S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4178
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 1, 2021
                                ___________
 
 Introduced  by M. of A. RODRIGUEZ, RA, STECK -- Multi-Sponsored by -- M.
   of A. FRIEND, McDONOUGH -- read once and referred to the Committee  on
   Health
 
 AN  ACT  to amend the public health law, in relation to establishing the
   Medicaid identification  and  anti-fraud  biometric  technology  pilot
   program; and to amend the social services law, in relation to conform-
   ing medical assistance identification with the Medicaid identification
   and  anti-fraud  biometric technology program; and making an appropri-
   ation therefor
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The  public health law is amended by adding a new article
 2-C to read as follows:
                                ARTICLE 2-C
             MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC
                         TECHNOLOGY PILOT PROGRAM
 SECTION 295. MEDICAID IDENTIFICATION AND ANTI-FRAUD BIOMETRIC TECHNOLOGY
                PILOT PROGRAM.
         296. DEFINITIONS.
         297. BIOMETRIC TECHNOLOGY USE REQUIREMENT.
         298. RULES AND REGULATIONS.
   § 295. MEDICAID IDENTIFICATION  AND  ANTI-FRAUD  BIOMETRIC  TECHNOLOGY
 PILOT  PROGRAM.  THERE IS HEREBY ESTABLISHED THE MEDICAID IDENTIFICATION
 AND ANTI-FRAUD BIOMETRIC TECHNOLOGY PILOT PROGRAM.
   § 296. DEFINITIONS. AS USED IN THIS ARTICLE:
   1. "BIOMETRIC TECHNOLOGY" MEANS TECHNOLOGY THAT MEASURES AND  ANALYZES
 BIOLOGICAL  DATA,  INCLUDING  BUT  NOT  LIMITED  TO DNA, FINGER IMAGING,
 VASCULAR PATTERNS,  EYE  RETINAS  AND  IRISES,  VOICE  PATTERNS,  FACIAL
 PATTERNS AND HAND MEASUREMENTS, FOR AUTHENTICATION PURPOSES.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD03043-01-1

              

