Bill - 2003-04 PPGG


              STATE OF NEW YORK
       ________________________________________________________________________
 
           S. 1408                                                  A. 2108
 
              SENATE - ASSEMBLY
 
                                   January 29, 2003
                                      ___________
 
       IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
         cle seven of the Constitution -- read twice and ordered  printed,  and
         when printed to be committed to the Committee on Finance
 
       IN  ASSEMBLY  --  A  BUDGET  BILL, submitted by the Governor pursuant to
         article seven of the Constitution -- read once  and  referred  to  the
         Committee on Ways and Means
 
       AN ACT to repeal chapter 174 of the laws of 1990, constituting the youth
         opportunity  program  act  (Part  A);  to  amend the executive law, in
         relation to community services for the elderly, and to repeal  certain
         provisions  of  such law relating thereto (Part B); to amend the state
         finance law, in relation to the alzheimer's disease  fund;  to  repeal
         subdivision  2-a  of section 89-e of the state finance law relating to
         the alzheimer's disease fund; to repeal chapter 438  of  the  laws  of
         2002  relating  to sterilizing flexible endoscopies, to repeal article
         27-I of the public health law, relating to reflex sympathetic  dystro-
         phy  syndrome; to repeal title 5 of article 2 of the public health law
         relating to obesity prevention; and  to  repeal  article  4-A  of  the
         public  health law relating to the licensing and regulation of tattoo-
         ing and body piercing parlors (Part C); to  amend  the  public  health
         law, the domestic relations law and the state finance law, in relation
         to  increasing  fees charged for vital records services; and repealing
         section 4178 of the public health law relating thereto  (Part  D);  to
         amend  the  public  health  law, in relation to eliminating the use of
         funds of the office of professional medical conduct for activities  of
         the  patient  health  information  and quality improvement act of 2000
         (Part E); to amend the mental hygiene law, in relation to the  closure
         of  the Nathan S. Kline Institute for Psychiatric Research and consol-
         idate its functions into the New York State Psychiatric Institute  and
         the closure of the Institute for Basic Research in Developmental Disa-
         bilities (Part F); to amend the mental hygiene law, in relation to the
         reinvestment  of  funds into community-based programs for persons with
         serious mental illness, including children and adolescents with  seri-
         ous  emotional disturbances, based upon inpatient bed closures and the
         closure of state-operated psychiatric centers;  to  provide  community
         mental  health  support and workforce reinvestment; and to provide for
         the repeal of certain provisions upon expiration thereof (Part G);  to
 
        EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD12111-01-3
       S. 1408                             2                            A. 2108
 
         amend  chapter  119  of  the  laws of 1997 relating to authorizing the
         department of health to establish certain payments to  general  hospi-
         tals, in relation to extending the authorization for the department of
         health  to  continue  those payments to general hospitals (Part H); to
         amend the public health law, in relation to limitations on  state  aid
         to  municipalities  for  public health services (Part I); to amend the
         executive law, in relation to the program for  elderly  pharmaceutical
         insurance  coverage (Part J); to amend the social services law and the
         public health law, in relation  to  expanding  Medicaid  coverage  and
         rates  of payment for residential health care facilities; to amend the
         executive law,  in  relation  to  integrated  settings  for  qualified
         persons  with  disabilities;  to  amend chapter 1 of the laws of 2002,
         amending the public health law, the social services law  and  the  tax
         law relating to the Health Care Reform Act of 2000, in relation to the
         effective  date  thereof;  to  amend  chapter 474 of the laws of 1996,
         amending the education law and other laws relating to rates for  resi-
         dential  health  care  facilities, in relation to extending the effec-
         tiveness of such rates; to amend chapter  81  of  the  laws  of  1995,
         amending  the  public  health  law  and other laws relating to medical
         reimbursement and welfare reform, in  relation  to  the  effectiveness
         thereof; to amend chapter 629 of the laws of 1986, amending the social
         services  law relating to establishing a demonstration program for the
         delivery of long-term home health care services to certain persons, in
         relation to the effectiveness thereof; to amend  chapter  165  of  the
         laws  of 1991, amending the public health law and other laws, relating
         to establishing payments for medical assistance, in relation to making
         certain provisions permanent; to amend chapter  433  of  the  laws  of
         1997,  amending  the  public health law and other laws relating to the
         rate of reimbursement paid to hospitals and  residential  health  care
         facilities,  in relation to extending the provisions thereof; to amend
         chapter 639 of the laws of 1996 amending the  public  health  law  and
         other  laws  relating  to  welfare reform, in relation to trend factor
         elimination; to amend chapter 483 of the laws of  1978,  amending  the
         public  health  law  relating  to rate of payment for each residential
         health care facility to real property costs, in relation to the effec-
         tiveness thereof; to amend chapter 649 of the laws of  1996,  amending
         the  public health law, the mental hygiene law and the social services
         law, relating to authorizing the establishment of special needs plans,
         in relation to making provisions permanent; to amend  chapter  710  of
         the  laws  of 1988, amending the social services law and the education
         law relating to medical assistance eligibility of certain persons  and
         providing for managed medical care demonstration programs, in relation
         to  making  certain  provisions permanent; to amend chapter 904 of the
         laws of 1984, amending the public health law and the  social  services
         law,   relating  to  encouraging  comprehensive  health  services,  in
         relation to extending the provisions thereof; to amend chapter 535  of
         the  laws of 1983, amending the social services law relating to eligi-
         bility of certain enrollees for medical  assistance,  in  relation  to
         making  provisions permanent; to amend chapter 19 of the laws of 1998,
         amending the social services law relating to limiting  the  method  of
         payment  for  prescription drugs under the medical assistance program,
         in relation to extending the provisions thereof; and to repeal  subdi-
         vision  21  of section 364-j and section 364-jj of the social services
         law relating to rate adjustments for certain  managed  care  providers
         and to the special advisory review panel on Medicaid managed care, and
         repealing  paragraph  (x)  of section 165 of chapter 41 of the laws of
       S. 1408                             3                            A. 2108
 
         1992 amending the public health law and other laws relating to  health
         care  provider  reimbursement  rates, relating to the effectiveness of
         certain provisions of such chapter (Part K); to amend chapter  639  of
         the  laws  of 1996 relating to the Health Care Reform Act of 1996, and
         to amend chapter 1 of the laws of 1999 relating to the New York Health
         Care Reform Act of 2000, in relation to extending  certain  provisions
         relating  thereto;  to  amend  the  public  health law, in relation to
         hospitals; to amend chapter 433 of  the  laws  of  1997  amending  the
         public  health  law  and other laws relating to rates of reimbursement
         paid to hospitals and residential health care facilities, in  relation
         to  allocation  for  grants;  to  amend  chapter 2 of the laws of 1998
         amending the public health law, the social services law and the insur-
         ance law relating to expanding the child  health  insurance  plan,  in
         relation  to  extending the effectiveness thereof; to amend the public
         health law, in relation to  the  definition  of  covered  health  care
         services;  to amend the social services law, in relation to the family
         health plus program; to amend the insurance law, in relation  to  stop
         loss funds; to amend chapter 82 of the laws of 2002 amending chapter 1
         of  the  laws  of  2002  amending  the  public  health law, the social
         services law, and the tax law relating to the Health Care  Reform  Act
         of 2000 relating to health care reform, in relation to authorizing the
         commissioner  of  health  to utilize existing cash balances in certain
         pools or transfer money from certain funds; to amend the public health
         law, in relation to patient services payments; to amend chapter 63  of
         the  laws of 2001 amending chapter 20 of the laws of 2001 amending the
         military law and other laws relating to making appropriations for  the
         support  of  government, the public health law and the social services
         law, in relation to making technical corrections relating thereto;  to
         amend  the insurance law, in relation to non-profit medical and dental
         indemnity, or health and hospital service corporations; to amend chap-
         ter 731 of the laws of 1993 amending the public health law  and  other
         laws  relating to reimbursement, delivery and capital costs of ambula-
         tory health care services and inpatient hospital services, in relation
         to extending certain provisions relating thereto; to amend the  social
         services  law,  in  relation  to  extending  certain provisions of the
         medical assistance information and payment system;  to  amend  chapter
         520  of  the  laws  of  1978 relating to providing for a comprehensive
         survey of health care financing, education and illness prevention  and
         creating  councils  for  the conduct thereof, in relation to extending
         the time period for the inpatient financing system; to  amend  chapter
         600 of the laws of 1986 amending the public health law relating to the
         development   of  pilot  reimbursement  program  for  ambulatory  care
         services, in relation to extending the effectiveness of such  chapter;
         and  to  amend  chapter  753  of  the laws of 1989 amending the public
         health law and other laws relating to general  hospital  reimbursement
         for  inpatient  and  ambulatory  surgery, in relation to extending the
         effectiveness of certain provisions relating  thereto;  to  amend  the
         public  health law, in relation to patient services payment; to repeal
         title 11-A of the social services law  relating  to  the  catastrophic
         health  care  expense program; and to repeal paragraph (g) of subdivi-
         sion 2 of section 2511 of the public health law relating to the  child
         health insurance plan (Part L); to amend the public health law and the
         penal law, in relation to control of forged and altered prescriptions;
         and to repeal sections 3335 and 3336 of the public health law relating
         to  written prescriptions (Part M); and to amend the insurance law and
         the public health law, in relation to establishing early  intervention
       S. 1408                             4                            A. 2108
 
         program  third party insurance standards and instituting parental cost
         sharing on a sliding fee scale (Part N)
 
         The  People of the State of New York, represented in Senate and Assem-
       bly, do enact as follows:
 
    1    Section 1. This act enacts into law major  components  of  legislation
    2  which are necessary to implement the state fiscal plan for the 2003-2004
    3  state  fiscal  year.    Each component is wholly contained within a Part
    4  identified as Parts A through N. The effective date for each  particular
    5  provision contained within such Part is set forth in the last section of
    6  such Part. Any provision in any section contained within a Part, includ-
    7  ing  the  effective date of the Part, which makes reference to a section
    8  "of this act", when used in connection with that  particular  component,
    9  shall  be  deemed  to mean and refer to the corresponding section of the
   10  Part in which it is found. Section three of  this  act  sets  forth  the
   11  general effective date of this act.
 
   12                                   PART A
 
   13    Section  1.  Chapter  174  of the laws of 1990, constituting the youth
   14  opportunity program act, is REPEALED.
   15     § 2. This act shall take effect April 1, 2003; provided,  however,  if
   16  this  act  shall become a law after such date it shall take effect imme-
   17  diately and shall be deemed to have been in full force and effect on and
   18  after April 1, 2003.
 
   19                                   PART B
 
   20    Section 1. Section 541 of the executive law  is  REPEALED  and  a  new
   21  section 541 is added to read as follows:
   22     § 541. Community services for the elderly. 1. Definitions.  As used in
   23  this section, the following words shall have the following meanings:
   24    (a)  "Director"  shall  mean  the director of the state office for the
   25  aging.
   26    (b) "Designated agency" shall mean an agency which  is  designated  by
   27  the  chief executive officer of the county if there be one, or otherwise
   28  the governing board of such county, or the chief  executive  officer  of
   29  the  city  of New York, or the governing board of an Indian tribal coun-
   30  cil; which is either a unit of county government or the city of New York
   31  or an Indian tribal organization or a  private  non-profit  agency,  and
   32  which  is the area agency on aging created pursuant to the federal older
   33  Americans act of nineteen hundred sixty-five.
   34    (c) "Elderly person" shall mean a person sixty years of age or older.
   35    (d) "County" shall mean a county, as defined in section three  of  the
   36  county  law,  except  that  the city of New York shall be considered one
   37  county.
   38    (e) "Community services" shall mean services for elderly persons which
   39  are provided by a public or governmental agency  or  non-profit  agency,
   40  and  which are provided in the home of an elderly person or in community
   41  settings such as senior citizens centers, housing  projects,  or  agency
   42  offices.  Such services shall not include any services provided pursuant
   43  to the public health law other than home care services.
   44    (f) "County plan"  shall  mean  a  comprehensive  plan  for  community
   45  services prepared by a county pursuant to this section.
       S. 1408                             5                            A. 2108
 
    1    (g) "Non-profit agency" shall mean a corporation organized or existing
    2  pursuant to the not-for-profit corporation law.
    3    (h)  "Program  year"  shall  mean  the period from April first through
    4  March thirty-first of the following calendar year.
    5    2. County plans for the availability  of  community  services  to  the
    6  elderly.  (a) Counties with a designated agency are required to submit a
    7  county plan for the delivery of community services for  elderly  persons
    8  living  within  the  county. The plan shall be for a two, three, or four
    9  year period, as determined by the director, with annual  adjustments  as
   10  may be necessary. Such plan shall provide the information, and be in the
   11  format, prescribed by the director.
   12    (b) The county plan for community services or annual adjustments shall
   13  be prepared by the designated agency and approved by the chief executive
   14  officer of the county, if there be one, or otherwise the governing board
   15  of  the  county,  or  the  chief  executive  of the city of New York and
   16  submitted to the director no later than ninety days prior to the  begin-
   17  ning of the program period covered by such plan or annual update.
   18    (c)  The  director  shall  review  such county plan and may approve or
   19  disapprove such plan, or  any  part  thereof,  and  shall  propose  such
   20  modifications  and  conditions  as are deemed appropriate and necessary.
   21  Compliance with paragraphs (a) and (b) of this subdivision shall be  the
   22  basis  for  approval  of  a county plan. In the event the director shall
   23  disapprove the proposed county plan, the county submitting such applica-
   24  tion shall be afforded an opportunity for an  adjudicatory  hearing,  as
   25  prescribed by article three of the state administrative procedure act.
   26    (d)  Notwithstanding  any provision of this section, nothing contained
   27  herein shall give the director or a designated  agency  any  administra-
   28  tive, fiscal, supervisory, or other authority whatsoever over any plans,
   29  programs  or  expenditures authorized pursuant to titles eighteen, nine-
   30  teen and twenty of the federal social security act, or over any unit  of
   31  state or local government.
   32    3.  Funding.  (a)  The director shall, within the amounts appropriated
   33  therefor, make funds available to designated agencies for the  provision
   34  of  services  provided  for  in  the  approved plans.   The annual state
   35  reimbursement shall be at a rate of seventy  per  centum  of  the  total
   36  annual expenditures for such approved plans.
   37    (b) The director shall distribute such funds based on a formula devel-
   38  oped by the state office for the aging which shall take into account the
   39  geographic distribution of older persons within the state, and any other
   40  factors  deemed  appropriate  by the director including, but not limited
   41  to, the geographic distribution of persons over the age of seventy-five.
   42    (c) The designated agency may use up to ten per centum  of  the  state
   43  aid  for planning and implementation of the community services under its
   44  approved plan.
   45    (d) The director shall provide  that  certain  non-county  moneys  and
   46  in-kind  equivalents  may  be  used to comprise the county share of such
   47  total annual approved expenditures,  provided  that  such  county  share
   48  shall  not  include  monies  received  from  the  federal government for
   49  services for the elderly allocated to the  state  or  local  governments
   50  according to the population or other such non-competitive basis.
   51    (e)  The  director  shall provide the requirements for any participant
   52  contribution used for community services and the manner for the account-
   53  ing and use of any such revenue.
   54    (f) Reimbursement shall not be available for community services  under
   55  the  plan  provided  to  elderly  persons  who  are eligible for, or are
   56  receiving services, to meet their needs  pursuant  to  titles  eighteen,
       S. 1408                             6                            A. 2108
 
    1  nineteen  or  twenty  of  the  federal  social security act or any other
    2  governmental programs, or for services provided to  residents  in  adult
    3  residential  care  facilities  which had previously been provided by the
    4  facility, or which are required by law to be provided by such facility.
    5    (g)  For  the purpose of determining the amount of state reimbursement
    6  for which a county is  eligible  pursuant  to  this  section,  the  last
    7  preceding federal decennial census shall be used.
    8    (h)  Claims  for  reimbursement  shall be submitted in accordance with
    9  procedures developed by the director  in  consultation  with  designated
   10  agencies.  Reimbursement  shall  be  available for approved expenditures
   11  incurred in accordance  with  an  approved  county  plan  for  community
   12  services.
   13    (i)  The  director  shall provide for the extent of cost-sharing to be
   14  required of elderly persons receiving services.
   15    4. Contracts for services. (a) For the purposes of this section, coun-
   16  ties are authorized to contract with  public  agencies,  municipalities,
   17  non-profit  agencies, or such other entities as the director may author-
   18  ize.
   19    (b) Pursuant to an agreement, two or more counties may  join  together
   20  for  the  purposes of this section. Such agreements shall make provision
   21  for the proportionate cost to be borne by each county, the employment of
   22  personnel, the receipt and disbursement of funds, and any other  matters
   23  deemed  necessary by the director.  Claims for reimbursement pursuant to
   24  subdivision three of this section shall be paid to each county and shall
   25  be limited to the amount to which each county would be entitled pursuant
   26  to such subdivision.
   27    5. Tribal organization agencies. For the purposes of  obtaining  state
   28  aid  within  the  amounts  appropriated  therefor  under this section, a
   29  designated agency of an Indian  tribal  organization  shall  qualify  as
   30  though it were a designated agency for a county.
   31     §  2.  This  act  shall take effect immediately and shall be deemed to
   32  have been in full force and effect on April 1, 2003.
 
   33                                   PART C
 
   34    Section 1. Subdivision 2 of section 89-e of the state finance law,  as
   35  amended  by  chapter  359  of  the  laws  of 2002, is amended to read as
   36  follows:
   37    2. Such fund shall consist of all revenues received by the  department
   38  of  taxation  and  finance,  pursuant  to  the provisions of section six
   39  hundred twenty-nine of the tax law and all  other  moneys  appropriated,
   40  credited,  or transferred thereto from any other fund or source pursuant
   41  to law.  [For each state fiscal year, there shall be appropriated to the
   42  fund by the state, in addition to all other moneys required to be depos-
   43  ited into such fund, an amount equal to the amounts of monies  collected
   44  and  deposited into the fund pursuant to section six hundred twenty-nine
   45  of the tax law during the preceding calendar year, as certified  by  the
   46  comptroller.]  Nothing  contained  herein  shall  prevent the state from
   47  receiving grants, gifts or bequests for the  purposes  of  the  fund  as
   48  defined  in  this section and depositing them into the fund according to
   49  law.
   50     § 2. Subdivision 2-a of section 89-e  of  the  state  finance  law  is
   51  REPEALED.
   52     §  3. Chapter 438 of the laws of 2002 relating to sterilizing flexible
   53  endoscopies is REPEALED.
   54     § 4. Article 27-I of the public health law is REPEALED.
       S. 1408                             7                            A. 2108
 
    1     § 5. Title 5 of article 2 of the public health law, as added by  chap-
    2  ter 538 of the laws of 2002, is REPEALED.
    3     § 6. Article 4-A of the public health law is REPEALED.
    4     § 7. This act shall take effect immediately.
 
    5                                   PART D
 
    6    Section  1.  Subdivisions 6 and 7 of section 4139 of the public health
    7  law, subdivision 6 as amended by chapter 61 of  the  laws  of  1989  and
    8  subdivision 7 as amended by chapter 103 of the laws of 1981, are amended
    9  to read as follows:
   10    6.  The  commissioner  shall  be entitled to a fee of [fifteen] thirty
   11  dollars for each certification, certified copy or  certified  transcript
   12  of certificate of dissolution of marriage furnished [by him].
   13    7.  For  a  search of the files where no such certification, certified
   14  copy, or certified transcript is furnished, or for a certification  that
   15  a  search  discloses no record of a dissolution of marriage, the commis-
   16  sioner shall be entitled to a fee of [five] thirty dollars.
   17     § 2. Subdivisions 2 and 3 of section 4174 of the  public  health  law,
   18  subdivision  2 as amended by chapter 61 of the laws of 1989 and subdivi-
   19  sion 3 as amended by chapter 413 of the laws of  1991,  are  amended  to
   20  read as follows:
   21    2.  Each  applicant for a certification of birth or death, certificate
   22  of birth data or for a certified copy or certified transcript of a birth
   23  or death certificate or certificate of birth data  shall  remit  to  the
   24  commissioner  with such application a fee of [fifteen] thirty dollars in
   25  payment for the search of the files and records and the furnishing of  a
   26  certification,  certified copy or certified transcript if such record is
   27  found or for a certification that a search  discloses  no  record  of  a
   28  birth or of a death.
   29    3.  For  any  search of the files and records conducted for authorized
   30  genealogical or  research  purposes,  the  commissioner  or  any  person
   31  authorized  by  him shall be entitled to, and the applicant shall pay, a
   32  fee of [ten] twenty dollars for each hour or fractional part of an  hour
   33  of  time  of search, together with a fee of [one dollar] two dollars for
   34  each uncertified copy or abstract of such record requested by the appli-
   35  cant or for a certification that a search discloses no record.
   36     § 3. Section 4174 of the public health law is amended by adding a  new
   37  subdivision 9 to read as follows:
   38    9. The commissioner may institute an additional fee of fifteen dollars
   39  for  priority  handling for each certification, certified copy or certi-
   40  fied transcript of certificates  of  birth,  death,  or  dissolution  of
   41  marriage;  or  fifteen  dollars  for  priority handling for each certif-
   42  ication, certified  copy  or  certified  transcript  of  certificate  of
   43  marriage.
   44     § 4.  Section 4178 of the public health law is REPEALED.
   45     §  5.  Subdivision  3  of section 15 of the domestic relations law, as
   46  amended by chapter 61 of the  laws  of  1989,  is  amended  to  read  as
   47  follows:
   48    3.  If it shall appear upon an application for a marriage license that
   49  either party is under the age of sixteen years, the town or  city  clerk
   50  shall require, in addition to any consents provided for in this section,
   51  the written approval and consent of a justice of the supreme court or of
   52  a  judge  of the family court, having jurisdiction over the town or city
   53  in which the application is made, to be attached to or endorsed upon the
   54  application, before the license is  issued.  The  application  for  such
       S. 1408                             8                            A. 2108
 
    1  approval and consent shall be heard by the judge at chambers. All papers
    2  and  records  pertaining  to any such application shall be sealed by him
    3  and withheld from inspection, except by order of a  court  of  competent
    4  jurisdiction.  Before issuing any licenses herein provided for, the town
    5  or city clerk shall be entitled to a fee of  [fifteen]  thirty  dollars,
    6  which  sum  shall  be  paid  by the applicants before or at the time the
    7  license is issued. Any town or city clerk who shall issue a  license  to
    8  marry  any  persons  one or both of whom shall not be at the time of the
    9  marriage under such license legally competent  to  marry  without  first
   10  requiring  the  parties  to  such  marriage  to make such affidavits and
   11  statements or who shall not require the production of documentary  proof
   12  of  age  or  the  procuring of the approval and consents provided for by
   13  this article, which shall show  that  the  parties  authorized  by  said
   14  license to be married are legally competent to marry, shall be guilty of
   15  a misdemeanor and on conviction thereof shall be fined in the sum of one
   16  hundred  dollars  for each and every offense. On or before the fifteenth
   17  day of each month, each town and city clerk, except in the city  of  New
   18  York,  shall transmit to the state commissioner of health [eleven] twen-
   19  ty-two dollars and [twenty-five] fifty cents of the amount received  for
   20  each  fee collected, which shall be paid into the [state treasury] vital
   21  records management account as provided by section [one  hundred  twenty-
   22  one] ninety-seven-cccc of the state finance law. In any city the balance
   23  of  all  fees  collected  for  the issuing of a marriage license, or for
   24  solemnizing a marriage, so far as collected for services rendered by any
   25  officer or employee of such city, shall be paid monthly  into  the  city
   26  treasury  and  may  by  ordinance be credited to any fund therein desig-
   27  nated, and said ordinance, when duly enacted, shall have  the  force  of
   28  law  in such city. Notwithstanding any other provisions of this article,
   29  the clerk of any city with the approval of the governing  body  of  such
   30  city  is  hereby  authorized  to designate, in writing filed in the city
   31  clerk's office, a deputy clerk, if any, and/or other city  employees  in
   32  such  office to receive applications for, examine applications, investi-
   33  gate and issue marriage licenses in the  absence  or  inability  of  the
   34  clerk  of  said  city to act, and said deputy and/or employees so desig-
   35  nated are hereby vested with all the powers  and  duties  of  said  city
   36  clerk  relative thereto. Such deputy and/or employees shall perform said
   37  duties without additional compensation.
   38     § 6. Section 20-a of the domestic relations law, as amended by chapter
   39  103 of the laws of 1981, is amended to read as follows:
   40     § 20-a. Certified transcripts of records; state commissioner of health
   41  may furnish.  The state commissioner of health or person  authorized  by
   42  him  shall, upon request, supply to any applicant a certified transcript
   43  of any marriage registered under the provisions of this article,  unless
   44  he  is  satisfied  that  the  same  does  not  appear to be necessary or
   45  required for judicial or other proper purposes. Any  transcript  of  the
   46  record  of a marriage, when properly certified by the state commissioner
   47  of health or person authorized to act for  him,  shall  be  prima  facie
   48  evidence  in  all courts and places of the facts therein stated. For any
   49  search of the  files  and  records  conducted  for  authorized  research
   50  purposes, the state commissioner of health shall be entitled to a fee of
   51  [five]  twenty  dollars  for  each hour or fractional part of an hour of
   52  time of search, together with a fee of [one dollar] two dollars for each
   53  uncertified copy or abstract of such marriage record  requested  by  the
   54  applicant,  said  fees to be paid by the applicant. Each applicant for a
   55  certified transcript of a marriage  record  shall  remit  to  the  state
   56  commissioner of health a fee of [five] thirty dollars in payment for the
       S. 1408                             9                            A. 2108
 
    1  search  of  the files and records and the furnishing of a certified copy
    2  if such record is found or for a certification that a  search  discloses
    3  no record of a marriage.
    4     §  7.  Subdivision 3 of section 20-b of the domestic relations law, as
    5  amended by chapter 103 of the laws  of  1981,  is  amended  to  read  as
    6  follows:
    7    3.  Each  applicant for a certification of marriage shall remit to the
    8  commissioner with such application a fee of  [five]  thirty  dollars  in
    9  payment  for  the  search of the files and records and the furnishing of
   10  such certification if a record thereof is found or for  a  certification
   11  that a search discloses no record of a marriage.
   12     §  8. The state finance law is amended by adding a new section 97-cccc
   13  to read as follows:
   14     § 97-cccc. Vital records management account. 1. There is hereby estab-
   15  lished in the joint custody of the state comptroller and the commission-
   16  er of taxation and finance  an  account  of  the  miscellaneous  special
   17  revenue fund to be known as the vital records management account.
   18    2.  Notwithstanding any other law, rule or regulation to the contrary,
   19  the state comptroller is hereby authorized and directed to  receive  for
   20  deposit  to the credit of the health department payments relating to the
   21  responsibilities of the vital records management program, including fees
   22  for certification, certified copy or certified  transcripts  of  certif-
   23  icates  of  birth,  death,  or  dissolution  of marriage; or for certif-
   24  ication, certified  copy  or  certified  transcript  of  certificate  of
   25  marriage.
   26    3. Moneys of this account, following appropriation by the legislature,
   27  shall be available to the health department for services and expenses of
   28  the vital records management program.
   29     § 9. This act shall take effect immediately.
 
   30                                   PART E
 
   31    Section  1.  Paragraph  (a)  of  subdivision  1 of section 2995 of the
   32  public health law, as added by chapter 542  of  the  laws  of  2000,  is
   33  amended to read as follows:
   34    (a)  The  department shall undertake an initiative for the purposes of
   35  increasing the information  available  to  patients  about  health  care
   36  providers  and  health  care  plans, and improving the quality of health
   37  care in this state, by creating a statewide health  information  system,
   38  collecting health information for dissemination by means of such system,
   39  and  studying additional uses of such information. Such moneys as may be
   40  necessary to effect the purpose of this section may be  appropriated  to
   41  the  department  for  its  expenses[,  but  in  no  event shall funds be
   42  diverted from existing  uses  of  the  office  of  professional  medical
   43  conduct in order to fulfill the purposes of this section].
   44     §  2.  This  act  shall take effect immediately and shall be deemed to
   45  have been in full force and effect on and after April 1, 2003.
 
   46                                   PART F
 
   47    Section 1. Subdivision (b) of section 7.17 of the mental hygiene  law,
   48  as  amended  by  chapter  333 of the laws of 1998, is amended to read as
   49  follows:
   50    (b) There shall be in the office the hospitals  named  below  for  the
   51  care,  treatment,  and  rehabilitation  of the mentally disabled and for
       S. 1408                            10                            A. 2108
 
    1  research and teaching in the science and skills required for  the  care,
    2  treatment, and rehabilitation of such mentally disabled.
    3    Binghamton Psychiatric Center
    4    Bronx Psychiatric Center
    5    Buffalo Psychiatric Center
    6    Capital District Psychiatric Center
    7    Central New York Psychiatric Center
    8    Creedmoor Psychiatric Center
    9    Elmira Psychiatric Center
   10    Hudson River Psychiatric Center
   11    Kingsboro Psychiatric Center
   12    Kirby Forensic Psychiatric Center
   13    Manhattan Psychiatric Center
   14    Middletown Psychiatric Center
   15    Mid-Hudson Forensic Psychiatric Center
   16    Mohawk Valley Psychiatric Center
   17    [Nathan S. Kline Institute for Psychiatric Research]
   18    New York State Psychiatric Institute
   19    Pilgrim Psychiatric Center
   20    Richard H. Hutchings Psychiatric Center
   21    Rochester Psychiatric Center
   22    Rockland Psychiatric Center
   23    St. Lawrence Psychiatric Center
   24    South Beach Psychiatric Center
   25    Bronx Children's Psychiatric Center
   26    Brooklyn Children's Psychiatric Center
   27    Queens Children's Psychiatric Center
   28    Rockland Children's Psychiatric Center
   29    Sagamore Children's Psychiatric Center
   30    Western New York Children's Psychiatric Center
   31    The  New  York  State  Psychiatric  Institute [and The Nathan S. Kline
   32  Institute for Psychiatric Research are] is designated as [institutes] an
   33  institute for the conduct  of  medical  research  and  other  scientific
   34  investigation  directed  towards  furthering  knowledge of the etiology,
   35  diagnosis, treatment, and prevention of mental illness.
   36     § 2. Paragraph 3 of subdivision (e) of  section  7.17  of  the  mental
   37  hygiene law, as amended by chapter 83 of the laws of 1995, is amended to
   38  read as follows:
   39    3. provide for a mechanism which may reasonably be expected to provide
   40  notice  to  local  governments,  community organizations, employee labor
   41  organizations, managerial and confidential employees, and  consumer  and
   42  advocacy  groups  of the potential for significant service reductions at
   43  such state-operated hospitals and state-operated research institutes  at
   44  least  twelve  months  prior  to  commencing  such service reduction[,];
   45  provided, however, that this requirement shall be deemed satisfied  with
   46  respect  to  reductions  at  Central  Islip  Psychiatric Center, Gowanda
   47  Psychiatric Center, Harlem Valley Psychiatric Center, Kings Park Psychi-
   48  atric Center, Willard Psychiatric  Center  [and],  Manhattan  Children's
   49  Psychiatric  Center,  and  Nathan  S.  Kline  Institute  for Psychiatric
   50  Research; and
   51     § 3. The second undesignated paragraph of section 13.01 of the  mental
   52  hygiene  law,  as amended by chapter 676 of the laws of 1994, is amended
   53  to read as follows:
   54    Therefore, it shall be the policy of the state  to  [conduct  research
   55  and  to]  develop programs to further the prevention and early detection
   56  of mental retardation  and  developmental  disabilities;  to  develop  a
       S. 1408                            11                            A. 2108
 
    1  comprehensive,  integrated  system  of services which has as its primary
    2  purposes the promotion and attainment of independence, inclusion,  indi-
    3  viduality,  and  productivity  for  persons  with mental retardation and
    4  developmental  disabilities; to serve the full range of needs of persons
    5  with mental retardation and developmental disabilities by expanding  the
    6  number  and types of community based services and developing new methods
    7  of service delivery; and to improve the equity, effectiveness, and effi-
    8  ciency of services for persons with mental retardation and developmental
    9  disabilities by serving persons in the community as  well  as  those  in
   10  developmental  centers,  by  improving  the  conditions in developmental
   11  centers, and by establishing accountability for carrying out  the  poli-
   12  cies of the state with regard to such persons.
   13     §  4.  Subdivision  (b) of section 13.17 of the mental hygiene law, as
   14  amended by section 1 of part N of chapter 57 of the  laws  of  2000,  is
   15  amended to read as follows:
   16    (b)  There  shall  be  in  the  office  the developmental disabilities
   17  services offices named below, serving  the  areas  either  currently  or
   18  previously served by a school, for the care and treatment of the mental-
   19  ly  retarded  and developmentally disabled and for research and teaching
   20  in the science and skills required for the care and  treatment  of  such
   21  mentally retarded and developmentally disabled:
   22    Bernard M. Fineson Developmental Disabilities Services Office
   23    Brooklyn Developmental Disabilities Services Office
   24    Broome Developmental Disabilities Services Office
   25    Capital District Developmental Disabilities Services Office
   26    Central New York Developmental Disabilities Services Office
   27    Finger Lakes Developmental Disabilities Services Office
   28    [Institute for Basic Research in Developmental Disabilities]
   29    Hudson Valley Developmental Disabilities Services Office
   30    Metro New York Developmental Disabilities Services Office
   31    Long Island Developmental Disabilities Services Office
   32    Sunmount Developmental Disabilities Services Office
   33    Taconic Developmental Disabilities Services Office
   34    Western New York Developmental Disabilities Services Office
   35    Staten Island Developmental Disabilities Services Office
   36    Valley Ridge Center for Intensive Treatment
   37    [The  New  York  State  Institute  for Basic Research in Developmental
   38  Disabilities is designated as an institute for the  conduct  of  medical
   39  research  and other scientific investigation directed towards furthering
   40  knowledge of the etiology, diagnosis, treatment and prevention of mental
   41  retardation and developmental disabilities.]
   42     § 5.  (a)  Closure  and  consolidation.    Notwithstanding  any  other
   43  provision  of  law to the contrary, the commissioner of mental health is
   44  authorized to close  the  Nathan  S.  Kline  Institute  for  Psychiatric
   45  Research and consolidate the remaining functions pursuant to subdivision
   46  (b)  of  this  section  into  the  New York State Psychiatric Institute,
   47  effective April 1, 2003.
   48    (b) Transfer of functions  and  employees.  The  remaining  functions,
   49  obligations, and duties of the Nathan S. Kline Institute for Psychiatric
   50  Research,  as  designated by the commissioner of mental health, shall be
   51  transferred and assigned to the New York  State  Psychiatric  Institute.
   52  Upon  such  transfer of functions, obligations, and duties of the Nathan
   53  S. Kline Institute for  Psychiatric  Research  to  the  New  York  State
   54  Psychiatric  Institute  pursuant  to  this act, the transfer of affected
   55  employees shall be in accordance with section 70 of  the  civil  service
   56  law.
       S. 1408                            12                            A. 2108
 
    1    (c)  Terms  occurring  in regulations, contracts, and other documents.
    2  Whenever the term Nathan S. Kline Institute for Psychiatric Research  is
    3  referred  to  or  designated  in  any  regulation, contract, or document
    4  pertaining to the functions, powers, obligations, and duties  which  are
    5  transferred  and  assigned,  as designated by the commissioner of mental
    6  health, pursuant to this section, such reference or designation shall be
    7  deemed to refer to the New York State Psychiatric Institute.
    8    (d) Notwithstanding any other law to the contrary,  including  section
    9  7.17  of the mental hygiene law, the commissioner of mental health shall
   10  be authorized to implement any service reduction at any  state  operated
   11  research institute as he or she shall deem necessary and appropriate.
   12     §  6.  Notwithstanding any other provision of law to the contrary, the
   13  commissioner of mental retardation  and  developmental  disabilities  is
   14  authorized  to  close  the Institute for Basic Research in Developmental
   15  Disabilities, effective April 1, 2003.
   16     § 7. This act shall take effect April 1, 2003.
 
   17                                   PART G
 
   18    Section 1. Subdivision (b) of section 7.17 of the mental hygiene  law,
   19  as  amended  by  chapter  333 of the laws of 1998, is amended to read as
   20  follows:
   21    (b) There shall be in the office the hospitals  named  below  for  the
   22  care,  treatment  and  rehabilitation  of  the mentally disabled and for
   23  research and teaching in the science and skills required for  the  care,
   24  treatment and rehabilitation of such mentally disabled.
   25    Binghamton Psychiatric Center
   26    [Bronx Psychiatric Center]
   27    Buffalo Psychiatric Center
   28    Capital District Psychiatric Center
   29    Central New York Psychiatric Center
   30    Creedmoor Psychiatric Center
   31    [Elmira Psychiatric Center]
   32    Hudson River Psychiatric Center
   33    Kingsboro Psychiatric Center
   34    Kirby Forensic Psychiatric Center
   35    Manhattan Psychiatric Center
   36    [Middletown Psychiatric Center]
   37    Mid-Hudson Forensic Psychiatric Center
   38    Mohawk Valley Psychiatric Center
   39    Nathan S. Kline Institute for Psychiatric Research
   40    New York State Psychiatric Institute
   41    Pilgrim Psychiatric Center
   42    [Richard H. Hutchings Psychiatric Center]
   43    Rochester Psychiatric Center
   44    Rockland Psychiatric Center
   45    St. Lawrence Psychiatric Center
   46    South Beach Psychiatric Center
   47    [Bronx Children's Psychiatric Center]
   48    Brooklyn Children's Psychiatric Center
   49    Queens Children's Psychiatric Center
   50    Rockland Children's Psychiatric Center
   51    Sagamore Children's Psychiatric Center
   52    Western New York Children's Psychiatric Center
   53    The  New  York  State  Psychiatric  Institute  and The Nathan S. Kline
   54  Institute for Psychiatric Research are designated as institutes for  the
       S. 1408                            13                            A. 2108
 
    1  conduct  of medical research and other scientific investigation directed
    2  towards furthering knowledge of the etiology, diagnosis,  treatment  and
    3  prevention of mental illness.
    4     §  2.  Paragraph  3  of  subdivision (e) of section 7.17 of the mental
    5  hygiene law, as amended by chapter 83 of the laws of 1995, is amended to
    6  read as follows:
    7    3. provide for a mechanism which may reasonably be expected to provide
    8  notice to local governments,  community  organizations,  employee  labor
    9  organizations, managerial and confidential employees, consumer and advo-
   10  cacy  groups of the potential for significant service reductions at such
   11  state-operated hospitals and state-operated research institutes at least
   12  twelve months prior to  commencing  such  service  reduction,  provided,
   13  however, that this requirement shall be deemed satisfied with respect to
   14  reductions  at  Central  Islip  Psychiatric  Center, Gowanda Psychiatric
   15  Center, Harlem Valley Psychiatric Center, Kings Park Psychiatric Center,
   16  Willard  Psychiatric  Center  [and],  Manhattan  Children's  Psychiatric
   17  Center,  Bronx Psychiatric Center, Elmira Psychiatric Center, Richard H.
   18  Hutchings Psychiatric Center, Middletown Psychiatric  Center  and  Bronx
   19  Children's Psychiatric Center; and
   20     §  3.  Subdivisions (a) and (b) of section 41.11 of the mental hygiene
   21  law, subdivision (a) as amended by chapter 672 of the laws of  1982  and
   22  subdivision  (b)  as  amended  by  chapter  206 of the laws of 1989, are
   23  amended to read as follows:
   24    (a) In all local governments with a population less than  one  hundred
   25  thousand,  community services [board] boards, at the option of the local
   26  government, shall have either nine or fifteen members appointed  by  the
   27  local  government.  In all other local governments, a community services
   28  board shall have fifteen members appointed by the local government.
   29    Whenever practicable at least one member shall be a licensed physician
   30  and one member shall be a certified psychologist and otherwise at  least
   31  two  members  shall  be licensed physicians, such members to have demon-
   32  strated an interest in the field of services for the mentally  disabled.
   33  The  other  members  shall  represent  the community interest in all the
   34  problems of the mentally disabled and shall include representatives from
   35  community agencies for the  mentally  ill,  the  mentally  retarded  and
   36  developmentally  disabled,  and  those  suffering  from  alcoholism  and
   37  substance abuse.  The  community  services  board  shall  have  separate
   38  subcommittees  for  mental  health, mental retardation and developmental
   39  disabilities, and alcoholism or, at the discretion of the local  govern-
   40  ment,  alcoholism  and substance abuse. Each separate subcommittee shall
   41  have no more than nine members appointed by the local government, except
   42  that each subcommittee for mental health shall have no more than  eleven
   43  members  appointed  by the local government.  Three of each such subcom-
   44  mittee shall be members of the board. Each separate  subcommittee  shall
   45  be composed of persons who have demonstrated an interest in the field of
   46  services for the particular class of mentally disabled and shall include
   47  former  patients, parents or relatives of such mentally disabled persons
   48  and  community  agencies  serving  the  particular  class  of   mentally
   49  disabled,  except that each subcommittee for mental health shall include
   50  at least two  members  who  are  or  were  consumers  of  mental  health
   51  services,  and  at  least  two  members  who are parents or relatives of
   52  persons with mental illness.   Each separate subcommittee  shall  advise
   53  the  community  services  board  and  the director of community services
   54  regarding the exercise of all policy-making  functions  vested  in  such
   55  board  or  director,  as such functions pertain to the field of services
   56  for the particular class of mentally disabled individuals represented by
       S. 1408                            14                            A. 2108
 
    1  such subcommittee.   In addition, each subcommittee  for  mental  health
    2  shall  be authorized to annually evaluate the local services plan or the
    3  unified services plan, as appropriate, and shall be authorized to report
    4  on  the consistency of such plans with the needs of persons with serious
    5  mental  illness,  including  children  and  adolescents   with   serious
    6  emotional  disturbances.  Any such report shall be forwarded annually to
    7  the community services board and the director of community services  and
    8  a copy shall also be sent to the commissioner prior to the submission of
    9  the  local services plan or unified services plan. Provided however that
   10  the provisions of this paragraph shall not apply to  cities  of  over  a
   11  million in population.
   12    (b)  In  cities  of  over  a  million a community services board shall
   13  consist of fifteen members to be appointed by the mayor. There shall  be
   14  at  least  two residents of each county within such cities on the board.
   15  At least one shall be a licensed physician and at least one shall  be  a
   16  certified  psychologist. The other members shall represent the community
   17  interest in all of the problems  of  the  mentally  disabled  and  shall
   18  include  representatives  from  community agencies for the mentally ill,
   19  the mentally retarded and developmentally disabled, and those  suffering
   20  from  alcoholism and substance abuse. The community services board shall
   21  have separate subcommittees for mental health,  mental  retardation  and
   22  developmental  disabilities, and alcoholism or, at the discretion of the
   23  local government, alcoholism and substance abuse. Each separate  subcom-
   24  mittee  shall  have  no  more  than  nine members appointed by the local
   25  government, except that each subcommittee for mental health  shall  have
   26  no  more  than  eleven members appointed by the local government.  Three
   27  members of each such subcommittee shall be members of  the  board.  Each
   28  separate subcommittee shall be composed of persons who have demonstrated
   29  an interest in the field of services for the particular class of mental-
   30  ly  disabled  and shall include former patients, parents or relatives of
   31  such mentally  disabled  persons  and  community  agencies  serving  the
   32  particular class of mentally disabled, except that each subcommittee for
   33  mental health shall include at least two members who are or were consum-
   34  ers  of mental health services, and two members who are parents or rela-
   35  tives of persons with mental illness.  Each separate subcommittee  shall
   36  advise  the  community  services  board  and  the  director of community
   37  services regarding the exercise of all policy-making functions vested in
   38  such board or director, as  such  functions  pertain  to  the  field  of
   39  services  for  the  particular  class  of  mentally disabled individuals
   40  represented by such subcommittee.   In addition, each  subcommittee  for
   41  mental  health  shall  be  authorized  to  annually  evaluate  the local
   42  services plan or the unified services plan, as appropriate, and shall be
   43  authorized to report on the consistency of such plans with the needs  of
   44  persons  with serious mental illness, including children and adolescents
   45  with serious emotional disturbances. Any such report shall be  forwarded
   46  annually  to  the community services board and the director of community
   47  services, and a copy shall also be sent to the commissioner prior to the
   48  submission of the local services plan or unified services plan.
   49     § 4. The mental hygiene law is amended by adding a new  section  41.56
   50  to read as follows:
   51   § 41.56 Community  mental  health  support  and  workforce  reinvestment
   52            program.
   53    (a) Community mental health support and workforce  reinvestment  funds
   54  shall be annually allocated by the commissioner based upon the following
   55  criteria:
       S. 1408                            15                            A. 2108
 
    1    (1)  the  efficiency  and  effectiveness of the use of funding for the
    2  delivery of services to persons with  serious  mental  illness  who  are
    3  discharged  to  the  community  in order to fund necessary mental health
    4  services; and
    5    (2)  other  relevant  factors that require the maintenance of existing
    6  mental health services and  the  development  or  support  of  community
    7  mental health services.
    8    (b)  Amounts  provided  pursuant to this section shall be used to fund
    9  mental health workforce related activities, or other general programmat-
   10  ic activities to help ensure a stable mental health system.
   11    (c) The commissioner is authorized and empowered to make  inspections,
   12  examine  records  and  conduct  on-site audits of books and records of a
   13  local governmental unit or a provider of services receiving  such  funds
   14  pursuant to this section. Such inspections, examinations or audits shall
   15  be  authorized  to  include all financial, statistical, program or other
   16  information that the commissioner may determine to be necessary, includ-
   17  ing but not  limited  to  all  medical,  service,  financial  and  other
   18  records,  receipts,  disbursements,  contracts,  loans  and other moneys
   19  relating to the financial operation of the local  governmental  unit  or
   20  provider.
   21    (d)  Nothing  in  this section shall create or be deemed to create any
   22  right, interest or entitlement to services or funds that are the subject
   23  of this section, or to any other services or funds, whether to  individ-
   24  uals, localities, providers or others, individually or collectively.
   25    (e)  Notwithstanding  any other provision of law to the contrary, each
   26  of the provisions of this section shall be subject to  annual  appropri-
   27  ations made therefor.
   28     §  5.  (a) The amount of community mental health support and workforce
   29  reinvestment funds for the office of mental health shall  be  determined
   30  in  the annual budget and shall include the amount of actual state oper-
   31  ations general fund appropriation reductions directly attributed to each
   32  non-geriatric adult inpatient bed  closed.  For  the  purposes  of  this
   33  section  a  bed shall be considered to be closed upon the elimination of
   34  funding for such bed in the annual budget. The appropriation  reductions
   35  as  a  result  of non-geriatric adult inpatient bed closures shall be no
   36  less than $70,000 per bed closed on a full  annual  basis,  as  annually
   37  recommended  by  the  commissioner  of  mental  health,  subject  to the
   38  approval of the director of the budget, provided, however, in  no  event
   39  shall the full annual value of community mental health support and work-
   40  force  reinvestment  funds  attributable  to  beds closed as a result of
   41  non-geriatric adult inpatient bed closures exceed the twelve month value
   42  of the office of mental health state operations general fund  reductions
   43  resulting  from such bed closures. Such funds made available pursuant to
   44  this subdivision shall be at the same amount  by  which  the  office  of
   45  mental health's state operations general fund appropriations are reduced
   46  each year as a result of non-geriatric adult inpatient bed closures.
   47    (b)  An additional amount of community mental health support and work-
   48  force reinvestment funds shall be  made  available,  subject  to  annual
   49  appropriations  made  therefor,  in  the  annual budget based upon state
   50  operations general fund appropriation reductions directly attributed  to
   51  the  closure  of  state  psychiatric  centers pursuant to this act. Such
   52  funds shall be made available at the same amount by which the office  of
   53  mental health's state operations general fund appropriations are reduced
   54  each year as a result of such facility closures.
   55    (c) The annual community mental health support and workforce reinvest-
   56  ment  appropriation shall reflect, subject to appropriations made there-
       S. 1408                            16                            A. 2108
 
    1  for,  the  amount  of  state  operations  general   fund   appropriation
    2  reductions  resulting  from  subdivisions  (a)  and (b) of this section.
    3  Within any fiscal year where appropriation increases are recommended for
    4  the  community mental health support and workforce reinvestment program,
    5  insofar as projected non-geriatric adult inpatient census decline and/or
    6  facility closure or closures do not occur as estimated, and state  oper-
    7  ations  general fund savings do not result, then the reinvestment appro-
    8  priations shall be made available, as  needed,  for  transfer  from  the
    9  office  of mental health general fund - aid to localities account to the
   10  office of mental health general fund - state purposes account to pay for
   11  any necessary adult inpatient expenses.
   12    (d) For purposes of this section, the term "state  operations  general
   13  fund"  shall  mean  the office of mental health state operations general
   14  fund appropriations before any offset from the special revenue  funds  -
   15  other,  miscellaneous special revenue fund - 339, mental hygiene patient
   16  income account.
   17    (e) Nothing in this act shall create or be deemed to create any right,
   18  interest or entitlement to services or funds that  are  the  subject  of
   19  this  act,  or  to  any other services or funds, whether to individuals,
   20  localities, providers or others, individually or collectively.
   21    (f) All methodologies used to determine allocation amounts made pursu-
   22  ant to this section and section 41.56 of  the  mental  hygiene  law,  as
   23  added  by  section  four  of  this  act,  shall be developed in the sole
   24  discretion of the commissioner of mental health and the director of  the
   25  budget.
   26    (g)  Notwithstanding  any other provision of law to the contrary, each
   27  of the provisions of this section shall be subject to  annual  appropri-
   28  ations made therefor.
   29     §  6.  Actual  state  operations general fund appropriation reductions
   30  directly attributed to children's inpatient bed  closures,  pursuant  to
   31  this  act,  shall  be  made  available  to  the office of mental health,
   32  subject to annual appropriations made therefor, for the development  and
   33  expansion  of  community mental health services for children and adoles-
   34  cents with serious emotional disturbances, which may  include,  but  are
   35  not limited to, crisis intervention beds, home-based crisis intervention
   36  teams, and home and community-based waiver slots.
   37     §  7.  Notwithstanding  section  7.21  of  the mental hygiene law, the
   38  commissioner of mental health, or his or  her  designee,  shall  be  the
   39  appointing  and removing authority for all officers and employees of the
   40  office of mental health, including but not limited to, the officers  and
   41  employees of the psychiatric hospitals and institutes listed in subdivi-
   42  sion  (b) of section 7.17 of the mental hygiene law, and he or she shall
   43  have the power, within amounts appropriated  therefor,  to  appoint  and
   44  remove,  in  accordance  with  the law and applicable rules of the state
   45  civil service commissioner, such officers and employees as are necessary
   46  for the efficient administration of the office.
   47     § 8. This act shall take effect immediately; except that:
   48    (a) notwithstanding any other law to the contrary, including, but  not
   49  limited  to,  subdivision (e) of section 7.17 of the mental hygiene law,
   50  the closure of Elmira Psychiatric Center, Richard H.  Hutchings  Psychi-
   51  atric Center, and Middletown Psychiatric Center, pursuant to section one
   52  of  this  act,  shall  take effect on July 1, 2003; the closure of Bronx
   53  Psychiatric Center and Bronx Children's Psychiatric Center, pursuant  to
   54  section one of this act, shall take effect on October 1, 2005; and
   55    (b) sections four, five and six of this act shall take effect on April
   56  1, 2004 and shall expire and be deemed repealed March 31, 2007.
       S. 1408                            17                            A. 2108
 
    1                                   PART H
 
    2    Section  1. Sections 1 and 3 of chapter 119 of the laws of 1997 relat-
    3  ing to  authorizing  the  department  of  health  to  establish  certain
    4  payments to general hospitals, section 1 as amended by section 1 of part
    5  M  of chapter 57 of the laws of 2000 and section 3 as separately amended
    6  by chapter 13 and section 1 of part M of chapter 57 of the laws of 2000,
    7  are amended to read as follows:
    8    Section 1. 1. Notwithstanding any inconsistent  provision  of  law  or
    9  regulation,  effective  for  the  period April 1, 1997 through March 31,
   10  1998 and for annual periods beginning April 1 thereafter, the department
   11  of health is authorized to pay voluntary non-profit general hospitals as
   12  defined in subdivision 10 of section 2801 of the public health law addi-
   13  tional payments for inpatient hospital services  as  medical  assistance
   14  payments  pursuant  to  title 11 of article 5 of the social services law
   15  and  federal  law  and  regulations  governing  disproportionate   share
   16  payments, based on the amount of state aid for which such general hospi-
   17  tals  are  eligible  pursuant  to  articles  25, 26 and 41 of the mental
   18  hygiene law and as identified in subdivision 2 of this section.  Payment
   19  made pursuant to this section shall not exceed each such general  hospi-
   20  tal's  cost  of  providing  services  to uninsured patients and patients
   21  eligible for medical assistance pursuant to title 11 of article 5 of the
   22  social services law after taking into consideration  all  other  medical
   23  assistance  received,  including disproportionate share payments made to
   24  such general hospital, and payments from or on behalf of such  uninsured
   25  patients, and shall also not exceed the total amount of state aid, iden-
   26  tified  by  subdivision  2  of  this  section, available to such general
   27  hospital by law. Payments made to such  general  hospitals  pursuant  to
   28  this  section  shall be made in lieu of any state aid payments available
   29  to such general hospital by law.
   30    2. The commissioners of mental health  and  alcoholism  and  substance
   31  abuse  services,  after  consultation with county directors of community
   32  services, shall identify to the commissioner of health for the office of
   33  mental health and office of  alcoholism  and  substance  abuse  services
   34  respectively,  each such general hospital and the amounts to be distrib-
   35  uted to each such general hospital pursuant to this section. For  annual
   36  periods  beginning  April  1,  1998  and  thereafter, in determining the
   37  disproportionate share amounts to be distributed to  each  such  general
   38  hospital  pursuant  to  this  section, such commissioners shall consider
   39  whether such general hospital has  served  populations  and/or  provided
   40  services  in  the  prior  year  similar  to  the  populations served and
   41  services provided with the state  aid  payments  and/or  the  additional
   42  disproportionate  share  payments  approved  by such commissioner in the
   43  prior state fiscal year [1996-97 utilized to  determine  the  dispropor-
   44  tionate share payments made pursuant to this section]. All amounts to be
   45  distributed  pursuant  to this section shall be approved by the director
   46  of the budget.
   47    3. Notwithstanding any other provision of law regarding a local social
   48  services district's share of payments pursuant to title 11 of article  5
   49  of  the social services law, the local social services district share of
   50  the non-federal share of the amount approved in subdivision  2  of  this
   51  section associated with mental health, chemical dependence, and alcohol-
   52  ism  and substance abuse state aid payments shall be the same proportion
   53  of the total non-federal share  as  the  amount  expended  for  services
   54  provided pursuant to an approved local plan required by section 41.16 of
       S. 1408                            18                            A. 2108
 
    1  the mental hygiene law [for the local district fiscal year commencing on
    2  or prior to January 1, 1997].
    3    4.  Revenues  from  payments  pursuant  to  this  section shall not be
    4  included in gross revenue for purposes of the  assessments  pursuant  to
    5  section  2807-d  of  the public health law, subject to the provisions of
    6  subdivision 12 of section 2807-d of the public health law and shall  not
    7  be  included  in  gross revenue received for purposes of the assessments
    8  pursuant to subdivision 18 of section 2807-c of the  public  health  law
    9  subject  to the provisions of paragraph (e) of subdivision 18 of section
   10  2807-c of the public health law.
   11    5. The commissioners of mental health  and  alcoholism  and  substance
   12  abuse services may adopt or amend or promulgate any regulation he or she
   13  determines necessary to implement any provision of this section.
   14    6.  Payments made pursuant to this section shall be based initially on
   15  reported 1995 reconciled data as further reconciled to  actual  reported
   16  [2000]  reconciled data. The payments may be made as quarterly aggregate
   17  payments to an eligible general hospital.
   18     § 3. This act shall take effect immediately and  shall  be  deemed  to
   19  have been in full force and effect on and after April 1, 1997.  This act
   20  shall expire [June 30, 2003] March 31, 2006.
   21     §  2. This act shall take effect immediately; provided that the amend-
   22  ments to section 1 of chapter 119 of the laws of 1997  made  by  section
   23  one  of  this  act  shall  not affect the expiration of such chapter and
   24  shall be deemed expired therewith.
 
   25                                   PART I
 
   26    Section 1. Subdivisions 2 and 3 of section 605 of  the  public  health
   27  law,  subdivision  2  as  amended by chapter 474 of the laws of 1996 and
   28  subdivision 3 as added by chapter 901 of the laws of 1986,  are  amended
   29  to read as follows:
   30    2.  State  aid  reimbursement for public health services provided by a
   31  municipality under this title, shall be made as follows:
   32    (a) if the municipality is providing some or all of the  basic  public
   33  health  services  identified  in  paragraph  (b) of subdivision three of
   34  section six hundred two of this title, pursuant to an approved plan,  at
   35  a  rate  of  up to fifty per centum but no less than [thirty-six] thirty
   36  per centum, except for vector emergencies pursuant to subdivision  three
   37  of section six hundred eleven of this article, of the difference between
   38  the  amount  of  moneys  expended  by the municipality for public health
   39  services required by paragraph (b) of subdivision three of  section  six
   40  hundred  two  of  this  title  during the fiscal year and the base grant
   41  provided  pursuant  to  subdivision  one  of  this  section.    No  such
   42  reimbursement shall be provided for services if they are not approved in
   43  a plan or if no plan is submitted for such services.
   44    (b) [if the municipality is providing] there shall be no reimbursement
   45  for  other  public  health  services [within limits to be] prescribed by
   46  regulation by the commissioner in addition to some or all of the  public
   47  health  services  required  in  paragraph  (b)  of  subdivision three of
   48  section six hundred two of this title, pursuant to an approved plan[, at
   49  a rate of up to fifty per centum but not less than thirty per centum  of
   50  the moneys expended by the municipality for such other services. No such
   51  reimbursement shall be provided for services if they are not approved in
   52  a plan or if no plan is submitted for such services].
   53    3.  Municipalities  shall  make  every  reasonable  effort  to collect
   54  payments for public health services provided. All such revenues  related
       S. 1408                            19                            A. 2108
 
    1  to  services  reimbursed  under paragraph (a) of subdivision two of this
    2  section shall be reported to the commissioner and will be deducted  from
    3  expenditures identified under subdivision two of this section to produce
    4  a  net  cost  eligible for state aid.   Municipalities are authorized to
    5  collect payments for any public  health  service  provided  pursuant  to
    6  paragraph (b) of subdivision two of this section.
    7     § 2. Subdivision 1 of section 616 of the public health law, as amended
    8  by chapter 474 of the laws of 1996, is amended to read as follows:
    9    1.  The  total  amount  of state aid provided pursuant to this article
   10  shall be limited to the amount of the annual appropriation made  by  the
   11  legislature.  In no event, however, shall such state aid be less than an
   12  amount to provide the full base grant [and,  as  otherwise  provided  by
   13  paragraph  (a)  of  subdivision  two of section six hundred five of this
   14  article, at least thirty-six per centum of the  difference  between  the
   15  amount of moneys expended by the municipality for public health services
   16  required  by  paragraph  (b) of subdivision three of section six hundred
   17  two of this article during the fiscal year and the base grant]  provided
   18  pursuant  to  subdivision  one of section six hundred five of this arti-
   19  cle[. A municipality shall also receive at least thirty  per  centum  of
   20  the  moneys  expended for other public health services pursuant to para-
   21  graph (b) of subdivision two of section six hundred five of  this  arti-
   22  cle, and, at least the minimum amount so required for the services iden-
   23  tified  in  title  two of this article.  Moreover, for services provided
   24  during calendar year nineteen hundred ninety-six, no county with a popu-
   25  lation of fifty thousand or less shall receive less reimbursement pursu-
   26  ant to subdivision one and paragraphs (a) and (b) of subdivision two  of
   27  section  six hundred five of this article than it would have had a chap-
   28  ter of the laws of nineteen hundred ninety-six amending these provisions
   29  as of August first, nineteen hundred ninety-six not been enacted].
   30     § 3. This act shall take effect immediately and  shall  be  deemed  to
   31  have been in full force and effect on and after December 31, 2002.
 
