[ ] is old law to be omitted.
LBD12272-04-0
S. 8090 2 A. 11372
health care facilities, in relation to hospital reimbursement
provisions; and providing for the repeal of certain provisions upon
expiration thereof (Part B; to authorize funding for the Consolidated
Local Street and Highway Improvement Program (CHIPS) and Marchiselli
program for state fiscal year 2010-2011; and to amend chapter 329 of the
laws of 1991, amending the state finance law and other laws relating to
the establishment of the dedicated highway and bridge trust fund, in
relation to funding therefor (Part C); to amend the navigation law, in
relation to the authorized reimbursement rate paid to governmental enti-
ties (Part D); to amend the executive law, in relation to reimbursement
for expenditures made by the office of children and family services and
providing for the repeal of such provisions upon expiration thereof
(Part E); and to amend the state finance law, in relation to the school
tax relief fund (Part F)
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act enacts into law major components of legislation
which are necessary to implement the state fiscal plan for the 2010-2011
state fiscal year. Each component is wholly contained within a Part
identified as Parts A through F. 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, includ-
ing the effective date of the Part, which makes reference to a section
"of this act", when used in connection with that particular component,
shall be deemed to mean and refer to the corresponding 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. The title heading of title 1-A of article 24 of the public
health law, as amended by chapter 300 of the laws of 1995, is amended to
read as follows:
[BREAST] CANCER DETECTION AND EDUCATION PROGRAM[; OVARIAN CANCER
INFORMATION PROGRAM]
S 2. Section 2405 of the public health law, as added by chapter 328 of
the laws of 1989, subdivision 1 as amended by chapter 554 of the laws of
2002 and paragraphs (a) and (d) of subdivision 2 as amended by chapter
515 of the laws of 2003, is amended to read as follows:
S 2405. [Breast cancer] CANCER detection and education program; estab-
lishment. 1. There is hereby created within the department the [breast]
cancer detection and education program, also known as the [healthy women
partnership] CANCER SERVICES PROGRAM. This program is established to
promote screening and detection of [breast] cancer among unserved or
underserved populations, to educate the public regarding [breast] cancer
and the benefits of early detection, and to provide counseling and
referral services. For purposes of this section, "unserved or under-
served populations" shall mean persons having inadequate access and
financial resources to obtain [breast] cancer screening and detection
services, including persons who lack health insurance or whose health
insurance coverage is inadequate or who cannot meet their deductible
obligations for purposes of accessing coverage under their health insur-
ance.
S. 8090 3 A. 11372
2. The program shall include:
(a) establishment of a statewide public education and outreach
campaign to publicize [breast] EVIDENCE BASED cancer detection and
education services, such campaign shall include: general community
education, outreach to specific underserved populations, EVIDENCE BASED
clinical [breast] cancer screening services [and follow-up care, infor-
mation on the extent of coverage for such services by health insurance,
the medical assistance program and other public and private programs],
and an informational summary that shall include an explanation of the
importance of clinical [breast] examinations[, breast-self-examinations
and mammography,] AND what to expect during [a] clinical [breast exam-
ination] EXAMINATIONS and [mammography, and how to perform breast-self-
examinations] CANCER SCREENING SERVICES;
(b) provision of grants to approved organizations under section twen-
ty-four hundred six of this title;
(c) compilation of data concerning the [breast] cancer detection and
education program and dissemination of the data to the public; and
(d) development of professional education programs including the bene-
fits of early detection of [breast] cancer[,] AND clinical [breast]
examinations [and breast-self-examinations], the recommended frequency
of clinical [breast] examinations[, breast-self-examinations,] and
[mammography] CANCER SCREENING SERVICES, and professionally recognized
best practices guidelines.
S 3. Subdivisions 2 and 3 of section 2406 of the public health law are
REPEALED.
S 4. Section 2409 of the public health law, as added by chapter 275 of
the laws of 1995, is REPEALED.
S 5. Subdivisions 2 and 3 of section 95-a of the state finance law, as
added by chapter 275 of the laws of 1995, are amended to read as
follows:
2. Such fund shall consist of all monies appropriated [for the purpose
of] TO such fund and any grant, gift or bequest made to the [breast
cancer detection and education program advisory council] FUND.
3. Monies of the fund shall be available [to the breast cancer
detection and education program advisory council] for the purposes of
the [New York state innovation in breast] cancer [early] detection and
[research awards] EDUCATION program, pursuant to section twenty-four
hundred [nine] FIVE of the public health law.
S 6. Subdivision 3-a of section 2407 of the public health law is
REPEALED.
S 7. Subdivisions 1, 4, 5 and 6 of section 2406 of the public health
law, subdivision 1 as amended by chapter 176 of the laws of 2006, subdi-
vision 4 as amended and subdivision 5 as renumbered by chapter 334 of
the laws of 1990, subdivision 5 as added by chapter 328 of the laws of
1989, and subdivision 6 as added by chapter 323 of the laws of 1995, are
amended to read as follows:
1. The commissioner[, in consultation with the breast cancer detection
and education program advisory council established pursuant to section
twenty-four hundred seven of this title,] shall make grants within the
amounts appropriated to approved organizations[, as defined in subdivi-
sion three of this section,] for the provision of services relating to
the EVIDENCE BASED screening and detection of [breast] cancer as part of
this program. Such services shall include but not be limited to:
(a) promotion and provision of early detection of [breast] cancer,
including [mammography,] clinical [examination, and breast self-examina-
tion] EXAMINATIONS AND CANCER SCREENING SERVICES;
S. 8090 4 A. 11372
(b) provision of counseling and information on treatment options and
referral for appropriate medical treatment;
(c) dissemination of information to unserved and underserved popu-
lations, to the general public and to health care professionals concern-
ing [breast] cancer, the benefits of early detection and treatment, and
the availability of [breast] cancer screening services;
(d) identification of local [breast] cancer screening services within
the approved organization's region;
(e) provision of information, counseling and referral services to
individuals diagnosed with [breast] cancer; and
(f) provision of information regarding the availability of medical
assistance, including medical assistance under paragraph (v) of subdivi-
sion four of section three hundred sixty-six of the social services law,
to an individual who requires treatment for [breast, cervical, colon or
prostate] cancer.
[4.] 2. The commissioner[, in consultation with the breast cancer
detection and education program advisory council,] shall give notice and
provide opportunity [for organizations described in subdivision three of
this section] to submit applications to provide [breast] cancer
detection and education programs. In order to be considered for a grant
to provide [breast] cancer detection and education programs, applicants
must show evidence of the following:
(a) ability to provide and to ensure consistent and quality [breast]
cancer detection services;
(b) expertise in [breast] cancer detection and treatment;
(c) capacity to coordinate services with physicians, hospitals and
other appropriate local institutions or agencies;
(d) ability to provide [breast] cancer detection and education
services to unserved or underserved populations; and
(e) ability to implement a [breast] cancer detection and education
program in accordance with the standards specified in subdivision [five]
THREE of this section.
Applications shall be made on forms provided by the commissioner. [The
breast cancer detection and education program advisory council shall
review and evaluate applications and make recommendations to the commis-
sioner for approval of grants to organizations to provide breast cancer
detection and education programs.]
[5.] 3. The commissioner[, in consultation with the breast cancer
detection and education program advisory council,] shall develop stand-
ards for the implementation of [breast] cancer detection and education
programs by approved organizations which shall ensure the following:
(a) integration of the approved organization with existing health care
providers;
(b) maximizing third party reimbursement;
(c) provision of services to unserved or underserved populations.
[6.] 4. Within the amounts of state or federal funds appropriated for
[cervical] cancer early detection and diagnosis, approved organizations
may be authorized by the department to provide such services for popu-
lations served pursuant to this title. Early detection services shall
include, but not be limited to, complete [pelvic] examinations, [pap
smears,] EVIDENCE BASED SCREENING, patient education, counseling,
follow-up and referral.
S 8. Section 2406-a of the public health law, as added by chapter 623
of the laws of 2007, is amended to read as follows:
S 2406-a. Grants to community-based organizations. 1. The commission-
er[, in consultation with the breast and cervical cancer detection and
S. 8090 5 A. 11372
education program advisory council established pursuant to section twen-
ty-four hundred seven of this title,] shall make grants within any such
amount as may be appropriated specifically for community-based organiza-
tions for the provision of counseling, education and outreach programs
for persons diagnosed with breast cancer.
2. For the purposes of this section, "community-based organizations"
shall mean grass roots, free-standing organizations in which breast
cancer survivors hold significant decision-making responsibility, and
which offer a broad range of breast cancer education and support
services free of charge.
3. The commissioner[, in consultations with the breast and cervical
cancer detection and education program advisory council,] shall provide
notice and opportunity for community-based organizations to submit
applications to provide post-diagnosis breast cancer counseling, educa-
tion and outreach programs. Such applications shall be on forms estab-
lished by the commissioner. [The breast and cervical cancer detection
and education program advisory council shall review and evaluate appli-
cations submitted pursuant to this subdivision and shall make recommen-
dations thereon to the commissioner for approval of grants to communi-
ty-based organizations for the provision of post-diagnosis breast cancer
counseling, education and outreach programs.]
S 9. Intentionally omitted.
S 10. Intentionally omitted.
S 11. Section 2799-f of the public health law, as added by chapter 114
of the laws of 2004, is amended to read as follows:
S 2799-f. Comprehensive care centers for eating disorders; estab-
lished. [1.] The commissioner shall [facilitate the development, and]
provide for the public identification[,] of comprehensive care centers
for persons with eating disorders[. The development and identification
of such centers shall be] for the purposes of:
[(a)] 1. Promoting the [development and] operation of a continuum of
comprehensive, coordinated care for persons with eating disorders;
[(b)] 2. Promoting ready access to information, referral and treatment
services on eating disorders for consumers, health practitioners,
providers and insurers, with access in every region of the state;
[(c)] 3. Promoting community education, prevention and patient entry
into care; and
[(d)] 4. Promoting and coordinating regional and statewide research
efforts into effective methods of education, prevention and treatment,
including research on the various models of care.
[2. In order to identify such comprehensive care centers, the commis-
sioner shall issue a request for applications ("hereinafter referred to
in this section as RFA"). The form and content of such RFA shall be
prepared with input from individuals and organizations who at a minimum
are representative of health care practitioners and providers with
expertise in the care of persons with eating disorders as well as from
persons and families with experience in the diagnosis and treatment of
these disorders. Such RFA shall be issued not later than one hundred
twenty days following the effective date of this article.]
S 12. Paragraph (d) of subdivision 1 of section 2799-g of the public
health law, as added by chapter 114 of the laws of 2004, is amended to
read as follows:
(d) The applicant meets such additional criteria as [is specified in
the RFA] ARE ESTABLISHED BY THE COMMISSIONER.
S 13. Subdivision 2 of section 2799-h of the public health law, as
added by chapter 114 of the laws of 2004, is amended to read as follows:
S. 8090 6 A. 11372
2. The commissioner's [written notice to applicants, which shall be
provided no later than ninety days following the receipt of a satisfac-
tory application, shall identify the applicant as a state-identified]
IDENTIFICATION OF A comprehensive care center for eating disorders under
this article[, provided however that such notice] shall be valid for not
more than a two year period from the date of issuance. The commissioner
may reissue such [written notices] IDENTIFICATIONS for subsequent peri-
ods of up to two years, provided that the comprehensive care center has
notified the commissioner of any material changes in structure or opera-
tion based on its original [RFA submission] APPLICATION, or since its
last written notice by the commissioner, and that the commissioner is
satisfied that the center continues to meet the criteria required pursu-
ant to this article.
S 14. Sections 2799-j and 2799-l of the public health law are
REPEALED.
S 15. Section 95-e of the state finance law, as added by chapter 114
of the laws of 2004, is REPEALED.
S 16. Section 207 of the public health law, as added by chapter 414 of
the laws of 2005, subdivision 1 as amended by chapter 471 of the laws of
2007, paragraph (f) of subdivision 1 as added by chapter 570 of the laws
of 2008 and paragraph (f) of subdivision 1 as added by chapter 573 of
the laws of 2008, is amended to read as follows:
S 207. Health care and wellness education and outreach program. 1.
There is hereby created within the department the health care and well-
ness education and outreach program. The department [shall] MAY conduct
education and outreach programs for consumers, patients, and health care
providers relating to any health care matters the commissioner deems
appropriate and:
(a) Various health conditions, diseases and health care procedures and
treatment options, INCLUDING BUT NOT LIMITED TO THOSE FOR BREAST, CERVI-
CAL, COLORECTAL, PROSTATE, TESTICULAR, SKIN, AND OVARIAN CANCER, SHAKEN
BABY SYNDROME, REFLEX SYMPATHETIC DYSTROPHY SYNDROME AND POST-POLIO
SEQUELAE.
(b) Recommended preventative and wellness practices and services,
including EVIDENCE BASED age and gender appropriate testing and screen-
ing exams and immunization schedules.
(c) Lymphedema, an abnormal swelling of the extremities including the
causes and symptoms of lymphedema, the value of early detection, possi-
ble options for treatment including their benefits and risks, and other
relevant information and the recommendation that hospitals treating
breast cancer patients implement a lymphedema alert program by placing a
bright pink wristband on the patient's affected arm.
(d) The need and importance of organ and tissue donation, including
information about being registered as an organ and tissue donor and
executing documents of gift under article forty-three of this chapter.