 A. 4178                             2
 
   2.    "BIOMETRIC  VERIFICATION DEVICE" MEANS A DEVICE CAPABLE OF USING
 BIOMETRIC VERIFICATION TECHNOLOGY TO VERIFY THE IDENTITY OF  A  MEDICAID
 RECIPIENT OR PROVIDER.
   §  297.  BIOMETRIC  TECHNOLOGY  USE REQUIREMENT. 1. THE DEPARTMENT, IN
 CONSULTATION WITH THE OFFICE OF THE MEDICAID INSPECTOR GENERAL  AND  THE
 OFFICE OF THE ATTORNEY GENERAL, SHALL DEVELOP A REQUEST FOR PROPOSALS TO
 IMPLEMENT  A PROGRAM AUTHORIZING THE USE OF BIOMETRIC TECHNOLOGY FOR THE
 PURPOSES OF PATIENT AND PROVIDER IDENTIFICATION AND FOR USE AS AN  ANTI-
 FRAUD APPLICATION IN THE MEDICAID PROGRAM.
   2.  SUCH  REQUEST  FOR  PROPOSALS  SHALL INCLUDE AT A MINIMUM THAT (A)
 MEDICAID RECIPIENTS AND PROVIDERS SHALL PROVIDE BIOMETRIC PROOF OF THEIR
 IDENTITY ALONG WITH OTHER INFORMATION DEEMED NECESSARY  BY  THE  COMMIS-
 SIONER.
   (B)  SUCH  PROGRAM  WILL BE CAPABLE OF STORING BIOMETRIC MARKERS AND A
 LOG OF DOCTOR AND PHARMACY VISITS FOR EACH SERVICE BILLED TO  THE  MEDI-
 CAID PROGRAM.
   (C)  MEDICAID  IDENTIFICATION  SHALL  BE ISSUED TO AND ACCEPTED BY THE
 ADMITTING STAFF OF THE HEALTH CARE FACILITY.
   (D) MEDICAID RECIPIENTS SHALL BE REQUIRED TO PROVIDE  BIOMETRIC  PROOF
 OF  IDENTITY AT THE TIME OF EACH VISIT TO A DOCTOR'S OFFICE OR CLINIC AT
 THE POINT OF ACTUALLY BEING SEEN BY THE DOCTOR OR  CLINICAL  STAFF,  AND
 SHALL  AGAIN  PROVIDE  PROOF  OF  IDENTITY  UPON  COMPLETION  OF CARE OR
 SERVICES.
   (E)  PROVISIONS  SHALL  BE  INCLUDED   FOR   EMERGENCY   SERVICES   OR
 PRESCRIPTIONS  AND ALTERNATE IDENTIFICATION METHODS FOR MEDICAID RECIPI-
 ENTS PHYSICALLY OR MENTALLY UNABLE TO PROVIDE BIOMETRIC IDENTIFICATION.
   (F) FRAUD PREVENTION MARKERS INCORPORATED INTO SOFTWARE WHICH SHALL BE
 USED TO OPERATE THE HARDWARE COMPONENT OF THE BIOMETRIC TECHNOLOGY SHALL
 PREVENT AND/OR REJECT THE PAYMENT BY THE MEDICAID PROGRAM AND ALERT  THE
 SERVICE  PROVIDER  AT  POINT  OF  SERVICE IF FRAUD OR POTENTIAL FRAUD IS
 IDENTIFIED BY THE BIOMETRIC TECHNOLOGY SYSTEM.
   (G) PROVISIONS SHALL BE INCLUDED TO ENSURE  THAT  MEDICAID  RECIPIENTS
 HAVE  ACCESS  TO  EMERGENCY  HEALTH  SERVICES IN THE CASE OF A BIOMETRIC
 TECHNOLOGY SYSTEM MALFUNCTION OR FRAUD DETECTION ALARM.
   (H) EVALUATION AND SELECTION OF AN IDENTITY CREDENTIALING SYSTEM  THAT
 ADDRESSES THE REQUIREMENTS OF MEDICAID BENEFICIARIES AND PROVIDERS SHALL
 BE  BASED  ON  THE  FOLLOWING  CRITERIA:  SECURITY,  PRIVACY, USABILITY,
 PERFORMANCE, HYGIENE, BIOMETRIC CAPTURE AND  STORAGE  REQUIREMENTS,  AND
 INTEROPERABILITY.
   (I)  SUCH PROGRAM SHALL BE OPERATIONAL WITHIN TWELVE MONTHS OF PROGRAM
 APPROVAL AND WILL OPERATE FOR THREE YEARS.
   3. SUCH REQUEST FOR PROPOSALS SHALL SET FORTH REQUIREMENTS AS  TO  THE
 RESULTS AND GOALS TO BE ACHIEVED, RATHER THAN SPECIFIC TECHNICAL METHODS
 OR  SYSTEMS,  TO  ALLOW  CONSIDERATION  OF THE WIDEST POSSIBLE CHOICE OF
 AVAILABLE TECHNOLOGY.
   4. SUCH REQUEST FOR PROPOSALS SHALL  REQUIRE:  (A)  THAT  THE  PROGRAM
 SHALL  BE  REVENUE NEUTRAL FROM INCEPTION, WHEREBY ANY PROGRAM COSTS ARE
 AT LEAST OFFSET BY STATE MEDICAID SAVINGS, AND SHALL HAVE AS  A  PRIMARY
 GOAL REDUCTION OF MEDICAID EXPENDITURES THROUGH ELIMINATION OF FRAUD AND
 ABUSE;  AND (B) THAT THE PROGRAM SHALL BE COST NEUTRAL TO PROVIDERS FROM
 INCEPTION, WHEREBY ANY PROVIDER COSTS ARE AT LEAST  OFFSET  BY  PROVIDER
 SAVINGS,  AND  SHALL  HAVE  AS  A  PRIMARY GOAL PROVIDER SAVINGS THROUGH
 INCREASED EFFICIENCIES.
   5. (A) SUCH REQUEST FOR PROPOSALS FOR THE IMPLEMENTATION OF A  PROGRAM
 FOR  BIOMETRIC  TECHNOLOGY  USE  SHALL BE PUBLISHED ON OR BEFORE JANUARY