   32                                   PART J
 
   33    Section  1.  Subparagraph  (i)  of  paragraph  (b) of subdivision 1 of
   34  section 547-j of the executive law, as amended by section 12 of  part  J
   35  of chapter 82 of the laws of 2002, is amended to read as follows:
   36    (i)  Average wholesale price discounted by [ten] fifteen percent, plus
   37  a dispensing fee as defined in paragraph (c) of this subdivision, or
   38     § 2. Section 547-e of the executive law is amended  by  adding  a  new
   39  subdivision 5 to read as follows:
   40    5.  Transition program participants to the revised quarterly registra-
   41  tion fees under section five hundred forty-seven-g of this  article  and
   42  the  deductible requirements under section five hundred forty-seven-h of
   43  this article within sixty days of the effective date  of  this  subdivi-
   44  sion, except that any registration fees for annual coverage periods paid
   45  prior to such transition in an annual lump sum in accordance with subdi-
   46  vision  two  of section five hundred forty-seven-g of this article shall
   47  not be revised.
   48     § 3. Paragraphs (i) and (ii) of subdivision 2 of section 547-g of  the
   49  executive  law,  as  amended by section 6 of part J of chapter 57 of the
   50  laws of 2000, are amended to read as follows:
   51    (i) quarterly  registration  fees  for  unmarried  individual  program
   52  participants:
 
   53    individual income of $5,000 or less .................... [$2.00] $2.25
       S. 1408                            20                            A. 2108
 
    1    individual income of $5,001 to $6,000 .................. [$2.00] $2.25
    2    individual income of $6,001 to $7,000 .................. [$4.00] $4.50
    3    individual income of $7,001 to $8,000 .................. [$5.50] $6.00
    4    individual income of $8,001 to $9,000 .................. [$7.00] $7.75
    5    individual income of $9,001 to $10,000 ................ [$9.00] $10.00
    6    individual income of $10,001 to $11,000 .............. [$10.00] $11.00
    7    individual income of $11,001 to $12,000 .............. [$11.50] $12.75
    8    individual income of $12,001 to $13,000 .............. [$13.50] $14.75
    9    individual income of $13,001 to $14,000 .............. [$15.00] $16.50
   10    individual income of $14,001 to $15,000 .............. [$20.00] $22.00
   11    individual income of $15,001 to $16,000 .............. [$27.50] $30.25
   12    individual income of $16,001 to $17,000 .............. [$35.00] $38.50
   13    individual income of $17,001 to $18,000 .............. [$42.50] $46.75
   14    individual income of $18,001 to $19,000 .............. [$50.00] $55.00
   15    individual income of $19,001 to $20,000 .............. [$57.50] $63.25
 
   16    (ii)  quarterly  registration fees for each married individual program
   17  participant:
 
   18    joint income of $5,000 or less ......................... [$2.00] $2.25
   19    joint income of $5,001 to $6,000 ....................... [$2.00] $2.25
   20    joint income of $6,001 to $7,000 ....................... [$3.00] $3.25
   21    joint income of $7,001 to $8,000 ....................... [$4.00] $4.50
   22    joint income of $8,001 to $9,000 ........................ [$5.00]$5.50
   23    joint income of $9,001 to $10,000 .......................[$6.00] $6.50
   24    joint income of $10,001 to $11,000 ..................... [$7.00] $7.75
   25    joint income of $11,001 to $12,000 ..................... [$8.00] $8.75
   26    joint income of $12,001 to $13,000 .................... [$9.00] $10.00
   27    joint income of $13,001 to $14,000 ................... [$10.00] $11.00
   28    joint income of $14,001 to $15,000 ................... [$10.00] $11.00
   29    joint income of $15,001 to $16,000 ................... [$21.00] $23.00
   30    joint income of $16,001 to $17,000 ................... [$26.50] $29.25
   31    joint income of $17,001 to $18,000 ................... [$31.50] $34.75
   32    joint income of $18,001 to $19,000 ................... [$37.50] $41.25
   33    joint income of $19,001 to $20,000 ................... [$43.00] $47.25
   34    joint income of $20,001 to $21,000 ................... [$48.50] $53.25
   35    joint income of $21,001 to $22,000 ................... [$54.00] $59.50
   36    joint income of $22,001 to $23,000 ................... [$59.50] $65.50
   37    joint income of $23,001 to $24,000 ................... [$65.00] $71.50
   38    joint income of $24,001 to $25,000 ................... [$68.75] $75.75
   39    joint income of $25,001 to $26,000 ................... [$75.00] $82.50
   40     § 4. Paragraphs (i) and (ii) of subdivision 2 of section 547-h of  the
   41  executive  law,  as  amended by section 7 of part J of chapter 57 of the
   42  laws of 2000, are amended to read as follows:
   43    (i) annual personal covered drug expenditures for unmarried individual
   44  eligible program participants:
 
   45    individual income of $20,001 to $21,000 .................. [$530] $583
   46    individual income of $21,001 to $22,000 .................. [$550] $605
   47    individual income of $22,001 to $23,000 .................. [$580] $638
   48    individual income of $23,001 to $24,000 .................. [$720] $792
   49    individual income of $24,001 to $25,000 .................. [$750] $825
   50    individual income of $25,001 to $26,000 .................. [$780] $858
   51    individual income of $26,001 to $27,000 .................. [$810] $891
   52    individual income of $27,001 to $28,000 .................. [$840] $924
   53    individual income of $28,001 to $29,000 .................. [$870] $957
       S. 1408                            21                            A. 2108
 
    1    individual income of $29,001 to $30,000 .................. [$900] $990
    2    individual income of $30,001 to $31,000 ................ [$930] $1,023
    3    individual income of $31,001 to $32,000 ................ [$960] $1,056
    4    individual income of $32,001 to $33,000 .............. [$1,160] $1,276
    5    individual income of $33,001 to $34,000 .............. [$1,190] $1,309
    6    individual income of $34,001 to $35,000 .............. [$1,230] $1,353
 
    7    (ii)  annual personal covered drug expenditures for each married indi-
    8  vidual eligible program participant:
 
    9    joint income of $26,001 to $27,000 ....................... [$650] $715
   10    joint income of $27,001 to $28,000 ....................... [$675] $743
   11    joint income of $28,001 to $29,000 ....................... [$700] $770
   12    joint income of $29,001 to $30,000 ....................... [$725] $798
   13    joint income of $30,001 to $31,000 ....................... [$900] $990
   14    joint income of $31,001 to $32,000 ..................... [$930] $1,023
   15    joint income of $32,001 to $33,000 ..................... [$960] $1,056
   16    joint income of $33,001 to $34,000 ..................... [$990] $1,089
   17    joint income of $34,001 to $35,000 ................... [$1,020] $1,122
   18    joint income of $35,001 to $36,000 ................... [$1,050] $1,155
   19    joint income of $36,001 to $37,000 ................... [$1,080] $1,188
   20    joint income of $37,001 to $38,000 ................... [$1,110] $1,221
   21    joint income of $38,001 to $39,000 ................... [$1,140] $1,254
   22    joint income of $39,001 to $40,000 ................... [$1,170] $1,287
   23    joint income of $40,001 to $41,000 ................... [$1,200] $1,320
   24    joint income of $41,001 to $42,000 ................... [$1,230] $1,353
   25    joint income of $42,001 to $43,000 ................... [$1,260] $1,386
   26    joint income of $43,001 to $44,000 ................... [$1,290] $1,419
   27    joint income of $44,001 to $45,000 ................... [$1,320] $1,452
   28    joint income of $45,001 to $46,000 ................... [$1,575] $1,733
   29    joint income of $46,001 to $47,000 ................... [$1,610] $1,771
   30    joint income of $47,001 to $48,000 ................... [$1,645] $1,810
   31    joint income of $48,001 to $49,000 ................... [$1,680] $1,848
   32    joint income of $49,001 to $50,000 ................... [$1,715] $1,887
   33     § 5. Subdivision 1 of section 547-a of the executive law,  as  amended
   34  by chapter 474 of the laws of 1996, is amended to read as follows:
   35    1.  "Covered  drug"  shall  mean a drug dispensed subject to a legally
   36  authorized prescription pursuant to section sixty-eight hundred  ten  of
   37  the  education  law,  and  insulin,  an  insulin  syringe, or an insulin
   38  needle. Such term shall not include: (a)  any  drug  determined  by  the
   39  commissioner  of the federal food and drug administration to be ineffec-
   40  tive or unsafe; (b) any drug dispensed in a package, or form  of  dosage
   41  or  administration, as to which the state commissioner of health finally
   42  determines in accordance with the provisions  of  section  five  hundred
   43  forty-seven-l  of this article that a less expensive package, or form of
   44  dosage or administration, is available that is  pharmaceutically  equiv-
   45  alent  and  equivalent  in its therapeutic effect for the general health
   46  characteristics of the eligible program participant population; and  (c)
   47  any  device  for the aid or correction of vision, or any drug, including
   48  vitamins,  which  is   generally   available   without   a   physician's
   49  prescription.  For  the  purpose  of  this  article, except as otherwise
   50  provided herein, a covered drug shall  be  dispensed  in  quantities  no
   51  greater  than  a  thirty  day  supply or one hundred units, whichever is
   52  greater. In the case of a drug dispensed in  a  form  of  administration
   53  other  than a tablet or capsule, the maximum allowed quantity shall be a
   54  thirty day supply[; the].  The panel is authorized to approve exceptions
       S. 1408                            22                            A. 2108
 
    1  to these limits, or require prior authorization based  on  certification
    2  of medical indication by the prescriber, for specific products following
    3  consideration  of recommendations from pharmaceutical or medical experts
    4  regarding commonly packaged quantities, unusual forms of administration,
    5  length  of treatment, health and safety concerns, or cost effectiveness.
    6  In the case of  a  drug  prescribed  pursuant  to  section  thirty-three
    7  hundred  thirty-two  of the public health law to treat one of the condi-
    8  tions that have been enumerated by the commissioner of  health  pursuant
    9  to regulation as warranting the prescribing of greater than a thirty day
   10  supply, such drug shall be dispensed in quantities not to exceed a three
   11  month supply.
   12     §  6.  Subparagraph  (ii) of paragraph (a) of subdivision 3 of section
   13  547-j of the executive law, as amended by section 7 of part C of chapter
   14  1 of the laws of 2002, is amended to read as follows:
   15    (ii) the program may reimburse  for  any  covered  drugs  pursuant  to
   16  subdivisions  one  and  two of this section, [which are rated 1-A by the
   17  federal food and drug administration and] for which a  rebate  agreement
   18  does  not  exist  and which are determined by the elderly pharmaceutical
   19  insurance coverage panel to  be  essential  to  the  health  of  persons
   20  participating in the program; and likely to provide effective therapy or
   21  diagnosis for a disease not adequately treated or diagnosed by any other
   22  covered  drug;  and which are recommended for reimbursement by the panel
   23  and approved by the commissioner of health.
   24     § 7. This act shall take effect immediately.
 
   25                                   PART K
 
   26    Section 1. Subdivision 1 of section 368-a of the social  services  law
   27  is amended by adding two new paragraphs (y) and (z) to read as follows:
   28    (y) Notwithstanding any other provision of law, one hundred percent of
   29  the  amount  expended  for  outpatient drugs provided in accordance with
   30  paragraph (g) of subdivision two of section three  hundred  sixty-five-a
   31  of this title, after first deducting therefrom any federal funds proper-
   32  ly received or to be received on account thereof.
   33    (z)  Subject  to the provisions of paragraphs (c), (f), (h), (i), (j),
   34  (l), (n), (q), (r) and (u) of this subdivision,  twenty-six  percent  of
   35  the amount expended for inpatient hospital services provided by a gener-
   36  al  hospital  in  accordance  with  paragraph  (b) of subdivision two of
   37  section three hundred sixty-five-a of  this  title  and  for  outpatient
   38  hospital  and  clinic  services  in a facility under the authority of an
   39  operating certificate issued pursuant to  article  twenty-eight  of  the
   40  public health law in accordance with paragraph (c) of subdivision two of
   41  section  three hundred sixty-five-a of this title, after first deducting
   42  therefrom any federal funds properly  received  or  to  be  received  on
   43  account thereof.
   44     §  2.  Subparagraph  (ii) of paragraph (b) of subdivision 9 of section
   45  367-a of the social services law, as amended by chapter 19 of  the  laws
   46  of 1998, is amended to read as follows:
   47    (ii) if the drug dispensed is a multiple source prescription drug or a
   48  brand-name  prescription drug for which no specific upper limit has been
   49  set by such federal agency, the lower of the estimated acquisition  cost
   50  of  such  drug  to  pharmacies,  or  the dispensing pharmacy's usual and
   51  customary price charged to the  general  public.  Estimated  acquisition
   52  cost means the average wholesale price of a prescription drug based upon
   53  the  package  size  dispensed from, as reported by the prescription drug
       S. 1408                            23                            A. 2108
 
    1  pricing service used by the department, less [ten] fifteen percent ther-
    2  eof, and updated monthly by the department.
    3     §  3.  Paragraph  (c)  of subdivision 6 of section 367-a of the social
    4  services law is amended by adding a new subparagraph (iii)  to  read  as
    5  follows:
    6    (iii)  Notwithstanding  any other provision of this paragraph, co-pay-
    7  ments charged for each generic  prescription  drug  dispensed  shall  be
    8  $1.00  and  for  each  brand  name  prescription drug dispensed shall be
    9  $3.00.
   10     § 4. Paragraph (f) of subdivision 6 of section  367-a  of  the  social
   11  services  law, as added by chapter 41 of the laws of 1992, is amended to
   12  read as follows:
   13    (f) (i) In the year commencing April first, nineteen  hundred  ninety-
   14  three and for each year thereafter, and ending in the year concluding on
   15  March  thirty-first,  two thousand three, no recipient shall be required
   16  to pay more than a total of one hundred dollars in co-payments  required
   17  by  this  subdivision,  nor  shall reductions in payments as a result of
   18  such co-payments exceed one hundred dollars for any recipient.
   19    (ii) In the year commencing April first, two thousand  three  and  for
   20  each  year thereafter, no recipient shall be required to pay more than a
   21  total of one hundred fifty  dollars  in  co-payments  required  by  this
   22  subdivision,  nor  shall  reductions  in  payments  as  a result of such
   23  co-payments exceed one hundred fifty dollars for any recipient.
   24     § 5. Paragraph (b) of subdivision 6 of section  367-a  of  the  social
   25  services  law,  as added by chapter 41 of the laws of 1992, subparagraph
   26  (iii) as amended by chapter 843 of the laws of 1992, is amended to  read
   27  as follows:
   28    (b)  Co-payments  shall apply to all eligible persons for the services
   29  defined in paragraph (d) of this subdivision with the exception of:
   30    (i) individuals under twenty-one years of age;
   31    (ii) pregnant women;
   32    (iii) individuals who are inpatients in a medical  facility  who  have
   33  been  required  to  spend  all  of their income for medical care, except
   34  their personal needs allowance or residents of community based  residen-
   35  tial facilities licensed by the office of mental health or the office of
   36  mental retardation and developmental disabilities who have been required
   37  to spend all of their income, except their personal needs allowance;
   38    (iv) individuals enrolled in health maintenance organizations or other
   39  entities  which  provide comprehensive health services, or other managed
   40  care programs for services covered by such programs,  except  that  such
   41  persons shall be subject to co-payments as described in subparagraph (v)
   42  of paragraph (d) of this subdivision; and
   43    (v)  any  other  individuals required to be excluded by federal law or
   44  regulations.
   45     § 6. Paragraph (a) of subdivision 2 of section 2807-d  of  the  public
   46  health  law  is  amended  by  adding  a  new subparagraph (v) to read as
   47  follows:
   48    (v) Notwithstanding any contrary provisions of this paragraph  or  any
   49  other provision of law or regulation to the contrary, for general hospi-
   50  tals the assessment shall be seven-tenths of one percent of each general
   51  hospital's  gross  receipts  received from all patient care services and
   52  other operating income on a cash basis beginning April first, two  thou-
   53  sand  three  for hospital or health-related services, including, but not
   54  limited to inpatient service,  outpatient  service,  emergency  service,
   55  referred  ambulatory  service  and ambulatory surgical services, but not
   56  including residential health care facilities  services  or  home  health
       S. 1408                            24                            A. 2108
 
    1  care  services;  provided,  however,  that  for  all such gross receipts
    2  received on or after April first, two  thousand  four,  such  assessment
    3  shall  be  fifty-three  hundredths  of one percent, and further provided
    4  that  for  all such gross receipts received on or after April first, two
    5  thousand five, such assessment shall be thirty-five  hundredths  of  one
    6  percent  and  further provided that for all such gross receipts received
    7  on and after April first, two thousand  six  such  assessment  shall  be
    8  eighteen  hundredths  of  one percent, and further provided that for all
    9  such gross receipts received on  or  after  April  first,  two  thousand
   10  seven, such assessment shall be zero.
   11     §  7.  Paragraph  (b) of subdivision 9 of section 2807-d of the public
   12  health law, as amended by section 25 of part J of chapter 82 of the laws
   13  of 2002, is amended to read as follows:
   14    (b) provided, however, that funds accumulated, including  income  from
   15  invested  funds,  from  the  [further additional assessment] assessments
   16  provided in accordance  with  subparagraph  (v)  of  paragraph  (a)  and
   17  subparagraphs  (iii), (iv), (v) and (vi) of paragraph (b) of subdivision
   18  two of this section, including interest and penalties, shall be deposit-
   19  ed by the commissioner and credited to a special  revenue-other  medical
   20  assistance  account  to be established by the comptroller. To the extent
   21  of funds appropriated  therefor,  funds  shall  be  made  available  for
   22  payments under the medical assistance program provided pursuant to title
   23  eleven of article five of the social services law;
   24     §  8.  1.  Notwithstanding  paragraph (c) of subdivision 10 of section
   25  2807-c of the public health law and section 21 of chapter 1 of the  laws
   26  of 1999 and any other inconsistent provision of law or regulation to the
   27  contrary, in determining rates of payment by state governmental agencies
   28  effective  for  services  provided on and after April 1, 2003, for inpa-
   29  tient and outpatient services provided by general  hospitals  and  inpa-
   30  tient  services  provided by residential health care facilities pursuant
   31  to article 28 of the public health law, for home care services  provided
   32  by  certified  home  health  agencies  and  long  term  home health care
   33  programs pursuant to article 36  of  the  public  health  law,  and  for
   34  personal  care services provided pursuant to section 365-a of the social
   35  services law, the commissioner of health shall  apply  no  trend  factor
   36  projections  attributable to the period January 1, 2003 through December
   37  31, 2003.
   38    2. The commissioner of health shall adjust rates of payment to reflect
   39  the exclusion pursuant to this section of such  specified  trend  factor
   40  projections or adjustments.
   41     §  9.  Notwithstanding  any  law,  rule or regulation to the contrary,
   42  volume adjustments made pursuant to paragraph (e) or (f) of  subdivision
   43  9  of  section  2807-c  of  the public health law to rates of payment by
   44  state governmental agencies for inpatient services provided by a general
   45  hospital on and after April 1, 2003, shall not  contain  any  adjustment
   46  reflecting  a  reduction  in  such  general hospital's case mix adjusted
   47  patient length of stay for non-Medicare beneficiaries based on a compar-
   48  ison of the rate year to 1987.
   49     § 10. Subdivision 5 of section 2807-c of  the  public  health  law  is
   50  amended by adding a new paragraph (e) to read as follows:
   51    (e)  Notwithstanding  any  inconsistent  provision  of  this  section,
   52  commencing on and after  April  first,  two  thousand  three,  rates  of
   53  payment  for  general hospitals, including hospitals reimbursed pursuant
   54  to paragraphs (f) and (k) of  subdivision  four  of  this  section,  for
   55  patients eligible for payments made by state governmental agencies shall
   56  be reduced by the commissioner to reflect more appropriate reimbursement
       S. 1408                            25                            A. 2108
 
    1  for  indirect  graduate medical education. Rates shall be reduced by the
    2  result of subtracting the amount calculated pursuant to subparagraph (i)
    3  of this paragraph from the amount calculated  pursuant  to  subparagraph
    4  (ii) of this paragraph:
    5    (i) This amount shall equal the product of:
    6    (A) the general hospital's group category average inpatient reimbursa-
    7  ble  operating cost per discharge calculated in accordance with subpara-
    8  graph (i) of paragraph (a) of subdivision seven of this section  without
    9  adjustments  made  pursuant  to  subparagraph  (ii)  of paragraph (c) of
   10  subdivision seven of this section; and
   11    (B) for the period April first, two thousand  three  through  December
   12  thirty-first, two thousand three, the general hospital's indirect teach-
   13  ing adjustment percentage determined by the following formula:
   14                                        .405
   15                          1.72 ((( 1 + r)    ) - 1)
   16  where  "r"  equals the hospital's weighted residents and fellows per bed
   17  calculated pursuant to subparagraph (iii) of  this  paragraph,  and  for
   18  those  specialty  hospitals  defined  in subparagraph (vi) of this para-
   19  graph, where "r" equals the hospital's ratio of  residents  and  fellows
   20  per bed calculated pursuant to subparagraph (vii) of this paragraph; or
   21    (C)  for  the period January first, two thousand four through December
   22  thirty-first, two thousand four, the general hospital's indirect  teach-
   23  ing adjustment percentage determined by the following formula:
   24                                        .405
   25                          1.60 ((( 1 + r)    ) - 1)
   26  where  "r"  equals the hospital's weighted residents and fellows per bed
   27  calculated pursuant to subparagraph (iii) of  this  paragraph,  and  for
   28  those  specialty  hospitals  defined  in subparagraph (vi) of this para-
   29  graph, where "r" equals the hospital's ratio of  residents  and  fellows
   30  per bed calculated pursuant to subparagraph (vii) of this paragraph; or
   31    (D)  for  the period January first, two thousand five through December
   32  thirty-first, two thousand five, the general hospital's indirect  teach-
   33  ing adjustment percentage determined by the following formula:
   34                                        .405
   35                          1.47 ((( 1 + r)    ) - 1)
   36  where  "r"  equals the hospital's weighted residents and fellows per bed
   37  calculated pursuant to subparagraph (iii) of  this  paragraph,  and  for
   38  those  specialty  hospitals  defined  in subparagraph (vi) of this para-
   39  graph, where "r" equals the hospital's ratio of  residents  and  fellows
   40  per bed calculated pursuant to subparagraph (vii) of this paragraph; or
   41    (E)  for  periods  on  and  after January first, two thousand six, the
   42  general hospital's indirect teaching adjustment percentage determined by
   43  the following formula:
   44                                        .405
   45                          1.35 ((( 1 + r)    ) - 1)
   46  where "r" equals the hospital's weighted residents and fellows  per  bed
   47  calculated  pursuant  to  subparagraph  (iii) of this paragraph, and for
   48  those specialty hospitals defined in subparagraph  (vi)  of  this  para-
   49  graph,  where  "r"  equals the hospital's ratio of residents and fellows
   50  per bed calculated pursuant to subparagraph (vii) of this paragraph.
   51    (ii) This amount shall equal the product of:
   52    (A) the general hospital's group category average inpatient reimbursa-
   53  ble operating cost per discharge calculated in accordance with  subpara-
   54  graph  (i) of paragraph (a) of subdivision seven of this section without
   55  adjustments made pursuant to  subparagraph  (ii)  of  paragraph  (c)  of
   56  subdivision seven of this section; and
       S. 1408                            26                            A. 2108
 
    1    (B)  the indirect teaching adjustment percentage determined in accord-
    2  ance with rules and regulations adopted by the state hospital review and
    3  planning council and approved by the commissioner for purposes of imple-
    4  menting subparagraph (ii) of paragraph (c) of subdivision seven of  this
    5  section  and  subdivision  twenty-five  of this section and in effect on
    6  July first, nineteen hundred ninety-eight.
    7    (iii) Weighted residents and fellows per bed shall  be  calculated  as
    8  follows:
    9    (A)  for  each general hospital, the residents and fellows, as defined
   10  in subparagraph (iv) of this paragraph, shall  be  aggregated  into  the
   11  categories  defined in rules and regulations adopted by the state hospi-
   12  tal review and planning council and approved  by  the  commissioner  for
   13  purposes  of implementing subdivision twenty-five of this section and in
   14  effect on July first, nineteen hundred ninety-eight and summed to deter-
   15  mine total residents and fellows by category.
   16    (B) the total residents and fellows for each category shall be  multi-
   17  plied  by the physician specialty weighting factor for that category set
   18  forth in rules and regulations adopted by the state hospital review  and
   19  planning council and approved by the commissioner for purposes of imple-
   20  menting  subdivision  twenty-five  of this section and in effect on July
   21  first, nineteen hundred ninety-eight; all categories' results  shall  be
   22  summed,  and  the  result  divided by the total residents and fellows to
   23  determine the resident weighting factor. Weighted residents and  fellows
   24  shall  be determined by multiplying the resident weighting factor by the
   25  lower of (a) the number of residents and fellows, as defined in subpara-
   26  graph (iv) of this paragraph, as of September fourth,  nineteen  hundred
   27  ninety,  and contained in the survey documents forwarded by the hospital
   28  to the department which was to  be  forwarded  no  later  than  November
   29  first,  nineteen  hundred  ninety;  or  (b)  the number of residents and
   30  fellows for the current rate period. Weighted residents and fellows  per
   31  bed  shall  be calculated by dividing the weighted residents and fellows
   32  as determined by this subparagraph by the certified beds for the general
   33  hospital as of January first, nineteen hundred ninety, excluding  exempt
   34  unit beds.
   35    (iv)  For  purposes  of  this  paragraph,  the number of residents and
   36  fellows are those full-time equivalents (FTEs) working  in  the  general
   37  hospital  or  those  non-hospital  residents  and  fellows in ambulatory
   38  settings that are enrolled in the residency  program  at  such  hospital
   39  excluding the portion of FTEs assigned to exempt units.
   40    (v) The indirect teaching adjustment percentage calculated pursuant to
   41  subparagraph  (i) of this paragraph shall be weighted based on projected
   42  medical education statistics for the general hospital as of  July  first
   43  for  the  period and subsequently reconciled to the actual allocation of
   44  residents and fellows for the period.
   45    (vi) Specialty hospitals shall be those hospitals,  specified  by  the
   46  commissioner,  whose  primary  care  mission  is  to engage in research,
   47  training and clinical care in specialty eye and  ear,  special  surgery,
   48  orthopedic,  joint  disease,  cancer,  chronic  care  or  rehabilitation
   49  services.
   50    (vii) The ratio of residents and fellows per bed for  those  specialty
   51  hospitals defined in subparagraph (vi) of this paragraph shall be calcu-
   52  lated by dividing:
   53    (A)  the  lower of (a) the number of residents and fellows, as defined
   54  in subparagraph (iv) of this paragraph, as of September  four,  nineteen
   55  hundred  ninety,  and contained in the survey documents forwarded by the
   56  hospital to the department which was  to  be  forwarded  no  later  than
       S. 1408                            27                            A. 2108
 
    1  November  first, nineteen hundred ninety; or (b) the number of residents
    2  and fellows for the current rate period; by
    3    (B)  the certified beds for the hospital as of January first, nineteen
    4  hundred ninety, excluding exempt unit beds.
    5    (viii) Discrete rates of payment calculated in accordance  with  para-
    6  graph  a-three  of  subdivision  one  of  this section shall reflect the
    7  reduction in rates of payment calculated in accordance with  this  para-
    8  graph.
    9    (ix) Hospitals shall furnish to the department such reports and infor-
   10  mation  required  by  the  commissioner  to assess the cost, quality and
   11  health system needs for medical education provided.
   12     § 11. Subparagraph (iii) of paragraph (b) of subdivision 5 of  section
   13  2807-c of the public health law, as amended by chapter 81 of the laws of
   14  1995,  clause  (A)  as separately amended by chapters 194 and 474 of the
   15  laws of 1996, clause (A) as amended by chapter 433 of the laws of  1997,
   16  is amended to read as follows:
   17    (iii)  [(A)  Except as provided in clause (B) of this subparagraph and
   18  subparagraph (iv) of this paragraph, for annual rate years commencing on
   19  or after January first, nineteen hundred  ninety,  average  reimbursable
   20  inpatient  operating  cost  per discharge shall be a composite sum of no
   21  less than forty-five percent of the general hospital's hospital-specific
   22  average reimbursable inpatient operating cost per  discharge  determined
   23  in  accordance with paragraph (a) of subdivision six of this section and
   24  a percentage amount not to exceed  fifty-five  percent  of  the  general
   25  hospital's  group category average inpatient reimbursable operating cost
   26  per discharge (price) determined in accordance  with  paragraph  (a)  of
   27  subdivision  seven  of  this section, such that the composite sum equals
   28  one hundred percent.]
   29    (A) Except as provided in [clause] clauses (B) and (C) of this subpar-
   30  agraph and subparagraphs (iv), (v) and (vi) of this paragraph, for annu-
   31  al rate years commencing on or after  January  first,  nineteen  hundred
   32  ninety,  average  reimbursable  inpatient  operating  cost per discharge
   33  shall be a composite sum of no  less  than  forty-five  percent  of  the
   34  general  hospital's  hospital-specific  average  reimbursable  inpatient
   35  operating cost per discharge determined in accordance with paragraph (a)
   36  of subdivision six of this section and a percentage amount not to exceed
   37  fifty-five percent of the  general  hospital's  group  category  average
   38  inpatient  reimbursable  operating cost per discharge (price) determined
   39  in accordance with paragraph (a) of subdivision seven of  this  section,
   40  such that the composite sum equals one hundred percent.
   41    (B)  For  discharges on or after April first, nineteen hundred ninety-
   42  five through March thirty-first, two thousand  three,  for  purposes  of
   43  reimbursement  of  inpatient hospital services for patients eligible for
   44  payments made by state governmental agencies  assigned  to  one  of  the
   45  twenty  most  common diagnosis-related groups for all general hospitals,
   46  the average reimbursable inpatient operating cost  per  discharge  of  a
   47  general  hospital  shall  be  the  lower of (I) the amount determined in
   48  accordance with clause (A) of this  subparagraph  or  (II)  the  average
   49  amount determined in accordance with clause (A) of this subparagraph for
   50  all  general  hospitals  in  the group category to which the hospital is
   51  assigned. The twenty  most  common  diagnosis-related  groups  shall  be
   52  determined using discharge data for the year two years prior to the rate
   53  year  for  all general hospitals, excluding beneficiaries of title XVIII
   54  of the federal social security act (medicare) and patients  assigned  to
   55  [diagnosis  related] diagnosis-related groups for human immunodeficiency
   56  virus (HIV) infection, acquired immune deficiency syndrome, alcohol/drug
       S. 1408                            28                            A. 2108
 
    1  use or alcohol/drug induced organic mental disorders, and exempt unit or
    2  exempt hospital patients.
    3    (C)  For  discharges on and after April first, two thousand three, for
    4  purposes of reimbursement of inpatient hospital  services  for  patients
    5  eligible for payments made by state governmental agencies, the reimburs-
    6  able  inpatient  operating cost component of case based rates of payment
    7  per diagnosis-related group shall be the lower of (I) the average  reim-
    8  bursable inpatient operating cost per discharge determined in accordance
    9  with  clause  (A)  of  this subparagraph, or (II) the general hospital's
   10  group  category  average  reimbursable  inpatient  operating  cost   per
   11  discharge  determined  in  accordance  with paragraph (a) of subdivision
   12  seven of this section.  Hospitals reimbursed pursuant to  paragraph  (f)
   13  of  subdivision  four  of  this  section  shall  not  be  subject to the
   14  provisions of this clause.
   15     § 12. Notwithstanding paragraph (e) of subdivision 4 of section 2807-c
   16  of the public health law or any other  inconsistent  provision  of  law,
   17  rule  or  regulation  to the contrary, for periods on and after April 1,
   18  2003, reimbursement for the operating component of  the  inpatient  per-
   19  diem hospital rates for general hospitals or distinct units of a general
   20  hospital,  excluding  those  general  hospitals  or  distinct units of a
   21  general  hospital  whose  primary  mission  is  the  treatment  of  AIDS
   22  patients,  for patients eligible for payments made by state governmental
   23  agencies, shall be reduced by five percent.
   24     § 13.   Notwithstanding any inconsistent provision  of  law,  rule  or
   25  regulation,  rates  or  other  payments  in effect on April 1, 2003, for
   26  general hospital outpatient  services  established  in  accordance  with
   27  subparagraph  (i)  of  paragraph (g) of subdivision 2 of section 2807 of
   28  the public  health  law,  which  have  been  designated  as  specialized
   29  services for purposes of waiving the maximum allowable payment set forth
   30  in  such subparagraph or established in accordance with paragraph (e) or
   31  (h) of subdivision 2 of section 2807 of the  public  health  law,  shall
   32  continue  in  effect,  provided,  however, that this provision shall not
   33  apply to general hospital outpatient clinics whose  primary  mission  is
   34  the treatment of AIDS/HIV.
   35     §  14.    Section 2808 of the public health law is amended by adding a
   36  new subdivision 20 to read as follows:
   37    20. Notwithstanding any inconsistent provision of law or regulation to
   38  the contrary:
   39    (a) (i) For services provided by residential  health  care  facilities
   40  beginning  April  first, two thousand three, except for services identi-
   41  fied  in  subparagraph  (ii)  of  this  paragraph,  and  for  facilities
   42  described  in  paragraph  (d) of this subdivision for purposes of estab-
   43  lishing the operating component of  rates  of  payment  by  governmental
   44  agencies,  the  commissioner  shall  utilize  the lower of the operating
   45  component of facility specific certified  rates  as  determined  by  the
   46  department  or  the  average of such operating component for residential
   47  health care facilities within the region determined as of January first,
   48  two thousand three, trended pursuant to law to the applicable rate peri-
   49  od and adjusted for each facility's case mix index.  Region  shall  mean
   50  those  regions as listed in paragraph (c) of this subdivision. In deter-
   51  mining such regional average rate, the commissioner shall  equalize  the
   52  allowable  costs  of different base year periods used to establish rates
   53  within each region.
   54    (ii) This subdivision shall not apply to rates  paid  for  residential
   55  health care facility services provided to:
       S. 1408                            29                            A. 2108
 
    1    (A)  residents  residing  in a residential health care facility desig-
    2  nated as an AIDS residential health  care  facility  or  residing  in  a
    3  discrete AIDS unit approved by the commissioner;
    4    (B)  residents  residing  in  discrete  units for the care of patients
    5  under the long-term inpatient rehabilitation program for traumatic brain
    6  injured patients established pursuant to department regulations;
    7    (C) residents residing in department approved discrete units  for  the
    8  care of long-term ventilator dependent residents;
    9    (D)  residents  residing in department approved discrete units specif-
   10  ically designated for the purpose of providing specialized programs  for
   11  residents requiring behavioral interventions; or
   12    (E)  residents in residential health care facilities or discrete units
   13  which provide extensive nursing, medical, psychological  and  counseling
   14  support services solely to children, as determined by the department.
   15    (b)  The  operating  component  of  the rate of payment shall mean all
   16  components of the rate except for the capital component.
   17    (c) The regions are established as follows:
   18    (i) Albany: Albany, Columbia, Greene, Montgomery, Rensselaer,  Sarato-
   19  ga, Schenectady, Schoharie, and Fulton counties;
   20    (ii) Binghamton: Broome, and Tioga counties;
   21    (iii)  Erie: Cattaraugus, Chautauqua, Erie, Niagara, and Orleans coun-
   22  ties;
   23    (iv) Elmira: Chemung, Steuben, and Schuyler counties;
   24    (v) Glens Falls: Essex, Warren, and Washington counties;
   25    (vi) Long Island: Nassau, and Suffolk counties;
   26    (vii) Orange: Chenango, Delaware, Orange, Otsego, Sullivan, and
   27    Ulster counties;
   28    (viii) New York City: Bronx, Kings, Queens,  Richmond,  and  New  York
   29  counties;
   30    (ix) Poughkeepsie: Dutchess, and Putnam counties;
   31    (x) Rochester: Livingston, Monroe, Ontario, and Wayne counties;
   32    (xi)  Central  Rural:  Cayuga,  Cortland,  Seneca, Tompkins, and Yates
   33  counties;
   34    (xii) Syracuse: Madison, and Onondaga counties;
   35    (xiii) Utica: Herkimer, Jefferson, Lewis, Oneida, and Oswego counties;
   36    (xiv) Westchester: Rockland, and Westchester counties;
   37    (xv) Northern Rural: Clinton, Franklin,  Hamilton,  and  St.  Lawrence
   38  counties; and
   39    (xvi) Western Rural: Allegany, Genesee, and Wyoming counties.
   40    (d)  For  any newly constructed residential health care facility which
   41  receives establishment approval by the public health council in  accord-
   42  ance with section twenty-eight hundred one-a of this article on or after
   43  April first, two thousand three; any new operator of an ongoing residen-
   44  tial  health  care facility established pursuant to section twenty-eight
   45  hundred one-a of this article on or  after  April  first,  two  thousand
   46  three;  or  any  facility  in receivership on and after April first, two
   47  thousand three, the operating component of the  rate  of  payment  shall
   48  equal  the  average  of  the  operating  component of certified rates of
   49  facilities within its region as determined pursuant to this subdivision.
   50    (e) Notwithstanding any inconsistent provision of the  state  adminis-
   51  trative procedure act or any other provision of law or regulation to the
   52  contrary, the commissioner is authorized to adopt or amend or promulgate
   53  on  an emergency basis any regulation the commissioner determines neces-
   54  sary to implement any provision of this subdivision.
   55    (f) Notwithstanding this subdivision,  effective  on  or  after  April
   56  first,  two  thousand  three, the amount of any governmental agency rate
       S. 1408                            30                            A. 2108
 
    1  reductions effectuated pursuant to this subdivision shall not exceed ten
    2  percent of the facility's governmental agency rate of payment in  effect
    3  as  of  March thirty-first, two thousand three for patient care services
    4  provided by such residential health care facility.
    5     §  15. Notwithstanding any inconsistent provision of law or regulation
    6  to the contrary, residential  health  care  facility  rates  of  payment
    7  determined  pursuant to article 28 of the public health law for services
    8  provided on and after April 1, 2003 through March 31, 2004,  except  for
    9  the  establishment  of  any  statewide  or any peer group base, mean, or
   10  ceiling prices per day, shall be calculated utilizing only the number of
   11  residents properly assessed and reported in each patient  classification
   12  group  and eligible for medical assistance pursuant to title 11 of arti-
   13  cle 5 of the social services law.
   14     § 16. Notwithstanding any inconsistent provision of law or  regulation
   15  to  the contrary, effective on and after April 1, 2003, the capital cost
   16  component of every proprietary residential health care facility rate  of
   17  payment determined pursuant to article 28 of the public health law shall
   18  not  include a payment factor to pay an annual rate of return on owner's
   19  equity or a payment factor to pay an annual rate of  return  on  average
   20  equity capital.
   21     §  17.  Paragraph (a) of subdivision 2 of section 3614-a of the public
   22  health law is amended by adding a  new  subparagraph  (iv)  to  read  as
   23  follows:
   24    (iv)  Notwithstanding any contrary provisions of this paragraph or any
   25  other provision of law or regulation to the contrary, for certified home
   26  health agencies the assessment shall be six-tenths  of  one  percent  of
   27  each  certified  home  health  agency's gross receipts received from all
   28  patient care services and other operating income on a cash basis  begin-
   29  ning  April  first, two thousand three for home care services; provided,
   30  however, that for all such gross receipts received  on  or  after  April
   31  first, two thousand four, such assessment shall be forty-five hundredths
   32  of  one  percent,  and further provided that for all such gross receipts
   33  received on or after April first, two  thousand  five,  such  assessment
   34  shall  be three-tenths of one percent, and further provided that for all
   35  such gross receipts received on or after April first, two thousand  six,
   36  such  assessment shall be fifteen-hundredths of one percent, and further
   37  provided that for all such gross receipts received  on  or  after  April
   38  first, two thousand seven, such assessment shall be zero.
   39     §  18.  Paragraph (b) of subdivision 2 of section 3614-a of the public
   40  health law is amended by adding a  new  subparagraph  (iv)  to  read  as
   41  follows:
   42    (iv)  Notwithstanding any contrary provisions of this paragraph or any
   43  other provision of law or regulation to the contrary, for long term home
   44  health care programs the assessment shall be six-tenths of  one  percent
   45  of  each  long  term  home health care program's gross receipts received
   46  from all patient care services and other  operating  income  on  a  cash
   47  basis  beginning  April  first,  two  thousand  three for long term home
   48  health care  services;  provided,  however,  that  for  all  such  gross
   49  receipts  received  on  or  after  April  first, two thousand four, such
   50  assessment shall be forty-five hundredths of one  percent,  and  further
   51  provided  that  for  all  such gross receipts received on or after April
   52  first, two thousand five, such assessment shall be three-tenths  of  one
   53  percent,  and further provided that for all such gross receipts received
   54  on or after April first, two thousand  six,  such  assessment  shall  be
   55  fifteen-hundredths  of  one  percent,  and further provided that for all
       S. 1408                            31                            A. 2108
 
    1  such gross receipts received on  or  after  April  first,  two  thousand
    2  seven, such assessment shall be zero.
    3     §  19.  Subdivision  9  of section 3614-a of the public health law, as
    4  added by chapter 938 of the laws of 1990, is amended to read as follows:
    5    9. (a) Funds accumulated, including income from invested  funds,  from
    6  the assessments specified in this section, including interest and penal-
    7  ties, shall be deposited by the commissioner and credited to the general
    8  fund[.];
    9    (b)  Provided,  however, that funds accumulated, including income from
   10  invested funds, from the assessment provided in accordance with subpara-
   11  graph (iv) of paragraph (a) and subparagraph (iv) of  paragraph  (b)  of
   12  subdivision two of this section, including interest and penalties, shall
   13  be deposited by the commissioner and credited to a special revenue-other
   14  medical  assistance account to be established by the comptroller. To the
   15  extent of funds appropriated therefor, funds shall be made available for
   16  payments under the medical assistance program provided pursuant to title
   17  eleven of article five of the social services law.
   18     § 20. Subdivision 2 of section 367-i of the social  services  law,  as
   19  amended  by section 10 of part CC of chapter 407 of the laws of 1999, is
   20  amended to read as follows:
   21    2. (a) The assessment shall be six-tenths of one percent of each  such
   22  provider's  gross  receipts received from all personal care services and
   23  other operating income on a cash basis beginning January first, nineteen
   24  hundred ninety-one; provided, however, that for all such gross  receipts
   25  received  on  or  after  April first, nineteen hundred ninety-nine, such
   26  assessment shall be two-tenths of one percent, and further provided that
   27  such assessment shall expire and be of no further effect  for  all  such
   28  gross receipts received on or after January first, two thousand.
   29    (b)  Notwithstanding paragraph (a) of this subdivision, the assessment
   30  shall be six-tenths  of  one  percent  of  each  such  provider's  gross
   31  receipts  received  from  all personal care services and other operating
   32  income on a cash  basis  beginning  April  first,  two  thousand  three;
   33  provided, however, that for all such gross receipts received on or after
   34  April  first,  two  thousand  four,  such assessment shall be forty-five
   35  hundredths of one percent, and further provided that for all such  gross
   36  receipts  received  on  or  after  April  first, two thousand five, such
   37  assessment shall be three-tenths of one percent,  and  further  provided
   38  that  for  all such gross receipts received on or after April first, two
   39  thousand six such assessment shall be fifteen hundredths of one percent,
   40  and further provided that for all such gross  receipts  received  on  or
   41  after April first, two thousand seven, such assessment shall be zero.
   42     §  21.  Subdivision  8 of section 367-i of the social services law, as
   43  added by chapter 938 of the laws of 1990, is amended to read as follows:
   44    8. (a) Funds accumulated, including income from invested  funds,  from
   45  the assessments specified in this section, including interest and penal-
   46  ties,  shall  be deposited by the commissioner of health and credited to
   47  the general fund[.];
   48    (b) Provided, however, that funds accumulated, including  income  from
   49  invested  funds,  from  the assessment provided in accordance with para-
   50  graph (b) of subdivision two of this  section,  including  interest  and
   51  penalties, shall be deposited by the commissioner of health and credited
   52  to  a special revenue-other medical assistance account to be established
   53  by the comptroller.  To the extent of funds appropriated therefor, funds
   54  shall be made  available  for  payments  under  the  medical  assistance
   55  program provided pursuant to this title.
       S. 1408                            32                            A. 2108
 
    1     §  22.  Subdivision  2  of  section 3614-b of the public health law as
    2  amended by section 9 of part CC of chapter 407 of the laws of  1999,  is
    3  amended to read as follows:
    4    2.  (a)  The  assessment  shall  be  six-tenths of one percent of such
    5  licensed home care services agency's gross receipts  received  from  all
    6  patient  care services and other operating income on a cash basis begin-
    7  ning April first, nineteen hundred ninety-two; provided,  however,  that
    8  for  all  such gross receipts received on or after April first, nineteen
    9  hundred ninety-nine, such assessment shall be two-tenths of one percent,
   10  and further provided that such assessment shall  expire  and  be  of  no
   11  further  effect for all such gross receipts received on or after January
   12  first, two thousand.
   13    (b) Notwithstanding any contrary provisions of this paragraph  or  any
   14  other  provision of law or regulation to the contrary, for licensed home
   15  care services agencies the assessment shall be six-tenths of one percent
   16  of each such agency's gross receipts  received  from  all  patient  care
   17  services  and  other  operating  income  on a cash basis beginning April
   18  first, two thousand three for home  care  services;  provided,  however,
   19  that  for  all such gross receipts received on or after April first, two
   20  thousand four, such assessment shall be  forty-five  hundredths  of  one
   21  percent,  and further provided that for all such gross receipts received
   22  on or after April first, two thousand five,  such  assessment  shall  be
   23  three-tenths  of  one  percent,  and  further provided that for all such
   24  gross receipts received on or after April first, two thousand six,  such
   25  assessment  shall  be  fifteen-hundredths  of  one  percent, and further
   26  provided that for all such gross receipts received  on  or  after  April
   27  first, two thousand seven, such assessment shall be zero.
   28     §  23.  Subdivision  9  of section 3614-b of the public health law, as
   29  added by chapter 41 of the laws of 1992, is amended to read as follows:
   30    9. (a) Funds accumulated, including income from invested  funds,  from
   31  the assessments specified in this section, including interest and penal-
   32  ties, shall be deposited by the commissioner and credited to the general
   33  fund[.];
   34    (b)  Provided,  however, that funds accumulated, including income from
   35  invested funds, from the assessment provided in  accordance  with  para-
   36  graph  (b)  of  subdivision  two of this section, including interest and
   37  penalties, shall be deposited by the  commissioner  and  credited  to  a
   38  special  revenue-other  medical  assistance account to be established by
   39  the comptroller. To the extent of  funds  appropriated  therefor,  funds
   40  shall  be  made  available  for  payments  under  the medical assistance
   41  program provided pursuant to title eleven of article five of the  social
   42  services law.
   43     §  24.  Subdivision  4  of section 3614-a of the public health law, as
   44  added by chapter 938 of the laws of 1990, is amended to read as follows:
   45    4. The commissioner is authorized to contract with the article  forty-
   46  three  insurance  law plans, or such other administrators as the commis-
   47  sioner shall designate, to receive and  distribute  home  care  provider
   48  assessment  funds  and  personal care services provider assessment funds
   49  assessed pursuant to section three hundred sixty-seven-i of  the  social
   50  services law. In the event contracts with the article forty-three insur-
   51  ance  law  plans  or other commissioner's designees are effectuated, the
   52  commissioner shall conduct annual audits of the receipt and distribution
   53  of the assessment funds. The reasonable costs and expenses of an  admin-
   54  istrator  as  approved  by the commissioner, not to exceed for personnel
   55  services on an annual basis [two] four hundred thousand dollars for  all
   56  assessments  established  pursuant to this section and the personal care
       S. 1408                            33                            A. 2108
 
    1  services provider  assessment  established  pursuant  to  section  three
    2  hundred sixty-seven-i of the social services law, shall be paid from the
    3  assessment funds.
    4     §  25.  Paragraph  (d) of subdivision 1 of section 367-a of the social
    5  services law, as amended by section 22 of part E of chapter  58  of  the
    6  laws of 1998, is amended to read as follows:
    7    (d)  [Amounts]  (i)  Except  as  provided in subparagraph (ii) of this
    8  paragraph, amounts payable under this title for medical  assistance  for
    9  items  and  services provided to eligible persons who are also benefici-
   10  aries under part A and/or part B of title XVIII of  the  federal  social
   11  security act and items and services provided to qualified medicare bene-
   12  ficiaries under part A of title XVIII of the federal social security act
   13  shall  not  be  [less than the amount of any deductible and co-insurance
   14  liability of such eligible persons or for which such eligible persons or
   15  such qualified medicare beneficiaries would be liable under federal  law
   16  were they not eligible for medical assistance or were they not qualified
   17  medicare  beneficiaries  with respect to such benefits under such part A
   18  and such part B] made to the extent that payment under  title  XVIII  of
   19  the federal social security act for the item or service would exceed the
   20  amount  that  otherwise  would be made under this title for such item or
   21  service if provided to an eligible person other than  a  person  who  is
   22  also  a  beneficiary  under  Part  A and/or Part B or who is a qualified
   23  medicare beneficiary.
   24    (ii) Amounts payable under  this  title  with  respect  to  items  and
   25  services  provided  by  a  facility  under the authority of an operating
   26  certificate issued pursuant to article  sixteen  or  thirty-one  of  the
   27  mental  hygiene  law  and  with  respect  to  services  provided to AIDS
   28  patients and HIV-positive patients by  a  clinic  licensed  pursuant  to
   29  article twenty-eight of the public health law which is designated in the
   30  regulations  of  the  department of health as eligible for special rates
   31  for the provision of such services, to eligible  persons  who  are  also
   32  beneficiaries  under  Part A and/or Part B of title XVIII of the federal
   33  social security act and such items and services  provided  to  qualified
   34  medicare beneficiaries under Part A of title XVIII of the federal social
   35  security  act  shall  not  be less than the amount of any deductible and
   36  co-insurance liability of such eligible persons or for which such eligi-
   37  ble persons or such qualified medicare  beneficiaries  would  be  liable
   38  under  federal law were they not eligible for medical assistance or were
   39  they not qualified medicare beneficiaries with respect to such  benefits
   40  under such Part A or such Part B.
   41     § 26. Notwithstanding the provisions of paragraph (h) of subdivision 1
   42  of section 368-a of the social services law, payments made to a district
   43  pursuant  to  such paragraph (h) during the period April 1, 2003 through
   44  March 31, 2004, and during each subsequent year commencing April  1  and
   45  ending  March  31,  shall  not exceed the payments made to such district
   46  during the period January 1, 2002 through December 31, 2002 as  adjusted
   47  by  changes  in state medicaid reimbursement percentages as set forth in
   48  section 368-a of the social services law between the base year  of  2002
   49  and  the payment years commencing April 1, 2003. Nothing in this section
   50  shall prohibit the office of mental health,  in  consultation  with  the
   51  department  of health and subject to the approval of the division of the
   52  budget, from expending funds to pay  for  the  local  share  of  medical
   53  assistance,  or  a  portion  thereof,  when  such  expenditures  are for
   54  services that were funded by the state in calendar year 2002, and to the
   55  extent such expenditures will be offset by the receipt of federal finan-
   56  cial participation.
       S. 1408                            34                            A. 2108
 
    1     § 27. Section 20 of part A of chapter 1 of the laws of 2002,  amending
    2  the  public health law, the social services law and the tax law relating
    3  to the health care reform act of 2000, as amended by section 19 of  part
    4  J of chapter 82 of the laws of 2002, is amended to read as follows:
    5     § 20. Notwithstanding any law, rule or regulation to the contrary, the
    6  commissioner  of  health shall credit, from the funds collected pursuant
    7  to the provisions of sections nineteen and twenty-one of this act, up to
    8  five hundred thirty-four million  dollars  for  the  state  fiscal  year
    9  beginning  April  1,  2002  and  ending  March 31, 2003 [and up to three
   10  hundred fifty-six million dollars for the state  fiscal  year  beginning
   11  April  1,  2003  and  each state fiscal year thereafter,] to the tobacco
   12  control and  insurance  initiatives  pool  as  established  pursuant  to
   13  section  2807-v of the public health law[. For], and up to three hundred
   14  fifty-six million dollars annually for state fiscal years on  and  after
   15  April  1,  2003,  to the medical assistance program, general fund/aid to
   16  localities, local assistance account-001, provided,  however,  that  for
   17  the  state  fiscal  year  beginning April 1, 2002 [and each state fiscal
   18  year thereafter,] and ending March 31, 2003, all funds collected  pursu-
   19  ant  to sections nineteen and twenty-one of this act which are not cred-
   20  ited to the tobacco control and  insurance  initiatives  pool  shall  be
   21  credited  to the medical assistance program, general fund/aid to locali-
   22  ties, local assistance account - 001.
   23     § 28. Paragraph (a) of subdivision 3 of section 2807-d of  the  public
   24  health  law, as amended by chapter 41 of the laws of 1992, is amended to
   25  read as follows:
   26    (a) for general hospitals, all monies received for or  on  account  of
   27  inpatient  hospital  service,  outpatient  service,  emergency  service,
   28  referred ambulatory service and ambulatory surgical  service,  or  other
   29  hospital or health-related services, excluding subject to the provisions
   30  of  subdivision  twelve  of this section distributions from bad debt and
   31  charity care regional  pools,  primary  health  care  services  regional
   32  pools,  bad  debt  and charity care for financially distressed hospitals
   33  statewide pools and bad debt and  charity  care  and  capital  statewide
   34  pools created in accordance with section twenty-eight hundred seven-c of
   35  this  article  and the components of rates of payment or charges related
   36  to the allowances provided in  accordance  with  subdivisions  fourteen,
   37  fourteen-b  and  fourteen-c of section twenty-eight hundred seven-c, the
   38  adjustment provided in accordance with subdivision fourteen-a of section
   39  twenty-eight hundred seven-c, the adjustment provided in accordance with
   40  subdivision fourteen-d of  section  twenty-eight  hundred  seven-c,  the
   41  adjustment  for  health  maintenance  organization  reimbursement  rates
   42  provided in accordance  with   subdivision  two-a,  the  adjustment  for
   43  [commerical] commercial insurer  reimbursement rates provided in accord-
   44  ance  with  paragraph  (i)  of  subdivision eleven or, if effective, the
   45  adjustment provided in accordance with subdivision  fifteen  of  section
   46  twenty-eight  hundred seven-c of this article or the adjustment provided
   47  in accordance with section eighteen of chapter two hundred sixty-six  of
   48  the  laws  of nineteen hundred eighty-six as amended and physician prac-
   49  tice or faculty practice plan revenue received  by  a  general  hospital
   50  based  on  discrete  billings  for private practicing physician services
   51  [and], revenue received by a general hospital  from  a  public  hospital
   52  pursuant to an affiliation agreement contract for the delivery of health
   53  care  services to such public hospital[;], and revenue received pursuant
   54  to sections twelve and fourteen of part  A  and  sections  thirteen  and
   55  fourteen of part B of chapter one of the laws of two thousand two.
       S. 1408                            35                            A. 2108
 
    1     §  29.  Paragraph  (e) of subdivision 12 of section 2808 of the public
    2  health law, as amended by chapter 1 of the laws of 1999, is  amended  to
    3  read as follows:
    4    (e)  Notwithstanding  any inconsistent provision of law or regulation,
    5  the commissioner shall provide,  in  addition  to  payments  established
    6  pursuant  to  this  article  prior to application of this section, addi-
    7  tional payments under the medical assistance program pursuant  to  title
    8  eleven of article five of the social services law for non-state operated
    9  public  residential health care facilities, including public residential
   10  health care facilities located in the county of Nassau and the county of
   11  Westchester, but excluding public  residential  health  care  facilities
   12  operated by a town or city within a county, in an aggregate amount of up
   13  to  $991.5 million in additional payments each state fiscal year for the
   14  period beginning April first, two thousand [through March  thirty-first,
   15  two thousand three] and annually thereafter.
   16     §  30.  Paragraph  (f) of subdivision 12 of section 2808 of the public
   17  health law, as amended by chapter 1 of the laws of 1999, is  amended  to
   18  read as follows:
   19    (f)  The  amount  allocated to each eligible public residential health
   20  care facility for each period shall be calculated as the result  of  (A)
   21  the total payment for each period multiplied by (B) the ratio of patient
   22  days  for  patients  eligible  for  medical assistance pursuant to title
   23  eleven of article five of the social services law provided by the public
   24  residential health care facility, divided by the total of  such  patient
   25  days  summed for all eligible public residential health care facilities.
   26  For the period August first, nineteen hundred ninety-six  through  March
   27  thirty-first,  nineteen  hundred  ninety-seven, nineteen hundred ninety-
   28  four patient days shall be utilized; for the period April  first,  nine-
   29  teen  hundred  ninety-seven through March thirty-first, nineteen hundred
   30  ninety-eight,  nineteen  hundred  ninety-five  patient  days  shall   be
   31  utilized;  for  the  period  April  first, nineteen hundred ninety-eight
   32  through  March  thirty-first,  nineteen  hundred  ninety-nine,  nineteen
   33  hundred  ninety-six patient days shall be utilized; for the period April
   34  first, nineteen hundred  ninety-nine  through  March  thirty-first,  two
   35  thousand,  nineteen hundred ninety-seven patient days shall be utilized;
   36  for the period April first, two thousand through March thirty-first, two
   37  thousand one,  nineteen  hundred  ninety-eight  patient  days  shall  be
   38  utilized;  for  the  period  April first, two thousand one through March
   39  thirty-first, two thousand two,  nineteen  hundred  ninety-nine  patient
   40  days  shall  be  utilized;  for the period April first, two thousand two
   41  through March thirty-first, two thousand  three,  two  thousand  patient
   42  days shall be utilized and for each state fiscal year on and after April
   43  first, two thousand three patient days from two years prior to each such
   44  state fiscal year shall be utilized.
   45     § 31. Subdivision 1 of section 212 of chapter 474 of the laws of 1996,
   46  amending the education law and other laws relating to rates for residen-
   47  tial  health care facilities, as amended by section 8 of part B of chap-
   48  ter 1 of the laws of 2002, is amended to read as follows:
   49    1. (a) Notwithstanding any inconsistent provision of law or regulation
   50  to the contrary, effective beginning August  1,  1996,  for  the  period
   51  April 1, 1997 through March 31, 1998, April 1, 1998 for the period April
   52  1,  1998 through March 31, 1999, August 1, 1999, for the period April 1,
   53  1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
   54  through March 31, 2001, April 1, 2001, for  the  period  April  1,  2001
   55  through  March  31,  2002,  April  1, 2002, for the period April 1, 2002
   56  through March 31, 2003, the department of health is  authorized  to  pay
       S. 1408                            36                            A. 2108
 
    1  public  general  hospitals, as defined in subdivision 10 of section 2801
    2  of the public health law, operated by the state of New York  or  by  the
    3  state  university  of New York or by a county, which shall not include a
    4  city  with  a  population of over one million, of the state of New York,
    5  and those public general hospitals located in the county of  Westchester
    6  or  the  county  of  Nassau,  additional payments for inpatient hospital
    7  services as medical assistance payments pursuant to title 11 of  article
    8  5 of the social services law for patients eligible for federal financial
    9  participation  under  title  XIX  of  the federal social security act in
   10  medical assistance pursuant to the federal laws and regulations  govern-
   11  ing  disproportionate  share  payments  to  hospitals based on each such
   12  public general hospital's medical assistance and uninsured patient loss-
   13  es after all other medical assistance, including disproportionate  share
   14  payments to such public general hospital for 1996, 1997, 1998, and 1999,
   15  based  initially  for  1996  on reported 1994 reconciled data as further
   16  reconciled to actual reported 1996 reconciled data, and for  1997  based
   17  initially  on  reported  1995  reconciled  data as further reconciled to
   18  actual reported 1997  reconciled  data,  for  1998  based  initially  on
   19  reported  1995  reconciled data as further reconciled to actual reported
   20  1998 reconciled data, for 1999 based initially on reported  1995  recon-
   21  ciled  data  as  further  reconciled  to actual reported 1999 reconciled
   22  data, for 2000 based initially  on  reported  1995  reconciled  data  as
   23  further reconciled to actual reported 2000 data, for 2001 based initial-
   24  ly  on  reported  1995  reconciled  data as further reconciled to actual
   25  reported 2001 data, for 2002 based initially on reported 2000 reconciled
   26  data as further reconciled to actual reported 2002  data.  The  payments
   27  may  be  added  to  rates of payment or made as aggregate payments to an
   28  eligible public general hospital.
   29    (b) Notwithstanding any inconsistent provision of law or regulation to
   30  the contrary, for state fiscal year periods beginning April 1, 2003  and
   31  ending  March  31,  2005,  the department of health is authorized to pay
   32  public general hospitals, as defined in subdivision 10 of  section  2801
   33  of  the  public  health law, operated by the state of New York or by the
   34  state university of New York or by a county, or by a city with  a  popu-
   35  lation  of  over  one million persons, additional payments for inpatient
   36  hospital services as medical assistance payments pursuant to title 11 of
   37  article 5 of the social services law for patients eligible  for  federal
   38  financial  participation  under title XIX of the federal social security
   39  act in medical assistance pursuant to the federal laws  and  regulations
   40  governing disproportionate share payments to hospitals up to 175 percent
   41  of  each such public general hospital's medical assistance and uninsured
   42  patient losses after all other medical assistance, including  dispropor-
   43  tionate  share payments to such public general hospital, based initially
   44  on reported 2000 reconciled data. Such payments for  the  period  ending
   45  March  31, 2004 and March 31, 2005 shall be further reconciled to actual
   46  reported 2003 and 2004 data respectively, provided,  however,  that  for
   47  public general hospitals located in a city with a population of over one
   48  million  persons, other than hospitals operated by the state of New York
   49  or the state university of New York, such payments for the period ending
   50  March 31, 2004, shall be further reconciled to actual reported  2003  or
   51  2004  data  and such payments for the period ending March 31, 2005 shall
   52  be further reconciled to actual reported 2004 or 2005 data  and  further
   53  provided  that such payments for all eligible hospitals shall be reduced
   54  to the extent such  payments  would  result  in  the  exceeding  of  the
   55  disproportionate  share  allotment limit as set forth in subdivision (f)
   56  of section 1923 of the federal social security act,  provided,  however,
       S. 1408                            37                            A. 2108
 
