY, (B) INDICATES WITHIN THE SIXTY-DAYS ITS INTENT NOT TO
COMPLETE SUCH A PROPOSAL, (C) FAILS TO SUBMIT A PROPOSAL WITHIN THE
FURTHER TIMEFRAME SPECIFIED BY THE COMMISSIONER IN THE REQUEST FOR
PROPOSALS, OR (D) IS NOT AWARDED THE ABILITY TO PARTICIPATE IN THE
MANAGED CARE PROGRAM UNDER PARAGRAPH (A) OF THIS SUBDIVISION, SHALL,
UPON DIRECTION FROM THE COMMISSIONER, TERMINATE ITS SERVICES AND OPER-
ATIONS IN ACCORDANCE WITH THE CONTRACT BETWEEN THE MANAGED CARE PROVIDER
AND THE DEPARTMENT AND SHALL BE ADDITIONALLY REQUIRED TO MAINTAIN COVER-
AGE OF PARTICIPANTS FOR SUCH PERIOD OF TIME AS DETERMINED NECESSARY BY
THE COMMISSIONER TO ACHIEVE THE SAFE AND ORDERLY TRANSFER OF PARTIC-
IPANTS.
(C) ADDRESSING NEEDS FOR ADDITIONAL MANAGED CARE PROVIDERS TO ENSURE
PARTICIPANT ACCESS AND CHOICE. IF NECESSARY TO ENSURE ACCESS TO A SUFFI-
CIENT NUMBER OF MANAGED CARE PROVIDERS ON A GEOGRAPHIC OR OTHER BASIS,
INCLUDING A LACK OF ADEQUATE AND APPROPRIATE CARE, LANGUAGE AND CULTURAL
COMPETENCE, OR SPECIAL NEEDS SERVICES, THE COMMISSIONER MAY REISSUE A
REQUEST FOR PROPOSALS AS PROVIDED FOR UNDER PARAGRAPH (A) OF THIS SUBDI-
VISION, PROVIDED HOWEVER THAT SUCH REQUEST MAY BE LIMITED TO THE
GEOGRAPHIC OR OTHER BASIS OF NEED THAT THE REQUEST FOR PROPOSALS IS
SEEKING TO ADDRESS. ANY AWARDS MADE SHALL BE SUBJECT TO THE REQUIREMENTS
OF THIS SECTION, INCLUDING BUT NOT LIMITED TO THE MINIMUM AND MAXIMUM
NUMBER OF AWARDS IN A REGION.
(D) The care and services described in subdivision four of this
section will be furnished by a managed care provider pursuant to the
provisions of this section when such services are furnished in accord-
ance with an agreement with the department of health, and meet applica-
ble federal law and regulations.
[(g)] (E) The commissioner of health may delegate some or all of the
tasks identified in this section to the local districts.
[(h)] (F) Any delegation pursuant to paragraph [(g)] (E) of this
subdivision shall be reflected in the contract between a managed care
provider and the commissioner of health.
§ 4. Subdivision 4 of section 365-m of the social services law is
REPEALED and a new subdivision 4 is added to read as follows:
4. THE COMMISSIONER OF HEALTH, JOINTLY WITH THE COMMISSIONERS OF THE
OFFICE OF MENTAL HEALTH AND THE OFFICE OF ADDICTION SERVICES AND
SUPPORTS, SHALL SELECT A LIMITED NUMBER OF SPECIAL NEEDS MANAGED CARE
PLANS UNDER SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE, IN ACCORD-
S. 8307--A 26 A. 8807--A
ANCE WITH SUBDIVISION FIVE OF SUCH SECTION, CAPABLE OF MANAGING THE
BEHAVIORAL AND PHYSICAL HEALTH NEEDS OF MEDICAL ASSISTANCE ENROLLEES
WITH SIGNIFICANT BEHAVIORAL HEALTH NEEDS.
§ 5. The opening paragraph of subdivision 2 of section 4403-f of the
public health law, as amended by section 8 of part C of chapter 58 of
the laws of 2007, is amended to read as follows:
CERTIFICATE OF AUTHORITY; FORM. An eligible applicant shall submit an
application for a certificate of authority to operate a managed long
term care plan upon forms prescribed by the commissioner, INCLUDING ANY
SUCH FORMS OR PROCESSES AS MAY BE REQUIRED OR PRESCRIBED BY THE COMMIS-
SIONER IN ACCORDANCE WITH THE COMPETITIVE BID PROCESS UNDER SUBDIVISION
SIX OF THIS SECTION. Such eligible applicant shall submit information
and documentation to the commissioner which shall include, but not be
limited to:
§ 6. Subdivision 3 of section 4403-f of the public health law, as
amended by section 41-a of part H of chapter 59 of the laws of 2011, is
amended to read as follows:
3. Certificate of authority; approval. (A) The commissioner shall not
approve an application for a certificate of authority unless the appli-
cant demonstrates to the commissioner's satisfaction:
[(a)] (I) that it will have in place acceptable quality-assurance
mechanisms, grievance procedures, mechanisms to protect the rights of
enrollees and case management services to ensure continuity, quality,
appropriateness and coordination of care;
[(b)] (II) that it will include an enrollment process which shall
ensure that enrollment in the plan is informed. The application shall
describe the disenrollment process, which shall provide that an other-
wise eligible enrollee shall not be involuntarily disenrolled on the
basis of health status;
[(c)] (III) satisfactory evidence of the character and competence of
the proposed operators and reasonable assurance that the applicant will
provide high quality services to an enrolled population;
[(d)] (IV) sufficient management systems capacity to meet the require-
ments of this section and the ability to efficiently process payment for
covered services;
[(e)] (V) readiness and capability to maximize reimbursement of and
coordinate services reimbursed pursuant to title XVIII of the federal
social security act and all other applicable benefits, with such benefit
coordination including, but not limited to, measures to support sound
clinical decisions, reduce administrative complexity, coordinate access
to services, maximize benefits available pursuant to such title and
ensure that necessary care is provided;
[(f)] (VI) readiness and capability to arrange and manage covered
services and coordinate non-covered services which could include prima-
ry, specialty, and acute care services reimbursed pursuant to title XIX
of the federal social security act;
[(g)] (VII) willingness and capability of taking, or cooperating in,
all steps necessary to secure and integrate any potential sources of
funding for services provided by the managed long term care plan,
including, but not limited to, funding available under titles XVI,
XVIII, XIX and XX of the federal social security act, the federal older
Americans act of nineteen hundred sixty-five, as amended, or any succes-
sor provisions subject to approval of the director of the state office
for aging, and through financing options such as those authorized pursu-
ant to section three hundred sixty-seven-f of the social services law;
S. 8307--A 27 A. 8807--A
[(h)] (VIII) that the contractual arrangements for providers of health
and long term care services in the benefit package are sufficient to
ensure the availability and accessibility of such services to the
proposed enrolled population consistent with guidelines established by
the commissioner; with respect to individuals in receipt of such
services prior to enrollment, such guidelines shall require the managed
long term care plan to contract with agencies currently providing such
services, in order to promote continuity of care. In addition, such
guidelines shall require managed long term care plans to offer and cover
consumer directed personal assistance services for eligible individuals
who elect such services pursuant to section three hundred sixty-five-f
of the social services law; and
[(i)] (IX) that the applicant is financially responsible and may be
expected to meet its obligations to its enrolled members.
(B) NOTWITHSTANDING PARAGRAPH (A) OF THIS SUBDIVISION, THE APPROVAL OF
ANY APPLICATION FOR CERTIFICATION AS A MANAGED LONG TERM CARE PLAN UNDER
THIS SECTION FOR A PLAN THAT SEEKS TO COVER A POPULATION OF ENROLLEES
ELIGIBLE FOR SERVICES UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY
ACT, SHALL BE SUBJECT TO AND CONDITIONED ON SELECTION THROUGH THE
COMPETITIVE BID PROCESS PROVIDED UNDER SUBDIVISION SIX OF THIS SECTION.
§ 7. Subdivision 6 of section 4403-f of the public health law, as
amended by section 41-b of part H of chapter 59 of the laws of 2011,
paragraph (a) as amended by section 2 of part I of chapter 57 of the
laws of 2023, paragraphs (d), (e), and (f) as added by section 5 of part
MM of chapter 56 of the laws of 2020, and the opening paragraph of
subparagraph (i) of paragraph (d) as amended by section 3 of part I of
chapter 57 of the laws of 2023, is amended to read as follows:
6. Approval authority. [(a)] An applicant shall be issued a certif-
icate of authority as a managed long term care plan upon a determination
by the commissioner that the applicant complies with the operating
requirements for a managed long term care plan under this section;
PROVIDED, HOWEVER, THAT ANY MANAGED LONG TERM CARE PLAN SEEKING TO
PROVIDE HEALTH AND LONG TERM CARE SERVICES TO A POPULATION OF ENROLLEES
THAT ARE ELIGIBLE UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT
SHALL NOT RECEIVE A CERTIFICATE OF AUTHORITY, NOR BE ELIGIBLE FOR A
CONTRACT TO PROVIDE SUCH SERVICES WITH THE DEPARTMENT, UNLESS SELECTED
THROUGH THE COMPETITIVE BID PROCESS DESCRIBED IN THIS SUBDIVISION. [The
commissioner shall issue no more than seventy-five certificates of
authority to managed long term care plans pursuant to this section.
(a-1) Nothing in this section shall be construed as requiring the
department to contract with or to contract for a particular line of
business with an entity certified under this section for the provision
of services available under title eleven of article five of the social
services law. A managed long term care plan that has been issued a
certificate of authority, or an applicant for a certificate of authority
as a managed long term care plan that has in any of the three calendar
years immediately preceding the application, met any of the following
criteria shall not be eligible for a contract for the provision of
services available under title eleven of article five of the social
services law: (i) classified as a poor performer, or substantially simi-
lar terminology, by the centers for medicare and medicaid services; or
(ii) an excessive volume of penalties, statements of findings, state-
ments of deficiency, intermediate sanctions or enforcement actions,
regardless of whether the applicant has addressed such issues in a time-
ly manner.
S. 8307--A 28 A. 8807--A
(b) An operating demonstration shall be issued a certificate of
authority as a managed long term care plan upon a determination by the
commissioner that such demonstration complies with the operating
requirements for a managed long term care plan under this section.
Nothing in this section shall be construed to affect the continued legal
authority of an operating demonstration to operate its previously
approved program.
(c) For the period beginning April first, two thousand twelve and
ending March thirty-first, two thousand fifteen, the majority leader of
the senate and the speaker of the assembly may each recommend to the
commissioner, in writing, up to four eligible applicants to convert to
be approved managed long term care plans. An applicant shall only be
approved and issued a certificate of authority if the commissioner
determines that the applicant meets the requirements of subdivision
three of this section. The majority leader of the senate or the speaker
of the assembly may assign their authority to recommend one or more
applicants under this section to the commissioner]
(A) NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED
SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND
ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW, AND ANY OTHER
INCONSISTENT PROVISION OF LAW, THE COMMISSIONER SHALL, THROUGH A COMPET-
ITIVE BID PROCESS BASED ON PROPOSALS SUBMITTED TO THE DEPARTMENT,
PROVIDE FOR THE SELECTION OF QUALIFIED MANAGED LONG TERM CARE PLANS TO
PROVIDE HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE
UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT PURSUANT TO A
CONTRACT WITH THE DEPARTMENT; PROVIDED, HOWEVER, THAT:
(I) A PROPOSAL SUBMITTED BY A MANAGED LONG TERM CARE PLAN SHALL
INCLUDE INFORMATION SUFFICIENT TO ALLOW THE COMMISSIONER TO EVALUATE THE
BIDDER IN ACCORDANCE WITH THE REQUIREMENTS IDENTIFIED IN SUBDIVISIONS
TWO, THREE AND FOUR OF THIS SECTION.
(II) IN ADDITION TO THE CRITERIA DESCRIBED IN SUBPARAGRAPH (I) OF THIS
PARAGRAPH, THE COMMISSIONER SHALL ALSO CONSIDER:
(A) ACCESSIBILITY AND GEOGRAPHIC DISTRIBUTION OF NETWORK PROVIDERS,
TAKING INTO ACCOUNT THE NEEDS OF PERSONS WITH DISABILITIES AND THE
DIFFERENCES BETWEEN RURAL, SUBURBAN, AND URBAN SETTINGS;
(B) THE EXTENT TO WHICH MAJOR PUBLIC HOSPITALS ARE INCLUDED IN THE
SUBMITTED PROVIDER NETWORK;
(C) DEMONSTRATED CULTURAL AND LANGUAGE COMPETENCIES SPECIFIC TO THE
POPULATION OF PARTICIPANTS;
(D) THE CORPORATE ORGANIZATION AND STATUS OF THE BIDDER AS A CHARITA-
BLE CORPORATION UNDER THE NOT-FOR-PROFIT CORPORATION LAW;
(E) THE ABILITY OF A BIDDER TO OFFER PLANS IN MULTIPLE REGIONS;
(F) THE TYPE AND NUMBER OF PRODUCTS THE BIDDER PROPOSES TO OPERATE,
INCLUDING PRODUCTS APPLIED FOR IN ACCORDANCE WITH THE PROVISIONS OF
SUBDIVISION FIVE OF SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
SERVICES LAW, AND OTHER PRODUCTS DETERMINED BY THE COMMISSIONER, INCLUD-
ING BUT NOT NECESSARILY LIMITED TO THOSE OPERATED UNDER TITLE ONE-A OF
ARTICLE TWENTY-FIVE OF THIS CHAPTER AND SECTION THREE HUNDRED SIXTY-
NINE-GG OF THE SOCIAL SERVICES LAW;
(G) WHETHER THE BIDDER PARTICIPATES IN PRODUCTS FOR INTEGRATED CARE
FOR PARTICIPANTS WHO ARE DUALLY ELIGIBLE FOR MEDICAID AND MEDICARE;
(H) WHETHER THE BIDDER PARTICIPATES IN VALUE BASED PAYMENT ARRANGE-
MENTS AS DEFINED BY THE DEPARTMENT, INCLUDING THE DELEGATION OF SIGNIF-
ICANT FINANCIAL RISK TO CLINICALLY INTEGRATED PROVIDER NETWORKS;
(I) THE BIDDER'S COMMITMENT TO PARTICIPATION IN MANAGED CARE IN THE
STATE;
S. 8307--A 29 A. 8807--A
(J) THE BIDDER'S COMMITMENT TO QUALITY IMPROVEMENT;
(K) THE BIDDER'S COMMITMENT TO COMMUNITY REINVESTMENT SPENDING, AS
SHALL BE DEFINED IN THE PROCUREMENT;
(L) FOR CURRENT OR PREVIOUSLY AUTHORIZED MANAGED CARE PROVIDERS, PAST
PERFORMANCE IN MEETING MANAGED CARE CONTRACT OR FEDERAL OR STATE
REQUIREMENTS, AND IF THE COMMISSIONER ISSUED ANY STATEMENTS OF FINDINGS,
STATEMENTS OF DEFICIENCY, INTERMEDIATE SANCTIONS OR ENFORCEMENT ACTIONS
TO A BIDDER FOR NON-COMPLIANCE WITH SUCH REQUIREMENTS, WHETHER THE
BIDDER ADDRESSED SUCH ISSUES IN A TIMELY MANNER; AND
(M) ANY OTHER CRITERIA DEEMED APPROPRIATE BY THE COMMISSIONER.
(III) SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH DESCRIBING PROPOSAL
CONTENT AND SELECTION CRITERIA REQUIREMENTS SHALL NOT BE CONSTRUED AS
LIMITING OR REQUIRING THE COMMISSIONER TO EVALUATE SUCH CONTENT OR
CRITERIA ON A PASS/FAIL SCALE, OR OTHER PARTICULAR METHODOLOGICAL BASIS;
PROVIDED HOWEVER, THAT THE COMMISSIONER MUST CONSIDER ALL SUCH CONTENT
AND CRITERIA USING METHODS DETERMINED BY THE COMMISSIONER IN THEIR
DISCRETION AND, AS APPLICABLE, IN CONSULTATION WITH THE COMMISSIONERS OF
THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL
DISABILITIES, THE OFFICE OF ADDICTION SERVICES AND SUPPORTS, AND THE
OFFICE OF CHILDREN AND FAMILY SERVICES.
(IV) THE DEPARTMENT SHALL POST ON ITS WEBSITE:
(A) THE REQUEST FOR PROPOSALS AND A DESCRIPTION OF THE PROPOSED
SERVICES TO BE PROVIDED PURSUANT TO CONTRACTS IN ACCORDANCE WITH THIS
SUBDIVISION;
(B) THE CRITERIA ON WHICH THE DEPARTMENT SHALL DETERMINE QUALIFIED
BIDDERS AND EVALUATE THEIR APPLICATIONS, INCLUDING ALL CRITERIA IDENTI-
FIED IN THIS SUBDIVISION;
(C) THE MANNER BY WHICH A PROPOSAL MAY BE SUBMITTED, WHICH MAY INCLUDE
SUBMISSION BY ELECTRONIC MEANS;
(D) THE MANNER BY WHICH A MANAGED LONG TERM CARE PLAN MAY CONTINUE TO
PROVIDE HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE
UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT PENDING AWARDS TO
MANAGED LONG TERM CARE PLANS THROUGH A COMPETITIVE BID PROCESS PURSUANT
TO THIS SUBDIVISION; AND
(E) UPON AWARD, THE MANAGED LONG TERM CARE PLANS THAT THE COMMISSIONER
INTENDS TO CONTRACT WITH PURSUANT TO THIS SUBDIVISION, PROVIDED THAT THE
COMMISSIONER SHALL UPDATE SUCH LIST TO INDICATE THE FINAL SLATE OF
CONTRACTED MANAGED LONG TERM CARE PLANS.
(V) AWARD AND CONTRACTING. (A) ALL RESPONSIBLE AND RESPONSIVE
SUBMISSIONS THAT ARE RECEIVED FROM BIDDERS IN A TIMELY FASHION SHALL BE
REVIEWED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONERS OF
THE OFFICE OF MENTAL HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL
DISABILITIES, THE OFFICE OF ADDICTION SERVICES AND SUPPORTS, AND THE
OFFICE OF CHILDREN AND FAMILY SERVICES, AS APPLICABLE. THE COMMISSIONER
SHALL CONSIDER COMMENTS RESULTING FROM THE REVIEW OF PROPOSALS AND MAKE
AWARDS IN CONSULTATION WITH SUCH AGENCIES.
(B) THE COMMISSIONER MAY MAKE AWARDS UNDER THIS SUBDIVISION, FOR EACH
PRODUCT FOR WHICH PROPOSALS WERE REQUESTED, TO TWO OR MORE MANAGED LONG
TERM CARE PLANS IN EACH GEOGRAPHIC REGION DEFINED BY THE COMMISSIONER IN
THE REQUEST FOR PROPOSALS FOR WHICH AT LEAST TWO MANAGED LONG TERM CARE
PLANS HAVE SUBMITTED A PROPOSAL, AND SHALL HAVE DISCRETION TO OFFER MORE
CONTRACTS BASED ON NEED FOR ACCESS.
(C) MANAGED LONG TERM CARE PLANS AWARDED UNDER THIS SUBDIVISION SHALL
BE ENTITLED TO ENTER INTO A CONTRACT WITH THE DEPARTMENT FOR THE PURPOSE
OF PROVIDING HEALTH AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE
ELIGIBLE UNDER TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT. SUCH
S. 8307--A 30 A. 8807--A
CONTRACTS SHALL RUN FOR A TERM TO BE DETERMINED BY THE COMMISSIONER,
WHICH MAY BE RENEWED OR MODIFIED FROM TIME TO TIME WITHOUT A NEW REQUEST
FOR PROPOSALS, TO ENSURE CONSISTENCY WITH CHANGES IN FEDERAL AND STATE
LAWS, REGULATIONS AND POLICIES, INCLUDING BUT NOT LIMITED TO THE EXPAN-
SION OR REDUCTION OF MEDICAL ASSISTANCE SERVICES AVAILABLE TO THE
PARTICIPANTS THROUGH A MANAGED LONG TERM CARE PLAN.
(D) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO TERMI-
NATE AWARDED CONTRACTS FOR CAUSE, WHICH SHALL INCLUDE BUT NOT BE LIMITED
TO ANY VIOLATION OF THE TERMS OF SUCH CONTRACTS OR VIOLATIONS OF STATE
OR FEDERAL LAWS AND REGULATIONS AND ANY LOSS OF NECESSARY STATE OR
FEDERAL FUNDING.
(E) NOTHING IN THIS PARAGRAPH OR OTHER PROVISION OF THIS SECTION SHALL
BE CONSTRUED TO LIMIT IN ANY WAY THE ABILITY OF THE DEPARTMENT TO ISSUE
A NEW REQUEST FOR PROPOSALS FOR A TERM FOLLOWING AN EXISTING TERM OF AN
AWARD.
(B) TRANSITIONING ENROLLEES WHO ARE ELIGIBLE UNDER TITLE XIX OF THE
FEDERAL SOCIAL SECURITY ACT (I) WITHIN SIXTY-DAYS OF THE DEPARTMENT
ISSUING THE REQUEST FOR PROPOSALS UNDER PARAGRAPH (A) OF THIS SUBDIVI-
SION, A MANAGED LONG TERM CARE PLAN THAT WAS APPROVED TO PROVIDE HEALTH
AND LONG TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE UNDER TITLE
XIX OF THE FEDERAL SOCIAL SECURITY ACT PRIOR TO THE ISSUANCE OF THE
REQUEST FOR PROPOSALS, SHALL SUBMIT ITS INTENTION TO COMPLETE SUCH
PROPOSAL TO THE DEPARTMENT.
(II) A MANAGED LONG TERM CARE PLAN THAT: (A) FAILS TO SUBMIT ITS
INTENT TIMELY; (B) INDICATES WITHIN THE SIXTY-DAYS ITS INTENT NOT TO
COMPLETE SUCH A PROPOSAL, (C) FAILS TO SUBMIT A PROPOSAL WITHIN THE
FURTHER TIMEFRAME SPECIFIED BY THE COMMISSIONER IN THE REQUEST FOR
PROPOSALS, OR (D) IS NOT AWARDED THE ABILITY TO PROVIDE HEALTH AND LONG
TERM CARE SERVICES TO ENROLLEES WHO ARE ELIGIBLE UNDER TITLE XIX OF THE
FEDERAL SOCIAL SECURITY ACT UNDER PARAGRAPH (A) OF THIS SUBDIVISION,
SHALL, UPON DIRECTION FROM THE COMMISSIONER, TERMINATE ITS SERVICES AND
OPERATIONS IN ACCORDANCE WITH THE CONTRACT BETWEEN THE MANAGED LONG TERM
CARE PLAN AND THE DEPARTMENT AND SHALL BE ADDITIONALLY REQUIRED TO MAIN-
TAIN COVERAGE OF ENROLLEES FOR SUCH PERIOD OF TIME AS DETERMINED NECES-
SARY BY THE COMMISSIONER TO ACHIEVE THE SAFE AND ORDERLY TRANSFER OF
ENROLLEES.
(C) ADDRESSING NEEDS FOR ADDITIONAL MANAGED LONG TERM CARE PLANS TO
ENSURE ACCESS AND CHOICE FOR ENROLLEES ELIGIBLE UNDER TITLE XIX OF THE
FEDERAL SOCIAL SECURITY ACT. IF NECESSARY TO ENSURE ACCESS TO A SUFFI-
CIENT NUMBER OF MANAGED LONG TERM CARE PLANS ON A GEOGRAPHIC OR OTHER
BASIS, INCLUDING A LACK OF ADEQUATE AND APPROPRIATE CARE, LANGUAGE AND
CULTURAL COMPETENCE, OR SPECIAL NEEDS SERVICES, THE COMMISSIONER MAY
REISSUE A REQUEST FOR PROPOSALS AS PROVIDED FOR UNDER PARAGRAPH (A) OF
THIS SUBDIVISION, PROVIDED HOWEVER THAT SUCH REQUEST MAY BE LIMITED TO
THE GEOGRAPHIC OR OTHER BASIS OF NEED THAT THE REQUEST FOR PROPOSALS
SEEKS TO ADDRESS. ANY AWARDS MADE SHALL BE SUBJECT TO THE REQUIREMENTS
OF THIS SECTION, INCLUDING BUT NOT LIMITED TO THE MINIMUM AND MAXIMUM
NUMBER OF AWARDS IN A REGION.
(d) (i) Effective April first, two thousand twenty, and expiring
[March thirty-first, two thousand twenty-seven] ON THE DATE THE COMMIS-
SIONER PUBLISHES ON THE DEPARTMENT'S WEBSITE A REQUEST FOR PROPOSALS IN
ACCORDANCE WITH SUBPARAGRAPH (IV) OF PARAGRAPH (A) OF THIS SUBDIVISION,
the commissioner shall place a moratorium on the processing and approval
of applications seeking a certificate of authority as a managed long
term care plan pursuant to this section, including applications seeking
S. 8307--A 31 A. 8807--A
authorization to expand an existing managed long term care plan's
approved service area or scope of eligible enrollee populations. Such
moratorium shall not apply to:
(A) applications submitted to the department prior to January first,
two thousand twenty;
(B) applications seeking approval to transfer ownership or control of
an existing managed long term care plan;
(C) applications demonstrating to the commissioner's satisfaction that
submission of the application for consideration would be appropriate to
address a serious concern with care delivery, such as a lack of adequate
access to managed long term care plans in a geographic area or a lack of
adequate and appropriate care, language and cultural competence, or
special needs services; and
(D) applications seeking to operate under the PACE (Program of All-In-
clusive Care for the Elderly) model as authorized by federal public law
105-33, subtitle I of title IV of the Balanced Budget Act of 1997, or to
serve individuals dually eligible for services and benefits under titles
XVIII and XIX of the federal social security act in conjunction with an
affiliated Medicare Dual Eligible Special Needs Plan, based on the need
for such plans and the experience of applicants in serving dually eligi-
ble individuals as determined by the commissioner in their discretion.
(ii) For the duration of the moratorium, the commissioner shall assess
the public need for managed long term care plans that are not integrated
with an affiliated Medicare plan, the ability of such plans to provide
high quality and cost effective care for their membership, and based on
such assessment develop a process and conduct an orderly wind-down and
elimination of such plans, which shall coincide with the expiration of
the moratorium unless the commissioner determines that a longer wind-
down period is needed.
(e) [For the duration of the moratorium under paragraph (d) of this
subdivision] FROM APRIL FIRST, TWO THOUSAND TWENTY, UNTIL MARCH THIRTY-
FIRST, TWO THOUSAND TWENTY-FOUR, the commissioner shall establish, and
enforce by means of a premium withholding equal to three percent of the
base rate, an annual cap on total enrollment (enrollment cap) for each
managed long term care plan, subject to subparagraphs (ii) and (iii) of
this paragraph, based on a percentage of each plan's reported enrollment
as of October first, two thousand twenty.
(i) The specific percentage of each plan's enrollment cap shall be
established by the commissioner based on: (A) the ability of individuals
eligible for such plans to access health and long term care services,
(B) plan quality of care scores, (C) historical plan disenrollment, (D)
the projected growth of individuals eligible for such plans in different
regions of the state, (E) historical plan enrollment of patients with
varying levels of need and acuity, and (F) other factors in the commis-
sioner's discretion to ensure compliance with federal requirements,
appropriate access to plan services, and choice by eligible individuals.
(ii) In the event that a plan exceeds its annual enrollment cap, the
commissioner is authorized under this paragraph to retain all or a
portion of the premium withheld based on the amount over which a plan
exceeds its enrollment cap. Penalties assessed pursuant to this subdivi-
sion shall be determined by regulation.
(iii) The commissioner may not establish an annual cap on total
enrollment under this paragraph for plans' lines of business operating
under the PACE (Program of All-Inclusive Care for the Elderly) model as
authorized by federal public law 105-33, subtitle I of title IV of the
Balanced Budget Act of 1997, or that serve individuals dually eligible
S. 8307--A 32 A. 8807--A
for services and benefits under titles XVIII and XIX of the federal
social security act in conjunction with an affiliated Medicare Dual
Eligible Special Needs Plan.
[(f) In implementing the provisions of paragraphs (d) and (e) of this
subdivision, the commissioner shall, to the extent practicable, consider
and select methodologies that seek to maximize continuity of care and
minimize disruption to the provider labor workforce, and shall, to the
extent practicable and consistent with the ratios set forth herein,
continue to support contracts between managed long term care plans and
licensed home care services agencies that are based on a commitment to
quality and value.]
§ 8. Section 1 of 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, is amended by adding two new subdivisions 3
and 4 to read as follows:
3. FOR THE STATE FISCAL YEARS BEGINNING APRIL 1, 2024, AND THEREAFTER,
ALL DEPARTMENT OF HEALTH MEDICAID PAYMENTS MADE TO MEDICAID MANAGED CARE
ORGANIZATIONS WILL NO LONGER BE SUBJECT TO THE UNIFORM RATE INCREASE IN
SUBDIVISION ONE OF THIS SECTION.
4. RATE ADJUSTMENTS MADE PURSUANT TO SUBDIVISIONS ONE THROUGH THREE OF
THIS SECTION SHALL NOT BE SUBJECT TO THE NOTIFICATION REQUIREMENTS SET
FORTH IN SUBDIVISION 7 OF SECTION 2807 OF THE PUBLIC HEALTH LAW.
§ 9. Section 364-j of the social services law is amended by adding a
new subdivision 40 to read as follows:
40. (A) THE COMMISSIONER SHALL BE ENTITLED TO RECOVER LIQUIDATED
DAMAGES FROM MANAGED CARE ORGANIZATIONS FOR FAILURE TO MEET THE CONTRAC-
TUAL OBLIGATIONS AND PERFORMANCE STANDARDS OF THEIR CONTRACT.
(B) THE COMMISSIONER SHALL HAVE SOLE DISCRETION IN DETERMINING WHETHER
TO IMPOSE A RECOVERY OF THE FINANCIAL LOSS AND DAMAGES FOR NONCOMPLIANCE
WITH ANY PROVISION OF THE CONTRACT.
(C) (I) LIQUIDATED DAMAGES IMPOSED BY THIS SUBDIVISION AGAINST A
MANAGED CARE ORGANIZATION SHALL BE FROM TWO HUNDRED FIFTY DOLLARS UP TO
TWENTY-FIVE THOUSAND DOLLARS PER VIOLATION DEPENDING ON THE SEVERITY OF
THE NONCOMPLIANCE DETERMINED BY THE COMMISSIONER.
(II) ANY LIQUIDATED DAMAGES FINDINGS AS A RESULT OF THE REVIEW
REQUIRED BY THIS SUBDIVISION SHALL BE DUE AND PAYABLE SIXTY CALENDAR
DAYS FROM THE ISSUANCE OF A STATEMENT OF DAMAGES REGARDLESS OF ANY
DISPUTE IN THE AMOUNT OR INTERPRETATION OF THE AMOUNT DUE CONTAINED IN
THE STATEMENT OF DAMAGES.
(III) THE COMMISSIONER MAY ELECT, IN THEIR SOLE DISCRETION, TO COLLECT
DAMAGES IMPOSED BY THIS SECTION FROM, AND AS A SET OFF AGAINST, PAYMENTS
DUE TO THE MANAGED CARE ORGANIZATION, OR PAYMENTS THAT BECOMES DUE ANY
TIME AFTER THE CALCULATION OF LIQUIDATED DAMAGES. DEDUCTIONS SHALL
CONTINUE UNTIL THE FULL AMOUNT OF THE NOTICED DAMAGES ARE PAID IN FULL.
(IV) ALL LIQUIDATED DAMAGES IMPOSED BY THIS SUBDIVISION SHALL BE PAID
OUT OF THE ADMINISTRATIVE COSTS AND PROFITS OF THE MANAGED CARE ORGAN-
IZATION.
(V) THE MANAGED CARE ORGANIZATION SHALL NOT PASS THE LIQUIDATED
DAMAGES IMPOSED UNDER THIS SUBDIVISION THROUGH TO ANY PROVIDER AND/OR
SUBCONTRACTOR.
(D)(I) MANAGED CARE ORGANIZATION MUST SUBMIT A WRITTEN REQUEST OF ITS
DISPUTE A MANAGED CARE ORGANIZATION MAY DISPUTE THE IMPOSITION OF LIQUI-
DATED DAMAGES IN WRITING, AND IN THE FORM AND MANNER PRESCRIBED BY THE
COMMISSIONER, WITHIN THIRTY CALENDAR DAYS FROM THE DATE OF THE STATE-
MENT OF DAMAGES.
S. 8307--A 33 A. 8807--A
(II) DISPUTES THAT ARE NOT DELIVERED IN THE FORMAT AND TIMEFRAME SPEC-
IFIED BY THE DEPARTMENT SHALL BE DENIED BY THE DEPARTMENT AND DEEMED
WAIVED BY THE MANAGED CARE ORGANIZATION.
(III) A MANAGED CARE ORGANIZATION SHALL WAIVE ANY ARGUMENTS, MATERI-
ALS, DATA, AND INFORMATION NOT CONTAINED IN OR ACCOMPANYING A TIMELY
SUBMITTED WRITTEN DISPUTE, INCLUDING FOR USE IN ANY SUBSEQUENT LEGAL OR
ADMINISTRATIVE PROCEEDING.
(IV) THE COMMISSIONER OR THEIR DESIGNEE SHALL DECIDE THE DISPUTE,
REDUCE THE DECISION TO WRITING AND ISSUE THEIR DECISION TO THE MANAGED
CARE ORGANIZATION WITHIN NINETY CALENDAR DAYS OF RECEIPT OF THE DISPUTE.
THIS WRITTEN DECISION SHALL BE FINAL.
(E) FOR THE PURPOSES OF THIS SUBDIVISION A VIOLATION SHALL MEAN: (I) A
DETERMINATION BY THE COMMISSIONER THAT THE MANAGED CARE ORGANIZATION
FAILED TO ACT AS REQUIRED UNDER THE MODEL CONTRACT OR APPLICABLE FEDERAL
AND STATE STATUTES, RULES OR REGULATIONS GOVERNING MANAGED CARE ORGAN-
IZATION; (II) EACH INSTANCE OF A MANAGED CARE ORGANIZATION FAILING TO
FURNISH NECESSARY AND/OR REQUIRED MEDICAL SERVICES OR ITEMS TO EACH
ENROLLEE SHALL BE A SEPARATE VIOLATION. FOR THE PURPOSES OF THIS SUBDI-
VISION, EACH DAY THAT AN ONGOING VIOLATION CONTINUES SHALL BE A SEPARATE
VIOLATION.
(F) FOR PURPOSES OF THIS SUBDIVISION MANAGED CARE ORGANIZATION SHALL
MEAN ANY MANAGED CARE ORGANIZATIONS SUBJECT TO THIS SECTION AND ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW, INCLUDING MANAGED LONG TERM CARE
PLANS.
(G) NOTHING IN THIS SUBDIVISION SHALL PROHIBIT THE IMPOSITION OF
DAMAGES, PENALTIES OR OTHER RELIEF, OTHERWISE AUTHORIZED BY LAW, INCLUD-
ING BUT NOT LIMITED TO CASES OF FRAUD, WASTE OR ABUSE.
§ 10. This act shall not be construed to prohibit managed care provid-
ers participating in the managed care program and managed long term care
plans approved to provide health and long term care services to enrol-
lees who are eligible under title XIX of the federal social security
act, that were so authorized as of the effective date of this act from
continuing operations as authorized until such time as awards are made
in accordance with this act and such additional time subject to direc-
tion from the commissioner of health to ensure the safe and orderly
transfer of participants.
§ 11. This act shall take effect immediately and shall apply to
disputes filed with the superintendent of financial services pursuant to
article six of the financial services law on or after such effective
date; provided that:
(a) the amendments to section 364-j of the social services law made by
sections two, three and nine of this act shall not affect the repeal of
such section and shall be deemed repealed therewith; and
(b) the amendments to section 4403-f of the public health law made by
sections five, six and seven of this act shall not affect the repeal of
such section and shall be deemed repealed therewith.
PART I
Section 1. Paragraph (a) of subdivision 4 of section 365-a of the
social services law, as amended by chapter 493 of the laws of 2010, is
amended to read as follows:
(a) drugs which may be dispensed without a prescription as required by
section sixty-eight hundred ten of the education law; provided, however,
that the state commissioner of health may by regulation specify certain
of such drugs which may be reimbursed as an item of medical assistance
S. 8307--A 34 A. 8807--A
in accordance with the price schedule established by such commissioner.
Notwithstanding any other provision of law, [additions] MODIFICATIONS to
the list of drugs reimbursable under this paragraph may be filed as
regulations by the commissioner of health without prior notice and
comment;
§ 2. Paragraph (b) of subdivision 3 of section 273 of the public
health law, as added by section 10 of part C of chapter 58 of the laws
of 2005, is amended to read as follows:
(b) In the event that the patient does not meet the criteria in para-
graph (a) of this subdivision, the prescriber may provide additional
information to the program to justify the use of a prescription drug
that is not on the preferred drug list. The program shall provide a
reasonable opportunity for a prescriber to reasonably present his or her
justification of prior authorization. [If, after consultation with the
program, the prescriber, in his or her reasonable professional judgment,
determines that] THE PROGRAM WILL CONSIDER THE ADDITIONAL INFORMATION
AND THE JUSTIFICATION PRESENTED TO DETERMINE WHETHER the use of a
prescription drug that is not on the preferred drug list is warranted,
AND the [prescriber's] PROGRAM'S determination shall be final.
§ 3. Subdivisions 25 and 25-a of section 364-j of the social services
law are REPEALED.
§ 4. Section 280 of the public health law, as amended by section 8 of
part D of chapter 57 of the laws of 2018, paragraph (b) of subdivision 2
as amended by section 5, subdivision 3 as amended by section 6, para-
graph (a) of subdivision 5 as amended by section 7, subparagraph (iii)
of paragraph (e) as amended by section 6-a and subdivision 8 as amended
by section 9 of part B of chapter 57 of the laws of 2019, paragraphs
(c) and (d) of subdivision 2 as amended and paragraph (e) of subdivision
2 as added by section 2 of part FFF of chapter 56 of the laws of 2020,
the opening paragraph of paragraph (a) of subdivision 6 and paragraph
(a) of subdivision 7 as amended by sections 3 and 4, respectively, of
part GG of chapter 56 of the laws of 2020, is amended to read as
follows:
§ 280. Medicaid drug cap. 1. The legislature hereby finds and declares
that there is a significant public interest for the Medicaid program to
manage drug costs in a manner that ensures patient access while provid-
ing financial stability for the state and participating providers.
Since two thousand eleven, the state has taken significant steps to
contain costs in the Medicaid program by imposing a statutory limit on
annual growth. Drug expenditures, however, continually outpace other
cost components causing significant pressure on the state, providers,
and patient access operating under the Medicaid global cap. It is there-
fore intended that the department establish a [Medicaid drug cap as a
separate component within the Medicaid global cap] SUPPLEMENTAL REBATE
PROGRAM as part of a focused and sustained effort to balance the growth
of drug expenditures with the growth of total Medicaid expenditures.
2. The commissioner shall [establish a year to year] REVIEW AT LEAST
ANNUALLY THE department of health state funds Medicaid drug [expenditure
growth target as follows:
(a) for state fiscal year two thousand seventeen--two thousand eigh-
teen, be limited to the ten-year rolling average of the medical compo-
nent of the consumer price index plus five percent and minus a pharmacy
savings target of fifty-five million dollars; and
(b) for state fiscal year two thousand eighteen--two thousand nine-
teen, be limited to the ten-year rolling average of the medical compo-
S. 8307--A 35 A. 8807--A
nent of the consumer price index plus four percent and minus a pharmacy
savings target of eighty-five million dollars;
(c) for state fiscal year two thousand nineteen--two thousand twenty,
be limited to the ten-year rolling average of the medical component of
the consumer price index plus four percent and minus a pharmacy savings
target of eighty-five million dollars;
(d) for state fiscal year two thousand twenty--two thousand twenty-
one, be limited to the ten-year rolling average of the medical component
of the consumer price index plus two percent; and
(e) for state fiscal year two thousand twenty-one--two thousand twen-
ty-two and fiscal years thereafter, be limited in accordance with subdi-
vision one of section ninety-one of part H of chapter fifty-nine of the
laws of two thousand eleven, as amended] EXPENDITURES TO IDENTIFY DRUGS,
INCLUDING BUT NOT LIMITED TO, DRUGS IN THE EIGHTIETH PERCENTILE OR HIGH-
ER OF TOTAL SPEND, NET OF REBATE OR IN THE EIGHTIETH PERCENTILE OR HIGH-
ER BASED ON COST PER CLAIM, NET OF REBATE.
3. (A) The [department and the division of the budget shall assess on
a quarterly basis the projected total amount to be expended in the year
on a cash basis by the Medicaid program for each drug, and the projected
annual amount of state funds Medicaid drug expenditures on a cash basis
for all drugs, which shall be a component of the projected department of
health state funds Medicaid expenditures calculated for purposes of
sections ninety-one and ninety-two of part H of chapter fifty-nine of
the laws of two thousand eleven. For purposes of this section, state
funds Medicaid drug expenditures include amounts expended for drugs in
both the Medicaid fee-for-service program and Medicaid managed care
programs, minus the amount of any drug rebates or supplemental drug
rebates received by the department, including rebates pursuant to subdi-
vision five of this section with respect to rebate targets. The depart-
ment and the division of the budget shall report in December of each
year, for the prior April through October, to the drug utilization
review board the projected state funds Medicaid drug expenditures
including the amounts, in aggregate thereof, attributable to the net
cost of: changes in the utilization of drugs by Medicaid recipients;
changes in the number of Medicaid recipients; changes to the cost of
brand name drugs and changes to the cost of generic drugs. The informa-
tion contained in the report shall not be publicly released in a manner
that allows for the identification of an individual drug or manufacturer
or that is likely to compromise the financial competitive, or proprie-
tary nature of the information.
(a) In the event the director of the budget determines, based on Medi-
caid drug expenditures for the previous quarter or other relevant infor-
mation, that the total department of health state funds Medicaid drug
expenditure is projected to exceed the annual growth limitation imposed
by subdivision two of this section, the] commissioner may identify and
refer drugs, INCLUDING BUT NOT LIMITED TO, DRUGS IN THE EIGHTIETH
PERCENTILE OR HIGHER OF TOTAL SPEND, NET OF REBATE OR IN THE EIGHTIETH
PERCENTILE OR HIGHER BASED ON COST PER CLAIM, NET OF REBATE, to the drug
utilization review board established by section three hundred sixty-
nine-bb of the social services law for a recommendation as to whether a
target supplemental Medicaid rebate should be paid by the manufacturer
of the drug to the department and the target amount of the rebate.
(b) If the department intends to refer a drug to the drug utilization
review board pursuant to paragraph (a) of this subdivision, the depart-
ment shall notify the manufacturer of such drug and shall attempt to
reach agreement with the manufacturer on a rebate for the drug prior to
S. 8307--A 36 A. 8807--A
referring the drug to the drug utilization review board for review.
Such rebate may be based on evidence-based research, including, but not
limited to, such research operated or conducted by or for other state
governments, the federal government, the governments of other nations,
and third party payers or multi-state coalitions, provided however that
the department shall account for the effectiveness of the drug in treat-
ing the conditions for which it is prescribed or in improving a
patient's health, quality of life, or overall health outcomes, and the
likelihood that use of the drug will reduce the need for other medical
care, including hospitalization.
(c) In the event that the commissioner and the manufacturer have
previously agreed to a supplemental rebate for a drug pursuant to para-
graph (b) of this subdivision or paragraph (e) of subdivision seven of
section three hundred sixty-seven-a of the social services law, the drug
shall not be referred to the drug utilization review board for any
further supplemental rebate for the duration of the previous rebate
agreement, provided however, the commissioner may refer a drug to the
drug utilization review board if the commissioner determines there are
significant and substantiated utilization or market changes, new
evidence-based research, or statutory or federal regulatory changes that
warrant additional rebates. In such cases, the department shall notify
the manufacturer and provide evidence of the changes or research that
would warrant additional rebates, and shall attempt to reach agreement
with the manufacturer on a rebate for the drug prior to referring the
drug to the drug utilization review board for review.
(d) The department shall consider a drug's actual cost to the state,
including current rebate amounts, prior to seeking an additional rebate
pursuant to paragraph (b) or (c) of this subdivision.
(e) [The commissioner shall be authorized to take the actions
described in this section only so long as total Medicaid drug expendi-
tures are projected to exceed the annual growth limitation imposed by
subdivision two of this section.] IF THE COMMISSIONER IS UNSUCCESSFUL IN
ENTERING INTO A REBATE ARRANGEMENT WITH THE MANUFACTURER OF THE DRUG
SATISFACTORY TO THE DEPARTMENT, THE DRUG MANUFACTURER SHALL, IN THAT
EVENT BE REQUIRED TO PROVIDE TO THE DEPARTMENT, ON A STANDARD REPORTING
FORM DEVELOPED BY THE DEPARTMENT, THE FOLLOWING INFORMATION:
(I) THE ACTUAL COST OF DEVELOPING, MANUFACTURING, PRODUCING (INCLUDING
THE COST PER DOSE OF PRODUCTION), AND DISTRIBUTING THE DRUG;
(II) RESEARCH AND DEVELOPMENT COSTS OF THE DRUG, INCLUDING PAYMENTS TO
PREDECESSOR ENTITIES CONDUCTING RESEARCH AND DEVELOPMENT, SUCH AS
BIOTECHNOLOGY COMPANIES, UNIVERSITIES AND MEDICAL SCHOOLS, AND PRIVATE
RESEARCH INSTITUTIONS;
(III) ADMINISTRATIVE, MARKETING, AND ADVERTISING COSTS FOR THE DRUG,
APPORTIONED BY MARKETING ACTIVITIES THAT ARE DIRECTED TO CONSUMERS,
MARKETING ACTIVITIES THAT ARE DIRECTED TO PRESCRIBERS, AND THE TOTAL
COST OF ALL MARKETING AND ADVERTISING THAT IS DIRECTED PRIMARILY TO
CONSUMERS AND PRESCRIBERS IN NEW YORK, INCLUDING BUT NOT LIMITED TO
PRESCRIBER DETAILING, COPAYMENT DISCOUNT PROGRAMS, AND DIRECT-TO-CONSUM-
ER MARKETING;
(IV) THE EXTENT OF UTILIZATION OF THE DRUG;
(V) PRICES FOR THE DRUG THAT ARE CHARGED TO PURCHASERS OUTSIDE THE
UNITED STATES;
(VI) PRICES CHARGED TO TYPICAL PURCHASERS IN THE STATE, INCLUDING BUT
NOT LIMITED TO PHARMACIES, PHARMACY CHAINS, PHARMACY WHOLESALERS, OR
OTHER DIRECT PURCHASERS;
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(VII) THE AVERAGE REBATES AND DISCOUNTS PROVIDED PER PAYER TYPE IN THE
STATE; AND
(VIII) THE AVERAGE PROFIT MARGIN OF EACH DRUG OVER THE PRIOR FIVE-YEAR
PERIOD AND THE PROJECTED PROFIT MARGIN ANTICIPATED FOR SUCH DRUG.
(F) ALL INFORMATION DISCLOSED PURSUANT TO PARAGRAPH (E) OF THIS SUBDI-
VISION SHALL BE CONSIDERED CONFIDENTIAL AND SHALL NOT BE DISCLOSED BY
THE DEPARTMENT IN A FORM THAT IDENTIFIES A SPECIFIC MANUFACTURER OR
PRICES CHARGED FOR DRUGS BY SUCH MANUFACTURER.
4. In determining whether to recommend a target supplemental rebate
for a drug, the drug utilization review board shall consider the actual
cost of the drug to the Medicaid program, including federal and state
rebates, and may consider, among other things:
(a) the drug's impact on the Medicaid drug spending growth target and
the adequacy of capitation rates of participating Medicaid managed care
plans, and the drug's affordability and value to the Medicaid program;
or
(b) significant and unjustified increases in the price of the drug; or
(c) whether the drug may be priced disproportionately to its therapeu-
tic benefits.
5. (a) If the drug utilization review board recommends a target rebate
amount on a drug referred by the commissioner, the department shall
negotiate with the drug's manufacturer for a supplemental rebate to be
paid by the manufacturer in an amount not to exceed such target rebate
amount. [A rebate requirement shall apply beginning with the first day
of the state fiscal year during which the rebate was required without
regard to the date the department enters into the rebate agreement with
the manufacturer.]
(b) The supplemental rebate required by paragraph (a) of this subdivi-
sion shall apply to drugs dispensed to enrollees of managed care provid-
ers pursuant to section three hundred sixty-four-j of the social
services law and to drugs dispensed to Medicaid recipients who are not
enrollees of such providers.
(c) [If the drug utilization review board recommends a target rebate
amount for a drug and the department is unable to negotiate a rebate
from the manufacturer in an amount that is at least seventy-five percent
of the target rebate amount, the commissioner is authorized to waive the
provisions of paragraph (b) of subdivision three of section two hundred
seventy-three of this article and the provisions of subdivisions twen-
ty-five and twenty-five-a of section three hundred sixty-four-j of the
social services law with respect to such drug; however, this waiver
shall not be implemented in situations where it would prevent access by
a Medicaid recipient to a drug which is the only treatment for a partic-
ular disease or condition. Under no circumstances shall the commissioner
be authorized to waive such provisions with respect to more than two
drugs in a given time.
(d)] Where the department and a manufacturer enter into a rebate
agreement pursuant to this section, which may be in addition to existing
rebate agreements entered into by the manufacturer with respect to the
same drug, no additional rebates shall be required to be paid by the
manufacturer to a managed care provider or any of a managed care provid-
er's agents, including but not limited to any pharmacy benefit manager,
while the department is collecting the rebate pursuant to this section.
[(e)] (D) In formulating a recommendation concerning a target rebate
amount for a drug, the drug utilization review board may consider:
(i) publicly available information relevant to the pricing of the
drug;
S. 8307--A 38 A. 8807--A
(ii) information supplied by the department relevant to the pricing of
the drug;
(iii) information relating to value-based pricing provided, however,
if the department directly invites any third party to provide cost-ef-
fectiveness analysis or research related to value-based pricing, and the
department receives and considers such analysis or research for use by
the board, such third party shall disclose any funding sources. The
department shall, if reasonably possible, make publicly available the
following documents in its possession that it relies upon to provide
cost effectiveness analyses or research related to value-based pricing:
(A) descriptions of underlying methodologies; (B) assumptions and limi-
tations of research findings; and (C) if available, data that presents
results in a way that reflects different outcomes for affected subpopu-
lations;
(iv) the seriousness and prevalence of the disease or condition that
is treated by the drug;
(v) the extent of utilization of the drug;
(vi) the effectiveness of the drug in treating the conditions for
which it is prescribed, or in improving a patient's health, quality of
life, or overall health outcomes;
(vii) the likelihood that use of the drug will reduce the need for
other medical care, including hospitalization;
(viii) the average wholesale price, wholesale acquisition cost, retail
price of the drug, and the cost of the drug to the Medicaid program
minus rebates received by the state;
(ix) in the case of generic drugs, the number of pharmaceutical
manufacturers that produce the drug;
(x) whether there are pharmaceutical equivalents to the drug; and
(xi) information supplied by the manufacturer, if any, explaining the
relationship between the pricing of the drug and the cost of development
of the drug and/or the therapeutic benefit of the drug, or that is
otherwise pertinent to the manufacturer's pricing decision; any such
information, INCLUDING THE INFORMATION ON THE STANDARD REPORTING FORM
REQUIREMENT IN PARAGRAPH (E) OF SUBDIVISION THREE OF THIS SECTION,
provided shall be considered confidential and shall not be disclosed by
the drug utilization review board in a form that identifies a specific
manufacturer or prices charged for drugs by such manufacturer.
6. [(a) If the drug utilization review board recommends a target
rebate amount or if the commissioner identifies a drug as a high cost
drug pursuant to subparagraph (vii) of paragraph (e) of subdivision 7 of
section three hundred sixty-seven-a of the social services law and the
department is unsuccessful in entering into a rebate arrangement with
the manufacturer of the drug satisfactory to the department, the drug
manufacturer shall in that event be required to provide to the depart-
ment, on a standard reporting form developed by the department, the
following information:
(i) the actual cost of developing, manufacturing, producing (including
the cost per dose of production), and distributing the drug;
(ii) research and development costs of the drug, including payments to
predecessor entities conducting research and development, such as
biotechnology companies, universities and medical schools, and private
research institutions;
(iii) administrative, marketing, and advertising costs for the drug,
apportioned by marketing activities that are directed to consumers,
marketing activities that are directed to prescribers, and the total
cost of all marketing and advertising that is directed primarily to
S. 8307--A 39 A. 8807--A
consumers and prescribers in New York, including but not limited to
prescriber detailing, copayment discount programs, and direct-to-consum-
er marketing;
(iv) the extent of utilization of the drug;
(v) prices for the drug that are charged to purchasers outside the
United States;
(vi) prices charged to typical purchasers in the state, including but
not limited to pharmacies, pharmacy chains, pharmacy wholesalers, or
other direct purchasers;
(vii) the average rebates and discounts provided per payer type in the
State; and
(viii) the average profit margin of each drug over the prior five-year
period and the projected profit margin anticipated for such drug.
(b) All information disclosed pursuant to paragraph (a) of this subdi-
vision shall be considered confidential and shall not be disclosed by
the department in a form that identifies a specific manufacturer or
prices charged for drugs by such manufacturer.
7.] (a) [If, after] AFTER taking into account all rebates and supple-
mental rebates received by the department, including rebates received to
date pursuant to this section[, total Medicaid drug expenditures are
still projected to exceed the annual growth limitation imposed by subdi-
vision two of this section], the commissioner may: subject any drug of a
manufacturer referred to the drug utilization review board under this
section to prior approval in accordance with existing processes and
procedures when such manufacturer has not entered into a supplemental
rebate arrangement as required by this section; direct a managed care
plan to limit or reduce reimbursement for a drug provided by a medical
practitioner if the drug utilization review board recommends a target
rebate amount for such drug and the manufacturer has failed to enter
into a rebate arrangement required by this section; direct managed care
plans to remove from their Medicaid formularies any drugs of a manufac-
turer who has a drug that the drug utilization review board recommends a
target rebate amount for and the manufacturer has failed to enter into a
rebate arrangement required by this section; promote the use of cost
effective and clinically appropriate drugs other than those of a
manufacturer who has a drug that the drug utilization review board
recommends a target rebate amount and the manufacturer has failed to
enter into a rebate arrangement required by this section; allow manufac-
turers to accelerate rebate payments under existing rebate contracts;
and such other actions as authorized by law. [The commissioner shall
provide written notice to the legislature thirty days prior to taking
action pursuant to this paragraph, unless action is necessary in the
fourth quarter of a fiscal year to prevent total Medicaid drug expendi-
tures from exceeding the limitation imposed by subdivision two of this
section, in which case such notice to the legislature may be less than
thirty days.]
(b) The commissioner shall be authorized to take the actions described
in paragraph (a) of this subdivision [only so long as total Medicaid
drug expenditures are projected to exceed the annual growth limitation
imposed by subdivision two of this section]. In addition, no such
actions shall be deemed to supersede the provisions of paragraph (b) of
subdivision three of section two hundred seventy-three of this article
or the provisions of subdivisions twenty-five and twenty-five-a of
section three hundred sixty-four-j of the social services law[, except
as allowed by paragraph (c) of subdivision five of this section];
provided further that nothing in this section shall prevent access by a
S. 8307--A 40 A. 8807--A
Medicaid recipient to a drug which is the only treatment for a partic-
ular disease or condition.
[8.] 7. The commissioner, UPON REQUEST OF THE CHAIR OF THE DRUG UTILI-
ZATION REVIEW BOARD, shall PROVIDE A report [by July first annually to
the drug utilization review board] on savings achieved through the drug
cap in the last fiscal year. Such report shall provide data on what
savings were achieved [through actions pursuant to subdivisions three,
five and seven of this section, respectively, and what savings were
achieved through other means] and how such savings were calculated and
implemented.
§ 5. Paragraph (e) of subdivision 7 of section 367-a of the social
services law, as amended by section 1 of part GG of chapter 56 of the
laws of 2020, the opening paragraph as amended by section 24 of part B
of chapter 57 of the laws of 2023, is amended to read as follows:
(e) During the period from April first, two thousand fifteen through
March thirty-first, two thousand twenty-six, the commissioner may, in
lieu of a managed care provider or pharmacy benefit manager, negotiate
directly and enter into an arrangement with a pharmaceutical manufactur-
er for the provision of supplemental rebates relating to pharmaceutical
utilization by enrollees of managed care providers pursuant to section
three hundred sixty-four-j of this title and may also negotiate directly
and enter into such an agreement relating to pharmaceutical utilization
by medical assistance recipients not so enrolled. Such rebate arrange-
ments shall be limited to the following: antiretrovirals approved by the
FDA for the treatment of HIV/AIDS, ACCELERATED APPROVAL DRUGS ESTAB-
LISHED PURSUANT TO SUBPARAGRAPH (IX) OF THIS PARAGRAPH, opioid depend-
ence agents and opioid antagonists listed in a statewide formulary
established pursuant to subparagraph (vii) of this paragraph, hepatitis
C agents, high cost drugs as provided for in subparagraph (viii) of this
paragraph, gene therapies as provided for in subparagraph (ix) of this
paragraph, and any other class or drug designated by the commissioner
for which the pharmaceutical manufacturer has in effect a rebate
arrangement with the federal secretary of health and human services
pursuant to 42 U.S.C. § 1396r-8, and for which the state has established
standard clinical criteria. No agreement entered into pursuant to this
paragraph shall have an initial term or be extended beyond the expira-
tion or repeal of this paragraph.
(i) The manufacturer shall not enter into any rebate arrangements with
a managed care provider, or any of a managed care provider's agents,
including but not limited to any pharmacy benefit manager on the gene
therapy, drug, or drug classes subject to this paragraph when the state
has a rebate arrangement in place and standard clinical criteria are
imposed on the managed care provider.
(ii) The commissioner shall establish adequate rates of reimbursement
which shall take into account both the impact of the commissioner nego-
tiating such arrangements and any limitations imposed on the managed
care provider's ability to establish clinical criteria relating to the
utilization of such drugs. In developing the managed care provider's
reimbursement rate, the commissioner shall identify the amount of
reimbursement for such drugs as a separate and distinct component from
the reimbursement otherwise made for prescription drugs as prescribed by
this section.
(iii) [The commissioner shall submit a report to the temporary presi-
dent of the senate and the speaker of the assembly annually by December
thirty-first. The report shall analyze the adequacy of rates to managed
S. 8307--A 41 A. 8807--A
care providers for drug expenditures related to the classes under this
paragraph.
(iv)] Nothing in this paragraph shall be construed to require a phar-
maceutical manufacturer to enter into a rebate arrangement satisfactory
to the commissioner relating to pharmaceutical utilization by enrollees
of managed care providers pursuant to section three hundred sixty-four-j
of this title or relating to pharmaceutical utilization by medical
assistance recipients not so enrolled.
[(v)] (IV) All clinical criteria, including requirements for prior
approval, and all utilization review determinations established by the
state as described in this paragraph for the gene therapies, drugs, or
drug classes subject to this paragraph shall be developed using
evidence-based and peer-reviewed clinical review criteria in accordance
with article two-A of the public health law, as applicable.
[(vi)] (V) All prior authorization and utilization review determi-
nations related to the coverage of any drug subject to this paragraph
shall be subject to article forty-nine of the public health law, section
three hundred sixty-four-j of this title, and article forty-nine of the
insurance law, as applicable. Nothing in this paragraph shall diminish
any rights relating to access, prior authorization, or appeal relating
to any drug class or drug afforded to a recipient under any other
provision of law.
[(vii)] (VI) The department shall publish a statewide formulary of
opioid dependence agents and opioid antagonists, which shall include as
"preferred drugs" all drugs in such classes, which shall include all
subclasses of a given drug that have a different pharmacological route
of administration, provided that:
(A) for all drugs that are included as of the date of the enactment of
this subparagraph on a formulary of a managed care provider, as defined
in section three hundred sixty-four-j of this title, or in the Medicaid
fee-for-service preferred drug program pursuant to section two hundred
seventy-two of the public health law, the cost to the department for
such drug is equal to or less than the lowest cost paid for the drug by
any managed care provider or by the Medicaid fee-for-service program
after the application of any rebates, as of the date that the department
implements the statewide formulary established by this subparagraph.
Where there is a generic version of the drug approved by the Food and
Drug Administration as bioequivalent to a brand name drug pursuant to 21
U.S.C. § 355(j)(8)(B), the cost to the department for the brand and
generic versions shall be equal to or less than the lower of the two
maximum costs determined pursuant to the previous sentence; and
(B) for all drugs that are not included as of the date of the enact-
ment of this subparagraph on a formulary of a managed care provider, as
defined in section three hundred sixty-four-j of this title, or in the
Medicaid fee-for-service preferred drug program pursuant to section two
hundred seventy-two of the public health law, the department is able to
obtain the drug at a cost that is equal to or less than the lowest cost
to the department of other comparable drugs in the class, after the
application of any rebates. Where there is a generic version of the drug
approved by the Food and Drug Administration as bioequivalent to a brand
name drug pursuant to 21 U.S.C. § 355(j)(8)(B), the cost to the depart-
ment for the brand and generic versions shall be equal to or less than
the lower of the two maximum costs determined pursuant to the previous
sentence.
[(viii)] (VII) The commissioner may identify and refer high cost
drugs, as defined in clause (D) of this subparagraph, that are not
S. 8307--A 42 A. 8807--A
included as of the date of the enactment of this subparagraph on a
formulary of a managed care provider or covered by the Medicaid fee for
service of program to the drug utilization review board established by
section three hundred sixty-nine-bb of this article for a recommendation
as to whether a target supplemental Medicaid rebate should be paid by
the manufacturer of the drug to the department and the target amount of
the rebate.
(A) If the commissioner intends to refer a high cost drug to the drug
utilization review board pursuant to this subparagraph, the commissioner
shall notify the manufacturer of such drug and shall attempt to reach
agreement with the manufacturer on a rebate arrangement satisfactory to
the commissioner for the drug prior to referring the drug to the drug
utilization review board for review. Such arrangement may be based on
evidence based research, including, but not limited to, such research
operated or conducted by or for other state governments, the federal
government, the governments of other nations, and third party payers or
multi-state coalitions, provided however that the department shall
account for the effectiveness of the drug in treating the conditions for
which it is prescribed or in improving a patient's health, quality of
life, or overall health outcomes, and the likelihood that use of the
drug will reduce the need for other medical care, including hospitaliza-
tion.
(B) In the event that the commissioner and the manufacturer have
previously agreed to a rebate arrangement for a drug pursuant to this
paragraph, the drug shall not be referred to the drug utilization review
board for any further rebate agreement for the duration of the previous
rebate agreement, provided however, the commissioner may refer a drug to
the drug utilization review board if the commissioner determines there
are significant and substantiated utilization or market changes, new
evidence-based research, or statutory or federal regulatory changes that
warrant additional rebates. In such cases, the department shall notify
the manufacturer and provide evidence of the changes or research that
would warrant additional rebates, and shall attempt to reach agreement
with the manufacturer on a rebate for the drug prior to referring the
drug to the drug utilization review board for review.
(C) If the commissioner is unsuccessful in entering into a rebate
arrangement with the manufacturer of the drug satisfactory to the
department, the drug manufacturer shall in that event be required to
provide to the department, on a standard reporting form developed by the
department, the information as described in PARAGRAPH (E) OF subdivision
[six] THREE of section two hundred eighty of the public health law. All
information disclosed pursuant to this clause shall be considered confi-
dential and shall not be disclosed by the department in a form that
identifies a specific manufacturer or prices charged for drugs by such
manufacturer.
(D) For the purposes of this subparagraph, the term "high cost drug"
shall mean a brand name drug or biologic that has a launch wholesale
acquisition cost of thirty thousand dollars or more per year or course
of treatment, or a biosimilar drug that has a launch wholesale acquisi-
tion cost that is not at least fifteen percent lower than the referenced
brand biologic at the time the biosimilar is launched, or a generic drug
that has a wholesale acquisition cost of one hundred dollars or more for
a thirty day supply or recommended dosage approved for labeling by the
federal Food and Drug Administration, or a brand name drug or biologic
that has a wholesale acquisition cost increase of three thousand dollars
S. 8307--A 43 A. 8807--A
or more in any twelve-month period, or course of treatment if less than
twelve months.
[(ix)] (VIII) For purposes of this paragraph, a "gene therapy" is a
drug (A) approved under section 505 of the Federal Food, Drug and
Cosmetics Act or licensed under subsection (a) or (k) of section 351 of
the Public Health Services Act; (B) that treats a rare disease or condi-
tion, as defined in 21 USC § 360bb(a)(2), that is life-threatening, as
defined in 42 CFR 321.18; (C) is considered a gene therapy by the feder-
al Food and Drug Administration for which a biologics license pursuant
to 21 CFR 600-680 is held; (D) if administered in accordance with the
labeling of such drug, is expected to result in either the cure of such
disease or condition or a reduction in the symptoms of such disease or
condition that materially improves the patient's length or quality of
life; and (E) is expected to achieve the result described in clause (D)
of this subparagraph after not more than three administrations.
(IX) FOR PURPOSES OF THIS PARAGRAPH, AN "ACCELERATED APPROVAL" IS A
DRUG OR LABELED INDICATION OF A DRUG AUTHORIZED BY THE FEDERAL FOOD,
DRUG AND COSMETIC ACT FOR DRUGS FOR SERIOUS CONDITIONS THAT FILL AN
UNMET MEDICAL NEED BASED ON WHETHER THE DRUG HAS AN EFFECT ON A SURRO-
GATE CLINICAL ENDPOINT, AND CONTINGENT UPON VERIFICATION OF CLINICAL
BENEFIT IN CONFIRMATORY TRIALS.
