RETRIEVE BILL HMH - 0607


                STATE OF NEW YORK
        ________________________________________________________________________

            S. 6457                                                  A. 9557

                SENATE - ASSEMBLY

                                   January 20, 2006
                                       ___________

        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  amend  the  social services law, the public health law, the
          penal law, the criminal procedure law, the labor law, the civil  prac-
          tice  law  and rules, the public health law, chapter 58 of the laws of
          2005, amending the public health law and other laws relating to imple-
          menting the state fiscal plan for the  2005-2006  state  fiscal  year,
          chapter  66  of  the laws of 1994, amending the public health law, the
          general municipal law and the insurance law relating to the  financing
          of life care communities, chapter 81 of the laws of 1995, amending the
          public health law and other laws relating to medical reimbursement and
          welfare  reform,  chapter  639 of the laws of 1996 amending the public
          health law and other laws relating to welfare reform, chapter  474  of
          the  laws  of 1996, amending the education law and other laws relating
          to rates for residential health care facilities, chapter  483  of  the
          laws  of  1978,  amending  the  public  health law relating to rate of
          payments for each residential health care facility  to  real  property
          costs,  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, 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, chapter 165
          of the laws of 1991, amending the public health  law  and  other  laws
          relating  to  establishing payments for medical assistance, 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, chapter 659 of the laws of 1997,  amending
          the  public health law and other laws relating to creation of continu-
          ing care retirement communities, 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 health

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD12271-01-6
        S. 6457                             2                            A. 9557

          reform; and to repeal section 366-f of the social services law, subdi-
          vision 11 of section 364-j of the social services law,  paragraph  (c)
          of  subdivision  3 of section 369-ee of the social services law, para-
          graph (j) of subdivision 2 of section 365-a of the social services law
          and  subdivision  (x) of section 165 of chapter 41 of the laws of 1992
          amending the public health law and other laws  relating  to  assessing
          certain  healthcare  providers relating thereto (Part A); to amend the
          insurance law and the public health law, in relation to  early  inter-
          vention services; to amend the public health law, in relation to state
          aid  for  municipalities;  to  amend the elder law, in relation to the
          elderly pharmaceutical insurance coverage program; to amend chapter 62
          of the laws of 2003 amending the public health law relating to  allow-
          ing for the use of funds of the office of professional medical conduct
          for  activities of the patient health information and quality improve-
          ment act of 2000, in relation to the effectiveness of such  provisions
          of  the  public  health  law  relating  thereto; and repealing certain
          provisions of the public health law  relating  thereto  (Part  B);  to
          establish  a  cost  of living adjustment for designated human services
          programs and providing for the repeal of such provisions upon  expira-
          tion  thereof (Part C); to amend the public health law, in relation to
          allocations for worker retraining, Roswell Park, anti-tobacco program,
          public health programs,  elderly  pharmaceutical  insurance  coverage,
          excess medical malpractice, nursing home financially distressed, phar-
          macy,  family health plus, healthcare efficiency and affordability law
          for New Yorkers, to amend the public health law, in relation  to  HCRA
          surcharges,  assessments  and  covered  lives assessment; bad debt and
          charity care; high need indigent care;  state  planning  and  research
          cooperative  systems  and  the  health  care reform act pool reporting
          requirements; to amend the state finance law, in relation to the  area
          health  education centers; to amend the insurance law, the tax law and
          chapter 235 of the laws of 1952 relating to enabling any city  of  the
          state  having  a  population of one million or more to adopt and amend
          local laws, imposing certain specified types of taxes  on  cigarettes,
          cigars  and  smoking  tobacco  which the legislature has or would have
          power and authority to impose, to  provide  for  the  review  of  such
          taxes, and to limit the application of such local laws, in relation to
          the tax on cigarettes; to amend the public authorities law in relation
          to  the  HCRA  resources fund; and to repeal certain provisions of the
          public health law relating  thereto  (Part  D);  to  amend  the  state
          finance law, in relation to the chemical dependence service fund (Part
          E);  to amend the mental hygiene law, in relation to funding of chemi-
          cal dependence and compulsive gambling services (Part F); to amend the
          public health law, in relation to eliminating mental health outpatient
          services as services that can be considered specialized services under
          section 2807 of the public health law (Part G); and to  amend  chapter
          119  of  the  laws  of  1997 relating to authorizing the department of
          health to establish certain payments to general hospitals, in relation
          to extending the authorization for the department of health to contin-
          ue certain payments to general hospitals

          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 2006-2007
        S. 6457                             3                            A. 9557

     1  state fiscal year. Each component is  wholly  contained  within  a  Part
     2  identified  as Parts A through H. The effective date for each particular
     3  provision contained within such Part is set forth in the last section of
     4  such Part. Any provision in any section contained within a Part, includ-
     5  ing the effective date of the Part, which makes a reference to a section
     6  "of  this  act", when used in connection with that particular component,
     7  shall be deemed to mean and refer to the corresponding  section  of  the
     8  Part  in  which  it  is  found. Section three of this act sets forth the
     9  general effective date of this act.

    10                                   PART A

    11    Section 1. Subdivision 4 of section 365-a of the social services  law,
    12  is amended by adding a new paragraph (f) to read as follows:
    13    (f)  for  eligible  persons who are also beneficiaries under part D of
    14  title XVIII of the federal social security act, drugs which are  denomi-
    15  nated  as  "covered  part D drugs" under section 1860D-2(e) of such act;
    16  provided however that, for purposes of this paragraph, "covered  part  D
    17  drugs"  shall not mean atypical anti-psychotics, anti-depressants, anti-
    18  retrovirals used in the treatment of HIV/AIDS, or  anti-rejection  drugs
    19  used for the treatment of organ and tissue transplants.
    20    §  2. Section 2808 of the public health law is amended by adding a new
    21  subdivision 24 to read as follows:
    22    24. Notwithstanding any inconsistent provision of law or regulation to
    23  the contrary, (a) The operating component of rates of payment by govern-
    24  mental agencies for services provided by residential health care facili-
    25  ties, except for residential health care facilities or discrete units of
    26  residential health care facilities as identified in paragraphs  (b)  and
    27  (c)  of  this  subdivision,  shall  be  computed  in accordance with the
    28  following base year cost data, as trended pursuant to applicable law  to
    29  the  applicable  rate  period and as adjusted for case mix in accordance
    30  with applicable regulations:
    31    (i) for the period January first, two thousand seven through  December
    32  thirty-first, two thousand seven, eighty percent of each such rate shall
    33  reflect  utilization  of  the reported base year operating costs used to
    34  set each facility's two thousand five rates, and twenty percent of  each
    35  such  rate  shall  reflect  utilization of each such facility's reported
    36  base year operating costs for two thousand three;
    37    (ii) for the period January first, two thousand eight through December
    38  thirty-first, two thousand eight, sixty percent of each such rate  shall
    39  reflect  utilization  of  the reported base year operating costs used to
    40  set each facility's two thousand five rates, and forty percent  of  each
    41  such  rate  shall  reflect  utilization of each such facility's reported
    42  base year operating costs for two thousand three;
    43    (iii) for the period January first, two thousand nine through December
    44  thirty-first, two thousand nine, forty percent of each such  rate  shall
    45  reflect  utilization  of  the reported base year operating costs used to
    46  set each facility's two thousand five rates, and sixty percent  of  each
    47  such  rate  shall  reflect  utilization of each such facility's reported
    48  base year operating costs for two thousand three;
    49    (iv) for the period January first, two thousand ten  through  December
    50  thirty-first,  two  thousand ten, twenty percent of each such rate shall
    51  reflect utilization of the reported base year operating  costs  used  to
    52  set  each facility's two thousand five rates, and eighty percent of each
    53  such rate shall reflect utilization of  each  such  facility's  reported
    54  base year operating costs for two thousand three; and
        S. 6457                             4                            A. 9557

     1    (v)  for periods on and after January first, two thousand eleven, each
     2  such rate shall reflect utilization of  each  such  facility's  reported
     3  base year operating costs for two thousand three.
     4    (b)  Residential  health  care  facilities  receiving rates of payment
     5  based on allowable operating costs for a period  subsequent  to  January
     6  first,  two  thousand  three, shall continue to receive rates of payment
     7  reflecting the allowable operating costs from such subsequent period.
     8    (c) Paragraph (a) of this subdivision shall  not  apply  to  rates  of
     9  payment  paid  for services provided in the following residential health
    10  care facilities or discrete units of such facilities if the  application
    11  of such paragraph would result in a lesser rate of payment:
    12    (i)  residential  health  care  facilities  or  discrete units of such
    13  facilities established for the care of AIDS patients, as approved by the
    14  commissioner;
    15    (ii) residential health facilities or discrete units of  such  facili-
    16  ties  established for the care of patients under the long-term inpatient
    17  rehabilitation program for traumatic brain injured patients,  as  estab-
    18  lished pursuant to applicable regulations;
    19    (iii)  residential  health  care  facilities or discrete units of such
    20  facilities established for the long-term care  of  ventilator  dependent
    21  residents, as approved by the commissioner;
    22    (iv)  residential  health  care  facilities  or discrete units of such
    23  facilities specifically designated and approved by the commissioner  for
    24  the  purpose  of  providing specialized programs for residents requiring
    25  behavioral interventions; and
    26    (v) residential health care  facilities  or  discrete  units  of  such
    27  facilities  which  provide extensive nursing, medical, psychological and
    28  counseling support services solely to children,  as  determined  by  the
    29  commissioner.
    30    §  3. Section 2808 of the public health law is amended by adding a new
    31  subdivision 22 to read as follows:
    32    22. Special provisions.
    33    (a) Notwithstanding any inconsistent provision of law or regulation to
    34  the contrary, residential health care facility rates of  payment  deter-
    35  mined  pursuant to this article for services provided on and after Janu-
    36  ary first, two thousand seven,  except  for  the  establishment  of  any
    37  statewide or any peer group base, mean, or ceiling prices per day, shall
    38  be  calculated  utilizing only the number of residents properly assessed
    39  and reported in each  patient  classification  group  and  eligible  for
    40  medical  assistance  pursuant  to  title  eleven  of article five of the
    41  social services law.
    42    (b) Notwithstanding any inconsistent provision of law or regulation to
    43  the contrary, for services provided on  and  after  January  first,  two
    44  thousand  seven,  the commissioner shall utilize the free-standing resi-
    45  dential health care facility indirect peer group prices, as computed  in
    46  accordance with applicable regulations, in computing the allowable indi-
    47  rect component of rates of payment for hospital based residential health
    48  care facilities.
    49    (c) Notwithstanding any inconsistent provision of law or regulation to
    50  the  contrary,  for  services  provided  on and after January first, two
    51  thousand seven, for computing the indirect component of rates of payment
    52  for residential health care facilities licensed under  this  article  to
    53  operate  three  hundred or more beds, the commissioner shall utilize the
    54  indirect peer  group  prices  for  residential  health  care  facilities
    55  licensed under this article to operate less than three hundred beds.
        S. 6457                             5                            A. 9557

     1    §  4.  Article  1  of the public health law is amended by adding a new
     2  title III to read as follows:

     3                                  TITLE III
     4                  OFFICE OF THE MEDICAID INSPECTOR GENERAL
     5  Section 30. Definitions.
     6          31. Establishment.
     7          32. Functions, duties and responsibilities.
     8          33. Cooperation of agency officials and employees.
     9          34. Transfer of employees.
    10          35. Reports required of the inspector.
    11          36. Disclosure of information.

    12    §  30.    Definitions.   For the purposes of this title, the following
    13  definitions shall apply:
    14    a. "Inspector" means the Medicaid inspector general  created  by  this
    15  section.
    16    b.  "Investigation"  means  investigations  of fraud, waste, abuse, or
    17  illegal acts perpetrated within the Medicaid program, by providers    or
    18  recipients of Medicaid care, services and supplies.
    19    c.    "Office"  means  the  office  of  the Medicaid inspector general
    20  created by this section.
    21    § 31. Establishment.  a. There is hereby created within the department
    22  the office of Medicaid inspector general. The office shall undertake and
    23  be responsible for the department's duties as the  single  state  agency
    24  for  the  administration  of the Medicaid program in New York state with
    25  respect to fraud, waste and abuse.   This responsibility  shall  include
    26  but not be limited to the Medicaid audit functions, pursuant to sections
    27  three  hundred  sixty-four and three hundred sixty-eight-c of the social
    28  services law, and  the function of   Medicaid   fraud, waste  and  abuse
    29  prevention,  pursuant  to  sections  one  hundred  forty-five-a  and one
    30  hundred forty-five-b of the social services law (transferred   to    the
    31  New York state department of health from the former department of social
    32  services  pursuant  to subdivision (e) of section one hundred twenty-two
    33  of part B of chapter four hundred thirty-six  of  the  chapter  laws  of
    34  nineteen hundred ninety-seven).
    35    b.  The head of the office shall be the Medicaid inspector general who
    36  shall be appointed by the governor by and with the advice and consent of
    37  the senate.  The inspector shall serve for a term  of  five  years.  The
    38  inspector shall report directly to the secretary to the governor.
    39    c.  The  inspector  shall  be  compensated  within the limits of funds
    40  available therefor, provided, however, such salary shall be no less than
    41  the salaries of certain state officers holding the  positions  indicated
    42  in paragraph (a) of subdivision one of section one hundred sixty-nine of
    43  the executive law.
    44    §  32.    Functions, duties and responsibilities.  The inspector shall
    45  have the following functions, duties and responsibilities:
    46    a. to appoint such deputies, directors, assistants and other  officers
    47  and  employees as may be needed for the performance of his or her duties
    48  and may prescribe their duties and fix  their  compensation  within  the
    49  amounts appropriated therefor;
    50    b. to conduct and supervise activities to prevent, detect and investi-
    51  gate  Medicaid fraud, waste and abuse amongst the following: the depart-
    52  ment; the offices of mental health, mental retardation and developmental
    53  disabilities, alcoholism and substance abuse services,  temporary  disa-
        S. 6457                             6                            A. 9557

     1  bility  assistance,  and children and family services; the department of
     2  education;
     3    c.  to  coordinate,  to  the  greatest  extent possible, activities to
     4  prevent, detect and investigate Medicaid fraud, waste and abuse  amongst
     5  the  following:    the  department; the offices of mental health, mental
     6  retardation and developmental  disabilities,  alcoholism  and  substance
     7  abuse services, temporary disability assistance, and children and family
     8  services;  the  department  of  education;  the fiscal agent employed to
     9  operate the Medicaid management information  system;  local  governments
    10  and  entities,  the  deputy attorney general for Medicaid fraud control;
    11  and the state comptroller;
    12    d. to keep the governor, attorney general, state  comptroller,  tempo-
    13  rary  president  and  minority leader of the senate, the speaker and the
    14  minority and majority leaders of the assembly, and the heads of agencies
    15  with responsibility for  the  administration  of  the  Medicaid  program
    16  apprised  of  efforts  to  prevent,  detect,  investigate, and prosecute
    17  fraud, waste and abuse within the Medicaid program;
    18    e. to pursue civil  and  administrative  enforcement  actions  against
    19  those who engage in fraud, waste, abuse or illegal or inappropriate acts
    20  perpetrated  within  the Medicaid program, including providers, contrac-
    21  tors, agents, recipients, individuals or other entities involved direct-
    22  ly or indirectly with the  provision  of  Medicaid  care,  services  and
    23  supplies;
    24    f.  to  make  information  and evidence relating to suspected criminal
    25  acts which he or she may obtain in carrying out his or her duties avail-
    26  able to the Deputy Attorney General for Medicaid Fraud Control  pursuant
    27  to  the requirements of federal law, as well as to other law enforcement
    28  officials where appropriate, and consulting  with  the  Deputy  Attorney
    29  General  for  Medicaid  Fraud  Control,  federal  prosecutors, and local
    30  district attorneys to  coordinate  criminal  investigations  and  prose-
    31  cutions;
    32    g.  to  subpoena  and  enforce the attendance of witnesses, administer
    33  oaths or affirmations,  examine witnesses under oath, and take  testimo-
    34  ny;
    35    h. to require and compel the production of such books, papers, records
    36  and  documents  as  he  or she may deem to be relevant or material to an
    37  investigation,  examination  or  review  undertaken  pursuant  to   this
    38  section;
    39    i.  to  examine  and  copy  or remove documents or records of any kind
    40  related to the Medicaid program or necessary for the Medicaid  inspector
    41  general  to  perform  its duties and responsibilities that are prepared,
    42  maintained or held by or available to any state agency or local  govern-
    43  mental  entity  the patients or clients of which are served by the Medi-
    44  caid program, or which is otherwise responsible for the control of Medi-
    45  caid fraud, waste and abuse;
    46    j. to recommend and implement policies relating to the prevention  and
    47  detection of fraud, waste and abuse;
    48    k.  to  monitor  the implementation of any recommendations made by the
    49  office of the Medicaid inspector general to agencies or  other  entities
    50  with responsibility for administration of the Medicaid program;
    51    l.  to  receive  and  to investigate complaints of alleged failures of
    52  state and local officials to prevent, detect and prosecute fraud, waste,
    53  and abuse; and
    54    m. perform any other functions that are necessary  or  appropriate  to
    55  fulfill the duties and responsibilities of the office.
        S. 6457                             7                            A. 9557

     1    §  33.  Cooperation of agency officials and employees.  a. In addition
     2  to the authority otherwise provided by this  title,  the  inspector,  in
     3  carrying out the provisions of this title, is authorized to request such
     4  information, assistance and cooperation from any federal, state or local
     5  governmental  department,  board, bureau, commission, or other agency or
     6  unit thereof as may be necessary for carrying out the duties and respon-
     7  sibilities enjoined upon the inspector by this section.  State and local
     8  agencies or units thereof are hereby authorized and directed to  provide
     9  such  information, assistance and cooperation.  Executive agencies shall
    10  coordinate and facilitate the  transfer  of  appropriate  functions  and
    11  positions  to the Medicaid inspector general as necessary and in accord-
    12  ance with applicable law.
    13    b. Notwithstanding any other provision of law, rule or  regulation  to
    14  the  contrary, no person shall prevent, seek to prevent, interfere with,
    15  obstruct or otherwise hinder any investigation being conducted  pursuant
    16  to  this  section.  No provision of law shall in any way be construed to
    17  restrict any person or governmental body from cooperating and  assisting
    18  the inspector or his or her employees in carrying out their duties under
    19  this  section.    Any violation of this paragraph shall constitute cause
    20  for suspension or removal from office or employment.
    21    § 34. Transfer of employees.  Upon the transfer of the Medicaid  audit
    22  and  fraud,  waste and abuse prevention functions from the department of
    23  health, the office of mental retardation and developmental disabilities,
    24  the office of mental health, and the office  of  alcohol  and  substance
    25  abuse  services  to  the office of Medicaid inspector general within the
    26  department pursuant to section thirty-one of this title, provision shall
    27  be made for the transfer of necessary officers  and  employees  who  are
    28  substantially  engaged  in  the performance of the function to be trans-
    29  ferred, and any documents and  records  necessary  and  related  to  the
    30  transfer  of  such functions.   The heads of the departments or agencies
    31  from which such function is to be transferred and the head of the office
    32  of the Medicaid inspector general shall confer to determine the officers
    33  and employees who are substantially engaged in the  Medicaid  audit  and
    34  fraud, waste, and abuse prevention function to be transferred.  Officers
    35  and  employees so transferred shall be transferred without further exam-
    36  ination or  qualification,  and  shall  retain  their  respective  civil
    37  service classification and status.
    38    §  35.  Reports  required  of the inspector.   The inspector shall, no
    39  later than October first of each year, submit to the governor, the state
    40  comptroller, the attorney general and the legislature a report summariz-
    41  ing the activities of the office during the preceding calendar year.
    42    § 36. Disclosure of information.  a. The inspector shall not  publicly
    43  disclose information which is specifically prohibited from disclosure by
    44  any other provision of law.
    45    b.  Notwithstanding  subdivision  a  of this section, any report under
    46  this section may be disclosed to the public in  a  form  which  includes
    47  information  with respect to a part of an ongoing criminal investigation
    48  if such information has been included in a public record.
    49    § 5. The penal law is amended by adding a new article 159 to  read  as
    50  follows:
    51                                 ARTICLE 159
    52                            HEALTH CARE OFFENSES
    53  Section 159.00 Definitions.
    54          159.05 Health care fraud in the fifth degree.
    55          159.10 Health care fraud in the fourth degree.
    56          159.15 Health care fraud in the third degree.

        S. 6457                             8                            A. 9557

     1          159.20 Health care fraud in the second degree.
     2          159.25 Health care fraud in the first degree.
     3          159.30 Making  false  statements  relating to health care in the
     4                   second degree.
     5          159.35 Making false statements relating to health  care  in  the
     6                   first degree.
     7  § 159.00 Definitions.
     8    The following definition is applicable to this article:
     9    "Health  plan" means any publicly funded plan or contract, under which
    10  any medical benefit, item, or service is provided to any individual  and
    11  includes  any  individual  or entity who is providing a medical benefit,
    12  item, or service for which  payment  may  be  made  under  the  plan  or
    13  contract.
    14  § 159.05 Health care fraud in the fifth degree.
    15    A person is guilty of health care fraud in the fifth degree when, with
    16  intent  to appropriate any benefit to himself, herself or another, he or
    17  she knowingly executes or conspires to execute a scheme or artifice to:
    18    (a) defraud any health plan in connection with  the  delivery  of,  or
    19  payment for, health care benefits, items or services; or
    20    (b)  obtain money or anything of value in connection with the delivery
    21  of, or payment for, health care benefits, items or services by means  of
    22  false  or fraudulent pretense, representation, statement or promise, any
    23  of which he or she knows to be false or fraudulent.
    24    Health care fraud in the fifth degree is a class A misdemeanor.
    25  § 159.10 Health care fraud in the fourth degree.
    26    A person is guilty of health care fraud in the fourth degree  when  he
    27  or  she  commits the crime of health care fraud in the fifth degree with
    28  the intent to appropriate to himself,  herself,  or  another  a  benefit
    29  worth one thousand dollars or more in the aggregate.
    30    Health care fraud in the fourth degree is a class E felony.
    31  § 159.15 Health care fraud in the third degree.
    32    A person is guilty of health care fraud in the third degree when he or
    33  she  commits the crime of health care fraud in the fifth degree with the
    34  intent to appropriate to himself, herself, or another  a  benefit  worth
    35  three thousand dollars or more in the aggregate.
    36    Health care fraud in the third degree is a class D felony.
    37  § 159.20 Health care fraud in the second degree.
    38    A  person  is guilty of health care fraud in the second degree when he
    39  or she commits the crime of health care fraud in the fifth degree:
    40    (a) with the intent to appropriate to  himself,  herself,  or  another
    41  benefit worth fifty thousand dollars or more in the aggregate; or
    42    (b) when commission of the offense results in serious physical injury,
    43  as defined in subdivision ten of section 10.00 of this chapter.
    44    Health care fraud in the second degree is a class C felony.
    45  § 159.25 Health care fraud in the first degree.
    46    A person is guilty of health care fraud in the first degree when he or
    47  she commits the crime of health care fraud in the fifth degree:
    48    (a)  with  the intent to appropriate to himself, herself, or another a
    49  benefit worth one million dollars or more in the aggregate; or
    50    (b) when commission of the offense results in death.
    51    Health care fraud in the first degree is a class B felony.
    52  § 159.30 Making false statements relating to health care in  the  second
    53             degree.
    54    A  person is guilty of making false statements relating to health care
    55  in the second degree when, in any matter related to a health plan, he or
        S. 6457                             9                            A. 9557

     1  she, in  connection  with  the  provision  of  health  care  or  related
     2  services, knowingly:
     3    (a)  falsifies,  conceals, or omits by any trick, scheme, artifice, or
     4  device a material fact; or
     5    (b) makes or uses any false, fictitious, or fraudulent  statements  or
     6  representations; or
     7    (c)  makes  or uses any false writing or document, knowing the same to
     8  contain any false, fictitious, or fraudulent statement or entry.
     9    Making false statements relating to health care in the  second  degree
    10  is a class A misdemeanor.
    11  § 159.35 Making  false  statements  relating to health care in the first
    12             degree.
    13    A person is guilty of making false statements relating to health  care
    14  in  the  first  degree  when he or she commits the crime of making false
    15  statements relating to health care in the second degree with  intent  to
    16  commit another crime or to aid or conceal the commission thereof.
    17    Making false statements relating to health care in the first degree is
    18  a class E felony.
    19    §  5-a.  Paragraph  (a) of subdivision 1 of section 70.02 of the penal
    20  law, as separately amended by chapters 764 and 765 of the laws of  2005,
    21  is amended to read as follows:
    22    (a)  Class  B  violent felony offenses: an attempt to commit the class
    23  A-I felonies of murder in  the  second  degree  as  defined  in  section
    24  125.25, kidnapping in the first degree as defined in section 135.25, and
    25  arson  in the first degree as defined in section 150.20; manslaughter in
    26  the first degree as defined in section 125.20,  aggravated  manslaughter
    27  in  the  first  degree  as  defined in section 125.22, rape in the first
    28  degree as defined in section 130.35, criminal sexual act  in  the  first
    29  degree  as  defined  in  section  130.50, aggravated sexual abuse in the
    30  first degree as defined in section  130.70,  course  of  sexual  conduct
    31  against  a  child  in  the  first  degree  as defined in section 130.75;
    32  assault in the first degree as defined in section 120.10, kidnapping  in
    33  the  second  degree  as defined in section 135.20, burglary in the first
    34  degree as defined in section 140.30,  arson  in  the  second  degree  as
    35  defined  in  section  150.15,  health  care fraud in the first degree as
    36  defined in subdivision (b) of  section  159.25,  robbery  in  the  first
    37  degree  as defined in section 160.15, criminal possession of a weapon in
    38  the first degree as defined in section 265.04, criminal use of a firearm
    39  in the first degree as defined in section 265.09,  criminal  sale  of  a
    40  firearm  in  the  first  degree as defined in section 265.13, aggravated
    41  assault upon a police officer or a peace officer as defined  in  section
    42  120.11,  gang  assault in the first degree as defined in section 120.07,
    43  intimidating a victim or witness in  the  first  degree  as  defined  in
    44  section  215.17,  hindering prosecution of terrorism in the first degree
    45  as defined in section 490.35, criminal possession of a  chemical  weapon
    46  or  biological weapon in the second degree as defined in section 490.40,
    47  and criminal use of a chemical weapon or biological weapon in the  third
    48  degree as defined in section 490.47.
    49    § 6. Paragraph (b) of subdivision 1 of section 70.02 of the penal law,
    50  as  separately  amended  by chapters 764 and 765 of the laws of 2005, is
    51  amended to read as follows:
    52    (b) Class C violent felony offenses: an attempt to commit any  of  the
    53  class  B  felonies  set  forth  in  paragraph (a); aggravated criminally
    54  negligent homicide as defined in section 125.11, aggravated manslaughter
    55  in the second degree as defined in  section  125.21,  aggravated  sexual
    56  abuse  in  the  second degree as defined in section 130.67, assault on a
        S. 6457                            10                            A. 9557

     1  peace officer, police officer, fireman  or  emergency  medical  services
     2  professional  as  defined  in section 120.08, gang assault in the second
     3  degree as defined in section 120.06, burglary in the  second  degree  as
     4  defined  in  section  140.25,  health care fraud in the second degree as
     5  defined in subdivision (b) of section  159.20,  robbery  in  the  second
     6  degree  as defined in section 160.10, criminal possession of a weapon in
     7  the second degree as defined  in  section  265.03,  criminal  use  of  a
     8  firearm in the second degree as defined in section 265.08, criminal sale
     9  of a firearm in the second degree as defined in section 265.12, criminal
    10  sale  of a firearm with the aid of a minor as defined in section 265.14,
    11  soliciting or providing support for an act of  terrorism  in  the  first
    12  degree  as defined in section 490.15, hindering prosecution of terrorism
    13  in the  second  degree  as  defined  in  section  490.30,  and  criminal
    14  possession of a chemical weapon or biological weapon in the third degree
    15  as defined in section 490.37.
    16    §  7.  Subparagraph  (iv)  of  paragraph c of subdivision 1 of section
    17  80.00 of the penal law, as added by chapter 338 of the laws of 1989,  is
    18  amended and a new paragraph d is added to read as follows:
    19    (iv) for C felonies, fifteen thousand dollars[.]; or
    20    d.  if the conviction is for any felony defined in article one hundred
    21  fifty-nine of this chapter, according to the following schedule:
    22    (i) for B felonies, seventy-five thousand dollars;
    23    (ii) for C felonies, fifty thousand dollars;
    24    (iii) for D felonies, twenty-five thousand dollars;
    25    (iv) for E felonies, ten thousand dollars.
    26    § 8. Subdivision 1 of section 80.05 of the penal law,  as  amended  by
    27  chapter 669 of the laws of 1984, is amended to read as follows:
    28    1.  Class A misdemeanor. A sentence to pay a fine for a class A misde-
    29  meanor shall be a sentence to pay an amount, fixed  by  the  court,  not
    30  exceeding the higher of:
    31    (a) one thousand dollars[, provided, however, that]; or
    32    (b)  for  a sentence imposed for a violation of section 215.80 of this
    33  chapter [may include], a fine in an  amount  equivalent  to  double  the
    34  value  of  the  property unlawfully disposed of in the commission of the
    35  crime; or
    36    (c) for a sentence imposed for a misdemeanor defined  in  article  one
    37  hundred fifty-nine of this chapter, five thousand dollars.
    38    §  9.  Subdivision  1  of section 80.10 of the penal law is amended to
    39  read as follows:
    40    1. In general. A sentence to pay a fine, when imposed on a corporation
    41  for an offense defined in this chapter or for an offense defined outside
    42  this chapter for which no special corporate fine is specified, shall  be
    43  a sentence to pay an amount, fixed by the court, not exceeding:
    44    (a) Ten thousand dollars, when the conviction is of a felony;
    45    (b)  Five thousand dollars, when the conviction is of a class A misde-
    46  meanor or of an unclassified misdemeanor for which a term  of  imprison-
    47  ment in excess of three months is authorized;
    48    (c)  Two  thousand dollars, when the conviction is of a class B misde-
    49  meanor or of an unclassified misdemeanor for which the  authorized  term
    50  of imprisonment is not in excess of three months;
    51    (d) Five hundred dollars, when the conviction is of a violation;
    52    (e)  Any  higher  amount not exceeding double the amount of the corpo-
    53  ration's gain from the commission of  the  offense,  provided,  however,
    54  that  if  the conviction is imposed under article one hundred fifty-nine
    55  of this chapter, according to the following schedule:
        S. 6457                            11                            A. 9557

     1    (i) one hundred thousand dollars, when the conviction is of a  felony;
     2  and
     3    (ii) fifty thousand dollars, when the conviction is of a misdemeanor.
     4    § 10. Paragraphs (a) and (b) of subdivision 1 of section 460.10 of the
     5  penal  law,  paragraph (a) as amended by chapter 489 of the laws of 2000
     6  and paragraph (b) as added by chapter 516  of  the  laws  of  1986,  are
     7  amended to read as follows:
     8    (a)  Any  of  the felonies set forth in this chapter: sections 120.05,
     9  120.10 and 120.11 relating to assault; sections 125.10 to 125.27  relat-
    10  ing  to  homicide;  sections 130.25, 130.30 and 130.35 relating to rape;
    11  sections 135.20 and 135.25 relating to kidnapping; section 135.65 relat-
    12  ing  to  coercion;  sections  140.20,  140.25  and  140.30  relating  to
    13  burglary;  sections  145.05,  145.10  and  145.12  relating  to criminal
    14  mischief; article one hundred fifty relating to arson; sections  155.30,
    15  155.35,  155.40  and  155.42 relating to grand larceny; sections 159.10,
    16  159.15, 159.20, 159.25, and 159.35 relating  to  health  care  offenses;
    17  article  one hundred sixty relating to robbery; sections 165.45, 165.50,
    18  165.52 and 165.54 relating to criminal possession  of  stolen  property;
    19  sections  170.10,  170.15,  170.25,  170.30,  170.40,  170.65 and 170.70
    20  relating to forgery; sections 175.10, 175.25, 175.35, 175.40 and  210.40
    21  relating to false statements; sections 176.15, 176.20, 176.25 and 176.30
    22  relating  to  insurance  fraud;  sections  178.20 and 178.25 relating to
    23  criminal  diversion  of  prescription  medications  and   prescriptions;
    24  sections 180.03, 180.08, 180.15, 180.25, 180.40, 180.45, 200.00, 200.03,
    25  200.04,  200.10, 200.11, 200.12, 200.20, 200.22, 200.25, 200.27, 215.00,
    26  215.05 and 215.19 relating to bribery; sections 190.40 and 190.42 relat-
    27  ing to criminal usury; section 190.65 relating to  schemes  to  defraud;
    28  sections  205.60  and 205.65 relating to hindering prosecution; sections
    29  210.10, 210.15, and 215.51 relating to  perjury  and  contempt;  section
    30  215.40  relating  to  tampering with physical evidence; sections 220.06,
    31  220.09, 220.16, 220.18, 220.21, 220.31, 220.34, 220.39, 220.41,  220.43,
    32  220.46,  220.55  and  220.60 relating to controlled substances; sections
    33  225.10 and 225.20 relating to gambling;  sections  230.25,  230.30,  and
    34  230.32  relating  to promoting prostitution; sections 235.06, 235.07 and
    35  235.21 relating to obscenity; section 263.10 relating  to  promoting  an
    36  obscene performance by a child; sections 265.02, 265.03, 265.04, 265.11,
    37  265.12,  265.13  and the provisions of section 265.10 which constitute a
    38  felony relating to firearms and other dangerous  weapons;  and  sections
    39  265.14  and  265.16  relating to criminal sale of a firearm; and section
    40  275.10, 275.20, 275.30, or 275.40 relating to  unauthorized  recordings;
    41  and  sections  470.05, 470.10, 470.15 and 470.20 relating to money laun-
    42  dering; or
    43    (b) Any felony set forth elsewhere in  the  laws  of  this  state  and
    44  defined  by the tax law relating to alcoholic beverage, cigarette, gaso-
    45  line and similar motor fuel taxes; [title] article  seventy-one  of  the
    46  environmental  conservation  law  relating to water pollution, hazardous
    47  waste or substances hazardous or acutely hazardous to public  health  or
    48  safety  of  the  environment; article [twenty-three-a] twenty-three-A of
    49  the general business law relating to prohibited acts concerning  stocks,
    50  bonds and other securities [or], article twenty-two of the general busi-
    51  ness  law  concerning  monopolies or article five of the social services
    52  law relating to bribery in health care services.
    53    § 11. Paragraph (b) of subdivision 8 of section 700.05 of the criminal
    54  procedure law, as amended by chapter 264 of the laws of 2003, is amended
    55  to read as follows:
        S. 6457                            12                            A. 9557

     1    (b) Any of the following felonies: assault in  the  second  degree  as
     2  defined  in section 120.05 of the penal law, assault in the first degree
     3  as defined in section 120.10 of the penal law, reckless endangerment  in
     4  the  first degree as defined in section 120.25 of the penal law, promot-
     5  ing  a  suicide  attempt  as defined in section 120.30 of the penal law,
     6  criminally negligent homicide as defined in section 125.10 of the  penal
     7  law,  manslaughter  in the second degree as defined in section 125.15 of
     8  the penal law, manslaughter in the first degree as  defined  in  section
     9  125.20  of  the  penal  law,  murder  in the second degree as defined in
    10  section 125.25 of the penal law, murder in the first degree  as  defined
    11  in  section  125.27  of  the penal law, abortion in the second degree as
    12  defined in section 125.40 of the penal law, abortion in the first degree
    13  as defined in section 125.45 of the penal law, rape in the third  degree
    14  as defined in section 130.25 of the penal law, rape in the second degree
    15  as  defined in section 130.30 of the penal law, rape in the first degree
    16  as defined in section 130.35 of the penal law, criminal  sexual  act  in
    17  the third degree as defined in section 130.40 of the penal law, criminal
    18  sexual  act  in  the  second  degree as defined in section 130.45 of the
    19  penal law, criminal sexual act in the first degree as defined in section
    20  130.50 of the penal law, sexual abuse in the first degree as defined  in
    21  section  130.65  of  the  penal  law, unlawful imprisonment in the first
    22  degree as defined in section 135.10 of the penal law, kidnapping in  the
    23  second  degree as defined in section 135.20 of the penal law, kidnapping
    24  in the first degree as defined in  section  135.25  of  the  penal  law,
    25  custodial  interference in the first degree as defined in section 135.50
    26  of the penal law, coercion in the first degree  as  defined  in  section
    27  135.65  of  the  penal  law,  criminal  trespass  in the first degree as
    28  defined in section 140.17 of the penal law, burglary in the third degree
    29  as defined in section 140.20 of the penal law, burglary  in  the  second
    30  degree  as  defined  in section 140.25 of the penal law, burglary in the
    31  first degree as defined in section 140.30 of  the  penal  law,  criminal
    32  mischief  in  the third degree as defined in section 145.05 of the penal
    33  law, criminal mischief in the second degree as defined in section 145.10
    34  of the penal law, criminal mischief in the first degree  as  defined  in
    35  section  145.12 of the penal law, criminal tampering in the first degree
    36  as defined in section 145.20 of the  penal  law,  arson  in  the  fourth
    37  degree as defined in section 150.05 of the penal law, arson in the third
    38  degree  as  defined  in  section  150.10  of the penal law, arson in the
    39  second degree as defined in section 150.15 of the penal  law,  arson  in
    40  the  first  degree  as defined in section 150.20 of the penal law, grand
    41  larceny in the fourth degree as defined in section 155.30 of  the  penal
    42  law,  grand  larceny in the third degree as defined in section 155.35 of
    43  the penal law, grand larceny in the second degree as defined in  section
    44  155.40 of the penal law, grand larceny in the first degree as defined in
    45  section  155.42 of the penal law, health care fraud in the fourth degree
    46  as defined in section 159.10 of the penal law, health care fraud in  the
    47  third  degree as defined in section 159.15 of the penal law, health care
    48  fraud in the second degree as defined in section  159.20  of  the  penal
    49  law,  health care fraud in the first degree as defined in section 159.25
    50  of the penal law, making false statements relating to health care in the
    51  first degree as defined in section 159.35  of  the  penal  law,  bribery
    52  relating  to health care as defined in section three hundred sixty-six-d
    53  of the social services law, robbery in the third degree  as  defined  in
    54  section 160.05 of the penal law, robbery in the second degree as defined
    55  in  section  160.10  of  the  penal  law, robbery in the first degree as
    56  defined in section 160.15 of the  penal  law,  unlawful  use  of  secret
        S. 6457                            13                            A. 9557