    1  that such reduction shall be based on each such hospital's proportionate
    2  share  of the sum of all such payments that would be made without regard
    3  to such allotment limit. Such payments may be added to rates of  payment
    4  or made as aggregate payments to an eligible public general hospital.
    5     §  32.  Section 75 of part A of chapter 1 of the laws of 2002 amending
    6  the public health law, the social services law and the tax law  relating
    7  to the Health Care Reform Act of 2000, as amended by section 1 of part J
    8  of chapter 82 of the laws of 2002, is amended to read as follows:
    9     §  75. This act shall take effect April 1, 2002; provided, however, if
   10  this act shall become a law after such date it shall take  effect  imme-
   11  diately and shall be deemed to have been in full force and effect on and
   12  after  April  1,  2002;  provided  further that sections eleven, twelve,
   13  fifteen, sixteen, seventeen, eighteen, twenty-one and twenty-two of this
   14  act shall take effect immediately and shall be deemed to  have  been  in
   15  full  force  and  effect  on  and  after September 1, 2001; and provided
   16  further that sections thirteen and  fourteen  of  this  act  shall  take
   17  effect  immediately  and  shall be deemed to have been in full force and
   18  effect on and after January 1,  2002;  provided  further  that  sections
   19  fifty-six,  fifty-seven,  fifty-eight  and sixty-seven of this act shall
   20  take effect October 1, 2002; provided further that sections  forty-four,
   21  forty-five,  forty-six,  forty-seven, forty-nine through fifty-four, and
   22  sixty-one through sixty-six, sixty-seven-a and sixty-eight of  this  act
   23  shall  take  effect April 1, 2003 provided, however, that the provisions
   24  of paragraph (b) of  subdivision  2  of  section  366-a  of  the  social
   25  services  law  added  by section fifty-one of this act shall take effect
   26  April 1, 2004, and the  commissioner  of  health  may  take  any  steps,
   27  including  the  promulgation of regulations on an emergency basis, which
   28  he or she determines to be necessary to  implement  such  provisions  on
   29  their  effective date or as soon as practicable thereafter, and that the
   30  amendments to subdivision 2 of section 2511 of  the  public  health  law
   31  made by sections forty-four and forty-five of this act and subdivision 9
   32  of  section  2511  of the public health law made by section forty-six of
   33  this act shall not  affect  the  expiration  of  certain  provisions  of
   34  section  2511  of  the public health law, and shall expire and be deemed
   35  repealed therewith; provided further that section thirty-two of this act
   36  shall take effect immediately; provided further  that  sections  thirty,
   37  thirty-one  and thirty-three of this act shall take effect April 3, 2002
   38  and shall apply to all cigarettes possessed in the state by  any  person
   39  for  sale  and use in the state by any person on and after April 3, 2002
   40  and to taxes, interest  and  penalties  collected  or  received  by  the
   41  commissioner of taxation and finance under sections 471 and 471-a of the
   42  tax law on and after such date; provided, however, that the commissioner
   43  of  taxation and finance shall be authorized on and after this act shall
   44  have become a law to take steps necessary to implement these  provisions
   45  on their effective date; provided further, however, that effective imme-
   46  diately,  the commissioner of health and the superintendent of insurance
   47  may take any steps, including the promulgation of  any  rules  or  regu-
   48  lations  on  an emergency basis, which he or she determines to be neces-
   49  sary to assure the timely implementation of any provisions of this  act.
   50  The  provisions  of  this act shall become effective notwithstanding the
   51  failure of the commissioner of health or superintendent of insurance  to
   52  promulgate  any rules or regulations implementing this act; and provided
   53  further that the amendments to paragraph (a) of subdivision 6 of section
   54  2807-s of the public health law made by section twenty-eight of this act
   55  and the amendments to paragraphs (c) and (d) of subdivision 3 of section
   56  364-j of the social services law made by sections sixty-six, sixty-seven
       S. 1408                            38                            A. 2108
 
    1  and sixty-seven-a of this act  shall  not  affect  the  repeal  of  such
    2  sections and shall be deemed repealed therewith.
    3     § 33. Sections 700, 701, 702 and 703 of the executive law, as added by
    4  chapter 551 of the laws of 2002, are amended to read as follows:
    5     §  700.  Legislative findings and intent. The Americans with Disabili-
    6  ties Act requires [New York state to ensure that people of all ages with
    7  disabilities reside and function in the most integrated  setting  possi-
    8  ble.]  that  all public entities shall administer services, programs and
    9  activities in the most integrated setting appropriate to  the  needs  of
   10  qualified persons with disabilities. This requirement was recognized and
   11  upheld  by  the  Supreme  Court  in the case of Olmstead[, Commissioner,
   12  Georgia Department of Human Resources, et al.]  v.  L.C.,  [by  zimring,
   13  guardian  ad litem and next friend, et al. (138 F. 3d 893)] 527 U.S. 581
   14  (1999). The Olmstead decision held that unjustified institutionalization
   15  of persons with disabilities violates the  Americans  with  Disabilities
   16  Act,  and  further  held  that  states are required to provide community
   17  based treatment for persons with mental disabilities  when  the  state's
   18  treatment  professionals  determine  that such placement is appropriate,
   19  the affected persons do not oppose such treatment and, the placement can
   20  be reasonably accommodated, taking into account the resources  available
   21  to  the  state  and  to  the  needs of others with similar disabilities.
   22  While New York state provides community supports for people of all  ages
   23  with  disabilities  and  while the state of New York does operate a home
   24  and community-based waiver  medicaid  program,  the  legislature  hereby
   25  finds  that  New  York  state  [has no centralized mechanism in place to
   26  determine whether or not] should evaluate the need  to  take  additional
   27  steps  to  ensure that people of all ages with disabilities are residing
   28  in the most integrated setting [possible].  In order to ensure that  the
   29  state of New York is in compliance with the requirements of the Olmstead
   30  decision, the legislature hereby finds that it [is incumbent upon] would
   31  be  beneficial  for  New  York  state to develop and implement a plan to
   32  reasonably accommodate the desire of people of all ages  with  disabili-
   33  ties  to  avoid  institutionalization and be appropriately placed in the
   34  most integrated setting [possible] and further finds that a  most  inte-
   35  grated  setting  coordinating  council  should be established to develop
   36  such a plan, and advise and make recommendations to state agencies.
   37     § 701. Definitions. As used in this article the following terms  shall
   38  mean:
   39    1. "council" means the most integrated setting coordinating council.
   40    2. "disability" means, with respect to an individual:
   41    (a)  a  physical or mental impairment that substantially limits one or
   42  more of the major life activities of such individual;
   43    (b) a record of such an impairment; or
   44    (c) being regarded as having such an impairment.
   45    3. "most integrated setting" means a setting that  is  appropriate  to
   46  the  needs  of the individual with the disability and enables that indi-
   47  vidual to interact with nondisabled persons to the fullest extent possi-
   48  ble.  A placement shall be considered the most integrated setting  if  a
   49  determination  is  made by the state's treatment professionals that such
   50  placement is appropriate; the affected individual does not  oppose  such
   51  placement; and the placement can be reasonably accommodated, taking into
   52  account  the  resources  available  to the state and the needs of others
   53  with similar disabilities. Further,  any  modifications  made  by  state
   54  agencies  to  accommodate  such placements shall not fundamentally alter
   55  the nature of the affected services or programs.
       S. 1408                            39                            A. 2108
 
    1     § 702. Most integrated setting coordinating council; organization.  1.
    2  The most integrated setting coordinating council is hereby created with-
    3  in  the  executive department to have and exercise the functions, powers
    4  and duties provided by the provisions of  this  article  and  any  other
    5  provision  of  law.  The council shall be comprised of the commissioners
    6  of: the department of health,  the  office  of  mental  retardation  and
    7  developmental  disabilities, the office of mental health, the department
    8  of transportation, the office  of  children  and  family  services,  the
    9  office of [alcohol] alcoholism and substance abuse services, the depart-
   10  ment of education, and the division of housing and community renewal. In
   11  addition,  the  council  shall consist of the director of the office for
   12  the aging, a representative from the office of the advocate for  persons
   13  with  disabilities,  a  representative from the commission on quality of
   14  care for the mentally disabled, three consumers of services for individ-
   15  uals with disabilities, one to be appointed by the governor, one  to  be
   16  appointed  by  the  temporary  president  of  the  senate, and one to be
   17  appointed by the speaker of the assembly, three individuals with  exper-
   18  tise  in  the  field  of  community services for people of all ages with
   19  disabilities, one to be appointed by the governor, one to  be  appointed
   20  by the temporary president of the senate, and one to be appointed by the
   21  speaker  of  the  assembly,  and  three individuals with expertise in or
   22  recipients of services available to senior citizens  with  disabilities,
   23  one  to  be appointed by the governor, one to be appointed by the tempo-
   24  rary president of the senate, and one to be appointed by the speaker  of
   25  the assembly.
   26    2.  The  governor  shall  appoint  the chairperson of the council from
   27  among the commissioners of the  department  of  health,  the  office  of
   28  mental  health, the office of mental retardation and developmental disa-
   29  bilities, and the director of the office for the aging [shall rotate  as
   30  chairperson of the council on a quarterly basis].
   31    3.  The  council  shall  meet as necessary to carry out its functions,
   32  powers and duties, but such meetings shall  occur  at  least  once  each
   33  quarter.
   34     §  703.  Functions,  powers  and duties of the council. 1. The council
   35  shall develop [and oversee the implementation of] a comprehensive state-
   36  wide plan which shall make recommendations to the affected  state  agen-
   37  cies for providing services to individuals of all ages with disabilities
   38  in  the most integrated setting. Such plan shall be completed within one
   39  year of the effective date of this article. Such plan shall include, but
   40  not be limited to
   41    (a) [the number of] an evaluation of  individuals  of  all  ages  with
   42  disabilities  who  are  currently institutionalized and are eligible for
   43  services in community-based settings, [the number of] individuals resid-
   44  ing in the community who are dependent on the assistance  of  community-
   45  based services to avoid institutionalization and any improvements neces-
   46  sary  to  be  made  to  current  data collection systems or any new data
   47  collection initiatives necessary to obtain such information;
   48    (b) a description of the current  assessment  procedures  utilized  to
   49  identify  individuals  of  all  ages with disabilities who could benefit
   50  from services in a more integrated setting and guidelines for the devel-
   51  opment of a [single assessment process for individuals of all ages  with
   52  disabilities  in  need  of  services,  to  be implemented] comprehensive
   53  community-based information and assistance service, coordinated, by  one
   54  community-based  agency in each county with expertise in community-based
   55  services for people of all ages with disabilities [through the use of  a
   56  uniform assessment tool]. Such agency would develop, maintain, and peri-
       S. 1408                            40                            A. 2108
 
    1  odically  update  a list of community-based services and supports avail-
    2  able to individuals with disabilities of all ages, and assist such indi-
    3  viduals in obtaining needed services and supports in the most integrated
    4  setting;
    5    (c)  the identification of what community-based services are available
    6  to individuals of all ages with disabilities in the state  of  New  York
    7  and  an  assessment  of  the  extent to which these programs are able to
    8  serve people in the most integrated settings;
    9    (d) the identification of what improvements need to  be  made  to  the
   10  system  of  community-based services to [ensure] provide that the system
   11  is comprehensive, accessible, meets the needs of persons who are  likely
   12  to  require  assistance  in  order to live in the community and provides
   13  high quality, adequate supports for individuals of all ages  with  disa-
   14  bilities;
   15    (e)  an  evaluation  of  the supports and services available to assist
   16  individuals of all ages with disabilities who reside in their own  homes
   17  with  the  presence of other family members or other informal caregivers
   18  and an evaluation of the supports and services available to address  the
   19  needs  of  individuals of all ages with disabilities who reside in their
   20  own homes without family members or other informal caregivers;
   21    (f) an examination of how the identified community-based supports  and
   22  services  integrate  individuals  of all ages with disabilities into the
   23  community;
   24    (g) a review of what funding sources are available  to  [increase  the
   25  availability of] provide adequate community-based services to meet needs
   26  identified  and  an analysis of how the varied funding sources available
   27  to meet the needs of individuals of all ages with  disabilities  in  the
   28  most  integrated setting can be organized into a more coherent system of
   29  long term care which affords people  reasonable  and  timely  access  to
   30  community-based services;
   31    (h)  an  assessment  of how well the current service system [works] is
   32  operating for different  populations,  including  but  not  limited  to,
   33  elderly  people  with  disabilities,  people with physical disabilities,
   34  people with developmental disabilities, people with mental illness,  and
   35  people  with HIV and AIDS, and a review of changes that might be desira-
   36  ble to make services a reality in the most integrated  setting  for  all
   37  populations;
   38    (i)  an  examination  of  waiting lists which may exist for community-
   39  based services and what might be done to ensure that waiting  lists  are
   40  [created  and]  accurately  maintained and that people are [able to come
   41  off] placed into community-based services from waiting lists and receive
   42  needed community-based services at a reasonable pace;
   43    (j) an examination of what information, education, outreach and refer-
   44  ral systems might  be  useful  to  [ensure]  complement  community-based
   45  information  and  assistance services to provide that individuals of all
   46  ages  with  disabilities  receive  the  information  necessary  to  make
   47  informed  choices  regarding  how their needs can best be met, including
   48  the evaluation of the creation of a toll free hotline  with  information
   49  on  community-based  services for individuals of all ages with disabili-
   50  ties;
   51    (k) an evaluation of how quality assurance and quality improvement can
   52  be conducted effectively as more people of all  ages  with  disabilities
   53  live in community settings; and
   54    (l)  an  examination of how the overall system of health and long term
   55  care can best be managed  so  that  placement  in  the  most  integrated
   56  setting [becomes the norm] occurs when appropriate.
       S. 1408                            41                            A. 2108
 
    1    2.  The  council  shall contract with an independent organization with
    2  expertise in the provision of community-based services  for  individuals
    3  of  all ages with disabilities and with expertise in the area of program
    4  evaluation research to conduct  an  evaluation  of  the  council's  plan
    5  created  pursuant to subdivision one of this section and the implementa-
    6  tion of such plan. Such evaluation shall be completed three years  after
    7  the effective date of this article.
    8    3. Each commissioner and director serving on the council shall [ensure
    9  that  his  or  her  agency implements] evaluate every aspect of the plan
   10  developed pursuant to subdivision one of this section which falls  under
   11  the  responsibilities  of  his or her agency, and submit to the governor
   12  and the legislature a proposed operational plan  for  each  such  agency
   13  designed  to implement the most integrated setting plan developed by the
   14  council, taking into account the resources available to  the  state  and
   15  the  needs  of  other  with similar disabilities. Such operational plans
   16  will be submitted one year after the submission of the  most  integrated
   17  setting  plan  and shall be revised to reflect the findings contained in
   18  the independent plan evaluation provided for in subdivision two of  this
   19  section,  and  thereafter,  as  needed or requested by the council.  The
   20  council shall oversee the implementation of the plan created pursuant to
   21  subdivision one of this section and shall update such plan as  necessary
   22  to  ensure that waiting lists for community-based services for people of
   23  all ages with disabilities are moving at a reasonable pace and to ensure
   24  that the state of New York is developing a system of long term care that
   25  allows individuals of all ages with disabilities to reside and  function
   26  in the most integrated setting.
   27    4.  The  council shall provide a report to the governor, the temporary
   28  president of the senate and the speaker of the assembly one  year  after
   29  the  effective date of this article and annually thereafter. Such report
   30  shall detail the plan developed pursuant  to  subdivision  one  of  this
   31  section,  any  changes  made  to such plan, all steps taken to implement
   32  such plan and their outcome, and any future actions planned.
   33    5. The plan to be developed under this article shall not be  construed
   34  to  increase,  decrease, or change the statutory authority of any person
   35  or entity and shall be implemented consistent with all otherwise  appli-
   36  cable law.
   37     §  34.   Subdivisions 2 and 4 of section 246 of chapter 81 of the laws
   38  of 1995, amending the public health  law  and  other  laws  relating  to
   39  medical reimbursement and welfare reform, as amended by chapter 1 of the
   40  laws of 1999, are amended to read as follows:
   41    2.  Sections  five,  seven  through nine, twelve through fourteen, and
   42  eighteen of this act shall be deemed to have  been  in  full  force  and
   43  effect  on  and  after  April  1, 1995 through March 31, 1999 and on and
   44  after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
   45  through March 31, 2003 and on and after April 1, 2003 through March  31,
   46  2004 and annually thereafter;
   47    4.  Section one of this act shall be deemed to have been in full force
   48  and effect on and after April 1, 1995 through March 31, 1999 and on  and
   49  after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
   50  through  March 31, 2003 and on and after April 1, 2003 through March 31,
   51  2004 and annually thereafter.
   52     § 35. Section 194 of chapter 474 of the  laws  of  1996  amending  the
   53  education  law  and  other laws relating to rates for residential health
   54  care facilities, as amended by section 7 of part A of chapter 57 of  the
   55  laws of 2000, is amended to read as follows:
       S. 1408                            42                            A. 2108
 
    1     §  194.  1. Notwithstanding any inconsistent provision of law or regu-
    2  lation, the trend factors used to project reimbursable  operating  costs
    3  to the rate period for purposes of determining rates of payment pursuant
    4  to  article  28  of  the  public  health law for residential health care
    5  facilities  for reimbursement of inpatient services provided to patients
    6  eligible for payments made by state governmental agencies on  and  after
    7  April  1, 1996 through March 31, 1999 and for payments made on and after
    8  July 1, 1999 through March 31, 2000 and  on  and  after  April  1,  2000
    9  through  March 31, 2003 and on and after April 1, 2003 through March 31,
   10  2004 and annually thereafter shall reflect no trend  factor  projections
   11  or adjustments for the period April 1, 1996, through March 31, 1997.
   12    2.  The  commissioner  of health shall adjust such rates of payment to
   13  reflect the exclusion pursuant to this section of such  specified  trend
   14  factor projections or adjustments.
   15     § 36. Notwithstanding any inconsistent provision of law, rule or regu-
   16  lation to the contrary, the provisions of section 1 of chapter 41 of the
   17  laws  of  1992, as amended, shall remain and be in full force and effect
   18  on and after April 1, 2000 through March 31, 2003 and on and after April
   19  1, 2003 through March 31, 2004 and annually thereafter.
   20     § 37. Subdivision 5-a of section 246 of chapter  81  of  the  laws  of
   21  1995,  amending the public health law and other laws relating to medical
   22  reimbursement and welfare reform, as amended by chapter 1 of the laws of
   23  1999, is amended to read as follows:
   24    5-a. Section sixty-four-a of this act shall be deemed to have been  in
   25  full  force and effect on and after April 1, 1995 through March 31, 1999
   26  and on and after July 1, 1999 through March 31, 2000 and  on  and  after
   27  April  1,  2000  through  March  31, 2003 and on and after April 1, 2003
   28  through March 31, 2004 and annually thereafter;
   29     § 38. Section 64-b of chapter 81 of the laws  of  1995,  amending  the
   30  public  health  law and other laws relating to medical reimbursement and
   31  welfare reform, as amended by chapter 1 of the laws of 1999, is  amended
   32  to read as follows:
   33     §  64-b.  Notwithstanding  any  inconsistent  provision  of  law,  the
   34  provisions of subdivision 7 of section 3614 of the public health law, as
   35  amended, shall remain and be in full force and effect on April  1,  1995
   36  through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
   37  and after April 1, 2000 through March 31, 2003 and on and after April 1,
   38  2003 through March 31, 2004 and annually thereafter.
   39     § 39. Section 4 of chapter 81 of the laws of 1995, amending the public
   40  health  law and other laws relating to medical reimbursement and welfare
   41  reform, as amended by chapter 1 of the laws of 1999, is amended to  read
   42  as follows:
   43     §  4. Notwithstanding any inconsistent provision of law, except subdi-
   44  vision 15 of section 2807 of the public health law and  section  364-j-2
   45  of  the social services law and section 32-g of part F of chapter 412 of
   46  the laws of 1999, rates of payment for diagnostic and treatment  centers
   47  established  in  accordance with paragraphs (b) and (h) of subdivision 2
   48  of section 2807 of the public health law for the period ending September
   49  30, 1995 shall continue in effect through September 30, 2000 and for the
   50  periods October 1, 2000 through September 30, 2003 and October  1,  2003
   51  through  September 30, 2004 and annually thereafter and further provided
   52  that rates in effect on March 31, 2003 as established in accordance with
   53  paragraph (e) of subdivision 2 of section 2807 of the public health  law
   54  shall  continue in effect for the period April 1, 2003 through September
   55  30, 2003 and annually thereafter.
       S. 1408                            43                            A. 2108
 
    1     § 40. Subdivision 5 of section 246 of chapter 81 of the laws of  1995,
    2  amending  the  public  health  law  and  other  laws relating to medical
    3  reimbursement and welfare reform, as amended by chapter 1 of the laws of
    4  1999, is amended to read as follows:
    5    5.  Section  three  of  this  act shall be deemed to have been in full
    6  force and effect on and after April 1, 1995 through March 31,  1999  and
    7  on  and after July 1, 1999 through March 31, 2000 and on and after April
    8  1, 2000 through March 31, 2003 and on and after April  1,  2003  through
    9  March 31, 2004 and annually thereafter;
   10     §  41.  The  opening  paragraph and paragraph (a) of subdivision 16 of
   11  section 2808 of the public health law, as amended by chapter  1  of  the
   12  laws of 1999, are amended to read as follows:
   13    Notwithstanding any inconsistent provision of law or regulation to the
   14  contrary,  residential  health care facility rates of payment determined
   15  pursuant to this article for governmental agencies for services provided
   16  on or after April first, nineteen hundred ninety-six through March thir-
   17  ty-first, nineteen hundred ninety-nine and on or after July first, nine-
   18  teen hundred ninety-nine through March thirty-first, two thousand and on
   19  and after April first, two  thousand  through  March  thirty-first,  two
   20  thousand  three and on and after April first, two thousand three through
   21  March thirty-first, two thousand four and annually thereafter, shall  be
   22  further  reduced  by the commissioner to encourage improved productivity
   23  and efficiency by providers by a factor determined as follows:
   24    (a) an aggregate reduction shall be calculated  for  each  residential
   25  health care facility commencing April first, nineteen hundred ninety-six
   26  through March thirty-first, nineteen hundred ninety-nine and on or after
   27  July first, nineteen hundred ninety-nine through March thirty-first, two
   28  thousand  and on and after April first, two thousand through March thir-
   29  ty-first, two thousand three and on and after April first, two  thousand
   30  three  through March thirty-first, two thousand four and annually there-
   31  after as the result of (i) fifty-six million dollars  on  an  annualized
   32  basis multiplied by (ii) the ratio of patient days for patients eligible
   33  for  payments  made by governmental agencies provided in a base year two
   34  years prior to the rate year by a residential health care  facility,  or
   35  for residential health care facility beds not fully in operation in such
   36  base  year  by  an  estimate of projected utilization for the rate year,
   37  divided by the total of such patient days  summed  for  all  residential
   38  health care facilities; and
   39     §  42.  Paragraph  (a) of subdivision 14 of section 2808 of the public
   40  health law, as amended by section 1 of part H of chapter 57 of the  laws
   41  of 2000, is amended to read as follows:
   42    (a) Notwithstanding any inconsistent provision of law or regulation to
   43  the  contrary,  for purposes of establishing rates of payment by govern-
   44  mental agencies for residential  health  care  facilities  for  services
   45  provided  on  or after April first, nineteen hundred ninety-five through
   46  March  thirty-first,  nineteen  hundred  ninety-nine  and  for  services
   47  provided  on  or  after July first, nineteen hundred ninety-nine through
   48  March thirty-first, two thousand and on and after April first, two thou-
   49  sand through March thirty-first, two thousand three  and  on  and  after
   50  April first, two thousand three through March thirty-first, two thousand
   51  four  and annually thereafter, the reimbursable base year administrative
   52  services and fiscal services costs, as defined in  the  New  York  state
   53  residential  health  care facility accounting and reporting manual, of a
   54  residential health care facility, excluding a provider of services reim-
   55  bursed on an initial budget basis, shall, except as  otherwise  provided
   56  in this subdivision, not exceed the statewide average of total reimburs-
       S. 1408                            44                            A. 2108
 
    1  able  base  year administrative and fiscal services costs of residential
    2  health care facilities. For the purposes of this subdivision, reimbursa-
    3  ble base year administrative and fiscal services costs shall mean  those
    4  base  year  administrative  and  fiscal  services  costs remaining after
    5  application of all other efficiency standards, including but not limited
    6  to, peer group cost ceilings or guidelines.
    7     § 43. Paragraph (b) of subdivision 14 of section 2808  of  the  public
    8  health law, as added by section 1 of part H of chapter 57 of the laws of
    9  2000, is amended to read as follows:
   10    (b)  A  separate  statewide  average  of  total reimbursable base year
   11  administrative and fiscal services costs shall be determined for each of
   12  those facilities wherein eighty percent or  more  of  its  patients  are
   13  classified with a patient acuity equal to or less than .83 which is used
   14  as  the  basis for a facility's case mix adjustment. For the period July
   15  first, two thousand through March thirty-first, two  thousand  one,  the
   16  total reimbursable base year administrative and fiscal services costs of
   17  such  facilities  shall  not exceed such separate statewide average plus
   18  one and  one-half  percentage  points.  For  annual  periods  thereafter
   19  [through March thirty-first, two thousand three,] the total reimbursable
   20  base  year  administrative  and fiscal services costs of such facilities
   21  shall not exceed such separate statewide average. In no event shall  the
   22  calculation of such separate statewide average result in a change in the
   23  statewide average determined under paragraph (a) of this subdivision.
   24     §  44.  Paragraph  (f) of subdivision 1 of section 64 of chapter 81 of
   25  the laws of 1995, amending the public health law and other laws relating
   26  to medical reimbursement and welfare reform, as added by  chapter  1  of
   27  the laws of 1999, is amended to read as follows:
   28    (f)  Prior  to  February  1,  2001, February 1, 2002, February 1, 2003
   29  [and], February 1, 2004, and February 1 of  each  year  thereafter,  the
   30  commissioner of health shall calculate the result of the statewide total
   31  of  residential  health care facility days of care provided to benefici-
   32  aries of title XVIII of the  federal  social  security  act  (medicare),
   33  divided  by  the  sum of such days of care plus days of care provided to
   34  residents eligible for payments pursuant to title 11 of article 5 of the
   35  social services law minus the  number  of  days  provided  to  residents
   36  receiving  hospice  care,  expressed  as  a  percentage,  for the period
   37  commencing January 1, through November 30, of the prior year respective-
   38  ly, based on such data for such period. This value shall be  called  the
   39  2000,  2001, 2002, [and] 2003, and each year thereafter statewide target
   40  percentage respectively.
   41     § 45. Paragraph (b) of subdivision 3 of section 64 of  chapter  81  of
   42  the laws of 1995, amending the public health law and other laws relating
   43  to  medical reimbursement and welfare reform, as amended by chapter 1 of
   44  the laws of 1999, is amended to read as follows:
   45    (b) (i) If the 1996 statewide target percentage is not  at  least  two
   46  percentage points higher than the statewide base percentage, the commis-
   47  sioner of health shall determine the percentage by which the 1996 state-
   48  wide target percentage is not at least two percentage points higher than
   49  the  statewide  base  percentage.  The percentage calculated pursuant to
   50  this paragraph shall be called the 1996 statewide reduction  percentage.
   51  If  the  1996  statewide  target  percentage  is at least two percentage
   52  points higher than the statewide base  percentage,  the  1996  statewide
   53  reduction percentage shall be zero.
   54    (ii)  If  the  1997, 1998, 2000, 2001, 2002 [and], 2003, and each year
   55  thereafter statewide target percentages are not for each year  at  least
   56  three  percentage  points higher than the statewide base percentage, the
       S. 1408                            45                            A. 2108
 
    1  commissioner of health shall  determine  the  percentage  by  which  the
    2  statewide target percentage for each year is not at least three percent-
    3  age  points  higher  than  the statewide base percentage. The percentage
    4  calculated  pursuant  to  this paragraph shall be called the 1997, 1998,
    5  2000,  2001,  2002  [or],  2003,  and  each  year  thereafter  statewide
    6  reduction  percentage  respectively. If the 1997, 1998, 2000, 2001, 2002
    7  [or], 2003, and each year thereafter statewide target percentage for the
    8  respective year is at least three  percentage  points  higher  than  the
    9  statewide  base  percentage,  the statewide reduction percentage for the
   10  respective year shall be zero.
   11    (iii) If the 1999 statewide target percentage is not at least two  and
   12  one-quarter percentage points higher than the statewide base percentage,
   13  the  commissioner  of health shall determine the percentage by which the
   14  1999 statewide target percentage is not at  least  two  and  one-quarter
   15  percentage  points  higher  than  the  statewide  base  percentage.  The
   16  percentage calculated pursuant to this paragraph  shall  be  called  the
   17  1999  statewide  reduction  percentage.  If  the  1999  statewide target
   18  percentage is at least two and one-quarter percentage points higher than
   19  the statewide base percentage, the 1999 statewide  reduction  percentage
   20  shall be zero.
   21     §  46.  Paragraph  (b) of subdivision 4 of section 64 of chapter 81 of
   22  the laws of 1995, amending the public health law and other laws relating
   23  to medical reimbursement and welfare reform, as amended by chapter 1  of
   24  the laws of 1999, is amended to read as follows:
   25    (b) (i) The 1996 statewide reduction percentage shall be multiplied by
   26  sixty-eight  million  dollars  to determine the 1996 statewide aggregate
   27  reduction amount. If the 1996 statewide reduction  percentage  shall  be
   28  zero, there shall be no 1996 reduction amount.
   29    (ii)  The  1997  statewide reduction percentage shall be multiplied by
   30  one hundred two million dollars to determine the 1997  statewide  aggre-
   31  gate  reduction amount. If the 1997 statewide reduction percentage shall
   32  be zero, there shall be no 1997 reduction amount.
   33    (iii) The 1998, 2000, 2001, 2002 [and], 2003, and each year thereafter
   34  statewide reduction percentage shall be multiplied by  one  hundred  two
   35  million  dollars  respectively  to  determine the 1998, 2000, 2001, 2002
   36  [or], 2003, and  each  year  thereafter  statewide  aggregate  reduction
   37  amount.  If the 1998 and the 2000, 2001, 2002 [and], 2003, and each year
   38  thereafter statewide reduction percentage shall  be  zero  respectively,
   39  there shall be no 1998, 2000, 2001, 2002 [or], 2003, and each year ther-
   40  eafter reduction amount.
   41    (iv)  The  1999  statewide reduction percentage shall be multiplied by
   42  seventy-six million five hundred thousand dollars to determine the  1999
   43  statewide  aggregate  reduction  amount. If the 1999 statewide reduction
   44  percentage shall be zero, there shall be no 1999 reduction amount.
   45     § 47. Paragraph (b) of subdivision 5 of section 64 of  chapter  81  of
   46  the laws of 1995, amending the public health law and other laws relating
   47  to  medical reimbursement and welfare reform, as amended by chapter 1 of
   48  the laws of 1999, is amended to read as follows:
   49    (b) The 1996, 1997, 1998, 1999, 2000, 2001, 2002 [and], 2003, and each
   50  year thereafter statewide aggregate reduction  amounts  shall  for  each
   51  year be allocated by the commissioner of health among residential health
   52  care  facilities  that are eligible to provide services to beneficiaries
   53  of title XVIII of the federal social security act (medicare)  and  resi-
   54  dents  eligible  for  payments  pursuant to title 11 of article 5 of the
   55  social services law on the basis of the extent of each facility's  fail-
   56  ure  to  achieve  a  two  percentage  points increase in the 1996 target
       S. 1408                            46                            A. 2108
 
    1  percentage, a three percentage point increase in the 1997,  1998,  2000,
    2  2001, 2002 [and], 2003, and each year thereafter target percentage and a
    3  two  and  one-quarter  percentage  point  increase  in  the  1999 target
    4  percentage for each year, compared to the base percentage, calculated on
    5  a  facility  specific  basis for this purpose, compared to the statewide
    6  total of the extent of each facility's failure to achieve a two percent-
    7  age points increase in the 1996 and a three percentage point increase in
    8  the 1997 and a three percentage point increase in the 1998 and a two and
    9  one-quarter percentage point increase in the 1999 target percentage  and
   10  a  three  percentage point increase in the 2000, 2001, 2002 [and], 2003,
   11  and each year thereafter target percentage compared to the base percent-
   12  age. These amounts shall be called the 1996,  1997,  1998,  1999,  2000,
   13  2001,  2002  [and],  2003,  and  each  year thereafter facility specific
   14  reduction amounts respectively.
   15     § 48. Section 228 of chapter 474 of the laws  of  1996,  amending  the
   16  education  law  and  other laws relating to rates for residential health
   17  care facilities, as amended by chapter 1 of the laws of 1999, is amended
   18  to read as follows:
   19     § 228. 1. Definitions. (a) Regions,  for  purposes  of  this  section,
   20  shall  mean  a downstate region to consist of Kings, New York, Richmond,
   21  Queens, Bronx, Nassau and Suffolk counties  and  an  upstate  region  to
   22  consist  of  all other New York state counties.  A certified home health
   23  agency or long term home health care program shall  be  located  in  the
   24  same county utilized by the commissioner of health for the establishment
   25  of rates pursuant to article 36 of the public health law.
   26    (b)  Certified  home  health  agency  (CHHA)  shall  mean such term as
   27  defined in section 3602 of the public health law.
   28    (c) Long term home health care program (LTHHCP) shall mean  such  term
   29  as defined in subdivision 8 of section 3602 of the public health law.
   30    (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
   31  ly, located within a region.
   32    (e)  Medicaid  revenue percentage, for purposes of this section, shall
   33  mean CHHA and LTHHCP  revenues  attributable  to  services  provided  to
   34  persons  eligible  for payments pursuant to title 11 of article 5 of the
   35  social services law divided by such revenues plus CHHA and LTHHCP reven-
   36  ues attributable to services provided to beneficiaries of Title XVIII of
   37  the federal social security act (medicare).
   38    (f) Base period, for purposes of this  section,  shall  mean  calendar
   39  year 1995.
   40    (g) Target period. For purposes of this section, the 1996 target peri-
   41  od  shall  mean  August  1, 1996 through March 31, 1997, the 1997 target
   42  period shall mean January 1, 1997 through November 30,  1997,  the  1998
   43  target  period shall mean January 1, 1998 through November 30, 1998, the
   44  1999 target period shall mean January 1, 1999 through November 30, 1999,
   45  the 2000 target period shall mean January 1, 2000 through  November  30,
   46  2000, the 2001 target period shall mean January 1, 2001 through November
   47  30,  2001,  the  2002  target  period shall mean January 1, 2002 through
   48  November 30, 2002, [and] the 2003 target period shall  mean  January  1,
   49  2003  through  November  30,  2003,  and each year thereafter the target
   50  period shall be January 1 through November 30 for that respective year.
   51    2. (a) Prior to February 1, 1997, for each regional group the  commis-
   52  sioner  of  health shall calculate the 1996 medicaid revenue percentages
   53  for the period commencing August 1, 1996 to the last date for which such
   54  data is available and reasonably accurate.
   55    (b) Prior to February 1, 1998, prior to February  1,  1999,  prior  to
   56  February  1, 2000, prior to February 1, 2001, prior to February 1, 2002,
       S. 1408                            47                            A. 2108
 
    1  prior to February 1, 2003, [and] prior to February 1, 2004, and prior to
    2  February 1 of each year thereafter for each regional group  the  commis-
    3  sioner  of  health  shall  calculate  the  prior year's medicaid revenue
    4  percentages  for  the period commencing January 1 through November 30 of
    5  such prior year.
    6    3. By September 15, 1996, for each regional group the commissioner  of
    7  health shall calculate the base period medicaid revenue percentage.
    8    4.  (a)  For  each  regional  group,  the 1996 target medicaid revenue
    9  percentage shall be calculated by subtracting the 1996 medicaid  revenue
   10  reduction percentages from the base period medicaid revenue percentages.
   11  The  1996  medicaid  revenue  reduction  percentage, taking into account
   12  regional and program differences in utilization of medicaid and medicare
   13  services, for the following regional groups shall be equal to:
   14    (i) one and one-tenth percentage points for CHHAs located  within  the
   15  downstate region;
   16    (ii)  six-tenths  of one percentage point for CHHAs located within the
   17  upstate region;
   18    (iii) one and eight-tenths percentage points for LTHHCPs located with-
   19  in the downstate region; and
   20    (iv) one and seven-tenths percentage points for LTHHCPs located within
   21  the upstate region.
   22    (b) For 1997, 1998, 2000, 2001, 2002, [and] 2003, and each year there-
   23  after for each regional group, the target  medicaid  revenue  percentage
   24  for  the  respective year shall be calculated by subtracting the respec-
   25  tive year's medicaid revenue reduction percentage from the  base  period
   26  medicaid  revenue percentage. The medicaid revenue reduction percentages
   27  for 1997, 1998, 2000, 2001, 2002 [and], 2003, and each  year  thereafter
   28  taking  into  account regional and program differences in utilization of
   29  medicaid and medicare services, for the following regional groups  shall
   30  be equal to for each such year:
   31    (i)  one  and one-tenth percentage points for CHHAs located within the
   32  downstate region;
   33    (ii) six-tenths of one percentage point for CHHAs located  within  the
   34  upstate region;
   35    (iii) one and eight-tenths percentage points for LTHHCPs located with-
   36  in the downstate region; and
   37    (iv) one and seven-tenths percentage points for LTHHCPs located within
   38  the upstate region.
   39    (c) For each regional group, the 1999 target medicaid revenue percent-
   40  age  shall  be  calculated  by  subtracting  the  1999  medicaid revenue
   41  reduction percentage from the base period medicaid  revenue  percentage.
   42  The  1999  medicaid  revenue  reduction percentages, taking into account
   43  regional and program differences in utilization of medicaid and medicare
   44  services, for the following regional groups shall be equal to:
   45    (i) eight hundred twenty-five thousandths  (.825)  of  one  percentage
   46  point for CHHAs located within the downstate region;
   47    (ii)  forty-five  hundredths  (.45)  of one percentage point for CHHAs
   48  located within the upstate region;
   49    (iii) one and thirty-five  hundredths  percentage  points  (1.35)  for
   50  LTHHPs located within the downstate region; and
   51    (iv)  one  and  two hundred seventy-five thousandths percentage points
   52  (1.275) for LTHHCPs located within the upstate region.
   53    5. (a) For each regional group, if the 1996 medicaid revenue  percent-
   54  age  is  not  equal  to  or  less  than the 1996 target medicaid revenue
   55  percentage, the commissioner of health shall compare the  1996  medicaid
   56  revenue  percentage  to  the  1996 target medicaid revenue percentage to
       S. 1408                            48                            A. 2108
 
    1  determine the amount of the shortfall which, when divided  by  the  1996
    2  medicaid   revenue  reduction  percentage,  shall  be  called  the  1996
    3  reduction factor. These amounts, expressed as a  percentage,  shall  not
    4  exceed  one hundred percent.  If the 1996 medicaid revenue percentage is
    5  equal to or less than the 1996 target medicaid revenue  percentage,  the
    6  1996 reduction factor shall be zero.
    7    (b)  For 1997, 1998, 1999, 2000, 2001, 2002, [and] 2003, and each year
    8  thereafter for each regional group, if the medicaid  revenue  percentage
    9  for the respective year is not equal to or less than the target medicaid
   10  revenue  percentage for such respective year, the commissioner of health
   11  shall compare such respective year's medicaid revenue percentage to such
   12  respective year's target medicaid revenue percentage  to  determine  the
   13  amount  of  the  shortfall  which, when divided by the respective year's
   14  medicaid revenue reduction percentage, shall  be  called  the  reduction
   15  factor  for such respective year. These amounts, expressed as a percent-
   16  age, shall not exceed one  hundred  percent.  If  the  medicaid  revenue
   17  percentage  for  a  particular  year is equal to or less than the target
   18  medicaid revenue percentage for that year, the reduction factor for that
   19  year shall be zero.
   20    6. (a) For each regional group, the 1996  reduction  factor  shall  be
   21  multiplied  by  the following amounts to determine each regional group's
   22  applicable 1996 state share reduction amount:
   23    (i) two million three hundred ninety thousand dollars ($2,390,000) for
   24  CHHAs located within the downstate region;
   25    (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
   26  within the upstate region;
   27    (iii) one million two hundred seventy  thousand  dollars  ($1,270,000)
   28  for LTHHCPs located within the downstate region; and
   29    (iv)  five  hundred  ninety  thousand  dollars  ($590,000) for LTHHCPs
   30  located within the upstate region.
   31    For each regional group reduction, if the 1996 reduction factor  shall
   32  be zero, there shall be no 1996 state share reduction amount.
   33    (b) For 1997, 1998, 2000, 2001, 2002, [and] 2003, and each year there-
   34  after  for  each regional group, the reduction factor for the respective
   35  year shall be multiplied by the  following  amounts  to  determine  each
   36  regional  group's  applicable  state  share  reduction  amount  for such
   37  respective year:
   38    (i) two million three hundred ninety thousand dollars ($2,390,000) for
   39  CHHAs located within the downstate region;
   40    (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
   41  within the upstate region;
   42    (iii) one million two hundred seventy  thousand  dollars  ($1,270,000)
   43  for LTHHCPs located within the downstate region; and
   44    (iv)  five  hundred  ninety  thousand  dollars  ($590,000) for LTHHCPs
   45  located within the upstate region.
   46    For each regional group reduction,  if  the  reduction  factor  for  a
   47  particular  year  shall be zero, there shall be no state share reduction
   48  amount for such year.
   49    (c) For each regional group, the 1999 reduction factor shall be multi-
   50  plied by the following amounts to determine each regional group's appli-
   51  cable 1999 state share reduction amount:
   52    (i) one million seven hundred ninety-two thousand five hundred dollars
   53  $1,792,500) for CHHAs located within the downstate region;
   54    (ii) five hundred sixty-two thousand five hundred  dollars  ($562,500)
   55  for CHHAs located within the upstate region;
       S. 1408                            49                            A. 2108
 
    1    (iii)  nine hundred fifty-two thousand five hundred dollars ($952,500)
    2  for LTHHCPs located within the downstate region; and
    3    (iv)  four  hundred forty-two thousand five hundred dollars ($442,500)
    4  for LTHHCPs located within the upstate region.
    5    For each regional group reduction, if the 1999 reduction factor  shall
    6  be zero, there shall be no 1999 state share reduction amount.
    7    7.  (a) For each regional group, the 1996 state share reduction amount
    8  shall be allocated by the commissioner of health among CHHAs and LTHHCPs
    9  on the basis of the extent  of  each  CHHA's  and  LTHHCP's  failure  to
   10  achieve  the  1996  target  medicaid revenue percentage, calculated on a
   11  provider specific basis utilizing revenues for this  purpose,  expressed
   12  as  a  proportion  of  the  total of each CHHA's and LTHHCP's failure to
   13  achieve the 1996 target medicaid revenue percentage within the  applica-
   14  ble  regional group. This proportion shall be multiplied by the applica-
   15  ble 1996 state share reduction amount calculation pursuant to  paragraph
   16  (a)  of  subdivision  6 of this section. This amount shall be called the
   17  1996 provider specific state share reduction amount.
   18    (b) For 1997, 1998, 1999, 2000, 2001, 2002, [and] 2003, and each  year
   19  thereafter for each regional group, the state share reduction amount for
   20  the  respective  year  shall  be allocated by the commissioner of health
   21  among CHHAs and LTHHCPs on the basis of the extent of  each  CHHA's  and
   22  LTHHCP's  failure  to achieve the target medicaid revenue percentage for
   23  the applicable year, calculated on a provider specific  basis  utilizing
   24  revenues  for  this  purpose,  expressed as a proportion of the total of
   25  each CHHA's and LTHHCP's failure to achieve the target medicaid  revenue
   26  percentage for the applicable year within the applicable regional group.
   27  This proportion shall be multiplied by the applicable year's state share
   28  reduction  amount calculation pursuant to paragraph (b) or (c) of subdi-
   29  vision 6 of this section. This  amount  shall  be  called  the  provider
   30  specific state share reduction amount for the applicable year.
   31    8.  (a)  The 1996 provider specific state share reduction amount shall
   32  be due to the state from each CHHA and LTHHCP and may be recouped by the
   33  state by March 31, 1997 in a lump sum amount or  amounts  from  payments
   34  due  to  the  CHHA  and  LTHHCP pursuant to title 11 of article 5 of the
   35  social services law.
   36    (b) The provider specific state share reduction amount for 1997, 1998,
   37  1999, 2000, 2001, 2002 [and], 2003, and each year thereafter respective-
   38  ly, shall be due to the state from each CHHA and LTHHCP  and  each  year
   39  the amount due for such year may be recouped by the state by March 31 of
   40  the  following year in a lump sum amount or amounts from payments due to
   41  the CHHA and LTHHCP pursuant to title 11 of  article  5  of  the  social
   42  services law.
   43    9.  CHHAs  and  LTHHCPs shall submit such data and information at such
   44  times as the commissioner of health may require  for  purposes  of  this
   45  section.  The  commissioner of health may use data available from third-
   46  party payors.
   47    10. On or about June 1, 1997, for each regional group the commissioner
   48  of health shall calculate for the period August 1,  1996  through  March
   49  31,  1997  a  medicaid  revenue  percentage, a reduction factor, a state
   50  share reduction amount, and a provider specific  state  share  reduction
   51  amount  in  accordance with the methodology provided in paragraph (a) of
   52  subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
   53  sion 6 and paragraph (a) of subdivision 7 of this section. The  provider
   54  specific state share reduction amount calculated in accordance with this
   55  subdivision  shall be compared to the 1996 provider specific state share
   56  reduction amount calculated in accordance with paragraph (a) of subdivi-
       S. 1408                            50                            A. 2108
 
    1  sion 7 of this section. Any amount in excess of the amount determined in
    2  accordance with paragraph (a) of subdivision 7 of this section shall  be
    3  due  to  the  state  from  each  CHHA  and LTHHCP and may be recouped in
    4  accordance  with paragraph (a) of subdivision 8 of this section.  If the
    5  amount is less than the amount determined in accordance  with  paragraph
    6  (a)  of  subdivision 7 of this section, the difference shall be refunded
    7  to the CHHA and LTHHCP by the state no later than July 15,  1997.  CHHAs
    8  and  LTHHCPs  shall  submit  data  for the period August 1, 1996 through
    9  March 31, 1997 to the commissioner of health by April 15, 1997.
   10    11. If a CHHA or LTHHCP  fails  to  submit  data  and  information  as
   11  required for purposes of this section:
   12    (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
   13  caid  revenue  percentage  between  the  applicable  base period and the
   14  applicable target period for purposes of the  calculations  pursuant  to
   15  this section; and
   16    (b)  the  commissioner of health shall reduce the current rate paid to
   17  such CHHA and such LTHHCP by state  governmental  agencies  pursuant  to
   18  article  36  of the public health law by one percent for a period begin-
   19  ning on the first day of the calendar month following the applicable due
   20  date as established by the commissioner of health and  continuing  until
   21  the last day of the calendar month in which the required data and infor-
   22  mation are submitted.
   23    12. The commissioner of health shall inform in writing the director of
   24  the  budget  and the chair of the senate finance committee and the chair
   25  of the assembly ways and means committee of the results  of  the  calcu-
   26  lations pursuant to this section.
   27     § 49. Notwithstanding any inconsistent provision of law, rule or regu-
   28  lation,  the  annual  percentage reductions set forth in sections forty-
   29  four through forty-eight of this act shall be prorated  by  the  commis-
   30  sioner  of  health for the period January 1, 2000 through March 31, 2003
   31  and each respective year thereafter.
   32     § 50. Section 3 of chapter 629 of  the  laws  of  1986,  amending  the
   33  social services law relating to establishing a demonstration program for
   34  the  delivery of long-term home health care services to certain persons,
   35  as amended by chapter 1 of the laws of  1999,  is  amended  to  read  as
   36  follows:
   37     §  3.  This  act  shall take effect July 1, 1986[, and shall remain in
   38  effect until March 31, 2003, when upon such date the provisions of  this
   39  act shall be deemed repealed].
   40     §  51.  Paragraph (x) of section 165 of chapter 41 of the laws of 1992
   41  amending the public health law and  other  laws  relating  to  assessing
   42  certain healthcare providers, is REPEALED.
   43     §  52. The opening paragraph, subdivisions 2, 3, 4, 5 and 6 of section
   44  36 of chapter 433 of the laws of 1997, amending the  public  health  law
   45  and  other  laws relating to the rate of reimbursement paid to hospitals
   46  and residential health care facilities, as amended by chapter 1  of  the
   47  laws of 1999, are amended to read as follows:
   48    Notwithstanding  any  provision of law to the contrary, for the period
   49  commencing July 1, 2000 and ending March 31,  2001  and  for  each  year
   50  thereafter [through March 31, 2003]:
   51    (2)(a)  For  the  purposes  of developing district-specific targets to
   52  enhance incentives for the efficient management of home  care  services,
   53  the  department  of health shall employ a methodology which includes the
   54  following components:
   55    (i) districts shall be assigned to one of  two  peer  groups  for  the
   56  purpose  of  creating standards for the comparison of home care utiliza-
       S. 1408                            51                            A. 2108
 
    1  tion across districts, the first group being comprised of the  districts
    2  of  Rockland,  Suffolk,  Westchester,  Nassau  and New York city and the
    3  second group being comprised of all districts not assigned to the  first
    4  group;
    5    (ii)  a  base  period  which  shall be defined, for target calculation
    6  purposes, as July 1, 1996 through March 31, 1997;
    7    (iii) target periods, which shall be defined as July 1,  2000  through
    8  March 31, 2001 and each year thereafter [through March 31, 2003];
    9    (iv)  each district's home care services expenditures per recipient in
   10  the base period shall be arrayed within each peer group  as  established
   11  pursuant to subparagraph (i) of this paragraph;
   12    (v)  standards  of efficiency, which shall be defined as the median of
   13  each peer group's array, provided that no standard of  efficiency  shall
   14  be  less  than  one hundred seventy-five percent of the statewide median
   15  and provided, further, that no standard of efficiency shall  exceed  two
   16  hundred fifty percent of the statewide median; and
   17    (vi)  a  district-specific  expenditure  per recipient variance, which
   18  shall be defined, for those districts whose home care services  expendi-
   19  tures per recipient exceed the applicable standard of efficiency, as the
   20  difference  between  each  district's expenditures per recipient and the
   21  standard of efficiency.
   22    (b) The district-specific expenditure per recipient variance shall  be
   23  multiplied  by  the  number  of  home  care  services recipients in that
   24  district in the base period and the product of that calculation shall be
   25  trended forward to the target period to account for projected price  and
   26  recipient  changes  by a trend factor to be determined by the department
   27  of health in consultation with the director of the division of the budg-
   28  et.
   29    (c) The state share of the product obtained by  the  calculation  made
   30  pursuant  to  paragraph  (b)  of this subdivision shall be reduced in an
   31  amount equal to sixty percent of the state share of the savings  attrib-
   32  utable  to  the  amount by which the district's utilization of long term
   33  nursing facility beds by Medicaid recipients is below the national aver-
   34  age (adjusted for population age sixty-five or older).  For the  purpose
   35  of  this calculation, the department of health may utilize the same data
   36  utilized by the department of social services in its calculation of  the
   37  nursing facility adjustment for savings targets for the target period of
   38  July 1, 1996 through March 31, 1997.
   39    (d)  The  department  of  health  shall  calculate  savings targets by
   40  adjusting all products obtained by  the  calculation  made  pursuant  to
   41  paragraph  (c) of this subdivision by an implementation factor such that
   42  the sum of all such products equals thirty-three  million  five  hundred
   43  sixty-five thousand dollars after first reducing any such sums which are
   44  less than twenty thousand dollars to zero.
   45    (e)  Notwithstanding  the calculation of savings targets made pursuant
   46  to paragraph (d) of this subdivision, any district for which  a  savings
   47  target  is  calculated  pursuant  to  such  paragraph  and which was not
   48  assigned a savings target pursuant to the provisions of section  226  of
   49  chapter 474 of the laws of 1996 shall be assigned a savings target equal
   50  to  twenty-five  percent of the amount calculated pursuant to such para-
   51  graph.
   52    (3) On or about January 1, 2001 and on and about  January  1  of  each
   53  year  thereafter  [through  January  1,  2003], the department of health
   54  shall notify districts as to  the  progress  made  toward  reaching  the
   55  savings targets. Such notice shall provide districts with aggregate data
   56  accumulated  by such department from the beginning of each target period
       S. 1408                            52                            A. 2108
 
    1  through the most recent full calendar month for which data is  available
    2  and  shall include information on the number of recipients in receipt of
    3  home care services, the type of home care services provided and the cost
    4  of such services.
    5    (4)(a)  On  or  before  March 1, 2001 and on or before March 1 of each
    6  year thereafter [through March 1, 2003], the department of health  shall
    7  notify  districts  as  to: the progress made toward reaching the savings
    8  targets; the amount, if any, by which the department projects,  pursuant
    9  to  paragraph (b) of this subdivision, the district will not achieve the
   10  savings targets; and the amount of state payments, if any, to be  inter-
   11  cepted by the department pursuant to subdivision five of this section.
   12    (b)  For  purposes  of  the  assessment  as  to achievement of savings
   13  targets required by paragraph (a) of this subdivision, the department of
   14  health shall take the following steps:
   15    (i) calculate the state share district-specific home care expenditures
   16  per recipient from the beginning of the target period through  the  most
   17  recent  full calendar month for which data is available and project such
   18  calculation to the full target  period;  provided,  however,  that  such
   19  calculation  shall  exclude  any  expenditures during such period caused
   20  solely by adjustments to rates of payment for service periods  prior  to
   21  the target period;
   22    (ii)  calculate  the  state share district-specific home care expendi-
   23  tures per recipient for the base period trended  forward  by  the  price
   24  projection factor utilized pursuant to paragraph (b) of subdivision 2 of
   25  this section;
   26    (iii)  the  district-specific projected savings shall be determined by
   27  subtracting the result of the calculation performed pursuant to subpara-
   28  graph (i) of this paragraph from the result of the calculation performed
   29  pursuant to subparagraph (ii) of this paragraph and, where the result of
   30  such subtraction is a positive number, multiplying the difference by the
   31  number of home care services recipients in the base period as  projected
   32  forward  by the utilization projection factor used pursuant to paragraph
   33  (b) of subdivision 2 of this section to the target period;
   34    (5)(a) The department of health is authorized and directed  to  inter-
   35  cept, on or before March 31, 2001 and on or before March 31 of each year
   36  thereafter  [through  March 31, 2003], state payments for public assist-
   37  ance and care, and any other payments  otherwise  to  be  made,  to  any
   38  district  which  the  department  projects, pursuant to subdivision 4 of
   39  this section, will fail to achieve the savings target calculated  pursu-
   40  ant to subdivision 2 of this section.
   41    (b)(i)  The  department  of health shall intercept the amount by which
   42  the savings calculated pursuant to subparagraph (iii) of  paragraph  (b)
   43  of subdivision 4 of this section is less than the savings targets calcu-
   44  lated pursuant to subdivision 2 of this section.
   45    (ii)  Notwithstanding the provisions of subparagraph (i) of this para-
   46  graph, the commissioner of health, in consultation with the director  of
   47  the  division  of  the  budget, may exercise discretion not to intercept
   48  from a district if the commissioner  of  health  reasonably  anticipates
   49  that  the district's projected additional savings through the end of the
   50  target period will exceed the amount otherwise subject  to  interception
   51  pursuant to this paragraph.
   52    (c) Payments intercepted pursuant to this subdivision shall be paid to
   53  the  state  general  fund and credited to the aid to localities, medical
   54  assistance program.
   55    (6) As soon as practicable after March 31, 2001 and as soon as  possi-
   56  ble  after  March  31 of each year thereafter [up to and including March
       S. 1408                            53                            A. 2108
 
    1  31, 2003], the department of health shall determine the actual home care
    2  services state share medical assistance savings achieved by a  district.
    3  The  department  shall  calculate  actual savings in the same manner set
    4  forth  in  subdivision 4 of this section, except that the calculation as
    5  to actual home care services expenditures per  recipient  set  forth  in
    6  subparagraph (i) of paragraph (b) of subdivision 4 of this section shall
    7  be  based on data for the entire target period. If the department deter-
    8  mines that payments to any district were intercepted, pursuant to subdi-
    9  visions 4 and 5 of this section, in an amount greater than was necessary
   10  to reimburse the department for the savings target, the department shall
   11  authorize payment of such amount to such district as soon  as  possible,
   12  but  in  no  event  later  than three months after the end of the target
   13  period.  In the case of a district for which, pursuant to subdivisions 4
   14  and 5 of this section, either no intercept, or  an  insufficient  inter-
   15  cept,  of  state  funds was made, if the department determines that such
   16  district failed to achieve savings sufficient  to  meet  its  home  care
   17  services  state  share medical assistance savings target, the department
   18  shall as soon as possible, but in no event later than three months after
   19  the end of the  target  period,  intercept  state  payments  for  public
   20  assistance  and care and any other payments otherwise to be made to such
   21  district in an amount sufficient to reimburse the state for the  savings
   22  target.
   23     §  53.  Subdivision  11  of section 2807-c of the public health law is
   24  amended by adding a new paragraph (s-6) to read as follows
   25    (s-6) To the extent funds are available otherwise notwithstanding  any
   26  inconsistent  provision  of  law to the contrary, for rate periods April
   27  first, two thousand through March thirty-first, two thousand  five,  the
   28  commissioner  shall  increase rates of payment for patients eligible for
   29  payments made by state governmental agencies by an amount not to  exceed
   30  forty-eight  million  dollars  annually  in the aggregate.   Such amount
   31  shall be allocated among those voluntary non-profit and private proprie-
   32  tary general hospitals which continue to provide inpatient  services  as
   33  of July first, nineteen hundred ninety-nine under a previous or new name
   34  and  which  qualified  for rate adjustments pursuant to paragraph (s) of
   35  this subdivision as in  effect  for  the  period  July  first,  nineteen
   36  hundred  ninety-five through June thirtieth, nineteen hundred ninety-six
   37  proportionally based on each such general hospital's proportional  share
   38  of  total  funds allocated pursuant to paragraph (s) of this subdivision
   39  as in effect for the period of July first, nineteen hundred  ninety-five
   40  through  June  thirtieth, nineteen hundred ninety-six, provided however,
   41  that amounts allocable to previously but no longer  qualified  hospitals
   42  shall  be  proportionally  reallocated to the remaining qualified hospi-
   43  tals. The rate adjustments calculated in accordance with this  paragraph
   44  shall  be  subject  to  retrospective reconciliation to ensure that each
   45  hospital receives in the aggregate its proportionate share of  the  full
   46  allocation,  to the extent allowable under federal law, provided however
   47  that the department shall not be required  to  reconcile  payments  made
   48  pursuant  to  paragraph  (s)  of  this subdivision applicable to periods
   49  prior to September first, nineteen hundred ninety-seven.
   50     § 54. Subparagraph (iii) of paragraph (f) of subdivision 4 of  section
   51  2807-c  of the public health law, as amended by chapter 1 of the laws of
   52  1999, is amended to read as follows:
   53    (iii) commencing April first, nineteen  hundred  ninety-seven  through
   54  March  thirty-first,  nineteen  hundred  ninety-nine and commencing July
   55  first, nineteen hundred  ninety-nine  through  March  thirty-first,  two
   56  thousand and on and after April first, two thousand [through March thir-
       S. 1408                            54                            A. 2108
 
    1  ty-first, two thousand three], the reimbursable inpatient operating cost
    2  component  of  case  based rates of payment per diagnosis-related group,
    3  excluding any operating cost components related to direct  and  indirect
    4  expenses  of  graduate  medical  education,  for  patients  eligible for
    5  payments made by state governmental agencies shall be reduced  by  three
    6  and  thirty-three  hundredths percent to encourage improved productivity
    7  and efficiency.  Such election shall not alter the  calculation  of  the
    8  group  price  component calculated pursuant to subparagraph (i) of para-
    9  graph (a) of subdivision seven of this section;
   10     § 55. Subparagraph (iii) of paragraph (k) of subdivision 4 of  section
   11  2807-c  of the public health law, as amended by chapter 1 of the laws of
   12  1999, is amended to read as follows:
   13    (iii) commencing April first, nineteen  hundred  ninety-seven  through
   14  March  thirty-first,  nineteen  hundred  ninety-nine and commencing July
   15  first, nineteen hundred  ninety-nine  through  March  thirty-first,  two
   16  thousand and on and after April first, two thousand [through March thir-
   17  ty-first,  two thousand three], the operating cost component of rates of
   18  payment, excluding any operating cost components related to  direct  and
   19  indirect  expenses  of graduate medical education, for patients eligible
   20  for payments made by a state governmental agency  shall  be  reduced  by
   21  three  and thirty-three hundredths percent to encourage improved produc-
   22  tivity and efficiency. The facility will  be  eligible  to  receive  the
   23  financial  incentives  for  the  physician specialty weighting incentive
   24  towards primary care pursuant to subparagraph (ii) of paragraph  (a)  of
   25  subdivision twenty-five of this section.
   26     §  56.  The  opening  clause  of subparagraph (vi) of paragraph (b) of
   27  subdivision 5 of section 2807-c of the public health law, as amended  by
   28  chapter 1 of the laws of 1999, is amended to read as follows:
   29    for  discharges on or after April first, nineteen hundred ninety-seven
   30  through  March  thirty-first,  nineteen  hundred  ninety-nine  and   for
   31  discharges  on or after July first, nineteen hundred ninety-nine through
   32  March thirty-first, two thousand and for discharges on  or  after  April
   33  first,  two  thousand  [through March thirty-first, two thousand three],
   34  for  purposes  of  reimbursement  of  inpatient  hospital  services  for
   35  patients  eligible for payments made by state governmental agencies, the
   36  average reimbursable inpatient operating cost per discharge of a general
   37  hospital shall, to encourage improved productivity  and  efficiency,  be
   38  the sum of:
   39     §  57.  The opening paragraph and subparagraph (i) of paragraph (c) of
   40  subdivision 5 of section 2807-c of the public health law, as amended  by
   41  chapter 1 of the laws of 1999, is amended to read as follows:
   42    Notwithstanding any inconsistent provision of this section, commencing
   43  July  first,  nineteen  hundred  ninety-six  through March thirty-first,
   44  nineteen hundred ninety-nine and July first,  nineteen  hundred  ninety-
   45  nine  through  March  thirty-first,  two thousand and on and after April
   46  first, two thousand [through March thirty-first,  two  thousand  three],
   47  rates  of  payment  for  a  general  hospital  for patients eligible for
   48  payments made by state governmental agencies shall be further reduced by
   49  the commissioner to encourage improved productivity  and  efficiency  by
   50  providers by a factor determined as follows:
   51    (i) an aggregate reduction shall be calculated for each general hospi-
   52  tal  commencing  July  first,  nineteen hundred ninety-six through March
   53  thirty-first, nineteen hundred  ninety-nine  and  July  first,  nineteen
   54  hundred  ninety-nine through March thirty-first, two thousand and on and
   55  after April first, two thousand [through March thirty-first,  two  thou-
   56  sand  three],  as  the  result  of (A) eighty-nine million dollars on an
       S. 1408                            55                            A. 2108
 
