S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    355
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 8, 2025
                                ___________
 
 Introduced  by  Sens.  RIVERA, ADDABBO, COONEY, LIU, MAY, RHOADS -- read
   twice and ordered printed, and when printed to  be  committed  to  the
   Committee on Health
 
 AN  ACT  to  amend the elder law, in relation to program eligibility for
   plans comparable to Medicare part D

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraphs (f) and (h) of subdivision 3 and subdivision 4
 of section 242 of the elder law,  paragraph  (f)  of  subdivision  3  as
 amended  by section 1 of part T of chapter 56 of the laws of 2012, para-
 graph (h) of subdivision 3 as amended by section 3-f of part A of  chap-
 ter  59  of the laws of 2011, and subdivision 4 as added by section 12-a
 of part T of chapter 56 of the laws of 2012,  are  amended  to  read  as
 follows:
   (f)  As  a  condition  of eligibility for benefits under this title, a
 program participant is required to be enrolled in Medicare  part  D,  OR
 ANY  OTHER  PUBLIC  OR  PRIVATE  DRUG PLAN WHICH HAS SUCCESSFULLY DEMON-
 STRATED TO CMS THAT THE COVERAGE IS AS GENEROUS  AS,  OR  MORE  GENEROUS
 THAN   THE   DEFINED   STANDARD  COVERAGE  UNDER  THE  MEDICARE  PART  D
 PRESCRIPTION DRUG BENEFIT, and to maintain such enrollment.  For  unmar-
 ried  participants  with  individual annual income less than or equal to
 twenty-three thousand dollars and married participants with joint annual
 income less than or equal to twenty-nine thousand dollars,  the  elderly
 pharmaceutical  insurance  coverage program shall pay for the portion of
 the part D OR COMPARABLE PLAN monthly premium that is the responsibility
 of the participant. Such payment shall  be  limited  to  the  low-income
 benchmark premium amount established by the federal centers for medicare
 and medicaid services and any other amount which such agency establishes
 under its de minimus premium policy.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00618-01-5
              

 S. 355                              2
 
   (h)  The  elderly pharmaceutical insurance coverage program is author-
 ized to represent program participants under this title with respect  to
 their Medicare part D OR COMPARABLE coverage.
   4.  As  a  condition  of  eligibility  for  benefits under this title,
 participants must be enrolled in [medicare]  MEDICARE  part  D,  OR  ANY
 OTHER PUBLIC OR PRIVATE DRUG PLAN WHICH HAS SUCCESSFULLY DEMONSTRATED TO
 CMS  THAT  THE  COVERAGE  IS  AS  GENEROUS AS, OR MORE GENEROUS THAN THE
 DEFINED STANDARD COVERAGE UNDER THE MEDICARE PART  D  PRESCRIPTION  DRUG
 BENEFIT,  and  maintain such enrollment. For persons who meet the eligi-
 bility requirements to participate in the elderly pharmaceutical  insur-
 ance  coverage  program,  the program will pay for a drug covered by the
 person's [medicare] MEDICARE part D plan OR COMPARABLE PLAN or a drug in
 a [medicare] MEDICARE part D excluded drug class, as defined in subdivi-
 sion eight of section two hundred forty-one of this title, provided that
 such drug is a covered drug, as defined in subdivision  one  of  section
 two  hundred  forty-one of this title, and that the participant complies
 with the point of sale co-payment requirements set forth in sections two
 hundred forty-seven and  two  hundred  forty-eight  of  this  title.  No
 payment  shall be made for [medicare] MEDICARE part D OR COMPARABLE plan
 deductibles.
   § 2. This act shall take effect on the first of April next  succeeding
 the date on which it shall have become a law.