     1  scientific material as defined in section 165.07 of the penal law, crim-
     2  inal  possession  of  stolen property in the fourth degree as defined in
     3  section 165.45 of the penal law, criminal possession of stolen  property
     4  in the third degree as defined in section 165.50 of the penal law, crim-
     5  inal  possession  of  stolen property in the second degree as defined by
     6  section 165.52 of the penal law, criminal possession of stolen  property
     7  in  the  first  degree  as  defined  by section 165.54 of the penal law,
     8  trademark counterfeiting in the  first  degree  as  defined  in  section
     9  165.73  of  the  penal  law,  forgery in the second degree as defined in
    10  section 170.10 of the penal law, forgery in the first degree as  defined
    11  in  section  170.15  of  the  penal law, criminal possession of a forged
    12  instrument in the second degree as defined  in  section  170.25  of  the
    13  penal  law,  criminal  possession  of  a  forged instrument in the first
    14  degree  as  defined  in  section  170.30  of  the  penal  law,  criminal
    15  possession  of forgery devices as defined in section 170.40 of the penal
    16  law, falsifying business records in  the  first  degree  as  defined  in
    17  section  175.10  of  the penal law, tampering with public records in the
    18  first degree as defined in section 175.25 of the penal law,  offering  a
    19  false  instrument  for  filing in the first degree as defined in section
    20  175.35 of the penal law, issuing  a  false  certificate  as  defined  in
    21  section  175.40  of  the  penal  law, criminal diversion of prescription
    22  medications and prescriptions in the second degree as defined in section
    23  178.20 of the penal law, criminal diversion of prescription  medications
    24  and  prescriptions  in  the first degree as defined in section 178.25 of
    25  the penal law, escape in the second degree as defined in section  205.10
    26  of  the  penal  law,  escape  in  the first degree as defined in section
    27  205.15 of the penal law, absconding from temporary release in the  first
    28  degree  as  defined in section 205.17 of the penal law, promoting prison
    29  contraband in the first degree as defined in section 205.25 of the penal
    30  law, hindering prosecution in the second degree as  defined  in  section
    31  205.60  of  the  penal law, hindering prosecution in the first degree as
    32  defined in section 205.65 of the penal law,  criminal  possession  of  a
    33  weapon  in  the third degree as defined in subdivisions two, three, four
    34  and five of section 265.02 of the penal law, criminal  possession  of  a
    35  weapon  in  the  second degree as defined in section 265.03 of the penal
    36  law, criminal possession of a dangerous weapon in the  first  degree  as
    37  defined  in  section  265.04  of  the penal law, manufacture, transport,
    38  disposition and defacement of  weapons  and  dangerous  instruments  and
    39  appliances  defined  as  felonies in subdivisions one, two, and three of
    40  section 265.10 of the penal law, sections 265.11, 265.12 and  265.13  of
    41  the  penal  law,  or prohibited use of weapons as defined in subdivision
    42  two of section 265.35 of the penal law, relating to firearms  and  other
    43  dangerous weapons;
    44    § 12. Section 366-d of the social services law, as added by chapter 41
    45  of  the  laws of 1992, subdivision 2 as amended by chapter 2 of the laws
    46  of 1998 and subdivision 3 as amended and subdivision 4 as added by chap-
    47  ter 81 of the laws of 1995, is amended to read as follows:
    48    § 366-d. [Medical assistance provider; prohibited  practices]  Bribery
    49  relating  to  health  care.  1.   [Definitions. As used in this section,
    50  "medical assistance  provider"  means  any  person,  firm,  partnership,
    51  group,  association,  fiduciary,  employer  or representative thereof or
    52  other entity who is furnishing care, services or  supplies  under  title
    53  eleven of article five of this chapter.
    54    2.]  No [medical assistance provider] person shall:
    55    (a)    solicit,  receive,  accept  or  agree  to receive or accept any
    56  payment or other consideration in any form from another  person  to  the
        S. 6457                            14                            A. 9557

     1  extent  such  payment  or  other  consideration  is given to induce such
     2  person to engage in or refrain from engaging in:
     3    (i)  [for]  the  referral  of  an  individual  to  that person for the
     4  furnishing or arranging for the furnishing of any item or services  [for
     5  which  payment  is made under title eleven of article five of this chap-
     6  ter] in connection with a health plan; or
     7    (ii) [to] the purchase, lease or order, or recommendation or  arrange-
     8  ment  to  purchase,  lease or order, any good, facility, service or item
     9  [for which payment is made under title eleven of article  five  of  this
    10  chapter] in connection with a health plan; or
    11    (b)    offer, agree to give or give any payment or other consideration
    12  in any form to another person  to  the  extent  such  payment  or  other
    13  consideration  is  given  to  induce such person to engage in or refrain
    14  from engaging in:
    15    (i) [for] the referral  of  an  individual  to  that  person  for  the
    16  furnishing  or arranging for the furnishing of any item or services [for
    17  which payment is made under title eleven of article five of  this  chap-
    18  ter] in connection with a health plan; or
    19    (ii)  [to] the purchase, lease or order, or recommendation or arrange-
    20  ment to purchase, lease or order any good,  facility,  service  or  item
    21  [for  which  payment  is made under title eleven of article five of this
    22  chapter;] in connection with a health plan.
    23    2. Definitions. [(c) as] As used in this section: (a) "person"   shall
    24  have the meaning  set forth in subdivision seven of section 10.00 of the
    25  penal law[.];
    26    [(d)  this  subdivision]  (b) "health plan" shall have the meaning set
    27  forth in section 159.00 of the penal law.
    28    3. Subdivision one of this section shall not  apply  to  any  activity
    29  specifically exempt by federal statute or federal regulations promulgat-
    30  ed thereunder.
    31    [3.]  4.  Any  [medical  assistance  provider] person who violates the
    32  provisions of this section is guilty of a misdemeanor punishable by:
    33    (a) a term of imprisonment in accordance with the penal law; or
    34    (b) a fine of not less than five hundred dollars  nor  more  than  ten
    35  thousand dollars; or
    36    (c)  if  the  defendant  has  obtained  money  or  property  through a
    37  violation of the provisions of this section, a fine in an amount,  fixed
    38  by  the  court,  not to exceed double the amount of the defendant's gain
    39  from a violation of such provisions. In such event,  the  provisions  of
    40  subdivision  three of section 80.00 of the penal law shall be applicable
    41  to the sentence; or
    42    (d) both the imprisonment and the fine.
    43    [4.] 5. Any [medical assistance  provider]  person  who  violates  the
    44  provisions  of this section and thereby obtains money or property having
    45  a value in excess of seven thousand five hundred dollars shall be guilty
    46  of a class E felony.
    47    § 13. Section 366-f of the social services law is REPEALED.
    48    § 14. Paragraph (b) of subdivision 3 of section 178.00  of  the  penal
    49  law,  as  added  by chapter 81 of the laws of 1995, is amended and a new
    50  subdivision 4 is added to read as follows:
    51    (b)  receives,  in  exchange  for  anything  of  pecuniary  value,   a
    52  prescription  medication  or device with knowledge or reasonable grounds
    53  to know that the [seller or transferor is not authorized by law to sell]
    54  sale or transfer of such prescription medication or device is  unlawful;
    55  or
        S. 6457                            15                            A. 9557

     1    4.  "Total  pecuniary value" means the lawful fair market value of all
     2  prescription medications or devices and prescriptions, in the aggregate,
     3  that are the subject of an act or series of acts in  violation  of  this
     4  article.
     5    §  15.  Subdivision  1 of section 178.15 of the penal law, as added by
     6  chapter 81 of the laws of 1995, is amended to read as follows:
     7    1. commits a criminal diversion act, and the  [value  of  the  benefit
     8  exchanged]  total  pecuniary  value  of  the prescription medications or
     9  devices and prescriptions is in excess of one thousand dollars; or
    10    § 16. Section 178.20 of the penal law, as added by chapter 81  of  the
    11  laws of 1995, is amended to read as follows:
    12  § 178.20 Criminal    diversion    of    prescription   medications   and
    13             prescriptions in the second degree.
    14    A person is guilty of criminal diversion of  prescription  medications
    15  and prescriptions in the second 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 medications or devices and prescriptions is in
    18  excess of three thousand dollars.
    19    Criminal diversion of prescription medications  and  prescriptions  in
    20  the second degree is a class D felony.
    21    §  17.  Section 178.25 of the penal law, as added by chapter 81 of the
    22  laws of 1995, is amended to read as follows:
    23  § 178.25 Criminal   diversion   of    prescription    medications    and
    24             prescriptions in the first degree.
    25    A  person  is guilty of criminal diversion of prescription medications
    26  and prescriptions in the first degree when he or she commits a  criminal
    27  diversion  act, and the [value of the benefit exchanged] total pecuniary
    28  value of the prescription medications or devices and prescriptions is in
    29  excess of fifty thousand dollars.
    30    Criminal diversion of prescription medications  and  prescriptions  in
    31  the first degree is a class C felony.
    32    §  18.  The  penal  law is amended by adding five new sections 178.30,
    33  178.35, 178.40, 178.45 and 178.50 to read as follows:
    34  § 178.30 Possession of criminally diverted prescription medications  and
    35             devices in the fourth degree.
    36    A  person  is guilty of possession of criminally diverted prescription
    37  medications and devices in the fourth degree when he  or  she  knowingly
    38  possesses  a  prescription medication or device with knowledge that such
    39  medication or device was transferred or delivered as  the  result  of  a
    40  criminal  diversion  act  or  under  circumstances evincing an intent to
    41  engage in a criminal diversion act.
    42    Possession of criminally diverted prescription medications and devices
    43  in the fourth degree is a class A misdemeanor.
    44  § 178.35 Possession of criminally diverted prescription medications  and
    45             devices in the third degree.
    46    A  person  is guilty of possession of criminally diverted prescription
    47  medications and devices in the third degree when he or she  commits  the
    48  crime  of possession of criminally diverted prescription medications and
    49  devices in the fourth degree and:
    50    1. has previously been convicted of any crime defined in this article;
    51  or
    52    2. the total  pecuniary  value  of  the  prescription  medications  or
    53  devices possessed is in excess of one thousand dollars.
    54    Possession of criminally diverted prescription medications and devices
    55  in the third degree is a class E felony.
        S. 6457                            16                            A. 9557

     1  § 178.40 Possession  of criminally diverted prescription medications and
     2             devices in the second degree.
     3    A  person  is guilty of possession of criminally diverted prescription
     4  medications and devices in the second degree when he or she commits  the
     5  crime of criminally diverted prescription medications and devices in the
     6  fourth  degree and the total pecuniary value of the prescription medica-
     7  tions or devices possessed is in excess of three thousand dollars.
     8    Possession of criminally diverted prescription medications and devices
     9  in the second degree is a class D felony.
    10  § 178.45 Possession of criminally_ diverted prescription medications and
    11             devices in the first degree.
    12    A person is guilty of possession of criminally  diverted  prescription
    13  medications  and  devices in the first degree when he or she commits the
    14  crime of possession of criminally diverted prescription medications  and
    15  devices  in  the  fourth  degree  and  the  total pecuniary value of the
    16  prescription medications or devices possessed  is  in  excess  of  fifty
    17  thousand dollars.
    18    Possession of criminally diverted prescription medications and devices
    19  in the first degree is a class C felony.
    20  § 178.50 Presumptions.
    21    Possession  of  false,  forged  or  stolen prescriptions by any person
    22  other than a person in the lawful pursuit of his or her profession shall
    23  be presumptive evidence of the  intent  to  use  such  prescriptions  to
    24  commit a criminal act under this article.
    25    §  19.  Paragraph  (b) of subdivision 4 of section 145-b of the social
    26  services law, as amended by chapter 2 of the laws of 1998, is amended to
    27  read as follows:
    28    (b)  Such penalty shall be in lieu of requiring a person to refund  or
    29  repay  all  or  part  of any payment from the medical assistance program
    30  received by such person or caused to be received by another person as  a
    31  result  of  a  violation  of the terms of this subdivision.  In no event
    32  shall the monetary penalty imposed exceed [two] ten thousand dollars for
    33  each item or service which was the subject of the determination  herein,
    34  except  that  where  a  penalty under this section has been imposed on a
    35  person within the previous five years, such  penalty  shall  not  exceed
    36  [seven]  thirty thousand [five hundred] dollars for each item or service
    37  which was the subject of the determination herein.
    38    § 20. Subdivision 1 of section 740 of the  labor  law  is  amended  by
    39  adding a new paragraph (g) to read as follows:
    40    (g)  "Health  care  offense"  means  health care fraud or making false
    41  statements relating to health care as defined  by  article  one  hundred
    42  fifty-nine  of  the  penal  law,  or  bribery relating to health care as
    43  defined in section three hundred sixty-six-d of the social services law.
    44    § 21. Paragraph (a) of subdivision 2 of section 740 of the labor  law,
    45  as  added  by  chapter  660  of  the laws of 1984, is amended to read as
    46  follows:
    47    (a) discloses, or threatens to disclose to a supervisor or to a public
    48  body an activity,  policy  or  practice  of  the  employer  that  is  in
    49  violation  of  law,  rule  or  regulation  which  violation  creates and
    50  presents a substantial and specific danger to the public health or safe-
    51  ty, or which constitutes a health care offense;
    52    § 22. Paragraph 2 of subdivision (b) of section 506 of the civil prac-
    53  tice law and rules, as amended by chapter 47 of the  laws  of  1992,  is
    54  amended to read as follows:
    55    2.  a proceeding against the regents of the university of the state of
    56  New York, the commissioner of education, the  commissioner  of  taxation
        S. 6457                            17                            A. 9557

     1  and  finance, the tax appeals tribunal except as provided in section two
     2  thousand sixteen of the tax law,  the  public  service  commission,  the
     3  commissioner  or  the  department of transportation relating to articles
     4  three,  four, five, six, seven, eight, nine or ten of the transportation
     5  law or to the railroad law, the water resources board,  the  comptroller
     6  [or],  the  department of agriculture and markets or the commissioner of
     7  the department of health to review a final administrative action against
     8  a Medicaid provider, shall be commenced in  the  supreme  court,  Albany
     9  county.
    10    § 23. The social services law is amended by adding a new section 364-l
    11  to read as follows:
    12    § 364-l. Chemung county demonstration project.  1. Notwithstanding any
    13  provision of law, rule or regulation to the contrary, the department and
    14  the  Chemung  county  department  of  social  services are authorized to
    15  conduct a Medicaid research and demonstration project for the purpose of
    16  testing the use of innovative administrative techniques, new  reimburse-
    17  ment methods, and management of care models, so as to promote more effi-
    18  cient use of health resources, a healthier population and containment of
    19  Medicaid program costs.
    20    2.  The  Chemung county department of social services is authorized to
    21  contract with an entity for the purposes of, without limitation,  devel-
    22  oping  and  managing  a  provider of care network, establishing provider
    23  payment rates and fees, paying provider claims, providing  care  manage-
    24  ment  services  to project participants, and managing the utilization of
    25  project services.
    26    3. Participation in the project shall be  mandatory  for  all  persons
    27  eligible  for  services  under  this  title  for whom the Chemung county
    28  department of social services  has  fiscal  responsibility  pursuant  to
    29  section three hundred sixty-five of this title and who reside within the
    30  project  catchment  area,  as  determined by the commissioner; provided,
    31  however, that eligible persons who are also  beneficiaries  under  title
    32  XVIII of the federal social security act and persons who reside in resi-
    33  dential  health  care facilities shall not be eligible to participate in
    34  the project.
    35    4. The provisions of this section shall not  take  effect  unless  all
    36  necessary  approvals under federal law and regulation have been obtained
    37  to receive federal financial participation in the costs of  health  care
    38  services provided pursuant to this section.
    39    5.  The  commissioner  is authorized to submit amendments to the state
    40  plan for medical assistance and/or submit one or more  applications  for
    41  waivers of the federal social security act as may be necessary to obtain
    42  the federal approvals necessary to implement this section.
    43    §  24.  Paragraphs  (b) and (c) of subdivision 3 of section 273 of the
    44  public health law, as added by section 10 of part C of chapter 58 of the
    45  laws of 2005, are amended to read as follows:
    46    (b) In the event that the patient does not meet the criteria in  para-
    47  graph  (a)  of  this  subdivision, the prescriber may provide additional
    48  information to the program to justify the use  of  a  prescription  drug
    49  that  is  not  on  the  preferred drug list. The program shall provide a
    50  reasonable opportunity for a prescriber to reasonably present his or her
    51  justification of prior authorization. [If, after consultation  with  the
    52  program, the prescriber, in his or her reasonable professional judgment,
    53  determines  that  the  use  of  a  prescription  drug that is not on the
    54  preferred drug list is warranted, the prescriber's  determination  shall
    55  be final.]
        S. 6457                            18                            A. 9557

     1    (c) [If a prescriber meets the requirements of paragraph (a) or (b) of
     2  this  subdivision,  the  prescriber shall be granted prior authorization
     3  under this section.] Prior  authorization  for  the  non-preferred  drug
     4  shall  be  denied  if  the  prescriber fails to meet the requirements of
     5  paragraph  (a)  of  this  subdivision or if, after consultation with the
     6  program as described in paragraph (b) of this subdivision,  the  program
     7  determines  that  the  use  of  a  prescription  drug that is not on the
     8  preferred drug list is not warranted.
     9    § 25. Subdivision 7 of section 274 of the public health law, as  added
    10  by section 10 of part C of chapter 58 of the laws of 2005, is amended to
    11  read as follows:
    12    7.  In  the  event  that  the  patient  does not meet the criteria for
    13  approval established by the commissioner  in  subdivision  six  of  this
    14  section,  the  clinical  drug  review program shall provide a reasonable
    15  opportunity for a prescriber to reasonably present his or her justifica-
    16  tion for prior authorization. If, after  the  prescriber's  consultation
    17  with the program, the [prescriber, in his or her reasonable professional
    18  judgment,]  program  determines that the use of the prescription drug is
    19  warranted, [the prescriber's determination shall  be  final  and]  prior
    20  authorization  shall  be  granted under this section; provided, however,
    21  that prior authorization may be denied in cases where,  after  consulta-
    22  tion  with  the  prescriber,  the program determines that the use of the
    23  prescription drug is not warranted, or where the department has substan-
    24  tial evidence that the prescriber or patient  is  engaged  in  fraud  or
    25  abuse relating to the drug.
    26    § 26. Subdivisions 7, 8 and 9 of section 272 of the public health law,
    27  as  added by section 10 of part C of chapter 58 of the laws of 2005, are
    28  amended to read as follows:
    29    7. The commissioner shall provide [thirty] ten days public  notice  on
    30  the department's website prior to any meeting of the committee to devel-
    31  op  recommendations  concerning  the preferred drug program. Such notice
    32  regarding meetings of the committee shall include a description  of  the
    33  proposed therapeutic class to be reviewed, a listing of drug products in
    34  the therapeutic class, and the proposals to be considered by the commit-
    35  tee.  The committee shall allow interested parties a reasonable opportu-
    36  nity to make an oral presentation to the committee related to the  prior
    37  authorization  of  the  therapeutic  class to be reviewed. The committee
    38  shall consider any information provided by any interested party, includ-
    39  ing, but not limited to, prescribers,  dispensers,  patients,  consumers
    40  and manufacturers of the drug in developing their recommendations.
    41    8. The commissioner shall provide notice of any recommendations devel-
    42  oped  by  the  committee  regarding the preferred drug program, at least
    43  [thirty] ten days before any final determination by the commissioner, by
    44  making such information available  on  the  department's  website.  Such
    45  public  notice  shall  include:  a  summary  of the deliberations of the
    46  committee; a summary of the positions of those making public comments at
    47  meetings of the committee;  the  response  of  the  committee  to  those
    48  comments, if any; and the findings and recommendations of the committee.
    49    9.  Within [ten days of] a reasonable time after a final determination
    50  regarding the preferred drug program,  the  commissioner  shall  provide
    51  public  notice  on  the  department's  website  of  such determinations,
    52  including: the nature of the determination; [and]  an  analysis  of  the
    53  impact  of  the commissioner's determination on state public health plan
    54  populations and providers; and the projected fiscal impact to the  state
    55  public health plan programs of the commissioner's determination.
        S. 6457                            19                            A. 9557

     1    §  27. Section 274 of the public health law is amended by adding a new
     2  subdivision 6-a to read as follows:
     3    6-a.  Notwithstanding  the requirements of subdivisions four, five and
     4  six of this section, the commissioner may  require  prior  authorization
     5  for  a drug for a period not to exceed ninety days when the commissioner
     6  determines  that  an  emergency  situation  requires  such  action.  For
     7  purposes  of this subdivision, an emergency includes, but is not limited
     8  to, approval by the federal food and drug administration of a  drug  for
     9  treatment  which  the commissioner determines is critical to the care of
    10  patients but which should be subject  to  prior  authorization.  If  the
    11  committee  fails  to  review  and  approve  the drug for continued prior
    12  authorization within such ninety day  period,  the  prior  authorization
    13  requirement under this subdivision will lapse.
    14    §  28.  Paragraphs  (b) and (c) of subdivision 3 of section 274 of the
    15  public health law, as added by section 10 of part C of chapter 58 of the
    16  laws of 2005, are amended to read as follows:
    17    (b) the potential for, or a history of, overuse, abuse, drug diversion
    18  or illegal utilization; [and]
    19    (c) the potential for, or a history of, utilization inconsistent  with
    20  approved indications[.]; and
    21    (d) the cost of the drug compared to other drug therapies for the same
    22  disease.  Where the commissioner finds that a drug meets at least one of
    23  these criteria, in determining whether to make the drug subject to prior
    24  authorization under the clinical drug review program,  the  commissioner
    25  shall  consider  whether  similarly effective alternatives are available
    26  for the same disease state and the effect of that availability  or  lack
    27  of availability.
    28    §  29. Paragraphs (d) and (e) of subdivision 4 of section 365-a of the
    29  social services law, paragraph (d) as amended and paragraph (e) as added
    30  by chapter 645 of the laws of 2005 are amended and a new  paragraph  (f)
    31  is added to read as follows:
    32    (d)  any  medical  care,  services  or  supplies furnished outside the
    33  state, except, when prior authorized in accordance with department regu-
    34  lations or for care, services and supplies furnished: as a result  of  a
    35  medical emergency; because the recipient's health would have been endan-
    36  gered if he or she had been required to travel to the state; because the
    37  care,  services  or  supplies  were  more readily available in the other
    38  state; or because it is the general practice for persons residing in the
    39  locality wherein the recipient resides to use medical providers  in  the
    40  other state; [or]
    41    (e)  drugs,  procedures  and  supplies  for  the treatment of erectile
    42  dysfunction when provided to, or prescribed for use by, a person who  is
    43  required  to register as a sex offender pursuant to article six-C of the
    44  correction law, provided that any denial of coverage  pursuant  to  this
    45  paragraph  shall  provide  the patient with the means of obtaining addi-
    46  tional information concerning both the denial and the means of challeng-
    47  ing such denial[.]; or
    48    (f) drugs for the treatment of sexual or erectile dysfunction,  unless
    49  such  drugs are used to treat a condition, other than sexual or erectile
    50  dysfunction, for which the drugs have been approved by the federal  food
    51  and drug administration.
    52    § 30. Paragraph (e-1) of subdivision 1 of section 369-ee of the social
    53  services law, as added by chapter 645 of the laws of 2005, is amended to
    54  read as follows:
    55    (e-1)  "Health care services" shall not include: (i) drugs, procedures
    56  and supplies for the treatment of erectile dysfunction when provided to,
        S. 6457                            20                            A. 9557

     1  or prescribed for use by, a person who is required to register as a  sex
     2  offender  pursuant  to article six-C of the correction law provided that
     3  any denial of coverage pursuant to  this  paragraph  shall  provide  the
     4  patient  with  the  means of obtaining additional information concerning
     5  both the denial and the means of challenging such denial; (ii) drugs for
     6  the treatment of sexual or erectile dysfunction, unless such  drugs  are
     7  used  to  treat  a condition, other than sexual or erectile dysfunction,
     8  for which the drugs have been approved by  the  federal  food  and  drug
     9  administration.
    10    §  31.  Subparagraph (ii) of paragraph (b) of subdivision 9 of section
    11  367-a of the social services law, as amended by section 3 of part  C  of
    12  chapter 58 of the laws of 2004, is amended to read as follows:
    13    (ii) if the drug dispensed is a multiple source prescription drug or a
    14  brand-name  prescription drug for which no specific upper limit has been
    15  set by such federal agency, the lower of the estimated acquisition  cost
    16  of  such  drug  to  pharmacies,  or  the dispensing pharmacy's usual and
    17  customary price charged to the general public.  For  sole  and  multiple
    18  source  brand  name  drugs, estimated acquisition cost means the average
    19  wholesale price of a prescription  drug  based  upon  the  package  size
    20  dispensed  from,  as  reported  by the prescription drug pricing service
    21  used by the department, less [twelve and seventy-five hundredths of one]
    22  fifteen percent thereof, and updated monthly by the department; or,  for
    23  a  specialized  HIV  pharmacy, as defined in paragraph [(F)] (f) of this
    24  subdivision, acquisition cost means the average  wholesale  price  of  a
    25  prescription  drug  based  upon  the  package  size  dispensed  from, as
    26  reported by the prescription drug pricing service used  by  the  depart-
    27  ment, less [twelve] fourteen percent thereof, and updated monthly by the
    28  department.  For  multiple  source  generic drugs, estimated acquisition
    29  cost means the lower of the average wholesale price  of  a  prescription
    30  drug  based  on  the  package  size  dispensed  from, as reported by the
    31  prescription drug pricing service used by the department, less  [sixteen
    32  and  one-half]  thirty percent thereof, or the maximum acquisition cost,
    33  if any, established pursuant to paragraph (e) of this  subdivision;  or,
    34  for  a  specialized  HIV  pharmacy,  as defined in paragraph (f) of this
    35  subdivision, acquisition cost means[,] the lower of the  average  whole-
    36  sale  price  of  a prescription drug based on the package size dispensed
    37  from, as reported by the prescription drug pricing service used  by  the
    38  department,  less  [twelve]  twenty-two  percent thereof, or the maximum
    39  acquisition cost, if any, established pursuant to paragraph (e) of  this
    40  subdivision.
    41    § 32. Subparagraphs (i) and (ii) of paragraph (d) of subdivision 25 of
    42  section 2807-c of the public health law, as added by section 7 of part B
    43  of chapter 58 of the laws of 2004, are amended to read as follows:
    44    (i)  For  periods  on  and  after  April first, two thousand four, the
    45  commissioner shall adjust inpatient medical assistance rates of  payment
    46  established  pursuant  to  this  section,  including  discrete  rates of
    47  payment calculated pursuant to paragraph a-three of subdivision  one  of
    48  this  section,  for non-public general hospitals, and for periods on and
    49  after April first, two thousand six, for public and  non-public  general
    50  hospitals,  in  accordance with subparagraph (ii) of this paragraph, for
    51  purposes of reimbursing graduate medical education costs  based  on  the
    52  following methodology:
    53    (ii)  Rate adjustments for each [non-public] general hospital shall be
    54  based on the difference between the graduate  medical  education  compo-
    55  nent,  direct and indirect, of the two thousand three medical assistance
    56  inpatient rates of payment, including exempt unit per diem rates, and an
        S. 6457                            21                            A. 9557

     1  estimate of what the graduate medical education  component,  direct  and
     2  indirect, of such medical assistance inpatient rates of payment, includ-
     3  ing  exempt  unit  per diem rates would be, stated at two thousand three
     4  levels and calculated as follows:
     5    (A)  Each  [non-public] general hospital's total direct medical educa-
     6  tion costs as reported in the two thousand one institutional cost report
     7  submitted as of December thirty-first, two thousand three, and
     8    (B) An estimate of the total indirect medical education costs for  two
     9  thousand  one  calculated  in accordance with the methodology applicable
    10  for purposes of determining an estimate of  indirect  medical  education
    11  costs  pursuant  to  subparagraph  (ii)  of paragraph (c) of subdivision
    12  seven of this section. The indirect medical education costs shall  equal
    13  the  product  of  two thousand one hospital specific inpatient operating
    14  costs, including exempt unit  costs,  and  the  indirect  teaching  cost
    15  percentage determined by the following formula:
    16            1-(1/(1+1.89(((1+r)-.405)-1)))
    17  where  r equals the ratio of residents and fellows to beds for two thou-
    18  sand one adjusted to reflect the projected two thousand  three  resident
    19  counts.
    20    (C)  Each  hospital's rate adjustment shall be limited to seventy-five
    21  percent of the graduate medical education component included in its  two
    22  thousand  three medical assistance inpatient rates of payment, including
    23  exempt unit rates.  For periods on and after April first,  two  thousand
    24  six,  the  seventy-five  percent limit shall not apply to rate decreases
    25  calculated pursuant to this paragraph.
    26    (D) [No] For the period April first, two thousand four  through  March
    27  thirty-first, two thousand six, no hospital shall receive a rate adjust-
    28  ment pursuant to this paragraph if such rate adjustment would be a nega-
    29  tive amount.  For periods on and after April first, two thousand six, no
    30  public  general hospital shall receive a rate increase calculated pursu-
    31  ant to this paragraph.
    32    § 33. Section 17 of part C of chapter 58 of the laws of 2005, amending
    33  the public health law and other laws relating to implementing the  state
    34  fiscal  plan for the 2005-2006 state fiscal year, as added by section 21
    35  of part E of chapter 63 of the laws of  2005,  is  amended  to  read  as
    36  follows:
    37    §  17.  1.  Notwithstanding any inconsistent provision of law, rule or
    38  regulation, for payments made by a state governmental agency to a gener-
    39  al hospital for [specialty]  inpatient  hospital  services  provided  to
    40  patients  eligible for payments pursuant to title 11 of article 5 of the
    41  social services law discharged on or after April 1, 2005 [through  March
    42  31,  2010],  the  commissioner of health, subject to the approval of the
    43  director of the budget, may:
    44    (a) after a hospital has agreed to participate in a  program  selected
    45  pursuant  to subdivision two of this section, establish rates of payment
    46  or special payment rate methodologies for [specialty] inpatient hospital
    47  services selected in accordance with subdivision  two  of  this  section
    48  provided to patients eligible for payments pursuant to title 11 of arti-
    49  cle  5 of the social services law through negotiations with hospitals in
    50  any area of the state. Such negotiated rates, if any, shall  be  negoti-
    51  ated  with  each  individual  selected  hospital. Such negotiation shall
    52  include a process for the  commissioner  of  health  and  each  selected
    53  hospital  to  mutually identify services for which such negotiated rates
    54  shall apply. [Such rates shall be reasonable and adequate  to  reimburse
    55  the  costs  of  an  economically  and  efficiently  operated provider of
    56  services.] The commissioner of health may establish  adjusted  rates  of
        S. 6457                            22                            A. 9557

     1  payment  pursuant  to an administrative rate appeal process to hospitals
     2  that participate in such negotiations and agree to receive  the  negoti-
     3  ated  payment  rates  established  under this paragraph for the patients
     4  described in this paragraph in lieu of rates of payment otherwise appli-
     5  cable  pursuant  to  section  2807-c  of the public health law without a
     6  competitive bid or request for proposal process; and/or
     7    (b) select among hospitals in any area of the state those eligible for
     8  reimbursement for [specialty] inpatient hospital  services  selected  in
     9  accordance  with  subdivision two of this section and establish payments
    10  for such services based on a competitive bidding process.
    11    2. The  commissioner  of  health  shall  select  [a  maximum  of  five
    12  geographically defined] inpatient hospital sites within a geographically
    13  defined  region for which reimbursement may be negotiated for [a maximum
    14  of five specialty] inpatient services that are  selected  based  on  the
    15  following criteria:
    16    (a)  such  services may be provided more efficiently and economically;
    17  [and]
    18    (b) [there is a correlation between the volume  of  such  services  or
    19  procedures  performed  by  an  inpatient  hospital  and improved patient
    20  outcomes that is accepted by medical experts in the field  as  evidenced
    21  by  inclusion  in  peer  reviewed scientific literature published and/or
    22  recognized by national organizations]  such  services  are  high  volume
    23  services  which  may  be appropriately reduced or may have a significant
    24  disparity in cost among hospitals in a region; [and]
    25    (c) identification of such services and  the  implementation  of  this
    26  section  with  respect  to such services is consistent with other initi-
    27  atives to enhance the quality and patient outcomes of inpatient services
    28  and procedures that are or are being planned to  be  undertaken  by  the
    29  department of health, including but not limited to projects that identi-
    30  fy centers of excellence for particular services; [and]
    31    (d)  identification of such services for purposes of implementing this
    32  section will not diminish access, including geographic access, which for
    33  purposes of this  section  shall  mean  that  a  patient  shall  not  be
    34  prevented from accessing services in a timely fashion due to distance or
    35  travel time; [and]
    36    (e)  such  services have low utilization or are provided in units with
    37  low occupancy; [and] or
    38    (f) any other criteria determined by the  commissioner  of  health  to
    39  promote  the  cost  effective delivery of [specialty] inpatient hospital
    40  services.
    41    3. Selection of hospitals by the commissioner of  health  pursuant  to
    42  subdivision  two  of  this  section shall be made based on the following
    43  criteria:
    44    (a)  Consultation  with  hospitals,  hospital  associations  or  other
    45  provider organizations, and consumers; and
    46    (b)  Assurances of patient access, including geographic access, to the
    47  selected [specialty] services; and
    48    (c) Historical volume of services provided by the hospital; and
    49    (d) Consistency with other quality  and  outcomes  improvement  initi-
    50  atives  being  or  planned  to  be  pursued by the department of health,
    51  including but not limited to, projects that identify centers  of  excel-
    52  lence; and
    53    (e) The order and timeline under which services identified pursuant to
    54  this section shall be provided; and
    55    (f)  Such  other  criteria  that  the  commissioner of health may deem
    56  appropriate.
        S. 6457                            23                            A. 9557

     1    4. Inpatient hospital services not selected  by  the  commissioner  of
     2  health  pursuant  to  this  section and not subject to negotiation under
     3  paragraph (a) of subdivision one of this section  provided  to  patients
     4  eligible  for  payments  pursuant to title 11 of article 5 of the social
     5  services  law  shall  be  reimbursed  pursuant  to section 2807-c of the
     6  public health law.
     7    5. Notwithstanding any inconsistent provisions of law, rule  or  regu-
     8  lation,  for  purposes  of  this program, no payments within a geograph-
     9  ically defined [site] region shall be  made  for  [specialty]  inpatient
    10  hospital  services  selected by the commissioner of health in accordance
    11  with subdivision two of this section for which there is an adjusted rate
    12  of payment with a hospital pursuant to paragraph (a) or (b) of  subdivi-
    13  sion  one  of  this  section when such services are provided to patients
    14  eligible for payments pursuant to title 11 of article 5  of  the  social
    15  services  law  by  a  hospital  which has not received adjusted rates of
    16  payment pursuant to paragraph (a) or (b)  of  subdivision  one  of  this
    17  section;  provided,  however,  payments  may be made to such hospital in
    18  accordance with section 2807-c of the public health law if the provision
    19  of such services has been prior approved by the commissioner of  health,
    20  or if the inpatient admission is a result of an emergency admission.
    21    6.  Payment of rates established pursuant to this section for purposes
    22  of this program shall be contingent upon federal approval  of  a  waiver
    23  application  submitted by the commissioner of health in order to receive
    24  federal  financial  participation  for  services  provided  under   this
    25  section[;  provided, however, the commissioner of health shall provide a
    26  copy of such waiver application to the legislature prior  to  submission
    27  for  federal  approval].  The  commissioner of health may take any steps
    28  necessary to implement this section prior to receiving federal  approval
    29  of such waiver application.
    30    7.  The  commissioner  of  health shall report to the governor and the
    31  legislature concerning the implementation  of  this  section,  including
    32  available  data  regarding  the  cost  effective delivery of [specialty]
    33  inpatient services selected in  accordance  with  this  section,  within
    34  eighteen  months  from the date of issuance of adjusted rates of payment
    35  entered into pursuant to paragraphs (a) and (b) of  subdivision  one  of
    36  this section.
    37    §  34.  Subdivision  9  of  section 2807-c of the public health law is
    38  amended by adding a new paragraph (i) to read as follows:
    39    (i) Notwithstanding any law,  rule  or  regulation  to  the  contrary,
    40  volume adjustments made pursuant to paragraphs (e) or (f) of this subdi-
    41  vision to case based rates of payment by state governmental agencies for
    42  inpatient  services  provided  by  a general hospital on and after April
    43  first, two thousand six, shall not contain  any  adjustments  to  volume
    44  attributable  to  rate  periods on and after January first, two thousand
    45  four, reflecting  a  reduction  in  such  general  hospital's  case  mix
    46  adjusted  patient length of stay for non-Medicare beneficiaries based on
    47  a comparison of the rate year to such general hospital's volume adjusted
    48  base year.
    49    § 35. Subparagraph (i) of paragraph (g) of subdivision  2  of  section
    50  2807  of the public health law, as amended by chapter 170 of the laws of
    51  1994, is amended to read as follows:
    52    (i) During  the  period  April  first,  nineteen  hundred  ninety-four
    53  through December thirty-first, nineteen hundred ninety-four and for each
    54  calendar  year rate period commencing on January first thereafter, rates
    55  of payment by governmental agencies for the operating cost component  of
    56  general  hospital  outpatient  services  shall be based on the operating
        S. 6457                            24                            A. 9557