    1  annualized basis for each year, multiplied by (B) the ratio  of  patient
    2  days for patients eligible for payments made by state governmental agen-
    3  cies  provided  in  a  base  year  two years prior to the rate year by a
    4  general  hospital,  divided by the total of such patient days summed for
    5  all general hospitals; and
    6     § 58. Clause (B-1) of subparagraph (i) of paragraph (f) of subdivision
    7  11 of section 2807-c of the public health law, as amended by  chapter  1
    8  of the laws of 1999, is amended to read as follows:
    9    (B-1)  The  increase  in the statewide average case mix in the periods
   10  January first, nineteen hundred ninety-seven through March thirty-first,
   11  two thousand and on and after April first, two thousand  [through  March
   12  thirty-first,  two  thousand three], from the statewide average case mix
   13  for the period January first, nineteen hundred ninety-six through Decem-
   14  ber thirty-first, nineteen  hundred  ninety-six  shall  not  exceed  one
   15  percent  for  nineteen  hundred  ninety-seven,  two percent for nineteen
   16  hundred ninety-eight, three percent for the period January first,  nine-
   17  teen  hundred  ninety-nine through September thirtieth, nineteen hundred
   18  ninety-nine, four percent for the period October first, nineteen hundred
   19  ninety-nine through December thirty-first, nineteen hundred  ninety-nine
   20  and  four  percent  for  two thousand plus an additional one percent per
   21  year thereafter, based on comparison of data only for patients that  are
   22  eligible for medical assistance pursuant to title eleven of article five
   23  of  the  social services law, including such patients enrolled in health
   24  maintenance organizations.
   25     § 59. Subdivision 1 of section 46 of chapter 639 of the laws  of  1996
   26  amending  the  public  health  law  and  other  laws relating to welfare
   27  reform, as amended by chapter 1 of the laws of 1999, is amended to  read
   28  as follows:
   29    1.  Notwithstanding any inconsistent provision of law or regulation to
   30  the contrary, the trend factors used to project  reimbursable  operating
   31  costs  to  the  rate period for purposes of determining rates of payment
   32  pursuant to article 28 of the public health law  for  general  hospitals
   33  for  reimbursement  of  inpatient hospital services provided to patients
   34  eligible for payments made by state governmental agencies on  and  after
   35  April 1, 1996 through June 30, 1996 and on or after July 1, 1996 through
   36  March  31, 1999 and on and after July 1, 1999 through March 31, 2000 and
   37  on and after April 1, 2000 [through March 31, 2003],  shall  reflect  no
   38  trend  factor  projections  or adjustments for the period April 1, 1996,
   39  through March 31, 1997.
   40     § 60. Section 3 of chapter 483 of  the  laws  of  1978,  amending  the
   41  public  health  law  relating  to  rate  of payment for each residential
   42  health care facility to real property costs, as amended by section 24 of
   43  part B of chapter 1 of the laws of 2002, is amended to read as follows:
   44     § 3. This act shall take effect immediately [provided,  however,  that
   45  the  provisions  of subdivision 2-a of section 2808 of the public health
   46  law, as added by section one of this act, shall remain in full force and
   47  effect until December 31, 2003].
   48     § 61. Notwithstanding any provision of law, rule or regulation to  the
   49  contrary, assessments due for any period prior to January 1, 2003, which
   50  are  paid  in  full  and  accompanied by appropriate reports pursuant to
   51  subparagraph (vi) of paragraph (b) of subdivision 2 of section 2807-d of
   52  the public health law and which are received on or before July 1,  2003,
   53  shall  not  be subject to interest or penalties as otherwise provided in
   54  section 2807-d of the public health law, provided,  however,  that  with
   55  regard  to all assessment, interest and penalty amounts collected by the
   56  commissioner of health by the effective date of this  act  the  interest
       S. 1408                            56                            A. 2108
 
    1  and  penalty provisions of section 2807-d of the public health law shall
    2  remain in full force and effect and such amounts collected shall not  be
    3  subject  to  further  reconciliation  or adjustment and further provided
    4  that  the  provisions  of this section shall not apply to any assessment
    5  payment made in response to an audit finding made by the commissioner of
    6  health or the commissioner of health's designee.
    7     § 62. Section 10 of chapter 649 of  the  laws  of  1996  amending  the
    8  public  health  law,  the mental hygiene law and the social services law
    9  relating to authorizing the establishment of  special  needs  plans,  as
   10  amended  by  section  1  of part B of chapter 57 of the laws of 2000, is
   11  amended to read as follows:
   12     § 10. This act shall take effect immediately and shall  be  deemed  to
   13  have been in full force and effect on and after July 1, 1996; [provided,
   14  however,  that  sections one, two and three of this act shall expire and
   15  be deemed repealed on December  31,  2003  provided,  however  that  the
   16  amendments  to  section 364-j of the social services law made by section
   17  four of this act shall not affect the expiration  of  such  section  and
   18  shall  be  deemed  to  expire therewith and] provided, further, that the
   19  provisions of subdivisions 8, 9 and 10 of section  4401  of  the  public
   20  health  law,  as added by section one of this act; section 4403-d of the
   21  public health law as added by section two of this act and the provisions
   22  of section seven of this act, except for the provisions relating to  the
   23  establishment  of  no  more  than twelve comprehensive HIV special needs
   24  plans, shall expire and be deemed repealed on July 1, 2000.
   25     § 63. Section 11 of chapter 710 of the  laws  of  1988,  amending  the
   26  social services law and the education law relating to medical assistance
   27  eligibility  of  certain  persons and providing for managed medical care
   28  demonstration programs, as amended by section 2 of part B of chapter  57
   29  of the laws of 2000, is amended to read as follows:
   30     §  11.  This  act  shall  take  effect  immediately;  except  that the
   31  provisions of sections one, two, three, four, eight and ten of this  act
   32  shall take effect on the ninetieth day after it shall have become a law;
   33  and  except  that the provisions of sections five, six and seven of this
   34  act shall take effect January 1, 1989; and except that  effective  imme-
   35  diately, the addition, amendment and/or repeal of any rule or regulation
   36  necessary  for  the implementation of this act on its effective date are
   37  authorized and directed to be made  and  completed  on  or  before  such
   38  effective date; [provided, however, that the provisions of section 364-j
   39  of  the  social  services law, as added by section one of this act shall
   40  expire and be deemed repealed on  and  after  December  31,  2003,]  the
   41  provisions  of  section  364-k  of  the social services law, as added by
   42  section two of this act, except subdivision 10 of  such  section,  shall
   43  expire  and  be  deemed  repealed  on and after January 1, 1994, and the
   44  provisions of subdivision 10 of section 364-k  of  the  social  services
   45  law,  as  added  by  section two of this act, shall expire and be deemed
   46  repealed on January 1, 1995.
   47     § 64. Subdivision (c) of section 62 of chapter  165  of  the  laws  of
   48  1991,  amending  the public health law and other laws relating to estab-
   49  lishing payments for medical assistance, as amended by section 3 of part
   50  B of chapter 57 of the laws of 2000, is amended to read as follows:
   51    (c) [section 364-j of the social services law, as amended  by  section
   52  eight  of  this  act  and  subdivision  6 of section 367-a of the social
   53  services law as added by section twelve of this act shall expire and  be
   54  deemed  repealed  on  December  31, 2003 and provided further, that] the
   55  amendments to the provisions of section 364-j of the social services law
       S. 1408                            57                            A. 2108
 
    1  shall only apply to managed care  programs  approved  on  or  after  the
    2  effective date of this act;
    3     § 65. Section 364-jj of the social services law is REPEALED.
    4     §  66.  Subdivision  1 of section 365-c of the social services law, as
    5  amended by chapter 477 of the laws  of  1972,  is  amended  to  read  as
    6  follows:
    7    1.    A medical advisory committee is hereby established to consist of
    8  twenty members who shall be appointed by the governor, by and  with  the
    9  advice  and  consent of the senate, for the following terms: seven shall
   10  be appointed for a term to expire on May thirty-first, nineteen  hundred
   11  seventy-four:    seven  shall  be  appointed for a term to expire on May
   12  thirty-first, nineteen hundred seventy-five: and six shall be  appointed
   13  for  a term to expire on May thirty-first, nineteen hundred seventy-six.
   14  Thereafter members appointed upon expiration of a term of  office  shall
   15  be  appointed  for  a  term of three years.   Vacancies caused by death,
   16  resignation or refusal to act or by removal  from  the  state  shall  be
   17  filled  for  the  unexpired term only.    At least seven members of such
   18  committee shall be duly licensed physicians.  The governor shall  desig-
   19  nate  a  chairman from among the members of the medical advisory commit-
   20  tee, to serve as such at the pleasure of the governor.    In  appointing
   21  the  members  of the medical advisory committee, the governor shall give
   22  consideration to  professional  qualifications  and  experience  and  to
   23  achieving  representation  of  the  professions of medicine, osteopathy,
   24  podiatry, mental health, social work, dentistry,  optometry,  chiroprac-
   25  tic,  physical  therapy, pharmacy, nursing, hospital and health adminis-
   26  tration and education for the health professions, of public and  private
   27  agencies in the field of medical assistance, of entities certified under
   28  article  forty-four  of  the public health law or article forty-three of
   29  the insurance law and provide services pursuant to section three hundred
   30  sixty-four-j of this title, and of recipients and consumers  of  medical
   31  assistance for needy persons.
   32     §  67.  Subdivision  2 of section 365-c of the social services law, as
   33  added by chapter 256 of the laws of 1966, is amended to read as follows:
   34    2. The medical advisory committee shall advise the  commissioner  with
   35  respect  to  health  and medical care services provided pursuant to this
   36  title.  Provided further, the medical advisory committee shall limit its
   37  recommendations pertaining to managed  care  programs  authorized  under
   38  section  three hundred sixty-four-j of this title to the following areas
   39  quality of care, marketing and  enrollment,  capacity  of  managed  care
   40  providers  to  accept  managed care enrollees, and enrollee satisfaction
   41  with managed care providers.
   42     § 68. Section 364-j of the social services law is amended by adding  a
   43  new subdivision 22 to read as follows:
   44    22.  (a)  As  a  means of protecting the health, safety and welfare of
   45  recipients, in addition to any other sanctions that may be  imposed  the
   46  commissioner  of  health shall appoint temporary management of a managed
   47  care provider upon  determining  that  the  managed  care  provider  has
   48  repeatedly  failed  to  meet  the  substantive  requirements of sections
   49  1903(m) and 1932 of the federal Social Security Act and regulations.   A
   50  hearing  shall  not  be  required  prior to the appointment of temporary
   51  management.
   52    (b) The commissioner of health and/or his or her designees, which  may
   53  be  individuals  within  the department or other individuals or entities
   54  with appropriate knowledge and experience, may be appointed as temporary
   55  management. The commissioner of health may appoint the superintendent of
   56  insurance and/or his or her designees as  temporary  management  of  any
       S. 1408                            58                            A. 2108
 
    1  managed  care  provider  which  is subject to rehabilitation pursuant to
    2  article seventy-four of the insurance law.
    3    (c)  The  responsibilities of temporary management shall include over-
    4  sight of the managed care provider for the purpose of removing the caus-
    5  es and conditions which led to  the  determination  requiring  temporary
    6  management,  the  imposition  of  improvements to remedy violations and,
    7  where necessary, the orderly reorganization, termination or  liquidation
    8  of the managed care provider.
    9    (d)  Temporary  management  may  hire  and  fire managed care provider
   10  personnel and expend managed care provider funds  in  carrying  out  the
   11  responsibilities imposed pursuant to this subdivision, and shall only be
   12  liable  for  acts  or  omissions that constitute gross, wilful or wanton
   13  negligence.
   14    (e) The commissioner of health, in consultation with  the  superinten-
   15  dent  of  insurance with respect to any managed care provider subject to
   16  rehabilitation pursuant to article seventy-four of  the  insurance  law,
   17  may  make available to temporary management for the benefit of a managed
   18  care provider for the maintenance  of  required  reserves  and  deposits
   19  monies from such funds as are appropriated for such purpose.
   20    (f)  The  commissioner  of  health is authorized to establish in regu-
   21  lation provisions for the payment of fees and expenses from funds appro-
   22  priated for such purpose for non-governmental individuals  and  entities
   23  appointed as temporary management pursuant to this subdivision.
   24    (g)  The commissioner of health may not terminate temporary management
   25  prior to his or her determination that the managed care provider has the
   26  capability to ensure that the sanctioned behavior will not recur.
   27    (h) During any period of temporary management individuals enrolled  in
   28  the  managed  care  provider  being managed may disenroll without cause.
   29  Upon reaching a determination that requires temporary  management  of  a
   30  managed  care  provider,  the  commissioner  of  health shall notify all
   31  recipient enrollees of such provider that they may terminate  enrollment
   32  without cause during the period of temporary management.
   33    (i)  The  commissioner  of  health may adopt and amend rules and regu-
   34  lations to effectuate the purposes and provisions of this subdivision.
   35     § 69. Subparagraph (i) of paragraph (e) of subdivision  4  of  section
   36  364-j  of the social services law, as amended by chapter 433 of the laws
   37  of 1997, is amended to read as follows:
   38    (i) In any social services district which has not implemented a manda-
   39  tory managed care program pursuant to this section, the commissioner  of
   40  health  shall  establish  marketing and enrollment guidelines, including
   41  but not limited to  regulations  governing  face-to-face  marketing  and
   42  enrollment  encounters  between managed care providers and recipients of
   43  medical assistance and locations for such encounters.  Such  regulations
   44  shall  prohibit,  at  a minimum, telephone cold-calling and door-to-door
   45  solicitation at the homes of medical assistance  recipients.  The  regu-
   46  lations  shall  also  require  the commissioner of health to approve any
   47  local district marketing guidelines. Managed  care  providers  shall  be
   48  permitted  to  assist  participants in completion of enrollment forms at
   49  approved health care provider sites and other approved locations. In  no
   50  case  may an emergency room be deemed an approved location. Upon enroll-
   51  ment, participants  will  sign  an  attestation  that:  they  have  been
   52  informed  that  managed care is a voluntary program; participants have a
   53  choice of managed care providers; participants have a choice of  primary
   54  care  practitioners; and participants must exclusively use their primary
   55  care practitioner and plan providers except  as  otherwise  provided  in
   56  this  section  including  but  not  limited  to the exceptions listed in
       S. 1408                            59                            A. 2108
 
    1  subparagraph (iii) of paragraph (a) of this  subdivision.  Managed  care
    2  providers must submit enrollment forms to the local department of social
    3  services.  The  local  department  of  social  services  will provide or
    4  arrange  for an audit of managed care provider enrollment forms; includ-
    5  ing telephone contacts to determine if participants were  provided  with
    6  the  information  required  by  this  subparagraph.  The commissioner of
    7  health or the local department of social services may suspend or curtail
    8  enrollment or impose  sanctions  for  failure  to  appropriately  notify
    9  clients as required in this subparagraph.
   10     §  70.  Subparagraph  (v) of paragraph (e) of subdivision 4 of section
   11  364-j of the social services law, as amended by chapter 433 of the  laws
   12  of 1997, is amended to read as follows:
   13    (v)  Upon  delivery  of  the  pre-enrollment  information,  the  local
   14  district or the enrollment organization shall certify the  participant's
   15  receipt  of such information. Upon verification that the participant has
   16  received  the  pre-enrollment  education  information,  a  managed  care
   17  provider,  a  local district or the enrollment organization may enroll a
   18  participant into a managed care plan. Managed care providers must submit
   19  enrollment forms to  the  local  department  of  social  services.  Upon
   20  enrollment,  participants  will  sign an attestation that they have been
   21  informed that:  participants have a choice of  managed  care  providers;
   22  participants have a choice of primary care practitioners; and, except as
   23  otherwise  provided  in  this  section, including but not limited to the
   24  exceptions listed in subparagraph (iii) of paragraph (a) of this  subdi-
   25  vision, participants must exclusively use their primary care practition-
   26  ers  and plan providers. The commissioner of health or the local depart-
   27  ment of social services may suspend  or  curtail  enrollment  or  impose
   28  sanctions  for  failure  to  appropriately notify clients as required in
   29  this subparagraph.
   30     § 71. Subdivision 19 of section 364-j of the social services  law,  as
   31  amended  by  chapter  649  of  the  laws  of 1996, is amended to read as
   32  follows:
   33    19. [(a)] The  commissioner  of  health[,  in  consultation  with  the
   34  commissioner,]  shall  promulgate  such  regulations as are necessary to
   35  implement the provisions  of  this  section,  including  regulations  to
   36  suspend  or  curtail  enrollment  or  impose sanctions on a managed care
   37  provider, including imposition of civil penalties, for failure to comply
   38  with the  provisions  of  this  section;  provided,  however,  that  the
   39  provisions of this subdivision shall not limit specific actions taken by
   40  the  department  of  health or the department in order to ensure federal
   41  financial participation.
   42     § 72. Section 18 of chapter 904 of the  laws  of  1984,  amending  the
   43  public  health  law  and the social services law relating to encouraging
   44  comprehensive health services, as amended by section 23  of  part  B  of
   45  chapter 1 of the laws of 2002, is amended to read as follows:
   46     §  18.  This  act  shall take effect immediately, except that sections
   47  six, nine, ten and eleven of this act shall take effect on the  sixtieth
   48  day  after  it shall have become a law, [sections] section three of this
   49  act shall expire and be of no further force or effect on or  after  July
   50  1,  2003,  section four [and nine] of this act shall expire and be of no
   51  further force or effect on or after July 1, [2003] 2005, section two  of
   52  this act shall take effect on April 1, 1985 or seventy-five days follow-
   53  ing  the  submission  of the report required by section one of this act,
   54  whichever is later, [and shall expire and be  of  no  further  force  or
   55  effect  after July 1, 2003] and sections eleven and thirteen of this act
       S. 1408                            60                            A. 2108
 
    1  shall expire and be of no further force or effect on or after March  31,
    2  1988.
    3     §  73.  Section  2  of  chapter  535 of the laws of 1983, amending the
    4  social services law relating to eligibility  of  certain  enrollees  for
    5  medical  assistance,  as amended by section 22 of part B of chapter 1 of
    6  the laws of 2002, is amended to read as follows:
    7     § 2. This act shall take effect immediately [and shall remain in  full
    8  force and effect through June 30, 2003].
    9     §  74.  Paragraphs (c), (s), (t), (u), (v) and (w) of subdivision 1 of
   10  section 364-j of the social services law, paragraph (c)  as  amended  by
   11  chapter  649  of  the  laws of 1996, paragraphs (s), (u), (v) and (w) as
   12  added by chapter 433 of the laws of 1997 and paragraph (t) as amended by
   13  section 24 of part E of chapter 58 of the laws of 1998, are  amended  to
   14  read as follows:
   15    (c)  "Managed care program". A statewide program [in a social services
   16  district] in which medical assistance recipients enroll on  a  voluntary
   17  or  mandatory  basis  to  receive medical assistance services, including
   18  case management, directly and indirectly (including by referral) from  a
   19  managed  care provider, and as applicable, a mental health special needs
   20  plan or a comprehensive HIV special needs plan, under this section.
   21    (s) "Existing rates". The rates  paid  pursuant  to  the  most  recent
   22  executed  contract between a local social services district or the state
   23  and a managed care provider[, which shall include any increase effective
   24  January  first,  nineteen  hundred  ninety-seven,  except   those   rate
   25  increases  resulting  from  subdivision  twenty-one of this section; and
   26  further provided that any adjustments made pursuant to a chapter of  the
   27  laws  of nineteen hundred ninety-seven, related to pharmacy benefits, if
   28  any, shall be reflected in such rates].
   29    (t) ["Competitive bidding process". The health plan procurement  proc-
   30  ess  undertaken  by  the  department  of  health  to select managed care
   31  providers under the Partnership Plan RFP released  November  fourteenth,
   32  nineteen  hundred  ninety-five, and with respect to any rate adjustments
   33  made under this section for any period  commencing  on  or  after  April
   34  first,  nineteen hundred ninety-eight, the health plan procurement proc-
   35  ess undertaken by Westchester county to select  managed  care  providers
   36  pursuant  to an RFP released September twelfth, nineteen hundred ninety-
   37  six.
   38    (u)] "Managed care rating regions". The regions established  [pursuant
   39  to  the competitive bidding process] by the department of health for the
   40  purpose of setting regional premium rates for managed care providers.
   41    [(v)] (u)"Premium group".  The various demographic, gender and recipi-
   42  ent categories utilized for rate-setting purposes by the  department  of
   43  health [in the competitive bidding process].
   44    [(w)]  (v)  "Upper payment limit".  The maximum reimbursement that the
   45  department of health may pay a managed care provider  for  providing  or
   46  arranging for medical services to participants in a managed care program
   47  in  accordance  with  the  federal  social  security act and regulations
   48  promulgated thereunder.
   49     § 75.  Paragraphs (a) and (b) of subdivision 3 of section 364-j of the
   50  social services law, as amended by chapter 649  of  the  laws  of  1996,
   51  subparagraph (iii) of paragraph (b) as amended by section 4 of part B of
   52  chapter 57 of the laws of 2000, are amended to read as follows:
   53    (a)  Every  person  eligible for or receiving medical assistance under
   54  this article, who  resides  in  a  social  services  district  providing
   55  medical assistance [under a managed care program approved by the commis-
   56  sioner  of  health  in cooperation with the commissioner and the commis-
       S. 1408                            61                            A. 2108
 
    1  sioner of  the  responsible  special  care  agencies  pursuant  to  this
    2  section],  which  has implemented the state's managed care program shall
    3  participate in the program authorized by this section.  Provided, howev-
    4  er,  that  participation  in a comprehensive HIV special needs plan also
    5  shall be in accordance with article forty-four of the public health  law
    6  and participation in a mental health special needs plan shall also be in
    7  accordance  with article forty-four of the public health law and article
    8  thirty-one of the mental hygiene law.
    9    (b) A medical assistance recipient shall not be  required  to  partic-
   10  ipate  in,  and shall be permitted to withdraw from [a] the managed care
   11  program upon a showing that:
   12    (i) a managed care provider is not geographically  accessible  to  the
   13  person  so  as  to  reasonably provide services to the person, or upon a
   14  showing of other good cause as defined in  regulation.  A  managed  care
   15  provider  is  not  geographically accessible if the person cannot access
   16  its services in a timely fashion due to distance or travel time;
   17    (ii) a pregnant woman with an established relationship, as defined  by
   18  the  commissioner  of health, with a comprehensive prenatal primary care
   19  provider, including a prenatal care assistance  program  as  defined  in
   20  title  two  of article twenty-five of the public health law, that is not
   21  associated with a managed care provider in the [managed care program  of
   22  the]  participant's social services district, may defer participation in
   23  the managed care program while pregnant and for sixty days post-partum;
   24    (iii) an individual with a chronic medical condition being treated  by
   25  a  specialist  physician  that  is  not  associated  with a managed care
   26  provider in the [managed  care  program  of  the]  participant's  social
   27  services  district,  may defer participation in the managed care program
   28  until the course of treatment is complete; and
   29    (iv) a participant cannot be served by a  managed  care  provider  who
   30  participates in a managed care program due to a language barrier.
   31     §  76.  The  opening paragraph and paragraphs (a), (e), (f) and (g) of
   32  subdivision 4 of section 364-j of the social services law,  the  opening
   33  paragraph  and  paragraphs  (a)  and (f) as amended and paragraph (e) as
   34  added by chapter 649 of the laws of 1996, subparagraph (i) of  paragraph
   35  (a) as amended by chapter 558 of the laws of 1999, subparagraphs (i) and
   36  (v)  of  paragraph  (e)  and  paragraph  (g) as amended and subparagraph
   37  (viii) of paragraph (e) as added by chapter 433 of the laws of 1997  and
   38  subparagraph  (iv) of paragraph (e) as amended by section 6 of part B of
   39  chapter 57 of the laws of 2000, are amended to read as follows:
   40    [Managed care programs] The managed care program shall provide partic-
   41  ipants access to comprehensive and coordinated health care delivered  in
   42  a cost effective manner consistent with the following provisions:
   43    (a)  (i)  a  managed  care  provider  shall  arrange for access to and
   44  enrollment of primary care  practitioners  and  other  medical  services
   45  providers.  Each  managed  care provider shall possess the expertise and
   46  sufficient resources to assure the delivery of quality medical  care  to
   47  participants  in an appropriate and timely manner and may include physi-
   48  cians, nurse practitioners,  county  health  departments,  providers  of
   49  comprehensive  health  service plans licensed pursuant to article forty-
   50  four of the public health law, and hospitals and diagnostic  and  treat-
   51  ment  centers  licensed  pursuant  to article twenty-eight of the public
   52  health law or otherwise authorized by law to offer comprehensive  health
   53  services  or  facilities licensed pursuant to articles sixteen, [twenty-
   54  three,] thirty-one and thirty-two of the mental hygiene law.
   55    (ii) provided, however, if a major public hospital, as defined in  the
   56  public  health  law,  is  designated by [a social services district] the
       S. 1408                            62                            A. 2108
 
    1  commissioner of health as a managed care provider, the [social  services
    2  district]  commissioner  of  health  shall  designate at least one other
    3  managed care provider which is not a major public hospital  or  facility
    4  operated by a major public hospital; and
    5    (iii)  under  a  managed  care program, not all managed care providers
    6  must be required to provide the same set of medical assistance services.
    7  [A] The managed care program shall establish  procedures  through  which
    8  participants  will  be assured access to all medical assistance services
    9  to which they are otherwise entitled, other  than  through  the  managed
   10  care provider, where:
   11    (A)  the  service  is  not reasonably available directly or indirectly
   12  from the managed care provider,
   13    (B) it is necessary because of emergency or geographic unavailability,
   14  or
   15    (C) the services provided are family planning services; or
   16    (D) other services as defined by the commissioner of health.
   17    (e) (i) In any social services district which has  not  implemented  a
   18  mandatory managed care program pursuant to this section, the commission-
   19  er  of  health  shall  establish  marketing  and  enrollment guidelines,
   20  including but not limited to regulations governing face-to-face  market-
   21  ing and enrollment encounters between managed care providers and recipi-
   22  ents of medical assistance and locations for such encounters. Such regu-
   23  lations  shall  prohibit,  at  a  minimum,  telephone  cold-calling  and
   24  door-to-door solicitation at the homes of medical assistance recipients.
   25  The regulations shall also require the commissioner of health to approve
   26  any local district marketing guidelines. Managed care providers shall be
   27  permitted to assist participants in completion of  enrollment  forms  at
   28  approved  health care provider sites and other approved locations. In no
   29  case may an emergency room be deemed an approved location. Upon  enroll-
   30  ment,  participants  will  sign  an  attestation  that:  they  have been
   31  informed that managed care is a voluntary program; participants  have  a
   32  choice  of managed care providers; participants have a choice of primary
   33  care practitioners; and participants must exclusively use their  primary
   34  care  practitioner  and  plan  providers except as otherwise provided in
   35  this section including but not  limited  to  the  exceptions  listed  in
   36  subparagraph  (iii)  of  paragraph (a) of this subdivision. Managed care
   37  providers must submit enrollment forms to the local department of social
   38  services. The local  department  of  social  services  will  provide  or
   39  arrange  for an audit of managed care provider enrollment forms; includ-
   40  ing telephone contacts to determine if participants were  provided  with
   41  the  information required by this subparagraph. The [local department of
   42  social services] commissioner of health may suspend or  curtail  enroll-
   43  ment  or impose sanctions for failure to appropriately notify clients as
   44  required in this subparagraph.
   45    (ii) In any social services district which has implemented a mandatory
   46  managed care program pursuant to this section, the requirements of  this
   47  subparagraph  shall  apply to the extent consistent with federal law and
   48  regulations. The department of health, may contract  with  one  or  more
   49  independent  organizations  to provide enrollment counseling and enroll-
   50  ment services, for participants  required  to  enroll  in  managed  care
   51  programs,  for  each social services district requesting the services of
   52  an enrollment broker. To select such organizations,  the  department  of
   53  health  shall  issue  a  request  for  proposals  (RFP),  shall evaluate
   54  proposals submitted in response to such RFP and, pursuant to  such  RFP,
   55  shall award a contract to one or more qualified and responsive organiza-
   56  tions. Such organizations shall not be owned, operated, or controlled by
       S. 1408                            63                            A. 2108
 
    1  any  governmental  agency,  managed  care  provider,  comprehensive  HIV
    2  special needs  plan,  mental  health  special  needs  plan,  or  medical
    3  services provider.
    4    (iii)  Such  independent organizations shall develop enrollment guides
    5  for participants which shall be approved by  the  department  of  health
    6  prior to distribution.
    7    (iv)  Local  social  services  districts  or  enrollment organizations
    8  through their enrollment counselors shall provide participants with  the
    9  opportunity  for face to face counseling including individual counseling
   10  upon request of the participant.  Local  social  services  districts  or
   11  enrollment  organizations through their enrollment counselors shall also
   12  provide participants with information in a culturally and linguistically
   13  appropriate and understandable manner, in  light  of  the  participant's
   14  needs,  circumstances and language proficiency, sufficient to enable the
   15  participant to make an informed selection of a  managed  care  provider.
   16  Such  information  shall  include,  but  shall not be limited to: how to
   17  access care within the program; a description of the medical  assistance
   18  services  that can be obtained other than through a managed care provid-
   19  er, mental health special needs plan or comprehensive HIV special  needs
   20  plan;  the available managed care providers, mental health special needs
   21  plans and comprehensive  HIV  special  needs  plans  and  the  scope  of
   22  services  covered  by  each; a listing of the medical services providers
   23  associated with each managed care  provider;  the  participants'  rights
   24  within  the  managed  care  program;  and  how  to exercise such rights.
   25  Enrollment counselors shall inquire  into  each  participant's  existing
   26  relationships  with  medical  services providers and explain whether and
   27  how such  relationships  may  be  maintained  within  the  managed  care
   28  program.  For  enrollments  made  during face to face counseling, if the
   29  participant has a preference for particular medical services  providers,
   30  enrollment  counselors  shall verify with the medical services providers
   31  that such  medical  services  providers  whom  the  participant  prefers
   32  participate  in the managed care provider's network and are available to
   33  serve the participant.
   34    (v)  Upon  delivery  of  the  pre-enrollment  information,  the  local
   35  district  or the enrollment organization shall certify the participant's
   36  receipt of such information. Upon verification that the participant  has
   37  received  the  pre-enrollment  education  information,  a  managed  care
   38  provider, a local district or the enrollment organization may  enroll  a
   39  participant into a managed care plan. Managed care providers must submit
   40  enrollment  forms  to  the  local  department  of  social services. Upon
   41  enrollment, participants will sign an attestation that  they  have  been
   42  informed  that:    participants have a choice of managed care providers;
   43  participants have a choice of primary care practitioners; and, except as
   44  otherwise provided in this section, including but  not  limited  to  the
   45  exceptions  listed in subparagraph (iii) of paragraph (a) of this subdi-
   46  vision, participants must exclusively use their primary care practition-
   47  ers and plan  providers.  The  [local  department  of  social  services]
   48  commissioner of health may suspend or curtail enrollment or impose sanc-
   49  tions  for  failure  to appropriately notify clients as required in this
   50  subparagraph.
   51    (vi) Enrollment counselors or local social  services  districts  shall
   52  further  inquire into each participant's health status in order to iden-
   53  tify physical or behavioral conditions that require immediate  attention
   54  or continuity of care, and provide to participants information regarding
   55  health care options available to persons with HIV and other illnesses or
   56  conditions  under the managed care program. Any information disclosed to
       S. 1408                            64                            A. 2108
 
    1  counselors shall be kept  confidential  in  accordance  with  applicable
    2  provisions  of  the  public  health  law, and as appropriate, the mental
    3  hygiene law.
    4    (vii)  Any  marketing  materials developed by a managed care provider,
    5  comprehensive HIV special needs plan or mental health special needs plan
    6  shall be approved by the  department  of  health  or  the  local  social
    7  services district and the commissioner of mental health, where appropri-
    8  ate,  within  sixty  days prior to distribution to recipients of medical
    9  assistance. All marketing materials shall be reviewed within sixty  days
   10  of submission.
   11    (viii)  In any social services district which has implemented a manda-
   12  tory managed care program pursuant to this section, the commissioner  of
   13  health  shall  establish  marketing and enrollment guidelines, including
   14  but not limited to  regulations  governing  face-to-face  marketing  and
   15  enrollment  encounters  between managed care providers and recipients of
   16  medical assistance and locations for such encounters.  Such  regulations
   17  shall  prohibit,  at  a minimum, telephone cold-calling and door-to-door
   18  solicitation at the homes of medical assistance  recipients.  The  regu-
   19  lations  shall  also  require  the commissioner of health to approve any
   20  local district marketing guidelines.
   21    (f) (i) Participants shall have no less than sixty days from the  date
   22  selected  by the district to enroll in [its] the managed care program to
   23  select a managed care provider, and  as  appropriate,  a  mental  health
   24  special  needs  plan,  and shall be provided with information to make an
   25  informed choice. Where a participant has not selected such a provider or
   26  mental health special needs  plan,  [a  social  services  official]  the
   27  commissioner  of  health shall assign such participant to a managed care
   28  provider, and as appropriate, to a mental  health  special  needs  plan,
   29  taking  into  account capacity and geographic accessibility. The commis-
   30  sioner may after the period of time established in subparagraph (ii)  of
   31  this  paragraph  assign  participants  to a managed care provider taking
   32  into account quality performance criteria and cost.   Provided  however,
   33  cost  criteria  shall  not  be of greater value than quality criteria in
   34  assigning participants.
   35    (ii) The commissioner may assign participants pursuant to such  crite-
   36  ria on a weighted basis, provided however that for twelve months follow-
   37  ing implementation of a mandatory program, pursuant to a federal waiver,
   38  twenty-five  percent  of  the  participants that do not choose a managed
   39  care provider shall be assigned to managed care providers  that  satisfy
   40  the  criteria  set  forth in subparagraph (i) of this paragraph, and are
   41  controlled by, sponsored by, or otherwise affiliated  through  a  common
   42  governance  or  through  a  parent corporation with, one or more private
   43  not-for-profit or public general hospitals or diagnostic  and  treatment
   44  centers  licensed  pursuant to article twenty-eight of the public health
   45  law.
   46    (iii) For twelve months  following  the  twelve  months  described  in
   47  subparagraph  (ii)  of this paragraph twenty-two and one-half percent of
   48  the participants that do not choose a managed  care  provider  shall  be
   49  assigned  to managed care providers, that satisfy the criteria set forth
   50  in subparagraph (i) of this paragraph and are controlled  by,  sponsored
   51  by,  or  otherwise  affiliated  through a common governance or through a
   52  parent corporation with, one or more private  not-for-profit  or  public
   53  general  hospitals or diagnostic and treatment centers licensed pursuant
   54  to article twenty-eight of the public health law.
   55    (iv) For twelve  months  following  the  twelve  months  described  in
   56  subparagraph  (iii) of this paragraph twenty percent of the participants
       S. 1408                            65                            A. 2108
 
    1  that do not choose a managed care provider  shall  be  assigned  equally
    2  among  each of the managed care providers, that satisfy the criteria set
    3  forth in subparagraph (i) of this paragraph and are controlled by, spon-
    4  sored by, or otherwise affiliated through a common governance or through
    5  a  parent  corporation with one or more private not-for-profit or public
    6  general hospitals or diagnostic and treatment centers licensed  pursuant
    7  to article twenty-eight of the public health law.
    8    (v)  The  commissioner  shall  assign  all  participants not otherwise
    9  assigned to a managed care plan pursuant to  subparagraphs  (ii),  (iii)
   10  and  (iv)  of  this  paragraph  equally  among  each of the managed care
   11  providers that meet the criteria established in subparagraph (i) of this
   12  paragraph.
   13    (g) If another managed care provider, mental health special needs plan
   14  or comprehensive HIV special needs plan is available,  participants  may
   15  change such provider or plan without cause within thirty days of notifi-
   16  cation  of  enrollment or the effective date of enrollment, whichever is
   17  later with a managed care provider, mental health special needs plan  or
   18  comprehensive  HIV  special  needs plan by making a request of the local
   19  social services district except that such  period  shall  be  forty-five
   20  days  for participants who have been assigned to a provider by [a social
   21  services official] the commissioner of  health.    However,  after  such
   22  thirty  or forty-five day period, whichever is applicable, a participant
   23  may be prohibited from changing managed care providers  more  frequently
   24  than  once  every  twelve months, as permitted by federal law except for
   25  good cause as determined by the commissioner  of  health  through  regu-
   26  lations.
   27     §  77.   Subdivision 5 of section 364-j of the social services law, as
   28  amended by chapter 649 of the laws of 1996, paragraph (b) as amended  by
   29  chapter 433 of the laws of 1997, is amended to read as follows:
   30    5.  Managed care programs shall be conducted [only] in accordance with
   31  [plans submitted by a social services district  or  any  combination  of
   32  social services districts and approved by the commissioner of health, in
   33  consultation with the commissioner and the commissioner of the responsi-
   34  ble  special  care  agency.  Such  plans  shall  be consistent with] the
   35  requirements of this section and, to the extent  practicable,  encourage
   36  the  provision of comprehensive medical services, pursuant to this arti-
   37  cle[, and shall:].
   38    (a) [identify and document the specific  problems  which  the  managed
   39  care  program  is designed to address including the current primary care
   40  and specialist network actually available to medical assistance  recipi-
   41  ents  within  the  district  and  a reasonable estimate of the program's
   42  local cost effectiveness;
   43    (b)] The managed care program shall provide for the selection of qual-
   44  ified managed care providers by  the  commissioner  of  health  and,  as
   45  appropriate,  mental  health  special  needs plans and comprehensive HIV
   46  special needs plans to participate in the  program,  provided,  however,
   47  that the commissioner of health may contract directly with comprehensive
   48  HIV  special  needs  plans  consistent  with standards set forth in this
   49  section, and assure that  such  providers  are  accessible  taking  into
   50  account  the  needs  of  persons  with  disabilities and the differences
   51  between rural, suburban, and urban settings, and in  sufficient  numbers
   52  to  meet  the  health care needs of participants, and shall consider the
   53  extent to which major public hospitals are included within such  provid-
   54  ers' networks;
       S. 1408                            66                            A. 2108
 
    1    [(c)  demonstrate  that health care providers, managed care providers,
    2  insurers, medical assistance recipients  and  the  general  public  were
    3  provided the opportunity to participate in the development of the plan;
    4    (d)  describe  the  enrollment process and any marketing materials and
    5  indicate whether enrollment will be conducted  by  the  social  services
    6  district or some other entity;
    7    (e) demonstrate that medical assistance recipients who are eligible to
    8  participate  in  a  managed  care program shall be fully informed of how
    9  services are provided through managed care programs, and provided suffi-
   10  cient information,  in  reasonably  understandable  and  culturally  and
   11  linguistically appropriate form, to assure that such recipients can make
   12  an informed choice of managed care and primary care providers.]
   13    (b)  A proposal submitted by a managed care provider to participate in
   14  the managed care program shall:
   15    (i) designate the geographic area to be served  by  the  program,  and
   16  estimate  the number of eligible participants and actual participants in
   17  such designated area;
   18    (ii) include a network of health care providers in sufficient  numbers
   19  and geographically accessible to service program participants;
   20    (iii)  describe  the procedures for marketing in the program location,
   21  including the designation of other entities which may perform such func-
   22  tions under contract with the organization;
   23    (iv) describe the  quality  assurance,  utilization  review  and  case
   24  management mechanisms to be implemented;
   25    (v)  demonstrate the applicant's ability to meet the data analysis and
   26  reporting requirements of the program;
   27    (vi) demonstrate financial feasibility of the program; and
   28    (vii) include such other information as the commissioner of health may
   29  deem appropriate.
   30    (c) The commissioner of health shall make a determination  whether  to
   31  approve, disapprove or recommend modification of the proposal.
   32    (d)  Notwithstanding  any  inconsistent  provision  of  this title and
   33  section one hundred sixty-three of the state finance  law,  the  commis-
   34  sioner of health may contract with managed care providers approved under
   35  paragraph  (b) of this subdivision, without a competitive bid or request
   36  for proposal process, to provide coverage for participants  pursuant  to
   37  this title.
   38    (e)  The  care  and  services  described  in  subdivision four of this
   39  section will be furnished by a managed care  provider  pursuant  to  the
   40  provisions  of  this section when such services are furnished in accord-
   41  ance with an agreement with the department of health and meet applicable
   42  federal law and regulations.
   43    (f) The commissioner of health may delegate some or all of  the  tasks
   44  identified in this section to the local districts.
   45    (g) Any delegation pursuant to paragraph (f) of this subdivision shall
   46  be  reflected  in  the  contract between a managed care provider and the
   47  commissioner of health.
   48     § 78. Paragraph (a) of subdivision 13 of section 364-j of  the  social
   49  services  law, as amended by chapter 649 of the laws of 1996, is amended
   50  to read as follows:
   51    (a) Notwithstanding  any  inconsistent  provisions  of  this  section,
   52  participation  in a managed care program will not diminish a recipient's
   53  medical  assistance  eligibility  or  the  scope  of  available  medical
   54  services to which he or she is entitled. Once a [plan] program is imple-
   55  mented  by the district, medical assistance for persons who require such
   56  assistance, who are eligible for or in receipt of such assistance in the
       S. 1408                            67                            A. 2108
 
    1  district and who are covered by the [plan] program shall be  limited  to
    2  payment  of  the  cost  of  care,  services  and supplies covered by the
    3  managed care  program,  only  when  furnished,  prescribed,  ordered  or
    4  approved by a managed care provider, mental health special needs plan or
    5  comprehensive  HIV  special  needs  plan  and otherwise under the [plan]
    6  program, together with the costs  of  medically  necessary  medical  and
    7  remedial  care,  services or supplies which are not available to partic-
    8  ipants under the [plan] program, but which would otherwise be  available
    9  to  such  persons under this title and the regulations of the department
   10  provided, however, that the [plan] program  may  contain  provision  for
   11  payment to be made for non-emergent care furnished in hospital emergency
   12  rooms consistent with subdivision ten of this section.
   13     §  79.  Subdivision  21 of section 364-j of the social services law is
   14  REPEALED.
   15     § 80. Section 4 of chapter 19   of the  laws  of  1998,  amending  the
   16  social  services  law  relating  to  limiting  the method of payment for
   17  prescription drugs under the medical assistance program, as  amended  by
   18  section  3  of  part  A of chapter 57 of the laws of 2000, is amended to
   19  read as follows:
   20     § 4. This act shall take effect 120 days after it shall have become  a
   21  law [and shall expire and be deemed repealed December 31, 2003].
   22     §  81.    Notwithstanding  any  inconsistent provision of law, rule or
   23  regulation, the effectiveness of subdivisions  4,  7,  7-a  and  7-b  of
   24  section 2807 of the public health law and section 18 of chapter 2 of the
   25  laws  of  1988,  as  they  relate to time frames for notice, approval or
   26  certification of rates of payment,  and  to  the  requirement  of  prior
   27  notice of rates of payment, are hereby suspended and shall, for purposes
   28  of implementing the provisions of this act, be deemed to have been with-
   29  out  any  force or effect from and after November 1, 2002 for such rates
   30  effective for the period January 1, 2003 through December 31, 2003.
   31     § 82.   Notwithstanding any inconsistent provision  of  law,  rule  or
   32  regulation, for purposes of implementing the provisions of article 28 of
   33  the  public  health law, references to titles XIX and XXI of the federal
   34  social security act in article 28 of the  public  health  law  shall  be
   35  deemed  to  include  and also to mean any successor titles thereto under
   36  the federal social security act.
   37     § 83. The commissioner of health is authorized to promulgate or  adopt
   38  any  rules  or regulations necessary to implement the provisions of this
   39  act and any procedures, forms, or instructions necessary for such imple-
   40  mentation may be adopted and issued on or after the  effective  date  of
   41  this act.
   42    Notwithstanding any inconsistent provision of the state administrative
   43  procedure  act  or  any  other provision of law, rule or regulation, the
   44  commissioner of health and  the  superintendent  of  insurance  and  any
   45  appropriate  council is authorized to adopt or amend or promulgate on an
   46  emergency basis any regulation he or  she  or  such  council  determines
   47  necessary to implement any provision of this act on its effective date.
   48     §  84. If any clause, sentence, paragraph, section or part of this act
   49  shall be adjudged by any court of competent jurisdiction to be  invalid,
   50  such judgment shall not affect, impair or invalidate the remainder ther-
   51  eof,  but  shall  be  confined in its operation to the clause, sentence,
   52  paragraph, section or part thereof directly involved in the  controversy
   53  in which such judgment shall have been rendered.
   54     §  85. This act shall take effect April 1, 2003 and shall be deemed to
   55  have been in full force and effect on and  after  such  date;  provided,
   56  however, that:
       S. 1408                            68                            A. 2108
 
    1    1. section thirty-two of this act shall be deemed to have been in full
    2  force and effect on and after January 25, 2002;
    3    2. the amendments to clause (A) of subparagraph (iii) of paragraph (b)
    4  of  subdivision  5  of  section  2807-c of the public health law made by
    5  section eleven of this act shall survive the expiration and reversion of
    6  any provision of such clause, as provided in subdivision  5  of  section
    7  168 of chapter 639 of the laws of 1996, as amended;
    8    3.  the  amendments to subparagraph (iii) of paragraph (f) of subdivi-
    9  sion 4 of section 2807-c of  the  public  health  law  made  by  section
   10  fifty-four  of  this  act  shall not affect the expiration and repeal of
   11  such paragraph and shall expire and be deemed repealed therewith;
   12    4. the amendments to subparagraph (iii) of paragraph (k)  of  subdivi-
   13  sion  4  of  section  2807-c  of  the  public health law made by section
   14  fifty-five of this act shall not affect the  expiration  and  repeal  of
   15  such paragraph and shall expire and be deemed repealed therewith;
   16    5.  the  amendments  to  the opening paragraph of subparagraph (vi) of
   17  paragraph (b) of subdivision 5 of section 2807-c of  the  public  health
   18  law  made  by section fifty-six of this act shall not affect the expira-
   19  tion and repeal of such subparagraph and  shall  expire  and  be  deemed
   20  repealed therewith;
   21    6.  the  amendments  to  the opening paragraph and subparagraph (i) of
   22  paragraph (c) of subdivision 5 of section 2807-c of  the  public  health
   23  law made by section fifty-seven of this act shall not affect the expira-
   24  tion  and  repeal  of  such  paragraph  and  shall  expire and be deemed
   25  repealed therewith; and
   26    7. the amendments to clause (B-1) of subparagraph (i) of paragraph (f)
   27  of subdivision 11 of section 2807-c of the public  health  law  made  by
   28  section  fifty-eight  of  this  act shall survive the expiration of such
   29  clause as provided by chapters 639 of the laws of 1996 and 1 of the laws
   30  of 1999, as amended.
 
   31                                   PART L
 
   32    Section 1. Subdivision 5 of section 168 of chapter 639 of the laws  of
   33  1996,  relating  to  the  Health  Care Reform Act of 1996, as amended by
   34  chapter 419 of the laws of 2000, is amended to read as follows:
   35    5. sections 2807-c, 2807-j, 2807-s and 2807-t  of  the  public  health
   36  law, as amended or as added by this act, shall expire on [June 30, 2003]
   37  July  1,  2005, and shall be thereafter effective only in respect to any
   38  act done on or before such date or action or proceeding arising  out  of
   39  such  act  including continued collections of funds from assessments and
   40  allowances and  surcharges  established  pursuant  to  sections  2807-c,
   41  2807-j,  2807-s  and 2807-t of the public health law, and administration
   42  and distributions of funds from pools established pursuant  to  sections
   43  2807-c,  2807-j, 2807-k, 2807-l, 2807-m, 2807-s and 2807-t of the public
   44  health law related to patient services provided before  July  1,  [2003]
   45  2005,  and  continued  expenditure  of funds authorized for programs and
   46  grants until the exhaustion of funds therefor;
   47     § 2. Subdivision 1 of section 138 of chapter 1 of the  laws  of  1999,
   48  relating  to  the New York Health Care Reform Act of 2000, as amended by
   49  chapter 419 of the laws of 2000, is amended to read as follows:
   50    1. sections 2807-c, 2807-j, 2807-s, and 2807-t of  the  public  health
   51  law,  as  amended  by  this act, shall expire on [June 30, 2003] July 1,
   52  2005, and thereafter effective only in respect to any  act  done  before
   53  such  date  or  action  or  proceeding arising out of such act including
   54  continued collections of  funds  from  assessments  and  allowances  and
       S. 1408                            69                            A. 2108
 
    1  surcharges  established  pursuant to sections 2807-c, 2807-j, 2807-s and
    2  2807-t of the public health law, and administration and distributions of
    3  funds from  pools  established  pursuant  to  sections  2807-c,  2807-j,
    4  2807-k,  2807-l, 2807-m, 2807-s, 2807-t, 2807-v and 2807-w of the public
    5  health law, as amended or added by this act, related to patient services
    6  provided before July 1, [2003] 2005, and continued expenditure of  funds
    7  authorized  for programs and grants until the exhaustion of funds there-
    8  for;
    9     § 3. Subdivision 2 of section 2807-j of  the  public  health  law,  as
   10  added  by  chapter  639 of the laws of 1996, paragraph (a) as amended by
   11  chapter 1 of the laws of 1999, and the opening  paragraph  of  paragraph
   12  (b)  and  paragraph (d) as amended by section 16 of part C of chapter 63
   13  of the laws of 2001, is amended to read as follows:
   14    2. (a) The total percentage allowance for any period during the period
   15  January first, nineteen hundred ninety-seven  through  December  thirty-
   16  first,  nineteen hundred ninety-nine and on and after January first, two
   17  thousand, for a designated provider of services applicable  to  a  payor
   18  shall  be  determined in accordance with this subdivision and applied to
   19  net patient service revenues.
   20    (b) The total percentage allowance for each payor, other than  govern-
   21  mental  agencies,  or  health  maintenance  organizations  for  services
   22  provided to subscribers eligible  for  medical  assistance  pursuant  to
   23  title  eleven  of  article  five of the social services law, or approved
   24  organizations for services provided  to  subscribers  eligible  for  the
   25  family health plus program pursuant to title eleven-D of article five of
   26  the  social services law, and other than payments for a patient that has
   27  no third-party coverage in whole or in part for services provided  by  a
   28  designated provider of services, shall be:
   29    (i)  the  sum  of (A) eight and eighteen-hundredths percent, provided,
   30  however, that for services provided on and after July first,  two  thou-
   31  sand  three,  the  percentage  shall be eight and eighty-five hundredths
   32  percent, plus (B)  twenty-four  percent,  provided,  however,  that  for
   33  services  provided  on  and  after  July  first, two thousand three, the
   34  percentage shall be twenty-five and ninety-seven hundredths percent, and
   35  plus (C) for a specified third-party payor  as  defined  in  subdivision
   36  one-a  of  section  twenty-eight  hundred  seven-s  of  this article the
   37  percentage allowance applicable for a  general  hospital  for  inpatient
   38  hospital  services  pursuant  to subdivision two of section twenty-eight
   39  hundred seven-s of this article;
   40    (ii) unless (A) an election in accordance with paragraph (a) of subdi-
   41  vision five of this section to pay the allowance directly to the commis-
   42  sioner or the commissioner's designee is in  effect  for  a  third-party
   43  payor, and in addition (B) for a specified third-party payor an election
   44  to  pay  the  assessment in accordance with section twenty-eight hundred
   45  seven-t of this article is in effect.
   46    (c) If an election in accordance with subdivision five of this section
   47  is in effect for a third-party payor and in addition in accordance  with
   48  section  twenty-eight  hundred  seven-t  of this article for a specified
   49  third-party payor,  the  total  percentage  allowance  factor  shall  be
   50  reduced  to  eight  and  eighteen-hundredths percent, provided, however,
   51  that for services provided on and after July first, two  thousand  three
   52  the  total  percentage  allowance  factor  shall be reduced to eight and
   53  eighty-five hundredths percent.
   54    (d) The total percentage allowance for payments by governmental  agen-
   55  cies,  as  determined  in  accordance  with  paragraphs (a) and (a-1) of
   56  subdivision one of section twenty-eight hundred seven-c of  [the  public
       S. 1408                            70                            A. 2108
 
    1  health law] this article as in effect on December thirty-first, nineteen
    2  hundred  ninety-six,  or  health  maintenance organizations for services
    3  provided to subscribers eligible  for  medical  assistance  pursuant  to
    4  title  eleven  of  article  five of the social services law, or approved
    5  organizations for services provided  to  subscribers  eligible  for  the
    6  family health plus program pursuant to title eleven-D of article five of
    7  the  social  services  law,  shall  be  five and ninety-eight-hundredths
    8  percent, provided, however, that for services provided on and after July
    9  first, two thousand three the total percentage allowance  shall  be  six
   10  and forty-seven hundredths percent.
   11    (e)  The total percentage allowance for payments for services provided
   12  by designated providers of services for which there  is  no  third-party
   13  coverage  in  whole  or  in  part shall be eight and eighteen-hundredths
   14  percent, provided, however, that for services provided on and after July
   15  first, two thousand three the total percentage allowance shall be  eight
   16  and  eighty-five  hundredths percent.  This paragraph shall not apply to
   17  patient deductibles and coinsurance amounts.
   18    (f) The total percentage allowance for patient deductibles and coinsu-
   19  rance amounts shall be  the  same  percentage  allowance  applicable  to
   20  payments  by  the primary third-party payor covering the patient in each
   21  case determined in accordance with paragraphs (a), (b) and (c)  of  this
   22  subdivision.
   23    (g)  The  total  percentage allowance for secondary third-party payors
   24  under coordination of benefits principles shall be the  same  percentage
   25  allowance applicable to payments by the primary third-party payor in the
   26  case  determined  in accordance with paragraphs (a), (b) and (c) of this
   27  subdivision.
   28     § 4. The opening paragraph and  paragraph  (a)  of  subdivision  6  of
   29  section  2807-s  of  the  public  health  law,  the opening paragraph as
   30  amended by chapter 1 of the laws of 1999 and paragraph (a) as amended by
   31  section 28 of part A of chapter 1 of the laws of 2002,  are  amended  to
   32  read as follows:
   33    The  amount  allocated  to each region for purposes of calculating the
   34  regional allowance percentage pursuant to this  section  for  each  year
   35  during  the  period January first, nineteen hundred ninety-seven through
   36  December thirty-first, nineteen hundred  ninety-nine  and  the  regional
   37  assessments  pursuant  to  section  twenty-eight hundred seven-t of this
   38  article for each year during the period January first, nineteen  hundred
   39  ninety-seven through December thirty-first, nineteen hundred ninety-nine
   40  and for each year on and after January first, two thousand, shall be the
   41  sum  of  the  factors  computed  in  paragraphs (b), (d) and (f) of this
   42  [section] subdivision as follows:
   43    (a) (i) A gross annual statewide amount for nineteen  hundred  ninety-
   44  seven shall be five hundred eighty-nine million dollars.
   45    (ii) A gross annual statewide amount for nineteen hundred ninety-eight
   46  shall be five hundred eighty-nine million dollars.
   47    (iii) A gross annual statewide amount for nineteen hundred ninety-nine
   48  shall be five hundred eighty-nine million dollars.
   49    (iv)  A  gross  annual statewide amount for two thousand shall be five
   50  hundred eighty-nine million dollars.
   51    (v) A gross annual statewide amount for two thousand one shall be five
   52  hundred sixty-nine million dollars.
   53    (vi) A gross annual statewide amount for two  thousand  two  shall  be
   54  five hundred eighty-nine million dollars.
   55    (vii)  A  gross annual statewide amount for [the period January first,
   56  two thousand three through June thirtieth,] two thousand three shall  be
       S. 1408                            71                            A. 2108
 
    1  [two  hundred  ninety-four  million  five hundred thousand] five hundred
    2  eighty-nine million dollars.
    3    (viii)  A gross annual statewide amount for two thousand four shall be
    4  six hundred twenty-four million dollars.
    5    (ix) A gross annual statewide amount for the period January first, two
    6  thousand five through June thirtieth, two thousand five shall  be  three
    7  hundred twelve million dollars.
    8     §  5.  Paragraph  (c) of subdivision 6 of section 2807-s of the public
    9  health law, as amended by chapter 1 of the laws of 1999, is  amended  to
   10  read as follows:
   11    (c)  (i)  A further gross annual statewide amount for nineteen hundred
   12  ninety-seven shall be sixty-four million dollars.
   13    (ii) A further gross annual  statewide  amount  for  nineteen  hundred
   14  ninety-eight shall be sixty-four million dollars.
   15    (iii)  A  further  gross  annual statewide amount for nineteen hundred
   16  ninety-nine shall be eighty-nine million dollars.
   17    (iv) A further gross annual statewide amount  for  two  thousand,  two
   18  thousand  one  [and], two thousand two, two thousand three and two thou-
   19  sand four, shall be eighty-nine million dollars.
   20    (v) A further gross statewide amount for the period January first, two
   21  thousand [three] five through June thirtieth, two thousand [three] five,
   22  shall be forty-four million five hundred thousand dollars.
   23     § 6. Paragraph (e) of subdivision 6 of section 2807-s  of  the  public
   24  health  law,  as amended by chapter 1 of the laws of 1999, is amended to
   25  read as follows:
   26    (e) (i) A further  gross  annual  statewide  amount  shall  be  twelve
   27  million  dollars [annually] for each periods prior to January first, two
   28  thousand [three] five.
   29    (ii) A further gross statewide amount for the  period  January  first,
   30  two  thousand  [three] five through June thirtieth, two thousand [three]
   31  five shall be six million dollars.
   32     § 7. Subdivision 3 and paragraphs (a) and (a-1) of  subdivision  4  of
   33  section  2807-k  of  the public health law, as amended by chapter 419 of
   34  the laws of 2000, are amended to read as follows:
   35    3. (a) Each major public  general  hospital  shall  be  allocated  for
   36  distribution  from  the  pools  established pursuant to this section for
   37  each year through December thirty-first, two  thousand  [two]  four,  an
   38  amount equal to the amount allocated to such major public general hospi-
   39  tal from the regional pool established pursuant to subdivision seventeen
   40  of  section  twenty-eight hundred seven-c of this article for the period
   41  January first, nineteen  hundred  ninety-six  through  December  thirty-
   42  first, nineteen hundred ninety-six.
   43    (b)  For  the  period January first, two thousand [three] five through
   44  June thirtieth, two thousand [three] five,  each  major  public  general
   45  hospital  shall be allocated for distribution from the pools established
   46  pursuant to this section for such period, an amount  equal  to  one-half
   47  the amount calculated pursuant to paragraph (a) of this subdivision.
   48    (a)  From  funds in the pool for each year, thirty-six million dollars
   49  shall be reserved on an annual basis through December thirty-first,  two
   50  thousand  [two]  four and eighteen million dollars shall be reserved for
   51  the period January first, two thousand [three] five through June thirti-
   52  eth, two thousand [three] five, for distribution as  high  need  adjust-
   53  ments in accordance with subdivision six of this section.
   54    (a-1)  From  funds  in  the  pool  for each year, twenty-seven million
   55  dollars shall be reserved on an annual basis  for  the  periods  January
   56  first,  two  thousand  through December thirty-first, two thousand [two]
       S. 1408                            72                            A. 2108
 