§ 6. Paragraph (g) of subdivision 2 of section 365-a of the social
services law, as amended by section 21 of part A of chapter 56 of the
laws of 2013, is amended to read as follows:
(g) sickroom supplies, eyeglasses, prosthetic appliances and dental
prosthetic appliances furnished in accordance with the regulations of
the department; provided further that: (i) the commissioner of health is
authorized to implement a preferred diabetic supply program wherein the
department of health will receive enhanced rebates from preferred
manufacturers [of] FOR PRODUCTS AND SUPPLIES, INCLUDING BUT NOT LIMITED
TO, glucometers and test strips, and may subject non-preferred manufac-
turers' PRODUCTS AND SUPPLIES, INCLUDING BUT NOT LIMITED TO, glucometers
and test strips to prior authorization under section two hundred seven-
ty-three of the public health law; (ii) enteral formula therapy and
nutritional supplements are limited to coverage only for nasogastric,
jejunostomy, or gastrostomy tube feeding, for treatment of an inborn
metabolic disorder, or to address growth and development problems in
children, or, subject to standards established by the commissioner, for
persons with a diagnosis of HIV infection, AIDS or HIV-related illness
or other diseases and conditions; (iii) prescription footwear and
inserts are limited to coverage only when used as an integral part of a
lower limb orthotic appliance, as part of a diabetic treatment plan, or
to address growth and development problems in children; (iv) compression
and support stockings are limited to coverage only for pregnancy or
treatment of venous stasis ulcers; and (v) the commissioner of health is
authorized to implement an incontinence supply utilization management
program to reduce costs without limiting access through the existing
provider network, including but not limited to single or multiple source
contracts or, a preferred incontinence supply program wherein the
department of health will receive enhanced rebates from preferred
manufacturers of incontinence supplies, and may subject non-preferred
manufacturers' incontinence supplies to prior approval pursuant to regu-
lations of the department, provided any necessary approvals under feder-
al law have been obtained to receive federal financial participation in
the costs of incontinence supplies provided pursuant to this subpara-
graph;
S. 8307--A 44 A. 8807--A
§ 7. The public health law is amended by adding a new section 280-d to
read as follows:
§ 280-D. PHARMACY COST REPORTING. 1. THE DEPARTMENT SHALL DEVELOP AND
IMPLEMENT A COST REPORTING PROGRAM FOR LICENSED PHARMACIES THAT PARTIC-
IPATE IN THE MEDICAID PROGRAM. SUCH PROGRAM SHALL INCLUDE A REQUIREMENT
TO SUBMIT AN ANNUAL COST REPORT ON A FORM DESIGNATED BY THE DEPARTMENT.
INFORMATION SHALL INCLUDE, BUT NOT BE LIMITED TO, COSTS INCURRED DURING
PROCUREMENT AND DISPENSING OF PRESCRIPTION DRUGS.
2. SUCH COST REPORTS ARE SUBJECT TO AUDIT. IN THE EVENT THAT ANY
INFORMATION OR DATA WHICH A PHARMACY HAS SUBMITTED TO THE DEPARTMENT, ON
THE REQUIRED REPORTING FORMS IS INACCURATE OR INCORRECT, SUCH PHARMACY
SHALL WITHIN FIFTEEN BUSINESS DAYS, SUBMIT TO THE DEPARTMENT A
CORRECTION OF SUCH INFORMATION OR DATA.
3. TIMELY FILING OF SUCH REPORT IS A REQUIREMENT OF PARTICIPATION IN
THE MEDICAID PHARMACY PROGRAM. IN THE EVENT THAT A PHARMACY FAILS TO
FILE THE REQUIRED REPORTS ON OR BEFORE THE REQUIRED DUE DATE, SUCH PHAR-
MACY MAY BE SUBJECT TO REMOVAL AS A PROVIDER FROM THE FEE-FOR-SERVICE
PHARMACY PROGRAM.
§ 8. Paragraphs (a), (b) and (c) of subdivision 9 of section 367-a of
the social services law, paragraphs (a) and (c) as amended by chapter 19
of the laws of 1998, paragraph (b) as amended by section 3 of part C of
chapter 58 of the laws of 2004, subparagraphs (i) and (ii) of paragraph
(b) as amended by section 7 of part D of chapter 57 of the laws of 2017,
and subparagraph (iii) of paragraph (b) as added by section 29 of part E
of chapter 63 of the laws of 2005, are amended to read as follows:
(a) for drugs provided by medical practitioners and claimed separately
by the practitioners[, the actual cost of the drugs to the practition-
ers; and] THE LOWER OF:
(I) (1) AN AMOUNT EQUAL TO THE NATIONAL AVERAGE DRUG ACQUISITION COST
SET BY THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR THE
DRUG, IF ANY, OR IF SUCH AMOUNT IS NOT AVAILABLE, THE WHOLESALE ACQUISI-
TION COST OF THE DRUG BASED ON THE PACKAGE SIZE DISPENSED FROM, AS
REPORTED BY THE PRESCRIPTION DRUG PRICING SERVICE USED BY THE DEPART-
MENT, (2) THE FEDERAL UPPER LIMIT, IF ANY, ESTABLISHED BY THE FEDERAL
CENTERS FOR MEDICARE AND MEDICAID SERVICES; (3) THE STATE MAXIMUM ACQUI-
SITION COST, IF ANY, ESTABLISHED PURSUANT TO PARAGRAPH (E) OF THIS
SUBDIVISION; OR (4) THE ACTUAL COST OF THE DRUG TO THE PRACTITIONER.
(II) NOTWITHSTANDING SUBPARAGRAPH (I) AND PARAGRAPH (E) OF THIS SUBDI-
VISION, IF A DRUG HAS BEEN PURCHASED FROM A MANUFACTURER BY A COVERED
ENTITY PURSUANT TO SECTION 340B OF THE FEDERAL PUBLIC HEALTH SERVICE ACT
(42 USCA § 256B), THE ACTUAL AMOUNT PAID BY SUCH COVERED ENTITY. FOR
PURPOSES OF THIS SUBPARAGRAPH, A "COVERED ENTITY" IS AN ENTITY THAT
MEETS THE REQUIREMENTS OF PARAGRAPH FOUR OF SUBSECTION (A) OF SUCH
SECTION, THAT ELECTS TO PARTICIPATE IN THE PROGRAM ESTABLISHED BY SUCH
SECTION, AND THAT CAUSES CLAIMS FOR PAYMENT FOR DRUGS COVERED BY THIS
SUBPARAGRAPH TO BE SUBMITTED TO THE MEDICAL ASSISTANCE PROGRAM, EITHER
DIRECTLY OR THROUGH AN AUTHORIZED CONTRACT PHARMACY. NO MEDICAL ASSIST-
ANCE PAYMENTS MAY BE MADE TO A COVERED ENTITY OR TO AN AUTHORIZED
CONTRACT PHARMACY OF A COVERED ENTITY FOR DRUGS THAT ARE ELIGIBLE FOR
PURCHASE UNDER THE SECTION 340B PROGRAM AND ARE DISPENSED ON AN OUTPA-
TIENT BASIS TO PATIENTS OF THE COVERED ENTITY, OTHER THAN UNDER THE
PROVISIONS OF THIS SUBPARAGRAPH.
(b) for drugs dispensed by pharmacies:
(i) (A) if the drug dispensed is a generic prescription drug, the
lower of: (1) an amount equal to the national average drug acquisition
cost set by the federal centers for medicare and medicaid services for
S. 8307--A 45 A. 8807--A
the drug, if any, or if such amount if not available, the wholesale
acquisition cost of the drug based on the package size dispensed from,
as reported by the prescription drug pricing service used by the depart-
ment, less seventeen and one-half percent thereof; (2) the federal upper
limit, if any, established by the federal centers for medicare and medi-
caid services; (3) the state maximum acquisition cost, if any, estab-
lished pursuant to paragraph (e) of this subdivision; or (4) the
dispensing pharmacy's usual and customary price charged to the general
public; (B) if the drug dispensed is available without a prescription as
required by section sixty-eight hundred ten of the education law but is
reimbursed as an item of medical assistance pursuant to paragraph (a) of
subdivision four of section three hundred sixty-five-a of this title,
the lower of (1) an amount equal to the national average drug acquisi-
tion cost set by the federal centers for medicare and medicaid services
for the drug, if any, or if such amount is not available, the wholesale
acquisition cost of the drug based on the package size dispensed from,
as reported by the prescription drug pricing service used by the depart-
ment, (2) the federal upper limit, if any, established by the federal
centers for medicare and medicaid services; (3) the state maximum acqui-
sition cost if any, established pursuant to paragraph (e) of this subdi-
vision; or (4) the dispensing pharmacy's usual and customary price
charged to the general public;
(ii) if the drug dispensed is a brand-name prescription drug, the
lower of:
(A) an amount equal to the national average drug acquisition cost set
by the federal centers for medicare and medicaid services for the drug,
if any, or if such amount is not available, the wholesale acquisition
cost of the drug based on the package size dispensed from, as reported
by the prescription drug pricing service used by the department[, less
three and three-tenths percent thereof]; or (B) the dispensing pharma-
cy's usual and customary price charged to the general public; and
(iii) notwithstanding subparagraphs (i) and (ii) of this paragraph and
paragraphs (d) and (e) of this subdivision, if the drug dispensed is a
drug that has been purchased from a manufacturer by a covered entity
pursuant to section 340B of the federal public health service act (42
USCA § 256b), the actual amount paid by such covered entity pursuant to
such section, plus the reasonable administrative costs, as determined by
the commissioner, incurred by the covered entity or by an authorized
contract pharmacy in connection with the purchase and dispensing of such
drug and the tracking of such transactions. For purposes of this subpar-
agraph, a "covered entity" is an entity that meets the requirements of
paragraph four of subsection (a) of such section, that elects to partic-
ipate in the program established by such section, and that causes claims
for payment for drugs covered by this subparagraph to be submitted to
the medical assistance program, either directly or through an authorized
contract pharmacy. No medical assistance payments may be made to a
covered entity or to an authorized contract pharmacy of a covered entity
for drugs that are eligible for purchase under the section 340B program
and are dispensed on an outpatient basis to patients of the covered
entity, other than under the provisions of this subparagraph. Pharmacies
submitting claims for reimbursement of drugs purchased pursuant to
section 340B of the public health service act shall notify the depart-
ment that the claim is eligible for purchase under the 340B program,
consistent with claiming instructions issued by the department to iden-
tify such claims.
S. 8307--A 46 A. 8807--A
(c) Notwithstanding subparagraph (i) of paragraph (b) of this subdivi-
sion, if a qualified prescriber certifies "brand medically necessary" or
"brand necessary" in his or her own handwriting directly on the face of
a prescription, OR IN THE CASE OF ELECTRONIC PRESCRIPTIONS, INSERTS AN
ELECTRONIC DIRECTION TO CLARIFY "BRAND MEDICALLY NECESSARY" OR "BRAND
NECESSARY", for a multiple source drug for which a specific upper limit
of reimbursement has been established by the federal agency, in addition
to writing "d a w" in the box provided for such purpose on the
prescription form, payment under this title for such drug must be made
under the provisions of subparagraph (ii) of such paragraph.
§ 9. This act shall take effect October 1, 2024; provided that
sections two and three of this act shall take effect January 1, 2025;
and provided however, that the amendments to paragraph (e) of subdivi-
sion 7 of section 367-a of the social services law made by section five
of this act shall not affect the repeal of such paragraph and shall be
deemed repealed therewith provided, further, that the amendments to
subdivision 9 of section 367-a of the social services law made by
section eight of this act shall not affect the expiration of such subdi-
vision pursuant to section 4 of chapter 19 of the laws of 1998, as
amended, and shall expire therewith.
PART J
Section 1. The title heading of title 11-D of article 5 of the social
services law, as amended by section 1 of part H of chapter 57 of the
laws of 2021, is amended to read as follows:
[BASIC HEALTH PROGRAM] ESSENTIAL PLAN
§ 2. Section 3 of part H of chapter 57 of the laws of 2021, amending
the social services law relating to eliminating consumer-paid premium
payments in the basic health program, is amended to read as follows:
§ 3. This act shall take effect June 1, 2021 [and]; PROVIDED, HOWEVER,
SECTION TWO OF THIS ACT shall expire and be deemed repealed should
federal approval be withdrawn or 42 U.S.C. 18051 be repealed; provided
that the commissioner of health shall notify the legislative bill draft-
ing commission upon the withdrawal of federal approval or the repeal of
42 U.S.C. 18051 in order that the commission may maintain an accurate
and timely effective data base of the official text of the laws of the
state of New York in furtherance of effectuating the provisions of
section 44 of the legislative law and section 70-b of the public offi-
cers law.
§ 3. Subdivisions (b) and (c) of section 8 of 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 eligi-
bility from two hundred to two hundred fifty percent, are amended to
read as follows:
(b) section four of this act shall expire and be deemed repealed
December 31, [2024] 2025; provided, however, the amendments to paragraph
(c) of subdivision 1 of section 369-gg of the social services law made
by such section of this act shall be subject to the expiration and
reversion of such paragraph pursuant to section 2 of part H of chapter
57 of the laws of 2021 when upon such date, the provisions of section
five of this act shall take effect; provided, however, the amendments to
such paragraph made by section five of this act shall expire and be
deemed repealed December 31, [2024] 2025;
S. 8307--A 47 A. 8807--A
(c) section six of this act shall take effect January 1, [2025] 2026;
provided, however, the amendments to paragraph (c) of subdivision 1 of
section 369-gg of the social services law made by such section of this
act shall be subject to the expiration and reversion of such paragraph
pursuant to section 2 of part H of chapter 57 of the laws of 2021 when
upon such date, the provisions of section seven of this act shall take
effect; and
§ 4. Paragraph (a) of subdivision 1 of section 268-c of the public
health law, as added by section 2 of part T of chapter 57 of the laws of
2019, is amended to read as follows:
(a) Perform eligibility determinations for federal and state insurance
affordability programs including medical assistance in accordance with
section three hundred sixty-six of the social services law, child health
plus in accordance with section twenty-five hundred eleven of this chap-
ter, the basic health program in accordance with section three hundred
sixty-nine-gg of the social services law, THE 1332 STATE INNOVATION
PROGRAM IN ACCORDANCE WITH SECTION THREE HUNDRED SIXTY-NINE-II OF THE
SOCIAL SERVICES LAW, premium tax credits and cost-sharing reductions and
qualified health plans in accordance with applicable law and other
health insurance programs as determined by the commissioner;
§ 5. Subdivision 16 of section 268-c of the public health law, as
added by section 2 of part T of chapter 57 of the laws of 2019, is
amended to read as follows:
16. In accordance with applicable federal and state law, inform indi-
viduals of eligibility requirements for the Medicaid program under title
XIX of the social security act and the social services law, the chil-
dren's health insurance program (CHIP) under title XXI of the social
security act and this chapter, the basic health program under section
three hundred sixty-nine-gg of the social services law, THE 1332 STATE
INNOVATION PROGRAM IN ACCORDANCE WITH SECTION THREE HUNDRED SIXTY-NINE-
II OF THE SOCIAL SERVICES LAW, or any applicable state or local public
health insurance program and if, through screening of the application by
the Marketplace, the Marketplace determines that such individuals are
eligible for any such program, enroll such individuals in such program.
§ 6. Section 268-c of the public health law is amended by adding a new
subdivision 26 to read as follows:
26. SUBJECT TO FEDERAL APPROVAL IF REQUIRED, THE USE OF STATE FUNDS
AND THE AVAILABILITY OF FUNDS IN THE 1332 STATE INNOVATION PROGRAM FUND
ESTABLISHED PURSUANT TO SECTION NINETY-EIGHT-D OF THE STATE FINANCE LAW,
THE COMMISSIONER SHALL HAVE THE AUTHORITY TO ESTABLISH A PROGRAM TO
PROVIDE SUBSIDIES FOR THE PAYMENT OF PREMIUM OR COST SHARING OR BOTH TO
ASSIST INDIVIDUALS WHO ARE ELIGIBLE TO PURCHASE QUALIFIED HEALTH PLANS
THROUGH THE MARKETPLACE, OR TAKE SUCH OTHER ACTION AS APPROPRIATE TO
REDUCE OR ELIMINATE QUALIFIED HEALTH PLAN PREMIUMS OR COST-SHARING OR
BOTH.
§ 7. Subparagraph (i) of paragraph (a) of subdivision 4 of section
268-e of the public health law, as added by section 2 of part T of chap-
ter 57 of the laws of 2019, is amended to read as follows:
(i) An initial determination of eligibility, including:
(A) eligibility to enroll in a qualified health plan;
(B) eligibility for Medicaid;
(C) eligibility for Child Health Plus;
(D) eligibility for the Basic Health Program;
(E) ELIGIBILITY FOR THE 1332 STATE INNOVATION PROGRAM;
(F) the amount of advance payments of the premium tax credit and level
of cost-sharing reductions;
S. 8307--A 48 A. 8807--A
[(F)] (G) the amount of any other subsidy that may be available under
law; and
[(G)] (H) eligibility for such other health insurance programs as
determined by the commissioner; and
§ 8. Section 268 of the public health law, as added by section 2 of
part T of chapter 57 of the laws of 2019, is amended to read as follows:
The purpose of this title is to codify the establishment of the health
benefit exchange in New York, known as NY State of Health, The Official
Health Plan Marketplace (Marketplace), in conformance with Executive
Order 42 (Cuomo) issued April 12, 2012. The Marketplace shall continue
to perform eligibility determinations for federal and state insurance
affordability programs including medical assistance in accordance with
section three hundred sixty-six of the social services law, child health
plus in accordance with section twenty-five hundred eleven of this chap-
ter, the basic health program in accordance with section three hundred
sixty-nine-gg of the social services law, THE 1332 STATE INNOVATION
PROGRAM IN ACCORDANCE WITH SECTION THREE HUNDRED SIXTY-NINE-II OF THE
SOCIAL SERVICE LAW, and premium tax credits and cost-sharing reductions,
together with performing eligibility determinations for qualified health
plans and such other health insurance programs as determined by the
commissioner. The Marketplace shall also facilitate enrollment in insur-
ance affordability programs, qualified health plans and other health
insurance programs as determined by the commissioner, the purchase and
sale of qualified health plans and/or other or additional health plans
certified by the Marketplace pursuant to this title, and shall continue
to have the authority to operate a small business health options program
("SHOP") to assist eligible small employers in selecting qualified
health plans and/or other or additional health plans certified by the
Marketplace and to determine small employer eligibility for purposes of
small employer tax credits. It is the intent of the legislature, by
codifying the Marketplace in state statute, to continue to promote qual-
ity and affordable health coverage and care, reduce the number of unin-
sured persons, provide a transparent marketplace, educate consumers and
assist individuals with access to coverage, premium assistance tax cred-
its and cost-sharing reductions. In addition, the legislature declares
the intent that the Marketplace continue to be properly integrated with
insurance affordability programs, including Medicaid, child health plus
and the basic health program, THE 1332 STATE INNOVATION PROGRAM, and
such other health insurance programs as determined by the commissioner.
§ 9. Subdivision 8 of section 268-a of the public health law, as added
by section 2 of part T of chapter 57 of the laws of 2019, is amened to
read as follows:
8. "Insurance affordability program" means Medicaid, child health
plus, the basic health program, THE 1332 STATE INNOVATION PROGRAM, post-
partum extended coverage and any other health insurance subsidy program
designated as such by the commissioner.
§ 10. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024; provided,
however, that section six of this act shall only take effect upon the
commissioner of health obtaining and maintaining all necessary approvals
from the secretary of health and human services and the secretary of the
treasury based on an amended application for a waiver for state inno-
vation pursuant to section 1332 of the patient protection and affordable
care act (P.L. 111-148) and subdivision 25 of section 268-c of the
public health law; and provided, further, that the commissioner of
health shall notify the legislative bill drafting commission upon the
S. 8307--A 49 A. 8807--A
occurrence of the enactment of the legislation provided for in section
six of this act in order that the commission may maintain an accurate
and timely effective data base of the official text of the laws of the
state of New York in furtherance of effectuating the provisions of
section 44 of the legislative law and section 70-b of the public offi-
cers law.
PART K
Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
of the laws of 1986, amending the civil practice law and rules and other
laws relating to malpractice and professional medical conduct, as
amended by section 1 of part F of chapter 57 of the laws of 2023, is
amended and a new subdivision 9 is added to read as follows:
(a) The superintendent of financial services and the commissioner of
health or their designee shall, from funds available in the hospital
excess liability pool created pursuant to subdivision 5 of this section,
purchase a policy or policies for excess insurance coverage, as author-
ized by paragraph 1 of subsection (e) of section 5502 of the insurance
law; or from an insurer, other than an insurer described in section 5502
of the insurance law, duly authorized to write such coverage and actual-
ly writing medical malpractice insurance in this state; or shall
purchase equivalent excess coverage in a form previously approved by the
superintendent of financial services for purposes of providing equiv-
alent excess coverage in accordance with section 19 of chapter 294 of
the laws of 1985, for medical or dental malpractice occurrences between
July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
between July 1, 1988 and June 30, 1989, between July 1, 1989 and June
30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991
and June 30, 1992, between July 1, 1992 and June 30, 1993, between July
1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between July
1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, between July 1, 2010 and June
30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012
and June 30, 2013, between July 1, 2013 and June 30, 2014, between July
1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016,
between July 1, 2016 and June 30, 2017, between July 1, 2017 and June
30, 2018, between July 1, 2018 and June 30, 2019, between July 1, 2019
and June 30, 2020, between July 1, 2020 and June 30, 2021, between July
1, 2021 and June 30, 2022, between July 1, 2022 and June 30, 2023, [and]
between July 1, 2023 and June 30, 2024, AND BETWEEN JULY 1, 2024 AND
JUNE 30, 2025 or reimburse the hospital where the hospital purchases
equivalent excess coverage as defined in subparagraph (i) of paragraph
(a) of subdivision 1-a of this section for medical or dental malpractice
occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988
and June 30, 1989, between July 1, 1989 and June 30, 1990, between July
1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,
between July 1, 1992 and June 30, 1993, between July 1, 1993 and June
30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995
S. 8307--A 50 A. 8807--A
and June 30, 1996, between July 1, 1996 and June 30, 1997, between July
1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999,
between July 1, 1999 and June 30, 2000, between July 1, 2000 and June
30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002
and June 30, 2003, between July 1, 2003 and June 30, 2004, between July
1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006,
between July 1, 2006 and June 30, 2007, between July 1, 2007 and June
30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009
and June 30, 2010, between July 1, 2010 and June 30, 2011, between July
1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013,
between July 1, 2013 and June 30, 2014, between July 1, 2014 and June
30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016
and June 30, 2017, between July 1, 2017 and June 30, 2018, between July
1, 2018 and June 30, 2019, between July 1, 2019 and June 30, 2020,
between July 1, 2020 and June 30, 2021, between July 1, 2021 and June
30, 2022, between July 1, 2022 and June 30, 2023, [and] between July 1,
2023 and June 30, 2024, AND BETWEEN JULY 1, 2024 AND JUNE 30, 2025 for
physicians or dentists certified as eligible for each such period or
periods pursuant to subdivision 2 of this section by a general hospital
licensed pursuant to article 28 of the public health law; provided that
no single insurer shall write more than fifty percent of the total
excess premium for a given policy year; and provided, however, that such
eligible physicians or dentists must have in force an individual policy,
from an insurer licensed in this state of primary malpractice insurance
coverage in amounts of no less than one million three hundred thousand
dollars for each claimant and three million nine hundred thousand
dollars for all claimants under that policy during the period of such
excess coverage for such occurrences or be endorsed as additional
insureds under a hospital professional liability policy which is offered
through a voluntary attending physician ("channeling") program previous-
ly permitted by the superintendent of financial services during the
period of such excess coverage for such occurrences. During such period,
such policy for excess coverage or such equivalent excess coverage
shall, when combined with the physician's or dentist's primary malprac-
tice insurance coverage or coverage provided through a voluntary attend-
ing physician ("channeling") program, total an aggregate level of two
million three hundred thousand dollars for each claimant and six million
nine hundred thousand dollars for all claimants from all such policies
with respect to occurrences in each of such years provided, however, if
the cost of primary malpractice insurance coverage in excess of one
million dollars, but below the excess medical malpractice insurance
coverage provided pursuant to this act, exceeds the rate of nine percent
per annum, then the required level of primary malpractice insurance
coverage in excess of one million dollars for each claimant shall be in
an amount of not less than the dollar amount of such coverage available
at nine percent per annum; the required level of such coverage for all
claimants under that policy shall be in an amount not less than three
times the dollar amount of coverage for each claimant; and excess cover-
age, when combined with such primary malpractice insurance coverage,
shall increase the aggregate level for each claimant by one million
dollars and three million dollars for all claimants; and provided
further, that, with respect to policies of primary medical malpractice
coverage that include occurrences between April 1, 2002 and June 30,
2002, such requirement that coverage be in amounts no less than one
million three hundred thousand dollars for each claimant and three
S. 8307--A 51 A. 8807--A
million nine hundred thousand dollars for all claimants for such occur-
rences shall be effective April 1, 2002.
(9) THIS SUBDIVISION SHALL APPLY ONLY TO EXCESS INSURANCE COVERAGE OR
EQUIVALENT EXCESS COVERAGE FOR PHYSICIANS OR DENTISTS THAT IS ELIGIBLE
TO BE PAID FOR FROM FUNDS AVAILABLE IN THE HOSPITAL EXCESS LIABILITY
POOL.
(A) NOTWITHSTANDING ANY LAW TO THE CONTRARY, FOR ANY POLICY PERIOD
BEGINNING ON OR AFTER JULY 1, 2023, EXCESS COVERAGE SHALL BE PURCHASED
BY A PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF EXCESS INSURANCE
COVERAGE OR EQUIVALENT EXCESS COVERAGE. AT THE CONCLUSION OF THE POLICY
PERIOD THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF
HEALTH OR THEIR DESIGNEE SHALL, FROM FUNDS AVAILABLE IN THE HOSPITAL
EXCESS LIABILITY POOL CREATED PURSUANT TO SUBDIVISION 5 OF THIS SECTION,
PAY FIFTY PERCENT OF THE PREMIUM TO THE PROVIDER OF EXCESS INSURANCE
COVERAGE OR EQUIVALENT EXCESS COVERAGE, AND THE REMAINING FIFTY PERCENT
SHALL BE PAID ONE YEAR THEREAFTER.
(B) NOTWITHSTANDING ANY LAW TO THE CONTRARY, FOR ANY POLICY PERIOD
BEGINNING ON OR AFTER JULY 1, 2024, EXCESS COVERAGE SHALL BE PURCHASED
BY A PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF EXCESS INSURANCE
COVERAGE OR EQUIVALENT EXCESS COVERAGE. SUCH PROVIDER OF EXCESS INSUR-
ANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE SHALL BILL, IN A MANNER
CONSISTENT WITH PARAGRAPH (F) OF THIS SUBDIVISION, THE PHYSICIAN OR
DENTIST FOR AN AMOUNT EQUAL TO FIFTY PERCENT OF THE PREMIUM FOR SUCH
COVERAGE, AS ESTABLISHED PURSUANT TO PARAGRAPH (D) OF THIS SUBDIVISION,
DURING THE POLICY PERIOD. AT THE CONCLUSION OF THE POLICY PERIOD THE
SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF HEALTH OR
THEIR DESIGNEE SHALL, FROM FUNDS AVAILABLE IN THE HOSPITAL EXCESS
LIABILITY POOL CREATED PURSUANT TO SUBDIVISION 5 OF THIS SECTION, PAY
HALF OF THE REMAINING FIFTY PERCENT OF THE PREMIUM TO THE PROVIDER OF
EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE, AND THE REMAIN-
ING TWENTY-FIVE PERCENT SHALL BE PAID ONE YEAR THEREAFTER. IF THE FUNDS
AVAILABLE IN THE HOSPITAL EXCESS LIABILITY POOL ARE INSUFFICIENT TO MEET
THE PERCENT OF THE COSTS OF THE EXCESS COVERAGE, THE PROVISIONS OF
SUBDIVISION 8 OF THIS SECTION SHALL APPLY.
(C) IF AT THE CONCLUSION OF THE POLICY PERIOD, A PHYSICIAN OR DENTIST,
ELIGIBLE FOR EXCESS COVERAGE PAID FOR FROM FUNDS AVAILABLE IN THE HOSPI-
TAL EXCESS LIABILITY POOL, HAS FAILED TO PAY AN AMOUNT EQUAL TO FIFTY
PERCENT OF THE PREMIUM AS ESTABLISHED PURSUANT TO PARAGRAPH (D) OF THIS
SUBDIVISION, SUCH EXCESS COVERAGE SHALL BE CANCELLED AND SHALL BE NULL
AND VOID AS OF THE FIRST DAY ON OR AFTER THE COMMENCEMENT OF A POLICY
PERIOD WHERE THE LIABILITY FOR PAYMENT PURSUANT TO THIS SUBDIVISION HAS
NOT BEEN MET. THE PROVIDER OF EXCESS COVERAGE SHALL REMIT ANY PORTION OF
PREMIUM PAID BY THE ELIGIBLE PHYSICIAN OR DENTIST FOR SUCH A POLICY
PERIOD.
(D) THE SUPERINTENDENT OF FINANCIAL SERVICES SHALL ESTABLISH A RATE
CONSISTENT WITH SUBDIVISION 3 OF THIS SECTION THAT PROVIDERS OF EXCESS
INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE WILL CHARGE FOR SUCH
COVERAGE FOR EACH POLICY PERIOD. FOR THE POLICY PERIOD BEGINNING JULY 1,
2024, THE SUPERINTENDENT OF FINANCIAL SERVICES MAY DIRECT THAT THE
PREMIUM FOR THAT POLICY PERIOD BE THE SAME AS IT WAS FOR THE POLICY
PERIOD THAT CONCLUDED JUNE 30, 2023.
(E) NO PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS
COVERAGE SHALL ISSUE EXCESS COVERAGE TO WHICH THIS SUBDIVISION APPLIES
TO ANY PHYSICIAN OR DENTIST UNLESS THAT PHYSICIAN OR DENTIST MEETS THE
ELIGIBILITY REQUIREMENTS FOR SUCH COVERAGE SET FORTH IN THIS SECTION.
THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF HEALTH
S. 8307--A 52 A. 8807--A
OR THEIR DESIGNEE SHALL NOT MAKE ANY PAYMENT UNDER THIS SUBDIVISION TO A
PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE FOR
EXCESS COVERAGE ISSUED TO A PHYSICIAN OR DENTIST WHO DOES NOT MEET THE
ELIGIBILITY REQUIREMENTS FOR PARTICIPATION IN THE HOSPITAL EXCESS
LIABILITY POOL PROGRAM SET FORTH IN THIS SECTION.
(F) A PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIVALENT COVERAGE
THAT ISSUES EXCESS COVERAGE UNDER THIS SUBDIVISION SHALL BILL THE PHYSI-
CIAN OR DENTIST FOR THE PORTION OF THE PREMIUM REQUIRED UNDER PARAGRAPH
(A) OF THIS SUBDIVISION IN TWELVE EQUAL MONTHLY INSTALLMENTS OR IN SUCH
OTHER MANNER AS THE PHYSICIAN OR DENTIST MAY AGREE.
(G) THE SUPERINTENDENT OF FINANCIAL SERVICES IN CONSULTATION WITH THE
COMMISSIONER OF HEALTH MAY PROMULGATE REGULATIONS GIVING EFFECT TO THE
PROVISIONS OF THIS SUBDIVISION.
§ 2. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
amending the civil practice law and rules and other laws relating to
malpractice and professional medical conduct, as amended by section 2 of
part F of chapter 57 of the laws of 2023, is amended to read as follows:
(3)(a) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance for medical or dental malpractice
occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
and June 30, 1989, between July 1, 1989 and June 30, 1990, between July
1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,
between July 1, 1992 and June 30, 1993, between July 1, 1993 and June
30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995
and June 30, 1996, between July 1, 1996 and June 30, 1997, between July
1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999,
between July 1, 1999 and June 30, 2000, between July 1, 2000 and June
30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002
and June 30, 2003, between July 1, 2003 and June 30, 2004, between July
1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006,
between July 1, 2006 and June 30, 2007, between July 1, 2007 and June
30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009
and June 30, 2010, between July 1, 2010 and June 30, 2011, between July
1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013,
between July 1, 2013 and June 30, 2014, between July 1, 2014 and June
30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016
and June 30, 2017, between July 1, 2017 and June 30, 2018, between July
1, 2018 and June 30, 2019, between July 1, 2019 and June 30, 2020,
between July 1, 2020 and June 30, 2021, between July 1, 2021 and June
30, 2022, between July 1, 2022 and June 30, 2023, [and] between July 1,
2023 and June 30, 2024, AND BETWEEN JULY 1, 2024 AND JUNE 30, 2025 allo-
cable to each general hospital for physicians or dentists certified as
eligible for purchase of a policy for excess insurance coverage by such
general hospital in accordance with subdivision 2 of this section, and
may amend such determination and certification as necessary.
(b) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance or equivalent excess coverage for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
S. 8307--A 53 A. 8807--A
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, between July 1, 2015 and June
30, 2016, between July 1, 2016 and June 30, 2017, between July 1, 2017
and June 30, 2018, between July 1, 2018 and June 30, 2019, between July
1, 2019 and June 30, 2020, between July 1, 2020 and June 30, 2021,
between July 1, 2021 and June 30, 2022, between July 1, 2022 and June
30, 2023, [and] between July 1, 2023 and June 30, 2024, AND BETWEEN JULY
1, 2024 AND JUNE 30, 2025 allocable to each general hospital for physi-
cians or dentists certified as eligible for purchase of a policy for
excess insurance coverage or equivalent excess coverage by such general
hospital in accordance with subdivision 2 of this section, and may amend
such determination and certification as necessary. The superintendent of
financial services shall determine and certify to each general hospital
and to the commissioner of health the ratable share of such cost alloca-
ble to the period July 1, 1987 to December 31, 1987, to the period Janu-
ary 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31,
1988, to the period January 1, 1989 to June 30, 1989, to the period July
1, 1989 to December 31, 1989, to the period January 1, 1990 to June 30,
1990, to the period July 1, 1990 to December 31, 1990, to the period
January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December
31, 1991, to the period January 1, 1992 to June 30, 1992, to the period
July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June
30, 1993, to the period July 1, 1993 to December 31, 1993, to the period
January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December
31, 1994, to the period January 1, 1995 to June 30, 1995, to the period
July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June
30, 1996, to the period July 1, 1996 to December 31, 1996, to the period
January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December
31, 1997, to the period January 1, 1998 to June 30, 1998, to the period
July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June
30, 1999, to the period July 1, 1999 to December 31, 1999, to the period
January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December
31, 2000, to the period January 1, 2001 to June 30, 2001, to the period
July 1, 2001 to June 30, 2002, to the period July 1, 2002 to June 30,
2003, to the period July 1, 2003 to June 30, 2004, to the period July 1,
2004 to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to
the period July 1, 2006 and June 30, 2007, to the period July 1, 2007
and June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the
period July 1, 2009 and June 30, 2010, to the period July 1, 2010 and
June 30, 2011, to the period July 1, 2011 and June 30, 2012, to the
period July 1, 2012 and June 30, 2013, to the period July 1, 2013 and
June 30, 2014, to the period July 1, 2014 and June 30, 2015, to the
period July 1, 2015 and June 30, 2016, to the period July 1, 2016 and
June 30, 2017, to the period July 1, 2017 to June 30, 2018, to the peri-
od July 1, 2018 to June 30, 2019, to the period July 1, 2019 to June 30,
2020, to the period July 1, 2020 to June 30, 2021, to the period July 1,
2021 to June 30, 2022, to the period July 1, 2022 to June 30, 2023,
S. 8307--A 54 A. 8807--A
[and] to the period July 1, 2023 to June 30, 2024, AND TO THE PERIOD
JULY 1, 2024 TO JUNE 30, 2025.
§ 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
18 of chapter 266 of the laws of 1986, amending the civil practice law
and rules and other laws relating to malpractice and professional
medical conduct, as amended by section 3 of part F of chapter 57 of the
laws of 2023, are amended to read as follows:
(a) To the extent funds available to the hospital excess liability
pool pursuant to subdivision 5 of this section as amended, and pursuant
to section 6 of part J of chapter 63 of the laws of 2001, as may from
time to time be amended, which amended this subdivision, are insuffi-
cient to meet the costs of excess insurance coverage or equivalent
excess coverage for coverage periods during the period July 1, 1992 to
June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
during the period July 1, 1997 to June 30, 1998, during the period July
1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
2000, during the period July 1, 2000 to June 30, 2001, during the period
July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
during the period July 1, 2006 to June 30, 2007, during the period July
1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
2009, during the period July 1, 2009 to June 30, 2010, during the period
July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
30, 2012, during the period July 1, 2012 to June 30, 2013, during the
period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to
June 30, 2015, during the period July 1, 2015 to June 30, 2016, during
the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
to June 30, 2018, during the period July 1, 2018 to June 30, 2019,
during the period July 1, 2019 to June 30, 2020, during the period July
1, 2020 to June 30, 2021, during the period July 1, 2021 to June 30,
2022, during the period July 1, 2022 to June 30, 2023, [and] during the
period July 1, 2023 to June 30, 2024, AND DURING THE PERIOD JULY 1, 2024
TO JUNE 30, 2025 allocated or reallocated in accordance with paragraph
(a) of subdivision 4-a of this section to rates of payment applicable to
state governmental agencies, each physician or dentist for whom a policy
for excess insurance coverage or equivalent excess coverage is purchased
for such period shall be responsible for payment to the provider of
excess insurance coverage or equivalent excess coverage of an allocable
share of such insufficiency, based on the ratio of the total cost of
such coverage for such physician to the sum of the total cost of such
coverage for all physicians applied to such insufficiency.
(b) Each provider of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, or covering
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
1996, or covering the period July 1, 1996 to June 30, 1997, or covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or covering
the period July 1, 2001 to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
S. 8307--A 55 A. 8807--A
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
covering the period July 1, 2012 to June 30, 2013, or covering the peri-
od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or
covering the period July 1, 2016 to June 30, 2017, or covering the peri-
od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
June 30, 2019, or covering the period July 1, 2019 to June 30, 2020, or
covering the period July 1, 2020 to June 30, 2021, or covering the peri-
od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to
June 30, 2023, or covering the period July 1, 2023 to June 30, 2024, OR
COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 shall notify a covered
physician or dentist by mail, mailed to the address shown on the last
application for excess insurance coverage or equivalent excess coverage,
of the amount due to such provider from such physician or dentist for
such coverage period determined in accordance with paragraph (a) of this
subdivision. Such amount shall be due from such physician or dentist to
such provider of excess insurance coverage or equivalent excess coverage
in a time and manner determined by the superintendent of financial
services.
(c) If a physician or dentist liable for payment of a portion of the
costs of excess insurance coverage or equivalent excess coverage cover-
ing the period July 1, 1992 to June 30, 1993, or covering the period
July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od July 1, 2001 to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
2003, or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
2007, or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
2011, or covering the period July 1, 2011 to June 30, 2012, or covering
the period July 1, 2012 to June 30, 2013, or covering the period July 1,
2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
2015, or covering the period July 1, 2015 to June 30, 2016, or covering
the period July 1, 2016 to June 30, 2017, or covering the period July 1,
2017 to June 30, 2018, or covering the period July 1, 2018 to June 30,
2019, or covering the period July 1, 2019 to June 30, 2020, or covering
the period July 1, 2020 to June 30, 2021, or covering the period July 1,
2021 to June 30, 2022, or covering the period July 1, 2022 to June 30,
2023, or covering the period July 1, 2023 to June 30, 2024, OR COVERING
THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 determined in accordance with
paragraph (a) of this subdivision fails, refuses or neglects to make
payment to the provider of excess insurance coverage or equivalent
excess coverage in such time and manner as determined by the superinten-
dent of financial services pursuant to paragraph (b) of this subdivi-
S. 8307--A 56 A. 8807--A
sion, excess insurance coverage or equivalent excess coverage purchased
for such physician or dentist in accordance with this section for such
coverage period shall be cancelled and shall be null and void as of the
first day on or after the commencement of a policy period where the
liability for payment pursuant to this subdivision has not been met.
(d) Each provider of excess insurance coverage or equivalent excess
coverage shall notify the superintendent of financial services and the
commissioner of health or their designee of each physician and dentist
eligible for purchase of a policy for excess insurance coverage or
equivalent excess coverage covering the period July 1, 1992 to June 30,
1993, or covering the period July 1, 1993 to June 30, 1994, or covering
the period July 1, 1994 to June 30, 1995, or covering the period July 1,
1995 to June 30, 1996, or covering the period July 1, 1996 to June 30,
1997, or covering the period July 1, 1997 to June 30, 1998, or covering
the period July 1, 1998 to June 30, 1999, or covering the period July 1,
1999 to June 30, 2000, or covering the period July 1, 2000 to June 30,
2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
ing the period April 1, 2002 to June 30, 2002, or covering the period
July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to
June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
covering the period July 1, 2005 to June 30, 2006, or covering the peri-
od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
covering the period July 1, 2009 to June 30, 2010, or covering the peri-
od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
covering the period July 1, 2013 to June 30, 2014, or covering the peri-
od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or
covering the period July 1, 2017 to June 30, 2018, or covering the peri-
od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
June 30, 2020, or covering the period July 1, 2020 to June 30, 2021, or
covering the period July 1, 2021 to June 30, 2022, or covering the peri-
od July 1, 2022 to June 30, 2023, or covering the period July 1, 2023 to
June 30, 2024, OR COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 that
has made payment to such provider of excess insurance coverage or equiv-
alent excess coverage in accordance with paragraph (b) of this subdivi-
sion and of each physician and dentist who has failed, refused or
neglected to make such payment.
(e) A provider of excess insurance coverage or equivalent excess
coverage shall refund to the hospital excess liability pool any amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
S. 8307--A 57 A. 8807--A
to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
to the period July 1, 2014 to June 30, 2015, and to the period July 1,
2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017, and
to the period July 1, 2017 to June 30, 2018, and to the period July 1,
2018 to June 30, 2019, and to the period July 1, 2019 to June 30, 2020,
and to the period July 1, 2020 to June 30, 2021, and to the period July
1, 2021 to June 30, 2022, and to the period July 1, 2022 to June 30,
2023, and to the period July 1, 2023 to June 30, 2024, AND TO THE PERIOD
JULY 1, 2024 TO JUNE 30, 2025 received from the hospital excess liabil-
ity pool for purchase of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, and covering
the period July 1, 1993 to June 30, 1994, and covering the period July
1, 1994 to June 30, 1995, and covering the period July 1, 1995 to June
30, 1996, and covering the period July 1, 1996 to June 30, 1997, and
covering the period July 1, 1997 to June 30, 1998, and covering the
period July 1, 1998 to June 30, 1999, and covering the period July 1,
1999 to June 30, 2000, and covering the period July 1, 2000 to June 30,
2001, and covering the period July 1, 2001 to October 29, 2001, and
covering the period April 1, 2002 to June 30, 2002, and covering the
period July 1, 2002 to June 30, 2003, and covering the period July 1,
2003 to June 30, 2004, and covering the period July 1, 2004 to June 30,
2005, and covering the period July 1, 2005 to June 30, 2006, and cover-
ing the period July 1, 2006 to June 30, 2007, and covering the period
July 1, 2007 to June 30, 2008, and covering the period July 1, 2008 to
June 30, 2009, and covering the period July 1, 2009 to June 30, 2010,
and covering the period July 1, 2010 to June 30, 2011, and covering the
period July 1, 2011 to June 30, 2012, and covering the period July 1,
2012 to June 30, 2013, and covering the period July 1, 2013 to June 30,
2014, and covering the period July 1, 2014 to June 30, 2015, and cover-
ing the period July 1, 2015 to June 30, 2016, and covering the period
July 1, 2016 to June 30, 2017, and covering the period July 1, 2017 to
June 30, 2018, and covering the period July 1, 2018 to June 30, 2019,
and covering the period July 1, 2019 to June 30, 2020, and covering the
period July 1, 2020 to June 30, 2021, and covering the period July 1,
2021 to June 30, 2022, and covering the period July 1, 2022 to June 30,
2023 for, and covering the period July 1, 2023 to June 30, 2024, AND
COVERING THE PERIOD JULY 1, 2024 TO JUNE 30, 2025 a physician or dentist
where such excess insurance coverage or equivalent excess coverage is
cancelled in accordance with paragraph (c) of this subdivision.
§ 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
practice law and rules and other laws relating to malpractice and
professional medical conduct, as amended by section 4 of part F of chap-
ter 57 of the laws of 2023, is amended to read as follows:
§ 40. The superintendent of financial services shall establish rates
for policies providing coverage for physicians and surgeons medical
malpractice for the periods commencing July 1, 1985 and ending June 30,
[2024] 2025; provided, however, that notwithstanding any other provision
of law, the superintendent shall not establish or approve any increase
in rates for the period commencing July 1, 2009 and ending June 30,
2010. The superintendent shall direct insurers to establish segregated
accounts for premiums, payments, reserves and investment income attrib-
utable to such premium periods and shall require periodic reports by the
insurers regarding claims and expenses attributable to such periods to
monitor whether such accounts will be sufficient to meet incurred claims
and expenses. On or after July 1, 1989, the superintendent shall impose
a surcharge on premiums to satisfy a projected deficiency that is
S. 8307--A 58 A. 8807--A
attributable to the premium levels established pursuant to this section
for such periods; provided, however, that such annual surcharge shall
not exceed eight percent of the established rate until July 1, [2024]
2025, at which time and thereafter such surcharge shall not exceed twen-
ty-five percent of the approved adequate rate, and that such annual
surcharges shall continue for such period of time as shall be sufficient
to satisfy such deficiency. The superintendent shall not impose such
surcharge during the period commencing July 1, 2009 and ending June 30,
2010. On and after July 1, 1989, the surcharge prescribed by this
section shall be retained by insurers to the extent that they insured
physicians and surgeons during the July 1, 1985 through June 30, [2024]
2025 policy periods; in the event and to the extent physicians and
surgeons were insured by another insurer during such periods, all or a
pro rata share of the surcharge, as the case may be, shall be remitted
to such other insurer in accordance with rules and regulations to be
promulgated by the superintendent. Surcharges collected from physicians
and surgeons who were not insured during such policy periods shall be
apportioned among all insurers in proportion to the premium written by
each insurer during such policy periods; if a physician or surgeon was
insured by an insurer subject to rates established by the superintendent
during such policy periods, and at any time thereafter a hospital,
health maintenance organization, employer or institution is responsible
for responding in damages for liability arising out of such physician's
or surgeon's practice of medicine, such responsible entity shall also
remit to such prior insurer the equivalent amount that would then be
collected as a surcharge if the physician or surgeon had continued to
remain insured by such prior insurer. In the event any insurer that
provided coverage during such policy periods is in liquidation, the
property/casualty insurance security fund shall receive the portion of
surcharges to which the insurer in liquidation would have been entitled.
The surcharges authorized herein shall be deemed to be income earned for
the purposes of section 2303 of the insurance law. The superintendent,
in establishing adequate rates and in determining any projected defi-
ciency pursuant to the requirements of this section and the insurance
law, shall give substantial weight, determined in his discretion and
judgment, to the prospective anticipated effect of any regulations
promulgated and laws enacted and the public benefit of stabilizing
malpractice rates and minimizing rate level fluctuation during the peri-
od of time necessary for the development of more reliable statistical
experience as to the efficacy of such laws and regulations affecting
medical, dental or podiatric malpractice enacted or promulgated in 1985,
1986, by this act and at any other time. Notwithstanding any provision
of the insurance law, rates already established and to be established by
the superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum authorized
annual surcharges to be imposed for a reasonable period of time whether
or not any such annual surcharge has been actually imposed as of the
establishment of such rates.
§ 5. Section 5 and subdivisions (a) and (e) of section 6 of 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, as amended by section 5
of part F of chapter 57 of the laws of 2023, are amended to read as
follows:
§ 5. The superintendent of financial services and the commissioner of
health shall determine, no later than June 15, 2002, June 15, 2003, June
S. 8307--A 59 A. 8807--A
15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15,
2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, June
15, 2018, June 15, 2019, June 15, 2020, June 15, 2021, June 15, 2022,
June 15, 2023, [and] June 15, 2024, AND JUNE 15, 2025 the amount of
funds available in the hospital excess liability pool, created pursuant
to section 18 of chapter 266 of the laws of 1986, and whether such funds
are sufficient for purposes of purchasing excess insurance coverage for
eligible participating physicians and dentists during the period July 1,
2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003
to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to
June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June
30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June 30,
2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 30,
2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30,
2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30,
2018, or July 1, 2018 to June 30, 2019, or July 1, 2019 to June 30,
2020, or July 1, 2020 to June 30, 2021, or July 1, 2021 to June 30,
2022, or July 1, 2022 to June 30, 2023, or July 1, 2023 to June 30,
2024, OR JULY 1, 2024 TO JUNE 30, 2025 as applicable.
(a) This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of financial
services and the commissioner of health, and a certification of such
determination to the state director of the budget, the chair of the
senate committee on finance and the chair of the assembly committee on
ways and means, that the amount of funds in the hospital excess liabil-
ity pool, created pursuant to section 18 of chapter 266 of the laws of
1986, is insufficient for purposes of purchasing excess insurance cover-
age for eligible participating physicians and dentists during the period
July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30,
2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30,
2018, or July 1, 2018 to June 30, 2019, or July 1, 2019 to June 30,
2020, or July 1, 2020 to June 30, 2021, or July 1, 2021 to June 30,
2022, or July 1, 2022 to June 30, 2023, or July 1, 2023 to June 30, 2024
, OR JULY 1, 2024 TO JUNE 30, 2025 as applicable.
(e) The commissioner of health shall transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by the superintendent
of financial services for the purchase of excess liability insurance
coverage for eligible participating physicians and dentists for the
policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, as applicable, and the cost of administering the hospital excess
liability pool for such applicable policy year, pursuant to the program
established in chapter 266 of the laws of 1986, as amended, no later
than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15,
S. 8307--A 60 A. 8807--A
2015, June 15, 2016, June 15, 2017, June 15, 2018, June 15, 2019, June
15, 2020, June 15, 2021, June 15, 2022, June 15, 2023, [and] June 15,
2024, AND JUNE 15, 2025 as applicable.
§ 6. Section 20 of 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 thereto, as amended by section 6 of part F
of chapter 57 of the laws of 2023, is amended to read as follows:
§ 20. Notwithstanding any law, rule or regulation to the contrary,
only physicians or dentists who were eligible, and for whom the super-
intendent of financial services and the commissioner of health, or their
designee, purchased, with funds available in the hospital excess liabil-
ity pool, a full or partial policy for excess coverage or equivalent
excess coverage for the coverage period ending the thirtieth of June,
two thousand [twenty-three] TWENTY-FOUR, shall be eligible to apply for
such coverage for the coverage period beginning the first of July, two
thousand [twenty-three] TWENTY-FOUR; provided, however, if the total
number of physicians or dentists for whom such excess coverage or equiv-
alent excess coverage was purchased for the policy year ending the thir-
tieth of June, two thousand [twenty-three] TWENTY-FOUR exceeds the total
number of physicians or dentists certified as eligible for the coverage
period beginning the first of July, two thousand [twenty-three] TWENTY-
FOUR, then the general hospitals may certify additional eligible physi-
cians or dentists in a number equal to such general hospital's propor-
tional share of the total number of physicians or dentists for whom
excess coverage or equivalent excess coverage was purchased with funds
available in the hospital excess liability pool as of the thirtieth of
June, two thousand [twenty-three] TWENTY-FOUR, as applied to the differ-
ence between the number of eligible physicians or dentists for whom a
policy for excess coverage or equivalent excess coverage was purchased
for the coverage period ending the thirtieth of June, two thousand
[twenty-three] TWENTY-FOUR and the number of such eligible physicians or
dentists who have applied for excess coverage or equivalent excess
coverage for the coverage period beginning the first of July, two thou-
sand [twenty-three] TWENTY-FOUR.
§ 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART L
Section 1. Subdivision 9 of section 2803 of the public health law is
REPEALED.
§ 2. Section 461-s of the social services law is REPEALED.
§ 3. Subdivision 1, paragraph (f) of subdivision 3, paragraphs (a) and
(d) of subdivision 5 and subdivisions 5-a and 12 of section 2807-m of
the public health law, subdivision 1, paragraph (f) of subdivision 3,
paragraph (a) of subdivision 5 and subdivision 12 as amended and para-
graph (d) of subdivision 5 as added by section 6 of part Y of chapter 56
of the laws of 2020 and subdivision 5-a as amended by section 6 of part
C of chapter 57 of the laws of 2023, are amended to read as follows:
1. Definitions. For purposes of this section, the following defi-
nitions shall apply, unless the context clearly requires otherwise:
(a) ["Clinical research" means patient-oriented research, epidemiolog-
ic and behavioral studies, or outcomes research and health services
research that is approved by an institutional review board by the time
the clinical research position is filled.
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(b) "Clinical research plan" means a plan submitted by a consortium or
teaching general hospital for a clinical research position which demon-
strates, in a form to be provided by the commissioner, the following:
(i) financial support for overhead, supervision, equipment and other
resources equal to the amount of funding provided pursuant to subpara-
graph (i) of paragraph (b) of subdivision five-a of this section by the
teaching general hospital or consortium for the clinical research posi-
tion;
(ii) experience the sponsor-mentor and teaching general hospital has
in clinical research and the medical field of the study;
(iii) methods, data collection and anticipated measurable outcomes of
the clinical research to be performed;
(iv) training goals, objectives and experience the researcher will be
provided to assess a future career in clinical research;
(v) scientific relevance, merit and health implications of the
research to be performed;
(vi) information on potential scientific meetings and peer review
journals where research results can be disseminated;
(vii) clear and comprehensive details on the clinical research posi-
tion;
(viii) qualifications necessary for the clinical research position and
strategy for recruitment;
(ix) non-duplication with other clinical research positions from the
same teaching general hospital or consortium;
(x) methods to track the career of the clinical researcher once the
term of the position is complete; and
(xi) any other information required by the commissioner to implement
subparagraph (i) of paragraph (b) of subdivision five-a of this section.
(xii) The clinical review plan submitted in accordance with this para-
graph may be reviewed by the commissioner in consultation with experts
outside the department of health.
(c) "Clinical research position" means a post-graduate residency posi-
tion which:
(i) shall not be required in order for the researcher to complete a
graduate medical education program;
(ii) may be reimbursed by other sources but only for costs in excess
of the funding distributed in accordance with subparagraph (i) of para-
graph (b) of subdivision five-a of this section;
(iii) shall exceed the minimum standards that are required by the
residency review committee in the specialty the researcher has trained
or is currently training;
(iv) shall not be previously funded by the teaching general hospital
or supported by another funding source at the teaching general hospital
in the past three years from the date the clinical research plan is
submitted to the commissioner;
(v) may supplement an existing research project;
(vi) shall be equivalent to a full-time position comprising of no less
than thirty-five hours per week for one or two years;
(vii) shall provide, or be filled by a researcher who has formalized
instruction in clinical research, including biostatistics, clinical
trial design, grant writing and research ethics;
(viii) shall be supervised by a sponsor-mentor who shall either (A) be
employed, contracted for employment or paid through an affiliated facul-
ty practice plan by a teaching general hospital which has received at
least one research grant from the National Institutes of Health in the
past five years from the date the clinical research plan is submitted to
S. 8307--A 62 A. 8807--A
the commissioner; (B) maintain a faculty appointment at a medical,
dental or podiatric school located in New York state that has received
at least one research grant from the National Institutes of Health in
the past five years from the date the clinical research plan is submit-
ted to the commissioner; or (C) be collaborating in the clinical
research plan with a researcher from another institution that has
received at least one research grant from the National Institutes of
Health in the past five years from the date the clinical research plan
is submitted to the commissioner; and
(ix) shall be filled by a researcher who is (A) enrolled or has
completed a graduate medical education program, as defined in paragraph
(i) of this subdivision; (B) a United States citizen, national, or
permanent resident of the United States; and (C) a graduate of a
medical, dental or podiatric school located in New York state, a gradu-
ate or resident in a graduate medical education program, as defined in
paragraph (i) of this subdivision, where the sponsoring institution, as
defined in paragraph (q) of this subdivision, is located in New York
state, or resides in New York state at the time the clinical research
plan is submitted to the commissioner.
(d)] "Consortium" means an organization or association, approved by
the commissioner in consultation with the council, of general hospitals
which provide graduate medical education, together with any affiliated
site; provided that such organization or association may also include
other providers of health care services, medical schools, payors or
consumers, and which meet other criteria pursuant to subdivision six of
this section.
[(e)] (B) "Council" means the New York state council on graduate
medical education.
[(f)] (C) "Direct medical education" means the direct costs of resi-
dents, interns and supervising physicians.
[(g)] (D) "Distribution period" means each calendar year set forth in
subdivision two of this section.
[(h)] (E) "Faculty" means persons who are employed by or under
contract for employment with a teaching general hospital or are paid
through a teaching general hospital's affiliated faculty practice plan
and maintain a faculty appointment at a medical school. Such persons
shall not be limited to persons with a degree in medicine.
[(i)] (F) "Graduate medical education program" means a post-graduate
medical education residency in the United States which has received
accreditation from a nationally recognized accreditation body or has
been approved by a nationally recognized organization for medical,
osteopathic, podiatric or dental residency programs including, but not
limited to, specialty boards.
[(j)] (G) "Indirect medical education" means the estimate of costs,
other than direct costs, of educational activities in teaching hospitals
as determined in accordance with the methodology applicable for purposes
of determining an estimate of indirect medical education costs for
reimbursement for inpatient hospital service pursuant to title XVIII of
the federal social security act (medicare).
[(k)] (H) "Medicare" means the methodology used for purposes of reim-
bursing inpatient hospital services provided to beneficiaries of title
XVIII of the federal social security act.
[(l)] (I) "Primary care" residents specialties shall include family
medicine, general pediatrics, primary care internal medicine, and prima-
ry care obstetrics and gynecology. In determining whether a residency is
in primary care, the commissioner shall consult with the council.
S. 8307--A 63 A. 8807--A
[(m)] (J) "Regions", for purposes of this section, shall mean the
regions as defined in paragraph (b) of subdivision sixteen of section
twenty-eight hundred seven-c of this article as in effect on June thir-
tieth, nineteen hundred ninety-six. For purposes of distributions pursu-
ant to subdivision five-a of this section, except distributions made in
accordance with paragraph (a) of subdivision five-a of this section,
"regions" shall be defined as New York city and the rest of the state.
[(n)] (K) "Regional pool" means a professional education pool estab-
lished on a regional basis by the commissioner from funds available
pursuant to sections twenty-eight hundred seven-s and twenty-eight
hundred seven-t of this article.
[(o)] (L) "Resident" means a person in a graduate medical education
program which has received accreditation from a nationally recognized
accreditation body or in a program approved by any other nationally
recognized organization for medical, osteopathic or dental residency
programs including, but not limited to, specialty boards.
[(p) "Shortage specialty" means a specialty determined by the commis-
sioner, in consultation with the council, to be in short supply in the
state of New York.
(q)] (M) "Sponsoring institution" means the entity that has the over-
all responsibility for a program of graduate medical education. Such
institutions shall include teaching general hospitals, medical schools,
consortia and diagnostic and treatment centers.
[(r)] (N) "Weighted resident count" means a teaching general hospi-
tal's total number of residents as of July first, nineteen hundred nine-
ty-five, including residents in affiliated non-hospital ambulatory
settings, reported to the commissioner. Such resident counts shall
reflect the weights established in accordance with rules and regulations
adopted by the state hospital review and planning council and approved
by the commissioner for purposes of implementing subdivision twenty-five
of section twenty-eight hundred seven-c of this article and in effect on
July first, nineteen hundred ninety-five. Such weights shall not be
applied to specialty hospitals, specified by the commissioner, whose
primary care mission is to engage in research, training and clinical
care in specialty eye and ear, special surgery, orthopedic, joint
disease, cancer, chronic care or rehabilitative services.
[(s)] (O) "Adjustment amount" means an amount determined for each
teaching hospital for periods prior to January first, two thousand nine
by:
(i) determining the difference between (A) a calculation of what each
teaching general hospital would have been paid if payments made pursuant
to paragraph (a-3) of subdivision one of section twenty-eight hundred
seven-c of this article between January first, nineteen hundred ninety-
six and December thirty-first, two thousand three were based solely on
the case mix of persons eligible for medical assistance under the
medical assistance program pursuant to title eleven of article five of
the social services law who are enrolled in health maintenance organiza-
tions and persons paid for under the family health plus program enrolled
in approved organizations pursuant to title eleven-D of article five of
the social services law during those years, and (B) the actual payments
to each such hospital pursuant to paragraph (a-3) of subdivision one of
section twenty-eight hundred seven-c of this article between January
first, nineteen hundred ninety-six and December thirty-first, two thou-
sand three.
S. 8307--A 64 A. 8807--A
(ii) reducing proportionally each of the amounts determined in subpar-
agraph (i) of this paragraph so that the sum of all such amounts totals
no more than one hundred million dollars;
(iii) further reducing each of the amounts determined in subparagraph
(ii) of this paragraph by the amount received by each hospital as a
distribution from funds designated in paragraph (a) of subdivision five
of this section attributable to the period January first, two thousand
three through December thirty-first, two thousand three, except that if
such amount was provided to a consortium then the amount of the
reduction for each hospital in the consortium shall be determined by
applying the proportion of each hospital's amount determined under
subparagraph (i) of this paragraph to the total of such amounts of all
hospitals in such consortium to the consortium award;
(iv) further reducing each of the amounts determined in subparagraph
(iii) of this paragraph by the amounts specified in paragraph [(t)] (P)
of this subdivision; and
(v) dividing each of the amounts determined in subparagraph (iii) of
this paragraph by seven.
[(t)] (P) "Extra reduction amount" shall mean an amount determined for
a teaching hospital for which an adjustment amount is calculated pursu-
ant to paragraph [(s)] (O) of this subdivision that is the hospital's
proportionate share of the sum of the amounts specified in paragraph
[(u)] (Q) of this subdivision determined based upon a comparison of the
hospital's remaining liability calculated pursuant to paragraph [(s)]
(O) of this subdivision to the sum of all such hospital's remaining
liabilities.
[(u)] (Q) "Allotment amount" shall mean an amount determined for
teaching hospitals as follows:
(i) for a hospital for which an adjustment amount pursuant to para-
graph [(s)] (O) of this subdivision does not apply, the amount received
by the hospital pursuant to paragraph (a) of subdivision five of this
section attributable to the period January first, two thousand three
through December thirty-first, two thousand three, or
(ii) for a hospital for which an adjustment amount pursuant to para-
graph [(s)] (O) of this subdivision applies and which received a
distribution pursuant to paragraph (a) of subdivision five of this
section attributable to the period January first, two thousand three
through December thirty-first, two thousand three that is greater than
the hospital's adjustment amount, the difference between the distrib-
ution amount and the adjustment amount.
(f) Effective January first, two thousand five through December thir-
ty-first, two thousand eight, each teaching general hospital shall
receive a distribution from the applicable regional pool based on its
distribution amount determined under paragraphs (c), (d) and (e) of this
subdivision and reduced by its adjustment amount calculated pursuant to
paragraph [(s)] (O) of subdivision one of this section and, for distrib-
utions for the period January first, two thousand five through December
thirty-first, two thousand five, further reduced by its extra reduction
amount calculated pursuant to paragraph [(t)] (P) of subdivision one of
this section.
(a) Up to thirty-one million dollars annually for the periods January
first, two thousand through December thirty-first, two thousand three,
and up to twenty-five million dollars plus the sum of the amounts speci-
fied in paragraph [(n)] (K) of subdivision one of this section for the
period January first, two thousand five through December thirty-first,
two thousand five, and up to thirty-one million dollars annually for the
S. 8307--A 65 A. 8807--A
period January first, two thousand six through December thirty-first,
two thousand seven, shall be set aside and reserved by the commissioner
from the regional pools established pursuant to subdivision two of this
section for supplemental distributions in each such region to be made by
the commissioner to consortia and teaching general hospitals in accord-
ance with a distribution methodology developed in consultation with the
council and specified in rules and regulations adopted by the commis-
sioner.
(d) Notwithstanding any other provision of law or regulation, for the
period January first, two thousand five through December thirty-first,
two thousand five, the commissioner shall distribute as supplemental
payments the allotment specified in paragraph [(n)] (K) of subdivision
one of this section.
5-a. Graduate medical education innovations pool. (a) Supplemental
distributions. (i) Thirty-one million dollars for the period January
first, two thousand eight through December thirty-first, two thousand
eight, shall be set aside and reserved by the commissioner from the
regional pools established pursuant to subdivision two of this section
and shall be available for distributions pursuant to subdivision five of
this section and in accordance with section 86-1.89 of title 10 of the
codes, rules and regulations of the state of New York as in effect on
January first, two thousand eight[; provided, however, for purposes of
funding the empire clinical research investigation program (ECRIP) in
accordance with paragraph eight of subdivision (e) and paragraph two of
subdivision (f) of section 86-1.89 of title 10 of the codes, rules and
regulations of the state of New York, distributions shall be made using
two regions defined as New York city and the rest of the state and the
dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
sion (f) of section 86-1.89 of title 10 of the codes, rules and regu-
lations of the state of New York shall be increased from sixty thousand
dollars to seventy-five thousand dollars].
(ii) For periods on and after January first, two thousand nine,
supplemental distributions pursuant to subdivision five of this section
and in accordance with section 86-1.89 of title 10 of the codes, rules
and regulations of the state of New York shall no longer be made and the
provisions of section 86-1.89 of title 10 of the codes, rules and regu-
lations of the state of New York shall be null and void.
