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A09007 Summary:

BILL NOA09007C
 
SAME ASSAME AS UNI. S08007-C
 
SPONSORBudget
 
COSPNSR
 
MLTSPNSR
 
Amd Various Laws, generally
 
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2022-2023 state fiscal year; relates to the implementation of the nurses across New York (NANY) program (Part A); allows pharmacists to direct limited service laboratories and order and administer COVID-19 and influenza tests; modernizes nurse practitioners; allows certain individuals to administer tests to determine the presence of COVID-19 or its antibodies or influenza virus in certain situations; relates to enacting the "nurse practitioners modernization act"; provides for the repeal of certain provisions upon the expiration thereof (Part C); relates to increasing general public health work base grants for both full-service and partial-service counties and allow for local health departments to claim up to fifty percent of personnel service costs (Part E); relates to general hospital reimbursement for annual rates, in relation to the cap on local Medicaid expenditures (Part H); provides a one percent across the board payment increase to all qualifying fee-for-service Medicaid rates (Part I); relates to extending the statutory requirement to reweight and rebase acute hospital rates (Part J); relates to the creation of a new statewide health care facility transformation program (Part K); relates to the definition of revenue in the minimum spending statute for nursing homes and the rates of payment and rates of reimbursement for residential health care facilities, in relation to making a temporary payment to facilities in severe financial distress; requires certain percentages of revenue be spent on direct resident care and resident-facing staffing (Part M); relates to private duty nursing services reimbursement for nurses servicing adult members; relates to rates of payment for continuous nursing services for certain adults; directs the department of health to establish or procure the services of an independent panel of clinical professionals and to develop and implement a uniform task-based assessment tool; directs the department of health to develop guidelines and standards for the use of tasking tools (Part O); relates to the essential plan and qualified health plans to contract with national cancer institute-designated cancer centers, where such centers agree to certain terms and conditions; requires the department of health to select an independent contractor to generate a report that reviews and makes recommendations concerning the status of services offered by managed care organizations contracting with the state to manage services provided under the Medicaid program (Part P); requires private insurance plans to cover abortion services without cost-sharing (Part R); relates to reimbursement for commercial and Medicaid services provided via telehealth; provides for the repeal of such provisions upon the expiration thereof (Part V); eliminates unnecessary requirements from the utilization threshold program (Part W); relates to marriage certificates (Part Y); relates to malpractice and professional medical conduct; relates to malpractice and professional medical conduct; extends certain provisions concerning the hospital excess liability pool; amends the New York Health Care Reform Act of 1996 and other laws relating to extending certain provisions; extends provisions relating to excess coverage (Part Z); relates to clarifying provisions regarding emergency medical services and surprise bills (Subpart A); relates to the federal no surprises act (Subpart B); relates to administrative simplification (Subpart C) (Part AA); extends various provisions relating to health and mental hygiene; relates to payment by governmental agencies for general hospital inpatient services; relates to the general public health work program; relates to rates for residential health care facilities; authorizes pharmacists to perform collaborative drug therapy management with physicians in certain settings; authorizes reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof; directs the department of health to convene a work group on rare diseases; creates the radon task force (Part CC); establishes a cost of living adjustment for designated human services programs (Part DD); relates to a 9-8-8 suicide prevention and behavioral health crisis hotline system (Part EE); relates to reinvesting savings recouped from behavioral health transition into managed care back into behavioral health services (Part FF); relates to waiver of certain regulations (Part GG); relates to community residences for addiction (Part II); relates to general hospital reimbursement for annual rates; extends government rates for behavioral services; references the office of addiction services and supports; increases Medicaid payments to providers through managed care organizations; provides equivalent fees through an ambulatory patient group methodology; extends government rates for behavioral services referencing the office of addiction services and supports (Part LL); relates to rental and mortgage payments for the mentally ill (Part NN); relates to the appointment of temporary operators for the continued operation of programs and the provision of services for persons with serious mental illness and/or developmental disabilities and/or chemical dependence (Part OO); relates to the process for the selection of fiscal intermediary services contractors for the consumer directed personal assistance program; relates to certain surveys and to the award of contracts (Part PP); relates to health homes and penalties for managed care providers; directs the department of health to establish or procure the services of an independent panel of clinical professionals and to develop and implement a uniform task-based assessment tool, in relation to prohibiting the extension of certain contracts (Part QQ); relates to the deposit of certain revenues from taxes into the New York state agency trust fund, distressed provider assistance account; relates to certain Medicaid management; repeals certain provisions relating to financially distressed hospitals (Part RR); directs the department of health to conduct a study within Kings county to determine ways to improve access to health services and facilities (Part SS); relates to general hospital inpatient reimbursement for annual rates, in relation to supplemental Medicaid managed care payments (Part TT)
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A09007 Memo:

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A09007 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
            S. 8007--C                                            A. 9007--C
 
                SENATE - ASSEMBLY
 
                                    January 19, 2022
                                       ___________
 
        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 -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee  --  committee  discharged,  bill  amended,  ordered
          reprinted  as  amended  and recommitted to said committee -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee
 
        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 --  committee  discharged,  bill  amended,
          ordered  reprinted  as  amended  and  recommitted to said committee --
          again reported from said committee with amendments, ordered  reprinted
          as  amended  and  recommitted to said committee -- again reported from
          said committee with  amendments,  ordered  reprinted  as  amended  and
          recommitted to said committee
 
        AN ACT to amend the public health law, in relation to the implementation
          of  the  nurses across New York (NANY) program (Part A); intentionally
          omitted (Part B); to amend the public health  law  and  the  education
          law,  in  relation  to  allowing pharmacists to direct limited service
          laboratories and order and administer COVID-19 and influenza tests and
          modernizing nurse  practitioners;  to  amend  the  education  law,  in
          relation  to  allowing  for certain individuals to administer tests to
          determine the presence of COVID-19  or  its  antibodies  or  influenza
          virus in certain situations; to amend part D of chapter 56 of the laws
          of  2014,  amending  the education law relating to enacting the "nurse
          practitioners modernization act", in  relation  to  the  effectiveness
          thereof;  and  providing for the repeal of certain provisions upon the
          expiration thereof (Part C); intentionally omitted (Part D); to  amend
          the public health law, in relation to increasing general public health
          work  base  grants  for both full-service and partial-service counties
          and allow for local health departments to claim up to fifty percent of
          personnel service costs (Part  E);  intentionally  omitted  (Part  F);
          intentionally  omitted  (Part G); to amend part H of chapter 59 of the
          laws of 2011, amending the public health law and other  laws  relating
          to general hospital reimbursement for annual rates, in relation to the
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD12671-06-2

        S. 8007--C                          2                         A. 9007--C
 
          cap  on local Medicaid expenditures (Part H); to provide a one percent
          across the board payment increase to  all  qualifying  fee-for-service
          Medicaid  rates  (Part I); to amend the public health law, in relation
          to  extending  the  statutory requirement to reweight and rebase acute
          hospital rates (Part J); to amend the public health law,  in  relation
          to the creation of a new statewide health care facility transformation
          program  (Part K); intentionally omitted (Part L); to amend the public
          health law, in relation to the definition of revenue  in  the  minimum
          spending  statute for nursing homes and the rates of payment and rates
          of reimbursement for residential health care facilities,  in  relation
          to  making  a  temporary  payment  to  facilities  in severe financial
          distress, and in relation to requiring certain percentages of  revenue
          be  spent  on  direct resident care and resident-facing staffing (Part
          M); intentionally omitted (Part N); to amend the social services  law,
          in  relation to private duty nursing services reimbursement for nurses
          servicing adult members; to amend the public health law,  in  relation
          to  rates  of  payment  for  continuous  nursing  services for certain
          adults; and to amend part MM of chapter 56 of the laws of 2020 direct-
          ing the department of health to establish  or procure the services  of
          an  independent  panel  of  clinical  professionals and to develop and
          implement a uniform task-based assessment tool, in relation to direct-
          ing the department of health to develop guidelines and  standards  for
          the  use  of  tasking tools (Part O); to amend the social services law
          and the public health law, in relation to the essential plan and qual-
          ified health plans to contract with national  cancer  institute-desig-
          nated  cancer  centers,  where such centers agree to certain terms and
          conditions; and to require the department of health to select an inde-
          pendent contractor to generate a report that reviews and makes  recom-
          mendations  concerning  the status of services offered by managed care
          organizations contracting with the state to manage  services  provided
          under  the  Medicaid program (Part P); intentionally omitted (Part Q);
          to amend the insurance law, in relation to requiring private insurance
          plans to cover abortion services without cost-sharing (Part R); inten-
          tionally omitted (Part S);  intentionally  omitted  (Part  T);  inten-
          tionally  omitted  (Part  U);  to  amend the public health law and the
          insurance law, in relation to reimbursement for commercial  and  Medi-
          caid services provided via telehealth; and providing for the repeal of
          such  provisions  upon  the  expiration thereof (Part V); to amend the
          social services law, in relation to eliminating  unnecessary  require-
          ments  from  the utilization threshold program (Part W); intentionally
          omitted (Part X); to amend the domestic relations law, in relation  to
          marriage  certificates  (Part  Y); to amend chapter 266 of the laws of
          1986 amending the civil practice law and rules and other laws relating
          to malpractice  and  professional  medical  conduct,  in  relation  to
          extending  the  effectiveness  of certain provisions thereof; to amend
          part J of chapter 63 of the laws of 2001 amending chapter 266  of  the
          laws of 1986, amending the civil practice law and rules and other laws
          relating  to malpractice and professional medical conduct, relating to
          the effectiveness of certain provisions of such chapter,  in  relation
          to extending certain provisions concerning the hospital excess liabil-
          ity  pool;  and  to  amend  part  H of chapter 57 of the laws of 2017,
          amending the New York Health Care Reform Act of 1996  and  other  laws
          relating to extending certain provisions relating thereto, in relation
          to extending provisions relating to excess coverage (Part Z); to amend
          the  financial  services  law, the insurance law and the public health
          law, in relation to clarifying provisions regarding emergency  medical

