S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    114
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
   Committee on Health
 
 AN ACT to amend the  social  services  law,  in  relation  to  including
   accountable care organizations within the definition of a managed care
   provider

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (b) of subdivision 1  of  section  364-j  of  the
 social  services  law,  as  amended  by chapter 649 of the laws of 1996,
 subparagraph (i) as  amended  by  section  35-a,  subparagraph  (ii)  as
 amended and subparagraph (iii) as added by section 77 of part A of chap-
 ter 56 of the laws of 2013, is amended to read as follows:
   (b)  "Managed  care provider". An entity that provides or arranges for
 the provision of medical assistance services  and  supplies  to  partic-
 ipants  directly  or  indirectly (including by referral), including case
 management; and:
   (i) is authorized to operate under article forty-four  of  the  public
 health  law  or article forty-three of the insurance law and provides or
 arranges, directly or indirectly (including  by  referral)  for  covered
 comprehensive  health  services  on a full capitation basis, including a
 special needs managed care plan or comprehensive HIV special needs plan;
 or
   (ii) is authorized  as  a  partially  capitated  program  pursuant  to
 section  three  hundred sixty-four-f of this title or section forty-four
 hundred three-e of the public health law or section 1915b of the  social
 security act; or
   (iii)  is  authorized  to  operate  under  section  forty-four hundred
 three-g of the public health law[.]; OR
   (IV) IS AN ACCOUNTABLE CARE ORGANIZATION UNDER  ARTICLE  TWENTY-NINE-E
 OF THE PUBLIC HEALTH LAW.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD00579-01-1

 A. 114                              2
 
   §  2.  Paragraph  (b)  of subdivision 1 of section 364-j of the social
 services law, as amended by chapter 649 of the laws  of  1996,  subpara-
 graph (i) as amended by section 35-a of part A of chapter 56 of the laws
 of  2013,  subparagraph  (ii)  as  amended by chapter 433 of the laws of
 1997, is amended to read as follows:
   (b)  "Managed  care provider". An entity that provides or arranges for
 the provision of medical assistance services  and  supplies  to  partic-
 ipants  directly  or  indirectly (including by referral), including case
 management; and:
   (i) is authorized to operate under article forty-four  of  the  public
 health  law  or article forty-three of the insurance law and provides or
 arranges, directly or indirectly (including  by  referral)  for  covered
 comprehensive  health  services  on a full capitation basis, including a
 special needs managed care plan or comprehensive HIV special needs plan;
 or
   (ii) is authorized  as  a  partially  capitated  program  pursuant  to
 section  three  hundred sixty-four-f of this title or section forty-four
 hundred three-e of the public health law or section 1915b of the  social
 security act[.]; OR
   (III)  IS AN ACCOUNTABLE CARE ORGANIZATION UNDER ARTICLE TWENTY-NINE-E
 OF THE PUBLIC HEALTH LAW.
   § 3. This act shall take effect one hundred eighty days after it shall
 have become a law; provided, that the amendments to  subparagraphs  (ii)
 and  (iii)  of paragraph (b) of section 364-j of the social services law
 made by section one of this act shall be subject to the  expiration  and
 reversion  and  repeal  of  such  subparagraphs  when upon such date the
 provisions of section two of this act shall take  effect;  and  provided
 further  that the amendments to section 364-j of the social services law
 made by this act shall be subject to the expiration and repeal  of  such
 section  and  shall  expire  and be deemed repealed therewith. Effective
 immediately, the commissioner of health shall make regulations and  take
 other actions reasonably necessary to implement this act on that date.