(b) [Empire clinical research investigator program (ECRIP). Nine
million one hundred twenty thousand dollars annually for the period
January first, two thousand nine through December thirty-first, two
thousand ten, and two million two hundred eighty thousand dollars for
the period January first, two thousand eleven, through March thirty-
first, two thousand eleven, nine million one hundred twenty thousand
dollars each state fiscal year for the period April first, two thousand
eleven through March thirty-first, two thousand fourteen, up to eight
million six hundred twelve thousand dollars each state fiscal year for
the period April first, two thousand fourteen through March thirty-
first, two thousand seventeen, up to eight million six hundred twelve
thousand dollars each state fiscal year for the period April first, two
thousand seventeen through March thirty-first, two thousand twenty, up
to eight million six hundred twelve thousand dollars each state fiscal
year for the period April first, two thousand twenty through March thir-
ty-first, two thousand twenty-three, and up to eight million six hundred
twelve thousand dollars each state fiscal year for the period April
first, two thousand twenty-three through March thirty-first, two thou-
sand twenty-six, shall be set aside and reserved by the commissioner
S. 8307--A 66 A. 8807--A
from the regional pools established pursuant to subdivision two of this
section to be allocated regionally with two-thirds of the available
funding going to New York city and one-third of the available funding
going to the rest of the state and shall be available for distribution
as follows:
Distributions shall first be made to consortia and teaching general
hospitals for the empire clinical research investigator program (ECRIP)
to help secure federal funding for biomedical research, train clinical
researchers, recruit national leaders as faculty to act as mentors, and
train residents and fellows in biomedical research skills based on
hospital-specific data submitted to the commissioner by consortia and
teaching general hospitals in accordance with clause (G) of this subpar-
agraph. Such distributions shall be made in accordance with the follow-
ing methodology:
(A) The greatest number of clinical research positions for which a
consortium or teaching general hospital may be funded pursuant to this
subparagraph shall be one percent of the total number of residents
training at the consortium or teaching general hospital on July first,
two thousand eight for the period January first, two thousand nine
through December thirty-first, two thousand nine rounded up to the near-
est one position.
(B) Distributions made to a consortium or teaching general hospital
shall equal the product of the total number of clinical research posi-
tions submitted by a consortium or teaching general hospital and
accepted by the commissioner as meeting the criteria set forth in para-
graph (b) of subdivision one of this section, subject to the reduction
calculation set forth in clause (C) of this subparagraph, times one
hundred ten thousand dollars.
(C) If the dollar amount for the total number of clinical research
positions in the region calculated pursuant to clause (B) of this
subparagraph exceeds the total amount appropriated for purposes of this
paragraph, including clinical research positions that continue from and
were funded in prior distribution periods, the commissioner shall elimi-
nate one-half of the clinical research positions submitted by each
consortium or teaching general hospital rounded down to the nearest one
position. Such reduction shall be repeated until the dollar amount for
the total number of clinical research positions in the region does not
exceed the total amount appropriated for purposes of this paragraph. If
the repeated reduction of the total number of clinical research posi-
tions in the region by one-half does not render a total funding amount
that is equal to or less than the total amount reserved for that region
within the appropriation, the funding for each clinical research posi-
tion in that region shall be reduced proportionally in one thousand
dollar increments until the total dollar amount for the total number of
clinical research positions in that region does not exceed the total
amount reserved for that region within the appropriation. Any reduction
in funding will be effective for the duration of the award. No clinical
research positions that continue from and were funded in prior distrib-
ution periods shall be eliminated or reduced by such methodology.
(D) Each consortium or teaching general hospital shall receive its
annual distribution amount in accordance with the following:
(I) Each consortium or teaching general hospital with a one-year ECRIP
award shall receive its annual distribution amount in full upon
completion of the requirements set forth in items (I) and (II) of clause
(G) of this subparagraph. The requirements set forth in items (IV) and
(V) of clause (G) of this subparagraph must be completed by the consor-
S. 8307--A 67 A. 8807--A
tium or teaching general hospital in order for the consortium or teach-
ing general hospital to be eligible to apply for ECRIP funding in any
subsequent funding cycle.
(II) Each consortium or teaching general hospital with a two-year
ECRIP award shall receive its first annual distribution amount in full
upon completion of the requirements set forth in items (I) and (II) of
clause (G) of this subparagraph. Each consortium or teaching general
hospital will receive its second annual distribution amount in full upon
completion of the requirements set forth in item (III) of clause (G) of
this subparagraph. The requirements set forth in items (IV) and (V) of
clause (G) of this subparagraph must be completed by the consortium or
teaching general hospital in order for the consortium or teaching gener-
al hospital to be eligible to apply for ECRIP funding in any subsequent
funding cycle.
(E) Each consortium or teaching general hospital receiving distrib-
utions pursuant to this subparagraph shall reserve seventy-five thousand
dollars to primarily fund salary and fringe benefits of the clinical
research position with the remainder going to fund the development of
faculty who are involved in biomedical research, training and clinical
care.
(F) Undistributed or returned funds available to fund clinical
research positions pursuant to this paragraph for a distribution period
shall be available to fund clinical research positions in a subsequent
distribution period.
(G) In order to be eligible for distributions pursuant to this subpar-
agraph, each consortium and teaching general hospital shall provide to
the commissioner by July first of each distribution period, the follow-
ing data and information on a hospital-specific basis. Such data and
information shall be certified as to accuracy and completeness by the
chief executive officer, chief financial officer or chair of the consor-
tium governing body of each consortium or teaching general hospital and
shall be maintained by each consortium and teaching general hospital for
five years from the date of submission:
(I) For each clinical research position, information on the type,
scope, training objectives, institutional support, clinical research
experience of the sponsor-mentor, plans for submitting research outcomes
to peer reviewed journals and at scientific meetings, including a meet-
ing sponsored by the department, the name of a principal contact person
responsible for tracking the career development of researchers placed in
clinical research positions, as defined in paragraph (c) of subdivision
one of this section, and who is authorized to certify to the commission-
er that all the requirements of the clinical research training objec-
tives set forth in this subparagraph shall be met. Such certification
shall be provided by July first of each distribution period;
(II) For each clinical research position, information on the name,
citizenship status, medical education and training, and medical license
number of the researcher, if applicable, shall be provided by December
thirty-first of the calendar year following the distribution period;
(III) Information on the status of the clinical research plan, accom-
plishments, changes in research activities, progress, and performance of
the researcher shall be provided upon completion of one-half of the
award term;
(IV) A final report detailing training experiences, accomplishments,
activities and performance of the clinical researcher, and data, meth-
ods, results and analyses of the clinical research plan shall be
provided three months after the clinical research position ends; and
S. 8307--A 68 A. 8807--A
(V) Tracking information concerning past researchers, including but
not limited to (A) background information, (B) employment history, (C)
research status, (D) current research activities, (E) publications and
presentations, (F) research support, and (G) any other information
necessary to track the researcher; and
(VI) Any other data or information required by the commissioner to
implement this subparagraph.
(H) Notwithstanding any inconsistent provision of this subdivision,
for periods on and after April first, two thousand thirteen, ECRIP grant
awards shall be made in accordance with rules and regulations promulgat-
ed by the commissioner. Such regulations shall, at a minimum:
(1) provide that ECRIP grant awards shall be made with the objective
of securing federal funding for biomedical research, training clinical
researchers, recruiting national leaders as faculty to act as mentors,
and training residents and fellows in biomedical research skills;
(2) provide that ECRIP grant applicants may include interdisciplinary
research teams comprised of teaching general hospitals acting in collab-
oration with entities including but not limited to medical centers,
hospitals, universities and local health departments;
(3) provide that applications for ECRIP grant awards shall be based on
such information requested by the commissioner, which shall include but
not be limited to hospital-specific data;
(4) establish the qualifications for investigators and other staff
required for grant projects eligible for ECRIP grant awards; and
(5) establish a methodology for the distribution of funds under ECRIP
grant awards.
(c)] Physician loan repayment program. One million nine hundred sixty
thousand dollars for the period January first, two thousand eight
through December thirty-first, two thousand eight, one million nine
hundred sixty thousand dollars for the period January first, two thou-
sand nine through December thirty-first, two thousand nine, one million
nine hundred sixty thousand dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten, four
hundred ninety thousand dollars for the period January first, two thou-
sand eleven through March thirty-first, two thousand eleven, one million
seven hundred thousand dollars each state fiscal year for the period
April first, two thousand eleven through March thirty-first, two thou-
sand fourteen, up to one million seven hundred five thousand dollars
each state fiscal year for the period April first, two thousand fourteen
through March thirty-first, two thousand seventeen, up to one million
seven hundred five thousand dollars each state fiscal year for the peri-
od April first, two thousand seventeen through March thirty-first, two
thousand twenty, up to one million seven hundred five thousand dollars
each state fiscal year for the period April first, two thousand twenty
through March thirty-first, two thousand twenty-three, and up to one
million seven hundred five thousand dollars each state fiscal year for
the period April first, two thousand twenty-three through March thirty-
first, two thousand twenty-six, shall be set aside and reserved by the
commissioner from the regional pools established pursuant to subdivision
two of this section and shall be available for purposes of physician
loan repayment in accordance with subdivision ten of this section.
Notwithstanding any contrary provision of this section, sections one
hundred twelve and one hundred sixty-three of the state finance law, or
any other contrary provision of law, such funding shall be allocated
regionally with one-third of available funds going to New York city and
two-thirds of available funds going to the rest of the state and shall
S. 8307--A 69 A. 8807--A
be distributed in a manner to be determined by the commissioner without
a competitive bid or request for proposal process as follows:
(i) Funding shall first be awarded to repay loans of up to twenty-five
physicians who train in primary care or specialty tracks in teaching
general hospitals, and who enter and remain in primary care or specialty
practices in underserved communities, as determined by the commissioner.
(ii) After distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to repay loans of physi-
cians who enter and remain in primary care or specialty practices in
underserved communities, as determined by the commissioner, including
but not limited to physicians working in general hospitals, or other
health care facilities.
(iii) In no case shall less than fifty percent of the funds available
pursuant to this paragraph be distributed in accordance with subpara-
graphs (i) and (ii) of this paragraph to physicians identified by gener-
al hospitals.
(iv) In addition to the funds allocated under this paragraph, for the
period April first, two thousand fifteen through March thirty-first, two
thousand sixteen, two million dollars shall be available for the
purposes described in subdivision ten of this section;
(v) In addition to the funds allocated under this paragraph, for the
period April first, two thousand sixteen through March thirty-first, two
thousand seventeen, two million dollars shall be available for the
purposes described in subdivision ten of this section;
(vi) Notwithstanding any provision of law to the contrary, and subject
to the extension of the Health Care Reform Act of 1996, sufficient funds
shall be available for the purposes described in subdivision ten of this
section in amounts necessary to fund the remaining year commitments for
awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
[(d)] (C) Physician practice support. Four million nine hundred thou-
sand dollars for the period January first, two thousand eight through
December thirty-first, two thousand eight, four million nine hundred
thousand dollars annually for the period January first, two thousand
nine through December thirty-first, two thousand ten, one million two
hundred twenty-five thousand dollars for the period January first, two
thousand eleven through March thirty-first, two thousand eleven, four
million three hundred thousand dollars each state fiscal year for the
period April first, two thousand eleven through March thirty-first, two
thousand fourteen, up to four million three hundred sixty thousand
dollars each state fiscal year for the period April first, two thousand
fourteen through March thirty-first, two thousand seventeen, up to four
million three hundred sixty thousand dollars for each state fiscal year
for the period April first, two thousand seventeen through March thir-
ty-first, two thousand twenty, up to four million three hundred sixty
thousand dollars for each fiscal year for the period April first, two
thousand twenty through March thirty-first, two thousand twenty-three,
and up to four million three hundred sixty thousand dollars for each
fiscal year for the period April first, two thousand twenty-three
through March thirty-first, two thousand twenty-six, shall be set aside
and reserved by the commissioner from the regional pools established
pursuant to subdivision two of this section and shall be available for
purposes of physician practice support. Notwithstanding any contrary
provision of this section, sections one hundred twelve and one hundred
sixty-three of the state finance law, or any other contrary provision of
law, such funding shall be allocated regionally with one-third of avail-
able funds going to New York city and two-thirds of available funds
S. 8307--A 70 A. 8807--A
going to the rest of the state and shall be distributed in a manner to
be determined by the commissioner without a competitive bid or request
for proposal process as follows:
(i) Preference in funding shall first be accorded to teaching general
hospitals for up to twenty-five awards, to support costs incurred by
physicians trained in primary or specialty tracks who thereafter estab-
lish or join practices in underserved communities, as determined by the
commissioner.
(ii) After distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to physicians to support
the cost of establishing or joining practices in underserved communi-
ties, as determined by the commissioner, and to hospitals and other
health care providers to recruit new physicians to provide services in
underserved communities, as determined by the commissioner.
(iii) In no case shall less than fifty percent of the funds available
pursuant to this paragraph be distributed to general hospitals in
accordance with subparagraphs (i) and (ii) of this paragraph.
[(e)] (D) Work group. For funding available pursuant to paragraphs (B)
AND (c)[, (d) and (e)] of this subdivision:
(i) The department shall appoint a work group from recommendations
made by associations representing physicians, general hospitals and
other health care facilities to develop a streamlined application proc-
ess by June first, two thousand twelve.
(ii) Subject to available funding, applications shall be accepted on a
continuous basis. The department shall provide technical assistance to
applicants to facilitate their completion of applications. An applicant
shall be notified in writing by the department within ten days of
receipt of an application as to whether the application is complete and
if the application is incomplete, what information is outstanding. The
department shall act on an application within thirty days of receipt of
a complete application.
[(f)] (E) Study on physician workforce. Five hundred ninety thousand
dollars annually for the period January first, two thousand eight
through December thirty-first, two thousand ten, one hundred forty-eight
thousand dollars for the period January first, two thousand eleven
through March thirty-first, two thousand eleven, five hundred sixteen
thousand dollars each state fiscal year for the period April first, two
thousand eleven through March thirty-first, two thousand fourteen, up to
four hundred eighty-seven thousand dollars each state fiscal year for
the period April first, two thousand fourteen through March thirty-
first, two thousand seventeen, up to four hundred eighty-seven thousand
dollars for each state fiscal year for the period April first, two thou-
sand seventeen through March thirty-first, two thousand twenty, up to
four hundred eighty-seven thousand dollars each state fiscal year for
the period April first, two thousand twenty through March thirty-first,
two thousand twenty-three, and up to four hundred eighty-seven thousand
dollars each state fiscal year for the period April first, two thousand
twenty-three through March thirty-first, two thousand twenty-six, shall
be set aside and reserved by the commissioner from the regional pools
established pursuant to subdivision two of this section and shall be
available to fund a study of physician workforce needs and solutions
including, but not limited to, an analysis of residency programs and
projected physician workforce and community needs. The commissioner
shall enter into agreements with one or more organizations to conduct
such study based on a request for proposal process.
S. 8307--A 71 A. 8807--A
[(g)] (F) Diversity in medicine/post-baccalaureate program. Notwith-
standing any inconsistent provision of section one hundred twelve or one
hundred sixty-three of the state finance law or any other law, one
million nine hundred sixty thousand dollars annually for the period
January first, two thousand eight through December thirty-first, two
thousand ten, four hundred ninety thousand dollars for the period Janu-
ary first, two thousand eleven through March thirty-first, two thousand
eleven, one million seven hundred thousand dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen, up to one million six hundred five
thousand dollars each state fiscal year for the period April first, two
thousand fourteen through March thirty-first, two thousand seventeen, up
to one million six hundred five thousand dollars each state fiscal year
for the period April first, two thousand seventeen through March thir-
ty-first, two thousand twenty, up to one million six hundred five thou-
sand dollars each state fiscal year for the period April first, two
thousand twenty through March thirty-first, two thousand twenty-three,
and up to one million six hundred five thousand dollars each state
fiscal year for the period April first, two thousand twenty-three
through March thirty-first, two thousand twenty-six, shall be set aside
and reserved by the commissioner from the regional pools established
pursuant to subdivision two of this section and shall be available for
distributions to the Associated Medical Schools of New York to fund its
diversity program including existing and new post-baccalaureate programs
for minority and economically disadvantaged students and encourage
participation from all medical schools in New York. The associated
medical schools of New York shall report to the commissioner on an annu-
al basis regarding the use of funds for such purpose in such form and
manner as specified by the commissioner.
[(h)] (G) In the event there are undistributed funds within amounts
made available for distributions pursuant to this subdivision, such
funds may be reallocated and distributed in current or subsequent
distribution periods in a manner determined by the commissioner for any
purpose set forth in this subdivision.
12. Notwithstanding any provision of law to the contrary, applications
submitted on or after April first, two thousand sixteen, for the physi-
cian loan repayment program pursuant to paragraph [(c)] (B) of subdivi-
sion five-a of this section and subdivision ten of this section or the
physician practice support program pursuant to paragraph [(d)] (C) of
subdivision five-a of this section, shall be subject to the following
changes:
(a) Awards shall be made from the total funding available for new
awards under the physician loan repayment program and the physician
practice support program, with neither program limited to a specific
funding amount within such total funding available;
(b) An applicant may apply for an award for either physician loan
repayment or physician practice support, but not both;
(c) An applicant shall agree to practice for three years in an under-
served area and each award shall provide up to forty thousand dollars
for each of the three years; and
(d) To the extent practicable, awards shall be timed to be of use for
job offers made to applicants.
§ 4. Subparagraph (xvi) of paragraph (a) of subdivision 7 of section
2807-s of the public health law, as amended by section 8 of part Y of
chapter 56 of the laws of 2020, is amended to read as follows:
S. 8307--A 72 A. 8807--A
(xvi) provided further, however, for periods prior to July first, two
thousand nine, amounts set forth in this paragraph shall be reduced by
an amount equal to the actual distribution reductions for all facilities
pursuant to paragraph [(s)] (O) of subdivision one of section twenty-
eight hundred seven-m of this article.
§ 5. Subdivision (c) of section 92-dd of the state finance law, as
amended by section 9 of part Y of chapter 56 of the laws of 2020, is
amended to read as follows:
(c) The pool administrator shall, from appropriated funds transferred
to the pool administrator from the comptroller, continue to make
payments as required pursuant to sections twenty-eight hundred seven-k,
twenty-eight hundred seven-m (not including payments made pursuant to
SUBDIVISION FIVE-B AND paragraphs (B), (c)[, (d),, (f)] and [(g)] (F) of
subdivision five-a of section twenty-eight hundred seven-m), and twen-
ty-eight hundred seven-w of the public health law, paragraph (e) of
subdivision twenty-five of section twenty-eight hundred seven-c of the
public health law, paragraphs (b) and (c) of subdivision thirty of
section twenty-eight hundred seven-c of the public health law, paragraph
(b) of subdivision eighteen of section twenty-eight hundred eight of the
public health law, subdivision seven of section twenty-five hundred-d of
the public health law and section eighty-eight of chapter one of the
laws of nineteen hundred ninety-nine.
§ 6. Paragraph (c) of subdivision 1 of section 461-b of the social
services law is REPEALED.
§ 7. Article 27-H of the public health law is REPEALED.
§ 8. Paragraph (c) of subdivision 11 of section 230 of the public
health law, as amended by chapter 343 of the laws of 1980, subparagraph
(ii) as amended by section 10 of part B of chapter 57 of the laws of
2023, is amended to read as follows:
(c) Notwithstanding the foregoing, no physician shall be responsible
for reporting pursuant to paragraph (a) of this subdivision with respect
to any information discovered by such physician solely as a result of:
[(i)] Participation in a properly conducted mortality and/or morbidity
conference, departmental meeting or a medical or tissue committee
constituted pursuant to the by-laws of a hospital which is duly estab-
lished pursuant to article twenty-eight of the public health law, unless
the procedures of such conference, department or committee of such
hospital shall have been declared to be unacceptable for the purpose
hereof by the commissioner, and provided that the obligations of report-
ing such information when appropriate to do so shall be the responsibil-
ity of the chairperson of such conference, department or committee[,
or].
[(ii) Participation and membership during a three year demonstration
period in a physician committee of the Medical Society of the State of
New York or the New York State Osteopathic Society whose purpose is to
confront and refer to treatment physicians who are thought to be suffer-
ing from alcoholism, drug abuse, or mental illness. Such demonstration
period shall commence on April first, nineteen hundred eighty and termi-
nate on May thirty-first, nineteen hundred eighty-three. An additional
demonstration period shall commence on June first, nineteen hundred
eighty-three and terminate on March thirty-first, nineteen hundred
eighty-six. An additional demonstration period shall commence on April
first, nineteen hundred eighty-six and terminate on March thirty-first,
nineteen hundred eighty-nine. An additional demonstration period shall
commence April first, nineteen hundred eighty-nine and terminate March
thirty-first, nineteen hundred ninety-two. An additional demonstration
S. 8307--A 73 A. 8807--A
period shall commence April first, nineteen hundred ninety-two and
terminate March thirty-first, nineteen hundred ninety-five. An addi-
tional demonstration period shall commence on April first, nineteen
hundred ninety-five and terminate on March thirty-first, nineteen
hundred ninety-eight. An additional demonstration period shall commence
on April first, nineteen hundred ninety-eight and terminate on March
thirty-first, two thousand three. An additional demonstration period
shall commence on April first, two thousand three and terminate on March
thirty-first, two thousand thirteen. An additional demonstration period
shall commence April first, two thousand thirteen and terminate on March
thirty-first, two thousand eighteen. An additional demonstration period
shall commence April first, two thousand eighteen and terminate on July
first, two thousand twenty-eight provided, however, that the commission-
er may prescribe requirements for the continuation of such demonstration
program, including periodic reviews of such programs and submission of
any reports and data necessary to permit such reviews. During these
additional periods, the provisions of this subparagraph shall also apply
to a physician committee of a county medical society.]
§ 9. Paragraph (g) of subdivision 11 of section 230 of the public
health law is REPEALED and paragraph (h) is relettered paragraph (g).
§ 10. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024; provided,
however, the amendments to subparagraph (xvi) of paragraph (a) of subdi-
vision 7 of section 2807-s of the public health law made by section four
of this act shall not affect the expiration of such section and shall be
deemed to expire therewith.
PART M
Section 1. Subparagraph 3 of paragraph (b) of subdivision 4 of section
366 of the social services law, as added by section 2 of part D of chap-
ter 56 of the laws of 2013, is amended to read as follows:
(3) (A) A child [under] BETWEEN the [age] AGES of SIX AND nineteen who
is determined eligible for medical assistance under the provisions of
this section, shall, consistent with applicable federal requirements,
remain eligible for such assistance until [the earlier of:
(i)] the last day of the month which is twelve months following the
determination [or redetermination] OR RENEWAL of eligibility for such
assistance[; or
(ii) the last day of the month in which the child reaches the age of
nineteen].
(B) A CHILD UNDER THE AGE OF SIX WHO IS DETERMINED ELIGIBLE FOR
MEDICAL ASSISTANCE UNDER THE PROVISIONS OF THIS SECTION, SHALL, CONSIST-
ENT WITH APPLICABLE FEDERAL REQUIREMENTS, REMAIN CONTINUOUSLY ELIGIBLE
FOR MEDICAL ASSISTANCE COVERAGE UNTIL THE LATER OF:
(I) THE LAST DAY OF THE TWELFTH MONTH FOLLOWING THE DETERMINATION OR
RENEWAL OF ELIGIBILITY FOR SUCH ASSISTANCE; OR
(II) THE LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE AGE OF
SIX.
§ 2. Subdivision 6 of section 2510 of the public health law is amended
by adding a new paragraph (e) to read as follows:
(E) AN ELIGIBLE CHILD UNDER SIX YEARS OF AGE SHALL, CONSISTENT WITH
APPLICABLE FEDERAL REQUIREMENTS, REMAIN CONTINUOUSLY ENROLLED UNTIL THE
LATER OF:
(I) THE LAST DAY OF THE TWELFTH MONTH FOLLOWING THE DATE OF ENROLLMENT
OR RECERTIFICATION IN THE CHILD HEALTH INSURANCE PLAN; OR
S. 8307--A 74 A. 8807--A
(II) THE LAST DAY OF THE MONTH IN WHICH THE CHILD REACHES THE AGE OF
SIX.
§ 3. This act shall take effect January 1, 2025.
PART N
Section 1. Paragraph (d) of subdivision 4 of section 206 of the public
health law, as added by chapter 602 of the laws of 2007, is amended and
a new paragraph (e) is added to read as follows:
(d) assess civil penalties against a public water system which
provides water to the public for human consumption through pipes or
other constructed conveyances, as further defined in the state sanitary
code or, in the case of mass gatherings, the person who holds or
promotes the mass gathering as defined in subdivision five of section
two hundred twenty-five of this article not to exceed twenty-five thou-
sand dollars per day, for each violation of or failure to comply with
any term or provision of the state sanitary code as it relates to public
water systems that serve a population of five thousand or more persons
or any mass gatherings, which penalty may be assessed after a hearing or
an opportunity to be heard[.];
(E) NOTWITHSTANDING SECTION SIXTY-FIVE HUNDRED THIRTY OF THE EDUCATION
LAW, ISSUE A NON-PATIENT SPECIFIC STATEWIDE STANDING ORDER FOR THE
PROVISION OF DOULA SERVICES FOR PREGNANT, BIRTHING, AND POSTPARTUM INDI-
VIDUALS THROUGH TWELVE MONTHS POSTPARTUM.
§ 2. Subdivision 3 of section 2504 of the public health law, as added
by chapter 976 of the laws of 1984, is amended to read as follows:
3. Any person, INCLUDING A MINOR, who is pregnant may give effective
consent for ANY AND ALL medical, dental, health and hospital services
relating to [prenatal] REPRODUCTIVE HEALTH care, INCLUDING CONSENT TO
TERMINATE A PREGNANCY FOR ANY REASON.
§ 3. The opening paragraph of section 2599-aa of the public health
law, as added by chapter 1 of the laws of 2019, is amended to read as
follows:
The legislature finds that comprehensive reproductive health care is a
fundamental component of every individual's health, privacy and
equality, INCLUDING MINORS. Therefore, it is the policy of the state
that:
§ 4. The public health law is amended by adding a new section
2599-bb-1 to read as follows:
§ 2599-BB-1. CONTRACEPTION. 1. A HEALTH CARE PRACTITIONER LICENSED,
CERTIFIED, OR AUTHORIZED UNDER TITLE EIGHT OF THE EDUCATION LAW, ACTING
WITHIN THEIR LAWFUL SCOPE OF PRACTICE, MAY PRESCRIBE OR DISTRIBUTE A
CONTRACEPTIVE DEVICE OR MEDICATION WHEN, ACCORDING TO THE PRACTITIONER'S
REASONABLE AND GOOD FAITH PROFESSIONAL JUDGMENT BASED ON THE FACTS OF
THE PATIENT'S CASE, THEY DETERMINE THE PATIENT IS ABLE TO MEDICALLY
TOLERATE SUCH TREATMENT.
2. THIS ARTICLE SHALL BE CONSTRUED AND APPLIED CONSISTENT WITH AND
SUBJECT TO APPLICABLE LAWS AND APPLICABLE AND AUTHORIZED REGULATIONS
GOVERNING HEALTH CARE PROCEDURES.
§ 5. SECTION 2504 OF THE PUBLIC HEALTH LAW IS AMENDED BY ADDING A NEW
SUBDIVISION 8 TO READ AS FOLLOWS:
8. DRUG, CANNABIS, OR ALCOHOL TESTING FOR PREGNANT OR POSTPARTUM INDI-
VIDUALS.
(A) DEFINITION. AS USED IN THIS SUBDIVISION, "TEST" SHALL MEAN A TEST
USING A BIOLOGICAL SAMPLE, INCLUDING, BUT NOT LIMITED TO, URINE, BLOOD,
OR HAIR, FOR THE PRESENCE OF DRUGS, CANNABIS, OR ALCOHOL.
S. 8307--A 75 A. 8807--A
(B) UNLESS LEGALLY AUTHORIZED TO DO SO, NO HEALTH CARE PROFESSIONAL
LICENSED, CERTIFIED, OR AUTHORIZED UNDER TITLE EIGHT OF THE EDUCATION
LAW SHALL:
(I) PERFORM A DRUG, CANNABIS, OR ALCOHOL TEST ON A PERSON WHO IS PREG-
NANT OR UP TO ONE YEAR POSTPARTUM UNLESS:
(A) THE PREGNANT OR POSTPARTUM PATIENT GIVES PRIOR VERBAL OR WRITTEN
INFORMED CONSENT SPECIFIC TO THE DRUG, CANNABIS, OR ALCOHOL TEST; AND
(B) THE PERFORMANCE OF THE DRUG, CANNABIS, OR ALCOHOL TEST IS WITHIN
THE SCOPE OF MEDICAL CARE BEING PROVIDED TO THE PATIENT.
(C) VERBAL OR WRITTEN INFORMED CONSENT TO A DRUG, CANNABIS, OR ALCOHOL
TEST PURSUANT TO THIS SUBDIVISION SHALL OCCUR PRIOR TO ADMINISTRATION,
IN LANGUAGE UNDERSTANDABLE TO THE PREGNANT OR POSTPARTUM PATIENT, UNDER
CIRCUMSTANCES THAT PROVIDE SUCH PERSON SUFFICIENT OPPORTUNITY TO CONSID-
ER WHETHER OR NOT TO AUTHORIZE THE DRUG, CANNABIS, OR ALCOHOL TEST AND
MINIMIZE THE POSSIBILITY OF COERCION OR UNDUE INFLUENCE, AND SHALL
CONSIST OF VERBAL AUTHORIZATION MEMORIALIZED IN THE MEDICAL RECORD OR
WRITTEN AUTHORIZATION THAT IS DATED AND SIGNED. SUCH AUTHORIZATION SHALL
INCLUDE THE FOLLOWING:
(I) A STATEMENT EXPLAINING THAT CONSENTING TO A DRUG, CANNABIS, OR
ALCOHOL TEST IS VOLUNTARY AND REQUIRES WRITTEN OR VERBAL INFORMED
CONSENT, EXCEPT WHEN CONDITIONS UNDER SUBDIVISION FOUR OF THIS SECTION
OR PARAGRAPH (D) OF THIS SUBDIVISION ARE MET;
(II) A STATEMENT THAT TESTING POSITIVE FOR DRUGS, CANNABIS, OR ALCOHOL
COULD HAVE LEGAL CONSEQUENCES;
(III) A STATEMENT EXPLAINING THE EXTENT OF CONFIDENTIALITY OF THE TEST
RESULTS;
(IV) A STATEMENT OF THE MEDICAL PURPOSE OF THE TEST; AND
(V) A GENERAL DESCRIPTION OF THE TEST.
(D) DRUG, CANNABIS, OR ALCOHOL TESTING PURSUANT TO THIS SUBDIVISION
MAY BE PERFORMED WITHOUT CONSENT OF THE PATIENT WHEN, IN THE HEALTH CARE
PROFESSIONAL'S JUDGMENT, AN EMERGENCY EXISTS AND THE PATIENT IS IN IMME-
DIATE NEED OF MEDICAL ATTENTION, AND AN ATTEMPT TO SECURE CONSENT WOULD
RESULT IN DELAY OF TREATMENT THAT COULD INCREASE THE RISK TO THE
PATIENT'S LIFE OR HEALTH. IN THE CASE THAT DRUG, CANNABIS, OR ALCOHOL
TESTING IS PERFORMED UNDER THESE CIRCUMSTANCES, THE RESULTS SHALL BE
DISCUSSED WITH THE PATIENT, IN LANGUAGE UNDERSTANDABLE TO THE PATIENT
AND SHALL CONSIST OF VERBAL NOTIFICATION OR WRITTEN NOTIFICATION THAT IS
DATED, SIGNED, AND INCLUDES THE FOLLOWING:
(I) A STATEMENT THAT TESTING POSITIVE FOR DRUGS, CANNABIS, OR ALCOHOL
COULD HAVE LEGAL CONSEQUENCES;
(II) A STATEMENT IN THE MEDICAL RECORD WITH A DESCRIPTION OF THE EMER-
GENCY THAT NECESSITATED UNCONSENTED DRUG, CANNABIS, OR ALCOHOL TESTING;
AND
(III) A STATEMENT EXPLAINING THE EXTENT OF CONFIDENTIALITY OF THE
RESULTS.
(E) NOTHING IN THIS SECTION SHALL DIMINISH ANY OTHER REQUIREMENT TO
OBTAIN INFORMED CONSENT FOR A DRUG, CANNABIS, OR ALCOHOL TEST OR ANY
OTHER PROCEDURE.
§ 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART O
Section 1. Subdivision 1 of section 2807-k of the public health law is
amended by adding a new paragraph (h) to read as follows:
S. 8307--A 76 A. 8807--A
(H) "UNDERINSURED" SHALL MEAN AN INDIVIDUAL WITH OUT OF POCKET MEDICAL
COSTS THAT AMOUNT TO MORE THAN TEN PERCENT OF SUCH INDIVIDUAL'S GROSS
ANNUAL INCOME FOR THE PAST TWELVE MONTHS.
§ 2. Subdivision 9-a of section 2807-k of the public health law, as
added by section 39-a of part A of chapter 57 of the laws of 2006 and
paragraph (k) as added by section 43 of part B of chapter 58 of the laws
of 2008, is amended to read as follows:
9-a. (a) As a condition for participation in pool distributions
authorized pursuant to this section and section twenty-eight hundred
seven-w of this article for periods on and after January first, two
thousand nine, general hospitals shall, effective for periods on and
after January first, two thousand seven, establish financial aid poli-
cies and procedures, in accordance with the provisions of this subdivi-
sion, for reducing charges otherwise applicable to low-income individ-
uals without health insurance OR UNDERINSURED INDIVIDUALS, or who have
exhausted their health insurance benefits, and who can demonstrate an
inability to pay full charges, and also, at the hospital's discretion,
for reducing or discounting the collection of co-pays and deductible
payments from those individuals who can demonstrate an inability to pay
such amounts.
(b) Such reductions from charges for [uninsured] patients with incomes
below at least [three] FOUR hundred percent of the federal poverty level
shall result in a charge to such individuals that does not exceed [the
greater of] the amount that would have been paid for the same services
[by the "highest volume payor" for such general hospital as defined in
subparagraph (v) of this paragraph, or for services provided pursuant to
title XVIII of the federal social security act (medicare), or for
services] provided pursuant to title XIX of the federal social security
act (medicaid), and provided further that such amounts shall be adjusted
according to income level as follows:
(i) For patients with incomes [at or] below at least [one] TWO hundred
percent of the federal poverty level, the hospital shall [collect no
more than a nominal payment amount, consistent with guidelines estab-
lished by the commissioner] WAIVE ALL CHARGES. NO NOMINAL PAYMENT SHALL
BE COLLECTED;
(ii) For patients with incomes between at least [one] TWO hundred
[one] percent and [one] UP TO THREE hundred [fifty] percent of the
federal poverty level, the hospital shall collect no more than the
amount identified after application of a proportional sliding fee sched-
ule under which patients with lower incomes shall pay the lowest amount.
Such schedule shall provide that the amount the hospital may collect for
such patients increases [from the nominal amount described in subpara-
graph (i) of this paragraph] in equal increments as the income of the
patient increases, up to a maximum of [twenty] TEN percent of the
[greater of the] amount that would have been paid for the same services
[by the "highest volume payor" for such general hospital, as defined in
subparagraph (v) of this paragraph, or for services provided pursuant to
title XVIII of the federal social security act (medicare) or for
services] provided pursuant to title XIX of the federal social security
act (medicaid), OR FOR UNDERINSURED PATIENTS, UP TO A MAXIMUM OF TEN
PERCENT OF THE AMOUNT THAT WOULD HAVE BEEN PAID PURSUANT TO SUCH
PATIENT'S INSURANCE COST SHARING;
(iii) For patients with incomes between at least [one] THREE hundred
[fifty-one] ONE percent and [two] FOUR hundred [fifty] percent of the
federal poverty level, the hospital shall collect no more than the
amount identified after application of a proportional sliding fee sched-
S. 8307--A 77 A. 8807--A
ule under which patients with lower income shall pay the lowest amounts.
Such schedule shall provide that the amount the hospital may collect for
such patients increases from the [twenty] TEN percent figure described
in subparagraph (ii) of this paragraph in equal increments as the income
of the patient increases, up to a maximum of [the greater] TWENTY
PERCENT of the amount that would have been paid for the same services
[by the "highest volume payor" for such general hospital, as defined in
subparagraph (v) of this paragraph, or for services provided pursuant to
title XVIII of the federal social security act (medicare) or for
services] provided pursuant to title XIX of the federal social security
act (medicaid), OR FOR UNDERINSURED PATIENTS, UP TO A MAXIMUM OF TWENTY
PERCENT OF THE AMOUNT THAT WOULD HAVE BEEN PAID PURSUANT TO SUCH
PATIENT'S INSURANCE COST SHARING; [and
(iv) For patients with incomes between at least two hundred fifty-one
percent and three hundred percent of the federal poverty level, the
hospital shall collect no more than the greater of the amount that would
have been paid for the same services by the "highest volume payor" for
such general hospital as defined in subparagraph (v) of this paragraph,
or for services provided pursuant to title XVIII of the federal social
security act (medicare), or for services provided pursuant to title XIX
of the federal social security act (medicaid).
(v) For the purposes of this paragraph, "highest volume payor" shall
mean the insurer, corporation or organization licensed, organized or
certified pursuant to article thirty-two, forty-two or forty-three of
the insurance law or article forty-four of this chapter, or other third-
party payor, which has a contract or agreement to pay claims for
services provided by the general hospital and incurred the highest
volume of claims in the previous calendar year.
(vi) A hospital may implement policies and procedures to permit, but
not require, consideration on a case-by-case basis of exceptions to the
requirements described in subparagraphs (i) and (ii) of this paragraph
based upon the existence of significant assets owned by the patient that
should be taken into account in determining the appropriate payment
amount for that patient's care, provided, however, that such proposed
policies and procedures shall be subject to the prior review and
approval of the commissioner and, if approved, shall be included in the
hospital's financial assistance policy established pursuant to this
section, and provided further that, if such approval is granted, the
maximum amount that may be collected shall not exceed the greater of the
amount that would have been paid for the same services by the "highest
volume payor" for such general hospital as defined in subparagraph (v)
of this paragraph, or for services provided pursuant to title XVIII of
the federal social security act (medicare), or for services provided
pursuant to title XIX of the federal social security act (medicaid). In
the event that a general hospital reviews a patient's assets in deter-
mining payment adjustments such policies and procedures shall not
consider as assets a patient's primary residence, assets held in a tax-
deferred or comparable retirement savings account, college savings
accounts, or cars used regularly by a patient or immediate family
members.
(vii)] (IV) Nothing in this paragraph shall be construed to limit a
hospital's ability to establish patient eligibility for payment
discounts at income levels higher than those specified herein and/or to
provide greater payment discounts for eligible patients than those
required by this paragraph.
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(c) Such policies and procedures shall be clear, understandable, in
writing and publicly available in summary form and each general hospital
participating in the pool shall ensure that every patient is made aware
of the existence of such policies and procedures and is provided, in a
timely manner, with a summary of such policies and procedures [upon
request]. Any summary provided to patients shall, at a minimum, include
specific information as to income levels used to determine eligibility
for assistance, a description of the primary service area of the hospi-
tal and the means of applying for assistance. For general hospitals with
twenty-four hour emergency departments, such policies and procedures
shall require the WRITTEN notification of patients during the intake and
registration process, AND DURING DISCHARGE OF THE PATIENT, AND through
the conspicuous posting of language-appropriate information in the
general hospital, and information on bills and statements sent to
patients, that financial aid may be available to qualified patients and
how to obtain further information. For specialty hospitals without twen-
ty-four hour emergency departments, such notification shall take place
through written materials provided to patients during the intake and
registration process prior to the provision of any health care services
or procedures, AND DURING DISCHARGE OF THE PATIENT, and through informa-
tion on bills and statements sent to patients, that financial aid may be
available to qualified patients and how to obtain further information.
Application materials shall include a notice to patients that upon
submission of a completed application, including any information or
documentation needed to determine the patient's eligibility pursuant to
the hospital's financial assistance policy, the patient may disregard
any bills until the hospital has rendered a decision on the application
in accordance with this paragraph.
(d) Such policies and procedures shall include clear, objective crite-
ria for determining a patient's ability to pay and for providing such
adjustments to payment requirements as are necessary. In addition to
adjustment mechanisms such as sliding fee schedules and discounts to
fixed standards, such policies and procedures shall also provide for the
use of installment plans for the payment of outstanding balances by
patients pursuant to the provisions of the hospital's financial assist-
ance policy. The monthly payment under such a plan shall not exceed
[ten] FIVE percent of the gross monthly income of the patient[,
provided, however, that if patient assets are considered under such a
policy, then patient assets which are not excluded assets pursuant to
subparagraph (vi) of paragraph (b) of this subdivision may be considered
in addition to the limit on monthly payments]. The rate of interest
charged to the patient on the unpaid balance, if any, shall not exceed
[the rate for a ninety-day security issued by the United States Depart-
ment of Treasury, plus .5] TWO percent and no plan shall include an
accelerator or similar clause under which a higher rate of interest is
triggered upon a missed payment. If such policies and procedures include
a requirement of a deposit prior to non-emergent, medically-necessary
care, such deposit must be included as part of any financial aid consid-
eration. Such policies and procedures shall be applied consistently to
all eligible patients.
(e) Such policies and procedures shall permit patients to apply for
assistance [within at least ninety days of the date of discharge or date
of service and provide at least twenty days for patients to submit a
completed application] AT ANY TIME DURING THE COLLECTION PROCESS. Such
policies and procedures may require that patients seeking payment
adjustments provide appropriate financial information and documentation
S. 8307--A 79 A. 8807--A
in support of their application, provided, however, that such applica-
tion process shall not be unduly burdensome or complex. General hospi-
tals shall, upon request, assist patients in understanding the hospi-
tal's policies and procedures and in applying for payment adjustments.
Application forms shall be printed in the "primary languages" of
patients served by the general hospital. For the purposes of this para-
graph, "primary languages" shall include any language that is either (i)
used to communicate, during at least five percent of patient visits in a
year, by patients who cannot speak, read, write or understand the
English language at the level of proficiency necessary for effective
communication with health care providers, or (ii) spoken by non-English
speaking individuals comprising more than one percent of the primary
hospital service area population, as calculated using demographic infor-
mation available from the United States Bureau of the Census, supple-
mented by data from school systems. Decisions regarding such applica-
tions shall be made within thirty days of receipt of a completed
application. Such policies and procedures shall require that the hospi-
tal issue any denial/approval of such application in writing with infor-
mation on how to appeal the denial and shall require the hospital to
establish an appeals process under which it will evaluate the denial of
an application. Nothing in this subdivision shall be interpreted as
prohibiting a hospital from making the availability of financial assist-
ance contingent upon the patient first applying for coverage under title
XIX of the social security act (medicaid) or another insurance program
if, in the judgment of the hospital, the patient may be eligible for
medicaid or another insurance program, and upon the patient's cooper-
ation in following the hospital's financial assistance application
requirements, including the provision of information needed to make a
determination on the patient's application in accordance with the hospi-
tal's financial assistance policy.
(f) Such policies and procedures shall provide that patients with
incomes below [three] FOUR hundred percent of the federal poverty level
are deemed presumptively eligible for payment adjustments and shall
conform to the requirements set forth in paragraph (b) of this subdivi-
sion, provided, however, that nothing in this subdivision shall be
interpreted as precluding hospitals from extending such payment adjust-
ments to other patients, either generally or on a case-by-case basis.
Such policies and procedures shall provide financial aid for emergency
hospital services, including emergency transfers pursuant to the federal
emergency medical treatment and active labor act (42 USC 1395dd), to
patients who reside in New York state and for medically necessary hospi-
tal services for patients who reside in the hospital's primary service
area as determined according to criteria established by the commission-
er. In developing such criteria, the commissioner shall consult with
representatives of the hospital industry, health care consumer advocates
and local public health officials. Such criteria shall be made available
to the public no less than thirty days prior to the date of implementa-
tion and shall, at a minimum:
(i) prohibit a hospital from developing or altering its primary
service area in a manner designed to avoid medically underserved commu-
nities or communities with high percentages of uninsured residents;
(ii) ensure that every geographic area of the state is included in at
least one general hospital's primary service area so that eligible
patients may access care and financial assistance; and
(iii) require the hospital to notify the commissioner upon making any
change to its primary service area, and to include a description of its
S. 8307--A 80 A. 8807--A
primary service area in the hospital's annual implementation report
filed pursuant to subdivision three of section twenty-eight hundred
three-l of this article.
(g) Nothing in this subdivision shall be interpreted as precluding
hospitals from extending payment adjustments for medically necessary
non-emergency hospital services to patients outside of the hospital's
primary service area. For patients determined to be eligible for finan-
cial aid under the terms of a hospital's financial aid policy, such
policies and procedures shall prohibit any limitations on financial aid
for services based on the medical condition of the applicant, other than
typical limitations or exclusions based on medical necessity or the
clinical or therapeutic benefit of a procedure or treatment.
(h) SUCH POLICIES AND PROCEDURES SHALL PROHIBIT THE DENIAL OF ADMIS-
SION OR DENIAL OF TREATMENT FOR SERVICES THAT ARE REASONABLY ANTICIPATED
TO BE MEDICALLY NECESSARY BECAUSE THE PATIENT HAS AN UNPAID MEDICAL
BILL. Such policies and procedures shall [not permit] PROHIBIT the
forced sale or foreclosure of a patient's primary residence in order to
collect an outstanding medical bill and shall require the hospital to
refrain from sending an account to collection if the patient has submit-
ted a completed application for financial aid, including any required
supporting documentation, while the hospital determines the patient's
eligibility for such aid. SUCH POLICIES AND PROCEDURES SHALL PROHIBIT
THE SALE OF MEDICAL DEBT ACCUMULATED PURSUANT TO THIS SECTION TO A THIRD
PARTY, UNLESS THE THIRD PARTY EXPLICITLY PURCHASES SUCH MEDICAL DEBT IN
ORDER TO RELIEVE THE DEBT OF THE PATIENT. Such policies and procedures
shall provide for written notification, which shall include notification
on a patient bill, to a patient not less than thirty days prior to the
referral of debts for collection and shall require that the collection
agency obtain the hospital's written consent prior to commencing a legal
action. SUCH POLICIES AND PROCEDURES SHALL PROHIBIT A HOSPITAL FROM
COMMENCING A LEGAL ACTION RELATED TO THE RECOVERY OF MEDICAL DEBT OR
UNPAID BILLS AGAINST PATIENTS WITH INCOMES BELOW FOUR HUNDRED PERCENT OF
THE FEDERAL POVERTY LEVEL. IN ANY LEGAL ACTION RELATED TO THE RECOVERY
OF MEDICAL DEBT OR UNPAID BILLS BY OR ON BEHALF OF A HOSPITAL, THE
COMPLAINT SHALL BE ACCOMPANIED BY AN AFFIDAVIT BY THE HOSPITAL'S CHIEF
FINANCIAL OFFICER STATING THAT BASED UPON THE HOSPITAL'S REASONABLE
EFFORT TO DETERMINE THE PATIENT'S INCOME, THE PATIENT WHOM THEY ARE
TAKING LEGAL ACTION AGAINST DOES NOT HAVE AN INCOME BELOW FOUR HUNDRED
PERCENT OF THE FEDERAL POVERTY LEVEL. Such policies and procedures shall
require all general hospital staff who interact with patients or have
responsibility for billing and collections to be trained in such poli-
cies and procedures, and require the implementation of a mechanism for
the general hospital to measure its compliance with such policies and
procedures. Such policies and procedures shall require that any
collection agency under contract with a general hospital for the
collection of debts follow the hospital's financial assistance policy,
including providing information to patients on how to apply for finan-
cial assistance where appropriate. Such policies and procedures shall
prohibit collections from a patient who is determined to be eligible for
medical assistance pursuant to title XIX of the federal social security
act at the time services were rendered and for which services medicaid
payment is available.
(i) Reports required to be submitted to the department by each general
hospital as a condition for participation in the pools, and which
contain, in accordance with applicable regulations, a certification from
an independent certified public accountant or independent licensed
S. 8307--A 81 A. 8807--A
public accountant or an attestation from a senior official of the hospi-
tal that the hospital is in compliance with conditions of participation
in the pools, shall also contain, for reporting periods on and after
January first, two thousand seven:
(i) a report on hospital costs incurred and uncollected amounts in
providing services to eligible patients without insurance[, including
the amount of care provided for a nominal payment amount,] during the
period covered by the report;
(ii) hospital costs incurred and uncollected amounts for deductibles
and coinsurance for eligible patients with insurance or other third-par-
ty payor coverage;
(iii) the number of patients, INCLUDING THEIR AGE, RACE, ETHNICITY,
GENDER AND INSURANCE STATUS, organized according to United States postal
service zip code, who applied for financial assistance pursuant to the
hospital's financial assistance policy, and the number, organized
according to United States postal service zip code, whose applications
were approved and whose applications were denied;
(iv) the reimbursement received for indigent care from the pool estab-
lished pursuant to this section;
(v) the amount of funds that have been expended on charity care from
charitable bequests made or trusts established for the purpose of
providing financial assistance to patients who are eligible in accord-
ance with the terms of such bequests or trusts;
(vi) for hospitals located in social services districts in which the
district allows hospitals to assist patients with such applications, the
number of applications for eligibility under title XIX of the social
security act (medicaid) that the hospital assisted patients in complet-
ing and the number denied and approved; AND
(vii) the hospital's financial losses resulting from services provided
under medicaid[; and
(viii) the number of liens placed on the primary residences of
patients through the collection process used by a hospital].
(j) Within ninety days of the effective date of this subdivision each
hospital shall submit to the commissioner a written report on its poli-
cies and procedures for financial assistance to patients which are used
by the hospital on the effective date of this subdivision. Such report
shall include copies of its policies and procedures, including material
which is distributed to patients, and a description of the hospital's
financial aid policies and procedures. Such description shall include
the income levels of patients on which eligibility is based, the finan-
cial aid eligible patients receive and the means of calculating such
aid, and the service area, if any, used by the hospital to determine
eligibility.
(k) In the event it is determined by the commissioner that the state
will be unable to secure all necessary federal approvals to include, as
part of the state's approved state plan under title nineteen of the
federal social security act, a requirement, as set forth in paragraph
[one] (A) of this subdivision, that compliance with this subdivision is
a condition of participation in pool distributions authorized pursuant
to this section and section twenty-eight hundred seven-w of this arti-
cle, then such condition of participation shall be deemed null and void
and, notwithstanding section twelve of this chapter, failure to comply
with the provisions of this subdivision by a hospital on and after the
date of such determination shall make such hospital liable for a civil
penalty not to exceed ten thousand dollars for each such violation. The
S. 8307--A 82 A. 8807--A
imposition of such civil penalties shall be subject to the provisions of
section twelve-a of this chapter.
(L) A HOSPITAL OR ITS COLLECTION AGENT SHALL NOT COMMENCE A CIVIL
ACTION AGAINST A PATIENT OR DELEGATE A COLLECTION ACTIVITY TO A DEBT
COLLECTOR FOR NONPAYMENT FOR AT LEAST ONE HUNDRED EIGHTY DAYS AFTER THE
FIRST POST-SERVICE BILL IS ISSUED AND UNTIL A HOSPITAL HAS MADE REASON-
ABLE EFFORTS TO DETERMINE WHETHER A PATIENT QUALIFIES FOR FINANCIAL
ASSISTANCE.
§ 3. The public health law is amended by adding a new section 18-c to
read as follows:
§ 18-C. SEPARATE PATIENT CONSENT FOR TREATMENT AND PAYMENT FOR HEALTH
CARE SERVICES. INFORMED CONSENT FROM A PATIENT TO PROVIDE ANY TREATMENT,
PROCEDURE, EXAMINATION OR OTHER DIRECT HEALTH CARE SERVICES SHALL BE
OBTAINED SEPARATELY FROM SUCH PATIENT'S CONSENT TO PAY FOR THE SERVICES.
CONSENT TO PAY FOR ANY HEALTH CARE SERVICES BY A PATIENT SHALL NOT BE
GIVEN PRIOR TO THE PATIENT RECEIVING SUCH SERVICES AND DISCUSSING TREAT-
MENT COSTS. FOR PURPOSES OF THIS SECTION, "CONSENT" MEANS AN ACTION
WHICH: (A) CLEARLY AND CONSPICUOUSLY COMMUNICATES THE INDIVIDUAL'S
AUTHORIZATION OF AN ACT OR PRACTICE; (B) IS MADE IN THE ABSENCE OF ANY
MECHANISM IN THE USER INTERFACE THAT HAS THE PURPOSE OR SUBSTANTIAL
EFFECT OF OBSCURING, SUBVERTING, OR IMPAIRING DECISION-MAKING OR CHOICE
TO OBTAIN CONSENT; AND (C) CANNOT BE INFERRED FROM INACTION.
§ 4. The general business law is amended by adding two new sections
349-g and 519-a to read as follows:
§ 349-G. RESTRICTIONS ON APPLICATIONS FOR AND USE OF CREDIT CARDS AND
MEDICAL FINANCIAL PRODUCTS. 1. FOR PURPOSES OF THIS SECTION, THE FOLLOW-
ING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
(A) "MEDICAL FINANCIAL PRODUCTS" SHALL MEAN MEDICAL CREDIT CARDS AND
THIRD-PARTY MEDICAL INSTALLMENT LOANS.
(B) "HEALTH CARE PROVIDER" SHALL MEAN A HEALTH CARE PROFESSIONAL
LICENSED, REGISTERED OR CERTIFIED PURSUANT TO TITLE EIGHT OF THE EDUCA-
TION LAW.
(C) "PROVIDER OFFICES" SHALL MEAN EITHER OF THE FOLLOWING:
(I) AN OFFICE OF A HEALTH CARE PROVIDER IN SOLO PRACTICE; OR
(II) AN OFFICE IN WHICH SERVICES OR GOODS ARE PERSONALLY PROVIDED BY
THE HEALTH CARE PROVIDER OR BY EMPLOYEES IN THAT OFFICE, OR PERSONALLY
BY INDEPENDENT CONTRACTORS IN THAT OFFICE, IN ACCORDANCE WITH LAW.
EMPLOYEES AND INDEPENDENT CONTRACTORS SHALL BE LICENSED OR CERTIFIED
WHEN LICENSURE OR CERTIFICATION IS REQUIRED BY LAW.
2. IT SHALL BE PROHIBITED FOR ANY INDIVIDUAL TO COMPLETE ANY PORTION
OF AN APPLICATION FOR MEDICAL FINANCIAL PRODUCTS FOR THE PATIENT OR
OTHERWISE ARRANGE FOR OR ESTABLISH AN APPLICATION THAT IS NOT COMPLETELY
FILLED OUT BY THE PATIENT.
§ 519-A. MEDICAL FINANCIAL PRODUCTS; PAYMENT FOR HEALTH CARE SERVICES.
1. FOR PURPOSES OF THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE
FOLLOWING MEANINGS:
(A) "CREDIT CARD" SHALL HAVE THE SAME MEANING AS IN SECTION FIVE
HUNDRED ELEVEN OF THIS ARTICLE.
(B) "MEDICAL CREDIT CARD" MEANS A CREDIT CARD ISSUED UNDER AN OPEN-END
OR CLOSED-END PLAN OFFERED SPECIFICALLY FOR THE PAYMENT OF HEALTH CARE
SERVICES, PRODUCTS, OR DEVICES PROVIDED TO A PERSON.
2. NO HEALTH CARE PROVIDER SHALL REQUIRE CREDIT CARD PRE-AUTHORIZATION
NOR REQUIRE THE PATIENT TO HAVE A CREDIT CARD ON FILE PRIOR TO PROVIDING
EMERGENCY OR MEDICALLY NECESSARY MEDICAL SERVICES TO SUCH PATIENT.
3. HEALTH CARE PROVIDERS SHALL NOTIFY ALL PATIENTS ABOUT THE RISKS OF
PAYING FOR MEDICAL SERVICES WITH A CREDIT CARD. SUCH NOTIFICATION SHALL
S. 8307--A 83 A. 8807--A
HIGHLIGHT THE FACT THAT BY USING A CREDIT CARD TO PAY FOR MEDICAL
SERVICES, THE PATIENT IS FORGOING STATE AND FEDERAL PROTECTIONS THAT
REGARD MEDICAL DEBT. THE COMMISSIONER OF HEALTH SHALL HAVE THE AUTHORI-
TY AND SOLE DISCRETION TO SET REQUIREMENTS FOR THE CONTENTS OF SUCH
NOTICES.
§ 5. This act shall take effect six months after it shall have become
a law.
PART P
Section 1. Section 8 of part C of chapter 57 of the laws of 2022
amending the public health law and the education law relating to allow-
ing pharmacists to direct limited service laboratories and order and
administer COVID-19 and influenza tests and modernizing nurse practi-
tioners, is amended to read as follows:
§ 8. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2022; provided,
however, that sections [one, two,] three[,] AND four[, six and seven] of
this act shall expire and be deemed repealed [two years after it shall
have become a law] APRIL 1, 2026.
§ 2. Section 5 of chapter 21 of the laws of 2011 amending the educa-
tion law relating to authorizing pharmacists to perform collaborative
drug therapy management with physicians in certain settings, as amended
by section 5 of part CC of chapter 57 of the laws of 2022, is amended to
read as follows:
§ 5. This act shall take effect on the one hundred twentieth day after
it shall have become a law[, provided, however, that the provisions of
sections two, three, and four of this act shall expire and be deemed
repealed July 1, 2024]; provided, however, that the amendments to subdi-
vision 1 of section 6801 of the education law made by section one of
this act shall be subject to the expiration and reversion of such subdi-
vision pursuant to section 8 of chapter 563 of the laws of 2008, when
upon such date the provisions of section one-a of this act shall take
effect; provided, further, that effective immediately, the addition,
amendment and/or repeal of any rule or regulation necessary for the
implementation of this act on its effective date are authorized and
directed to be made and completed on or before such effective date.
§ 3. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART Q
Section 1. Section 6542 of the education law, as amended by chapter 48
of the laws of 2012, subdivisions 3 and 5 as amended by section 1 of
part T of chapter 57 of the laws of 2013, is amended to read as follows:
§ 6542. Performance of medical services. 1. Notwithstanding any other
provision of law, a physician assistant may perform medical services,
but only when under the supervision of a physician and only when such
acts and duties as are assigned to him or her are within the scope of
practice of such supervising physician UNLESS OTHERWISE PERMITTED BY
THIS SECTION.
1-A. (A) A PHYSICIAN ASSISTANT MAY PRACTICE WITHOUT THE SUPERVISION OF
A PHYSICIAN UNDER THE FOLLOWING CIRCUMSTANCES:
(I) WHERE THE PHYSICIAN ASSISTANT, LICENSED UNDER SECTION SIXTY-FIVE
HUNDRED FORTY-ONE OF THIS ARTICLE HAS PRACTICED FOR MORE THAN EIGHT
THOUSAND HOURS; AND
S. 8307--A 84 A. 8807--A
(A) IS PRACTICING IN PRIMARY CARE. FOR PURPOSES OF THIS CLAUSE,
"PRIMARY CARE" SHALL MEAN NON-SURGICAL CARE IN THE FIELDS OF GENERAL
PEDIATRICS, GENERAL ADULT MEDICINE, GENERAL GERIATRIC MEDICINE, GENERAL
INTERNAL MEDICINE, OBSTETRICS AND GYNECOLOGY, FAMILY MEDICINE, OR SUCH
OTHER RELATED AREAS AS DETERMINED BY THE COMMISSIONER OF HEALTH; OR
(B) IS EMPLOYED BY A HEALTH SYSTEM OR HOSPITAL ESTABLISHED UNDER ARTI-
CLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, AND THE HEALTH SYSTEM OR
HOSPITAL DETERMINES THE PHYSICIAN ASSISTANT MEETS THE QUALIFICATIONS OF
THE MEDICAL STAFF BYLAWS AND THE HEALTH SYSTEM OR HOSPITAL GIVES THE
PHYSICIAN ASSISTANT PRIVILEGES; AND
(II) WHERE A PHYSICIAN ASSISTANT LICENSED UNDER SECTION SIXTY-FIVE
HUNDRED FORTY-ONE OF THIS ARTICLE HAS COMPLETED A PROGRAM APPROVED BY
THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
(B) THE DEPARTMENT AND THE DEPARTMENT OF HEALTH ARE AUTHORIZED TO
PROMULGATE AND UPDATE REGULATIONS PURSUANT TO THIS SECTION.
2. [Supervision] WHERE SUPERVISION IS REQUIRED BY THIS SECTION, IT
shall be continuous but shall not be construed as necessarily requiring
the physical presence of the supervising physician at the time and place
where such services are performed.
3. [No physician shall employ or supervise more than four physician
assistants in his or her private practice.
4.] Nothing in this article shall prohibit a hospital from employing
physician assistants provided they [work under the supervision of a
physician designated by the hospital and not beyond the scope of prac-
tice of such physician. The numerical limitation of subdivision three of
this section shall not apply to services performed in a hospital.
5. Notwithstanding any other provision of this article, nothing shall
prohibit a physician employed by or rendering services to the department
of corrections and community supervision under contract from supervising
no more than six physician assistants in his or her practice for the
department of corrections and community supervision.
6. Notwithstanding any other provision of law, a trainee in an
approved program may perform medical services when such services are
performed within the scope of such program.] MEET THE QUALIFICATIONS OF
THE MEDICAL STAFF BYLAWS AND ARE GIVEN PRIVILEGES AND OTHERWISE MEET THE
REQUIREMENTS OF THIS SECTION.
4. A PHYSICIAN ASSISTANT SHALL BE AUTHORIZED TO PRESCRIBE, DISPENSE,
ORDER, ADMINISTER, OR PROCURE ITEMS NECESSARY TO COMMENCE OR COMPLETE A
COURSE OF THERAPY.
5. A PHYSICIAN ASSISTANT MAY PRESCRIBE AND ORDER A PATIENT SPECIFIC
ORDER OR NON-PATIENT SPECIFIC REGIMEN TO A LICENSED PHARMACIST OR REGIS-
TERED PROFESSIONAL NURSE, PURSUANT TO REGULATIONS PROMULGATED BY THE
COMMISSIONER OF HEALTH, AND CONSISTENT WITH THE PUBLIC HEALTH LAW, FOR
ADMINISTERING IMMUNIZATIONS. NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE
UNLICENSED PERSONS TO ADMINISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
[7] 6. Nothing in this article, or in article thirty-seven of the
public health law, shall be construed to authorize physician assistants
to perform those specific functions and duties specifically delegated by
law to those persons licensed as allied health professionals under the
public health law or this chapter.
§ 2. Subdivision 1 of section 3701 of the public health law, as
amended by chapter 48 of the laws of 2012, is amended to read as
follows:
1. to promulgate regulations defining and restricting the duties
[which may be assigned to] OF physician assistants [by their supervising
S. 8307--A 85 A. 8807--A
physician, the degree of supervision required and the manner in which
such duties may be performed] CONSISTENT WITH SECTION SIXTY-FIVE HUNDRED
FORTY-TWO OF THE EDUCATION LAW.;
§ 3. Section 3702 of the public health law, as amended by chapter 48
of the laws of 2012, is amended to read as follows:
§ 3702. Special provisions. 1. Inpatient medical orders. A licensed
physician assistant employed or extended privileges by a hospital may,
if permissible under the bylaws, rules and regulations of the hospital,
write medical orders, including those for controlled substances AND
DURABLE MEDICAL EQUIPMENT, for inpatients [under the care of the physi-
cian responsible for his or her supervision. Countersignature of such
orders may be required if deemed necessary and appropriate by the super-
vising physician or the hospital, but in no event shall countersignature
be required prior to execution].
2. Withdrawing blood. A licensed physician assistant or certified
nurse practitioner acting within his or her lawful scope of practice may
supervise and direct the withdrawal of blood for the purpose of deter-
mining the alcoholic or drug content therein under subparagraph one of
paragraph (a) of subdivision four of section eleven hundred ninety-four
of the vehicle and traffic law, notwithstanding any provision to the
contrary in clause (ii) of such subparagraph.
3. Prescriptions for controlled substances. A licensed physician
assistant, in good faith and acting within his or her lawful scope of
practice, and to the extent assigned by his or her supervising physician
AS APPLICABLE BY SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE EDUCATION
LAW, may prescribe controlled substances as a practitioner under article
thirty-three of this chapter, to patients under the care of such physi-
cian responsible for his or her supervision. The commissioner, in
consultation with the commissioner of education, may promulgate such
regulations as are necessary to carry out the purposes of this section.
§ 4. Section 3703 of the public health law, as amended by chapter 48
of the laws of 2012, is amended to read as follows:
§ 3703. Statutory construction. A physician assistant may perform any
function in conjunction with a medical service lawfully performed by the
physician assistant, in any health care setting, that a statute author-
izes or directs a physician to perform and that is appropriate to the
education, training and experience of the licensed physician assistant
and within the ordinary practice of the supervising physician, AS APPLI-
CABLE PURSUANT TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE EDUCATION
LAW. This section shall not be construed to increase or decrease the
lawful scope of practice of a physician assistant under the education
law.
§ 5. Paragraph a of subdivision 2 of section 902 of the education law,
as amended by chapter 376 of the laws of 2015, is amended to read as
follows:
a. The board of education, and the trustee or board of trustees of
each school district, shall employ, at a compensation to be agreed upon
by the parties, a qualified physician, A PHYSICIAN ASSISTANT, or a nurse
practitioner to the extent authorized by the nurse practice act and
consistent with subdivision three of section six thousand nine hundred
two of this chapter, to perform the duties of the director of school
health services, including any duties conferred on the school physician
or school medical inspector under any provision of law, to perform and
coordinate the provision of health services in the public schools and to
provide health appraisals of students attending the public schools in
the city or district. The physicians, PHYSICIANS ASSISTANTS or nurse
S. 8307--A 86 A. 8807--A
practitioners so employed shall be duly licensed pursuant to applicable
law.
§ 6. Subdivision 5 of section 6810 of the education law, as added by
chapter 881 of the laws of 1972, is amended to read as follows:
5. Records of all prescriptions filled or refilled shall be maintained
for a period of at least five years and upon request made available for
inspection and copying by a representative of the department. Such
records shall indicate date of filling or refilling, [doctor's]
PRESCRIBER'S name, patient's name and address and the name or initials
of the pharmacist who prepared, compounded, or dispensed the
prescription. Records of prescriptions for controlled substances shall
be maintained pursuant to requirements of article thirty-three of the
public health law.