        S. 8007--C                          3                         A. 9007--C
 
          services  and  surprise bills; and to repeal certain provisions of the
          financial services law relating thereto  (Subpart  A);  to  amend  the
          insurance  law  and the public health law, in relation the the federal
          no  surprises  act (Subpart B); and to amend the insurance law and the
          public  health  law,  in  relation  to  administrative  simplification
          (Subpart  C)  (Part AA); intentionally omitted (Part BB); to amend the
          social services law, the executive law and the public health  law,  in
          relation to extending various provisions relating to health and mental
          hygiene;  to  amend part C of chapter 58 of the laws of 2009, amending
          the public health law relating to payment by governmental agencies for
          general hospital inpatient services, in relation to the  effectiveness
          thereof;  to  amend part E of chapter 56 of the laws of 2013, amending
          the public health law relating  to  the  general  public  health  work
          program,  in  relation  to the effectiveness thereof; to amend chapter
          474 of the laws of 1996, amending the education  law  and  other  laws
          relating  to rates for residential health care facilities, in relation
          to the effectiveness thereof; to amend chapter 21 of the laws of 2011,
          amending the education law  relating  to  authorizing  pharmacists  to
          perform  collaborative  drug  therapy  management  with  physicians in
          certain settings, in relation to the effectiveness thereof;  to  amend
          part  II of chapter 54 of the laws of 2016, amending part C of chapter
          58 of the laws of 2005  relating  to  authorizing  reimbursements  for
          expenditures  made  by  or  on behalf of social services districts for
          medical assistance for needy persons and  administration  thereof,  in
          relation to the effectiveness thereof; to amend chapter 74 of the laws
          of  2020,  relating to directing the department of health to convene a
          work group on rare diseases, in relation to the effectiveness thereof;
          and to amend chapter 414 of the laws of 2018, creating the radon  task
          force,  in relation to the effectiveness thereof (Part CC); establish-
          ing a cost of living adjustment for designated human services programs
          (Part DD); to amend the mental hygiene law, in  relation  to  a  9-8-8
          suicide  prevention  and behavioral health crisis hotline system (Part
          EE); to amend the social services law, in  relation    to  reinvesting
          savings  recouped  from behavioral health transition into managed care
          back into behavioral health services (Part FF); to  amend  part  H  of
          chapter 57 of the laws of 2019 amending the public health law relating
          to  waiver  of  certain  regulations, in relation to the effectiveness
          thereof (Part GG); intentionally  omitted  (Part  HH);  to  amend  the
          mental  hygiene law, in relation to community residences for addiction
          (Part II); intentionally  omitted  (Part  JJ);  intentionally  omitted
          (Part KK); to amend chapter 56 of the laws of 2013 amending the public
          health  law  and other laws relating to general hospital reimbursement
          for annual rates, in relation to extending government rates for behav-
          ioral services and referencing the office of  addiction  services  and
          supports;  to amend part H of chapter 111 of the laws of 2010 relating
          to increasing Medicaid payments  to  providers  through  managed  care
          organizations  and  providing  equivalent  fees  through an ambulatory
          patient group methodology, in relation to extending  government  rates
          for  behavioral  services referencing the office of addiction services
          and supports and in relation to the effectiveness thereof  (Part  LL);
          intentionally  omitted  (Part MM); to amend the mental hygiene law, in
          relation to rental and mortgage payments for the  mentally  ill  (Part
          NN);  to  amend part L of chapter 59 of the laws of 2016, amending the
          mental hygiene law relating to the appointment of temporary  operators
          for  the  continued    operation    of   programs and the provision of
          services for persons with serious mental illness and/or  developmental

        S. 8007--C                          4                         A. 9007--C
 
          disabilities  and/or chemical  dependence,  in  relation to the effec-
          tiveness thereof (Part OO); to  amend  the  social  services  law,  in
          relation  to  the  process  for  the  selection of fiscal intermediary
          services  contractors  for  the  consumer directed personal assistance
          program; to repeal subdivision 4 and paragraphs  (b-2)  and  (b-3)  of
          subdivision  4-a  of section 365-f of the social services law relating
          to certain surveys and to the award of contracts (Part PP);  to  amend
          the  social  services  law,  part C of chapter 57 of the laws of 2018,
          amending the social services law and the public health law relating to
          health homes and penalties for managed care providers, and part MM  of
          chapter  56 of the laws of 2020, directing the department of health to
          establish or procure the services of an independent panel of  clinical
          professionals  and  to  develop  and  implement  a  uniform task-based
          assessment tool, in relation to prohibiting the extension  of  certain
          contracts  (Part QQ); to amend the tax law, in relation to the deposit
          of certain revenues from taxes into the New York  state  agency  trust
          fund,  distressed  provider  assistance  account;  to amend part ZZ of
          chapter 56 of the laws of 2020 amending the tax  law  and  the  social
          services  law  relating to certain Medicaid management, in relation to
          the effectiveness thereof; and to repeal certain provisions of the tax
          law relating to financially distressed hospitals (Part RR);  directing
          the  department  of  health  to conduct a study within Kings county to
          determine ways to improve access to  health  services  and  facilities
          (Part  SS);  and  to  amend  part H of chapter 59 of the laws of 2011,
          amending the public health law and other  laws,  relating  to  general
          hospital  inpatient  reimbursement  for  annual  rates, in relation to
          supplemental Medicaid managed care payments (Part TT)
 
          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  necessary to implement the state health and mental  hygiene  budget  for
     3  the  2022-2023  state  fiscal  year.  Each component is wholly contained
     4  within a Part identified as Parts A through TT. The effective  date  for
     5  each particular provision contained within such Part is set forth in the
     6  last section of such Part. Any provision in any section contained within
     7  a  Part,  including the effective date of the Part, which makes a refer-
     8  ence to a section "of this act",  when  used  in  connection  with  that
     9  particular  component,  shall  be deemed to mean and refer to the corre-
    10  sponding section of the Part in which it is found. Section three of this
    11  act sets forth the general effective date of this act.
 
    12                                   PART A

    13    Section 1. Short title. This act shall be known and may  be  cited  as
    14  the "nurses across New York (NANY) program".
    15    §  2. The public health law is amended by adding a new section 2807-aa
    16  to read as follows:
    17    § 2807-aa. Nurse loan repayment program. 1.(a) Monies  shall  be  made
    18  available,  subject  to  appropriations,  for purposes of loan repayment
    19  awards in accordance with the provisions of this section for  registered
    20  professional  nurses  licensed  to  practice  under  section  sixty-nine
    21  hundred five of the education law and licensed practical nurses licensed
    22  under section sixty-nine hundred six of the education law. Notwithstand-

        S. 8007--C                          5                         A. 9007--C

     1  ing sections one hundred twelve and one hundred sixty-three of the state
     2  finance law and sections one hundred forty-two and  one  hundred  forty-
     3  three  of  the economic development law, or any other contrary provision
     4  of  law,  such  funding  shall be allocated regionally with one-third of
     5  available funds going to New York city and two-thirds of available funds
     6  going to the rest of the state and shall be distributed in a  manner  to
     7  be  determined  by the commissioner without a competitive bid or request
     8  for proposals.
     9    (i) Loan repayment awards made under this section shall be awarded  to
    10  repay  student loans of nurses who work in areas determined to be under-
    11  served areas in New York state and who agree to work in such areas for a
    12  period of three consecutive years. A nurse may be deemed to be  practic-
    13  ing  in  an underserved area if they practice in a facility, physician's
    14  office, nurse practitioner's office,  or  physician  assistant's  office
    15  that  primarily  serves  an  underserved  population,  without regard to
    16  whether the population or the facility or office is located in an under-
    17  served area.  For purposes of this section, "underserved areas" shall be
    18  located in New York state and shall include,  but  not  be  limited  to,
    19  areas  designated  by  the  federal  government as a health professional
    20  shortage area, a medically underserved area,  or  medically  underserved
    21  population,  non-profit diagnostic and treatment centers which primarily
    22  serve Medicaid eligible or uninsured patients, and other areas and popu-
    23  lations as determined by the commissioner.
    24    (ii) Loan repayment awards made under this section  shall  not  exceed
    25  the total qualifying outstanding debt of the nurse from student loans to
    26  cover tuition and other related educational expenses, made by or guaran-
    27  teed  by the federal or state government, or made by a lending or educa-
    28  tional institution approved under title IV of the federal higher  educa-
    29  tion  act.    Loan  repayment  awards shall be used solely to repay such
    30  outstanding debt.
    31    (iii) Nurses shall be eligible for a loan repayment award to be deter-
    32  mined by the  commissioner  over  a  three-year  period  distributed  as
    33  follows:  thirty  percent  of  total  award  for  the first year; thirty
    34  percent of total award for the second year; and any  unpaid  balance  of
    35  the  total  award  not  to exceed the maximum award amount for the third
    36  year.
    37    (iv) In the event that a three-year commitment under this  section  is
    38  not  fulfilled,  the  recipient  shall  be  responsible for repayment of
    39  amounts paid which shall be calculated in accordance  with  the  formula
    40  set  forth  in  subdivision  (b)  of section two hundred fifty-four-o of
    41  title forty-two of the United States Code,  as  amended,  or  any  regu-
    42  lations made thereunder.
    43    (b)  The  commissioner may postpone, change or waive the service obli-
    44  gation and repayment amounts set forth in subparagraphs (i) and (iv)  of
    45  paragraph  (a)  of  this  subdivision  in individual circumstances where
    46  there is compelling need or hardship.
    47    2. To develop a streamlined application process  for  the  nurse  loan
    48  repayment  program  set  forth  under this section, the department shall
    49  appoint a stakeholder work group from recommendations  made  by  associ-
    50  ations  representing  nurses,  general  hospitals  and other health care
    51  facilities. Such recommendations shall be made by  September  thirtieth,
    52  two thousand twenty-two.
    53    3.  In  the  event  there  are undistributed funds within amounts made
    54  available for distributions under this  section,  such  funds  shall  be
    55  reallocated  and distributed in current or subsequent distribution peri-