     1  costs reported in the base year cost report adjusted by the trend factor
     2  applicable to the general hospital in which the services were  provided;
     3  provided,  however,  that  the  maximum  payment  for the operating cost
     4  component  of outpatient services shall be sixty-seven dollars and fifty
     5  cents plus the addition of the capital cost per visit. The capital  cost
     6  per  visit  shall  be based on the base year cost report except that the
     7  capital cost per visit may be  adjusted  for  major  outpatient  capital
     8  expenditures  incurred  subsequent  to  the  reporting  year,  when such
     9  expenditures have received the requisite approvals and the facility  has
    10  provided  the  commissioner  with  a certified statement of the expendi-
    11  tures. The base year for the period April first, nineteen hundred  nine-
    12  ty-four  through  December  thirty-first,  nineteen  hundred ninety-four
    13  shall be nineteen hundred ninety-two and  shall  be  advanced  one  year
    14  thereafter  for  each subsequent calendar year rate period. Further, the
    15  provisions of subdivision seven of this section  shall  not  apply.  The
    16  commissioner  may waive the maximum allowable payment and limitations on
    17  the rate of payment as prescribed herein to provide for  the  reimburse-
    18  ment  of  offering  and  arranging  services eligible for ninety percent
    19  federal funds as set forth in section  nineteen  hundred  three  of  the
    20  federal  social  security  act,  and to provide for the reimbursement of
    21  specialized services having separately identifiable  costs  and  statis-
    22  tics,  including  but  not limited to hemodialysis services and surgical
    23  services provided on an outpatient basis, provided, however, that during
    24  the period April first, two thousand six through December  thirty-first,
    25  two thousand six and for each calendar year rate period commencing ther-
    26  eafter, such specialty services shall not include services for which the
    27  rate  of  payment is established by the office of mental health pursuant
    28  to section 43.02 of the mental hygiene law.  Such waiver shall be grant-
    29  ed only when the commissioner finds that the services are being provided
    30  efficiently and at minimum cost. The commissioner shall promptly promul-
    31  gate rules and regulations necessary to identify  such  services.  Among
    32  the  criteria  which  the  commissioner  shall  consider  in the case of
    33  specialized services are whether the services require highly specialized
    34  staff, equipment or facilities, thereby generating a cost that  substan-
    35  tially  exceeds  that  of more routine diagnostic or treatment services;
    36  whether the facility in which the services  are  provided  is  presently
    37  providing  the  services  to  the  population  in need; and, whether the
    38  services may be provided safely and effectively on an  outpatient  basis
    39  at  a  lower  cost  than  through  inpatient  admission. In addition the
    40  commissioner shall provide for a waiver of the maximum allowable payment
    41  for those outpatient services medically necessary which include surgical
    42  procedures where delay  in  surgical  intervention  would  substantially
    43  increase  the  medical  risk associated with such surgical intervention.
    44  Where the commissioner waives the  maximum  allowable  payment  for  any
    45  specified  service he may, in accordance with the foregoing criteria and
    46  such other criteria as he deems appropriate, establish a maximum  allow-
    47  able payment for such specified service.
    48    §  36.  Notwithstanding  sections 2807 and 2807-c of the public health
    49  law, section 1 of part C of chapter 58 of the  laws  of  2005,  and  any
    50  other  contrary  provision  of  law  and  subject to the availability of
    51  federal financial participation, for  designated  rate  periods  on  and
    52  after April 1, 2006:
    53    (a)  the  commissioner of health, with the approval of the director of
    54  the budget, may increase the capital cost components of rates of payment
    55  by governmental agencies for inpatient and outpatient services  provided
    56  by  public  general  hospitals,  not  including public general hospitals
        S. 6457                            25                            A. 9557

     1  operated by the state of New York or the state university  of  New  York
     2  but including public general hospitals operated by public benefit corpo-
     3  rations, to reflect the difference between the current fair market value
     4  of  the  fixed  capital  assets held by such hospitals and the amount of
     5  capital cost reimbursement of such  fixed  capital  assets  as  computed
     6  pursuant  to  the provisions of section 2807-c of the public health law;
     7  provided, however, that reimbursement by the state of the amount of such
     8  increased capital cost reimbursement to such general hospitals,  whether
     9  made  by the department of health on behalf of a social service district
    10  or by a social services district directly, for  general  hospital  inpa-
    11  tient and outpatient hospital services provided in accordance with para-
    12  graph  (b) of subdivision 2 of section 365-a of the social services law,
    13  shall be limited to the amount of federal funds properly received or  to
    14  be  received on account of such expenditures; provided further, however,
    15  that the social services district in which an  eligible  public  general
    16  hospital  is  physically  located shall be responsible for the increased
    17  payments provided herein for such public general hospital for all hospi-
    18  tal inpatient and outpatient services provided by  such  general  public
    19  hospital  in  accordance  with section 365-a of the social services law,
    20  regardless of whether another social services district or the department
    21  of health may otherwise be responsible for furnishing medical assistance
    22  to the eligible persons receiving such services; and
    23    (b) the commissioner of health, with the approval of the  director  of
    24  the  budget,  may  also increase the capital cost components of rates of
    25  payment by governmental agencies for inpatient and  outpatient  services
    26  provided  by  public general hospitals operated by the state of New York
    27  and by the state university of  New  York,  to  reflect  the  difference
    28  between  the  fair market value of the fixed capital assets held by such
    29  hospitals and the amount of capital cost  reimbursement  of  such  fixed
    30  capital  assets as computed pursuant to the provisions of section 2807-c
    31  of the public health law; further provided, however, that such  payments
    32  made  to  public general hospitals operated by the state of New York and
    33  the state university of New York shall  be  the  responsibility  of  the
    34  state and shall not include a local share; and
    35    (c)  the commissioner of health shall issue regulations, and may issue
    36  emergency regulations if deemed necessary by the commissioner of health,
    37  to implement the adjustments to rates  of  payment  authorized  by  this
    38  section.
    39    §  37.  Subdivision  4  of  section 2807-c of the public health law is
    40  amended by adding a new paragraph (l) to read as follows:
    41    (l) Notwithstanding any law or regulation to the  contrary,  rates  of
    42  payment to general hospitals for inpatient services provided to patients
    43  discharged  on and after April first, two thousand six, who are eligible
    44  for payments made by state governmental agencies and who are  determined
    45  to  be  in  diagnosis-related groups numbered seven hundred forty-three,
    46  seven hundred forty-five, seven hundred forty-six, seven hundred  forty-
    47  eight,  seven  hundred  forty-nine,  or seven hundred fifty-one shall be
    48  made in accordance with the following:
    49    (i) for the period April first,  two  thousand  six  through  December
    50  thirty-first,  two  thousand six, such rates shall consist of the higher
    51  of: (A) the sum of seventy-five percent of the  operating  component  of
    52  the  case-based  rate  per  discharge, as adjusted by applicable service
    53  intensity weights, provided for pursuant to this section,  plus  capital
    54  cost  reimbursement  as  provided pursuant to this section and plus rate
    55  adjustments as provided in subdivisions thirty, thirty-one  and  thirty-
    56  two  of  this section, or, (B) the sum of an amount equal to one hundred
        S. 6457                            26                            A. 9557

     1  twenty percent of the fees paid in the same locality pursuant to section
     2  43.02 of the mental  hygiene  law  for  community  based  detoxification
     3  services  provided in facilities licensed pursuant to article thirty-two
     4  of  the mental hygiene law, plus an amount equal to the rate adjustments
     5  as provided in subdivisions thirty, thirty-one and  thirty-two  of  this
     6  section;
     7    (ii) for the period January first, two thousand seven through December
     8  thirty-first, two thousand seven, such rates shall consist of the higher
     9  of: (A) the sum of fifty percent of the operating component of the case-
    10  based  rate  per  discharge, as adjusted by applicable service intensity
    11  weights, provided for  pursuant  to  this  section,  plus  capital  cost
    12  reimbursement  as  provided  for  pursuant to this section and plus rate
    13  adjustments as provided in subdivisions thirty, thirty-one  and  thirty-
    14  two  of  this section, or, (B) the sum of an amount equal to one hundred
    15  twenty percent of the fees paid in the same locality pursuant to section
    16  43.02 of the mental  hygiene  law  for  medically  supervised  inpatient
    17  crisis  services  provided  in  facilities  licensed pursuant to article
    18  thirty-two of the mental hygiene law, plus an amount equal to  the  rate
    19  adjustments  as  provided in subdivisions thirty, thirty-one and thirty-
    20  two of this section; and
    21    (iii) for periods on and after January first, two thousand eight,  the
    22  commissioner shall develop, in consultation with the commissioner of the
    23  office of alcoholism and substance abuse services, regulations providing
    24  for appropriate per diem payment amounts.
    25    §  38. Notwithstanding any law, rule or regulation to the contrary and
    26  in accordance with the provisions of subdivision 10 of section  2807  of
    27  the public health law, for the period April 1, 2006 through December 31,
    28  2008,  the commissioner of health, in consultation with the commissioner
    29  of the office of alcoholism and substance abuse services,  shall  estab-
    30  lish  a demonstration program, to be administered by the office of alco-
    31  holism and substance abuse services in conjunction with  the  department
    32  of  health,  for  adjustments  to  inpatient rates of payment to general
    33  hospitals to provide supplemental Medicaid rates  of  payments  to  such
    34  general hospitals to provide for enhanced discharge planning with regard
    35  to inpatients who are determined to be at risk for multiple re-admission
    36  for  inpatient  detoxification services, for the purpose of ensuring the
    37  transitioning of such patients to community  based  chemical  dependence
    38  treatment  programs  certified  pursuant  to  article  32  of the mental
    39  hygiene law, and to reduce  the  rate  of  chemical  dependence  related
    40  re-admission  of  such  patients to general hospitals.  In addition, the
    41  commissioner of health, in consultation with  the  commissioner  of  the
    42  office  of  alcoholism  and  substance abuse services, may seek authori-
    43  zation from the federal government for additional Medicaid  payments  to
    44  providers of chemical dependence treatment services to perform expedited
    45  chemical dependence assessments of Medicaid eligible hospital inpatients
    46  who  are  also  potentially  eligible for inclusion in the demonstration
    47  program authorized by this section.
    48    § 39. Section 2807-k of the public health law is amended by  adding  a
    49  new subdivision 9-a to read as follows:
    50    9-a.  (a)  As  a  condition  for  participation  in pool distributions
    51  authorized pursuant to this section  and  section  twenty-eight  hundred
    52  seven-w  of  this  article  for  periods on and after January first, two
    53  thousand nine, general hospitals shall, effective  for  periods  on  and
    54  after  January  first, two thousand seven, establish financial aid poli-
    55  cies and procedures, in accordance with the provisions of this  subdivi-
    56  sion,  for  reducing charges otherwise applicable to low-income individ-
        S. 6457                            27                            A. 9557

     1  uals without health  insurance,  or  who  have  exhausted  their  health
     2  insurance  benefits,  and  who  can demonstrate an inability to pay full
     3  charges, and also for reducing or discounting the collection of  co-pays
     4  and  deductible  payments  from those individuals who can demonstrate an
     5  inability to pay such amounts.
     6    (b) Such policies and procedures shall be  clear,  understandable,  in
     7  writing  and  publicly available and each general hospital participating
     8  in the pool shall ensure that every patient is made aware of the  exist-
     9  ence  of  such  policies  and  procedures  and  is provided, in a timely
    10  manner, with a  written  copy  of  such  policies  and  procedures  upon
    11  request.
    12    (c) Such policies and procedures shall include clear, objective crite-
    13  ria  for  determining  a patient's ability to pay and for providing such
    14  adjustments to payment requirements as are  necessary.  Such  adjustment
    15  mechanisms  may include sliding fee schedules, discounts to fixed stand-
    16  ards and flexible or extended payment plans. Such  policies  and  proce-
    17  dures shall be applied consistently to all eligible patients.
    18    (d)  Such  policies  and  procedures may require that patients seeking
    19  payment  adjustments  provide  appropriate  financial  information   and
    20  documentation  in  support of their application, provided, however, that
    21  such application process shall not  be  unduly  burdensome  or  complex.
    22  General  hospitals shall, upon request, assist patients in understanding
    23  the hospital's policies and  procedures  and  in  applying  for  payment
    24  adjustments.    Decisions regarding such applications shall be made in a
    25  timely manner.
    26    (e) Such policies and procedures  shall  provide  that  patients  with
    27  incomes  below  two  hundred  percent  of  the federal poverty level are
    28  deemed presumptively eligible for payment adjustments, provided,  howev-
    29  er,  that nothing in this subdivision shall be interpreted as precluding
    30  hospitals from extending such payment  adjustments  to  other  patients,
    31  either generally or on a case by case basis.
    32    (f)  Such  policies and procedures shall not permit the forced sale or
    33  foreclosure of a patient's primary residence  in  order  to  collect  an
    34  outstanding medical bill.
    35    (g) Reports required to be submitted to the department by each general
    36  hospital  as  a  condition  for  participation  in  the  pools and which
    37  contain, in accordance with applicable regulations, a certification from
    38  an independent  certified  public  accountant  or  independent  licensed
    39  public  accountant that the hospital is in compliance with conditions of
    40  participation in the pools, shall also contain, for reporting periods on
    41  and after January first, two thousand seven, a certification  from  such
    42  accountant  that  such  hospital is in compliance with the provisions of
    43  this subdivision.
    44    § 40. Paragraph (a) of subdivision 1 of section 212 of chapter 474  of
    45  the  laws of 1996, amending the education law and other laws relating to
    46  rates for residential health care facilities, as amended by chapter  161
    47  of the laws of 2005, is amended to read as follows:
    48    (a) Notwithstanding any inconsistent provision of law or regulation to
    49  the  contrary,  effective beginning August 1, 1996, for the period April
    50  1, 1997 through March 31, 1998, April 1, 1998 for the  period  April  1,
    51  1998  through  March  31,  1999, August 1, 1999, for the period April 1,
    52  1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
    53  through March 31, 2001, April 1, 2001, for  the  period  April  1,  2001
    54  through  March  31,  2002,  April  1, 2002, for the period April 1, 2002
    55  through March 31, 2003, and for the state fiscal year beginning April 1,
    56  2005 through March 31, 2006, and for the  state  fiscal  year  beginning
        S. 6457                            28                            A. 9557

     1  April  1, 2006 through March 31, 2007, and each state fiscal year there-
     2  after, the department of health is  authorized  to  pay  public  general
     3  hospitals,  as  defined  in subdivision 10 of section 2801 of the public
     4  health law, operated by the state of New York or by the state university
     5  of  New York or by a county, which shall not include a city with a popu-
     6  lation of over one million, of the state of New York, and  those  public
     7  general  hospitals  located  in the county of Westchester, the county of
     8  Erie or the county of Nassau, additional payments for inpatient hospital
     9  services as medical assistance payments pursuant to title 11 of  article
    10  5 of the social services law for patients eligible for federal financial
    11  participation  under  title  XIX  of  the federal social security act in
    12  medical assistance pursuant to the federal laws and regulations  govern-
    13  ing  disproportionate  share  payments  to  hospitals  up to one hundred
    14  percent of each such public general hospital's  medical  assistance  and
    15  uninsured  patient  losses after all other medical assistance, including
    16  disproportionate share payments to  such  public  general  hospital  for
    17  1996,  1997,  1998,  and 1999, based initially for 1996 on reported 1994
    18  reconciled data as further reconciled to actual reported 1996 reconciled
    19  data, and for 1997 based initially on reported 1995 reconciled  data  as
    20  further  reconciled  to  actual  reported 1997 reconciled data, for 1998
    21  based initially on reported 1995 reconciled data as  further  reconciled
    22  to  actual  reported  1998  reconciled data, for 1999 based initially on
    23  reported 1995 reconciled data as further reconciled to  actual  reported
    24  1999  reconciled  data, for 2000 based initially on reported 1995 recon-
    25  ciled data as further reconciled to actual reported 2000 data, for  2001
    26  based  initially  on reported 1995 reconciled data as further reconciled
    27  to actual reported 2001 data, for 2002 based initially on reported  2000
    28  reconciled  data as further reconciled to actual reported 2002 data, and
    29  for state fiscal years beginning on April 1, 2005,  based  initially  on
    30  reported  2000  reconciled data as further reconciled to actual reported
    31  data for 2005, and to actual reported data for each respective  succeed-
    32  ing  year.    The  payments  may be added to rates of payment or made as
    33  aggregate payments to an eligible public general hospital.
    34    § 41.  Paragraph (b) of subdivision 1 of section 211 of chapter 474 of
    35  the laws of 1996, amending the education law and other laws relating  to
    36  rates  for residential health care facilities, as amended by chapter 161
    37  of the laws of 2005, is amended to read as follows:
    38    (b) Notwithstanding any inconsistent provision of law or regulation to
    39  the contrary, effective beginning  April  1,  2000,  the  department  of
    40  health  is  authorized to pay public general hospitals, other than those
    41  operated by the state of New York or the state university of  New  York,
    42  as  defined  in subdivision 10 of section 2801 of the public health law,
    43  located in a city with  a  population  of  over  1  million,  additional
    44  initial  payments for inpatient hospital services of $120 million during
    45  each state fiscal year until March 31, 2003,  and  up  to  $120  million
    46  during  the  state fiscal year beginning April 1, 2005 through March 31,
    47  2006 and during the state fiscal year beginning April 1, 2006  and  each
    48  state fiscal year thereafter, as medical assistance payments pursuant to
    49  title  11  of article 5 of the social services law for patients eligible
    50  for federal financial participation  under  title  XIX  of  the  federal
    51  social  security  act in medical assistance pursuant to the federal laws
    52  and regulations governing disproportionate share payments  to  hospitals
    53  based  on  the  relative  share  of  each such non-state operated public
    54  general hospital of medical  assistance  and  uninsured  patient  losses
    55  after  all  other  medical  assistance, including disproportionate share
    56  payments to such public general hospitals for payments made  during  the
        S. 6457                            29                            A. 9557

     1  state  fiscal  year  ending  March 31, 2001, based initially on reported
     2  1995 reconciled data as further reconciled to actual  reported  2000  or
     3  2001  data,  for payments made during the state fiscal year ending March
     4  31,  2002,  based  initially on reported 1995 reconciled data as further
     5  reconciled to actual reported 2001  or  2002  data,  for  payments  made
     6  during  the  state fiscal year ending March 31, 2003, based initially on
     7  reported 2000 reconciled data as further reconciled to  actual  reported
     8  2002 or 2003 data, for payments made during state fiscal years ending on
     9  and  after  March  31, 2006, based initially on reported 2000 reconciled
    10  data as further reconciled to actual reported 2005 or 2006 data, and  to
    11  actual  reported data for each respective succeeding year.  The payments
    12  may be added to rates of payment or made as  aggregate  payments  to  an
    13  eligible public general hospital.
    14    §  42.  1.  Notwithstanding paragraph (c) of subdivision 10 of section
    15  2807-c of the public health law and section 21 of chapter 1 of the  laws
    16  of 1999 and any other inconsistent provision of law or regulation to the
    17  contrary,  in  determining rates of payments by state governmental agen-
    18  cies effective for services provided beginning April 1, 2006, and there-
    19  after for inpatient and outpatient services provided by  general  hospi-
    20  tals  and  for  inpatient  and outpatient adult day health care services
    21  provided by residential health care facilities pursuant to article 28 of
    22  the public health law, the commissioner of health shall apply  no  trend
    23  factor  projections  attributable  to the period January 1, 2006 through
    24  December 31, 2006.
    25    2. The commissioner of health shall adjust rates of payment to reflect
    26  the exclusion pursuant to this section of such  specified  trend  factor
    27  projections or adjustments.
    28    §  43. Notwithstanding section 4 of chapter 81 of the laws of 1995, as
    29  amended, and any other inconsistent provision of law  or  regulation  to
    30  the  contrary, on and after October 1, 2006, rates of payment by govern-
    31  mental agencies to  residential health care  facilities  and  diagnostic
    32  and treatment centers licensed under article 28 of the public health law
    33  for adult day health care services provided to registrants with acquired
    34  immunodeficiency  syndrome  (AIDS) or other human immunodeficiency virus
    35  (HIV) related illnesses, shall reflect trend factor adjustments computed
    36  pursuant to paragraph (c) of subdivision 10 of  section  2807-c  of  the
    37  public  health  law to project for the effects of inflation attributable
    38  to periods on and after October 1, 2006 through December 31, 2009.
    39    § 44. Section 2808 of the public health law is amended by adding a new
    40  subdivision 22-a to read as follows:
    41    22-a. Modifications.
    42    (a) Notwithstanding any inconsistent provision of law or regulation to
    43  the contrary, effective April first, two thousand  six  and  thereafter,
    44  residential health care facility rates of payment determined pursuant to
    45  this  section  for  payments  made  by  governmental  agencies shall not
    46  contain a payment factor for interest on  current  indebtedness  if  the
    47  residential  health care facility cost report utilized to determine such
    48  payment factor also shows a withdrawal of equity, a transfer of  assets,
    49  or a positive net income.
    50    (b) Notwithstanding any inconsistent provision of law or regulation to
    51  the  contrary,  for  residential  health  care facility rates of payment
    52  determined pursuant to this article for services provided on  and  after
    53  April  first,  two  thousand  six,  the annual cost report filed by each
    54  residential health care facility for two thousand five and for each year
    55  thereafter shall be examined  and  in  the  event  the  operating  costs
    56  reported  by  each  such  facility  in any such cost report is less than
        S. 6457                            30                            A. 9557

     1  ninety percent of the operating costs reported in the cost report  which
     2  is  being  utilized  to  set  such  facility's existing rates of payment
     3  trended to two thousand five and each year thereafter, then  such  rates
     4  of  payment  shall  be  recalculated  utilizing the more recent reported
     5  operating cost data.
     6    (c) Notwithstanding any inconsistent provision of law or regulation to
     7  the contrary, effective on and after April first, two thousand six,  for
     8  purposes  of  establishing rates of payment by governmental agencies for
     9  residential health care facilities licensed pursuant  to  this  article,
    10  the  operating  component  of  the  rate for any residential health care
    11  facility that did not or does not  achieve  ninety  percent  or  greater
    12  occupancy  for  any  year  within  five  calendar years from the date of
    13  commencing operation, shall be  recalculated  utilizing  the  facility's
    14  most recently available reported allowable costs divided by patient days
    15  imputed  at ninety percent occupancy. Such recalculated rates of payment
    16  shall be effective January first of the sixth  calendar  year  following
    17  the  date the facility commenced operations or April first, two thousand
    18  six, whichever is later.
    19    § 45. Subparagraph (vi) of paragraph (b) of subdivision 2  of  section
    20  2807-d  of  the public health law, as amended by section 23 of part E of
    21  chapter 63 of the laws of 2005, is amended to read as follows:
    22    (vi) Notwithstanding any contrary provision of this paragraph  or  any
    23  other  provision  of  law or regulation to the contrary, for residential
    24  health care facilities the assessment shall be six percent of each resi-
    25  dential health care facility's gross receipts received from all  patient
    26  care  services and other operating income on a cash basis for the period
    27  April first, two thousand two through March thirty-first,  two  thousand
    28  three  for  hospital  or  health-related  services,  including adult day
    29  services; provided, however, that residential  health  care  facilities'
    30  gross receipts attributable to payments received pursuant to title XVIII
    31  of the federal social security act (medicare) shall be excluded from the
    32  assessment; provided, however, that for all such gross receipts received
    33  on  or after April first, two thousand three through March thirty-first,
    34  two thousand five, such assessment shall be five  percent,  and  further
    35  provided  that  for  all  such gross receipts received on or after April
    36  first, two thousand  five  [through  March  thirty-first,  two  thousand
    37  seven], such assessment shall be six percent.
    38    § 46. Section 2808 of the public health law is amended by adding a new
    39  subdivision 23 to read as follows:
    40    23. Notwithstanding any inconsistent provision of law or regulation to
    41  the contrary:
    42    (a)  (i)  For  adult  day health care services provided by residential
    43  health care facilities, effective April  first,  two  thousand  six  and
    44  thereafter,  the  operating component of the rate of payment established
    45  pursuant to this article for an adult day health care program which  has
    46  achieved  an  occupancy  percentage  of  ninety percent or greater for a
    47  calendar year prior to April first, two thousand six,  shall  be  calcu-
    48  lated  utilizing allowable costs reported in the two thousand three, two
    49  thousand four, or two thousand five  calendar  year  residential  health
    50  care  facility  cost  report  filed by the sponsoring residential health
    51  care facility, whichever is the earliest  of  such  calendar  year  cost
    52  reports  in  which  the  program has achieved an occupancy percentage of
    53  ninety percent or greater,  except  that  programs  receiving  rates  of
    54  payment  based on allowable costs for a period prior to April first, two
    55  thousand six shall continue to receive rates of payment  based  on  such
    56  period.
        S. 6457                            31                            A. 9557

     1    (ii) For such programs which achieved an occupancy percentage of nine-
     2  ty  percent  or  greater  prior  to calendar year two thousand three but
     3  which did not maintain occupancy of ninety percent or greater in  calen-
     4  dar  years  two thousand three, two thousand four, or two thousand five,
     5  the  operating  component of the rate of payment established pursuant to
     6  this article shall be calculated utilizing allowable costs  reported  in
     7  the  two  thousand  three  calendar  year  cost report divided by visits
     8  imputed at ninety percent occupancy.
     9    (iii) For such programs which have not achieved an occupancy  percent-
    10  age  of  ninety  percent  or  greater for a calendar year prior to April
    11  first, two thousand six, the operating component of the rate of  payment
    12  established  pursuant  to  this  article  shall  be calculated utilizing
    13  allowable costs reported in the first calendar year after  two  thousand
    14  five  in which such a program achieves an occupancy percentage of ninety
    15  percent or greater effective January first of such calendar year  except
    16  for  calendar  year  two  thousand  six, effective no earlier than April
    17  first of such year, provided, however, that effective January first, two
    18  thousand eight,  for  programs  that  have  not  achieved  an  occupancy
    19  percentage  of  ninety  percent  or greater for a calendar year prior to
    20  January first, two thousand eight, the operating component of  the  rate
    21  of  payment  established  pursuant  to  this article shall be calculated
    22  utilizing allowable costs reported in the two thousand eight cost report
    23  filed by the sponsoring residential  health  care  facility  divided  by
    24  visits  imputed  at  actual    or ninety percent occupancy, whichever is
    25  greater.
    26    (b) For a residential health care  facility  approved  to  operate  an
    27  adult day health care program on or after April first, two thousand six,
    28  rates  of  payment for such programs shall be computed based upon annual
    29  budgeted allowable costs, as submitted by the  residential  health  care
    30  facility,  and  total  estimated  annual visits by adult day health care
    31  registrants of not less than ninety percent of licensed  occupancy,  and
    32  in accordance with the following:
    33    (i)  Each  program  shall  be required to submit an individual budget.
    34  Multiple programs operated by the same residential health care  facility
    35  shall  submit  a  separate  budget for each program.   Multiple programs
    36  operated by the same residential health care facility shall  have  sepa-
    37  rate rates of payment.
    38    (ii)  Rates developed based upon budgets shall remain in effect for no
    39  longer than two calendar years from the earlier of:
    40    (A) the date the program commences operations; or
    41    (B) the date the sponsoring residential health care facility submits a
    42  full calendar year residential health care facility cost report in which
    43  the program has achieved ninety percent or  greater  occupancy.    If  a
    44  sponsoring  residential  health care facility submits such a cost report
    45  within  two years of the date the  program  commences  operation,  rates
    46  shall then be computed utilizing such cost report.
    47    (iii) If a program fails to achieve ninety percent or greater occupan-
    48  cy  within  two calendar years of the date of its commencing operations,
    49  rates shall be calculated utilizing allowable  costs  reported  in  such
    50  second  calendar year residential health care facility's cost report for
    51  the  applicable  sponsoring  residential health care facility divided by
    52  visits imputed at ninety percent occupancy.
    53    (c) Effective January first, two thousand seven, allowable costs shall
    54  not include the costs of transportation.
    55    (d) All rates of payment established pursuant to this subdivision  are
    56  subject  to  the  maximum daily rate provided by law. Such maximum daily
        S. 6457                            32                            A. 9557

     1  rate of payment for adult day health care programs operated by  residen-
     2  tial  health  care  facilities that undergo a change of ownership subse-
     3  quent to nineteen hundred ninety shall be determined  by  utilizing  the
     4  inpatient  rate of payment of the prior operator as in effect on January
     5  first, nineteen hundred ninety. In the event a residential  health  care
     6  facility  establishes  an off-site adult day health care program outside
     7  the regional input price adjustment region in which it is  located,  the
     8  computation  of the maximum daily rate of payment for such program shall
     9  utilize the weighted average of the  inpatient  rates  of  payments  for
    10  residential health care facilities in the region in which the program is
    11  located,  as  in  effect  on  January first, nineteen hundred ninety, in
    12  place of the sponsoring residential  health  care  facility's  inpatient
    13  rate of payment.
    14    (e)  Notwithstanding  any inconsistent provision of the state adminis-
    15  trative procedure act or any other law or regulation  to  the  contrary,
    16  the  commissioner  shall  adopt or amend on an emergency basis any regu-
    17  lations the commissioner shall  determine  necessary  to  implement  any
    18  provision of this subdivision.
    19    §  47.  Subdivision  1  of  section  12-d of the public health law, as
    20  amended by chapter 843 of the laws  of  1992,  is  amended  to  read  as
    21  follows:
    22    1.  [In] Notwithstanding any contrary provision of law, in the event a
    23  medical facility or other provider fails to file the required  financial
    24  and statistical reports, or specific additional data related to the rate
    25  setting  process,  on or before the prescribed due dates, or as the same
    26  may be extended by the commissioner, the commissioner shall  reduce  the
    27  current rate established for payments by governmental agencies by [up to
    28  two] ten percent for a period beginning on the first day of the calendar
    29  month  following  the original due date of the required reports or addi-
    30  tional data and continuing until the last day of the calendar  month  in
    31  which said reports or data are filed.
    32    §  48.  Subdivision  4  of  section  12-d of the public health law, as
    33  amended by chapter 575 of the laws  of  1992,  is  amended  to  read  as
    34  follows:
    35    4.  For  the  purposes  of  this  section,  "medical facility or other
    36  provider" shall mean a residential health care facility, general  hospi-
    37  tal, free-standing ambulatory care facility, diagnostic and/or treatment
    38  center  and  clinic  authorized under article twenty-eight of this chap-
    39  ter[, and]; a certified home health  agency  [and],  a  long  term  home
    40  health care program and an AIDS home care program authorized under arti-
    41  cle  thirty-six  of  this chapter; and a personal care services provider
    42  authorized under article five of the social services law.
    43    § 49. Paragraph (a) of subdivision 3 of  section  366  of  the  social
    44  services  law, as amended by chapter 110 of the laws of 1971, is amended
    45  to read as follows:
    46    (a) Medical assistance shall  be  furnished  to  applicants  in  cases
    47  where,  although  such  applicant has a responsible relative with suffi-
    48  cient income and resources to provide medical assistance  as  determined
    49  by  the  regulations  of the department, the income and resources of the
    50  responsible relative are not available to such applicant because of  the
    51  absence  of such relative [or] and the refusal or failure of such absent
    52  relative to provide the necessary care and assistance.   In such  cases,
    53  however,  the  furnishing  of  such  assistance  shall create an implied
    54  contract with such relative, and the cost thereof may be recovered  from
    55  such  relative  in  accordance with title six of article three and other
    56  applicable provisions of law.
        S. 6457                            33                            A. 9557

     1    § 50. Paragraph (d) of subdivision 5 of  section  366  of  the  social
     2  services  law,  as  added by chapter 170 of the laws of 1994, is amended
     3  and a new subparagraph 7 is added to read as follows:
     4    (d)  For  transfers  made after August tenth, nineteen hundred ninety-
     5  three:
     6    (1) (i) "assets" means all income and resources of an  individual  and
     7  of  the  individual's spouse, including income or resources to which the
     8  individual or the individual's spouse is  entitled  but  which  are  not
     9  received  because  of  action  by:  the  individual  or the individual's
    10  spouse; a person with legal authority to act in place of or on behalf of
    11  the individual or the individual's spouse; a person acting at the direc-
    12  tion or upon the request of the individual or the  individual's  spouse;
    13  or  by  a  court  or  administrative body with legal authority to act in
    14  place of or on behalf of the individual or the individual's spouse or at
    15  the direction or upon the request of the individual or the  individual's
    16  spouse.
    17    (ii)  "blind"  has  the  same  meaning  given  to such term in section
    18  1614(a)(2) of the federal [social] social security act.
    19    (iii) "disabled" has the same meaning given to such  term  in  section
    20  1614(a)(3) of the federal social security act.
    21    (iv)  "income" has the same meaning given to such term in section 1612
    22  of the federal social security act.
    23    (v) "resources" has the same meaning given to  such  term  in  section
    24  1613  of the federal social security act, without regard, in the case of
    25  an institutionalized  individual,  to  the  exclusion  provided  for  in
    26  subsection (a)(1) of such section.
    27    (vi)  "look-back period" means the thirty-six month period, or, in the
    28  case of payments from a trust or portions of a trust which  are  treated
    29  as  assets  disposed  of  by the individual pursuant to department regu-
    30  lations, the sixty-month period, immediately preceding the date that  an
    31  institutionalized  individual  is both institutionalized and has applied
    32  for medical assistance, or in the case of a non-institutionalized  indi-
    33  vidual,  the date that such non-institutionalized individual applies for
    34  medical assistance coverage of long term care services; provided, howev-
    35  er, that the look-back period for all types of transfers shall be  sixty
    36  months  if  the  commissioner  of health obtains all necessary approvals
    37  under federal law and regulation to implement such a  look-back  period;
    38  provided  further that the use of a sixty-month look-back period for all
    39  types of transfers shall continue only if and for so long as the use  of
    40  such  a  look-back period does not prevent the receipt of federal finan-
    41  cial  participation  under  the  medical  assistance  program;  provided
    42  further  that the commissioner of health shall submit such waiver appli-
    43  cations and/or state plan amendments  as  may  be  necessary  to  obtain
    44  approval  to  implement  a sixty-month look-back period for all types of
    45  transfers and to ensure continued federal financial participation.
    46    (vii) "institutionalized individual" means any individual  who  is  an
    47  in-patient in a nursing facility, including an intermediate care facili-
    48  ty  for  the  mentally  retarded,  or  who is an in-patient in a medical
    49  facility and is receiving a level of care provided in a nursing  facili-
    50  ty,  or who is receiving care, services or supplies pursuant to a waiver
    51  granted pursuant to subsection (c) of section 1915 of the federal social
    52  security act.
    53    (viii) "intermediate care facility for the mentally retarded" means  a
    54  facility  certified  under article sixteen of the mental hygiene law and
    55  which has a valid agreement with the department for providing intermedi-
        S. 6457                            34                            A. 9557

     1  ate care facility services and receiving payment  therefor  under  title
     2  XIX of the federal social security act.
     3    (ix)  "nursing  facility"  means  a nursing home as defined by section
     4  twenty-eight hundred one of the public health law  and  an  intermediate
     5  care facility for the mentally retarded.
     6    (x)  "nursing facility services" means nursing care and health related
     7  services provided in a nursing facility; a level of care provided  in  a
     8  hospital  which is equivalent to the care which is provided in a nursing
     9  facility; and care, services or supplies provided pursuant to  a  waiver
    10  granted pursuant to subsection (c) of section 1915 of the federal social
    11  security act.
    12    (xi) "non-institutionalized individual" means an individual who is not
    13  an  institutionalized  individual,  as  defined  in clause (vii) of this
    14  subparagraph.
    15    (xii) "long term care  services"  means  home  health  care  services,
    16  personal  care services, assisted living program services and such other
    17  services for which medical assistance is otherwise available under  this
    18  chapter  which  are  designated  as long term care services in the regu-
    19  lations of the department.
    20    (2) The uncompensated value of an asset is the fair  market  value  of
    21  such asset at the time of transfer, minus the amount of the compensation
    22  received in exchange for the asset.
    23    (3)  In  determining the medical assistance eligibility of an institu-
    24  tionalized individual, any transfer of an asset by the individual or the
    25  individual's spouse for less than fair market value made within or after
    26  the look-back period shall render the individual ineligible for  nursing
    27  facility  services for the period of time specified in subparagraph four
    28  of this paragraph.  In determining the medical assistance eligibility of
    29  a non-institutionalized individual, any transfer  of  an  asset  by  the
    30  individual  or  the  individual's spouse for less than fair market value
    31  made within or after the look-back period shall  render  the  individual
    32  ineligible  for long term care services for the period of time specified
    33  in subparagraph four of this paragraph. Notwithstanding  the  provisions
    34  of this subparagraph, an individual shall not be ineligible for services
    35  solely by reason of any such transfer to the extent that:
    36    (i) [in the case of an institutionalized individual,] the asset trans-
    37  ferred  was  a  home  and  title  to the home as transferred to: (A) the
    38  spouse of the individual; or (B) a child of the individual who is  under
    39  the  age of twenty-one years or blind or disabled; or (C) in the case of
    40  an institutionalized individual, a sibling of the individual who has  an
    41  equity  interest  in such home and who resided in such home for a period
    42  of at least one year immediately before the date the  individual  became
    43  an institutionalized individual; or (D) in the case of an institutional-
    44  ized individual, a child of the individual who was residing in such home
    45  for a period of at least two years immediately before the date the indi-
    46  vidual  became an institutionalized individual, and who provided care to
    47  the individual which permitted the individual to reside at  home  rather
    48  than in an institution or facility; or
    49    (ii)  the  assets: (A) were transferred to the individual's spouse, or
    50  to another for the sole benefit of the individual's spouse; or (B)  were
    51  transferred from the individual's spouse to another for the sole benefit
    52  of  the individual's spouse; or (C) were transferred to the individual's
    53  child who is blind or disabled, or to a trust established solely for the
    54  benefit of such child; or (D) were transferred to  a  trust  established
    55  solely  for  the  benefit of an individual under sixty-five years of age
    56  who is disabled; or
        S. 6457                            35                            A. 9557

     1    (iii) a satisfactory showing is made that: (A) the individual  or  the
     2  individual's  spouse  intended  to  dispose of the assets either at fair
     3  market value, or for other valuable consideration;  or  (B)  the  assets
     4  were  transferred  exclusively  for  a purpose other than to qualify for
     5  medical  assistance;  or  (C)  all assets transferred for less than fair
     6  market value have been returned to the individual; or
     7    (iv) denial of eligibility would cause an undue  hardship,  as  deter-
     8  mined  pursuant  to the regulations of the department in accordance with
     9  criteria established by the  secretary  of  the  federal  department  of
    10  health and human services.
    11    (4)  (i) Any transfer made by an individual or the individual's spouse
    12  under subparagraph three of this paragraph shall cause the person to  be
    13  ineligible  for  services  for  a  period equal to the total, cumulative
    14  uncompensated value of all assets transferred during or after the  look-
    15  back  period,  divided  by the average monthly costs of nursing facility
    16  services provided to a private patient for a given period of time at the
    17  time of application, as determined pursuant to the  regulations  of  the
    18  department.  The  period of ineligibility shall begin with the first day
    19  of the first month during or after which assets  have  been  transferred
    20  for  less  than fair market value, and which does not occur in any other
    21  periods of ineligibility under this  paragraph.  For  purposes  of  this
    22  subparagraph,  the average monthly costs of nursing facility services to
    23  a private patient for a given period of time at the time of  application
    24  shall  be  presumed  to  be  one  hundred  twenty percent of the average
    25  medical assistance rate of payment as of the first  day  of  January  of
    26  each year for nursing facilities within the region wherein the applicant
    27  resides, as established pursuant to paragraph (b) of subdivision sixteen
    28  of section twenty-eight hundred seven-c of the public health law.
    29    (ii)  Notwithstanding any provision of clause (i) of this subparagraph
    30  to the contrary, the period of  ineligibility  described  therein  shall
    31  begin  on  the  first day the individual is receiving services for which
    32  medical assistance coverage would be available but for the provisions of
    33  subparagraph three of this paragraph, and which does not  occur  in  any
    34  other periods of ineligibility under this paragraph, if the commissioner
    35  of  health  obtains  all necessary approvals under federal law and regu-
    36  lation to implement such a period of ineligibility. The use  of  such  a
    37  period  of  ineligibility  shall  continue only if and for so long as it
    38  does not prevent the receipt of federal  financial  participation  under
    39  the  medical assistance program. The commissioner of health shall submit
    40  such waiver applications and/or state plan amendments as may  be  neces-
    41  sary  to  obtain  approval  to  implement  the  period  of ineligibility
    42  described in this clause  and  to  ensure  continued  federal  financial
    43  participation.
    44    (5)  In  the  case  of  an  asset held by an individual in common with
    45  another person or persons in a joint  tenancy,  tenancy  in  common,  or
    46  similar  arrangement,  the  asset, or the affected portion of the asset,
    47  shall be considered to be transferred by such individual when any action
    48  is taken, either by such individual or by any other person, that reduces
    49  or eliminates such individual's ownership or control of such asset.
    50    (6) In the case of a trust established by the  individual,  as  deter-
    51  mined  pursuant to the regulations of the department, any payment, other
    52  than a payment to or for the benefit of the individual, from a revocable
    53  trust is considered to be a transfer of assets by the individual and any
    54  payment, other than to or for the benefit of the  individual,  from  the
    55  portion  of an irrevocable trust which, under any circumstance, could be
    56  made available to the individual is  considered  to  be  a  transfer  of
        S. 6457                            36                            A. 9557

