S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4965
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             February 19, 2021
                                ___________
 
 Introduced  by  Sen.  RIVERA -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law and the social  services  law,  in
   relation  to  automatic  enrollment and recertification simplification
   for Medicaid eligible recipients

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (b)  of subdivision 7 of section 4403-f of the
 public health law is amended by adding a new subparagraph (iv)  to  read
 as follows:
   (IV) WHERE A PERSON DETERMINED ELIGIBLE FOR MEDICAID ("MEDICAID RECIP-
 IENT") HAS BEEN DETERMINED BY THE COMMISSIONER OR HIS OR HER DESIGNEE TO
 REQUIRE  COMMUNITY-BASED LONG TERM CARE SERVICES FOR MORE THAN A CONTIN-
 UOUS PERIOD OF ONE HUNDRED TWENTY DAYS, AND THE MEDICAID  RECIPIENT  HAS
 NOT  SELECTED AND ENROLLED IN A MANAGED LONG TERM CARE PLAN PRIOR TO ANY
 EXPIRATION DATE OF SUCH DETERMINATION OF NEED FOR LONG TERM CARE,  AFTER
 BEING  PROVIDED WITH INFORMATION TO MAKE AN INFORMED CHOICE, THE COMMIS-
 SIONER SHALL ASSIGN THE RECIPIENT TO A  MANAGED  LONG  TERM  CARE  PLAN,
 TAKING  INTO  ACCOUNT  CONSISTENCY WITH ANY PRIOR COMMUNITY-BASED DIRECT
 CARE WORKERS HAVING RECENTLY SERVED THE RECIPIENT,  QUALITY  PERFORMANCE
 CRITERIA,  CAPACITY, AND GEOGRAPHIC ACCESSIBILITY.  THE COMMISSIONER MAY
 ASSIGN PARTICIPANTS PURSUANT TO SUCH CRITERIA ON A WEIGHTED  BASIS.    A
 RECIPIENT  ASSIGNED TO A MANAGED LONG TERM CARE PLAN UNDER THIS SUBPARA-
 GRAPH SHALL BE DEEMED TO HAVE BEEN DETERMINED TO BE IN NEED OF LONG TERM
 CARE SERVICES FOR MORE THAN A CONTINUOUS PERIOD OF  ONE  HUNDRED  TWENTY
 DAYS AND ELIGIBLE TO BE ENROLLED IN A MANAGED LONG TERM CARE PLAN.
   §  2.  Paragraph  (b)  of subdivision 2 of section 366-a of the social
 services law, as added by section 51 of part A of chapter 1 of the  laws
 of 2002, is amended to read as follows:
   (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
 sion, an applicant or recipient may attest to the amount of his  or  her
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD00500-01-1

 S. 4965                             2
 
 accumulated  resources,  unless  such  applicant or recipient is seeking
 medical assistance payment for long term care  services  FOR  THE  FIRST
 TIME.  A  RECIPIENT  WHO HAS ALREADY PROVIDED DOCUMENTATION OF RESOURCES
 MAY ATTEST TO THE AMOUNT OF ACCUMULATED RESOURCES IF IT HAS REMAINED THE
 SAME  OR IS LESS THAN THE AMOUNT ORIGINALLY DOCUMENTED.  For purposes of
 this paragraph, long term care  services  shall  mean  care,  treatment,
 maintenance,  and services described in paragraph (b) of subdivision [1]
 ONE of section three hundred  sixty-seven-f  of  this  title,  with  the
 exception  of  short term rehabilitation, as defined by the commissioner
 of health.
   § 3. Paragraph (d) of subdivision 5 of section  366-a  of  the  social
 services  law,  as  amended by section 12 of part D of chapter 56 of the
 laws of 2013, is relettered paragraph (e) and three new paragraphs  (f),
 (g) and (h) are added to read as follows:
   (F)  NOTWITHSTANDING  PARAGRAPH (B) OF SUBDIVISION TWO OF THIS SECTION
 AND PARAGRAPHS (A), (B), (C) AND (D) OF THIS SUBDIVISION, THE  FOLLOWING
 RECIPIENTS  WILL  BE  RECERTIFIED AUTOMATICALLY, UNLESS THERE HAS BEEN A
 FINDING OF LACK OF ELIGIBILITY FOR MEDICAID:
   (I) ENROLLEES IN MEDICAID MANAGED LONG TERM CARE PLANS AS  DEFINED  IN
 SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW;
   (II)  ENROLLEES  IN  MEDICAID MANAGED CARE PLANS AS DEFINED IN SECTION
 THREE HUNDRED SIXTY-FOUR-J OF  THIS  TITLE  WHO  RECEIVE  PERSONAL  CARE
 SERVICES  PURSUANT  TO PARAGRAPH (E) OF SUBDIVISION TWO OF SECTION THREE
 HUNDRED SIXTY-FIVE-A OF THIS TITLE OR CONSUMER DIRECTED PERSONAL ASSIST-
 ANCE SERVICES PURSUANT TO SECTION THREE  HUNDRED  SIXTY-FIVE-F  OF  THIS
 TITLE;
   (III)  ENROLLEES  RECEIVING  MEDICAID  IN THE AGED, BLIND AND DISABLED
 CATEGORY WHO RECEIVE FIXED INCOME  FROM  THE  SOCIAL  SECURITY  ADMINIS-
 TRATION (SSA); AND
   (IV) MEDICARE SAVINGS PROGRAM (MSP) RECIPIENTS WHO HAVE A FIXED INCOME
 FROM THE SOCIAL SECURITY ADMINISTRATION (SSA).
   (G)  NOTHING  IN PARAGRAPH (E) OF THIS SUBDIVISION SHOULD BE CONSTRUED
 TO ALTER A MEDICAID RECIPIENT'S OBLIGATION TO INFORM THE PUBLIC  WELFARE
 DISTRICT  OF CHANGES IN INCOME OR OTHER FACTORS THAT MIGHT IMPACT ELIGI-
 BILITY PURSUANT TO SUBDIVISION FOUR OF THIS SECTION.
   (H) UPON A FINDING OF LACK OF ELIGIBILITY,  RECIPIENTS  IDENTIFIED  IN
 PARAGRAPH (E) OF THIS SUBDIVISION WILL BE ENTITLED TO NOTICE AND HEARING
 RIGHTS AS PROVIDED IN SECTION TWENTY-TWO OF THIS CHAPTER.
   § 4. This act shall take effect on the one hundred eightieth day after
 it  shall  have  become a law; provided that the amendments to paragraph
 (b) of subdivision 7 of section 4403-f of the public health law made  by
 section one of this act shall be subject to the expiration and reversion
 of  such paragraph and shall expire and be deemed repealed therewith and
 provided further that such amendments shall not  affect  the  repeal  of
 such  section  and shall expire and be deemed repealed therewith. Effec-
 tive immediately, the commissioner of health shall make regulations  and
 take  other  actions  reasonably necessary to implement this act on that
 date.