(e) The need and importance for consumers and patients to have an
advance directive, particularly a health care proxy, and the need and
importance for health care providers to play a leadership role in
discussing end-of-life care preferences and values with patients and to
provide patients with health care proxy forms.
(f) Uterine fibroids, an abnormal growth that occurs in the uterus,
including the causes and symptoms of uterine fibroids, the value of
early detection, possible options for treatment including their benefits
and risks, information on the elevated risk for minority women and other
relevant information.
S. 8090 7 A. 11372
[(f)] (G) Improving birth outcomes, including the importance of
preconceptional care, early prenatal care, considerations of health
risks during pregnancy, considerations of benefits and risks of labor
and delivery options including, but not limited to, vaginal and cesarean
section delivery, elective or repeat cesarean sections, and appropriate
use of drugs during delivery.
2. Programs under this section, dealing with one or more subjects, may
include but not be limited to any of the following elements:
(a) educational and informational materials in print, audio, visual,
electronic or other media;
(b) public service announcements and advertisements; and
(c) establishment of toll-free telephone hotlines and electronic
services to provide information.
3. The department [shall] MAY produce, make available to others for
reproduction, or contract with others to develop such materials
mentioned in this section as the commissioner deems appropriate. These
materials shall be made available to the public free of charge as appro-
priate or for a fee under certain circumstances. The commissioner may
require where appropriate any health care provider to make these materi-
als available to patients.
4. In exercising any of his or her powers under this section, the
commissioner [shall] MAY consult with appropriate health care profes-
sionals, providers, consumers, and patients or organizations represent-
ing them.
5. The commissioner shall ensure that all information and materials
produced pursuant to this section are maintained and updated to reflect
best practice recommendations.
6. The commissioner may appoint as appropriate advisory councils
relating to various matters that are or are proposed to be the subjects
of programs under this section. All such councils shall include repre-
sentation of health care professionals, providers, consumers, patients
and other appropriate interests. The members of the councils shall
receive no compensation for their services, but shall be allowed their
actual and necessary expenses incurred in performance of their duties.
7. In addition to state funds appropriated for programs under this
section, the commissioner may accept grants from public or private
sources for these programs. The commissioner, in administering this
section, shall seek to coordinate the department's programs with other
public and private programs, and may undertake joint or cooperative
programs with other public or private entities.
8. The commissioner may make rules and regulations necessary and
appropriate for implementation of this section.
S 17. Article 43-C of the public health law is REPEALED.
S 18. Section 2745 of the public health law is REPEALED.
S 19. Paragraph (c) of subdivision 3 of section 242 of the elder law,
as amended by section 4 of part A of chapter 58 of the laws of 2005, is
amended to read as follows:
(c) (1) The fact that some of an individual's prescription drug
expenses are paid or reimbursable under the provisions of the medicare
program shall not disqualify an individual, if he or she is otherwise
eligible, from receiving assistance under this title. In such cases, the
state shall pay the portion of the cost of those prescriptions for qual-
ified drugs for which no payment or reimbursement is made by the medi-
care program or any federally funded prescription drug benefit, less the
participant's co-payment required on the amount not paid by the medicare
program. [In addition, the participant registration fee charged to
S. 8090 8 A. 11372
eligible program participants for comprehensive coverage pursuant to
section two hundred forty-seven of this title shall be waived for the
portion of the annual coverage period that the participant is also
enrolled as a transitional assistance beneficiary in the medicare
prescription drug discount card program, authorized pursuant to title
XVIII of the federal social security act, provided that: (i) any sponsor
of such drug discount card program has signed an agreement to complete
coordination of benefit functions with EPIC, and has been endorsed by
the EPIC panel; or (ii) any exclusive sponsor of such drug discount card
program authorized pursuant to title XVIII of the federal social securi-
ty act that limits the participants to the medicare prescription drug
discount card program sponsored by such exclusive sponsor, shall coordi-
nate benefits available under such discount card program with EPIC.]
(2) COVERAGE UNDER THIS PARAGRAPH SHALL BE AVAILABLE ONLY AFTER THE
PARTICIPANT HAS FIRST EXHAUSTED THE FIRST TWO LEVELS OF APPEAL AVAILABLE
UNDER PART D OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT AND THE
APPEAL HAS BEEN DENIED. DURING THE COVERAGE DETERMINATION AND APPEAL
PERIOD, THE ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PROGRAM SHALL
PROVIDE UP TO A NINETY DAY SUPPLY OF THE PRESCRIBED MEDICATION, OR SUCH
LESSER SUPPLY AS SPECIFIED ON THE PRESCRIPTION, IF: (I) THE PHARMACIST
NOTIFIES THE PRESCRIBER THAT THE PARTICIPANT'S MEDICARE PART D PLAN AND
THE ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PROGRAM HAVE DENIED
PAYMENT FOR THE PRESCRIBED MEDICATION AND THAT IF THE PRESCRIBER DOES
NOT CHOOSE TO CHANGE THE PRESCRIPTION TO A DRUG THAT IS COVERED BY THE
PARTICIPANT'S MEDICARE PART D PLAN, A MEDICARE PART D APPEAL MUST BE
PURSUED; AND (II) THE PRESCRIBER NOTIFIES THE ELDERLY PHARMACEUTICAL
INSURANCE COVERAGE PROGRAM OF THE PRESCRIBER'S INTENT TO PROVIDE NECES-
SARY INFORMATION AND COOPERATION IN THE PURSUIT OF THE MEDICARE PART D
APPEAL. IN INSTANCES WHERE THE PHARMACIST IS UNABLE TO IMMEDIATELY REACH
THE PRESCRIBER, THE ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PROGRAM
SHALL, UPON THE REQUEST OF THE PHARMACIST, AUTHORIZE A THREE DAY EMER-
GENCY SUPPLY OF THE PRESCRIBED MEDICATION. THE ELDERLY PHARMACEUTICAL
INSURANCE COVERAGE PROGRAM SHALL AUTHORIZE SUCH ADDITIONAL NINETY DAY
SUPPLIES OF THE PRESCRIBED MEDICATION, OR SUCH LESSER SUPPLY AS SPECI-
FIED ON THE PRESCRIPTION, AND SUCH ADDITIONAL THREE DAY EMERGENCY
SUPPLIES AS REQUIRED TO ENSURE COVERAGE OF THE PRESCRIBED MEDICATION
DURING THE PENDENCY OF THE MEDICARE PART D APPEAL.
(3) The participant registration fee charged to eligible program
participants for comprehensive coverage pursuant to section two hundred
forty-seven of this title shall be waived for the portion of the annual
coverage period that the participant is also enrolled as a full subsidy
individual in a prescription drug or MA-PD plan under Part D of title
XVIII of the federal social security act.
S 19-a. Subdivision 6 of section 250 of the elder law, as added by
section 31 of part A of chapter 58 of the laws of 2008, is amended to
read as follows:
6. (a) The EPIC program shall be the payor of last resort for individ-
uals qualified in both the EPIC program and title XVIII of the federal
social security act (Medicare). For such individuals, no reimbursement
shall be available under EPIC for covered drug expenses except:
(i) where a prescription drug plan authorized by Part D of the federal
social security act (referred to in this subdivision as a Medicare Part
D plan) has approved coverage and EPIC has an obligation under this
title to pay a portion of the participant's cost-sharing responsibility
under Medicare Part D; or
S. 8090 9 A. 11372
(ii) where the provider pharmacy has certified that[: (1)] a Medicare
Part D plan has denied coverage[, and (2) either, after consultation
with the prescriber, the prescriber has declined to revise the
prescription to a drug that would be covered by the Medicare Part D
plan, or the provider pharmacy has been unable to contact the prescri-
ber].
(b) If the provider pharmacy certifies as set forth in subparagraph
(ii) of paragraph (a) of this subdivision, the EPIC program shall pay
for the drug as the primary payor[. If determined by the EPIC program to
be practical and cost-effective, the program, or its contractor, shall
attempt to obtain Medicare Part D coverage of the drug by initiating a
Medicare Part D appeal. If the initial appeal is denied by the Medicare
Part D plan, the EPIC program shall pursue additional levels of Medicare
Part D appeals when practical and cost-effective] UPON A SHOWING OF
COMPLIANCE WITH THE NOTIFICATION AND APPEAL PROVISIONS OF SUBPARAGRAPH
TWO OF PARAGRAPH (C) OF SUBDIVISION THREE OF SECTION TWO HUNDRED FORTY-
TWO OF THIS TITLE.
S 20. Article 27-I of the public health law is REPEALED.
S 21. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2010; provided
however, that sections nineteen and nineteen-a of this act shall take
effect October 1, 2010.
PART B
Section 1. Notwithstanding paragraph (c) of subdivision 10 of section
2807-c of the public health law, subdivision 2-b of section 2808 of the
public health law, section 21 of chapter 1 of the laws of 1999, and any
other contrary provision of law, in determining rates of payments by
state governmental agencies effective for services provided on and after
April 1, 2010, for inpatient and outpatient services provided by general
hospitals, for inpatient services and adult day health care outpatient
services provided by residential health care facilities pursuant to
article 28 of the public health law, except for residential health care
facilities that provide extensive nursing, medical, psychological and
counseling support services to children, for home health care services
provided pursuant to article 36 of the public health law by certified
home health agencies, long term home health care programs and AIDS home
care programs, and for personal care services provided pursuant to
section 365-a of the social services law, the commissioner of health
shall apply zero trend factor projections attributable to the 2010
calendar year in accordance with paragraph (c) of subdivision 10 of
section 2807-c of the public health law, provided, however, that such
zero trend factor projections for such 2010 calendar year shall also be
applied to rates of payment for personal care services provided in those
local social services districts, including New York city, whose rates of
payment for such services are established by such local social services
districts pursuant to a rate-setting exemption issued by the commission-
er of health to such local social services districts in accordance with
applicable regulations, and provided further, however, that for rates of
payment for assisted living program services provided on and after April
1, 2010, trend factor projections attributable to the 2010 calendar year
shall be established at zero percent.
S 2. Subparagraph (v) of paragraph (b) of subdivision 35 of section
2807-c of the public health law, as added by section 2 of part C of
chapter 58 of the laws of 2009, is amended to read as follows:
S. 8090 10 A. 11372
(v) Such regulations [may] SHALL incorporate quality related measures
pertaining to potentially preventable complications and re-admissions
(PPRS) AND PROVIDE FOR RATE ADJUSTMENTS OR PAYMENT DISALLOWANCES RELATED
TO PPRS, WHICH SHALL BE CALCULATED IN ACCORDANCE WITH METHODOLOGIES AS
DETERMINED BY THE COMMISSIONER, PROVIDED, HOWEVER, THAT SUCH METHODOL-
OGIES SHALL BE BASED ON A RISK ADJUSTED COMPARISON OF THE ACTUAL AND THE
EXPECTED NUMBER OF PPRS IN A GIVEN HOSPITAL AND WITH BENCHMARKS ESTAB-
LISHED BY THE COMMISSIONER AND PROVIDED FURTHER THAT SUCH RATE ADJUST-
MENTS OR PAYMENT DISALLOWANCES SHALL RESULT IN AN AGGREGATE REDUCTION IN
MEDICAID PAYMENTS OF NO LESS THAN THIRTY-FIVE MILLION DOLLARS FOR THE
PERIOD JULY FIRST, TWO THOUSAND TEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND ELEVEN AND NO LESS THAN FORTY-SEVEN MILLION DOLLARS FOR THE
PERIOD APRIL FIRST, TWO THOUSAND ELEVEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWELVE; AND PROVIDED FURTHER THAT THE REGULATIONS PROMULGATED
PURSUANT TO THIS SUBPARAGRAPH SHALL BE EFFECTIVE ON AND AFTER JULY
FIRST, TWO THOUSAND TEN, AND PROVIDED FURTHER, HOWEVER, THAT FOR THE
PERIOD JULY FIRST, TWO THOUSAND TEN THROUGH MARCH THIRTY-FIRST, TWO
THOUSAND TWELVE, SUCH RATE ADJUSTMENTS OR PAYMENT DISALLOWANCES SHALL
NOT APPLY TO BEHAVIORAL HEALTH PPRS; OR TO READMISSIONS THAT OCCUR ON OR
AFTER FIFTEEN DAYS FOLLOWING AN INITIAL ADMISSION. BY NO LATER THAN
APRIL FIRST, TWO THOUSAND ELEVEN THE COMMISSIONER SHALL ENTER INTO
CONSULTATIONS WITH REPRESENTATIVES OF THE HEALTH CARE FACILITIES SUBJECT
TO THIS SECTION REGARDING POTENTIAL PROSPECTIVE REVISIONS TO APPLICABLE
METHODOLOGIES AND BENCHMARKS SET FORTH IN REGULATIONS ISSUED PURSUANT TO
THIS SUBPARAGRAPH;
S 3. Section 2807-k of the public health law is amended by adding a
new subdivision 5-c to read as follows:
5-C. (A) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND SUBJECT TO
THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, FOR THE PERIOD
JULY FIRST, TWO THOUSAND TEN THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND
TEN, DISTRIBUTIONS PURSUANT TO THIS SECTION AND SECTION TWENTY-EIGHT
HUNDRED SEVEN-W OF THIS ARTICLE, SHALL REFLECT AN AGGREGATE REDUCTION OF
SIXTY-NINE MILLION FOUR HUNDRED THOUSAND DOLLARS, BASED ON THE PROPOR-
TION OF EACH HOSPITAL'S INDIGENT CARE ALLOCATIONS TO THE TOTAL ALLO-
CATIONS OF ALL HOSPITALS' INDIGENT CARE ALLOCATIONS PRIOR TO APPLICATION
OF THIS REDUCTION, PROVIDED, HOWEVER, THAT SUCH REDUCTIONS SHALL NOT BE
APPLIED TO DISTRIBUTIONS TO MAJOR PUBLIC HOSPITALS, INCLUDING MAJOR
PUBLIC HOSPITALS OPERATED BY PUBLIC BENEFIT CORPORATIONS, AND ALSO SHALL
NOT BE APPLIED TO DISTRIBUTIONS MADE PURSUANT TO SUBPARAGRAPH (II),
(III) OR (IV) OF PARAGRAPH (B) OF SUBDIVISION FIVE-B OF THIS SECTION.