     1  assets  by  the  individual and, further, the value of any portion of an
     2  irrevocable trust from which no payment could be made to the  individual
     3  under  any circumstances is considered to be a transfer of assets by the
     4  individual  for purposes of this section as of the date of establishment
     5  of the trust, or, if later, the date on which payment to the  individual
     6  is foreclosed.
     7    (7)  In  the  case  of  a transfer by an individual which results in a
     8  period of ineligibility for such individual or his or her  spouse,  such
     9  period of ineligibility will continue without regard to the individual's
    10  becoming  an institutionalized individual if the transfer was made while
    11  the individual was a non-institutionalized individual and without regard
    12  to the individual's becoming a non-institutionalized individual  if  the
    13  transfer was made while the individual was an institutionalized individ-
    14  ual.  In  no event shall the total period of ineligibility for long term
    15  care services and nursing facility  services  resulting  from  the  same
    16  transfer of assets exceed the period calculated pursuant to subparagraph
    17  four of this paragraph.
    18    §  51.  Paragraph  (b) of subdivision 5 of section 366-c of the social
    19  services law as added by chapter 558 of the laws of 1989, is amended  to
    20  read as follows:
    21    (b)  An  institutionalized  spouse shall not be ineligible for medical
    22  assistance by reason of excess resources determined under paragraph  (a)
    23  of  this  subdivision,  if  (i) the institutionalized spouse executes an
    24  assignment of support from the community spouse in favor of  the  social
    25  services district and the department, or the institutionalized spouse is
    26  unable  to execute such assignment due to physical or mental impairment,
    27  [or] and (ii) to deny assistance would  create  an  undue  hardship,  as
    28  defined by the commissioner.
    29    §  52.  Subdivision  6  of  section 369 of the social services law, as
    30  added by chapter 170 of the laws of 1994, is amended to read as follows:
    31    6. For purposes of this section, the term "estate" means all real  and
    32  personal  property  and  other  assets  included within the individual's
    33  estate and passing under the terms of a valid will or by intestacy,  and
    34  all  real  or  personal  property,  tangible or intangible, in which the
    35  individual at the time of his or her  death  had  any  right,  title  or
    36  interest, including any property in which the individual had an interest
    37  as  a joint tenant, joint tenant with right of survivorship, life tenant
    38  or beneficiary of a trust.
    39    § 53. Subdivision 2-a of section 369-ee of the social services law, as
    40  amended by section 26 of part E of chapter 63 of the laws  of  2005,  is
    41  amended to read as follows:
    42    2-a.  Co-payments. Subject to federal approval pursuant to subdivision
    43  six of this section, persons receiving family health plus coverage under
    44  this section shall be responsible to make co-payments in accordance with
    45  the terms of subdivision six of section three hundred  sixty-seven-a  of
    46  this  article,  including  those  individuals who are otherwise exempted
    47  under the provisions of subparagraph (iv) of paragraph (b)  of  subdivi-
    48  sion  six  of  section  three  hundred  sixty-seven-a  of  this article,
    49  provided however, that the limitations in paragraph (f) of such subdivi-
    50  sion shall not apply and  provided  further,  that  notwithstanding  the
    51  provisions of paragraphs (c) and (d) of such subdivision:
    52    (i)  co-payments  charged for each generic prescription drug dispensed
    53  shall be three  dollars  and  for  each  brand  name  prescription  drug
    54  dispensed shall be six dollars;
    55    (ii)  the  co-payment  charged  for each dental service visit shall be
    56  five dollars, provided that no enrollee shall be required  to  pay  more
        S. 6457                            37                            A. 9557

     1  than  twenty-five  dollars  per year in co-payments for dental services;
     2  [and]
     3    (iii)  the co-payment for clinic services and physician services shall
     4  be five dollars;
     5  [and provided further that the limitations  in  paragraph  (f)  of  such
     6  subdivision shall not apply.]
     7    (iv)  the co-payments charged for emergency room services provided for
     8  non-urgent or non-emergency medical care shall be  twenty-five  dollars;
     9  and
    10    (v) notwithstanding the provisions of paragraphs (a) and (g) of subdi-
    11  vision  six  of  section three hundred sixty-seven-a of this article, it
    12  shall not be an  unacceptable  practice  under  the  medical  assistance
    13  program  for  a  provider  to  deny  services  to  a person eligible for
    14  services under this section based on such person's inability  to  pay  a
    15  co-payment amount required by this subdivision.
    16    §  54. Subparagraph (iii) of paragraph (a) of subdivision 2 of section
    17  369-ee of the social services law, as amended by section 28 of part E of
    18  chapter 63 of the laws of 2005, is amended to read as follows:
    19    (iii) does not have equivalent health care coverage under insurance or
    20  equivalent mechanisms, as defined by the  commissioner  in  consultation
    21  with  the  superintendent  of  insurance, is not employed by an employer
    22  with more than one hundred employees, and is not a federal, state, coun-
    23  ty, municipal or school district employee that is  eligible  for  health
    24  care coverage through his or her employer;
    25    §  55.  Subdivision  11 of section 364-j of the social services law is
    26  REPEALED.
    27    § 56. Paragraph (c) of subdivision 3 of section 369-ee of  the  social
    28  services law is REPEALED.
    29    §  57.  Paragraph  b  of  subdivision 4 of section 364-j of the social
    30  services law, as amended by chapter 649 of the laws of 1996, is  amended
    31  to read as follows:
    32    (b) Participants shall select a managed care provider from among those
    33  designated  under the managed care program, provided, however, a partic-
    34  ipant shall be provided with a choice of no less than two  managed  care
    35  providers.    Notwithstanding  the  foregoing,  a  local social services
    36  district designated a rural area as defined  in  42  U.S.C.  1395ww  may
    37  limit  a  participant  to  one  managed  care provider.   A managed care
    38  provider in a rural area shall offer a participant a choice of at  least
    39  three  physicians or case managers and permit the individual to obtain a
    40  service or seek a provider outside of the  managed  care  network  where
    41  such  service  or provider is not available from within the managed care
    42  provider network.
    43    § 58. Paragraph (j) of subdivision 2 of section 365-a  of  the  social
    44  services law is REPEALED.
    45    §  59.  Paragraph  (iii)  of subdivision (g) of section 1 of part C of
    46  chapter 58 of the laws of 2005, amending the public health law and other
    47  laws relating to implementing the state fiscal plan for  the  2005--2006
    48  state fiscal year is amended to read as follows:
    49    (iii)  During each state fiscal year subject to the provisions of this
    50  section, the commissioner shall maintain an accounting, for each  social
    51  services  district, of the net amounts that would have been expended by,
    52  or on behalf of, such district had the social services district  medical
    53  assistance  shares  provisions in effect on January 1, 2005 been applied
    54  to such district.  For purposes of this paragraph, fifty percent of  the
    55  payments  made by New York State to the secretary of the federal depart-
    56  ment of health and human services pursuant to  section  1935(c)  of  the
        S. 6457                            38                            A. 9557

     1  social  security  act  shall  be deemed to be payments made on behalf of
     2  social services districts; such fifty percent share shall be apportioned
     3  to each district in the same ratio as the number of  "full-benefit  dual
     4  eligible  individuals," as that term is defined in section 1935(c)(6) of
     5  such act, for whom such district has fiscal responsibility  pursuant  to
     6  section  365  of  the  social services law, relates to the total of such
     7  individuals for whom districts have fiscal responsibility.  As  soon  as
     8  practicable  after  the  conclusion  of each such fiscal year, but in no
     9  event later than six months after the conclusion  of  each  such  fiscal
    10  year, the commissioner shall reconcile such net amounts with such fiscal
    11  year's  social  services district expenditure cap amount. Such reconcil-
    12  iation shall be based on actual expenditures made by  or  on  behalf  of
    13  social  services  districts,  and  revenues  received by social services
    14  districts, during such fiscal year and shall be made without  regard  to
    15  expenditures  made, and revenues received, outside such fiscal year that
    16  are related to services provided during, or prior to, such fiscal  year.
    17  The  commissioner shall pay to each social services district the amount,
    18  if any, by which such district's expenditure cap amount exceeds such net
    19  amount.
    20    § 60. Subdivision (a) of section 1 of part C of chapter 58 of the laws
    21  of 2005, amending the public health  law  and  other  laws  relating  to
    22  implementing  the state fiscal plan for the 2005-2006 state fiscal year,
    23  as amended by chapter 161 of the laws of 2005, is  amended  to  read  as
    24  follows:
    25    (a)  Notwithstanding  the  provisions  of  section 368-a of the social
    26  services law, or any other provision of law, the  department  of  health
    27  shall  provide  reimbursement  for  expenditures made by or on behalf of
    28  social services districts for medical assistance for needy persons,  and
    29  the  administration  thereof,  in accordance with the provisions of this
    30  section; provided, however, that this section shall not apply to amounts
    31  expended for health care services under section  369-ee  of  the  social
    32  services law, which amounts shall be reimbursed in accordance with para-
    33  graph  (t)  of  subdivision  1 of section 368-a of such law and shall be
    34  excluded from all  calculations  made  pursuant  to  this  section;  and
    35  provided  further  that amounts paid to the public hospitals pursuant to
    36  subdivision 14-f of section 2807-c of the public health law and  amounts
    37  expended  pursuant  to:  subdivision  12  of  section 2808 of the public
    38  health law; sections 211 and 212 of chapter 474 of the laws of 1996,  as
    39  amended;  and sections 11 through 14 of part A and sections 13 and 14 of
    40  part B of chapter 1 of the laws of 2002,  shall  be  excluded  from  all
    41  calculations made pursuant to this section.
    42    §  61.  Any  payments  made  on  and after January 1, 2006: (i) by the
    43  department of health to a social services district for  the  purpose  of
    44  providing  such  district  with  reimbursement  for  medical  assistance
    45  district share  overpayments  caused  by  miscategorization  of  persons
    46  described in subdivision 5 of section 365 of the social services law, or
    47  (ii)  by  a social services district to the department of health for the
    48  purpose of providing  the  department  with  reimbursement  for  medical
    49  assistance  district  share underpayments caused by miscategorization of
    50  such persons, shall not be governed by the provisions of  section  1  of
    51  Part  C  of  chapter 58 of the laws of 2005; provided, however, that any
    52  portion of such payments that are made on or before  June  1,  2006  and
    53  that  are  attributable  to  shares adjustments for expenditures made in
    54  calendar year 2005 shall  be  included  in  the  base  year  calculation
    55  required by subdivision (b) of such section 1.
        S. 6457                            39                            A. 9557

     1    §  62. Paragraph (e-1) of subdivision 12 of section 2808 of the public
     2  health law, as added by section 39 of part C of chapter 58 of  the  laws
     3  of 2005, is amended to read as follows:
     4    (e-1) 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, the county of
    11  Westchester and the county of Erie,  but  excluding  public  residential
    12  health care facilities operated by a town or city within a county, in an
    13  aggregate  amount  of  up  to one hundred fifty million dollars in addi-
    14  tional payments for state fiscal [year] years beginning April first, two
    15  thousand five. The amount allocated to each eligible public  residential
    16  health  care  facility  for  this period shall be computed in accordance
    17  with the provisions of paragraph  (f)  of  this  subdivision,  provided,
    18  however,  that  patient  days  shall  be  utilized  for such computation
    19  reflecting actual reported data for two thousand three and  each  repre-
    20  sentative succeeding year as applicable.
    21    §  63. Section 461-b of the social services law is amended by adding a
    22  new subdivision 9 to read as follows:
    23    9. No operator of an adult care facility, assisted living  program  or
    24  assisted  living  residence that is licensed pursuant to this article or
    25  article 46-b of the public health law  shall,  directly  or  indirectly,
    26  make  any  charitable  contribution  of state monies, medical assistance
    27  payments or social security  or  supplemental  security  income  or  any
    28  interest  or other income earned thereon, except as expressly authorized
    29  by the commissioner; provided, however, the provisions of this  subdivi-
    30  sion  shall  not  apply to receipts or donations from private or non-go-
    31  vernmental sources and any interest or other income earned thereon.
    32    § 64. Section 15 of chapter 66 of  the  laws  of  1994,  amending  the
    33  public  health  law,  the  general  municipal  law and the insurance law
    34  relating to the financing of life care communities, as amended by  chap-
    35  ter 659 of the laws of 1997, is amended to read as follows:
    36    §  15.  This act shall take effect immediately, provided, however that
    37  the amendment made to subdivision 4 of section 854 of the general munic-
    38  ipal law by section eight of this act shall not affect the reversion  of
    39  such  subdivision as provided by section 5 of chapter 905 of the laws of
    40  1986, as amended and that where the [life care] continuing care  retire-
    41  ment  community  council is authorized to promulgate regulations by this
    42  act, it is hereby authorized to implement the provisions of this act  in
    43  advance  of  such  regulations[; and provided further that sections one,
    44  three, seven, eight, nine, ten, eleven, twelve and thirteen of this act,
    45  and paragraph m of subdivision 2 of section 4602 of  the  public  health
    46  law, as added by section two of this act, shall apply only to applicants
    47  for  a  certificate  of  authority  pursuant to article 46 of the public
    48  health law that have been approved to receive  and  have  received  such
    49  certificate of authority on or before July 1, 2005].
    50    § 65. Section 364-j of the social services law, is amended by adding a
    51  new subdivision 22 to read as follows:
    52    22.  (a)  As  a  means of protecting the health, safety and welfare of
    53  recipients, in addition to any other sanctions that may be imposed,  the
    54  commissioner  shall  appoint  temporary  management  of  a  managed care
    55  provider upon determining that the managed care provider has  repeatedly
    56  failed to meet the substantive requirements of sections 1903(m) and 1932
        S. 6457                            40                            A. 9557

     1  of  the federal Social Security Act and regulations. A hearing shall not
     2  be required prior to the appointment of temporary management.
     3    (b)  The  commissioner and/or his or her designees, which may be indi-
     4  viduals within the department or  other  individuals  or  entities  with
     5  appropriate  knowledge  and  experience,  may  be appointed as temporary
     6  management. The commissioner may appoint the superintendent of insurance
     7  and/or his or her designees as temporary management of any managed  care
     8  provider  which  is subject to rehabilitation pursuant to article seven-
     9  ty-four of the insurance law.
    10    (c) The responsibilities of temporary management shall  include  over-
    11  sight of the managed care provider for the purpose of removing the caus-
    12  es  and  conditions  which  led to the determination requiring temporary
    13  management, the imposition of improvements  to  remedy  violations  and,
    14  where  necessary, the orderly reorganization, termination or liquidation
    15  of the managed care provider.
    16    (d) Temporary management may  hire  and  fire  managed  care  provider
    17  personnel  and  expend  managed  care provider funds in carrying out the
    18  responsibilities imposed pursuant to this subsection, and shall only  be
    19  liable  for  acts  or  omissions that constitute gross, wilful or wanton
    20  negligence.
    21    (e) The commissioner, in consultation  with  the  superintendent  with
    22  respect  to any managed care provider subject to rehabilitation pursuant
    23  to article seventy-four of the insurance  law,  may  make  available  to
    24  temporary  management for the benefit of a managed care provider for the
    25  maintenance of required reserves and deposits monies from such funds  as
    26  are appropriated for such purpose.
    27    (f)   The  commissioner  is  authorized  to  establish  in  regulation
    28  provisions for the payment of fees and expenses from funds  appropriated
    29  for such purpose for non-governmental individuals and entities appointed
    30  as temporary management pursuant to this subdivision.
    31    (g)  The  commissioner may not terminate temporary management prior to
    32  his or her determination that the managed care provider has the capabil-
    33  ity to ensure that the sanctioned behavior will not recur.
    34    (h) During any period of temporary management individuals enrolled  in
    35  the  managed  care  provider  being managed may disenroll without cause.
    36  Upon reaching a determination that requires temporary  management  of  a
    37  managed  care  provider,  the  commissioner  shall  notify all recipient
    38  enrollees of such provider that they may  terminate  enrollment  without
    39  cause during the period of temporary management.
    40    (i)  The  commissioner  may  adopt  and amend rules and regulations to
    41  effectuate the purposes and provisions of this subdivision.
    42    § 66. Subdivision 2 of section 4900  of  the  public  health  law,  as
    43  amended  by  chapter  586  of  the  laws  of 1998, is amended to read as
    44  follows:
    45    2. "Clinical peer reviewer" means for purposes of this article:
    46    (a) [for purposes of title one of this article:
    47    (i) a physician who  possesses  a  current  and  valid  non-restricted
    48  license to practice medicine; or
    49    (ii) a health care professional other than a licensed physician who:
    50    (A)  where  applicable,  possesses  a current and valid non-restricted
    51  license, certificate or  registration  or,  where  no  provision  for  a
    52  license,  certificate  or  registration  exists,  is credentialed by the
    53  national accrediting body appropriate to the profession; and
    54    (B) is in the same profession and same or  similar  specialty  as  the
    55  health  care  provider  who  typically  manages the medical condition or
        S. 6457                            41                            A. 9557

     1  disease or provides the health care service or treatment  under  review;
     2  and
     3    (b) for purposes of title two of this article:
     4    (i)] a physician who:
     5    [(A)]  (i)  possesses  a  current  and valid non-restricted license to
     6  practice medicine;
     7    [(B)] (ii) where applicable, is board certified or board  eligible  in
     8  the  same or similar specialty as the health care provider who typically
     9  manages the medical condition or disease or  provides  the  health  care
    10  service or treatment under appeal;
    11    [(C)] (iii) has been practicing in such area of specialty for a period
    12  of at least five years; and
    13    [(D)] (iv) is knowledgeable about the health care service or treatment
    14  under appeal; or
    15    [(ii)]  (b) a health care professional other than a licensed physician
    16  who:
    17    [(A)] (i) where applicable, possesses a  current  and  valid  non-res-
    18  tricted license, certificate or registration;
    19    [(B)] (ii) where applicable, is credentialed by the national accredit-
    20  ing  body  appropriate to the profession in the same profession and same
    21  or similar specialty as the health care provider who  typically  manages
    22  the  medical condition or disease or provides the health care service or
    23  treatment under appeal;
    24    [(C)] (iii) has been practicing in such area of specialty for a period
    25  of at least five years;
    26    [(D)] (iv) is knowledgeable about the health care service or treatment
    27  under appeal; and
    28    [(E)] (v) where applicable to such health care professional's scope of
    29  practice, is clinically supported by a physician who possesses a current
    30  and valid non-restricted license to practice medicine.
    31    (c) Nothing herein shall be construed to  change  any  statutorily-de-
    32  fined scope of practice.
    33    §  67.  Subparagraph  (v) of paragraph (e) of subdivision 4 of section
    34  364-j of the social services law, as amended by section 14 of part C  of
    35  chapter 58 of the laws of 2004, is amended to read as follows:
    36    (v)  Upon  delivery  of  the  pre-enrollment  information,  the  local
    37  district or the enrollment organization shall certify the  participant's
    38  receipt  of such information. Upon verification that the participant has
    39  received  the  pre-enrollment  education  information,  a  managed  care
    40  provider,  a  local district or the enrollment organization may enroll a
    41  participant into a managed care provider. Managed  care  providers  must
    42  submit enrollment forms to the local department of social services. Upon
    43  enrollment,  participants  will  sign an attestation that they have been
    44  informed that: participants have a choice  of  managed  care  providers;
    45  participants have a choice of primary care practitioners; and, except as
    46  otherwise  provided  in  this  section, including but not limited to the
    47  exceptions listed in subparagraph (iii) of paragraph (a) of this  subdi-
    48  vision, participants must exclusively use their primary care practition-
    49  ers and plan providers. The commissioner of health [or with respect to a
    50  managed  care  plan  serving participants in a city with a population of
    51  over two million, the local department of social services in such city,]
    52  may suspend or curtail enrollment or impose  sanctions  for  failure  to
    53  appropriately notify clients as required in this subparagraph.
    54    § 68. Paragraphs (d), (e) and (f) of subdivision 5 of section 364-j of
    55  the  social services law, as added by section 15 of part C of chapter 58
    56  of the laws of 2004, are amended to read as follows:
        S. 6457                            42                            A. 9557

     1    (d) Notwithstanding any  inconsistent  provision  of  this  title  and
     2  section  one  hundred  sixty-three of the state finance law, the commis-
     3  sioner of health [or the local department of social services in  a  city
     4  with  a  population  of over two million] may contract with managed care
     5  providers  approved  under  paragraph (b) of this subdivision, without a
     6  competitive bid or request for proposal process, to provide coverage for
     7  participants pursuant to this title.
     8    (e) Notwithstanding any  inconsistent  provision  of  this  title  and
     9  section  one  hundred  forty-three  of  the economic development law, no
    10  notice in the procurement opportunities newsletter shall be required for
    11  contracts awarded by the commissioner of health [or the local department
    12  of social services in a city with a population of over two million],  to
    13  qualified managed care providers pursuant to this section.
    14    (f)  The  care  and  services  described  in  subdivision four of this
    15  section will be furnished by a managed care  provider  pursuant  to  the
    16  provisions  of  this section when such services are furnished in accord-
    17  ance with an agreement with the  department  of  health  [or  the  local
    18  department  of  social  services in a city with a population of over two
    19  million], and meet applicable federal law and regulations.
    20    § 69. Subdivisions 2 and 4 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 section 53 of part C of
    23  chapter 58 of the laws of 2005 are amended to read as follows:
    24    2. Sections five, seven through nine,  twelve  through  fourteen,  and
    25  eighteen  of  this  act  shall  be deemed to have been in full force and
    26  effect on and after April 1, 1995 through March  31,  1999  and  on  and
    27  after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
    28  through  March 31, 2003 and on and after April 1, 2003 through March 31,
    29  2006 and on and after April 1, 2006;
    30    4. Section one of this act shall be deemed to have been in full  force
    31  and  effect on and after April 1, 1995 through March 31, 1999 and on and
    32  after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
    33  through March 31, 2003 and on and after April 1, 2003 through March  31,
    34  2006 and on and after April 1, 2006.
    35    §  70. Subparagraph (iii) of paragraph (f) of subdivision 4 of section
    36  2807-c of the public health law, as amended by section 69 of part  C  of
    37  chapter 58 of the laws of 2005, is amended to read as follows:
    38    (iii)  commencing  April  first, nineteen hundred ninety-seven through
    39  March thirty-first, nineteen hundred  ninety-nine  and  commencing  July
    40  first,  nineteen  hundred  ninety-nine  through  March thirty-first, two
    41  thousand and April first, two thousand through March  thirty-first,  two
    42  thousand  five and for periods commencing April first, two thousand five
    43  through March thirty-first, two thousand six and for periods  commencing
    44  on  and  after April first, two thousand six, the reimbursable inpatient
    45  operating cost component of case based rates of payment  per  diagnosis-
    46  related group, excluding any operating cost components related to direct
    47  and indirect expenses of graduate medical education, for patients eligi-
    48  ble for payments made by state governmental agencies shall be reduced by
    49  three  and thirty-three hundredths percent to encourage improved produc-
    50  tivity and efficiency. Such election shall not alter the calculation  of
    51  the  group  price  component  calculated pursuant to subparagraph (i) of
    52  paragraph (a) of subdivision seven of this section;
    53    § 71. Subparagraph (iii) of paragraph (k) of subdivision 4 of  section
    54  2807-c  of  the public health law, as amended by section 70 of part C of
    55  chapter 58 of the laws of 2005, is amended to read as follows:
        S. 6457                            43                            A. 9557

     1    (iii) commencing April first, nineteen  hundred  ninety-seven  through
     2  March  thirty-first,  nineteen  hundred  ninety-nine and commencing July
     3  first, nineteen hundred  ninety-nine  through  March  thirty-first,  two
     4  thousand  and  April first, two thousand through March thirty-first, two
     5  thousand  five  and  commencing  April  first, two thousand five through
     6  March thirty-first, two thousand six, and for periods commencing on  and
     7  after  April  first,  two  thousand six, the operating cost component of
     8  rates of payment, excluding any operating  cost  components  related  to
     9  direct and indirect expenses of graduate medical education, for patients
    10  eligible  for  payments  made  by  a  state governmental agency shall be
    11  reduced by  three  and  thirty-three  hundredths  percent  to  encourage
    12  improved  productivity  and efficiency. The facility will be eligible to
    13  receive the financial incentives for the physician  specialty  weighting
    14  incentive  towards  primary  care pursuant to subparagraph (ii) of para-
    15  graph (a) of subdivision twenty-five of this section.
    16    § 72. The opening paragraph of subparagraph (vi) of paragraph  (b)  of
    17  subdivision  5 of section 2807-c of the public health law, as amended by
    18  section 71 of part C of chapter 58 of the laws of 2005,  is  amended  to
    19  read as follows:
    20    for  discharges on or after April first, nineteen hundred ninety-seven
    21  through  March  thirty-first,  nineteen  hundred  ninety-nine  and   for
    22  discharges  on or after July first, nineteen hundred ninety-nine through
    23  March thirty-first, two thousand and for discharges on  or  after  April
    24  first,  two  thousand  through March thirty-first, two thousand five and
    25  for discharges on or after April first, two thousand five through  March
    26  thirty-first,  two  thousand  six,  and for discharges on or after April
    27  first, two thousand six, for  purposes  of  reimbursement  of  inpatient
    28  hospital  services  for  patients  eligible  for  payments made by state
    29  governmental agencies, the average reimbursable inpatient operating cost
    30  per discharge of a general hospital shall, to encourage improved produc-
    31  tivity and efficiency, be the sum of:
    32    § 73. The opening paragraph and subparagraph (i) of paragraph  (c)  of
    33  subdivision  5 of section 2807-c of the public health law, as amended by
    34  section 72 of part C of chapter 58 of the laws of 2005,  is  amended  to
    35  read as follows:
    36    Notwithstanding any inconsistent provision of this section, commencing
    37  July  first,  nineteen  hundred  ninety-six  through March thirty-first,
    38  nineteen hundred ninety-nine and July first,  nineteen  hundred  ninety-
    39  nine through March thirty-first, two thousand and April first, two thou-
    40  sand  through  March  thirty-first, two thousand five and for periods on
    41  and after April first, two thousand five through March thirty-first, two
    42  thousand six, and for periods on and after  April  first,  two  thousand
    43  six,  rates  of payment for a general hospital for patients eligible for
    44  payments made by state governmental agencies shall be further reduced by
    45  the commissioner to encourage improved productivity  and  efficiency  by
    46  providers by a factor determined as follows:
    47    (i) an aggregate reduction shall be calculated for each general hospi-
    48  tal  commencing  July  first,  nineteen hundred ninety-six through March
    49  thirty-first, nineteen hundred  ninety-nine  and  July  first,  nineteen
    50  hundred  ninety-nine  through March thirty-first, two thousand and April
    51  first, two thousand through March thirty-first, two  thousand  five  and
    52  for  periods  on  and after April first, two thousand five through March
    53  thirty-first, two thousand six, and  for  periods  on  and  after  April
    54  first,  two  thousand  six,  as  the  result  of (A) eighty-nine million
    55  dollars on an annualized basis for each  year,  multiplied  by  (B)  the
    56  ratio  of  patient days for patients eligible for payments made by state
        S. 6457                            44                            A. 9557

     1  governmental agencies provided in a base year two  years  prior  to  the
     2  rate  year  by  a general hospital, divided by the total of such patient
     3  days summed for all general hospitals; and
     4    § 74. Clause (B-1) of subparagraph (i) of paragraph (f) of subdivision
     5  11  of section 2807-c of the public health law, as amended by section 73
     6  of part C of chapter 58 of the laws of  2005,  is  amended  to  read  as
     7  follows:
     8    (B-1)  The  increase  in the statewide average case mix in the periods
     9  January first, nineteen hundred ninety-seven through March thirty-first,
    10  two thousand and on and after April first, two  thousand  through  March
    11  thirty-first,  two  thousand six and on and after April first, two thou-
    12  sand six, from the statewide average case mix  for  the  period  January
    13  first,  nineteen hundred ninety-six through December thirty-first, nine-
    14  teen hundred ninety-six  shall  not  exceed  one  percent  for  nineteen
    15  hundred  ninety-seven,  two  percent  for nineteen hundred ninety-eight,
    16  three percent for the period January first, nineteen hundred ninety-nine
    17  through September thirtieth, nineteen hundred ninety-nine, four  percent
    18  for  the  period  October  first,  nineteen  hundred ninety-nine through
    19  December thirty-first, nineteen hundred ninety-nine,  and  four  percent
    20  for  two  thousand  plus  an additional one percent per year thereafter,
    21  based on comparison of data only for  patients  that  are  eligible  for
    22  medical  assistance  pursuant  to  title  eleven  of article five of the
    23  social services law, including such patients enrolled in health  mainte-
    24  nance organizations.
    25    §  75.  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 section 74 of part C of chapter 58 of the laws of
    28  2005, is amended to read 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, 2005 and on and after April
    38  1,  2005  through March [thirty-first, two thousand six] 31, 2006 and on
    39  and after April 1, 2006, shall reflect no trend  factor  projections  or
    40  adjustments for the period April 1, 1996, through March 31, 1997.
    41    § 76. Section 4 of chapter 81 of the laws of 1995, amending the public
    42  health  law and other laws relating to medical reimbursement and welfare
    43  reform, as amended by section 54 of part C of chapter 58 of the laws  of
    44  2005, is amended to read as follows:
    45    §  4. Notwithstanding any inconsistent provision of law, except subdi-
    46  vision 15 of section 2807 of the public health law and  section  364-j-2
    47  of  the social services law and section 32-g of part F of chapter 412 of
    48  the laws of 1999, rates of payment for diagnostic and treatment  centers
    49  established  in  accordance with paragraphs (b) and (h) of subdivision 2
    50  of section 2807 of the public health law for the period ending September
    51  30, 1995 shall continue in effect through September 30, 2000 and for the
    52  periods October 1, 2000 through September 30, 2003 and October  1,  2003
    53  through September 30, 2006 and on and after October 1, 2006, and further
    54  provided  that  rates  in  effect  on  March  31, 2003 as established in
    55  accordance with paragraph (e) of subdivision 2 of section  2807  of  the
    56  public  health law shall continue in effect for the period April 1, 2003
        S. 6457                            45                            A. 9557

     1  through September 30, 2006 and on and after October  1,  2006,  provided
     2  however  that,  subject  to  the approval of the director of the budget,
     3  such rates may be adjusted to include expenditures in  those  components
     4  of rates not subject to the ceilings of the corresponding rate methodol-
     5  ogy.
     6    §  77. Subdivision 5 of section 246 of chapter 81 of the laws of 1995,
     7  amending the public health  law  and  other  laws  relating  to  medical
     8  reimbursement  and welfare reform, as amended by section 55 of part C of
     9  chapter 58 of the laws of 2005, is amended to read as follows:
    10    5. Section three of this act shall be deemed  to  have  been  in  full
    11  force  and  effect on and after April 1, 1995 through March 31, 1999 and
    12  on and after July 1, 1999 through March 31, 2000 and on and after  April
    13  1,  2000  through  March 31, 2003 and on and after April 1, 2003 through
    14  March 31, 2006 and on and after April 1, 2006;
    15    § 78. Section 194 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 section 56 of part C of chapter 58 of the
    18  laws of 2005, is amended to read as follows:
    19    § 194. 1. Notwithstanding any inconsistent provision of law  or  regu-
    20  lation,  the  trend factors used to project reimbursable operating costs
    21  to the rate period for purposes of determining rates of payment pursuant
    22  to article 28 of the public  health  law  for  residential  health  care
    23  facilities  for reimbursement of inpatient services provided to patients
    24  eligible for payments made by state governmental agencies on  and  after
    25  April  1, 1996 through March 31, 1999 and for payments made on and after
    26  July 1, 1999 through March 31, 2000 and  on  and  after  April  1,  2000
    27  through  March 31, 2003 and on and after April 1, 2003 through March 31,
    28  2006 and on and after April  1,  2006  shall  reflect  no  trend  factor
    29  projections  or  adjustments for the period April 1, 1996, through March
    30  31, 1997.
    31    2. The commissioner of health shall adjust such rates  of  payment  to
    32  reflect  the  exclusion pursuant to this section of such specified trend
    33  factor projections or adjustments.
    34    § 79. The opening paragraph and paragraph (a)  of  subdivision  16  of
    35  section  2808 of the public health law, as amended by section 57 of part
    36  C of chapter 58 of the laws of 2005, are amended to read as follows:
    37    Notwithstanding any inconsistent provision of law or regulation to the
    38  contrary, residential health care facility rates of  payment  determined
    39  pursuant to this article for governmental agencies for services provided
    40  on or after April first, nineteen hundred ninety-six through March thir-
    41  ty-first, nineteen hundred ninety-nine and on or after July first, nine-
    42  teen hundred ninety-nine through March thirty-first, two thousand and on
    43  and  after  April  first,  two  thousand through March thirty-first, two
    44  thousand three and on and after April first, two thousand three  through
    45  March  thirty-first,  two thousand six and on and after April first, two
    46  thousand six, shall be further reduced by the commissioner to  encourage
    47  improved productivity and efficiency by providers by a factor determined
    48  as follows:
    49    (a)  an  aggregate  reduction shall be calculated for each residential
    50  health care facility commencing April first, nineteen hundred ninety-six
    51  through March thirty-first, nineteen hundred ninety-nine and on or after
    52  July first, nineteen hundred ninety-nine through March thirty-first, two
    53  thousand and on and after April first, two thousand through March  thir-
    54  ty-first,  two thousand three and on and after April first, two thousand
    55  three through March thirty-first, two thousand  six  and  on  and  after
    56  April  first,  two  thousand  six as the result of (i) fifty-six million
        S. 6457                            46                            A. 9557

     1  dollars on an annualized basis multiplied by (ii) the ratio  of  patient
     2  days  for  patients  eligible for payments made by governmental agencies
     3  provided in a base year two years prior to the rate year by  a  residen-
     4  tial  health care facility, or for residential health care facility beds
     5  not fully in operation in such base year by  an  estimate  of  projected
     6  utilization for the rate year, divided by the total of such patient days
     7  summed for all residential health care facilities; and
     8    §  80.  Paragraph  (a) of subdivision 14 of section 2808 of the public
     9  health law, as amended by section 58 of part C of chapter 58 of the laws
    10  of 2005, is amended to read as follows:
    11    (a) Notwithstanding any inconsistent provision of law or regulation to
    12  the contrary, for purposes of establishing rates of payment  by  govern-
    13  mental  agencies  for  residential  health  care facilities for services
    14  provided on or after April first, nineteen hundred  ninety-five  through
    15  March  thirty-first,  nineteen  hundred  ninety-nine  and  for  services
    16  provided on or after July first, nineteen  hundred  ninety-nine  through
    17  March thirty-first, two thousand and on and after April first, two thou-
    18  sand  through  March  thirty-first,  two thousand three and on and after
    19  April first, two thousand three through March thirty-first, two thousand
    20  six and on and after April first, two  thousand  six,  the  reimbursable
    21  base  year administrative services and fiscal services costs, as defined
    22  in the New York state residential health care  facility  accounting  and
    23  reporting  manual,  of  a  residential health care facility, excluding a
    24  provider of services reimbursed  on  an  initial  budget  basis,  shall,
    25  except  as otherwise provided in this subdivision, not exceed the state-
    26  wide average of total reimbursable base year administrative  and  fiscal
    27  services  costs  of residential health care facilities. For the purposes
    28  of this subdivision, reimbursable base year  administrative  and  fiscal
    29  services  costs  shall  mean  those  base year administrative and fiscal
    30  services costs remaining after application of all other efficiency stan-
    31  dards, including but not limited to, peer group cost ceilings or  guide-
    32  lines.
    33    §  81.  Paragraph  (b) of subdivision 14 of section 2808 of the public
    34  health law, as amended by section 59 of part C of chapter 58 of the laws
    35  of 2005, is amended to read as follows:
    36    (b) A separate statewide  average  of  total  reimbursable  base  year
    37  administrative and fiscal services costs shall be determined for each of
    38  those  facilities  wherein  eighty  percent  or more of its patients are
    39  classified with a patient acuity equal to or less than .83 which is used
    40  as the basis for a facility's case mix adjustment. For the  period  July
    41  first,  two  thousand  through March thirty-first, two thousand one, the
    42  total reimbursable base year administrative and fiscal services costs of
    43  such facilities shall not exceed such separate  statewide  average  plus
    44  one  and  one-half  percentage  points.  For  annual  periods thereafter
    45  [through March thirty-first, two thousand six], the  total  reimbursable
    46  base  year  administrative  and fiscal services costs of such facilities
    47  shall not exceed such separate statewide average. In no event shall  the
    48  calculation of such separate statewide average result in a change in the
    49  statewide average determined under paragraph (a) of this subdivision.
    50    §  82.  Paragraph  (f) of subdivision 1 of section 64 of chapter 81 of
    51  the laws of 1995, amending the public health law and other laws relating
    52  to medical reimbursement and welfare reform, as amended by section 60 of
    53  part C of chapter 58 of the laws of 2005, is amended to read as follows:
    54    (f) Prior to February 1, 2001, February 1,  2002,  February  1,  2003,
    55  February 1, 2004, February 1, 2005 [and], February 1, 2006, and February
    56  1  of  each  year thereafter, the commissioner of health shall calculate
        S. 6457                            47                            A. 9557