§ 7. Subdivision 27 of section 3302 of the public health law, as
amended by chapter 92 of the laws of 2021, is amended to read as
follows:
27. "Practitioner" means:
A physician, PHYSICIAN ASSISTANT, dentist, podiatrist, veterinarian,
scientific investigator, or other person licensed, or otherwise permit-
ted to dispense, administer or conduct research with respect to a
controlled substance in the course of a licensed professional practice
or research licensed pursuant to this article. Such person shall be
deemed a "practitioner" only as to such substances, or conduct relating
to such substances, as is permitted by [his] THEIR license, permit or
otherwise permitted by law.
§ 8. Section 6908 of the education law is amended by adding a new
subdivision 3 to read as follows:
3. THIS ARTICLE SHALL NOT BE CONSTRUED AS PROHIBITING MEDICATION
RELATED TASKS PROVIDED BY A CERTIFIED MEDICATION AIDE WORKING IN A RESI-
DENTIAL HEALTH CARE FACILITY, AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED
ONE OF THE PUBLIC HEALTH LAW, IN ACCORDANCE WITH REGULATIONS DEVELOPED
BY THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH.
THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH, SHALL
ADOPT REGULATIONS GOVERNING CERTIFIED MEDICATION AIDES THAT, AT A MINI-
MUM, SHALL:
A. SPECIFY THE MEDICATION-RELATED TASKS THAT MAY BE PERFORMED BY
CERTIFIED MEDICATION AIDES PURSUANT TO THIS SUBDIVISION. SUCH TASKS
SHALL INCLUDE THE ADMINISTRATION OF MEDICATIONS WHICH ARE ROUTINE AND
PRE-FILLED OR OTHERWISE PACKAGED IN A MANNER THAT PROMOTES RELATIVE EASE
OF ADMINISTRATION, PROVIDED THAT ADMINISTRATION OF MEDICATIONS BY
INJECTION, STERILE PROCEDURES, AND CENTRAL LINE MAINTENANCE SHALL BE
PROHIBITED. PROVIDED, HOWEVER, SUCH PROHIBITION SHALL NOT APPLY TO
INJECTIONS OF INSULIN OR OTHER INJECTIONS FOR DIABETES CARE, TO
INJECTIONS OF LOW MOLECULAR WEIGHT HEPARIN, AND TO PRE-FILLED AUTO-IN-
JECTIONS OF NALOXONE AND EPINEPHRINE FOR EMERGENCY PURPOSES, AND
PROVIDED, FURTHER, THAT ENTITIES EMPLOYING CERTIFIED MEDICATION AIDES
PURSUANT TO THIS SUBDIVISION SHALL ESTABLISH A SYSTEMATIC APPROACH TO
ADDRESS DRUG DIVERSION;
B. PROVIDE THAT MEDICATION-RELATED TASKS PERFORMED BY CERTIFIED MEDI-
CATION AIDES MAY BE PERFORMED ONLY UNDER THE SUPERVISION OF A REGISTERED
PROFESSIONAL NURSE LICENSED IN NEW YORK STATE, AS SET FORTH IN THIS
SUBDIVISION AND SUBDIVISION TWELVE OF SECTION SIXTY-NINE HUNDRED NINE OF
THIS ARTICLE;
C. ESTABLISH A PROCESS BY WHICH A REGISTERED PROFESSIONAL NURSE MAY
ASSIGN MEDICATION-RELATED TASKS TO A CERTIFIED MEDICATION AIDE. SUCH
PROCESS SHALL INCLUDE, BUT NOT BE LIMITED TO:
S. 8307--A 87 A. 8807--A
(I) ALLOWING ASSIGNMENT OF MEDICATION-RELATED TASKS TO A CERTIFIED
MEDICATION AIDE ONLY WHERE SUCH CERTIFIED MEDICATION AIDE HAS DEMON-
STRATED TO THE SATISFACTION OF THE SUPERVISING REGISTERED PROFESSIONAL
NURSE COMPETENCY IN EVERY MEDICATION-RELATED TASK THAT SUCH CERTIFIED
MEDICATION AIDE IS AUTHORIZED TO PERFORM, A WILLINGNESS TO PERFORM SUCH
MEDICATION-RELATED TASKS, AND THE ABILITY TO EFFECTIVELY AND EFFICIENTLY
COMMUNICATE WITH THE INDIVIDUAL RECEIVING SERVICES AND UNDERSTAND SUCH
INDIVIDUAL'S NEEDS;
(II) AUTHORIZING THE SUPERVISING REGISTERED PROFESSIONAL NURSE TO
REVOKE ANY ASSIGNED MEDICATION-RELATED TASK FROM A CERTIFIED MEDICATION
AIDE FOR ANY REASON; AND
(III) AUTHORIZING MULTIPLE REGISTERED PROFESSIONAL NURSES TO JOINTLY
AGREE TO ASSIGN MEDICATION-RELATED TASKS TO A CERTIFIED MEDICATION AIDE,
PROVIDED FURTHER THAT ONLY ONE REGISTERED PROFESSIONAL NURSE SHALL BE
REQUIRED TO DETERMINE IF THE CERTIFIED MEDICATION AIDE HAS DEMONSTRATED
COMPETENCY IN THE MEDICATION-RELATED TASK TO BE PERFORMED;
D. PROVIDE THAT MEDICATION-RELATED TASKS MAY BE PERFORMED ONLY IN
ACCORDANCE WITH AND PURSUANT TO AN AUTHORIZED HEALTH PRACTITIONER'S
ORDERED CARE;
E. PROVIDE THAT ONLY A CERTIFIED NURSE AIDE MAY PERFORM MEDICATION-RE-
LATED TASKS AS A CERTIFIED MEDICATION AIDE WHEN SUCH AIDE HAS:
(I) A VALID NEW YORK STATE NURSE AIDE CERTIFICATE;
(II) A HIGH SCHOOL DIPLOMA, OR ITS EQUIVALENT;
(III) EVIDENCE OF BEING AT LEAST EIGHTEEN YEARS OLD;
(IV) AT LEAST ONE YEAR OF EXPERIENCE PROVIDING NURSE AIDE SERVICES IN
A RESIDENTIAL HEALTH CARE FACILITY LICENSED PURSUANT TO ARTICLE TWENTY-
EIGHT OF THE PUBLIC HEALTH LAW OR A SIMILARLY LICENSED FACILITY IN
ANOTHER STATE OR UNITED STATES TERRITORY;
(V) THE ABILITY TO READ, WRITE, AND SPEAK ENGLISH AND TO PERFORM BASIC
MATH SKILLS;
(VI) COMPLETED THE REQUISITE TRAINING AND DEMONSTRATED COMPETENCIES OF
A CERTIFIED MEDICATION AIDE AS DETERMINED BY THE COMMISSIONER OF HEALTH
IN CONSULTATION WITH THE COMMISSIONER;
(VII) SUCCESSFULLY COMPLETED COMPETENCY EXAMINATIONS SATISFACTORY TO
THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER; AND
(VIII) MEETS OTHER APPROPRIATE QUALIFICATIONS AS DETERMINED BY THE
COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER;
F. PROHIBIT A CERTIFIED MEDICATION AIDE FROM HOLDING THEMSELVES OUT,
OR ACCEPTING EMPLOYMENT AS, A PERSON LICENSED TO PRACTICE NURSING UNDER
THE PROVISIONS OF THIS ARTICLE;
G. PROVIDE THAT A CERTIFIED MEDICATION AIDE IS NOT REQUIRED NOR
PERMITTED TO ASSESS THE MEDICATION OR MEDICAL NEEDS OF AN INDIVIDUAL;
H. PROVIDE THAT A CERTIFIED MEDICATION AIDE SHALL NOT BE AUTHORIZED TO
PERFORM ANY MEDICATION-RELATED TASKS OR ACTIVITIES PURSUANT TO THIS
SUBDIVISION THAT ARE OUTSIDE THE SCOPE OF PRACTICE OF A LICENSED PRACTI-
CAL NURSE OR ANY MEDICATION-RELATED TASKS THAT HAVE NOT BEEN APPROPRI-
ATELY ASSIGNED BY THE SUPERVISING REGISTERED PROFESSIONAL NURSE;
I. PROVIDE THAT A CERTIFIED MEDICATION AIDE SHALL DOCUMENT ALL MEDICA-
TION-RELATED TASKS PROVIDED TO AN INDIVIDUAL, INCLUDING MEDICATION
ADMINISTRATION TO EACH INDIVIDUAL THROUGH THE USE OF A MEDICATION ADMIN-
ISTRATION RECORD; AND
J. PROVIDE THAT THE SUPERVISING REGISTERED PROFESSIONAL NURSE SHALL
RETAIN THE DISCRETION TO DECIDE WHETHER TO ASSIGN MEDICATION-RELATED
TASKS TO CERTIFIED MEDICATION AIDES UNDER THIS PROGRAM AND SHALL NOT BE
SUBJECT TO COERCION, RETALIATION, OR THE THREAT OF RETALIATION.
S. 8307--A 88 A. 8807--A
§ 9. Section 6909 of the education law is amended by adding two new
subdivisions 12 and 13 to read as follows:
12. A REGISTERED PROFESSIONAL NURSE, WHILE WORKING FOR A RESIDENTIAL
HEALTH CARE FACILITY LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE
PUBLIC HEALTH LAW, MAY, IN ACCORDANCE WITH THIS SUBDIVISION, ASSIGN
CERTIFIED MEDICATION AIDES TO PERFORM MEDICATION-RELATED TASKS FOR INDI-
VIDUALS PURSUANT TO THE PROVISIONS OF SUBDIVISION THREE OF SECTION
SIXTY-NINE HUNDRED EIGHT OF THIS ARTICLE AND SUPERVISE CERTIFIED MEDICA-
TION AIDES WHO PERFORM ASSIGNED MEDICATION-RELATED TASKS.
13. NOTWITHSTANDING SUBDIVISION SEVEN OF SECTION SIXTY-FIVE HUNDRED
NINE OF THIS TITLE, A CERTIFIED NURSE PRACTITIONER MAY DIRECTLY ASSIGN
AND SUPERVISE A MEDICAL ASSISTANT IN AN OUTPATIENT SETTING THE TASK OF
DRAWING AND ADMINISTERING IMMUNIZATIONS TO PATIENTS, PROVIDED SUCH
MEDICAL ASSISTANT RECEIVES APPROPRIATE TRAINING FROM THE CERTIFIED NURSE
PRACTITIONER AND THE CERTIFIED NURSE PRACTITIONER REMAINS RESPONSIBLE
FOR THE ACTIONS OF THE MEDICAL ASSISTANT.
§ 10. Paragraph (a) of subdivision 3 of section 2803-j of the public
health law, as added by chapter 717 of the laws of 1989, is amended to
read as follows:
(a) Identification of individuals who have successfully completed a
nurse aide training and competency evaluation program, [or] a nurse aide
competency evaluation program, OR A MEDICATION AIDE PROGRAM;
§ 11. Section 6527 of the education law is amended by adding a new
subdivision 12 to read as follows:
12. NOTWITHSTANDING SUBDIVISION ELEVEN OF SECTION SIXTY-FIVE HUNDRED
THIRTY OF THIS TITLE, A LICENSED PHYSICIAN MAY DIRECTLY ASSIGN AND
SUPERVISE A MEDICAL ASSISTANT IN AN OUTPATIENT SETTING THE TASK OF DRAW-
ING AND ADMINISTERING IMMUNIZATIONS TO PATIENTS, PROVIDED SUCH MEDICAL
ASSISTANT RECEIVES APPROPRIATE TRAINING FROM THE LICENSED PHYSICIAN AND
THE LICENSED PHYSICIAN REMAINS RESPONSIBLE FOR THE ACTIONS OF THE
MEDICAL ASSISTANT.
§ 12. Section 6545 of the education law, as amended by chapter 48 of
the laws of 2012, is amended to read as follows:
§ 6545. [Emergency services rendered by physician assistant] SPECIAL
PROVISIONS. 1. Notwithstanding any inconsistent provision of any gener-
al, special or local law, any physician assistant properly licensed in
this state who voluntarily and without the expectation of monetary
compensation renders first aid or emergency treatment at the scene of an
accident or other emergency, outside a hospital, doctor's office or any
other place having proper and necessary medical equipment, to a person
who is unconscious, ill or injured, shall not be liable for damages for
injuries alleged to have been sustained by such person or for damages
for the death of such person alleged to have occurred by reason of an
act or omission in the rendering of such first aid or emergency treat-
ment unless it is established that such injuries were or such death was
caused by gross negligence on the part of such physician assistant.
Nothing in this section shall be deemed or construed to relieve a
licensed physician assistant from liability for damages for injuries or
death caused by an act or omission on the part of a physician assistant
while rendering professional services in the normal and ordinary course
of his or her practice.
2. NOTWITHSTANDING SUBDIVISION ELEVEN OF SECTION SIXTY-FIVE HUNDRED
THIRTY OF THIS TITLE, A LICENSED PHYSICIAN ASSISTANT AUTHORIZED PURSUANT
TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THIS ARTICLE TO PRACTICE
WITHOUT SUPERVISION OF A PHYSICIAN, MAY DIRECTLY ASSIGN AND SUPERVISE A
MEDICAL ASSISTANT IN AN OUTPATIENT SETTING THE TASK OF DRAWING AND
S. 8307--A 89 A. 8807--A
ADMINISTERING IMMUNIZATIONS TO PATIENTS, PROVIDED SUCH MEDICAL ASSISTANT
RECEIVES APPROPRIATE TRAINING FROM THE LICENSED PHYSICIAN ASSISTANT AND
THE LICENSED PHYSICIAN ASSISTANT REMAINS RESPONSIBLE FOR THE ACTIONS OF
THE MEDICAL ASSISTANT.
§ 13. Section 6601 of the education law, as amended by chapter 576 of
the laws of 2001, is amended to read as follows:
§ 6601. Definition of practice of dentistry. The practice of the
profession of dentistry is defined as diagnosing, treating, operating,
or prescribing for any disease, pain, injury, deformity, or physical
condition of the oral and maxillofacial area related to restoring and
maintaining dental health. The practice of dentistry includes the
prescribing and fabrication of dental prostheses and appliances. The
practice of dentistry may include performing physical evaluations in
conjunction with the provision of dental treatment, INCLUDING THE ADMIN-
ISTRATION OF VACCINATIONS AGAINST INFLUENZA, SARS-COV-2, HUMAN PAPILLO-
MAVIRUS (HPV), AND VACCINATIONS RELATED TO A DECLARED PUBLIC HEALTH
EMERGENCY. THE PRACTICE OF DENTISTRY MAY ALSO INCLUDE OFFERING OF HIV,
HEPATITIS C, AND HEMOGLOBIN A1C SCREENING OR DIAGNOSTIC TESTS.
§ 14. Section 6605-b of the education law, as added by chapter 437 of
the laws of 2001 and subdivision 1 as amended by chapter 198 of the laws
of 2022, is amended to read as follows:
§ 6605-b. Dental hygiene restricted local infiltration AND BLOCK
anesthesia/nitrous oxide analgesia certificate. 1. A dental hygienist
shall not administer or monitor nitrous oxide analgesia or local infil-
tration OR BLOCK anesthesia in the practice of dental hygiene without a
dental hygiene restricted local infiltration AND BLOCK
anesthesia/nitrous oxide analgesia certificate and except under the
personal supervision of a dentist and in accordance with regulations
promulgated by the commissioner. Personal supervision, for purposes of
this section, means that the supervising dentist remains in the dental
office where the local infiltration OR BLOCK anesthesia or nitrous oxide
analgesia services are being performed, personally authorizes and
prescribes the use of local infiltration OR BLOCK anesthesia or nitrous
oxide analgesia for the patient and, before dismissal of the patient,
personally examines the condition of the patient after the use of local
infiltration OR BLOCK anesthesia or nitrous oxide analgesia is
completed. It is professional misconduct for a dentist to fail to
provide the supervision required by this section, and any dentist found
guilty of such misconduct under the procedures prescribed in section
sixty-five hundred ten of this title shall be subject to the penalties
prescribed in section sixty-five hundred eleven of this title.
2. The commissioner shall promulgate regulations establishing stand-
ards and procedures for the issuance of such certificate. Such standards
shall require completion of an educational program and/or course of
training or experience sufficient to ensure that a dental hygienist is
specifically trained in the administration and monitoring of nitrous
oxide analgesia and local infiltration OR BLOCK anesthesia, the possible
effects of such use, and in the recognition of and response to possible
emergency situations.
3. The fee for a dental hygiene restricted local infiltration AND
BLOCK anesthesia/nitrous oxide analgesia certificate shall be twenty-
five dollars and shall be paid on a triennial basis upon renewal of such
certificate. A certificate may be suspended or revoked in the same
manner as a license to practice dental hygiene.
§ 15. Subdivision 1 of section 6606 of the education law, as amended
by chapter 239 of the laws of 2013, is amended to read as follows:
S. 8307--A 90 A. 8807--A
1. The practice of the profession of dental hygiene is defined as the
performance of dental services which shall include removing calcareous
deposits, accretions and stains from the exposed surfaces of the teeth
which begin at the epithelial attachment and applying topical agents
indicated for a complete dental prophylaxis, removing cement, placing or
removing rubber dam, removing sutures, placing matrix band, providing
patient education, applying topical medication, PLACING PRE-FIT ORTHO-
DONTIC BANDS, USING LIGHT-CURE COMPOSITE MATERIAL, TAKING CEPHALOMETRIC
RADIOGRAPHS, TAKING TWO-DIMENSIONAL AND THREE-DIMENSIONAL PHOTOGRAPHY OF
DENTITION, ADJUSTING REMOVABLE APPLIANCES INCLUDING NIGHTGUARDS, BLEACH-
ING TRAYS, RETAINERS AND DENTURES, placing and exposing diagnostic
dental X-ray films, performing topical fluoride applications and topical
anesthetic applications, polishing teeth, taking medical history, chart-
ing caries, taking impressions for study casts, placing and removing
temporary restorations, administering and monitoring nitrous oxide
analgesia and administering and monitoring local infiltration AND BLOCK
anesthesia, subject to certification in accordance with section sixty-
six hundred five-b of this article, and any other function in the defi-
nition of the practice of dentistry as may be delegated by a licensed
dentist in accordance with regulations promulgated by the commissioner.
The practice of dental hygiene may be conducted in the office of any
licensed dentist or in any appropriately equipped school or public
institution but must be done either under the supervision of a licensed
dentist or, in the case of a registered dental hygienist working for a
hospital as defined in article twenty-eight of the public health law[,]
OR pursuant to a collaborative arrangement with a licensed and regis-
tered dentist [who has a formal relationship with the same hospital]
PURSUANT TO SECTION SIXTY-SIX HUNDRED SEVEN-A OF THIS ARTICLE AND in
accordance with regulations promulgated by the department in consulta-
tion with the department of health. [Such collaborative arrangement
shall not obviate or supersede any law or regulation which requires
identified services to be performed under the personal supervision of a
dentist. When dental hygiene services are provided pursuant to a colla-
borative agreement, such dental hygienist shall instruct individuals to
visit a licensed dentist for comprehensive examination or treatment.]
§ 16. The education law is amended by adding a new section 6607-a to
read as follows:
§ 6607-A. PRACTICE OF COLLABORATIVE PRACTICE DENTAL HYGIENE AND USE OF
TITLE "REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE" (RDH-CP). 1.
THE PRACTICE OF THE PROFESSION OF DENTAL HYGIENE, AS DEFINED UNDER THIS
ARTICLE, MAY BE PERFORMED IN COLLABORATION WITH A LICENSED DENTIST
PROVIDED SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRAC-
TICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS TO BE KNOWN AS A COLLABO-
RATIVE PRACTICE AGREEMENT. UNDER A COLLABORATIVE PRACTICE AGREEMENT,
DENTAL HYGIENISTS MAY PERFORM ALL SERVICES WHICH ARE DESIGNATED IN REGU-
LATION WITHOUT PRIOR EVALUATION OF A DENTIST OR MEDICAL PROFESSIONAL AND
MAY BE PERFORMED WITHOUT SUPERVISION IN A COLLABORATIVE PRACTICE
SETTING.
2. (A) THE COLLABORATIVE PRACTICE AGREEMENT SHALL INCLUDE CONSIDER-
ATION FOR MEDICALLY COMPROMISED PATIENTS, SPECIFIC MEDICAL CONDITIONS,
AND AGE-AND PROCEDURE-SPECIFIC PRACTICE PROTOCOLS, INCLUDING, BUT NOT
LIMITED TO RECOMMENDED INTERVALS FOR THE PERFORMANCE OF DENTAL HYGIENE
SERVICES AND A PERIODICITY IN WHICH AN EXAMINATION BY A DENTIST SHOULD
OCCUR.
(B) THE COLLABORATIVE AGREEMENT SHALL BE:
S. 8307--A 91 A. 8807--A
(I) SIGNED AND MAINTAINED BY THE DENTIST, THE DENTAL HYGIENIST, AND
THE FACILITY, PROGRAM, OR ORGANIZATION;
(II) REVIEWED ANNUALLY BY THE COLLABORATING DENTIST AND DENTAL HYGIEN-
IST; AND
(III) MADE AVAILABLE TO THE DEPARTMENT AND OTHER INTERESTED PARTIES
UPON REQUEST.
(C) ONLY ONE AGREEMENT BETWEEN A COLLABORATING DENTIST AND REGISTERED
DENTAL HYGIENIST, COLLABORATIVE PRACTICE (RDH-CP) MAY BE IN FORCE AT A
TIME.
3. BEFORE PERFORMING ANY SERVICES AUTHORIZED UNDER THIS SECTION, A
DENTAL HYGIENIST SHALL PROVIDE THE PATIENT WITH A WRITTEN STATEMENT
ADVISING THE PATIENT THAT THE DENTAL HYGIENE SERVICES PROVIDED ARE NOT A
SUBSTITUTE FOR A DENTAL EXAMINATION BY A LICENSED DENTIST AND INSTRUCT-
ING INDIVIDUALS TO VISIT A LICENSED DENTIST FOR COMPREHENSIVE EXAMINA-
TION OR TREATMENT. IF THE DENTAL HYGIENIST MAKES ANY REFERRALS TO THE
PATIENT FOR FURTHER DENTAL PROCEDURES, THE DENTAL HYGIENIST MUST FILL
OUT A REFERRAL FORM AND PROVIDE A COPY OF THE FORM TO THE COLLABORATING
DENTIST.
4. THE COLLABORATIVE PRACTICE DENTAL HYGIENIST MAY ENTER INTO A
CONTRACTUAL ARRANGEMENT WITH ANY NEW YORK STATE LICENSED AND REGISTERED
DENTIST, HEALTH CARE FACILITY, PROGRAM, AND/OR NON-PROFIT ORGANIZATION
TO PERFORM DENTAL HYGIENE SERVICES IN THE FOLLOWING SETTINGS: DENTAL
OFFICES; LONG-TERM CARE FACILITIES/SKILLED NURSING FACILITIES; PUBLIC OR
PRIVATE SCHOOLS; PUBLIC HEALTH AGENCIES/FEDERALLY QUALIFIED HEALTH
CENTERS; CORRECTIONAL FACILITIES; PUBLIC INSTITUTIONS/MENTAL HEALTH
FACILITIES; DRUG TREATMENT FACILITIES; AND DOMESTIC VIOLENCE SHELTERS.
5. A COLLABORATING DENTIST SHALL HAVE COLLABORATIVE AGREEMENTS WITH NO
MORE THAN SIX COLLABORATIVE PRACTICE DENTAL HYGIENISTS. THE DEPARTMENT
MAY GRANT EXCEPTIONS TO THESE LIMITATIONS FOR PUBLIC HEALTH SETTINGS ON
A CASE-BY-CASE BASIS.
6. A DENTAL HYGIENIST MUST MAKE APPLICATION TO THE DEPARTMENT TO PRAC-
TICE AS A REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE (RDH-CP)
AND PAY A FEE SET BY THE DEPARTMENT. AS A CONDITION OF COLLABORATIVE
PRACTICE, THE DENTAL HYGIENIST SHALL HAVE BEEN ENGAGED IN PRACTICE FOR
AT LEAST THREE YEARS WITH A MINIMUM OF FOUR THOUSAND FIVE HUNDRED PRAC-
TICE HOURS AND SHALL COMPLETE AN EIGHT HOUR CONTINUING EDUCATION PROGRAM
THAT INCLUDES INSTRUCTION IN MEDICAL EMERGENCY PROCEDURES, RISK MANAGE-
MENT, DENTAL HYGIENE JURISPRUDENCE AND PROFESSIONAL ETHICS.
§ 17. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024; provided,
however, that sections one through seven of this act shall take effect
one year after this act shall have become a law.
PART R
Section 1. The education law is amended by adding a new article 169 to
read as follows:
ARTICLE 169
INTERSTATE MEDICAL LICENSURE COMPACT
SECTION 8860. SHORT TITLE.
8861. PURPOSE.
8862. DEFINITIONS.
8863. ELIGIBILITY.
8864. DESIGNATION OF STATE OF PRINCIPAL LICENSE.
8865. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE.
8866. FEES FOR EXPEDITED LICENSURE.
S. 8307--A 92 A. 8807--A
8867. RENEWAL AND CONTINUED PARTICIPATION.
8868. COORDINATED INFORMATION SYSTEM.
8869. JOINT INVESTIGATIONS.
8870. DISCIPLINARY ACTIONS.
8871. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION.
8872. POWERS AND DUTIES OF THE INTERSTATE COMMISSION.
8873. FINANCE POWERS.
8874. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION.
8875. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION.
8876. OVERSIGHT OF INTERSTATE COMPACT.
8877. ENFORCEMENT OF INTERSTATE COMPACT.
8878. DEFAULT PROCEDURES.
8879. DISPUTE RESOLUTION.
8880. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT.
8881. WITHDRAWAL.
8882. DISSOLUTION.
8883. SEVERABILITY AND CONSTRUCTION.
8884. BINDING EFFECT OF COMPACT AND OTHER LAWS.
§ 8860. SHORT TITLE. THIS ARTICLE SHALL BE KNOWN AND MAY BE CITED AS
THE "INTERSTATE MEDICAL LICENSURE COMPACT".
§ 8861. PURPOSE. IN ORDER TO STRENGTHEN ACCESS TO HEALTH CARE, AND IN
RECOGNITION OF THE ADVANCES IN THE DELIVERY OF HEALTH CARE, THE MEMBER
STATES OF THE INTERSTATE MEDICAL LICENSURE COMPACT HAVE ALLIED IN COMMON
PURPOSE TO DEVELOP A COMPREHENSIVE PROCESS THAT COMPLEMENTS THE EXISTING
LICENSING AND REGULATORY AUTHORITY OF STATE MEDICAL BOARDS, PROVIDES A
STREAMLINED PROCESS THAT ALLOWS PHYSICIANS TO BECOME LICENSED IN MULTI-
PLE STATES, THEREBY ENHANCING THE PORTABILITY OF A MEDICAL LICENSE AND
ENSURING THE SAFETY OF PATIENTS. THE COMPACT CREATES ANOTHER PATHWAY
FOR LICENSURE AND DOES NOT OTHERWISE CHANGE A STATE'S EXISTING MEDICAL
PRACTICE ACT. THE COMPACT ALSO ADOPTS THE PREVAILING STANDARD FOR LICEN-
SURE AND AFFIRMS THAT THE PRACTICE OF MEDICINE OCCURS WHERE THE PATIENT
IS LOCATED AT THE TIME OF THE PHYSICIAN-PATIENT ENCOUNTER, AND THERE-
FORE, REQUIRES THE PHYSICIAN TO BE UNDER THE JURISDICTION OF THE STATE
MEDICAL BOARD WHERE THE PATIENT IS LOCATED. STATE MEDICAL BOARDS THAT
PARTICIPATE IN THE COMPACT RETAIN THE JURISDICTION TO IMPOSE AN ADVERSE
ACTION AGAINST A LICENSE TO PRACTICE MEDICINE IN THAT STATE ISSUED TO A
PHYSICIAN THROUGH THE PROCEDURES IN THE COMPACT.
§ 8862. DEFINITIONS. IN THIS COMPACT:
1. "BYLAWS" MEANS THOSE BYLAWS ESTABLISHED BY THE INTERSTATE COMMIS-
SION PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF THIS ARTI-
CLE FOR ITS GOVERNANCE, OR FOR DIRECTING AND CONTROLLING ITS ACTIONS AND
CONDUCT.
2. "COMMISSIONER" MEANS THE VOTING REPRESENTATIVE APPOINTED BY EACH
MEMBER BOARD PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF
THIS ARTICLE.
3. "CONVICTION" MEANS A FINDING BY A COURT THAT AN INDIVIDUAL IS GUIL-
TY OF A CRIMINAL OFFENSE THROUGH ADJUDICATION, OR ENTRY OF A PLEA OF
GUILT OR NO CONTEST TO THE CHARGE BY THE OFFENDER. EVIDENCE OF AN ENTRY
OF A CONVICTION OF A CRIMINAL OFFENSE BY THE COURT SHALL BE CONSIDERED
FINAL FOR PURPOSES OF DISCIPLINARY ACTION BY A MEMBER BOARD.
4. "EXPEDITED LICENSE" MEANS A FULL AND UNRESTRICTED MEDICAL LICENSE
GRANTED BY A MEMBER STATE TO AN ELIGIBLE PHYSICIAN THROUGH THE PROCESS
SET FORTH IN THE COMPACT.
5. "INTERSTATE COMMISSION" MEANS THE INTERSTATE COMMISSION CREATED
PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-ONE OF THIS ARTICLE.
S. 8307--A 93 A. 8807--A
6. "LICENSE" MEANS AUTHORIZATION BY A MEMBER STATE FOR A PHYSICIAN TO
ENGAGE IN THE PRACTICE OF MEDICINE, WHICH WOULD BE UNLAWFUL WITHOUT
AUTHORIZATION.
7. "MEDICAL PRACTICE ACT" MEANS LAWS AND REGULATIONS GOVERNING THE
PRACTICE OF ALLOPATHIC AND OSTEOPATHIC MEDICINE WITHIN A MEMBER STATE.
8. "MEMBER BOARD" MEANS A STATE AGENCY IN A MEMBER STATE THAT ACTS IN
THE SOVEREIGN INTERESTS OF THE STATE BY PROTECTING THE PUBLIC THROUGH
LICENSURE, REGULATION, AND EDUCATION OF PHYSICIANS AS DIRECTED BY THE
STATE GOVERNMENT.
9. "MEMBER STATE" MEANS A STATE THAT HAS ENACTED THE COMPACT.
10. "PRACTICE OF MEDICINE" MEANS THE CLINICAL PREVENTION, DIAGNOSIS,
OR TREATMENT OF HUMAN DISEASE, INJURY, OR CONDITION REQUIRING A PHYSI-
CIAN TO OBTAIN AND MAINTAIN A LICENSE IN COMPLIANCE WITH THE MEDICAL
PRACTICE ACT OF A MEMBER STATE.
11. "PHYSICIAN" MEANS ANY PERSON WHO:
(A) IS A GRADUATE OF A MEDICAL SCHOOL ACCREDITED BY THE LIAISON
COMMITTEE ON MEDICAL EDUCATION, THE COMMISSION ON OSTEOPATHIC COLLEGE
ACCREDITATION, OR A MEDICAL SCHOOL LISTED IN THE INTERNATIONAL MEDICAL
EDUCATION DIRECTORY OR ITS EQUIVALENT;
(B) PASSED EACH COMPONENT OF THE UNITED STATES MEDICAL LICENSING EXAM-
INATION (USMLE) OR THE COMPREHENSIVE OSTEOPATHIC MEDICAL LICENSING EXAM-
INATION (COMLEX-USA) WITHIN THREE ATTEMPTS, OR ANY OF ITS PREDECESSOR
EXAMINATIONS ACCEPTED BY A STATE MEDICAL BOARD AS AN EQUIVALENT EXAMINA-
TION FOR LICENSURE PURPOSES;
(C) SUCCESSFULLY COMPLETED GRADUATE MEDICAL EDUCATION APPROVED BY THE
ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION OR THE AMERICAN
OSTEOPATHIC ASSOCIATION;
(D) HOLDS SPECIALTY CERTIFICATION OR A TIME-UNLIMITED SPECIALTY
CERTIFICATE RECOGNIZED BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES OR
THE AMERICAN OSTEOPATHIC ASSOCIATION'S BUREAU OF OSTEOPATHIC SPECIAL-
ISTS;
(E) POSSESSES A FULL AND UNRESTRICTED LICENSE TO ENGAGE IN THE PRAC-
TICE OF MEDICINE ISSUED BY A MEMBER BOARD;
(F) HAS NEVER BEEN CONVICTED, RECEIVED ADJUDICATION, DEFERRED ADJUDI-
CATION, COMMUNITY SUPERVISION, OR DEFERRED DISPOSITION FOR ANY OFFENSE
BY A COURT OF APPROPRIATE JURISDICTION;
(G) HAS NEVER HELD A LICENSE AUTHORIZING THE PRACTICE OF MEDICINE
SUBJECTED TO DISCIPLINE BY A LICENSING AGENCY IN ANY STATE, FEDERAL, OR
FOREIGN JURISDICTION, EXCLUDING ANY ACTION RELATED TO NON-PAYMENT OF
FEES RELATED TO A LICENSE;
(H) HAS NEVER HAD A CONTROLLED SUBSTANCE LICENSE OR PERMIT SUSPENDED
OR REVOKED BY A STATE OR THE UNITED STATES DRUG ENFORCEMENT ADMINIS-
TRATION; AND
(I) IS NOT UNDER ACTIVE INVESTIGATION BY A LICENSING AGENCY OR LAW
ENFORCEMENT AUTHORITY IN ANY STATE, FEDERAL, OR FOREIGN JURISDICTION.
12. "OFFENSE" MEANS A FELONY, GROSS MISDEMEANOR, OR CRIME OF MORAL
TURPITUDE.
13. "RULE" MEANS A WRITTEN STATEMENT BY THE INTERSTATE COMMISSION
PROMULGATED PURSUANT TO SECTION EIGHTY-EIGHT HUNDRED SEVENTY-TWO OF THIS
ARTICLE THAT IS OF GENERAL APPLICABILITY, IMPLEMENTS, INTERPRETS, OR
PRESCRIBES A POLICY OR PROVISION OF THE COMPACT, OR AN ORGANIZATIONAL,
PROCEDURAL, OR PRACTICE REQUIREMENT OF THE INTERSTATE COMMISSION, AND
HAS THE FORCE AND EFFECT OF STATUTORY LAW IN A MEMBER STATE, AND
INCLUDES THE AMENDMENT, REPEAL, OR SUSPENSION OF AN EXISTING RULE.
14. "STATE" MEANS ANY STATE, COMMONWEALTH, DISTRICT, OR TERRITORY OF
THE UNITED STATES.
S. 8307--A 94 A. 8807--A
15. "STATE OF PRINCIPAL LICENSE" MEANS A MEMBER STATE WHERE A PHYSI-
CIAN HOLDS A LICENSE TO PRACTICE MEDICINE AND WHICH HAS BEEN DESIGNATED
AS SUCH BY THE PHYSICIAN FOR PURPOSES OF REGISTRATION AND PARTICIPATION
IN THE COMPACT.
§ 8863. ELIGIBILITY. 1. A PHYSICIAN MUST MEET THE ELIGIBILITY REQUIRE-
MENTS AS DEFINED IN SUBDIVISION ELEVEN OF SECTION EIGHTY-EIGHT HUNDRED
SIXTY-TWO OF THIS ARTICLE TO RECEIVE AN EXPEDITED LICENSE UNDER THE
TERMS AND PROVISIONS OF THE COMPACT.
2. A PHYSICIAN WHO DOES NOT MEET THE REQUIREMENTS OF SUBDIVISION ELEV-
EN OF SECTION EIGHTY-EIGHT HUNDRED SIXTY-TWO OF THIS ARTICLE MAY OBTAIN
A LICENSE TO PRACTICE MEDICINE IN A MEMBER STATE IF THE INDIVIDUAL
COMPLIES WITH ALL LAWS AND REQUIREMENTS, OTHER THAN THE COMPACT, RELAT-
ING TO THE ISSUANCE OF A LICENSE TO PRACTICE MEDICINE IN THAT STATE.
§ 8864. DESIGNATION OF STATE OF PRINCIPAL LICENSE. 1. A PHYSICIAN
SHALL DESIGNATE A MEMBER STATE AS THE STATE OF PRINCIPAL LICENSE FOR
PURPOSES OF REGISTRATION FOR EXPEDITED LICENSURE THROUGH THE COMPACT IF
THE PHYSICIAN POSSESSES A FULL AND UNRESTRICTED LICENSE TO PRACTICE
MEDICINE IN THAT STATE, AND THE STATE IS:
(A) THE STATE OF PRINCIPAL RESIDENCE FOR THE PHYSICIAN, OR
(B) THE STATE WHERE AT LEAST TWENTY-FIVE PERCENT OF THE PRACTICE OF
MEDICINE OCCURS, OR
(C) THE LOCATION OF THE PHYSICIAN'S EMPLOYER, OR
(D) IF NO STATE QUALIFIES UNDER PARAGRAPH (A), (B), OR (C) OF THIS
SUBDIVISION, THE STATE DESIGNATED AS STATE OF RESIDENCE FOR PURPOSE OF
FEDERAL INCOME TAX.
2. A PHYSICIAN MAY REDESIGNATE A MEMBER STATE AS STATE OF PRINCIPAL
LICENSE AT ANY TIME, AS LONG AS THE STATE MEETS THE REQUIREMENTS OF
SUBDIVISION ONE OF THIS SECTION.
3. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO FACILI-
TATE REDESIGNATION OF ANOTHER MEMBER STATE AS THE STATE OF PRINCIPAL
LICENSE.
§ 8865. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE. 1. A PHYSI-
CIAN SEEKING LICENSURE THROUGH THE COMPACT SHALL FILE AN APPLICATION FOR
AN EXPEDITED LICENSE WITH THE MEMBER BOARD OF THE STATE SELECTED BY THE
PHYSICIAN AS THE STATE OF PRINCIPAL LICENSE.
2. UPON RECEIPT OF AN APPLICATION FOR AN EXPEDITED LICENSE, THE MEMBER
BOARD WITHIN THE STATE SELECTED AS THE STATE OF PRINCIPAL LICENSE SHALL
EVALUATE WHETHER THE PHYSICIAN IS ELIGIBLE FOR EXPEDITED LICENSURE AND
ISSUE A LETTER OF QUALIFICATION, VERIFYING OR DENYING THE PHYSICIAN'S
ELIGIBILITY, TO THE INTERSTATE COMMISSION.
(A) STATIC QUALIFICATIONS, WHICH INCLUDE VERIFICATION OF MEDICAL
EDUCATION, GRADUATE MEDICAL EDUCATION, RESULTS OF ANY MEDICAL OR LICENS-
ING EXAMINATION, AND OTHER QUALIFICATIONS AS DETERMINED BY THE INTER-
STATE COMMISSION THROUGH RULE, SHALL NOT BE SUBJECT TO ADDITIONAL PRIMA-
RY SOURCE VERIFICATION WHERE ALREADY PRIMARY SOURCE VERIFIED BY THE
STATE OF PRINCIPAL LICENSE.
(B) THE MEMBER BOARD WITHIN THE STATE SELECTED AS THE STATE OF PRINCI-
PAL LICENSE SHALL, IN THE COURSE OF VERIFYING ELIGIBILITY, PERFORM A
CRIMINAL BACKGROUND CHECK OF AN APPLICANT, INCLUDING THE USE OF THE
RESULTS OF FINGERPRINT OR OTHER BIOMETRIC DATA CHECKS COMPLIANT WITH THE
REQUIREMENTS OF THE FEDERAL BUREAU OF INVESTIGATION, WITH THE EXCEPTION
OF FEDERAL EMPLOYEES WHO HAVE SUITABILITY DETERMINATION IN ACCORDANCE
WITH U.S. C.F.R. § 731.202.
(C) APPEAL ON THE DETERMINATION OF ELIGIBILITY SHALL BE MADE TO THE
MEMBER STATE WHERE THE APPLICATION WAS FILED AND SHALL BE SUBJECT TO THE
LAW OF THAT STATE.
S. 8307--A 95 A. 8807--A
3. UPON VERIFICATION UNDER SUBDIVISION TWO OF THIS SECTION, PHYSICIANS
ELIGIBLE FOR AN EXPEDITED LICENSE SHALL COMPLETE THE REGISTRATION PROC-
ESS ESTABLISHED BY THE INTERSTATE COMMISSION TO RECEIVE A LICENSE IN A
MEMBER STATE SELECTED PURSUANT TO SUBDIVISION ONE OF THIS SECTION,
INCLUDING THE PAYMENT OF ANY APPLICABLE FEES.
4. AFTER RECEIVING VERIFICATION OF ELIGIBILITY UNDER SUBDIVISION TWO
OF THIS SECTION AND ANY FEES UNDER SUBDIVISION THREE OF THIS SECTION, A
MEMBER BOARD SHALL ISSUE AN EXPEDITED LICENSE TO THE PHYSICIAN. THIS
LICENSE SHALL AUTHORIZE THE PHYSICIAN TO PRACTICE MEDICINE IN THE ISSU-
ING STATE CONSISTENT WITH THE MEDICAL PRACTICE ACT AND ALL APPLICABLE
LAWS AND REGULATIONS OF THE ISSUING MEMBER BOARD AND MEMBER STATE.
5. AN EXPEDITED LICENSE SHALL BE VALID FOR A PERIOD CONSISTENT WITH
THE LICENSURE PERIOD IN THE MEMBER STATE AND IN THE SAME MANNER AS
REQUIRED FOR OTHER PHYSICIANS HOLDING A FULL AND UNRESTRICTED LICENSE
WITHIN THE MEMBER STATE.
6. AN EXPEDITED LICENSE OBTAINED THOUGH THE COMPACT SHALL BE TERMI-
NATED IF A PHYSICIAN FAILS TO MAINTAIN A LICENSE IN THE STATE OF PRINCI-
PAL LICENSURE FOR A NON-DISCIPLINARY REASON, WITHOUT REDESIGNATION OF A
NEW STATE OF PRINCIPAL LICENSURE.
7. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES REGARDING
THE APPLICATION PROCESS, INCLUDING PAYMENT OF ANY APPLICABLE FEES, AND
THE ISSUANCE OF AN EXPEDITED LICENSE.
§ 8866. FEES FOR EXPEDITED LICENSURE. 1. A MEMBER STATE ISSUING AN
EXPEDITED LICENSE AUTHORIZING THE PRACTICE OF MEDICINE IN THAT STATE MAY
IMPOSE A FEE FOR A LICENSE ISSUED OR RENEWED THROUGH THE COMPACT.
2. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES REGARDING
FEES FOR EXPEDITED LICENSES.
§ 8867. RENEWAL AND CONTINUED PARTICIPATION. 1. A PHYSICIAN SEEKING TO
RENEW AN EXPEDITED LICENSE GRANTED IN A MEMBER STATE SHALL COMPLETE A
RENEWAL PROCESS WITH THE INTERSTATE COMMISSION IF THE PHYSICIAN:
(A) MAINTAINS A FULL AND UNRESTRICTED LICENSE IN A STATE OF PRINCIPAL
LICENSE;
(B) HAS NOT BEEN CONVICTED, RECEIVED ADJUDICATION, DEFERRED ADJUDI-
CATION, COMMUNITY SUPERVISION, OR DEFERRED DISPOSITION FOR ANY OFFENSE
BY A COURT OF APPROPRIATE JURISDICTION;
(C) HAS NOT HAD A LICENSE AUTHORIZING THE PRACTICE OF MEDICINE SUBJECT
TO DISCIPLINE BY A LICENSING AGENCY IN ANY STATE, FEDERAL, OR FOREIGN
JURISDICTION, EXCLUDING ANY ACTION RELATED TO NON-PAYMENT OF FEES
RELATED TO A LICENSE; AND
(D) HAS NOT HAD A CONTROLLED SUBSTANCE LICENSE OR PERMIT SUSPENDED OR
REVOKED BY A STATE OR THE UNITED STATES DRUG ENFORCEMENT ADMINISTRATION.
2. PHYSICIANS SHALL COMPLY WITH ALL CONTINUING PROFESSIONAL DEVELOP-
MENT OR CONTINUING MEDICAL EDUCATION REQUIREMENTS FOR RENEWAL OF A
LICENSE ISSUED BY A MEMBER STATE.
3. THE INTERSTATE COMMISSION SHALL COLLECT ANY RENEWAL FEES CHARGED
FOR THE RENEWAL OF A LICENSE AND DISTRIBUTE THE FEES TO THE APPLICABLE
MEMBER BOARD.
4. UPON RECEIPT OF ANY RENEWAL FEES COLLECTED IN SUBDIVISION THREE OF
THIS SECTION, A MEMBER BOARD SHALL RENEW THE PHYSICIAN'S LICENSE.
5. PHYSICIAN INFORMATION COLLECTED BY THE INTERSTATE COMMISSION DURING
THE RENEWAL PROCESS WILL BE DISTRIBUTED TO ALL MEMBER BOARDS.
6. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO ADDRESS
RENEWAL OF LICENSES OBTAINED THROUGH THE COMPACT.
§ 8868. COORDINATED INFORMATION SYSTEM. 1. THE INTERSTATE COMMISSION
SHALL ESTABLISH A DATABASE OF ALL PHYSICIANS LICENSED, OR WHO HAVE
S. 8307--A 96 A. 8807--A
APPLIED FOR LICENSURE, UNDER SECTION EIGHTY-EIGHT HUNDRED SIXTY-FIVE OF
THIS ARTICLE.
2. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, MEMBER BOARDS SHALL
REPORT TO THE INTERSTATE COMMISSION ANY PUBLIC ACTION OR COMPLAINTS
AGAINST A LICENSED PHYSICIAN WHO HAS APPLIED OR RECEIVED AN EXPEDITED
LICENSE THROUGH THE COMPACT.
3. MEMBER BOARDS SHALL REPORT DISCIPLINARY OR INVESTIGATORY INFORMA-
TION DETERMINED AS NECESSARY AND PROPER BY RULE OF THE INTERSTATE
COMMISSION.
4. MEMBER BOARDS MAY REPORT ANY NON-PUBLIC COMPLAINT, DISCIPLINARY, OR
INVESTIGATORY INFORMATION NOT REQUIRED BY SUBDIVISION THREE OF THIS
SECTION TO THE INTERSTATE COMMISSION.
5. MEMBER BOARDS SHALL SHARE COMPLAINT OR DISCIPLINARY INFORMATION
ABOUT A PHYSICIAN UPON REQUEST OF ANOTHER MEMBER BOARD.
6. ALL INFORMATION PROVIDED TO THE INTERSTATE COMMISSION OR DISTRIB-
UTED BY MEMBER BOARDS SHALL BE CONFIDENTIAL, FILED UNDER SEAL, AND USED
ONLY FOR INVESTIGATORY OR DISCIPLINARY MATTERS.
7. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES FOR
MANDATED OR DISCRETIONARY SHARING OF INFORMATION BY MEMBER BOARDS.
§ 8869. JOINT INVESTIGATIONS. 1. LICENSURE AND DISCIPLINARY RECORDS OF
PHYSICIANS ARE DEEMED INVESTIGATIVE.
2. IN ADDITION TO THE AUTHORITY GRANTED TO A MEMBER BOARD BY ITS
RESPECTIVE MEDICAL PRACTICE ACT OR OTHER APPLICABLE STATE LAW, A MEMBER
BOARD MAY PARTICIPATE WITH OTHER MEMBER BOARDS IN JOINT INVESTIGATIONS
OF PHYSICIANS LICENSED BY THE MEMBER BOARDS.
3. A SUBPOENA ISSUED BY A MEMBER STATE SHALL BE ENFORCEABLE IN OTHER
MEMBER STATES.
4. MEMBER BOARDS MAY SHARE ANY INVESTIGATIVE, LITIGATION, OR COMPLI-
ANCE MATERIALS IN FURTHERANCE OF ANY JOINT OR INDIVIDUAL INVESTIGATION
INITIATED UNDER THE COMPACT.
5. ANY MEMBER STATE MAY INVESTIGATE ACTUAL OR ALLEGED VIOLATIONS OF
THE STATUTES AUTHORIZING THE PRACTICE OF MEDICINE IN ANY OTHER MEMBER
STATE IN WHICH A PHYSICIAN HOLDS A LICENSE TO PRACTICE MEDICINE.
§ 8870. DISCIPLINARY ACTIONS. 1. ANY DISCIPLINARY ACTION TAKEN BY ANY
MEMBER BOARD AGAINST A PHYSICIAN LICENSED THROUGH THE COMPACT SHALL BE
DEEMED UNPROFESSIONAL CONDUCT WHICH MAY BE SUBJECT TO DISCIPLINE BY
OTHER MEMBER BOARDS, IN ADDITION TO ANY VIOLATION OF THE MEDICAL PRAC-
TICE ACT OR REGULATIONS IN THAT STATE.
2. IF A LICENSE GRANTED TO A PHYSICIAN BY THE MEMBER BOARD IN THE
STATE OF PRINCIPAL LICENSE IS REVOKED, SURRENDERED OR RELINQUISHED IN
LIEU OF DISCIPLINE, OR SUSPENDED, THEN ALL LICENSES ISSUED TO THE PHYSI-
CIAN BY MEMBER BOARDS SHALL AUTOMATICALLY BE PLACED, WITHOUT FURTHER
ACTION NECESSARY BY ANY MEMBER BOARD, ON THE SAME STATUS. IF THE MEMBER
BOARD IN THE STATE OF PRINCIPAL LICENSE SUBSEQUENTLY REINSTATES THE
PHYSICIAN'S LICENSE, A LICENSE ISSUED TO THE PHYSICIAN BY ANY OTHER
MEMBER BOARD SHALL REMAIN ENCUMBERED UNTIL THAT RESPECTIVE MEMBER BOARD
TAKES ACTION TO REINSTATE THE LICENSE IN A MANNER CONSISTENT WITH THE
MEDICAL PRACTICE ACT OF THAT STATE.
3. IF DISCIPLINARY ACTION IS TAKEN AGAINST A PHYSICIAN BY A MEMBER
BOARD NOT IN THE STATE OF PRINCIPAL LICENSE, ANY OTHER MEMBER BOARD MAY
DEEM THE ACTION CONCLUSIVE AS TO MATTER OF LAW AND FACT DECIDED, AND:
(A) IMPOSE THE SAME OR LESSER SANCTION OR SANCTIONS AGAINST THE PHYSI-
CIAN SO LONG AS SUCH SANCTIONS ARE CONSISTENT WITH THE MEDICAL PRACTICE
ACT OF THAT STATE; OR
S. 8307--A 97 A. 8807--A
(B) PURSUE SEPARATE DISCIPLINARY ACTION AGAINST THE PHYSICIAN UNDER
ITS RESPECTIVE MEDICAL PRACTICE ACT, REGARDLESS OF THE ACTION TAKEN IN
OTHER MEMBER STATES.
4. IF A LICENSE GRANTED TO A PHYSICIAN BY A MEMBER BOARD IS REVOKED,
SURRENDERED, OR RELINQUISHED IN LIEU OF DISCIPLINE, OR SUSPENDED, THEN
ANY LICENSE OR LICENSES ISSUED TO THE PHYSICIAN BY ANY OTHER MEMBER
BOARD OR BOARDS SHALL BE SUSPENDED, AUTOMATICALLY AND IMMEDIATELY WITH-
OUT FURTHER ACTION NECESSARY BY THE OTHER MEMBER BOARD OR BOARDS, FOR
NINETY DAYS UPON ENTRY OF THE ORDER BY THE DISCIPLINING BOARD, TO PERMIT
THE MEMBER BOARD OR BOARDS TO INVESTIGATE THE BASIS FOR THE ACTION UNDER
THE MEDICAL PRACTICE ACT OF THAT STATE. A MEMBER BOARD MAY TERMINATE THE
AUTOMATIC SUSPENSION OF THE LICENSE IT ISSUED PRIOR TO THE COMPLETION OF
THE NINETY DAY SUSPENSION PERIOD IN A MANNER CONSISTENT WITH THE MEDICAL
PRACTICE ACT OF THAT STATE.
§ 8871. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION. 1. THE MEMBER
STATES HEREBY CREATE THE "INTERSTATE MEDICAL LICENSURE COMPACT COMMIS-
SION".
2. THE PURPOSE OF THE INTERSTATE COMMISSION IS THE ADMINISTRATION OF
THE INTERSTATE MEDICAL LICENSURE COMPACT, WHICH IS A DISCRETIONARY STATE
FUNCTION.
3. THE INTERSTATE COMMISSION SHALL BE A BODY CORPORATE AND JOINT AGEN-
CY OF THE MEMBER STATES AND SHALL HAVE ALL THE RESPONSIBILITIES, POWERS,
AND DUTIES SET FORTH IN THE COMPACT, AND SUCH ADDITIONAL POWERS AS MAY
BE CONFERRED UPON IT BY A SUBSEQUENT CONCURRENT ACTION OF THE RESPECTIVE
LEGISLATURES OF THE MEMBER STATES IN ACCORDANCE WITH THE TERMS OF THE
COMPACT.
4. THE INTERSTATE COMMISSION SHALL CONSIST OF TWO VOTING REPRESEN-
TATIVES APPOINTED BY EACH MEMBER STATE WHO SHALL SERVE AS COMMISSIONERS.
IN STATES WHERE ALLOPATHIC AND OSTEOPATHIC PHYSICIANS ARE REGULATED BY
SEPARATE MEMBER BOARDS, OR IF THE LICENSING AND DISCIPLINARY AUTHORITY
IS SPLIT BETWEEN MULTIPLE MEMBER BOARDS WITHIN A MEMBER STATE, THE
MEMBER STATE SHALL APPOINT ONE REPRESENTATIVE FROM EACH MEMBER BOARD. A
COMMISSIONER SHALL BE A OR AN:
(A) ALLOPATHIC OR OSTEOPATHIC PHYSICIAN APPOINTED TO A MEMBER BOARD;
(B) EXECUTIVE DIRECTOR, EXECUTIVE SECRETARY, OR SIMILAR EXECUTIVE OF A
MEMBER BOARD; OR
(C) MEMBER OF THE PUBLIC APPOINTED TO A MEMBER BOARD.
5. THE INTERSTATE COMMISSION SHALL MEET AT LEAST ONCE EACH CALENDAR
YEAR. A PORTION OF THIS MEETING SHALL BE A BUSINESS MEETING TO ADDRESS
SUCH MATTERS AS MAY PROPERLY COME BEFORE THE COMMISSION, INCLUDING THE
ELECTION OF OFFICERS. THE CHAIRPERSON MAY CALL ADDITIONAL MEETINGS AND
SHALL CALL FOR A MEETING UPON THE REQUEST OF A MAJORITY OF THE MEMBER
STATES.
6. THE BYLAWS MAY PROVIDE FOR MEETINGS OF THE INTERSTATE COMMISSION TO
BE CONDUCTED BY TELECOMMUNICATION OR ELECTRONIC COMMUNICATION.
7. EACH COMMISSIONER PARTICIPATING AT A MEETING OF THE INTERSTATE
COMMISSION IS ENTITLED TO ONE VOTE. A MAJORITY OF COMMISSIONERS SHALL
CONSTITUTE A QUORUM FOR THE TRANSACTION OF BUSINESS, UNLESS A LARGER
QUORUM IS REQUIRED BY THE BYLAWS OF THE INTERSTATE COMMISSION. A COMMIS-
SIONER SHALL NOT DELEGATE A VOTE TO ANOTHER COMMISSIONER. IN THE ABSENCE
OF ITS COMMISSIONER, A MEMBER STATE MAY DELEGATE VOTING AUTHORITY FOR A
SPECIFIED MEETING TO ANOTHER PERSON FROM THAT STATE WHO SHALL MEET THE
REQUIREMENTS OF SUBDIVISION FOUR OF THIS SECTION.
8. THE INTERSTATE COMMISSION SHALL PROVIDE PUBLIC NOTICE OF ALL MEET-
INGS AND ALL MEETINGS SHALL BE OPEN TO THE PUBLIC. THE INTERSTATE
COMMISSION MAY CLOSE A MEETING, IN FULL OR IN PORTION, WHERE IT DETER-
S. 8307--A 98 A. 8807--A
MINES BY A TWO-THIRDS VOTE OF THE COMMISSIONERS PRESENT THAT AN OPEN
MEETING WOULD BE LIKELY TO:
(A) RELATE SOLELY TO THE INTERNAL PERSONNEL PRACTICES AND PROCEDURES
OF THE INTERSTATE COMMISSION;
(B) DISCUSS MATTERS SPECIFICALLY EXEMPTED FROM DISCLOSURE BY FEDERAL
STATUTE;
(C) DISCUSS TRADE SECRETS, COMMERCIAL, OR FINANCIAL INFORMATION THAT
IS PRIVILEGED OR CONFIDENTIAL;
(D) INVOLVE ACCUSING A PERSON OF A CRIME, OR FORMALLY CENSURING A
PERSON;
(E) DISCUSS INFORMATION OF A PERSONAL NATURE WHERE DISCLOSURE WOULD
CONSTITUTE A CLEARLY UNWARRANTED INVASION OF PERSONAL PRIVACY;
(F) DISCUSS INVESTIGATIVE RECORDS COMPILED FOR LAW ENFORCEMENT
PURPOSES; OR
(G) SPECIFICALLY RELATE TO THE PARTICIPATION IN A CIVIL ACTION OR
OTHER LEGAL PROCEEDING.
9. THE INTERSTATE COMMISSION SHALL KEEP MINUTES WHICH SHALL FULLY
DESCRIBE ALL MATTERS DISCUSSED IN A MEETING AND SHALL PROVIDE A FULL AND
ACCURATE SUMMARY OF ACTIONS TAKEN, INCLUDING RECORD OF ANY ROLL CALL
VOTES.
10. THE INTERSTATE COMMISSION SHALL MAKE ITS INFORMATION AND OFFICIAL
RECORDS, TO THE EXTENT NOT OTHERWISE DESIGNATED IN THE COMPACT OR BY ITS
RULES, AVAILABLE TO THE PUBLIC FOR INSPECTION.
11. THE INTERSTATE COMMISSION SHALL ESTABLISH AN EXECUTIVE COMMITTEE,
WHICH SHALL INCLUDE OFFICERS, MEMBERS, AND OTHERS AS DETERMINED BY THE
BYLAWS. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO ACT ON BEHALF OF
THE INTERSTATE COMMISSION, WITH THE EXCEPTION OF RULEMAKING, DURING
PERIODS WHEN THE INTERSTATE COMMISSION IS NOT IN SESSION. WHEN ACTING ON
BEHALF OF THE INTERSTATE COMMISSION, THE EXECUTIVE COMMITTEE SHALL OVER-
SEE THE ADMINISTRATION OF THE COMPACT INCLUDING ENFORCEMENT AND COMPLI-
ANCE WITH THE PROVISIONS OF THE COMPACT, ITS BYLAWS AND RULES, AND OTHER
SUCH DUTIES AS NECESSARY.
12. THE INTERSTATE COMMISSION SHALL ESTABLISH OTHER COMMITTEES FOR
GOVERNANCE AND ADMINISTRATION OF THE COMPACT.
§ 8872. POWERS AND DUTIES OF THE INTERSTATE COMMISSION. THE INTERSTATE
COMMISSION SHALL HAVE THE DUTY AND POWER TO:
1. OVERSEE AND MAINTAIN THE ADMINISTRATION OF THE COMPACT;
2. PROMULGATE RULES WHICH SHALL BE BINDING TO THE EXTENT AND IN THE
MANNER PROVIDED FOR IN THE COMPACT;
3. ISSUE, UPON THE REQUEST OF A MEMBER STATE OR MEMBER BOARD, ADVISORY
OPINIONS CONCERNING THE MEANING OR INTERPRETATION OF THE COMPACT, ITS
BYLAWS, RULES, AND ACTIONS;
4. ENFORCE COMPLIANCE WITH COMPACT PROVISIONS, THE RULES PROMULGATED
BY THE INTERSTATE COMMISSION, AND THE BYLAWS, USING ALL NECESSARY AND
PROPER MEANS, INCLUDING BUT NOT LIMITED TO THE USE OF JUDICIAL PROCESS;
5. ESTABLISH AND APPOINT COMMITTEES INCLUDING, BUT NOT LIMITED TO, AN
EXECUTIVE COMMITTEE AS REQUIRED BY SECTION EIGHTY-EIGHT HUNDRED SEVEN-
TY-ONE OF THIS ARTICLE, WHICH SHALL HAVE THE POWER TO ACT ON BEHALF OF
THE INTERSTATE COMMISSION IN CARRYING OUT ITS POWERS AND DUTIES;
6. PAY, OR PROVIDE FOR THE PAYMENT OF THE EXPENSES RELATED TO THE
ESTABLISHMENT, ORGANIZATION, AND ONGOING ACTIVITIES OF THE INTERSTATE
COMMISSION;
7. ESTABLISH AND MAINTAIN ONE OR MORE OFFICES;
8. BORROW, ACCEPT, HIRE, OR CONTRACT FOR SERVICES OF PERSONNEL;
9. PURCHASE AND MAINTAIN INSURANCE AND BONDS;
S. 8307--A 99 A. 8807--A
10. EMPLOY AN EXECUTIVE DIRECTOR WHO SHALL HAVE SUCH POWERS TO EMPLOY,
SELECT OR APPOINT EMPLOYEES, AGENTS, OR CONSULTANTS, AND TO DETERMINE
THEIR QUALIFICATIONS, DEFINE THEIR DUTIES, AND FIX THEIR COMPENSATION;
11. ESTABLISH PERSONNEL POLICIES AND PROGRAMS RELATING TO CONFLICTS OF
INTEREST, RATES OF COMPENSATION, AND QUALIFICATIONS OF PERSONNEL;
12. ACCEPT DONATIONS AND GRANTS OF MONEY, EQUIPMENT, SUPPLIES, MATERI-
ALS AND SERVICES, AND TO RECEIVE, UTILIZE, AND DISPOSE OF IT IN A MANNER
CONSISTENT WITH THE CONFLICT OF INTEREST POLICIES ESTABLISHED BY THE
INTERSTATE COMMISSION;
13. LEASE, PURCHASE, ACCEPT CONTRIBUTIONS OR DONATIONS OF, OR OTHER-
WISE TO OWN, HOLD, IMPROVE, OR USE, ANY PROPERTY, REAL, PERSONAL, OR
MIXED;
14. SELL, CONVEY, MORTGAGE, PLEDGE, LEASE, EXCHANGE, ABANDON, OR
OTHERWISE DISPOSE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED;
15. ESTABLISH A BUDGET AND MAKE EXPENDITURES;
16. ADOPT A SEAL AND BYLAWS GOVERNING THE MANAGEMENT AND OPERATION OF
THE INTERSTATE COMMISSION;
17. REPORT ANNUALLY TO THE LEGISLATURES AND GOVERNORS OF THE MEMBER
STATES CONCERNING THE ACTIVITIES OF THE INTERSTATE COMMISSION DURING THE
PRECEDING YEAR. SUCH REPORTS SHALL ALSO INCLUDE REPORTS OF FINANCIAL
AUDITS AND ANY RECOMMENDATIONS THAT MAY HAVE BEEN ADOPTED BY THE INTER-
STATE COMMISSION;
18. COORDINATE EDUCATION, TRAINING, AND PUBLIC AWARENESS REGARDING THE
COMPACT, ITS IMPLEMENTATION, AND ITS OPERATION;
19. MAINTAIN RECORDS IN ACCORDANCE WITH THE BYLAWS;
20. SEEK AND OBTAIN TRADEMARKS, COPYRIGHTS, AND PATENTS; AND
21. PERFORM SUCH FUNCTIONS AS MAY BE NECESSARY OR APPROPRIATE TO
ACHIEVE THE PURPOSES OF THE COMPACT.
§ 8873. FINANCE POWERS. 1. THE INTERSTATE COMMISSION MAY LEVY ON AND
COLLECT AN ANNUAL ASSESSMENT FROM EACH MEMBER STATE TO COVER THE COST OF
THE OPERATIONS AND ACTIVITIES OF THE INTERSTATE COMMISSION AND ITS
STAFF. THE TOTAL ASSESSMENT MUST BE SUFFICIENT TO COVER THE ANNUAL BUDG-
ET APPROVED EACH YEAR FOR WHICH REVENUE IS NOT PROVIDED BY OTHER SOURC-
ES. THE AGGREGATE ANNUAL ASSESSMENT AMOUNT SHALL BE ALLOCATED UPON A
FORMULA TO BE DETERMINED BY THE INTERSTATE COMMISSION, WHICH SHALL
PROMULGATE A RULE BINDING UPON ALL MEMBER STATES.
2. THE INTERSTATE COMMISSION SHALL NOT INCUR OBLIGATIONS OF ANY KIND
PRIOR TO SECURING THE FUNDS ADEQUATE TO MEET THE SAME.
3. THE INTERSTATE COMMISSION SHALL NOT PLEDGE THE CREDIT OF ANY OF THE
MEMBER STATES, EXCEPT BY, AND WITH THE AUTHORITY OF, THE MEMBER STATE.
4. THE INTERSTATE COMMISSION SHALL BE SUBJECT TO A YEARLY FINANCIAL
AUDIT CONDUCTED BY A CERTIFIED OR LICENSED PUBLIC ACCOUNTANT AND THE
REPORT OF THE AUDIT SHALL BE INCLUDED IN THE ANNUAL REPORT OF THE INTER-
STATE COMMISSION.
§ 8874. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION. 1.
THE INTERSTATE COMMISSION SHALL, BY A MAJORITY OF COMMISSIONERS PRESENT
AND VOTING, ADOPT BYLAWS TO GOVERN ITS CONDUCT AS MAY BE NECESSARY OR
APPROPRIATE TO CARRY OUT THE PURPOSES OF THE COMPACT WITHIN TWELVE
MONTHS OF THE FIRST INTERSTATE COMMISSION MEETING.
2. THE INTERSTATE COMMISSION SHALL ELECT OR APPOINT ANNUALLY FROM
AMONG ITS COMMISSIONERS A CHAIRPERSON, A VICE-CHAIRPERSON, AND A TREAS-
URER, EACH OF WHOM SHALL HAVE SUCH AUTHORITY AND DUTIES AS MAY BE SPECI-
FIED IN THE BYLAWS. THE CHAIRPERSON, OR IN THE CHAIRPERSON'S ABSENCE OR
DISABILITY, THE VICE-CHAIRPERSON, SHALL PRESIDE AT ALL MEETINGS OF THE
INTERSTATE COMMISSION.