(B) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND SUBJECT TO THE
AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, FOR THE PERIOD JANUARY
FIRST, TWO THOUSAND ELEVEN THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND
ELEVEN AND EACH CALENDAR YEAR THEREAFTER, DISTRIBUTIONS PURSUANT TO THIS
SECTION AND SECTION TWENTY-EIGHT HUNDRED SEVEN-W OF THIS ARTICLE SHALL
REFLECT AN AGGREGATE REDUCTION OF SEVENTY-THREE MILLION TWO HUNDRED
THOUSAND DOLLARS, BASED ON THE PROPORTION OF EACH HOSPITAL'S INDIGENT
CARE ALLOCATION TO THE TOTAL ALLOCATIONS OF ALL HOSPITALS' INDIGENT CARE
ALLOCATIONS PRIOR TO APPLICATION OF THIS REDUCTION, PROVIDED, HOWEVER,
THAT SUCH REDUCTIONS SHALL NOT BE APPLIED TO DISTRIBUTIONS TO MAJOR
PUBLIC HOSPITALS, INCLUDING MAJOR PUBLIC HOSPITALS OPERATED BY PUBLIC
BENEFIT CORPORATIONS, AND SHALL ALSO NOT BE APPLIED TO DISTRIBUTIONS
MADE PURSUANT TO SUBPARAGRAPH (II), (III) OR (IV) OF PARAGRAPH (B) OF
SUBDIVISION FIVE-B OF THIS SECTION.
S 3-a. Subdivision 35 of section 2807-c of the public health law is
amended by adding a new paragraph (i) to read as follows:
S. 8090 11 A. 11372
(I) (I) 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 JULY FIRST, TWO
THOUSAND TEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND ELEVEN, AND EACH
STATE FISCAL YEAR PERIOD THEREAFTER, THE COMMISSIONER SHALL MAKE ADDI-
TIONAL 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 AND THREE HUNDRED FOURTEEN
MILLION DOLLARS FOR EACH STATE FISCAL YEAR THEREAFTER, TO GENERAL HOSPI-
TALS, OTHER THAN MAJOR PUBLIC GENERAL HOSPITALS, PROVIDING EMERGENCY
ROOM SERVICES AND INCLUDING SAFETY 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-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. 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 FEDERAL FINANCIAL PARTICIPATION UNDER TITLE XIX OF
THE FEDERAL SOCIAL SECURITY ACT AND IN ACCORDANCE WITH THE FOLLOWING:
(A) THIRTY PERCENT OF SUCH PAYMENTS SHALL BE ALLOCATED TO SAFETY NET
HOSPITALS BASED ON EACH ELIGIBLE HOSPITAL'S PROPORTIONATE SHARE OF ALL
ELIGIBLE SAFETY NET HOSPITALS' MEDICAID DISCHARGES FOR INPATIENT HOSPI-
TAL SERVICES, INCLUDING BOTH MEDICAID FEE-FOR-SERVICE AND MANAGED CARE
DISCHARGES FOR ACUTE AND EXEMPT SERVICES, 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;
(B) SEVENTY PERCENT OF SUCH PAYMENTS SHALL BE ALLOCATED TO ELIGIBLE
GENERAL HOSPITALS BASED ON EACH SUCH HOSPITAL'S PROPORTIONATE SHARE OF
ALL ELIGIBLE HOSPITALS' MEDICAID DISCHARGES FOR INPATIENT HOSPITAL
SERVICES, INCLUDING BOTH MEDICAID FEE-FOR-SERVICE AND MANAGED CARE
DISCHARGES FOR ACUTE AND EXEMPT SERVICES, 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;
(C) NO ELIGIBLE GENERAL HOSPITAL'S ANNUAL PAYMENT AMOUNT PURSUANT TO
THIS PARAGRAPH 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 THIS ARTICLE; 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 PURSUANT TO CLAUSES (A) AND (B)
OF THIS SUBPARAGRAPH 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 CLAUSES (A)
AND (B) OF THIS SUBPARAGRAPH TO THE TOTAL OF ALL PAYMENT AMOUNTS FOR
SUCH ELIGIBLE HOSPITALS;
S. 8090 12 A. 11372
(D) SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION,
THE PAYMENT METHODOLOGY SET FORTH IN THIS SUBPARAGRAPH MAY BE FURTHER
REVISED BY THE COMMISSIONER ON AN ANNUAL BASIS PURSUANT TO REGULATIONS
ISSUED PURSUANT TO THIS SUBDIVISION FOR PERIODS ON AND AFTER APRIL
FIRST, TWO THOUSAND ELEVEN; AND
(E) SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION AND
IN CONFORMANCE WITH ALL APPLICABLE FEDERAL STATUTES AND REGULATIONS,
SUCH PAYMENTS SHALL BE MADE AS UPPER PAYMENT LIMIT PAYMENTS AND,
FURTHER, SUCH PAYMENTS SHALL BE MADE AS AGGREGATE MONTHLY PAYMENTS TO
ELIGIBLE GENERAL HOSPITALS AND PROVIDED FURTHER, HOWEVER, THAT PAYMENTS
MADE PURSUANT TO THIS PARAGRAPH SHALL NOT BE AVAILABLE FOR PERIODS AFTER
THE LAST DAY OF THE CALENDAR YEAR DURING WHICH ENHANCED FEDERAL MEDICAID
ASSISTANCE PERCENTAGES (FMAP) PAYMENTS TO GENERAL HOSPITALS IN THE STATE
OF NEW YORK PURSUANT TO SECTION FIVE THOUSAND ONE OF THE FEDERAL AMERI-
CAN RECOVERY AND REINVESTMENT ACT OF 2009, OR PURSUANT TO AN OTHERWISE
APPLICABLE FEDERAL LAW, CEASE TO BE AVAILABLE, PROVIDED, HOWEVER, THAT
THE DEPARTMENT WILL IN CONJUNCTION WITH HOSPITAL REPRESENTATIVES REVIEW
THE IMPACT ASSOCIATED WITH THE EXPIRATION OF SUCH FUNDING AVAILABILITY
NO LATER THAN SIXTY DAYS PRIOR TO SUCH EXPIRATION.
(II) IN THE EVENT THAT THE COMMISSIONER DETERMINES THAT FEDERAL
FINANCIAL PARTICIPATION WILL NOT BE AVAILABLE FOR AGGREGATE PAYMENTS
MADE IN ACCORDANCE WITH CLAUSE (E) OF SUBPARAGRAPH (I) OF THIS PARA-
GRAPH, PAYMENTS PURSUANT TO THIS PARAGRAPH SHALL BE INCLUDED AS RATE
ADD-ONS TO MEDICAL ASSISTANCE INPATIENT RATES OF PAYMENT ESTABLISHED
PURSUANT TO THIS SUBDIVISION 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,
PROVIDED, HOWEVER, THAT IF SUCH PAYMENTS ARE MADE AS RATE ADD-ONS, THE
COMMISSIONER SHALL ESTABLISH A PROCEDURE TO RECONCILE PAYMENT AMOUNTS TO
REFLECT CHANGES IN MEDICAL ASSISTANCE UTILIZATION FROM THE PERIOD TWO
YEARS PRIOR TO THE RATE YEAR AND THE ACTUAL RATE YEAR BASED ON DATA AS
REPORTED ON EACH HOSPITAL'S ANNUAL INSTITUTIONAL COST REPORT FOR THE
RESPECTIVE RATE YEAR, AS SUBMITTED TO THE DEPARTMENT AS OF OCTOBER FIRST
OF THE YEAR FOLLOWING THE RATE YEAR.
(III) NOTWITHSTANDING ANY OTHER LAW, RULE OR REGULATION TO THE CONTRA-
RY, PROJECTIONS OF EACH GENERAL HOSPITAL'S DISPROPORTIONATE SHARE LIMI-
TATIONS AS COMPUTED BY THE COMMISSIONER PURSUANT TO APPLICABLE REGU-
LATIONS SHALL BE ADJUSTED TO REFLECT ANY ADDITIONAL REVENUE RECEIVED OR
ANTICIPATED TO BE RECEIVED BY EACH SUCH GENERAL HOSPITAL PURSUANT TO
THIS PARAGRAPH.
S 3-b. Section 2807-k of the public health law is amended by adding a
new subdivision 17 to read as follows:
17. INDIGENT CARE REDUCTIONS. FOR EACH HOSPITAL RECEIVING PAYMENTS
PURSUANT TO PARAGRAPH (I) OF SUBDIVISION THIRTY-FIVE OF SECTION TWENTY-
EIGHT HUNDRED SEVEN-C OF THIS ARTICLE, THE COMMISSIONER SHALL REDUCE THE
SUM OF ANY AMOUNTS PAID PURSUANT TO THIS SECTION AND PURSUANT TO
SECTION TWENTY-EIGHT HUNDRED SEVEN-W OF THIS ARTICLE, AS COMPUTED BASED
ON PROJECTED FACILITY SPECIFIC DISPROPORTIONATE SHARE HOSPITAL CEILINGS,
BY AN AMOUNT EQUAL TO THE LOWER OF SUCH SUM OR EACH SUCH HOSPITAL'S
PAYMENTS PURSUANT TO PARAGRAPH (I) OF SUBDIVISION THIRTY-FIVE OF SECTION
TWENTY-EIGHT HUNDRED SEVEN-C OF THIS ARTICLE, PROVIDED, HOWEVER, THAT
ANY ADDITIONAL AGGREGATE REDUCTIONS ENACTED IN A CHAPTER OF THE LAWS OF
TWO THOUSAND TEN TO THE AGGREGATE AMOUNTS PAYABLE PURSUANT TO THIS
SECTION AND PURSUANT TO SECTION TWENTY-EIGHT HUNDRED SEVEN-W OF THIS
ARTICLE SHALL BE APPLIED SUBSEQUENT TO THE ADJUSTMENTS OTHERWISE
PROVIDED FOR IN THIS SUBDIVISION.
S. 8090 13 A. 11372
S 3-c. Section 2807-w of the public health law is amended by adding a
new subdivision 5 to read as follows:
5. FOR EACH HOSPITAL RECEIVING PAYMENTS PURSUANT TO PARAGRAPH (I) OF
SUBDIVISION THIRTY-FIVE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-C OF THIS
ARTICLE, THE COMMISSIONER SHALL REDUCE THE SUM OF ANY AMOUNTS PAID
PURSUANT TO THIS SECTION AND PURSUANT TO SECTION TWENTY-EIGHT HUNDRED
SEVEN-K OF THIS ARTICLE, AS COMPUTED BASED ON PROJECTED FACILITY
SPECIFIC DISPROPORTIONATE SHARE HOSPITAL CEILINGS, BY AN AMOUNT EQUAL
TO THE LOWER OF SUCH SUM OR EACH SUCH HOSPITAL'S PAYMENTS PURSUANT TO
PARAGRAPH (I) OF SUBDIVISION THIRTY-FIVE OF SECTION TWENTY-EIGHT HUNDRED
SEVEN-C OF THIS ARTICLE, PROVIDED, HOWEVER, THAT ANY ADDITIONAL AGGRE-
GATE REDUCTIONS ENACTED IN A CHAPTER OF THE LAWS OF TWO THOUSAND TEN TO
THE AGGREGATE AMOUNTS PAYABLE PURSUANT TO THIS SECTION AND PURSUANT TO
SECTION TWENTY-EIGHT HUNDRED SEVEN-K OF THIS ARTICLE SHALL BE APPLIED
SUBSEQUENT TO THE ADJUSTMENTS OTHERWISE PROVIDED FOR IN THIS SUBDIVI-
SION.
S 3-d. Paragraph (d) of subdivision 18 of section 2807-c of the public
health law, as amended by section 12 of part A of chapter 58 of the laws
of 2007, is amended to read as follows:
(d) Gross revenue received shall mean all moneys received for or on
account of inpatient hospital service, provided, however, that subject
to the provisions of paragraph (e) of this subdivision gross revenue
received shall not include distributions from bad debt and charity care
regional pools, health care services pools, bad debt and charity care
for financially distressed hospitals statewide pools and bad debt and
charity care and capital statewide pools created in accordance with this
section or distributions from funds allocated in accordance with section
twenty-eight hundred seven-l, twenty-eight hundred seven-k, twenty-eight
hundred seven-v or twenty-eight hundred seven-w of this article and
shall not include the components of rates of payment or charges related
to the allowances provided in accordance with subdivisions fourteen,
fourteen-b and fourteen-c of this section, the adjustment provided in
accordance with subdivision fourteen-a of this section, the adjustment
provided in accordance with subdivision fourteen-d of this section, the
adjustment for health maintenance organization reimbursement rates
provided in accordance with former subdivision two-a of this section,
PAYMENTS MADE PURSUANT TO PARAGRAPH (I) OF SUBDIVISION THIRTY-FIVE OF
THIS SECTION or, if effective, the adjustment provided in accordance
with subdivision fifteen of this section, the adjustment provided in
accordance with section eighteen of chapter two hundred sixty-six of the
laws of nineteen hundred eighty-six as amended, revenue received from
physician practice or faculty practice plan discrete billings for
private practicing physician services, revenue from affiliation agree-
ments or contracts with public hospitals for the delivery of health care
services at such public hospitals, revenue received as disproportionate
share hospital payments in accordance with title nineteen of the federal
social security act, or revenue from government deficit financing,
provided, however, that funds received as medical assistance payments
which include state share amounts authorized pursuant to section twen-
ty-eight hundred seven-v of this article that are not disproportionate
share hospital payments shall be included within the meaning of gross
revenue for purposes of this subdivision.