     1  the result of the statewide total of residential  health  care  facility
     2  days  of  care  provided  to beneficiaries of title XVIII of the federal
     3  social security act (medicare), divided by the sum of such days of  care
     4  plus  days  of care provided to residents eligible for payments pursuant
     5  to title 11 of article 5 of the social services law minus the number  of
     6  days  provided  to  residents  receiving  hospice  care,  expressed as a
     7  percentage, for the period commencing January 1, through November 30, of
     8  the prior year respectively, based on such data for  such  period.  This
     9  value  shall  be  called the 2000, 2001, 2002, 2003, 2004, 2005 and 2006
    10  each year thereafter statewide target percentage respectively.
    11    § 83. Subparagraph (ii) of paragraph (b) of subdivision 3  of  section
    12  64 of chapter 81 of the laws of 1995, amending the public health law and
    13  other  laws  relating  to  medical  reimbursement and welfare reform, as
    14  amended by section 61 of part C of chapter 58 of the laws  of  2005,  is
    15  amended to read as follows:
    16    (ii)  If  the  1997,  1998,  2000, 2001, 2002, 2003, 2004, 2005, [and]
    17  2006, and each year thereafter statewide target percentages are not  for
    18  each  year  at  least  three percentage points higher than the statewide
    19  base percentage, the commissioner of health shall determine the percent-
    20  age by which the statewide target percentage for each  year  is  not  at
    21  least three percentage points higher than the statewide base percentage.
    22  The percentage calculated pursuant to this paragraph shall be called the
    23  1997,  1998,  2000,  2001,  2002, 2003, 2004, 2005, [and] 2006, and each
    24  year thereafter statewide  reduction  percentage  respectively.  If  the
    25  1997,  1998,  2000,  2001,  2002, 2003, 2004, 2005, [and] 2006, and each
    26  year thereafter statewide target percentage for the respective  year  is
    27  at least three percentage points higher than the statewide base percent-
    28  age, the statewide reduction percentage for the respective year shall be
    29  zero.
    30    §  84. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
    31  64 of chapter 81 of the laws of 1995, amending the public health law and
    32  other laws relating to medical  reimbursement  and  welfare  reform,  as
    33  amended  by  section  62 of part C of chapter 58 of the laws of 2005, is
    34  amended to read as follows:
    35    (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005,  [and]  2006,  and
    36  each  year thereafter statewide reduction percentage shall be multiplied
    37  by one hundred two million dollars respectively to determine  the  1998,
    38  2000, 2001, 2002, 2003, 2004, 2005, [and] 2006, and each year thereafter
    39  statewide  aggregate  reduction  amount. If the 1998 and the 2000, 2001,
    40  2002, 2003, 2004, 2005, [and] 2006, and each year  thereafter  statewide
    41  reduction percentage shall be zero respectively, there shall be no 1998,
    42  2000, 2001, 2002, 2003, 2004, 2005, [and] 2006, and each year thereafter
    43  reduction amount.
    44    §  85.  Paragraph  (b) of subdivision 5 of section 64 of chapter 81 of
    45  the laws of 1995, amending the public health law and other laws relating
    46  to medical reimbursement and welfare reform, as amended by section 63 of
    47  part C of chapter 58 of the laws of 2005, is amended to read as follows:
    48    (b) The 1996, 1997, 1998, 1999, 2000, 2001, 2002,  2003,  2004,  2005,
    49  [and]  2006,  and  each  year  thereafter  statewide aggregate reduction
    50  amounts shall for each year be allocated by the commissioner  of  health
    51  among  residential  health  care facilities that are eligible to provide
    52  services to beneficiaries of title XVIII of the federal social  security
    53  act  (medicare) and residents eligible for payments pursuant to title 11
    54  of article 5 of the social services law on the basis of  the  extent  of
    55  each  facility's  failure to achieve a two percentage points increase in
    56  the 1996 target percentage, a three percentage  point  increase  in  the
        S. 6457                            48                            A. 9557

     1  1997,  1998,  2000,  2001,  2002, 2003, 2004, 2005, [and] 2006, and each
     2  year thereafter target percentage and a two and  one-quarter  percentage
     3  point  increase in the 1999 target percentage for each year, compared to
     4  the  base  percentage,  calculated on a facility specific basis for this
     5  purpose, compared to the statewide total of the extent of  each  facili-
     6  ty's failure to achieve a two percentage points increase in the 1996 and
     7  a  three  percentage  point  increase in the 1997 and a three percentage
     8  point increase in the 1998 and a two and  one-quarter  percentage  point
     9  increase  in  the  1999  target  percentage and a three percentage point
    10  increase in the 2000, 2001, 2002, 2003, 2004, 2005, [and] 2006, and each
    11  year thereafter target percentage compared to the base percentage. These
    12  amounts shall be called the 1996, 1997, 1998, 1999,  2000,  2001,  2002,
    13  2003, 2004, 2005, [and] 2006, and each year thereafter facility specific
    14  reduction amounts respectively.
    15    § 86. Notwithstanding any inconsistent provision of law, rule or regu-
    16  lation,  the  annual  percentage  reductions  set  forth  in sections 82
    17  through 85 and section 88 of this act shall be prorated by  the  commis-
    18  sioner of health for the period April 1, 2006 through March 31, 2007 and
    19  each respective year thereafter.
    20    §  87.  Section  3  of  chapter  483 of the laws of 1978, amending the
    21  public health law relating to  rate  of  payment  for  each  residential
    22  health care facility to real property costs, as amended by section 75 of
    23  part C of chapter 58 of the laws of 2005, is amended to read as follows:
    24    §  3.  This  act shall take effect immediately provided, however, that
    25  the provisions of subdivision 2-a of section 2808 of the  public  health
    26  law, as added by section one of this act, shall remain in full force and
    27  effect until December 31, 2006 and on and after January 1, 2007.
    28    §  88.  Section  228  of chapter 474 of the laws of 1996, amending the
    29  education law and other laws relating to rates for  residential  health-
    30  care facilities, as amended by section 66 of part C of chapter 58 of the
    31  laws of 2005, is amended to read as follows:
    32    §  228.  1.  Definitions.  (a)  Regions, for purposes of this section,
    33  shall mean a downstate region to consist of Kings, New  York,  Richmond,
    34  Queens,  Bronx,  Nassau  and  Suffolk  counties and an upstate region to
    35  consist of all other New York state counties. A  certified  home  health
    36  agency  or  long  term  home health care program shall be located in the
    37  same county utilized by the commissioner of health for the establishment
    38  of rates pursuant to article 36 of the public health law.
    39    (b) Certified home health  agency  (CHHA)  shall  mean  such  term  as
    40  defined in section 3602 of the public health law.
    41    (c)  Long  term home health care program (LTHHCP) shall mean such term
    42  as defined in subdivision 8 of section 3602 of the public health law.
    43    (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
    44  ly, located within a region.
    45    (e) Medicaid revenue percentage, for purposes of this  section,  shall
    46  mean  CHHA  and  LTHHCP  revenues  attributable  to services provided to
    47  persons eligible for payments pursuant to title 11 of article 5  of  the
    48  social services law divided by such revenues plus CHHA and LTHHCP reven-
    49  ues attributable to services provided to beneficiaries of Title XVIII of
    50  the federal social security act (medicare).
    51    (f)  Base  period,  for  purposes of this section, shall mean calendar
    52  year 1995.
    53    (g) Target period. For purposes of this section, the 1996 target peri-
    54  od shall mean August 1, 1996 through March 31,  1997,  the  1997  target
    55  period  shall  mean  January 1, 1997 through November 30, 1997, the 1998
    56  target period shall mean January 1, 1998 through November 30, 1998,  the
        S. 6457                            49                            A. 9557

     1  1999 target period shall mean January 1, 1999 through November 30, 1999,
     2  the  2000  target period shall mean January 1, 2000 through November 30,
     3  2000, the 2001 target period shall mean January 1, 2001 through November
     4  30,  2001,  the  2002  target  period shall mean January 1, 2002 through
     5  November 30, 2002, the 2003 target period shall  mean  January  1,  2003
     6  through  November 30, 2003, the 2004 target period shall mean January 1,
     7  2004 through November 30, 2004, and the 2005 target  period  shall  mean
     8  January 1, 2005 through November 30, [2006] 2005, the 2006 target period
     9  shall  mean  January  1,  2006  through November 30, 2006, and each year
    10  thereafter the target period shall be January 1 through November 30, for
    11  that respective year.
    12    2. (a) Prior to February 1, 1997, for each regional group the  commis-
    13  sioner  of  health shall calculate the 1996 medicaid revenue percentages
    14  for the period commencing August 1, 1996 to the last date for which such
    15  data is available and reasonably accurate.
    16    (b) Prior to February 1, 1998, prior to February  1,  1999,  prior  to
    17  February  1, 2000, prior to February 1, 2001, prior to February 1, 2002,
    18  prior to February 1, 2003, prior to February 1, 2004, prior to  February
    19  1, 2005, prior to February 1, 2006, and prior to February 1 of each year
    20  thereafter  for  each  regional  group  the commissioner of health shall
    21  calculate the prior year's medicaid revenue percentages for  the  period
    22  commencing January 1 through November 30 of such prior year.
    23    3.  By September 15, 1996, for each regional group the commissioner of
    24  health shall calculate the base period medicaid revenue percentage.
    25    4. (a) For each regional  group,  the  1996  target  medicaid  revenue
    26  percentage  shall be calculated by subtracting the 1996 medicaid revenue
    27  reduction percentages from the base period medicaid revenue percentages.
    28  The 1996 medicaid revenue  reduction  percentage,  taking  into  account
    29  regional and program differences in utilization of medicaid and medicare
    30  services, for the following regional groups shall be equal to:
    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    (b)  For  1997,  1998, 2000, 2001, 2002, 2003, 2004, 2005 [and], 2006,
    40  and each year thereafter for each regional group,  the  target  medicaid
    41  revenue  percentage  for  the  respective  year  shall  be calculated by
    42  subtracting the respective year's medicaid revenue reduction  percentage
    43  from  the  base period medicaid revenue percentage. The medicaid revenue
    44  reduction percentages for 1997, 1998,  2000,  2001,  2002,  2003,  2004,
    45  2005,  [and] 2006, and each year thereafter taking into account regional
    46  and  program  differences  in  utilization  of  medicaid  and   medicare
    47  services,  for  the following regional groups shall be equal to for each
    48  such year:
    49    (i) one and one-tenth percentage points for CHHAs located  within  the
    50  downstate region;
    51    (ii)  six-tenths  of one percentage point for CHHAs located within the
    52  upstate region;
    53    (iii) one and eight-tenths percentage points for LTHHCPs located with-
    54  in the downstate region; and
    55    (iv) one and seven-tenths percentage points for LTHHCPs located within
    56  the upstate region.
        S. 6457                            50                            A. 9557

     1    (c) For each regional group, the 1999 target medicaid revenue percent-
     2  age shall  be  calculated  by  subtracting  the  1999  medicaid  revenue
     3  reduction  percentage  from the base period medicaid revenue percentage.
     4  The 1999 medicaid revenue reduction  percentages,  taking  into  account
     5  regional and program differences in utilization of medicaid and medicare
     6  services, for the following regional groups shall be equal to:
     7    (i)  eight  hundred  twenty-five  thousandths (.825) of one percentage
     8  point for CHHAs located within the downstate region;
     9    (ii) forty-five hundredths (.45) of one  percentage  point  for  CHHAs
    10  located within the upstate region;
    11    (iii)  one  and  thirty-five  hundredths  percentage points (1.35) for
    12  LTHHCPs located within the downstate region; and
    13    (iv) one and two hundred seventy-five  thousandths  percentage  points
    14  (1.275) for LTHHCPs located within the upstate region.
    15    5.  (a) For each regional group, if the 1996 medicaid revenue percent-
    16  age is not equal to or  less  than  the  1996  target  medicaid  revenue
    17  percentage,  the  commissioner of health shall compare the 1996 medicaid
    18  revenue percentage to the 1996 target  medicaid  revenue  percentage  to
    19  determine  the  amount  of the shortfall which, when divided by the 1996
    20  medicaid  revenue  reduction  percentage,  shall  be  called  the   1996
    21  reduction  factor.  These  amounts, expressed as a percentage, shall not
    22  exceed one hundred percent. If the 1996 medicaid revenue  percentage  is
    23  equal  to  or less than the 1996 target medicaid revenue percentage, the
    24  1996 reduction factor shall be zero.
    25    (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003,  2004,  2005  [and],
    26  2006,  and each year thereafter for each regional group, if the medicaid
    27  revenue percentage for the respective year is not equal to or less  than
    28  the  target  medicaid  revenue  percentage for such respective year, the
    29  commissioner of health shall compare  such  respective  year's  medicaid
    30  revenue  percentage  to  such  respective year's target medicaid revenue
    31  percentage to determine the amount of the shortfall which, when  divided
    32  by the respective year's medicaid revenue reduction percentage, shall be
    33  called  the  reduction  factor  for such respective year. These amounts,
    34  expressed as a percentage, shall not exceed one hundred percent. If  the
    35  medicaid  revenue  percentage  for a particular year is equal to or less
    36  than the target medicaid revenue percentage for that year, the reduction
    37  factor for that year shall be zero.
    38    6. (a) For each regional group, the 1996  reduction  factor  shall  be
    39  multiplied  by  the following amounts to determine each regional group's
    40  applicable 1996 state share reduction amount:
    41    (i) two million three hundred ninety thousand dollars ($2,390,000) for
    42  CHHAs located within the downstate region;
    43    (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
    44  within the upstate region;
    45    (iii) one million two hundred seventy  thousand  dollars  ($1,270,000)
    46  for LTHHCPs located within the downstate region; and
    47    (iv)  five  hundred  ninety  thousand  dollars  ($590,000) for LTHHCPs
    48  located within the upstate region.
    49    For each regional group reduction, if the 1996 reduction factor  shall
    50  be zero, there shall be no 1996 state share reduction amount.
    51    (b)  For  1997,  1998, 2000, 2001, 2002, 2003, 2004, 2005 [and], 2006,
    52  and each year thereafter for each regional group, the  reduction  factor
    53  for  the respective year shall be multiplied by the following amounts to
    54  determine each regional group's applicable state share reduction  amount
    55  for such respective year:
        S. 6457                            51                            A. 9557

     1    (i) two million three hundred ninety thousand dollars ($2,390,000) for
     2  CHHAs located within the downstate region;
     3    (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
     4  within the upstate region;
     5    (iii)  one  million  two hundred seventy thousand dollars ($1,270,000)
     6  for LTHHCPs located within the downstate region; and
     7    (iv) five hundred  ninety  thousand  dollars  ($590,000)  for  LTHHCPs
     8  located within the upstate region.
     9    For  each  regional  group  reduction,  if  the reduction factor for a
    10  particular year shall be zero, there shall be no state  share  reduction
    11  amount for such year.
    12    (c) For each regional group, the 1999 reduction factor shall be multi-
    13  plied by the following amounts to determine each regional group's appli-
    14  cable 1999 state share reduction amount:
    15    (i) one million seven hundred ninety-two thousand five hundred dollars
    16  ($1,792,500) for CHHAs located within the downstate region;
    17    (ii)  five  hundred sixty-two thousand five hundred dollars ($562,500)
    18  for CHHAs located within the upstate region;
    19    (iii) nine hundred fifty-two thousand five hundred dollars  ($952,500)
    20  for LTHHCPs located within the downstate region; and
    21    (iv)  four  hundred forty-two thousand five hundred dollars ($442,500)
    22  for LTHHCPs located within the upstate region.
    23    For each regional group reduction, if the 1999 reduction factor  shall
    24  be zero, there shall be no 1999 state share reduction amount.
    25    7.  (a) For each regional group, the 1996 state share reduction amount
    26  shall be allocated by the commissioner of health among CHHAs and LTHHCPs
    27  on the basis of the extent  of  each  CHHA's  and  LTHHCP's  failure  to
    28  achieve  the  1996  target  medicaid revenue percentage, calculated on a
    29  provider specific basis utilizing revenues for this  purpose,  expressed
    30  as  a  proportion  of  the  total of each CHHA's and LTHHCP's failure to
    31  achieve the 1996 target medicaid revenue percentage within the  applica-
    32  ble  regional group. This proportion shall be multiplied by the applica-
    33  ble 1996 state share reduction amount calculation pursuant to  paragraph
    34  (a)  of  subdivision  6 of this section. This amount shall be called the
    35  1996 provider specific state share reduction amount.
    36    (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003,  2004,  2005  [and],
    37  2006,  and each year thereafter for each regional group, the state share
    38  reduction amount for the respective  year  shall  be  allocated  by  the
    39  commissioner  of  health  among  CHHAs  and  LTHHCPs on the basis of the
    40  extent of each CHHA's and LTHHCP's failure to achieve the  target  medi-
    41  caid revenue percentage for the applicable year, calculated on a provid-
    42  er  specific  basis  utilizing revenues for this purpose, expressed as a
    43  proportion of the total of each CHHA's and LTHHCP's failure  to  achieve
    44  the  target  medicaid  revenue percentage for the applicable year within
    45  the applicable regional group. This proportion shall  be  multiplied  by
    46  the  applicable year's state share reduction amount calculation pursuant
    47  to paragraph (b) or (c) of subdivision 6 of this  section.  This  amount
    48  shall  be  called the provider specific state share reduction amount for
    49  the applicable year.
    50    8. (a) The 1996 provider specific state share reduction  amount  shall
    51  be due to the state from each CHHA and LTHHCP and may be recouped by the
    52  state  by  March  31, 1997 in a lump sum amount or amounts from payments
    53  due to the CHHA and LTHHCP pursuant to title 11  of  article  5  of  the
    54  social services law.
    55    (b) The provider specific state share reduction amount for 1997, 1998,
    56  1999,  2000,  2001,  2002,  2003,  2004, 2005 [and], 2006, and each year
        S. 6457                            52                            A. 9557

     1  thereafter respectively, shall be due to the state from  each  CHHA  and
     2  LTHHCP and each year the amount due for such year may be recouped by the
     3  state  by March 31 of the following year in a lump sum amount or amounts
     4  from payments due to the CHHA and LTHHCP pursuant to title 11 of article
     5  5 of the social services law.
     6    9.  CHHAs  and  LTHHCPs shall submit such data and information at such
     7  times as the commissioner of health may require  for  purposes  of  this
     8  section.  The  commissioner of health may use data available from third-
     9  party payors.
    10    10. On or about June 1, 1997, for each regional group the commissioner
    11  of health shall calculate for the period August 1,  1996  through  March
    12  31,  1997  a  medicaid  revenue  percentage, a reduction factor, a state
    13  share reduction amount, and a provider specific  state  share  reduction
    14  amount  in  accordance with the methodology provided in paragraph (a) of
    15  subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
    16  sion 6 and paragraph (a) of subdivision 7 of this section. The  provider
    17  specific state share reduction amount calculated in accordance with this
    18  subdivision  shall be compared to the 1996 provider specific state share
    19  reduction amount calculated in accordance with paragraph (a) of subdivi-
    20  sion 7 of this section. Any amount in excess of the amount determined in
    21  accordance with paragraph (a) of subdivision 7 of this section shall  be
    22  due  to  the  state  from  each  CHHA  and LTHHCP and may be recouped in
    23  accordance with paragraph (a) of subdivision 8 of this section.  If  the
    24  amount  is  less than the amount determined in accordance with paragraph
    25  (a) of subdivision 7 of this section, the difference shall  be  refunded
    26  to  the  CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
    27  and LTHHCPs shall submit data for the  period  August  1,  1996  through
    28  March 31, 1997 to the commissioner of health by April 15, 1997.
    29    11.  If  a  CHHA  or  LTHHCP  fails  to submit data and information as
    30  required for purposes of this section:
    31    (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
    32  caid revenue percentage between  the  applicable  base  period  and  the
    33  applicable  target  period  for purposes of the calculations pursuant to
    34  this section; and
    35    (b) the commissioner of health shall reduce the current rate  paid  to
    36  such  CHHA  and  such  LTHHCP by state governmental agencies pursuant to
    37  article 36 of the public health law by one percent for a  period  begin-
    38  ning on the first day of the calendar month following the applicable due
    39  date  as  established by the commissioner of health and continuing until
    40  the last day of the calendar month in which the required data and infor-
    41  mation are submitted.
    42    12. The commissioner of health shall inform in writing the director of
    43  the budget and the chair of the senate finance committee and  the  chair
    44  of  the  assembly  ways and means committee of the results of the calcu-
    45  lations pursuant to this section.
    46    § 89. Subdivision 5-a of section 246 of chapter  81  of  the  laws  of
    47  1995,  amending the public health law and other laws relating to medical
    48  reimbursement and welfare reform, as amended by section 64 of part C  of
    49  chapter 58 of the laws of 2005, is amended to read as follows:
    50    [5-a. Section sixty-four-a of this act shall be deemed to have been in
    51  full  force and effect on and after April 1, 1995 through March 31, 1999
    52  and on and after July 1, 1999 through March 31, 2000 and  on  and  after
    53  April  1,  2000  through  March  31, 2003 and on and after April 1, 2003
    54  through March 31, 2006;]
    55    § 90. Section 64-b of chapter 81 of the laws  of  1995,  amending  the
    56  public  health  law and other laws relating to medical reimbursement and
        S. 6457                            53                            A. 9557

     1  welfare reform, as amended by section 65 of part C of chapter 58 of  the
     2  laws of 2005, is amended to read as follows:
     3    [§  64-b.  Notwithstanding  any  inconsistent  provision  of  law, the
     4  provisions of subdivision 7 of section 3614 of the public health law, as
     5  amended, shall remain and be in full force and effect on April  1,  1995
     6  through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
     7  and after April 1, 2000 through March 31, 2003 and on and after April 1,
     8  2003 through March 31, 2006.]
     9    §  91.  Subdivision  7-a  of section 3614 of the public health law, as
    10  added by section 28 of part C of chapter 58 of  the  laws  of  2005,  is
    11  amended to read as follows:
    12    7-a.  Notwithstanding any inconsistent provision of law or regulation,
    13  for the purposes of establishing rates of payment by governmental  agen-
    14  cies for long term home health care programs for the period April first,
    15  two thousand five, through December thirty-first, two thousand five, and
    16  for  the  period  January  first, two thousand six through March thirty-
    17  first, two thousand six, and on and after April first, two thousand six,
    18  the reimbursable base year administrative and general costs of a provid-
    19  er of services shall not exceed the statewide average of total reimburs-
    20  able base year administrative and general costs  of  such  providers  of
    21  services.
    22    No such limit shall be applied to a provider of services reimbursed on
    23  an  initial budget basis, or a new provider, excluding changes in owner-
    24  ship or changes in name, who begins operations in the year prior to  the
    25  year which is used as a base year in determining rates of payment.
    26    For  the  purposes  of this subdivision, reimbursable base year opera-
    27  tional costs shall mean those  base  year  operational  costs  remaining
    28  after  application of all other efficiency standards, including, but not
    29  limited to, cost guidelines.
    30    The limitation on reimbursement for provider administrative and gener-
    31  al expenses provided  by  this  subdivision  shall  be  expressed  as  a
    32  percentage  reduction  for  the  rate promulgated by the commissioner to
    33  each long term home health care program provider.
    34    § 92. Section 10 of chapter 649 of  the  laws  of  1996  amending  the
    35  public  health  law,  the mental hygiene law and the social services law
    36  relating to authorizing the establishment of  special  needs  plans,  as
    37  amended  by  section 41 of part Z2 of chapter 62 of the laws of 2003, is
    38  amended to read as follows:
    39    § 10. This act shall take effect immediately and shall  be  deemed  to
    40  have  been in full force and effect on and after July 1, 1996; provided,
    41  however, that sections one, two and three of this act shall  expire  and
    42  be  deemed  repealed on March 31, [2006] 2009 provided, however that the
    43  amendments to section 364-j of the social services law made  by  section
    44  four  of  this  act  shall not affect the expiration of such section and
    45  shall be deemed to expire therewith  and  provided,  further,  that  the
    46  provisions  of  subdivisions  8,  9 and 10 of section 4401 of the public
    47  health law, as added by section one of this act; section 4403-d  of  the
    48  public health law as added by section two of this act and the provisions
    49  of  section seven of this act, except for the provisions relating to the
    50  establishment of no more than twelve  comprehensive  HIV  special  needs
    51  plans, shall expire and be deemed repealed on July 1, 2000.
    52    §  93.  Section  11  of  chapter 710 of the laws of 1988, amending the
    53  social services law and the education law relating to medical assistance
    54  eligibility of certain persons and providing for  managed  medical  care
    55  demonstration  programs,  as amended by section 42 of part Z2 of chapter
    56  62 of the laws of 2003, is amended to read as follows:
        S. 6457                            54                            A. 9557

     1    § 11.  This  act  shall  take  effect  immediately;  except  that  the
     2  provisions  of sections one, two, three, four, eight and ten of this act
     3  shall take effect on the ninetieth day after it shall have become a law;
     4  and except that the provisions of sections five, six and seven  of  this
     5  act  shall  take effect January 1, 1989; and except that effective imme-
     6  diately, the addition, amendment and/or repeal of any rule or regulation
     7  necessary for the implementation of this act on its effective  date  are
     8  authorized  and  directed  to  be  made  and completed on or before such
     9  effective date; [provided, however, that the provisions of section 364-j
    10  of the social services law, as added by section one of  this  act  shall
    11  expire  and  be  deemed  repealed  on  and  after  March  31, 2006,] the
    12  provisions of section 364-k of the social  services  law,  as  added  by
    13  section  two  of  this act, except subdivision 10 of such section, shall
    14  expire and be deemed repealed on and after  January  1,  1994,  and  the
    15  provisions  of  subdivision  10  of section 364-k of the social services
    16  law, as added by section two of this act, shall  expire  and  be  deemed
    17  repealed on January 1, 1995.
    18    §  94.  Subdivision  (c)  of  section 62 of chapter 165 of the laws of
    19  1991, amending the public health law and other laws relating  to  estab-
    20  lishing  payments  for  medical  assistance, as amended by section 43 of
    21  part Z2 of chapter 62 of the  laws  of  2003,  is  amended  to  read  as
    22  follows:
    23    (c)  [section  364-j of the social services law, as amended by section
    24  eight of this act and subdivision 6  of  section  367-a  of  the  social
    25  services  law as added by section twelve of this act shall expire and be
    26  deemed repealed on March 31 2006 and provided further, that] the  amend-
    27  ments  to  the provisions of [such] section 364-j of the social services
    28  law shall only apply to managed care programs approved on or  after  the
    29  effective date of this act;
    30    § 95. Subdivision (x) of section 165 of chapter 41 of the laws of 1992
    31  amending  the  public  health  law  and other laws relating to assessing
    32  certain healthcare providers is REPEALED.
    33    § 96. Section 4 of chapter 19 of the laws of 1998, amending the social
    34  services law relating to limiting the method of payment for prescription
    35  drugs under the medical assistance program, as amended by section 46  of
    36  part  Z2  of  chapter  62  of  the  laws  of 2003, is amended to read as
    37  follows:
    38    § 4. This act shall take effect 120 days after it shall have become  a
    39  law and shall expire and be deemed repealed March 31, [2006] 2009.
    40    §  97.  Section  97  of  chapter 659 of the laws of 1997, amending the
    41  public health law and other laws relating to creation of continuing care
    42  retirement communities is amended to read as follows:
    43    § 97. This act shall take effect immediately, provided, however,  that
    44  the  amendments to subdivision 4 of section 854 of the general municipal
    45  law made by section seventy of this act shall not affect the  expiration
    46  of such subdivision and shall be deemed to expire therewith and provided
    47  further  that  sections  sixty-seven  and  sixty-eight of this act shall
    48  apply to taxable years  beginning  on  or  after  January  1,  1998  and
    49  provided  further that sections eighty-one [through], eighty-two, eight-
    50  y-four, eighty-five, eighty-six  and  eighty-seven  of  this  act  shall
    51  expire  and  be deemed repealed on December 31, [2006] 2009 and provided
    52  further that the amendments made by section  eighty-three  of  this  act
    53  shall  expire  and  be  deemed  repealed  on  April 1, 2006 and provided
    54  further, however, that the amendments to  section  ninety  of  this  act
    55  shall  take  effect  January  1,  1998  and shall apply to all policies,
    56  contracts, certificates, riders or other evidences of coverage  of  long
        S. 6457                            55                            A. 9557

     1  term  care  insurance  issued,  renewed, altered or modified pursuant to
     2  section 3229 of the insurance law on or after such date.
     3    §  98.  Section  18  of  chapter 904 of the laws of 1984, amending the
     4  public health law and the social services law  relating  to  encouraging
     5  comprehensive  health  services, as amended by chapter 69 of the laws of
     6  2004, is amended to read as follows:
     7    § 18. This act shall take effect  immediately,  except  that  sections
     8  six,  nine, ten and eleven of this act shall take effect on the sixtieth
     9  day after it shall have become a law, [sections  two,  three,  four  and
    10  nine of this act shall expire and be of no further force or effect on or
    11  after  March  31,  2006,]  section  two of this act shall take effect on
    12  April 1, 1985 or seventy-five  days  following  the  submission  of  the
    13  report  required  by  section  one  of this act, whichever is later, and
    14  sections eleven and thirteen of this act  shall  expire  and  be  of  no
    15  further force or effect on or after March 31, 1988.
    16    §  99. The commissioner of health is authorized to promulgate or adopt
    17  any rules or regulations necessary to implement the provisions  of  this
    18  act and any procedures, forms, or instructions necessary for such imple-
    19  mentation  may  be  adopted and issued on or after the effective date of
    20  this act. Notwithstanding any inconsistent provision of the state admin-
    21  istrative procedure act or any other provision of  law,  rule  or  regu-
    22  lation  the  commissioner  of health and the superintendent of insurance
    23  and any appropriate council is authorized to adopt or amend  or  promul-
    24  gate  on  an  emergency  basis  any regulation he or she or such council
    25  determines necessary to implement any  provision  of  this  act  on  its
    26  effective date.
    27    § 100. If any clause, sentence, paragraph, section or part of this act
    28  shall  be adjudged by any court of competent jurisdiction to be invalid,
    29  such judgment shall not affect,  impair,  or  invalidate  the  remainder
    30  thereof, but shall be confined in its operation to the clause, sentence,
    31  paragraph, subdivision, section or part thereof directly involved in the
    32  controversy in which such judgment shall have been rendered. It is here-
    33  by declared to be the intent of the legislature that this act would have
    34  been enacted even if such invalid provisions had not been included ther-
    35  ein.
    36    §  101.  This act shall take effect immediately and shall be deemed to
    37  have been in full force and effect on and after April 1, 2006;  provided
    38  however, that:
    39    1.  In the event any provision of law relating to cost containment set
    40  forth in section three of this act is repealed or amended in such manner
    41  as is deemed by the director of budget to negate the  efficacy  of  such
    42  provisions  set forth therein, the provisions of section two of this act
    43  shall be deemed repealed; upon the occurrence  of  the  contingency  set
    44  forth  above,  the  director of budget shall notify the legislative bill
    45  drafting commission upon the occurrence of the enactment of  the  legis-
    46  lation  provided  for  in  section  three  of this act in order that the
    47  commission may maintain an accurate and timely effective  data  base  of
    48  the official text of the laws of the state of New York in furtherance of
    49  effecting  the  provisions  of  section  44  of  the legislative law and
    50  section 70-b of the public officers law.
    51    2. Section one of this act shall take effect July 1, 2006;
    52    3. Section thirty-nine of this act shall take effect January 1, 2007;
    53    4. Sections five through twenty-two of  this  act  shall  take  effect
    54  November 1, 2006;
    55    5. Section thirty-one of this act shall take effect July 1, 2006;
        S. 6457                            56                            A. 9557

     1    6.  Section  forty-three of this act shall take effect October 1, 2006
     2  and shall remain in full force and effect until December 31, 2009;
     3    7.  Sections  fifty-three  through  fifty-seven of this act shall take
     4  effect July 1, 2007;
     5    8. Sections forty-nine through fifty-one of this act  shall  not  take
     6  effect  unless  and until the commissioner of health receives all neces-
     7  sary approvals  under  federal  law  and  regulation  to  implement  its
     8  provisions, and provided that such provisions do not prevent the receipt
     9  of federal financial participation under the medical assistance program.
    10  The  commissioner of health shall submit such waiver applications and/or
    11  state plan amendments as may be necessary to obtain such  approvals  and
    12  to ensure continued federal financial participation;
    13    9.  No  section of this act shall be required to be implemented sooner
    14  than sixty days following receipt of all waivers and approvals necessary
    15  under federal law and regulation to implement the provisions of this act
    16  with federal financial participation; the commissioner of  health  shall
    17  submit  such  waiver applications and/or state plan amendments as may be
    18  necessary to obtain such  approvals  and  to  ensure  continued  federal
    19  financial participation;
    20    10.  The  amendments  to  paragraphs  (b)  and (c) of subdivision 3 of
    21  section 273 of the public health law made by section twenty-four of this
    22  act shall not affect the repeal of such  section  and  shall  be  deemed
    23  repealed therewith;
    24    11.  The  amendments  to  section 274 of the public health law made by
    25  sections twenty-five, twenty-seven and twenty-eight of  this  act  shall
    26  not affect the repeal of such section and shall be deemed repealed ther-
    27  ewith;
    28    12.  The  amendments  to subdivisions 7, 8 and 9 of section 272 of the
    29  public health law made by section  twenty-six  of  this  act  shall  not
    30  affect  the  repeal  of such section and shall be deemed repealed there-
    31  with;
    32    13. The amendments to subdivision 9 of section  367-a  of  the  social
    33  services law made by section thirty-one of this act shall not affect the
    34  repeal of such subdivision and shall be deemed repealed therewith;
    35    14.  The  amendments  to  paragraphs  (f)  and (k) of subdivision 4 of
    36  section 2807-c of the public health law made  by  sections  seventy  and
    37  seventy-one  of  this  act shall not affect the expiration of such para-
    38  graphs and shall be deemed to expire therewith;
    39    15. The amendments to subparagraph (vi) of paragraph (b)  of  subdivi-
    40  sion 5 of section 2807-c of the public health law made by section seven-
    41  ty-two  of this act shall not affect the expiration of such subparagraph
    42  and shall be deemed to expire therewith; and
    43    16. The amendments to paragraph (c) of subdivision 5 of section 2807-c
    44  of the public health law made by section seventy-three of this act shall
    45  not affect the expiration of such  paragraph  and  shall  be  deemed  to
    46  expire therewith.