S. 8307--A 100 A. 8807--A
3. OFFICERS SELECTED PURSUANT TO SUBDIVISION TWO OF THIS SECTION SHALL
SERVE WITHOUT REMUNERATION FROM THE INTERSTATE COMMISSION.
4. THE OFFICERS AND EMPLOYEES OF THE INTERSTATE COMMISSION SHALL BE
IMMUNE FROM SUIT AND LIABILITY, EITHER PERSONALLY OR IN THEIR OFFICIAL
CAPACITY, FOR A CLAIM FOR DAMAGE TO OR LOSS OF PROPERTY OR PERSONAL
INJURY OR OTHER CIVIL LIABILITY CAUSED OR ARISING OUT OF, OR RELATING
TO, AN ACTUAL OR ALLEGED ACT, ERROR, OR OMISSION THAT OCCURRED, OR THAT
SUCH PERSON HAD A REASONABLE BASIS FOR BELIEVING OCCURRED, WITHIN THE
SCOPE OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES, OR RESPONSIBILITIES;
PROVIDED THAT SUCH PERSON SHALL NOT BE PROTECTED FROM SUIT OR LIABILITY
FOR DAMAGE, LOSS, INJURY, OR LIABILITY CAUSED BY THE INTENTIONAL OR
WILLFUL AND WANTON MISCONDUCT OF SUCH PERSON.
(A) THE LIABILITY OF THE EXECUTIVE DIRECTOR AND EMPLOYEES OF THE
INTERSTATE COMMISSION OR REPRESENTATIVES OF THE INTERSTATE COMMISSION,
ACTING WITHIN THE SCOPE OF SUCH PERSON'S EMPLOYMENT OR DUTIES FOR ACTS,
ERRORS, OR OMISSIONS OCCURRING WITHIN SUCH PERSON'S STATE, MAY NOT
EXCEED THE LIMITS OF LIABILITY SET FORTH UNDER THE CONSTITUTION AND LAWS
OF THAT STATE FOR STATE OFFICIALS, EMPLOYEES, AND AGENTS. THE INTERSTATE
COMMISSION IS CONSIDERED TO BE AN INSTRUMENTALITY OF THE STATES FOR THE
PURPOSES OF ANY SUCH ACTION. NOTHING IN THIS PARAGRAPH SHALL BE
CONSTRUED TO PROTECT SUCH PERSON FROM SUIT OR LIABILITY FOR DAMAGE,
LOSS, INJURY, OR LIABILITY CAUSED BY THE INTENTIONAL OR WILLFUL AND
WANTON MISCONDUCT OF SUCH PERSON.
(B) THE INTERSTATE COMMISSION SHALL DEFEND THE EXECUTIVE DIRECTOR, ITS
EMPLOYEES, AND SUBJECT TO THE APPROVAL OF THE ATTORNEY GENERAL OR OTHER
APPROPRIATE LEGAL COUNSEL OF THE MEMBER STATE REPRESENTED BY AN INTER-
STATE COMMISSION REPRESENTATIVE, SHALL DEFEND SUCH INTERSTATE COMMISSION
REPRESENTATIVE IN ANY CIVIL ACTION SEEKING TO IMPOSE LIABILITY ARISING
OUT OF AN ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT OCCURRED WITHIN
THE SCOPE OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES OR RESPONSIBIL-
ITIES, OR THAT THE DEFENDANT HAD A REASONABLE BASIS FOR BELIEVING
OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION EMPLOYMENT, DUTIES,
OR RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED ACT, ERROR, OR
OMISSION DID NOT RESULT FROM INTENTIONAL OR WILLFUL AND WANTON MISCON-
DUCT ON THE PART OF SUCH PERSON.
(C) TO THE EXTENT NOT COVERED BY THE STATE INVOLVED, MEMBER STATE, OR
THE INTERSTATE COMMISSION, THE REPRESENTATIVES OR EMPLOYEES OF THE
INTERSTATE COMMISSION SHALL BE HELD HARMLESS IN THE AMOUNT OF A SETTLE-
MENT OR JUDGMENT, INCLUDING ATTORNEY'S FEES AND COSTS, OBTAINED AGAINST
SUCH PERSONS ARISING OUT OF AN ACTUAL OR ALLEGED ACT, ERROR, OR OMISSION
THAT OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION EMPLOYMENT,
DUTIES, OR RESPONSIBILITIES, OR THAT SUCH PERSONS HAD A REASONABLE BASIS
FOR BELIEVING OCCURRED WITHIN THE SCOPE OF INTERSTATE COMMISSION EMPLOY-
MENT, DUTIES, OR RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED
ACT, ERROR, OR OMISSION DID NOT RESULT FROM INTENTIONAL OR WILLFUL AND
WANTON MISCONDUCT ON THE PART OF SUCH PERSONS.
§ 8875. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION. 1. THE
INTERSTATE COMMISSION SHALL PROMULGATE REASONABLE RULES IN ORDER TO
EFFECTIVELY AND EFFICIENTLY ACHIEVE THE PURPOSES OF THE COMPACT.
NOTWITHSTANDING THE FOREGOING, IN THE EVENT THE INTERSTATE COMMISSION
EXERCISES ITS RULEMAKING AUTHORITY IN A MANNER THAT IS BEYOND THE SCOPE
OF THE PURPOSES OF THE COMPACT, OR THE POWERS GRANTED HEREUNDER, THEN
SUCH AN ACTION BY THE INTERSTATE COMMISSION SHALL BE INVALID AND HAVE NO
FORCE OR EFFECT.
2. RULES DEEMED APPROPRIATE FOR THE OPERATIONS OF THE INTERSTATE
COMMISSION SHALL BE MADE PURSUANT TO A RULEMAKING PROCESS THAT SUBSTAN-
S. 8307--A 101 A. 8807--A
TIALLY CONFORMS TO THE FEDERAL MODEL STATE ADMINISTRATIVE PROCEDURE ACT
OF 2010, AND SUBSEQUENT AMENDMENTS THERETO.
3. NOT LATER THAN THIRTY DAYS AFTER A RULE IS PROMULGATED, ANY PERSON
MAY FILE A PETITION FOR JUDICIAL REVIEW OF THE RULE IN THE UNITED STATES
DISTRICT COURT FOR THE DISTRICT OF COLUMBIA OR THE FEDERAL DISTRICT
WHERE THE INTERSTATE COMMISSION HAS ITS PRINCIPAL OFFICES, PROVIDED THAT
THE FILING OF SUCH A PETITION SHALL NOT STAY OR OTHERWISE PREVENT THE
RULE FROM BECOMING EFFECTIVE UNLESS THE COURT FINDS THAT THE PETITIONER
HAS A SUBSTANTIAL LIKELIHOOD OF SUCCESS. THE COURT SHALL GIVE DEFERENCE
TO THE ACTIONS OF THE INTERSTATE COMMISSION CONSISTENT WITH APPLICABLE
LAW AND SHALL NOT FIND THE RULE TO BE UNLAWFUL IF THE RULE REPRESENTS A
REASONABLE EXERCISE OF THE AUTHORITY GRANTED TO THE INTERSTATE COMMIS-
SION.
§ 8876. OVERSIGHT OF INTERSTATE COMPACT. 1. THE EXECUTIVE, LEGISLA-
TIVE, AND JUDICIAL BRANCHES OF STATE GOVERNMENT IN EACH MEMBER STATE
SHALL ENFORCE THE COMPACT AND SHALL TAKE ALL ACTIONS NECESSARY AND
APPROPRIATE TO EFFECTUATE THE COMPACT'S PURPOSES AND INTENT. THE
PROVISIONS OF THE COMPACT AND THE RULES PROMULGATED HEREUNDER SHALL HAVE
STANDING AS STATUTORY LAW BUT SHALL NOT OVERRIDE EXISTING STATE AUTHORI-
TY TO REGULATE THE PRACTICE OF MEDICINE.
2. ALL COURTS SHALL TAKE JUDICIAL NOTICE OF THE COMPACT AND THE RULES
IN ANY JUDICIAL OR ADMINISTRATIVE PROCEEDING IN A MEMBER STATE PERTAIN-
ING TO THE SUBJECT MATTER OF THE COMPACT WHICH MAY AFFECT THE POWERS,
RESPONSIBILITIES OR ACTIONS OF THE INTERSTATE COMMISSION.
3. THE INTERSTATE COMMISSION SHALL BE ENTITLED TO RECEIVE ALL SERVICE
OF PROCESS IN ANY SUCH PROCEEDING, AND SHALL HAVE STANDING TO INTERVENE
IN THE PROCEEDING FOR ALL PURPOSES. FAILURE TO PROVIDE SERVICE OF PROC-
ESS TO THE INTERSTATE COMMISSION SHALL RENDER A JUDGMENT OR ORDER VOID
AS TO THE INTERSTATE COMMISSION, THE COMPACT, OR PROMULGATED RULES.
§ 8877. ENFORCEMENT OF INTERSTATE COMPACT. 1. THE INTERSTATE COMMIS-
SION, IN THE REASONABLE EXERCISE OF ITS DISCRETION, SHALL ENFORCE THE
PROVISIONS AND RULES OF THE COMPACT.
2. THE INTERSTATE COMMISSION MAY, BY MAJORITY VOTE OF THE COMMISSION-
ERS, INITIATE LEGAL ACTION IN THE UNITED STATES DISTRICT COURT FOR THE
DISTRICT OF COLUMBIA, OR, AT THE DISCRETION OF THE INTERSTATE COMMIS-
SION, IN THE FEDERAL DISTRICT WHERE THE INTERSTATE COMMISSION HAS ITS
PRINCIPAL OFFICES, TO ENFORCE COMPLIANCE WITH THE PROVISIONS OF THE
COMPACT, AND ITS PROMULGATED RULES AND BYLAWS, AGAINST A MEMBER STATE IN
DEFAULT. THE RELIEF SOUGHT MAY INCLUDE BOTH INJUNCTIVE RELIEF AND
DAMAGES. IN THE EVENT JUDICIAL ENFORCEMENT IS NECESSARY, THE PREVAILING
PARTY SHALL BE AWARDED ALL COSTS OF SUCH LITIGATION INCLUDING REASONABLE
ATTORNEY'S FEES.
3. THE REMEDIES HEREIN SHALL NOT BE THE EXCLUSIVE REMEDIES OF THE
INTERSTATE COMMISSION. THE INTERSTATE COMMISSION MAY AVAIL ITSELF OF
ANY OTHER REMEDIES AVAILABLE UNDER STATE LAW OR THE REGULATION OF A
PROFESSION.
§ 8878. DEFAULT PROCEDURES. 1. THE GROUNDS FOR DEFAULT INCLUDE, BUT
ARE NOT LIMITED TO, FAILURE OF A MEMBER STATE TO PERFORM SUCH OBLI-
GATIONS OR RESPONSIBILITIES IMPOSED UPON IT BY THE COMPACT, OR THE RULES
AND BYLAWS OF THE INTERSTATE COMMISSION PROMULGATED UNDER THE COMPACT.
2. IF THE INTERSTATE COMMISSION DETERMINES THAT A MEMBER STATE HAS
DEFAULTED IN THE PERFORMANCE OF ITS OBLIGATIONS OR RESPONSIBILITIES
UNDER THE COMPACT, OR THE BYLAWS OR PROMULGATED RULES, THE INTERSTATE
COMMISSION SHALL:
(A) PROVIDE WRITTEN NOTICE TO THE DEFAULTING STATE AND OTHER MEMBER
STATES, OF THE NATURE OF THE DEFAULT, THE MEANS OF CURING THE DEFAULT,
S. 8307--A 102 A. 8807--A
AND ANY ACTION TAKEN BY THE INTERSTATE COMMISSION. THE INTERSTATE
COMMISSION SHALL SPECIFY THE CONDITIONS BY WHICH THE DEFAULTING STATE
MUST CURE ITS DEFAULT; AND
(B) PROVIDE REMEDIAL TRAINING AND SPECIFIC TECHNICAL ASSISTANCE
REGARDING THE DEFAULT.
3. IF THE DEFAULTING STATE FAILS TO CURE THE DEFAULT, THE DEFAULTING
STATE SHALL BE TERMINATED FROM THE COMPACT UPON AN AFFIRMATIVE VOTE OF A
MAJORITY OF THE COMMISSIONERS AND ALL RIGHTS, PRIVILEGES, AND BENEFITS
CONFERRED BY THE COMPACT SHALL TERMINATE ON THE EFFECTIVE DATE OF TERMI-
NATION. A CURE OF THE DEFAULT DOES NOT RELIEVE THE OFFENDING STATE OF
OBLIGATIONS OR LIABILITIES INCURRED DURING THE PERIOD OF THE DEFAULT.
4. TERMINATION OF MEMBERSHIP IN THE COMPACT SHALL BE IMPOSED ONLY
AFTER ALL OTHER MEANS OF SECURING COMPLIANCE HAVE BEEN EXHAUSTED. NOTICE
OF INTENT TO TERMINATE SHALL BE GIVEN BY THE INTERSTATE COMMISSION TO
THE GOVERNOR, THE MAJORITY AND MINORITY LEADERS OF THE DEFAULTING
STATE'S LEGISLATURE, AND EACH OF THE MEMBER STATES.
5. THE INTERSTATE COMMISSION SHALL ESTABLISH RULES AND PROCEDURES TO
ADDRESS LICENSES AND PHYSICIANS THAT ARE MATERIALLY IMPACTED BY THE
TERMINATION OF A MEMBER STATE, OR THE WITHDRAWAL OF A MEMBER STATE.
6. THE MEMBER STATE WHICH HAS BEEN TERMINATED IS RESPONSIBLE FOR ALL
DUES, OBLIGATIONS, AND LIABILITIES INCURRED THROUGH THE EFFECTIVE DATE
OF TERMINATION INCLUDING OBLIGATIONS, THE PERFORMANCE OF WHICH EXTENDS
BEYOND THE EFFECTIVE DATE OF TERMINATION.
7. THE INTERSTATE COMMISSION SHALL NOT BEAR ANY COSTS RELATING TO ANY
STATE THAT HAS BEEN FOUND TO BE IN DEFAULT OR WHICH HAS BEEN TERMINATED
FROM THE COMPACT, UNLESS OTHERWISE MUTUALLY AGREED UPON IN WRITING
BETWEEN THE INTERSTATE COMMISSION AND THE DEFAULTING STATE.
8. THE DEFAULTING STATE MAY APPEAL THE ACTION OF THE INTERSTATE
COMMISSION BY PETITIONING THE UNITED STATES DISTRICT COURT FOR THE
DISTRICT OF COLUMBIA OR THE FEDERAL DISTRICT WHERE THE INTERSTATE
COMMISSION HAS ITS PRINCIPAL OFFICES. THE PREVAILING PARTY SHALL BE
AWARDED ALL COSTS OF SUCH LITIGATION INCLUDING REASONABLE ATTORNEY'S
FEES.
§ 8879. DISPUTE RESOLUTION. 1. THE INTERSTATE COMMISSION SHALL
ATTEMPT, UPON THE REQUEST OF A MEMBER STATE, TO RESOLVE DISPUTES WHICH
ARE SUBJECT TO THE COMPACT AND WHICH MAY ARISE AMONG MEMBER STATES OR
MEMBER BOARDS.
2. THE INTERSTATE COMMISSION SHALL PROMULGATE RULES PROVIDING FOR BOTH
MEDIATION AND BINDING DISPUTE RESOLUTION AS APPROPRIATE.
§ 8880. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT. 1. ANY STATE IS
ELIGIBLE TO BECOME A MEMBER STATE OF THE COMPACT.
2. THE COMPACT SHALL BECOME EFFECTIVE AND BINDING UPON LEGISLATIVE
ENACTMENT OF THE COMPACT INTO LAW BY NO LESS THAN SEVEN STATES. THERE-
AFTER, IT SHALL BECOME EFFECTIVE AND BINDING ON A STATE UPON ENACTMENT
OF THE COMPACT INTO LAW BY THAT STATE.
3. THE GOVERNORS OF NON-MEMBER STATES, OR THEIR DESIGNEES, SHALL BE
INVITED TO PARTICIPATE IN THE ACTIVITIES OF THE INTERSTATE COMMISSION ON
A NON-VOTING BASIS PRIOR TO ADOPTION OF THE COMPACT BY ALL STATES.
4. THE INTERSTATE COMMISSION MAY PROPOSE AMENDMENTS TO THE COMPACT FOR
ENACTMENT BY THE MEMBER STATES. NO AMENDMENT SHALL BECOME EFFECTIVE AND
BINDING UPON THE INTERSTATE COMMISSION AND THE MEMBER STATES UNLESS AND
UNTIL IT IS ENACTED INTO LAW BY UNANIMOUS CONSENT OF THE MEMBER STATES.
§ 8881. WITHDRAWAL. 1. ONCE EFFECTIVE, THE COMPACT SHALL CONTINUE IN
FORCE AND REMAIN BINDING UPON EACH AND EVERY MEMBER STATE; PROVIDED THAT
A MEMBER STATE MAY WITHDRAW FROM THE COMPACT BY SPECIFICALLY REPEALING
THE STATUTE WHICH ENACTED THE COMPACT INTO LAW.
S. 8307--A 103 A. 8807--A
2. WITHDRAWAL FROM THE COMPACT SHALL BE BY THE ENACTMENT OF A STATUTE
REPEALING THE SAME, BUT SHALL NOT TAKE EFFECT UNTIL ONE YEAR AFTER THE
EFFECTIVE DATE OF SUCH STATUTE AND UNTIL WRITTEN NOTICE OF THE WITH-
DRAWAL HAS BEEN GIVEN BY THE WITHDRAWING STATE TO THE GOVERNOR OF EACH
OTHER MEMBER STATE.
3. THE WITHDRAWING STATE SHALL IMMEDIATELY NOTIFY THE CHAIRPERSON OF
THE INTERSTATE COMMISSION IN WRITING UPON THE INTRODUCTION OF LEGIS-
LATION REPEALING THE COMPACT IN THE WITHDRAWING STATE.
4. THE INTERSTATE COMMISSION SHALL NOTIFY THE OTHER MEMBER STATES OF
THE WITHDRAWING STATE'S INTENT TO WITHDRAW WITHIN SIXTY DAYS OF ITS
RECEIPT OF NOTICE PROVIDED UNDER SUBDIVISION THREE OF THIS SECTION.
5. THE WITHDRAWING STATE IS RESPONSIBLE FOR ALL DUES, OBLIGATIONS AND
LIABILITIES INCURRED THROUGH THE EFFECTIVE DATE OF WITHDRAWAL, INCLUDING
OBLIGATIONS, THE PERFORMANCE OF WHICH EXTEND BEYOND THE EFFECTIVE DATE
OF WITHDRAWAL.
6. REINSTATEMENT FOLLOWING WITHDRAWAL OF A MEMBER STATE SHALL OCCUR
UPON THE WITHDRAWING STATE REENACTING THE COMPACT OR UPON SUCH LATER
DATE AS DETERMINED BY THE INTERSTATE COMMISSION.
7. THE INTERSTATE COMMISSION IS AUTHORIZED TO DEVELOP RULES TO ADDRESS
THE IMPACT OF THE WITHDRAWAL OF A MEMBER STATE ON LICENSES GRANTED IN
OTHER MEMBER STATES TO PHYSICIANS WHO DESIGNATED THE WITHDRAWING MEMBER
STATE AS THE STATE OF PRINCIPAL LICENSE.
§ 8882. DISSOLUTION. 1. THE COMPACT SHALL DISSOLVE EFFECTIVE UPON THE
DATE OF THE WITHDRAWAL OR DEFAULT OF THE MEMBER STATE WHICH REDUCES THE
MEMBERSHIP IN THE COMPACT TO ONE MEMBER STATE.
2. UPON THE DISSOLUTION OF THE COMPACT, THE COMPACT BECOMES NULL AND
VOID AND SHALL BE OF NO FURTHER FORCE OR EFFECT, AND THE BUSINESS AND
AFFAIRS OF THE INTERSTATE COMMISSION SHALL BE CONCLUDED AND SURPLUS
FUNDS SHALL BE DISTRIBUTED IN ACCORDANCE WITH THE BYLAWS.
§ 8883. SEVERABILITY AND CONSTRUCTION. 1. THE PROVISIONS OF THE
COMPACT SHALL BE SEVERABLE, AND IF ANY PHRASE, CLAUSE, SENTENCE, OR
PROVISION IS DEEMED UNENFORCEABLE, THE REMAINING PROVISIONS OF THE
COMPACT SHALL BE ENFORCEABLE.
2. THE PROVISIONS OF THE COMPACT SHALL BE LIBERALLY CONSTRUED TO
EFFECTUATE ITS PURPOSES.
3. NOTHING IN THE COMPACT SHALL BE CONSTRUED TO PROHIBIT THE APPLICA-
BILITY OF OTHER INTERSTATE COMPACTS TO WHICH THE STATES ARE MEMBERS.
§ 8884. BINDING EFFECT OF COMPACT AND OTHER LAWS. 1. NOTHING CONTAINED
IN THIS ARTICLE SHALL PREVENT THE ENFORCEMENT OF ANY OTHER LAW OF A
MEMBER STATE THAT IS NOT INCONSISTENT WITH THE COMPACT.
2. ALL LAWS IN A MEMBER STATE IN CONFLICT WITH THE COMPACT ARE SUPER-
SEDED TO THE EXTENT OF THE CONFLICT.
3. ALL LAWFUL ACTIONS OF THE INTERSTATE COMMISSION, INCLUDING ALL
RULES AND BYLAWS PROMULGATED BY THE COMMISSION, ARE BINDING UPON THE
MEMBER STATES.
4. ALL AGREEMENTS BETWEEN THE INTERSTATE COMMISSION AND THE MEMBER
STATES ARE BINDING IN ACCORDANCE WITH THEIR TERMS.
5. IN THE EVENT ANY PROVISION OF THE COMPACT EXCEEDS THE CONSTITU-
TIONAL LIMITS IMPOSED ON THE LEGISLATURE OF ANY MEMBER STATE, SUCH
PROVISION SHALL BE INEFFECTIVE TO THE EXTENT OF THE CONFLICT WITH THE
CONSTITUTIONAL PROVISION IN QUESTION IN THAT MEMBER STATE.
§ 2. Article 170 of the education law is renumbered article 171 and a
new article 170 is added to title 8 of the education law to read as
follows:
ARTICLE 170
NURSE LICENSURE COMPACT
S. 8307--A 104 A. 8807--A
SECTION 8900. NURSE LICENSURE COMPACT.
8901. FINDINGS AND DECLARATION OF PURPOSE.
8902. DEFINITIONS.
8903. GENERAL PROVISIONS AND JURISDICTION.
8904. APPLICATIONS FOR LICENSURE IN A PARTY STATE.
8905. ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING
BOARDS.
8906. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE OF
INFORMATION.
8907. ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE LICEN-
SURE COMPACT ADMINISTRATORS.
8908. RULEMAKING.
8909. OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT.
8910. EFFECTIVE DATE, WITHDRAWAL AND AMENDMENT.
8911. CONSTRUCTION AND SEVERABILITY.
§ 8900. NURSE LICENSURE COMPACT. THE NURSE LICENSE COMPACT AS SET
FORTH IN THE ARTICLE IS HEREBY ADOPTED AND ENTERED INTO WITH ALL PARTY
STATES JOINING THEREIN.
§ 8901. FINDINGS AND DECLARATION OF PURPOSE 1. FINDINGS. THE PARTY
STATES FIND THAT:
A. THE HEALTH AND SAFETY OF THE PUBLIC ARE AFFECTED BY THE DEGREE OF
COMPLIANCE WITH AND THE EFFECTIVENESS OF ENFORCEMENT ACTIVITIES RELATED
TO STATE NURSE LICENSURE LAWS;
B. VIOLATIONS OF NURSE LICENSURE AND OTHER LAWS REGULATING THE PRAC-
TICE OF NURSING MAY RESULT IN INJURY OR HARM TO THE PUBLIC;
C. THE EXPANDED MOBILITY OF NURSES AND THE USE OF ADVANCED COMMUNI-
CATION TECHNOLOGIES AS PART OF OUR NATION'S HEALTH CARE DELIVERY SYSTEM
REQUIRE GREATER COORDINATION AND COOPERATION AMONG STATES IN THE AREAS
OF NURSE LICENSURE AND REGULATION;
D. NEW PRACTICE MODALITIES AND TECHNOLOGY MAKE COMPLIANCE WITH INDI-
VIDUAL STATE NURSE LICENSURE LAWS DIFFICULT AND COMPLEX;
E. THE CURRENT SYSTEM OF DUPLICATIVE LICENSURE FOR NURSES PRACTICING
IN MULTIPLE STATES IS CUMBERSOME AND REDUNDANT FOR BOTH NURSES AND
STATES; AND
F. UNIFORMITY OF NURSE LICENSURE REQUIREMENTS THROUGHOUT THE STATES
PROMOTES PUBLIC SAFETY AND PUBLIC HEALTH BENEFITS.
2. DECLARATION OF PURPOSE. THE GENERAL PURPOSES OF THIS COMPACT ARE
TO:
A. FACILITATE THE STATES' RESPONSIBILITY TO PROTECT THE PUBLIC'S
HEALTH AND SAFETY;
B. ENSURE AND ENCOURAGE THE COOPERATION OF PARTY STATES IN THE AREAS
OF NURSE LICENSURE AND REGULATION;
C. FACILITATE THE EXCHANGE OF INFORMATION BETWEEN PARTY STATES IN THE
AREAS OF NURSE REGULATION, INVESTIGATION AND ADVERSE ACTIONS;
D. PROMOTE COMPLIANCE WITH THE LAWS GOVERNING THE PRACTICE OF NURSING
IN EACH JURISDICTION;
E. INVEST ALL PARTY STATES WITH THE AUTHORITY TO HOLD A NURSE ACCOUNT-
ABLE FOR MEETING ALL STATE PRACTICE LAWS IN THE STATE IN WHICH THE
PATIENT IS LOCATED AT THE TIME CARE IS RENDERED THROUGH THE MUTUAL
RECOGNITION OF PARTY STATE LICENSES;
F. DECREASE REDUNDANCIES IN THE CONSIDERATION AND ISSUANCE OF NURSE
LICENSES; AND
G. PROVIDE OPPORTUNITIES FOR INTERSTATE PRACTICE BY NURSES WHO MEET
UNIFORM LICENSURE REQUIREMENTS.
§ 8902. DEFINITIONS. 1. DEFINITIONS. AS USED IN THIS COMPACT:
S. 8307--A 105 A. 8807--A
A. "ADVERSE ACTION" MEANS ANY ADMINISTRATIVE, CIVIL, EQUITABLE OR
CRIMINAL ACTION PERMITTED BY A STATE'S LAWS WHICH IS IMPOSED BY A
LICENSING BOARD OR OTHER AUTHORITY AGAINST A NURSE, INCLUDING ACTIONS
AGAINST AN INDIVIDUAL'S LICENSE OR MULTISTATE LICENSURE PRIVILEGE SUCH
AS REVOCATION, SUSPENSION, PROBATION, MONITORING OF THE LICENSEE, LIMI-
TATION ON THE LICENSEE'S PRACTICE, OR ANY OTHER ENCUMBRANCE ON LICENSURE
AFFECTING A NURSE'S AUTHORIZATION TO PRACTICE, INCLUDING ISSUANCE OF A
CEASE AND DESIST ACTION.
B. "ALTERNATIVE PROGRAM" MEANS A NON-DISCIPLINARY MONITORING PROGRAM
APPROVED BY A LICENSING BOARD.
C. "COORDINATED LICENSURE INFORMATION SYSTEM" MEANS AN INTEGRATED
PROCESS FOR COLLECTING, STORING AND SHARING INFORMATION ON NURSE LICEN-
SURE AND ENFORCEMENT ACTIVITIES RELATED TO NURSE LICENSURE LAWS THAT IS
ADMINISTERED BY A NONPROFIT ORGANIZATION COMPOSED OF AND CONTROLLED BY
LICENSING BOARDS.
D. "COMMISSION" MEANS THE INTERSTATE COMMISSION OF NURSE LICENSURE
COMPACT ADMINISTRATORS.
E. "CURRENT SIGNIFICANT INVESTIGATIVE INFORMATION" MEANS:
1. INVESTIGATIVE INFORMATION THAT A LICENSING BOARD, AFTER A PRELIMI-
NARY INQUIRY THAT INCLUDES NOTIFICATION AND AN OPPORTUNITY FOR THE NURSE
TO RESPOND, IF REQUIRED BY STATE LAW, HAS REASON TO BELIEVE IS NOT
GROUNDLESS AND, IF PROVED TRUE, WOULD INDICATE MORE THAN A MINOR INFRAC-
TION; OR
2. INVESTIGATIVE INFORMATION THAT INDICATES THAT THE NURSE REPRESENTS
AN IMMEDIATE THREAT TO PUBLIC HEALTH AND SAFETY REGARDLESS OF WHETHER
THE NURSE HAS BEEN NOTIFIED AND HAD AN OPPORTUNITY TO RESPOND.
F. "ENCUMBRANCE" MEANS A REVOCATION OR SUSPENSION OF, OR ANY LIMITA-
TION ON, THE FULL AND UNRESTRICTED PRACTICE OF NURSING IMPOSED BY A
LICENSING BOARD.
G. "HOME STATE" MEANS THE PARTY STATE WHICH IS THE NURSE'S PRIMARY
STATE OF RESIDENCE.
H. "LICENSING BOARD" MEANS A PARTY STATE'S REGULATORY BODY RESPONSIBLE
FOR ISSUING NURSE LICENSES.
I. "MULTISTATE LICENSE" MEANS A LICENSE TO PRACTICE AS A REGISTERED
NURSE (RN) OR AS A LICENSED PRACTICAL/VOCATIONAL NURSE (LPN/VN), WHICH
IS ISSUED BY A HOME STATE LICENSING BOARD, AND WHICH AUTHORIZES THE
LICENSED NURSE TO PRACTICE IN ALL PARTY STATES UNDER A MULTISTATE LICEN-
SURE PRIVILEGE.
J. "MULTISTATE LICENSURE PRIVILEGE" MEANS A LEGAL AUTHORIZATION ASSO-
CIATED WITH A MULTISTATE LICENSE PERMITTING THE PRACTICE OF NURSING AS
EITHER A RN OR A LPN/VN IN A REMOTE STATE.
K. "NURSE" MEANS RN OR LPN/VN, AS THOSE TERMS ARE DEFINED BY EACH
PARTY STATE'S PRACTICE LAWS.
L. "PARTY STATE" MEANS ANY STATE THAT HAS ADOPTED THIS COMPACT.
M. "REMOTE STATE" MEANS A PARTY STATE, OTHER THAN THE HOME STATE.
N. "SINGLE-STATE LICENSE" MEANS A NURSE LICENSE ISSUED BY A PARTY
STATE THAT AUTHORIZES PRACTICE ONLY WITHIN THE ISSUING STATE AND DOES
NOT INCLUDE A MULTISTATE LICENSURE PRIVILEGE TO PRACTICE IN ANY OTHER
PARTY STATE.
O. "STATE" MEANS A STATE, TERRITORY OR POSSESSION OF THE UNITED STATES
AND THE DISTRICT OF COLUMBIA.
P. "STATE PRACTICE LAWS" MEANS A PARTY STATE'S LAWS, RULES AND REGU-
LATIONS THAT GOVERN THE PRACTICE OF NURSING, DEFINE THE SCOPE OF NURSING
PRACTICE, AND CREATE THE METHODS AND GROUNDS FOR IMPOSING DISCIPLINE.
"STATE PRACTICE LAWS" SHALL NOT INCLUDE REQUIREMENTS NECESSARY TO OBTAIN
S. 8307--A 106 A. 8807--A
AND RETAIN A LICENSE, EXCEPT FOR QUALIFICATIONS OR REQUIREMENTS OF THE
HOME STATE.
§ 8903. GENERAL PROVISIONS AND JURISDICTION. 1. GENERAL PROVISIONS AND
JURISDICTION. A. A MULTISTATE LICENSE TO PRACTICE REGISTERED OR LICENSED
PRACTICAL/VOCATIONAL NURSING ISSUED BY A HOME STATE TO A RESIDENT IN
THAT STATE WILL BE RECOGNIZED BY EACH PARTY STATE AS AUTHORIZING A NURSE
TO PRACTICE AS A REGISTERED NURSE (RN) OR AS A LICENSED
PRACTICAL/VOCATIONAL NURSE (LPN/VN), UNDER A MULTISTATE LICENSURE PRIVI-
LEGE, IN EACH PARTY STATE.
B. A STATE SHALL IMPLEMENT PROCEDURES FOR CONSIDERING THE CRIMINAL
HISTORY RECORDS OF APPLICANTS FOR AN INITIAL MULTISTATE LICENSE OR
LICENSURE BY ENDORSEMENT. SUCH PROCEDURES SHALL INCLUDE THE SUBMISSION
OF FINGERPRINTS OR OTHER BIOMETRIC-BASED INFORMATION BY APPLICANTS FOR
THE PURPOSE OF OBTAINING AN APPLICANT'S CRIMINAL HISTORY RECORD INFORMA-
TION FROM THE FEDERAL BUREAU OF INVESTIGATION AND THE AGENCY RESPONSIBLE
FOR RETAINING THAT STATE'S CRIMINAL RECORDS.
C. EACH PARTY STATE SHALL REQUIRE ITS LICENSING BOARD TO AUTHORIZE AN
APPLICANT TO OBTAIN OR RETAIN A MULTISTATE LICENSE IN THE HOME STATE
ONLY IF THE APPLICANT:
I. MEETS THE HOME STATE'S QUALIFICATIONS FOR LICENSURE OR RENEWAL OF
LICENSURE, AND COMPLIES WITH ALL OTHER APPLICABLE STATE LAWS;
II. (1) HAS GRADUATED OR IS ELIGIBLE TO GRADUATE FROM A LICENSING
BOARD-APPROVED RN OR LPN/VN PRELICENSURE EDUCATION PROGRAM; OR
(2) HAS GRADUATED FROM A FOREIGN RN OR LPN/VN PRELICENSURE EDUCATION
PROGRAM THAT HAS BEEN: (A) APPROVED BY THE AUTHORIZED ACCREDITING BODY
IN THE APPLICABLE COUNTRY, AND (B) VERIFIED BY AN INDEPENDENT CREDEN-
TIALS REVIEW AGENCY TO BE COMPARABLE TO A LICENSING BOARD-APPROVED PREL-
ICENSURE EDUCATION PROGRAM;
III. HAS, IF A GRADUATE OF A FOREIGN PRELICENSURE EDUCATION PROGRAM
NOT TAUGHT IN ENGLISH OR IF ENGLISH IS NOT THE INDIVIDUAL'S NATIVE
LANGUAGE, SUCCESSFULLY PASSED AN ENGLISH PROFICIENCY EXAMINATION THAT
INCLUDES THE COMPONENTS OF READING, SPEAKING, WRITING AND LISTENING;
IV. HAS SUCCESSFULLY PASSED AN NCLEX-RN OR NCLEX-PN EXAMINATION OR
RECOGNIZED PREDECESSOR, AS APPLICABLE;
V. IS ELIGIBLE FOR OR HOLDS AN ACTIVE, UNENCUMBERED LICENSE;
VI. HAS SUBMITTED, IN CONNECTION WITH AN APPLICATION FOR INITIAL
LICENSURE OR LICENSURE BY ENDORSEMENT, FINGERPRINTS OR OTHER BIOMETRIC
DATA FOR THE PURPOSE OF OBTAINING CRIMINAL HISTORY RECORD INFORMATION
FROM THE FEDERAL BUREAU OF INVESTIGATION AND THE AGENCY RESPONSIBLE FOR
RETAINING THAT STATE'S CRIMINAL RECORDS;
VII. HAS NOT BEEN CONVICTED OR FOUND GUILTY, OR HAS ENTERED INTO AN
AGREED DISPOSITION, OF A FELONY OFFENSE UNDER APPLICABLE STATE OR FEDER-
AL CRIMINAL LAW;
VIII. HAS NOT BEEN CONVICTED OR FOUND GUILTY, OR HAS ENTERED INTO AN
AGREED DISPOSITION, OF A MISDEMEANOR OFFENSE RELATED TO THE PRACTICE OF
NURSING AS DETERMINED ON A CASE-BY-CASE BASIS;
IX. IS NOT CURRENTLY ENROLLED IN AN ALTERNATIVE PROGRAM;
X. IS SUBJECT TO SELF-DISCLOSURE REQUIREMENTS REGARDING CURRENT
PARTICIPATION IN AN ALTERNATIVE PROGRAM; AND
XI. HAS A VALID UNITED STATES SOCIAL SECURITY NUMBER.
D. ALL PARTY STATES SHALL BE AUTHORIZED, IN ACCORDANCE WITH EXISTING
STATE DUE PROCESS LAW, TO TAKE ADVERSE ACTION AGAINST A NURSE'S MULTI-
STATE LICENSURE PRIVILEGE SUCH AS REVOCATION, SUSPENSION, PROBATION OR
ANY OTHER ACTION THAT AFFECTS A NURSE'S AUTHORIZATION TO PRACTICE UNDER
A MULTISTATE LICENSURE PRIVILEGE, INCLUDING CEASE AND DESIST ACTIONS. IF
A PARTY STATE TAKES SUCH ACTION, IT SHALL PROMPTLY NOTIFY THE ADMINIS-
S. 8307--A 107 A. 8807--A
TRATOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM. THE ADMINISTRA-
TOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM SHALL PROMPTLY NOTI-
FY THE HOME STATE OF ANY SUCH ACTIONS BY REMOTE STATES.
E. A NURSE PRACTICING IN A PARTY STATE SHALL COMPLY WITH THE STATE
PRACTICE LAWS OF THE STATE IN WHICH THE CLIENT IS LOCATED AT THE TIME
SERVICE IS PROVIDED. THE PRACTICE OF NURSING IS NOT LIMITED TO PATIENT
CARE BUT SHALL INCLUDE ALL NURSING PRACTICE AS DEFINED BY THE STATE
PRACTICE LAWS OF THE PARTY STATE IN WHICH THE CLIENT IS LOCATED. THE
PRACTICE OF NURSING IN A PARTY STATE UNDER A MULTISTATE LICENSURE PRIVI-
LEGE WILL SUBJECT A NURSE TO THE JURISDICTION OF THE LICENSING BOARD,
THE COURTS AND THE LAWS OF THE PARTY STATE IN WHICH THE CLIENT IS
LOCATED AT THE TIME SERVICE IS PROVIDED.
F. INDIVIDUALS NOT RESIDING IN A PARTY STATE SHALL CONTINUE TO BE ABLE
TO APPLY FOR A PARTY STATE'S SINGLE-STATE LICENSE AS PROVIDED UNDER THE
LAWS OF EACH PARTY STATE. HOWEVER, THE SINGLE-STATE LICENSE GRANTED TO
THESE INDIVIDUALS WILL NOT BE RECOGNIZED AS GRANTING THE PRIVILEGE TO
PRACTICE NURSING IN ANY OTHER PARTY STATE. NOTHING IN THIS COMPACT SHALL
AFFECT THE REQUIREMENTS ESTABLISHED BY A PARTY STATE FOR THE ISSUANCE OF
A SINGLE-STATE LICENSE.
G. ANY NURSE HOLDING A HOME STATE MULTISTATE LICENSE, ON THE EFFECTIVE
DATE OF THIS COMPACT, MAY RETAIN AND RENEW THE MULTISTATE LICENSE ISSUED
BY THE NURSE'S THEN-CURRENT HOME STATE, PROVIDED THAT:
I. A NURSE, WHO CHANGES PRIMARY STATE OF RESIDENCE AFTER THIS
COMPACT'S EFFECTIVE DATE, SHALL MEET ALL APPLICABLE REQUIREMENTS SET
FORTH IN THIS ARTICLE TO OBTAIN A MULTISTATE LICENSE FROM A NEW HOME
STATE.
II. A NURSE WHO FAILS TO SATISFY THE MULTISTATE LICENSURE REQUIREMENTS
SET FORTH IN THIS ARTICLE DUE TO A DISQUALIFYING EVENT OCCURRING AFTER
THIS COMPACT'S EFFECTIVE DATE SHALL BE INELIGIBLE TO RETAIN OR RENEW A
MULTISTATE LICENSE, AND THE NURSE'S MULTISTATE LICENSE SHALL BE REVOKED
OR DEACTIVATED IN ACCORDANCE WITH APPLICABLE RULES ADOPTED BY THE
COMMISSION.
§ 8904. APPLICATIONS FOR LICENSURE IN A PARTY STATE. 1. APPLICATIONS
FOR LICENSURE IN A PARTY STATE. A. UPON APPLICATION FOR A MULTISTATE
LICENSE, THE LICENSING BOARD IN THE ISSUING PARTY STATE SHALL ASCERTAIN,
THROUGH THE COORDINATED LICENSURE INFORMATION SYSTEM, WHETHER THE APPLI-
CANT HAS EVER HELD, OR IS THE HOLDER OF, A LICENSE ISSUED BY ANY OTHER
STATE, WHETHER THERE ARE ANY ENCUMBRANCES ON ANY LICENSE OR MULTISTATE
LICENSURE PRIVILEGE HELD BY THE APPLICANT, WHETHER ANY ADVERSE ACTION
HAS BEEN TAKEN AGAINST ANY LICENSE OR MULTISTATE LICENSURE PRIVILEGE
HELD BY THE APPLICANT AND WHETHER THE APPLICANT IS CURRENTLY PARTICIPAT-
ING IN AN ALTERNATIVE PROGRAM.
B. A NURSE MAY HOLD A MULTISTATE LICENSE, ISSUED BY THE HOME STATE, IN
ONLY ONE PARTY STATE AT A TIME.
C. IF A NURSE CHANGES PRIMARY STATE OF RESIDENCE BY MOVING BETWEEN TWO
PARTY STATES, THE NURSE MUST APPLY FOR LICENSURE IN THE NEW HOME STATE,
AND THE MULTISTATE LICENSE ISSUED BY THE PRIOR HOME STATE WILL BE DEAC-
TIVATED IN ACCORDANCE WITH APPLICABLE RULES ADOPTED BY THE COMMISSION.
I. THE NURSE MAY APPLY FOR LICENSURE IN ADVANCE OF A CHANGE IN PRIMARY
STATE OF RESIDENCE.
II. A MULTISTATE LICENSE SHALL NOT BE ISSUED BY THE NEW HOME STATE
UNTIL THE NURSE PROVIDES SATISFACTORY EVIDENCE OF A CHANGE IN PRIMARY
STATE OF RESIDENCE TO THE NEW HOME STATE AND SATISFIES ALL APPLICABLE
REQUIREMENTS TO OBTAIN A MULTISTATE LICENSE FROM THE NEW HOME STATE.
D. IF A NURSE CHANGES PRIMARY STATE OF RESIDENCE BY MOVING FROM A
PARTY STATE TO A NON-PARTY STATE, THE MULTISTATE LICENSE ISSUED BY THE
S. 8307--A 108 A. 8807--A
PRIOR HOME STATE WILL CONVERT TO A SINGLE-STATE LICENSE, VALID ONLY IN
THE FORMER HOME STATE.
§ 8905. ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING
BOARDS. 1. LICENSING BOARD AUTHORITY. IN ADDITION TO THE OTHER POWERS
CONFERRED BY STATE LAW, A LICENSING BOARD SHALL HAVE THE AUTHORITY TO:
A. TAKE ADVERSE ACTION AGAINST A NURSE'S MULTISTATE LICENSURE PRIVI-
LEGE TO PRACTICE WITHIN THAT PARTY STATE.
I. ONLY THE HOME STATE SHALL HAVE THE POWER TO TAKE ADVERSE ACTION
AGAINST A NURSE'S LICENSE ISSUED BY THE HOME STATE.
II. FOR PURPOSES OF TAKING ADVERSE ACTION, THE HOME STATE LICENSING
BOARD SHALL GIVE THE SAME PRIORITY AND EFFECT TO REPORTED CONDUCT
RECEIVED FROM A REMOTE STATE AS IT WOULD IF SUCH CONDUCT HAD OCCURRED
WITHIN THE HOME STATE. IN SO DOING, THE HOME STATE SHALL APPLY ITS OWN
STATE LAWS TO DETERMINE APPROPRIATE ACTION.
B. ISSUE CEASE AND DESIST ORDERS OR IMPOSE AN ENCUMBRANCE ON A NURSE'S
AUTHORITY TO PRACTICE WITHIN THAT PARTY STATE.
C. COMPLETE ANY PENDING INVESTIGATIONS OF A NURSE WHO CHANGES PRIMARY
STATE OF RESIDENCE DURING THE COURSE OF SUCH INVESTIGATIONS. THE LICENS-
ING BOARD SHALL ALSO HAVE THE AUTHORITY TO TAKE APPROPRIATE ACTION OR
ACTIONS AND SHALL PROMPTLY REPORT THE CONCLUSIONS OF SUCH INVESTIGATIONS
TO THE ADMINISTRATOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM.
THE ADMINISTRATOR OF THE COORDINATED LICENSURE INFORMATION SYSTEM SHALL
PROMPTLY NOTIFY THE NEW HOME STATE OF ANY SUCH ACTIONS.
D. ISSUE SUBPOENAS FOR BOTH HEARINGS AND INVESTIGATIONS THAT REQUIRE
THE ATTENDANCE AND TESTIMONY OF WITNESSES, AS WELL AS THE PRODUCTION OF
EVIDENCE. SUBPOENAS ISSUED BY A LICENSING BOARD IN A PARTY STATE FOR THE
ATTENDANCE AND TESTIMONY OF WITNESSES OR THE PRODUCTION OF EVIDENCE FROM
ANOTHER PARTY STATE SHALL BE ENFORCED IN THE LATTER STATE BY ANY COURT
OF COMPETENT JURISDICTION, ACCORDING TO THE PRACTICE AND PROCEDURE OF
THAT COURT APPLICABLE TO SUBPOENAS ISSUED IN PROCEEDINGS PENDING BEFORE
IT. THE ISSUING AUTHORITY SHALL PAY ANY WITNESS FEES, TRAVEL EXPENSES,
MILEAGE AND OTHER FEES REQUIRED BY THE SERVICE STATUTES OF THE STATE IN
WHICH THE WITNESSES OR EVIDENCE ARE LOCATED.
E. OBTAIN AND SUBMIT, FOR EACH NURSE LICENSURE APPLICANT, FINGERPRINT
OR OTHER BIOMETRIC-BASED INFORMATION TO THE FEDERAL BUREAU OF INVESTI-
GATION FOR CRIMINAL BACKGROUND CHECKS, RECEIVE THE RESULTS OF THE FEDER-
AL BUREAU OF INVESTIGATION RECORD SEARCH ON CRIMINAL BACKGROUND CHECKS
AND USE THE RESULTS IN MAKING LICENSURE DECISIONS.
F. IF OTHERWISE PERMITTED BY STATE LAW, RECOVER FROM THE AFFECTED
NURSE THE COSTS OF INVESTIGATIONS AND DISPOSITION OF CASES RESULTING
FROM ANY ADVERSE ACTION TAKEN AGAINST THAT NURSE.
G. TAKE ADVERSE ACTION BASED ON THE FACTUAL FINDINGS OF THE REMOTE
STATE, PROVIDED THAT THE LICENSING BOARD FOLLOWS ITS OWN PROCEDURES FOR
TAKING SUCH ADVERSE ACTION.
2. ADVERSE ACTIONS. A. IF ADVERSE ACTION IS TAKEN BY THE HOME STATE
AGAINST A NURSE'S MULTISTATE LICENSE, THE NURSE'S MULTISTATE LICENSURE
PRIVILEGE TO PRACTICE IN ALL OTHER PARTY STATES SHALL BE DEACTIVATED
UNTIL ALL ENCUMBRANCES HAVE BEEN REMOVED FROM THE MULTISTATE LICENSE.
ALL HOME STATE DISCIPLINARY ORDERS THAT IMPOSE ADVERSE ACTION AGAINST A
NURSE'S MULTISTATE LICENSE SHALL INCLUDE A STATEMENT THAT THE NURSE'S
MULTISTATE LICENSURE PRIVILEGE IS DEACTIVATED IN ALL PARTY STATES DURING
THE PENDENCY OF THE ORDER.
B. NOTHING IN THIS COMPACT SHALL OVERRIDE A PARTY STATE'S DECISION
THAT PARTICIPATION IN AN ALTERNATIVE PROGRAM MAY BE USED IN LIEU OF
ADVERSE ACTION. THE HOME STATE LICENSING BOARD SHALL DEACTIVATE THE
S. 8307--A 109 A. 8807--A
MULTISTATE LICENSURE PRIVILEGE UNDER THE MULTISTATE LICENSE OF ANY NURSE
FOR THE DURATION OF THE NURSE'S PARTICIPATION IN AN ALTERNATIVE PROGRAM.
§ 8906. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE OF
INFORMATION. 1. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE
OF INFORMATION. A. ALL PARTY STATES SHALL PARTICIPATE IN A COORDINATED
LICENSURE INFORMATION SYSTEM OF ALL LICENSED REGISTERED NURSES (RNS) AND
LICENSED PRACTICAL/VOCATIONAL NURSES (LPNS/VNS). THIS SYSTEM WILL
INCLUDE INFORMATION ON THE LICENSURE AND DISCIPLINARY HISTORY OF EACH
NURSE, AS SUBMITTED BY PARTY STATES, TO ASSIST IN THE COORDINATION OF
NURSE LICENSURE AND ENFORCEMENT EFFORTS.
B. THE COMMISSION, IN CONSULTATION WITH THE ADMINISTRATOR OF THE COOR-
DINATED LICENSURE INFORMATION SYSTEM, SHALL FORMULATE NECESSARY AND
PROPER PROCEDURES FOR THE IDENTIFICATION, COLLECTION AND EXCHANGE OF
INFORMATION UNDER THIS COMPACT.
C. ALL LICENSING BOARDS SHALL PROMPTLY REPORT TO THE COORDINATED
LICENSURE INFORMATION SYSTEM ANY ADVERSE ACTION, ANY CURRENT SIGNIFICANT
INVESTIGATIVE INFORMATION, DENIALS OF APPLICATIONS WITH THE REASONS FOR
SUCH DENIALS AND NURSE PARTICIPATION IN ALTERNATIVE PROGRAMS KNOWN TO
THE LICENSING BOARD REGARDLESS OF WHETHER SUCH PARTICIPATION IS DEEMED
NONPUBLIC OR CONFIDENTIAL UNDER STATE LAW.
D. CURRENT SIGNIFICANT INVESTIGATIVE INFORMATION AND PARTICIPATION IN
NONPUBLIC OR CONFIDENTIAL ALTERNATIVE PROGRAMS SHALL BE TRANSMITTED
THROUGH THE COORDINATED LICENSURE INFORMATION SYSTEM ONLY TO PARTY STATE
LICENSING BOARDS.
E. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ALL PARTY STATE LICENS-
ING BOARDS CONTRIBUTING INFORMATION TO THE COORDINATED LICENSURE INFOR-
MATION SYSTEM MAY DESIGNATE INFORMATION THAT MAY NOT BE SHARED WITH
NON-PARTY STATES OR DISCLOSED TO OTHER ENTITIES OR INDIVIDUALS WITHOUT
THE EXPRESS PERMISSION OF THE CONTRIBUTING STATE.
F. ANY PERSONALLY IDENTIFIABLE INFORMATION OBTAINED FROM THE COORDI-
NATED LICENSURE INFORMATION SYSTEM BY A PARTY STATE LICENSING BOARD
SHALL NOT BE SHARED WITH NON-PARTY STATES OR DISCLOSED TO OTHER ENTITIES
OR INDIVIDUALS EXCEPT TO THE EXTENT PERMITTED BY THE LAWS OF THE PARTY
STATE CONTRIBUTING THE INFORMATION.
G. ANY INFORMATION CONTRIBUTED TO THE COORDINATED LICENSURE INFORMA-
TION SYSTEM THAT IS SUBSEQUENTLY REQUIRED TO BE EXPUNGED BY THE LAWS OF
THE PARTY STATE CONTRIBUTING THAT INFORMATION SHALL ALSO BE EXPUNGED
FROM THE COORDINATED LICENSURE INFORMATION SYSTEM.
H. THE COMPACT ADMINISTRATOR OF EACH PARTY STATE SHALL FURNISH A
UNIFORM DATA SET TO THE COMPACT ADMINISTRATOR OF EACH OTHER PARTY STATE,
WHICH SHALL INCLUDE, AT A MINIMUM:
I. IDENTIFYING INFORMATION;
II. LICENSURE DATA;
III. INFORMATION RELATED TO ALTERNATIVE PROGRAM PARTICIPATION; AND
IV. OTHER INFORMATION THAT MAY FACILITATE THE ADMINISTRATION OF THIS
COMPACT, AS DETERMINED BY COMMISSION RULES.
I. THE COMPACT ADMINISTRATOR OF A PARTY STATE SHALL PROVIDE ALL INVES-
TIGATIVE DOCUMENTS AND INFORMATION REQUESTED BY ANOTHER PARTY STATE.
§ 8907. ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE LICENSURE
COMPACT ADMINISTRATORS. 1. COMMISSION OF NURSE LICENSURE COMPACT ADMIN-
ISTRATORS. THE PARTY STATES HEREBY CREATE AND ESTABLISH A JOINT PUBLIC
ENTITY KNOWN AS THE INTERSTATE COMMISSION OF NURSE LICENSURE COMPACT
ADMINISTRATORS. THE COMMISSION IS AN INSTRUMENTALITY OF THE PARTY
STATES.
2. VENUE. VENUE IS PROPER, AND JUDICIAL PROCEEDINGS BY OR AGAINST THE
COMMISSION SHALL BE BROUGHT SOLELY AND EXCLUSIVELY, IN A COURT OF COMPE-
S. 8307--A 110 A. 8807--A
TENT JURISDICTION WHERE THE PRINCIPAL OFFICE OF THE COMMISSION IS
LOCATED. THE COMMISSION MAY WAIVE VENUE AND JURISDICTIONAL DEFENSES TO
THE EXTENT IT ADOPTS OR CONSENTS TO PARTICIPATE IN ALTERNATIVE DISPUTE
RESOLUTION PROCEEDINGS.
3. SOVEREIGN IMMUNITY. NOTHING IN THIS COMPACT SHALL BE CONSTRUED TO
BE A WAIVER OF SOVEREIGN IMMUNITY.
4. MEMBERSHIP, VOTING AND MEETINGS. A. EACH PARTY STATE SHALL HAVE AND
BE LIMITED TO ONE ADMINISTRATOR. THE HEAD OF THE STATE LICENSING BOARD
OR DESIGNEE SHALL BE THE ADMINISTRATOR OF THIS COMPACT FOR EACH PARTY
STATE. ANY ADMINISTRATOR MAY BE REMOVED OR SUSPENDED FROM OFFICE AS
PROVIDED BY THE LAW OF THE STATE FROM WHICH THE ADMINISTRATOR IS
APPOINTED. ANY VACANCY OCCURRING IN THE COMMISSION SHALL BE FILLED IN
ACCORDANCE WITH THE LAWS OF THE PARTY STATE IN WHICH THE VACANCY EXISTS.
B. EACH ADMINISTRATOR SHALL BE ENTITLED TO ONE VOTE WITH REGARD TO THE
PROMULGATION OF RULES AND CREATION OF BYLAWS AND SHALL OTHERWISE HAVE AN
OPPORTUNITY TO PARTICIPATE IN THE BUSINESS AND AFFAIRS OF THE COMMIS-
SION. AN ADMINISTRATOR SHALL VOTE IN PERSON OR BY SUCH OTHER MEANS AS
PROVIDED IN THE BYLAWS. THE BYLAWS MAY PROVIDE FOR AN ADMINISTRATOR'S
PARTICIPATION IN MEETINGS BY TELEPHONE OR OTHER MEANS OF COMMUNICATION.
C. THE COMMISSION SHALL MEET AT LEAST ONCE DURING EACH CALENDAR YEAR.
ADDITIONAL MEETINGS SHALL BE HELD AS SET FORTH IN THE BYLAWS OR RULES OF
THE COMMISSION.
D. ALL MEETINGS SHALL BE OPEN TO THE PUBLIC, AND PUBLIC NOTICE OF
MEETINGS SHALL BE GIVEN IN THE SAME MANNER AS REQUIRED UNDER THE RULE-
MAKING PROVISIONS IN SECTION EIGHTY-NINE HUNDRED EIGHT OF THIS ARTICLE.
5. CLOSED MEETINGS. A. THE COMMISSION MAY CONVENE IN A CLOSED, NONPUB-
LIC MEETING IF THE COMMISSION SHALL DISCUSS:
I. NONCOMPLIANCE OF A PARTY STATE WITH ITS OBLIGATIONS UNDER THIS
COMPACT;
II. THE EMPLOYMENT, COMPENSATION, DISCIPLINE OR OTHER PERSONNEL
MATTERS, PRACTICES OR PROCEDURES RELATED TO SPECIFIC EMPLOYEES OR OTHER
MATTERS RELATED TO THE COMMISSION'S INTERNAL PERSONNEL PRACTICES AND
PROCEDURES;
III. CURRENT, THREATENED OR REASONABLY ANTICIPATED LITIGATION;
IV. NEGOTIATION OF CONTRACTS FOR THE PURCHASE OR SALE OF GOODS,
SERVICES OR REAL ESTATE;
V. ACCUSING ANY PERSON OF A CRIME OR FORMALLY CENSURING ANY PERSON;
VI. DISCLOSURE OF TRADE SECRETS OR COMMERCIAL OR FINANCIAL INFORMATION
THAT IS PRIVILEGED OR CONFIDENTIAL;
VII. DISCLOSURE OF INFORMATION OF A PERSONAL NATURE WHERE DISCLOSURE
WOULD CONSTITUTE A CLEARLY UNWARRANTED INVASION OF PERSONAL PRIVACY;
VIII. DISCLOSURE OF INVESTIGATORY RECORDS COMPILED FOR LAW ENFORCEMENT
PURPOSES;
IX. DISCLOSURE OF INFORMATION RELATED TO ANY REPORTS PREPARED BY OR ON
BEHALF OF THE COMMISSION FOR THE PURPOSE OF INVESTIGATION OF COMPLIANCE
WITH THIS COMPACT; OR
X. MATTERS SPECIFICALLY EXEMPTED FROM DISCLOSURE BY FEDERAL OR STATE
STATUTE.
B. IF A MEETING, OR PORTION OF A MEETING, IS CLOSED PURSUANT TO THIS
PARAGRAPH THE COMMISSION'S LEGAL COUNSEL OR DESIGNEE SHALL CERTIFY THAT
THE MEETING MAY BE CLOSED AND SHALL REFERENCE EACH RELEVANT EXEMPTING
PROVISION. THE COMMISSION SHALL KEEP MINUTES THAT FULLY AND CLEARLY
DESCRIBE ALL MATTERS DISCUSSED IN A MEETING AND SHALL PROVIDE A FULL AND
ACCURATE SUMMARY OF ACTIONS TAKEN, AND THE REASONS THEREFOR, INCLUDING A
DESCRIPTION OF THE VIEWS EXPRESSED. ALL DOCUMENTS CONSIDERED IN
CONNECTION WITH AN ACTION SHALL BE IDENTIFIED IN SUCH MINUTES. ALL
S. 8307--A 111 A. 8807--A
MINUTES AND DOCUMENTS OF A CLOSED MEETING SHALL REMAIN UNDER SEAL,
SUBJECT TO RELEASE BY A MAJORITY VOTE OF THE COMMISSION OR ORDER OF A
COURT OF COMPETENT JURISDICTION.
C. THE COMMISSION SHALL, BY A MAJORITY VOTE OF THE ADMINISTRATORS,
PRESCRIBE BYLAWS OR RULES TO GOVERN ITS CONDUCT AS MAY BE NECESSARY OR
APPROPRIATE TO CARRY OUT THE PURPOSES AND EXERCISE THE POWERS OF THIS
COMPACT, INCLUDING BUT NOT LIMITED TO:
I. ESTABLISHING THE FISCAL YEAR OF THE COMMISSION;
II. PROVIDING REASONABLE STANDARDS AND PROCEDURES:
(1) FOR THE ESTABLISHMENT AND MEETINGS OF OTHER COMMITTEES; AND
(2) GOVERNING ANY GENERAL OR SPECIFIC DELEGATION OF ANY AUTHORITY OR
FUNCTION OF THE COMMISSION;
III. PROVIDING REASONABLE PROCEDURES FOR CALLING AND CONDUCTING MEET-
INGS OF THE COMMISSION, ENSURING REASONABLE ADVANCE NOTICE OF ALL MEET-
INGS AND PROVIDING AN OPPORTUNITY FOR ATTENDANCE OF SUCH MEETINGS BY
INTERESTED PARTIES, WITH ENUMERATED EXCEPTIONS DESIGNED TO PROTECT THE
PUBLIC'S INTEREST, THE PRIVACY OF INDIVIDUALS, AND PROPRIETARY INFORMA-
TION, INCLUDING TRADE SECRETS. THE COMMISSION MAY MEET IN CLOSED SESSION
ONLY AFTER A MAJORITY OF THE ADMINISTRATORS VOTE TO CLOSE A MEETING IN
WHOLE OR IN PART. AS SOON AS PRACTICABLE, THE COMMISSION MUST MAKE
PUBLIC A COPY OF THE VOTE TO CLOSE THE MEETING REVEALING THE VOTE OF
EACH ADMINISTRATOR, WITH NO PROXY VOTES ALLOWED;
IV. ESTABLISHING THE TITLES, DUTIES AND AUTHORITY AND REASONABLE
PROCEDURES FOR THE ELECTION OF THE OFFICERS OF THE COMMISSION;
V. PROVIDING REASONABLE STANDARDS AND PROCEDURES FOR THE ESTABLISHMENT
OF THE PERSONNEL POLICIES AND PROGRAMS OF THE COMMISSION. NOTWITHSTAND-
ING ANY CIVIL SERVICE OR OTHER SIMILAR LAWS OF ANY PARTY STATE, THE
BYLAWS SHALL EXCLUSIVELY GOVERN THE PERSONNEL POLICIES AND PROGRAMS OF
THE COMMISSION; AND
VI. PROVIDING A MECHANISM FOR WINDING UP THE OPERATIONS OF THE COMMIS-
SION AND THE EQUITABLE DISPOSITION OF ANY SURPLUS FUNDS THAT MAY EXIST
AFTER THE TERMINATION OF THIS COMPACT AFTER THE PAYMENT OR RESERVING OF
ALL OF ITS DEBTS AND OBLIGATIONS.
6. GENERAL PROVISIONS. A. THE COMMISSION SHALL PUBLISH ITS BYLAWS AND
RULES, AND ANY AMENDMENTS THERETO, IN A CONVENIENT FORM ON THE WEBSITE
OF THE COMMISSION.
B. THE COMMISSION SHALL MAINTAIN ITS FINANCIAL RECORDS IN ACCORDANCE
WITH THE BYLAWS.
C. THE COMMISSION SHALL MEET AND TAKE SUCH ACTIONS AS ARE CONSISTENT
WITH THE PROVISIONS OF THIS COMPACT AND THE BYLAWS.
7. POWERS OF THE COMMISSION. THE COMMISSION SHALL HAVE THE FOLLOWING
POWERS:
A. TO PROMULGATE UNIFORM RULES TO FACILITATE AND COORDINATE IMPLEMEN-
TATION AND ADMINISTRATION OF THIS COMPACT. THE RULES SHALL HAVE THE
FORCE AND EFFECT OF LAW AND SHALL BE BINDING IN ALL PARTY STATES;
B. TO BRING AND PROSECUTE LEGAL PROCEEDINGS OR ACTIONS IN THE NAME OF
THE COMMISSION, PROVIDED THAT THE STANDING OF ANY LICENSING BOARD TO SUE
OR BE SUED UNDER APPLICABLE LAW SHALL NOT BE AFFECTED;
C. TO PURCHASE AND MAINTAIN INSURANCE AND BONDS;
D. TO BORROW, ACCEPT OR CONTRACT FOR SERVICES OF PERSONNEL, INCLUDING,
BUT NOT LIMITED TO, EMPLOYEES OF A PARTY STATE OR NONPROFIT ORGANIZA-
TIONS;
E. TO COOPERATE WITH OTHER ORGANIZATIONS THAT ADMINISTER STATE
COMPACTS RELATED TO THE REGULATION OF NURSING, INCLUDING BUT NOT LIMITED
TO SHARING ADMINISTRATIVE OR STAFF EXPENSES, OFFICE SPACE OR OTHER
RESOURCES;
S. 8307--A 112 A. 8807--A
F. TO HIRE EMPLOYEES, ELECT OR APPOINT OFFICERS, FIX COMPENSATION,
DEFINE DUTIES, GRANT SUCH INDIVIDUALS APPROPRIATE AUTHORITY TO CARRY OUT
THE PURPOSES OF THIS COMPACT, AND TO ESTABLISH THE COMMISSION'S PERSON-
NEL POLICIES AND PROGRAMS RELATING TO CONFLICTS OF INTEREST, QUALIFICA-
TIONS OF PERSONNEL AND OTHER RELATED PERSONNEL MATTERS;
G. TO ACCEPT ANY AND ALL APPROPRIATE DONATIONS, GRANTS AND GIFTS OF
MONEY, EQUIPMENT, SUPPLIES, MATERIALS AND SERVICES, AND TO RECEIVE,
UTILIZE AND DISPOSE OF THE SAME; PROVIDED THAT AT ALL TIMES THE COMMIS-
SION SHALL AVOID ANY APPEARANCE OF IMPROPRIETY OR CONFLICT OF INTEREST;
H. TO LEASE, PURCHASE, ACCEPT APPROPRIATE GIFTS OR DONATIONS OF, OR
OTHERWISE TO OWN, HOLD, IMPROVE OR USE, ANY PROPERTY, WHETHER REAL,
PERSONAL OR MIXED; PROVIDED THAT AT ALL TIMES THE COMMISSION SHALL AVOID
ANY APPEARANCE OF IMPROPRIETY;
I. TO SELL, CONVEY, MORTGAGE, PLEDGE, LEASE, EXCHANGE, ABANDON OR
OTHERWISE DISPOSE OF ANY PROPERTY, WHETHER REAL, PERSONAL OR MIXED;
J. TO ESTABLISH A BUDGET AND MAKE EXPENDITURES;
K. TO BORROW MONEY;
L. TO APPOINT COMMITTEES, INCLUDING ADVISORY COMMITTEES COMPRISED OF
ADMINISTRATORS, STATE NURSING REGULATORS, STATE LEGISLATORS OR THEIR
REPRESENTATIVES, AND CONSUMER REPRESENTATIVES, AND OTHER SUCH INTERESTED
PERSONS;
M. TO PROVIDE AND RECEIVE INFORMATION FROM, AND TO COOPERATE WITH, LAW
ENFORCEMENT AGENCIES;
N. TO ADOPT AND USE AN OFFICIAL SEAL; AND
O. TO PERFORM SUCH OTHER FUNCTIONS AS MAY BE NECESSARY OR APPROPRIATE
TO ACHIEVE THE PURPOSES OF THIS COMPACT CONSISTENT WITH THE STATE REGU-
LATION OF NURSE LICENSURE AND PRACTICE.