    1  four and  thirteen  million  five  hundred  thousand  dollars  shall  be
    2  reserved for the period January first, two thousand [three] five through
    3  June  thirtieth,  two thousand [three] five, for distribution in accord-
    4  ance with subdivision sixteen of this section.
    5     §  8.  Subparagraphs (iv) and (v) of paragraph (a) of subdivision 9 of
    6  section 2807-j of the public health law, as added by chapter  1  of  the
    7  laws of 1999, are amended to read as follows:
    8    (iv)  seven  hundred  sixty-five million dollars annually of the funds
    9  accumulated for the periods January first, two thousand through December
   10  thirty-first, two thousand [two] four, and
   11    (v) three hundred [eighty-three] eighty-two million five hundred thou-
   12  sand dollars of the funds accumulated for the period January first,  two
   13  thousand [three] five through June thirtieth, two thousand [three] five,
   14  and
   15     § 9. The opening paragraph, paragraph (a) of subdivision 1, and subdi-
   16  vision 2 of section 2807-w of the public health law, as amended by chap-
   17  ter 419 of the laws of 2000, are amended to read as follows:
   18    Funds  allocated  pursuant  to  paragraph  (p)  of  subdivision one of
   19  section twenty-eight hundred seven-v of this article, shall be deposited
   20  as authorized and used for the purpose  of  making  medicaid  dispropor-
   21  tionate  share  payments  within the limits established on an annualized
   22  basis pursuant to subdivision twenty-one of section twenty-eight hundred
   23  seven-c of this article, for the  period  January  first,  two  thousand
   24  through  June  thirtieth,  two thousand [three] five, in accordance with
   25  the following:
   26    (a) Each eligible rural hospital shall receive one hundred forty thou-
   27  sand dollars on an annualized basis for the periods January  first,  two
   28  thousand  through  December  thirty-first,  two  thousand [two] four and
   29  seventy thousand dollars for the  period  January  first,  two  thousand
   30  [three] five through June thirtieth, two thousand [three] five, provided
   31  as  a  disproportionate  share  payment; provided, however, that if such
   32  payment pursuant to  this  paragraph  exceeds  a  hospital's  applicable
   33  disproportionate  share  limit,  then the total amount in excess of such
   34  limit shall be provided as a nondisproportionate share  payment  in  the
   35  form  of  a  grant  directly  from  this  pool without allocation to the
   36  special revenue funds - other, indigent care fund - 068;
   37    2. From the funds in the pool each year, thirty-six million dollars on
   38  an annualized basis for the periods January first, two thousand  through
   39  December  thirty-first,  two  thousand  [two]  four and eighteen million
   40  dollars for the period January first, two thousand [three] five  through
   41  June  thirtieth, two thousand [three] five, of the funds not distributed
   42  in accordance with subdivision one of this section, shall be distributed
   43  in accordance with the formula set forth in subdivision six  of  section
   44  twenty-eight hundred seven-k of this article.
   45     §  10. Subparagraphs (iv) and (v) of paragraph (a) of subdivision 7 of
   46  section 2807-s of the public health law, as added by chapter  1  of  the
   47  laws  of  1999, are amended and a new subparagraph (vi) is added to read
   48  as follows:
   49    (iv) four hundred ninety-four million dollars on an annual  basis  for
   50  the  periods  January first, two thousand through December thirty-first,
   51  two thousand [two] four,
   52    (v) two hundred forty-seven million dollars  for  the  period  January
   53  first,  two  thousand  [three] five through June thirtieth, two thousand
   54  [three; and] five,
   55    (vi) provided, however, amounts set forth in  this  paragraph  may  be
   56  reduced  by the commissioner in an amount to be approved by the director
       S. 1408                            73                            A. 2108
 
    1  of the budget to reflect the amount received from the federal government
    2  under the state's 1115 waiver which is  directed  under  its  terms  and
    3  conditions  to the graduate medical education program established pursu-
    4  ant to section twenty-eight hundred seven-m of this article; and
    5     § 11. Subparagraphs (i) and (iii) of paragraph (d) of subdivision 3 of
    6  section  2807-m  of  the public health law, as amended by chapter 419 of
    7  the laws of 2000, are amended to read as follows:
    8    (i) the commissioner shall establish a reduction percentage by  divid-
    9  ing twenty-seven million dollars each year for the period January first,
   10  two  thousand through December thirty-first, two thousand [two] four and
   11  thirteen million five hundred thousand dollars for  the  period  January
   12  first,  two  thousand  [three] five through June thirtieth, two thousand
   13  [three] five, by the sum of initial hospital distribution amounts calcu-
   14  lated pursuant to paragraph (c) of this subdivision;
   15    (iii) each teaching general hospital shall have its  initial  distrib-
   16  ution amount as determined pursuant to paragraph (c) of this subdivision
   17  reduced  by  an  amount up to the amount calculated pursuant to subpara-
   18  graph (ii) of this paragraph and subject to the requirements of subpara-
   19  graph (iv) of this paragraph, provided, however,  that  if  the  sum  of
   20  reduction  amounts for all facilities thus calculated is less than twen-
   21  ty-seven million dollars on a statewide basis each year for  the  period
   22  January  first, two thousand through December thirty-first, two thousand
   23  [two] four and thirteen million five hundred thousand  dollars  for  the
   24  period  January first, two thousand [three] five through June thirtieth,
   25  two thousand [three] five, the commissioner may increase  the  reduction
   26  percentage  subject to the provisions of subparagraph (iv) of this para-
   27  graph so that the sum of the reduction amounts  for  all  facilities  is
   28  twenty-seven million dollars each year for the period January first, two
   29  thousand  through  December  thirty-first,  two  thousand [two] four and
   30  thirteen million five hundred thousand dollars for  the  period  January
   31  first,  two  thousand  [three] five through June thirtieth, two thousand
   32  [three] five.
   33     § 12. Paragraph (a) of subdivision 5 of section 2807-m of  the  public
   34  health  law,  as amended by chapter 1 of the laws of 1999, is amended to
   35  read as follows:
   36    (a) Up to thirty-one million dollars annually for the periods  January
   37  first,  two  thousand  through December thirty-first, two thousand [two]
   38  four, and up to fifteen million five hundred thousand  dollars  for  the
   39  period  January first, two thousand [three] five through June thirtieth,
   40  two thousand [three] five, shall  be  set  aside  and  reserved  by  the
   41  commissioner  annually  from  the regional pools established pursuant to
   42  subdivision two of this section for supplemental distributions  in  each
   43  such  region  to  be  made by the commissioner to consortia and teaching
   44  general hospitals in accordance with a distribution  methodology  devel-
   45  oped  in  consultation with the council and specified in rules and regu-
   46  lations adopted by the commissioner.
   47     § 13. Paragraph (c) of subdivision 2 of section 2807-s of  the  public
   48  health  law,  as  added  by chapter 1 of the laws of 1999, is amended to
   49  read as follows:
   50    (c) (i) The regional percentage allowance  for  the  periods  [on  and
   51  after]  January first, two thousand through June thirtieth, two thousand
   52  three, for all general hospitals in the region applicable  to  specified
   53  third-party  payors,  and  applicable to related patient coinsurance and
   54  deductible amounts, shall be  the  same  regional  percentage  allowance
   55  calculated  pursuant to paragraph (b) of this subdivision for the period
       S. 1408                            74                            A. 2108
 
    1  January first, nineteen hundred  ninety-nine  through  December  thirty-
    2  first, nineteen hundred ninety-nine.
    3    (ii) The regional percentage allowance for the periods July first, two
    4  thousand three through June thirtieth, two thousand five, for all gener-
    5  al  hospitals  in the region applicable to specified third-party payors,
    6  and applicable to related patient coinsurance  and  deductible  amounts,
    7  shall  be  the same regional percentage allowance calculated pursuant to
    8  paragraph (b) of this subdivision for the period January first, nineteen
    9  hundred ninety-nine  through  December  thirty-first,  nineteen  hundred
   10  ninety-nine  multiplied  by  one  hundred  eight and nineteen hundredths
   11  percent.
   12     § 14.  Section 2807-1 of the public health law, as amended by  chapter
   13  1  of  the  laws of 1999, clauses (D), (E), (F), and (G) of subparagraph
   14  (i) and subparagraph (ii) of paragraph (b),  the  opening  paragraph  of
   15  paragraph  (c),  subparagraph  (v) of paragraph (i), subparagraph (v) of
   16  paragraph (k), and the opening paragraph of paragraph (m) of subdivision
   17  1, subdivision 2, and subdivision 3 as amended by  chapter  419  of  the
   18  laws  of 2000, paragraph (f) of subdivision 1 as amended by section 6 of
   19  part A of chapter 57 of the laws of 2000, is amended to read as follows:
   20     § 2807-l. Health care initiatives pool distributions. 1. Funds accumu-
   21  lated in the health care initiatives pools pursuant to paragraph (b)  of
   22  subdivision  nine  of section twenty-eight hundred seven-j of this arti-
   23  cle, including income from  invested  funds,  shall  be  distributed  or
   24  retained by the commissioner in accordance with the following.
   25    (a)  Funds  shall be reserved and accumulated from year to year by the
   26  commissioner and shall be  available,  including  income  from  invested
   27  funds,  for purposes of distributions to programs to provide health care
   28  coverage for uninsured or underinsured  children  pursuant  to  sections
   29  twenty-five  hundred  ten and twenty-five hundred eleven of this chapter
   30  from the respective health care initiatives pools  established  for  the
   31  following periods in the following amounts:
   32    (i) from the pool for the period January first, nineteen hundred nine-
   33  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
   34  up to one hundred twenty million six hundred thousand dollars;
   35    (ii) from the pool for the  period  January  first,  nineteen  hundred
   36  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
   37  eight, up to  one  hundred  sixty-four  million  five  hundred  thousand
   38  dollars;
   39    (iii)  from  the  pool  for the period January first, nineteen hundred
   40  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   41  up to one hundred eighty-one million dollars;
   42    (iv) from the pool for the period January first, two thousand  through
   43  December thirty-first, two thousand, two hundred seven million dollars;
   44    (v)  from  the  pool  for  the  period January first, two thousand one
   45  through December thirty-first, two thousand one, two hundred thirty-five
   46  million dollars;
   47    (vi) from the pool for the period  January  first,  two  thousand  two
   48  through  December  thirty-first, two thousand two, three hundred twenty-
   49  four million dollars;
   50    (vii) from the pool for the period January first, two  thousand  three
   51  through [June thirtieth] December thirty-first, two thousand three, [one
   52  hundred  seventy-four  million]  up to four hundred twenty-three million
   53  nine hundred thousand dollars; [and]
   54    (viii) from the pool for the period January first, two  thousand  four
   55  through  December  thirty-first,  two thousand four, up to three hundred
   56  eighty-one million seven hundred thousand dollars;
       S. 1408                            75                            A. 2108
 
    1    (ix) from the pool for the period January  first,  two  thousand  five
    2  through June thirtieth, two thousand five, up to two hundred two million
    3  three hundred thousand dollars; and
    4    (x)  If funds allocated pursuant to this paragraph are insufficient to
    5  cover the costs required to meet the state's obligations established  in
    6  [section] sections twenty-five hundred ten and twenty-five hundred elev-
    7  en  of  this  chapter, the commissioner [shall] may transfer and deposit
    8  funds accumulated pursuant to this  section  and  sections  twenty-eight
    9  hundred  seven-j,  twenty-eight  hundred seven-k,   twenty-eight hundred
   10  seven-s, twenty-eight hundred seven-t and twenty-eight  hundred  seven-v
   11  of  this  article  into  the  special  revenue fund-other, miscellaneous
   12  special revenue fund-339, child health insurance account,  such  amounts
   13  necessary to fully fund such obligations.
   14    (b)  Funds  shall be reserved and accumulated from year to year by the
   15  commissioner and shall be  available,  including  income  from  invested
   16  funds, for purposes of distributions for health insurance programs under
   17  the  New  York state small business health insurance partnership program
   18  established pursuant to article nine-A of this chapter, a voucher insur-
   19  ance program established pursuant to section eleven  hundred  twenty-one
   20  of  the  insurance law, individual subsidy programs established pursuant
   21  to the expanded health care coverage act  of  nineteen  hundred  eighty-
   22  eight  as  amended,  and  the  catastrophic  health care expense program
   23  established pursuant to title eleven-A of article  five  of  the  social
   24  services  law  and  for  evaluation of such programs from the respective
   25  health care initiatives pools established for the following  periods  in
   26  the following amounts:
   27    (i)  (A)  from the pool for the period January first, nineteen hundred
   28  ninety-seven through December thirty-first, nineteen hundred ninety-sev-
   29  en, up to twenty-four million dollars;
   30    (B) from the pool for the period January first, nineteen hundred nine-
   31  ty-eight through December thirty-first, nineteen  hundred  ninety-eight,
   32  up to twenty-four million dollars;
   33    (C) from the pool for the period January first, nineteen hundred nine-
   34  ty-nine  through December thirty-first, nineteen hundred ninety-nine, up
   35  to twenty-four million dollars;
   36    (D) from the pool for the period January first, two  thousand  through
   37  December thirty-first, two thousand, up to seventeen million dollars;
   38    (E)  from  the  pool  for  the  period January first, two thousand one
   39  through December thirty-first, two thousand one, up to fourteen  million
   40  [five] two hundred thousand dollars;
   41    (F)  from  the  pool  for  the  period January first, two thousand two
   42  through December thirty-first, two thousand two, up to [twelve  million]
   43  eleven million three hundred thousand dollars; and
   44    (G)  from  the  pool  for the period January first, two thousand three
   45  through June thirtieth, two thousand three, up  to  [four]  one  million
   46  five hundred thousand dollars.
   47    (ii)  provided  however,  that  from  such funds allocated pursuant to
   48  subparagraph (i) of this paragraph:
   49    (A) an amount not to exceed six million dollars on an annualized basis
   50  for the periods during the period January first, nineteen hundred  nine-
   51  ty-seven through December thirty-first, nineteen hundred ninety-nine; up
   52  to  six  million  dollars  for  the  period  January first, two thousand
   53  through December thirty-first, two thousand; up to five million  dollars
   54  for  the period January first, two thousand one through December thirty-
   55  first, two thousand one; up to four million dollars for the period Janu-
   56  ary first, two thousand two through December thirty-first, two  thousand
       S. 1408                            76                            A. 2108
 
    1  two; and up to [one million] five hundred thousand dollars for the peri-
    2  od  January  first, two thousand three through June thirtieth, two thou-
    3  sand three shall be allocated to the health insurance programs under the
    4  New  York  state  small  business  health  insurance partnership program
    5  established pursuant to article nine-A of this chapter;
    6    (B) an amount not to exceed five  million  dollars  on  an  annualized
    7  basis  for  the  periods  January  first,  nineteen hundred ninety-seven
    8  through December thirty-first, nineteen hundred ninety-nine  and  up  to
    9  one  million  dollars for the period January first, two thousand through
   10  December thirty-first, two thousand and up to [five] two  hundred  thou-
   11  sand  dollars  for  the  period  January first, two thousand one through
   12  December thirty-first, two thousand one shall be allocated to the vouch-
   13  er insurance program;
   14    (C) an amount not to exceed six million dollars on an annualized basis
   15  for the periods January first,  nineteen  hundred  ninety-seven  through
   16  December  thirty-first,  nineteen hundred ninety-nine; up to six million
   17  dollars for the period January  first,  two  thousand  through  December
   18  thirty-first,  two  thousand;  up to five million dollars for the period
   19  January first, two thousand one through December thirty-first, two thou-
   20  sand one; up to four million dollars for the period January  first,  two
   21  thousand  two through December thirty-first, two thousand two; and up to
   22  one million dollars for the period January  first,  two  thousand  three
   23  through  June  thirtieth, two thousand three shall be allocated to indi-
   24  vidual subsidy programs; and
   25    (D) an amount not to exceed seven million  dollars  on  an  annualized
   26  basis  for the periods during the period January first, nineteen hundred
   27  ninety-seven through December thirty-first, nineteen hundred ninety-nine
   28  and four million dollars annually for the  periods  January  first,  two
   29  thousand  through  December  thirty-first,  two  thousand  [two, and two
   30  million dollars for the period January first, two thousand three through
   31  June thirtieth, two  thousand  three,]  one,  and  three  million  three
   32  hundred  thousand dollars for the period January first, two thousand two
   33  through December thirty-first, two thousand two, shall be  allocated  to
   34  the catastrophic health care expense program.
   35    (iii)  Notwithstanding  any law to the contrary, the characterizations
   36  of the New  York  state  small  business  health  insurance  partnership
   37  program,  voucher  program,  individual subsidy program and catastrophic
   38  health care expense program, may, for the purposes of identifying match-
   39  ing funds for the community health care conversion demonstration project
   40  described in a waiver of the provisions of  title  XIX  of  the  federal
   41  social  security  act  granted  to  the state of New York and dated July
   42  fifteenth, nineteen hundred ninety-seven, may continue  to  be  used  to
   43  characterize  the  insurance  programs  in  sections four thousand three
   44  hundred twenty-one-a, four thousand  three  hundred  twenty-two-a,  four
   45  thousand  three hundred twenty-six and four thousand three hundred twen-
   46  ty-seven of the insurance law, which are  successor  programs  to  these
   47  programs.
   48    (c)  Up to seventy-eight million dollars shall be reserved and accumu-
   49  lated from year to year by the commissioner from the pool for the period
   50  January first, nineteen hundred ninety-seven  through  December  thirty-
   51  first,  nineteen  hundred  ninety-seven,  for  purposes of public health
   52  programs, up to seventy-six million dollars shall be reserved and  accu-
   53  mulated  from  year  to  year by the commissioner from the pools for the
   54  periods January first, nineteen hundred  ninety-eight  through  December
   55  thirty-first,  nineteen hundred ninety-eight and January first, nineteen
   56  hundred ninety-nine  through  December  thirty-first,  nineteen  hundred
       S. 1408                            77                            A. 2108
 
    1  ninety-nine,  up  to  eighty-four  million dollars shall be reserved and
    2  accumulated from year to year by the commissioner from the pools for the
    3  period January first, two thousand through  December  thirty-first,  two
    4  thousand,  up to eighty-five million dollars shall be reserved and accu-
    5  mulated from year to year by the commissioner from  the  pools  for  the
    6  period  January  first,  two thousand one through December thirty-first,
    7  two thousand one, up to eighty-six million dollars shall be reserved and
    8  accumulated from year to year by the commissioner from the pools for the
    9  period January first, two thousand two  through  December  thirty-first,
   10  two  thousand two, [and] up to [forty-four million] eighty-three million
   11  eight hundred thousand dollars shall be reserved  and  accumulated  from
   12  year  to  year by the commissioner from the pools for the period January
   13  first,  two   thousand   three   through   [June   thirtieth]   December
   14  thirty-first,  two  thousand  three,  up  to  eighty-three million eight
   15  hundred thousand dollars shall be reserved and accumulated from year  to
   16  year  by  the  commissioner from the pools for the period January first,
   17  two thousand four through December thirty-first, two thousand four,  and
   18  up to forty-three million dollars shall be reserved and accumulated from
   19  year  to  year by the commissioner from the pools for the period January
   20  first, two thousand five through June thirtieth, two thousand five,  and
   21  shall be available, including income from invested funds, for:
   22    (i)  deposit by the commissioner, within amounts appropriated, and the
   23  state comptroller is hereby  authorized  and  directed  to  receive  for
   24  deposit  to, to the credit of the department of health's special revenue
   25  fund - other, hospital based grants program  account,  for  purposes  of
   26  services  and expenses related to general hospital based grant programs,
   27  up to twenty-two million dollars  annually  from  the  nineteen  hundred
   28  ninety-seven  pool, nineteen hundred ninety-eight pool, nineteen hundred
   29  ninety-nine pool, two thousand pool, two thousand one pool and two thou-
   30  sand two pool, respectively, [and] up  to  [eleven]  twenty-two  million
   31  dollars  from  the  two  thousand  three  pool, up to twenty-two million
   32  dollars for the period January first, two thousand four through December
   33  thirty-first, two thousand four, and up to eleven  million  dollars  for
   34  the  period January first, two thousand five through June thirtieth, two
   35  thousand five;
   36    (ii) deposit by the commissioner, within amounts appropriated, and the
   37  state comptroller is hereby  authorized  and  directed  to  receive  for
   38  deposit  to,  to  the  credit of the emergency medical services training
   39  account established [for purposes of] in section ninety-seven-q  of  the
   40  state  finance law, up to sixteen million dollars on an annualized basis
   41  for the periods January first,  nineteen  hundred  ninety-seven  through
   42  December  thirty-first,  nineteen  hundred  ninety-nine,  up  to  twenty
   43  million dollars for the  period  January  first,  two  thousand  through
   44  December  thirty-first,  two  thousand, up to twenty-one million dollars
   45  for the period January first, two thousand one through December  thirty-
   46  first, two thousand one, up to twenty-two million dollars for the period
   47  January first, two thousand two through December thirty-first, two thou-
   48  sand  two,  [and]  up  to  [twelve million] twenty million seven hundred
   49  thousand dollars for  the  period  January  first,  two  thousand  three
   50  through  [June  thirtieth] December thirty-first, two thousand three, up
   51  to twenty million seven hundred thousand dollars for the period  January
   52  first,  two  thousand  four  through December thirty-first, two thousand
   53  four, and up to eleven million two  hundred  thousand  dollars  for  the
   54  period  January  first,  two  thousand  five through June thirtieth, two
   55  thousand five;
       S. 1408                            78                            A. 2108
 
    1    (iii) priority distributions by  the  commissioner  up  to  thirty-two
    2  million  dollars  on  an  annualized  basis  to be allocated (A) for the
    3  purposes established pursuant to subparagraph (ii) of paragraph  (f)  of
    4  subdivision  nineteen  of  section  twenty-eight hundred seven-c of this
    5  article  as in effect on December thirty-first, nineteen hundred ninety-
    6  six and as may thereafter be amended,  up  to  fifteen  million  dollars
    7  annually  for  the  periods January first, two thousand through December
    8  thirty-first, two thousand [two] four, and  up  to  seven  million  five
    9  hundred  thousand  dollars  for  the  period January first, two thousand
   10  [three] five through June thirtieth, two thousand [three] five; and
   11    (B) pursuant to a memorandum of  understanding  entered  into  by  the
   12  commissioner,  the  majority leader of the senate and the speaker of the
   13  assembly, for the purposes outlined in such memorandum upon  the  recom-
   14  mendation  of  the  majority  leader  of the senate, up to eight million
   15  five hundred thousand dollars annually for the period January first, two
   16  thousand through December thirty-first, two thousand [two] four, and  up
   17  to  four million two hundred fifty thousand dollars for the period Janu-
   18  ary first, two thousand [three] five through June thirtieth,  two  thou-
   19  sand [three] five, and for the purposes outlined in such memorandum upon
   20  the  recommendation  of the speaker of the assembly, up to eight million
   21  five hundred thousand dollars annually for the  periods  January  first,
   22  two thousand through December thirty-first, two thousand [two] four, and
   23  up  to  four  million  two hundred fifty thousand dollars for the period
   24  January first, two thousand [three] five  through  June  thirtieth,  two
   25  thousand [three] five;
   26    (iv)  distributions  by  the  commissioner  related  to poison control
   27  centers pursuant to subdivision seven of section  twenty-five  hundred-d
   28  of  this  chapter,  up  to  five  million dollars for the period January
   29  first, nineteen  hundred  ninety-seven  through  December  thirty-first,
   30  nineteen hundred ninety-seven, up to three million dollars on an annual-
   31  ized  basis  for  the  periods during the period January first, nineteen
   32  hundred ninety-eight through  December  thirty-first,  nineteen  hundred
   33  ninety-nine, up to five million dollars annually for the periods January
   34  first,  two  thousand  through  December thirty-first, two thousand two,
   35  [and] up to [two million five hundred thousand] four million one hundred
   36  thousand dollars annually for the [period] periods  January  first,  two
   37  thousand  three  through  [June  thirtieth, two thousand three] December
   38  thirty-first, two thousand four, and up to  two  million  three  hundred
   39  thousand dollars for the period January first, two thousand five through
   40  June thirtieth, two thousand five; and
   41    (v)  deposit by the commissioner, within amounts appropriated, and the
   42  state comptroller is hereby  authorized  and  directed  to  receive  for
   43  deposit  to, to the credit of the department of health's special revenue
   44  fund - other, miscellaneous special revenue  fund  -  339  maternal  and
   45  child  HIV  services  account, for purposes of a special program for HIV
   46  services for infants and pregnant women pursuant to section  seventy-one
   47  of  chapter  seven  hundred  thirty-one  of the laws of nineteen hundred
   48  ninety-three, amending the public health law and other laws relating  to
   49  reimbursement,  delivery  and  capital  costs  of ambulatory health care
   50  services and inpatient hospital services, up  to  five  million  dollars
   51  annually  for  the  periods January first, two thousand through December
   52  thirty-first, two thousand two, [and] up to [two  million  five  hundred
   53  thousand]  five  million dollars for the period January first, two thou-
   54  sand three through [June thirtieth] December thirty-first, two  thousand
   55  three,  up  to  five  million  dollars for the period January first, two
   56  thousand four through December thirty-first, two thousand four,  and  up
       S. 1408                            79                            A. 2108
 
    1  to  two  million  five  hundred  thousand dollars for the period January
    2  first, two thousand five through June thirtieth, two thousand five, plus
    3  such amounts as may be available from prior year pool reserves.
    4    (d)  (i)  An  amount  of up to twenty million dollars annually for the
    5  period January first, two thousand through  December  thirty-first,  two
    6  thousand  [two] four, and up to ten million dollars for the period Janu-
    7  ary first, two thousand [three] five through June thirtieth,  two  thou-
    8  sand  [three]  five,  shall  be  transferred  by the commissioner to the
    9  health facility restructuring pool established pursuant to section twen-
   10  ty-eight hundred fifteen of this article;
   11    (ii) provided, however, amounts transferred pursuant  to  subparagraph
   12  (i) of this paragraph may be reduced by the commissioner in an amount to
   13  be approved by the director of the budget to reflect the amount received
   14  from  the  federal  government  under  the  state's 1115 waiver which is
   15  directed under its terms and conditions to the health facility  restruc-
   16  turing program.
   17    (e)  Funds  shall be reserved and accumulated from year to year by the
   18  commissioner and shall be available,   including  income  from  invested
   19  funds,  for  purposes  of  distributions to organizations to support the
   20  health workforce retraining  program  established  pursuant  to  section
   21  twenty-eight hundred seven-g of this  article from the respective health
   22  care  initiatives  pools  established  for  the following periods in the
   23  following amounts from the pools during the period January first,  nine-
   24  teen   hundred  ninety-seven  through  December  thirty-first,  nineteen
   25  hundred ninety-nine, up to fifty million dollars on an annualized basis,
   26  up to thirty million dollars for the period January first, two  thousand
   27  through December thirty-first, two thousand, up to forty million dollars
   28  for  the period January first, two thousand one through December thirty-
   29  first, two thousand one, up to fifty  million  dollars  for  the  period
   30  January first, two thousand two through December thirty-first, two thou-
   31  sand  two, [and] up to [thirty million] twenty-five million four hundred
   32  thousand dollars for  the  period  January  first,  two  thousand  three
   33  through  [June  thirtieth] December thirty-first, two thousand three, up
   34  to twenty-five million three hundred thousand  dollars  for  the  period
   35  January  first,  two  thousand  four  through December thirty-first, two
   36  thousand four, and up  to  twenty-one  million  three  hundred  thousand
   37  dollars  for  the  period  January first, two thousand five through June
   38  thirtieth, two thousand five, less the amount  of  funds  available  for
   39  allocations  for  rate  adjustments  for workforce training programs for
   40  payments by state governmental agencies for inpatient hospital services.
   41    (f) Funds shall be accumulated and transferred from as follows:
   42    (i) from the pool for the period January first, nineteen hundred nine-
   43  ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
   44  (A)  thirty-four  million   six hundred thousand dollars shall be trans-
   45  ferred to funds reserved and accumulated pursuant to  paragraph  (b)  of
   46  subdivision  nineteen  of  section  twenty-eight hundred seven-c of this
   47  article, and (B) eighty-two million dollars  shall  be  transferred  and
   48  deposited  and  credited to the credit of the state general fund medical
   49  assistance local assistance account;
   50    (ii) from the pool for the  period  January  first,  nineteen  hundred
   51  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
   52  eight, eighty-two million dollars shall be transferred and deposited and
   53  credited to the credit of the  state  general  fund  medical  assistance
   54  local assistance account;
   55    (iii)  from  the  pool  for the period January first, nineteen hundred
   56  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
       S. 1408                            80                            A. 2108
 
    1  eighty-two million dollars shall be transferred and deposited and  cred-
    2  ited  to  the  credit of the state general fund medical assistance local
    3  assistance account; [and]
    4    (iv)  from the pool for the period January first, two thousand through
    5  December thirty-first,  two  thousand  [two]  four,  eighty-two  million
    6  dollars annually, and for the period January first, two thousand [three]
    7  five  through  June  thirtieth,  two  thousand  [three]  five, forty-one
    8  million dollars shall be deposited by the commissioner,  and  the  state
    9  comptroller  is hereby authorized and directed to receive for deposit to
   10  the credit of the state special revenue  fund  -  other,  HCRA  transfer
   11  fund, medical assistance account.
   12    (g)  Funds  shall be transferred by the commissioner to primary health
   13  care services pools created by the commissioner, and shall be available,
   14  including income from invested funds, for  distributions  in  accordance
   15  with  section  twenty-eight  hundred  seven-bb  of this article from the
   16  respective health care initiatives pools for the  following  periods  in
   17  the following percentage amounts of funds remaining after allocations in
   18  accordance with paragraphs (a) through (f) of this subdivision:
   19    (i) from the pool for the period January first, nineteen hundred nine-
   20  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
   21  fifteen and [eighty-seven-hundreths] eighty-seven-hundredths percent;
   22    (ii) from the pool for the  period  January  first,  nineteen  hundred
   23  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
   24  eight, fifteen and eighty-seven-hundredths percent; and
   25    (iii) from the pool for the period  January  first,  nineteen  hundred
   26  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   27  sixteen  and  [thirteen-hundreths] thirteen-hundredths percent, less two
   28  million five hundred thousand dollars.
   29    (h) Funds shall be reserved and accumulated from year to year  by  the
   30  commissioner  and  shall  be  available,  including income from invested
   31  funds, for purposes of primary care education and training  pursuant  to
   32  article nine of this chapter from the respective health care initiatives
   33  pools  established for the following periods in the following percentage
   34  amounts of funds remaining after allocations in  accordance  with  para-
   35  graphs  (a)  through  (f) of this subdivision and shall be available for
   36  distributions as follows:
   37    (i) funds shall be reserved and accumulated:
   38    (A) from the pool for the period January first, nineteen hundred nine-
   39  ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
   40  six and [thirty-five-hundreths] thirty-five-hundredths percent;
   41    (B) from the pool for the period January first, nineteen hundred nine-
   42  ty-eight  through  December thirty-first, nineteen hundred ninety-eight,
   43  six and thirty-five-hundredths percent; and
   44    (C) from the pool for the period January first, nineteen hundred nine-
   45  ty-nine through December thirty-first, nineteen hundred ninety-nine, six
   46  and forty-five-hundredths percent;
   47    (ii) funds shall be available for distributions including income  from
   48  invested funds as follows:
   49    (A)  for purposes of the primary care physician loan repayment program
   50  in accordance with section nine hundred three of  this  chapter,  up  to
   51  five million dollars on an annualized basis;
   52    (B)  for purposes of the primary care practitioner scholarship program
   53  in accordance with section nine hundred four of this chapter, up to  two
   54  million dollars on an annualized basis; [and]
       S. 1408                            81                            A. 2108
 
    1    (C) for purposes of minority participation in medical education grants
    2  in  accordance  with section nine hundred six of this chapter, up to one
    3  million dollars on an annualized basis; and
    4    (D)  provided, however, that the commissioner may reallocate any funds
    5  remaining or unallocated for distributions for the primary care  practi-
    6  tioner  scholarship program in accordance with section nine hundred four
    7  of this chapter.
    8    (i) Funds shall be reserved and accumulated from year to year  by  the
    9  commissioner  and  shall  be  available,  including income from invested
   10  funds, for distributions in accordance with section twenty-nine  hundred
   11  fifty-two  and  section  twenty-nine hundred fifty-eight of this chapter
   12  for rural health care delivery development and rural health care  access
   13  development,  respectively,  from the respective health care initiatives
   14  pools for the following periods in the following percentage  amounts  of
   15  funds  remaining  after  allocations  in  accordance with paragraphs (a)
   16  through (f) of this subdivision, and for periods on  and  after  January
   17  first, two thousand, in the following amounts:
   18    (i) from the pool for the period January first, nineteen hundred nine-
   19  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
   20  thirteen and forty-nine-hundredths percent;
   21    (ii) from the pool for the  period  January  first,  nineteen  hundred
   22  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
   23  eight, thirteen and forty-nine-hundredths percent;
   24    (iii) from the pool for the period  January  first,  nineteen  hundred
   25  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   26  thirteen and seventy-one-hundredths percent;
   27    (iv) from the pool for the periods January first, two thousand through
   28  December thirty-first, two thousand two, seventeen million dollars annu-
   29  ally, and for the period January first, two thousand three through [June
   30  thirtieth]  December  thirty-first,  two  thousand three, [eight million
   31  five hundred thousand] up to fourteen  million  three  hundred  thousand
   32  dollars; [and]
   33    (v)  from  the  pool  for  the period January first, two thousand four
   34  through December thirty-first, two thousand four, up to fourteen million
   35  two hundred thousand dollars, and for  the  period  January  first,  two
   36  thousand  five  through  June  thirtieth, two thousand five, up to seven
   37  million eight hundred thousand dollars; and
   38    (vi) if funds accumulated for distributions pursuant to sections twen-
   39  ty-nine hundred fifty-two and twenty-nine hundred  fifty-eight  of  this
   40  chapter  are insufficient to meet the funding amounts established pursu-
   41  ant to [subparagraph] subparagraphs (iv) and (v) of this paragraph,  the
   42  commissioner  is  authorized  to  transfer funds accumulated pursuant to
   43  section twenty-eight hundred seven-v of this article to the health  care
   44  initiatives  pool  to  fully  fund the amounts specified in subparagraph
   45  (iv) of this paragraph; provided however, the provisions of this subpar-
   46  agraph shall only be  effective  contingent  upon  meeting  all  funding
   47  amounts established pursuant to paragraphs (a), (b), (c), (d), (e), (f),
   48  (l),  (m),  (n),  (q) and (r) of subdivision one of section twenty-eight
   49  hundred seven-v of this article, and paragraph (a) of this subdivision.
   50    (j) Funds shall be reserved and accumulated  from  year  to  year  and
   51  shall  be  available, including income from invested funds, for purposes
   52  of distributions related to health information and health  care  quality
   53  improvement  pursuant  to  section  twenty-eight hundred seven-n of this
   54  article from the respective health care  initiatives  pools  established
   55  for  the  following periods in the following percentage amounts of funds
       S. 1408                            82                            A. 2108
 
    1  remaining after allocations in accordance with  paragraphs  (a)  through
    2  (f) of this subdivision:
    3    (i) from the pool for the period January first, nineteen hundred nine-
    4  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
    5  six and thirty-five-hundredths percent;
    6    (ii) from the pool for the  period  January  first,  nineteen  hundred
    7  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
    8  eight, six and thirty-five-hundredths percent; and
    9    (iii) from the pool for the period  January  first,  nineteen  hundred
   10  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   11  six and forty-five-hundredths percent.
   12    (k)  Funds  shall  be  reserved  and accumulated from year to year and
   13  shall be available, including income  from  invested  funds,  for  allo-
   14  cations  and  distributions  in  accordance  with  section  twenty-eight
   15  hundred seven-p of this article  for  diagnostic  and  treatment  center
   16  uncompensated care from the respective health care initiatives pools for
   17  the  following  periods  in  the  following percentage  amounts of funds
   18  remaining after allocations in accordance with  paragraphs  (a)  through
   19  (f) of this subdivision, and for periods on and after January first, two
   20  thousand, in the following amounts:
   21    (i) from the pool for the period January first, nineteen hundred nine-
   22  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
   23  thirty-eight and [one-tenths] one-tenth percent;
   24    (ii) from the pool for the  period  January  first,  nineteen  hundred
   25  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
   26  eight, thirty-eight and [one-tenths] one-tenth percent;
   27    (iii) from the pool for the period  January  first,  nineteen  hundred
   28  ninety-nine through December thirty-first, nineteen hundred ninety-nine,
   29  thirty-eight and seventy-one-hundredths percent;
   30    (iv) from the pool for the periods January first, two thousand through
   31  December  thirty-first,  two  thousand  two, forty-eight million dollars
   32  annually, and for the period January first, two thousand  three  through
   33  June thirtieth, two thousand three, twenty-four million dollars; [and]
   34    (v)  from  the  pool  for  the  period  July first, two thousand three
   35  through December thirty-first, two thousand three, up to  three  million
   36  one hundred thousand dollars, for the period January first, two thousand
   37  four through December thirty-first, two thousand four, up to six million
   38  two  hundred  thousand  dollars,  and  for the period January first, two
   39  thousand five through June thirtieth, two thousand  five,  up  to  three
   40  million one hundred thousand dollars;
   41    (vi)  if funds accumulated for distributions pursuant to section twen-
   42  ty-eight hundred seven-p of this article are insufficient  to  meet  the
   43  funding  amounts established pursuant to subparagraph (iv) of this para-
   44  graph, the commissioner is  authorized  to  transfer  funds  accumulated
   45  pursuant  to  section  twenty-eight hundred seven-v of this article into
   46  the health care initiatives pool to fully fund the  amounts  established
   47  pursuant to [subparagraph] subparagraphs (iv) and (v) of this paragraph;
   48  provided  however,  the  provisions  of  this subparagraph shall only be
   49  effective contingent upon meeting all funding amounts established pursu-
   50  ant to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n),  (q)  and
   51  (r)  of  subdivision one of section twenty-eight hundred seven-v of this
   52  article, and paragraph (a) of this subdivision; and
   53    (vii) funds reserved and accumulated pursuant to  this  paragraph  for
   54  periods  on and after July first, two thousand three, shall be deposited
   55  by the commissioner, within amounts appropriated, and  the  state  comp-
   56  troller  is hereby authorized and directed to receive for deposit to the
       S. 1408                            83                            A. 2108
 
    1  credit of the state special revenue funds - other, HCRA  transfer  fund,
    2  medical  assistance  account, for purposes of funding the state share of
    3  rate adjustments made pursuant to twenty-eight hundred seven-p  of  this
    4  article.
    5    (l)  Funds  shall be reserved and accumulated from year to year by the
    6  commissioner and shall be  available,  including  income  from  invested
    7  funds, for transfer to and allocation  for services and expenses for the
    8  payment  of benefits to recipients of  drugs under the AIDS drug assist-
    9  ance program (ADAP) - HIV uninsured  care  program  as  administered  by
   10  Health  Research  Incorporated  from  the respective  health care initi-
   11  atives pools established for the  following  periods  in  the  following
   12  percentage  amounts  of  funds remaining after allocations in accordance
   13  with paragraphs (a) through (f) of this subdivision, and for periods  on
   14  and after January first, two thousand, in the following amounts:
   15    (i) from the pool for the period January first, nineteen hundred nine-
   16  ty-seven  through  December thirty-first, nineteen hundred ninety-seven,
   17  nine and fifty-two-hundredths percent;
   18    (ii) from the pool for the  period  January  first,  nineteen  hundred
   19  ninety-eight  through  December  thirty-first,  nineteen hundred ninety-
   20  eight, nine and fifty-two-hundredths percent;
   21    (iii) from the pool for the period  January  first,  nineteen  hundred
   22  ninety-nine  and  December  thirty-first,  nineteen hundred ninety-nine,
   23  nine and sixty-eight-hundredths percent; [and]
   24    (iv) from the pool for the periods January first, two thousand through
   25  December thirty-first, two thousand two, up to  twelve  million  dollars
   26  annually,  and  for the period January first, two thousand three through
   27  [June thirtieth] December thirty-first, two thousand three, up to  [six]
   28  forty million dollars; and
   29    (v)  from  the  pool  for the periods January first, two thousand four
   30  through December  thirty-first,  two  thousand  four,  up  to  fifty-six
   31  million  dollars,  and  for  the period January first, two thousand five
   32  through June thirtieth, two thousand five, up to thirty million dollars.
   33    (m) Funds shall be reserved and accumulated from year to year  by  the
   34  commissioner  and  shall  be  available,  including income from invested
   35  funds, for purposes of distributions pursuant  to  section  twenty-eight
   36  hundred  seven-r  of  this  article for cancer related services from the
   37  respective health care initiatives pools established for  the  following
   38  periods  in  the  following  percentage amounts of funds remaining after
   39  allocations in accordance with paragraphs (a) through (f) of this subdi-
   40  vision, and for periods on and after January first, two thousand, in the
   41  following amounts:
   42    (i) from the pool for the period January first, nineteen hundred nine-
   43  ty-seven through December thirty-first, nineteen  hundred  ninety-seven,
   44  seven and ninety-four-hundredths percent;
   45    (ii)  from  the  pool  for  the period January first, nineteen hundred
   46  ninety-eight through December  thirty-first,  nineteen  hundred  ninety-
   47  eight, seven and ninety-four-hundredths percent;
   48    (iii)  from  the  pool  for the period January first, nineteen hundred
   49  ninety-nine and December thirty-first, nineteen hundred ninety-nine, six
   50  and forty-five-hundredths percent;
   51    (iv) from the pool for the [periods] period January first,  two  thou-
   52  sand  through December thirty-first, two thousand two, up to ten million
   53  dollars on an annual basis; [and]
   54    (v) from the pool for the period January  first,  two  thousand  three
   55  through  [June  thirtieth]  December  thirty-first, two thousand [three]
       S. 1408                            84                            A. 2108
 
    1  four, up to [five million] seven million five hundred  thousand  dollars
    2  on an annual basis; and
    3    (vi)  from  the  pool  for the period January first, two thousand five
    4  through June thirtieth, two thousand five,  up  to  four  million  three
    5  hundred thousand dollars.
    6    2.  In  the  event residual funds are available after allocations have
    7  been made pursuant to this section, such  funds  may  be  allocated  and
    8  distributed  in a manner determined by the commissioner for purposes set
    9  forth in subdivision one of this section, section  twenty-eight  hundred
   10  seven-k or section twenty-eight hundred seven-m of this article.
   11    3.  Notwithstanding  any  inconsistent provision of law, rule or regu-
   12  lation, any funds accumulated  in  the  health  care  initiatives  pools
   13  pursuant  to  paragraph  (b) of subdivision nine of section twenty-eight
   14  hundred seven-j of this article, as a result of surcharges,  assessments
   15  or  other obligations during the periods January first, nineteen hundred
   16  ninety-seven through December  thirty-first,  nineteen  hundred  ninety-
   17  nine, which are unused or uncommitted for distributions pursuant to this
   18  section  shall  be  reserved  and  accumulated  from year to year by the
   19  commissioner and, within amounts appropriated, transferred and deposited
   20  into the special revenue funds - other,  miscellaneous  special  revenue
   21  fund  -  339,  child  health insurance account, for purposes of distrib-
   22  utions to implement  the  child  health  insurance  program  established
   23  pursuant  to  sections  twenty-five  hundred ten and twenty-five hundred
   24  eleven of this chapter for periods on and after January first, two thou-
   25  sand one; provided, however, funds reserved and accumulated for priority
   26  distributions pursuant to subparagraph (iii) of paragraph (c) of  subdi-
   27  vision  one  of this section shall not be transferred and deposited into
   28  such account pursuant to this subdivision; and provided further,  howev-
   29  er,  the  primary health care services grant program pursuant to section
   30  twenty-eight hundred seven-bb of this article, as  in  effect  prior  to
   31  January first, two thousand, shall be funded up to allocated amounts set
   32  forth  in  paragraph (g) of subdivision one of this section less amounts
   33  set aside and distributed by the commissioner in accordance with section
   34  thirty-two-c of part F of chapter four hundred twelve  of  the  laws  of
   35  nineteen hundred ninety-nine, and shall not be transferred and deposited
   36  into  such  account  pursuant to this subdivision; and provided further,
   37  however, that any unused or uncommitted pool funds accumulated and allo-
   38  cated pursuant to paragraph (j) of subdivision one of this section shall
   39  be distributed for  purposes  of  the  health  information  and  quality
   40  improvement act of 2000.
   41    4.  Revenue  from  distributions pursuant to this section shall not be
   42  included in gross revenue  received  for  purposes  of  the  assessments
   43  pursuant to subdivision eighteen of section twenty-eight hundred seven-c
   44  of  this article, subject to the provisions of paragraph (e) of subdivi-
   45  sion eighteen of section twenty-eight hundred seven-c of  this  article,
   46  and  shall not be included in gross revenue received for purposes of the
   47  assessments pursuant to section twenty-eight  hundred  seven-d  of  this
   48  article,  subject  to  the  provisions  of subdivision twelve of section
   49  twenty-eight hundred seven-d of this article.
   50    5. Notwithstanding any inconsistent provision of law, the commissioner
   51  may borrow from pool reserves from pools established or funded  pursuant
   52  to  sections twenty-eight hundred seven-c, twenty-eight hundred seven-j,
   53  twenty-eight hundred seven-k, twenty-eight hundred seven-m, twenty-eight
   54  hundred seven-s and twenty-eight hundred seven-t  of  this  article  and
   55  this  section,  and if not sufficient from pool funds collected pursuant
   56  to section twenty-eight hundred seven-j of this  article  and  allocated
       S. 1408                            85                            A. 2108
 
    1  for  distributions  pursuant  to  paragraph  (b)  of subdivision nine of
    2  section twenty-eight hundred seven-j of this  article,  or  pursuant  to
    3  sections  twenty-eight  hundred seven-s and twenty-eight hundred seven-t
    4  of  this article and allocated  for distributions pursuant to paragraphs
    5  (a) and (c) of subdivision seven of section twenty-eight hundred seven-s
    6  of this article, such funds as shall be necessary,  not  to  exceed  the
    7  amount  projected  to be available pursuant to paragraph (b) of subdivi-
    8  sion nine of section twenty-eight hundred seven-j of  this  article,  or
    9  paragraphs  (a)  and  (c)  of  subdivision seven of section twenty-eight
   10  hundred seven-s of this article, for distributions  in  accordance  with
   11  any of paragraphs (a) through (j) of subdivision one of this section for
   12  a  period  and shall refund such moneys when pool funds become available
   13  pursuant to paragraph (b) of subdivision nine  of  section  twenty-eight
   14  hundred  seven-j  and  paragraphs  (a)  and (c) of subdivision  seven of
   15  section twenty-eight hundred seven-s of this article  for  such  purpose
   16  for such period.
   17     §  15.  Section  84  of chapter 1 of the laws of 1999, relating to the
   18  Health Care Reform Act of 2000, is amended to read as follows:
   19     § 84.   Notwithstanding any inconsistent provision  of  law,  rule  or
   20  regulation, up to two hundred seventy-six million dollars ($276,000,000)
   21  for  the  period  January 1, 2000 through December 31, 2000; up to three
   22  hundred five million dollars ($305,000,000) for the  period  January  1,
   23  2001 through December 31, 2001; up to three hundred eighty-three million
   24  dollars  ($383,000,000)  for the period January 1, 2002 through December
   25  31, 2002; and up to [three hundred sixty] four hundred fifty-six million
   26  dollars ($[360,000,000] 456,000,000) for  the  period  January  1,  2003
   27  through  [June  30]  December 31, 2003 shall be transferred by the state
   28  comptroller from the tobacco settlement fund to the tobacco control  and
   29  insurance  initiatives  pool  to  be  established and distributed by the
   30  commissioner of health in accordance with section 2807-v of  the  public
   31  health  law.    Such  transfer  shall be initiated upon direction by the
   32  state director of the budget.
   33     § 16. Section 2807-v of the public health law, as added by  chapter  1
   34  of  the  laws  of  1999, paragraphs (a), (b), (f), (p), (s), the opening
   35  paragraphs of paragraphs (c), (l), (m), (n), and (r), and  subparagraphs
   36  (i),  (ii)  and  (iii)  of paragraph (t) of subdivision 1, as amended by
   37  chapter 419 of the laws of 2000,  paragraph  (d)  of  subdivision  1  as
   38  amended by section 37 of part J of chapter 82 of the laws of 2002, para-
   39  graph (e) of subdivision 1 as amended by section 38 of part J of chapter
   40  82 of the laws of 2002, subparagraphs (iii) and (iv) of paragraph (n) of
   41  subdivision  1  as  amended by section 36 of part J of chapter 82 of the
   42  laws of 2002, paragraph (v) of subdivision 1 as amended by section 8  of
   43  part  J  of  chapter 82 of the laws of 2002, subparagraph (iii) of para-
   44  graph (x) of subdivision 1 as amended by section 4 of part J of  chapter
   45  82  of  the  laws  of 2002, paragraph (y) of subdivision 1 as amended by
   46  section 5 of part J of chapter 82 of the laws of 2002, paragraph (bb) of
   47  subdivision 1 as amended by section 60 of part J of chapter  82  of  the
   48  laws  of  2002,  subparagraph (iv) of paragraph (cc) of subdivision 1 as
   49  amended by section 6 of part J of chapter 82 of the laws of 2002,  para-
   50  graph  (dd) of subdivision 1 as added by section 34 of part J of chapter
   51  82 of the laws of 2002, paragraph (ii) of  subdivision  1  as  added  by
   52  section  33  of part J of chapter 82 of the laws of 2002, paragraph (ii)
   53  of subdivision 1 as added by section 3 of part K of chapter  82  of  the
   54  laws  of 2002, paragraph (jj) of subdivision 1 as added by section 42 of
   55  part J of chapter 82 of the laws of 2002, paragraph (kk) of  subdivision
   56  1  as  added  by section 43 of part J of chapter 82 of the laws of 2002,
       S. 1408                            86                            A. 2108
 
    1  subparagraphs (ii), (iii) and (iv) of paragraph (k) of subdivision 1  as
    2  amended  by  section  35  of  part  A  of section 1 of the laws of 2002,
    3  subparagraphs (iii) and (iv)  of  paragraph  (o)  of  subdivision  1  as
    4  amended  by section 34 of part A of chapter 1 of the laws of 2002, para-
    5  graph (u) of subdivision 1 as added by section 6 of part A of chapter  1
    6  of  the laws of 2002, paragraph (w) of subdivision 1 as added by section
    7  60 of part A of chapter 1 of the laws of 2002, paragraph (x) of subdivi-
    8  sion 1 as added by section 2 of part A of chapter 1 of the laws of 2002,
    9  paragraphs (z), (aa) and (cc) of subdivision 1 as added by section 2  of
   10  part A of chapter 1 of the laws of 2002, paragraph (ee) of subdivision 1
   11  as  added  by  section  7-b  of part A of chapter 1 of the laws of 2002,
   12  paragraph (ff) of subdivision 1 as added by section  69  of  part  A  of
   13  chapter  1 of the laws of 2002, paragraph (gg) of subdivision 1 as added
   14  by section 1-a of part A of chapter 1 of the  laws  of  2002,  paragraph
   15  (hh)  of  subdivision 1 as added by section 26 of part A of chapter 1 of
   16  the laws of 2002, subdivision 4 as amended by section 23 of  part  A  of
   17  chapter  1  of  the laws of 2002, and the opening paragraph of paragraph
   18  (o) of subdivision 1 as amended by chapter 13 of the laws  of  2000,  is
   19  amended to read as follows:
   20     §  2807-v.  Tobacco  control  and  insurance initiatives pool distrib-
   21  utions.   1. Funds accumulated in  the  tobacco  control  and  insurance
   22  initiatives  pool,  including  income  from  invested  funds,  shall  be
   23  distributed or retained by  the  commissioner  in  accordance  with  the
   24  following:
   25    (a)  Funds  shall  be  deposited  by  the commissioner, within amounts
   26  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   27  directed  to  receive  for  deposit  to  the credit of the state special
   28  revenue funds - other, HCRA transfer fund, medicaid  fraud  hotline  and
   29  medicaid  administration  account, for purposes of services and expenses
   30  related to the toll-free medicaid fraud hotline established pursuant  to
   31  section one hundred eight of chapter one of the laws of nineteen hundred
   32  ninety-nine  from  the  tobacco  control  and insurance initiatives pool
   33  established for the following periods in  the  following  amounts:  four
   34  hundred  thousand  dollars  annually  for the periods January first, two
   35  thousand through December  thirty-first,  two  thousand  two,  [and  two
   36  hundred  thousand]  up  to  four hundred thousand dollars for the period
   37  January first, two thousand three  through  [June  thirtieth,]  December
   38  thirty-first,  two  thousand  three, up to four hundred thousand dollars
   39  for the period January first, two thousand four through  December  thir-
   40  ty-first,  two thousand four, and up to two hundred thousand dollars for
   41  the period January first, two thousand five through June thirtieth,  two
   42  thousand five.
   43    (b)  Funds  shall be reserved and accumulated from year to year by the
   44  commissioner and shall be  available,  including  income  from  invested
   45  funds, for purposes of payment of audits or audit contracts necessary to
   46  determine  payor  and provider compliance with requirements set forth in
   47  sections twenty-eight hundred seven-j, twenty-eight hundred seven-s  and
   48  twenty-eight  hundred  seven-t  of  this article and hospital compliance
   49  with paragraph six of subdivision (a) of section 405.4 of  title  10  of
   50  the official compilation of codes, rules and regulations of the state of
   51  New  York  in  accordance  with subdivision nine of section twenty-eight
   52  hundred three of this article from the  tobacco  control  and  insurance
   53  initiatives  pool established for the following periods in the following
   54  amounts: five million six hundred  thousand  dollars  annually  for  the
   55  periods  January  first, two thousand through December thirty-first, two
   56  thousand two, [and two] up  to  five  million  [five  hundred  thousand]
       S. 1408                            87                            A. 2108
 
    1  dollars  for  the period January first, two thousand three through [June
    2  thirtieth,] December  thirty-first,  two  thousand  three,  up  to  five
    3  million  dollars for the period January first, two thousand four through
    4  December  thirty-first,  two  thousand  four, and up to two million five
    5  hundred thousand dollars for the period January first, two thousand five
    6  through June thirtieth, two thousand five.
    7    (c) Funds shall be  deposited  by  the  commissioner,  within  amounts
    8  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    9  directed to receive for deposit to  the  credit  of  the  state  special
   10  revenue  funds  - other, HCRA transfer fund, enhanced community services
   11  account,  for  mental  health  services  programs  for  case  management
   12  services  for adults and children; supported housing; home and community
   13  based waiver services; family based treatment; family support  services;
   14  mobile  mental  health  teams; transitional housing; and community over-
   15  sight, established pursuant to  articles  seven  and  forty-one  of  the
   16  mental  hygiene law and subdivision nine of section three hundred sixty-
   17  six of the social services law from the tobacco  control  and  insurance
   18  initiatives  pool established for the following periods in the following
   19  amounts:
   20    (i) forty-eight million dollars to be reserved, to be retained or  for
   21  distribution  pursuant to a chapter of the laws of two thousand, for the
   22  period January first, two thousand through  December  thirty-first,  two
   23  thousand; [and]
   24    (ii)  eighty-seven  million  dollars to be reserved, to be retained or
   25  for distribution pursuant to a chapter of the laws of two thousand  one,
   26  for  the period January first, two thousand one through December thirty-
   27  first, two thousand one;
   28    (iii) eighty-seven million dollars to be reserved, to be  retained  or
   29  for  distribution pursuant to a chapter of the laws of two thousand two,
   30  for the period January first, two thousand two through December  thirty-
   31  first, two thousand two;
   32    (iv) [forty-four million] eighty-eight million dollars to be reserved,
   33  to  be retained or for distribution pursuant to a chapter of the laws of
   34  two thousand three, for the period January  first,  two  thousand  three
   35  through [June thirtieth,] December thirty-first, two thousand three;
   36    (v) eighty-eight million dollars to be reserved, to be retained or for
   37  distribution pursuant to a chapter of the laws of two thousand four, for
   38  the  period  January  first,  two thousand four through December thirty-
   39  first, two thousand four; and
   40    (vi) forty-four million dollars to be reserved, to be retained or  for
   41  distribution pursuant to a chapter of the laws of two thousand five, for
   42  the  period January first, two thousand five through June thirtieth, two
   43  thousand five.
   44    (d) Funds shall be  deposited  by  the  commissioner,  within  amounts
   45  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   46  directed to receive for deposit to  the  credit  of  the  state  special
   47  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   48  for purposes of funding the state share of services and expenses related
   49  to the family health plus program  including  up  to  two  and  one-half
   50  million  dollars  annually  for  the  period January first, two thousand
   51  through December thirty-first, two thousand two, [and  one  million  two
   52  hundred  fifty  thousand dollars for the period January first, two thou-
   53  sand three through June thirtieth,  two  thousand  three]  for  adminis-
   54  tration  and  marketing  costs  associated with such program established
   55  pursuant to clause (A) of subparagraph (v) of paragraph (a) of  subdivi-
   56  sion  two  of section three hundred sixty-nine-ee of the social services
       S. 1408                            88                            A. 2108
 
    1  law from the tobacco control and insurance initiatives pool  established
    2  for the following periods in the following amounts:
    3    (i) three million five hundred thousand dollars for the period January
    4  first, two thousand through December thirty-first, two thousand;
    5    (ii)  twenty-seven  million  dollars for the period January first, two
    6  thousand one through December thirty-first, two thousand one; and
    7    (iii) fifty-seven million dollars for the period  January  first,  two
    8  thousand two through December thirty-first, two thousand two[; and
    9    (iv)  forty-three  million  dollars  for the period January first, two
   10  thousand three through June thirtieth, two thousand three].
   11    (e) Funds shall be  deposited  by  the  commissioner,  within  amounts
   12  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   13  directed to receive for deposit to  the  credit  of  the  state  special
   14  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   15  for purposes of funding the state share of services and expenses related
   16  to the family health plus program  including  up  to  two  and  one-half
   17  million  dollars  annually  for  the  period January first, two thousand
   18  through December thirty-first, two thousand two  [and  one  million  two
   19  hundred  fifty  thousand dollars for the period January first, two thou-
   20  sand three through June thirtieth,  two  thousand  three]  for  adminis-
   21  tration  and  marketing  costs  associated with such program established
   22  pursuant to clause (B) of subparagraph (v) of paragraph (a) of  subdivi-
   23  sion  two  of section three hundred sixty-nine-ee of the social services
   24  law from the tobacco control and insurance initiatives pool  established
   25  for the following periods in the following amounts:
   26    (i)  two  million five hundred thousand dollars for the period January
   27  first, two thousand through December thirty-first, two thousand;
   28    (ii) thirty million five hundred thousand dollars for the period Janu-
   29  ary first, two thousand one through December thirty-first, two  thousand
   30  one; and
   31    (iii)  sixty-six  million  dollars  for  the period January first, two
   32  thousand two through December thirty-first, two thousand two[; and
   33    (iv) forty-four million dollars for  the  period  January  first,  two
   34  thousand three through June thirtieth, two thousand three].
   35    (f)  Funds  shall  be  deposited  by  the commissioner, within amounts
   36  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   37  directed  to  receive  for  deposit  to  the credit of the state special
   38  revenue funds - other, HCRA transfer fund, medicaid  fraud  hotline  and
   39  medicaid  administration account, for purposes of payment of administra-
   40  tive expenses of the  department  related  to  the  family  health  plus
   41  program  established  pursuant to section three hundred sixty-nine-ee of
   42  the social services law from the tobacco control  and  insurance  initi-
   43  atives  pool  established  for  the  following  periods in the following
   44  amounts: five hundred thousand dollars on an annual basis for the  peri-
   45  ods January first, two thousand through December thirty-first, two thou-
   46  sand  [two]  four, and two hundred fifty thousand dollars for the period
   47  January first, two thousand [three] five  through  June  thirtieth,  two
   48  thousand [three] five.
   49    (g)  Funds  shall be reserved and accumulated from year to year by the
   50  commissioner and shall be  available,  including  income  from  invested
   51  funds,  contingent upon meeting all funding amounts established pursuant
   52  to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
   53  and (s) of this  subdivision,  paragraph  (a)  of  subdivision  nine  of
   54  section  twenty-eight  hundred  seven-j  of this article, and paragraphs
   55  (a), (i) and (k) of subdivision  one  of  section  twenty-eight  hundred
   56  seven-l of this article for purposes of services and expenses related to
       S. 1408                            89                            A. 2108
 
    1  the  health  maintenance  organization  direct pay market program estab-
    2  lished pursuant to sections forty-three hundred twenty-one-a and  forty-
    3  three hundred twenty-two-a of the insurance law from the tobacco control
    4  and  insurance initiatives pool established for the following periods in
    5  the following amounts:
    6    (i) up to thirty-five million dollars for the  period  January  first,
    7  two  thousand through December thirty-first, two thousand of which fifty
    8  percentum shall be allocated to the program  pursuant  to  section  four
    9  thousand  three  hundred  twenty-one-a  of  the  insurance law and fifty
   10  percentum to the program pursuant to section four thousand three hundred
   11  twenty-two-a of the insurance law;
   12    (ii) up to thirty-six million dollars for the  period  January  first,
   13  two  thousand  one  through  December  thirty-first, two thousand one of
   14  which fifty percentum shall be allocated  to  the  program  pursuant  to
   15  section  four  thousand  three hundred twenty-one-a of the insurance law
   16  and fifty percentum to the program pursuant  to  section  four  thousand
   17  three hundred twenty-two-a of the insurance law;
   18    (iii)  up to thirty-nine million dollars for the period January first,
   19  two thousand two through December  thirty-first,  two  thousand  two  of
   20  which  fifty  percentum  shall  be  allocated to the program pursuant to
   21  section four thousand three hundred twenty-one-a of  the  insurance  law
   22  and  fifty  percentum  to  the program pursuant to section four thousand
   23  three hundred twenty-two-a of the insurance law; [and]
   24    (iv) up to [twenty] forty  million  dollars  for  the  period  January
   25  first,  two  thousand  three  through [June thirtieth,] December thirty-
   26  first, two thousand three of which fifty percentum shall be allocated to
   27  the program pursuant to section four thousand three hundred twenty-one-a
   28  of the insurance law and fifty percentum  to  the  program  pursuant  to
   29  section four thousand three hundred twenty-two-a of the insurance law;
   30    (v)  up  to  forty  million  dollars for the period January first, two
   31  thousand four through December thirty-first, two thousand four of  which
   32  fifty  percentum  shall  be allocated to the program pursuant to section
   33  four thousand three hundred twenty-one-a of the insurance law and  fifty
   34  percentum to the program pursuant to section four thousand three hundred
   35  twenty-two-a of the insurance law; and
   36    (vi)  up  to  twenty million dollars for the period January first, two
   37  thousand five through June thirtieth, two thousand five of  which  fifty
   38  percentum  shall  be  allocated  to the program pursuant to section four
   39  thousand three hundred twenty-one-a  of  the  insurance  law  and  fifty
   40  percentum to the program pursuant to section four thousand three hundred
   41  twenty-two-a of the insurance law.
   42    (h)  Funds  shall be reserved and accumulated from year to year by the
   43  commissioner and shall be  available,  including  income  from  invested
   44  funds,  contingent upon meeting all funding amounts established pursuant
   45  to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
   46  and (s) of this  subdivision,  paragraph  (a)  of  subdivision  nine  of
   47  section  twenty-eight  hundred  seven-j  of this article, and paragraphs
   48  (a), (i) and (k) of subdivision  one  of  section  twenty-eight  hundred
   49  seven-l of this article for purposes of services and expenses related to
   50  the healthy New York individual program established pursuant to sections
   51  [forty-three]  four  thousand three hundred twenty-six and [forty-three]
   52  four thousand three hundred twenty-seven of the insurance law  from  the
   53  tobacco  control  and  insurance  initiatives  pool  established for the
   54  following periods in the following amounts:
   55    (i) up to six million dollars for the period January first, two  thou-
   56  sand one through December thirty-first, two thousand one;
       S. 1408                            90                            A. 2108
 