    47                                   PART B

    48    Section  1. Section 3235-a of the insurance law, as added by section 3
    49  of part C of chapter 1 of the laws  of  2002,  is  amended  to  read  as
    50  follows:
    51    §  3235-a.  Payment  for early intervention services. (a) No policy of
    52  accident and health insurance, including contracts  issued  pursuant  to
    53  article  forty-three  of this chapter, shall exclude coverage for other-
    54  wise covered services solely on the basis that the  services  constitute
        S. 6457                            57                            A. 9557

     1  early  intervention  program services under title two-A of article twen-
     2  ty-five of the public health law.
     3    (b)  Where  a  policy  of  accident  and health insurance, including a
     4  contract  issued  pursuant  to  article  forty-three  of  this  chapter,
     5  provides  coverage  for  [an  early  intervention  program service,] the
     6  following  early  intervention  program  services:  evaluation  services
     7  covered  under  the  policy  or  contract provided that a written order,
     8  referral or recommendation for such evaluation  is  obtained  when  such
     9  order,  referral or recommendation is required pursuant to the education
    10  law, nursing services, occupational therapy services,  physical  therapy
    11  services,  speech  therapy  services or other early intervention program
    12  health services, such coverage shall not be applied against any  maximum
    13  annual or lifetime monetary limits set forth in such policy or contract.
    14  Visit  limitations  [and  other terms and conditions of the policy] will
    15  continue to apply to early intervention program services.  However,  any
    16  visits used for early intervention program services shall not reduce the
    17  number  of  visits  otherwise available under the policy or contract for
    18  such services.
    19    (c) Where a policy of  accident  and  health  insurance,  including  a
    20  contract  issued  pursuant  to  article  forty-three  of  this  chapter,
    21  provides coverage for the following early intervention program services:
    22  evaluation services covered under the policy or contract provided that a
    23  written  order,  referral  or  recommendation  for  such  evaluation  is
    24  obtained  when such order, referral or recommendation is required pursu-
    25  ant  to  the  education  law,  nursing  services,  occupational  therapy
    26  services,  physical  therapy  services, speech therapy services or other
    27  early intervention program health services, a written order, referral or
    28  recommendation when required pursuant to the education  law,  signed  by
    29  the covered child's pediatrician or other primary care provider, includ-
    30  ing  where  appropriate  a speech pathologist acting within the scope of
    31  his or her practice, shall be  deemed  to  meet  any  pre-certification,
    32  preauthorization  and medical necessity requirements imposed on benefits
    33  under the policy.
    34    (d) No policy of accident and health insurance, including  a  contract
    35  issued  pursuant  to  article  forty-three  of  this chapter, shall deny
    36  coverage for early intervention program services on the following bases:
    37    (i) the location where services are provided;
    38    (ii) the duration of the child's condition  and/or  that  the  child's
    39  condition  is  not  amenable to significant improvement within a certain
    40  period of time as specified in the policy; or
    41    (iii) that the provider of services is not a participating provider in
    42  the insurer's network unless the insurer maintains an  adequate  network
    43  of participating providers who are approved under title two-A of article
    44  twenty-five  of  the  public  health  law  to deliver early intervention
    45  program services; provided however that an insurer shall not deny cover-
    46  age on the basis that the provider of service  is  not  a  participating
    47  provider  in  the insurer's network where the provider is approved under
    48  title two-A of article twenty-five of  the  public  health  law  and  is
    49  either  a diagnostic and treatment center licensed under article twenty-
    50  eight of the public health law which provides, as its principal mission,
    51  services to individuals with developmental disabilities or mental retar-
    52  dation, or a provider licensed  under  article  sixteen  of  the  mental
    53  hygiene  law which provides, as its principal mission, services to indi-
    54  viduals with developmental disabilities  or  mental  retardation,  or  a
    55  provider  approved under section forty-four hundred ten of the education
    56  law to provide special education classes and/or special  classes  in  an
        S. 6457                            58                            A. 9557

     1  integrated  setting in accordance with section forty-four hundred ten of
     2  the education law and section 200.16 (h) of title  8  of  the  New  York
     3  codes, rules and regulations.
     4    (e)  Where  a  policy  of  accident  and health insurance, including a
     5  contract  issued  pursuant  to  article  forty-three  of  this  chapter,
     6  provides coverage for the following early intervention program services:
     7  evaluation services covered under the policy or contract provided that a
     8  written  order,  referral  or  recommendation  for  such  evaluation  is
     9  obtained when such order, referral or recommendation is required  pursu-
    10  ant  to  the  education  law,  nursing  services,  occupational  therapy
    11  services, speech therapy services, or other early  intervention  program
    12  health  services,  reimbursement  for  such  services  shall be at rates
    13  established by the commissioner of health for such services  in  accord-
    14  ance  with  section 69-4.30 of title 10 of the New York codes, rules and
    15  regulations;  provided  however  that  where  an  insurer  maintains  an
    16  adequate network of participating providers who are approved under title
    17  two-A  of  article  twenty-five of the public health law to deliver such
    18  early intervention program services and has negotiated rates of  payment
    19  with the providers of such services, then reimbursement shall be at such
    20  negotiated  rates;  provided further that where the provider is approved
    21  under title two-A of article twenty-five of the public health law and is
    22  either a diagnostic and treatment center licensed under article  twenty-
    23  eight of the public health law which provides, as its principal mission,
    24  services to individuals with developmental disabilities or mental retar-
    25  dation,  or  a  provider  licensed  under  article sixteen of the mental
    26  hygiene law which provides, as its principal mission, services to  indi-
    27  viduals  with  developmental  disabilities  or  mental retardation, or a
    28  provider approved under section forty-four hundred ten of the  education
    29  law  to  provide  special education classes and/or special classes in an
    30  integrated setting in accordance with section forty-four hundred ten  of
    31  the  education  law  and  section  200.16 (h) of title 8 of the New York
    32  codes, rules and regulations, reimbursement for such early  intervention
    33  program  services  shall  be at rates established by the commissioner of
    34  health for such services in accordance with section 69-4.30 of title  10
    35  of  the  New  York codes, rules and regulations. Nothing in this section
    36  shall prohibit an insurer from applying any  deductible,  co-payment  or
    37  coinsurance as set forth in the policy.
    38    [(c)] (f) Any right of subrogation to benefits which a municipality is
    39  entitled  in  accordance  with  paragraph  (d)  of  subdivision three of
    40  section twenty-five hundred fifty-nine of the public health law shall be
    41  valid and enforceable to the extent benefits  are  available  under  any
    42  accident  and health insurance policy. The right of subrogation does not
    43  attach to insurance benefits paid or provided  under  any  accident  and
    44  health  insurance  policy  prior  to  receipt  by the insurer of written
    45  notice from the municipality.   Upon the insurer's  receipt  of  written
    46  notice from the municipality, the insurer shall provide the municipality
    47  with information on the extent of benefits available to an insured under
    48  the policy.
    49    [(d)]  (g)  No  insurer,  including  a health maintenance organization
    50  issued a certificate of authority under article forty-four of the public
    51  health law and a corporation organized under article forty-three of this
    52  chapter, shall refuse to issue an accident and health  insurance  policy
    53  or  contract  or refuse to renew an accident and health insurance policy
    54  or contract  solely  because  the  applicant  or  insured  is  receiving
    55  services under the early intervention program.
        S. 6457                            59                            A. 9557

     1    §  2. Subdivision 5 of section 4403 of the public health law, as added
     2  by chapter 705 of the laws of 1996, paragraph (a) as amended by  chapter
     3  586 of the laws of 1998, is amended to read as follows:
     4    5.  (a)  The  commissioner, at the time of initial licensure, at least
     5  every three years thereafter, and  upon  application  for  expansion  of
     6  service  area,  shall  ensure  that  the health maintenance organization
     7  maintains a network of  health  care  providers  adequate  to  meet  the
     8  comprehensive  health needs of its enrollees and to provide an appropri-
     9  ate choice of providers sufficient to provide the services covered under
    10  its enrollee's contracts by determining that (i) there are a  sufficient
    11  number  of geographically accessible participating providers; (ii) there
    12  are opportunities to select from at least three primary  care  providers
    13  pursuant  to  travel  and  distance  time standards, providing that such
    14  standards account for the conditions of  accessing  providers  in  rural
    15  areas;  (iii)  there  are sufficient providers in each area of specialty
    16  practice to meet the needs of the enrollment population; (iv)  there  is
    17  no  exclusion of any appropriately licensed type of provider as a class;
    18  and (v) contracts entered into with health care providers neither trans-
    19  fer financial risk to providers,  in  a  manner  inconsistent  with  the
    20  provisions  of  paragraph  (c)  of  subdivision one of this section, nor
    21  penalize providers for unfavorable case mix  so  as  to  jeopardize  the
    22  quality  of  or  enrollees'  appropriate  access  to medically necessary
    23  services; provided, however, that payment at less  than  prevailing  fee
    24  for  service  rates  or capitation shall not be deemed or presumed prima
    25  facie to jeopardize quality or access.
    26    (b) Upon the effective date of a chapter of the laws of  two  thousand
    27  six  which  amended  this  subdivision,  at the time of every three year
    28  review by the commissioner as set forth in paragraph (a) of this  subdi-
    29  vision,  and upon application for expansion of service area, the commis-
    30  sioner shall ensure that the health maintenance  organization  maintains
    31  an  adequate  network  of  providers  who  are approved to deliver early
    32  intervention program services as set forth under title two-A of  article
    33  twenty-five  of this chapter, by determining that (i) there are a suffi-
    34  cient number of geographically accessible participating providers;  (ii)
    35  there  are sufficient providers in each area of specialty of practice to
    36  meet the needs of the enrollment population; (iii) there is no exclusion
    37  of any appropriately licensed type of providers as  a  class;  and  (iv)
    38  contracts  entered  into  with  health  care  providers neither transfer
    39  financial  risk  to  providers,  in  a  manner  inconsistent  with   the
    40  provisions  of  paragraph  (c)  of  subdivision one of this section, nor
    41  penalize providers for unfavorable case mix  so  as  to  jeopardize  the
    42  quality  of  or  enrollee's  appropriate  access  to medically necessary
    43  services; provided, however, that payment at less  than  prevailing  fee
    44  for  service  rates  or capitation shall not be deemed or presumed prima
    45  facie to jeopardize quality or access.
    46    (c) The following criteria shall be considered by the commissioner  at
    47  the  time  of  a  review: (i) the availability of appropriate and timely
    48  care that is provided in compliance with the standards  of  the  Federal
    49  Americans  with  Disability  Act to assure access to health care for the
    50  enrollee population; (ii) the network's ability  to  provide  culturally
    51  and  linguistically  competent  care  to  meet the needs of the enrollee
    52  population; and (iii) with  the  exception  of  initial  licensure,  the
    53  number  of  grievances  filed by enrollees relating to waiting times for
    54  appointments, appropriateness of referrals and other indicators of  plan
    55  capacity.
        S. 6457                            60                            A. 9557

     1    [(c)] (d) Each organization shall report on an annual basis the number
     2  of enrollees and the number of participating providers in each organiza-
     3  tion.  Each organization shall further report to the commissioner and to
     4  municipalities on a quarterly basis the names of participating providers
     5  in  the  organization's network who are approved to deliver early inter-
     6  vention program services.
     7    § 3. Section 4406 of the public health law is amended by adding a  new
     8  subdivision 5 to read as follows:
     9    5.(a)  No  contract  shall  exclude  coverage  for  otherwise  covered
    10  services solely on the basis that the services constitute  early  inter-
    11  vention  program  services  under  title two-A of article twenty-five of
    12  this chapter.
    13    (b) Where a contract provides coverage for the following early  inter-
    14  vention program services: evaluation services covered under the contract
    15  provided that a written order, referral or recommendation for such eval-
    16  uation  is  obtained  when  such  order,  referral  or recommendation is
    17  required pursuant to the education law, occupational  therapy  services,
    18  physical therapy services, speech therapy services or other early inter-
    19  vention  program  health  services,  such  coverage shall not be applied
    20  against any maximum annual or lifetime monetary limits set forth in such
    21  contract. Visit limitations as set forth in the contract will  apply  to
    22  early  intervention program services. However, any visits used for early
    23  intervention program services shall not  reduce  the  number  of  visits
    24  otherwise available under the contract for such services.
    25    (c)  Where a contract provides coverage for the following early inter-
    26  vention program services: evaluation services covered under the contract
    27  provided that a written order, referral or recommendation for such eval-
    28  uation is obtained  when  such  order,  referral  or  recommendation  is
    29  required  pursuant  to the education law, nursing services, occupational
    30  therapy services, physical therapy services, speech therapy services  or
    31  other  early  intervention  program  health  services,  a written order,
    32  referral or recommendation, when required for such service  pursuant  to
    33  the  education  law, signed by the covered child's pediatrician or other
    34  primary care provider, including where appropriate a speech  pathologist
    35  acting  within the scope of his or her practice, shall be deemed to meet
    36  any pre-certification, preauthorization and medical  necessity  require-
    37  ments imposed on benefits under the contract.
    38    (d)  No  contract  shall  deny  or permit denial of coverage for early
    39  intervention program services on the following bases:
    40    (i) the location where services are provided;
    41    (ii) the duration of the child's condition  and/or  that  the  child's
    42  condition  is  not  amenable to significant improvement within a certain
    43  period of time as specified in the contract; or
    44    (iii) that the provider of services is not a participating provider in
    45  the organization's network unless it has been  determined,  pursuant  to
    46  subdivision five of section forty-four hundred three of this title, that
    47  the  organization maintains an adequate network of participating provid-
    48  ers who are approved under title two-A of article  twenty-five  of  this
    49  chapter to deliver early intervention program services; provided however
    50  that  an  organization  shall  not  deny  coverage on the basis that the
    51  provider of service is not a participating  provider  in  the  organiza-
    52  tion's network where the provider is approved under title two-A of arti-
    53  cle twenty-five of this chapter and is either a diagnostic and treatment
    54  center  licensed  under  article  twenty-eight  of  this  chapter  which
    55  provides, as its principal mission, services to individuals with  devel-
    56  opmental  disabilities  or  mental  retardation,  or a provider licensed
        S. 6457                            61                            A. 9557

     1  under article sixteen of the mental hygiene law which provides,  as  its
     2  principal  mission, services to individuals with developmental disabili-
     3  ties or mental retardation, or a provider approved under section  forty-
     4  four  hundred  ten  of  the  education  law to provide special education
     5  classes and/or special classes in an integrated  setting  in  accordance
     6  with  section  forty-four  hundred  ten of the education law and section
     7  200.16 (h) of title 8 of the New York codes, rules and regulations.
     8    (e) Where a contract provides coverage for the following early  inter-
     9  vention program services: evaluation services covered under the contract
    10  provided that a written order, referral or recommendation for such eval-
    11  uation  is  obtained  when  such  order,  referral  or recommendation is
    12  required pursuant to the education law, nursing  services,  occupational
    13  therapy  services,  speech therapy services, or other early intervention
    14  program health services, reimbursement for such  services  shall  be  at
    15  rates  established  by  the commissioner for such services in accordance
    16  with section 69-4.30 of title 10 of the New York codes, rules and  regu-
    17  lations; provided however that where it has been determined, pursuant to
    18  subdivision five of section forty-four hundred three of this title, that
    19  the  organization maintains an adequate network of participating provid-
    20  ers who are approved under title two-A of article  twenty-five  of  this
    21  chapter to deliver early intervention program services and the organiza-
    22  tion  has  negotiated  rates  of  payment  with  the  providers  of such
    23  services, then reimbursement shall be at such negotiated rates; provided
    24  further that if the provider is approved under title  two-A  of  article
    25  twenty-five  of  this  chapter  and is either a diagnostic and treatment
    26  center  licensed  under  article  twenty-eight  of  this  chapter  which
    27  provides,  as its principal mission, services to individuals with devel-
    28  opmental disabilities or mental  retardation,  or  a  provider  licensed
    29  under  article  sixteen of the mental hygiene law which provides, as its
    30  principal mission, services to individuals with developmental  disabili-
    31  ties  or mental retardation, or a provider approved under section forty-
    32  four hundred ten of the  education  law  to  provide  special  education
    33  classes  and/or  special  classes in an integrated setting in accordance
    34  with section forty-four hundred ten of the  education  law  and  section
    35  200.16  (h)  of  title  8  of the New York codes, rules and regulations,
    36  reimbursement for such services shall be at  rates  established  by  the
    37  commissioner  for  such  services  in accordance with section 69-4.30 of
    38  title 10 of the New York codes, rules and regulations.   Nothing  herein
    39  shall  prohibit an organization from applying any deductible, co-payment
    40  or coinsurance as set forth in the contract.
    41    (f) Any right of subrogation to benefits which a municipality is enti-
    42  tled in accordance with paragraph (d) of subdivision  three  of  section
    43  twenty-five  hundred  fifty-nine  of  this  chapter  shall  be valid and
    44  enforceable to the extent benefits are available under any contract. The
    45  right of subrogation does not attach to benefits paid or provided  under
    46  any contract prior to receipt by the organization of written notice from
    47  the municipality. Upon the organization's receipt of written notice from
    48  the  municipality,  the organization shall provide the municipality with
    49  information on the extent of benefits available to an enrollee under the
    50  contract.
    51    (g) No organization shall refuse to issue  a  contract  or  refuse  to
    52  renew  a  contract solely because the applicant or enrollee is receiving
    53  services under the early intervention program.
    54    § 4. The public health law is amended by adding a new  section  2545-a
    55  to read as follows:
        S. 6457                            62                            A. 9557

     1    §  2545-a.  Use  of network providers.   1. When an eligible child has
     2  coverage through an insurance policy which maintains an adequate network
     3  of participating providers who are approved under this title to  deliver
     4  such early intervention program services, or a health maintenance organ-
     5  ization  which  has  been  determined,  pursuant  to subdivision five of
     6  section forty-four  hundred  three  of  this  chapter,  to  maintain  an
     7  adequate  network  of  providers  who  are  approved under this title to
     8  deliver early intervention program services, who provide one or more  of
     9  the  covered  services set forth in the eligible child's IFSP, the early
    10  intervention official shall select and the  parent  and  eligible  child
    11  shall  use  a provider within the insurer's or health maintenance organ-
    12  ization's network for the provision of services, but only to the  extent
    13  that:
    14    (a)  the  network provider is available to receive the referral and to
    15  begin providing services to the eligible  child  as  set  forth  in  the
    16  eligible child's IFSP; and
    17    (b)  the  network  provider  has received approval under this title to
    18  provide early intervention program services and is under  contract  with
    19  the  municipality  responsible for payment of the eligible child's early
    20  intervention services when third party payment is not available  or  has
    21  been exhausted.
    22    2. If an eligible child has been receiving services from a non-network
    23  provider  and the early intervention official determines that the eligi-
    24  ble child has coverage through an insurance policy  which  maintains  an
    25  adequate  network of participating providers who are approved under this
    26  title to deliver such early intervention program services or is enrolled
    27  in a health maintenance organization which has been determined, pursuant
    28  to subdivision five of section forty-four hundred three of this chapter,
    29  to maintain an adequate network of providers who are approved under this
    30  title to deliver early intervention program services, the  early  inter-
    31  vention  official  shall  require  the  eligible  child to transfer to a
    32  network provider at the time of the eligible child's next IFSP review or
    33  evaluation, whichever is earlier.
    34    3. Notwithstanding subdivisions one  and  two  of  this  section,  the
    35  parent and eligible child shall not be required to use a provider within
    36  the  insurer's  or  health  maintenance  organization's  network for the
    37  provision of services if the eligible child  receives  services  from  a
    38  provider who is approved under this title and is either a diagnostic and
    39  treatment  center  licensed  under  article twenty-eight of this chapter
    40  which provides, as its principal mission, services to  individuals  with
    41  developmental  disabilities  or  mental  retardation, or from a provider
    42  licensed under article sixteen of the mental hygiene law which provides,
    43  as its principal mission, services  to  individuals  with  developmental
    44  disabilities  or mental retardation or a provider approved under section
    45  forty-four hundred ten of the education law to provide special education
    46  classes and/or special classes in an integrated  setting  in  accordance
    47  with  section  forty-four  hundred  ten of the education law and section
    48  200.16 (h) of title 8 of the New York codes, rules and regulations.
    49    § 5. Section 2545 of the public health law is amended by adding a  new
    50  subdivision 10 to read as follows:
    51    10.  Where  a  written  order,  referral or recommendation is required
    52  pursuant to the education law for an early intervention program service,
    53  the early intervention official shall ensure that such  order,  referral
    54  or  recommendation  is  obtained  from the eligible child's primary care
    55  physician or pediatrician, including where appropriate a speech patholo-
        S. 6457                            63                            A. 9557

     1  gist, acting within the scope of his or her practice, on a  form  to  be
     2  developed by the department.
     3    §  6.  Paragraphs  (a) and (d) of subdivision 3 of section 2559 of the
     4  public health law, paragraph (a) as amended and paragraph (d)  as  added
     5  by chapter 231 of the laws of 1993, are amended to read as follows:
     6    (a)  (i)  Providers  of early intervention services and transportation
     7  services shall in the first instance and where applicable, seek  payment
     8  from  all  third  party  payors including governmental agencies prior to
     9  claiming payment from a given  municipality  for  services  rendered  to
    10  eligible  children,  provided  that,  for the purpose of seeking payment
    11  from the medical assistance program or from other  third  party  payors,
    12  the municipality shall be deemed the provider of such early intervention
    13  services  to  the extent that the provider has promptly furnished to the
    14  municipality adequate and complete information necessary to support  the
    15  municipality  billing,  and provided further that the obligation to seek
    16  payment shall not apply to a payment from a third party payor who is not
    17  prohibited from applying such payment, and will apply such  payment,  to
    18  an annual or lifetime limit specified in the insured's policy.
    19    (ii)  Notwithstanding any inconsistent provision of law, rule or regu-
    20  lation, payments made to an approved early intervention  provider  by  a
    21  third  party  payor  for  early  intervention  services covered under an
    22  insurance policy, comprehensive health services plan or  health  benefit
    23  plan shall be at rates established under an agreement negotiated between
    24  the  provider  and  third party payor. Such payments shall be considered
    25  payments in full for such services rendered to the  eligible  child  and
    26  the  provider  shall  not seek additional payment from the municipality,
    27  eligible child and his or her parents for any portion of the  costs  for
    28  said  services.  Nothing  in  this  section shall prohibit a third party
    29  payor from applying a copayment, coinsurance or deductible as set  forth
    30  in the policy or plan. A provider shall not seek payment of a copayment,
    31  coinsurance  or  deductible  from  the  eligible  child  and  his or her
    32  parents. Payments for copayments, coinsurance or  deductibles  shall  be
    33  made in accordance with paragraph (b) of this subdivision.
    34    (iii)  Payments  made  to an approved early intervention provider by a
    35  third party payor for  early  intervention  services  covered  under  an
    36  insurance  policy,  comprehensive health services plan or health benefit
    37  plan where there is no agreement negotiated  between  the  provider  and
    38  third  party  payor  shall  be  at rates established pursuant to section
    39  69-4.30 of title 10 of the New York codes, rules and regulations.
    40    (iv) Reimbursement for early  intervention  services  provided  by  an
    41  early intervention service provider who is approved under this title and
    42  is either a diagnostic and treatment center licensed under article twen-
    43  ty-eight  of  this  chapter  which  provides,  as its principal mission,
    44  services to individuals with developmental disabilities or mental retar-
    45  dation, or a provider licensed  under  article  sixteen  of  the  mental
    46  hygiene  law which provides, as its principal mission, services to indi-
    47  viduals with developmental  disabilities  or  mental  retardation  or  a
    48  provider  approved under section forty-four hundred ten of the education
    49  law to provide special education classes and/or special  classes  in  an
    50  integrated  setting in accordance with section forty-four hundred ten of
    51  the education law and section 200.16 (h) of title  8  of  the  New  York
    52  codes,  rules  and  regulations  shall  be  at  rates established by the
    53  commissioner for such services in accordance  with  section  69-4.30  of
    54  title 10 of the New York codes, rules and regulations.
        S. 6457                            64                            A. 9557

     1    (v)  When  third party payment is not available or has been exhausted,
     2  providers shall seek payment for services in accordance with subdivision
     3  one of section twenty-five hundred fifty-seven of this title.
     4    (d)  A  municipality, or its designee, when deemed the provider of the
     5  early intervention service, shall be subrogated, to the  extent  of  the
     6  expenditures  by  such  municipality  for  early  intervention  services
     7  furnished to persons eligible for benefits  under  this  title,  to  any
     8  rights  such  person  may  have  or  be  entitled  to  from  third party
     9  reimbursement. The right of subrogation does not attach to benefits paid
    10  or provided under any  health  insurance  policy,  comprehensive  health
    11  services plan or health benefits plan prior to receipt of written notice
    12  of the exercise of subrogation rights by the insurer or plan administra-
    13  tor  providing  such  benefits.    A municipality, or its designee, when
    14  deemed the provider of early intervention services,  shall,  immediately
    15  upon receipt of the eligible child's third party payor coverage informa-
    16  tion,  file  a  notice  of  the exercise of subrogation rights with such
    17  third party payor on a form to be developed by the department.
    18    § 7. Subdivision 5 of  section  2557  of  the  public  health  law  is
    19  REPEALED and two new subdivisions 5 and 6 are added to read as follows:
    20    5.  The  commissioner may contract with an independent organization to
    21  act as the fiscal agent for each of the municipalities and  the  depart-
    22  ment  and each municipality shall use such fiscal agent for early inter-
    23  vention program fiscal management and  claiming  as  determined  by  the
    24  commissioner. Each municipality shall grant full authority to the fiscal
    25  agent  to  act  on  the municipality's behalf with respect to all fiscal
    26  management and claiming responsibilities and duties.
    27    6. Municipalities and providers of services shall provide  information
    28  and  documentation  as  required  by  the  fiscal agent to carry out the
    29  fiscal agent's duties.
    30    § 8. Subdivision 2 of section 347 of the public health law is REPEALED
    31  and a new subdivision 2 is added to read as follows:
    32    2. The board of health of a county or part-county health  district  is
    33  hereby  authorized to enter into contracts with one or more counties for
    34  mutual aid in the delivery of health services, including but not limited
    35  to public health emergency responses such as disease surveillance,  mass
    36  immunization  programs,  mass  antibiotic  distribution, and handling of
    37  mass casualties, provided approval of such contracts  by  the  board  of
    38  supervisors of each county and of the commissioner is obtained.
    39    §  9. Subdivision 1, paragraph (d) of subdivision 2 and subparagraph 2
    40  of paragraph (b) of subdivision 3 of section 602 of  the  public  health
    41  law, as added by chapter 901 of the laws of 1986, are amended to read as
    42  follows:
    43    1.  Every  municipality  shall  [biennially] every four years, on such
    44  dates as may be fixed by the commissioner, submit  to  the  commissioner
    45  for his or her approval a public health services plan.
    46    (d) a projected [two-year] four-year plan of expenditures necessary to
    47  implement the programs;
    48    (2)  disease  control,  which  shall include activities to control and
    49  mitigate the extent of non-infectious diseases, particularly those of  a
    50  chronic,  degenerative  nature, and infectious diseases. Such activities
    51  shall include surveillance and epidemiological programs, and programs to
    52  detect diseases in their early stages. Specific activities shall include
    53  immunizations against infectious diseases [and], prevention  and  treat-
    54  ment  of  sexually  transmissible  diseases,  and arthropod vector-borne
    55  disease prevention.
        S. 6457                            65                            A. 9557

     1    § 10. Subdivision 1 of section  605  of  the  public  health  law,  as
     2  amended  by  chapter  474  of  the  laws  of 1996, is amended to read as
     3  follows:
     4    1.  A  state  aid base grant shall be reimbursed to municipalities for
     5  the base public health services identified in paragraph (b) of  subdivi-
     6  sion three of section six hundred two of this title, in an amount of the
     7  greater  of [forty-five] fifty-five cents per capita, for each person in
     8  the municipality, or [four] five hundred fifty thousand dollars provided
     9  that the municipality expends at least [four] five hundred  fifty  thou-
    10  sand  dollars  for such base public health services. A municipality must
    11  provide all the basic public health services identified in paragraph (b)
    12  of subdivision three of section six hundred two of this title to qualify
    13  for such base grant unless the municipality  has  the  approval  of  the
    14  commissioner  to  expend the base grant on a portion of such base public
    15  health services. If any services in such paragraph (b) are not  approved
    16  in  the  plan  or if no plan is submitted for such services, the commis-
    17  sioner may limit the municipality's per capita or  base  grant  to  that
    18  proportionate share which will fund those services that are submitted in
    19  a  plan  and subsequently approved. The commissioner may use the propor-
    20  tionate share that is not granted to  contract  with  agencies,  associ-
    21  ations, or organizations to provide such services; or the health depart-
    22  ment  may  use  such  proportionate  share  to provide the services upon
    23  approval of the director of the division of the budget.
    24    § 11. Subdivision 2 of section  605  of  the  public  health  law,  as
    25  amended  by  chapter  474  of  the  laws  of 1996, is amended to read as
    26  follows:
    27    2. State aid reimbursement for public health services  provided  by  a
    28  municipality under this title, shall be made as follows:
    29    (a)  if  the municipality is providing some or all of the basic public
    30  health services identified in paragraph  (b)  of  subdivision  three  of
    31  section  six hundred two of this title, pursuant to an approved plan, at
    32  a rate of [up to fifty per centum  but]  no  less  than  thirty-six  per
    33  centum  of  the  difference between the amount of moneys expended by the
    34  municipality for public health services required  by  paragraph  (b)  of
    35  subdivision  three  of  section six hundred two of this title during the
    36  fiscal year and the base grant provided pursuant to subdivision  one  of
    37  this  section.   No such reimbursement shall be provided for services if
    38  they are not approved in a plan or if no  plan  is  submitted  for  such
    39  services.
    40    (b)  if  the  municipality  is  providing other public health services
    41  within limits to be prescribed by  regulation  by  the  commissioner  in
    42  addition  to some or all of the public health services required in para-
    43  graph (b) of subdivision three of section six hundred two of this title,
    44  pursuant to an approved plan, at a rate of [up to fifty per centum  but]
    45  not  less  than [thirty] thirty-six per centum of the moneys expended by
    46  the municipality for such other services provided the  municipality  can
    47  demonstrate  a  material  new  or  materially  increased  allocation  of
    48  resources in one or more areas designated by the commissioner  as  areas
    49  of  particular  public  health  significance. A municipality that cannot
    50  demonstrate this will receive reimbursement at the rate  of  thirty  per
    51  centum.    No  such reimbursement shall be provided for services if they
    52  are not approved in a community health assessment  and  plan  or  if  no
    53  community health assessment and plan is submitted for such services.
    54    § 12. Section 611 of the public health law is REPEALED.
        S. 6457                            66                            A. 9557

     1    §  13.  Subdivision  1  of  section  616  of the public health law, as
     2  amended by chapter 474 of the laws  of  1996,  is  amended  to  read  as
     3  follows:
     4    1.  The  total  amount  of state aid provided pursuant to this article
     5  shall be limited to the amount of the annual appropriation made  by  the
     6  legislature.  In no event, however, shall such state aid be less than an
     7  amount to provide the full base grant  and,  as  otherwise  provided  by
     8  paragraph  (a)  of  subdivision  two of section six hundred five of this
     9  article, at least thirty-six per centum of the  difference  between  the
    10  amount of moneys expended by the municipality for public health services
    11  required  by  paragraph  (b) of subdivision three of section six hundred
    12  two of this article during the fiscal year and the base  grant  provided
    13  pursuant to subdivision one of section six hundred five of this article.
    14  A  municipality  shall  also  receive  at least thirty per centum of the
    15  moneys expended for other public health services pursuant  to  paragraph
    16  (b) of subdivision two of section six hundred five of this article, and,
    17  at  least  the minimum amount so required for the services identified in
    18  title two of this article, and thirty-six per centum for  those  munici-
    19  palities  meeting  the conditions described in paragraph (b) of subdivi-
    20  sion two of section six hundred five of this article.    [Moreover,  for
    21  services  provided  during calendar year nineteen hundred ninety-six, no
    22  county with a population of fifty thousand or less  shall  receive  less
    23  reimbursement  pursuant to subdivision one and paragraphs (a) and (b) of
    24  subdivision two of section six hundred five  of  this  article  than  it
    25  would  have  had  a  chapter  of the laws of nineteen hundred ninety-six
    26  amending these provisions as of August first, nineteen  hundred  ninety-
    27  six not been enacted.]
    28    §  14. The public health law is amended by adding a new section 621 to
    29  read as follows:
    30    § 621. State aid; public health emergencies.  If the state commission-
    31  er or a county health department or part-county department of health  or
    32  municipality,  with  the  approval of the state commissioner, determines
    33  that there is an imminent threat to public health, the department  shall
    34  reimburse counties or municipalities at fifty per centum for the cost of
    35  emergency  measures  as  approved  by  the department and subject to the
    36  approval of the director of the budget. Such funds shall be made  avail-
    37  able  from  funds  appropriated  for  public health emergencies, only to
    38  those counties or municipalities, which have expended  all  other  state
    39  aid  which  may  be  available for related activities and have developed
    40  measures to adequately address the emergency.  Reimbursement  is  condi-
    41  tioned upon availability of appropriated funds.
    42    § 15. Article 27-I of the public health law is REPEALED.
    43    § 16. Article 36-A of the public health law is REPEALED.
    44    § 17. Section 276-a of the public health law is REPEALED.
    45    § 18. Section 207 of the public health law is REPEALED.
    46    § 19. Subdivision 1 of section 2701 of the public health law, as added
    47  by chapter 821 of the laws of 1956, is amended to read as follows:
    48    1. Plan and implement public health programs to aid in the prevention,
    49  rehabilitation   and   control  of  degenerative  diseases  and  chronic
    50  illnesses.
    51    § 20. Subdivisions 4, 5, 6 and 7 of section 460 of the  public  health
    52  law are REPEALED and subdivisions 8 and 9 are renumbered 4 and 5.
    53    § 21. Section 461 of the public health law, as added by chapter 562 of
    54  the laws of 2001, is amended to read as follows:
    55    §  461.  [Permit  required.  1.  No  person  shall  be a body piercing
    56  specialist or tattooist and no person, firm,  corporation,  partnership,
        S. 6457                            67                            A. 9557

     1  or  other  association  shall  operate  a body piercing studio or tattoo
     2  studio without first obtaining a permit from the department.
     3    2.]  Promulgation  of  rules  and  regulations.  All  body piercing or
     4  tattooing shall be performed in accordance  with  the  rules  and  regu-
     5  lations  promulgated  by the commissioner pursuant to [the public health
     6  law] this chapter.  Such rules and regulations shall include but are not
     7  limited to operational standards and complaint investigation.
     8    [3. The department shall issue a permit if the body piercing  special-
     9  ist  and  body  piercing  studio  or  tattooist and tattoo studio are in
    10  compliance with this article, the penal law and the state sanitary  code
    11  and are not otherwise disqualified under this article.]
    12    § 22. Section 462 of the public health law, as added by chapter 562 of
    13  the laws of 2001, is amended to read as follows:
    14    §  462. Application of article. 1. [This article shall not apply to or
    15  affect a physician duly licensed under article one hundred thirty-one of
    16  the education law or x-ray technicians.
    17    2.] This article shall not apply to, affect, or restrict  the  ability
    18  of  a  city,  town, village, or county to enact a local law or ordinance
    19  prohibiting or restricting body piercing or tattooing within such  city,
    20  town, village or county.
    21    [3.]  2. Nothing contained in this article shall be construed to limit
    22  the duty or power of an officer to  act  with  regard  to  an  immediate
    23  threat  to the health of the [customers of a body piercing specialist or
    24  tattooist or body piercing studio or tattoo studio or the] community  in
    25  which  [it]  the  body piercing or tattooing operation is located, or to
    26  alter or abridge any of the duties and powers now or hereafter  existing
    27  in  the  commissioner,  state district health officers, county boards of
    28  health, county commissioners of health or local boards of health.
    29    § 23. Sections 463, 464, 465, and 466 of the  public  health  law  are
    30  REPEALED.
    31    §  24.  Subdivision  1  of section 241 of the elder law, as amended by
    32  section 3 of chapter 645 of the laws of 2005,  is  amended  to  read  as
    33  follows:
    34    1.  "Covered  drug"  shall  mean a drug dispensed subject to a legally
    35  authorized prescription pursuant to section sixty-eight hundred  ten  of
    36  the  education  law,  and  insulin,  an  insulin  syringe, or an insulin
    37  needle. Such term shall not include: (a)  any  drug  determined  by  the
    38  commissioner  of the federal food and drug administration to be ineffec-
    39  tive or unsafe; (b) any drug dispensed in a package, or form  of  dosage
    40  or administration, as to which the commissioner of health finally deter-
    41  mines  in  accordance with the provisions of section two hundred [fifty]
    42  fifty-two of this title that a less expensive package, or form of dosage
    43  or administration, is available that is pharmaceutically equivalent  and
    44  equivalent  in  its therapeutic effect for the general health character-
    45  istics of the eligible program participant population;  (c)  any  device
    46  for  the  aid or correction of vision; (d) any drug, including vitamins,
    47  which is generally available without a physician's prescription; and (e)
    48  drugs for the treatment of [erectile dysfunction when prescribed for use
    49  by a person who is required to register as a sex  offender  pursuant  to
    50  article  six-C of the correction law, provided that any denial of cover-
    51  age for such drugs shall provide the patient with the means of obtaining
    52  additional information concerning both the denial and the means of chal-
    53  lenging such denial] sexual or erectile dysfunction, unless  such  drugs
    54  are  used  to  treat a condition, other than sexual or erectile dysfunc-
    55  tion, for which the drugs have been approved by  the  federal  food  and
    56  drug  administration.    Any  of  the  drugs enumerated in the preceding
        S. 6457                            68                            A. 9557

     1  sentence shall be considered a covered drug or a prescription  drug  for
     2  purposes of this article if it is added to the preferred drug list under
     3  article  two-A  of the public health law. For the purpose of this title,
     4  except  as  otherwise  provided in this section, a covered drug shall be
     5  dispensed in quantities no greater than  a  thirty  day  supply  or  one
     6  hundred  units, whichever is greater. In the case of a drug dispensed in
     7  a form of administration other than a tablet  or  capsule,  the  maximum
     8  allowed  quantity  shall be a thirty day supply; the panel is authorized
     9  to approve exceptions to these limits for  specific  products  following
    10  consideration  of recommendations from pharmaceutical or medical experts
    11  regarding commonly packaged quantities, unusual forms of administration,
    12  length of treatment or  cost  effectiveness.  In  the  case  of  a  drug
    13  prescribed  pursuant  to  section thirty-three hundred thirty-two of the
    14  public health law to treat one of the conditions that have been  enumer-
    15  ated  by the commissioner of health pursuant to regulation as warranting
    16  the prescribing of greater than a thirty day supply, such drug shall  be
    17  dispensed in quantities not to exceed a three month supply.
    18    §  25.  Subdivision  1  of section 241 of the elder law, as amended by
    19  section 4 of chapter 645 of the laws of 2005,  is  amended  to  read  as
    20  follows:
    21    1.  "Covered  drug"  shall  mean a drug dispensed subject to a legally
    22  authorized prescription pursuant to section sixty-eight hundred  ten  of
    23  the  education  law,  and  insulin,  an  insulin  syringe, or an insulin
    24  needle. Such term shall not include: (a)  any  drug  determined  by  the
    25  commissioner  of the federal food and drug administration to be ineffec-
    26  tive or unsafe; (b) any drug dispensed in a package, or form  of  dosage
    27  or administration, as to which the commissioner of health finally deter-
    28  mines  in  accordance with the provisions of section two hundred [fifty]
    29  fifty-two of this title that a less expensive package, or form of dosage
    30  or administration, is available that is pharmaceutically equivalent  and
    31  equivalent  in  its therapeutic effect for the general health character-
    32  istics of the eligible program participant population;  (c)  any  device
    33  for  the  aid  or correction of vision, or any drug, including vitamins,
    34  which is generally available without a physician's prescription; and (d)
    35  drugs for the treatment of [erectile dysfunction when prescribed for use
    36  by a person who is required to register pursuant to article six-C of the
    37  correction law, provided that any denial  of  coverage  for  such  drugs
    38  shall  provide the patient with the means of obtaining additional infor-
    39  mation concerning both the denial and  the  means  of  challenging  such
    40  denial]  sexual  or  erectile dysfunction, unless such drugs are used to
    41  treat a condition, other than sexual or erectile dysfunction, for  which
    42  the   drugs   have   been   approved   by  the  federal  food  and  drug
    43  administration.   For the purpose of this  title,  except  as  otherwise
    44  provided  in  this section, a covered drug shall be dispensed in quanti-
    45  ties no greater than a thirty day supply or one hundred units, whichever
    46  is greater. In the case of a drug dispensed in a form of  administration
    47  other  than a tablet or capsule, the maximum allowed quantity shall be a
    48  thirty day supply; the panel is  authorized  to  approve  exceptions  to
    49  these  limits for specific products following consideration of recommen-
    50  dations from pharmaceutical or medical experts regarding commonly  pack-
    51  aged quantities, unusual forms of administration, length of treatment or
    52  cost effectiveness. In the case of a drug prescribed pursuant to section
    53  thirty-three hundred thirty-two of the public health law to treat one of
    54  the  conditions  that have been enumerated by the commissioner of health
    55  pursuant to regulation as warranting the prescribing of greater  than  a
        S. 6457                            69                            A. 9557

     1  thirty  day  supply,  such  drug shall be dispensed in quantities not to
     2  exceed a three month supply.
     3    § 26. Subdivision 2 of section 241 of the elder law is amended to read
     4  as follows:
     5    2.  "Provider  pharmacy" shall mean a pharmacy registered in the state
     6  of New York pursuant to section sixty-eight hundred eight of the  educa-
     7  tion  law or a pharmacy registered in a state bordering the state of New
     8  York when certified as necessary by the executive director  pursuant  to
     9  section  two  hundred  [fifty]  fifty-three  of this title, for which an
    10  agreement to provide pharmacy services  for  purposes  of  this  program
    11  pursuant to section two hundred forty-nine of this title is in effect.
    12    § 27. Paragraph (b) of subdivision 1, paragraphs (a) and (b) of subdi-
    13  vision  2 and paragraph (d) of subdivision 3 of section 242 of the elder
    14  law, paragraph (d) of subdivision 3 as added by section 2 of part  A  of
    15  chapter 49 of the laws of 2004, are amended to read as follows:
    16    (b)  any  married resident who is at least sixty-five years of age and
    17  whose income for the calendar year immediately preceding  the  effective
    18  date  of the annual coverage period when combined with the income in the
    19  same calendar year of such married person's spouse beginning on or after
    20  January first, two thousand [five] one, is less than or equal  to  twen-
    21  ty-six thousand dollars. After the initial determination of eligibility,
    22  each  eligible  individual  must be redetermined eligible at least every
    23  twenty-four months.
    24    (a) any unmarried resident who is at least sixty-five years of age and
    25  whose income for the calendar year immediately preceding  the  effective
    26  date  of the annual coverage period beginning on or after January first,
    27  two thousand [five] one, is more than twenty thousand and less  than  or
    28  equal  to  thirty-five thousand dollars. After the initial determination
    29  of eligibility, each eligible individual must be  redetermined  eligible
    30  at least every twenty-four months; and
    31    (b)  any  married resident who is at least sixty-five years of age and
    32  whose income for the calendar year immediately preceding  the  effective
    33  date  of the annual coverage period when combined with the income in the
    34  same calendar year of such married person's spouse beginning on or after
    35  January first, two thousand [five] one, is more than twenty-six thousand
    36  dollars and less than or equal to  fifty  thousand  dollars.  After  the
    37  initial  determination  of eligibility, each eligible individual must be
    38  redetermined eligible at least every twenty-four months.
    39    (d) The elderly pharmaceutical insurance coverage program  is  author-
    40  ized  to  apply for transitional assistance under the [medical] medicare
    41  prescription drug discount program with a specific  drug  discount  card
    42  under title XVIII of the federal social security act on behalf of appli-
    43  cants and eligible program participants under this [article] title.  The
    44  elderly  pharmaceutical  insurance coverage program shall provide appli-
    45  cants and eligible program participants with prior  written  notice  of,
    46  and the opportunity to decline, such automatic enrollment.
    47    §  28.  Paragraphs (h), (i) and (j) of subdivision 5 of section 244 of
    48  the elder law are amended to read as follows:
    49    (h) prepare an evaluation report on the experience of the program  for
    50  the  governor  and  the  legislature  no later than November first, [two
    51  thousand five] nineteen hundred ninety-five.  Such report should include
    52  the recommendations of the panel  concerning  the  continuation  of  the
    53  program beyond its expiration;
    54    (i) establish policies and procedures to allow individuals who partic-
    55  ipate  in the catastrophic deductible plan on December thirty-first, two
    56  thousand [five] to continue to receive benefits under the provisions  of
        S. 6457                            70                            A. 9557