8. FINANCING OF THE COMMISSION. A. THE COMMISSION SHALL PAY, OR
PROVIDE FOR THE PAYMENT OF, THE REASONABLE EXPENSES OF ITS ESTABLISH-
MENT, ORGANIZATION AND ONGOING ACTIVITIES.
B. THE COMMISSION MAY ALSO LEVY ON AND COLLECT AN ANNUAL ASSESSMENT
FROM EACH PARTY STATE TO COVER THE COST OF ITS OPERATIONS, ACTIVITIES
AND STAFF IN ITS ANNUAL BUDGET AS APPROVED EACH YEAR. THE AGGREGATE
ANNUAL ASSESSMENT AMOUNT, IF ANY, SHALL BE ALLOCATED BASED UPON A FORMU-
LA TO BE DETERMINED BY THE COMMISSION, WHICH SHALL PROMULGATE A RULE
THAT IS BINDING UPON ALL PARTY STATES.
C. THE COMMISSION SHALL NOT INCUR OBLIGATIONS OF ANY KIND PRIOR TO
SECURING THE FUNDS ADEQUATE TO MEET THE SAME; NOR SHALL THE COMMISSION
PLEDGE THE CREDIT OF ANY OF THE PARTY STATES, EXCEPT BY, AND WITH THE
AUTHORITY OF, SUCH PARTY STATE.
D. THE COMMISSION SHALL KEEP ACCURATE ACCOUNTS OF ALL RECEIPTS AND
DISBURSEMENTS. THE RECEIPTS AND DISBURSEMENTS OF THE COMMISSION SHALL BE
SUBJECT TO THE AUDIT AND ACCOUNTING PROCEDURES ESTABLISHED UNDER ITS
BYLAWS. HOWEVER, ALL RECEIPTS AND DISBURSEMENTS OF FUNDS HANDLED BY THE
COMMISSION SHALL BE AUDITED YEARLY BY A CERTIFIED OR LICENSED PUBLIC
ACCOUNTANT, AND THE REPORT OF THE AUDIT SHALL BE INCLUDED IN AND BECOME
PART OF THE ANNUAL REPORT OF THE COMMISSION.
9. QUALIFIED IMMUNITY, DEFENSE AND INDEMNIFICATION. A. THE ADMINISTRA-
TORS, OFFICERS, EXECUTIVE DIRECTOR, EMPLOYEES AND REPRESENTATIVES OF THE
COMMISSION SHALL BE IMMUNE FROM SUIT AND LIABILITY, EITHER PERSONALLY OR
IN THEIR OFFICIAL CAPACITY, FOR ANY CLAIM FOR DAMAGE TO OR LOSS OF PROP-
ERTY OR PERSONAL INJURY OR OTHER CIVIL LIABILITY CAUSED BY OR ARISING
OUT OF ANY ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT OCCURRED, OR
THAT THE PERSON AGAINST WHOM THE CLAIM IS MADE HAD A REASONABLE BASIS
FOR BELIEVING OCCURRED, WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT,
DUTIES OR RESPONSIBILITIES; PROVIDED THAT NOTHING IN THIS PARAGRAPH
S. 8307--A 113 A. 8807--A
SHALL BE CONSTRUED TO PROTECT ANY SUCH PERSON FROM SUIT OR LIABILITY FOR
ANY DAMAGE, LOSS, INJURY OR LIABILITY CAUSED BY THE INTENTIONAL, WILLFUL
OR WANTON MISCONDUCT OF THAT PERSON.
B. THE COMMISSION SHALL DEFEND ANY ADMINISTRATOR, OFFICER, EXECUTIVE
DIRECTOR, EMPLOYEE OR REPRESENTATIVE OF THE COMMISSION IN ANY CIVIL
ACTION SEEKING TO IMPOSE LIABILITY ARISING OUT OF ANY ACTUAL OR ALLEGED
ACT, ERROR OR OMISSION THAT OCCURRED WITHIN THE SCOPE OF THE COMMIS-
SION'S EMPLOYMENT, DUTIES OR RESPONSIBILITIES, OR THAT THE PERSON
AGAINST WHOM THE CLAIM IS MADE HAD A REASONABLE BASIS FOR BELIEVING
OCCURRED WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT, DUTIES OR
RESPONSIBILITIES; PROVIDED THAT NOTHING HEREIN SHALL BE CONSTRUED TO
PROHIBIT THAT PERSON FROM RETAINING HIS OR HER OWN COUNSEL; AND PROVIDED
FURTHER THAT THE ACTUAL OR ALLEGED ACT, ERROR OR OMISSION DID NOT RESULT
FROM THAT PERSON'S INTENTIONAL, WILLFUL OR WANTON MISCONDUCT.
C. THE COMMISSION SHALL INDEMNIFY AND HOLD HARMLESS ANY ADMINISTRATOR,
OFFICER, EXECUTIVE DIRECTOR, EMPLOYEE OR REPRESENTATIVE OF THE COMMIS-
SION FOR THE AMOUNT OF ANY SETTLEMENT OR JUDGMENT OBTAINED AGAINST THAT
PERSON ARISING OUT OF ANY ACTUAL OR ALLEGED ACT, ERROR OR OMISSION THAT
OCCURRED WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT, DUTIES OR
RESPONSIBILITIES, OR THAT SUCH PERSON HAD A REASONABLE BASIS FOR BELIEV-
ING OCCURRED WITHIN THE SCOPE OF THE COMMISSION'S EMPLOYMENT, DUTIES OR
RESPONSIBILITIES, PROVIDED THAT THE ACTUAL OR ALLEGED ACT, ERROR OR
OMISSION DID NOT RESULT FROM THE INTENTIONAL, WILLFUL OR WANTON MISCON-
DUCT OF THAT PERSON.
§ 8908. RULEMAKING. 1. RULEMAKING. A. THE COMMISSION SHALL EXERCISE
ITS RULEMAKING POWERS PURSUANT TO THE CRITERIA SET FORTH IN THIS ARTICLE
AND THE RULES ADOPTED THEREUNDER. RULES AND AMENDMENTS SHALL BECOME
BINDING AS OF THE DATE SPECIFIED IN EACH RULE OR AMENDMENT AND SHALL
HAVE THE SAME FORCE AND EFFECT AS PROVISIONS OF THIS COMPACT.
B. RULES OR AMENDMENTS TO THE RULES SHALL BE ADOPTED AT A REGULAR OR
SPECIAL MEETING OF THE COMMISSION.
2. NOTICE. A. PRIOR TO PROMULGATION AND ADOPTION OF A FINAL RULE OR
RULES BY THE COMMISSION, AND AT LEAST SIXTY DAYS IN ADVANCE OF THE MEET-
ING AT WHICH THE RULE WILL BE CONSIDERED AND VOTED UPON, THE COMMISSION
SHALL FILE A NOTICE OF PROPOSED RULEMAKING:
I. ON THE WEBSITE OF THE COMMISSION; AND
II. ON THE WEBSITE OF EACH LICENSING BOARD OR THE PUBLICATION IN WHICH
EACH STATE WOULD OTHERWISE PUBLISH PROPOSED RULES.
B. THE NOTICE OF PROPOSED RULEMAKING SHALL INCLUDE:
I. THE PROPOSED TIME, DATE AND LOCATION OF THE MEETING IN WHICH THE
RULE WILL BE CONSIDERED AND VOTED UPON;
II. THE TEXT OF THE PROPOSED RULE OR AMENDMENT, AND THE REASON FOR THE
PROPOSED RULE;
III. A REQUEST FOR COMMENTS ON THE PROPOSED RULE FROM ANY INTERESTED
PERSON; AND
IV. THE MANNER IN WHICH INTERESTED PERSONS MAY SUBMIT NOTICE TO THE
COMMISSION OF THEIR INTENTION TO ATTEND THE PUBLIC HEARING AND ANY WRIT-
TEN COMMENTS.
C. PRIOR TO ADOPTION OF A PROPOSED RULE, THE COMMISSION SHALL ALLOW
PERSONS TO SUBMIT WRITTEN DATA, FACTS, OPINIONS AND ARGUMENTS, WHICH
SHALL BE MADE AVAILABLE TO THE PUBLIC.
3. PUBLIC HEARINGS ON RULES. A. THE COMMISSION SHALL GRANT AN OPPORTU-
NITY FOR A PUBLIC HEARING BEFORE IT ADOPTS A RULE OR AMENDMENT.
B. THE COMMISSION SHALL PUBLISH THE PLACE, TIME AND DATE OF THE SCHED-
ULED PUBLIC HEARING.
S. 8307--A 114 A. 8807--A
I. HEARINGS SHALL BE CONDUCTED IN A MANNER PROVIDING EACH PERSON WHO
WISHES TO COMMENT A FAIR AND REASONABLE OPPORTUNITY TO COMMENT ORALLY OR
IN WRITING. ALL HEARINGS WILL BE RECORDED, AND A COPY WILL BE MADE
AVAILABLE UPON REQUEST.
II. NOTHING IN THIS SECTION SHALL BE CONSTRUED AS REQUIRING A SEPARATE
HEARING ON EACH RULE. RULES MAY BE GROUPED FOR THE CONVENIENCE OF THE
COMMISSION AT HEARINGS REQUIRED BY THIS SECTION.
C. IF NO ONE APPEARS AT THE PUBLIC HEARING, THE COMMISSION MAY PROCEED
WITH PROMULGATION OF THE PROPOSED RULE.
D. FOLLOWING THE SCHEDULED HEARING DATE, OR BY THE CLOSE OF BUSINESS
ON THE SCHEDULED HEARING DATE IF THE HEARING WAS NOT HELD, THE COMMIS-
SION SHALL CONSIDER ALL WRITTEN AND ORAL COMMENTS RECEIVED.
4. VOTING ON RULES. THE COMMISSION SHALL, BY MAJORITY VOTE OF ALL
ADMINISTRATORS, TAKE FINAL ACTION ON THE PROPOSED RULE AND SHALL DETER-
MINE THE EFFECTIVE DATE OF THE RULE, IF ANY, BASED ON THE RULEMAKING
RECORD AND THE FULL TEXT OF THE RULE.
5. EMERGENCY RULES. UPON DETERMINATION THAT AN EMERGENCY EXISTS, THE
COMMISSION MAY CONSIDER AND ADOPT AN EMERGENCY RULE WITHOUT PRIOR
NOTICE, OPPORTUNITY FOR COMMENT OR HEARING, PROVIDED THAT THE USUAL
RULEMAKING PROCEDURES PROVIDED IN THIS COMPACT AND IN THIS SECTION SHALL
BE RETROACTIVELY APPLIED TO THE RULE AS SOON AS REASONABLY POSSIBLE, IN
NO EVENT LATER THAN NINETY DAYS AFTER THE EFFECTIVE DATE OF THE RULE.
FOR THE PURPOSES OF THIS PROVISION, AN EMERGENCY RULE IS ONE THAT MUST
BE ADOPTED IMMEDIATELY IN ORDER TO:
A. MEET AN IMMINENT THREAT TO PUBLIC HEALTH, SAFETY OR WELFARE;
B. PREVENT A LOSS OF THE COMMISSION OR PARTY STATE FUNDS; OR
C. MEET A DEADLINE FOR THE PROMULGATION OF AN ADMINISTRATIVE RULE THAT
IS REQUIRED BY FEDERAL LAW OR RULE.
6. REVISIONS. THE COMMISSION MAY DIRECT REVISIONS TO A PREVIOUSLY
ADOPTED RULE OR AMENDMENT FOR PURPOSES OF CORRECTING TYPOGRAPHICAL
ERRORS, ERRORS IN FORMAT, ERRORS IN CONSISTENCY OR GRAMMATICAL ERRORS.
PUBLIC NOTICE OF ANY REVISIONS SHALL BE POSTED ON THE WEBSITE OF THE
COMMISSION. THE REVISION SHALL BE SUBJECT TO CHALLENGE BY ANY PERSON FOR
A PERIOD OF THIRTY DAYS AFTER POSTING. THE REVISION MAY BE CHALLENGED
ONLY ON GROUNDS THAT THE REVISION RESULTS IN A MATERIAL CHANGE TO A
RULE. A CHALLENGE SHALL BE MADE IN WRITING, AND DELIVERED TO THE
COMMISSION, PRIOR TO THE END OF THE NOTICE PERIOD. IF NO CHALLENGE IS
MADE, THE REVISION WILL TAKE EFFECT WITHOUT FURTHER ACTION. IF THE
REVISION IS CHALLENGED, THE REVISION MAY NOT TAKE EFFECT WITHOUT THE
APPROVAL OF THE COMMISSION.
§ 8909. OVERSIGHT, DISPUTE RESOLUTION AND ENFORCEMENT. 1. OVERSIGHT.
A. EACH PARTY STATE SHALL ENFORCE THIS COMPACT AND TAKE ALL ACTIONS
NECESSARY AND APPROPRIATE TO EFFECTUATE THIS COMPACT'S PURPOSES AND
INTENT.
B. THE COMMISSION SHALL BE ENTITLED TO RECEIVE SERVICE OF PROCESS IN
ANY PROCEEDING THAT MAY AFFECT THE POWERS, RESPONSIBILITIES OR ACTIONS
OF THE COMMISSION, AND SHALL HAVE STANDING TO INTERVENE IN SUCH A
PROCEEDING FOR ALL PURPOSES. FAILURE TO PROVIDE SERVICE OF PROCESS IN
SUCH PROCEEDING TO THE COMMISSION SHALL RENDER A JUDGMENT OR ORDER VOID
AS TO THE COMMISSION, THIS COMPACT OR PROMULGATED RULES.
2. DEFAULT, TECHNICAL ASSISTANCE AND TERMINATION. A. IF THE COMMISSION
DETERMINES THAT A PARTY STATE HAS DEFAULTED IN THE PERFORMANCE OF ITS
OBLIGATIONS OR RESPONSIBILITIES UNDER THIS COMPACT OR THE PROMULGATED
RULES, THE COMMISSION SHALL:
S. 8307--A 115 A. 8807--A
I. PROVIDE WRITTEN NOTICE TO THE DEFAULTING STATE AND OTHER PARTY
STATES OF THE NATURE OF THE DEFAULT, THE PROPOSED MEANS OF CURING THE
DEFAULT OR ANY OTHER ACTION TO BE TAKEN BY THE COMMISSION; AND
II. PROVIDE REMEDIAL TRAINING AND SPECIFIC TECHNICAL ASSISTANCE
REGARDING THE DEFAULT.
B. IF A STATE IN DEFAULT FAILS TO CURE THE DEFAULT, THE DEFAULTING
STATE'S MEMBERSHIP IN THIS COMPACT MAY BE TERMINATED UPON AN AFFIRMATIVE
VOTE OF A MAJORITY OF THE ADMINISTRATORS, AND ALL RIGHTS, PRIVILEGES AND
BENEFITS CONFERRED BY THIS COMPACT MAY BE TERMINATED ON THE EFFECTIVE
DATE OF TERMINATION. A CURE OF THE DEFAULT DOES NOT RELIEVE THE OFFEND-
ING STATE OF OBLIGATIONS OR LIABILITIES INCURRED DURING THE PERIOD OF
DEFAULT.
C. TERMINATION OF MEMBERSHIP IN THIS COMPACT SHALL BE IMPOSED ONLY
AFTER ALL OTHER MEANS OF SECURING COMPLIANCE HAVE BEEN EXHAUSTED. NOTICE
OF INTENT TO SUSPEND OR TERMINATE SHALL BE GIVEN BY THE COMMISSION TO
THE GOVERNOR OF THE DEFAULTING STATE AND TO THE EXECUTIVE OFFICER OF THE
DEFAULTING STATE'S LICENSING BOARD AND EACH OF THE PARTY STATES.
D. A STATE WHOSE MEMBERSHIP IN THIS COMPACT HAS BEEN TERMINATED IS
RESPONSIBLE FOR ALL ASSESSMENTS, OBLIGATIONS AND LIABILITIES INCURRED
THROUGH THE EFFECTIVE DATE OF TERMINATION, INCLUDING OBLIGATIONS THAT
EXTEND BEYOND THE EFFECTIVE DATE OF TERMINATION.
E. THE COMMISSION SHALL NOT BEAR ANY COSTS RELATED TO A STATE THAT IS
FOUND TO BE IN DEFAULT OR WHOSE MEMBERSHIP IN THIS COMPACT HAS BEEN
TERMINATED UNLESS AGREED UPON IN WRITING BETWEEN THE COMMISSION AND THE
DEFAULTING STATE.
F. THE DEFAULTING STATE MAY APPEAL THE ACTION OF THE COMMISSION BY
PETITIONING THE U.S. DISTRICT COURT FOR THE DISTRICT OF COLUMBIA OR THE
FEDERAL DISTRICT IN WHICH THE COMMISSION HAS ITS PRINCIPAL OFFICES. THE
PREVAILING PARTY SHALL BE AWARDED ALL COSTS OF SUCH LITIGATION, INCLUD-
ING REASONABLE ATTORNEYS' FEES.
3. DISPUTE RESOLUTION. A. UPON REQUEST BY A PARTY STATE, THE COMMIS-
SION SHALL ATTEMPT TO RESOLVE DISPUTES RELATED TO THE COMPACT THAT ARISE
AMONG PARTY STATES AND BETWEEN PARTY AND NON-PARTY STATES.
B. THE COMMISSION SHALL PROMULGATE A RULE PROVIDING FOR BOTH MEDIATION
AND BINDING DISPUTE RESOLUTION FOR DISPUTES, AS APPROPRIATE.
C. IN THE EVENT THE COMMISSION CANNOT RESOLVE DISPUTES AMONG PARTY
STATES ARISING UNDER THIS COMPACT:
I. THE PARTY STATES MAY SUBMIT THE ISSUES IN DISPUTE TO AN ARBITRATION
PANEL, WHICH WILL BE COMPRISED OF INDIVIDUALS APPOINTED BY THE COMPACT
ADMINISTRATOR IN EACH OF THE AFFECTED PARTY STATES, AND AN INDIVIDUAL
MUTUALLY AGREED UPON BY THE COMPACT ADMINISTRATORS OF ALL THE PARTY
STATES INVOLVED IN THE DISPUTE.
II. THE DECISION OF A MAJORITY OF THE ARBITRATORS SHALL BE FINAL AND
BINDING.
4. ENFORCEMENT. A. THE COMMISSION, IN THE REASONABLE EXERCISE OF ITS
DISCRETION, SHALL ENFORCE THE PROVISIONS AND RULES OF THIS COMPACT.
B. BY MAJORITY VOTE, THE COMMISSION MAY INITIATE LEGAL ACTION IN THE
U.S. DISTRICT COURT FOR THE DISTRICT OF COLUMBIA OR THE FEDERAL
DISTRICT IN WHICH THE COMMISSION HAS ITS PRINCIPAL OFFICES AGAINST A
PARTY STATE THAT IS IN DEFAULT TO ENFORCE COMPLIANCE WITH THE PROVISIONS
OF THIS COMPACT AND ITS PROMULGATED RULES AND BYLAWS. THE RELIEF SOUGHT
MAY INCLUDE BOTH INJUNCTIVE RELIEF AND DAMAGES. IN THE EVENT JUDICIAL
ENFORCEMENT IS NECESSARY, THE PREVAILING PARTY SHALL BE AWARDED ALL
COSTS OF SUCH LITIGATION, INCLUDING REASONABLE ATTORNEYS' FEES.
S. 8307--A 116 A. 8807--A
C. THE REMEDIES HEREIN SHALL NOT BE THE EXCLUSIVE REMEDIES OF THE
COMMISSION. THE COMMISSION MAY PURSUE ANY OTHER REMEDIES AVAILABLE UNDER
FEDERAL OR STATE LAW.
§ 8910. EFFECTIVE DATE, WITHDRAWAL AND AMENDMENT. 1. EFFECTIVE DATE.
A. THIS COMPACT SHALL BECOME EFFECTIVE AND BINDING ON THE EARLIER OF
THE DATE OF LEGISLATIVE ENACTMENT OF THIS COMPACT INTO LAW BY NO LESS
THAN TWENTY-SIX STATES OR THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS
OF TWO THOUSAND TWENTY-FOUR THAT ENACTED THIS COMPACT. THEREAFTER, THE
COMPACT SHALL BECOME EFFECTIVE AND BINDING AS TO ANY OTHER COMPACTING
STATE UPON ENACTMENT OF THE COMPACT INTO LAW BY THAT STATE. ALL PARTY
STATES TO THIS COMPACT, THAT ALSO WERE PARTIES TO THE PRIOR NURSE LICEN-
SURE COMPACT, SUPERSEDED BY THIS COMPACT, (HEREIN REFERRED TO AS "PRIOR
COMPACT"), SHALL BE DEEMED TO HAVE WITHDRAWN FROM SAID PRIOR COMPACT
WITHIN SIX MONTHS AFTER THE EFFECTIVE DATE OF THIS COMPACT.
B. EACH PARTY STATE TO THIS COMPACT SHALL CONTINUE TO RECOGNIZE A
NURSE'S MULTISTATE LICENSURE PRIVILEGE TO PRACTICE IN THAT PARTY STATE
ISSUED UNDER THE PRIOR COMPACT UNTIL SUCH PARTY STATE HAS WITHDRAWN FROM
THE PRIOR COMPACT.
2. WITHDRAWAL. A. ANY PARTY STATE MAY WITHDRAW FROM THIS COMPACT BY
ENACTING A STATUTE REPEALING THE SAME. A PARTY STATE'S WITHDRAWAL SHALL
NOT TAKE EFFECT UNTIL SIX MONTHS AFTER ENACTMENT OF THE REPEALING STAT-
UTE.
B. A PARTY STATE'S WITHDRAWAL OR TERMINATION SHALL NOT AFFECT THE
CONTINUING REQUIREMENT OF THE WITHDRAWING OR TERMINATED STATE'S LICENS-
ING BOARD TO REPORT ADVERSE ACTIONS AND SIGNIFICANT INVESTIGATIONS
OCCURRING PRIOR TO THE EFFECTIVE DATE OF SUCH WITHDRAWAL OR TERMINATION.
C. NOTHING CONTAINED IN THIS COMPACT SHALL BE CONSTRUED TO INVALIDATE
OR PREVENT ANY NURSE LICENSURE AGREEMENT OR OTHER COOPERATIVE ARRANGE-
MENT BETWEEN A PARTY STATE AND A NON-PARTY STATE THAT IS MADE IN ACCORD-
ANCE WITH THE OTHER PROVISIONS OF THIS COMPACT.
3. AMENDMENT. A. THIS COMPACT MAY BE AMENDED BY THE PARTY STATES. NO
AMENDMENT TO THIS COMPACT SHALL BECOME EFFECTIVE AND BINDING UPON THE
PARTY STATES UNLESS AND UNTIL IT IS ENACTED INTO THE LAWS OF ALL PARTY
STATES.
B. REPRESENTATIVES OF NON-PARTY STATES TO THIS COMPACT SHALL BE
INVITED TO PARTICIPATE IN THE ACTIVITIES OF THE COMMISSION, ON A NONVOT-
ING BASIS, PRIOR TO THE ADOPTION OF THIS COMPACT BY ALL STATES.
§ 8911. CONSTRUCTION AND SEVERABILITY. 1. CONSTRUCTION AND SEVERABIL-
ITY. THIS COMPACT SHALL BE LIBERALLY CONSTRUED SO AS TO EFFECTUATE THE
PURPOSES THEREOF. THE PROVISIONS OF THIS COMPACT SHALL BE SEVERABLE, AND
IF ANY PHRASE, CLAUSE, SENTENCE OR PROVISION OF THIS COMPACT IS DECLARED
TO BE CONTRARY TO THE CONSTITUTION OF ANY PARTY STATE OR OF THE UNITED
STATES, OR IF THE APPLICABILITY THEREOF TO ANY GOVERNMENT, AGENCY,
PERSON OR CIRCUMSTANCE IS HELD TO BE INVALID, THE VALIDITY OF THE
REMAINDER OF THIS COMPACT AND THE APPLICABILITY THEREOF TO ANY GOVERN-
MENT, AGENCY, PERSON OR CIRCUMSTANCE SHALL NOT BE AFFECTED THEREBY. IF
THIS COMPACT SHALL BE HELD TO BE CONTRARY TO THE CONSTITUTION OF ANY
PARTY STATE, THIS COMPACT SHALL REMAIN IN FULL FORCE AND EFFECT AS TO
THE REMAINING PARTY STATES AND IN FULL FORCE AND EFFECT AS TO THE PARTY
STATE AFFECTED AS TO ALL SEVERABLE MATTERS.
§ 3. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART S
S. 8307--A 117 A. 8807--A
Section 1. The public health law is amended by adding a new section
2825-i to read as follows:
§ 2825-I. HEALTHCARE SAFETY NET TRANSFORMATION PROGRAM. 1. A STATEWIDE
HEALTHCARE SAFETY NET TRANSFORMATION PROGRAM SHALL BE ESTABLISHED WITHIN
THE DEPARTMENT FOR THE PURPOSE OF SUPPORTING THE TRANSFORMATION OF SAFE-
TY NET HOSPITALS TO IMPROVE ACCESS, EQUITY, QUALITY, AND OUTCOMES WHILE
INCREASING THE FINANCIAL SUSTAINABILITY OF SAFETY NET HOSPITALS. SUCH
PROGRAM MAY PROVIDE OR UTILIZE NEW OR EXISTING CAPITAL FUNDING, OR OPER-
ATING SUBSIDIES, OR BOTH. ANY APPLICATION FOR THIS PROGRAM MUST BE
JOINTLY SUBMITTED BY A SAFETY NET HOSPITAL AND AT LEAST ONE PARTNER
ORGANIZATION.
2. THE COMMISSIONER SHALL ENTER AN AGREEMENT WITH THE PRESIDENT OF THE
DORMITORY AUTHORITY OF THE STATE OF NEW YORK PURSUANT TO SECTION SIXTEEN
HUNDRED EIGHTY-R OF THE PUBLIC AUTHORITIES LAW, AS REQUIRED, WHICH SHALL
APPLY TO THIS AGREEMENT, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE
DIVISION OF THE BUDGET, FOR THE PURPOSES OF THE DISTRIBUTION AND ADMIN-
ISTRATION OF AVAILABLE FUNDS PURSUANT TO SUCH AGREEMENT AND MADE AVAIL-
ABLE PURSUANT TO THIS SECTION AND SUBJECT TO APPROPRIATION. SUCH FUNDS
MAY BE AWARDED AND DISTRIBUTED BY THE DEPARTMENT TO SAFETY NET HOSPI-
TALS, OR A PARTNER ORGANIZATION, IN THE FORM OF GRANTS. TO QUALIFY AS A
SAFETY NET HOSPITAL FOR PURPOSES OF THIS SECTION, A HOSPITAL SHALL:
(A) BE EITHER A PUBLIC HOSPITAL, A RURAL EMERGENCY HOSPITAL, CRITICAL
ACCESS HOSPITAL OR SOLE COMMUNITY HOSPITAL;
(B) HAVE AT LEAST THIRTY PERCENT OF ITS INPATIENT DISCHARGES MADE UP
OF MEDICAL ASSISTANCE PROGRAM ELIGIBLE INDIVIDUALS, UNINSURED INDIVID-
UALS OR MEDICAL ASSISTANCE PROGRAM DUALLY ELIGIBLE INDIVIDUALS AND AT
LEAST THIRTY-FIVE PERCENT OF ITS OUTPATIENT VISITS MADE UP OF MEDICAL
ASSISTANCE PROGRAM ELIGIBLE INDIVIDUALS, UNINSURED INDIVIDUALS OR
MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGIBLE INDIVIDUALS;
(C) SERVE AT LEAST THIRTY PERCENT OF THE RESIDENTS OF A COUNTY OR A
MULTI-COUNTY AREA WHO ARE MEDICAL ASSISTANCE PROGRAM ELIGIBLE INDIVID-
UALS, UNINSURED INDIVIDUALS OR MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGI-
BLE INDIVIDUALS; OR
(D) IN THE DISCRETION OF THE COMMISSIONER, SERVE A SIGNIFICANT POPU-
LATION OF MEDICAL ASSISTANCE PROGRAM ELIGIBLE INDIVIDUALS, UNINSURED
INDIVIDUALS OR MEDICAL ASSISTANCE PROGRAM DUALLY-ELIGIBLE INDIVIDUALS.
3. PARTNER ORGANIZATIONS MAY INCLUDE, BUT ARE NOT LIMITED TO, HEALTH
SYSTEMS, HOSPITALS, HEALTH PLANS, RESIDENTIAL HEALTH CARE FACILITIES,
PHYSICIAN GROUPS, COMMUNITY-BASED ORGANIZATION, OR OTHER HEALTHCARE
ENTITIES WHO CAN SERVE AS PARTNERS IN THE TRANSFORMATION OF THE SAFETY
NET HOSPITAL. THE COMMISSIONER SHALL HAVE THE DISCRETION TO DEEM ANY
ORGANIZATION A PARTNER ORGANIZATION UPON A FINDING THAT DEEMING SO WILL
ADVANCE THE GOALS OF THIS SECTION.
4. NOTWITHSTANDING ANY LAW TO THE CONTRARY, AND IN ACCORDANCE WITH
SECTION FOUR OF THE STATE FINANCE LAW, THE COMPTROLLER IS HEREBY AUTHOR-
IZED AND DIRECTED TO TRANSFER, UPON REQUEST OF THE DIRECTOR OF BUDGET,
ON OR BEFORE MARCH THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE, UP TO FIVE
HUNDRED MILLION DOLLARS TO THE DEPARTMENT FROM AMOUNTS APPROPRIATED TO
ADMINISTER THE PROGRAMS ESTABLISHED IN SECTIONS TWENTY-EIGHT HUNDRED
TWENTY-FIVE-G AND TWENTY-EIGHT HUNDRED TWENTY-FIVE-H OF THIS ARTICLE TO
SUPPORT THIS PROGRAM. NOTWITHSTANDING SECTION ONE HUNDRED SIXTY-THREE
OF THE STATE FINANCE LAW, SECTIONS ONE HUNDRED FORTY-TWO AND ONE HUNDRED
FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW OR ANY INCONSISTENT
PROVISIONS OF LAW TO THE CONTRARY, AWARDS MAY BE PROVIDED WITHOUT A
COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS TO SAFETY NET HOSPITALS
OR PARTNER ORGANIZATIONS FOR PURPOSES OF INCREASING ACCESS, EQUITY,
S. 8307--A 118 A. 8807--A
QUALITY, OUTCOMES, AND LONG-TERM FINANCIAL SUSTAINABILITY OF SUCH SAFETY
NET HOSPITALS.
5. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, THE COMMIS-
SIONER IS AUTHORIZED TO WAIVE ANY REGULATORY REQUIREMENTS TO ALLOW
APPLICANTS TO MORE EFFECTIVELY OR EFFICIENTLY IMPLEMENT PROJECTS AWARDED
THROUGH THE HEALTHCARE SAFETY NET TRANSFORMATION PROGRAM, PROVIDED,
HOWEVER, THAT REGULATIONS PERTAINING TO PATIENT SAFETY, PATIENT AUTON-
OMY, PATIENT PRIVACY, PATIENT RIGHTS, DUE PROCESS, SCOPE OF PRACTICE,
PROFESSIONAL LICENSURE, ENVIRONMENTAL PROTECTIONS, PROVIDER REIMBURSE-
MENT METHODOLOGIES, OR OCCUPATIONAL STANDARDS AND EMPLOYEE RIGHTS MAY
NOT BE WAIVED, NOR SHALL ANY REGULATIONS BE WAIVED IF SUCH WAIVER WOULD
RISK PATIENT SAFETY. SUCH WAIVER SHALL NOT EXCEED THE LIFE OF THE
PROJECT OR SUCH SHORTER TIME PERIODS AS THE COMMISSIONER MAY DETERMINE.
ANY REGULATORY RELIEF GRANTED PURSUANT TO THIS SUBDIVISION SHALL BE
SPECIFICALLY DESCRIBED AND REQUESTED WITHIN EACH PROJECT APPLICATION AND
BE REVIEWED BY THE COMMISSIONER. THE WAIVER OF ANY REGULATORY REQUIRE-
MENTS SHALL BE MADE IN THE SOLE DISCRETION OF THE COMMISSIONER.
6. QUALIFYING SAFETY NET HOSPITALS AND THEIR DESIGNATED PARTNER ORGAN-
IZATION OR ORGANIZATIONS SHALL PROVIDE, AS PART OF THE APPLICATION,
WHICH SHALL BE IN A MANNER AS PRESCRIBED BY THE COMMISSIONER, A TRANS-
FORMATION PLAN THAT INCLUDES AT LEAST A FIVE-YEAR STRATEGIC AND OPERA-
TIONAL PLAN OUTLINING THE ROLES AND RESPONSIBILITIES OF EACH ENTITY AND
SPECIFICALLY STATE ANY REGULATORY FLEXIBILITY WHICH MAY BE REQUIRED TO
IMPLEMENT SUCH PLAN. THE TRANSFORMATION PLAN SHALL ALSO INCLUDE A TIME-
LINE OF KEY METRICS AND GOALS RELATED TO IMPROVED ACCESS, EQUITY, QUALI-
TY, OUTCOMES, AND INCREASED FINANCIAL SUSTAINABILITY OF THE SAFETY NET
HOSPITAL. THE REQUEST FOR LEVEL AND TYPE OF SUPPORT SHALL BE SPECIFIC
AND DETAILED IN THE APPLICATION. CONTINUED SUPPORT SHALL BE CONTINGENT
UPON THE IMPLEMENTATION OF THE APPROVED PLAN AND KEY MILESTONES. APPLI-
CATIONS MAY INCLUDE A RANGE OF COLLABORATION MODELS, INCLUDING BUT NOT
BE LIMITED TO MERGER, ACQUISITION, A MANAGEMENT SERVICES CONTRACT, OR A
CLINICAL INTEGRATION.
7. THE RELEASE OF ANY FUNDING WILL BE CONTINGENT UPON COMPLIANCE WITH
THE TRANSFORMATION PLAN AND A DETERMINATION THAT ACCEPTABLE PROGRESS HAS
BEEN MADE WITH SUCH PLAN. IF KEY MILESTONES AND GOALS ARE NOT MET, ADDI-
TIONAL FINANCIAL RESOURCES MAY BE WITHHELD AND REDIRECTED, UPON THE
RECOMMENDATION OF THE COMMISSIONER AND APPROVAL BY THE DIRECTOR OF BUDG-
ET.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART T
Section 1. Subdivision 1 of section 2130 of the public health law, as
amended by chapter 308 of the laws of 2010, is amended to read as
follows:
1. (A) Every physician or other person authorized by law to order
diagnostic tests or make a medical diagnosis, or any laboratory perform-
ing such tests shall immediately [(a)] (I) upon determination that a
person is [infected] POSITIVE/REACTIVE with human immunodeficiency virus
(HIV), [(b)] (II) upon diagnosis [that a person is afflicted] with [the
disease known as] acquired immune deficiency syndrome (AIDS), [(c)]
(III) upon diagnosis [that a person is afflicted] with HIV related
illness, and [(d)] (IV) upon periodic monitoring of HIV infection by any
laboratory tests report such case or data to the commissioner.
S. 8307--A 119 A. 8807--A
(B) ANY PERMITTED CLINICAL LABORATORY, AS DEFINED IN SECTION FIVE
HUNDRED SEVENTY-ONE OF THIS CHAPTER, PERFORMING SUCH DIAGNOSTIC TESTS
SHALL ALSO, UPON DETERMINATION THAT A TEST RESULT IS NOT
POSITIVE/REACTIVE FOR HIV, REPORT SUCH NEGATIVE HIV TEST RESULT TO THE
COMMISSIONER.
§ 2. Subdivision 1 of section 2102 of the public health law is amended
to read as follows:
1. Whenever any laboratory examination discloses evidence of communi-
cable disease, AND FOR HEPATITIS B VIRUS OR SYPHILIS UPON DETERMINATION
THAT A TEST RESULT IS NOT POSITIVE/REACTIVE, the results of such exam-
ination together with all required pertinent facts, shall be immediately
reported by the person in charge of the laboratory or the person making
such examination to the local or state health official to whom the
attending physician is required to report such case.
§ 3. The public health law is amended by adding a new section 2172 to
read as follows:
§ 2172. HCV INFECTION; DUTY TO REPORT. IN ADDITION TO REPORTING THAT A
HEPATITIS C VIRUS (HCV) CLINICAL LABORATORY TEST IS REACTIVE/POSITIVE AS
REQUIRED BY SECTION TWENTY-ONE HUNDRED TWO OF THIS ARTICLE, ANY PERMIT-
TED CLINICAL LABORATORY, AS DEFINED IN SECTION FIVE HUNDRED SEVENTY-ONE
OF THIS CHAPTER, PERFORMING SUCH TESTS SHALL ALSO, UPON DETERMINATION
THAT A TEST RESULT IS NOT POSITIVE/REACTIVE WITH HCV, REPORT SUCH NEGA-
TIVE HCV TEST RESULT TO THE COMMISSIONER.
§ 4. Section 2781 of the public health law, as amended by chapter 308
of the laws of 2010, subdivisions 1 and 2 as amended by chapter 502 of
the laws of 2016 and subdivision 4 as amended by section 2 of part A of
chapter 60 of the laws of 2014, is amended to read as follows:
§ 2781. HIV related testing. 1. Except as provided in section three
thousand one hundred twenty-one of the civil practice law and rules, or
unless otherwise specifically authorized or required by a state or
federal law, no person shall order the performance of an HIV related
test without first, at a minimum, [orally advising] PROVIDING NOTICE BY
MEANS READILY ACCESSIBLE IN MULTIPLE LANGUAGES TO the protected individ-
ual, or, when the protected individual lacks capacity to consent, a
person authorized to consent to health care for such individual, that an
HIV-related test is being performed, or over the objection of such indi-
vidual or authorized persons. Such [advisement and objection, when
applicable] NOTICE MAY BE PROVIDED ORALLY, IN WRITING, BY PROMINENTLY
DISPLAYED SIGNAGE, OR BY ELECTRONIC MEANS OR OTHER APPROPRIATE FORM OF
COMMUNICATION. SUCH NOTICE SHALL INCLUDE INFORMATION THAT HIV TESTING IS
VOLUNTARY. A REFUSAL OF AN HIV RELATED TEST shall be noted in the indi-
vidual's record.
2. A person ordering the performance of an HIV related test shall
provide either directly or through a representative to the subject of an
HIV related test or, if the subject lacks capacity to consent, to a
person authorized pursuant to law to consent to health care for the
subject, an explanation that:
(a) HIV causes AIDS and can be transmitted through sexual activities
and needle-sharing, by pregnant women to their fetuses, and through
breastfeeding infants;
(b) there is treatment for HIV that can help an individual stay heal-
thy;
(c) individuals with HIV or AIDS can adopt safe practices to protect
uninfected and infected people in their lives from becoming infected or
multiply infected with HIV;
S. 8307--A 120 A. 8807--A
(d) testing is voluntary and can be done anonymously at a public test-
ing center;
(e) the law protects the confidentiality of HIV related test results;
(f) the law prohibits discrimination based on an individual's HIV
status and services are available to help with such consequences; and
(g) the law requires that an individual be advised before an HIV-re-
lated test is performed, and that no test shall be performed over his or
her objection.
Protocols shall be in place to ensure compliance with this section.
4. [A person authorized pursuant to law to order the performance of an
HIV related test shall provide directly or through a representative to
the person seeking such test, an opportunity to remain anonymous through
use of a coded system with no linking of individual identity to the test
request or results.] A health care provider who is not authorized by the
commissioner to provide HIV related tests on an anonymous basis shall
refer a person who requests an anonymous test to a test site which does
provide anonymous testing. The provisions of this subdivision shall not
apply to a health care provider ordering the performance of an HIV
related test on an individual proposed for insurance coverage.
5. At the time of communicating the test result to the subject of the
test, a person ordering the performance of an HIV related test shall,
directly or through a representative:
(a) in the case of a test indicating evidence of HIV infection,
provide the subject of the test or, if the subject lacks capacity to
consent, the person authorized pursuant to law to consent to health care
for the subject with counseling or referrals for counseling:
(i) for coping with the emotional consequences of learning the result;
(ii) regarding the discrimination problems that disclosure of the
result could cause;
(iii) for behavior change to prevent transmission or contraction of
HIV infection;
(iv) to inform such person of available medical treatments; [and]
(v) regarding the need to notify his or her contacts; AND
(VI) REGARDING PRE- AND POST-EXPOSURE PROPHYLAXIS MEDICATIONS AVAIL-
ABLE TO SEXUAL PARTNERS TO PREVENT HIV INFECTION; and
(b) in the case of a test not indicating evidence of HIV infection,
provide (in a manner which may consist of oral or written reference to
information previously provided) the subject of the test, or if the
subject lacks capacity to consent, the person authorized pursuant to law
to consent to health care for the subject, with information:
(I) concerning the risks of participating in high risk sexual or
needle-sharing behavior; AND
(II) REGARDING PRE- AND POST-EXPOSURE PROPHYLAXIS MEDICATIONS AVAIL-
ABLE TO PREVENT HIV INFECTION.
5-a. With the consent of the subject of a test indicating evidence of
HIV infection or, if the subject lacks capacity to consent, with the
consent of the person authorized pursuant to law to consent to health
care for the subject, the person who ordered the performance of the HIV
related test, or such person's representative, shall provide or arrange
with a health care provider for an appointment for follow-up medical
care for HIV for such subject.
6. The provisions of this section shall not apply to the performance
of an HIV related test:
(a) by a health care provider or health facility in relation to the
procuring, processing, distributing or use of a human body or a human
body part, including organs, tissues, eyes, bones, arteries, blood,
S. 8307--A 121 A. 8807--A
semen, or other body fluids, for use in medical research or therapy, or
for transplantation to individuals provided, however, that where the
test results are communicated to the subject, post-test counseling, as
described in subdivision five of this section, shall nonetheless be
required; or
(b) for the purpose of research if the testing is performed in a
manner by which the identity of the test subject is not known and may
not be retrieved by the researcher; or
(c) on a deceased person, when such test is conducted to determine the
cause of death or for epidemiological purposes; or
(d) conducted pursuant to section twenty-five hundred-f of this chap-
ter; or
(e) in situations involving occupational exposures which create a
significant risk of contracting or transmitting HIV infection, as
defined in regulations of the department and pursuant to protocols
adopted by the department,
(i) provided that:
(A) the person who is the source of the occupational exposure is
deceased, comatose or is determined by his or her attending health care
professional to lack mental capacity to consent to an HIV related test
and is not reasonably expected to recover in time for the exposed person
to receive appropriate medical treatment, as determined by the exposed
person's attending health care professional who would order or provide
such treatment;
(B) there is no person available or reasonably likely to become avail-
able who has the legal authority to consent to the HIV related test on
behalf of the source person in time for the exposed person to receive
appropriate medical treatment; and
(C) the exposed person will benefit medically by knowing the source
person's HIV test results, as determined by the exposed person's health
care professional and documented in the exposed person's medical record;
(ii) in which case
(A) a provider shall order an anonymous HIV test of the source person;
and
(B) the results of such anonymous test, but not the identity of the
source person, shall be disclosed only to the attending health care
professional of the exposed person solely for the purpose of assisting
the exposed person in making appropriate decisions regarding post-expo-
sure medical treatment; and
(C) the results of the test shall not be disclosed to the source
person or placed in the source person's medical record.
7. In the event that an HIV related test is ordered by a physician or
certified nurse practitioner pursuant to the provisions of the education
law providing for non-patient specific regimens, then for the purposes
of this section the individual administering the test shall be deemed to
be the individual ordering the test.
§ 5. Subdivision 4 of section 6909 of the education law is amended by
adding a new paragraph (m) to read as follows:
(M) UNDERTAKING THE COLLECTION OF SPECIMENS NECESSARY TO TEST TO
DETERMINE THE PRESENCE OF THE HEPATITIS B VIRUS.
§ 6. Subdivision 6 of section 6527 of the education law is amended by
adding a new paragraph (m) to read as follows:
(M) UNDERTAKING THE COLLECTION OF SPECIMENS NECESSARY TO TEST TO
DETERMINE THE PRESENCE OF THE HEPATITIS B VIRUS.
§ 7. Section 6801 of the education law is amended by adding a new
subdivision 10 to read as follows:
S. 8307--A 122 A. 8807--A
10. A. A LICENSED PHARMACIST MAY EXECUTE A NON-PATIENT SPECIFIC ORDER
FOR THE DISPENSING OF HIV PRE-EXPOSURE PROPHYLAXIS (PREP) PRESCRIBED OR
ORDERED BY THE COMMISSIONER OF HEALTH, A PHYSICIAN LICENSED IN THIS
STATE OR A NURSE PRACTITIONER CERTIFIED IN THIS STATE PURSUANT TO RULES
AND REGULATIONS PROMULGATED BY THE COMMISSIONER.
B. PRIOR TO DISPENSING HIV PREP TO A PATIENT, AND AT A MINIMUM OF
EVERY TWELVE MONTHS FOR EACH RETURNING PATIENT, THE PHARMACIST SHALL:
(I) ENSURE THAT THE PATIENT IS HIV NEGATIVE, AS DOCUMENTED BY A NEGA-
TIVE HIV TEST RESULT OBTAINED WITHIN THE PREVIOUS SEVEN DAYS FROM AN HIV
ANTIGEN/ANTIBODY TEST OR ANTIBODY-ONLY TEST OR FROM A RAPID, POINT-OF-
CARE FINGERSTICK BLOOD TEST APPROVED BY THE FEDERAL FOOD AND DRUG ADMIN-
ISTRATION. IF THE PATIENT DOES NOT PROVIDE EVIDENCE OF A NEGATIVE HIV
TEST IN ACCORDANCE WITH THIS PARAGRAPH, THE PHARMACIST MAY RECOMMEND OR
PRESCRIBE AN HIV TEST. IF THE PATIENT TESTS POSITIVE FOR HIV INFECTION,
THE PHARMACIST SHALL DIRECT THE PATIENT TO A LICENSED PHYSICIAN AND
PROVIDE THE PATIENT WITH A LIST OF HEALTH CARE SERVICE PROVIDERS AND
CLINICS WITHIN THE COUNTY WHERE THE PHARMACIST IS LOCATED OR ADJACENT
COUNTIES;
(II) PROVIDE THE PATIENT WITH A SELF-SCREENING RISK ASSESSMENT QUES-
TIONNAIRE, DEVELOPED BY THE COMMISSIONER OF HEALTH IN CONSULTATION WITH
THE COMMISSIONER, TO BE REVIEWED BY THE PHARMACIST TO IDENTIFY ANY KNOWN
RISK FACTORS AND ASSIST THE PATIENT'S SELECTION OF AN APPROPRIATE PREP
MEDICATION; AND
(III) PROVIDE THE PATIENT WITH A FACT SHEET, DEVELOPED BY THE COMMIS-
SIONER OF HEALTH, THAT INCLUDES BUT IS NOT LIMITED TO, THE CLINICAL
CONSIDERATIONS AND RECOMMENDATIONS FOR USE OF PREP, THE APPROPRIATE
METHOD FOR USING PREP, INFORMATION ON THE IMPORTANCE OF FOLLOW-UP HEALTH
CARE, HEALTH CARE REFERRAL INFORMATION, AND THE ABILITY OF THE PATIENT
TO OPT OUT OF PRACTITIONER REPORTING REQUIREMENTS.
C. NO PHARMACIST SHALL DISPENSE PREP UNDER THIS SUBDIVISION WITHOUT
RECEIVING TRAINING IN ACCORDANCE WITH REGULATIONS PROMULGATED BY THE
COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER.
D. A PHARMACIST SHALL NOTIFY THE PATIENT'S PRIMARY HEALTH CARE PRACTI-
TIONER, UNLESS THE PATIENT OPTS OUT OF SUCH NOTIFICATION, WITHIN SEVEN-
TY-TWO HOURS OF DISPENSING PREP, THAT PREP HAS BEEN DISPENSED. IF THE
PATIENT DOES NOT HAVE A PRIMARY HEALTH CARE PRACTITIONER, OR IS UNABLE
TO PROVIDE CONTACT INFORMATION FOR THEIR PRIMARY HEALTH CARE PRACTITION-
ER, THE PHARMACIST SHALL PROVIDE THE PATIENT WITH A WRITTEN RECORD OF
THE PREP MEDICATIONS DISPENSED, AND ADVISE THE PATIENT TO CONSULT AN
APPROPRIATE HEALTH CARE PRACTITIONER.
E. NOTHING IN THIS SUBDIVISION SHALL PREVENT A PHARMACIST FROM REFUS-
ING TO DISPENSE A NON-PATIENT SPECIFIC ORDER OF PREP PURSUANT TO THIS
SUBDIVISION IF, IN THEIR PROFESSIONAL JUDGMENT, POTENTIAL ADVERSE
EFFECTS, INTERACTIONS, OR OTHER THERAPEUTIC COMPLICATIONS COULD ENDANGER
THE HEALTH OF THE PATIENT.
§ 8. Section 6801 of the education law is amended by adding a new
subdivision 11 to read as follows:
11. A LICENSED PHARMACIST WITHIN THEIR LAWFUL SCOPE OF PRACTICE MAY
ADMINISTER TO PATIENTS EIGHTEEN YEARS OF AGE OR OLDER, IMMUNIZING AGENTS
TO PREVENT MPOX PURSUANT TO A PATIENT SPECIFIC ORDER OR A NON-PATIENT
SPECIFIC ORDER. WHEN A LICENSED PHARMACIST ADMINISTERS AN MPOX IMMUNIZ-
ING AGENT, THEY SHALL COMPLY WITH SUBDIVISIONS TWO, THREE AND FOUR OF
THIS SECTION.
§ 9. Section 2307 of the public health law is REPEALED.
§ 10. This act shall take effect immediately; provided, however,
sections one, two, and three of this act shall take effect on the one
S. 8307--A 123 A. 8807--A
hundred eightieth day after it shall have become a law. Effective imme-
diately, the addition, amendment and/or repeal of any rule or regulation
necessary for the implementation of this act on its effective date are
authorized to be made and completed on or before such effective date.
PART U
Section 1. Section 3302 of the public health law is amended by adding
a new subdivision 42 to read as follows:
42. "PUBLIC HEALTH SURVEILLANCE" MEANS THE CONTINUOUS, SYSTEMATIC
COLLECTION, ANALYSIS, AND INTERPRETATION OF HEALTH-RELATED DATA NEEDED
FOR THE PLANNING, IMPLEMENTATION, AND EVALUATION OF PUBLIC HEALTH PRAC-
TICE. PUBLIC HEALTH SURVEILLANCE MAY BE USED FOR ALL OF THE FOLLOWING
PURPOSES:
(A) AS AN EARLY WARNING SYSTEM FOR IMPENDING PUBLIC HEALTH EMERGEN-
CIES;
(B) TO DOCUMENT THE IMPACT OF AN INTERVENTION;
(C) TO TRACK PROGRESS TOWARDS SPECIFIED GOALS;
(D) TO MONITOR AND CLARIFY THE EPIDEMIOLOGY OF HEALTH OUTCOMES;
(E) TO ESTABLISH PUBLIC HEALTH PRIORITIES; AND
(F) TO INFORM PUBLIC HEALTH POLICY AND STRATEGIES.
§ 2. Subparagraphs (ix) and (x) of paragraph (a) of subdivision 2 of
section 3343-a of the public health law, as added by section 2 of part A
of chapter 447 of the laws of 2012, are amended and a new subparagraph
(xi) is added to read as follows:
(ix) a situation where the registry is not operational as determined
by the department or where it cannot be accessed by the practitioner due
to a temporary technological or electrical failure, as set forth in
regulation; [or]
(x) a practitioner who has been granted a waiver due to technological
limitations that are not reasonably within the control of the practi-
tioner, or other exceptional circumstance demonstrated by the practi-
tioner, pursuant to a process established in regulation, and in the
discretion of the commissioner[.]; OR
(XI) A PRACTITIONER PRESCRIBING OR ORDERING A CONTROLLED SUBSTANCE FOR
USE ON THE PREMISES OF A CORRECTIONAL FACILITY, AN INPATIENT MENTAL
HEALTH FACILITY LICENSED UNDER THE MENTAL HYGIENE LAW, OR A NURSING HOME
LICENSED UNDER ARTICLE TWENTY-EIGHT OF THIS CHAPTER.
§ 3. Subdivision 4 of section 3370 of the public health law, as added
by chapter 965 of the laws of 1974 and as renumbered by chapter 178 of
the laws of 2010, is amended to read as follows:
4. The department shall cause to be expunged or otherwise destroyed,
within [five] TEN years from the date of receipt thereof, any record of
the name of any patient received by it pursuant to the filing require-
ments of subdivision six of section thirty-three hundred thirty-one,
subdivision four of section thirty-three hundred thirty-three, and
subdivision four of section thirty-three hundred thirty-four of this
article.
§ 4. Subdivision 1 of section 3371 of the public health law, as
amended by chapter 178 of the laws of 2010, paragraphs (d) and (e) as
amended and paragraphs (f), (g), (h), (i), and (j) as added by section 4
of part A of chapter 447 of the laws of 2012, is amended to read as
follows:
1. No person, who has knowledge by virtue of his or her office of the
identity of a particular patient or research subject, a manufacturing
S. 8307--A 124 A. 8807--A
process, a trade secret or a formula shall disclose such knowledge, or
any report or record thereof, except:
(a) to another person employed by the department, for purposes of
executing provisions of this article;
(b) pursuant to judicial subpoena or court order in a criminal inves-
tigation or proceeding;
(c) to an agency, department of government, or official board author-
ized to regulate, license or otherwise supervise a person who is author-
ized by this article to deal in controlled substances, or in the course
of any investigation or proceeding by or before such agency, department
or board;
(d) to the prescription monitoring program registry and to authorized
users of such registry as set forth in subdivision two of this section;
(e) TO A VENDOR OR CONTRACTOR, AS AUTHORIZED BY THE DEPARTMENT AS
NECESSARY FOR THE OPERATION AND MAINTENANCE OF THE PRESCRIPTION MONITOR-
ING PROGRAM REGISTRY;
(F) to a practitioner to inform him or her that a patient may be under
treatment with a controlled substance by another practitioner for the
purposes of subdivision two of this section, and to facilitate the
department's review of individual challenges to the accuracy of
controlled substances histories pursuant to subdivision six of section
thirty-three hundred forty-three-a of this article;
[(f)] (G) to a pharmacist to provide information regarding
prescriptions for controlled substances presented to the pharmacist for
the purposes of subdivision two of this section and to facilitate the
department's review of individual challenges to the accuracy of
controlled substances histories pursuant to subdivision six of section
thirty-three hundred forty-three-a of this article;
[(g)] (H) to the deputy attorney general for medicaid fraud control,
or his or her designee, in furtherance of an investigation of fraud,
waste or abuse of the Medicaid program, pursuant to an agreement with
the department;
[(h)] (I) TO A PROGRAM AREA WITHIN THE DEPARTMENT FOR THE PURPOSE OF
CONDUCTING PUBLIC HEALTH RESEARCH, PUBLIC HEALTH SURVEILLANCE, OR EDUCA-
TION WITH DATA CONTAINED IN THE PRESCRIPTION MONITORING PROGRAM REGISTRY
AND NOT FOR PATIENT-LEVEL OUTREACH:
(I) PURSUANT TO AN AGREEMENT WITH THE COMMISSIONER;
(II) WHEN THE RELEASE OF SUCH INFORMATION IS DEEMED APPROPRIATE BY THE
COMMISSIONER;
(III) FOR USE IN ACCORDANCE WITH MEASURES REQUIRED BY THE COMMISSIONER
TO ENSURE THAT THE SECURITY AND CONFIDENTIALITY OF THE DATA IS
PROTECTED;
(IV) FOR USE AND RETENTION NO LONGER THAN TEN YEARS; AND
(V) PROVIDED THAT DISCLOSURE IS RESTRICTED TO INDIVIDUALS WITHIN THE
DEPARTMENT WHO ARE ENGAGED IN PUBLIC HEALTH RESEARCH, PUBLIC HEALTH
SURVEILLANCE, OR EDUCATION;
(J) to a local health department for the purpose of conducting public
health research, PUBLIC HEALTH SURVEILLANCE, or education AND NOT FOR
PATIENT-LEVEL OUTREACH:
(i) pursuant to an agreement with the commissioner;
(ii) when the release of such information is deemed appropriate by the
commissioner;
(iii) for use in accordance with measures required by the commissioner
to ensure that the security and confidentiality of the data is
protected;
(IV) FOR USE AND RETENTION NO LONGER THAN TEN YEARS; and
S. 8307--A 125 A. 8807--A
[(iv)] (V) provided that disclosure is restricted to individuals with-
in the local health department who are engaged in the research or educa-
tion;
[(i)] (K) to a medical examiner or coroner who is an officer of or
employed by a state or local government, pursuant to his or her official
duties; and
[(j)] (L) to an individual for the purpose of providing such individ-
ual with his or her own controlled substance history or, in appropriate
circumstances, in the case of a patient who lacks capacity to make
health care decisions, a person who has legal authority to make such
decisions for the patient and who would have legal access to the
patient's health care records, if requested from the department pursuant
to subdivision six of section thirty-three hundred forty-three-a of this
article or from a treating practitioner pursuant to subparagraph (iv) of
paragraph (a) of subdivision two of this section.
§ 5. Subdivision (b) of schedule I of section 3306 of the public
health law is amended by adding eleven new paragraphs 93, 94, 95, 96,
97, 98, 99, 100, 101, 102 and 103 to read as follows:
(93) 1-METHOXY-3-{4-(2-METHOXY-2-PHENYLETHYL)PIPERAZIN-1-YL}-1-PHENYLP
ROPAN-2-OL. OTHER NAME: ZIPEPROL.
(94) N,N-DIETHYL-2-(2-(4-METHOXYBENZYL)-5-NITRO-1H-BENZIMIDAZOL-1-YL)E
THAN-1-AMINE. OTHER NAMES: METONITAZENE.
(95) META-FLUOROFENTANYL (N-(3-FLUOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4
-YL)PROPIONAMIDE).
(96) META-FLUOROISOBUTYRYL FENTANYL (N-(3-FLUOROPHENYL)-N-(1-PHENETHY
LPIPERIDIN-4-YL)ISOBUTYRAMIDE).
(97) PARA-METHOXYFURANYL FENTANYL (N-(4-METHOXYPHENYL)-N-(1-PHENETHYL
PIPERIDIN-4-YL)FURAN-2-CARBOXAMIDE).
(98) 3-FURANYL FENTANYL (N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLFURAN-
3-CARBOXAMIDE).
(99) 2',5'-DIMETHOXYFENTANYL (N-(1-(2,5-DIMETHOXYPHENETHYL)PIPERIDIN-4
-YL)-N-PHENYLPROPIONAMIDE).
(100) ISOVALERYL FENTANYL (3-METHYL-N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PH
ENYLBUTANAMIDE).
(101) ORTHO-FLUOROFURANYL FENTANYL (N-(2-FLUOROPHENYL)-N-(1-PHENETHYLP
IPERIDIN-4-YL)FURAN-2-CARBOXAMIDE).
(102) ALPHA'-METHYL BUTYRYL FENTANYL (2-METHYL-N-(1-PHENETHYLPIPERIDIN
-4-YL)-N-PHENYLBUTANAMIDE).
(103) PARA-METHYLCYCLOPROPYL FENTANYL (N-(4-METHYLPHENYL)-N-(1-PHENETH
YLPIPERIDIN-4-YL)CYCLOPROPANECARBOXAMIDE).
§ 6. Paragraphs 11 and 36 of subdivision (d) of schedule I of section
3306 of the public health law, paragraph 11 as added by chapter 664 of
the laws of 1985 and paragraph 36 as added by section 5 of part BB of
chapter 57 of the laws of 2018, are amended to read as follows:
(11) [Ibogane] IBOGAINE. Some trade and other names: [7-ethyl-6, 6&,
7, 8, 9, 10, 12, 13-octahydro-2-methoxy-6, 9-methano-5h-pyrido
{1',2':1,2} azepino {5,4-b} indole: tabernanthe iboga.]
7-ETHYL-6,6&,7,8,9,10,12,13-OCTAHYDRO-2-METHOXY-6,9-METHANO-5H-PYRIOD{1'
,2':1,2} AZEPINO {5,4-B} INDOLE; TABERNANTHE IBOGA.
(36) 5-methoxy-N,N-dimethyltryptamine. SOME TRADE OR OTHER NAMES:
5-METHOXY-3-{2-(DIMETHYLAMINO)ETHYL}INDOLE; 5-MEO-DMT.
§ 7. Subdivision (d) of schedule I of section 3306 of the public
health law is amended by adding nineteen new paragraphs 32, 39, 40, 41,
42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55 and 56 to read as
follows:
(32) 4-METHYL-N-ETHYLCATHINONE. SOME TRADE OR OTHER NAMES: 4-MEC.
S. 8307--A 126 A. 8807--A
(39) 4-METHYL-ALPHA-PYRROLIDINOPROPIOPHENONE. SOME TRADE OR OTHER
NAMES: 4-MEPPP.
(40) ALPHA-PYRROLIDINOPENTIOPHENONE. SOME TRADE OR OTHER NAMES: @-PVP.
(41) 1-(1,3-BENZODIOXOL-5-YL)-2-(METHYLAMINO)BUTAN-1-ONE. SOME TRADE
OR OTHER NAMES: BUTYLONE; BK-MBDB.
(42) 2-(METHYLAMINO)-1-PHENYLPENTAN-1-ONE. SOME TRADE OR OTHER NAMES:
PENTEDRONE.
(43) 1-(1,3-BENZODIOXOL-5-YL)-2-(METHYLAMINO)PENTAN-1-ONE. SOME TRADE
OR OTHER NAMES: PENTYLONE; BK-MBDP.
(44) 1-(NAPHTHALEN-2-YL)-2-(PYRROLIDIN-1-YL)PENTAN-1-ONE. SOME TRADE
OR OTHER NAMES: NAPHYRONE.
(45) ALPHA-PYRROLIDINOBUTIOPHENONE. SOME TRADE OR OTHER NAMES: @-PBP.
(46) 1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)PROPAN-1-ONE (ETHYLONE).
(47) N-ETHYLPENTYLONE. SOME TRADE OR OTHER NAMES: EPHYLONE,
1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)PENTAN-1-ONE).
(48) 1-(4-METHOXYPHENYL)-N-METHYLPROPAN-2-AMINE. SOME TRADE OR OTHER
NAMES: PARA-METHOXYMETHAMPHETAMINE; PMMA.
(49) N-ETHYLHEXEDRONE. SOME TRADE OR OTHER NAMES:
@-ETHYLAMINOHEXANOPHENONE; 2-(ETHYLAMINO)-1-PHENYLHEXAN-1-ONE.
(50) ALPHA-PYRROLIDINOHEXANOPHENONE. SOME TRADE OR OTHER NAMES: @-PHP;
ALPHA-PYRROLIDINOHEXANOPHENONE; 1-PHENYL-2-(PYRROLIDIN-1-YL)HEXAN-1-ONE.
(51) 4-METHYL-ALPHA-ETHYLAMINOPENTIOPHENONE. SOME TRADE OR OTHER
NAMES: 4-MEAP; 2-(ETHYLAMINO)-1-(4-METHYLPHENYL)PENTAN-1-ONE.
(52) 4'-METHYL-ALPHA-PYRROLIDINOHEXIOPHENONE. SOME TRADE OR OTHER
NAMES: MPHP; 4'-METHYL-ALPHA-PYRROLIDINOHEXANOPHENONE;
1-(4-METHYLPHENYL)-2-(PYRROLIDIN-1-YL)HEXAN-1-ONE.
(53) ALPHA-PYRROLIDINOHEPTAPHENONE. SOME TRADE OR OTHER NAMES: PV8;
1-PHENYL-2-(PYRROLIDIN-1-YL)HEPTAN-1-ONE.
(54) 4'-CHLORO-ALPHA-PYRROLIDINOVALEROPHENONE. SOME TRADE OR OTHER
NAMES: 4-CHLORO-@-PVP; 4'-CHLORO-ALPHA-PYRROLIDINOPENTIOPHENONE;
1-(4-CHLOROPHENYL)-2-(PYRROLIDIN-1-YL)PENTAN-1-ONE.
(55) 2-(ETHYLAMINO)-2-(3-METHOXYPHENYL)CYCLOHEXAN-1-ONE (METHOXETAMIN
E, MXE).
(56) 1-(1,3-BENZODIOXOL-5-YL)-2-(ETHYLAMINO)BUTAN-1-ONE. SOME TRADE OR
OTHER NAMES: EUTYLONE; BK-EBDB.
§ 8. Subdivision (e) of schedule I of section 3306 of the public
health law is amended by adding five new paragraphs 7, 8, 9, 10 and 11
to read as follows:
(7) 4-(2-CHLOROPHENYL)-2-ETHYL-9-METHYL-6H-THIENO{3,2-F}{1,2,4}TRIAZOL
O{4,3-{ALPHA}}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: ETIZOLAM.