S 3-e. Paragraph (a) of subdivision 3 of section 2807-d of the public
health law, as amended by section 13 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
S. 8090 14 A. 11372
(a) for general hospitals, all monies received for or on account of
inpatient hospital service, outpatient service, emergency service,
referred ambulatory service and ambulatory surgical service, or other
hospital or health-related services, excluding, subject to the
provisions of subdivision twelve of this section: distributions from bad
debt and charity care regional pools, primary health care services
regional pools, bad debt and charity care for financially distressed
hospitals statewide pools and bad debt and charity care and capital
statewide pools created in accordance with section twenty-eight hundred
seven-c of this article and the components of rates of payment or charg-
es related to the allowances provided in accordance with subdivisions
fourteen, fourteen-b and fourteen-c, the adjustment provided in accord-
ance with subdivision fourteen-a, the adjustment provided in accordance
with subdivision fourteen-d, the adjustment for health maintenance
organization reimbursement rates provided in accordance with section
twenty-eight hundred seven-f of this article, the adjustment for commer-
cial insurer reimbursement rates provided in accordance with paragraph
(i) of subdivision eleven of section twenty-eight hundred seven-c of
this article or, if effective, the adjustment provided in accordance
with subdivision fifteen of section twenty-eight hundred seven-c of this
article or the adjustment provided in accordance with section eighteen
of chapter two hundred sixty-six of the laws of nineteen hundred eight-
y-six as amended and physician practice or faculty practice plan revenue
received by a general hospital based on discrete billings for private
practicing physician services, revenue received by a general hospital
from a public hospital pursuant to an affiliation agreement contract for
the delivery of health care services to such public hospital, REVENUE
RECEIVED PURSUANT TO PARAGRAPH (I) OF SUBDIVISION THIRTY-FIVE OF SECTION
TWENTY-EIGHT HUNDRED SEVEN-C OF THIS ARTICLE, revenue received pursuant
to section twenty-eight hundred seven-w of this article, all revenue
received as disproportionate share hospital payments, in accordance with
title nineteen of the federal Social Security Act, revenue received
pursuant to sections eleven, twelve, thirteen and fourteen of part A of
chapter one of the laws of two thousand two, revenue received pursuant
to sections thirteen and fourteen of part B of chapter one of the laws
of two thousand two, revenue from patient personal fund allowances,
revenue from income earned on patient funds, investment income from
externally restricted funds, revenue from investment sinking funds,
revenue from investment operating escrow accounts, investment income
from funded depreciation, investment income from mortgage repayment
escrow accounts, revenue derived from the operation of schools leading
to licensure, and revenue from the collection of sales and excise taxes;
S 4. The opening paragraph and subparagraph (i) of paragraph (b) of
subdivision 5-a of section 2807-m of the public health law, the opening
paragraph as amended by section 98 of part C of chapter 58 of the laws
of 2009, and subparagraph (i) as added by section 75-c of part C of
chapter 58 of the laws of 2008, are amended and subparagraph (ii) of
paragraph (b) of subdivision 5-a is renumbered subdivision 5-b and
amended to read as follows:
Empire clinical research investigator program (ECRIP) [and other grad-
uate medical education reforms. Thirty]. NINE million [four] ONE hundred
TWENTY thousand dollars annually for the period January first, two thou-
sand nine through December thirty-first, two thousand ten, and [seven]
TWO million [six] TWO hundred EIGHTY thousand dollars for the period
January first, two thousand eleven through March thirty-first, two thou-
sand eleven, shall be set aside and reserved by the commissioner from
S. 8090 15 A. 11372
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:
[(i)] 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 consor-
tia and teaching general hospitals in accordance with clause (G) of this
subparagraph. Such distributions shall be made in accordance with the
following 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 thirty percent of the funding available pursuant to
this paragraph, or an amount equal to the sum of one clinical research
position per teaching general hospital in the region, whichever is
greater, 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 thirty percent of the regional pool, or an amount equal to the
sum of one clinical research position per teaching general hospital in
the region, whichever is greater. No clinical research positions that
continue from and were funded in prior distribution periods shall be
eliminated by such reduction.
(D) Each consortium or teaching general hospital shall receive fifty
percent of its annual distribution amount calculated pursuant to this
subparagraph once the requirements set forth in clause (G) of this
subparagraph have been met. The remaining distribution amount shall be
disbursed subsequent to the submission of information required pursuant
to clause (G) of this subparagraph.
(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.
S. 8090 16 A. 11372
(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 six months after the clinical research
position has commenced and every six months thereafter for a full-time
position and for a half-time position, one year after the clinical
research position has commenced and every year thereafter;
(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
(V) Any other data or information required by the commissioner to
implement this subparagraph.
[(ii)] 5-B. OTHER GRADUATE MEDICAL EDUCATION REFORMS. Any funds
[remaining after distributions in accordance with subparagraph (i)]
SPECIFICALLY APPROPRIATED FOR THE PURPOSES of this [paragraph] SUBDIVI-
SION shall be used to fund innovative graduate medical education reforms
to be determined by the commissioner in consultation with the council,
including, but not limited to, [(A)] (A) development of primary care
residency and specialty position training tracks for graduates to serve
rural or inner-city communities, [(B)] (B) development of regional pilot
network programs to affiliate major academic centers with community
teaching general hospitals, [(C)] (C) support for faculty development
programs, including designating faculty to mentor students and residents
in primary care, [(D)] (D) support training in fields which serve the
geriatric population; [(E)] (E) increase training in cultural compe-
tence, [(F)] (F) promote training of physicians who will serve persons
with developmental disabilities, and [(G)] (G) any other reforms neces-
sary to improve patient care management, interdisciplinary training, or
S. 8090 17 A. 11372
quality in graduate medical education programs. Such funding shall be
distributed to consortia and teaching general hospitals in each region
on a competitive basis pursuant to a request for proposal process.
S 5. Subdivision 8 of section 272 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:
8. The commissioner shall provide notice of any recommendations devel-
oped by the committee regarding the preferred drug program, at least
[thirty] FIVE days before any final determination by the commissioner,
by making such information available on the department's website. Such
public notice shall include: a summary of the deliberations of the
committee; a summary of the positions of those making public comments at
meetings of the committee; the response of the committee to those
comments, if any; and the findings and recommendations of the committee.
S 6. Intentionally Omitted.
S 7. Intentionally Omitted.
S 8. Intentionally Omitted.
S 9. Subparagraphs (vii) and (viii) of paragraph (uu) of subdivision 1
of section 2807-v of the public health law, as amended by section 120 of
part C of chapter 58 of the laws of 2009, are amended to read as
follows:
(vii) [seven] ONE million [five] EIGHT hundred SEVENTY-FIVE thousand
dollars for the period January first, two thousand ten through [Decem-
ber] MARCH thirty-first, two thousand ten shall be available for disease
management demonstration programs[; and
(viii) one million eight hundred seventy-five thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven shall be available for disease management demon-
stration programs].
S 10. Paragraph (jj) of subdivision 1 of section 2807-v of the public
health law, as amended by section 5 of part B of chapter 58 of the laws
of 2008, is amended to read as follows:
(jj) Funds shall be reserved and accumulated from year to year and
shall be available, including income from invested funds, for the
purposes of a grant program to improve access to infertility services,
treatments and procedures, from the tobacco control and insurance initi-
atives pool established for the period January first, two thousand two
through December thirty-first, two thousand two in the amount of nine
million one hundred seventy-five thousand dollars, for the period April
first, two thousand six through March thirty-first, two thousand seven
in the amount of five million dollars, for the period April first, two
thousand seven through March thirty-first, two thousand eight in the
amount of five million dollars, for the period April first, two thousand
eight through March thirty-first, two thousand nine in the amount of
five million dollars, AND for the period April first, two thousand nine
through March thirty-first, two thousand ten in the amount of five
million dollars, and for the period April first, two thousand ten
through March thirty-first, two thousand eleven in the amount of [five]
TWO million TWO HUNDRED THOUSAND dollars.
S 11. Subparagraphs (vii) and (viii) of paragraph (qq) of subdivision
1 of section 2807-v of the public health law, as amended by section 5 of
part B of chapter 58 of the laws of 2008, are amended to read as
follows:
(vii) up to [five million] FOUR HUNDRED EIGHTY-EIGHT THOUSAND dollars
for the period January first, two thousand ten through [December] MARCH
thirty-first, two thousand ten; of such funds [one million nine] FOUR
S. 8090 18 A. 11372
hundred [fifty] EIGHTY-EIGHT thousand dollars shall be made available to
the department for the purpose of developing, implementing and adminis-
tering the long-term care insurance education and outreach program [and
three million fifty thousand dollars shall be made available to the
office for the aging for the purpose of providing the long-term care
insurance resource centers with the necessary resources to carry out
their operations; and
(viii) up to one million two hundred fifty thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven; of such funds four hundred eighty-seven thousand
five hundred dollars shall be made available to the department for the
purpose of developing, implementing and administering the long-term care
insurance education and outreach program and seven hundred sixty-two
thousand five hundred dollars shall be made available to the office for
the aging for the purpose of providing the long-term care insurance
resource centers with the necessary resources to carry out their oper-
ations].
S 12. Subparagraphs (xi) and (xii) of paragraph (j) of subdivision 1
of section 2807-v of the public health law, as amended by section 5 of
part B of chapter 58 of the laws of 2008, are amended to read as
follows:
(xi) up to [ninety-four] EIGHTY-SEVEN million [one] SEVEN hundred
[fifty] SEVENTY-FIVE thousand dollars for the period January first, two
thousand ten through December thirty-first, two thousand ten; and
(xii) up to [twenty-three] TWENTY-ONE million [five] FOUR hundred
[thirty-seven] TWELVE thousand dollars for the period January first, two
thousand eleven through March thirty-first, two thousand eleven.
S 13. Subparagraph (iv) of paragraph (c) of subdivision 1 of section
2807-l of the public health law, as amended by section 4 of part B of
chapter 58 of the laws of 2008, is amended to read as follows:
(iv) distributions by the commissioner related to poison control
centers pursuant to subdivision seven of section twenty-five hundred-d
of this chapter, up to five million dollars for the period January
first, nineteen hundred ninety-seven through December thirty-first,
nineteen hundred ninety-seven, up to three million dollars on an annual-
ized basis for the periods during the period January first, nineteen
hundred ninety-eight through December thirty-first, nineteen hundred
ninety-nine, up to five million dollars annually for the periods January
first, two thousand through December thirty-first, two thousand two, up
to four million six hundred thousand dollars annually for the periods
January first, two thousand three through December thirty-first, two
thousand four, up to five million one hundred thousand dollars for the
period January first, two thousand five through December thirty-first,
two thousand six annually, up to five million one hundred thousand
dollars annually for the period January first, two thousand seven
through December thirty-first, two thousand [ten,] NINE, UP TO THREE
MILLION SIX HUNDRED THOUSAND DOLLARS FOR THE PERIOD JANUARY FIRST, TWO
THOUSAND TEN THROUGH DECEMBER THIRTY-FIRST, TWO THOUSAND TEN, and up to
[one million two] SEVEN hundred seventy-five thousand dollars for the
period January first, two thousand eleven through March thirty-first,
two thousand eleven; and
S 14. Section 365-a of the social services law is amended by adding a
new subdivision 9 to read as follows:
9. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, ANY UTILIZA-
TION CONTROLS ON OCCUPATIONAL THERAPY OR PHYSICAL THERAPY, INCLUDING BUT
NOT LIMITED TO, PRIOR APPROVAL OF SERVICES, UTILIZATION THRESHOLDS OR
S. 8090 19 A. 11372
OTHER LIMITATIONS IMPOSED ON SUCH THERAPY SERVICES IN RELATION TO A
CHRONIC CONDITION IN CLINICS CERTIFIED UNDER ARTICLE TWENTY-EIGHT OF THE
PUBLIC HEALTH LAW OR ARTICLE SIXTEEN OF THE MENTAL HYGIENE LAW SHALL BE:
(I) DEVELOPED BY THE DEPARTMENT OF HEALTH IN CONCURRENCE WITH THE OFFICE
OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES; AND (II) IN ACCORD
WITH NATIONALLY RECOGNIZED PROFESSIONAL STANDARDS. IN THE EVENT THAT
NATIONALLY RECOGNIZED PROFESSIONAL STANDARDS DO NOT EXIST, SUCH THRESH-
OLDS SHALL BE BASED UPON THE REASONABLY RECOGNIZED PROFESSIONAL STAND-
ARDS OF THOSE WITH A SPECIFIC EXPERTISE IN TREATING INDIVIDUALS SERVED
BY CLINICS CERTIFIED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW
OR ARTICLE SIXTEEN OF THE MENTAL HYGIENE LAW.