     1  section  two  hundred  forty-eight  of  this title in effect on December
     2  thirty-first, two thousand [five], if and for as long as the enrollee so
     3  chooses; and
     4    (j)  facilitate  implementation  of an expanded elderly pharmaceutical
     5  insurance coverage program on January first, two thousand [six] one,  by
     6  commencing  no  later  than October first, two thousand [five], outreach
     7  activities, including but not limited to the dissemination  of  informa-
     8  tion  to  local  governments and senior citizen provider advocacy groups
     9  regarding such expanded  program.  The  panel  shall  make  applications
    10  available  for  the  expanded  elderly pharmaceutical insurance coverage
    11  program on October first, two thousand [five].
    12    § 29. Subdivision 4 of section 245 of the elder law is amended to read
    13  as follows:
    14    4. Establish procedures to prorate registration fees for  any  partic-
    15  ipant's  annual  coverage  period  which  began after January first, two
    16  thousand [five] and before January first, two thousand [six]  one.  Such
    17  proration  shall  be calculated on a daily basis and ensure that program
    18  participants are afforded  an  equitable  transition  from  the  program
    19  established  pursuant  to  this  title to the revised program to go into
    20  effect on January first, two thousand [six] one.
    21    § 30. Paragraphs (c) and (d) of subdivision 2  and  paragraph  (c)  of
    22  subdivision  4  of  section  247 of the elder law are amended to read as
    23  follows:
    24    (c) In the event that the state expenditures per  participant  meeting
    25  the  registration  fee  requirements  of  this subdivision, exclusive of
    26  expenditures for program administration, in the program year  commencing
    27  October first, [two thousand five] nineteen hundred ninety-eight, and in
    28  each  program  year thereafter, exceed such expenditures in the previous
    29  program year by a minimum of ten percent, the annual  registration  fees
    30  set  forth in this subdivision may, unless otherwise provided by law, be
    31  increased, pro-rata, for the subsequent program year, provided that such
    32  increase shall not exceed 7.5 percent of  the  prior  year  registration
    33  fees as may have been adjusted in accordance with this paragraph.
    34    (d)  In  the  event  that the state expenditures per such participant,
    35  incurred pursuant to this subdivision,  exclusive  of  expenditures  for
    36  program  administration,  in  the program year commencing October first,
    37  [two thousand five] nineteen hundred ninety-eight, and in  each  program
    38  year thereafter, are less than such expenditures in the previous program
    39  year by a minimum of ten percent, the annual registration fees set forth
    40  in this subdivision may, unless otherwise provided by law, be decreased,
    41  pro-rata,  for  the subsequent program year, provided that such decrease
    42  shall not exceed 7.5 percent of the prior year registration fees as  may
    43  have been adjusted in accordance with this paragraph.
    44    (c)  Effective  October  first,  [two  thousand five] nineteen hundred
    45  ninety-eight, the limits on point of sale co-payments as  set  forth  in
    46  this subdivision may be adjusted by the panel on the anniversary date of
    47  each  program  participant's annual coverage period, and such adjustment
    48  shall be in effect for the duration of that annual coverage period.  Any
    49  such  annual  adjustment  shall  be  made  using a percentage adjustment
    50  factor which shall not exceed one-half of  the  difference  between  the
    51  year-to-year  percentage  increase  in  the consumer price index for all
    52  urban consumers, as published by the United States Department of  Labor,
    53  and,  if  larger,  the year-to-year percentage increase in the aggregate
    54  average cost of covered drugs purchased under this title, which year-to-
    55  year percentage increase in such cost shall be determined by  comparison
    56  of  such  cost  in  the same month of each of the appropriate successive
        S. 6457                            71                            A. 9557

     1  years; provided, however, that for any such adjustment based  wholly  on
     2  experience  in  the program year commencing October first, [two thousand
     3  five]  nineteen  hundred  ninety-eight,  the   year-to-year   percentage
     4  increase  in such cost shall be determined by comparison of such cost in
     5  each of two months no less  than  five  months  apart  and  within  such
     6  program  year,  which  comparison  shall  be annualized. Such percentage
     7  adjustment factor shall be the same as that used to determine any  simi-
     8  lar  annual  adjustment for the same annual coverage periods pursuant to
     9  the provisions of subdivision [two] four of section two  hundred  forty-
    10  eight of this title.
    11    §  31.  Paragraphs  (c)  and (d) of subdivision 2 and paragraph (c) of
    12  subdivision 4 of section 248 of the elder law are  amended  to  read  as
    13  follows:
    14    (c)  In the event that the state expenditures per participant electing
    15  to meet the deductible requirements of this  subdivision,  exclusive  of
    16  expenditures  for program administration, in the program year commencing
    17  October first, [two thousand five] nineteen hundred ninety-eight, and in
    18  each program year thereafter, exceed such expenditures in  the  previous
    19  program  year  by  a minimum of ten percent, the annual personal covered
    20  drug expenditures set forth in this subdivision  may,  unless  otherwise
    21  provided  by  law,  be  increased,  pro-rata, for the subsequent program
    22  year, provided that such increase shall not exceed eight percent of  the
    23  prior  year personal covered drug expenditures as may have been adjusted
    24  in accordance with this paragraph.
    25    (d) In the event that the state  expenditures  per  such  participant,
    26  incurred  pursuant  to  this  subdivision, exclusive of expenditures for
    27  program administration, in the program year  commencing  October  first,
    28  [two  thousand  five] nineteen hundred ninety-eight, and in each program
    29  year thereafter, are less than such expenditures in the previous program
    30  year by a minimum of ten  percent,  the  annual  personal  covered  drug
    31  expenditures  set  forth  in  this  subdivision  may,  unless  otherwise
    32  provided by law, be decreased,  pro-rata,  for  the  subsequent  program
    33  year,  provided that such decrease shall not exceed eight percent of the
    34  prior year personal covered drug expenditures as may have been  adjusted
    35  in accordance with this paragraph.
    36    (c)  Effective  October  first,  [two  thousand five] nineteen hundred
    37  ninety-eight, the limits on point of sale co-payments as  set  forth  in
    38  this subdivision may be adjusted by the panel on the anniversary date of
    39  each  program  participant's annual coverage period, and such adjustment
    40  shall be in effect for the duration of that annual coverage period.  Any
    41  such  annual  adjustment  shall  be  made  using a percentage adjustment
    42  factor which shall not exceed one-half of  the  difference  between  the
    43  year-to-year  percentage  increase  in  the consumer price index for all
    44  urban consumers, as published by the United States Department of  Labor,
    45  and,  if  larger,  the year-to-year percentage increase in the aggregate
    46  average cost of covered drugs purchased under this title, which year-to-
    47  year percentage increase in such cost shall be determined by  comparison
    48  of  such  cost  in  the same month of each of the appropriate successive
    49  years; provided, however, that for any such adjustment based  wholly  on
    50  experience  in  the program year commencing October first, [two thousand
    51  five]  nineteen  hundred  ninety-eight,  the   year-to-year   percentage
    52  increase  in such cost shall be determined by comparison of such cost in
    53  each of two months no less  than  five  months  apart  and  within  such
    54  program  year,  which  comparison  shall  be annualized. Such percentage
    55  adjustment factor shall be the same as that used to determine any  simi-
    56  lar  annual  adjustment for the same annual coverage periods pursuant to
        S. 6457                            72                            A. 9557

     1  the provisions of subdivision four of section two hundred forty-seven of
     2  this title. Such annual adjustments shall be calculated  by  multiplying
     3  the  percentage  adjustment  factor  by (1) ten percent and applying the
     4  resulting percentage to the upper income limitation of each income level
     5  for  unmarried  individuals  contained  in  this subdivision, and by (2)
     6  seven and one-half percent and applying the resulting percentage to  the
     7  upper  income  limitation  of  each income level for married individuals
     8  contained in this subdivision; each result of such  calculations,  minus
     9  any  applicable deductible increases made pursuant to subdivision two of
    10  this section and plus the result of applying the  percentage  adjustment
    11  factor  to the sum of any such annual adjustments applicable thereto for
    12  any prior annual coverage period, shall be the amount by which the limit
    13  on co-payments for each such income level  may  be  adjusted,  and  such
    14  amount  shall be in addition to any such amount or amounts applicable to
    15  prior annual coverage periods.
    16    § 32. Subparagraph 1 of paragraph (a) of subdivision 3 and subdivision
    17  5 of section 250 of the elder law are amended to read as follows:
    18    (1) any agreement between the program and a manufacturer entered  into
    19  before  August  first,  [two thousand five] nineteen hundred ninety-one,
    20  shall be deemed to have been entered into on April first, [two  thousand
    21  five]  nineteen  hundred  ninety-one;  and  provided  further, that if a
    22  manufacturer has not entered  into  an  agreement  with  the  department
    23  before  August  first,  [two thousand five] nineteen hundred ninety-one,
    24  such agreement shall not be effective until April first,  [two  thousand
    25  five]  nineteen  hundred ninety-one, unless such agreement provides that
    26  rebates will be retroactively calculated as if the agreement had been in
    27  effect on April first, [two thousand five] nineteen hundred  ninety-one;
    28  and
    29    5.  Notwithstanding  any  other provision of law, the [commissioner of
    30  the office of children and family services]  panel  shall  maximize  the
    31  coordination  of  benefits for persons enrolled under Title XVIII of the
    32  federal social security act (medicare) and enrolled under this title  in
    33  order to facilitate medicare payment of claims. The [commissioner of the
    34  office  of children and family services] panel may select an independent
    35  contractor, through  a  request-for-proposal  process,  to  implement  a
    36  centralized  coordination  of benefits system under this subdivision for
    37  individuals qualified in both the [medical assistance]  elderly  pharma-
    38  ceutical  insurance  coverage  (EPIC)  program and medicare programs who
    39  receive[,  including  but  not  limited  to,]   medications[,   sickroom
    40  supplies]  or  other covered products from a pharmacy provider currently
    41  enrolled in the [medical assistance]  elderly  pharmaceutical  insurance
    42  coverage (EPIC) program.
    43    §  33. Subparagraph 2 of paragraph (a) of subdivision 1 of section 250
    44  of the elder law, as amended by section 17 of part A of  chapter  58  of
    45  the laws of 2004, is amended to read as follows:
    46    (2)  The  sum  of  the upper limit set by the centers for medicare and
    47  medicaid services for such multiple source drug,  or  average  wholesale
    48  price  discounted by [sixteen and one-half] thirty percent when no upper
    49  limit has been established by the centers for  [Medicare]  medicare  and
    50  [Medicaid]  medicaid  services  for  such  multiple  source drug, plus a
    51  dispensing fee as defined in paragraph (c) of this subdivision.
    52    § 34. Subparagraph 1 of paragraph (b) of subdivision 1 of section  250
    53  of  the  elder  law, as amended by section 17 of part A of chapter 58 of
    54  the laws of 2004, is amended to read as follows:
        S. 6457                            73                            A. 9557

     1    (1) Average wholesale price discounted  by  [twelve  and  seventy-five
     2  hundredths  of one] fifteen percent, plus a dispensing fee as defined in
     3  paragraph (c) of this subdivision, or
     4    §  35. Paragraph (e) of subdivision 3 of section 242 of the elder law,
     5  as added by section 5 of part A of chapter 58 of the laws  of  2005,  is
     6  amended to read as follows:
     7    (e)  As  a  condition of continued eligibility for benefits under this
     8  title, a program participant is required to provide,  and  to  authorize
     9  the  elderly pharmaceutical insurance program to obtain, any information
    10  or documentation required to establish the participant's eligibility for
    11  a full premium subsidy under section  1860D-14  of  the  federal  social
    12  security  act.  A  program  participant  who  is found eligible for such
    13  subsidy must enroll in Part D as a condition of continued  participation
    14  in  the program, unless such enrollment will result in significant addi-
    15  tional financial liability on behalf of the  participant.  In  order  to
    16  maximize  prescription  drug coverage under Part D of title XVIII of the
    17  federal social security act, the elderly pharmaceutical insurance cover-
    18  age program is authorized to represent program participants  under  this
    19  title  in  the  pursuit of such coverage.  Such representation shall not
    20  result in any additional financial liability on behalf of  such  program
    21  participants  and  shall  include,  but not be limited to, the following
    22  actions:
    23    (i) application for the premium and cost-sharing subsidies  on  behalf
    24  of eligible program participants;
    25    (ii) enrollment in a prescription drug plan or MA-PD plan; the elderly
    26  pharmaceutical  insurance coverage program shall provide program partic-
    27  ipants with prior written notice of, and  the  opportunity  to  decline,
    28  such enrollment;
    29    (iii) pursuit of appeals, grievances, or coverage determinations.
    30    §  36.  Section 4 of part X2 of chapter 62 of the laws of 2003, amend-
    31  ing the public health law relating to allowing for the use of  funds  of
    32  the office of professional medical conduct for activities of the patient
    33  health  information  and  quality improvement act of 2000, as amended by
    34  section 8 of part A of chapter 58 of the laws of  2005,  is  amended  to
    35  read as follows:
    36    §  4.  This  act  shall  take  effect  immediately;  provided that the
    37  provisions of section one of this act shall be deemed to  have  been  in
    38  full  force  and  effect  on  and after April 1, 2003[, and shall expire
    39  March 31, 2006 when upon such date the provisions of such section  shall
    40  be deemed repealed].
    41    §  37.  This  act shall take effect immediately and shall be deemed to
    42  have been in full force and effect on or after April 1, 2006;  provided,
    43  however,  that  sections  ten  through fourteen of this act, relating to
    44  article VI of the public health law, shall take  effect  on  January  1,
    45  2007  and sections thirty-one through thirty-five of this act shall take
    46  effect July 1, 2006; provided, further, that the amendments to  subdivi-
    47  sion  1  of  section 241 of the elder law made by section twenty-four of
    48  this act shall be subject to the expiration and reversion of such subdi-
    49  vision pursuant to section 79 of part C of chapter 58  of  the  laws  of
    50  2005,  as amended, when upon such date the provisions of section twenty-
    51  five of this act shall take effect.

    52                                   PART C

    53    Section 1. 1. Subject to available appropriations,  the  commissioners
    54  of  the office of mental health, office of mental retardation and devel-
        S. 6457                            74                            A. 9557

     1  opmental  disabilities,  office  of  alcoholism  and   substance   abuse
     2  services,  department  of health, office of children and family services
     3  and the state office for the aging shall establish  an  annual  cost  of
     4  living adjustment (COLA), subject to the approval of the director of the
     5  budget,  effective  April  first  of  each  state fiscal year, provided,
     6  however, that in state fiscal year 2006-07, the cost of  living  adjust-
     7  ment  will  be  effective  October  first, to project for the effects of
     8  inflation, for rates  of  payments,  contracts  or  any  other  form  of
     9  reimbursement  for  the  programs listed in paragraphs (i), (ii), (iii),
    10  (iv), (v) and (vi) of subdivision four of this section. The  COLA  shall
    11  be  applied to the appropriate portion of reimbursable costs or contract
    12  amounts.
    13    2. In developing cost of living adjustments  under  this  subdivision,
    14  the  commissioners shall use the most recent congressional budget office
    15  estimate of the budget year's U. S. consumer price index for  all  urban
    16  consumers  published  in  the  congressional  budget office economic and
    17  budget outlook after June first of the budget year prior to the year for
    18  which rates of payments, contracts or any other  form  of  reimbursement
    19  are being developed.
    20    3.  After final U. S. consumer price index (CPI) for all urban consum-
    21  ers published by the United States department of labor, bureau of  labor
    22  statistics, for a particular budget year, the commissioners shall recon-
    23  cile  such  final  CPI with the estimate used in subdivision two of this
    24  section and any difference will be included in the next prospective cost
    25  of living adjustment.
    26    4. Programs eligible.
    27    (i) Programs eligible for the cost of  living  adjustments  under  the
    28  auspice  of  the  office  of  mental health (OMH) include: comprehensive
    29  outpatient program (COPS), non-COPS and community support program compo-
    30  nents of the reimbursement for OMH licensed outpatient programs,  pursu-
    31  ant  to part 592, part 588.13 and part 588.14 respectively of the office
    32  of mental health regulations; disproportionate share payments made under
    33  chapter 119 of the laws of 1997  as  amended;  partial  hospitalization;
    34  intensive  psychiatric  rehabilitation treatment; outreach; crisis resi-
    35  dence; crisis/respite beds; comprehensive psychiatric emergency  program
    36  crisis  outreach;  comprehensive  psychiatric  emergency  program crisis
    37  beds; crisis intervention; home based crisis intervention; comprehensive
    38  psychiatric emergency program crisis intervention; family  care;  family
    39  based  treatment;  supported  single  room occupancy; supported housing;
    40  supported housing community services;  treatment  congregate;  supported
    41  congregate; community residence - children & youth; treatment/apartment;
    42  supported  apartment; community residence single room occupancy; on-site
    43  rehabilitation; sheltered workshop/satellite sheltered workshop; transi-
    44  tional employment; recreation; respite care;  transportation;  psychoso-
    45  cial  club; assertive community treatment; case management; blended case
    46  management; local government unit administration; monitoring and  evalu-
    47  ation;  children  and  youth  vocational  services; enclave in industry;
    48  single point of access; assisted competitive employment; school  program
    49  without  clinic;  family  support  children  and youth; advocacy/support
    50  services; drop in centers; intensive case management; transition manage-
    51  ment services; bridger; home and community based waiver services  pursu-
    52  ant to subdivision 9 of section 366 of the social services law; affirma-
    53  tive  business industries; self-help programs; consumer service dollars;
    54  intensive  case  management/supportive  case   management/blended   case
    55  management  emergency  and  non-emergency service dollars; conference of
    56  local mental hygiene directors; client worker; multicultural initiative;
        S. 6457                            75                            A. 9557

     1  ongoing integrated supported employment services;  supported  education;
     2  MICA  network;  personalized recovery oriented service except for clinic
     3  treatment fee component; supportive case management; assertive community
     4  treatment  team service dollars; and state aid funding provided pursuant
     5  to article 41 of the mental hygiene law for residential treatment facil-
     6  ity transition coordinator, inpatient  psychiatric  unit  of  a  general
     7  hospital, day treatment, clinic and continuing day treatment.
     8    (ii)  Programs  eligible  for the cost of living adjustments under the
     9  auspice of the office of mental retardation and developmental  disabili-
    10  ties  include:  local/unified  services;  chapter  620; direct sheltered
    11  workshop; long term sheltered employment; voluntary  operated  community
    12  residences;  article 16 clinics; day treatment; family support services;
    13  100% day training; epilepsy services; and individual support services.
    14    (iii) Programs eligible for the cost of living adjustments  under  the
    15  auspice  of  the  office  of  alcoholism  and  substance  abuse services
    16  include:  chemical dependence crisis services; inpatient  rehabilitation
    17  services;   residential   services;  outpatient  services;  chemotherapy
    18  substance abuse programs; residential rehabilitation services for youth;
    19  compulsive gambling programs; chemical dependence school and  community-
    20  based  prevention  and  education  programs; managed addiction treatment
    21  services; case management; vocational and job placement services; recov-
    22  ery services; and program support services, provided that such  programs
    23  receive  state  aid  funding  support  from the office of alcoholism and
    24  substance abuse services. State aid funding  support,  for  purposes  of
    25  cost  of  living adjustment eligibility, is limited to the local assist-
    26  ance account of the general fund, federal substance abuse prevention and
    27  treatment block grant funds, and federal safe and drug-free schools  and
    28  communities  grant  funds appropriated to and administered by the office
    29  of alcoholism and substance abuse services.
    30    (iv) Programs eligible for the cost of living  adjustments  under  the
    31  auspice of the department of health include: adolescent services/ACT for
    32  youth;  adolescent  services/general; adolescent services/schools; clin-
    33  ical education;  clinical  guidelines  development;  clinical  scholars;
    34  clinical  trials  experimental  treatment;  community development initi-
    35  ative; community HIV prevention and  primary  care;  community  services
    36  programs;  criminal  justice;  education  and  training;  evaluation and
    37  research; expanded syringe access program; families in transition; fami-
    38  ly  centered  care;  harm  reduction/general;   harm   reduction/syringe
    39  exchange;  HIV  health care and support services for women and kids; HIV
    40  prevention/primary care/support services for substance abusers; homeless
    41  shelters;  legal  services  and  advocacy;   lesbian,   gay,   bisexual,
    42  transgender/adolescent;  lesbian,  gay,  bisexual,  transgender/general;
    43  lesbian, gay,  bisexual,  transgender/substance  use;  multiple  service
    44  agency; nutritional services; pediatric centers of excellence; permanen-
    45  cy  planning;  racial  and ethnic minority; social day care; specialized
    46  care centers for youth; specialty; supportive housing; treatment  adher-
    47  ence;   women's   services/general;   women's   services/peer;   women's
    48  services/supportive services; youth  access  program;  minority  health;
    49  center  for  community health program; red cross emergency preparedness;
    50  nutrition outreach and education; obesity  prevention;  women,  infants,
    51  and children; hunger prevention and nutrition assistance; Indian health;
    52  asthma;  prenatal  care  assistance  program;  rape crisis; early inter-
    53  vention; health  and  human  services  sexuality  related;  infertility;
    54  maternity/early childhood foundation; abstinence education; family plan-
    55  ning;  school  health;  sudden  infant  death  syndrome;  childhood lead
    56  poisoning prevention; enhanced services for kids; act for  youth;  chil-
        S. 6457                            76                            A. 9557

     1  dren  with  special  health care needs; regional perinatal data centers;
     2  migrant health; dental services; osteoporosis prevention; eating  disor-
     3  ders;  cancer  services;  cancer  registry;  healthy  heart; alzheimer's
     4  disease  assistance  centers;  alzheimer's disease - research and educa-
     5  tion; diabetes screening, education  and  prevention;  tobacco  control;
     6  rabies; tick-borne; immunization; public health campaign; sexually tran-
     7  smitted disease; and tuberculosis control.
     8    (v)  Programs  eligible  for  the cost of living adjustments under the
     9  auspice of the state office for the aging  include:  community  services
    10  for  the elderly; expanded in-home services for the elderly; and supple-
    11  mental nutrition assistance program.
    12    (vi) Programs eligible  for  cost  of  living  adjustments  under  the
    13  auspice  of the office of children and family services include: programs
    14  for which the office of children and family services establishes maximum
    15  state aid rates pursuant to section 398-a of the social services law and
    16  sections 4003 and 4405 of the education law,  foster  parents,  adoptive
    17  parents, and home and community based waiver services pursuant to subdi-
    18  vision  9  of  section  366  of the social services law for which social
    19  services districts have chosen  to  use  preventive  services  funds  to
    20  support a portion of the costs.
    21    5.  Furthermore,  each  provider receiving such funding shall submit a
    22  written certification, in such form and at such time as each commission-
    23  er shall prescribe, attesting how such funding will be or  was  used  to
    24  promote the recruitment and retention of staff or respond to other crit-
    25  ical  non-personal  service  costs during the State fiscal year in which
    26  the cost of living adjustment was applied.
    27    § 2. This act shall take effect immediately and  shall  be  deemed  to
    28  have been in full force and effect on and after April 1, 2006, and shall
    29  expire and be deemed repealed April 1, 2009.

    30                                   PART D

    31    Section  1.  Paragraph  (e)  of subdivision 1 of section 2807-l of the
    32  public health law, as amended by section 19 of part E of chapter  63  of
    33  the laws of 2005, is amended to read as follows:
    34    (e)  Funds  shall  be  reserved  and accumulated from year to year and
    35  shall be available,  including income from invested funds, for  purposes
    36  of  distributions  to  organizations  to  support  the  health workforce
    37  retraining program established pursuant to section twenty-eight  hundred
    38  seven-g  of  this   article  from the respective health care initiatives
    39  pools established for the following periods  in  the  following  amounts
    40  from  the  pools during the period January first, nineteen hundred nine-
    41  ty-seven through December thirty-first, nineteen hundred ninety-nine, up
    42  to fifty million dollars on an annualized basis, up  to  thirty  million
    43  dollars  for  the  period  January  first, two thousand through December
    44  thirty-first, two thousand, up to forty million dollars for  the  period
    45  January first, two thousand one through December thirty-first, two thou-
    46  sand  one, up to fifty million dollars for the period January first, two
    47  thousand two through December thirty-first,  two  thousand  two,  up  to
    48  forty-one  million  one  hundred  fifty  thousand dollars for the period
    49  January first, two thousand three  through  December  thirty-first,  two
    50  thousand  three,  up  to  forty-one  million  one hundred fifty thousand
    51  dollars for the period January first, two thousand four through December
    52  thirty-first, two thousand four, up to fifty-eight million three hundred
    53  sixty thousand dollars for the period January first, two  thousand  five
    54  through  December  thirty-first,  two  thousand  five,  up to [fifty-two
        S. 6457                            77                            A. 9557

     1  million three hundred sixty thousand] twenty-nine  million  two  hundred
     2  thousand  dollars for the period January first, two thousand six through
     3  December thirty-first, two thousand six and up to  [twenty-nine  million
     4  one  hundred  eighty  thousand]  fourteen  million  six hundred thousand
     5  dollars for the period January first, two thousand  seven  through  June
     6  thirtieth,  two  thousand  seven, less the amount of funds available for
     7  allocations for rate adjustments for  workforce  training  programs  for
     8  payments by state governmental agencies for inpatient hospital services.
     9    §  2. Subparagraphs (vii) and (viii) of paragraph (j) of subdivision 1
    10  of section 2807-v of the public health law, subparagraph (vii) as  added
    11  and  subparagraph (viii) as amended by section 3 of part B of chapter 58
    12  of the laws of 2005, are amended to read as follows:
    13    (vii) up to [forty] eighty-one million  [six]  nine  hundred  thousand
    14  dollars  for the period January first, two thousand six through December
    15  thirty-first, two thousand six, provided, however, that  within  amounts
    16  appropriated,  a portion of such funds may be transferred to the Roswell
    17  Park Cancer Institute  Corporation  to  support  costs  associated  with
    18  cancer research; and
    19    (viii)  up to [twenty] forty-seven million [three] eight hundred thou-
    20  sand dollars for the period January first, two  thousand  seven  through
    21  June  thirtieth,  two  thousand  seven,  provided,  however, that within
    22  amounts appropriated, a portion of such funds may be transferred to  the
    23  Roswell  Park  Cancer  Institute Corporation to support costs associated
    24  with cancer research.
    25    § 3. Subparagraphs (vii) and (viii) of paragraph (k) of subdivision  1
    26  of  section 2807-v of the public health law, subparagraph (vii) as added
    27  and subparagraph (viii) as amended by section 3 of part B of chapter  58
    28  of the laws of 2005, are amended to read as follows:
    29    (vii)  one  hundred  [forty-one] fifty-six million [eight] six hundred
    30  thousand dollars, plus an additional five hundred thousand dollars,  for
    31  the  period  January  first,  two  thousand six through December thirty-
    32  first, two thousand six; and
    33    (viii) [seventy] seventy-five million  [six]  seven  hundred  thousand
    34  dollars,  plus an additional two hundred fifty thousand dollars, for the
    35  period January first, two thousand seven  through  June  thirtieth,  two
    36  thousand seven.
    37    §  4. Subparagraphs (vii) and (viii) of paragraph (n) of subdivision 1
    38  of section 2807-v of the public health law, subparagraph (vii) as  added
    39  and  subparagraph (viii) as amended by section 3 of part B of chapter 58
    40  of the laws of 2005, are amended to read as follows:
    41    (vii) [six hundred twenty] five hundred  sixty  million  four  hundred
    42  thousand  dollars for the period January first, two thousand six through
    43  December thirty-first, two thousand six; and
    44    (viii) three hundred [thirty-six] sixteen million one hundred thousand
    45  dollars for the period January first, two thousand  seven  through  June
    46  thirtieth, two thousand seven.
    47    §  5.  Subparagraph (vii) of paragraph (o) of subdivision 1 of section
    48  2807-v of the public health law, as added by section  3  of  part  B  of
    49  chapter 58 of the laws of 2005, is amended to read as follows:
    50    (vii)  [seventy-eight] ninety-one million dollars for the period Janu-
    51  ary first, two thousand six through December thirty-first, two  thousand
    52  six; and
    53    §  6.  Subparagraphs (v) and (vi) of paragraph (v) of subdivision 1 of
    54  section 2807-v of the public health law, subparagraph (v) as  added  and
    55  subparagraph (vi) as amended by section 3 of part B of chapter 58 of the
    56  laws of 2005, are amended to read as follows:
        S. 6457                            78                            A. 9557

     1    (v)  up  to  [sixty-five]  one  hundred thirteen million eight hundred
     2  thousand dollars for the period January first, two thousand six  through
     3  December thirty-first, two thousand six; and
     4    (vi) up to [thirty-two] forty-eight million [five] eight hundred thou-
     5  sand  dollars  for  the period January first, two thousand seven through
     6  June thirtieth, two thousand seven.
     7    § 7. The opening paragraph of  paragraph  (hh)  of  subdivision  1  of
     8  section 2807-v of the public health law, as amended by section 3 of part
     9  B of chapter 58 of the laws of 2005, is amended to read as follows:
    10    Funds shall be deposited by the commissioner, within amounts appropri-
    11  ated,  and  the  state  comptroller is hereby authorized and directed to
    12  receive for deposit to the credit of the special revenue fund  -  other,
    13  HCRA  transfer  fund,  [health care services] medical assistance account
    14  for purposes of providing financial  assistance  to  residential  health
    15  care  facilities  pursuant  to  subdivisions  nineteen and twenty-one of
    16  section twenty-eight hundred eight of this  article,  from  the  tobacco
    17  control  and  insurance  initiatives  pool established for the following
    18  periods in the following amounts:
    19    § 8. Subparagraphs (v) and (vi) of paragraph (kk) of subdivision 1  of
    20  section  2807-v  of the public health law, subparagraph (v) as added and
    21  subparagraph (vi) as amended by section 3 of part B of chapter 58 of the
    22  laws of 2005, are amended to read as follows:
    23    (v) up to [five]  eight  hundred  [seventy]  sixty-six  million  three
    24  hundred  thousand dollars for the period January first, two thousand six
    25  through December thirty-first, two thousand six; and
    26    (vi) up to [one]  two  hundred  [thirty]  twenty-eight  million  eight
    27  hundred  thousand  dollars  for  the  period January first, two thousand
    28  seven through June thirtieth, two thousand seven.
    29    § 9. Subparagraphs (iv) and (v) of paragraph (mm) of subdivision 1  of
    30  section  2807-v of the public health law, subparagraph (iv) as added and
    31  subparagraph (v) as amended by section 3 of part B of chapter 58 of  the
    32  laws of 2005, are amended to read as follows:
    33    (iv)  [three]  two  hundred  [three]  ninety-seven million one hundred
    34  thousand dollars for the period January first, two thousand six  through
    35  December thirty-first, two thousand six; and
    36    (v) one hundred [fifty-seven] fifty-five million dollars for the peri-
    37  od  January  first, two thousand seven through June thirtieth, two thou-
    38  sand seven.
    39    § 10. Subparagraphs (ii) and (iii) of paragraph (zz) of subdivision  1
    40  of  section  2807-v of the public health law, as added by chapter 161 of
    41  the laws of 2005, are amended to read as follows:
    42    (ii) [sixteen million two hundred fifty]  one  hundred  eight  million
    43  three  hundred  thousand dollars for the period January first, two thou-
    44  sand six through December  thirty-first,  two  thousand  six,  provided,
    45  however,  that  within amounts appropriated, a portion of such funds may
    46  be transferred to the Roswell Park Cancer Institute Corporation to  fund
    47  capital costs; and
    48    (iii) [sixteen million two hundred fifty] eighty million eight hundred
    49  thousand  dollars  for  the  period  January  first,  two thousand seven
    50  through June thirtieth, two  thousand  seven,  provided,  however,  that
    51  within  amounts appropriated, a portion of such funds may be transferred
    52  to the Roswell Park Cancer Institute Corporation to fund capital costs.
    53    § 11. Section 2807-b of the public health law is REPEALED  and  a  new
    54  section 2807-b is added to read as follows:
    55    §  2807-b.    Outstanding  payments  and reports due under subdivision
    56  eighteen of section twenty-eight hundred seven-c, sections  twenty-eight
        S. 6457                            79                            A. 9557

     1  hundred  seven-d,  twenty-eight  hundred  seven-j,  twenty-eight hundred
     2  seven-s and twenty-eight hundred seven-t of this article.   1. If  there
     3  is  a  basis  for  estimating  the amount of outstanding payments due in
     4  accordance  with  subdivision  eighteen  of section twenty-eight hundred
     5  seven-c of this article,  and  sections  twenty-eight  hundred  seven-d,
     6  twenty-eight  hundred  seven-j, twenty-eight hundred seven-s and twenty-
     7  eight hundred seven-t of  this  article,  the  commissioner  shall  bill
     8  applicable  providers and payors for such payments, including any inter-
     9  est and penalties set forth in this article, no later than  ninety  days
    10  after each calendar quarter following enactment of this section.
    11    2.  If  there  is  no  basis  for estimating the amount of outstanding
    12  payments due in accordance with subdivision eighteen of section  twenty-
    13  eight hundred seven-c of this article, and sections twenty-eight hundred
    14  seven-d,  twenty-eight hundred seven-j, twenty-eight hundred seven-s and
    15  twenty-eight hundred seven-t of this  article,  the  commissioner  shall
    16  notify  applicable  providers  and  payors  of  outstanding  reports and
    17  payments no later than ninety days after each calendar quarter following
    18  the effective date of this section.  Such notice shall include  informa-
    19  tion  regarding  any interest, penalties or other sanctions which may be
    20  implemented in accordance with this article.
    21    § 12. Paragraph (d) of subdivision 18 of section 2807-c of the  public
    22  health  law,  as amended by chapter 1 of the laws of 1999, is amended to
    23  read as follows:
    24    (d) Gross revenue received shall mean all moneys received  for  or  on
    25  account  of  inpatient hospital service, provided, however, that subject
    26  to the provisions of paragraph (e) of  this  subdivision  gross  revenue
    27  received  shall not include distributions from bad debt and charity care
    28  regional pools, health care services pools, bad debt  and  charity  care
    29  for  financially  distressed  hospitals statewide pools and bad debt and
    30  charity care and capital statewide pools created in accordance with this
    31  section or distributions from funds allocated in accordance with section
    32  twenty-eight hundred seven-l, twenty-eight hundred seven-k, twenty-eight
    33  hundred seven-v or twenty-eight hundred  seven-w  of  this  article  and
    34  shall  not include the components of rates of payment or charges related
    35  to the allowances provided in  accordance  with  subdivisions  fourteen,
    36  fourteen-b  and  fourteen-c  of this section, the adjustment provided in
    37  accordance with subdivision fourteen-a of this section,  the  adjustment
    38  provided  in accordance with subdivision fourteen-d of this section, the
    39  adjustment  for  health  maintenance  organization  reimbursement  rates
    40  provided  in  accordance  with former subdivision two-a of this section,
    41  or, if effective, the adjustment provided in accordance with subdivision
    42  fifteen of this section [or] the adjustment provided in accordance  with
    43  section  eighteen  of chapter two hundred sixty-six of the laws of nine-
    44  teen hundred eighty-six as  amended,  revenue  received  from  physician
    45  practice or faculty practice plan discrete billings for private practic-
    46  ing physician services, revenue from affiliation agreements or contracts
    47  with  public  hospitals for the delivery of health care services at such
    48  public hospitals, revenue received as  disproportionate  share  hospital
    49  payments in accordance with title nineteen of the federal social securi-
    50  ty act, or revenue from government deficit financing.
    51    §  13.  Paragraph (a) of subdivision 3 of section 2807-d of the public
    52  health law, as amended by chapter 161 of the laws of 2005, is amended to
    53  read as follows:
    54    (a) for general hospitals, all monies received for or  on  account  of
    55  inpatient  hospital  service,  outpatient  service,  emergency  service,
    56  referred ambulatory service and ambulatory surgical  service,  or  other
        S. 6457                            80                            A. 9557

     1  hospital   or   health-related   services,  excluding,  subject  to  the
     2  provisions of subdivision twelve of this section: distributions from bad
     3  debt and charity care  regional  pools,  primary  health  care  services
     4  regional  pools,  bad  debt  and charity care for financially distressed
     5  hospitals statewide pools and bad debt  and  charity  care  and  capital
     6  statewide  pools created in accordance with section twenty-eight hundred
     7  seven-c of this article and the components of rates of payment or charg-
     8  es related to the allowances provided in  accordance  with  subdivisions
     9  fourteen,  fourteen-b and fourteen-c, the adjustment provided in accord-
    10  ance with subdivision fourteen-a, the adjustment provided in  accordance
    11  with  subdivision  fourteen-d,  the  adjustment  for  health maintenance
    12  organization reimbursement rates provided  in  accordance  with  section
    13  twenty-eight hundred seven-f of this article, the adjustment for commer-
    14  cial  insurer  reimbursement rates provided in accordance with paragraph
    15  (i) of subdivision eleven of section  twenty-eight  hundred  seven-c  of
    16  this  article  or,  if  effective, the adjustment provided in accordance
    17  with subdivision fifteen of section twenty-eight hundred seven-c of this
    18  article or the adjustment provided in accordance with  section  eighteen
    19  of  chapter two hundred sixty-six of the laws of nineteen hundred eight-
    20  y-six as amended and physician practice or faculty practice plan revenue
    21  received by a general hospital based on discrete  billings  for  private
    22  practicing  physician  services,  revenue received by a general hospital
    23  from a public hospital pursuant to an affiliation agreement contract for
    24  the delivery of health care services to such  public  hospital,  revenue
    25  received  pursuant to section twenty-eight hundred seven-w of this arti-
    26  cle, all revenue received as disproportionate share  hospital  payments,
    27  in  accordance  with  title nineteen of the federal Social Security Act,
    28  revenue received pursuant to sections eleven, twelve, thirteen and four-
    29  teen of part A of chapter one of the laws of  two  thousand  two,  [and]
    30  revenue received pursuant to sections thirteen and fourteen of part B of
    31  chapter  one  of  the  laws  of  two  thousand two, revenue from patient
    32  personal fund allowances, revenue from income earned on  patient  funds,
    33  investment income from externally restricted funds, revenue from invest-
    34  ment  sinking  funds, revenue from investment operating escrow accounts,
    35  investment income from funded depreciation, investment income from mort-
    36  gage repayment escrow accounts, revenue derived from  the  operation  of
    37  schools  leading  to licensure, and revenue from the collection of sales
    38  and excise taxes;
    39    § 14. Subdivision 12 of section 2807-k of the  public  health  law  is
    40  amended by adding a new paragraph (c) to read as follows:
    41    (c)  Such  reports shall comply with the reporting requirements estab-
    42  lished for receipt of  bad  debt  and  charity  care  pool  payments  as
    43  provided in accordance with section twenty-eight hundred seven-c of this
    44  article  and  regulations  promulgated  thereunder  for periods prior to
    45  January first, nineteen hundred ninety-seven.
    46    § 15. Paragraph (f) of subdivision 18 of section 2807-c of the  public
    47  health law, as amended by section 42 of part B of chapter 58 of the laws
    48  of 2005, is amended to read as follows:
    49    (f) Payments of assessments and allowances required to be submitted by
    50  general hospitals pursuant to this subdivision and subdivisions fourteen
    51  and  fourteen-b  of this section and paragraph (a) of subdivision two of
    52  section twenty-eight hundred seven-d of this article shall be subject to
    53  audit by the commissioner for a period of six years following the  close
    54  of  the  calendar  year in which such payments are due, after which such
    55  payments shall be deemed final and not subject to further adjustment  or
    56  reconciliation,   provided,   however,  that  nothing  herein  shall  be
        S. 6457                            81                            A. 9557