 A. 4178                             3
 
 FIFTEENTH, TWO THOUSAND TWENTY-THREE, AND SHALL PROVIDE  THAT  PROPOSALS
 SHALL BE OPENED ON OR BEFORE MARCH FIRST, TWO THOUSAND TWENTY-THREE.
   (B) THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRES-
 IDENT  OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, AND THE CHAIRS OF THE
 SENATE AND ASSEMBLY HEALTH COMMITTEES ON OR BEFORE MARCH THIRTIETH,  TWO
 THOUSAND  TWENTY-THREE  WITH REGARD TO THE PROGRESS MADE IN THE DEVELOP-
 MENT OF CRITERIA FOR A PROGRAM OF BIOMETRIC IDENTIFICATION  AND  OF  THE
 IMPLEMENTATION OF SUCH PROGRAM.
   6.    THE COMMISSIONER SHALL, UPON SUBMISSION OF SATISFACTORY EVIDENCE
 OF COMPLIANCE WITH THE PROVISIONS OF THIS TITLE,  APPROVE  TWO  MEDICAID
 IDENTIFICATION  AND  ANTI-FRAUD BIOMETRIC TECHNOLOGY PILOT PROGRAMS, ONE
 TO BE LOCATED IN AN UPSTATE HOSPITAL AND ONE TO BE LOCATED  IN  A  DOWN-
 STATE HOSPITAL.
   7.  EACH  HOSPITAL WILL BE APPROPRIATED THREE HUNDRED THOUSAND DOLLARS
 TO ASSIST IN ENABLING THE MEDICAID IDENTIFICATION AND ANTI-FRAUD  BIOME-
 TRIC TECHNOLOGY PILOT PROGRAM.
   §  298.  RULES  AND  REGULATIONS.  THE  COMMISSIONER IS AUTHORIZED AND
 DIRECTED TO PROMULGATE SUCH RULES AND REGULATIONS AS HE OR SHE MAY  DEEM
 NECESSARY OR APPROPRIATE TO EFFECTUATE THE PURPOSES OF THIS ARTICLE.
   §  2.    Subdivision 1 of section 367-b of the social services law, as
 added by chapter 639 of the laws of 1976, is amended to read as follows:
   1. The department, IN CONSULTATION WITH THE  COMMISSIONER  OF  HEALTH,
 shall  design  and  implement a statewide medical assistance information
 and payments system for the purpose of providing individual  and  aggre-
 gate  data  to  social services districts to assist them in making basic
 management decisions, to the department  and  other  state  agencies  to
 assist  in  the administration of the medical assistance program, and to
 the governor and the legislature as may be necessary to assist in making
 major administrative and policy decisions affecting such program.   Such
 system shall be designed so as to be capable of the following:
   a. receiving and processing information relating to the eligibility of
 each  person  applying  for  medical assistance and of issuing a medical
 assistance identification card, AND WHEN AVAILABLE UTILIZING THE  BIOME-
 TRIC  IDENTIFICATION  ISSUED  BY THE DEPARTMENT OF HEALTH, CONFORMING TO
 THE REQUIREMENTS SET FORTH IN THE MEDICAID IDENTIFICATION AND ANTI-FRAUD
 BIOMETRIC TECHNOLOGY PILOT PROGRAM ESTABLISHED PURSUANT TO ARTICLE TWO-C
 OF THE PUBLIC HEALTH LAW to persons  determined  by  a  social  services
 official to be eligible for such assistance;
   b.    ACTIVATING  MEDICAL  ASSISTANCE  IDENTIFICATION  BY REQUIRING AN
 APPLICANT RECEIVING SUCH IDENTIFICATION FROM THE DEPARTMENT TO  HAVE  IT
 VERIFIED  AT  A  SOCIAL  SERVICES DISTRICT OFFICE IN THE SOCIAL SERVICES
 DISTRICT IN WHICH THE APPLICANT RESIDES;
   C. receiving and processing information  relating  to  each  qualified
 provider of medical assistance furnishing care, services or supplies for
 which claims for payment are made pursuant to this title;
   [c.]  D.  receiving and processing, in a form and manner prescribed by
 the department, all claims for medical care, services and supplies,  and
 making  payments for valid claims to providers of medical care, services
 and supplies on behalf of social services districts;
   [d.] E. maintaining information necessary  to  allow  the  department,
 consistent  with  the  powers and duties of the department of health, to
 review the appropriateness, scope and duration of medical care, services
 and supplies provided to any eligible person pursuant to  this  chapter;
 and
   [e.]  F.  initiating  implementation of such a system for the district
 comprising the city of New York, in a manner compatible  with  expansion

 A. 4178                             4
 
 of  such system to districts other than the district comprising the city
 of New York.
   §  3.   The sum of six hundred thousand dollars ($600,000), or so much
 thereof as may be necessary, is hereby appropriated to the department of
 health out of any moneys in the state treasury in the  general  fund  to
 the credit of the Medicaid identification and anti-fraud biometric tech-
 nology  pilot  program, not otherwise appropriated, and made immediately
 available, for the purpose of carrying out the provisions of  this  act.
 Such moneys shall be payable on the audit and warrant of the comptroller
 on  vouchers  certified  or  approved by the department of health in the
 manner prescribed by law.
   § 4.  This act shall take effect immediately.