    1    (ii)  up  to twenty-nine million dollars for the period January first,
    2  two thousand two through December thirty-first, two thousand two; [and]
    3    (iii)  up  to  [twenty-one]  twenty-nine million four hundred thousand
    4  dollars for the period January first, two thousand three  through  [June
    5  thirtieth,] December thirty-first, two thousand three[.];
    6    (iv)  up  to  twenty-four million six hundred thousand dollars for the
    7  period January first, two thousand four through  December  thirty-first,
    8  two thousand four; and
    9    (v) up to twenty-two million dollars for the period January first, two
   10  thousand five through June thirtieth, two thousand five.
   11    (i)  Funds  shall be reserved and accumulated from year to year by the
   12  commissioner and shall be  available,  including  income  from  invested
   13  funds,  contingent upon meeting all funding amounts established pursuant
   14  to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
   15  and (s) of this  subdivision,  paragraph  (a)  of  subdivision  nine  of
   16  section  twenty-eight  hundred  seven-j  of this article, and paragraphs
   17  (a), (i) and (k) of subdivision  one  of  section  twenty-eight  hundred
   18  seven-l of this article for purposes of services and expenses related to
   19  the  healthy  New  York  group  program established pursuant to sections
   20  [forty-three] four thousand three hundred twenty-six  and  [forty-three]
   21  four  thousand  three hundred twenty-seven of the insurance law from the
   22  tobacco control and  insurance  initiatives  pool  established  for  the
   23  following periods in the following amounts:
   24    (i)  up  to  thirty-four million dollars for the period January first,
   25  two thousand one through December thirty-first, two thousand one;
   26    (ii) up to seventy-seven million dollars for the period January first,
   27  two thousand two through December thirty-first, two thousand two; [and]
   28    (iii) up to [fifty-two] sixty million four  hundred  thousand  dollars
   29  for  the  period January first, two thousand three through [June thirti-
   30  eth,] December thirty-first, two thousand three;
   31    (iv) up to twenty-four million six hundred thousand  dollars  for  the
   32  period  January  first, two thousand four through December thirty-first,
   33  two thousand four; and
   34    (v) up to twenty-two million dollars for the period January first, two
   35  thousand five through June thirtieth, two thousand five.
   36    (j) Funds shall be reserved and accumulated from year to year  by  the
   37  commissioner  and  shall  be  available,  including income from invested
   38  funds, contingent upon meeting all funding amounts established  pursuant
   39  to paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
   40  and  (s)  of  this  subdivision,  paragraph  (a)  of subdivision nine of
   41  section twenty-eight hundred seven-j of  this  article,  and  paragraphs
   42  (a),  (i)  and  (k)  of  subdivision one of section twenty-eight hundred
   43  seven-l of this article for purposes of services and expenses related to
   44  the tobacco use prevention and control program established  pursuant  to
   45  sections  thirteen  hundred  ninety-nine-ii and thirteen hundred ninety-
   46  nine-jj of this chapter, from the tobacco control and  insurance  initi-
   47  atives  pool  established  for  the  following  periods in the following
   48  amounts:
   49    (i) up to thirty million dollars for the  period  January  first,  two
   50  thousand through December thirty-first, two thousand;
   51    (ii)  up  to  forty  million dollars for the period January first, two
   52  thousand one through December thirty-first, two thousand one;
   53    (iii) up to forty million dollars for the period  January  first,  two
   54  thousand two through December thirty-first, two thousand two; [and]
       S. 1408                            91                            A. 2108
 
    1    (iv) up to [twenty million] thirty-three million dollars for the peri-
    2  od  January first, two thousand three through [June thirtieth,] December
    3  thirty-first, two thousand three;
    4    (v)  up  to thirty-three million dollars for the period January first,
    5  two thousand four through December thirty-first, two thousand four; and
    6    (vi) up to eighteen million three hundred  thousand  dollars  for  the
    7  period  January  first,  two  thousand  five through June thirtieth, two
    8  thousand five.
    9    (k) Funds shall be  deposited  by  the  commissioner,  within  amounts
   10  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   11  directed to receive for deposit to  the  credit  of  the  state  special
   12  revenue  fund - other, HCRA transfer fund, health care services account,
   13  contingent upon meeting all  funding  amounts  established  pursuant  to
   14  paragraphs  (a),  (b),  (c), (d), (e), (f), (l), (m), (n), (p), (q), (r)
   15  and (s) of this  subdivision,  paragraph  (a)  of  subdivision  nine  of
   16  section  twenty-eight  hundred  seven-j  of this article, and paragraphs
   17  (a), (i) and (k) of subdivision  one  of  section  twenty-eight  hundred
   18  seven-l of this article for purposes of services and expenses related to
   19  public  health  programs  from  the tobacco control and insurance initi-
   20  atives pool established for  the  following  periods  in  the  following
   21  amounts;
   22    (i) up to thirty-one million dollars for the period January first, two
   23  thousand through December thirty-first, two thousand;
   24    (ii) up to forty-one million dollars for the period January first, two
   25  thousand one through December thirty-first, two thousand one;
   26    (iii)  up  to eighty-one million dollars for the period January first,
   27  two thousand two through December thirty-first, two thousand two; [and]
   28    (iv) [up to sixty-five] one hundred twenty-two  million  five  hundred
   29  thousand  dollars  for  the  period  January  first,  two thousand three
   30  through [June thirtieth,] December thirty-first, two thousand three;
   31    (v) eighty-one million five hundred thousand dollars  for  the  period
   32  January  first,  two  thousand  four  through December thirty-first, two
   33  thousand four; and
   34    (vi) thirty-five million four hundred thousand dollars for the  period
   35  January  first,  two  thousand five through June thirtieth, two thousand
   36  five.
   37    (l) Funds shall be  deposited  by  the  commissioner,  within  amounts
   38  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   39  directed to receive for deposit to  the  credit  of  the  state  special
   40  revenue  funds  -  other, HCRA transfer fund, medical assistance account
   41  for purposes of funding the state share of the personal care and  certi-
   42  fied  home  health  agency rate or fee increases established pursuant to
   43  subdivision three of section three hundred sixty-seven-o of  the  social
   44  services  law  from  the  tobacco control and insurance initiatives pool
   45  established for the following periods in the following amounts:
   46    (i) twenty-three million two hundred thousand dollars for  the  period
   47  January first, two thousand through December thirty-first, two thousand;
   48    (ii)  twenty-three million two hundred thousand dollars for the period
   49  January first, two thousand one through December thirty-first, two thou-
   50  sand one;
   51    (iii) twenty-three million two hundred thousand dollars for the period
   52  January first, two thousand two through December thirty-first, two thou-
   53  sand two; [and]
   54    (iv) [twelve] up to twenty-three million two hundred thousand  dollars
   55  for  the  period January first, two thousand three through [June thirti-
   56  eth,] December thirty-first two thousand three;
       S. 1408                            92                            A. 2108
 
    1    (v) up to twenty-three million two hundred thousand  dollars  for  the
    2  period  January  first, two thousand four through December thirty-first,
    3  two thousand four; and
    4    (vi)  up  to  twelve million dollars for the period January first, two
    5  thousand five through June thirtieth, two thousand five.
    6    (m) Funds shall be  deposited  by  the  commissioner,  within  amounts
    7  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    8  directed to receive for deposit to  the  credit  of  the  state  special
    9  revenue  funds  -  other, HCRA transfer fund, medical assistance account
   10  for purposes of funding the state share of services and expenses related
   11  to home care workers insurance pilot demonstration programs  established
   12  pursuant  to  subdivision  two of section three hundred sixty-seven-o of
   13  the social services law from the tobacco control  and  insurance  initi-
   14  atives  pool  established  for  the  following  periods in the following
   15  amounts:
   16    (i) three million eight hundred thousand dollars for the period  Janu-
   17  ary first, two thousand through December thirty-first, two thousand;
   18    (ii) three million eight hundred thousand dollars for the period Janu-
   19  ary  first, two thousand one through December thirty-first, two thousand
   20  one;
   21    (iii) three million eight hundred  thousand  dollars  for  the  period
   22  January first, two thousand two through December thirty-first, two thou-
   23  sand two; [and]
   24    (iv)  [two] up to three million eight hundred thousand dollars for the
   25  period January first,  two  thousand  three  through  [June  thirtieth,]
   26  December thirty-first, two thousand three[.];
   27    (v)  up to three million eight hundred thousand dollars for the period
   28  January first, two thousand  four  through  December  thirty-first,  two
   29  thousand four; and
   30    (vi) up to two million dollars for the period January first, two thou-
   31  sand five through June thirtieth, two thousand five.
   32    (n) Funds shall be transferred by the commissioner and shall be depos-
   33  ited  to  the credit of the special revenue funds - other, miscellaneous
   34  special revenue fund - 339, elderly  pharmaceutical  insurance  coverage
   35  program premium account authorized pursuant to the provisions of article
   36  nineteen-K  of  the executive law for funding state expenses relating to
   37  the program from the tobacco  control  and  insurance  initiatives  pool
   38  established for the following periods in the following amounts:
   39    (i)  one  hundred  seven million dollars for the period January first,
   40  two thousand through December thirty-first, two thousand;
   41    (ii) one hundred sixty-four million dollars  for  the  period  January
   42  first, two thousand one through December thirty-first, two thousand one;
   43    (iii)  three hundred twenty-two million seven hundred thousand dollars
   44  for the period January first, two thousand two through December  thirty-
   45  first, two thousand two; [and]
   46    (iv)  [two  hundred  sixteen million] four hundred twenty million nine
   47  hundred thousand dollars for the  period  January  first,  two  thousand
   48  three  through  [June  thirtieth,]  December  thirty-first, two thousand
   49  three;
   50    (v) four hundred thirty-three million seven hundred  thousand  dollars
   51  for  the  period January first, two thousand four through December thir-
   52  ty-first, two thousand four; and
   53    (vi) two hundred thirty-eight million three hundred  thousand  dollars
   54  for  the period January first, two thousand five through June thirtieth,
   55  two thousand five.
       S. 1408                            93                            A. 2108
 
    1    (o) Funds shall  be  reserved  and  accumulated  by  the  commissioner
    2  contingent  upon  meeting  all  funding  amounts established pursuant to
    3  paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n),  (p),  (q),  (r)
    4  and  (s)  of  this  subdivision,  paragraph  (a)  of subdivision nine of
    5  section  twenty-eight  hundred  seven-j  of this article, and paragraphs
    6  (a), (i) and (k) of subdivision  one  of  section  twenty-eight  hundred
    7  seven-l  of  this  article  and shall be transferred to the Roswell Park
    8  Cancer Institute Corporation, from the  tobacco  control  and  insurance
    9  initiatives  pool established for the following periods in the following
   10  amounts:
   11    (i) up to ninety million dollars for the  period  January  first,  two
   12  thousand through December thirty-first, two thousand;
   13    (ii)  up  to  sixty  million dollars for the period January first, two
   14  thousand one through December thirty-first, two thousand one;
   15    (iii) up to eighty-five million dollars for the period January  first,
   16  two thousand two through December thirty-first, two thousand two; [and]
   17    (iv)  [up  to  forty-three]  eighty-two  million five hundred thousand
   18  dollars for the period January first, two thousand three  through  [June
   19  thirtieth,] December thirty-first, two thousand three;
   20    (v)  eighty million dollars for the period January first, two thousand
   21  four through December thirty-first, two thousand four; and
   22    (vi) forty million dollars for the period January first, two  thousand
   23  five through June thirtieth, two thousand five.
   24    (p)  Funds  shall  be  deposited  by  the commissioner, within amounts
   25  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   26  directed  to  receive  for  deposit  to  the credit of the state special
   27  revenue funds - other, indigent care fund - 068, indigent care  account,
   28  contingent  upon  meeting  all  funding  amounts established pursuant to
   29  paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n), (q) and  (r)  of
   30  this  subdivision  and paragraph (a) of subdivision one of section twen-
   31  ty-eight hundred seven-l of this article for  purposes  of  providing  a
   32  medicaid disproportionate share payment from the high need indigent care
   33  adjustment  pool  established  pursuant  to section twenty-eight hundred
   34  seven-w of this article, from the tobacco control and  insurance  initi-
   35  atives  pool  established  for  the  following  periods in the following
   36  amounts:
   37    (i) eighty-two million dollars annually for the periods January first,
   38  two thousand through December thirty-first, two thousand two; [and]
   39    (ii) [forty-one] up to eighty-two million dollars for the period Janu-
   40  ary first, two thousand three through [June thirtieth,]  December  thir-
   41  ty-first, two thousand three;
   42    (iii)  up  to eighty-two million dollars for the period January first,
   43  two thousand four through December thirty-first, two thousand four; and
   44    (iv) up to forty-one million dollars for the period January first, two
   45  thousand five through June thirtieth, two thousand five.
   46    (q) Funds shall be reserved and accumulated from year to year  by  the
   47  commissioner  and  shall  be  available,  including income from invested
   48  funds, for purposes of providing distributions to eligible school  based
   49  health  centers established pursuant to [the] chapter one of the laws of
   50  nineteen hundred ninety-nine which enacted  the  New  York  Health  Care
   51  Reform  Act  of 2000, from the tobacco control and insurance initiatives
   52  pool established for the following periods in the following amounts:
   53    (i) seven million dollars annually for the period January  first,  two
   54  thousand through December thirty-first, two thousand two; [and]
       S. 1408                            94                            A. 2108
 
    1    (ii)  [three] up to seven million [five hundred thousand]  dollars for
    2  the period January first, two thousand three through  [June  thirtieth,]
    3  December thirty-first, two thousand three;
    4    (iii)  up  to  seven million dollars for the period January first, two
    5  thousand four through December thirty-first, two thousand four; and
    6    (iv) up to three million five hundred thousand dollars for the  period
    7  January  first,  two  thousand five through June thirtieth, two thousand
    8  five.
    9    (r) Funds shall be deposited by the commissioner within amounts appro-
   10  priated, and the state comptroller is hereby authorized and directed  to
   11  receive  for  deposit to the credit of the state special revenue funds -
   12  other, HCRA transfer fund, medical assistance account, for  purposes  of
   13  providing distributions for supplementary medical insurance for Medicare
   14  part  B  premiums,  physicians  services,  outpatient  services, medical
   15  equipment, supplies and other health services, from the tobacco  control
   16  and  insurance initiatives pool established for the following periods in
   17  the following amounts:
   18    (i) forty-three million dollars for  the  period  January  first,  two
   19  thousand through December thirty-first, two thousand;
   20    (ii) sixty-one million dollars for the period January first, two thou-
   21  sand one through December thirty-first, two thousand one;
   22    (iii)  sixty-five  million  dollars  for the period January first, two
   23  thousand two through December thirty-first, two thousand two; [and]
   24    (iv) [thirty-four] sixty-seven million five hundred  thousand  dollars
   25  for  the  period January first, two thousand three through [June thirti-
   26  eth,] December thirty-first, two thousand three;
   27    (v) sixty-eight million dollars for  the  period  January  first,  two
   28  thousand four through December thirty-first, two thousand four; and
   29    (vi)  thirty-four  million  dollars  for the period January first, two
   30  thousand five through June thirtieth, two thousand five.
   31    (s) Funds shall be deposited by the commissioner within amounts appro-
   32  priated, and the state comptroller is hereby authorized and directed  to
   33  receive  for  deposit to the credit of the state special revenue funds -
   34  other, HCRA transfer fund, medical assistance account,  contingent  upon
   35  meeting all funding amounts established pursuant to paragraphs (a), (b),
   36  (c), (d), (e), (f), (l), (m), (n), (q), and (r) of this subdivision, and
   37  paragraph (a) of subdivision one of section twenty-eight hundred seven-l
   38  of  this  article,  for  purposes of providing distributions pursuant to
   39  paragraph (s-5) of subdivision eleven of  section  twenty-eight  hundred
   40  seven-c  of  this  article from the tobacco control and insurance initi-
   41  atives pool established for  the  following  periods  in  the  following
   42  amounts:
   43    (i)  eighteen  million dollars for the period January first, two thou-
   44  sand through December thirty-first, two thousand;
   45    (ii) twenty-four million dollars  annually  for  the  periods  January
   46  first, two thousand one through December thirty-first, two thousand two;
   47  [and]
   48    (iii)  [six]  up to twenty-four million dollars for the period January
   49  first, two thousand three through  [March]  December  thirty-first,  two
   50  thousand three;
   51    (iv)  up  to twenty-four million dollars for the period January first,
   52  two thousand four through December thirty-first, two thousand four; and
   53    (v) up to six million dollars for the period January first, two  thou-
   54  sand five through June thirtieth, two thousand five.
       S. 1408                            95                            A. 2108
 
    1    (t)  Funds  shall be reserved and accumulated from year to year by the
    2  commissioner and shall be made available, including income from invested
    3  funds:
    4    (i)  For  the  purpose  of making grants to a state owned and operated
    5  medical school which does not have a state owned and  operated  hospital
    6  on  site  and  available for teaching purposes. Notwithstanding sections
    7  one hundred twelve and one hundred sixty-three of the state finance law,
    8  such grants shall be made in the amount of up to five  hundred  thousand
    9  dollars  for  the  period  January  first, two thousand through December
   10  thirty-first, two thousand;
   11    (ii) For the purpose of making grants to medical schools  pursuant  to
   12  section  eighty-six-a  of  chapter  one  of the laws of nineteen hundred
   13  ninety-nine in the sum of up to four  million  dollars  for  the  period
   14  January first, two thousand through December thirty-first, two thousand;
   15  and
   16    (iii)  The  funds  disbursed pursuant to subparagraphs (i) and (ii) of
   17  this paragraph from the tobacco control and insurance  initiatives  pool
   18  are  contingent upon meeting all funding amounts established pursuant to
   19  paragraphs (a), (b), (c), (d), (e), (f), (l), (m), (n),  (p),  (q),  (r)
   20  and  (s)  of  this  subdivision,  paragraph  (a)  of subdivision nine of
   21  section twenty-eight hundred seven-j of  this  article,  and  paragraphs
   22  (a),  (i)  and  (k)  of  subdivision one of section twenty-eight hundred
   23  seven-l of this article.
   24    (u) Funds shall be  deposited  by  the  commissioner,  within  amounts
   25  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   26  directed to receive for deposit to  the  credit  of  the  state  special
   27  revenue  funds  -  other, HCRA transfer fund, medical assistance account
   28  for purposes of funding the state share of services and expenses related
   29  to the nursing home quality  improvement  demonstration  program  estab-
   30  lished  pursuant to section twenty-eight hundred eight-d of this article
   31  from the tobacco control and insurance initiatives pool established  for
   32  the following periods in the following amounts:
   33    (i)  up  to twenty-five million dollars for the period beginning April
   34  first, two thousand two and ending December thirty-first,  two  thousand
   35  two,  and  on  an  annualized  basis,  for each annual period thereafter
   36  beginning January first, two thousand three and ending December  thirty-
   37  first, two thousand four, and up to twelve million five hundred thousand
   38  dollars  for  the  period  January first, two thousand five through June
   39  thirtieth, two thousand five.
   40    (v) Funds shall be transferred by the commissioner and shall be depos-
   41  ited to the credit of the hospital excess liability pool created  pursu-
   42  ant  to section eighteen of chapter two hundred sixty-six of the laws of
   43  nineteen hundred eighty-six for purposes  of  expenses  related  to  the
   44  purchase  of excess medical malpractice insurance and the cost of admin-
   45  istrating the pool, including costs associated with the risk  management
   46  program  established  pursuant to section forty-two of part A of chapter
   47  one of the laws of two thousand two required by paragraph (a) of  subdi-
   48  vision  one  of section eighteen of chapter two hundred sixty-six of the
   49  laws of nineteen hundred eighty-six as may be amended from time to time,
   50  from the tobacco control and insurance initiatives pool established  for
   51  the following periods in the following amounts:
   52    (i) up to fifty million dollars or so much as is needed for the period
   53  January first, two thousand two through December thirty-first, two thou-
   54  sand two; [and]
   55    (ii)  up  to [twenty-eight] seventy-six million seven hundred thousand
   56  dollars [or so much as is needed] for  the  period  January  first,  two
       S. 1408                            96                            A. 2108
 
    1  thousand  three  through  [June  thirtieth,]  December thirty-first, two
    2  thousand three;
    3    (iii)  up  to sixty-five million dollars for the period January first,
    4  two thousand four through December thirty-first, two thousand four; and
    5    (iv) up to thirty-two million five hundred thousand  dollars  for  the
    6  period  January  first,  two  thousand  five through June thirtieth, two
    7  thousand five.
    8    (w) Funds shall be  deposited  by  the  commissioner,  within  amounts
    9  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   10  directed to receive for deposit to  the  credit  of  the  state  special
   11  revenue  funds  -  other, HCRA transfer fund, medical assistance account
   12  for purposes of funding the state share of the treatment of  breast  and
   13  cervical cancer pursuant to paragraph (v) of subdivision four of section
   14  three  hundred  sixty-six  of  the social services law, from the tobacco
   15  control and insurance initiatives pool  established  for  the  following
   16  periods in the following amounts:
   17    (i)  up  to four hundred fifty thousand dollars for the period January
   18  first, two thousand two through December thirty-first, two thousand two;
   19  [and]
   20    (ii) up to [one] two million [fifty] one hundred thousand dollars  for
   21  the  period January first, two thousand three through [June thirtieth,]
   22  December thirty-first two thousand three;
   23    (iii) up to two million one hundred thousand dollars  for  the  period
   24  January  first,  two  thousand  four  through December thirty-first, two
   25  thousand four; and
   26    (iv) up to one million one hundred thousand  dollars  for  the  period
   27  January  first,  two  thousand five through June thirtieth, two thousand
   28  five.
   29    (x) Funds shall be  deposited  by  the  commissioner,  within  amounts
   30  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   31  directed to receive for deposit to  the  credit  of  the  state  special
   32  revenue  funds  -  other, HCRA transfer fund, medical assistance account
   33  for purposes of funding the state share of the non-public general hospi-
   34  tal rates increases for recruitment and retention of health care workers
   35  pursuant to paragraph (a) of subdivision thirty and subdivision  thirty-
   36  one  of  section  twenty-eight  hundred seven-c of this article from the
   37  tobacco control and  insurance  initiatives  pool  established  for  the
   38  following periods in the following amounts:
   39    (i) twenty-seven million one hundred thousand dollars on an annualized
   40  basis  for  the  period January first, two thousand two through December
   41  thirty-first, two thousand two;
   42    (ii) [fifty] thirty-two million [eight] five hundred thousand  dollars
   43  on  an annualized basis for the period January first, two thousand three
   44  through December thirty-first, two thousand three; [and]
   45    (iii) [sixty-nine] thirty-six million  [three]  one  hundred  thousand
   46  dollars  on  an annualized basis for the period January first, two thou-
   47  sand four through December thirty-first, two thousand four; and
   48     (iv) eighteen million one hundred thousand  dollars  for  the  period
   49  January  first,  two  thousand five through June thirtieth, two thousand
   50  five.
   51    (y) Funds shall be reserved and accumulated from year to year  by  the
   52  commissioner  and  shall  be  available,  including income from invested
   53  funds, for purposes of grants to public general hospitals  for  recruit-
   54  ment  and  retention of health care workers pursuant to paragraph (b) of
   55  subdivision thirty of section twenty-eight hundred seven-c of this arti-
       S. 1408                            97                            A. 2108
 
    1  cle from the tobacco control and insurance initiatives pool  established
    2  for the following periods in the following amounts:
    3    (i)  eighteen  million  five hundred thousand dollars on an annualized
    4  basis for the period January first, two thousand  two  through  December
    5  thirty-first, two thousand two;
    6    (ii)  thirty-seven million four hundred thousand dollars on an annual-
    7  ized basis for the period January  first,  two  thousand  three  through
    8  December thirty-first, two thousand three; [and]
    9    (iii)  fifty-two million two hundred thousand dollars on an annualized
   10  basis for the period January first, two thousand four  through  December
   11  thirty-first, two thousand four;
   12    (iv)  twenty-six  million  one hundred thousand dollars for the period
   13  January first, two thousand five through June  thirtieth,  two  thousand
   14  five;
   15    (v)  provided,  however,  amounts  pursuant  to  this paragraph may be
   16  reduced by the commissioner in an amount to be approved by the  director
   17  of  the  budget  to reflect amounts received from the federal government
   18  under the state's 1115 waiver which are directed  under  its  terms  and
   19  conditions to the health workforce recruitment and retention program.
   20    (z)  Funds  shall  be  deposited  by  the commissioner, within amounts
   21  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   22  directed  to  receive  for  deposit  to  the credit of the state special
   23  revenue funds - other, HCRA transfer fund,  medical  assistance  account
   24  for  purposes  of  funding the state share of the non-public residential
   25  health care facility rate increases for  recruitment  and  retention  of
   26  health care workers pursuant to paragraph (a) of subdivision eighteen of
   27  section  twenty-eight  hundred  eight  of  this article from the tobacco
   28  control and insurance initiatives pool  established  for  the  following
   29  periods in the following amounts:
   30    (i)  twenty-one million five hundred thousand dollars on an annualized
   31  basis for the period January first, two thousand  two  through  December
   32  thirty-first, two thousand two;
   33    (ii) thirty-three million three hundred thousand dollars on an annual-
   34  ized  basis  for  the  period  January first, two thousand three through
   35  December thirty-first, two thousand three; [and]
   36    (iii) forty-six million three hundred thousand dollars on  an  annual-
   37  ized  basis  for  the  period  January  first, two thousand four through
   38  December thirty-first, two thousand four; and
   39    (iv) twenty-three million two hundred thousand dollars for the  period
   40  January  first,  two  thousand five through June thirtieth, two thousand
   41  five.
   42    (aa) Funds shall be reserved and accumulated from year to year by  the
   43  commissioner  and  shall  be  available,  including income from invested
   44  funds, for purposes of grants to public residential health care  facili-
   45  ties  for  recruitment  and retention of health care workers pursuant to
   46  paragraph (b) of subdivision eighteen of  section  twenty-eight  hundred
   47  eight of this article from the tobacco control and insurance initiatives
   48  pool established for the following periods in the following amounts:
   49    (i) seven million five hundred thousand dollars on an annualized basis
   50  for  the period January first, two thousand two through December thirty-
   51  first, two thousand two;
   52    (ii) eleven million seven hundred thousand dollars  on  an  annualized
   53  basis  for the period January first, two thousand three through December
   54  thirty-first, two thousand three; [and]
       S. 1408                            98                            A. 2108
 
    1    (iii) sixteen million two hundred thousand dollars  on  an  annualized
    2  basis  for  the period January first, two thousand four through December
    3  thirty-first, two thousand four; and
    4    (iv) eight million one hundred thousand dollars for the period January
    5  first, two thousand five through June thirtieth, two thousand five.
    6    (bb)(i)  Funds  shall be deposited by the commissioner, within amounts
    7  appropriated, and subject  to  the  availability  of  federal  financial
    8  participation,  and  the  state  comptroller  is  hereby  authorized and
    9  directed to receive for deposit to  the  credit  of  the  state  special
   10  revenue  funds  -  other, HCRA transfer fund, medical assistance account
   11  for the purpose of supporting the state share of adjustments to Medicaid
   12  rates of payment for personal care services provided pursuant  to  para-
   13  graph  (e)  of  subdivision two of section three hundred sixty-five-a of
   14  the social services  law,  for  local  social  service  districts  which
   15  include  a  city  with  a  population  of  over  one million persons and
   16  computed and distributed in accordance with memorandums of understanding
   17  to be entered into between the state of New York and such  local  social
   18  service  districts  for  the  purpose  of supporting the recruitment and
   19  retention of personal care service workers or  any  worker  with  direct
   20  patient  care  responsibility,  from  the  tobacco control and insurance
   21  initiatives pool established for the following periods and the following
   22  amounts:
   23    (A) forty-four million dollars, on an annualized basis, for the period
   24  April first, two thousand two through December thirty-first,  two  thou-
   25  sand two;
   26    (B)  seventy-four  million  dollars,  on  an annualized basis, for the
   27  period January first, two thousand three through December  thirty-first,
   28  two thousand three;
   29    (C)  one hundred four million dollars, on an annualized basis, for the
   30  period January first, two thousand four through  December  thirty-first,
   31  two thousand four; and
   32    (D)  one  hundred  thirty-six million dollars, on an annualized basis,
   33  for the period January first, two thousand five through  December  thir-
   34  ty-first, two thousand five.
   35    (ii)  Adjustments  to  Medicaid  rates made pursuant to this paragraph
   36  shall not, in aggregate, exceed the following amounts for the  following
   37  periods:
   38    (A)  for  the  period  April  first, two thousand two through December
   39  thirty-first, two thousand two, one hundred ten million dollars;
   40    (B) for the period January first, two thousand three through  December
   41  thirty-first,  two  thousand  three,  one  hundred  eighty-five  million
   42  dollars;
   43    (C) for the period January first, two thousand four  through  December
   44  thirty-first, two thousand four, two hundred sixty million dollars; and
   45    (D)  for  the period January first, two thousand five through December
   46  thirty-first, two thousand five, three hundred forty million dollars.
   47    (iii) Personal care service providers which have their rates  adjusted
   48  pursuant  to  this  paragraph  shall  use  such funds for the purpose of
   49  recruitment and retention  of  non-supervisory  personal  care  services
   50  workers  or  any worker with direct patient care responsibility only and
   51  are prohibited from using such funds for any other  purpose.  Each  such
   52  personal  care services provider shall submit, at a time and in a manner
   53  to be determined by the commissioner, a written certification  attesting
   54  that  such  funds will be used solely for the purpose of recruitment and
   55  retention of non-supervisory personal care services workers or any work-
   56  er with direct patient care responsibility. The commissioner is  author-
       S. 1408                            99                            A. 2108
 
    1  ized  to  audit each such provider to ensure compliance with the written
    2  certification required by this subdivision and shall  recoup  any  funds
    3  determined  to  have  been  used for purposes other than recruitment and
    4  retention of non-supervisory personal care services workers or any work-
    5  er  with direct patient care responsibility. Such recoupment shall be in
    6  addition to any other penalties provided by law.
    7    (cc) Funds shall be deposited  by  the  commissioner,  within  amounts
    8  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
    9  directed to receive for deposit to  the  credit  of  the  state  special
   10  revenue  funds  -  other, HCRA transfer fund, medical assistance account
   11  for the purpose of supporting the state share of adjustments to Medicaid
   12  rates of payment for personal care services provided pursuant  to  para-
   13  graph  (e)  of  subdivision two of section three hundred sixty-five-a of
   14  the social services law, for local social service districts which  shall
   15  not include a city with a population of over one million persons for the
   16  purpose  of supporting the personal care services worker recruitment and
   17  retention program as  established  pursuant  to  section  three  hundred
   18  sixty-seven-q  of  the social services law, from the tobacco control and
   19  insurance initiatives pool established for the following periods and the
   20  following amounts:
   21    (i) two million eight hundred thousand dollars for  the  period  April
   22  first, two thousand two through December thirty-first, two thousand two;
   23    (ii)  five  million  six  hundred  thousand  dollars, on an annualized
   24  basis, for the period January first, two thousand three through December
   25  thirty-first, two thousand three;
   26    (iii) eight million four hundred thousand dollars,  on  an  annualized
   27  basis,  for the period January first, two thousand four through December
   28  thirty-first, two thousand four; and
   29    (iv) ten million eight hundred  thousand  dollars,  on  an  annualized
   30  basis,  for the period January first, two thousand five through December
   31  thirty-first, two thousand five.
   32    (dd) Funds shall be deposited  by  the  commissioner,  within  amounts
   33  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   34  directed to receive for deposit to  the  credit  of  the  state  special
   35  revenue fund - other, HCRA transfer fund, medical assistance account for
   36  purposes  of funding the state share of Medicaid expenditures for physi-
   37  cian services from the tobacco control and  insurance  initiatives  pool
   38  established for the following periods in the following amounts:
   39    (i)  up to fifty-two million dollars for the period January first, two
   40  thousand two through December thirty-first, two thousand two; [and]
   41    (ii) [up to  forty-three]  eighty-one  million  two  hundred  thousand
   42  dollars  for  the period January first, two thousand three through [June
   43  thirtieth,] December thirty-first, two thousand three;
   44    (iii) eighty-five million two hundred thousand dollars for the  period
   45  January  first,  two  thousand  four  through December thirty-first, two
   46  thousand four; and
   47    (iv) forty-two million six hundred thousand  dollars  for  the  period
   48  January  first,  two  thousand five through June thirtieth, two thousand
   49  five.
   50    (ee) Funds shall be deposited  by  the  commissioner,  within  amounts
   51  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   52  directed to receive for deposit to  the  credit  of  the  state  special
   53  revenue fund - other, HCRA transfer fund, medical assistance account for
   54  purposes  of funding the state share of the free-standing diagnostic and
   55  treatment center rate increases for recruitment and retention of  health
   56  care  workers  pursuant to subdivision seventeen of section twenty-eight
       S. 1408                            100                           A. 2108
 
    1  hundred seven of this chapter from the  tobacco  control  and  insurance
    2  initiatives  pool established for the following periods in the following
    3  amounts:
    4    (i)  three  million  two hundred fifty thousand dollars for the period
    5  April first, two thousand two through December thirty-first,  two  thou-
    6  sand two;
    7    (ii) [three] two million [two] one hundred [fifty] thousand dollars on
    8  an  annualized  basis  for  the period January first, two thousand three
    9  through December thirty-first, two thousand three; [and]
   10    (iii) [three] one million [two] seven hundred [fifty] thousand dollars
   11  on an annualized basis for the period January first, two  thousand  four
   12  through December thirty-first, two thousand four; and
   13    (iv)  nine  hundred thousand dollars for the period January first, two
   14  thousand five through June thirtieth, two thousand five.
   15    (ff) Funds shall be deposited  by  the  commissioner,  within  amounts
   16  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   17  directed to receive for deposit to  the  credit  of  the  state  special
   18  revenue fund - other, HCRA transfer fund, medical assistance account for
   19  purposes  of  funding the state share of Medicaid expenditures for disa-
   20  bled persons as authorized pursuant to subparagraphs twelve and thirteen
   21  of paragraph (a) of subdivision one of section three  hundred  sixty-six
   22  of the social services law from the tobacco control and insurance initi-
   23  atives  pool  established  for  the  following  periods in the following
   24  amounts:
   25    (i) one million eight hundred thousand dollars for  the  period  April
   26  first, two thousand two through December thirty-first, two thousand two;
   27    (ii)  [five] sixteen million [two] four hundred thousand dollars on an
   28  annualized basis for  the  period  January  first,  two  thousand  three
   29  through December thirty-first, two thousand three; [and]
   30    (iii)  [twenty] eighteen million [four] seven hundred thousand dollars
   31  on an annualized basis for the period January first, two  thousand  four
   32  through December thirty-first, two thousand four; and
   33    (iv)  fifteen  million  three  hundred thousand dollars for the period
   34  January first, two thousand five through June  thirtieth,  two  thousand
   35  five.
   36    (gg)  Funds shall be reserved and accumulated from year to year by the
   37  commissioner and shall be  available,  including  income  from  invested
   38  funds,  for  purposes of grants to non-public general hospitals pursuant
   39  to paragraph (c) of subdivision thirty of section  twenty-eight  hundred
   40  seven-c  of  this  article from the tobacco control and insurance initi-
   41  atives pool established for  the  following  periods  in  the  following
   42  amounts:
   43    (i)  up to one million three hundred thousand dollars on an annualized
   44  basis for the period January first, two thousand  two  through  December
   45  thirty-first, two thousand two;
   46    (ii)  up  to  three  million [four] two hundred thousand dollars on an
   47  annualized basis for  the  period  January  first,  two  thousand  three
   48  through December thirty-first, two thousand three; [and]
   49    (iii) up to five million six hundred thousand dollars on an annualized
   50  basis  for  the period January first, two thousand four through December
   51  thirty-first, two thousand four; and
   52    (iv) up to two million eight hundred thousand dollars for  the  period
   53  January  first,  two  thousand five through June thirtieth, two thousand
   54  five.
   55    (hh) Funds shall be reserved and accumulated from year to year by  the
   56  commissioner  and  shall  be  available,  including income from invested
       S. 1408                            101                           A. 2108
 
    1  funds, for purposes of grants to residential health care facilities  for
    2  financial  assistance  pursuant to subdivision nineteen of section twen-
    3  ty-eight hundred eight of this article, from  the  tobacco  control  and
    4  insurance  initiatives pool established for the following periods in the
    5  following amounts:
    6    (i) for the period April first,  two  thousand  two  through  December
    7  thirty-first, two thousand two, ten million dollars;
    8    (ii) for the period January first, two thousand three through December
    9  thirty-first,  two  thousand  three,  [ten]  eight million seven hundred
   10  thousand dollars; [and]
   11    (iii) for the period January first, two thousand four through December
   12  thirty-first, two thousand four, [ten] eight million six  hundred  thou-
   13  sand dollars; and
   14    (iv)  up to four million seven hundred thousand dollars for the period
   15  January first, two thousand five through June  thirtieth,  two  thousand
   16  five.
   17    (ii)  Funds  shall  be  deposited  by the commissioner, within amounts
   18  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   19  directed  to  receive  for  deposit  to  the credit of the state special
   20  revenue funds - other, HCRA transfer fund,  medical  assistance  account
   21  for  the  purpose of supporting the state share of Medicaid expenditures
   22  for disabled persons as authorized by sections 1619 (a) and (b)  of  the
   23  federal  social  security act pursuant to the tobacco control and insur-
   24  ance initiatives pool established  for  the  following  periods  in  the
   25  following amounts:
   26    (i)  six  million  four  hundred thousand dollars for the period April
   27  first, two thousand two through December thirty-first, two thousand two;
   28  [and]
   29    (ii) [four] eight million [three] five hundred thousand  dollars,  for
   30  the  period  January first, two thousand three through [June thirtieth,]
   31  December thirty-first, two thousand three;
   32    (iii) eight million five hundred thousand dollars for the period Janu-
   33  ary first, two thousand four through December thirty-first, two thousand
   34  four; and
   35    (iv) four million three hundred thousand dollars for the period  Janu-
   36  ary first, two thousand five through June thirtieth, two thousand five.
   37    [(ii)]  (jj) Funds shall be reserved and accumulated from year to year
   38  by the commissioner  and  shall  be  available,  including  income  from
   39  invested funds, for the purposes of a grant program to improve access to
   40  infertility  services,  treatments  and  procedures,  from  the  tobacco
   41  control and insurance initiatives pool established for the period  Janu-
   42  ary  first, two thousand two through December thirty-first, two thousand
   43  two in the amount of [ten] eight million nine hundred thousand dollars.
   44    [(jj)] (kk) Funds shall  be  deposited  by  the  commissioner,  within
   45  amounts appropriated, and the state comptroller is hereby authorized and
   46  directed  to  receive  for  deposit  to  the credit of the state special
   47  revenue funds -- other, HCRA transfer fund, medical  assistance  account
   48  for  purposes  of  funding  the state share of Medicaid expenditures for
   49  pharmacy services from the tobacco  control  and  insurance  initiatives
   50  pool established for the following periods in the following amounts:
   51    (i) thirty-eight million eight hundred thousand dollars for the period
   52  January first, two thousand two through December thirty-first, two thou-
   53  sand two; [and]
   54    (ii)  [seventy-seven]  two  hundred  ninety-five million [five hundred
   55  thousand] dollars for the  period  January  first,  two  thousand  three
   56  through [June thirtieth,] December thirty-first, two thousand three;
       S. 1408                            102                           A. 2108
 
    1    (iii)  four hundred seventy-two million dollars for the period January
    2  first, two thousand four through  December  thirty-first,  two  thousand
    3  four; and
    4    (iv)  two  hundred  fifty-five  million dollars for the period January
    5  first, two thousand five through June thirtieth, two thousand five.
    6    [(kk)] (ll) Funds shall  be  deposited  by  the  commissioner,  within
    7  amounts appropriated, and the state comptroller is hereby authorized and
    8  directed  to  receive  for  deposit  to  the credit of the state special
    9  revenue funds -- other, HCRA transfer fund, medical  assistance  account
   10  for purposes of funding the state share of Medicaid expenditures related
   11  to  the  city  of New York from the tobacco control and insurance initi-
   12  atives pool established for  the  following  periods  in  the  following
   13  amounts:
   14    (i)  eighty-two  million seven hundred thousand dollars for the period
   15  January first, two thousand two through December thirty-first, two thou-
   16  sand two; [and]
   17    (ii) [sixty-seven] one hundred twenty-four million [five] six  hundred
   18  thousand  dollars  for  the  period  January  first,  two thousand three
   19  through [June thirtieth,] December thirty-first, two thousand three[.];
   20    (iii) one hundred twenty-four million seven hundred  thousand  dollars
   21  for  the  period January first, two thousand four through December thir-
   22  ty-first, two thousand four; and
   23    (iv) sixty-two million four hundred thousand dollars  for  the  period
   24  January  first,  two  thousand five through June thirtieth, two thousand
   25  five.
   26    (mm) Funds shall be deposited  by  the  commissioner,  within  amounts
   27  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   28  directed to receive for deposit to  the  credit  of  the  state  special
   29  revenue  funds  - other, HCRA transfer fund, medical assistance account,
   30  for purposes of funding the state share of services and expenses related
   31  to the family health plus program including up to five  million  dollars
   32  annually for the period January first, two thousand three through Decem-
   33  ber  thirty-first, two thousand four, and up to two million five hundred
   34  thousand dollars for the period January first, two thousand five through
   35  June thirtieth, two thousand five for administration and marketing costs
   36  associated with such program established pursuant to clauses (A) and (B)
   37  of subparagraph (v) of paragraph (a) of subdivision two of section three
   38  hundred sixty-nine-ee of  the  social  services  law  from  the  tobacco
   39  control  and  insurance  initiatives  pool established for the following
   40  periods in the following amount:
   41    (i) one hundred seventy million six hundred thousand dollars  for  the
   42  period  January first, two thousand three through December thirty-first,
   43  two thousand three;
   44    (ii) two hundred thirty-three million six hundred thousand dollars for
   45  the period January first, two thousand  four  through  December  thirty-
   46  first, two thousand four; and
   47    (iii) one hundred forty-six million eight hundred thousand dollars for
   48  the  period January first, two thousand five through June thirtieth, two
   49  thousand five.
   50    (nn) Funds shall be deposited  by  the  commissioner,  within  amounts
   51  appropriated,  and  the  state  comptroller  is  hereby  authorized  and
   52  directed to receive for deposit to  the  credit  of  the  state  special
   53  revenue  fund - other, HCRA transfer fund, health care services account,
   54  for purposes related to an adult  home  initiative  including,  but  not
   55  limited  to, assessments, social and recreational services, advocacy and
   56  legal support, medication management and case  management  for  medicaid
       S. 1408                            103                           A. 2108
 
    1  eligible  residents  of  residential  facilities  licensed  pursuant  to
    2  section four hundred sixty-b of the social services law from the tobacco
    3  control and insurance initiatives pool  established  for  the  following
    4  periods in the following amounts;
    5    (i) up to four million dollars for the period January first, two thou-
    6  sand three through December thirty-first, two thousand three;
    7    (ii) up to six million dollars for the period January first, two thou-
    8  sand four through December thirty-first, two thousand four; and
    9    (iii)  up  to  four  million dollars for the period January first, two
   10  thousand five through June thirtieth, two thousand five.
   11    2. (a) The commissioner is authorized to  contract  with  the  article
   12  forty-three  insurance  law  plans,  or  such  other  contractors as the
   13  commissioner shall designate, to receive and distribute funds  from  the
   14  tobacco  control  and insurance initiatives pool established pursuant to
   15  this section. In the event contracts with the article forty-three insur-
   16  ance law plans or other commissioner's designees  are  effectuated,  the
   17  commissioner shall conduct annual audits of the receipt and distribution
   18  of  such funds. The reasonable costs and expenses of an administrator as
   19  approved by the commissioner, not to exceed for personnel services on an
   20  annual basis five hundred thousand dollars, for collection and  distrib-
   21  ution of funds pursuant to this section shall be paid from such funds.
   22    (b)  Notwithstanding any inconsistent provision of section one hundred
   23  twelve or one hundred sixty-three of the state finance law or any  other
   24  law,  at the discretion of the commissioner without a competitive bid or
   25  request for proposal process, contracts in effect for administration  of
   26  pools  established  pursuant  to  sections twenty-eight hundred seven-k,
   27  twenty-eight hundred seven-l and twenty-eight hundred  seven-m  of  this
   28  article  for  the  period  January  first,  nineteen hundred ninety-nine
   29  through December  thirty-first,  nineteen  hundred  ninety-nine  may  be
   30  extended  to provide for administration pursuant to this section and may
   31  be amended as may be necessary.
   32    3. Revenue from distributions pursuant to this section  shall  not  be
   33  included  in  gross  revenue  received  for  purposes of the assessments
   34  pursuant to subdivision eighteen of section twenty-eight hundred seven-c
   35  of this article, subject to the provisions of paragraph (e) of  subdivi-
   36  sion  eighteen  of section twenty-eight hundred seven-c of this article,
   37  and shall not be included in gross revenue received for purposes of  the
   38  assessments  pursuant  to  section  twenty-eight hundred seven-d of this
   39  article, subject to the provisions  of  subdivision  twelve  of  section
   40  twenty-eight hundred seven-d of this article.
   41    4.  In  the  event residual funds are available in the tobacco control
   42  and insurance initiatives  pool  established  for  the  periods  January
   43  first,  two  thousand through June thirtieth, two thousand [three] five,
   44  after allocations have been made pursuant to this section for the  peri-
   45  ods  January  first,  two  thousand through June thirtieth, two thousand
   46  [three] five, any amount of such funds may be transferred to the  health
   47  care  initiatives  pool  established  pursuant  to  section twenty-eight
   48  hundred seven-l of this article for the periods January first, two thou-
   49  sand through June thirtieth, two thousand [three] five, to be  allocated
   50  and  distributed  proportionally  among affected programs by the commis-
   51  sioner to cover any shortfall in programs  and  purposes  set  forth  in
   52  subdivision one of section twenty-eight hundred seven-l of this article.
   53     § 17. Section 2807-p of the public health law, as added by chapter 639
   54  of  the  laws  of  1996,  subdivision 1, paragraph (a) of subdivision 3,
   55  subparagraph (i) of paragraph (a) of subdivision 4 as amended and subdi-
   56  vision 8 as added by chapter 1 of the laws of 1999, subparagraphs  (iii)
       S. 1408                            104                           A. 2108
 
    1  and  (iv) of paragraph (a) of subdivision 4 as amended by chapter 419 of
    2  the laws of 2000, is amended to read as follows:
    3     § 2807-p. Comprehensive diagnostic and treatment centers indigent care
    4  program.    1.  [The]  (a) For periods prior to July first, two thousand
    5  three, the commissioner is authorized to make payments to eligible diag-
    6  nostic and treatment centers, to the extent of funds available therefor,
    7  to assist in meeting losses resulting  from  uncompensated  care.    The
    8  amount  of funds available for such payments shall be the amount remain-
    9  ing after the allocation provided  in  section  seven  of  chapter  four
   10  hundred thirty-three of the laws of nineteen hundred ninety-seven.
   11    (b)  For  periods  on  and  after  July first, two thousand three, the
   12  commissioner shall, subject to the  availability  of  federal  financial
   13  participation,  adjust  medical assistance rates of payment to assist in
   14  meeting losses resulting from uncompensated care.
   15    2. Definitions. (a) "Eligible diagnostic and treatment  centers",  for
   16  purposes  of  this section, shall mean voluntary non-profit and publicly
   17  sponsored diagnostic and treatment  centers  providing  a  comprehensive
   18  range  of primary health care services which can demonstrate losses from
   19  disproportionate share of uncompensated care during a  base  period  two
   20  years prior to the grant period.
   21    (b)  "Uncompensated  care  need",  for purposes of this section, means
   22  losses from reported self-pay and free visits multiplied by the  facili-
   23  ty's  medical  assistance  payment  rate for the applicable distribution
   24  year, offset by payments received from such patients during the  report-
   25  ing period.
   26    3.  (a) During the period January first, nineteen hundred ninety-seven
   27  through September thirtieth, nineteen hundred ninety-seven and for  each
   28  fiscal year period commencing on October first thereafter through Decem-
   29  ber  thirty-first,  nineteen  hundred ninety-nine and for periods on and
   30  after January first, two  thousand,  diagnostic  and  treatment  centers
   31  shall  be  eligible  for  allocations  of  funds or for rate adjustments
   32  determined in accordance with this section to reflect the needs  of  the
   33  diagnostic  and  treatment  center for the financing of losses resulting
   34  from uncompensated care.
   35    (b) A diagnostic and treatment center qualifying for a distribution or
   36  a rate adjustment pursuant to  this  section  shall  provide  assurances
   37  satisfactory  to  the  commissioner  that  it shall undertake reasonable
   38  efforts to maintain financial support from community and public  funding
   39  sources  and  reasonable  efforts  to collect payments for services from
   40  third-party  insurance  payors,  governmental  payors  and   self-paying
   41  patients.
   42    (c)  To  be  eligible  for an allocation of funds or a rate adjustment
   43  pursuant to this section, a diagnostic and treatment center must provide
   44  a comprehensive range of primary health care services  and  must  demon-
   45  strate  that  a  minimum of five percent of total clinic visits reported
   46  during the applicable base year period were  to  uninsured  individuals.
   47  The  commissioner may retrospectively reduce the allocations of funds or
   48  the rate adjustments to a diagnostic  and  treatment  center  if  it  is
   49  determined  that  provider management actions or decisions have caused a
   50  significant reduction for the grant period in the delivery of comprehen-
   51  sive primary health care services to uncompensated care residents of the
   52  community.
   53    4.(a) (i) The total amount of funds to be  allocated  and  distributed
   54  for  uncompensated  care to eligible voluntary non-profit diagnostic and
   55  treatment centers for a distribution period prior  to  July  first,  two
   56  thousand  three  in accordance with this subdivision shall be limited to
       S. 1408                            105                           A. 2108
 
    1  thirty-three percent of the funds available therefor pursuant  to  para-
    2  graph (a) of subdivision one of this section.
    3    (ii)  The  total  amount  of funds to be allocated and distributed for
    4  uncompensated care to eligible publicly sponsored diagnostic and  treat-
    5  ment  centers for a grant period prior to July first, two thousand three
    6  in accordance with this subdivision  shall  be  limited  to  sixty-seven
    7  percent  of funds available therefor pursuant paragraph (a) of to subdi-
    8  vision one of this section; provided, however, that forty-one percent of
    9  the amount of funds allocated  for  distribution  to  eligible  publicly
   10  sponsored  diagnostic and treatment centers shall be available for clin-
   11  ics operating under the auspices of the New York city health and  hospi-
   12  tals  corporation  as established by chapter one thousand sixteen of the
   13  laws of nineteen hundred sixty-nine as amended.
   14    (iii) (A) Notwithstanding the provisions of subparagraph (ii) of  this
   15  paragraph  and any other provision of this chapter, municipalities which
   16  received state aid pursuant to article two of [the  public  health  law]
   17  this  chapter  for  the  nineteen  hundred eighty-nine--nineteen hundred
   18  ninety state fiscal year in support of non-hospital based  free-standing
   19  or  local  health  department  operated  general  medical  clinics shall
   20  receive an uncompensated care grant allocation of funds on an annualized
   21  basis through December thirty-first, two thousand two, of not less  than
   22  the  amount  received  in  the  nineteen  hundred  eighty-nine--nineteen
   23  hundred ninety state fiscal year for general medical clinics.
   24    (B) For the period January first,  two  thousand  three  through  June
   25  thirtieth,  two  thousand three, each such municipality shall receive an
   26  uncompensated care grant allocation of funds of not less  than  one-half
   27  the amount calculated pursuant to clause (A) of this subparagraph.
   28    (iv) (A) Notwithstanding any inconsistent provision of this paragraph,
   29  for  the  period  January  first,  nineteen hundred ninety-seven through
   30  December thirty-first, nineteen hundred ninety-nine and for  periods  on
   31  and after January first, two thousand through December thirty-first, two
   32  thousand  two, diagnostic and treatment centers which received an allow-
   33  ance pursuant to paragraph (f) of subdivision  two  of  section  twenty-
   34  eight  hundred  seven  of  this  article for the period through December
   35  thirty-first, nineteen hundred ninety-six shall receive an uncompensated
   36  care distribution allocation of funds of not less than the  amount  that
   37  would  have been received for any losses associated with the delivery of
   38  bad debt and charity care  for  nineteen  hundred  ninety-five  had  the
   39  provisions  of  paragraph (f) of subdivision two of section twenty-eight
   40  hundred seven of this article remained in effect.
   41    (B) For the period January first,  two  thousand  three  through  June
   42  thirtieth, two thousand three, each such diagnostic and treatment center
   43  shall  receive an uncompensated care distribution allocation of funds of
   44  not less than one-half the amount calculated pursuant to clause  (A)  of
   45  this subparagraph.
   46    (b)  (i)  A nominal payment amount for the financing of losses associ-
   47  ated with the delivery of uncompensated care  will  be  established  for
   48  each  eligible  diagnostic  and  treatment  center.  The nominal payment
   49  amount shall be calculated as the sum of the dollars attributable to the
   50  application of an incrementally increasing nominal  coverage  percentage
   51  of base year period losses associated with the delivery of uncompensated
   52  care  for  percentage  increases  in  the relationship between base year
   53  period eligible uninsured care clinic visits and base year period  total
   54  clinic visits according to the following scale:
   55    % of eligible bad debt and charity care       % of nominal financial
   56    clinic visits to total visits                loss coverage
       S. 1408                            106                           A. 2108
 
    1       up to 15%                                      50%
    2       15 - 30%                                       75%
    3       30% +                                          100%
    4    (ii) If the sum of the nominal payment amounts for all eligible volun-
    5  tary  non-profit  diagnostic  and  treatment centers or for all eligible
    6  public diagnostic and treatment centers or  for  all  clinics  operating
    7  under the auspices of the New York city health and hospitals corporation
    8  is  less  than  the  amount  allocated for uncompensated care allowances
    9  pursuant to paragraph (a) of this subdivision for  such  diagnostic  and
   10  treatment centers respectively, the nominal coverage percentages of base
   11  year  period  losses  associated with the delivery of uncompensated care
   12  pursuant to this scale may be increased to not  more  than  one  hundred
   13  percent for voluntary non-profit diagnostic and treatment centers or for
   14  public  diagnostic  and  treatment  centers or for all clinics operating
   15  under the auspices of the New York city health and hospitals corporation
   16  in accordance with rules and regulations  adopted  by  the  council  and
   17  approved by the commissioner.
   18    (c)  The  uncompensated  care  allocations  of funds for each eligible
   19  voluntary non-profit diagnostic and treatment center shall be  based  on
   20  the dollar value of the result of the ratio of total funds allocated for
   21  distributions  for voluntary non-profit diagnostic and treatment centers
   22  pursuant to paragraph (a) of this subdivision  to  the  total  statewide
   23  nominal payment amounts for all eligible voluntary non-profit diagnostic
   24  and  treatment  centers  determined  in accordance with paragraph (b) of
   25  this subdivision applied to the nominal payment  amount  for  each  such
   26  diagnostic and treatment center.
   27    (d)  The  uncompensated  care  allocations  of funds for each eligible
   28  public diagnostic and treatment center,  other  than  clinics  operating
   29  under  the  auspices  of  the  New York city health and hospitals corpo-
   30  ration, shall be based on the dollar value of the result of the ratio of
   31  total funds allocated for distributions for public diagnostic and treat-
   32  ment centers, other than clinics operating under the auspices of the New
   33  York city health and hospitals corporation, pursuant to paragraph (a) of
   34  this subdivision to the total statewide nominal payment amounts for  all
   35  eligible  public  diagnostic  and  treatment centers, other than clinics
   36  operating under the auspices of the New York city health  and  hospitals
   37  corporation,  determined in accordance with paragraph (b) of this subdi-
   38  vision applied to the nominal payment amount for  each  such  diagnostic
   39  and treatment center.
   40    (e)  The uncompensated care grant allocations of funds for each eligi-
   41  ble public diagnostic and treatment center operating under the  auspices
   42  of  the New York city health and hospitals corporation shall be based on
   43  the dollar value of the result of the ratio of total funds allocated for
   44  distributions for public  diagnostic  and  treatment  centers  operating
   45  under the auspices of the New York city health and hospitals corporation
   46  pursuant  to  paragraph  (a)  of this subdivision to the total statewide
   47  nominal payment amounts for all eligible public diagnostic and treatment
   48  centers operating under the auspices of the New  York  city  health  and
   49  hospitals  corporation  determined  in  accordance with paragraph (b) of
   50  this subdivision applied to the nominal payment  amount  for  each  such
   51  diagnostic and treatment center.
   52    (f) Any residual amount allocated for distribution to a classification
   53  of  diagnostic and treatment centers in accordance with this subdivision
   54  shall be reallocated by the commissioner for distributions to the  other
   55  classifications based on remaining need.
       S. 1408                            107                           A. 2108
 
    1    4-a.(a)(i)  For  periods  on and after July first, two thousand three,
    2  funds shall be made available for adjustments to rates of payments  made
    3  pursuant  to paragraph (b) of subdivision one of this section for eligi-
    4  ble voluntary non-profit diagnostic and treatment centers in  accordance
    5  with  subparagraphs  (ii) and (iii) of this paragraph, for the following
    6  periods in the following aggregate amounts:
    7    (A) For the period July first, two  thousand  three  through  December
    8  thirty-first, two thousand three, up to seven million five hundred thou-
    9  sand dollars;
   10    (B)  For  the period January first, two thousand four through December
   11  thirty-first, two thousand four, up to fifteen million dollars;
   12    (C) For the period January first, two thousand five through June thir-
   13  tieth, two thousand five, up to  seven  million  five  hundred  thousand
   14  dollars.
   15    (ii)  A  nominal payment amount for the financing of losses associated
   16  with the delivery of uncompensated care will  be  established  for  each
   17  eligible  diagnostic  and  treatment  center. The nominal payment amount
   18  shall be calculated as the sum of the dollars attributable to the appli-
   19  cation of an incrementally increasing  nominal  coverage  percentage  of
   20  base  year  period  losses associated with the delivery of uncompensated
   21  care for percentage increases in  the  relationship  between  base  year
   22  period  eligible uninsured care clinic visits and base year period total
   23  clinic visits according to the following scale:
   24    % of eligible bad debt and charity care      % of nominal
   25    clinic visits to total visits                financial loss
   26                                                 coverage
   27       up to 15%                                      50%
   28       15-30%                                         75%
   29       30% +                                          100%
   30    (iii) The uncompensated care rate adjustments for each eligible volun-
   31  tary non-profit diagnostic and treatment center shall be  based  on  the
   32  dollar  value  of  the  result of the ratio of total funds allocated for
   33  distributions for voluntary non-profit diagnostic and treatment  centers
   34  pursuant  to  subparagraph (i) of this paragraph, to the total statewide
   35  nominal payment amounts for all eligible voluntary non-profit diagnostic
   36  and treatment centers determined in accordance with subparagraph (ii) of
   37  this paragraph applied to the nominal payment amount for each such diag-
   38  nostic and treatment center.
   39    (b)(i) For periods on and after July first, two thousand  three  funds
   40  shall be made available for adjustments to rates of payments made pursu-
   41  ant  to  paragraph  (b)  of subdivision one of this section for eligible
   42  public diagnostic and treatment centers,  other  than  clinics  operated
   43  under  the  auspices  of  the  New York city health and hospitals corpo-
   44  ration, in accordance with subparagraphs (ii) and (iii)  of  this  para-
   45  graph, for the following periods in the following aggregate amounts:
   46    (A)  For  the  period  July first, two thousand three through December
   47  thirty-first, two thousand three, up to nine million dollars;
   48    (B) For the period January first, two thousand four  through  December
   49  thirty-first, two thousand four, up to eighteen million dollars;
   50    (C) For the period January first, two thousand five through June thir-
   51  tieth, two thousand five, up to nine million dollars.
   52    (ii)  A  nominal payment amount for the financing of losses associated
   53  with the delivery of uncompensated care will  be  established  for  each
   54  eligible  diagnostic  and  treatment  center. The nominal payment amount
   55  shall be calculated as the sum of the dollars attributable to the appli-
   56  cation of an incrementally increasing  nominal  coverage  percentage  of
       S. 1408                            108                           A. 2108
 