(8) 8-CHLORO-6-(2-FLUOROPHENYL)-1-METHYL-4H-BENZO{F}{1,2,4}TRIAZOLO{4,
3-{ALPHA}}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: FLUALPRAZOLAM.
(9) 6-(2-CHLOROPHENYL)-1-METHYL-8-NITRO-4H-BENZO{F}{1,2,4}TRIAZOLO{4,3
-{ALPHA}}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: CLONAZOLAM.
(10) 8-BROMO-6-(2-FLUOROPHENYL)-1-METHYL-4H-BENZO{F}{1,2,4}TRIAZOLO{4,
3-{ALPHA}}{1,4}DIAZEPINE. SOME TRADE OR OTHER NAMES: FLUBROMAZOLAM.
(11) 7-CHLORO-5-(2-CHLOROPHENYL)-1-METHYL-1,3-DIHYDRO-2H-BENZO{E}{1,4}
DIAZEPIN-2-ONE. SOME TRADE OR OTHER NAMES: DICLAZEPAM.
§ 9. Paragraphs 13 and 14 of subdivision (f) of schedule I of section
3306 of the public health law, as added by chapter 341 of the laws of
2013, are amended and four new paragraphs 25, 26, 27 and 28 are added to
read as follows:
(13) 3-Fluoromethcathinone. SOME TRADE OR OTHER NAMES: 3-FLUORO-N
-METHYLCATHINONE; 3-FMC.
(14) 4-Fluoromethcathinone. SOME TRADE OR OTHER NAMES: 4-FLUORO-N-ME-
THYLCATHINONE; 4-FMC; FLEPHEDRONE.
S. 8307--A 127 A. 8807--A
(25) 7-{(10,11-DIHYDRO-5H-DIBENZO{A,D}CYCLOHEPTEN-5-YL)AMINO}HEPTANOIC
ACID. OTHER NAME: AMINEPTINE.
(26) N-PHENYL-N'-(3-(1-PHENYLPROPAN-2-YL)-1,2,3-OXADIAZOL-3-IUM-5-YL)
CARBAMIMIDATE. OTHER NAME: MESOCARB.
(27) N-METHYL-1-(THIOPHEN-2-YL)PROPAN-2-AMINE. OTHER NAME: METHIOPRO-
PAMINE.
(28) 4,4'-DIMETHYLAMINOREX. SOME TRADE OR OTHER NAMES: 4,4'-DMAR;
4,5-DIHYDRO-4-METHYL-5-(4-METHYLPHENYL)-2-OXAZOLAMINE; 4-METHYL-5-(4-MET
HYLPHENYL)-4,5-DIHYDRO-1,3-OXAZOL-2-AMINE.
§ 10. Paragraphs 2, 6 and 10 of subdivision (g) of schedule I of
section 3306 of the public health law, as added by section 7 of part BB
of chapter 57 of the laws of 2018, are amended to read as follows:
(2) [{1-(5-fluro-pentyl)-1H-indol-3-yl}(2,2,3,3-tetramethylcyclopropyl)
methanone.] {1-(5-FLUORO-PENTYL)-1H-INDOL-3-YL}(2,2,3,3-TETRAMETHYL
CYCLOPROPYL)METHONE. Some trade names or other names:
5-fluoro-UR-144[,]; XLR11.
(6) [N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazo
[-]le-3-carboxamide.] N-(1-AMINO-3-METHYL-1-OXOBUTAN-2-YL)-1-(4-FLUOROB
ENZYL)-1H-INDAZO[-]LE-3-CARBOXAMIDE. Some trade or other names: AB-
FUBINACA.
(10) [{1-(5-fluoropentyl)-1H-indazol-3-yl}(naphthalen-1- [y1] YL)meth-
anone.] {1-(5-FLUOROPENTYL)-1H-INDAZOL -3-YL}(NAPHTHALEN-1-[y1
]YL)METHANONE.
Some trade or other names: THJ-2201.
§ 11. Subdivision (g) of schedule I of section 3306 of the public
health law is amended by adding nineteen new paragraphs 11, 12, 13, 14,
15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 and 29 to read as
follows:
(11) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(CYCLOHEXYLMETHYL)-1H-
INDAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: MAB-CHMINACA;
ADB-CHMINACA.
(12) METHYL 2-(1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3-METHYLB
UTANOATE. SOME TRADE OR OTHER NAMES: FUB-AMB; MMB-FUBINACA; AMBFUBINACA.
(13) METHYL 2-(1-(CYCLOHEXYLMETHYL)-1H-INDOLE-3-CARBOXAMIDO)-3,3-
DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: MDMB-CHMICA; MMB-CHMINACA.
(14) METHYL 2-(1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-
DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: MDMB-FUBINACA.
(15) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(4-FLUOROBENZYL)-1H-IN
DAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: ADB-FUBINACA.
(16) N-(ADAMANTAN-1-YL)-1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDE.
SOME TRADE OR OTHER NAMES: 5F-APINACA; 5F-AKB48.
(17) METHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3-METH
YLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-AMB.
(18) METHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-
DIMETHYLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-ADB; 5F-MDMB-PINACA.
(19) NAPHTHALEN-1-YL 1-(5-FLUOROPENTYL)-1H-INDOLE-3-CARBOXYLATE. SOME
TRADE OR OTHER NAMES: NM2201; CBL2201.
(20) N-(1-AMINO-3-METHYL-1-OXOBUTAN-2-YL)-1-(5-FLUOROPENTYL)-1H-INDAZOL
E-3-CAR BOXAMIDE. SOME TRADE OR OTHER NAMES: 5F-AB-PINACA.
(21) 1-(4-CYANOBUTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-INDAZOLE-3-CARBOXAMID
E. SOME TRADE OR OTHER NAMES: 4-CN-CUMYL-BUTINACA;
4-CYANO-CUMYL-BUTINACA; 4-CN-CUMYL BINACA; CUMYL-4CN-BINACA; SGT-78.
(22) METHYL 2-(1-(CYCLOHEXYLMETHYL)-1H-INDOLE-3-CARBOXAMIDO)-3-METHYL
BUTANOATE. SOME TRADE OR OTHER NAMES: MMB-CHMICA; AMB-CHMICA.
(23) 1-(5-FLUOROPENTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-PYRROLO{2,3-B}PYRID
INE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: 5F-CUMYL-P7AICA.
S. 8307--A 128 A. 8807--A
(24) METHYL 2-(1-(4-FLUOROBUTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-DIMET
HYLBUTANOATE. SOME TRADE OR OTHER NAMES: 4F-MDMB-BINACA;
4F-MDMB-BUTINACA.
(25) ETHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-DIMET
HYLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-EDMB-PINACA.
(26) METHYL 2-(1-(5-FLUOROPENTYL)-1H-INDOLE-3-CARBOXAMIDO)-3,3-DIMETH
YLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-MDMB-PICA; 5F-MDMB-2201.
(27) N-(ADAMANTAN-1-YL)-1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDE.
SOME TRADE OR OTHER NAMES: FUB-AKB48; FUB-APINACA; AKB48
N-(4-FLUOROBENZYL).
(28) 1-(5-FLUOROPENTYL)-N-(2-PHENYLPROPAN-2-YL)-1H-INDAZOLE-3-CARBOX
AMIDE. SOME TRADE OR OTHER NAMES: 5F-CUMYL-PINACA; SGT-25.
(29) (1-4-FLUOROBENZYL)-1H-INDOL-3-YL)(2,2,3,3-TETRAMETHYLCYCLOPROPYL)
METHANONE. SOME TRADE OR OTHER NAMES: FUB-144.
§ 12. Paragraph 1 of subdivision (b) of schedule II of section 3306 of
the public health law, as amended by section 1 of part C of chapter 447
of the laws of 2012, is amended to read as follows:
(1) Opium and opiate, and any salt, compound, derivative, or prepara-
tion of opium or opiate, excluding apomorphine, dextrorphan, nalbuphine,
NALDEMEDINE, nalmefene, NALOXEGOL, naloxone, [and] 6&-NALTREXOL,
naltrexone, AND SAMIDORPHAN, and their respective salts, but including
the following:
1. Raw opium.
2. Opium extracts.
3. Opium fluid.
4. Powdered opium.
5. Granulated opium.
6. Tincture of opium.
7. Codeine.
8. Ethylmorphine.
9. Etorphine hydrochloride.
10. Hydrocodone (also known as dihydrocodeinone).
11. Hydromorphone.
12. Metopon.
13. Morphine.
14. Oxycodone.
15. Oxymorphone.
16. Thebaine.
17. Dihydroetorphine.
18. Oripavine.
19. NOROXYMORPHONE.
§ 13. Subdivision (c) of schedule II of section 3306 of the public
health law is amended by adding a new paragraph 30 to read as follows:
(30) OLICERIDINE. (N-{(3-METHOXYTHIOPHEN-2-YL)METHYL}({2-{(9R)-9-
(PYRIDIN-2-YL)-6-OXASPIRO{4.5}DECAN-9-YL}ETHYL})AMINE).
§ 14. Subdivision (f) of schedule II of section 3306 of the public
health law, as amended by chapter 589 of the laws of 1996, the undesig-
nated paragraph as amended by chapter 575 of the laws of 2001, is
amended to read as follows:
(f) Hallucinogenic substances.
(1) [Nabilone: Another name for nabilone: (+,-)-trans
-3-(1,1-dimethylheptyl)-6, 6a, 7, 8, 10, 10a-hexahydro-1-hydroxy-6,
6-dimethyl-9H-dibenzo{b,d}pyran-9-one.] NABILONE. ANOTHER NAME FOR NABI-
LONE. +,-)-TRANS-3-(1,1-DIMETHYLHEPTYL)-6,6A,7,8,10,10A-HEX AHYDRO-1-HYD
ROXY-6,6-DIMETHYL-9H-DIBENZO{B,D}PYRAN-9-ONE.
S. 8307--A 129 A. 8807--A
(2) DRONABINOL {(-)-DELTA-9-TRANS TETRAHYDROCANNABINOL} IN AN ORAL
SOLUTION IN A DRUG PRODUCT APPROVED FOR MARKETING BY THE UNITED STATES
FOOD AND DRUG ADMINISTRATION.
§ 15. Subparagraph (i) of paragraph 3 of subdivision (g) of schedule
II of section 3306 of the public health law, as amended by section 2 of
part BB of chapter 57 of the laws of 2023, is amended to read as
follows:
(i) [4-anilino-N-phenenethylpiperidine] [(ANPP)] 4-ANILINO-N-PHEN
ETHYLPIPERIDINE (ANPP)..
§ 16. Subdivision (h) of schedule II of section 3306 of the public
health law, as amended by section 8 of part C of chapter 447 of the laws
of 2012, is amended to read as follows:
(h) (1) Anabolic steroids. Unless specifically excepted or unless
listed in another schedule, "anabolic steroid" shall mean any drug or
hormonal substance, chemically and pharmacologically related to testos-
terone (other than estrogens, progestins, corticosteroids and dehydroe-
piandrosterone) and includes:
[(1)] (I) [3{beta}, 17-dihydroxy-5a-androstane] 3{BETA},17{BETA}-DIHYD
ROXY-5{ALPHA}-ANDROSTANE.
[(2)] (II) [3{alpha}, 17{beta}-dihydroxy-5a-androstane] 3{ALPHA},17
{BETA}-DIHYDROXY-5{ALPHA}-ANDROSTANE.
[(3)] (III) 5{alpha}-androstan-3,17-dione.
[(4)] (IV) 1-androstenediol (3{beta},17{beta}-dihydroxy-5
{alpha}-androst-1- ene).
[(5)] (V) 1-androstenediol (3{alpha},17{beta}-dihydroxy-5
{alpha}-androst-1- ene).
[(6)] (VI) 4-androstenediol [(3{beta}, 17{beta}-dihydroxy-androst
-4-ene)] (3{BETA},17{BETA}-DIHYDROXY-ANDROST-4-ENE).
[(7)] (VII) 5-androstenediol [(3{beta}, 17{beta}-dihydroxy- androst-
5-ene)] (3{BETA},17{BETA}-DIHYDROXY-ANDROST-5-ENE).
[(8)] (VIII) 1-androstenedione [({5{alpha}}-androst-1-en-3, 17-dione)]
(5{ALPHA}-ANDROST-1-EN-3,17-DIONE).
[(9)] (IX) 4-androstenedione (androst-4-en-3,17-dione).
[(10)] (X) 5-androstenedione (androst-5-en-3,17-dione).
[(11)] (XI) Bolasterone [(7{alpha},17{alpha}-dimethyl-17{beta}-
hydroxyandrost-4-en-3-one)] (7{ALPHA},17{ALPHA}-DIMETHYL-17{BETA}-HYDRO
XYANDROST-4-EN-3-ONE).
[(12)] (XII) Boldenone [(17{beta}-hydroxyandrost-1, 4,-diene-3-one)]
(17{BETA}-HYDROXYANDROST-1,4,-DIENE-3-ONE).
[(13)] (XIII) Boldione (androsta-1,4-diene-3,17-dione).
[(14)] (XIV) Calusterone [(7{beta}, 17{alpha}-dimethyl-17{b -hydrox-
yandrost-4-en-3-one)] (7{BETA},17{ALPHA}-DIMETHYL-17{BETA}-HYDROXYANDR
OST-4-EN-3-ONE).
[(15)] (XV) Clostebol [(4-chloro-17{beta}-hydroxyandrost-4-en-3-o ne)]
(4-CHLORO-17{BETA}-HYDROXYANDROST-4-EN-3-ONE).
[(16)] (XVI) Dehydrochloromethyltestosterone (4-chloro-17
{beta}-hydroxy-17{alpha}-methyl-androst-1, 4-dien- 3-one).
[(17)] (XVII) [{Delta} 1-dihydrotestosterone] {DELTA}1-DIHYDROTESTOST
ERONE (a.k.a. '1-testosterone') (17{beta}-hydroxy-5{alpha}-androst-1-en-
3-one).
[(18)] (XVIII) 4-dihydrotestosterone (17{beta}-hydroxy-
androstan-3-one).
[(19)] (XIX) Drostanolone (17{beta}-hydroxy-2{alpha}-methyl
-5{alpha} -androstan-3-one).
[(20)] (XX) Ethylestrenol (17{alpha}-ethyl-17{beta}-hydroxy
estr-4-ene).
S. 8307--A 130 A. 8807--A
[(21)] (XXI) Fluoxymesterone [(9-fluoro-17{alpha}-methyl-11{beta},
17 {beta}-dihydroxyandrost-4-en-3-one)] (9-FLUORO-17{ALPHA}-METHYL-
11{BETA},17{BETA}-DIHYDROXYANDROST-4-EN-3-ONE).
[(22)] (XXII) Formebolone [(2-formyl-17{alpha}-methyl-11{alpha},
17{beta}-dihydroxyandrost-1, 4-dien-3-one)] (2-FORMYL-17{ALPHA}-METHYL
-11{ALPHA},17{BETA}-DIHYDROXYANDROST-1,4-DIEN-3-ONE).
[(23)] (XXIII) Furazabol [(17{alpha}-methyl-17{beta}-hydroxyandro
stano {2, 3-c}-furazan)] (17{ALPHA}-METHYL-17{BETA}-HYDROXYANDROSTANO
{2,3-C}-FURAZAN).
[(24)] (XXIV) [13{beta}-ethyl-17{beta}-hyroxygon-4-en-3-one] 13{BETA}-
ETHYL-17{BETA}-HYDROXYGON-4-EN-3-ONE.
[(25)] (XXV) 4-hydroxytestosterone [(4, 17{beta}-dihydroxy-andros
t-4-en-3-one)] (4,17{BETA}-DIHYDROXY-ANDROST-4-EN-3-ONE).
[(26)] (XXVI) 4-hydroxy-19-nortestosterone [(4,17{beta}-dihydroxy
-estr-4-en-3-one)] (4,17{BETA}-DIHYDROXYESTR-4-EN-3-ONE).
[(27)] (XXVII) [desoxymethyltestosterone] DESOXYMETHYLTESTOSTERONE
(17{alpha}-methyl-5 {alpha}-androst-2-en-17{beta}-ol) (a.k.a., [madol)]
'MADOL').
[(28)] (XXVIII) Mestanolone [(17{alpha}-methyl-17{beta}-hydroxy-
5-androstan-3-one)] (17{ALPHA}-METHYL-17{BETA}-HYDROXY-5-ANDROSTAN
-3-ONE).
[(29)] (XXIX) Mesterolone [(1{alpha}methyl-17{beta}-hydroxy-
{5{alpha}}-androstan-3-one)] (1{ALPHA}-METHYL-17{BETA}-HYDROXY-5{ALPHA}
-ANDROSTAN-3-ONE).
[(30)] (XXX) Methandienone [(17{alpha}-methyl-17{beta}-hydroxyand
rost-1, 4-dien-3-one)] (17{ALPHA}-METHYL-17{BETA}-HYDROXYANDROST-1,
4-DIEN-3-ONE.
[(31)] (XXXI) Methandriol [(17{alpha}-methyl-3{beta}, 17
{beta}-dihydroxyandrost-5-ene)] (17{ALPHA}-METHYL-3{BETA},17{BETA}-
DIHYDROXYANDROST-5-ENE).
[(32)] (XXXII) Methenolone [(1-methyl- 17{beta}-hydroxy-5 {alpha}
-androst- 1-en-3-one)] (1-METHYL-17{BETA}-HYDROXY-5 {ALPHA}-ANDROST-1-
EN-3-ONE).
[(33)] (XXXIII) [17{alpha}-methyl-3{beta},17{beta}-dihydroxydroxy
oxy- 5a-androstane] 17{ALPHA}-METHYL-3{BETA},17{BETA}-DIHYDROXY-5A
{ALPHA}-ANDROSTANE.
[(34)] (XXXIV) [17{alpha}-methyl-3{alpha}, 17{beta}- dihydroxy- 5a-an-
drostane] 17{ALPHA}-METHYL-3{ALPHA},17{BETA}-DIHYDROXY5A{ALPHA}-ANDROS
TANE
[(35)] (XXXV) [17{alpha}-methyl-3{beta}, 17{beta}-dihyd
roxyandrost-4-ene.] 17{ALPHA}-METHYL-3{BETA},17{BETA}-DIHYDROXYANDROST
-4-ENE.
[(36)] (XXXVI) [17{alpha}-methyl-4-hydroxynandrolone(17{alpha}-
methyl-4-hydroxy-17{beta}-hydroxyestr-4-en-3-one).] 17{ALPHA}-METHYL
-4-HYDROXYNANDROLONE(17{ALPHA}-METHYL-4-HYDROXY-17{BETA}-HYDROXYESTR-4-
EN-3-ONE).
[(37)] (XXXVII) Methyldienolone [(17{alpha}-methyl-17{beta} -hydrox-
yestra- 4,9(10)-dien-3-one).] (17{ALPHA}-METHYL-17{BETA}-HYDROXYES-TR
A-4,9(10)-DIEN-3-ONE).
[(38)] (XXXVIII) Methyltrienolone [(17{alpha}-methyl-17{beta}-hydroxy
estra-4,9-11-trien-3-one).] (17{ALPHA}-METHYL-17{BETA}-HYDROXYESTRA-4,
9-11-TRIEN-3-ONE).
[(39)] (XXXIX) Methyltestosterone(17{alpha}-methyl-17{beta} -hydrox-
yandrost-4-en-3-one).
[(40)] (XL) Mibolerone (7{alpha},17{alpha}-dimethyl-17
{beta}-hydroxyestr-4-en-3-one).
S. 8307--A 131 A. 8807--A
[(41)] (XLI) [17{alpha}-methyl-{Delta} 1-dihydrotestosterone(17b{beta}
-hydroxy-17{alpha}-methyl-5{alpha}-androst-1-en-3-one)] 17{ALPHA}-
METHYL-{DELTA}1-DIHYDROTESTOSTERONE(17{BETA}-HYDROXY-17{ALPHA}-METHYL-5{
ALPHA}-ANDROST-1-EN-3-ONE) (a.k.a. '17-{alpha}-methyl-1-testosterone').
[(42)] (XLII) [Nandrolone(17{beta}-hydroxyestr-4-en-3-one).] NANDRO-
LONE (17{BETA}-HYDROXYESTR-4-EN-3-ONE).
[(43)] (XLIII) 19-nor-4-androstenediol [(3{beta},17{beta}-dihydro
xyestr- 4-ene).] (3{BETA},17{BETA}-DIHYDROXYESTR-4-ENE).
[(44)] (XLIV) 19-nor-4-androstenediol [(3{alpha},17{beta}-dihydrox-
yestr-4-ene).] (3{ALPHA},17{BETA}-DIHYDROXYESTR-4 -ENE).
[(45)] (XLV) 19-nor-5-androstenediol [(3{beta},17{bet a}.ct-
dihydroxyestr -5-ene).] (3{BETA},17{BETA}-DIHYDROXYESTR-5- ENE).
[(46)] (XLVI) 19-nor-5-androstenediol [(3{alpha},17{beta}-dihydrox-
yestr-5-ene).] (3{ALPHA},17{BETA}-DIHYDROXYESTR-5-ENE).
[(47)] (XLVII) [19-nor-4,9(10)-androstadienedione (estra-4,9(10)-
diene-3,17-dione).] 19-NOR-4,9(10)-ANDROSTADIENEDIONE(ESTRA-4,9(10)
-DIENE-3,17-DIONE).
[(48)] (XLVIII) 19-nor-4-androstenedione (estr-4-en-3,17-dione).
[(49)] (XLIX) 19-nor-5-androstenedione (estr-5-en-3,17-dione).
[(50)] (L) Norbolethone [(13{beta}, 17{alpha}-diethyl-17
{beta} -hydroxygon-4-en-3-one).]
(13{BETA},17{ALPHA}-DIETHYL-17{BETA}-HYDROXYGON-4-EN-3-ONE).
[(51)] (LI) Norclostebol [(4-chloro-17{beta}-hydroxyestr-4-
en-3-one).] (4-CHLORO-17{BETA}-HYDROXYESTR-4-EN-3-ONE).
[(52)] (LII) Norethandrolone (17{alpha}-ethyl-17{beta}-hydroxyes
tr-4-en-3-one).
[(53)] (LIII) Normethandrolone [(17 {alpha}-methyl-17{beta}-hydrox
estr-4-en-3-one).] (17{ALPHA}-METHYL-17{BETA}-HYDROXYESTR-4-EN-3-ONE).
[(54)] (LIV) Oxandrolone [(17{alpha}-methyl-17{beta}-hydroxy-2-
oxa- {5{alpha}}-androstan-3-one).]
(17{ALPHA}-METHYL-17{BETA}-HYDROXY-2-OXA-5{ALPHA}-ANDROSTAN-3-ONE).
[(55)] (LV) Oxymesterone [(17{alpha}-methyl-4, 17 {beta}-dihydroxy
androst-4-en-3-one).]
(17{ALPHA}-METHYL-4,17{BETA}-DIHYDROXYANDROST-4-EN-3-ONE).
[(56)] (LVI) Oxymetholone [(17 {alpha}-methyl-2-hydroxymet
hylene-17 {beta}-hydroxy-{5{alpha}}- androstan-3-one).] (17{ALPHA}-
METHYL-2-HYDROXYMETHYLENE-17{BETA}-HYDROXY-5{ALPHA}-ANDROST AN-3-ONE).
[(57)] (LVII) Stanozolol [(17{alpha}-methyl-17{beta}-hydro
xy-{5{alpha}}- androst-2-eno{3, 2-c}-pyrazole).]
(17{ALPHA}-METHYL-17{BETA}-HYDROXY-5{ALPHA}-ANDROST-2-ENO{3,2-C}-PYRAZ
OLE).
[(58)] (LVIII) Stenbolone [(17{beta}-hydroxy-2-methyl-{5{alpha}}-
androst- 1-en-3- one).] (17{BETA}-HYDROXY-2-METHYL-5{ALPHA} -ANDROST-1-
EN-3-ONE).
[(59)] (LIX) Testolactone [(13-hydroxy-3-oxo-13, 17-secoandrosta-
1, 4-dien-17-oic acid lactone).] (13-HYDROXY-3-OXO-13,17-
SECOANDROSTA1,4-DIEN-17-OIC ACID LACTONE).
[(60)] (LX) Testosterone (17{beta}-hydroxyandrost-4-en-3-one).
[(61)] (LXI) Tetrahydrogestrinone [(13{beta}, 17{alpha}
-diethyl-17{beta}-hydroxygon-4, 9, 11 -trien-3-one).]
(13{BETA}, 17{ALPHA}-DIETHYL-17{BETA}-HYDROXYGON-4,9,11-TRIEN-3-ONE).
[(62)] (LXII) Trenbolone [(17{beta}-hydroxyestr-4, 9, 11-trien-
3-one).] (17{BETA}-HYDROXYESTR-4,9,11-TRIEN-3-ONE).
[(63)] (LXIII)5{ALPHA}-ANDROSTAN-3,6,17-TRIONE.
(LXIV) 6-BROMO-ANDROSTA-1,4-DIENE-3,17-DIONE.
(LXV) 6-BROMO-ANDROSTAN-3,17-DIONE.
S. 8307--A 132 A. 8807--A
(LXVI) 4-CHLORO-17{ALPHA}-METHYL-ANDROSTA-1,4-DIENE-3,17{BETA}-DIOL.
(LXVII) 4-CHLORO-17{ALPHA}-METHYL-ANDROST-4-ENE-3{BETA},17{BETA}-DIOL.
(LXVIII) 4-CHLORO-17{ALPHA}-METHYL-17{BETA}HYDROXY-ANDROST-4-EN-3-ONE.
(LXIX) 4-CHLORO-17{ALPHA}-METHYL-17{BETA}HYDROXY-ANDROST-4-ENE-3,11-DI
ONE.
(LXX) 2{ALPHA},17{ALPHA}-DIMETHYL-17{BETA}-HYDROXY-5{BETA}-ANDROSTAN-
3-ONE.
(LXXI) 2{ALPHA},3{ALPHA}-EPITHIO-17{ALPHA}-METHYL-5{ALPHA}ANDROSTAN-17
{BETA}-OL.
(LXXII) ESTRA-4,9,11-TRIENE-3,17-DIONE.
(LXXIII) {3,2-C}FURAZAN-5{ALPHA}-ANDROSTAN-17{BETA}-OL.
(LXXIV) 18A-HOMO-3-HYDROXY-ESTRA-2,5(10)-DIEN-17-ONE.
(LXXV) 4-HYDROXY-ANDROST-4-ENE-3,17-DIONE.
(LXXVI) 17{BETA}-HYDROXY-ANDROSTANO{2,3-D}ISOXAZOLE.
(LXXVII) 17{BETA}-HYDROXY-ANDROSTANO{3,2-C}ISOXAZOLE.
(LXXVIII) 3{BETA}-HYDROXY-ESTRA-4,9,11-TRIEN-17-ONE.
(LXXIX) METHASTERONE (2{ALPHA},17{ALPHA}-DIMETHYL-5{ALPHA}-ANDROSTAN-1
7{BETA}-OL3-ONE OR 2{ALPHA},17{ALPHA}-DIMETHYL-17{BETA}-HYDROXY-5{ALPHA}
-ANDROSTAN-3-ONE).
(LXXX) 17{ALPHA}-METHYL-ANDROSTA-1,4-DIENE-3,17{BETA}-DIOL.
(LXXXI) 17{ALPHA}-METHYL-5{ALPHA}-ANDROSTAN-17{BETA}-OL.
(LXXXII) 17{ALPHA}-METHYL-ANDROSTAN-3-HYDROXYIMINE-17{BETA}-OL.
(LXXXIII) 6{ALPHA}-METHYL-ANDROST-4-ENE-3,17-DIONE.
(LXXXIV) 17{ALPHA}-METHYL-ANDROST-2-ENE-3,17{BETA}DIOL.
(LXXXV) PROSTANOZOL (17{BETA}-HYDROXY-5{ALPHA}-ANDROSTANO{3,2-C}PYRAZOLE) OR
{3,2-C}PYRAZOLE-5{ALPHA}-ANDROSTAN-17{BETA}-OL.
(LXXXVI) {3,2-C}PYRAZOLE-ANDROST-4-EN-17{BETA}-OL.
(LXXXVII) Any salt, ester or ether of a drug or substance described or
listed in this subdivision.
(2) (I) SUBJECT TO SUBPARAGRAPH (II) OF THIS PARAGRAPH, A DRUG OR
HORMONAL SUBSTANCE, OTHER THAN ESTROGENS, PROGESTINS, CORTICOSTEROIDS,
AND DEHYDROEPIANDROSTERONE, THAT IS NOT LISTED IN PARAGRAPH ONE OF THIS
SUBDIVISION AND IS DERIVED FROM, OR HAS A CHEMICAL STRUCTURE SUBSTAN-
TIALLY SIMILAR TO, ONE OR MORE ANABOLIC STEROIDS LISTED IN PARAGRAPH ONE
OF THIS SUBDIVISION SHALL BE CONSIDERED TO BE AN ANABOLIC STEROID FOR
PURPOSES OF THIS SCHEDULE IF:
(A) THE DRUG OR SUBSTANCE HAS BEEN CREATED OR MANUFACTURED WITH THE
INTENT OF PRODUCING A DRUG OR OTHER SUBSTANCE THAT EITHER:
1. PROMOTES MUSCLE GROWTH; OR
2. OTHERWISE CAUSES A PHARMACOLOGICAL EFFECT SIMILAR TO THAT OF
TESTOSTERONE; OR
(B) THE DRUG OR SUBSTANCE HAS BEEN, OR IS INTENDED TO BE, MARKETED OR
OTHERWISE PROMOTED IN ANY MANNER SUGGESTING THAT CONSUMING IT WILL
PROMOTE MUSCLE GROWTH OR ANY OTHER PHARMACOLOGICAL EFFECT SIMILAR TO
THAT OF TESTOSTERONE.
(II) A SUBSTANCE SHALL NOT BE CONSIDERED TO BE A DRUG OR HORMONAL
SUBSTANCE FOR PURPOSES OF THIS SUBDIVISION IF:
(A) IT IS:
1. AN HERB OR OTHER BOTANICAL;
2. A CONCENTRATE, METABOLITE, OR EXTRACT OF, OR A CONSTITUENT ISOLATED
DIRECTLY FROM, AN HERB OR OTHER BOTANICAL; OR
3. A COMBINATION OF TWO OR MORE SUBSTANCES DESCRIBED IN CLAUSE ONE OR
TWO OF THIS ITEM;
(B) IT IS A DIETARY INGREDIENT FOR PURPOSES OF THE FEDERAL FOOD, DRUG,
AND COSMETIC ACT (21 U.S.C. 301 ET SEQ.); AND
(C) IT IS NOT ANABOLIC OR ANDROGENIC.
S. 8307--A 133 A. 8807--A
(III) IN ACCORDANCE WITH SUBDIVISION ONE OF SECTION THIRTY-THREE
HUNDRED NINETY-SIX OF THIS ARTICLE, ANY PERSON CLAIMING THE BENEFIT OF
AN EXEMPTION OR EXCEPTION UNDER SUBPARAGRAPH (II) OF THIS PARAGRAPH
SHALL BEAR THE BURDEN OF GOING FORWARD WITH THE EVIDENCE WITH RESPECT TO
SUCH EXEMPTION OR EXCEPTION.
§ 17. Subdivision (c) of schedule III of section 3306 of the public
health law is amended by adding two new paragraphs 15 and 16 to read as
follows:
(15) PERAMPANEL, ITS SALTS, ISOMERS AND SALTS OF ISOMERS.
(16) XYLAZINE, ITS SALTS, ISOMERS AND SALTS OF ISOMERS, EXCEPT WHEN
EXPRESSLY INTENDED FOR USE BY A VETERINARIAN IN THE COURSE OF THE
PROFESSIONAL PRACTICE OF VETERINARY MEDICINE; PROVIDED, HOWEVER, THAT
SUCH SUBSTANCE STOCKS SHALL BE AT ALL TIMES PROPERLY SAFEGUARDED AND
SECURED, AND ACCESS SHALL BE LIMITED TO THE MINIMUM NUMBER OF EMPLOYEES
ACTUALLY REQUIRED TO EFFICIENTLY HANDLE THE CUSTODY, DISPENSING, ADMIN-
ISTRATION OR OTHER HANDLING OF SUCH SUBSTANCE; AND FURTHER PROVIDED,
HOWEVER, THAT ALL VETERINARIANS SHALL MAINTAIN RECORDS, ORDERS AND
PRESCRIPTIONS OF THE SUBSTANCE FOR A PERIOD OF FIVE YEARS FROM THE DATE
OF TRANSACTION, WHICH SHALL BE READILY AVAILABLE AND PROMPTLY PRODUCED,
IN ELECTRONIC OR HARDCOPY FORMAT THAT IS READILY UNDERSTANDABLE, FOR
INSPECTION AND COPYING UPON REQUEST BY AUTHORIZED REPRESENTATIVES OF THE
DEPARTMENT. ANY INDIVIDUAL WHO KNOWINGLY AND WILLFULLY ADMINISTERS THEM-
SELVES OR ANOTHER PERSON, PRESCRIBES, DISPENSES OR DISTRIBUTES SUCH
SUBSTANCE WHEN ANY SUCH SUBSTANCE IS INTENDED FOR HUMAN CONSUMPTION OR
FOR ANY PURPOSE OTHER THAN THE NORMAL COURSE OF PRACTICE OF VETERINARY
MEDICINE SHALL BE SUBJECT TO THE SAME PENALTIES AS ANY INDIVIDUAL OR
PRACTITIONER WHO VIOLATES THE PROVISIONS OF THIS SECTION AND ANY OTHER
PENALTIES PRESCRIBED BY LAW.
§ 18. Subdivision (c) of schedule IV of section 3306 of the public
health law is amended by adding seven new paragraphs 54, 55, 56, 57, 58,
59 and 60 to read as follows:
(54) ALFAXALONE.
(55) BREXANOLONE.
(56) DARIDOREXANT.
(57) LEMBOREXANT.
(58) REMIMAZOLAM.
(59) SUVOREXANT.
(60) ZURANOLONE.
§ 19. Subdivision (e) of schedule IV of section 3306 of the public
health law is amended by AMENDING PARAGRAPH 10 AND adding two new para-
graphs 13 and 14 to read as follows:
(10) SPA((-)[)]-1-DIMETHYLAMINO-1,2-DIPHENYLETHANE).
(13) SERDEXMETHYLPHENIDATE.
(14) SOLRIAMFETOL.(2-AMINO-3-PHENYLPROPYL CARBAMATE; BENZENEPROPANOL,
BETA-AMINO-, CARBAMATE(ESTER)).
§ 20. Subdivision (f) of schedule IV of section 3306 of the public
health law, as added by chapter 664 of the laws of 1985, paragraph 2 as
added by chapter 457 of the laws of 2006 and paragraph 3 as added by
section 14 of part C of chapter 447 of the laws of 2012, is amended to
read as follows:
(f) Other substances. Unless specifically excepted or unless listed in
another schedule, any material, compound, mixture or preparation which
contains any quantity of the following substances, including its salts,
ISOMERS, AND SALTS OF SUCH ISOMERS, WHENEVER THE EXISTENCE OF SUCH
SALTS, ISOMERS, AND SALTS OF ISOMERS IS POSSIBLE:
(1) Pentazocine.
S. 8307--A 134 A. 8807--A
(2) Butorphanol (including its optical isomers).
(3) Tramadol in any quantities.
(4) ELUXADOLINE. (5-{{{(2S))-2-AMINO-3-{4-AMINOCARBONYL)-2,6-DIMETHYL
PHENYL}-1-OXOPROPYL}{(1S)-1-(4-PHENYL-1H-IMIDAZOL-2-YL)ETHYL}AMINO}METH
YL}-2-METHOXYBENZOIC ACID) (INCLUDING ITS OPTICAL ISOMERS) AND ITS
SALTS, ISOMERS, AND SALTS OF ISOMERS.
(5) LORCASERIN.
§ 21. Subdivision (d) of schedule V of section 3306 of the public
health law is amended by adding four new paragraphs 4, 5, 6 and 7 to
read as follows:
(4) BRIVARACETAM ( (2S)-2-{ (4R) -2-OXO-4-PROPYLPYRROLIDIN-1-YL}
BUTANAMIDE). SOME TRADE OR OTHER NAMES: BRV; UCB-34714; BRIVIACT)
(INCLUDING ITS SALTS).
(5) CENOBAMATE ({1R)-1-(2-CHLOROPHENYL)-2-(TETRAZOL-2-YL)ETHYL}
CARBAMATE; 2H-TETRAZOLE-2-ETHANOL, ALPHA-(2-CHLOROPHENYL)-, CARBAMATE
(ESTER), (ALPHAR)-; CARBAMIC ACID(R)-(+)-1-(2-CHLOROPHENYL) -2- (2H-TE-
TRA ZOL-2-YL)ETHYL ESTER).
(6) GANAXOLONE. 3{ALPHA}-HYDROXY-3{BETA}-METHYL-5{ALPHA}-PREGNAN-20-
ONE.
(7) LASMIDITAN
{2,4,6-TRIFLUORO-N-(6-(1-METHYLPIPERIDINE-4-CARBONYL)PYRIDINE-2-YL-BENZAM
IDE}.
§ 22. Subdivision 2 of section 3342 of the public health law, as
amended by chapter 692 of the laws of 1976, is amended to read as
follows:
2. An institutional dispenser may dispense controlled substances for
use off its premises only pursuant to a prescription, prepared and filed
in conformity with this title, provided, however, that, in an emergency
situation as defined by rule or regulation of the department, a practi-
tioner in a hospital without a full-time pharmacy may dispense
controlled substances to a patient in a hospital emergency room for use
off the premises of the institutional dispenser for a period not to
exceed twenty-four hours, UNLESS THE FEDERAL DRUG ENFORCEMENT ADMINIS-
TRATION HAS AUTHORIZED A LONGER TIME PERIOD FOR THE PURPOSE OF INITIAT-
ING MAINTENANCE TREATMENT, DETOXIFICATION TREATMENT, OR BOTH.
§ 23. Subdivision 1 of section 3302 of the public health law, as
amended by chapter 92 of the laws of 2021, is amended to read as
follows:
1. "[Addict] PERSON WITH A SUBSTANCE USE DISORDER" means a person who
habitually uses a controlled substance for a non-legitimate or unlawful
use, and who by reason of such use is dependent thereon.
§ 24. Subdivision 1 of section 3331 of the public health law, as added
by chapter 878 of the laws of 1972, is amended to read as follows:
1. Except as provided in titles III or V of this article, no substance
in schedules II, III, IV, or V may be prescribed for or dispensed or
administered to [an addict] A PERSON WITH A SUBSTANCE USE DISORDER or
habitual user.
§ 25. The title heading of title 5 of article 33 of the public health
law, as added by chapter 878 of the laws of 1972, is amended to read as
follows:
DISPENSING TO [ADDICTS] PERSONS WITH A SUBSTANCE USE
DISORDER AND HABITUAL USERS
S. 8307--A 135 A. 8807--A
§ 26. Section 3350 of the public health law, as added by chapter 878 of
the laws of 1972, is amended to read as follows:
§ 3350. Dispensing prohibition. Controlled substances may not be
prescribed for, or administered or dispensed to [addicts] PERSONS WITH A
SUBSTANCE USE DISORDER or habitual users of controlled substances,
except as provided by this title or title III.
§ 27. Section 3351 of the public health law, as added by chapter 878
of the laws of 1972, subdivision 5 as amended by chapter 558 of the laws
of 1999, is amended to read as follows:
§ 3351. Dispensing for medical use. 1. Controlled substances may be
prescribed for, or administered or dispensed to [an addict] A PERSON
WITH A SUBSTANCE USE DISORDER or habitual user:
(a) during emergency medical treatment unrelated to [abuse] SUCH
SUBSTANCE USE DISORDER OR HABITUAL USE of controlled substances;
(b) who is a bona fide patient suffering from an incurable and fatal
disease such as cancer or advanced tuberculosis;
(c) who is aged, infirm, or suffering from serious injury or illness
and the withdrawal from controlled substances would endanger the life or
impede or inhibit the recovery of such person.
1-A. A PRACTITIONER MAY PRESCRIBE, ORDER AND DISPENSE ANY SCHEDULE
III, IV, OR V NARCOTIC DRUG APPROVED BY THE FEDERAL FOOD AND DRUG ADMIN-
ISTRATION SPECIFICALLY FOR USE IN MAINTENANCE OR DETOXIFICATION TREAT-
MENT TO A PERSON WITH A SUBSTANCE USE DISORDER OR HABITUAL USER.
2. Controlled substances may be ordered for use by [an addict] A
PERSON WITH A SUBSTANCE USE DISORDER or habitual user by a practitioner
and administered by a practitioner [or], registered nurse, OR PARAMEDIC
to relieve acute withdrawal symptoms.
3. Methadone, or such other controlled substance designated by the
commissioner as appropriate for such use, may be ordered for use of [an
addict] A PERSON WITH A SUBSTANCE USE DISORDER by a practitioner and
dispensed or administered by a practitioner or his designated agent as
interim treatment for [an addict on a waiting list for admission to an
authorized maintenance program] A PERSON WITH A SUBSTANCE USE DISORDER
WHILE ARRANGEMENTS ARE BEING MADE FOR REFERRAL TO TREATMENT FOR SUCH
ADDICTION TO CONTROLLED SUBSTANCES.
4. Methadone, or such other controlled substance designated by the
commissioner as appropriate for such use, may be administered to [an
addict] A PERSON WITH A SUBSTANCE USE DISORDER by a practitioner or by
[his] THEIR designated agent acting under the direction and supervision
of a practitioner, as part of a [regime] REGIMEN designed and intended
AS MAINTENANCE OR DETOXIFICATION TREATMENT OR to withdraw a patient from
addiction to controlled substances.
5. [Methadone] NOTWITHSTANDING ANY OTHER LAW AND CONSISTENT WITH
FEDERAL REQUIREMENTS, METHADONE, or such other controlled substance
designated by the commissioner as appropriate for such use, may be
administered OR DISPENSED DIRECTLY to [an addict] A PERSON WITH A
SUBSTANCE USE DISORDER by a practitioner or by [his] THEIR designated
agent acting under the direction and supervision of a practitioner, as
part of a substance [abuse or chemical dependence] USE DISORDER program
approved pursuant to article [twenty-three or] thirty-two of the mental
hygiene law.
§ 28. Section 3372 of the public health law is REPEALED.
§ 29. This act shall take effect immediately.
PART V
S. 8307--A 136 A. 8807--A
Section 1. Section 2805-x of the public health law, as added by
section 48 of part B of chapter 57 of the laws of 2015, paragraph (d) of
subdivision 4 as added by chapter 697 of the laws of 2023, is amended to
read as follows:
§ 2805-x. [Hospital-home care-physician] HEALTH CARE DELIVERY collab-
oration program. 1. The purpose of this section shall be to facilitate
innovation in [hospital, home care agency and physician collaboration in
meeting] COLLABORATIONS BETWEEN LICENSED AND CERTIFIED HEALTH CARE
PROVIDERS AND AGENCIES, INCLUDING: HOSPITALS, HOME CARE AGENCIES, EMER-
GENCY MEDICAL SERVICES, SKILLED NURSING FACILITIES, AND HOSPICES, AS
WELL AS PAYORS AND OTHER INTERDISCIPLINARY PROVIDERS, PRACTITIONERS AND
SERVICE ENTITIES, TO MEET the community's EVOLVING health care needs IN
A CHANGING HEALTH CARE DELIVERY LANDSCAPE. It shall provide a framework
to support voluntary initiatives in collaboration to improve patient
care access and management, patient health outcomes, cost-effectiveness
in the use of health care services and community population health.
[Such collaborative initiatives may also include payors, skilled nursing
facilities and other interdisciplinary providers, practitioners and
service entities.]
2. For purposes of this section:
(a) "Hospital" shall include a general hospital as defined in this
article or other inpatient facility for rehabilitation or specialty care
within the definition of hospital in this article.
(b) "Home care agency" shall mean a certified home health agency, long
term home health care program or licensed home care services agency as
defined in article thirty-six of this chapter.
(c) "Payor" shall mean a health plan approved pursuant to article
forty-four of this chapter, or article thirty-two or forty-three of the
insurance law.
(d) "Practitioner" shall mean any of the health, mental health or
health related professions licensed pursuant to title eight of the
education law.
(E) "PHYSICIAN" SHALL MEAN A PERSON DULY LICENSED PURSUANT TO ARTICLE
ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW.
(F) "HOSPICE" SHALL MEAN AN AGENCY APPROVED UNDER ARTICLE FORTY OF
THIS CHAPTER.
(G) "EMERGENCY MEDICAL SERVICES" SHALL MEAN AN AGENCY APPROVED UNDER
ARTICLE THIRTY OF THIS CHAPTER.
(H) "SKILLED NURSING FACILITY" SHALL MEAN A RESIDENTIAL HEALTH CARE
FACILITY OR NURSING HOME LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF
THIS CHAPTER.
3. The commissioner is authorized to provide financing including, but
not limited to, grants or positive adjustments in medical assistance
rates or premium payments, to the extent of funds available and allo-
cated or appropriated therefor, including funds provided to the state
through federal waivers, funds made available through state appropri-
ations and/or funding through section twenty-eight hundred seven-v of
this article, as well as waivers of regulations under title ten of the
New York codes, rules and regulations, to support the voluntary initi-
atives and objectives of this section.
4. [Hospital-home care-physician] HEALTH CARE DELIVERY collaborative
initiatives under this section may include, but shall not be limited to:
(a) [Hospital-home care-physician integration] INTEGRATION initiatives
BETWEEN AT LEAST TWO OF THE FOLLOWING: HOSPITALS, HOME CARE AGENCIES,
PHYSICIAN, PHYSICIANS' GROUP, EMERGENCY MEDICAL SERVICES, HOSPICE, AND
SKILLED NURSING FACILITIES, including but not limited to:
S. 8307--A 137 A. 8807--A
(i) transitions in care initiatives to help effectively transition
patients to post-acute care at home, coordinate follow-up care and
address issues critical to care plan success and readmission avoidance;
(ii) clinical pathways for specified conditions, guiding patients'
progress and outcome goals, as well as effective health services use;
(iii) application of telehealth/telemedicine services in monitoring
and managing patient conditions, and promoting self-care/management,
improved outcomes and effective services use;
(iv) facilitation of physician house calls to homebound patients
and/or to patients for whom such home visits are determined necessary
and effective for patient care management;
(v) additional models for prevention of avoidable hospital readmis-
sions and emergency room visits;
(vi) health home development;
(vii) development and demonstration of new models of integrated or
collaborative care and care management not otherwise achievable through
existing models; and
(viii) bundled payment demonstrations for hospital-to-post-acute-care
for specified conditions or categories of conditions, in particular,
conditions predisposed to high prevalence of readmission, including
those currently subject to federal/state penalty, and other discharges
with extensive post-acute needs;
(b) Recruitment, training and retention of hospital/home care direct
care staff and physicians, in geographic or clinical areas of demon-
strated need. Such initiatives may include, but are not limited to, the
following activities:
(i) outreach and public education about the need and value of service
in health occupations;
(ii) training/continuing education and regulatory facilitation for
cross-training to maximize flexibility in the utilization of staff,
including:
(A) training of hospital nurses in home care;
(B) dual certified nurse aide/home health aide certification; and
(C) dual personal care aide/HHA certification;
(iii) salary/benefit enhancement;
(iv) career ladder development; and
(v) other incentives to practice in shortage areas; and
(c) [Hospital - home care - physician] HEALTH CARE DELIVERY collabora-
tives for the care and management of special needs, high-risk and high-
cost patients, including but not limited to best practices, and training
and education of direct care practitioners and service employees.
(d) Collaborative programs to address disparities in health care
access or treatment, and/or conditions of higher prevalence, in certain
populations, where such collaborative programs could provide and manage
services in a more effective, person-centered and cost-efficient manner
for reduction or elimination of such disparities.
(i) Such programs may target one or more disparate conditions, or
areas of under-service, evidenced in defined populations, including but
not be limited to:
(A) cardiovascular disease;
(B) hypertension;
(C) diabetes;
(D) chronic kidney disease;
(E) obesity;
(F) asthma;
(G) sickle cell disease;
S. 8307--A 138 A. 8807--A
(H) sepsis;
(I) lupus;
(J) breast, lung, prostate and colorectal cancers;
(K) geographic shortage of primary care, prenatal/obstetric care,
specialty medical care, home health care, or culturally and linguis-
tically compatible care;
(L) alcohol, tobacco, or substance abuse;
(M) post-traumatic stress disorder and other conditions more prevalent
among veterans of the United States military services;
(N) attracting members of minority populations to the field and prac-
tice of medicine; and
(O) such other areas approved by the commissioner.
(ii) Collaborative [hospital-home care-physician] HEALTH CARE
DELIVERY, and as applicable additional partner, models may include under
such disparities programs:
(A) service planning and design;
(B) recruitment of specialty personnel and/or specialty training of
professionals or other direct care personnel (including physicians, home
care and hospital staffs), patients and informal caregivers;
(C) continuing medical education and clinical training for physicians,
follow-up evaluations, and supporting educational materials;
(D) use of evidenced-based approaches and/or best practices to treat-
ment;
(E) reimbursement of uncovered services;
(F) bundled or other integrated payment methods to support the neces-
sary, coordinated and cost-effective services;
(G) regulatory waivers to facilitate flexibility in provider collab-
oration and person-centered care;
(H) patient/family peer support and education;
(I) data collection, research and evaluation of efficacy; and/or
(J) other components or innovations satisfactory to the commissioner.
(iii) Nothing contained in this paragraph shall prevent a physician,
[physicians] PHYSICIANS' group, home care agency, or hospital from indi-
vidually applying for said grant.
(iv) The commissioner shall consult with physicians, home care agen-
cies, hospitals, consumers, statewide associations representative of
such participants, and other experts in health care disparities, in
developing an application process for grant funding or rate adjustment,
and for request of state regulatory waivers, to facilitate implementa-
tion of disparities programs under this paragraph.
5. AT A MINIMUM, APPLICATIONS FOR COLLABORATIVE INITIATIVES UNDER
THIS SECTION MUST SPECIFICALLY IDENTIFY THE SERVICE GAPS AND/OR COMMUNI-
TY NEED THE COLLABORATION SEEKS TO ADDRESS, AND OUTLINE A PROJECTED
TIMELINE FOR IMPLEMENTATION AND DELIVERABLE DATA TO DEMONSTRATE MILE-
STONES TO SUCCESS.
6. Hospitals and home care agencies which are provided financing or
waivers pursuant to this section shall report to the commissioner on the
patient, service and cost experiences pursuant to this section, includ-
ing the extent to which the project goals are achieved. The commissioner
shall compile and make such reports available on the department's
website.
§ 2. Subdivision 2 of section 3602 of the public health law, as added
by chapter 895 of the laws of 1977, is amended to read as follows:
2. "Home care services agency" means an organization primarily engaged
in arranging and/or providing directly or through contract arrangement
one or more of the following: Nursing services, home health aide
S. 8307--A 139 A. 8807--A
services, and other therapeutic and related services which may include,
but shall not be limited to, physical, speech and occupational therapy,
nutritional services, medical social services, personal care services,
homemaker services, and housekeeper or chore services, which may be of a
preventive, therapeutic, rehabilitative, health guidance, and/or
supportive nature to persons at home. FOR THE PURPOSES OF THIS ARTICLE,
A GENERAL HOSPITAL LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THIS
CHAPTER SHALL NOT BE CONSIDERED "PRIMARILY ENGAGED IN ARRANGING AND/OR
PROVIDING" NURSING, HOME HEALTH, OR OTHER THERAPEUTIC SERVICES NOTWITH-
STANDING THAT SUCH SERVICES MAY BE PROVIDED IN A PATIENT'S RESIDENCE,
PROVIDED THAT AT LEAST FIFTY-ONE PERCENT OF PATIENT CARE HOURS FOR SUCH
GENERAL HOSPITAL IS GENERATED FROM THE TREATMENT OF PATIENTS WITHIN THE
HOSPITAL, AND THAT ANY PATIENTS TREATED IN THEIR RESIDENCE HAVE A PREEX-
ISTING CLINICAL RELATIONSHIP WITH THE GENERAL HOSPITAL.
§ 3. Section 2803 of the public health law is amended by adding a new
subdivision 15 to read as follows:
15. SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION AND
NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS ARTICLE, OR ANY RULE OR
REGULATION TO THE CONTRARY, THE COMMISSIONER SHALL ALLOW GENERAL HOSPI-
TALS TO PROVIDE OFF-SITE ACUTE CARE MEDICAL SERVICES, THAT ARE:
(A) NOT HOME CARE SERVICES DEFINED IN SUBDIVISION ONE OF SECTION THIR-
TY-SIX HUNDRED TWO OF THIS CHAPTER OR THE PROFESSIONAL SERVICES ENUMER-
ATED IN SUBDIVISION TWO OF SUCH SECTION;
(B) PROVIDED BY A MEDICAL PROFESSIONAL, INCLUDING A PHYSICIAN, REGIS-
TERED NURSE, NURSE PRACTITIONER, OR PHYSICIAN ASSISTANT, TO A PATIENT
WITH A PRE-EXISTING CLINICAL RELATIONSHIP WITH THE GENERAL HOSPITAL, OR
WITH THE HEALTH CARE PROFESSIONAL PROVIDING THE SERVICE; AND
(C) PROVIDED TO A PATIENT FOR WHOM A MEDICAL PROFESSIONAL HAS DETER-
MINED IS APPROPRIATE TO RECEIVE ACUTE MEDICAL SERVICES AT THEIR RESI-
DENCE.
(D) NOTHING IN THIS SUBDIVISION SHALL PRECLUDE A FEDERALLY QUALIFIED
HEALTH CENTER FROM PROVIDING OFF-SITE SERVICES IN ACCORDANCE WITH
DEPARTMENT REGULATIONS.
(E) THE DEPARTMENT IS AUTHORIZED TO ESTABLISH MEDICAL ASSISTANCE
PROGRAM RATES TO EFFECTUATE THIS SUBDIVISION. FOR THE PURPOSES OF THE
DEPARTMENT DETERMINING THE APPLICABLE RATES PURSUANT TO SUCH AUTHORITY,
ANY GENERAL HOSPITAL APPROVED PURSUANT TO THIS SUBDIVISION SHALL REPORT
TO THE DEPARTMENT, IN THE FORM AND FORMAT REQUIRED BY THE DEPARTMENT,
ITS ANNUAL OPERATING COSTS, SPECIFICALLY FOR SUCH OFF-SITE ACUTE
SERVICES. FAILURE TO TIMELY SUBMIT SUCH COST DATA TO THE DEPARTMENT MAY
RESULT IN REVOCATION OF AUTHORITY TO PARTICIPATE IN A PROGRAM UNDER THIS
SECTION DUE TO THE INABILITY TO ESTABLISH APPROPRIATE REIMBURSEMENT
RATES.
§ 4. Subdivision 3 of section 3018 of the public health law, as added
by chapter 137 of the laws of 2023, is amended to read as follows:
3. (A) This program shall authorize mobile integrated and community
paramedicine programs presently operating and approved by the department
as of May eleventh, two thousand twenty-three, under the authority of
Executive Order Number 4 of two thousand twenty-one, entitled "Declaring
a Statewide Disaster Emergency Due to Healthcare staffing shortages in
the State of New York" to continue in the same manner and capacity as
currently approved [for a period of two years following the effective
date of this section] THROUGH MARCH THIRTY-FIRST, TWO THOUSAND THIRTY-
ONE.
(B) ANY PROGRAM NOT CURRENTLY APPROVED AND OPERATING IN ACCORDANCE
WITH PARAGRAPH (A) OF THIS SUBDIVISION MAY APPLY TO THE DEPARTMENT FOR
S. 8307--A 140 A. 8807--A
APPROVAL TO OPERATE A MOBILE INTEGRATED AND COMMUNITY PARAMEDICINE
PROGRAM, AND ANY PROGRAM CURRENTLY OPERATING PURSUANT TO PARAGRAPH (A)
OF THIS SUBDIVISION FOR A LIMITED PURPOSE, INCLUDING BUT NOT LIMITED TO
VACCINATION ADMINISTRATION, MAY APPLY TO THE DEPARTMENT FOR APPROVAL TO
MODIFY ITS EXISTING COMMUNITY PARAMEDICINE PROGRAM. THE DEPARTMENT MAY
APPROVE UP TO TWO HUNDRED NEW OR MODIFIED PROGRAMS PURSUANT TO THIS
PARAGRAPH. SUCH APPLICATIONS MUST BE SUBMITTED IN THE FORM AND FORMAT
PRESCRIBED BY THE DEPARTMENT. PROGRAMS APPROVED PURSUANT TO THIS PARA-
GRAPH MAY BE PERMITTED TO OPERATE THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND THIRTY-ONE.
§ 5. Section 2 of chapter 137 of the laws of 2023 amending the public
health law relating to establishing a community-based paramedicine
demonstration program, is amended to read as follows:
§ 2. This act shall take effect immediately and shall expire and be
deemed repealed [2 years after such date] MARCH 31, 2031; provided,
however, that if this act shall have become a law on or after May 22,
2023 this act shall take effect immediately and shall be deemed to have
been in full force and effect on and after May 22, 2023.
§ 6. Subdivision 1 of section 3001 of the public health law, as
amended by chapter 804 of the laws of 1992, is amended to read as
follows:
1. "Emergency medical service" means [initial emergency medical
assistance including, but not limited to, the treatment of trauma,
burns, respiratory, circulatory and obstetrical emergencies] A COORDI-
NATED SYSTEM OF HEALTHCARE DELIVERY THAT RESPONDS TO THE NEEDS OF SICK
AND INJURED INDIVIDUALS, BY PROVIDING: ESSENTIAL EMERGENCY, NON-EMERGEN-
CY, SPECIALTY NEED OR PUBLIC EVENT MEDICAL CARE; COMMUNITY EDUCATION AND
PREVENTION PROGRAMS; GROUND AND AIR AMBULANCE SERVICES; EMERGENCY
MEDICAL DISPATCH; TRAINING FOR EMERGENCY MEDICAL SERVICES PRACTITIONERS;
MEDICAL FIRST RESPONSE; MOBILE TRAUMA CARE SYSTEMS; MASS CASUALTY
MANAGEMENT; AND MEDICAL DIRECTION.
§ 7. Section 6909 of the education law is amended by adding a new
subdivision 12 to read as follows:
12. A CERTIFIED NURSE PRACTITIONER MAY PRESCRIBE AND ORDER A NON-PA-
TIENT SPECIFIC REGIMEN TO AN EMERGENCY MEDICAL SERVICES PRACTITIONER
LICENSED BY THE DEPARTMENT OF HEALTH PURSUANT TO ARTICLE THIRTY OF THE
PUBLIC HEALTH LAW, PURSUANT TO REGULATIONS PROMULGATED BY THE COMMIS-
SIONER, AND CONSISTENT WITH THE PUBLIC HEALTH LAW, FOR ADMINISTERING
IMMUNIZATIONS. NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED
PERSONS TO ADMINISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
§ 8. Section 6527 of the education law is amended by adding a new
subdivision 12 to read as follows:
12. A LICENSED PHYSICIAN MAY PRESCRIBE AND ORDER A NON-PATIENT SPECIF-
IC REGIMEN TO AN EMERGENCY MEDICAL SERVICES PRACTITIONER LICENSED BY THE
DEPARTMENT OF HEALTH PURSUANT TO ARTICLE THIRTY OF THE PUBLIC HEALTH
LAW, PURSUANT TO REGULATIONS PROMULGATED BY THE COMMISSIONER, AND
CONSISTENT WITH THE PUBLIC HEALTH LAW, FOR ADMINISTERING IMMUNIZATIONS.
NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED PERSONS TO ADMIN-
ISTER IMMUNIZATIONS, VACCINES OR OTHER DRUGS.
§ 9. The public health law is amended by adding a new article 30-D to
read as follows:
ARTICLE 30-D
EMERGENCY MEDICAL SERVICES ESSENTIAL SERVICES ACT
SECTION 3080. DECLARATION OF PURPOSE.
3081. APPLICATION OF ARTICLE.
3082. DEFINITIONS.
S. 8307--A 141 A. 8807--A
3083. DESIGNATION OF MEDICAL EMERGENCY RESPONSE AND EMERGENCY
MEDICAL DISPATCH AGENCIES AS ESSENTIAL SERVICES.
3084. PROVISION OF EMERGENCY MEDICAL DISPATCH.
3085. RULES AND REGULATIONS.
§ 3080. DECLARATION OF PURPOSE. 1. THE PROVISION OF PROMPT, EFFICIENT,
AND EFFECTIVE EMERGENCY MEDICAL SERVICES AND EMERGENCY MEDICAL DISPATCH
IS CRUCIAL TO THE HEALTH AND SAFETY OF THE RESIDENTS OF NEW YORK STATE.
2. THE ESTABLISHMENT OF A COMPREHENSIVE AND STANDARDIZED SYSTEM FOR
MEDICAL EMERGENCY RESPONSE IS ESSENTIAL TO ADDRESS LIFE-THREATENING
CONDITIONS AND ENSURE THE WELL-BEING OF INDIVIDUALS IN NEED OF URGENT
MEDICAL CARE.
3. ENSURING THAT EVERY COUNTY WITHIN NEW YORK STATE HAS THE NECESSARY
RESOURCES, TRAINED PERSONNEL, AND OPERATIONAL CAPABILITIES TO PROVIDE
MEDICAL EMERGENCY RESPONSE IS A MATTER OF PUBLIC INTEREST AND STATE
PRIORITY.
4. IT IS IMPERATIVE TO STANDARDIZE THE APPROACH TO MEDICAL EMERGENCY
RESPONSE AND DISPATCH SERVICES TO ENHANCE THE QUALITY OF CARE, MAXIMIZE
EFFICIENCY, AND IMPROVE OUTCOMES FOR PATIENTS EXPERIENCING MEDICAL EMER-
GENCIES.
5. THE DESIGNATION OF MEDICAL EMERGENCY RESPONSE AND EMERGENCY MEDICAL
DISPATCH AS ESSENTIAL SERVICES WILL ENSURE A UNIFORM, EFFECTIVE, AND
COORDINATED RESPONSE TO MEDICAL EMERGENCIES ACROSS THE STATE.
6. THIS ARTICLE AIMS TO ESTABLISH A FRAMEWORK FOR THE PROVISION, OPER-
ATION, AND REGULATION OF MEDICAL EMERGENCY RESPONSE AND DISPATCH
SERVICES, THEREBY SAFEGUARDING THE HEALTH AND SAFETY OF NEW YORK STATE'S
RESIDENTS AND VISITORS.
§ 3081. APPLICATION OF ARTICLE. THIS ARTICLE SHALL APPLY TO EVERY
COUNTY EXCEPT A COUNTY WHOLLY CONTAINED WITHIN A CITY.
§ 3082. DEFINITIONS. AS USED IN THIS ARTICLE, THE FOLLOWING TERMS
SHALL HAVE THE FOLLOWING MEANINGS:
1. "MEDICAL EMERGENCY RESPONSE" SHALL MEAN THE RAPID DEPLOYMENT OF
AMBULANCE SERVICES, ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICES, AND
OTHER FIRST RESPONSE SERVICES AUTHORIZED BY THE DEPARTMENT TO PROVIDE
EMERGENCY MEDICAL SERVICES, AS DEFINED IN SECTION THREE THOUSAND ONE OF
THIS CHAPTER, FOR THE PURPOSE OF PROVIDING IMMEDIATE EMERGENCY MEDICAL
CARE IN RESPONSE TO EMERGENCY CALLS FOR ACUTE CONDITIONS WHERE RAPID
INTERVENTION IS VITAL TO PREVENT DEATH OR SERIOUS HARM.
2. "EMERGENCY MEDICAL DISPATCH" MEANS A PROTOCOL-DRIVEN SYSTEM
APPROVED BY THE DEPARTMENT DESIGNED TO MANAGE, ASSESS, AND PRIORITIZE
MEDICAL EMERGENCY CALLS, PROVIDE CRITICAL PRE-ARRIVAL INSTRUCTIONS, AND
DISPATCH MEDICAL EMERGENCY RESPONSE SERVICES BY AN EMS MEDICAL DISPATCH
AGENCY OR PROVIDE REFERRAL TO APPROPRIATE NON-EMERGENCY MEDICAL SERVICES
WHERE APPROPRIATE.
3. "EMS MEDICAL DISPATCH AGENCY" MEANS ANY INDIVIDUAL, PARTNERSHIP,
ASSOCIATION, CORPORATION, MUNICIPALITY OR ANY LEGAL OR PUBLIC ENTITY OR
SUBDIVISION THEREOF LICENSED BY THE DEPARTMENT WHO IS ENGAGED IN RECEIV-
ING REQUESTS FOR EMERGENCY MEDICAL ASSISTANCE FROM THE PUBLIC AND
DISPATCHING MEDICAL EMERGENCY RESPONSE SERVICES AS NEEDED, EXCEPT FOR
ANY SUCH INDIVIDUAL OR ENTITY THAT IS SUBJECT TO MINIMUM STANDARDS
PROMULGATED UNDER SECTION THREE-HUNDRED TWENTY-EIGHT OF COUNTY LAW.
4. "MEDICAL EMERGENCY READINESS ASSESSMENT" MEANS THE RATING SYSTEM
EVALUATING THE PREPAREDNESS, EFFICIENCY, AND EFFECTIVENESS OF MEDICAL
EMERGENCY RESPONSE WITHIN A COMMUNITY.
§ 3083. DESIGNATION OF MEDICAL EMERGENCY RESPONSE AND EMERGENCY
MEDICAL DISPATCH AGENCIES AS ESSENTIAL SERVICES. 1. MEDICAL EMERGENCY
S. 8307--A 142 A. 8807--A
RESPONSE AND EMERGENCY MEDICAL DISPATCH AGENCIES ARE HEREBY DECLARED
ESSENTIAL SERVICES WITHIN NEW YORK STATE.