(B) PRIOR APPROVAL BY THE DEPARTMENT OF HEALTH OF A PHYSICAL THERAPY
EVALUATION OR AN OCCUPATIONAL THERAPY EVALUATION BY A QUALIFIED PRACTI-
TIONER PRACTICING WITHIN THE SCOPE OF SUCH PRACTITIONER'S LICENSURE
SHALL NOT BE REQUIRED. THE DEPARTMENT MAY REQUIRE PRIOR APPROVAL FOR
TREATMENT AS RECOMMENDED BY SUCH AN EVALUATION. IN THE EVENT THAT PRIOR
APPROVAL IS REQUIRED, AND THE DEPARTMENT FAILS TO MAKE A DETERMINATION
WITHIN EIGHT DAYS OF PRESENTATION OF A TREATMENT REQUEST FOR PHYSICAL OR
OCCUPATIONAL THERAPY SERVICES, THE DEPARTMENT SHALL AUTOMATICALLY
APPROVE FOUR THERAPY VISITS. IN THE CASE OF ANY DENIAL OF A PRIOR
APPROVAL REQUEST FOR PHYSICAL THERAPY OR OCCUPATIONAL THERAPY, THE
DEPARTMENT SHALL PROVIDE A REASONABLE OPPORTUNITY FOR THE QUALIFIED
PRACTITIONER TO PROVIDE HIS OR HER ASSESSMENT OF THE BENEFICIARY'S PHYS-
ICAL AND FUNCTIONAL STATUS AS DOCUMENTED IN A TREATMENT PLAN WITH
REASONABLE AND OBTAINABLE GOALS. IF, UPON COMPLETION OF SUCH FOUR THER-
APY VISITS, THE DEPARTMENT HAS NOT YET RENDERED A DETERMINATION ON THE
REQUEST FOR PHYSICAL OR OCCUPATIONAL THERAPY SERVICES, THE DEPARTMENT
SHALL AUTOMATICALLY APPROVE AN ADDITIONAL FOUR THERAPY VISITS. SUBSE-
QUENT AUTOMATIC APPROVALS SHALL BE ISSUED IN THE SAME MANNER UNTIL SUCH
TIME AS THE DEPARTMENT ISSUES A DETERMINATION, BUT IN NO EVENT SHALL
SUCH APPROVALS EXCEED THE NUMBER OF SERVICES OR THE PERIOD OF TIME
RECOMMENDED BY THE EVALUATION. IF THE QUALIFIED PRACTITIONER PROVIDES
DOCUMENTATION THAT IS IN ACCORD WITH REASONABLY RECOGNIZED PROFESSIONAL
STANDARDS, THE RECOMMENDED TREATMENT PLAN SHALL BE FINAL, AND THE PRIOR
APPROVAL REQUEST SHALL BE APPROVED.
S 15. Paragraph (d) of subdivision 1 of section 453 of the general
business law, as amended by chapter 557 of the laws of 2001, is amended
to read as follows:
(d) Moneys paid for such an agreement for an applicant or recipient of
supplemental security income benefits under section two hundred nine of
the social services law or of medical assistance under section three
hundred sixty-six of such law, OR MONEYS PAID BY SUCH AN APPLICANT OR
RECIPIENT FOR SUCH AN AGREEMENT FOR HIS OR HER FAMILY MEMBER, shall be
placed into a trust which shall be irrevocable but under which such
applicant/recipient reserves the right to select any funeral firm,
funeral director, undertaker, cemetery or any other person, firm or
corporation to whom such payment is made and to change such selection
any time to any type of funeral or any funeral firm, funeral director,
cemetery or any other person, firm or corporation to whom such payment
is made, located in the state of New York or any other state. Any such
change must be carried out within ten business days following receipt of
a request by the purchaser to the funeral firm, funeral director, ceme-
tery or any other person, firm or corporation to whom such payment is
made, with which such trust was established. This requirement is subject
to any limits set forth in federal law or regulation pertaining to
disregarded resources or income.
S. 8090 20 A. 11372
S 16. Paragraph (f) of subdivision 3 of section 453 of the general
business law, as added by chapter 660 of the laws of 1996, is amended to
read as follows:
(f) With respect to an agreement for an irrevocable trust fund pursu-
ant to section two hundred nine of the social services law OR PARAGRAPH
(D) OF SUBDIVISION ONE OF THIS SECTION, include the following statement
in the agreement in conspicuous print of at least twelve point type:
DISCLOSURE
NEW YORK LAW REQUIRES THIS AGREEMENT TO BE IRREVOCABLE FOR APPLICANTS
FOR [RECEIPT] AND RECIPIENTS OF SUPPLEMENTAL SECURITY BENEFITS UNDER
SECTION TWO HUNDRED NINE OF THE SOCIAL SERVICES LAW OR OF MEDICAL
ASSISTANCE UNDER SECTION THREE HUNDRED SIXTY-SIX OF THE SOCIAL SERVICES
LAW, AND FOR THE MONEYS PUT INTO A TRUST UNDER THIS AGREEMENT TO BE USED
ONLY FOR FUNERAL AND BURIAL EXPENSES. WHETHER THE AGREEMENT IS FOR YOUR
FUNERAL AND BURIAL EXPENSES OR FOR THOSE OF A FAMILY MEMBER, IF ANY
MONEY IS LEFT OVER AFTER YOUR FUNERAL AND BURIAL EXPENSES HAVE BEEN
PAID, IT WILL GO TO THE COUNTY. YOU MAY CHANGE YOUR CHOICE OF FUNERAL
HOME AT ANY TIME. IF THIS AGREEMENT IS FOR THE FUNERAL AND BURIAL
EXPENSES OF A FAMILY MEMBER, AFTER YOUR DEATH SUCH FAMILY MEMBER MAY
CHANGE THE CHOICE OF FUNERAL HOME AT ANY TIME.
S 17. Subdivision 6 of section 209 of the social services law, as
amended by chapter 660 of the laws of 1996, paragraphs (a) and (b) as
amended by chapter 317 of the laws of 2002, is amended to read as
follows:
6. (a) As applicable federal law, rules and regulations so provide, a
recipient of supplemental security income benefits or medical assistance
in the state of New York or any other state may establish an irrevocable
trust fund for the exclusive purpose of their OR A FAMILY MEMBER'S
funeral and burial. Such trust fund and any accumulated interest not
withdrawn by the recipient shall remain the responsibility of the funer-
al firm, funeral director, undertaker, cemetery or any other person,
firm or corporation to whom such payment is made to administer for
funeral and burial expenses of the recipient. Those persons who estab-
lish such a trust fund shall be given the opportunity to select the
funeral firm, funeral director, undertaker, cemetery or any other
person, firm or corporation to whom such payment is made of their choice
to provide for their OR A FAMILY MEMBER'S burial arrangements and to
change such selection at any time to any funeral firm, funeral director,
undertaker, cemetery or any other person, firm or corporation to whom
such payment is made, located either in the state of New York or any
other state. Any such change of funeral firm, funeral director, under-
taker, cemetery, or any other person, firm or corporation to whom such
payment is made, must be carried out within ten business days following
receipt of a request by the purchaser to the funeral firm, funeral
director, undertaker, cemetery, or any other person, firm or corporation
to whom such payment is made with which the current trust fund was
established. Funds in such trust fund shall be placed in an interest
bearing account pursuant to section four hundred fifty-three of the
general business law. Accumulated interest from such account shall not
be reported as "countable income" pursuant to section two hundred eight
of this title.
(b) An applicant for or a recipient of medical assistance in the state
of New York or any other state who enters into an agreement pursuant to
section four hundred fifty-three of the general business law FOR THEIR
OWN BENEFIT OR FOR THE BENEFIT OF A FAMILY MEMBER shall establish a
S. 8090 21 A. 11372
single irrevocable trust fund FOR EACH SUCH BENEFICIARY pursuant to
paragraph (a) of this subdivision.
(c) A funeral firm, funeral director, undertaker, cemetery, or any
other person, firm or corporation which makes an agreement for and
accepts payment for such an irrevocable trust fund, shall comply with
the provisions of section four hundred fifty-three of the general busi-
ness law, and shall include the following statement in any such agree-
ment in conspicuous print of at least twelve point type:
DISCLOSURE
NEW YORK LAW REQUIRES THIS AGREEMENT TO BE IRREVOCABLE FOR APPLICANTS
FOR [RECEIPT] AND RECIPIENTS OF SUPPLEMENTAL SECURITY BENEFITS UNDER
SECTION TWO HUNDRED NINE OF THE SOCIAL SERVICES LAW OR OF MEDICAL
ASSISTANCE UNDER SECTION THREE HUNDRED SIXTY-SIX OF THE SOCIAL SERVICES
LAW, AND FOR THE MONEYS PUT INTO A TRUST UNDER THIS AGREEMENT TO BE USED
ONLY FOR FUNERAL AND BURIAL EXPENSES. WHETHER THIS AGREEMENT IS FOR YOUR
FUNERAL AND BURIAL EXPENSES OR FOR THOSE OF A FAMILY MEMBER, IF ANY
MONEY IS LEFT OVER AFTER YOUR FUNERAL AND BURIAL EXPENSES HAVE BEEN
PAID, IT WILL GO TO THE COUNTY. YOU MAY CHANGE YOUR CHOICE OF FUNERAL
HOME AT ANY TIME. IF THIS AGREEMENT IS FOR THE FUNERAL AND BURIAL
EXPENSES OF A FAMILY MEMBER, AFTER YOUR DEATH SUCH FAMILY MEMBER MAY
CHANGE THE CHOICE OF FUNERAL HOME AT ANY TIME.
(d) Any promotional literature prepared after January first, nineteen
hundred ninety-seven by a funeral firm, funeral director, undertaker,
cemetery, or any other person, firm or corporation for prearranged
funeral and burial services must contain language disclosing the irrev-
ocable nature of burial trusts established BY OR for an applicant or
recipient of supplemental security income benefits or medical assist-
ance.
S 18. Paragraph (g) of subdivision 3 of section 453 of the general
business law, as added by chapter 660 of the laws of 1996, is amended to
read as follows:
(g) Any promotional literature prepared after January first, nineteen
hundred ninety-seven by a funeral firm, funeral director, undertaker,
cemetery, or any other person, firm or corporation for prearranged
funeral and burial services must contain language disclosing the irrev-
ocable nature of burial trusts established BY OR for an applicant or
recipient of supplemental security income benefits or medical assist-
ance.
S 19. Subdivision 6 of section 141 of the social services law, as
added by chapter 660 of the laws of 1996, is amended to read as follows:
6. If an applicant for or a recipient of public assistance or care or
of medical assistance under section two hundred nine or three hundred
sixty-six of this chapter [dies having established] ESTABLISHES an irre-
vocable trust for the payment of his or her funeral expenses, OR THOSE
OF A FAMILY MEMBER, under section four hundred fifty-three of the gener-
al business law, any funds remaining in such trust after the payment of
all funeral expenses must be paid over to the social services official
responsible for arranging for burials under this section in the local
government subdivision where the decedent resided.
S 20. Section 365-h of the social services law, as added by chapter 81
of the laws of 1995 and subdivision 3 as amended by section 26 of part B
of chapter 1 of the laws of 2002, is amended to read as follows:
S 365-h. Provision and reimbursement of transportation costs. 1. The
local social services official AND, SUBJECT TO THE PROVISIONS OF SUBDI-
VISION FOUR OF THIS SECTION, THE COMMISSIONER OF HEALTH shall have
responsibility for prior authorizing transportation of eligible persons
S. 8090 22 A. 11372
and for limiting the provision of such transportation to those recipi-
ents and circumstances where such transportation is essential, medically
necessary and appropriate to obtain medical care, services or supplies
otherwise available under this title.
2. In exercising this responsibility, the local social services offi-
cial AND, AS APPROPRIATE, THE COMMISSIONER OF HEALTH shall:
(a) make appropriate and economical use of transportation resources
available in the district in meeting the anticipated demand for trans-
portation within the district, including, but not limited to: transpor-
tation generally available free-of-charge to the general public or
specific segments of the general public, public transportation,
promotion of group rides, county vehicles, coordinated transportation,
and direct purchase of services; and
(b) maintain quality assurance mechanisms in order to ensure that (i)
only such transportation as is essential, medically necessary and appro-
priate to obtain medical care, services or supplies otherwise available
under this title is provided [and]; (ii) no expenditures for taxi or
livery transportation are made when public transportation or lower cost
transportation is reasonably available to eligible persons; AND (III)
TRANSPORTATION SERVICES ARE PROVIDED IN A SAFE, TIMELY, AND RELIABLE
MANNER BY PROVIDERS THAT COMPLY WITH STATE AND LOCAL REGULATORY REQUIRE-
MENTS AND MEET CONSUMER SATISFACTION CRITERIA APPROVED BY THE COMMIS-
SIONER OF HEALTH.
3. In the event that coordination or other such cost savings measures
are implemented, the commissioner shall assure compliance with applica-
ble standards governing the safety and quality of transportation of the
population served.