    1  base  year  period  losses associated with the delivery of uncompensated
    2  care for percentage increases in  the  relationship  between  base  year
    3  period  eligible uninsured care clinic visits and base year period total
    4  clinic visits according to the following scale:
    5    % of eligible bad debt and charity care      % of nominal financial
    6    clinic visits to total visits                loss coverage
    7       up to 15%                                      50%
    8       15-30%                                         75%
    9       30% +                                          100%
   10    (iii) The uncompensated care rate adjustments for each eligible public
   11  diagnostic  and treatment center, other than clinics operating under the
   12  auspices of the New York city health and hospitals corporation, shall be
   13  based on the dollar value of the result of  the  ratio  of  total  funds
   14  allocated for distributions for public diagnostic and treatment centers,
   15  other  than  clinics  operating  under the auspices of the New York city
   16  health and hospitals corporation, pursuant to subparagraph (i)  of  this
   17  paragraph  to the total statewide nominal payment amounts for all eligi-
   18  ble public diagnostic and treatment centers, other than clinics  operat-
   19  ing  under the auspices of the New York city health and hospitals corpo-
   20  ration,  determined  in  accordance  with  subparagraph  (ii)  of   this
   21  paragraph applied to the nominal payment amount for each such diagnostic
   22  and treatment center.
   23    (c)(i)  For periods on and after July first, two thousand three, funds
   24  shall be made available for adjustments to rates of payments made pursu-
   25  ant to paragraph (b) of subdivision one of  this  section  for  eligible
   26  public  diagnostic and treatment centers operating under the auspices of
   27  the New York city health and hospitals corporation, in  accordance  with
   28  subparagraphs  (ii) and (iii) of this paragraph, for the following peri-
   29  ods in the following aggregate amounts:
   30    (A) For the period July first, two  thousand  three  through  December
   31  thirty-first, two thousand three, up to six million dollars;
   32    (B)  For  the period January first, two thousand four through December
   33  thirty-first, two thousand four, up to twelve million dollars;
   34    (C) For the period January first, two thousand five through June thir-
   35  tieth, two thousand five, up to six million dollars.
   36    (ii) A nominal payment amount for the financing of  losses  associated
   37  with  the  delivery  of  uncompensated care will be established for each
   38  eligible diagnostic and treatment center.  The  nominal  payment  amount
   39  shall be calculated as the sum of the dollars attributable to the appli-
   40  cation  of  an  incrementally  increasing nominal coverage percentage of
   41  base year period losses associated with the  delivery  of  uncompensated
   42  care  for  percentage  increases  in  the relationship between base year
   43  period eligible uninsured care clinic visits and base year period  total
   44  clinic visits according to the following scale:
   45    % of eligible bad debt and charity care      % of nominal financial
   46    clinic visits to total visits                loss coverage
   47       up to 15%                                      50%
   48       15-30%                                         75%
   49       30% +                                          100%
   50    (iii) The uncompensated care rate adjustment, for each eligible public
   51  diagnostic  and treatment center operating under the auspices of the New
   52  York city health and hospitals corporation shall be based on the  dollar
   53  value  of  the result of the ratio of total funds allocated for distrib-
   54  utions for public diagnostic and treatment centers operating  under  the
   55  auspices  of the New York city health and hospitals corporation pursuant
   56  to subparagraph (i) of this paragraph to  the  total  statewide  nominal
       S. 1408                            109                           A. 2108
 
    1  payment amounts for all eligible public diagnostic and treatment centers
    2  operating  under  the auspices of the New York city health and hospitals
    3  corporation determined in accordance  with  subparagraph  (ii)  of  this
    4  paragraph applied to the nominal payment amount for each such diagnostic
    5  and treatment center.
    6    (d) (i) Notwithstanding the provisions of paragraph (b) of this subdi-
    7  vision  and  any  other provisions of this chapter, municipalities which
    8  received state aid pursuant to article two of this chapter for the nine-
    9  teen hundred eighty-nine--nineteen hundred ninety state fiscal  year  in
   10  support  of  non-hospital based free-standing or local health department
   11  operated general medical clinics shall  receive  an  uncompensated  care
   12  rate  adjustment  for  the period July first, two thousand three through
   13  December thirty-first, two thousand three, of not less than one-half the
   14  amount received in the nineteen  hundred  eighty-nine--nineteen  hundred
   15  ninety state fiscal year for general medical clinics.
   16    (ii)  For the period January first, two thousand four through December
   17  thirty-first, two thousand four, each such municipality shall receive an
   18  uncompensated care rate adjustment of not less  than  twice  the  amount
   19  calculated pursuant to subparagraph (i) of this paragraph.
   20    (iii)  For  the  period  January first, two thousand five through June
   21  thirtieth, two thousand five, each such municipality  shall  receive  an
   22  uncompensated  care  rate  adjustment of not less than the amount calcu-
   23  lated pursuant to subparagraph (i) of this paragraph.
   24    (e) (i) Notwithstanding any inconsistent provision  of  this  subdivi-
   25  sion,  for  the  period  July first, two thousand three through December
   26  thirty-first, two thousand three, diagnostic and treatment centers which
   27  received an allowance pursuant to paragraph (f) of  subdivision  two  of
   28  section  twenty-eight  hundred  seven  of  this  article  for the period
   29  through December thirty-first, nineteen hundred ninety-six shall receive
   30  an uncompensated care rate adjustment of  not  less  than  one-half  the
   31  amount  that would have been received for any losses associated with the
   32  delivery of bad debt and charity care for nineteen  hundred  ninety-five
   33  had  the provisions of paragraph (f) of subdivision two of section twen-
   34  ty-eight hundred seven of this article remained in effect.
   35    (ii) For the period January first, two thousand four through  December
   36  thirty-first,  two  thousand  four,  each  such diagnostic and treatment
   37  center shall receive an uncompensated care rate adjustment of  not  less
   38  than  twice  the  amount calculated pursuant to subparagraph (i) of this
   39  paragraph.
   40    (iii) For the period January first, two  thousand  five  through  June
   41  thirtieth,  two thousand five, each such diagnostic and treatment center
   42  shall receive an uncompensated care rate adjustment of not less than the
   43  amount calculated pursuant to subparagraph (i) of  this  paragraph,  and
   44  shall be subject to subsequent adjustment or reconciliation.
   45    (f) Any residual amount allocated for distribution to a classification
   46  of  diagnostic and treatment centers in accordance with this subdivision
   47  shall be reallocated by the commissioner for distributions to the  other
   48  classifications based on remaining need.
   49    4-b.(a)  For periods on and after July first, two thousand three funds
   50  shall be made available for adjustments to rates of payment made  pursu-
   51  ant  to  paragraph  (b)  of subdivision one of this section for eligible
   52  diagnostic and treatment centers with less than two years  of  operating
   53  experience,  and  diagnostic  and  treatment centers which have received
   54  certificate of need approval on applications which  indicate  a  signif-
   55  icant increase in uninsured visits, for the following periods and in the
   56  following aggregate amounts:
       S. 1408                            110                           A. 2108
 
    1    (i)  For  the  period  July first, two thousand three through December
    2  thirty-first, two thousand three, up to one million five  hundred  thou-
    3  sand dollars;
    4    (ii)  For the period January first, two thousand four through December
    5  thirty-first, two thousand four, up to three million dollars;
    6    (iii) For the period January first, two  thousand  five  through  June
    7  thirtieth,  two  thousand  five, up to one million five hundred thousand
    8  dollars.
    9    (b) To be eligible for a rate adjustment pursuant to this  section,  a
   10  diagnostic  and  treatment  center  shall  be a voluntary, non-profit or
   11  publicly sponsored diagnostic and treatment center providing  a  compre-
   12  hensive range of primary health care services and be eligible to receive
   13  a  medicaid  budgeted  rate  prior to April first of the applicable rate
   14  adjustment period after which time,  the  department  shall  issue  rate
   15  adjustments  pursuant to this subdivision for such periods. Rate adjust-
   16  ments made pursuant to this subdivision shall be  allocated  based  upon
   17  each  eligible  facility's  proportional  share  of  costs  for services
   18  rendered to uninsured patients which have otherwise not  been  used  for
   19  establishing  distributions  pursuant  to  subdivision  four-a  of  this
   20  section. For the purposes of this subdivision costs shall be measured by
   21  multiplying each facility's medicaid  budgeted  rate  by  the  estimated
   22  number  of  visits  reported  for services anticipated to be rendered to
   23  uninsured patients meeting the aforementioned criteria, less any  antic-
   24  ipated  patient  service revenues received from such uninsured patients,
   25  during the applicable rate adjustment period.
   26    5. Diagnostic and treatment centers shall furnish  to  the  department
   27  such  reports  and information as may be required by the commissioner to
   28  assess the cost, quality, access to,  effectiveness  and  efficiency  of
   29  uncompensated  care  provided.  The  council shall adopt rules and regu-
   30  lations, subject to the  approval  of  the  commissioner,  to  establish
   31  uniform  reporting and accounting principles designed to enable diagnos-
   32  tic and treatment centers to fairly and accurately determine and  report
   33  uncompensated  care visits and the costs of uncompensated care. In order
   34  to be eligible for an allocation of funds pursuant to  this  section,  a
   35  diagnostic  and  treatment  center  must be [incompliance] in compliance
   36  with uncompensated care reporting requirements.
   37    6. Notwithstanding any inconsistent provision of law to the  contrary,
   38  the  availability  or  payment  of  funds  to a diagnostic and treatment
   39  center pursuant to this section shall not be admissible  as  a  defense,
   40  offset  or reduction in any action or proceeding relating to any bill or
   41  claim for amounts due for services provided by a diagnostic  and  treat-
   42  ment center.
   43    7.  Revenue  from  distributions  to a diagnostic and treatment center
   44  pursuant to this section shall not be included in gross revenue received
   45  for purposes of the assessments pursuant to section twenty-eight hundred
   46  seven-d of this article, subject to the provisions of subdivision twelve
   47  of section twenty-eight hundred seven-d of this article.
   48    8. (a) For periods on or after January  first,  two  thousand  through
   49  June  thirtieth,  two thousand three, payments made to an eligible diag-
   50  nostic and treatment center pursuant to this section shall be reduced or
   51  increased by an amount equal to the amount of any overpayments or under-
   52  payments made against grants awarded pursuant to section seven of  chap-
   53  ter  four  hundred  thirty-three of the laws of nineteen hundred ninety-
   54  seven for the period  three  years  prior  to  the  annual  awards  made
   55  pursuant to this section.
       S. 1408                            111                           A. 2108
 
    1    (b)  The  determination of such overpayments or underpayments shall be
    2  based on the submission by eligible  facilities  of  reports  reflecting
    3  actual  uncompensated  care data, as required by the commissioner, which
    4  are attributable to prior periods.  Submission  of  such  reports  is  a
    5  condition  for  an  eligible  facility's receipt of payments pursuant to
    6  this section.
    7    (c) For any periods in which a  facility  does  not  receive  payments
    8  pursuant to this section, the amount of any prior period overpayment may
    9  be  offset against payments for medical assistance made to such facility
   10  pursuant to title eleven of article five of the social services law  and
   11  credited  to  funds allocated pursuant to this section. Any prior period
   12  underpayment to an eligible facility may be paid to such facility  in  a
   13  subsequent period.
   14    9.  Adjustments  to rates of payment made pursuant to this section may
   15  be added to rates of payment or made as aggregate payments  to  eligible
   16  diagnostic  and treatment centers and shall not be subject to subsequent
   17  adjustment or reconciliation.
   18     § 18. Section 7 of chapter 433 of  the  laws  of  1997,  amending  the
   19  public health law and other laws relating to rates of reimbursement paid
   20  to hospitals and residential health care facilities, as amended by chap-
   21  ter 1 of the laws of 1999, is amended to read as follows:
   22     §  7.  Notwithstanding any inconsistent provision of law or regulation
   23  to the contrary effective January 1, 1997 through  [December  31,  1999,
   24  and  on  and after January first, two thousand,] June 30, 2003, a sum of
   25  6.25 percent of the total funds available pursuant to paragraph  (a)  of
   26  subdivision  one  of  section  2807-p  of the public health law shall be
   27  allocated for grants for  indigent  care  for  eligible  diagnostic  and
   28  treatment  centers with less than two years of operating experience, and
   29  diagnostic and treatment centers which have received certificate of need
   30  approval on applications which indicate a significant increase in  unin-
   31  sured  visits.    To be eligible for a grant pursuant to this section, a
   32  diagnostic and treatment center shall: (a) be a voluntary, non-profit or
   33  publicly sponsored diagnostic and treatment center providing  a  compre-
   34  hensive  range  of primary health care services and (b) (i) for the 1997
   35  grant period, be eligible to receive a   medicaid budgeted  rate  on  or
   36  before  the  effective  date of this chapter or (ii) for the 1998[, 1999
   37  and subsequent] through June 30, 2003, grant  periods,  be  eligible  to
   38  receive  a  medicaid  budgeted  rate  prior to April 1 of the applicable
   39  grant period after which time, the  department  of  health  shall  award
   40  grants  for such periods.  Awards granted pursuant to this section shall
   41  be allocated based upon each eligible facility's proportional  share  of
   42  costs  for  services rendered to uninsured patients which have otherwise
   43  not been used for establishing distributions pursuant to section  2807-p
   44  of  the public health law.  For the purposes of this section costs shall
   45  be measured by multiplying each facility's medicaid budgeted rate by the
   46  estimated number of visits  reported  for  services  anticipated  to  be
   47  rendered to uninsured patients meeting the aforementioned criteria, less
   48  any  anticipated  patient  service revenues received from such uninsured
   49  patients, during the applicable grant period.
   50     § 19. Notwithstanding any law to the  contrary,  the  commissioner  of
   51  health  shall deposit and the state comptroller is hereby authorized and
   52  directed to receive for deposit to  the  credit  of  the  state  special
   53  revenue  fund-other, CHCCDP transfer account, all federal matching funds
   54  earned pursuant to the community health  care  conversion  demonstration
   55  project  authorized  in the amended terms and conditions included in the
   56  extension of the section 1115 waiver  demonstration  project,  which  is
       S. 1408                            112                           A. 2108
 
    1  entitled  the  partnership  plan,  as  approved  by the secretary of the
    2  federal department of health and human  services  and  accepted  by  the
    3  state for the extension period beginning April 1, 2003.
    4     §  20. The opening paragraph of section 2952 of the public health law,
    5  as amended by chapter 639 of the laws of 1996, is  amended  to  read  as
    6  follows:
    7    To  the  extent  of funds available therefor, the sum of seven million
    8  dollars shall annually be available for periods prior to January  first,
    9  two thousand three, and up to six million dollars annually for the peri-
   10  od  January first, two thousand three through December thirty-first, two
   11  thousand four, and up to four million dollars  for  the  period  January
   12  first, two thousand five through June thirtieth, two thousand five shall
   13  be  available  to the commissioner from funds made available pursuant to
   14  section twenty-eight hundred seven-l of this chapter for grants pursuant
   15  to this section.
   16     § 20-a. Subdivision 1 of section 2958 of the  public  health  law,  as
   17  added by chapter 639 of the laws of 1996, is amended to read as follows:
   18    1.  To  the extent of funds available therefor, the sum of ten million
   19  dollars shall annually be made available for periods  prior  to  January
   20  first,  two  thousand three, and up to eight million three hundred thou-
   21  sand dollars for the period January first, two  thousand  three  through
   22  December  thirty-first,  two  thousand  three,  up  to eight million two
   23  hundred thousand dollars for the period January first, two thousand four
   24  through December thirty-first,  two  thousand  four,  and  up  to  three
   25  million eight hundred thousand dollars for the period January first, two
   26  thousand  five through June thirtieth, two thousand five shall be avail-
   27  able to the commissioner from funds  pursuant  to  section  twenty-eight
   28  hundred  seven-l of this chapter to provide assistance to general hospi-
   29  tals classified as a rural hospital for purposes of determining  payment
   30  for  inpatient  services provided to beneficiaries of title XVIII of the
   31  federal social security act (Medicare) or under  state  regulations,  in
   32  recognition  of the unique costs incurred by these facilities to provide
   33  hospital services in remote or  sparsely  populated  areas  pursuant  to
   34  [subdivisions] subdivision two [and three] of this section.
   35     §  21.  Subdivisions 3, 4 and 5 of section 47 of chapter 2 of the laws
   36  of 1998, amending the public health law, the social services law and the
   37  insurance law relating to expanding the child health insurance plan,  as
   38  amended  by  section  55 of part A of chapter 1 of the laws of 2002, are
   39  amended to read as follows:
   40    3. section six  of  this  act  shall  take  effect  January  1,  1999;
   41  provided,  however, that subparagraph (iii) of paragraph (c) of subdivi-
   42  sion 9 of section 2510 of the public health law, as added by  this  act,
   43  shall expire on July 1, [2003] 2005;
   44    4.  sections  two, three, four, seven, eight, nine, fourteen, fifteen,
   45  sixteen, eighteen,  eighteen-a,  [twenty-three,]  twenty-four,  [twenty-
   46  five]  and twenty-nine of this act shall take effect January 1, 1999 and
   47  shall expire on July 1, [2003] 2005, and sections twenty-three and twen-
   48  ty-five of this act shall take effect January 1, 1999 and  shall  expire
   49  on July 1, 2003;
   50    5.  section  twelve  of  this  act  shall take effect January 1, 1999;
   51  provided, however, [paragraphs] paragraph (g) [and (h)] of subdivision 2
   52  of section 2511 of the public health law,  as  added  by  such  section,
   53  shall  expire  on  July  1,  2003, and paragraph (h) of subdivision 2 of
   54  section 2511 of the public health law, as added by this  section,  shall
   55  expire on July 1, 2005;
       S. 1408                            113                           A. 2108
 
    1     §  22.  Paragraph  (g)  of subdivision 2 of section 2511 of the public
    2  health law is REPEALED and paragraphs (h) and (j) of subdivision  2  are
    3  relettered paragraphs (g) and (h), respectively.
    4     §  22-a.  Notwithstanding  the  operation  of  subdivisions 4 and 6 of
    5  section 47 of chapter 2 of the laws of 1998, subdivision 4 as amended by
    6  section twenty-one of this act, a person who would be otherwise ineligi-
    7  ble for medical assistance due solely to the expiration of paragraph (t)
    8  or (u) of subdivision 4 of section 366 of the social services law  shall
    9  remain  eligible for medical assistance until such time as such person's
   10  eligibility is redetermined by the social services district pursuant  to
   11  such person's next scheduled recertification.
   12     § 23. Notwithstanding any inconsistent provision of section 112 or 163
   13  of  the  state  finance  law  or any other law, at the discretion of the
   14  commissioner of  health,  without  a  competitive  bid  or  request  for
   15  proposal  process, contractual arrangements with approved organizations,
   16  as defined in subdivision 2 of section 2510 of the  public  health  law,
   17  and outreach and facilitated enrollment contractors pursuant to subdivi-
   18  sion 9 of section 2511 of the public health law in effect in 2002 may be
   19  extended  through  July 1, 2005 to provide an uninterrupted continuation
   20  of services and may be amended as deemed necessary.
   21     § 24. Clause (A) of subparagraph (v) of paragraph (a) of subdivision 2
   22  of section 369-ee of the social services law, as amended by chapter  419
   23  of the laws of 2000, is amended to read as follows:
   24    (A)  in the case of a parent or stepparent of a child under the age of
   25  twenty-one who lives with such child, has gross family income  equal  to
   26  or  less  than  the  applicable  percent  of the federal income official
   27  poverty line (as defined and updated by the United States Department  of
   28  Health  and  Human Services) for a family of the same size; for purposes
   29  of this clause, the applicable percent effective as of:
   30    (I) January first, two thousand one, is one  hundred  twenty  percent;
   31  and
   32    (II)  October  first,  two  thousand  one, is one hundred thirty-three
   33  percent; and
   34    (III) October first, two thousand two, is one hundred  fifty  percent;
   35  [or] and
   36    (IV) February first, two thousand three, or upon receipt of all neces-
   37  sary  approvals  under  federal  law  and  regulation to receive federal
   38  financial participation under the program described in title  eleven  of
   39  this  article,  whichever is later, one hundred thirty-three percent for
   40  family health plus applicants whose  eligibility  is  determined  on  or
   41  after February first, two thousand three; or
   42     §  25.  Paragraph (c) of subdivision 3 of section 369-ee of the social
   43  services law, as added by chapter 1 of the laws of 1999, is  amended  to
   44  read as follows:
   45    (c)  Participants  under  this section who have lost their eligibility
   46  for health care services before the end of a six month period  beginning
   47  on  the  date of the participant's initial enrollment in a family health
   48  insurance plan shall have  their  eligibility  for  family  health  plus
   49  continued  until  the  end  of the six month enrollment period, provided
   50  that federal financial participation in the cost  of  such  coverage  is
   51  available.  The  provisions of this paragraph shall not apply to persons
   52  whose family income is in excess of the  income  standard  specified  in
   53  subclause  (IV)  of  clause  (A) of subparagraph (v) of paragraph (a) of
   54  subdivision two of this section, who are determined eligible for  family
   55  health plus on or after February first, two thousand three, but prior to
       S. 1408                            114                           A. 2108
 
    1  the effective date of such income standard, and who lose eligibility for
    2  health care services due to such income standard taking effect.
    3     §  26. Subsection (s) of section 4327 of the insurance law, as amended
    4  by chapter 419 of the laws of 2000, is amended to read as follows:
    5    (s) The superintendent may access funding from the small employer stop
    6  loss fund and/or the  qualifying  individual  stop  loss  fund  for  the
    7  purposes  of  developing and implementing public education, outreach and
    8  facilitated enrollment strategies targeted to small employers and  work-
    9  ing  adults  without  health  insurance. The superintendent may contract
   10  with marketing organizations to perform or provide assistance with  such
   11  education,  outreach,  and  enrollment  strategies.  [The superintendent
   12  shall determine the amount of funding available for the purposes of this
   13  subsection which in no event shall exceed  ten  percent  of  the  annual
   14  funding amounts for the small employer stop loss fund and the qualifying
   15  individual stop loss fund.]
   16     § 27. Section 59 of part J of chapter 82 of the laws of 2002, amending
   17  chapter 1 of the laws of 2002 amending the public health law, the social
   18  services  law, and the tax law relating to the Health Care Reform Act of
   19  2000 relating to health care reform, is amended to read as follows:
   20     § 59. Notwithstanding any law, rule or regulation to the contrary, the
   21  commissioner of health is authorized to [borrow]  utilize  any  existing
   22  cash  balances  in  pools  established  or  funded  pursuant to sections
   23  2807-j, 2807-k, 2807-m, 2807-s, 2807-t and 2807-v of the  public  health
   24  law  for  the  purpose  of  meeting any funding obligations set forth in
   25  sections 2807-k, 2807-l, 2807-m or 2807-v of  the  public  health  law[,
   26  provided,  however,  that  such  authorization shall expire and be of no
   27  further effect in the event the two hundred million dollars  transferred
   28  from  pools  established  pursuant  to sections 2807-j and 2807-v of the
   29  public health law pursuant to section fifty-eight of this act are trans-
   30  ferred back to said pools from the state general fund or otherwise;  and
   31  further provided that such authorization shall in no event extend beyond
   32  December 31, 2005; and further provided that, commencing with the effec-
   33  tive  date  of  this section, reports of cash transfers made pursuant to
   34  this section shall be submitted on a semi-annual basis to  the  director
   35  of  the budget, the temporary president of the senate and the speaker of
   36  the assembly].
   37     § 28. Section 58 of part J of chapter 82 of the laws of 2002, amending
   38  chapter 1 of the laws of 2002 amending the public health law, the social
   39  services law,  and the tax law relating to the Health Care Reform Act of
   40  2000 relating to health care reform, is amended to read as follows:
   41     § 58. (1) Notwithstanding any law, rule or regulation to the contrary,
   42  and in accordance with section 4 of the state finance law,  the  commis-
   43  sioner  of  health,  with the approval of the director of the budget, is
   44  authorized to [borrow] utilize two hundred million  dollars  from  funds
   45  collected  or to be collected in pools established pursuant to paragraph
   46  (b) of subdivision 9 of section 2807-j of  the  public  health  law  and
   47  section  2807-v of the public health law which shall be allocated pursu-
   48  ant to subdivision two of this section, and  [to  transfer  such  funds]
   49  transferred  to  the  state special revenue funds - other, HCRA transfer
   50  fund, medical assistance account for Medicaid purposes,  including,  but
   51  not  limited  to,  disaster relief Medicaid[, provided, however, that in
   52  the event that the commissioner of health and the director of the budget
   53  subsequently determine prior to the expiration date of such sections  as
   54  set  forth  in  section  138 of chapter 1 of the laws of 1999 that addi-
   55  tional funds are required to meet  obligations  set  forth  in  sections
   56  2807-k,  2807-l,  2807-m  or 2807-v of the public health law, that up to
       S. 1408                            115                           A. 2108
 
    1  two hundred million dollars shall be transferred from the state  general
    2  fund  to pools established pursuant to paragraph (b) of subdivision 9 of
    3  section 2807-j of the public health law and section 2807-v of the public
    4  health  law;  and  further  provided that the commissioner of health and
    5  director of the budget shall ensure that the authorizations contained in
    6  this section and section fifty-nine  of  this  act  shall  in  no  event
    7  impede, limit or otherwise impair, in any way, the implementation of, or
    8  the  time  frames  or  levels of financial distributions for, any of the
    9  initiatives financed pursuant  to  section  2807-k,  2807-l,  2807-m  or
   10  2807-v of the public health law].
   11    (2)  The  two hundred million dollars transferred pursuant to subdivi-
   12  sion one of this section shall be charged against the following programs
   13  in the following amounts:
   14    (a) From the allocations for the New York state small business  health
   15  insurance  partnership  program  as  set forth pursuant to clause (A) of
   16  subparagraph (ii) of paragraph (b) of subdivision 1 of section 2807-l of
   17  the public health law for the periods January 1, 2002 through  June  30,
   18  2003, four million two hundred thousand dollars;
   19    (b)  From  the allocation for the hospital based grant programs as set
   20  forth pursuant to subparagraph (i) of paragraph (c) of subdivision 1  of
   21  section  2807-l  of the public health law for the period January 1, 2003
   22  through December 31, 2003, eight million dollars;
   23    (c) From the allocation for the emergency  medical  services  training
   24  account  as  set forth pursuant to subparagraph (ii) of paragraph (c) of
   25  subdivision 1 of section 2807-l of the  public  health  law  the  period
   26  January 1, 2003 through December 31, 2003, seven million dollars;
   27    (d)  From  the  allocation  for the primary health care services grant
   28  program as set forth pursuant to subparagraph (iii) of paragraph (g)  of
   29  subdivision  1 of 2807-l of the public health law for the period January
   30  1, 1999 through December 31, 1999, five million eight  hundred  thousand
   31  dollars;
   32    (e) From the allocation for the healthy New York individual program as
   33  set  forth  pursuant to subparagraphs (ii) and (iii) of paragraph (h) of
   34  subdivision 1 of section 2807-v of the public health law for the  period
   35  January  1,  2002  two  through  December  31, 2003, forty-eight million
   36  dollars; and
   37    (f) From the allocation for the healthy New York group program as  set
   38  forth  pursuant  to  subparagraphs  (ii)  and  (iii) of paragraph (i) of
   39  subdivision 1 of section 2807-v of the public health law for the  period
   40  January  1,  2002  through  December  31, 2003, one hundred twenty-seven
   41  million dollars.
   42     § 29. Subparagraph (i) of paragraph (a) of subdivision  5  of  section
   43  2807-j  of the public health law, as amended by chapter 1 of the laws of
   44  1999, is amended to read as follows:
   45    (i) The election pursuant to this paragraph to be effective must be in
   46  writing, filed with the commissioner or the commissioner's  designee  on
   47  such  forms  and  in  such  manner as the commissioner shall require. An
   48  election must apply to all classes of designated  providers  of  service
   49  and  to  all  providers  within each class. An election by a payor shall
   50  take effect [for nineteen hundred ninety-seven,] on the  next  following
   51  January  first, April first, July first, or October first, [and for each
   52  calendar year thereafter on the next following January first,] not  less
   53  than thirty days after the election is filed. [Beginning December first,
   54  nineteen  hundred  ninety-seven,  an election pursuant to this paragraph
   55  must be made no later than December first  of  the  year  prior  to  the
   56  assessment  year.  However, any payor licensed pursuant to the insurance
       S. 1408                            116                           A. 2108
 
    1  law or certified pursuant to article forty-four of this chapter  between
    2  December  first  of  the  year prior to the assessment year and December
    3  thirty-first of the assessment year may make an election  subsequent  to
    4  such  licensure, and during said time period, to take effect on the next
    5  following January first, April first, July first or  October  first  not
    6  less  than  thirty  days after such election is filed. Payors other than
    7  those licensed pursuant to the insurance law or  certified  pursuant  to
    8  this  chapter  which  have  not  provided  third-party coverage prior to
    9  December first of the year prior to the  assessment  year  may  make  an
   10  election  at  any  time  from  December  first of the year prior to said
   11  assessment year to December thirty-first of the assessment year, to take
   12  effect on the next following January first, April first, July  first  or
   13  October first not less than thirty days after the election is filed.]
   14     §  30.  Subparagraph  (a)  of subdivision 5-a of section 2807-j of the
   15  public health law, as amended by chapter 419 of the  laws  of  2000,  is
   16  amended to read as follows:
   17    (a)  Payments  by  or on behalf of designated providers of services to
   18  the commissioner or the commissioner's designee of funds  due  from  the
   19  allowances  pursuant  to  subdivision two of this section or pursuant to
   20  payment obligations incurred pursuant to  section  twenty-eight  hundred
   21  seven-s  of this article or section twenty-eight hundred seven-t of this
   22  article shall be made on a monthly basis, provided,  however,  that  for
   23  reporting periods relating to payments for services provided or dates of
   24  inpatient  discharge  or  contracted service obligations occurring on or
   25  after January first, two  thousand  one,  the  commissioner  may  permit
   26  certain  third-party  payors  which  have at least one full year of pool
   27  payment experience to submit such payments on an annual basis, based  on
   28  an annual demonstration by a payor through its prior year's pool payment
   29  experience  that  total pool obligations under this section and sections
   30  twenty-eight hundred seven-s and twenty-eight hundred  seven-t  of  this
   31  article  are not expected to exceed ten thousand dollars [in the current
   32  pool year] for annual periods prior to January first, two thousand four,
   33  and twenty-five thousand dollars for annual periods on and after January
   34  first, two thousand four.   Payments  due  by  designated  providers  of
   35  services on account of payors in accordance with paragraph (b) of subdi-
   36  vision  two of this section shall be two percentage points less than the
   37  percentage specified in  such  paragraph.  The  designated  provider  of
   38  services  shall  retain for compensation for such provider's administra-
   39  tive  responsibilities  the  amount  that  represents  the   difference.
   40  Payments due by designated providers of services on account of all other
   41  payors  shall  be  calculated  on  the basis of the percentage allowance
   42  applicable to such payor pursuant to paragraphs (d), (e), (f) and (g) of
   43  subdivision two of this section. Payments shall be due on or before  the
   44  thirtieth  day  following the end of a calendar month to which an allow-
   45  ance applies.
   46     § 31. Paragraphs (a) and (b) of subdivision 7 of section 2807-j of the
   47  public health law, paragraph (a) as added by chapter 639 of the laws  of
   48  1996,  and  paragraph (b) as amended by chapter 419 of the laws of 2000,
   49  are amended to read as follows:
   50    (a) Every designated provider of services shall submit reports of  net
   51  patient  service revenues received for or on account of patient services
   52  for each month which shall be in such form as may be prescribed  by  the
   53  commissioner  to  accurately  disclose information required to implement
   54  this section.   For periods on and after  January  first,  two  thousand
   55  five,  reports  by  designated  providers of services shall be submitted
   56  electronically in a  form  as  may  be  required  by  the  commissioner;
       S. 1408                            117                           A. 2108
 
    1  provided, however, any designated provider of services is not prohibited
    2  from  submitting  reports  electronically  on a voluntary basis prior to
    3  such date.
    4    (b)  (i) Every third-party payor making an election in accordance with
    5  paragraph (a) of subdivision five of this section shall  submit  reports
    6  of  patient  service  expenditures  for  services provided by designated
    7  providers of services for each month which shall be in such form as  may
    8  be  prescribed  by  the  commissioner to accurately disclose information
    9  required to implement this section, provided, however, that for  report-
   10  ing periods relating to payments for services provided or dates of inpa-
   11  tient  discharge or contracted service obligations occurring on or after
   12  January first, two thousand one, the  commissioner  may  permit  certain
   13  third-party  payors  which  have  at least one full year of pool payment
   14  experience to submit such reports on an annual basis, based on an annual
   15  demonstration by a payor through its prior year's pool  payment  experi-
   16  ence  that  total pool obligations under this section and sections twen-
   17  ty-eight hundred seven-s and twenty-eight hundred seven-t of this  arti-
   18  cle are not expected to exceed ten thousand dollars [in the current pool
   19  year]  for annual periods prior to January first, two thousand four, and
   20  twenty-five thousand dollars for annual periods  on  and  after  January
   21  first, two thousand four.
   22    (ii)  For  periods on and after July first, two thousand four, reports
   23  submitted on a monthly basis by third-party payors  in  accordance  with
   24  subparagraph (i) of this paragraph and reports submitted on a monthly or
   25  annual  basis by payors acting in an administrative services capacity on
   26  behalf of electing third-party payors in  accordance  with  subparagraph
   27  (i)  of  this paragraph shall be made electronically in a form as may be
   28  required by the commissioner; provided, however, any third-party  payor,
   29  except payors acting in an administrative services capacity on behalf of
   30  electing third-party payors, which, on or after January first, two thou-
   31  sand  four,  elects to make payments directly to the commissioner or the
   32  commissioner's designee pursuant to subdivision five  of  this  section,
   33  shall  be  subject to this subparagraph only after one full year of pool
   34  payment experience which results in reports being submitted on a monthly
   35  basis. This subparagraph shall not be interpreted to prohibit any third-
   36  party payor from submitting reports electronically on a voluntary basis.
   37     § 32. Paragraph (b) of subdivision 20 of section 2807-c of the  public
   38  health law, as amended by chapter 731 of the laws of 1993, is amended to
   39  read as follows:
   40    (b)  (i) Payments by or on behalf of general hospitals to the bad debt
   41  and charity care and capital  statewide  pool  of  funds  due  from  the
   42  assessments  pursuant  to  subdivision eighteen of this section shall be
   43  made on a time schedule established  by  the  council,  subject  to  the
   44  approval  of  the  commissioner,  by regulation; provided, however, that
   45  estimated payments of amounts due for patients discharged in a  calendar
   46  month  commencing on or after October first, nineteen hundred ninety-one
   47  must be made within sixty days of the end of each month unless  payments
   48  of  actual  amounts  due  for such calendar months have been made within
   49  such sixty day time  period.  Upon  receipt  of  notification  from  the
   50  commissioner,  the  comptroller,  or a fiscal intermediary designated by
   51  the director of the budget, [or the commissioner of social services,] or
   52  a corporation organized and operating in accordance with article  forty-
   53  three  of  the  insurance law or an organization operating in accordance
   54  with article forty-four of this chapter shall withhold from  the  amount
   55  of  any  payment  to  be  made  by the state or such article forty-three
   56  corporation or article forty-four organization to a general hospital the
       S. 1408                            118                           A. 2108
 
    1  amount of any arrearage resulting from such general  hospital's  failure
    2  to  make  a  timely payment to the bad debt and charity care and capital
    3  statewide pool of funds due from the assessments. Upon withholding  such
    4  amount,  the  comptroller,  or a designated fiscal intermediary, [or the
    5  commissioner of social services,] or a corporation organized and operat-
    6  ing in accordance with article forty-three of the insurance  law  or  an
    7  organization  operating  in  accordance  with article forty-four of this
    8  chapter shall pay the commissioner, or his designee, such  amount  with-
    9  held  for  deposit  into  the  applicable  pool. Any general hospital in
   10  arrears resulting from failure to make a timely payment to the bad  debt
   11  and  charity care and capital statewide pool shall not be eligible for a
   12  distribution from the bad  debt  and  charity  care  regional  pools  in
   13  accordance  with  subdivision  seventeen of this section or the bad debt
   14  and charity care and capital statewide pool in accordance with  subdivi-
   15  sion nineteen of this section until such arrearage is satisfied.
   16    (ii)  For  periods  on  and  after  January  first, two thousand five,
   17  reports submitted by general hospitals to implement the  assessment  set
   18  forth  in  subdivision eighteen of this section shall be submitted elec-
   19  tronically in a form as may be required by the  commissioner;  provided,
   20  however,  general  hospitals  are not prohibited from submitting reports
   21  electronically on a voluntary basis prior to such date.
   22     § 33. Notwithstanding any provision of law, rule or regulation to  the
   23  contrary, assessments and allowances due for any period prior to January
   24  1,  2003,  which are paid in full and accompanied by appropriate reports
   25  pursuant to sections 2807-j, 2807-s, 2807-t, paragraph (a)  of  subdivi-
   26  sion  18  of  section  2807-c or subdivision 20 of section 2807-c of the
   27  public health law and which are received on or before December 31, 2003,
   28  shall not be subject to interest or penalties as otherwise  provided  in
   29  sections  2807-j,  2807-s,  2807-t  or  2807-c of the public health law,
   30  provided, however, that with regard  to  all  assessment,  interest  and
   31  penalty amounts collected by the commissioner of health by the effective
   32  date of this act the interest and penalty provisions of sections 2807-j,
   33  2807-s,  2807-t and 2807-c of the public health law shall remain in full
   34  force and effect and such amounts collected  shall  not  be  subject  to
   35  further  reconciliation  or  adjustment  and  further  provided that the
   36  provisions of this section shall not apply  to  any  assessment  payment
   37  made  in response to an audit finding made by the commissioner of health
   38  or the commissioner of health's designee.
   39     § 34. Subdivisions (b) and (c) of section 6 of part J of chapter 63 of
   40  the laws of 2001 amending chapter 20 of the laws of  2001  amending  the
   41  military  law  and  other laws relating to making appropriations for the
   42  support of government, as amended by section 4 of part T of chapter  383
   43  of the laws of 2001, are amended to read as follows:
   44    (b)  Notwithstanding  any  law or regulation to the contrary, upon the
   45  determination and certification made pursuant to subdivision (a) of this
   46  section, the commissioner of health shall be authorized and directed  to
   47  [borrow] utilize for the purpose of transferring the amount specified in
   48  subdivision (e) of this section from funds accumulated and pooled pursu-
   49  ant  to  subdivision 14-b of section 2807-c of the public health law. If
   50  however, at any time, the commissioner of  health  determines  that  the
   51  funds  pooled  pursuant  to  subdivision  14-b  of section 2807-c of the
   52  public health law are insufficient to make  payments  which  would  have
   53  been  made  except  for  the  transfer  authorized by this section, such
   54  commissioner shall be authorized to transfer such amounts that shall  be
   55  necessary  from  any  of  the  pooled  funds established pursuant to the
   56  following: chapters 536, 537 and 538 of the laws of 1982,  chapters  807
       S. 1408                            119                           A. 2108
 
    1  and  906  of  the  laws of 1985, chapters 2 and 605 of the laws of 1988,
    2  chapters 922 and 923 of the laws of 1990, chapter 731  of  the  laws  of
    3  1993  and  chapter  81  of  the laws of 1995, but in no event shall such
    4  transfers exceed thirty-four million five hundred thousand dollars.
    5    (c)  Notwithstanding  any  law or regulation to the contrary, upon the
    6  determination and certification made pursuant to subdivision (a) of this
    7  section, the commissioner of health shall be authorized and directed  to
    8  [borrow] utilize for the purpose of transferring the amount specified in
    9  subdivision  (e)  of this section from interest earnings associated with
   10  the pooled funds established pursuant to the  following:  chapters  536,
   11  537  and  538  of  the laws of 1982, chapters 807 and 906 of the laws of
   12  1985, chapters 2 and 605 of the laws of 1988, chapters 922  and  923  of
   13  the  laws of 1990, chapter 731 of the laws of 1993 and chapter 81 of the
   14  laws of 1995, but in no event shall such transfers  exceed  ten  million
   15  three hundred thousand dollars.
   16     §  35.    Paragraphs  1 and 2 of subsection (j) of section 4301 of the
   17  insurance law, paragraph 1 as  amended  and  paragraph  2  as  added  by
   18  section  8  of  part  A of chapter 1 of the laws of 2002, are amended to
   19  read as follows:
   20    (1) [No] Except as provided below,  every  medical  expense  indemnity
   21  corporation, dental expense indemnity corporation, health service corpo-
   22  ration,  or  hospital  service  corporation  shall  be [converted into a
   23  corporation organized for pecuniary profit. Every such corporation shall
   24  be] maintained and operated for the benefit of its members and subscrib-
   25  ers as a co-operative corporation.
   26    (2) An article forty-three corporation [which was the  subject  of  an
   27  initial  opinion  and decision issued by the superintendent on or before
   28  December thirty-first, nineteen hundred ninety-nine, as the same may  be
   29  amended,]  may be converted into a corporation or other entity organized
   30  for pecuniary profit, or into a for-profit  organization,  in  any  such
   31  case,  in accordance with the provisions of section seven thousand three
   32  hundred seventeen of this chapter.
   33     § 36. Paragraph 1 of subsection (a) of section 7317 of  the  insurance
   34  law,  as added by section 10 of part A of chapter 1 of the laws of 2002,
   35  is amended to read as follows:
   36    (1) An article forty-three corporation [which was the  subject  of  an
   37  initial  opinion  and decision issued by the superintendent on or before
   38  December thirty-first, nineteen hundred ninety-nine, as the same may  be
   39  amended,]  which  seeks  to  convert  into a corporation or other entity
   40  organized for pecuniary profit or into a for-profit organization of  any
   41  kind  shall  submit  a proposed plan of conversion to the superintendent
   42  for approval pursuant to this section.
   43     § 37. Subdivision 1 of section 76 of chapter 731 of the laws of  1993,
   44  amending the public health law and other laws relating to reimbursement,
   45  delivery  and capital costs of ambulatory health care services and inpa-
   46  tient hospital services, as amended by chapter 1 of the laws of 1999, is
   47  amended to read as follows:
   48    (1)  sections two through twenty-one, thirty through thirty-two, thir-
   49  ty-four  through  thirty-seven,  forty-six,  fifty  through   fifty-two,
   50  fifty-four,  fifty-six,  fifty-seven, fifty-nine through sixty-seven and
   51  seventy through seventy-four of this act shall take effect on January 1,
   52  1994, provided, however, that:
   53    (a) section 2904-c of the public health law as added by section  four-
   54  teen  of  this  act,  and  sections fifty-one, fifty-two, sixty-two, and
   55  sixty-three of this act shall expire June 30, 1996; and
       S. 1408                            120                           A. 2108
 
    1    (b) sections fifteen through nineteen, subdivision 3 of section 2807-e
    2  of the public health law as added by section twenty  of  this  act,  and
    3  section seventy-four of this act shall expire on June 30, [2003] 2005;
    4     §  38.  Paragraph (a) of subdivision 12 of section 367-b of the social
    5  services law, as amended by chapter 1 of the laws of 1999, is amended to
    6  read as follows:
    7    (a) For the purpose of regulating cash flow for general hospitals, the
    8  department shall develop and implement a payment methodology to  provide
    9  for  timely  payments  for inpatient hospital services eligible for case
   10  based payments per discharge based on diagnosis-related groups  provided
   11  during  the  period January first, nineteen hundred eighty-eight through
   12  June thirtieth, two thousand [three] five, by such hospitals which elect
   13  to participate in the system.
   14     § 39. Paragraph (i) of subdivision (b) of section 1 of chapter 520  of
   15  the  laws  of  1978, relating to providing for a comprehensive survey of
   16  health care financing, education and  illness  prevention  and  creating
   17  councils for the conduct thereof, as amended by chapter 1 of the laws of
   18  1999, is amended to read as follows:
   19    (i)    oversight  and  evaluation of the inpatient financing system in
   20  place for 1988 through June 30, [2003] 2005, and the appropriateness and
   21  effectiveness of the bad debt and charity care financing provisions;
   22     § 40. Section 2 of chapter 600 of  the  laws  of  1986,  amending  the
   23  public  health  law  relating  to the development of pilot reimbursement
   24  programs for ambulatory care services, as amended by chapter  1  of  the
   25  laws of 1999, is amended to read as follows:
   26     §  2.  This  act  shall  take effect immediately, except that this act
   27  shall expire and be of no further force and effect on and after June 30,
   28  [2003] 2005; provided, however, that the commissioner  of  health  shall
   29  submit a report to the governor and the legislature detailing the objec-
   30  tive,  impact, design and computation of any pilot reimbursement program
   31  established pursuant to this act, on or before March 31, 1994 and  annu-
   32  ally  thereafter.  Such report shall include an assessment of the finan-
   33  cial impact of such payment system on providers, as well as  the  impact
   34  of such system on access to care.
   35     §  41.  Section  11  of  chapter 753 of the laws of 1989, amending the
   36  public health law and other laws relating to general hospital reimburse-
   37  ment for inpatient and ambulatory surgery, as amended by  chapter  1  of
   38  the laws of 1999, is amended to read as follows:
   39     §  11. This act shall take effect immediately; provided, however, that
   40  section one shall expire and have no further force or effect on or after
   41  June 30, [2003] 2005, section two of this act shall be  deemed  to  have
   42  been  in  full  force  and effect on and after January 1, 1988, sections
   43  three through eight of this act shall be deemed to  have  been  in  full
   44  force  and  effect on and after January 1, 1989, and that the amendments
   45  made to section 2807-c of the public health law by sections two  through
   46  six of this act shall expire on the same date as such section expires.
   47     §  42.  (1) Notwithstanding any inconsistent provision of law, rule or
   48  regulation, the commissioner of health is authorized to transfer  within
   49  amounts  appropriated  and  the  state  comptroller  is  authorized  and
   50  directed to receive for deposit to  the  credit  of  the  department  of
   51  health's  special  revenue  fund  - other, miscellaneous special revenue
   52  fund - 339, provider collection monitoring account, five  hundred  thou-
   53  sand dollars ($500,000), or so much thereof as may be necessary, annual-
   54  ly  of funds collected and accumulated pursuant to section 2807-v of the
   55  public health law, including income from invested funds, for the purpose
   56  of payment for administrative costs of the department of health  related
       S. 1408                            121                           A. 2108
 
    1  to  administration  of statutory duties for the collections and distrib-
    2  utions authorized by section 2807-v of the public health law.
    3    (2)  Notwithstanding  any inconsistent provision of law, rule or regu-
    4  lation, the commissioner of health is authorized  to  transfer  and  the
    5  comptroller  is  authorized  to  deposit  five  hundred thousand dollars
    6  ($500,000), or so much thereof as may be necessary,  annually  of  funds
    7  collected  and  accumulated  and  interest  earned through surcharges on
    8  payments for health care services pursuant  to  section  2807-s  of  the
    9  public health law and from assessments pursuant to section 2807-t of the
   10  public health law for the purpose of payment for administrative costs of
   11  the  department  of health related to administration of statutory duties
   12  for the collections and distributions  authorized  by  sections  2807-s,
   13  2807-t,  and  2807-m  of the public health law into such accounts estab-
   14  lished within the department of health for such purposes.
   15    (3) Notwithstanding any inconsistent provision of law, rule  or  regu-
   16  lations,  the  commissioner  of health is authorized to transfer and the
   17  comptroller is authorized to deposit, within amounts appropriated, those
   18  funds authorized for distribution in accordance with the  provisions  of
   19  paragraph  (a)  of  subdivision 1 of section 2807-l of the public health
   20  law for the purposes of payment for administrative costs of the  depart-
   21  ment  of  health  related  to  the  child  health insurance plan program
   22  authorized pursuant to title 1-A of article 25 of the public health  law
   23  into  the  special  revenue funds - other, miscellaneous special revenue
   24  fund - 339,  child  health  insurance  account  established  within  the
   25  department of health.
   26    (4)  Notwithstanding  any inconsistent provision of law, rule or regu-
   27  lation, the commissioner of health is authorized  to  transfer  and  the
   28  comptroller is authorized to deposit, within amounts appropriated, those
   29  funds  authorized  for distribution in accordance with the provisions of
   30  paragraph (e) of subdivision 1 of section 2807-1 of  the  public  health
   31  law  for  the purpose of payment for administrative costs of the depart-
   32  ment of health related to the health occupation  development  and  work-
   33  place  demonstration  program established pursuant to section 2807-h and
   34  the health workforce retraining program established pursuant to  section
   35  2807-g  of the public health law into the special revenue funds - other,
   36  miscellaneous special revenue fund - 339, health occupation  development
   37  and  workplace  demonstration  program  account  established  within the
   38  department of health.
   39    (5) Notwithstanding any inconsistent provision of law, rule  or  regu-
   40  lation,  the  commissioner  of  health is authorized to transfer and the
   41  comptroller is authorized to deposit two million  dollars  ($2,000,000),
   42  or  so  much  thereof  as  may be necessary, annually of funds allocated
   43  pursuant to paragraph (j) of subdivision 1  of  section  2807-v  of  the
   44  public health law for the purpose of payment for administrative costs of
   45  the department of health related to administration of the state's tobac-
   46  co  control  programs  and cancer services provided pursuant to sections
   47  2807-r and 1399-ii of the public health law into  such  accounts  estab-
   48  lished within the department of health for such purposes.
   49    (6)  Notwithstanding  any inconsistent provision of law, rule or regu-
   50  lation, the commissioner of health is authorized to transfer and deposit
   51  six hundred fifty thousand dollars ($650,000), or so much thereof as may
   52  be necessary, annually of funds authorized for distribution  in  accord-
   53  ance with the provisions of section 2807-l of the public health law from
   54  monies  accumulated  and  interest  earned  through funds authorized for
   55  distribution in accordance with the provisions of section 2807-l of  the
   56  public health law for the purpose of payment for administrative costs of
       S. 1408                            122                           A. 2108
 
    1  the  department of health related to programs funded pursuant to section
    2  2807-l of the public health law into the special revenue funds -  other,
    3  miscellaneous special revenue fund - 339, primary care initiatives moni-
    4  toring account established within the department of health.
    5    (7)  Notwithstanding  any inconsistent provision of law, rule or regu-
    6  lation, the commissioner of health is authorized to transfer and deposit
    7  one hundred thousand dollars ($100,000), or so much thereof  as  may  be
    8  necessary,  annually  of funds authorized for distribution in accordance
    9  with the provisions of section 2807-l of the public health law  for  the
   10  purposes of payment for administrative costs of the department of health
   11  related  to the programs funded pursuant to section 2807-l of the public
   12  health law into the special revenue funds - other, miscellaneous special
   13  revenue fund - 339, primary care initiatives monitoring  account  estab-
   14  lished within the department of health.
   15    (8)  Notwithstanding  any inconsistent provision of law, rule or regu-
   16  lation, the commissioner of health is authorized  to  transfer  and  the
   17  comptroller  is  authorized to deposit, within amounts appropriated, the
   18  funds authorized for distribution in accordance with the  provisions  of
   19  section  2807-l of the public health law for the purposes of payment for
   20  administrative costs of the department of health related to the programs
   21  funded pursuant to section 2807-l of the  public  health  law  into  the
   22  special revenue funds - other, miscellaneous special revenue fund - 339,
   23  pilot  health  insurance  account  established  within the department of
   24  health.
   25    (9) Notwithstanding any inconsistent provision of law, rule  or  regu-
   26  lation,  the  commissioner  of  health is authorized to transfer and the
   27  comptroller is authorized to deposit, within amounts appropriated, those
   28  funds authorized for distribution in accordance with the  provisions  of
   29  subparagraph  (ii)  of paragraph (f) of subdivision 19 of section 2807-c
   30  of the public health law from monies accumulated and interest earned  in
   31  the  bad  debt  and  charity care and capital statewide pools through an
   32  assessment charged to general hospitals pursuant to  the  provisions  of
   33  subdivision  18  of  section  2807-c  of the public health law and those
   34  funds authorized for distribution in accordance with the  provisions  of
   35  section  2807-l of the public health law for the purposes of payment for
   36  administrative costs of the department of health related  to  monitoring
   37  the  implementation  and  effectiveness of programs funded under section
   38  2807-l of the public health law into the special revenue funds -  other,
   39  miscellaneous special revenue fund - 339, primary care initiatives moni-
   40  toring account established within the department of health.
   41    (10)  Notwithstanding any inconsistent provision of law, rule or regu-
   42  lation, the commissioner of health is authorized  to  transfer  and  the
   43  comptroller is authorized to deposit, within amounts appropriated, those
   44  funds  authorized  for distribution in accordance with section 2807-l of
   45  the public health law for the purposes  of  payment  for  administrative
   46  costs  of  the  department  of  health  related to programs funded under
   47  section 2807-l of the public health law into the special revenue funds -
   48  other, miscellaneous special revenue fund - 339,  health  care  delivery
   49  improvement  grant administration account established within the depart-
   50  ment of health.
   51    (11) Notwithstanding any inconsistent provision of law, rule or  regu-
   52  lation,  the  commissioner  of  health is authorized to transfer and the
   53  comptroller is authorized to deposit, within amounts appropriated, those
   54  funds authorized pursuant to sections 2807-d, 3614-a and 3614-b  of  the
   55  public  health  law and section 367-i of the social services law and for
   56  distribution in accordance with  the  provisions  of  subdivision  9  of
       S. 1408                            123                           A. 2108
 
    1  section  2807-j  of the public health law for the purpose of payment for
    2  administration of statutory duties for the collections and distributions
    3  authorized by sections 2807-c, 2807-d, 2807-j,  2807-k,  2807-l,  3614-a
    4  and  3614-b  of  the  public  health law and section 367-i of the social
    5  services law into the  special  revenue  funds  -  other,  miscellaneous
    6  special  revenue  fund  -  339,  provider  collection monitoring account
    7  established within the department of health.
    8     § 43. Paragraph (a) of subdivision 4 of section 2807-j of  the  public
    9  health  law,  as added by chapter 639 of the laws of 1996, is amended to
   10  read as follows:
   11    (a) The commissioner  is  authorized  to  contract  with  the  article
   12  forty-three  insurance  law  plans,  or  such  other  contractors as the
   13  commissioner shall designate, to receive and distribute funds  from  the
   14  allowances  established  pursuant  to  this  section, and funds from the
   15  assessments established pursuant  to  subdivision  eighteen  of  section
   16  twenty-eight  hundred  seven-c  of  this article. In the event contracts
   17  with the article forty-three insurance law plans or other commissioner's
   18  designees are effectuated, the commissioner shall conduct annual  audits
   19  of  the  receipt and distribution of the funds. The reasonable costs and
   20  expenses of an administrator as approved by  the  commissioner,  not  to
   21  exceed  for personnel services on an annual basis [six hundred thousand]
   22  two million two hundred thousand dollars for collection and distribution
   23  of allowances and assessments established pursuant to this  section  and
   24  subdivision  eighteen  of  section  twenty-eight hundred seven-c of this
   25  article [and four hundred thousand dollars for  distributions  of  funds
   26  from the allowances established pursuant to this section and assessments
   27  established  pursuant  to  subdivision  eighteen of section twenty-eight
   28  hundred seven-c of this article], shall be paid from the  allowance  and
   29  assessment funds.
   30     §  44.  Paragraph (a) of subdivision 4 of section 2807-s of the public
   31  health law, as added by chapter 639 of the laws of 1996, is  amended  to
   32  read as follows:
   33    (a)  The  commissioner  is  authorized  to  contract  with the article
   34  forty-three insurance law  plans,  or  such  other  contractors  as  the
   35  commissioner  shall  designate, to receive and distribute funds from the
   36  allowances established pursuant to  this  section  and  funds  from  the
   37  assessments established pursuant to section twenty-eight hundred seven-t
   38  of  this  article.  In  the event contracts with the article forty-three
   39  insurance law plans or other commissioner's designees  are  effectuated,
   40  the commissioner shall conduct annual audits of the receipt and distrib-
   41  ution  of the funds. The reasonable costs and expenses of an administra-
   42  tor as approved  by  the  commissioner,  not  to  exceed  for  personnel
   43  services  on an annual basis [four hundred] eight hundred fifty thousand
   44  dollars for collection and distribution of allowances established pursu-
   45  ant to this section and assessments established pursuant to this section
   46  and assessments established pursuant  to  section  twenty-eight  hundred
   47  seven-t  of this article shall be paid from the allowance and assessment
   48  funds.
   49     § 45. Paragraph (f) of subdivision 1 and subdivision 10 of section 206
   50  of the public health law, paragraph (f) of subdivision 1 as  amended  by
   51  chapter 474 of the laws of 1996 and subdivision 10 as amended by chapter
   52  703 of the laws of 1988, are amended to read as follows:
   53    (f)  enforce  the  public  health  law,  the  sanitary  code  and  the
   54  provisions of the medical assistance program, or its successor, pursuant
   55  to titles eleven[, eleven-A] and eleven-B of the social services law, as
   56  amended by this chapter;
       S. 1408                            124                           A. 2108
 
    1    10. The commissioner, with the approval of the state director  of  the
    2  budget, shall establish and promulgate a schedule of proportional shares
    3  for  cost sharing [under subdivision one of section three hundred sixty-
    4  nine-d of the social services law]. In developing such a  schedule,  the
    5  commissioner shall take into consideration various options available for
    6  obtaining  health  care services, the availability of such services, and
    7  the  impact  of  cost  sharing  on  prudent  utilization  and  efficient
    8  provision of services [without undue barriers to care for persons eligi-
    9  ble  for  assistance  under the catastrophic health care expense program
   10  established by section three hundred sixty-nine-c of the social services
   11  law].
   12     § 46. Subdivisions 1 and 6 of section 2 of the social services law, as
   13  amended by chapter 474 of the laws of  1996,  are  amended  to  read  as
   14  follows:
   15    1.  Department means the state department of social services, provided
   16  however that for purposes of titles eleven[, eleven-A] and  eleven-B  of
   17  article  five  of this chapter, department means the state department of
   18  health, except that in subdivisions  two  and  three  of  section  three
   19  hundred  sixty-four-i, clause (d) of subparagraph three of paragraph (b)
   20  of subdivision two of section three hundred sixty-six, paragraph (b)  of
   21  subdivision  four  of  section three hundred sixty-six, subdivisions one
   22  through five of section three hundred sixty-six-a, subdivision seven  of
   23  section  three  hundred  sixty-six-a,  and  section three hundred sixty-
   24  eight-c of this chapter and where the context thereof  clearly  requires
   25  otherwise, department means the state department of social services.
   26    6.  Commissioner  means  the  state  commissioner  of social services,
   27  provided however that for purposes  of  titles  eleven[,  eleven-A]  and
   28  eleven-B  of  article five of this chapter, commissioner means the state
   29  commissioner of health, except that in clause (c) of subparagraph  three
   30  of  paragraph  (b) of subdivision two of section three hundred sixty-six
   31  of this chapter and where the context thereof  clearly  requires  other-
   32  wise, commissioner means the state commissioner of social services.
   33     § 47. Title 11-A of the social services law is REPEALED.
   34     § 48. Notwithstanding such repeal, and within the amounts specifically
   35  allocated  to  the catastrophic health care expense program prior to the
   36  effective date of such repeal, participating social  services  districts
   37  are  authorized to provide reimbursement to families that, prior to such
   38  effective date, incur health care expenses  eligible  for  reimbursement
   39  under  the program and provided further that districts are authorized to
   40  expend amounts within  such  allocation  necessary  to  administer  such
   41  reimbursement.
   42     § 49. Notwithstanding any inconsistent provision of law, rule or regu-
   43  lation, for purposes of implementing the provisions of article 28 of the
   44  public  health  law,  references  to  titles  XIX and XXI of the federal
   45  social security act in article 28 of the  public  health  law  shall  be
   46  deemed  to  include  and also to mean any successor titles thereto under
   47  the federal social security act.
   48     § 50. Notwithstanding any inconsistent provision of law, rule or regu-
   49  lation, the effectiveness of subdivisions 4, 7, 7-a and 7-b  of  section
   50  2807 of the public health law and section 18 of chapter 2 of the laws of
   51  1998,  as  they  relate  to  time frames for notice, approval or certif-
   52  ication of rates of payment, and to the requirement of prior  notice  of
   53  rates of payment, are hereby suspended and shall, for purposes of imple-
   54  menting  the  provisions of this act, be deemed to have been without any
   55  force or effect from and after November 1, 2002 for such rates effective
   56  for the period January 1, 2003 through December 31, 2003.
       S. 1408                            125                           A. 2108
 
    1     § 51. Severability clause. If any clause, sentence, paragraph,  subdi-
    2  vision,  section  or  part of this act shall be adjudged by any court of
    3  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    4  impair or invalidate the remainder thereof, but shall be confined in its
    5  operation  to  the  clause, sentence, paragraph, subdivision, section or
    6  part thereof directly involved in the controversy in which such judgment
    7  shall have been rendered. It is hereby declared to be the intent of  the
    8  legislature  that  this act would have been enacted even if such invalid
    9  provisions had not been included herein.
   10     § 52. This act shall take effect immediately, provided, however, that:
   11    1. The amendments to section 2807-s of the public health law  made  by
   12  sections four, five, six, ten, thirteen and forty-four of this act shall
   13  not  affect the expiration of such section and shall be deemed to expire
   14  therewith;
   15    2. The amendments to section 2807-j of the public health law  made  by
   16  sections  three,  eight, twenty-nine, thirty, thirty-one and forty-three
   17  of this act shall not affect the expiration of such section and shall be
   18  deemed to expire therewith;
   19    3. The amendments to paragraph (h) of subdivision 2 of section 2511 of
   20  the public health law, made by section twenty-two of this act, shall not
   21  affect the expiration of such paragraph, as provided in subdivision 5 of
   22  section 47 of chapter 2 of the laws of 1998, as amended;
   23    4. The  amendment made to paragraph (j) of subdivision  2  of  section
   24  2511  of  the  public health law, made by section twenty-two of this act
   25  shall take effect on the same date as section 45 of part A of chapter  1
   26  of the laws of 2002, as amended;
   27    5.  Sections  forty-five  through  forty-eight  of this act shall take
   28  effect July 1, 2003;
   29    6. Sections thirty-five and thirty-six of this act shall  take  effect
   30  immediately and shall be deemed to have been in full force and effect on
   31  and after April 1, 2001;
   32    7.  Provided,  however,  that  any  rules  or regulations necessary to
   33  implement the provisions of this act may be promulgated and  any  proce-
   34  dures,  forms,  or instructions necessary for such implementation may be
   35  adopted and issued on or after the date this act  shall  have  become  a
   36  law;
   37    8. This act shall not be construed to alter, change, affect, impair or
   38  defeat any rights, obligations, duties or interests accrued, incurred or
   39  conferred prior to the enactment of this act;
   40    9.  The commissioner of health and the superintendent of insurance and
   41  any appropriate council may take any steps necessary to  implement  this
   42  act prior to its effective date;
   43    10.  Notwithstanding  any inconsistent provision of the state adminis-
   44  trative procedure act or any other provision of law, rule or regulation,
   45  the commissioner of health and the superintendent of insurance  and  any
   46  appropriate  council is authorized to adopt or amend or promulgate on an
   47  emergency basis any regulation he or  she  or  such  council  determines
   48  necessary to implement any provision of this act on its effective date;
   49    11.  The provisions of this act shall become effective notwithstanding
   50  the failure of the commissioner  of  health  or  the  superintendent  of
   51  insurance  or  any  council  to adopt or amend or promulgate regulations
   52  implementing this act; and
   53    12. Nothing contained in this act shall be deemed to affect the appli-
   54  cation, qualification, expiration, reversion or repeal of any  provision
   55  of law amended by any section of this act and the provisions of this act
   56  shall  be  applied  or  qualified or shall expire or revert or be deemed
       S. 1408                            126                           A. 2108
 
    1  repealed in the same manner, to the same extent and on the same date  as
    2  the case may be as otherwise provided by law.
 