        S. 8007--C                          6                         A. 9007--C
 
     1  ods in a manner determined by the commissioner for the purpose set forth
     2  in this section.
     3    §  3.  This act shall take effect immediately; provided, however, that
     4  section two of this act shall be deemed to have been in full  force  and
     5  effect on and after April 1, 2022.
 
     6                                   PART B
 
     7                            Intentionally Omitted
 
     8                                   PART C
 
     9    Section  1.  Subdivision 6 of section 571 of the public health law, as
    10  amended by chapter 444 of the laws  of  2013,  is  amended  to  read  as
    11  follows:
    12    6.  "Qualified  health  care professional" means a physician, dentist,
    13  podiatrist, optometrist performing a clinical laboratory test that  does
    14  not  use  an invasive modality as defined in section seventy-one hundred
    15  one of the education law, pharmacist administering COVID-19 and influen-
    16  za tests pursuant to subdivision seven of  section  sixty-eight  hundred
    17  one  of  the  education  law, physician assistant, specialist assistant,
    18  nurse practitioner, or midwife, who is licensed and registered with  the
    19  state education department.
    20    §  2.  Section  6801  of the education law, is amended by adding a new
    21  subdivision 7 to read as follows:
    22    7. A licensed pharmacist is a qualified health care professional under
    23  section five hundred seventy-one  of  the  public  health  law  for  the
    24  purposes  of  directing  a  limited  service laboratory and ordering and
    25  administering COVID-19 and influenza tests authorized by  the  Food  and
    26  Drug Administration (FDA), subject to certificate of waiver requirements
    27  established  pursuant to the federal clinical laboratory improvement act
    28  of nineteen hundred eighty-eight.
    29    § 3. Subparagraph (iv) of paragraph (a) of subdivision  3  of  section
    30  6902  of the education law, as amended by section 2 of part D of chapter
    31  56 of the laws of 2014, is amended to read as follows:
    32    (iv) The practice protocol shall reflect current accepted medical  and
    33  nursing  practice[.  The  protocols  shall  be filed with the department
    34  within ninety days of the commencement  of  the  practice]  and  may  be
    35  updated periodically. The commissioner shall make regulations establish-
    36  ing the procedure for the review of protocols and the disposition of any
    37  issues arising from such review.
    38    §  4.  Paragraph (b) of subdivision 3 of section 6902 of the education
    39  law, as added by section 2 of part D of chapter 56 of the laws of  2014,
    40  is amended to read as follows:
    41    (b) Notwithstanding subparagraph (i) of paragraph (a) of this subdivi-
    42  sion,  a  nurse practitioner, certified under section sixty-nine hundred
    43  ten of this article and practicing for  more  than  three  thousand  six
    44  hundred  hours  [may  comply  with  this paragraph in lieu of complying]
    45  shall not be required to comply with the requirements of  paragraph  (a)
    46  of  this subdivision relating to collaboration with a physician, a writ-
    47  ten practice agreement and written practice protocols. [A nurse  practi-
    48  tioner  complying with this paragraph shall have collaborative relation-
    49  ships with one or more licensed physicians qualified to  collaborate  in
    50  the  specialty  involved  or  a hospital, licensed under article twenty-
    51  eight of the public health law, that provides services through  licensed

        S. 8007--C                          7                         A. 9007--C

     1  physicians qualified to collaborate in the specialty involved and having
     2  privileges  at such institution. As evidence that the nurse practitioner
     3  maintains collaborative  relationships,  the  nurse  practitioner  shall
     4  complete  and  maintain  a form, created by the department, to which the
     5  nurse practitioner  shall  attest,  that  describes  such  collaborative
     6  relationships.  For purposes of this paragraph, "collaborative relation-
     7  ships" shall mean that the nurse practitioner shall communicate, whether
     8  in person, by telephone or through written (including electronic) means,
     9  with a licensed physician qualified  to  collaborate  in  the  specialty
    10  involved  or,  in  the  case  of a hospital, communicate with a licensed
    11  physician qualified to collaborate in the specialty involved and  having
    12  privileges at such hospital, for the purposes of exchanging information,
    13  as  needed,  in  order to provide comprehensive patient care and to make
    14  referrals as necessary. Such form shall also reflect the  nurse  practi-
    15  tioner's  acknowledgement  that  if  reasonable  efforts  to resolve any
    16  dispute that may arise with the collaborating physician or, in the  case
    17  of  a collaboration with a hospital, with a licensed physician qualified
    18  to collaborate in the specialty involved and having privileges  at  such
    19  hospital,  about a patient's care are not successful, the recommendation
    20  of the physician shall prevail. Such form shall be updated as needed and
    21  may be subject to review by the department. The nurse practitioner shall
    22  maintain documentation that supports such  collaborative  relationships.
    23  Failure  to  comply  with  the requirements found in this paragraph by a
    24  nurse practitioner who is not complying with such  provisions  of  para-
    25  graph  (a) of this subdivision, shall be subject to professional miscon-
    26  duct provisions as set forth in  article  one  hundred  thirty  of  this
    27  title.]
    28    §  5.  Section 3 of part D of chapter 56 of the laws of 2014, amending
    29  the education law relating to enacting the "nurse practitioners  modern-
    30  ization  act",  as  amended by section 10 of part S of chapter 57 of the
    31  laws of 2021, is amended to read as follows:
    32    § 3. This act shall take effect on the first of January after it shall
    33  have become a law [and shall expire June 30 of the seventh year after it
    34  shall have become a law, when upon such date the provisions of this  act
    35  shall  be deemed repealed]; provided, however, that effective immediate-
    36  ly, the addition, amendment and/or repeal  of  any  rule  or  regulation
    37  necessary  for  the  implementation of this act on its effective date is
    38  authorized and directed to be made  and  completed  on  or  before  such
    39  effective date.
    40    §  6. Subdivision 6 of section 6527 of the education law is amended by
    41  adding a new paragraph (h) to read as follows:
    42    (h) administering tests to determine the presence of COVID-19  or  its
    43  antibodies or influenza virus.
    44    §  7. Subdivision 4 of section 6909 of the education law is amended by
    45  adding a new paragraph (h) to read as follows:
    46    (h) administering tests to determine the presence of COVID-19  or  its
    47  antibodies or influenza virus.
    48    §  8.  This  act  shall take effect immediately and shall be deemed to
    49  have been in full force and effect on and after April 1, 2022; provided,
    50  however, that sections one, two, three, four, six and seven of this  act
    51  shall expire and be deemed repealed two years after it shall have become
    52  a law.
 