4. THE COMMISSIONER OF HEALTH IS AUTHORIZED TO ASSUME RESPONSIBILITY
FROM A LOCAL SOCIAL SERVICES OFFICIAL FOR THE PROVISION AND REIMBURSE-
MENT OF TRANSPORTATION COSTS UNDER THIS SECTION. IF THE COMMISSIONER
ELECTS TO ASSUME SUCH RESPONSIBILITY, THE COMMISSIONER SHALL NOTIFY THE
LOCAL SOCIAL SERVICES OFFICIAL IN WRITING AS TO THE ELECTION, THE DATE
UPON WHICH THE ELECTION SHALL BE EFFECTIVE AND SUCH INFORMATION AS TO
TRANSITION OF RESPONSIBILITIES AS THE COMMISSIONER DEEMS PRUDENT. THE
COMMISSIONER IS AUTHORIZED TO CONTRACT WITH A TRANSPORTATION MANAGER OR
MANAGERS TO MANAGE TRANSPORTATION SERVICES IN ANY LOCAL SOCIAL SERVICES
DISTRICT. ANY TRANSPORTATION MANAGER OR MANAGERS SELECTED BY THE COMMIS-
SIONER TO MANAGE TRANSPORTATION SERVICES SHALL HAVE PROVEN EXPERIENCE IN
COORDINATING TRANSPORTATION SERVICES IN A GEOGRAPHIC AND DEMOGRAPHIC
AREA SIMILAR TO THE AREA IN NEW YORK STATE WITHIN WHICH THE CONTRACTOR
WOULD MANAGE THE PROVISION OF SERVICES UNDER THIS SECTION. SUCH A
CONTRACT OR CONTRACTS MAY INCLUDE RESPONSIBILITY FOR: REVIEW, APPROVAL
AND PROCESSING OF TRANSPORTATION ORDERS; MANAGEMENT OF THE APPROPRIATE
LEVEL OF TRANSPORTATION BASED ON DOCUMENTED PATIENT MEDICAL NEED; AND
DEVELOPMENT OF NEW TECHNOLOGIES LEADING TO EFFICIENT TRANSPORTATION
SERVICES. IF THE COMMISSIONER ELECTS TO ASSUME SUCH RESPONSIBILITY FROM
A LOCAL SOCIAL SERVICES DISTRICT, THE COMMISSIONER SHALL EXAMINE AND, IF
APPROPRIATE, ADOPT QUALITY ASSURANCE MEASURES THAT MAY INCLUDE, BUT ARE
NOT LIMITED TO, GLOBAL POSITIONING TRACKING SYSTEM REPORTING REQUIRE-
MENTS AND SERVICE VERIFICATION MECHANISMS. ANY AND ALL REIMBURSEMENT
RATES DEVELOPED BY TRANSPORTATION MANAGERS UNDER THIS SUBDIVISION SHALL
BE SUBJECT TO THE REVIEW AND APPROVAL OF THE COMMISSIONER. NOTWITH-
STANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED TWELVE AND
ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTION ONE HUNDRED
FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR ANY OTHER LAW, THE COMMIS-
SIONER IS AUTHORIZED TO ENTER INTO A CONTRACT OR CONTRACTS UNDER THIS
S. 8090 23 A. 11372
SUBDIVISION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS,
PROVIDED, HOWEVER, THAT:
(A) THE DEPARTMENT 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; AND
(C) THE COMMISSIONER SHALL SELECT SUCH CONTRACTOR OR CONTRACTORS THAT,
IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF THIS
SECTION.
S 21. Subdivision 7 of section 2510 of the public health law, as
amended by chapter 645 of the laws of 2005, is amended to read as
follows:
7. "Covered health care services" means: the services of physicians,
optometrists, nurses, nurse practitioners, midwives and other related
professional personnel which are provided on an outpatient basis,
including routine well-child visits; diagnosis and treatment of illness
and injury; inpatient health care services; laboratory tests; diagnostic
x-rays; prescription and non-prescription drugs and durable medical
equipment; radiation therapy; chemotherapy; hemodialysis; emergency room
services; hospice services; emergency, preventive and routine dental
care, [except orthodontia and] INCLUDING MEDICALLY NECESSARY ORTHODONTIA
BUT EXCLUDING cosmetic surgery; emergency, preventive and routine vision
care, including eyeglasses; speech and hearing services; and, inpatient
and outpatient mental health, alcohol and substance abuse services as
defined by the commissioner in consultation with the superintendent.
"Covered health care services" shall not include drugs, procedures and
supplies for the treatment of erectile dysfunction when provided to, or
prescribed for use by, a person who is required to register as a sex
offender pursuant to article six-C of the correction law, provided that
any denial of coverage of such drugs, procedures or supplies shall
provide the patient with the means of obtaining additional information
concerning both the denial and the means of challenging such denial.
S 21-a. Subdivision 8 of section 2511 of the public health law is
amended by adding a new paragraph (e) to read as follows:
(E) THE COMMISSIONER SHALL ADJUST SUBSIDY PAYMENTS TO APPROVED ORGAN-
IZATIONS MADE ON AND AFTER APRIL FIRST, TWO THOUSAND TEN, SO THAT THE
AMOUNT OF EACH SUCH PAYMENT, AS OTHERWISE CALCULATED PURSUANT TO THIS
SUBDIVISION, IS REDUCED BY TWENTY-EIGHT PERCENT OF THE AMOUNT BY WHICH
SUCH CALCULATED PAYMENT EXCEEDS THE STATEWIDE AVERAGE SUBSIDY PAYMENT
FOR ALL APPROVED ORGANIZATIONS IN EFFECT ON APRIL FIRST, TWO THOUSAND
TEN. SUCH STATEWIDE AVERAGE SUBSIDY PAYMENT SHALL BE CALCULATED BY THE
COMMISSIONER AND SHALL NOT REFLECT ADJUSTMENTS MADE PURSUANT TO THIS
PARAGRAPH.
S 22. Subdivision 4 of section 6 of part C of chapter 58 of the laws
of 2005, amending the public health law and other laws relating to
authorizing reimbursements for expenditures made by social services
districts for medical assistance, is amended to read as follows:
S. 8090 24 A. 11372
4. If the commissioner of health finds that a district has either
substantially failed to demonstrate due diligence, including due dili-
gence with respect to the identification and reporting of fraud and
abuse, according to the prescribed requirements and guidelines or
continues to fail to comply with such requirements then such commission-
er may impose such sanctions and penalties as are permitted under the
public health law and the social services law. IN ADDITION, IF THE
FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES, OR A SUCCESSOR AGEN-
CY, DISALLOWS CLAIMS FOR FEDERAL FINANCIAL PARTICIPATION SUBMITTED TO IT
BY THE DEPARTMENT OF HEALTH, OR IF ANY FEDERAL AGENCY DETERMINES TO
RECOVER FEDERAL MEDICAID FUNDS PREVIOUSLY PAID TO THE DEPARTMENT OF
HEALTH, THE DEPARTMENT MAY RECOVER FROM A DISTRICT THE AMOUNT OF SUCH
DISALLOWANCE OR RECOVERY THAT THE COMMISSIONER DETERMINES WAS CAUSED BY
A DISTRICT'S FAILURE TO PROPERLY ADMINISTER, SUPERVISE OR OPERATE THE
MEDICAID PROGRAM. ANY SUCH RECOVERY MAY BE MADE BY THE DEPARTMENT OF
HEALTH ONLY AFTER A FINDING BY THE COMMISSIONER OF HEALTH THAT THE
DISTRICT HAS VIOLATED A STATUTE, REGULATION OR CLEARLY ARTICULATED WRIT-
TEN POLICY AND THAT SUCH VIOLATION WAS A DIRECT CAUSE OF THE FEDERAL
DISALLOWANCE OR RECOVERY. A DISTRICT SUBJECT TO SUCH FINDINGS SHALL HAVE
THE OPPORTUNITY TO SUBMIT TO THE COMMISSIONER WRITTEN OBJECTIONS TO SUCH
FINDINGS WITHIN THIRTY DAYS AFTER NOTICE OF THE FINDINGS IS TRANSMITTED
TO THE DISTRICT. THE TIME TO MAKE SUCH SUBMISSION MAY BE EXTENDED AT THE
DISCRETION OF THE COMMISSIONER. THE COMMISSIONER SHALL ISSUE A WRITTEN
DETERMINATION IN RESPONSE TO ANY SUCH OBJECTIONS, PRIOR TO INITIATION OF
RECOVERY BY THE DEPARTMENT. THE DISTRICT MAY CHALLENGE SUCH DETERMI-
NATION IN A PROCEEDING COMMENCED UNDER ARTICLE SEVENTY-EIGHT OF THE
CIVIL PRACTICE LAW AND RULES. ANY RECOVERY FROM A DISTRICT PURSUANT TO
THIS SUBDIVISION SHALL BE MADE NOTWITHSTANDING, AND IN ADDITION TO, ANY
DISTRICT MEDICAID SHARE AMOUNTS CALCULATED PURSUANT TO SECTION ONE OF
THIS PART.
S 23. Subdivision (f) of section 1 of part C of chapter 58 of the laws
of 2005, amending the public health law and other laws relating to
authorizing reimbursements for expenditures made by social services
districts for medical assistance, as amended by section 62 of part C of
chapter 58 of the laws of 2007, is amended to read as follows:
(f) Subject to paragraph (g) of this section, the state fiscal year
social services district expenditure cap amount calculated for each
social services district pursuant to paragraph (d) of this section shall
be allotted to each district during that fiscal year and paid to the
department in equal weekly amounts in a manner to be determined by the
commissioner and communicated to such districts and, SUBJECT TO THE
PROVISIONS OF SUBDIVISION FOUR OF SECTION SIX OF THIS PART, shall repre-
sent each district's maximum responsibility for medical assistance
expenditures governed by this section.
S 24. Subdivision (b) of section 1 of part C of chapter 58 of the laws
of 2005, amending the public health law and other laws relating to
authorizing reimbursements for expenditures made by social services
districts for medical assistance, is amended to read as follows:
(b) Commencing with the period April 1, 2005 though March 31, 2006, a
social services district's yearly net share of medical assistance
expenditures shall be calculated in relation to a reimbursement base
year which, for purposes of this section, is defined as January 1, 2005
through December 31, 2005. The final base year expenditure calculation
for each social services district shall be made by the commissioner of
health, and approved by the director of the division of the budget, no
later than June 30, 2006. Such calculations shall be based on actual
S. 8090 25 A. 11372
expenditures made by or on behalf of social services districts, and
revenues received by social services districts, during the base year and
shall be made without regard to expenditures made, and revenues
received, outside the base year that are related to services provided
during, or prior to, the base year. Such base year calculations shall be
based on the social services district medical assistance shares
provisions in effect on January 1, 2005. SUBJECT TO THE PROVISIONS OF
SUBDIVISION FOUR OF SECTION SIX OF THIS PART, THE STATE/LOCAL SOCIAL
SERVICES DISTRICT RELATIVE PERCENTAGES OF THE NON-FEDERAL SHARE OF
MEDICAL ASSISTANCE EXPENDITURES INCURRED PRIOR TO JANUARY 1, 2006 SHALL
NOT BE SUBJECT TO ADJUSTMENT ON AND AFTER JULY 1, 2006.
S 25. Notwithstanding any inconsistent provision of section 112 or 163
of the state finance law or any other contrary provision of the state
finance law or any other contrary provision of law, the commissioner of
health may, without a competitive bid or request for proposal process,
enter into contracts with one or more certified public accounting firms
for the purpose of conducting audits of disproportionate share hospital
payments made by the state of New York to general hospitals and for the
purpose of conducting audits of hospital cost reports as submitted to
the state of New York in accordance with article 28 of the public health
law.
S 26. Subdivision 7-a of section 101 of part A of chapter 57 of the
laws of 2006, amending the social services law relating to medically
fragile children, as amended by section 65 of part C of chapter 58 of
the laws of 2008, is amended to read as follows:
7-a. Sections fifty-eight, fifty-eight-a and fifty-eight-b shall take
effect January 1, 2007 [and shall expire and be deemed repealed January
1, 2011].
S 27. Paragraph (d) of subdivision 3 of section 367-a of the social
services law, as added by chapter 33 of the laws of 1998, subparagraphs
1 and 2 as amended by section 2 of part G of chapter 23 of the laws of
2002, is amended to read as follows:
(d) (1) Beginning April first, two thousand two and to the extent that
federal financial participation is available at a one hundred percent
federal Medical assistance percentage and subject to sections 1933 and
1902(a)(10)(E)(iv) of the federal social security act, medical assist-
ance shall be available for full payment of medicare part B premiums for
individuals (referred to as qualified individuals 1) who are entitled to
hospital insurance benefits under part A of title XVIII of the federal
social security act and whose income exceeds the income level estab-
lished by the state and is at least one hundred twenty percent, but less
than one hundred thirty-five percent, of the federal poverty level, for
a family of the size involved and who are not otherwise eligible for
medical assistance under the state plan;
(2) [Beginning April first, two thousand two and to the extent that
federal financial participation is available at a one hundred percent
federal Medical assistance percentage and subject to sections 1933 and
1902(a)(10)(E)(iv) of the federal social security act, medical assist-
ance shall be available for payment of that portion of the medicare part
B premium increase that is attributable to the operation of the amend-
ments made by section 4611(e)(3) of the balanced budget act of 1997, for
individuals (referred to as qualified individuals 2) who are entitled to
hospital insurance benefits under part A of title XVIII of the federal
social security act and whose income exceeds the income level estab-
lished by the state and is at least one hundred thirty-five percent, but
less than one hundred seventy-five percent, of the federal poverty
S. 8090 26 A. 11372
level, for a family of the size involved and who are not otherwise
eligible for medical assistance under the state plan;
(3)] Premium payments for the individuals described in [subparagraphs]
SUBPARAGRAPH one [and two] of this paragraph will be one hundred percent
federally funded up to the amount of the federal allotment. The depart-
ment shall discontinue enrollment into the program when the part B
premium payments made pursuant to [such paragraphs] SUBPARAGRAPH ONE OF
THIS PARAGRAPH meet the yearly federal allotment.