2. EVERY COUNTY, ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER COUNTY,
CITY, TOWN, AND VILLAGE, SHALL ENSURE THAT AN EMERGENCY MEDICAL SERVICE,
AMBULANCE SERVICE, ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICE, OTHER
FIRST RESPONSE SERVICES AUTHORIZED BY THE DEPARTMENT TO PROVIDE EMERGEN-
CY MEDICAL SERVICES, OR A COMBINATION OF SUCH SERVICES ARE PROVIDED FOR
THE PURPOSES OF EFFECTUATING MEDICAL EMERGENCY RESPONSE WITHIN THE BOUN-
DARIES OF THE COUNTY.
3. EVERY COUNTY ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER COUNTY,
CITY, TOWN, AND VILLAGE, SHALL DEVELOP, IMPLEMENT, AND MAINTAIN A
COMPREHENSIVE COUNTY MEDICAL EMERGENCY RESPONSE PLAN APPROVED BY THE
DEPARTMENT, ENSURING THE EFFECTIVE OPERATION, COORDINATION, UTILIZATION
OF EXISTING AMBULANCE SERVICES LICENSED BY THE DEPARTMENT, AND FUNDING
OF MEDICAL EMERGENCY RESPONSE. IN FURTHERANCE OF THAT PURPOSE, THE COUN-
TY SHALL DESIGNATE ONE OR MORE PRIMARY MEDICAL EMERGENCY RESPONSE AGEN-
CIES THAT SHALL RESPOND TO ALL CALLS AND DEMANDS FOR SUCH MEDICAL EMER-
GENCY RESPONSE TO PERSONS ENTITLED THERETO, SUBJECT TO ANY LIMITATIONS
UPON SUCH SERVICE SPECIFIED IN AN AGREEMENT, WITHIN THE BOUNDARIES OF
THE COUNTY. ANY PROPOSED PERMANENT CHANGES, INCLUDING A FULL CLOSURE OR
SIGNIFICANT MODIFICATION OF COVERAGE OF A PRIMARY MEDICAL EMERGENCY
RESPONSE AGENCY DESIGNATED BY A COUNTY SHALL BE SUBMITTED IN WRITING TO
THE COUNTY AND THE DEPARTMENT NO LATER THAN 180 DAYS BEFORE THE CHANGE.
SUCH CHANGES SHALL NOT BE MADE UNTIL RECEIPT OF THE APPROPRIATE DEPART-
MENT APPROVAL. NO COUNTY SHALL REMOVE OR REASSIGN AN AREA SERVED BY AN
EXISTING MEDICAL EMERGENCY RESPONSE AGENCY WHERE THAT AGENCY IS COMPLI-
ANT WITH ALL STATUTORY AND REGULATORY REQUIREMENTS OF THE DEPARTMENT,
AND THAT HAS AGREED TO THE PROVISION OF APPROVED PLAN. NO MEDICAL EMER-
GENCY RESPONSE AGENCY, DESIGNATED BY THE COUNTY IN THE PLAN, MAY REFUSE
TO RESPOND TO A REQUEST FOR SERVICE UNLESS THEY CAN PROVE, TO THE SATIS-
FACTION OF THE DEPARTMENT, THAT THEY ARE UNABLE TO RESPOND BECAUSE OF
CAPACITY LIMITATIONS.
4. NOTWITHSTANDING THE PROVISIONS OF SECTION THREE THOUSAND EIGHT OF
THIS CHAPTER, ANY COUNTY ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER
COUNTY, CITY, TOWN, AND VILLAGE, THAT PROVIDES, EITHER DIRECTLY OR
THROUGH AGREEMENT WITH EXISTING SERVICES, AN EMERGENCY MEDICAL SERVICE
OR GENERAL AMBULANCE SERVICE IN ACCORDANCE WITH SECTION ONE HUNDRED
TWENTY-TWO-B OF THE GENERAL MUNICIPAL LAW, FOR THE PURPOSE OF EFFECTUAT-
ING MEDICAL EMERGENCY RESPONSE, UPON MEETING OR EXCEEDING ALL ADMINIS-
TRATIVE AND OPERATIONAL STANDARDS SET BY THE DEPARTMENT, AND UPON FILING
WRITTEN NOTICE TO THE DEPARTMENT IN A MANNER PRESCRIBED BY THE DEPART-
MENT, SHALL BE DEEMED TO HAVE SATISFIED ANY AND ALL REQUIREMENTS FOR
DETERMINATION OF PUBLIC NEED FOR THE ESTABLISHMENT OF ADDITIONAL EMER-
GENCY MEDICAL SERVICES AND THE DEPARTMENT SHALL ISSUE A NON-TRANSFERA-
BLE, PERMANENT MUNICIPAL AMBULANCE SERVICE OPERATING CERTIFICATE. NOTH-
ING IN THIS ARTICLE SHALL BE DEEMED TO EXCLUDE ANY COUNTY ISSUED A
MUNICIPAL AMBULANCE SERVICE OPERATING CERTIFICATE FROM COMPLYING WITH
ANY OTHER REQUIREMENT OF ARTICLE THIRTY OF THIS CHAPTER OR ANY OTHER
APPLICABLE PROVISION OF LAW OR REGULATIONS PROMULGATED THEREUNDER.
5. ANY COUNTY ACTING INDIVIDUALLY OR JOINTLY WITH ANY OTHER COUNTY,
CITY, TOWN, AND VILLAGE, THAT PROVIDES, EITHER DIRECTLY OR THROUGH
AGREEMENT WITH AN EXISTING SERVICE, AN EMERGENCY MEDICAL SERVICE OR
GENERAL AMBULANCE SERVICE IN ACCORDANCE WITH SECTION ONE HUNDRED TWEN-
TY-TWO-B OF THE GENERAL MUNICIPAL LAW, FOR THE PURPOSE OF EFFECTUATING
MEDICAL EMERGENCY RESPONSE MAY ESTABLISH A SPECIAL DISTRICT, AFTER NINE-
TY DAYS NOTICE TO THE DEPARTMENT, AS DEFINED IN SUBDIVISION SIXTEEN OF
S. 8307--A 143 A. 8807--A
SECTION ONE HUNDRED TWO OF THE REAL PROPERTY TAX LAW, FOR THE FINANCING
AND OPERATION OF SUCH EMERGENCY MEDICAL SERVICE OR GENERAL AMBULANCE
SERVICE IN ACCORDANCE WITH SECTION ONE HUNDRED TWENTY-TWO-B OF THE
GENERAL MUNICIPAL LAW WITH AN EMERGENCY MEDICAL SERVICES AGENCY LICENSED
BY THE DEPARTMENT TO PROVIDE EMERGENCY MEDICAL SERVICES IN THE STATE.
SUCH SPECIAL DISTRICT SHALL BE EXEMPT FROM THE PROVISIONS OF SECTION
THREE-C OF THE GENERAL MUNICIPAL LAW UNTIL FIVE YEARS AFTER THE ESTAB-
LISHMENT OF THE SPECIAL DISTRICT.
6. THE DEPARTMENT SHALL ESTABLISH STANDARDS, WITH THE ADVICE FROM THE
STATE EMERGENCY MEDICAL SERVICES COUNCIL, THE STATE EMERGENCY MEDICAL
ADVISORY COMMITTEE AND THE STATE TRAUMA ADVISORY COMMITTEE, ESTABLISHING
MINIMUM STANDARDS FOR THE PROVISION OF EMERGENCY MEDICAL SERVICES BY
FIRST AID SQUADS, BASIC LIFE SUPPORT FIRST RESPONSE SERVICES, SPECIAL
EVENT MEDICAL SERVICES, AND OTHER FIRST RESPONSE SERVICES NOT OTHERWISE
DEFINED IN ARTICLE THIRTY OF THIS CHAPTER.
§ 3084. PROVISION OF EMERGENCY MEDICAL DISPATCH. 1. EVERY EMS MEDICAL
DISPATCH AGENCY, AS DEFINED IN THIS SECTION, OPERATING WITHIN NEW YORK
STATE SHALL PROVIDE EMERGENCY MEDICAL DISPATCH SERVICES IN ACCORDANCE
WITH EMERGENCY MEDICAL DISPATCH PROTOCOLS APPROVED BY THE DEPARTMENT.
2. ALL EMS MEDICAL DISPATCH AGENCIES MAY BE REQUIRED TO BE LICENSED BY
THE DEPARTMENT. THE DEPARTMENT, IN CONSULTATION WITH THE STATE INTEROP-
ERABLE EMERGENCY COMMUNICATIONS BOARD, MAY ESTABLISH CRITERIA FOR THE
LICENSING OF EMS MEDICAL DISPATCH AGENCIES, AS DEFINED IN THIS SECTION,
TO ENSURE COMPLIANCE WITH EMS MEDICAL DISPATCH STANDARDS.
3. ALL EMERGENCY MEDICAL DISPATCHERS WITH A PRIMARY ROLE OF PROVIDING
EMERGENCY MEDICAL DISPATCH SERVICES WHILE EMPLOYED BY EMS MEDICAL
DISPATCH AGENCIES, AS DEFINED IN THIS SECTION, MUST COMPLETE AN EMERGEN-
CY MEDICAL DISPATCH CERTIFICATION TRAINING COURSE APPROVED BY THE
DEPARTMENT, IN CONSULTATION WITH THE STATE INTEROPERABLE EMERGENCY
COMMUNICATIONS BOARD, AND MAINTAIN CONTINUOUS CERTIFICATION WHILE
EMPLOYED BY THE EMS MEDICAL DISPATCH AGENCY, AS DEFINED IN THIS SECTION,
WITH A PRIMARY ROLE AS AN EMERGENCY MEDICAL DISPATCHER, AND MAY BE
REQUIRED TO BE LICENSED BY THE DEPARTMENT. THE DEPARTMENT, IN CONSULTA-
TION WITH THE STATE INTEROPERABLE EMERGENCY COMMUNICATIONS BOARD, MAY
ESTABLISH MINIMUM STANDARDS FOR EMERGENCY MEDICAL DISPATCH CERTIFICATION
TRAINING COURSES AND DISPATCHER LICENSURE.
§ 3085. RULES AND REGULATIONS. THE COMMISSIONER MAY PROMULGATE RULES
AND REGULATIONS TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
§ 10. The public health law is amended by adding a new section 3019 to
read as follows:
§ 3019. EMERGENCY MEDICAL SERVICES DEMONSTRATION PROGRAMS. 1. THE
PURPOSE OF THIS SECTION SHALL BE TO FACILITATE INNOVATION IN MEDICAL
CARE PROVIDED BY EMERGENCY MEDICAL SERVICE PRACTITIONERS IN MEETING THE
COMMUNITY'S HEALTH CARE NEEDS, INCLUDING COLLABORATION WITH OTHER HEALTH
CARE ORGANIZATIONS OPERATING UNDER THE PROVISIONS OF SECTION TWENTY-
EIGHT HUNDRED FIVE-X OF THIS CHAPTER. IT SHALL PROVIDE A FRAMEWORK TO
SUPPORT VOLUNTARY INITIATIVES TO IMPROVE PATIENT CARE ACCESS AND MANAGE-
MENT, PATIENT HEALTH OUTCOMES, AND COST-EFFECTIVENESS IN THE USE OF
HEALTH CARE SERVICES AND COMMUNITY POPULATION HEALTH.
2. THE COMMISSIONER IS AUTHORIZED TO PROVIDE FINANCING INCLUDING, TO
THE EXTENT OF FUNDS AVAILABLE AND ALLOCATED OR APPROPRIATED THEREFOR, AS
WELL AS WAIVERS OF CERTAIN PARTS OF THIS ARTICLE, ARTICLE THIRTY-A OF
THIS CHAPTER, AND REGULATIONS UNDER TITLE TEN OF THE NEW YORK CODES,
RULES AND REGULATIONS, TO SUPPORT THE VOLUNTARY INITIATIVES AND OBJEC-
TIVES OF THIS SECTION.
S. 8307--A 144 A. 8807--A
§ 11. The public health law is amended by adding a new section 3055 to
read as follows:
§ 3055. EMS LICENSURE AND CREDENTIALING. 1. THE DEPARTMENT, WITH THE
APPROVAL OF THE STATE EMERGENCY MEDICAL SERVICES COUNCIL, MAY ESTABLISH
MINIMUM STANDARDS FOR THE LICENSURE OF EMERGENCY MEDICAL SERVICES PRAC-
TITIONERS INCLUDING BUT NOT LIMITED TO EMERGENCY MEDICAL TECHNICIANS AND
ADVANCED EMERGENCY MEDICAL TECHNICIANS BY THE DEPARTMENT.
2. THE DEPARTMENT, WITH THE APPROVAL OF THE STATE EMERGENCY MEDICAL
SERVICES COUNCIL, MAY ESTABLISH MINIMUM STANDARDS FOR SPECIALIZED
CREDENTIALING OF EMERGENCY MEDICAL SERVICE PRACTITIONERS WHICH SHALL
INCLUDE, BUT NOT BE LIMITED TO, EMERGENCY VEHICLE OPERATOR, CRITICAL
CARE PARAMEDIC, EMERGENCY MEDICAL DISPATCHER, EMERGENCY MEDICAL SERVICES
FIELD TRAINING OFFICER, EMERGENCY MEDICAL SERVICES ADMINISTRATOR, EMER-
GENCY MEDICAL CONTROL PHYSICIAN, AND EMERGENCY MEDICAL SERVICES AGENCY
MEDICAL DIRECTOR.
§ 12. The public health law is amended by adding a new section 3029 to
read as follows:
§ 3029. PARAMEDIC URGENT CARE PROGRAM. 1. THE DEPARTMENT SHALL ESTAB-
LISH A PARAMEDIC URGENT CARE PROGRAM TO EFFECTUATE THE ROLE OF EMERGENCY
MEDICAL SERVICES PERSONNEL IN THE DELIVERY OF HEALTH CARE SERVICES IN
RURAL COUNTIES OF NEW YORK STATE.
2. ANY ORGANIZATION THAT IS AUTHORIZED TO PROVIDE ADVANCED LIFE
SUPPORT SERVICES, IN ACCORDANCE WITH SECTION THREE THOUSAND THIRTY OF
THIS ARTICLE, MAY APPLY TO THE DEPARTMENT FOR APPROVAL TO OPERATE A
PARAMEDIC URGENT CARE.
3. ANY PARAMEDIC URGENT CARE PROGRAMS APPROVED BY THE DEPARTMENT UNDER
THIS SECTION SHALL: (A) BE UNDER THE OVERALL SUPERVISION AND DIRECTION
OF A QUALIFIED PHYSICIAN; (B) BE STAFFED BY QUALIFIED MEDICAL AND HEALTH
PERSONNEL, PHYSICIAN ASSISTANTS, OR NURSE PRACTITIONERS; (C) UTILIZE
ADVANCED EMERGENCY MEDICAL TECHNICIANS WHOSE SCOPE OF PRACTICE IS APPRO-
PRIATE FOR THE MEDICAL SERVICES PROVIDED; (D) MAINTAIN A TREATMENT-MAN-
AGEMENT RECORD FOR EACH PATIENT; AND (E) BE INTEGRATED WITH A HOSPITAL
OR OTHER APPROPRIATE HEALTHCARE ORGANIZATION.
4. PARAMEDIC URGENT CARE PROGRAMS MAY INTEGRATE TELEHEALTH PROVIDED BY
A TELEHEALTH PROVIDER, AS THOSE TERMS ARE DEFINED IN SECTION TWENTY-NINE
HUNDRED NINETY-NINE-CC OF THIS CHAPTER. THE COMMISSIONER MAY SPECIFY IN
REGULATION ADDITIONAL ACCEPTABLE MODALITIES FOR THE DELIVERY OF HEALTH
CARE SERVICES BY PARAMEDIC CARE PROGRAMS VIA TELEHEALTH, INCLUDING BUT
NOT LIMITED TO AUDIO-ONLY OR VIDEO-ONLY TELEPHONE COMMUNICATIONS, ONLINE
PORTALS AND SURVEY APPLICATIONS.
5. NOTHING IN THIS SECTION SHALL BE DEEMED TO ALLOW A PERSON TO
PROVIDE ANY SERVICE FOR WHICH A LICENSE, REGISTRATION, CERTIFICATION OR
OTHER AUTHORIZATION UNDER TITLE EIGHT OF THE EDUCATION LAW IS REQUIRED
AND WHICH THE PERSON DOES NOT POSSESS, PROVIDED THAT ANY SERVICE BEING
EXCLUDED PURSUANT TO THIS SUBDIVISION SHALL NOT INCLUDE A SERVICE THAT
IS WITHIN THE SCOPE OF PRACTICE FOR THE RESPECTIVE EMERGENCY MEDICAL
SERVICES PERSONNEL.
§ 13. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024; provided,
however, that the amendments to subdivision 3 of section 3018 of the
public health law made by section four of this act shall not affect the
repeal of such section and shall be deemed repealed therewith.
PART W
S. 8307--A 145 A. 8807--A
Section 1. The elder law is amended by adding a new section 226 to
read as follows:
§ 226. INTERAGENCY ELDER JUSTICE COORDINATING COUNCIL. 1. THERE IS
HEREBY CREATED WITHIN THE OFFICE AN ELDER JUSTICE COORDINATING COUNCIL
CONSISTING OF REPRESENTATIVES OF STATE AGENCIES WHOSE WORK INVOLVES
ELDER JUSTICE TO CREATE GREATER COLLABORATION AND DEVELOP OVERARCHING
STRATEGIES, SYSTEMS, AND PROGRAMS TO BE CARRIED OUT IN ACCORDANCE WITH
THE GOVERNOR'S ELDER JUSTICE PRIORITIES, WITH A GOAL OF PROTECTING OLDER
ADULTS FROM ABUSE AND MISTREATMENT. THE COUNCIL SHALL COLLABORATE TO
IDENTIFY AND SUPPORT CONSISTENT POLICIES AND PROGRAM OPERATION, FACILI-
TATE COMMUNICATION AMONG STATE AGENCIES, FOSTER COLLABORATIVE RELATION-
SHIPS, AND HELP STATE AGENCIES KEEP INFORMED OF LOCAL, STATE, AND
NATIONAL DEVELOPMENTS IN ELDER JUSTICE.
2. THE COUNCIL SHALL BE CHAIRED BY THE DIRECTOR OF THE OFFICE FOR THE
AGING, AND SHALL INCLUDE REPRESENTATION FROM THE OFFICE OF VICTIMS
SERVICES, THE OFFICE OF CHILDREN AND FAMILY SERVICES, THE DEPARTMENT OF
FINANCIAL SERVICES, THE DIVISION OF CRIMINAL JUSTICE SERVICES, THE
OFFICE OF MENTAL HEALTH, THE OFFICE FOR THE PREVENTION OF DOMESTIC
VIOLENCE, THE DEPARTMENT OF HEALTH, THE OFFICE FOR PEOPLE WITH DEVELOP-
MENTAL DISABILITIES, THE NEW YORK STATE POLICE, THE JUSTICE CENTER FOR
THE PROTECTION OF PEOPLE WITH SPECIAL NEEDS, AND THE DEPARTMENT OF
STATE'S DIVISION OF CONSUMER PROTECTION. ADDITIONALLY, THE COUNCIL SHALL
REQUEST INPUT FROM STAKEHOLDERS, ADVOCATES, EXPERTS, AND COALITIONS.
3. THE COUNCIL SHALL:
(A) DEVELOP AND IMPLEMENT A COHESIVE, COMPREHENSIVE STATE PLAN ON
ELDER JUSTICE THAT ALIGNS STATE ELDER JUSTICE POLICY AND PROGRAMS ACROSS
STATE AGENCY RESPONSIBILITIES;
(B) DEVELOP PLANS FOR A COORDINATED AND COMPREHENSIVE RESPONSE FROM
STATE AND LOCAL GOVERNMENT AND OTHER ENTITIES WHEN ELDER ABUSE IS
REPORTED;
(C) FACILITATE INTERAGENCY PLANNING AND POLICY DEVELOPMENT ON ELDER
JUSTICE;
(D) REVIEW AND PROPOSE SPECIFIC AGENCY INITIATIVES FOR THEIR IMPACT ON
SYSTEMS AND SERVICES RELATED TO ELDER JUSTICE;
(E) COORDINATE ACTIVITIES FOR WORLD ELDER ABUSE AWARENESS DAY AND
OTHER EVENTS; AND
(F) MAKE RECOMMENDATIONS TO THE GOVERNOR THAT WILL IMPROVE NEW YORK'S
ELDER ABUSE PREVENTION AND INTERVENTION EFFORTS.
4. EACH MEMBER AGENCY SHALL MAINTAIN CONTROL OVER, AND RESPONSIBILITY
FOR, ITS OWN PROGRAMS AND POLICIES. THE COUNCIL SHALL NOT TAKE THE PLACE
OF ANY EXISTING INTERAGENCY COUNCILS AND COMMITTEES. THE COUNCIL SHALL
SERVE TO FOCUS ATTENTION ON ELDER JUSTICE COMPREHENSIVELY AND CREATE A
MULTIDISCIPLINARY MECHANISM TO WORK TOWARD ALIGNMENT ACROSS AGENCIES TO
HELP ACHIEVE THE GOVERNOR'S ELDER JUSTICE PRIORITIES.
5. THE COUNCIL SHALL MEET REGULARLY AND SHALL SUBMIT A REPORT ON ITS
ACTIVITIES TO THE GOVERNOR AND THE LEGISLATURE NO LATER THAN DECEMBER
THIRTY-FIRST, TWO THOUSAND TWENTY-FIVE AND ANNUALLY THEREAFTER.
§ 2. This act shall take effect immediately.
PART X
Intentionally Omitted.
PART Y
S. 8307--A 146 A. 8807--A
Section 1. Section 7 of part R2 of 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 program,
the membership of subcommittees for mental health of community services
boards and the duties of such subcommittees and creating the community
mental health and workforce reinvestment account, as amended by section
1 of part W of chapter 57 of the laws of 2021, is amended to read as
follows:
§ 7. This act shall take effect immediately [and shall expire March
31, 2024 when upon such date the provisions of this act shall be deemed
repealed].
§ 2. This act shall take effect immediately.
PART Z
Section 1. Section 2 of part NN of chapter 58 of the laws of 2015,
amending the mental hygiene law relating to clarifying the authority of
the commissioners in the department of mental hygiene to design and
implement time-limited demonstration programs, as amended by section 1
of part V of chapter 57 of the laws of 2021, is amended to read as
follows:
§ 2. This act shall take effect immediately [and shall expire and be
deemed repealed March 31, 2024].
§ 2. This act shall take effect immediately.
PART AA
Section 1. Paragraph 31 of subsection (i) of section 3216 of the
insurance law is amended by adding a new subparagraph (J) to read as
follows:
(J) THIS SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF ADDICTION
SERVICES AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE OUTPA-
TIENT, OUTPATIENT REHABILITATION AND OPIOID TREATMENT THAT ARE PARTIC-
IPATING IN THE INSURER'S PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF
THE SOCIAL SERVICES LAW.
§ 2. Paragraph 35 of subsection (i) of section 3216 of the insurance
law is amended by adding a new subparagraph (K) to read as follows:
(K) THIS SUBPARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN
A FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE OF THE MENTAL
HYGIENE LAW, OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO SECTION 36.01
OF THE MENTAL HYGIENE LAW, THAT IS PARTICIPATING IN THE INSURER'S
PROVIDER NETWORK. REIMBURSEMENT FOR COVERED OUTPATIENT TREATMENT
PROVIDED BY SUCH A FACILITY SHALL BE AT A RATE THAT IS NOT LESS THAN THE
RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT TO THE MEDICAL
ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL
SERVICES LAW.
§ 3. Paragraph 5 of subsection (l) of section 3221 of the insurance
law is amended by adding a new subparagraph (K) to read as follows:
(K) THIS SUBPARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN
A FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
S. 8307--A 147 A. 8807--A
HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE OF THE MENTAL
HYGIENE LAW, OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO SECTION 36.01
OF THE MENTAL HYGIENE LAW, THAT IS PARTICIPATING IN THE INSURER'S
PROVIDER NETWORK. REIMBURSEMENT FOR COVERED OUTPATIENT TREATMENT
PROVIDED BY SUCH A FACILITY SHALL BE AT A RATE THAT IS NOT LESS THAN THE
RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT TO THE MEDICAL
ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL
SERVICES LAW.
§ 4. Paragraph 7 of subsection (l) of section 3221 of the insurance
law is amended by adding a new subparagraph (J) to read as follows:
(J) THIS SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF ADDICTION
SERVICES AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE OUTPA-
TIENT, OUTPATIENT REHABILITATION AND OPIOID TREATMENT THAT ARE PARTIC-
IPATING IN THE INSURER'S PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF
THE SOCIAL SERVICES LAW.
§ 5. Subsection (g) of section 4303 of the insurance law is amended by
adding a new paragraph 12 to read as follows:
(12) THIS PARAGRAPH SHALL APPLY TO OUTPATIENT TREATMENT PROVIDED IN A
FACILITY ISSUED AN OPERATING CERTIFICATE BY THE COMMISSIONER OF MENTAL
HEALTH PURSUANT TO THE PROVISIONS OF ARTICLE THIRTY-ONE OF THE MENTAL
HYGIENE LAW, OR IN A FACILITY OPERATED BY THE OFFICE OF MENTAL HEALTH,
OR IN A CRISIS STABILIZATION CENTER LICENSED PURSUANT TO SECTION 36.01
OF THE MENTAL HYGIENE LAW, THAT IS PARTICIPATING IN THE CORPORATION'S
PROVIDER NETWORK. REIMBURSEMENT FOR COVERED OUTPATIENT TREATMENT
PROVIDED BY SUCH FACILITY SHALL BE AT A RATE THAT IS NOT LESS THAN THE
RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT TO THE MEDICAL
ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL
SERVICES LAW.
§ 6. Subsection (l) of section 4303 of the insurance law is amended by
adding a new paragraph 10 to read as follows:
(10) THIS PARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE THAT ARE
LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED BY THE OFFICE OF ADDICTION
SERVICES AND SUPPORTS FOR THE PROVISION OF OUTPATIENT, INTENSIVE OUTPA-
TIENT, OUTPATIENT REHABILITATION AND OPIOID TREATMENT THAT ARE PARTIC-
IPATING IN THE CORPORATION'S PROVIDER NETWORK. REIMBURSEMENT FOR COVERED
OUTPATIENT TREATMENT PROVIDED BY SUCH FACILITIES SHALL BE AT A RATE THAT
IS NOT LESS THAN THE RATE THAT WOULD BE PAID FOR SUCH TREATMENT PURSUANT
TO THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE FIVE OF
THE SOCIAL SERVICES LAW.
§ 7. This act shall take effect January 1, 2025 and shall apply to
policies and contracts issued, renewed, modified, altered, or amended on
and after such date.
PART BB
Section 1. Sections 19 and 21 of chapter 723 of the laws of 1989
amending the mental hygiene law and other laws relating to comprehensive
psychiatric emergency programs, as amended by section 1 of part PPP of
chapter 58 of the laws of 2020, are amended to read as follows:
§ 19. Notwithstanding any other provision of law, the commissioner of
mental health shall[, until July 1, 2024,] be solely authorized, in his
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or her discretion, to designate those general hospitals, local govern-
mental units and voluntary agencies which may apply and be considered
for the approval and issuance of an operating certificate pursuant to
article 31 of the mental hygiene law for the operation of a comprehen-
sive psychiatric emergency program.
§ 21. This act shall take effect immediately[, and sections one, two
and four through twenty of this act shall remain in full force and
effect, until July 1, 2024, at which time the amendments and additions
made by such sections of this act shall be deemed to be repealed, and
any provision of law amended by any of such sections of this act shall
revert to its text as it existed prior to the effective date of this
act].
§ 2. This act shall take effect immediately.
PART CC
Section 1. Subdivision 2 of section 493 of the social services law, as
added by section 1 of part B of chapter 501 of the laws of 2012, is
amended to read as follows:
2. For substantiated reports of abuse or neglect in facilities or
provider agencies in receipt of medical assistance AND WHICH ARE NO
LONGER SUBJECT TO AMENDMENT OR APPEAL PURSUANT TO SECTION FOUR HUNDRED
NINETY-FOUR OF THIS ARTICLE, such information shall also be forwarded by
the justice center to the office of the Medicaid inspector general when
such abuse or neglect may [be relevant to an investigation of unaccepta-
ble practices as such practices are defined] RESULT in [regulations of]
POSSIBLE EXCLUSION OR OTHER SANCTION BY the office of the Medicaid
inspector general AS DETERMINED IN CONSULTATION WITH THE OFFICE OF THE
MEDICAID INSPECTOR GENERAL.
§ 2. This act shall take effect immediately.
PART DD
Section 1. Section 3 of 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, as amended by
section 1 of part T of chapter 57 of the laws of 2021, is amended to
read as follows:
§ 3. This act shall take effect immediately[; and shall expire and be
deemed repealed June 30, 2024].
§ 2. This act shall take effect immediately.
PART EE
Section 1. Subparagraph (v) of paragraph (a) of subdivision 1 of
section 6908 of the education law is renumbered subparagraph (vi) and a
new subparagraph (v) is added to read as follows:
(V) TASKS PROVIDED BY A DIRECT SUPPORT STAFF IN NON-FACILITY BASED
PROGRAMS CERTIFIED, AUTHORIZED OR APPROVED BY THE OFFICE FOR PEOPLE WITH
DEVELOPMENTAL DISABILITIES, SO LONG AS SUCH STAFF DOES NOT HOLD THEMSELF
OUT AS ONE WHO ACCEPTS EMPLOYMENT SOLELY FOR PERFORMING SUCH CARE, AND
WHERE NURSING SERVICES ARE UNDER THE INSTRUCTION OF A SERVICE RECIPIENT
OR FAMILY OR HOUSEHOLD MEMBER DETERMINED BY A REGISTERED PROFESSIONAL
NURSE TO BE CAPABLE OF PROVIDING SUCH INSTRUCTION. IN THE EVENT THAT
THE REGISTERED NURSE DETERMINES THAT THE SERVICE RECIPIENT, FAMILY, OR
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HOUSEHOLD MEMBER IS NOT CAPABLE OF PROVIDING SUCH INSTRUCTION, NURSING
TASKS MAY BE PERFORMED BY DIRECT SUPPORT STAFF PURSUANT TO SUBPARAGRAPH
(VI) OF THIS PARAGRAPH SUBJECT TO THE REQUIREMENTS SET FORTH THEREIN; OR
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART FF
Section 1. 1. Subject to available appropriations and approval of the
director of the budget, the commissioners of the office of mental
health, office for people with developmental disabilities, office of
addiction services and supports, office of temporary and disability
assistance, office of children and family services, and the state office
for the aging shall establish a state fiscal year 2024-2025 cost of
living adjustment (COLA), effective April 1, 2024, for projecting for
the effects of inflation upon rates of payments, contracts, or any other
form of reimbursement for the programs and services listed in paragraphs
(i), (ii), (iii), (iv), (v), and (vi) of subdivision four of this
section. The COLA established herein shall be applied to the appropriate
portion of reimbursable costs or contract amounts. Where appropriate,
transfers to the department of health (DOH) shall be made as reimburse-
ment for the state share of medical assistance.
2. Notwithstanding any inconsistent provision of law, subject to the
approval of the director of the budget and available appropriations
therefore, for the period of April 1, 2024 through March 31, 2025, the
commissioners shall provide funding to support a one and five-tenths
percent (1.5%) cost of living adjustment under this section for all
eligible programs and services as determined pursuant to subdivision
four of this section.
3. Notwithstanding any inconsistent provision of law, and as approved
by the director of the budget, the 1.5 percent cost of living adjustment
(COLA) established herein shall be inclusive of all other cost of living
type increases, inflation factors, or trend factors that are newly
applied effective April 1, 2024. Except for the 1.5 percent cost of
living adjustment (COLA) established herein, for the period commencing
on April 1, 2024 and ending March 31, 2025 the commissioners shall not
apply any other new cost of living adjustments for the purpose of estab-
lishing rates of payments, contracts or any other form of reimbursement.
The phrase "all other cost of living type increases, inflation factors,
or trend factors" as defined in this subdivision shall not include
payments made pursuant to the American Rescue Plan Act or other federal
relief programs related to the Coronavirus Disease 2019 (COVID-19)
pandemic public health emergency. This subdivision shall not prevent the
office of children and family services from applying additional trend
factors or staff retention factors to eligible programs and services
under paragraph (v) of subdivision four of this section.
4. Eligible programs and services. (i) Programs and services funded,
licensed, or certified by the office of mental health (OMH) eligible for
the cost of living adjustment established herein, pending federal
approval where applicable, include: office of mental health licensed
outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of
the office of mental health regulations including clinic, continuing day
treatment, day treatment, intensive outpatient programs and partial
hospitalization; outreach; crisis residence; crisis stabilization,
crisis/respite beds; mobile crisis, part 590 comprehensive psychiatric
emergency program services; crisis intervention; home based crisis
S. 8307--A 150 A. 8807--A
intervention; family care; supported single room occupancy; supported
housing; supported housing community services; treatment congregate;
supported congregate; community residence - children and youth;
treatment/apartment; supported apartment; community residence single
room occupancy; on-site rehabilitation; employment programs; recreation;
respite care; transportation; psychosocial club; assertive community
treatment; case management; care coordination, including health home
plus services; local government unit administration; monitoring and
evaluation; children and youth vocational services; single point of
access; school-based mental health program; family support children and
youth; advocacy/support services; drop in centers; recovery centers;
transition management services; bridger; home and community based waiver
services; behavioral health waiver services authorized pursuant to the
section 1115 MRT waiver; self-help programs; consumer service dollars;
conference of local mental hygiene directors; multicultural initiative;
ongoing integrated supported employment services; supported education;
mentally ill/chemical abuse (MICA) network; personalized recovery
oriented services; children and family treatment and support services;
residential treatment facilities operating pursuant to part 584 of title
14-NYCRR; geriatric demonstration programs; community-based mental
health family treatment and support; coordinated children's service
initiative; homeless services; and promises zone.
(ii) Programs and services funded, licensed, or certified by the
office for people with developmental disabilities (OPWDD) eligible for
the cost of living adjustment established herein, pending federal
approval where applicable, include: local/unified services; chapter 620
services; voluntary operated community residential services; article 16
clinics; day treatment services; family support services; 100% day
training; epilepsy services; traumatic brain injury services; hepatitis
B services; independent practitioner services for individuals with
intellectual and/or developmental disabilities; crisis services for
individuals with intellectual and/or developmental disabilities; family
care residential habilitation; supervised residential habilitation;
supportive residential habilitation; respite; day habilitation; prevoca-
tional services; supported employment; community habilitation; interme-
diate care facility day and residential services; specialty hospital;
pathways to employment; intensive behavioral services; community transi-
tion services; family education and training; fiscal intermediary;
support broker; and personal resource accounts.
(iii) Programs and services funded, licensed, or certified by the
office of addiction services and supports (OASAS) eligible for the cost
of living adjustment established herein, pending federal approval where
applicable, include: medically supervised withdrawal services - residen-
tial; medically supervised withdrawal services - outpatient; medically
managed detoxification; medically monitored withdrawal; inpatient reha-
bilitation services; outpatient opioid treatment; residential opioid
treatment; KEEP units outpatient; residential opioid treatment to absti-
nence; problem gambling treatment; medically supervised outpatient;
outpatient rehabilitation; specialized services substance abuse
programs; home and community based waiver services pursuant to subdivi-
sion 9 of section 366 of the social services law; children and family
treatment and support services; continuum of care rental assistance case
management; NY/NY III post-treatment housing; NY/NY III housing for
persons at risk for homelessness; permanent supported housing; youth
clubhouse; recovery community centers; recovery community organizing
initiative; residential rehabilitation services for youth (RRSY); inten-
S. 8307--A 151 A. 8807--A
sive residential; community residential; supportive living; residential
services; job placement initiative; case management; family support
navigator; local government unit administration; peer engagement; voca-
tional rehabilitation; support services; HIV early intervention
services; dual diagnosis coordinator; problem gambling resource centers;
problem gambling prevention; prevention resource centers; primary
prevention services; other prevention services; and community services.
(iv) Programs and services funded, licensed, or certified by the
office of temporary and disability assistance (OTDA) eligible for the
cost of living adjustment established herein, pending federal approval
where applicable, include: nutrition outreach and education program
(NOEP).
(v) Programs and services funded, licensed, or certified by the office
of children and family services (OCFS) eligible for the cost of living
adjustment established herein, pending federal approval where applica-
ble, include: programs for which the office of children and family
services establishes maximum state aid rates pursuant to section 398-a
of the social services law and section 4003 of the education law; emer-
gency foster homes; foster family boarding homes and therapeutic foster
homes; supervised settings as defined by subdivision twenty-two of
section 371 of the social services law; adoptive parents receiving
adoption subsidy pursuant to section 453 of the social services law; and
congregate and scattered supportive housing programs and supportive
services provided under the NY/NY III supportive housing agreement to
young adults leaving or having recently left foster care.
(vi) Programs and services funded, licensed, or certified by the state
office for the aging (SOFA) eligible for the cost of living adjustment
established herein, pending federal approval where applicable, include:
community services for the elderly; expanded in-home services for the
elderly; and supplemental nutrition assistance program.
5. Each local government unit or direct contract provider receiving
funding for the cost of living adjustment established herein shall
submit a written certification, in such form and at such time as each
commissioner shall prescribe, attesting how such funding will be or was
used to first promote the recruitment and retention of non-executive
direct care staff, non-executive direct support professionals, non-exe-
cutive clinical staff, or respond to other critical non-personal service
costs prior to supporting any salary increases or other compensation for
executive level job titles.
6. Notwithstanding any inconsistent provision of law to the contrary,
agency commissioners shall be authorized to recoup funding from a local
governmental unit or direct contract provider for the cost of living
adjustment established herein determined to have been used in a manner
inconsistent with the appropriation, or any other provision of this
section. Such agency commissioners shall be authorized to employ any
legal mechanism to recoup such funds, including an offset of other funds
that are owed to such local governmental unit or direct contract provid-
er.
§ 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024.
PART GG
Section 1. Subdivision 29 of section 364-j of the social services law,
as added by section 49 of part C of chapter 60 of the laws of 2014, is
amended to read as follows:
S. 8307--A 152 A. 8807--A
29. In the event that the department receives approval from the
Centers for Medicare and Medicaid Services to amend its 1115 waiver
[known as the Partnership Plan] or receives approval for a new 1115
waiver [for the purpose of reinvesting savings resulting from the rede-
sign of the medical assistance program] PRIOR TO OR FOLLOWING THE EFFEC-
TIVE DATE OF THIS SUBDIVISION, the commissioner is authorized to enter
into contracts[, and/or] AND to amend the terms of contracts awarded
prior to [the effective date of this subdivision] APRIL FIRST, TWO THOU-
SAND TWENTY-FOUR, for the purpose of assisting the department of health
with implementing projects authorized under such waiver approval.
Notwithstanding the provisions of sections one hundred twelve and one
hundred sixty-three of the state finance law, or sections one hundred
forty-two and one hundred forty-three of the economic development law,
or any contrary provision of law, contracts may be entered or contract
amendments may be made pursuant to this subdivision without a compet-
itive bid or request for proposal process [if the term of any such
contract or contract amendment does not extend beyond March thirty-
first, two thousand nineteen]; provided, however, in the case of a
contract entered into after the effective date of this subdivision,
that:
(a) The department of health shall post on its website, for a period
of no less than thirty days:
(i) A description of the proposed services to be provided pursuant to
the contract or contracts;
(ii) The criteria for selection of a contractor or contractors;
(iii) The period of time during which a prospective contractor may
seek selection, which shall be no less than thirty days after such
information is first posted on the website; and
(iv) The manner by which a prospective contractor may seek such
selection, which may include submission by electronic means;
(b) All reasonable and responsive submissions that are received from
prospective contractors in timely fashion shall be reviewed by the
commissioner of health; and
(c) The commissioner of health shall select such contractor or
contractors that, in [his or her] SUCH COMMISSIONER'S discretion, are
best suited to serve the purposes of this section.
§ 2. This act shall take effect immediately; provided, however, that
the amendments to section 364-j of the social services law made by
section one of this act shall not affect the repeal of such section and
shall be deemed repealed therewith.
PART HH
Section 1. Subparagraphs (i) and (ii) of paragraph (a) of subdivision
4-a of section 365-f of the social services law, as amended by section 3
of part G of chapter 57 of the laws of 2019, the opening paragraph of
subparagraph (i) as amended by section 2 of part PP of chapter 57 of the
laws of 2022, are amended to read as follows:
(i) "Fiscal intermediary" means an entity that provides fiscal inter-
mediary services and has a contract for providing such services with
[the department of health and is selected through the procurement proc-
ess described in paragraphs (b), (b-1), (b-2) and (b-3) of this subdivi-
sion. Eligible applicants for contracts shall be entities that are capa-
ble of appropriately providing fiscal intermediary services, performing
the responsibilities of a fiscal intermediary, and complying with this
section, including but not limited to entities that:
S. 8307--A 153 A. 8807--A
(A) are a service center for independent living under section one
thousand one hundred twenty-one of the education law; or
(B) have been established as fiscal intermediaries prior to January
first, two thousand twelve and have been continuously providing such
services for eligible individuals under this section.]:
(A) A LOCAL DEPARTMENT OF SOCIAL SERVICES;
(B) AN ORGANIZATION LICENSED UNDER ARTICLE FORTY-FOUR OF THE PUBLIC
HEALTH LAW; OR
(C) AN ACCOUNTABLE CARE ORGANIZATION CERTIFIED UNDER ARTICLE TWENTY-
NINE-E OF THE PUBLIC HEALTH LAW OR AN INTEGRATED DELIVERY SYSTEM
COMPOSED PRIMARILY OF HEALTH CARE PROVIDERS RECOGNIZED BY THE DEPARTMENT
AS A PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM INCEN-
TIVE PAYMENT PROGRAM.
(ii) Fiscal intermediary services shall include the following
services, performed on behalf of the consumer to facilitate [his or her]
THE CONSUMER'S role as the employer:
(A) wage and benefit processing for consumer directed personal assist-
ants;
(B) processing all income tax and other required wage withholdings;
(C) complying with workers' compensation, disability and unemployment
requirements;
(D) maintaining personnel records for each consumer directed personal
assistant, including time records and other documentation needed for
wages and benefit processing and a copy of the medical documentation
required pursuant to regulations established by the commissioner;
(E) ensuring that the health status of each consumer directed personal
assistant is assessed prior to service delivery pursuant to regulations
issued by the commissioner;
(F) maintaining records of service authorizations or reauthorizations;
(G) monitoring the consumer's or, if applicable, the designated repre-
sentative's continuing ability to fulfill the consumer's responsibil-
ities under the program and promptly notifying the authorizing entity of
any circumstance that may affect the consumer's or, if applicable, the
designated representative's ability to fulfill such responsibilities;
(H) complying with regulations established by the commissioner speci-
fying the responsibilities of fiscal intermediaries providing services
under this title; AND
(I) entering into a department approved memorandum of understanding
with the consumer that describes the parties' responsibilities under
this program[; and
(J) other related responsibilities which may include, as determined by
the commissioner, assisting consumers to perform the consumers' respon-
sibilities under this section and department regulations in a manner
that does not infringe upon the consumer's responsibilities and self-di-
rection].
§ 2. Paragraphs (b) and (c) of subdivision 4-a of section 365-f of the
social services law are REPEALED and two new paragraphs (b) and (c) are
added to read as follows:
(B) AS OF JANUARY FIRST, TWO THOUSAND TWENTY-FIVE NO ENTITY SHALL
PROVIDE, DIRECTLY OR THROUGH CONTRACT, FISCAL INTERMEDIARY SERVICES
WITHOUT AN AUTHORIZATION AS A FISCAL INTERMEDIARY ISSUED BY THE COMMIS-
SIONER IN ACCORDANCE WITH THIS SUBDIVISION. IN ESTABLISHING AUTHORI-
ZATION STANDARDS AND PROCESSES, THE COMMISSIONER MAY CONSIDER DEMON-
STRATED COMPLIANCE WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND
REGULATIONS, INCLUDING BUT NOT LIMITED TO, MARKETING AND LABOR PRAC-
TICES, COST REPORTING, AND ELECTRONIC VISIT VERIFICATION REQUIREMENTS;
S. 8307--A 154 A. 8807--A
PROVIDED, HOWEVER, THAT THIS SHALL NOT BE CONSTRUED TO LIMIT THE COMMIS-
SIONER'S DISCRETION IN ESTABLISHING SUCH STANDARDS AND PROCESSES.
NOTWITHSTANDING THE PRECEDING REQUIREMENT FOR AUTHORIZATION, A FISCAL
INTERMEDIARY THAT IS IN OPERATION PRIOR TO JANUARY FIRST, TWO THOUSAND
TWENTY-FOUR MAY CONTINUE TO PROVIDE FISCAL INTERMEDIARY SERVICES WITHOUT
AN AUTHORIZATION UNTIL SUCH TIME AS THE COMMISSIONER DETERMINES THAT THE
CONTINUED PROVISION OF SERVICES THROUGH UNAUTHORIZED FISCAL INTERME-
DIARIES IS NO LONGER NECESSARY TO ENSURE ACCESS TO SERVICES; SUCH DETER-
MINATION MAY BE MADE ON A STATEWIDE, REGIONAL, OR COUNTY BASIS.
(C) THE COMMISSIONER IS AUTHORIZED TO DETERMINE THE MAXIMUM NUMBER OF
FISCAL INTERMEDIARIES A LOCAL DEPARTMENT OF SOCIAL SERVICES OR AN ORGAN-
IZATION LICENSED UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, OR
AN ACCOUNTABLE CARE ORGANIZATION CERTIFIED UNDER ARTICLE TWENTY-NINE-E
OF THE PUBLIC HEALTH LAW OR AN INTEGRATED DELIVERY SYSTEM COMPOSED
PRIMARILY OF HEALTH CARE PROVIDERS RECOGNIZED BY THE DEPARTMENT AS A
PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM INCENTIVE
PAYMENT PROGRAM MAY CONTRACT WITH, PROVIDED IT IS DETERMINED THAT THERE
REMAINS ADEQUATE ACCESS TO SERVICES; SUCH DETERMINATION MAY BE MADE ON A
STATEWIDE, REGIONAL OR COUNTY LEVEL BASIS.
§ 3. Paragraphs (b-1), (b-2) and (b-3) of subdivision 4-a of section
365-f of the social services law are REPEALED.
§ 4. Subdivision 4-b of section 365-f of the social services law, as
amended by section 8 of part G of chapter 57 of the laws of 2019, is
amended to read as follows:
4-b. Actions involving the authorization of a fiscal intermediary.
(a) [The department may terminate a fiscal intermediary's contract
under this section or suspend or limit the fiscal intermediary's rights
and privileges under the contract upon thirty day's written notice to
the fiscal intermediary, if the commissioner finds that the fiscal
intermediary has failed to comply with the provisions of this section or
regulations promulgated hereunder. The written notice shall include:
(i) A description of the conduct and the issues related thereto that
have been identified as failure of compliance; and
(ii) the time frame of the conduct that fails compliance] A FISCAL
INTERMEDIARY'S AUTHORIZATION MAY BE REVOKED, SUSPENDED, LIMITED, OR
ANNULLED UPON THIRTY DAYS' WRITTEN NOTICE TO THE FISCAL INTERMEDIARY, IF
THE COMMISSIONER FINDS THAT THE FISCAL INTERMEDIARY HAS FAILED TO COMPLY
WITH THE PROVISIONS OF THIS SUBDIVISION OR REGULATIONS PROMULGATED HERE-
UNDER.
(b) Notwithstanding the foregoing, upon determining that the public
health or safety would be imminently endangered by the continued opera-
tion or actions of the fiscal intermediary, the commissioner may [termi-
nate] REVOKE, SUSPEND, LIMIT, OR ANNUL the fiscal intermediary's
[contract or suspend or limit the fiscal intermediary's rights and priv-
ileges under the contract] AUTHORIZATION immediately [upon written
notice].
(c) THE COMMISSIONER MAY ISSUE ORDERS AND TAKE OTHER ACTIONS AS NECES-
SARY AND APPROPRIATE TO PROHIBIT AND PREVENT THE PROVISION OF FISCAL
INTERMEDIARY SERVICES BY AN UNAUTHORIZED ENTITY.
(D) All orders or determinations under this subdivision shall be
subject to review as provided in article seventy-eight of the civil
practice law and rules.
§ 5. Paragraph (c) of subdivision 4-d of section 365-f of the social
services law, as added by section 7 of part G of chapter 57 of the laws
of 2019, is amended to read as follows:
S. 8307--A 155 A. 8807--A
(c) Where a fiscal intermediary is suspending or ceasing operation
pursuant to an order under subdivision four-b of this section, or has
failed to [submit an offer for a contract] APPLY FOR AUTHORIZATION, or
has been denied [a contract] AUTHORIZATION under this section, all the
provisions of this subdivision shall apply except subparagraph (i) of
paragraph (a) of this subdivision, notice of which to all parties shall
be provided by the department, WITH THE ASSISTANCE OF ANY LOCAL SOCIAL
SERVICES DISTRICTS OR MANAGED CARE PLANS WITH WHICH THE FISCAL INTERME-
DIARY CONTRACTS, as appropriate.
§ 6. Paragraph (d) of subdivision 4-d of section 365-f of the social
services law is REPEALED.
§ 7. Paragraph (b) of subdivision 5 of section 365-f of the social
services law, as added by chapter 81 of the laws of 1995, is amended to
read as follows:
(b) Notwithstanding any other provision of law, the commissioner is
authorized to waive any provision of section three hundred sixty-seven-b
of this title related to payment and may promulgate regulations, INCLUD-
ING EMERGENCY REGULATIONS, necessary to carry out the objectives of the
program INCLUDING MINIMUM SELECTION CRITERIA AND TRAINING REQUIREMENTS
FOR PERSONAL ASSISTANTS, THE ESTABLISHMENT OF LIMITATIONS ON THE NUMBER
OF HOURS A PERSONAL ASSISTANT MAY WORK ON A DAILY AND WEEKLY BASIS, and
which describe the responsibilities of the eligible individuals in
arranging and paying for services and the protections assured such indi-
viduals if they are unable or no longer desire to continue in the
program, THE FISCAL INTERMEDIARY AUTHORIZATION PROCESS, STANDARDS, AND
TIME FRAMES, AND THOSE REGULATIONS NECESSARY TO ENSURE ADEQUATE ACCESS
TO SERVICES, INCLUDING BUT NOT LIMITED TO THE MAXIMUM NUMBER OF FISCAL
INTERMEDIARIES A LOCAL DEPARTMENT OF SOCIAL SERVICES OR AN ORGANIZATION
LICENSED UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, OR AN
ACCOUNTABLE CARE ORGANIZATION CERTIFIED UNDER ARTICLE TWENTY-NINE-E OF
THE PUBLIC HEALTH LAW OR INTEGRATED DELIVERY SYSTEMS COMPOSED PRIMARILY
OF HEALTH CARE PROVIDERS RECOGNIZED BY THE DEPARTMENT AS A PERFORMING
PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT
PROGRAM MAY CONTRACT WITH; SUCH DETERMINATION MAY BE MADE ON A STATE-
WIDE, REGIONAL, OR COUNTY BASIS.
§ 8. Paragraphs (e) and (f) of subdivision 2 of section 3605-c of the
public health law, as added by section 10 of part MM of chapter 56 of
the laws of 2020, are amended and a new paragraph (g) is added to read
as follows:
(e) the commissioner may institute a continuous recruitment process
provided that the information required under paragraph (a) of this
subdivision remains on the department's website for the entire duration
of the recruitment process, until such date as the commissioner may
determine upon no less than ten days notice being posted on the website;
[and]
(f) the commissioner may reoffer contracts under the same terms of
this subdivision, if determined necessary by the commissioner, on a
statewide or regional basis[.]; AND
(G) ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-FOUR, THE DEPARTMENT
SHALL NOT ALLOW THE ENROLLMENT OR RE-ENROLLMENT OF A LHCSA INTO THE
MEDICAL ASSISTANCE PROGRAM IF SUCH LHCSA IS MAJORITY OWNED BY A COMPANY
WHICH PROVIDES FISCAL INTERMEDIARY SERVICES, OR IS MAJORITY OWNED BY A
COMPANY WHICH ALSO HAS MAJORITY OWNERSHIP OVER A COMPANY THAT PROVIDES
FISCAL INTERMEDIARY SERVICES, OR ITSELF PROVIDES FISCAL INTERMEDIARY
SERVICES IN THE STATE CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAM, OR
IS THE MAJORITY OWNER OF A COMPANY THAT PROVIDES FISCAL INTERMEDIARY
S. 8307--A 156 A. 8807--A
SERVICES, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
SERVICES LAW. FOR THE PURPOSES OF THIS SECTION, "MAJORITY OWNED" OR
"MAJORITY OWNERSHIP" SHALL BE DEFINED AS CONTROLLING INTEREST IN A
COMPANY, OR BEING THE LARGEST HOLDER OF THE COMMON STOCK OR ORDINARY
SHARES OF A COMPANY.
§ 9. Paragraphs (g) and (h) of subdivision 1 of section 4403 of the
public health law, paragraph (g) as added by chapter 938 of the laws of
1976 and paragraph (h) as amended by chapter 805 of the laws of 1984,
are amended and two new paragraphs (i) and (j) are added to read as
follows:
(g) approved mechanisms exist to resolve complaints and grievances
initiated by any enrolled member; [and]
(h) the contract between the enrollee and the organization meet the
requirements of the superintendent as set forth in section forty-four
hundred six of this article, as to the provisions contained therein for
health services, the procedures for offering, renewing, converting and
terminating contracts to enrollees, and the rates for such contracts
including but not limited to, compliance with the provisions of section
one thousand one hundred nine of the insurance law[.];
(I) THAT THE APPLICANT IS NOT CONTROLLED, AS DEFINED UNDER REGULATION,
BY AN ENTITY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES, IS NOT
CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER AN ENTITY THAT
PROVIDES FISCAL INTERMEDIARY SERVICES, DOES NOT ITSELF PROVIDE FISCAL
INTERMEDIARY SERVICES IN THE STATE CONSUMER DIRECTED PERSONAL ASSISTANCE
PROGRAM, AND DOES NOT CONTROL AN ENTITY THAT PROVIDES FISCAL INTERME-
DIARY SERVICES, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FIVE-F OF THE
SOCIAL SERVICES LAW; AND
(J) THAT THE APPLICANT IS NOT CONTROLLED, AS DEFINED UNDER REGULATION,
BY AN ENTITY WHICH PROVIDES LICENSED HOME CARE SERVICES, IS NOT
CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER A COMPANY THAT
PROVIDES LICENSED HOME CARE SERVICES, DOES NOT ITSELF PROVIDE LICENSED
HOME CARE SERVICES, AND DOES NOT CONTROL AN ENTITY THAT PROVIDES
LICENSED HOME CARE SERVICES.
§ 10. Section 4403 of the public health law is amended by adding a new
subdivision 1-a to read as follows:
1-A. (A) BY APRIL FIRST, TWO THOUSAND TWENTY-FIVE, ANY HEALTH MAINTE-
NANCE ORGANIZATION WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR
LICENSED HOME CARE SERVICES, IS CONTROLLED BY AN ENTITY WHICH PROVIDES
FISCAL INTERMEDIARY SERVICES OR LICENSED HOME CARE SERVICES, HAS CONTROL
OVER AN ENTITY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED
HOME CARE SERVICES, OR IS CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL
OVER AN ENTITY THAT PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED
HOME CARE SERVICES, SHALL BE REQUIRED TO RESUBMIT AN APPLICATION FOR A
CERTIFICATE OF AUTHORITY PURSUANT TO SECTION FOUR THOUSAND FOUR HUNDRED
TWO OF THIS ARTICLE.
(B) AFTER APRIL FIRST, TWO THOUSAND TWENTY-FIVE, NO HEALTH MAINTENANCE
ORGANIZATION WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED
HOME CARE SERVICES, IS CONTROLLED BY AN ENTITY WHICH PROVIDES FISCAL
INTERMEDIARY SERVICES OR LICENSED HOME CARE SERVICES, HAS CONTROL OVER
AN ENTITY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME
CARE SERVICES, OR IS CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER
AN ENTITY THAT PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME
CARE SERVICES, MAY MAINTAIN CERTIFICATION TO OPERATE AS A HEALTH MAINTE-
NANCE ORGANIZATION.
(C) FOR THE PURPOSES OF THIS SUBDIVISION, "CONTROL" SHALL BE DEFINED
IN REGULATION.
S. 8307--A 157 A. 8807--A
§ 11. Paragraphs (h) and (i) of subdivision 3 of section 4403-f of the
public health law, as amended by section 41-a of part H of chapter 59 of
the laws of 2011, are amended and two new paragraphs (j) and (k) are
added to read as follows:
(h) that the contractual arrangements for providers of health and long
term care services in the benefit package are sufficient to ensure the
availability and accessibility of such services to the proposed enrolled
population consistent with guidelines established by the commissioner;
with respect to individuals in receipt of such services prior to enroll-
ment, such guidelines shall require the managed long term care plan to
contract with agencies currently providing such services, in order to
promote continuity of care. In addition, such guidelines shall require
managed long term care plans to offer and cover consumer directed
personal assistance services for eligible individuals who elect such
services pursuant to section three hundred sixty-five-f of the social
services law; [and]
(i) that the applicant is financially responsible and may be expected
to meet its obligations to its enrolled members[.];
(J) THAT THE APPLICANT IS NOT CONTROLLED, AS DEFINED UNDER REGULATION,
BY AN ENTITY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES, IS NOT
CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER AN ENTITY THAT
PROVIDES FISCAL INTERMEDIARY SERVICES, DOES NOT ITSELF PROVIDE FISCAL
INTERMEDIARY SERVICES IN THE STATE CONSUMER DIRECTED PERSONAL ASSISTANCE
PROGRAM, AND DOES NOT CONTROL AN ENTITY THAT PROVIDES FISCAL INTERME-
DIARY SERVICES, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FIVE-F OF THE
SOCIAL SERVICES LAW; AND
(K) THAT THE APPLICANT IS NOT CONTROLLED, AS DEFINED UNDER REGULATION,
BY AN ENTITY WHICH PROVIDES LICENSED HOME CARE SERVICES, IS NOT
CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER A COMPANY THAT
PROVIDES LICENSED HOME CARE SERVICES, DOES NOT ITSELF PROVIDE LICENSED
HOME CARE SERVICES, AND DOES NOT CONTROL AN ENTITY THAT PROVIDES
LICENSED HOME CARE SERVICES.
§ 12. Section 4403-f of the public health law is amended by adding a
new subdivision 3-a to read as follows:
3-A. (A) BY APRIL FIRST, TWO THOUSAND TWENTY-FIVE, ANY MANAGED LONG
TERM CARE PLAN WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED
HOME CARE SERVICES, IS CONTROLLED BY AN ENTITY WHICH PROVIDES FISCAL
INTERMEDIARY SERVICES OR LICENSED HOME CARE SERVICES, HAS CONTROL OVER
AN ENTITY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME
CARE SERVICES, OR IS CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER
AN ENTITY THAT PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME
CARE SERVICES, SHALL BE REQUIRED TO RESUBMIT AN APPLICATION FOR A
CERTIFICATE OF AUTHORITY PURSUANT TO SUBDIVISION TWO OF THIS SECTION.
(B) AFTER APRIL FIRST, TWO THOUSAND TWENTY-FIVE, NO MANAGED LONG TERM
CARE PLAN WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME
CARE SERVICES, IS CONTROLLED BY AN ENTITY WHICH PROVIDES FISCAL INTERME-
DIARY SERVICES OR LICENSED HOME CARE SERVICES, HAS CONTROL OVER AN ENTI-
TY WHICH PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME CARE
SERVICES, OR IS CONTROLLED BY AN ENTITY WHICH ALSO HAS CONTROL OVER AN
ENTITY THAT PROVIDES FISCAL INTERMEDIARY SERVICES OR LICENSED HOME CARE
SERVICES, MAY MAINTAIN CERTIFICATION TO OPERATE AS A MANAGED LONG TERM
CARE PLAN.
(C) FOR THE PURPOSES OF THIS SUBDIVISION, "CONTROL" SHALL HAVE THE
SAME MEANING AS DEFINED IN REGULATION.
S. 8307--A 158 A. 8807--A
§ 13. Subparagraphs (v) and (vi) of paragraph (e) of subdivision 2 of
section 365-a of the social services law are renumbered subparagraphs
(vi) and (vii) and a new subparagraph (v) is added to read as follows:
(V) THE COMMISSIONER OF HEALTH MAY ISSUE REGULATIONS, INCLUDING EMER-
GENCY REGULATIONS, TO ESTABLISH THE MAXIMUM DAILY AND WEEKLY HOURS ANY
INDIVIDUAL AIDE PROVIDING PERSONAL CARE SERVICES AVAILABLE PURSUANT TO
THIS PARAGRAPH SHALL WORK;
§ 14. Paragraph (c) of subdivision 2 of section 365-f of the social
services law, as amended by section 3 of part MM of chapter 56 of the
laws of 2020, is amended to read as follows:
(c) has been determined by the social services district, pursuant to
an assessment of the person's appropriateness for the program, conducted
with an appropriate long term home health care program, a certified home
health agency, or an AIDS home care program or pursuant to the personal
care program, as being in need of home care services or private duty
nursing and as needing at least limited assistance with physical maneu-
vering with more than two activities of daily living, or for persons
with a dementia or Alzheimer's diagnosis, as needing at least super-
vision with more than one activity of daily living, provided that the
provisions related to activities of daily living in this paragraph shall
only apply to persons who initially seek eligibility for the program on
or after October first, two thousand twenty, and who is able and willing
[or has a designated representative, including a legal guardian able and
willing] to make informed choices, [or a designated relative or other
adult who is able and willing to assist in making informed choices,] as
to the type and quality of services, including but not limited to such
services as nursing care, personal care, transportation and respite
services; and
§ 15. Subdivision 3 of section 365-f of the social services law, as
amended by section 9 of part QQ of chapter 56 of the laws of 2020, is
amended to read as follows:
3. Division of responsibilities. (A) Eligible individuals who elect to
participate in the program assume the responsibility for services under
such program as mutually agreed to by the eligible individual and
provider and as documented in the eligible individual's record, includ-
ing, but not limited to, recruiting, hiring and supervising their
personal assistants. [For the purposes of this section,]
(B) A personal assistant [shall mean], FOR THE PURPOSES OF THIS
SECTION, IS an adult who:
(1) has obtained an individual unique identifier from the state by or
before a date determined by the commissioner of health in consultation
with the Medicaid inspector general[,]; and
(2) provides services under this section to the eligible individual
under the eligible individual's instruction, supervision, and direction
[or under the instruction, supervision and direction of the eligible
individual's designated representative, provided that a].
(C) A person legally responsible for an eligible individual's care and
support, an eligible individual's spouse [or designated representative],
may not be the personal assistant for the eligible individual; however,
a personal assistant may include any other adult relative of the eligi-
ble individual, provided, however, that the program determines that the
services provided by such relative are consistent with an individual's
plan of care and that the aggregate cost for such services does not
exceed the aggregate costs for equivalent services provided by a non-re-
lative personal assistant.
S. 8307--A 159 A. 8807--A
(D) Any personal information submitted to obtain [such] A unique iden-
tifier UNDER THIS SUBDIVISION shall be maintained as confidential pursu-
ant to article six-A of the public officers law ("New York state privacy
protection law"). Such individuals shall be assisted as appropriate with
service coverage, supervision, advocacy and management.
(E) Providers shall not be liable for fulfillment of responsibilities
agreed to be undertaken by the eligible individual. This subdivision,
however, shall not diminish the participating provider's liability for
failure to exercise reasonable care in properly carrying out its respon-
sibilities under this program, which shall include monitoring such indi-
vidual's continuing ability to fulfill those responsibilities documented
in his or her records. Failure of the individual to carry out his or her
agreed to responsibilities may be considered in determining such indi-
vidual's continued appropriateness for the program.
§ 16. Clause (G) of subparagraph (ii) of paragraph (a) of subdivision
4-a of section 365-f of the social services law, as amended by section 3
of part G of chapter 57 of the laws of 2019, is amended to read as
follows:
(G) monitoring the consumer's [or, if applicable, the designated
representative's] continuing ability to fulfill the consumer's responsi-
bilities under the program and promptly notifying the authorizing entity
of any circumstance that may affect the consumer's [or, if applicable,
the designated representative's] ability to fulfill such responsibil-
ities;
§ 17. Subparagraph (iii) of paragraph (a) subdivision 4-a of section
365-f of the social services law, as added by section 1 of part E of
chapter 57 of the laws of 2017, is amended to read as follows:
(iii) Fiscal intermediaries are not responsible for, and fiscal inter-
mediary services shall not include, fulfillment of the responsibilities
of the consumer [or, if applicable, the consumer's designated represen-
tative] as established by the commissioner. A fiscal intermediary's
responsibilities shall not include, and a fiscal intermediary shall not
engage in: managing the plan of care including recruiting and hiring a
sufficient number of individuals who meet the definition of consumer
directed personal assistant, as such term is defined by the commission-
er, to provide authorized services that are included on the consumer's
plan of care; training, supervising and scheduling each consumer
directed personal assistant; terminating the consumer directed personal
assistant's employment; or assuring that each consumer directed personal
assistant competently and safely performs the personal care services,
home health aide services and skilled nursing tasks that are included on
the consumer's plan of care. A fiscal intermediary shall exercise
reasonable care in properly carrying out its responsibilities under the
program.
§ 18. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2024; provided,
however, that sections thirteen, fourteen, fifteen, sixteen and seven-
teen of this act shall take effect October 1, 2024; and provided,
further, that the amendments to section 4403-f of the public health law
made by sections eleven and twelve of this act shall not affect the
repeal of such section and shall be deemed repealed therewith.
§ 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph, subdivision, section
S. 8307--A 160 A. 8807--A
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would have been enacted even if such
invalid provisions had not been included herein.
§ 3. This act shall take effect immediately provided, however, that
the applicable effective date of Parts A through HH of this act shall be
as specifically set forth in the last section of such Parts.