    53                                   PART D
 
    54                            Intentionally Omitted

        S. 8007--C                          8                         A. 9007--C
 
     1                                   PART E
 
     2    Section  1.  Subdivision 1 of section 605 of the public health law, as
     3  amended by section 20 of part E of chapter 56 of the laws  of  2013,  is
     4  amended to read as follows:
     5    1.  A  state  aid base grant shall be reimbursed to municipalities for
     6  the core public health services identified in section six hundred two of
     7  this title, in an amount of the greater of [sixty-five] one  dollar  and
     8  thirty  cents  per  capita, for each person in the municipality, or [six
     9  hundred fifty thousand dollars] seven hundred  fifty  thousand  dollars,
    10  provided that the municipality expends at least [six hundred fifty thou-
    11  sand dollars] seven hundred fifty thousand dollars, for such core public
    12  health  services. A municipality must provide all the core public health
    13  services identified in section six hundred two of this title to  qualify
    14  for  such  base  grant  unless  the municipality has the approval of the
    15  commissioner to expend the base grant on a portion of such  core  public
    16  health  services.  If any services in such section are not provided, the
    17  commissioner [may] shall limit the municipality's  per  capita  or  base
    18  grant  to reflect the scope of the reduced services, in an amount not to
    19  exceed five hundred seventy-seven thousand  five  hundred  dollars.  The
    20  commissioner  may  use  the  amount that is not granted to contract with
    21  agencies, associations, or organizations to provide  such  services;  or
    22  the  health  department  may use such proportionate share to provide the
    23  services upon approval of the director of the division of the budget.
    24    § 2. Subdivision 2 of section 605 of the public health law, as amended
    25  by section 1 of part O of chapter 57 of the laws of 2019, is amended  to
    26  read as follows:
    27    2.  State  aid  reimbursement for public health services provided by a
    28  municipality under this title, shall be  made  if  the  municipality  is
    29  providing  some  or all of the core public health services identified in
    30  section six hundred two of this title, pursuant to an approved  applica-
    31  tion  for  state  aid,  at a rate of no less than thirty-six per centum,
    32  except for the city of New York which shall receive no less than  twenty
    33  per  centum,  of the difference between the amount of moneys expended by
    34  the municipality for public health  services  required  by  section  six
    35  hundred  two  of  this  title  during the fiscal year and the base grant
    36  provided pursuant to subdivision one of this section. Provided, however,
    37  that a municipality's documented fringe benefit costs submitted under an
    38  application for state aid and otherwise eligible for reimbursement under
    39  this article shall not exceed fifty per  centum  of  the  municipality's
    40  eligible personnel services. No such reimbursement shall be provided for
    41  services that are not eligible for state aid pursuant to this article.
    42    §  3.  Subdivision 2 of section 616 of the public health law, as added
    43  by chapter 901 of the laws of 1986, is amended and a new  subdivision  4
    44  is added to read as follows:
    45    2.  No payments shall be made from moneys appropriated for the purpose
    46  of this article to a municipality for contributions by the  municipality
    47  for  indirect  costs [and fringe benefits, including but not limited to,
    48  employee retirement funds, health insurance  and  federal  old  age  and
    49  survivors insurance].
    50    4.  Moneys  appropriated for the purposes of this article to a munici-
    51  pality may include reimbursement of a  municipality's  fringe  benefits,
    52  including but not limited to employee retirement funds, health insurance
    53  and  federal  old age and survivor's insurance. However, costs submitted
    54  under an application for state aid must be  consistent  with  a  munici-

        S. 8007--C                          9                         A. 9007--C
 
     1  pality's  documented fringe benefit costs and shall not exceed fifty per
     2  centum of the municipality's eligible personnel services.
     3    §  4.  This  act  shall take effect immediately and shall be deemed to
     4  have been in full force and effect on and after April 1, 2022.
 
     5                                   PART F
 
     6                            Intentionally Omitted
 
     7                                   PART G
 
     8                            Intentionally Omitted
 
     9                                   PART H
 
    10    Section 1. Subdivision 1 of section 91 of part H of chapter 59 of  the
    11  laws  of 2011, amending the public health law and other laws relating to
    12  general hospital reimbursement for annual rates, as amended by section 2
    13  of part A of chapter 56 of the laws of  2013,  is  amended  to  read  as
    14  follows:
    15    1.  Notwithstanding  any  inconsistent provision of state law, rule or
    16  regulation to the contrary, subject to federal  approval,  the  year  to
    17  year  rate of growth of department of health state funds Medicaid spend-
    18  ing shall not exceed the [ten] five year rolling average of the [medical
    19  component of the consumer price index as published by the United  States
    20  department  of  labor,  bureau  of  labor statistics,] Medicaid spending
    21  annual growth rate projections within the  National  Health  Expenditure
    22  Accounts  produced  by  the office of the actuary in the federal Centers
    23  for Medicare and Medicaid services for the preceding [ten]  five  years;
    24  provided,  however,  that  for  state  fiscal  year 2013-14 and for each
    25  fiscal year thereafter, the maximum allowable  annual  increase  in  the
    26  amount  of  department  of health state funds Medicaid spending shall be
    27  calculated by multiplying the department of health state funds  Medicaid
    28  spending  for  the  previous year, minus the amount of any department of
    29  health state operations spending included therein, by  such  [ten]  five
    30  year rolling average.
    31    § 2. Paragraph (a) of subdivision 1 of section 92 of part H of chapter
    32  59  of  the  laws of 2011, amending the public health law and other laws
    33  relating to general hospital reimbursement for annual rates, as  amended
    34  by  section 1 of part A of chapter 57 of the laws of 2021, is amended to
    35  read as follows:
    36    (a) For state fiscal years  2011-12  through  [2021-22]  2023-24,  the
    37  director  of the budget, in consultation with the commissioner of health
    38  referenced as "commissioner" for purposes of this section, shall  assess
    39  on  a  quarterly  basis,  as  reflected in quarterly reports pursuant to
    40  subdivision five of this  section  known  and  projected  department  of
    41  health  state  funds medicaid expenditures by category of service and by
    42  geographic regions, as defined by the commissioner.
    43    § 3. Subdivision 5 of section 92 of part H of chapter 59 of  the  laws
    44  of  2011,  amending  the  public  health  law and other laws relating to
    45  general hospital reimbursement for annual rates, as amended by section 2
    46  of part A of chapter 57 of the laws of  2021,  is  amended  to  read  as
    47  follows:
    48    5.  The  commissioner  of health, in consultation with the director of
    49  budget, shall prepare a quarterly report that sets forth:

        S. 8007--C                         10                         A. 9007--C
 
     1    (a) known and projected department of health medicaid expenditures  as
     2  described  in  subdivision  one  of this section, and factors that could
     3  result in medicaid disbursements for the relevant state fiscal  year  to
     4  exceed  the  projected department of health state funds disbursements in
     5  the  enacted  budget financial plan pursuant to subdivision 3 of section
     6  23 of the state finance law, including spending increases  or  decreases
     7  due  to: enrollment fluctuations, rate changes, utilization changes, MRT
     8  investments, [and] shift of beneficiaries to managed care;  [and]  vari-
     9  ations  in  offline  medicaid  payments;  the  methodology by which such
    10  projections are compiled or determined; and for periods following  April
    11  1,  2022,  the  projected  savings or investment from the enacted budget
    12  that implemented the program or initiative, along  with  the  actual  or
    13  known savings or investment from such program or initiative;
    14    (b)  the  actions  taken  to implement any medicaid savings allocation
    15  adjustment implemented pursuant to subdivisions one  and  four  of  this
    16  section,  including information concerning the impact of such actions on
    17  each category of service and each geographic region of the state.
    18    (c) The price, to include the base rate plus any upcoming rate adjust-
    19  ment; utilization, to include current enrollment,  projected  enrollment
    20  changes  and  acuity;  and, to the extent practicable, Medicaid Redesign
    21  Team initiatives, one-time initiatives and other initiatives  describing
    22  the  proposed  budget  action  impact,  any  prior  year initiative with
    23  current and future year impacts for the following categories  of  spend-
    24  ing:
    25    (i) inpatient;
    26    (ii) outpatient;
    27    (iii) emergency room;
    28    (iv) clinic;
    29    (v) nursing homes;
    30    (vi) other long term care;
    31    (vii) medicaid managed care;
    32    (viii) family health plus;
    33    (ix) pharmacy;
    34    (x) transportation;
    35    (xi) dental;
    36    (xii) non-institutional and all other categories;
    37    (xiii) affordable housing;
    38    (xiv) vital access provider services;
    39    (xv) behavioral health vital access provider services;
    40    (xvi) health home establishment grants;
    41    (xvii) grants for facilitating transition of behavioral health service
    42  to managed care;
    43    (xviii) Finger Lakes health services agency;
    44    (xix) the transition of vulnerable populations to managed care;
    45    (xx) audit recoveries and settlements; [and]
    46    (xxi) vital access provider assurance program;
    47    (xxii) home care;
    48    (xxiii) personal care, including consumer directed personal assistance
    49  program;
    50    (xxiv) any programs that were instituted subsequent to the last report
    51  issued under this subdivision and not reported; and
    52    (d)  where  price  and utilization are not applicable, detail shall be
    53  provided on spending, to include but not be limited to:
    54    (i) demographic information of targeted recipients;
    55    (ii) number of recipients;
    56    (iii) award amounts;

        S. 8007--C                         11                         A. 9007--C
 
     1    (iv) timing of awards; and
     2    (v) the impact of Medicaid Redesign Team and/or one-time initiatives.
     3    Information  required  by  paragraphs  (a) and (b) of this subdivision
     4  shall be provided to the chairs of the senate finance and  the  assembly
     5  ways  and  means  committees,  and  shall be posted on the department of
     6  health's website in the timely manner.
     7    (e) Beginning on July 1,  2014,  additional  information  required  by
     8  paragraphs  (c)  and  (d)  of  this subdivision shall be provided to the
     9  governor, the temporary president of the  senate,  the  speaker  of  the
    10  assembly,  the  chair  of the senate finance committee, the chair of the
    11  assembly ways and means committee, and the  chairs  of  the  senate  and
    12  assembly health committees.
    13    (f)  any  projected Medicaid savings determined by the commissioner of
    14  health pursuant to section 34 of part C of a  chapter  of  the  laws  of
    15  2014,  relating  to  the implementation of the health and mental hygiene
    16  budget, and the proposed allocation plan spending adjustment with regard
    17  to such savings.
    18    (g) any material impact to the global  cap  annual  projection,  along
    19  with  an  explanation of the variance from the projection at the time of
    20  the enacted budget. Such material impacts  shall  include,  but  not  be
    21  limited  to,  policy and programmatic changes, significant transactions,
    22  and any actions taken, administrative or otherwise,  which  would  mate-
    23  rially  impact expenditures under the global cap. Reporting requirements
    24  under this paragraph shall include material impacts from  the  preceding
    25  quarter  and  any  anticipated material impacts for the quarter in which
    26  the report required under this subdivision is issued, as well as  antic-
    27  ipated  material  impacts for the quarter subsequent to such report. The
    28  report will also include, to the extent practicable,  an  appendix  that
    29  will provide, including but not limited to: (1) the methodology by which
    30  projections  for  such  material impacts are compiled or determined; (2)
    31  program trends, including enrollment actuals and projections; (3) detail
    32  on the anticipated spending outside of the Global Cap  relating  to  DOH
    33  Medicaid;  (4)  detail  on  the anticipated and projected mental hygiene
    34  stabalization fund transfer; (5) the  number  of  fiscal  intermediaries
    35  contracted  with  the  Department  of  Health; (6) links to the approved
    36  fee-for-service rates for  general  hospitals,  inclusive  of  any  rate
    37  appeals and rate adjustments; and (7) links to the approved fee-for-ser-
    38  vice rates of pharmaceutical drugs on the preferred drug list.
    39    §  4.  This  act  shall take effect immediately and shall be deemed to
    40  have been in full force and effect on and after April 1, 2022.
 