[(4)] (3) The commissioner of health shall develop a simplified appli-
cation form, consistent with federal law, for payments pursuant to this
section. The commissioner of health, in cooperation with the office for
the aging, shall publicize the availability of such payments to medicare
beneficiaries.
S 28. Section 2 of chapter 33 of the laws of 1998, amending the social
services law relating to authorizing payment of medicare part B premiums
to certain medicaid recipients, as amended by chapter 415 of the laws of
2008, is amended to read as follows:
S 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after January 1, 1998[,
provided, however that such provisions shall expire and be deemed
repealed December 31, 2010].
S 29. Section 45 of part D of chapter 58 of the laws of 2009 amending
the public health law and other laws relating to residential health care
facilities is amended to read as follows:
S 45. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of subdivisions 4, 7, 7-a and 7-b of section
2807 of the public health law and section 18 of chapter 2 of the laws of
1988, as they relate to time frames for notice, approval or certif-
ication of rates of payment, are hereby suspended and shall, for
purposes of implementing the provisions of this act AND THE PROVISIONS
OF PARTS B AND C OF THIS CHAPTER, be deemed to have been without any
force or effect from and after [November 1, 2007 for such rates effec-
tive for the period January 1, 2008 through December 31, 2008] MARCH 1,
2009.
S 30. Subdivision 17 of section 2808 of the public health law, as
added by chapter 433 of the laws of 1997, is amended to read as follows:
17. (A) Notwithstanding any inconsistent provision of law or regu-
lation to the contrary, for the period April first, nineteen hundred
ninety-seven through March thirty-first, nineteen hundred ninety-eight,
the commissioner shall not be required to revise a certified rate of
payment established pursuant to this article based on consideration of
rate appeals filed by a residential health care facility or based upon
adjustments to capital cost reimbursement as a result of approval by the
commissioner of an application for construction under section twenty-
eight hundred two of this article. For the period April first, nineteen
hundred ninety-eight, through March thirty-first, nineteen hundred nine-
ty-nine, the commissioner shall revise certified rates of payment in an
aggregate amount not to exceed twenty million dollars, state share
medical assistance. In cases where the commissioner determines that a
significant financial hardship exists, he or she may, subject to the
approval of the director of the budget, consider an exemption to this
subdivision. Beginning April first, nineteen hundred ninety-nine and
thereafter, the commissioner shall consider such rate appeals within a
reasonable period.
(B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO
THE CONTRARY, FOR THE STATE FISCAL YEAR BEGINNING APRIL FIRST, TWO THOU-
S. 8090 27 A. 11372
SAND TEN AND ENDING MARCH THIRTY-FIRST, TWO THOUSAND ELEVEN, THE COMMIS-
SIONER SHALL NOT BE REQUIRED TO REVISE CERTIFIED RATES OF PAYMENT ESTAB-
LISHED PURSUANT TO THIS ARTICLE FOR RATE PERIODS PRIOR TO APRIL FIRST,
TWO THOUSAND ELEVEN, BASED ON CONSIDERATION OF RATE APPEALS FILED BY
RESIDENTIAL HEALTH CARE FACILITIES OR BASED UPON ADJUSTMENTS TO CAPITAL
COST REIMBURSEMENT AS A RESULT OF APPROVAL BY THE COMMISSIONER OF AN
APPLICATION FOR CONSTRUCTION UNDER SECTION TWENTY-EIGHT HUNDRED TWO OF
THIS ARTICLE, IN EXCESS OF AN AGGREGATE ANNUAL AMOUNT OF EIGHTY MILLION
DOLLARS FOR SUCH STATE FISCAL YEAR. IN REVISING SUCH RATES WITHIN SUCH
FISCAL LIMIT, THE COMMISSIONER SHALL, IN PRIORITIZING SUCH RATE
APPEALS, INCLUDE CONSIDERATION OF WHICH FACILITIES THE COMMISSIONER
DETERMINES ARE FACING SIGNIFICANT FINANCIAL HARDSHIP AS WELL AS SUCH
OTHER CONSIDERATIONS AS THE COMMISSIONER DEEMS APPROPRIATE AND, FURTHER,
THE COMMISSIONER IS AUTHORIZED TO ENTER INTO AGREEMENTS WITH SUCH FACIL-
ITIES OR ANY OTHER FACILITY TO RESOLVE MULTIPLE PENDING RATE APPEALS
BASED UPON A NEGOTIATED AGGREGATE AMOUNT AND MAY OFFSET SUCH NEGOTIATED
AGGREGATE AMOUNTS AGAINST ANY AMOUNTS OWED BY THE FACILITY TO THE
DEPARTMENT, INCLUDING, BUT NOT LIMITED TO, AMOUNTS OWED PURSUANT TO
SECTION TWENTY-EIGHT HUNDRED SEVEN-D OF THIS ARTICLE. RATE ADJUSTMENTS
MADE PURSUANT TO THIS PARAGRAPH REMAIN FULLY SUBJECT TO APPROVAL BY THE
DIRECTOR OF THE BUDGET IN ACCORDANCE WITH THE PROVISIONS OF SUBDIVISION
TWO OF SECTION TWENTY-EIGHT HUNDRED SEVEN OF THIS ARTICLE.
S 31. Section 2808 of the public health law is amended by adding a new
subdivision 25 to read as follows:
25. RESERVED BED DAYS. (A) FOR PURPOSES OF THIS SUBDIVISION, A
"RESERVED BED DAY" IS A DAY FOR WHICH A GOVERNMENTAL AGENCY PAYS A RESI-
DENTIAL HEALTH CARE FACILITY TO RESERVE A BED FOR A PERSON ELIGIBLE FOR
MEDICAL ASSISTANCE PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THE
SOCIAL SERVICES LAW WHILE HE OR SHE IS TEMPORARILY HOSPITALIZED OR ON
LEAVE OF ABSENCE FROM THE FACILITY.
(B) NOTWITHSTANDING ANY OTHER PROVISIONS OF THIS SECTION OR ANY OTHER
LAW OR REGULATION TO THE CONTRARY, FOR RESERVED BED DAYS PROVIDED ON
BEHALF OF PERSONS TWENTY-ONE YEARS OF AGE OR OLDER:
(I) PAYMENTS FOR RESERVED BED DAYS SHALL BE MADE AT NINETY-FIVE
PERCENT OF THE MEDICAID RATE OTHERWISE PAYABLE TO THE FACILITY FOR
SERVICES PROVIDED ON BEHALF OF SUCH PERSON;
(II) PAYMENT TO A FACILITY FOR RESERVED BED DAYS PROVIDED ON BEHALF OF
SUCH PERSON FOR TEMPORARY HOSPITALIZATIONS MAY NOT EXCEED FOURTEEN DAYS
IN ANY TWELVE MONTH PERIOD;
(III) PAYMENT TO A FACILITY FOR RESERVED BED DAYS PROVIDED ON BEHALF
OF SUCH PERSON FOR NON-HOSPITALIZATION LEAVES OF ABSENCE MAY NOT EXCEED
TEN DAYS IN ANY TWELVE MONTH PERIOD.
S 32. Section 2808 of the public health law is amended by adding a new
subdivision 26 to read as follows:
26. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, FOR RATE PERI-
ODS ON AND AFTER APRIL FIRST, TWO THOUSAND TEN, RESIDENTIAL HEALTH CARE
FACILITY MEDICAID RATES OF PAYMENT SHALL NOT INCLUDE REIMBURSEMENT FOR
THE COST OF PRESCRIPTION DRUGS. SUCH REIMBURSEMENT SHALL BE IN ACCORD-
ANCE WITH OTHERWISE APPLICABLE PROVISIONS OF SECTION THREE HUNDRED
SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
S 33. Subdivision 2 of section 3616 of the public health law, as
amended by chapter 622 of the laws of 1988, is amended to read as
follows:
2. Continued provision of a long term home health care program, AIDS
home care program or certified home health agency services paid for by
government funds shall be based upon a comprehensive assessment of the
S. 8090 28 A. 11372
medical, social and environmental needs of the recipient of the
services. Such assessment shall be performed at least every one hundred
[twenty] EIGHTY days by the provider of a long term home health care
program, AIDS home care program or the certified home health agency
providing services for the patient and the local department of social
services, and shall be reviewed by a physician charged with the respon-
sibility by the commissioner. The commissioner shall prescribe the forms
on which the assessment will be made.
S 34. Notwithstanding any provision of law or regulation to the
contrary, and subject to the availability of federal financial partic-
ipation, the commissioner of health shall establish procedures to permit
long-term home health care programs and providers of other services
covered pursuant to federal waivers, or which provide case management
services, to collaborate to jointly serve individuals when the services
of both entities are necessary to meet such an individual's needs;
provided, however, that such entities shall maintain distinct yet coor-
dinated service and case management responsibilities and shall not
duplicate benefits.
S 35. Federal-state Medicare shared savings partnership program.
Notwithstanding any provision of law to the contrary, the commissioner
of health shall seek federal approval for the establishment of a feder-
al-state Medicare shared savings partnership program. Such program may
include, among others, the following features: (a) an incentive through
shared savings to the state for achieving federal cost-savings and effi-
ciencies to Medicare, such as from reduced expenditures for hospital,
long-term care and other medical care provided to beneficiaries eligible
for both Medicare and Medicaid, which result from state initiatives in
the care and management of such beneficiaries; such incentive shall
provide for a reinvestment of a portion of such federal savings into the
state's health care system; (b) acceptance of risk by the state for the
delivery and financing of Medicare-covered services; and (c) an incen-
tive to permit providers of medical services to share in demonstrated
Medicare savings.
S 36. Paragraphs (b) and (c) of subdivision 5 of section 2808 of the
public health law, paragraph (b) as added by section 12 of part OO of
chapter 57 of the laws of 2008, and paragraph (c) as added by section 11
of part D of chapter 58 of the laws of 2009, are amended to read as
follows:
(b) On and after April first, two thousand [eight] TEN, no NON-PUBLIC
residential health care facility may withdraw equity or transfer assets
which in the aggregate exceed three percent of such facility's total
[Medicaid] REPORTED ANNUAL revenue [in any calendar year] FOR PATIENT
CARE SERVICES, BASED ON THE FACILITY'S MOST RECENTLY AVAILABLE REPORTED
DATA, without prior written notification to the commissioner. Notifica-
tion shall be made in a form acceptable to the department by certified
or registered mail.
(c) Notwithstanding any inconsistent provision of this subdivision, on
and after April first, two thousand [nine] TEN, no non-public residen-
tial health care facility, whether operated as A for-profit facility or
as a not-for-profit facility, may withdraw equity or transfer assets
which in the aggregate exceed three percent of such facility's total
[Medicaid] REPORTED ANNUAL revenue [in the prior calendar year] FOR
PATIENT CARE SERVICES, BASED ON THE FACILITY'S MOST RECENTLY AVAILABLE
REPORTED DATA, without the prior written approval of the commissioner.
The commissioner shall make a determination to approve or disapprove a
request for withdrawal of equity or assets under this subdivision within
S. 8090 29 A. 11372
sixty days of the date of the receipt of a written request from the
facility. Requests shall be made in a form acceptable to the department
by certified or registered mail. In reviewing such requests the commis-
sioner shall consider the facility's overall financial condition, any
indications of financial distress, whether the facility is delinquent in
any payment owed to the department, whether the facility has been cited
for immediate jeopardy or substandard quality of care, and such other
factors as the commissioner deems appropriate. In addition to any other
remedy or penalty available under this chapter, and after opportunity
for a hearing, the commissioner may require replacement of the withdrawn
equity or assets and may impose a penalty for violation of the
provisions of this subdivision in an amount not to exceed ten percent of
any amount withdrawn without prior approval.
S 36-a. Subdivision 1 of section 367-w of the social services law as
added by section 29 of part D of chapter 58 of the laws of 2009, is
amended to read as follows:
1. Notwithstanding any provision of law to the contrary, the depart-
ment of health is authorized to establish a demonstration program, which
shall be three years in duration, under which the department shall
designate [two] ONE OR MORE long-term care assessment centers[, the
first of which shall] TO be established in [a] AND TOGETHER SERVE AN
ENTIRE county within the city of New York and [the second of which will]
SHALL DESIGNATE A LONG TERM CARE ASSESSMENT CENTER TO be established in
another region consisting of one or more contiguous counties elsewhere
in the state. Such centers shall serve the purpose of transferring from
the social services district to the regional long-term care assessment
centers responsibility for activities related to the assessment of a
person's need for, and the authorization of, long-term care services and
programs identified in subdivisions two, three and four of this section.
The department is authorized to contract with one or more entities WITH-
IN EACH COUNTY to operate regional long-term care assessment centers.
S 37. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public health law and the social
services law shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
S 38. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
S 39. Severability clause. If any clause, sentence, paragraph, subdi-
vision, 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 or
part thereof directly involved in the controversy in which such judgment
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.