     1  construed as precluding the commissioner from pursuing collection of any
     2  such assessments and allowances which are identified as delinquent with-
     3  in such six year period, or which are  identified  as  delinquent  as  a
     4  result  of an audit commenced within such six year audit period, or from
     5  conducting an audit of any adjustment or reconciliation made by a gener-
     6  al hospital within such six year period.   General hospitals  which,  in
     7  the  course  of  such  an  audit,  fail to produce data or documentation
     8  requested in furtherance of such an audit, within thirty  days  of  such
     9  request  may  be  assessed a civil penalty of up to ten thousand dollars
    10  for each such failure, provided, however, that such civil penalty  shall
    11  not be imposed if the hospital demonstrates good cause for such failure.
    12  The  imposition  of  such  civil  penalties  shall  be  subject  to  the
    13  provisions of section twelve-a of this chapter.
    14    § 16. Paragraph (a) of subdivision 8-a of section 2807-j of the public
    15  health law, as added by section 43 of part B of chapter 58 of  the  laws
    16  of 2005, is amended to read as follows:
    17    (a)  Payments and reports submitted or required to be submitted to the
    18  commissioner or to the commissioner's designee pursuant to this  section
    19  and  section  twenty-eight hundred seven-s of this article by designated
    20  providers of services and by third-party payors which  have  elected  to
    21  make  payments  directly  to  the  commissioner or to the commissioner's
    22  designee in accordance with subdivision five-a of this section, shall be
    23  subject to audit by the commissioner for a period of six years following
    24  the close of the calendar year in which such payments  and  reports  are
    25  due,  after which such payments shall be deemed final and not subject to
    26  further adjustment or reconciliation, provided,  however,  that  nothing
    27  herein  shall  be construed as precluding the commissioner from pursuing
    28  collection of any such payments which are identified as delinquent with-
    29  in such six year period, or which are  identified  as  delinquent  as  a
    30  result  of  an  audit  commenced  within  such  six year period, or from
    31  conducting an audit of any adjustment or reconciliation made by a desig-
    32  nated provider of services or by a third party payor which  has  elected
    33  to make such payments directly to the commissioner or the commissioner's
    34  designee.
    35    §  17. Paragraph (a) of subdivision 10 of section 2807-t of the public
    36  health law, as added by section 45 of part B of chapter 58 of  the  laws
    37  of 2005, is amended to read as follows:
    38    (a)  Payments and reports submitted or required to be submitted to the
    39  commissioner or to the commissioner's designee pursuant to this  section
    40  by specified third-party payors shall be subject to audit by the commis-
    41  sioner  for  a  period  of six years following the close of the calendar
    42  year in which such payments  and  reports  are  due,  after  which  such
    43  payments  shall be deemed final and not subject to further adjustment or
    44  reconciliation,  provided,  however,  that  nothing  herein   shall   be
    45  construed as precluding the commissioner from pursuing collection of any
    46  such  payments  which  are identified as delinquent within such six year
    47  period, or which are identified as delinquent as a result  of  an  audit
    48  commenced  within  such  six year period, or from conducting an audit of
    49  any adjustments and reconciliation made by a specified third party payor
    50  within such six year period.
    51    § 18. Section 2807-w of the public health law is amended by  adding  a
    52  new subdivision 4 to read as follows:
    53    4.  In  order  for a general hospital to be eligible to participate in
    54  the distribution of funds pursuant to this section, such general  hospi-
    55  tal  must be in compliance with the provisions of subdivisions nine, ten
    56  and twelve of section twenty-eight hundred seven-k of this article.
        S. 6457                            82                            A. 9557

     1    § 19. Paragraph (a) of subdivision 2 of section  2816  of  the  public
     2  health  law  is  amended  by  adding  a  new subparagraph (v) to read as
     3  follows:
     4    (v) all other ambulatory care data from general hospitals and diagnos-
     5  tic  and treatment centers licensed under this article, provided, howev-
     6  er, that notwithstanding any contrary provision of law the  commissioner
     7  is  authorized to promulgate or adopt any rules or regulations necessary
     8  to implement the collection of data pursuant to this subparagraph.
     9    § 20. Subdivision (c) of section 92-dd of the state  finance  law,  as
    10  amended  by  chapter  161  of  the  laws  of 2005, is amended to read as
    11  follows:
    12    (c) The pool administrator shall, from appropriated funds  transferred
    13  to  the  pool  administrator  from  the  comptroller,  continue  to make
    14  payments as required pursuant to sections twenty-eight hundred  seven-k,
    15  twenty-eight  hundred  seven-m  (not including payments made pursuant to
    16  subdivision seven of section twenty-eight hundred seven-m), and  twenty-
    17  eight  hundred seven-w of the public health law, paragraph (e) of subdi-
    18  vision twenty-five of section twenty-eight hundred seven-c of the public
    19  health law, paragraphs (b) and (c)  of  subdivision  thirty  of  section
    20  twenty-eight  hundred seven-c of the public health law, paragraph (b) of
    21  subdivision eighteen of section twenty-eight hundred eight of the public
    22  health law, subdivision seven of section twenty-five  hundred-d  of  the
    23  public health law and section eighty-eight of chapter one of the laws of
    24  nineteen hundred ninety-nine.
    25    §  21.  Paragraph (c) of subdivision 1 of section 2807-s of the public
    26  health law is REPEALED.
    27    § 22. Subdivision 18 of section 2807-c of the  public  health  law  is
    28  amended by adding a new paragraph (g) to read as follows:
    29    (g)  If  a  general  hospital  fails  to produce data or documentation
    30  requested in furtherance of an audit for a month to which an  assessment
    31  applies, the commissioner may estimate, based on available financial and
    32  statistical  data  as determined by the commissioner, the amount due for
    33  such month. If the impact of exemptions permitted pursuant to  paragraph
    34  (d)  of this subdivision cannot be determined from such available finan-
    35  cial and statistical data the estimated amount due may be calculated  on
    36  the  basis  of  the general hospital's aggregate gross inpatient revenue
    37  amount, as determined from such available financial and statistical data
    38  for the year subject to audit. Estimated amounts due  pursuant  to  this
    39  paragraph shall be paid by a general hospital within sixty days or with-
    40  in  such  other  time  period  as  agreed to by the commissioner and the
    41  facility. Thereafter the commissioner shall take all necessary steps  to
    42  collect  amounts  owed  pursuant to this paragraph, including by offset-
    43  ting, or by directing the state comptroller to offset, such amounts  due
    44  from  any  other  payments  made  by  state governmental agencies to the
    45  general hospital pursuant to this article. Interest and penalties  shall
    46  be  applied  to  such  amounts  due in accordance with the provisions of
    47  paragraph (c) of subdivision twenty of this section.
    48    § 23. Paragraph (c) of subdivision 6 of section 2807-j of  the  public
    49  health  law,  as added by chapter 639 of the laws of 1996, is amended to
    50  read as follows:
    51    (c) Upon receipt of notification from the commissioner of a designated
    52  provider of services' deficiency under this section, the comptroller  or
    53  a  fiscal  intermediary designated by the director of the budget, or the
    54  commissioner of social services, or a corporation organized and  operat-
    55  ing  in  accordance with article forty-three of the insurance law, or an
    56  organization operating in accordance with  article  forty-four  of  this
        S. 6457                            83                            A. 9557

     1  chapter  shall withhold from the amount of any payment to be made by the
     2  state or by such article forty-three corporation or  article  forty-four
     3  organization  to  the  designated provider of services the amount of the
     4  deficiency  determined  under paragraph (a), (b) or (e) of this subdivi-
     5  sion or paragraph (d) of subdivision eight-a of this section. Upon with-
     6  holding such amount, the comptroller or  a  designated  fiscal  interme-
     7  diary,  or the commissioner of [social services] the office of temporary
     8  and disability assistance, or corporation  organized  and  operating  in
     9  accordance with article forty-three of the insurance law or organization
    10  operating  in  accordance  with article forty-four of this chapter shall
    11  pay the commissioner, or the commissioner's designee, such amount  with-
    12  held on behalf of the designated provider of services. Such amount shall
    13  represent,  in  whole  or  in  part, the amounts due from the designated
    14  provider of services.
    15    § 24. Paragraph (d) of subdivision 6 of section 2807-j of  the  public
    16  health  law,  as added by chapter 639 of the laws of 1996, is amended to
    17  read as follows:
    18    (d) The commissioner shall provide a designated provider  of  services
    19  with  notice  of any estimate of an amount due for an allowance pursuant
    20  to paragraph (a) or (b) of this subdivision or paragraph (d) of subdivi-
    21  sion eight-a of this section at least three days prior to collection  of
    22  such amount by the commissioner. Such notice shall contain the financial
    23  basis for the commissioner's estimate.
    24    §  25.  Paragraph (e) of subdivision 6 of section 2807-j of the public
    25  health law, as added by chapter 639 of the laws of 1996, is  amended  to
    26  read as follows:
    27    (e) In the event a designated provider of services objects to an esti-
    28  mate by the commissioner pursuant to paragraph (a) or (b) of this subdi-
    29  vision  or  paragraph  (d) of subdivision eight-a of this section of the
    30  amount due for an allowance, the designated provider of services, within
    31  sixty days of notice of an amount due, may request a public hearing.  If
    32  a  hearing  is  requested, the commissioner shall provide the designated
    33  provider of services an opportunity to be heard and to present  evidence
    34  bearing  on  the  amount  due  for an allowance within thirty days after
    35  collection of an amount due or receipt  of  a  request  for  a  hearing,
    36  whichever  is  later. An administrative hearing is not a prerequisite to
    37  seeking judicial relief.
    38    § 26. Subdivision 8-a of section 2807-j of the public  health  law  is
    39  amended by adding a new paragraph (d) to read as follows:
    40    (d)  If a designated provider of services or a third party payor fails
    41  to produce data or documentation requested in furtherance  of  an  audit
    42  pursuant  to  this  section  or pursuant to section twenty-eight hundred
    43  seven-s of this article, for a month to which an allowance applies,  the
    44  commissioner  may estimate, based on available financial and statistical
    45  data as determined by the commissioner, the amount due for  such  month.
    46  If  the  impact  of  the  patient  services revenue exemptions specified
    47  pursuant to this section, or pursuant to  section  twenty-eight  hundred
    48  seven-s of this article, cannot be determined from such available finan-
    49  cial and statistical data, the amount due may be calculated on the basis
    50  of  the  aggregate  total  of patient services revenue derived from such
    51  data for the year subject to audit.  The  commissioner  shall  take  all
    52  necessary  steps  to  collect amounts due as determined pursuant to this
    53  paragraph, including directing the  state  comptroller  to  offset  such
    54  amounts due from any payments made by the state pursuant to this article
    55  to  a  designated  provider of services or a third party payor. Interest
        S. 6457                            84                            A. 9557

     1  and penalties shall be applied to such amounts due  in  accordance  with
     2  the provisions of subdivision eight of this section.
     3    §  27.  Subdivision  10  of section 2807-t of the public health law is
     4  amended by adding a new paragraph (d) to read as follows:
     5    (d) If a specified third-party payor fails to produce data or documen-
     6  tation requested in furtherance of an audit pursuant to this section for
     7  a month to which an assessment applies, the commissioner  may  estimate,
     8  based  on  available financial and statistical data as determined by the
     9  commissioner, the amount due for  such  month.  If  the  impact  of  the
    10  enrollment  exemptions  permitted  pursuant  to  this  section cannot be
    11  determined from such available financial and statistical data, the esti-
    12  mated amount due may be  calculated  on  the  basis  of  aggregate  data
    13  derived  from  such  available  data  for the year subject to audit. The
    14  commissioner shall take all necessary steps to collect  amounts  due  as
    15  determined  pursuant  to  this  paragraph, including directing the state
    16  comptroller to offset such amounts due from any  payments  made  by  the
    17  state  to  the  third party payor pursuant to this article. Interest and
    18  penalties shall be applied to such amounts due in  accordance  with  the
    19  provisions  of subdivision eight of section twenty-eight hundred seven-j
    20  of this article.
    21    § 28. Paragraphs 1 and 2 of subsection (j)  of  section  4301  of  the
    22  insurance  law,  paragraph  1  as  amended  and  paragraph 2 as added by
    23  section 8 of part A of chapter 1 of the laws of  2002,  are  amended  to
    24  read as follows:
    25    (1)  [No] Except as provided in this subsection, every medical expense
    26  indemnity corporation,  dental  expense  indemnity  corporation,  health
    27  service corporation, or hospital service corporation shall be [converted
    28  into  a  corporation  organized  for pecuniary profit. Every such corpo-
    29  ration shall be] maintained and operated for the benefit of its  members
    30  and subscribers as a co-operative corporation.
    31    (2)  An  article  forty-three corporation [which was the subject of an
    32  initial opinion and decision issued by the superintendent on  or  before
    33  December  thirty-first, nineteen hundred ninety-nine, as the same may be
    34  amended] and its not-for-profit subsidiaries (including, without limita-
    35  tion, any such subsidiary  licensed  as  a  health  service  corporation
    36  pursuant  to this chapter or as a health maintenance organization organ-
    37  ized pursuant to article forty-four of the public health  law),  may  be
    38  converted  into [a corporation or other entity] one or more corporations
    39  or other entities organized for pecuniary profit, or into [a  for-profit
    40  organization] one or more for-profit organizations, in any such case, in
    41  accordance  with  the provisions of section seven thousand three hundred
    42  seventeen of this chapter.
    43    § 29. Paragraph 1 of subsection (a) of section 7317 of  the  insurance
    44  law,  as added by section 10 of part A of chapter 1 of the laws of 2002,
    45  is amended to read as follows:
    46    (1) An article forty-three corporation [which was the  subject  of  an
    47  initial  opinion  and decision issued by the superintendent on or before
    48  December thirty-first, nineteen hundred ninety-nine, as the same may  be
    49  amended] and its not-for-profit subsidiaries (including, without limita-
    50  tion,  any  such  subsidiary  licensed  as  a health service corporation
    51  pursuant to this chapter or as a health maintenance organization  organ-
    52  ized  pursuant  to  article  forty-four of the public health law), which
    53  seeks to convert into [a corporation or other entity] one or more corpo-
    54  rations or other entities organized for  pecuniary  profit  or  into  [a
    55  for-profit  organization]  one  or  more for-profit organizations of any
        S. 6457                            85                            A. 9557

     1  kind shall submit a proposed plan of conversion  to  the  superintendent
     2  for approval pursuant to this section.
     3    §  30.  Subdivision  1  of  section  471 of the tax law, as amended by
     4  section 30 of part A of chapter 1 of the laws of  2002,  is  amended  to
     5  read as follows:
     6    1.  There  is hereby imposed and shall be paid a tax on all cigarettes
     7  possessed in the state by any person for sale, except that no tax  shall
     8  be  imposed  on cigarettes sold under such circumstances that this state
     9  is without power to impose such tax or sold to the United States or sold
    10  to or by a voluntary unincorporated organization of the armed forces  of
    11  the  United  States  operating a place for the sale of goods pursuant to
    12  regulations promulgated by  the  appropriate  executive  agency  of  the
    13  United  States,  to  the  extent provided in such regulations and policy
    14  statements of such an agency applicable to such sales. Such tax on ciga-
    15  rettes shall be at the rate of [seventy-five] one dollar and twenty-five
    16  cents for each ten cigarettes or fraction  thereof,  provided,  however,
    17  that  if  a  package of cigarettes contains more than twenty cigarettes,
    18  the rate of tax on the cigarettes in such package in  excess  of  twenty
    19  shall be [thirty-seven] sixty-two and one-half cents for each five ciga-
    20  rettes or fraction thereof. Such tax is intended to be imposed upon only
    21  one  sale  of  the same package of cigarettes. It shall be presumed that
    22  all cigarettes within the state are subject to tax until the contrary is
    23  established, and the burden of proof that any cigarettes are not taxable
    24  hereunder shall be upon the person in possession thereof.
    25    § 31. Section 471-a of the tax law, as amended by section 31 of part A
    26  of chapter 1 of the laws of 2002, is amended to read as follows:
    27    § 471-a. Use tax on cigarettes. There is hereby imposed and  shall  be
    28  paid  a  tax  on  all cigarettes used in the state by any person, except
    29  that no tax shall be imposed (1) if the tax  provided  in  section  four
    30  hundred  seventy-one  is  paid,  (2)  on the use of cigarettes which are
    31  exempt from the tax imposed by said section, or (3) on the use  of  four
    32  hundred  or  less  cigarettes,  brought  into  the  state  on, or in the
    33  possession of, any person. Such tax on cigarettes shall be at  the  rate
    34  of  [seventy-five]  one  dollar and twenty-five cents for each ten ciga-
    35  rettes or fraction thereof, provided, however,  that  if  a  package  of
    36  cigarettes  contains more than twenty cigarettes, the rate of tax on the
    37  cigarettes in such package in excess of twenty shall  be  [thirty-seven]
    38  sixty-two and one-half cents for each five cigarettes or fraction there-
    39  of.  Within  twenty-four hours after liability for the tax accrues, each
    40  such person shall file with the commissioner a return in  such  form  as
    41  the  commissioner  may  prescribe  together with a remittance of the tax
    42  shown to be due thereon. For purposes of this article,  the  word  "use"
    43  means  the  exercise  of  any  right or power actual or constructive and
    44  shall include but is not limited to the receipt, storage or any  keeping
    45  or  retention  for  any length of time, but shall not include possession
    46  for sale. All other provisions of this article if not inconsistent shall
    47  apply to the administration and enforcement of the tax imposed  by  this
    48  section  in  the  same  manner as if the language of said provisions had
    49  been incorporated in full into this section.
    50    § 32. Section 482 of the tax law, as amended by section 53 of  part  J
    51  of chapter 82 of the laws of 2002, is amended to read as follows:
    52    §  482.  Deposit and disposition of revenue. All taxes, fees, interest
    53  and penalties collected or received by the commissioner under this arti-
    54  cle and article twenty-A of this chapter shall be deposited and disposed
    55  of pursuant to the provisions of section one  hundred  seventy-one-a  of
    56  this  chapter.  From  the  taxes and interest and penalties collected or
        S. 6457                            86                            A. 9557

     1  received by the commissioner under sections four hundred seventy-one and
     2  four hundred seventy-one-a of this article, effective on and after March
     3  first, two thousand, forty-nine and fifty-five hundredths; and effective
     4  on  and  after February first, two thousand two, forty-three and seventy
     5  hundredths; and effective on and after  May  first,  two  thousand  two,
     6  sixty-four  and  fifty-five hundredths; and effective on and after April
     7  first, two thousand three, sixty-one and twenty-two hundredths  percent;
     8  and  effective  on and after June first, two thousand six, seventy-three
     9  and twenty-six hundredths  percent  collected  or  received  under  such
    10  sections  shall  be  deposited  to the credit of the tobacco control and
    11  insurance initiatives pool to be  established  and  distributed  by  the
    12  commissioner  of  health in accordance with section twenty-eight hundred
    13  seven-v of the public health law.
    14    § 33. Paragraph (a) of subdivision 1 of section 1 of  chapter  235  of
    15  the  laws  of  1952  relating to enabling any city of the state having a
    16  population of one million or more to adopt, and amend local laws, impos-
    17  ing certain specified types of taxes on cigarettes, cigars  and  smoking
    18  tobacco  which  the legislature has or would have power and authority to
    19  impose, to provide for the review of such taxes, and to limit the appli-
    20  cation of such local laws, as amended by section 1 of part E of  chapter
    21  93 of the laws of 2002, is amended to read as follows:
    22    (a) The rate of such tax on cigarettes shall not exceed [seventy-five]
    23  twenty-five cents for each ten cigarettes or fraction thereof, provided,
    24  however, that if a package of cigarettes contains more than twenty ciga-
    25  rettes,  the  rate of tax on the cigarettes in such package in excess of
    26  twenty shall be [thirty-eight] thirteen cents for each  five  cigarettes
    27  or fraction thereof. Such tax is intended to be imposed only once on the
    28  same package of cigarettes.
    29    §  34. Section 2 of chapter 235 of the laws of 1952 relating to enabl-
    30  ing any city of the state having a population of one million or more  to
    31  adopt,  and  amend local laws, imposing certain specified types of taxes
    32  on cigarettes, cigars and smoking tobacco which the legislature  has  or
    33  would  have  power and authority to impose, to provide for the review of
    34  such taxes, and to limit the application of such local laws, as  amended
    35  by  section 4 of part E of chapter 93 of the laws of 2002, is amended to
    36  read as follows:
    37    § 2. Revenues resulting from the imposition  of  taxes  authorized  by
    38  this  act  shall be paid into the treasury of any such city and shall be
    39  credited to and deposited in the general fund of any such  city,  except
    40  that, after the payment of refunds with respect to such taxes, effective
    41  on  and  after  July 2, 2002 and before April 1, 2003, 46.5 percent and,
    42  effective on and after April 1, 2003 and before June 1, 2006, 46 percent
    43  of such revenues (including taxes, interest and penalties) collected  or
    44  received  shall be paid to the state comptroller.  The state comptroller
    45  is hereby authorized and directed to transfer all such amounts  so  paid
    46  to  the  credit of the tobacco control and insurance initiatives pool to
    47  be distributed by the commissioner of health in accordance with  section
    48  2807-v of the public health law.
    49    §  35.  Subdivision 3 of section 1680-j of the public authorities law,
    50  as added by section 54 of part B of chapter 58 of the laws of  2005,  is
    51  amended to read as follows:
    52    3.  Notwithstanding  any  law  in the contrary, and in accordance with
    53  section four of the state finance law, the comptroller is hereby author-
    54  ized and directed to transfer from the health  care  reform  act  (HCRA)
    55  resources  fund  [(F04)]  (061) to the general fund, upon the request of
    56  the director of the budget, up to $6,500,000  on  or  before  March  31,
        S. 6457                            87                            A. 9557

     1  2006,  and  the comptroller is further hereby authorized and directed to
     2  transfer from the healthcare reform act (HCRA); Resources fund (061)  to
     3  the  Capital  Projects Fund, upon the request of the director of budget,
     4  up  to  [$16,250,000]  $138,800,000 for the period April 1, 2006 through
     5  March 31, 2007 [and], up to [$32,500,000] $168,500,000  for  the  period
     6  April  1,  2007  through  March 31, 2008, and up to $188,000,000 for the
     7  period April 1, 2008 through March 31, 2009.
     8    § 36. Notwithstanding any inconsistent provision of law, rule or regu-
     9  lation, for the purposes of implementing the provisions  of  the  public
    10  health  law,  tax  law,  state finance law, insurance law and the social
    11  services law, references to titles XIX and XXI  of  the  federal  social
    12  security  act in the public health law and the social services law shall
    13  be deemed to include and also to mean any successor titles thereto under
    14  the federal social security act.
    15    § 37. Notwithstanding any inconsistent provision of law, rule or regu-
    16  lation, the effectiveness of subdivisions 4, 7, 7-a and 7-b  of  section
    17  2807 of the public health law and section 18 of chapter 2 of the laws of
    18  1988,  as  they  relate  to  time frames for notice, approval or certif-
    19  ication of rates  of  payment,  are  hereby  suspended  and  shall,  for
    20  purposes  of  implementing the provisions of this act, be deemed to have
    21  been without any force or effect from and after  November  1,  2005  for
    22  such rates effective for the period January 1, 2006 through December 31,
    23  2006.
    24    §  38. Severability clause. If any clause, sentence, paragraph, subdi-
    25  vision, section or part of this act shall be adjudged by  any  court  of
    26  competent  jurisdiction  to  be invalid, such judgment shall not affect,
    27  impair or invalidate the remainder thereof, but shall be confined in its
    28  operation to the clause, sentence, paragraph,  subdivision,  section  or
    29  part thereof directly involved in the controversy in which such judgment
    30  shall  have been rendered. It is hereby declared to be the intent of the
    31  legislature that this act would have been enacted even if  such  invalid
    32  provisions had not been included herein.
    33    § 39. This act shall take effect immediately provided, however, that:
    34    1.  Sections  thirty through thirty-four of this act shall take effect
    35  June 1, 2006; further provided that notwithstanding any other  provision
    36  of  law to the contrary, the tax due on cigarettes possessed in New York
    37  state as of the close of business on June 1, 2006 by any person for sale
    38  solely attributable to the increase imposed by the amendments to section
    39  471 of the tax law, made by section thirty of this act, may be  paid  in
    40  two installments due on the twenty-first day of August and the twentieth
    41  day  of  December,  2006,  subject  to  such terms and conditions as the
    42  commissioner of taxation and finance may prescribe;  provided,  however,
    43  no less than 25 percent of each such tax due shall be paid by August 21,
    44  2006;
    45    2. Section twenty-one of this act shall be deemed to have been in full
    46  force and effect on and after April 1, 2005;
    47    3. The amendments to paragraph (d) of subdivision 18 of section 2807-c
    48  of  the  public  health law made by section twelve of this act shall not
    49  affect the expiration of such paragraph and shall be  deemed  to  expire
    50  therewith;
    51    4.  The  amendments to section 2807-j of the public health law made by
    52  sections sixteen, twenty-three, twenty-four, twenty-five and  twenty-six
    53  of this act shall not affect the expiration of such section and shall be
    54  deemed to expire therewith;
        S. 6457                            88                            A. 9557

     1    5.  The  amendments to section 2807-t of the public health law made by
     2  sections seventeen and twenty-seven of this act  shall  not  affect  the
     3  expiration of such section and shall be deemed to expire therewith;
     4    6.  The  amendments  to paragraph (a) of subdivision 1 of section 1 of
     5  chapter 235 of the laws of 1952 made by section thirty-three of this act
     6  shall not affect the expiration of such paragraph and shall be deemed to
     7  expire therewith;
     8    7. Any rules or regulations necessary to implement the  provisions  of
     9  this  act  may be promulgated and any procedures, forms, or instructions
    10  necessary for such implementation may be adopted and issued on or  after
    11  the date this act shall have become a law;
    12    8. This act shall not be construed to alter, change, affect, impair or
    13  defeat  any rights, obligations, duties or interest accrued, incurred or
    14  conferred prior to the enactment of this act;
    15    9. The commissioner of health and superintendent of insurance and  any
    16  appropriate council may take any steps necessary to implement provisions
    17  of this act prior to its effective date;
    18    10.  Notwithstanding  any inconsistent provision of the state adminis-
    19  trative procedure act or any other provision of law, rule or regulation,
    20  the commissioner of health and the superintendent of insurance  and  any
    21  appropriate  council is authorized to adopt or amend or promulgate on an
    22  emergency basis any regulation he or  she  or  such  council  determines
    23  necessary  to implement any provision of this act on its effective date;
    24  and
    25    11. The provisions of this act shall become effective  notwithstanding
    26  the  failure  of  the  commissioner  of  health or the superintendent of
    27  insurance or any council to adopt or  amend  or  promulgate  regulations
    28  implementing this act.

    29                                   PART E

    30    Section  1. Section 97-w of the state finance law, as amended by chap-
    31  ter 398 of the laws of 2004, is amended to read as follows:
    32    § 97-w. Chemical dependence service fund. 1. There  is  hereby  estab-
    33  lished  in  the  custody  of  the state comptroller a special fund to be
    34  known as the chemical dependence service fund.
    35    2. Such fund shall consist of all moneys appropriated for the  purpose
    36  of  such  fund,  all  moneys  transferred  to such fund pursuant to law,
    37  penalties and fines received by the office of alcoholism  and  substance
    38  abuse  services,  contributions  consisting of promises or grants of any
    39  money or property of any kind or value, or any  other  thing  of  value,
    40  including  grants  or  other  financial  assistance  from  any agency of
    41  government and all moneys required by the provisions of this section  or
    42  any other law to be paid into or credited to this fund.
    43    3.  Moneys  of  the  fund,  when  allocated, shall be available to the
    44  commissioner of the office of alcoholism and  substance  abuse  services
    45  and shall be used to provide support for funded agencies approved by the
    46  New  York  state  office of alcoholism and substance abuse services, and
    47  local school-based and community programs which provide chemical depend-
    48  ence prevention and education services. Consideration shall be given  to
    49  innovative approaches to providing chemical dependence services.
    50    4.  Notwithstanding  any other law to the contrary, moneys of the fund
    51  generated from a penalty, fine or other enforcement action may  be  used
    52  for  expenses that arise from the assumption of operational responsibil-
    53  ities by  local  governments,  voluntary  and  for-profit  providers  of
    54  services  and/or  the  office of alcoholism and substance abuse services
        S. 6457                            89                            A. 9557

     1  for facilities operated under a receivership pursuant to  section  19.41
     2  of  the mental hygiene law. Such moneys may also be used for state oper-
     3  ations expenses of the office of alcoholism and substance abuse services
     4  and/or  any  other state agency related to the staffing for, and associ-
     5  ated costs of, enforcement and compliance activities.
     6    5. Notwithstanding the provisions of any general or  special  law,  no
     7  moneys  shall  be  available  from such chemical dependence service fund
     8  until a certificate of allocation and a schedule of amounts to be avail-
     9  able therefor shall have been issued by the director of the budget, upon
    10  the recommendation of the commissioner of the office of  alcoholism  and
    11  substance  abuse services, and a copy of such certificate filed with the
    12  comptroller, the chairman of the senate finance committee and the chair-
    13  man of the assembly ways and means committee. Such  certificate  may  be
    14  amended from time to time by the director of the budget, upon the recom-
    15  mendation  of the commissioner of the office of alcoholism and substance
    16  abuse services, and a copy of such amendment shall  be  filed  with  the
    17  comptroller, the chairman of the senate finance committee and the chair-
    18  man of the assembly ways and means committee.
    19    [5.]6. The moneys when allocated, shall be paid out of the fund on the
    20  audit  and  warrant of the comptroller on vouchers certified or approved
    21  by the commissioner of the office  of  alcoholism  and  substance  abuse
    22  services,  or  by an officer or employee of the office of alcoholism and
    23  substance abuse services designated by the commissioner.
    24    [6.]7. The commissioner of the  office  of  alcoholism  and  substance
    25  abuse  services shall promulgate rules and regulations pertaining to the
    26  allocation of moneys from this fund.
    27    § 2. This act shall take effect immediately and  shall  be  deemed  to
    28  have been in full force and effect on and after April 1, 2006.

    29                                   PART F

    30    Section  1.  Section  26.00  of  the  mental hygiene law is amended by
    31  adding a new subdivision (k) to read as follows:
    32    (k) Notwithstanding any other law to the contrary, state  aid  may  be
    33  made available to fund a receiver, including a voluntary agency and/or a
    34  for-profit  corporation, appointed by a court or the commissioner pursu-
    35  ant to section 19.41 of this chapter.
    36    § 2. This act shall take effect immediately and  shall  be  deemed  to
    37  have been in full force and effect on and after April 1, 2006.

    38                                   PART G

    39    Section  1.  Subparagraph  (i)  of  paragraph  (g) of subdivision 2 of
    40  section 2807 of the public health law, as amended by chapter 170 of  the
    41  laws of 1994, is amended to read as follows:
    42    (i)  During  the  period  April  first,  nineteen  hundred ninety-four
    43  through December thirty-first, nineteen hundred ninety-four and for each
    44  calendar year rate period commencing on January first thereafter,  rates
    45  of  payment by governmental agencies for the operating cost component of
    46  general hospital outpatient services shall be  based  on  the  operating
    47  costs reported in the base year cost report adjusted by the trend factor
    48  applicable  to the general hospital in which the services were provided;
    49  provided, however, that the  maximum  payment  for  the  operating  cost
    50  component  of outpatient services shall be sixty-seven dollars and fifty
    51  cents plus the addition of the capital cost per visit. The capital  cost
    52  per  visit  shall  be based on the base year cost report except that the
        S. 6457                            90                            A. 9557

     1  capital cost per visit may be  adjusted  for  major  outpatient  capital
     2  expenditures  incurred  subsequent  to  the  reporting  year,  when such
     3  expenditures have received the requisite approvals and the facility  has
     4  provided  the  commissioner  with  a certified statement of the expendi-
     5  tures. The base year for the period April first, nineteen hundred  nine-
     6  ty-four  through  December  thirty-first,  nineteen  hundred ninety-four
     7  shall be nineteen hundred ninety-two and  shall  be  advanced  one  year
     8  thereafter  for  each subsequent calendar year rate period. Further, the
     9  provisions of subdivision seven of this section  shall  not  apply.  The
    10  commissioner  may waive the maximum allowable payment and limitations on
    11  the rate of payment as prescribed herein to provide for  the  reimburse-
    12  ment  of  offering  and  arranging  services eligible for ninety percent
    13  federal funds as set forth in section  nineteen  hundred  three  of  the
    14  federal  social  security  act,  and to provide for the reimbursement of
    15  specialized services having separately identifiable  costs  and  statis-
    16  tics,  including  but  not limited to hemodialysis services and surgical
    17  services provided on an outpatient basis, provided, however, that during
    18  the period April first, two thousand six through December  thirty-first,
    19  two thousand six and for each calendar year rate period commencing ther-
    20  eafter,  such  specialized services shall not include services for which
    21  the rate of payment is established by the office of mental health pursu-
    22  ant to section 43.02 of the mental hygiene law.  Such  waiver  shall  be
    23  granted  only  when  the  commissioner finds that the services are being
    24  provided efficiently and at minimum cost. The commissioner shall prompt-
    25  ly promulgate rules and regulations necessary to identify such services.
    26  Among the criteria which the commissioner shall consider in the case  of
    27  specialized services are whether the services require highly specialized
    28  staff,  equipment or facilities, thereby generating a cost that substan-
    29  tially exceeds that of more routine diagnostic  or  treatment  services;
    30  whether  the  facility  in  which the services are provided is presently
    31  providing the services to the  population  in  need;  and,  whether  the
    32  services  may  be provided safely and effectively on an outpatient basis
    33  at a lower cost  than  through  inpatient  admission.  In  addition  the
    34  commissioner shall provide for a waiver of the maximum allowable payment
    35  for those outpatient services medically necessary which include surgical
    36  procedures  where  delay  in  surgical  intervention would substantially
    37  increase the medical risk associated with  such  surgical  intervention.
    38  Where  the  commissioner  waives  the  maximum allowable payment for any
    39  specified service he may, in accordance with the foregoing criteria  and
    40  such  other criteria as he deems appropriate, establish a maximum allow-
    41  able payment for such specified service.
    42    § 2. This act shall take effect immediately and  shall  be  deemed  to
    43  have been in full force and effect on and after April 1, 2006.

    44                                   PART H

    45    Section  1.  Section  3 of chapter 119 of the laws of 1997 relating to
    46  authorizing the department of health to establish  certain  payments  to
    47  general  hospitals,  as amended by section 1 of part S2 of chapter 62 of
    48  the laws of 2003, is amended to read as follows:
    49    § 3. This act shall take effect immediately and  shall  be  deemed  to
    50  have been in full force and effect on and after April 1, 1997.  This act
    51  shall expire [March 31, 2006] April 1, 2009.
    52    §  2.  This  act  shall take effect immediately and shall be deemed to
    53  have been in full force and effect on and after April 1, 2006.
        S. 6457                            91                            A. 9557

     1    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
     2  sion, 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
     5  its  operation  to the clause, sentence, paragraph, subdivision, section
     6  or part thereof directly involved in the controversy in which such judg-
     7  ment shall have been rendered. It is hereby declared to be the intent of
     8  the legislature that this act would  have  been  enacted  even  if  such
     9  invalid provisions had not been included herein.
    10    §  3.  This  act shall take effect immediately provided, however, that
    11  the applicable effective date of Parts A through H of this act shall  be
    12  as specifically set forth in the last section of such Parts.
        S. 6457                            92                            A. 9557

     1                  2006-2007 NEW YORK STATE EXECUTIVE BUDGET
     2                          HEALTH AND MENTAL HYGIENE
     3                           ARTICLE VII LEGISLATION

     4                                  CONTENTS

     5                                                               STARTING
     6                                                                 PAGE
     7  PART   DESCRIPTION                                            NUMBER

     8  A      Ensure a seamless transition to the new Federal          3
     9         Medicare prescription drug program (Part D);
    10         restructure the nursing home reimbursement
    11         methodology; implement saving measures to reduce
    12         Medicaid costs and establish the Office of
    13         Medicaid Inspector General to combat fraud, waste
    14         and abuse.
    15  B      Improve public health services by eliminating            56
    16         low-priority programs, implementing cost saving
    17         measures, strengthen fiscal and programmatic
    18         oversight and make new investments in local public
    19         health programs.
    20  C      Provide a three year Cost of Living Adjustment           73
    21         (COLA) for designated human services programs.
    22  D      Modify the Health Care Reform Act (HCRA) and             76
    23         enact proposals to preserve its fiscal stability,
    24         and authorize additional non-profit insurance
    25         company conversions.
    26  E      Authorize regulatory enforcement action fines to         88
    27         be deposited in the Chemical Dependency Service
    28         Fund.
    29  F      Authorize OASAS to make State aid payments to            89
    30         entities which assume either temporary or
    31         permanent responsibility for certain chemical
    32         dependency programs.
    33  G      Eliminate mental health outpatient services as           89
    34         services that can be considered specialized under
    35         section 2807 of the Public Health Law.
    36  H      Authorize OMH/OASAS voluntary hospitals to receive       90
    37         Federal disproportionate share payments.