    41                                   PART I
 
    42    Section 1. 1. Notwithstanding any provision of law  to  the  contrary,
    43  for  the state fiscal years beginning April 1, 2022, and thereafter, all
    44  department of health Medicaid payments made for services provided on and
    45  after April 1, 2022, shall be subject to a uniform rate increase of  one
    46  percent,  subject  to the approval of the commissioner of the department
    47  of health and director of  the  budget.  Such  rate  increase  shall  be
    48  subject to federal financial participation.
    49    2.  The  following  types  of  payments shall be exempt from increases
    50  pursuant to this section:
    51    (a) payments that would violate federal law including, but not limited
    52  to, hospital disproportionate share payments that would be in excess  of
    53  federal statutory caps;

        S. 8007--C                         12                         A. 9007--C
 
     1    (b)  payments  made by other state agencies including, but not limited
     2  to, those made pursuant to articles 16, 31 and 32 of the mental  hygiene
     3  law;
     4    (c)  payments  the state is obligated to make pursuant to court orders
     5  or judgments;
     6    (d) payments for which the non-federal  share  does  not  reflect  any
     7  state funding; and
     8    (e)  at  the discretion of the commissioner of health and the director
     9  of the budget, payments with regard  to  which  it  is  determined  that
    10  application of increases pursuant to this section would result, by oper-
    11  ation  of  federal law, in a lower federal medical assistance percentage
    12  applicable to such payments.
    13    § 2. This act shall take effect immediately and  shall  be  deemed  to
    14  have been in full force and effect on and after April 1, 2022.
 
    15                                   PART J
 
    16    Section  1.  Paragraph  (c) of subdivision 35 of section 2807-c of the
    17  public health law, as amended by section 32 of part C of chapter  60  of
    18  the laws of 2014, is amended to read as follows:
    19    (c)  1.  The  base period reported costs and statistics used for rate-
    20  setting for operating cost components, including the weights assigned to
    21  diagnostic related groups, shall be  updated  no  less  frequently  than
    22  every  four  years  and  the  new base period shall be no more than four
    23  years prior to the first applicable rate period that utilizes  such  new
    24  base  period provided, however, that the first updated base period shall
    25  begin on or after April first, two thousand fourteen, but no later  than
    26  July first, two thousand fourteen; and further provided that the updated
    27  base  period subsequent to July first, two thousand eighteen shall begin
    28  on or after January first, two thousand twenty-four.
    29    2. In the event of a declaration of a federal public health emergency,
    30  as defined in 42 USC § 247d, or a state disaster emergency,  as  defined
    31  in  section  twenty  of the executive law, that severely impacts general
    32  hospitals within the state, the department may exclude, for purposes  of
    33  this  paragraph,  the  audited reported costs and statistics during such
    34  declaration.
    35    § 2. This act shall take effect immediately and  shall  be  deemed  to
    36  have been in full force and effect on and after April 1, 2022.
 
    37                                   PART K
 
    38    Section  1.  The  public health law is amended by adding a new section
    39  2825-g to read as follows:
    40    § 2825-g. Health care facility transformation program:  statewide  IV.
    41  1.  A  statewide  health  care facility transformation program is hereby
    42  established within the department for the purpose of transforming, rede-
    43  signing, and strengthening quality health  care  services  in  alignment
    44  with  statewide  and  regional  health  care  needs,  and in the ongoing
    45  pandemic response. The program shall also provide  funding,  subject  to
    46  lawful  appropriation,  in  support  of capital projects that facilitate
    47  furthering such transformational goals.
    48    2. The commissioner shall enter into an agreement with  the  president
    49  of  the dormitory authority of the state of New York pursuant to section
    50  sixteen hundred eighty-r of the  public  authorities  law,  which  shall
    51  apply  to this agreement, subject to the approval of the director of the
    52  division of the budget, for the purposes of the distribution and  admin-

        S. 8007--C                         13                         A. 9007--C
 
     1  istration of available funds pursuant to such agreement, and made avail-
     2  able  pursuant  to  this  section  and  appropriation. Such funds may be
     3  awarded and distributed by the department  for  grants  to  health  care
     4  providers  including  but  not limited to, hospitals, residential health
     5  care facilities, adult care facilities licensed under title two of arti-
     6  cle seven of the social services law, diagnostic and  treatment  centers
     7  licensed  or  granted an operating certificate under this chapter, clin-
     8  ics, including but not limited to those licensed or granted an operating
     9  certificate under this chapter or the  mental  hygiene  law,  children's
    10  residential  treatment  facilities  licensed under article thirty-one of
    11  the mental hygiene law, assisted living programs approved by the depart-
    12  ment pursuant to section four hundred sixty-one-l of the social services
    13  law, behavioral health  facilities  licensed  or  granted  an  operating
    14  certificate pursuant to articles thirty-one and thirty-two of the mental
    15  hygiene  law,  home  care  providers certified or licensed under article
    16  thirty-six of this chapter, primary care providers, hospices licensed or
    17  granted an operating certificate pursuant to article forty of this chap-
    18  ter, community-based programs funded under the office of mental  health,
    19  the  office  of  addiction  services and supports, the office for people
    20  with developmental disabilities, or through local governmental units  as
    21  defined  under  article forty-one of the mental hygiene law, independent
    22  practice  associations  or  organizations, and residential facilities or
    23  day program facilities licensed  or  granted  an  operating  certificate
    24  under  article  sixteen of the mental hygiene law. A copy of such agree-
    25  ment, and any amendments thereto, shall be provided by the department to
    26  the chair of the senate finance committee, the  chair  of  the  assembly
    27  ways and means committee, and the director of the division of the budget
    28  no  later  than thirty days after such agreement is finalized.  Projects
    29  awarded, in whole or part, under sections twenty-eight  hundred  twenty-
    30  five-a  and twenty-eight hundred twenty-five-b of this article shall not
    31  be eligible for grants or awards made available under this section.
    32    3. Notwithstanding subdivision two of this section or any inconsistent
    33  provision of law to the contrary, and upon approval of the  director  of
    34  the  budget, the commissioner may, subject to the availability of lawful
    35  appropriation, award up to four hundred fifty  million  dollars  of  the
    36  funds  made  available  pursuant  to  this  section for unfunded project
    37  applications submitted in response to the request for application number
    38  18406 issued by the department  on  September  thirtieth,  two  thousand
    39  twenty-one  pursuant  to  section  twenty-eight hundred twenty-five-f of
    40  this article. Authorized amounts to be awarded pursuant to  applications
    41  submitted  in response to the request for application number 18406 shall
    42  be awarded no later than December thirty-first, two thousand twenty-two.
    43  Provided, however, that a minimum of:
    44    (a) twenty-five million dollars of total awarded funds shall  be  made
    45  to  community-based  health  care  providers, which for purposes of this
    46  section shall be defined as diagnostic and treatment centers licensed or
    47  granted an operating certificate under this chapter;  independent  prac-
    48  tice  associations  or  organizations;  home care providers certified or
    49  licensed pursuant to article thirty-six of this  chapter;  and  hospices
    50  licensed  or  granted an operating certificate pursuant to article forty
    51  of this chapter;
    52    (b) twenty-five million dollars of total awarded funds shall  be  made
    53  to  a  mental health clinic licensed or granted an operating certificate
    54  under  article  thirty-one  of  the  mental  hygiene  law;  alcohol  and
    55  substance  use disorder treatment clinics licensed or granted an operat-
    56  ing certificate under article thirty-two  of  the  mental  hygiene  law;