    3                                   PART M
 
    4    Section  1.  Legislative  findings. The legislature finds and declares
    5  that the welfare of the citizens of this state and the financial  integ-
    6  rity of governmental reimbursement and private insurance programs admin-
    7  istered  for  their  benefit  are  threatened  by the growing problem of
    8  prescription drug abuse, particularly  the  trafficking  in  forged  and
    9  altered  prescriptions  for oral drugs and items; that the submission of
   10  claims for payment for these forged prescriptions results in fiscal harm
   11  to these programs and that the repackaging and  resale  of  these  drugs
   12  creates a serious health hazard for the public.  The legislature further
   13  finds  that the use of electronic mail and media for the transmission of
   14  prescriptions requires appropriate measures to  ensure  the  health  and
   15  safety  of  the  citizens of this state. The legislature finds that this
   16  act will promote the fiscal integrity of government funded programs  and
   17  private  insurance  coverage that cover the costs of such prescriptions;
   18  deter the trafficking in forged and altered prescriptions for oral drugs
   19  and items and protect the public from  the  hazards  of  repackaged  and
   20  adulterated drugs.
   21     §  2.  Short  title.   This act shall be known and may be cited as the
   22  "Pharmacy Consumer Protection Act of 2003".
   23     § 3. The public health law is amended by adding a new  section  21  to
   24  read as follows:
   25     §  21.  Official New York state prescription forms. 1. Notwithstanding
   26  any inconsistent provision of section sixty-eight  hundred  ten  of  the
   27  education law or article thirty-three of this chapter, all prescriptions
   28  written  in  this  state  shall be on serialized official New York state
   29  prescription forms provided by  the  department.  Such  forms  shall  be
   30  furnished  to  practitioners  authorized  to  write prescriptions and to
   31  institutional dispensers, and shall be non-reproducible  and  non-trans-
   32  ferable.  The commissioner may promulgate regulations for the electronic
   33  transmission  of  prescriptions  from  prescribers  to  pharmacists  for
   34  prescriptions  written  for  recipients  eligible for medical assistance
   35  pursuant to title eleven of article five of the social services law, for
   36  participants in the program for elderly pharmaceutical insurance  cover-
   37  age  pursuant  to  article  nineteen-k  of  the  executive  law  and for
   38  prescriptions written pursuant to article thirty-three of this  chapter.
   39  Nothing in this section shall prohibit the commissioner from permitting,
   40  pursuant  to emergency regulation, different formats of the prescription
   41  blank for different types of prescribers or from permitting the  use  of
   42  both  the  official  New  York state prescription form and prescriptions
   43  written pursuant to the requirements of section sixty-eight hundred  ten
   44  of the education law or article thirty-three of this chapter for a peri-
   45  od  not  longer  than  twelve  months  after  the effective date of this
   46  section.
   47    2. The commissioner is authorized and empowered  to  make  any  rules,
   48  regulations  and  determinations  which  in  his  or her judgment may be
   49  necessary or proper to supplement the  provisions  of  this  section  to
   50  effectuate its purposes and intent thereof, or to clarify its provisions
   51  so as to provide the procedure or details to secure effective and proper
   52  enforcement of its provisions, including, but not limited to, the manner
   53  in  which the department shall furnish such prescription blanks to prac-
   54  titioners and institutional dispensers.
       S. 1408                            127                           A. 2108
 
    1     § 4. Subdivision 31 of section 3302 of the public health law, as added
    2  by chapter 878 of the laws of 1972 and as renumbered by chapter  537  of
    3  the laws of 1998, is amended to read as follows:
    4    31.  "Prescription" shall mean an official New York state prescription
    5  uniquely identified for controlled substances, a  written  prescription,
    6  an oral prescription, or any one.
    7     §  5.  Subdivision  6  of  section  3331  of the public health law, as
    8  amended by chapter 537 of the laws  of  1998,  is  amended  to  read  as
    9  follows:
   10    6. A practitioner dispensing a schedule II controlled substance [which
   11  may be prescribed only upon an official New York state prescription must
   12  at  the  time  of  such  dispensing  prepare  an official New York state
   13  prescription in the manner set forth in subdivision two of section thir-
   14  ty-three hundred thirty-two of  this  article.  The  practitioner  shall
   15  retain  the  original for a period of five years. The practitioner shall
   16  file a copy of such prescription with the department or, solely  at  his
   17  or  her option,] or any schedule III or schedule IV controlled substance
   18  that the commissioner may, by regulation, require, shall be required  to
   19  file  [such  prescription]  information pursuant to such dispensing with
   20  the department by electronic means in such a manner and  detail  as  the
   21  commissioner  shall, by regulation, require. Such [copy or prescription]
   22  information shall be filed by not later than the fifteenth  day  of  the
   23  next  month  following  the  month in which the controlled substance was
   24  delivered. This requirement shall not apply to the dispensing by a prac-
   25  titioner pursuant to subdivision five of  section  thirty-three  hundred
   26  fifty-one of this article.
   27     §  6.  Subdivision  1  of  section  3332  of the public health law, as
   28  amended by chapter 537 of the laws  of  1998,  is  amended  to  read  as
   29  follows:
   30    1.  No  controlled  substance  [for  which  an official New York state
   31  prescription is required] may be prescribed by a practitioner except  on
   32  an  official  New  York state prescription, and in good faith and in the
   33  course of his or her professional practice only.
   34     § 7. Section 3333 of the public health law, as added by chapter 878 of
   35  the laws of 1972, subdivisions 1, 3 and 4 as amended and  subdivision  5
   36  as  added  by chapter 537 of the laws of 1998 and subdivision 2 as added
   37  by chapter 415 of the laws of 1981, is amended to read as follows:
   38     § 3333. Dispensing upon official New York  state  prescription.  1.  A
   39  licensed  pharmacist  may, in good faith and in the course of his or her
   40  professional practice, sell and dispense to an ultimate user  controlled
   41  substances  [for  which  an  official  New  York  state  prescription is
   42  required] listed in schedules II, III, IV and V of section  thirty-three
   43  hundred  six  of this article only upon the delivery to such pharmacist,
   44  within thirty days of the date [such] the prescription was signed by  an
   45  authorized practitioner, of [the original and one copy of such] an offi-
   46  cial  New  York  state prescription; provided, however, a pharmacist may
   47  dispense a part or portion of such prescription in accordance  with  the
   48  regulations  of  the commissioner. No pharmacy or pharmacist may sell or
   49  dispense greater than a thirty day supply of a controlled  substance  to
   50  an  ultimate  user  unless and until the ultimate user has exhausted all
   51  but a seven day supply of the controlled substance provided pursuant  to
   52  any  previously issued official New York state prescription, except that
   53  a pharmacy or pharmacist may sell or dispense up to a three month supply
   54  of a controlled substance if there appears, on the face of the  official
   55  New  York  state prescription, a statement that the controlled substance
   56  has been prescribed to treat  one  of  the  conditions  that  have  been
       S. 1408                            128                           A. 2108
 
    1  enumerated  by  the  regulations  of  the commissioner as warranting the
    2  prescribing of  greater  than  a  thirty  day  supply  of  a  controlled
    3  substance.  A  pharmacy  or  pharmacist may sell or dispense up to a six
    4  month supply of any substance listed in subdivision (h) or [subdivision]
    5  (j)  of  Schedule II of section [three thousand three hundred six] thir-
    6  ty-three hundred six of this article if there appears, on  the  face  of
    7  the official New York state prescription, a statement that the substance
    8  has  been  prescribed  to  treat  one  of  the conditions that have been
    9  enumerated by the regulations of  the  commissioner  as  warranting  the
   10  prescribing of a specified greater supply.
   11    2.  No  [such] controlled substance may be so dispensed or sold unless
   12  it is enclosed within a suitable container, and:
   13    (a) Affixed to such container is  a  label  upon  which  is  indelibly
   14  typed, printed, or otherwise legibly written the following:
   15    (i)  the  name and address of the ultimate user for whom the substance
   16  is intended, or if intended for use upon an animal, the species of  such
   17  animal  and  the  name  and address of the owner or person in custody of
   18  such animal;
   19    (ii) the name, address, and telephone  number  of  the  pharmacy  from
   20  which such substance is dispensed;
   21    (iii) specific directions for use as stated on the prescription;
   22    (iv) the name of the prescribing practitioner;
   23    (v)  the  legend,  prominently marked or printed in either boldface or
   24  upper case lettering: "CONTROLLED SUBSTANCE, DANGEROUS  UNLESS  USED  AS
   25  DIRECTED";
   26    (vi)  the number of the prescription under which it is recorded in the
   27  pharmacist's prescription file;
   28    (vii) such code number assigned by the department for  the  particular
   29  substance  pursuant  to  section  thirty-three  hundred eighteen of this
   30  article, or when  requested  by  the  practitioner,  the  name  of  such
   31  substance;
   32    (b)  Such  container  shall be identified as a controlled substance by
   33  either:
   34    (i) an orange label;
   35    (ii) a label of another color over which  is  superimposed  an  orange
   36  transparent adhesive tape; or
   37    (iii) an auxiliary orange label affixed to the front of such container
   38  and  bearing  the  legend,  prominently  marked  or  printed "Controlled
   39  Substance, Dangerous Unless Used As Directed";
   40    (c) Any label, transparency, or auxiliary label shall be applied in  a
   41  manner which would inhibit its removal.
   42    3.  The pharmacist filling the controlled substance prescription shall
   43  endorse upon the original the date of delivery[,] and his or her  signa-
   44  ture[, and the Federal registration number of the pharmacy].
   45    4.  [The  endorsed] Endorsed original [prescription] prescriptions for
   46  controlled substances shall be retained by the proprietor of the pharma-
   47  cy for a period of five years. The proprietor of the pharmacy shall file
   48  [a copy of such prescription with the department or, solely  at  his  or
   49  her  option,  file  such] prescription information for all prescriptions
   50  for schedule II controlled substances or for any schedule III or  sched-
   51  ule  IV controlled substances which the commissioner may, by regulation,
   52  require, with the department by electronic  means  in  such  manner  and
   53  detail as the commissioner shall, by regulation, require. Such [copy or]
   54  prescription  information shall be filed by not later than the fifteenth
   55  day of the next month following the month in  which  the  substance  was
   56  delivered.
       S. 1408                            129                           A. 2108
 
    1    5. [If] When filing prescription information for controlled substances
    2  electronically pursuant to subdivision four of this section, the propri-
    3  etor  of  the  pharmacy  shall  dispose  of  any electronically recorded
    4  prescription information in such manner as  the  commissioner  shall  by
    5  regulation require.
    6     § 8. Section 3334 of the public health law, as added by chapter 878 of
    7  the laws of 1972, subdivision 3 as amended by chapter 537 of the laws of
    8  1998, is amended to read as follows:
    9     §  3334.  Emergency oral prescriptions for [schedule II drugs] certain
   10  controlled substances. 1. In an emergency situation, as defined by  rule
   11  or regulation of the department, a practitioner may orally prescribe and
   12  a  pharmacist  may dispense to an ultimate user controlled substances in
   13  schedule II or those schedule III or schedule IV  controlled  substances
   14  the commissioner may, by regulation, require; provided however the phar-
   15  macist shall:
   16    (a) contemporaneously reduce such prescription to writing;
   17    (b)  dispense  the  substance in conformity with the labeling require-
   18  ments applicable to the type of prescription which would be required but
   19  for the emergency; and
   20    (c) make a good faith effort to verify the practitioner's identity, if
   21  the practitioner is unknown to the pharmacist.
   22    2. No oral prescription shall be filled for a quantity  of  controlled
   23  substances  which  would  exceed a five day supply if the substance were
   24  used in accordance with the directions for use.
   25    3.   Within seventy-two hours  after  authorizing  an  emergency  oral
   26  prescription,  the  prescribing practitioner shall cause to be delivered
   27  to  the  pharmacist  the  original  of  an  official  New   York   state
   28  prescription.  Such  prescription  shall, in addition to the information
   29  otherwise required, also have written or typed upon its face the  words:
   30  "Authorization  for  emergency  dispensing."  If the pharmacist fails to
   31  receive such prescription he or she shall notify the department in writ-
   32  ing within seven days from the date of dispensing the substance.
   33    4. Such official  New  York  state  prescription  shall  be  endorsed,
   34  retained  and filed in the same manner as is otherwise required for such
   35  prescriptions.
   36     § 9. Sections 3335 and 3336 of the public health law are REPEALED.
   37     § 10. Section 3337 of the public health law, as added by  chapter  878
   38  of the laws of 1972, subdivision 2 as amended by chapter 961 of the laws
   39  of 1974 and subdivision 3 as amended by chapter 965 of the laws of 1974,
   40  is amended to read as follows:
   41     §  3337.  Oral  prescriptions schedule III, IV and V substances.  1. A
   42  practitioner may orally prescribe and a pharmacist may  dispense  to  an
   43  ultimate user those controlled substances in schedules III, IV or V [for
   44  which an official New York state prescription is not required;] provided
   45  however the pharmacist shall:
   46    (a) contemporaneously reduce such prescription to writing;
   47    (b)  dispense  the  substance in conformity with the labeling require-
   48  ments applicable to a written prescription; and
   49    (c) make a good faith effort to verify the practitioner's identity, if
   50  the practitioner is unknown to the pharmacist.
   51    2. No oral prescription shall be filled for a quantity  of  controlled
   52  substances  which  would  exceed  a  five  day  supply if the controlled
   53  substance were used in accordance with the directions  for  use,  except
   54  that with respect to a schedule IV substance such prescription shall not
   55  exceed  a  thirty-day  supply  or one hundred dosage units, whichever is
   56  less; provided, however, that this provision  shall  not  apply  to  any
       S. 1408                            130                           A. 2108
 
    1  schedule  IV  controlled substance required to be dispensed only upon an
    2  official New York state prescription.
    3    3.   Within   seventy-two   hours   after  authorizing  such  an  oral
    4  prescription, the prescribing practitioner shall cause to  be  delivered
    5  to  the  pharmacist [a written] an official New York state prescription.
    6  If the pharmacist fails to receive such prescription  he  shall  make  a
    7  record  of  such  fact in such manner and detail as the commissioner, by
    8  regulation, shall require.
    9    4. Such [written]  official  New  York  state  prescription  shall  be
   10  endorsed, retained and filed in the same manner as is otherwise required
   11  for such prescriptions.
   12     §  11.  Section 3338 of the public health law, as added by chapter 878
   13  of the laws of 1972, subdivisions 1 and 4 as amended by chapter  537  of
   14  the laws of 1998, is amended to read as follows:
   15     §  3338.  Official  New York state prescription forms. 1. Official New
   16  York state prescription forms  shall  be  prepared  and  issued  by  the
   17  department  in  [groups  of twenty-five or one hundred forms] the manner
   18  and detail as the commissioner may, by regulation,  require,  and,  each
   19  form  [serially  numbered]  shall  be  serialized.  Such  forms shall be
   20  furnished [at a cost of twelve dollars and  fifty  cents  per  group  of
   21  twenty-five  forms  or  fifty dollars per group of one hundred forms] to
   22  practitioners authorized to write such  prescriptions  and  to  institu-
   23  tional dispensers. Such prescription blanks shall not be transferable.
   24    2.  Except  as  expressly  authorized  by section thirty-three hundred
   25  thirty-four  or  thirty-three  hundred  thirty-seven  of  this  article,
   26  controlled  substances  [listed  in  schedule  II]  may be prescribed or
   27  dispensed only upon an official New York state prescription.
   28    3.  The  commissioner  may,  by  rule  or  regulation,  require   that
   29  prescription  information  or  dispensing  information  for a particular
   30  substance in schedule III or schedule  IV,  or  particular  preparations
   31  containing  such substance, be [prescribed or dispensed upon an official
   32  New York state prescription] filed with the department by the  dispenser
   33  or that prescriptions for controlled substances in schedule III or sche-
   34  dule IV may not be refilled.
   35    4.  The  commissioner is hereby authorized and empowered to make rules
   36  and regulations, not inconsistent with this article, with respect to the
   37  retention or filing of such official New York state prescription  forms,
   38  including  information  required  to  be  filed with the department, the
   39  maximum number of forms which may be issued at any one time, the  manner
   40  in  which  such forms shall be issued, the period of time after issuance
   41  by the department that such form shall remain valid  for  use,  and  the
   42  manner  in  which practitioners associated with institutional dispensers
   43  may use such forms, or any other matter of procedure or detail necessary
   44  to effectuate or clarify the provisions of this section  and  to  secure
   45  proper and effective enforcement of the provisions of this article.
   46    5.  Upon  a  finding  by  the  commissioner that a person has wilfully
   47  failed to comply with the provisions of this article,  the  commissioner
   48  may  revoke,  cancel  or  withhold  official New York state prescription
   49  forms which have been issued or for which application has been made.
   50     § 12. Subdivisions 1, 2 and 3 of section 3339  of  the  public  health
   51  law,  subdivisions  1  and 3 as added by chapter 878 of the laws of 1972
   52  and subdivision 2 as amended by chapter 965 of the  laws  of  1974,  are
   53  amended to read as follows:
   54     §  3339.  Refilling of prescriptions for controlled substances.  1. An
   55  official New York  state  prescription  for  a  schedule  II  controlled
       S. 1408                            131                           A. 2108
 
    1  substance  or  those  schedule  III or schedule IV controlled substances
    2  which the commissioner may, by regulation, require may not be refilled.
    3    2.  [A  written] An official New York state prescription, except for a
    4  schedule II controlled substance or those schedule III  or  schedule  IV
    5  controlled   substances  which  the  commissioner  may,  by  regulation,
    6  require, may be refilled not more than the number of times  specifically
    7  authorized  by the prescriber upon the prescription, provided however no
    8  such authorization shall be effective for  a  period  greater  than  six
    9  months  from  the date the prescription is signed. In the event that the
   10  prescription authorizes the dispensing of more than a thirty day  supply
   11  of  schedule III, schedule IV or schedule V substances pursuant to regu-
   12  lations of the commissioner enumerating conditions warranting  specified
   13  greater supplies, the prescription may be refilled only once.
   14    3.  Unless  an  earlier  refilling is authorized by the prescriber, no
   15  [written] official New York state prescription may be  refilled  earlier
   16  than  seven days prior to the date the previously dispensed supply would
   17  be exhausted if used in conformity with the directions for use.
   18     § 13. Subdivision 1 of section 3343 of the public health law, as added
   19  by chapter 878 of the laws of 1972, paragraph (a) as amended by  chapter
   20  537 of the laws of 1998, is amended to read as follows:
   21    1. Prescriptions and copies of prescriptions shall be preserved in the
   22  following manner:
   23    (a)  [dispensing]  practitioners [shall preserve the original official
   24  New York state prescription in a separate  file  maintained  exclusively
   25  for  such  records.  If] dispensing schedule II controlled substances or
   26  those schedule III  or  schedule  IV  controlled  substances  which  the
   27  commissioner  may,  by  regulation,  require,  when  filing prescription
   28  information electronically pursuant to subdivision six of section  thir-
   29  ty-three hundred thirty-one of this article, [the dispensing practition-
   30  er] shall dispose of any electronically recorded [prescription] informa-
   31  tion in such manner as the commissioner shall by regulation require;
   32    (b)  pharmacists  dispensing  controlled  substances upon prescription
   33  shall preserve such prescriptions in such  manner  as  the  commissioner
   34  shall, by regulation, require.
   35     §  14.  Section  155.35 of the penal law, as amended by chapter 515 of
   36  the laws of 1986, is amended to read as follows:
   37   § 155.35 Grand larceny in the third degree.
   38    A person is guilty of grand larceny in the third degree when he or she
   39  steals property and when the value of the property exceeds  three  thou-
   40  sand  dollars  or  where  the  property  is  an  official New York state
   41  prescription form as provided in section twenty-one or  article  thirty-
   42  three of the public health law.
   43    Grand larceny in the third degree is a class D felony.
   44     §  15.  Section  155.40 of the penal law, as amended by chapter 515 of
   45  the laws of 1986, is amended to read as follows:
   46   § 155.40 Grand larceny in the second degree.
   47    A person is guilty of grand larceny in the second degree  when  he  or
   48  she steals property and when:
   49    1. The value of the property exceeds fifty thousand dollars; or
   50    2.  The  property,  regardless of its nature and value, is obtained by
   51  extortion committed by instilling in the victim a fear that the actor or
   52  another person will (a) cause physical injury  to  some  person  in  the
   53  future,  or (b) cause damage to property, or (c) use or abuse his or her
   54  position as a public servant by engaging in conduct within or related to
   55  his or her official duties, or by failing  or  refusing  to  perform  an
   56  official duty, in such manner as to affect some person adversely; or
       S. 1408                            132                           A. 2108
 
    1    3.  The  property  is ten or more official New York state prescription
    2  forms, as provided pursuant to section  twenty-one  or  article  thirty-
    3  three of the public health law.
    4    Grand larceny in the second degree is a class C felony.
    5     § 16. Section 170.15 of the penal law is amended to read as follows:
    6   § 170.15 Forgery in the first degree.
    7    A person is guilty of forgery in the first degree when, with intent to
    8  defraud,  deceive  or injure another, he or she falsely makes, completes
    9  or alters a written instrument which is or purports to be, or  which  is
   10  calculated to become or to represent if completed:
   11    1.  Part  of  an  issue of money, stamps, securities or other valuable
   12  instruments issued by a government or governmental instrumentality; or
   13    2. Part of an issue of stock, bonds or other instruments  representing
   14  interests  in or claims against a corporate or other organization or its
   15  property; or
   16    3. Ten or more official New York state prescription forms, as provided
   17  pursuant to section twenty-one or article  thirty-three  of  the  public
   18  health law.
   19    Forgery in the first degree is a class C felony.
   20     § 17. Article 178 of the penal law, as added by chapter 81 of the laws
   21  of 1995, is amended to read as follows:
   22                                  ARTICLE 178
   23               CRIMINAL DIVERSION OF PRESCRIPTION MEDICATIONS
   24                              AND PRESCRIPTIONS
   25  Section 178.00 Criminal   diversion   of  prescription  medications  and
   26                   prescriptions; definitions.
   27          178.05 Criminal  diversion  of  prescription   medications   and
   28                   prescriptions; limitation.
   29          178.10 Criminal   diversion   of  prescription  medications  and
   30                   prescriptions in the fourth degree.
   31          178.15 Criminal  diversion  of  prescription   medications   and
   32                   prescriptions in the third degree.
   33          178.20 Criminal   diversion   of  prescription  medications  and
   34                   prescriptions in the second degree.
   35          178.25 Criminal  diversion  of  prescription   medications   and
   36                   prescriptions in the first degree.
   37          178.30 Criminal  possession  of criminally diverted prescription
   38                   medications and devices in the fourth degree.
   39          178.35 Criminal possession of criminally  diverted  prescription
   40                   medications and devices in the third degree.
   41          178.40 Criminal  possession  of criminally diverted prescription
   42                   medications and devices in the second degree.
   43          178.45 Criminal possession of criminally  diverted  prescription
   44                   medications and devices in the first degree.
   45          178.50 Presumption.
   46   § 178.00 Criminal    diversion    of    prescription   medications   and
   47             prescriptions; definitions.
   48    The following definitions are applicable to this article:
   49    1. "Prescription medication or device" means any article  or  articles
   50  for  which  a prescription is or for which prescriptions are required in
   51  order to be lawfully sold, delivered or distributed  by  any  person  or
   52  persons authorized by law to engage in the practice of the profession of
   53  pharmacy.
   54    2.  "Prescription"  means  a  direction or authorization by means of a
   55  written prescription form or an oral prescription which permits a person
       S. 1408                            133                           A. 2108
 
    1  to lawfully obtain a prescription medication or device from  any  person
    2  authorized to dispense such prescription medication or device.
    3    3.  "Criminal  diversion  act"  means an act or acts in which a person
    4  knowingly:
    5    (a) transfers or delivers,  in  exchange  for  anything  of  pecuniary
    6  value,  a prescription medication or device with knowledge or reasonable
    7  grounds to know that the recipient has no medical need for it; or
    8    (b)  receives,  in  exchange  for  anything  of  pecuniary  value,   a
    9  prescription  medication  or device with knowledge or reasonable grounds
   10  to know that the [seller or transferor is not authorized by law to sell]
   11  sale or transfer of such prescription medication or device  is  unlawful
   12  and in violation of the law; or
   13    (c)  transfers or delivers a prescription or prescriptions in exchange
   14  for anything of pecuniary value; or
   15    (d) receives a prescription or prescriptions in exchange for  anything
   16  of pecuniary value.
   17    4.  "Total pecuniary value of the prescription medication or device or
   18  prescription or prescriptions" means the  lawful  market  value  of  all
   19  prescription  medications  or  devices  or prescription or prescriptions
   20  resulting from an act or series of acts which is in  violation  of  this
   21  article.
   22   § 178.05 Criminal    diversion    of    prescription   medications   and
   23             prescriptions; limitation.
   24    1. The provisions of this article shall not apply to:
   25    (a) a duly licensed physician or other person authorized  to  issue  a
   26  prescription  acting  in  good  faith in the lawful course of his or her
   27  profession; or
   28    (b) a duly licensed pharmacist acting in  good  faith  in  the  lawful
   29  course of the practice of pharmacy; or
   30    (c)  a  person  acting  in  good faith seeking treatment for a medical
   31  condition or assisting another person to obtain treatment for a  medical
   32  condition.
   33    2.    No  provision  of  this  article  relating  to  the  sale  of  a
   34  prescription medication or device shall be deemed to authorize  any  act
   35  prohibited  by  article thirty-three of the public health law or article
   36  two hundred twenty of this chapter.
   37   § 178.10 Criminal   diversion   of    prescription    medications    and
   38             prescriptions in the fourth degree.
   39    A  person  is guilty of criminal diversion of prescription medications
   40  and prescriptions in the fourth degree when he or she commits a criminal
   41  diversion act.
   42    Criminal diversion of prescription medications  and  prescriptions  in
   43  the fourth degree is a class A misdemeanor.
   44   § 178.15 Criminal    diversion    of    prescription   medications   and
   45             prescriptions in the third degree.
   46    A person is guilty of criminal diversion of  prescription  medications
   47  and prescriptions in the third degree when he or she:
   48    1.  commits  a  criminal  diversion act, and the [value of the benefit
   49  exchanged] total pecuniary  value  of  the  prescription  medication  or
   50  device  or  prescription  or  prescriptions is in excess of one thousand
   51  dollars; or
   52    2. commits the crime of criminal diversion of prescription medications
   53  and  prescriptions  in  the  fourth  degree,  and  has  previously  been
   54  convicted of the crime of criminal diversion of prescription medications
   55  and prescriptions in the fourth degree.
       S. 1408                            134                           A. 2108
 
    1    Criminal  diversion  of  prescription medications and prescriptions in
    2  the third degree is a class E felony.
    3   § 178.20 Criminal    diversion    of    prescription   medications   and
    4             prescriptions in the second degree.
    5    A person is guilty of criminal diversion of  prescription  medications
    6  and prescriptions in the second degree when he or she commits a criminal
    7  diversion  act, and the [value of the benefit exchanged] total pecuniary
    8  value of the  prescription  medication  or  device  or  prescription  or
    9  prescriptions is in excess of three thousand dollars.
   10    Criminal  diversion  of  prescription medications and prescriptions in
   11  the second degree is a class D felony.
   12   § 178.25 Criminal   diversion   of    prescription    medications    and
   13             prescriptions in the first degree.
   14    A  person  is guilty of criminal diversion of prescription medications
   15  and prescriptions in the first degree when he or she commits a  criminal
   16  diversion  act, and the [value of the benefit exchanged] total pecuniary
   17  value of the  prescription  medication  or  device  or  prescription  or
   18  prescriptions is in excess of fifty thousand dollars.
   19    Criminal  diversion  of  prescription medications and prescriptions in
   20  the first degree is a class C felony.
   21   § 178.30 Criminal possession of criminally diverted prescription medica-
   22             tions and devices in the fourth degree.
   23    A person is guilty  of  criminal  possession  of  criminally  diverted
   24  prescription medications and devices in the fourth degree when he or she
   25  knowingly  possesses  a prescription medication or device with knowledge
   26  that such medication or device  was  transferred  or  delivered  as  the
   27  result  of a criminal diversion act or with intent to engage in a crimi-
   28  nal diversion act.
   29    Criminal possession of criminally  diverted  prescription  medications
   30  and devices in the fourth degree is a class A misdemeanor.
   31   § 178.35 Criminal possession of criminally diverted prescription medica-
   32             tions and devices in the third degree.
   33    A  person  is  guilty  of  criminal  possession of criminally diverted
   34  prescription medications and devices in the third degree when he or  she
   35  commits   the  crime  of  criminal  possession  of  criminally  diverted
   36  prescription medications and devices in the fourth degree and:
   37    1. has previously been convicted of any crime defined in this article;
   38  or
   39    2. the total pecuniary value of the prescription medication or  device
   40  possessed is in excess of one thousand dollars.
   41    Criminal  possession  of  criminally diverted prescription medications
   42  and devices in the third degree is a class E felony.
   43   § 178.40 Criminal possession of criminally diverted prescription medica-
   44             tions and devices in the second degree.
   45    A person is guilty  of  criminal  possession  of  criminally  diverted
   46  prescription medications and devices in the second degree when he or she
   47  commits   the  crime  of  criminal  possession  of  criminally  diverted
   48  prescription medications and devices in the fourth degree and the  total
   49  pecuniary value of the prescription medication or device possessed is in
   50  excess of three thousand dollars.
   51    Criminal  possession  of  criminally diverted prescription medications
   52  and devices in the second degree is a class D felony.
   53   § 178.45 Criminal possession of criminally diverted prescription medica-
   54             tions and devices in the first degree.
   55    A person is guilty  of  criminal  possession  of  criminally  diverted
   56  prescription  medications and devices in the first degree when he or she
       S. 1408                            135                           A. 2108
 
    1  commits  the  crime  of  criminal  possession  of  criminally   diverted
    2  prescription  medications and devices in the fourth degree and the total
    3  pecuniary value of the prescription medication or device possessed is in
    4  excess of fifty thousand dollars.
    5    Criminal  possession  of  criminally diverted prescription medications
    6  and devices in the first degree is a class C felony.
    7   § 178.50 Presumption.
    8    Possession of a false, forged or stolen  prescription  by  any  person
    9  other  than  a person in the lawful pursuit of their profession shall be
   10  presumptive evidence of the intent to use the same to commit a  criminal
   11  act under this article.
   12     §  18.  Subdivision  3 of section 190.26 of the penal law, as added by
   13  chapter 2 of the laws of 1998, is amended to read as follows:
   14    3. Pretending to be a duly licensed physician or other person  author-
   15  ized  to  issue  a prescription for any drug or any instrument or device
   16  used in the taking or administering of drugs for which a prescription is
   17  required by law, communicates to a pharmacist an oral prescription which
   18  is required to be reduced to writing pursuant  to  section  thirty-three
   19  hundred [thirty-two] thirty-seven of the public health law.
   20     §  19.  This  act shall take effect on the sixtieth day after it shall
   21  have become a law; provided, however, that  notwithstanding  any  incon-
   22  sistent provision of the state administrative procedure act, or sections
   23  three, four, five, six, seven, eight, nine, ten, eleven, twelve or thir-
   24  teen  of  this  act,  the commissioner of health is authorized to adopt,
   25  amend or promulgate on an emergency  basis  any  regulation  he  or  she
   26  determines  necessary  to  implement  the  provisions of sections three,
   27  four, five, six, seven, eight, nine, ten, eleven, twelve and thirteen of
   28  this act, including authority to permit prescriptions  written  in  this
   29  state to be written without regard to the provisions of section three of
   30  this  act  for  a  period not to exceed twelve months after such section
   31  three of this act takes effect; provided, further, that  sections  four-
   32  teen,  fifteen,  sixteen  and seventeen of this act shall take effect on
   33  the first of November next succeeding the date on which this  act  shall
   34  have become a law; provided, further, that the amendments to subdivision
   35  6 of section 3331 of the public health law, made by section five of this
   36  act  and  the  amendments to subdivision 4 of section 3333 of the public
   37  health law, made by section  seven  of  this  act,  relating  to  filing
   38  prescription  information  with  the  department of health by electronic
   39  means, shall not be implemented until the  commissioner  of  health  has
   40  promulgated regulations relating thereto, and the commissioner of health
   41  shall notify the legislative bill drafting commission upon the promulga-
   42  tion  of  such regulations in order that such commission may maintain an
   43  accurate and timely effective data base of the official text of the laws
   44  of the state of New York in furtherance of effecting the  provisions  of
   45  section  44  of the legislative law and section 70-b of the public offi-
   46  cers law.
 
   47                                   PART N
 
   48    Section 1. Subsection (k) of section 3221  of  the  insurance  law  is
   49  amended by adding a new paragraph 14 to read as follows:
   50    (14) Every group or blanket policy delivered or issued for delivery in
   51  this  state  which  includes coverage for physician services in a physi-
   52  cian's office, and every policy which provides major medical or  similar
   53  comprehensive-type  coverage  shall  provide  coverage  for early inter-
   54  vention services as set forth under title two-A of  article  twenty-five
       S. 1408                            136                           A. 2108
 
    1  of the public health law at the rate established under such title.  Such
    2  coverage  shall  not  be  subject to annual deductibles and coinsurance,
    3  provided however coverage shall not exceed  five  thousand  dollars  per
    4  covered child per calendar year. The individualized family services plan
    5  certified  by  the  early  intervention  official, as defined in section
    6  twenty-five hundred forty-one of the public health law,  or  such  offi-
    7  cial's  designee,  shall  be deemed to meet any precertification, preau-
    8  thorization and medical necessity requirements imposed on benefits under
    9  the policy.
   10     § 2. Section 4303 of the insurance law is  amended  by  adding  a  new
   11  subsection (dd) to read as follows:
   12    (dd) Every group or blanket contract issued by a health service corpo-
   13  ration  or a medical expense indemnity corporation which includes cover-
   14  age for physician services in a physician's office, and  every  contract
   15  which  provides  major  medical  or similar comprehensive-type coverage,
   16  shall provide coverage for early intervention services set  forth  under
   17  title  two-A of article twenty-five of the public health law at the rate
   18  established under such title.   Such coverage shall not  be  subject  to
   19  annual  deductibles and coinsurance, provided however coverage shall not
   20  exceed five thousand dollars per covered child per  calendar  year.  The
   21  individualized  family services plan certified by the early intervention
   22  official, as defined in section twenty-five  hundred  forty-one  of  the
   23  public  health law, or such official's designee, shall be deemed to meet
   24  any precertification, preauthorization and  medical  necessity  require-
   25  ments imposed on benefits under the policy.
   26     §  3.  Section  3235-a  of the insurance law, as added by section 3 of
   27  part C of chapter 1 of the laws of 2002, is amended to read as follows:
   28     § 3235-a. Payment for early intervention services. (a) [No  policy  of
   29  accident  and  health  insurance, including contracts issued pursuant to
   30  article forty-three of this chapter, shall exclude coverage  for  other-
   31  wise  covered  services solely on the basis that the services constitute
   32  early intervention program services under title two-A of  article  twen-
   33  ty-five of the public health law.
   34    (b)  Where  a  policy  of  accident  and health insurance, including a
   35  contract  issued  pursuant  to  article  forty-three  of  this  chapter,
   36  provides coverage for an early intervention program service, such cover-
   37  age shall not be applied against any maximum annual or lifetime monetary
   38  limits set forth in such policy or contract. Visit limitations and other
   39  terms  and  conditions  of  the  policy  will continue to apply to early
   40  intervention services. However, any visits used for  early  intervention
   41  program  services shall not reduce the number of visits otherwise avail-
   42  able under the policy or contract for such services.
   43    (c)] Any right of subrogation to benefits which  [a  municipality]  an
   44  early intervention evaluator and service provider is entitled in accord-
   45  ance  with  paragraph  [(d)] (f) of subdivision three of section twenty-
   46  five hundred fifty-nine of the public health  law  shall  be  valid  and
   47  enforceable  to the extent benefits are available under any accident and
   48  health insurance policy. The right of subrogation  does  not  attach  to
   49  insurance benefits paid or provided under any accident and health insur-
   50  ance  policy  prior to receipt by the insurer of written notice from the
   51  [municipality] early intervention evaluator and service provider.
   52    [(d)] (b) No insurer,  including  a  health  maintenance  organization
   53  issued a certificate of authority under article forty-four of the public
   54  health law and a corporation organized under article forty-three of this
   55  chapter,  shall  refuse to issue an accident and health insurance policy
   56  or contract or refuse to renew an accident and health  insurance  policy
       S. 1408                            137                           A. 2108
 
    1  or  contract  solely  because  the  applicant  or  insured  is receiving
    2  services under the early intervention program.
    3    (c)  No  insurer, including a health maintenance organization issued a
    4  certificate of authority under article forty-four of the  public  health
    5  law  and a corporation organized under article forty-three of this chap-
    6  ter, shall deny coverage of a claim  submitted  for  early  intervention
    7  services  covered  pursuant  to  paragraph fourteen of subsection (k) of
    8  section three thousand two hundred  twenty-one  or  subsection  (dd)  of
    9  section  four  thousand  three hundred three of this chapter solely upon
   10  the basis that the provider of services is not a participating  provider
   11  in the insurer's network.
   12     §  4.  Subdivision  7  of  section  2510  of the public health law, as
   13  amended by chapter 526 of the laws  of  2002,  is  amended  to  read  as
   14  follows:
   15    7.  "Covered  health care services" means: the services of physicians,
   16  optometrists, nurses, nurse practitioners, midwives  and  other  related
   17  professional  personnel  which  are  provided  on  an  outpatient basis,
   18  including routine well-child visits; diagnosis and treatment of  illness
   19  and injury; inpatient health care services; laboratory tests; diagnostic
   20  x-rays;  prescription  and  non-prescription  drugs  and durable medical
   21  equipment; radiation therapy; chemotherapy; hemodialysis; emergency room
   22  services; hospice services; emergency,  preventive  and  routine  dental
   23  care, except orthodontia and cosmetic surgery; emergency, preventive and
   24  routine  vision care, including eyeglasses; speech and hearing services;
   25  [and,] inpatient and outpatient mental  health,  alcohol  and  substance
   26  abuse  services;  and  early  intervention  services  as  defined by the
   27  commissioner in consultation with the superintendent.
   28     § 5. Subdivision 7 of section 2510 of the public health law, as  added
   29  by  chapter  922  of the laws of 1990, paragraph a as amended by chapter
   30  526 of the laws of 2002, is amended to read as follows:
   31    7. a.  "Primary  and  preventive  health  care  services"  means:  the
   32  services  of  physicians,  optometrists,  nurses,  nurse  practitioners,
   33  midwives and other related professional personnel which are provided  on
   34  an  outpatient basis, including routine well-child visits; diagnosis and
   35  treatment of illness and injury; laboratory  tests;  diagnostic  x-rays;
   36  prescription drugs; radiation therapy; chemotherapy; hemodialysis; emer-
   37  gency  room  services;  hospice  services; [and,] outpatient alcohol and
   38  substance abuse services; and early intervention services as defined  by
   39  the commissioner in consultation with the superintendent.
   40    b.  "Optional  primary  and  preventive  health  care services" means:
   41  dental, vision, speech and hearing services as defined  by  the  commis-
   42  sioner in consultation with the superintendent.
   43     §  6.  Subdivision  10  of  section  2511 of the public health law, as
   44  amended by chapter 2 of the laws of 1998, is amended to read as follows:
   45    10. (a) Notwithstanding any other law or agreement  to  the  contrary,
   46  and  except in the case of a child or children who also becomes eligible
   47  for medical assistance, benefits under this title  shall  be  considered
   48  secondary  to any other plan of insurance or benefit program, except the
   49  physically handicapped children's program  and  the  early  intervention
   50  program, under which an eligible child may have coverage.
   51    (b)  Notwithstanding  subdivision seven of section twenty-five hundred
   52  ten of this article, coverage for early intervention services  shall  be
   53  provided  in  accordance with section three thousand two hundred thirty-
   54  five-a and subsection (dd) of section four thousand three hundred  three
   55  of the insurance law.
       S. 1408                            138                           A. 2108
 
    1     §  7.  Paragraph  (a)  of  subdivision 8 of section 2541 of the public
    2  health law, as added by chapter 428 of the laws of 1992, is  amended  to
    3  read as follows:
    4    (a) "Eligible child" means an infant or toddler from birth through age
    5  two  who  has  a  disability; provided, however, that any toddler with a
    6  disability who has been determined to be eligible for  program  services
    7  under section forty-four hundred ten of the education law and:
    8    (i)  who turns three years of age on or before the thirty-first day of
    9  August shall, if requested by the parent, be eligible to  receive  early
   10  intervention  services  contained  in  an  IFSP  until  the first day of
   11  September of that calendar year; or
   12    (ii) who turns three years of age on or after the first day of Septem-
   13  ber shall, if requested by the parent and if already receiving  services
   14  pursuant  to this title, be eligible to continue receiving such services
   15  until the second day of January of the following calendar year.
   16     § 8. Section 2543 of the public health law is amended by adding a  new
   17  subdivision 3 to read as follows:
   18    3. Prior to implementation of an IFSP and thereafter if necessary, the
   19  parent  of  the  eligible child shall provide and the early intervention
   20  official shall collect such  information  and  or  documentation  as  is
   21  necessary  and  sufficient to determine the eligible child's third party
   22  payor coverage and to seek payment from all third party payors including
   23  the medical assistance program and other governmental agency payors.
   24     § 9. Section 2548 of the public health law, as added by chapter 428 of
   25  the laws of 1992, is amended to read as follows:
   26     § 2548. Transition plan.  To the extent that a toddler with a disabil-
   27  ity is thought to be eligible for services pursuant  to  section  forty-
   28  four  hundred  ten of the education law, the early intervention official
   29  shall [notify] refer the child in writing to the committee on  preschool
   30  special  education  of  the  local  school district in which an eligible
   31  child resides [of the potential transition  of  such  child]  and,  with
   32  parental  consent,  [ensure that] arrange for a conference [is convened]
   33  among the service coordinator, the parent and  the  chairperson  of  the
   34  preschool  committee  on  special  education  or his or her designee [at
   35  least ninety days] to be held before [such child would be  eligible  for
   36  services  under section forty-four hundred ten of the education law] the
   37  child reaches the age of two years and six months to review the  child's
   38  program  options and to establish a transition plan, if appropriate.  If
   39  a parent does not consent to a conference with the  service  coordinator
   40  and  the  chairperson of the preschool committee on special education or
   41  his or her designee to determine  whether  the  child  is  eligible  for
   42  services  under section forty-four hundred ten of the education law, and
   43  the child is therefore not determined to be eligible for  such  services
   44  prior  to  the child's third birthday, the child's eligibility for early
   45  intervention program services shall end at the child's third birthday.
   46     § 10. Subdivision 2 of section 2550 of the public health law, as added
   47  by chapter 428 of the laws of 1992, is amended to read as follows:
   48    2. In meeting the requirements of subdivision one of this section, the
   49  lead agency shall adopt and use  proper  methods  of  administering  the
   50  early intervention program, including:
   51    (a)  establishing  standards  for evaluators, service coordinators and
   52  providers of early intervention services;
   53    (b) approving, and periodically re-approving evaluators, service coor-
   54  dinators and providers of early intervention services who  meet  depart-
   55  ment standards;
       S. 1408                            139                           A. 2108
 
    1    (c)  compiling  and  disseminating  to  the  municipalities  lists  of
    2  approved evaluators, service coordinators and providers of early  inter-
    3  vention services;
    4    [(b)] (d) monitoring of agencies, institutions and organizations under
    5  this  title and agencies, institutions and organizations providing early
    6  intervention services which are under the jurisdiction of a state  early
    7  intervention service agency;
    8    [(c)]  (e)  enforcing  any obligations imposed on those agencies under
    9  this title or Part H of the federal individuals with disabilities educa-
   10  tion act and its regulations;
   11    [(d)] (f) providing training and technical assistance to  those  agen-
   12  cies,  institutions  and  organizations,  including  initial and ongoing
   13  training and technical assistance to municipalities to help enable  them
   14  to  identify,  locate  and  evaluate  eligible  children, develop IFSPs,
   15  ensure the provision of appropriate early intervention services, promote
   16  the development of new services, where there is a demonstrated need  for
   17  such  services  and afford procedural safeguards to infants and toddlers
   18  and their families;
   19    [(e)] (g) correcting deficiencies that are identified through monitor-
   20  ing; and
   21    [(f)] (h) in monitoring early intervention services, the  commissioner
   22  shall  provide  municipalities  with  the results of any review of early
   23  intervention services undertaken and shall  provide  the  municipalities
   24  with the opportunity to comment thereon.
   25     § 11. Subdivision 8 of section 2551 of the public health law, as added
   26  by chapter 428 of the laws of 1992, is amended to read as follows:
   27    8.  The  early intervention service agencies, in consultation with the
   28  director of the budget, shall, where appropriate, require as a condition
   29  of approval that evaluators and providers of early intervention services
   30  [participate] enroll as providers in the medical assistance program.
   31     § 12. Section 2552 of the public health law is amended by adding a new
   32  subdivision 4 to read as follows:
   33    4. The early intervention official shall require an  eligible  child's
   34  parent  to  furnish  the  parents'  and eligible child's social security
   35  numbers for the purpose of the department's and municipality's  adminis-
   36  tration of the program.
   37     §  13.  Section 2557 of the public health law, as added by chapter 428
   38  of the laws of 1992, subdivision 1 as amended by section 4 of part C  of
   39  chapter 1 of the laws of 2002, is amended to read as follows:
   40     §  2557.  Financial  responsibility and reimbursement. 1. The approved
   41  costs for an evaluation and service coordination services received by an
   42  eligible child  [who  receives  an  evaluation  and  early  intervention
   43  services] pursuant to this title shall be a charge upon the municipality
   44  wherein the eligible child resides or, where the services are covered by
   45  the  medical assistance program, upon the local social services district
   46  of fiscal responsibility with respect to those eligible children who are
   47  also eligible for medical assistance.  [All] Except for evaluations  and
   48  service  coordination services covered by the medical assistance program
   49  or third party payors, approved costs  for  an  evaluation  and  service
   50  coordination  services  shall be paid in the first instance and at least
   51  quarterly by the appropriate governing body or officer  of  the  munici-
   52  pality  upon  vouchers  presented  and audited in the same manner as the
   53  case of other  claims  against  the  municipality.  Notwithstanding  the
   54  insurance  law  or  regulations  thereunder  relating to the permissible
   55  exclusion of payments for services under governmental programs, no  such
   56  exclusion  shall  apply  with  respect to payments made pursuant to this
       S. 1408                            140                           A. 2108
 
    1  title. Notwithstanding the insurance law or any other law  or  agreement
    2  to the contrary, benefits under this title shall be considered secondary
    3  to any plan of insurance or state government benefit program under which
    4  an  eligible  child  may  have  coverage. [Nothing in this section shall
    5  increase or enhance coverages provided for within an insurance  contract
    6  subject to the provisions of this title.]
    7    2.  Except as provided in subdivision one of this section and in para-
    8  graph (d) of subdivision three of section twenty-five hundred fifty-nine
    9  of this title, the approved costs for an  eligible  child  who  receives
   10  early  intervention services pursuant to this title shall be a charge in
   11  the amount of eighty percent of the service rate upon  the  municipality
   12  wherein the eligible child resides or, where the services are covered by
   13  the  medical assistance program, one hundred percent of the service rate
   14  of the approved costs shall be a charge upon the local  social  services
   15  district  of  fiscal responsibility with respect to those eligible chil-
   16  dren who are also eligible for medical assistance. Except  for  services
   17  covered  by  the  medical  assistance  program  or  third  party payors,
   18  approved costs in the amount of eighty percent of the service rate shall
   19  be paid in the first instance and at least quarterly by the  appropriate
   20  governing  body  or  officer of the municipality upon vouchers presented
   21  and audited in the same manner as the case of other claims  against  the
   22  municipality.  Notwithstanding  the  insurance law or regulations there-
   23  under relating to the permissible exclusion  of  payments  for  services
   24  under  governmental programs, no such exclusion shall apply with respect
   25  to payments made pursuant to section twenty-five hundred  fifty-nine  of
   26  this title.
   27    3. The department shall reimburse the approved costs paid by a munici-
   28  pality  for the purposes of this title, other than those reimbursable by
   29  the medical assistance program or by third party payors, in an amount of
   30  fifty percent of the amount expended in accordance with  the  rules  and
   31  regulations of the commissioner. Such state reimbursement to the munici-
   32  pality  shall  not be paid prior to April first of the year in which the
   33  approved costs are paid by the municipality.
   34    [3. Such] 4. The department may perform audits, which may include site
   35  visitation, of the municipalities, service coordinators, evaluators  and
   36  or  providers  of  early  intervention  services.  The  department shall
   37  provide the municipalities with a copy of the findings of  such  audits.
   38  Early  intervention  program  state aid reimbursement or portion thereof
   39  may be withheld if, on post-audit and  review,  the  commissioner  finds
   40  that the early intervention services were not provided or those provided
   41  were  not  in  substantial  conformance  with  the rules and regulations
   42  established by the commissioner or that the recipient of  such  services
   43  was  not  an  eligible  child  as defined in section twenty-five hundred
   44  forty-one of this title. In the event that the  commissioner  determines
   45  that  there  may  be a withholding of state reimbursement to any munici-
   46  pality under this section, he shall inform the state early  intervention
   47  coordinating  council  and the relevant local early intervention coordi-
   48  nating council and shall consider alternative courses of  action  recom-
   49  mended  within  sixty  days  by  either  body prior to withholding state
   50  reimbursement.
   51    [4.] 5. Each municipality may perform an audit, which may include site
   52  visitation, of evaluators and providers  of  such  services  within  its
   53  municipality in accordance with standards established by the commission-
   54  er.    Payment  for  services  to  an evaluator, service coordinator and
   55  provider may be withheld by a municipality and a municipality is author-
   56  ized to directly recover overpayments to an evaluator, service coordina-
       S. 1408                            141                           A. 2108
 
    1  tor and/or provider if, on post-audit and review, the municipality finds
    2  that the early intervention services were not provided or those provided
    3  were not in  substantial  conformance  with  the  contractual  agreement
    4  between  the municipality and the evaluator and/or provider, or with the
    5  rules and regulations established by the commissioner. The  municipality
    6  shall  submit  the  results  of  any  such audit to the commissioner for
    7  review and, if warranted, adjustments in state aid reimbursement  pursu-
    8  ant to subdivision [three] four of this section, as well as for recovery
    9  by the municipality of its share of any disallowances identified in such
   10  audit.
   11    6.  Each  municipality  may  negotiate  rates which are lower than the
   12  rates established by the department for evaluations and  approved  early
   13  intervention  services  provided  to eligible children who reside within
   14  the municipality.  The municipality must ensure that  there  are  suffi-
   15  cient  providers  to  provide service coordination services, evaluations
   16  and/or early intervention services.
   17    7. A municipality which has negotiated rates  for  early  intervention
   18  services  and  evaluations shall not seek reimbursement from the depart-
   19  ment in an amount exceeding fifty percent of  the  rate  negotiated  and
   20  actually paid to the provider.
   21    8. The department may contract with an independent organization to act
   22  as  the  fiscal  agent for each of the municipalities and the department
   23  and each municipality shall use such fiscal agent for early intervention
   24  program fiscal management and claiming as determined by the  commission-
   25  er.
   26    9.  Municipalities and providers of services shall provide information
   27  and documentation as required by the  fiscal  agent  to  carry  out  the
   28  fiscal agent's duties.
   29     § 14. Subdivision 3 of section 2558 of the public health law, as added
   30  by chapter 428 of the laws of 1992, is amended to read as follows:
   31    3.  Contract  and  payment responsibility. The municipality of current
   32  location shall be the municipality of  record  for  an  eligible  foster
   33  child  or  homeless  child for the purposes of this title, provided that
   34  notwithstanding the [provision] provisions of subdivision [two] three of
   35  section twenty-five hundred fifty-seven of this title, the  state  shall
   36  reimburse one hundred percent of the approved costs paid by such munici-
   37  pality  which  shall be offset by the local contribution due pursuant to
   38  subdivision four of this section.
   39     § 15. Subdivision 3 of section 2559 of the public health law, as added
   40  by chapter 428 of the laws of 1992, paragraph (a) as amended  and  para-
   41  graph  (d)  as  added  by chapter 231 of the laws of 1993, is amended to
   42  read as follows:
   43    3. (a) Providers  of  evaluations,  early  intervention  services  and
   44  transportation  services  shall in the first instance and where applica-
   45  ble, seek payment from all third party  payors  including  [governmental
   46  agencies]  the medical assistance program prior to claiming payment from
   47  a given  municipality  for  services  rendered  to  eligible  children[,
   48  provided  that,  for  the  purpose  of  seeking payment from the medical
   49  assistance program or from other third party  payors,  the  municipality
   50  shall  be deemed the provider of such early intervention services to the
   51  extent that the provider has  promptly  furnished  to  the  municipality
   52  adequate  and complete information necessary to support the municipality
   53  billing, and provided further that the obligation to seek payment  shall
   54  not  apply  to  a payment from a third party payor who is not prohibited
   55  from applying such payment, and will apply such payment, to an annual or
   56  lifetime limit specified in the insured's policy].
       S. 1408                            142                           A. 2108
 
    1    (b) [The commissioner, in consultation with the director of budget and
    2  the superintendent of insurance, shall promulgate regulations  providing
    3  public  reimbursement  for  deductibles and copayments which are imposed
    4  under an insurance policy or health benefit plan to the extent that such
    5  deductibles   and   copayments  are  applicable  to  early  intervention
    6  services.
    7    (c) Payments made for early intervention services under  an  insurance
    8  policy  or  health  benefit  plan  which are provided as part of an IFSP
    9  pursuant to section twenty-five hundred forty-five of this  title  shall
   10  not  be applied by the insurer or plan administrator against any maximum
   11  lifetime or annual limits specified in the  policy  or  health  benefits
   12  plan,  pursuant to section eleven of the chapter of the laws of nineteen
   13  hundred ninety-two which added this title.
   14    (d) A municipality, or its designee,] When medical assistance  program
   15  reimbursement  or  third  party  payment  is not available or when third
   16  party  payment  has  been  expended,  providers  of  early  intervention
   17  services  and  transportation  services, except providers of evaluations
   18  and service coordination services, shall be  responsible  for  obtaining
   19  payment  in  the  amount  of  twenty  percent  of  the rate for services
   20  rendered to an eligible child from the eligible child's  parent  to  the
   21  extent  permissible  under the sliding fee scale established under para-
   22  graph (c) of this subdivision.
   23    (c) The commissioner, in consultation with the director of the budget,
   24  shall  establish  parent  participation  fees  for  early   intervention
   25  services based upon the following sliding fee scale:
   26       Household Net Income                       Cap
   27       Below 160 % Federal Poverty Level (FPL).  No Fee
   28       161% FPL to 300% FPL                      $500 per child, per year
   29       301% FPL to 400% FPL                      $1500 per child, per year
   30       401% FPL to 500% FPL                      $3000 per child, per year
   31       501% FPL to 600% FPL                      $5000 per child, per year
   32       Above 601% FPL                            No cap
   33    The  commissioner  may  waive a parent's participation fees based upon
   34  the parent's financial resources and the costs of the services  required
   35  by the eligible child.
   36    (d)  The  fiscal agent, or the service coordinator in the absence of a
   37  fiscal agent, shall collect from an eligible child's  parent  documenta-
   38  tion  of  payments  made  to providers of services as required under the
   39  sliding fee scale and shall notify the early intervention  official  and
   40  the  eligible  child's  early intervention service providers of the date
   41  upon which the parent's participation fee cap has been reached and  that
   42  the parent is therefore no longer required to participate in the payment
   43  of early intervention services for the remainder of the program year.
   44    (e)  When  parent  participation is not required as set forth in para-
   45  graph (c) of this subdivision, or when  parent  participation  has  been
   46  expended  and  medical assistance program coverage is unavailable and/or
   47  all other third party payor coverage is  unavailable  or  expended,  one
   48  hundred  percent  of the service rate of approved costs shall be paid in
   49  the first instance and at least quarterly by the  appropriate  governing
   50  body  or officer of the municipality upon vouchers presented and audited
   51  in the same manner as the case of other claims against the municipality.
   52  The department shall reimburse such approved costs to  the  municipality
   53  in  an amount of fifty percent of the amount expended in accordance with
   54  the rules and regulations of the commissioner. Such state  reimbursement
   55  to  the  municipality shall not be paid prior to April first of the year
   56  in which the approved costs are paid by the municipality.
       S. 1408                            143                           A. 2108
 
    1    (f) Early intervention  evaluators  and  service  providers  shall  be
    2  subrogated,  to  the  extent  of the [expenditures by such municipality]
    3  approved costs for early  intervention  services  furnished  to  persons
    4  eligible  for  benefits  under this title, to any rights such person may
    5  have  or  be  entitled  to from third party reimbursement.  The right of
    6  subrogation does not attach to  benefits  paid  or  provided  under  any
    7  health  insurance  policy  or  health  benefits plan prior to receipt of
    8  written notice of the exercise of subrogation rights by the  insurer  or
    9  plan administrator providing such benefits.
   10    (g)  Paragraphs (b) through (e) of this subdivision shall not apply to
   11  providers of evaluations and service coordination services. When medical
   12  assistance program reimbursement or third party payment is not available
   13  or when third party payment has been expended, providers of  evaluations
   14  and  service  coordination services shall seek payment for such services
   15  as provided for  in  subdivision  one  of  section  twenty-five  hundred
   16  fifty-seven of this title.
   17     §  16.  This  act shall take effect immediately; provided however that
   18  sections one, two, three, four and six of this act shall  apply  to  all
   19  policies issued, renewed, modified, altered or amended on and after such
   20  date;  provided  further  that sections twelve, thirteen and fourteen of
   21  this act shall take effect on the  sixtieth  day  after  it  shall  have
   22  become  a  law;  and  provided  further, however, that the amendments to
   23  subdivision 7 of section 2510 of the public health law made  by  section
   24  four  of  this  act  shall be subject to the expiration and reversion of
   25  such subdivision pursuant to section 47 of chapter  2  of  the  laws  of
   26  1998,  as amended, when upon such date the provisions of section five of
   27  this act shall take effect.
   28     § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
   29  sion, section or part of this act shall be  adjudged  by  any  court  of
   30  competent  jurisdiction  to  be invalid, such judgment shall not affect,
   31  impair, or invalidate the remainder thereof, but shall  be  confined  in
   32  its  operation  to the clause, sentence, paragraph, subdivision, section
   33  or part thereof directly involved in the controversy in which such judg-
   34  ment shall have been rendered. It is hereby declared to be the intent of
   35  the legislature that this act would  have  been  enacted  even  if  such
   36  invalid provisions had not been included herein.
   37     §  3.  This  act shall take effect immediately provided, however, that
   38  the applicable effective date of Parts A through N of this act shall  be
   39  as specifically set forth in the last section of such Parts.