S 40. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2010, provided
that:
S. 8090 30 A. 11372
(a) sections two, three, three-a, three-b, three-c, three-d, three-e
and twenty-one of this act shall take effect July 1, 2010; sections
fifteen, sixteen, seventeen, eighteen and nineteen of this act shall
take effect January 1, 2011; and provided further that section twenty of
this act shall be deemed repealed four years after the date the contract
entered into pursuant to section 365-h of the social services law, as
amended by section twenty of this act, is executed; provided that the
commissioner of health shall notify the legislative bill drafting
commission upon the execution of the contract entered into pursuant to
section 367-h of the social services law 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 officers law;
(b) any rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms, or instructions
necessary for such implementation may be adopted and issued on or after
the date this act shall have become a law;
(c) this act shall not be construed to alter, change, affect, impair
or defeat any rights, obligations, duties or interests accrued, incurred
or conferred prior to the effective date of this act;
(d) the commissioner of health and the superintendent of insurance and
any appropriate council may take any steps necessary to implement this
act prior to its effective date;
(e) notwithstanding any inconsistent provision of the state adminis-
trative procedure act or any other provision of law, rule or regulation,
the commissioner of health and the superintendent of insurance and any
appropriate council is authorized to adopt or amend or promulgate on an
emergency basis any regulation he or she or such council determines
necessary to implement any provision of this act on its effective date;
(f) the provisions of this act shall become effective notwithstanding
the failure of the commissioner of health or the superintendent of
insurance or any council to adopt or amend or promulgate regulations
implementing this act;
(g) the amendments to subdivision 8 of section 272 of the public
health law made by section five of this act shall not affect the repeal
of such section and shall be deemed repealed therewith;
(h) the amendments to subparagraph (ii) of paragraph (b) of subdivi-
sion 9 of section 367-a of the social services law made by section seven
of this act shall not affect the expiration of such subdivision and
shall be deemed to expire therewith;
(i) the amendments to subdivision 7 of section 2510 of the public
health law made by section twenty-one of this act shall not affect the
expiration of such subdivision and shall be deemed to expire therewith;
and
(j) the amendments made to paragraph (d) of subdivision 18 of section
2807-c of the public health law by section three-d of this act shall not
affect the expiration of such paragraph and shall be deemed to expire
therewith.
PART C
Section 1. The sum of four hundred two million seven hundred ninety-
seven thousand dollars ($402,797,000), or so much thereof as shall be
necessary, and in addition to amounts previously appropriated by law, is
hereby made available, in accordance with subdivision 1 of section 380
S. 8090 31 A. 11372
of the public authorities law as amended, according to the following
schedule. Payments pursuant to subdivision (a) of this section shall be
made available as moneys become available for such payments. Payments
pursuant to subdivisions (b) and (c) of this section shall be made
available on the fifteenth day of June, September, December and March or
as soon thereafter as moneys become available for such payments. No
moneys of the state in the state treasury or any of its funds shall be
available for payments pursuant to this section:
SCHEDULE
(a) Thirty-nine million seven hundred thousand dollars ($39,700,000)
to municipalities for repayment of eligible costs of federal aid munici-
pal street and highway projects pursuant to section 15 of chapter 329 of
the laws of 1991, as added by section 9 of chapter 330 of the laws of
1991, as amended. The department of transportation shall provide such
information to the municipalities as may be necessary to maintain the
federal tax exempt status of any bonds, notes, or other obligations
issued by such municipalities to provide for the non-federal share of
the cost of projects pursuant to chapter 330 of the laws of 1991 or
section 80-b of the highway law.
The program authorized pursuant to section 15 of chapter 329 of the
laws of 1991, as added by section 9 of chapter 330 of the laws of 1991,
as amended, shall additionally make payments for reimbursement according
to the following schedule:
State Fiscal Year Amount
2010-11 $39,700,000
(b) Three hundred four million three hundred thousand dollars
($304,300,000) to counties, cities, towns and villages for reimbursement
of eligible costs of local highway and bridge projects pursuant to
sections 16 and 16-a of chapter 329 of the laws of 1991, as added by
section 9 of chapter 330 of the laws of 1991, as amended. For the
purposes of computing allocations to municipalities, the amount distrib-
uted pursuant to section 16 of chapter 329 of the laws of 1991 shall be
deemed to be $121,520,000. The amount distributed pursuant to section
16-a of chapter 329 of the laws of 1991 shall be deemed to be
$182,780,000. Notwithstanding the provisions of any general or special
law, the amounts deemed distributed in accordance with section 16 of
chapter 329 of the laws of 1991 shall be adjusted so that such amounts
will not be less than 83.807 percent of the "funding level" as defined
in subdivision 5 of section 10-c of the highway law for each such muni-
cipality. In order to achieve the objectives of section 16 of chapter
329 of the laws of 1991, to the extent necessary, the amounts in excess
of 83.807 percent of the funding level to be deemed distributed to each
municipality under this subdivision shall be reduced in equal propor-
tion.
(c) Fifty-eight million seven hundred ninety-seven thousand dollars
($58,797,000) to municipalities for reimbursement of eligible costs of
local highway and bridge projects pursuant to sections 16 and 16-a of
chapter 329 of the laws of 1991, as added by section 9 of chapter 330 of
the laws of 1991, as amended. For the purposes of computing allocations
to municipalities, the amount distributed pursuant to section 16 of
chapter 329 of the laws of 1991 shall be deemed to be $23,480,000. The
amount distributed pursuant to section 16-a of chapter 329 of the laws
of 1991 shall be deemed to be $35,317,000. Notwithstanding the
provisions of any general or special law, the amounts deemed distributed
in accordance with section 16 of chapter 329 of the laws of 1991 shall
be adjusted so that such amounts will not be less than 16.193 percent of
S. 8090 32 A. 11372
the "funding level" as defined in subdivision 5 of section 10-c of the
highway law for each such municipality. In order to achieve the objec-
tives of section 16 of chapter 329 of the laws of 1991, to the extent
necessary, the amounts in excess of 16.193 percent of the funding level
to be deemed distributed to each municipality under this subdivision
shall be reduced in equal proportion. To the extent that the total of
remaining payment allocations calculated herein varies from $58,797,000,
the payment amounts to each locality shall be adjusted by a uniform
percentage so that the total payments equal $58,797,000.
The program authorized pursuant to sections 16 and 16-a of chapter 329
of the laws of 1991, as added by section 9 of chapter 330 of the laws of
1991, as amended, shall additionally make payments for reimbursement
according to the following schedule:
State Fiscal Year Amount
2010-11 $363,097,000
S 2. Subdivision (b) of section 11 of chapter 329 of the laws of 1991,
amending the state finance law and other laws relating to the establish-
ment of the dedicated highway and bridge trust fund, as amended by
section 49 of part PP of chapter 56 of the laws of 2009, is amended to
read as follows:
(b) Any service contract or contracts for projects authorized pursuant
to sections 10-c, 10-f, 10-g and 80-b of the highway law and section
14-k of the transportation law, and entered into pursuant to subdivision
(a) of this section, shall provide for state commitments to provide
annually to the thruway authority a sum or sums, upon such terms and
conditions as shall be deemed appropriate by the director of the budget,
to fund, or fund the debt service requirements of any bonds or any obli-
gations of the thruway authority issued to fund such projects having a
cost not in excess of [$5,860,800,000] $6,286,660,000 cumulatively by
the end of fiscal year [2009-10] 2010-2011.
S 3. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2010.
PART D
Section 1. Subdivision 3 of section 79-b of the navigation law, as
separately amended by chapters 768 and 805 of the laws of 1992, is
amended to read as follows:
3. The amount of state aid to be allocated to eligible governmental
entities pursuant to this article shall be determined by the commission-
er as hereinafter provided. [He] THE COMMISSIONER shall determine the
percentage proportion which the authorized expenditures of each individ-
ual entity, not exceeding four hundred thousand dollars for each county
including municipalities therein, shall bear to the total authorized
expenditures of all entities. Such percentage proportion shall then be
applied against an amount equal to [three-quarters] ONE-HALF of the
total of the amount received by the state in each preceding program year
in [fees] VESSEL REGISTRATION FEES AS PROVIDED IN SECTION TWENTY-TWO
HUNDRED FIFTY-ONE OF THE VEHICLE AND TRAFFIC LAW, less no more than
thirty percent, subject to appropriation, which may be used by the
commissioner and the commissioner of motor vehicles for administrative
costs of the program, including training and equipment, and by the
department of environmental conservation, the division of state police
and other state agencies, subject to the approval of the commissioner,
for the purposes of this article [for the registration of vessels], plus
the entire amount received pursuant to subdivision nine of section
S. 8090 33 A. 11372
forty-four of this chapter. The amount thus determined shall constitute
the maximum amount of state aid to which each such entity shall be enti-
tled; provided, however, that no entity shall receive state aid in an
amount in excess of [seventy-five] FIFTY percent of its authorized
expenditures as approved by the commissioner for such program year. The
commissioner shall certify to the comptroller the amount thus determined
for each eligible local governmental entity as the amount of state aid
to be apportioned to such eligible local governmental entity. The allo-
cation of state aid to any county, town or village within the Lake
George park shall not be reduced because of the allocation of state aid
to the Lake George park commission. Of the remaining funds received by
the state for the registration of vessels AS PROVIDED IN SECTION TWEN-
TY-TWO HUNDRED FIFTY-ONE OF THE VEHICLE AND TRAFFIC LAW, no less than
six percent shall be made available to the commissioner for the expenses
of the office in providing navigation law enforcement training and
administering the provisions of this section.
S 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2010.
PART E
Section 1. Paragraph (c) of subdivision 6 of section 529 of the execu-
tive law, as added by chapter 906 of the laws of 1973, is amended to
read as follows:
(c) The [director] COMMISSIONER of the [division for youth] OFFICE OF
CHILDREN AND FAMILY SERVICES, subject to the approval of the director of
the budget and certification to the [chairmen] CHAIRS of the senate
finance and assembly ways and means committees, may establish a single
per diem rate for all [division] OFFICE facilities or may establish
separate rates as may be appropriate to reflect the differentials in
cost of specific [division] OFFICE programs INCLUDING MAKING ANY ADJUST-
MENTS TO THE COSTS INCLUDED IN DETERMINING SUCH RATES TO REFLECT ANY
CHANGES IN FEDERAL FUNDING MADE AVAILABLE TO THE OFFICE OR TO SOCIAL
SERVICES DISTRICTS FOR SUCH COSTS.
S 2. Subdivision 9 of section 529 of the executive law, as added by
section 2 of part G of chapter 57 of the laws of 2007, is amended to
read as follows:
9. All reimbursement made by social services districts for care, main-
tenance and supervision under this section shall be paid directly to the
state through the office of children and family services for deposit
into a miscellaneous special revenue fund known as the youth facility
per diem account. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, IF A
SOCIAL SERVICES DISTRICT FAILS TO PROVIDE REIMBURSEMENT TO SUCH OFFICE
WITHIN SIXTY DAYS OF RECEIVING A BILL FOR SUCH SERVICES OR BY THE DATE
CERTAIN SET BY THE OFFICE FOR PROVIDING SUCH REIMBURSEMENT, WHICHEVER IS
LATER, THE OFFICES OF THE DEPARTMENT OF FAMILY ASSISTANCE ARE AUTHORIZED
TO EXERCISE THE STATE'S SET-OFF RIGHTS BY WITHHOLDING ANY AMOUNTS DUE
AND OWING TO SUCH DISTRICT FROM SUCH OFFICE UNDER THIS ARTICLE OR THE
SOCIAL SERVICES LAW UP TO THE AMOUNTS DUE AND OWING TO THE STATE UNDER
THIS SECTION AND TRANSFERRING SUCH FUNDS TO THE YOUTH FACILITIES PER
DIEM ACCOUNT.
S 3. Notwithstanding any law to the contrary, and in accordance with
section 4 of the state finance law, the comptroller is hereby authorized
and directed to transfer, upon request of the director of the budget, on
or before March 31, 2011, up to $27,000,000 from the miscellaneous
S. 8090 34 A. 11372
special revenue fund (339), youth facility per diem account (YF), to the
general fund.
S 4. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2010; provided,
however, that the provisions of section one of this act shall apply to
all per diems established by the office of children and family services
for office programs for the 2002 calendar year and thereafter; provided
further, however, that the provisions of section two of this act shall
apply to all outstanding reimbursements due by social services districts
to the office of children and family services on or before April 1, 2010
and thereafter; and provided further that this act shall expire and be
deemed repealed April 1, 2013.
PART F
Section 1. Subdivision 5 of section 97-rrr of the state finance law,
as amended by section 13 of part PP of chapter 56 of the laws of 2009,
is amended to read as follows:
5. Notwithstanding the provisions of section one hundred
seventy-one-a of the tax law, as separately amended by chapters four
hundred eighty-one and four hundred eighty-four of the laws of nineteen
hundred eighty-one, or any other provisions of law to the contrary,
during the fiscal year beginning April first, two thousand [nine] TEN,
the state comptroller is hereby authorized and directed to deposit to
the fund created pursuant to this section from amounts collected pursu-
ant to article twenty-two of the tax law and pursuant to a schedule
submitted by the director of the budget, up to [$3,524,450,000]
$496,624,180, as may be certified in such schedule as necessary to meet
the purposes of such fund for the fiscal year beginning April first, two
thousand [nine] TEN.
S 2. This act shall take effect immediately; provided, however, that
the amendments to subdivision 5 of section 97-rrr of the state finance
law made by this act shall not affect the expiration of such subdivision
and shall be deemed to expire therewith.
S 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
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.
S 3. This act shall take effect immediately provided, however, that
the applicable effective date of Parts A through F of this act shall be
as specifically set forth in the last section of such Parts.