        S. 8007--C                         14                         A. 9007--C
 
     1  clinics  licensed  or  granted  an  operating  certificate under article
     2  sixteen of the mental hygiene law; and community-based  programs  funded
     3  under  the  office  of mental health or the office of addiction services
     4  and  supports or through local governmental units as defined under arti-
     5  cle forty-one of the mental hygiene law; and
     6    (c) fifty million dollars of total awarded  funds  shall  be  made  to
     7  residential  health  care  facilities  or adult care facilities licensed
     8  under title two of article seven of the social services law.
     9    4. Notwithstanding sections one hundred twelve and one hundred  sixty-
    10  three  of  the state finance law, sections one hundred forty-two and one
    11  hundred forty-three of the economic development law, or any inconsistent
    12  provision of law to the contrary, up to two hundred million  dollars  of
    13  the  funds  appropriated  for  this  program shall be awarded, without a
    14  competitive bid or request for proposal process, for  grants  to  health
    15  care  providers for purposes of modernization of an emergency department
    16  of regional significance. For purposes of this subdivision, an emergency
    17  department shall be considered to have regional significance if it:  (a)
    18  serves  as  Level 1 trauma center with the highest volume in its region;
    19  (b) includes  the  capacity  to  segregate  patients  with  communicable
    20  diseases,  trauma or severe behavioral health issues from other patients
    21  in the emergency department; (c) provides training in emergency care and
    22  trauma care to residents from multiple hospitals in the region; and  (d)
    23  serves a high proportion of Medicaid patients.
    24    5.  (a)  Notwithstanding  sections  one hundred twelve and one hundred
    25  sixty-three of the state finance law, sections one hundred forty-two and
    26  one hundred forty-three of the economic development law, or  any  incon-
    27  sistent  provision  of  law  to  the contrary, up to seven hundred fifty
    28  million dollars of the funds appropriated  for  this  program  shall  be
    29  awarded,  without a competitive bid or request for proposal process, for
    30  grants to health care providers, as defined in subdivision two  of  this
    31  section.
    32    (b)  Awards  made  pursuant  to this subdivision shall provide funding
    33  only for capital projects, to the extent lawful appropriation and  fund-
    34  ing  is available, to build innovative, patient-centered models of care,
    35  increase access to care, to improve the quality of care  and  to  ensure
    36  financial sustainability of health care providers.
    37    (c) Provided, however, that a minimum of:
    38    (i)  twenty-five  million dollars of total awarded funds shall be made
    39  to community-based health care providers, which  for  purposes  of  this
    40  section shall be defined as diagnostic and treatment centers licensed or
    41  granted  an  operating certificate pursuant to this chapter; independent
    42  practice associations or organizations; home care providers certified or
    43  licensed pursuant to article thirty-six of this  chapter;  and  hospices
    44  licensed  or  granted an operating certificate pursuant to article forty
    45  of this chapter;
    46    (ii) twenty-five million dollars of total awarded funds shall  be made
    47  to a mental health clinic licensed or granted an  operating  certificate
    48  under  article  thirty-one  of  the  mental  hygiene  law;  alcohol  and
    49  substance use disorder treatment clinics licensed or granted an  operat-
    50  ing  certificate  under  article  thirty-two  of the mental hygiene law;
    51  clinics licensed or  granted  an  operating  certificate  under  article
    52  sixteen  of  the mental hygiene law; and community-based programs funded
    53  under the office of mental health or the office  of  addiction  services
    54  and  supports or through local governmental units as defined under arti-
    55  cle forty-one of the mental hygiene law; and

        S. 8007--C                         15                         A. 9007--C
 
     1    (iii) twenty-five million dollars of total awarded funds shall be made
     2  to residential health care facilities or adult care facilities  licensed
     3  under title two of article seven of the social services law.
     4    6.  Notwithstanding sections one hundred twelve and one hundred sixty-
     5  three of the state finance law, sections one hundred forty-two  and  one
     6  hundred forty-three of the economic development law, or any inconsistent
     7  provision  of  law  to  the  contrary,  up  to one hundred fifty million
     8  dollars of the funds appropriated for this  program  shall  be  awarded,
     9  without  a  competitive bid or request for proposal process, for techno-
    10  logical and telehealth transformation projects.
    11    7. Notwithstanding sections one hundred twelve and one hundred  sixty-
    12  three  of  the state finance law, sections one hundred forty-two and one
    13  hundred forty-three of the economic development law, or any inconsistent
    14  provision of law to the contrary, up to fifty  million  dollars  of  the
    15  funds  appropriated for this program shall be awarded, without a compet-
    16  itive bid or a request for proposal process, to residential and communi-
    17  ty-based alternatives to the traditional model of nursing home care.
    18    8. Selection of awards made by the department pursuant to subdivisions
    19  three, four, five, six and seven of this section shall be contingent  on
    20  an evaluation process acceptable to the commissioner and approved by the
    21  director  of the division of the budget. Disbursement of  awards  may be
    22  contingent on the health care provider as defined in subdivision two  of
    23  this  section achieving   certain   process  and performance metrics and
    24  milestones that are structured to ensure that the goals of  the  project
    25  are achieved.
    26    9.  The  department shall provide a report on a quarterly basis to the
    27  chairs of the senate finance, assembly ways and means,  and  senate  and
    28  assembly health committees, until such time as the department determines
    29  that  the  projects  that  receive  funding pursuant to this section are
    30  substantially complete. Such reports shall be submitted  no  later  than
    31  sixty  days  after the close of the quarter, and shall include, for each
    32  award, the name of the health care provider as  defined  in  subdivision
    33  two of this section, a description of the project or purpose, the amount
    34  of  the  award,  disbursement date, and status of achievement of process
    35  and performance metrics and milestones pursuant to  subdivision  six  of
    36  this section.
    37    §  2.  This  act  shall take effect immediately and shall be deemed to
    38  have been in full force and effect on and after April 1, 2022.
 
    39                                   PART L
 
    40                            Intentionally Omitted
 
    41                                   PART M
 
    42    Section 1. Paragraph (a) of subdivision  2  of  section  2828  of  the
    43  public health law, as added by section 1 of part GG of chapter 57 of the
    44  laws of 2021, is amended to read as follows:
    45    (a) "Revenue" shall mean the total operating revenue from or on behalf
    46  of residents of the residential health care facility, government payers,
    47  or third-party payers, to pay for a resident's occupancy of the residen-
    48  tial health care facility, resident care, and the operation of the resi-
    49  dential  health care facility as reported in the residential health care
    50  facility cost reports submitted to the  department;  provided,  however,
    51  that revenue shall exclude:

        S. 8007--C                         16                         A. 9007--C
 
     1    (i)  the  average  increase  in  the  capital  portion of the Medicaid
     2  reimbursement rate from the prior three years;
     3    (ii)  funding  received  as  reimbursement  for  the  assessment under
     4  subparagraph (vi) of paragraph (b) of subdivision two of  section  twen-
     5  ty-eight  hundred  seven-d  of  this  article, as reconciled pursuant to
     6  paragraph (c) of subdivision ten of section twenty-eight hundred seven-d
     7  of this article;
     8    (iii) the capital per diem portion of the reimbursement rate for nurs-
     9  ing homes that have an overall four- or five-star rating assigned pursu-
    10  ant to the inspection rating system of the U.S. Centers for Medicare and
    11  Medicaid Services (CMS rating), provided  however  that  such  exclusion
    12  shall  not  apply  to  any amount of the capital per diem portion of the
    13  reimbursement rate that is attributable to a capital expenditure made to
    14  a corporation, other entity, or individual, with a  common  or  familial
    15  ownership  to the operator or the facility as reported under subdivision
    16  one of section twenty-eight hundred three-x of this chapter; and
    17    (iv) any grant funds from the federal government for reimbursement  of
    18  COVID-19  pandemic-related  expenses, including but not limited to funds
    19  received  from  the  federal  emergency  management  agency  or   health
    20  resources and services administration.
    21    §  2.  Paragraph  (d) of subdivision 2-c of section 2808 of the public
    22  health law, as amended by section 26-a of part C of chapter  60  of  the
    23  laws of 2014, is amended to read as follows:
    24    (d)  The commissioner shall promulgate regulations, and may promulgate
    25  emergency regulations, to implement the provisions of this  subdivision.
    26  Such  regulations  shall  be  developed in consultation with the nursing
    27  home industry and advocates for residential health care  facility  resi-
    28  dents and, further, the commissioner shall provide notification concern-
    29  ing  such  regulations  to  the chairs of the senate and assembly health
    30  committees, the chair of the senate finance committee and the  chair  of
    31  the  assembly  ways  and means committee. Such regulations shall include
    32  provisions for rate adjustments or payment enhancements to facilitate  a
    33  minimum four-year transition of facilities to the rate-setting methodol-
    34  ogy  established  by  this  subdivision and may also include, but not be
    35  limited to, provisions for facilitating quality improvements in residen-
    36  tial health  care  facilities.  For  purposes  of  facilitating  quality
    37  improvements through the establishment of a nursing home quality pool to
    38  be  funded  at  the discretion of the commissioner by (i) adjustments in
    39  medical assistance rates, (ii) funds made available through state appro-
    40  priations,  or  (iii)  a  combination  thereof,  those  facilities  that
    41  contribute  to  the  quality pool, but are deemed ineligible for quality
    42  pool payments due exclusively to a specific case of employee misconduct,
    43  shall nevertheless be eligible for a quality pool payment if the facili-
    44  ty properly reported the incident, did not  receive  a  survey  citation
    45  from  the commissioner or the Centers for Medicare and Medicaid Services
    46  establishing the facility's culpability with regard to  such  misconduct
    47  and,  but  for  the  specific  case of employee misconduct, the facility
    48  would have  otherwise  received  a  quality  pool  payment.  Regulations
    49  pertaining to the facilitation of quality improvement may be made effec-
    50  tive for periods on and after January first, two thousand thirteen.
    51    §  3.  The  opening  paragraph and paragraph (i) of subdivision (g) of
    52  section 2826 of the public health law, as added by section 6 of  part  J
    53  of chapter 60 of the laws of 2015, are amended to read as follows:
    54    Notwithstanding  subdivision  (a)  of this section, and within amounts
    55  appropriated for such purposes as described herein, for  the  period  of
    56  April  first,  two  thousand  [fifteen] twenty-two through March thirty-

