S T A T E O F N E W Y O R K
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1617
2025-2026 Regular Sessions
I N S E N A T E
January 13, 2025
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Introduced by Sens. RIVERA, JACKSON, MAY -- 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 THE DESIGNEE OF SUCH
COMMISSIONER TO REQUIRE COMMUNITY-BASED LONG TERM CARE SERVICES FOR MORE
THAN A CONTINUOUS 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 COMMISSIONER 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 SUBPARAGRAPH 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:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04128-01-5
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(b) Notwithstanding the provisions of paragraph (a) of this subdivi-
sion, an applicant or recipient may attest to the amount of [his or her]
THEIR accumulated resources, unless such applicant or recipient is seek-
ing 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. Provided, further, that sections two and three of this act shall
only take effect when the federal center for Medicaid and Medicare
services (CMS) approves in writing to the state commissioner of health
that the changes do not affect federal financial participation; provided
that the commissioner of health shall notify the legislative bill draft-
ing commission upon the occurrence of the enactment of the legislation
provided for in sections two and three of this act in order that the
S. 1617 3
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.