        S. 8007--C                         17                         A. 9007--C
 
     1  first, two thousand [sixteen] twenty-three, the commissioner may award a
     2  temporary adjustment to the non-capital components  of  rates,  or  make
     3  temporary  lump-sum  Medicaid  payments  to eligible [general hospitals]
     4  facilities  in  severe  financial  distress to enable such facilities to
     5  maintain operations and vital services while such  facilities  establish
     6  long  term  solutions  to achieve sustainable health services. Provided,
     7  however, the commissioner is authorized to make such a temporary adjust-
     8  ment or make such temporary lump sum payment only pursuant to  criteria,
     9  an evaluation process, and transformation plan acceptable to the commis-
    10  sioner  in consultation with the director of the division of the budget.
    11  The department shall publish on its  website  the  criteria,  evaluation
    12  process  and  guidance  for transformation plans and notification of any
    13  award recipients.
    14    (i) Eligible [general hospitals] facilities shall include:
    15    (A) a public hospital, which for purposes of this  subdivision,  shall
    16  mean  a general hospital operated by a county or municipality, but shall
    17  exclude any such hospital operated by a public benefit corporation;
    18    (B) a federally designated critical access hospital;
    19    (C) a federally designated sole community hospital; [or]
    20    (D) a residential health care facility;
    21    (E) a general hospital that  is  a  safety  net  hospital,  which  for
    22  purpose of this subdivision shall mean:
    23    (1)  such  hospital  has  at  least  thirty  percent  of its inpatient
    24  discharges made up of Medicaid eligible individuals, uninsured  individ-
    25  uals  or  Medicaid dually eligible individuals and with at least thirty-
    26  five percent of its outpatient visits made up of Medicaid eligible indi-
    27  viduals, uninsured individuals or Medicaid dually-eligible  individuals;
    28  or
    29    (2) such hospital serves at least thirty percent of the residents of a
    30  county  or  a  multi-county  area who are Medicaid eligible individuals,
    31  uninsured individuals or Medicaid dually-eligible individuals; or
    32    (F) an independent practice association or accountable care  organiza-
    33  tion authorized under applicable regulations that participate in managed
    34  care  provider  network  arrangements  with any of the provider types in
    35  subparagraphs (A) through (F) of this paragraph.
    36    § 4. Paragraph (c) of subdivision 1 of  section  2828  of  the  public
    37  health  law,  as added by section 1 of part GG of chapter 57 of the laws
    38  of 2021, is amended to read as follows:
    39    (c) Such regulations shall further include at a minimum that any resi-
    40  dential health care facility for which total operating  revenue  exceeds
    41  total  operating and non-operating expenses by more than five percent of
    42  total operating and non-operating expenses or that fails  to  spend  the
    43  minimum  amount  necessary to comply with the minimum spending standards
    44  for resident-facing staffing or direct resident care, calculated  on  an
    45  annual  basis,  or  for  the year two thousand twenty-two, on a pro-rata
    46  basis for only that portion of the year during which the  failure  of  a
    47  residential  health  care facility to spend a minimum of seventy percent
    48  of revenue on direct resident care, and  forty  percent  of  revenue  on
    49  resident-facing staffing, may be held to be a violation of this chapter,
    50  shall  remit  such excess revenue, or the difference between the minimum
    51  spending requirement and the actual amount of spending on  resident-fac-
    52  ing  staffing or direct care staffing, as the case may be, to the state,
    53  with such excess revenue which shall be  payable,  in  a  manner  to  be
    54  determined  by such regulations, by November first in the year following
    55  the year in which  the  expenses  are  incurred.  The  department  shall
    56  collect such payments by methods including, but not limited to, bringing

        S. 8007--C                         18                         A. 9007--C
 
     1  suit in a court of competent jurisdiction on its own behalf after giving
     2  notice  of such suit to the attorney general, deductions or offsets from
     3  payments made pursuant to the Medicaid program, and shall  deposit  such
     4  recouped funds into the nursing home quality pool, as set forth in para-
     5  graph d of subdivision two-c of section two thousand eight hundred eight
     6  of  this article.  Provided further that such payments of excess revenue
     7  shall be in addition to and shall not affect a residential  health  care
     8  facility's  obligations  to make any other payments required by state or
     9  federal law into the nursing home quality pool, including but not limit-
    10  ed to medicaid rate reductions  required  pursuant  to  paragraph  g  of
    11  subdivision  two-c  of  section two thousand eight hundred eight of this
    12  article and department regulations  promulgated  pursuant  thereto.  The
    13  commissioner  or their designees shall have authority to audit the resi-
    14  dential health care facilities' reports  for  compliance  in  accordance
    15  with this section.
    16    §  5.  This  act  shall take effect immediately and shall be deemed to
    17  have been in full force and effect on and after April 1, 2022.
 
    18                                   PART N

    19                            Intentionally Omitted
 
    20                                   PART O
 
    21    Section 1. Subdivisions 2  and  3  of  section  367-r  of  the  social
    22  services  law,  subdivision  2  as amended and subdivision 3 as added by
    23  section 2 of part PP of chapter 56 of the laws of 2020, are  amended  to
    24  read as follows:
    25    2.  Medically  fragile  children and medically fragile adults.  (a) In
    26  addition, the commissioner shall further increase rates for private duty
    27  nursing services that are provided  to  medically  fragile  children  to
    28  ensure the availability of such services to such children.  Furthermore,
    29  no  later than sixty days after the effective date of the chapter of the
    30  laws of two thousand twenty-two that amended this subdivision, increased
    31  rates shall be extended for private duty nursing  services  provided  to
    32  medically  fragile  adults.  In establishing rates of payment under this
    33  subdivision, the commissioner shall consider the cost neutrality of such
    34  rates as related to the cost effectiveness of caring for medically frag-
    35  ile children and medically fragile adults in a non-institutional setting
    36  as compared to an  institutional  setting.  Medically  fragile  children
    37  shall, for the purposes of this subdivision, have the same meaning as in
    38  subdivision three-a of section thirty-six hundred fourteen of the public
    39  health law.  For purposes of this subdivision, "medically fragile adult"
    40  shall  be  defined  as  including  but not limited to any individual who
    41  previously qualified as a medically fragile child but  no  longer  meets
    42  the  age requirement. Such increased rates for services rendered to such
    43  children and adults may take into consideration the  elements  of  cost,
    44  geographical  differentials in the elements of cost considered, economic
    45  factors in the area  in  which  the  private  duty  nursing  service  is
    46  provided,  costs  associated  with the provision of private duty nursing
    47  services to medically fragile children and medically fragile adults, and
    48  the need for incentives to improve services and institute economies  and
    49  such  increased rates shall be payable only to those private duty nurses
    50  who can demonstrate, to the satisfaction of the  department  of  health,
    51  satisfactory  training  and experience to provide services to such chil-

        S. 8007--C                         19                         A. 9007--C

     1  dren and medically fragile adults.  Such increased rates shall be deter-
     2  mined based on application of the case mix adjustment  factor  for  AIDS
     3  home  care  program  services rates as determined pursuant to applicable
     4  regulations of the department of health. The commissioner may promulgate
     5  regulations to implement the provisions of this subdivision.
     6    (b)  Private  duty  nursing  services providers which have their rates
     7  adjusted pursuant to paragraph (b) of subdivision one  of  this  section
     8  and  paragraph  (a)  of this subdivision shall use such funds solely for
     9  the purposes of recruitment and retention of private duty nurses  or  to
    10  ensure  the delivery of private duty nursing services to medically frag-
    11  ile children and medically fragile adults and are prohibited from  using
    12  such  funds for any other purpose. Funds provided under paragraph (b) of
    13  subdivision one of this section and paragraph (a)  of  this  subdivision
    14  are  not  intended  to  supplant support provided by a local government.
    15  Each such provider, with the exception  of  self-employed  private  duty
    16  nurses,  shall submit, at a time and in a manner to be determined by the
    17  commissioner of health, a  written  certification  attesting  that  such
    18  funds  will  be used solely for the purpose of recruitment and retention
    19  of private duty nurses or to ensure the delivery of private duty nursing
    20  services to medically fragile children  and  medically  fragile  adults.
    21  The  commissioner of health is authorized to audit each such provider to
    22  ensure compliance with the written certification required by this subdi-
    23  vision and shall recoup all funds  determined  to  have  been  used  for
    24  purposes  other than recruitment and retention of private duty nurses or
    25  the delivery of private duty nursing services to medically fragile chil-
    26  dren and medically fragile adults.  Such recoupment shall be in addition
    27  to any other penalties provided by law.
    28    (c) The commissioner of health shall, subject  to  the  provisions  of
    29  paragraph  (b)  of  this  subdivision, and the provisions of subdivision
    30  three of this section, and subject to the availability of federal finan-
    31  cial participation,  annually  increase  fees  for  the  fee-for-service
    32  reimbursement  of  private  duty  nursing services provided to medically
    33  fragile  children  by  fee-for-service  private  duty  nursing  services
    34  providers  who enroll and participate in the provider directory pursuant
    35  to subdivision three of this section, over  a  period  of  three  years,
    36  commencing  October  first,  two  thousand  twenty,  by one-third annual
    37  increments, until such fees for reimbursement equal the final  benchmark
    38  payment designed to ensure adequate access to the service. In developing
    39  such  benchmark  the  commissioner of health may utilize the average two
    40  thousand eighteen Medicaid managed care payments  for  reimbursement  of
    41  such  private  duty  nursing  services.  The commissioner may promulgate
    42  regulations to implement the provisions of this paragraph.
    43    (d) The commissioner of health shall, subject  to  the  provisions  of
    44  paragraph  (b)  of  this  subdivision, and the provisions of subdivision
    45  three of this section, and subject to the availability of federal finan-
    46  cial participation, increase fees for the fee-for-service  reimbursement
    47  of private duty nursing services provided to medically fragile adults by
    48  fee-for-service  private  duty nursing services providers who enroll and
    49  participate in the provider directory pursuant to subdivision  three  of
    50  this  section,  no later than sixty days after the effective date of the
    51  chapter of the laws of two thousand twenty-two that amended this  subdi-
    52  vision,  so  such  fees  for  reimbursement  equal the benchmark payment
    53  designed to ensure adequate access to the service.   In developing  such
    54  benchmark  the  commissioner of health may utilize the average two thou-
    55  sand twenty Medicaid managed care payments  for  reimbursement  of  such

        S. 8007--C                         20                         A. 9007--C
 
     1  private  duty  nursing services.   The commissioner may promulgate regu-
     2  lations to implement the provisions of this paragraph.
     3    3.   Provider  directory  for  fee-for-service  private  duty  nursing
     4  services provided to medically fragile children  and  medically  fragile
     5  adults.   The commissioner of health is authorized to establish a direc-
     6  tory of qualified providers for the purpose of promoting the availabili-
     7  ty  and  ensuring  delivery  of  fee-for-service  private  duty  nursing
     8  services  to  medically  fragile children [and individuals transitioning
     9  out of such category of care] and medically fragile adults.    Qualified
    10  providers  enrolling  in the directory shall ensure the availability and
    11  delivery of and shall provide such services to those individuals as  are
    12  in  need of such services, and shall receive increased reimbursement for
    13  such services pursuant to [paragraph] paragraphs (c) and (d) of subdivi-
    14  sion two of this section. The directory shall offer  enrollment  to  all
    15  private  duty  nursing  services  providers  to  promote  and ensure the
    16  participation in the directory of all nursing services providers  avail-
    17  able to serve medically fragile children and medically fragile adults.
    18    §  2.    Subdivision  3-a of section 3614 of the public health law, as
    19  amended by section 9 of part C of chapter 109 of the laws  of  2006,  is
    20  amended to read as follows:
    21    3-a.  Medically  fragile children and medically fragile adults.  Rates
    22  of payment for continuous nursing services for medically  fragile  chil-
    23  dren  and  medically  fragile adults provided by a certified home health
    24  agency, a licensed home care services agency or a long term home  health
    25  care  program  shall  be  established to ensure the availability of such
    26  services, whether provided by registered nurses  or  licensed  practical
    27  nurses  who  are  employed  by  or  under contract with such agencies or
    28  programs, and shall be established at a rate that is at least  equal  to
    29  rates  of  payment  for  such services rendered to patients eligible for
    30  AIDS home care programs; provided, however, that a certified home health
    31  agency, a licensed home care services agency or a long term home  health
    32  care  program  that  receives such enhanced rates for continuous nursing
    33  services for medically fragile children  and  medically  fragile  adults
    34  shall  use such enhanced rates to increase payments to registered nurses
    35  and licensed practical nurses who provide such services. In the case  of
    36  services  provided  by certified home health agencies and long term home
    37  health care programs through contracts with licensed home care  services
    38  agencies, rate increases received by such certified home health agencies
    39  and  long  term  home  health care programs pursuant to this subdivision
    40  shall be reflected in payments made to the registered nurses or licensed
    41  practical nurses employed by such licensed home care  services  agencies
    42  to  render  services to these children and medically fragile adults.  In
    43  establishing rates of payment under this subdivision,  the  commissioner
    44  shall  consider the cost neutrality of such rates as related to the cost
    45  effectiveness of caring for medically  fragile  children  and  medically
    46  fragile adults in a non-institutional setting as compared to an institu-
    47  tional  setting. For the purposes of this subdivision, a medically frag-
    48  ile child shall mean a child who is at risk of hospitalization or insti-
    49  tutionalization,  including  but  not  limited  to  children   who   are
    50  technologically-dependent   for  life  or  health-sustaining  functions,
    51  require complex medication regimen or medical interventions to  maintain
    52  or  to  improve their health status or are in need of ongoing assessment
    53  or intervention to prevent serious deterioration of their health  status
    54  or medical complications that place their life, health or development at
    55  risk,  but  who  are capable of being cared for at home if provided with
    56  appropriate home care  services,  including  but  not  limited  to  case

        S. 8007--C                         21                         A. 9007--C

     1  management  services  and  continuous nursing services. The commissioner
     2  shall promulgate regulations to implement provisions of this subdivision
     3  and may also direct the  providers  specified  in  this  subdivision  to
     4  provide such additional information and in such form as the commissioner
     5  shall  determine  is reasonably necessary to implement the provisions of
     6  this subdivision.
     7    § 3. Section 21 of part MM of chapter 56 of the laws of 2020,  direct-
     8  ing  the  department of health to establish  or  procure the services of
     9  an independent panel of clinical professionals and to develop and imple-
    10  ment a uniform  task-based  assessment  tool,  is  amended  to  read  as
    11  follows:
    12    §  21.  The  department  of health shall develop[, directly or through
    13  procurement, and shall implement an evidenced  based  validated  uniform
    14  task-based  assessment tool no later than April 1, 2021,] guidelines and
    15  standards in consultation with subject matter experts  for  the  use  of
    16  tasking  tools  to  assist  managed  care plans and local departments of
    17  social services to make appropriate  and  individualized  determinations
    18  for  utilization  of  home  care  services in accordance with applicable
    19  state and federal law and regulations, including the number of  personal
    20  care  services  and  consumer directed personal assistance hours of care
    21  each day[,] provided pursuant to the state's medical assistance program,
    22  and how Medicaid recipients' needs for  assistance  with  activities  of
    23  daily  living  can  be  met,  such  as through telehealth, provided that
    24  services rendered via telehealth  meet  equivalent  quality  and  safety
    25  standards  of  services provided through non-electronic means, and other
    26  available alternatives, including family and social supports.  [Notwith-
    27  standing  the  provisions  of  section  163 of the state finance law, or
    28  sections 142 and 143 of the economic development law,  or  any  contrary
    29  provision of law, a contract may be entered without a competitive bid or
    30  request  for  proposal  process  if  such contract is for the purpose of
    31  developing the evidence based validated  uniform  task-based  assessment
    32  tool described in this section, provided that:
    33    (a)  The  department of health shall post on its website, for a period
    34  of no less than 30 days:
    35    (i) A description of the evidence based validated  uniform  task-based
    36  assessment tool to be developed pursuant to the contract;
    37    (ii) The criteria for contractor selection;
    38    (iii)  The  period  of  time during which a prospective contractor may
    39  seek to be selected by the department of health, which shall be no  less
    40  than 30 days after such information is first posted on the website; and
    41    (iv)  The  manner  by  which  a  prospective  contractor  may submit a
    42  proposal for selection,  which  may  include  submission  by  electronic
    43  means;
    44    (b)  All  reasonable and responsive submissions that are received from
    45  prospective contractors in a timely fashion shall  be  reviewed  by  the
    46  commissioner of health;
    47    (c)  The  commissioner  of health shall select such contractor that is
    48  best suited to serve the purposes of  this  section  and  the  needs  of
    49  recipients; and
    50    (d)  All  decisions made and approaches taken pursuant to this section
    51  shall be documented in a procurement record as defined  in  section  one
    52  hundred sixty-three of the state finance law.]
    53    § 4. Severability clause. If any clause, sentence, paragraph, subdivi-
    54  sion,  section  or  part  of  this act shall be adjudged by any court of
    55  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    56  impair,  or  invalidate  the remainder thereof, but shall be confined in

        S. 8007--C                         22                         A. 9007--C
 
     1  its operation to the clause, sentence, paragraph,  subdivision,  section
     2  or part thereof directly involved in the controversy in which such judg-
     3  ment shall have been rendered. It is hereby declared to be the intent of
     4  the  legislature  that  this  act  would  have been enacted even if such
     5  invalid provisions had not been included herein.
     6    § 5. This act shall take effect immediately and  shall  be  deemed  to
     7  have been in full force and effect on and after April 1, 2022.
 
     8                                   PART P
 
     9    Section 1.  Notwithstanding sections 112 and 163 of the  state finance
    10  law, the department of health shall select an independent  contractor to
    11  generate a report that reviews and makes recommendations  concerning the
    12  status  of  services  offered by managed care organizations  contracting
    13  with the state to manage services provided under the Medicaid   program.
    14  Such  report shall be provided to the governor, the temporary  president
    15  of the senate and the speaker of the assembly no later than October  31,
    16  2022, and shall be for the purpose of   informing the development  of  a
    17  plan  to reform the delivery of services offered  by managed care organ-
    18  izations in the Medicaid program. The report shall  include the  follow-
    19  ing:  1.  A market assessment of the managed care organizations offering
    20  products in each market, including the  appropriate  number  of  managed
    21  care organizations to  each region to address member needs;  2. Analysis
    22  of  areas  of  potential  improvements  or  challenges as they relate to
    23  healthcare access, delivery, outcomes, administrative  costs,  efficien-
    24  cies and oversight that may result from competitive procurement; 3. Cost
    25  savings  analysis  that  may  result  from a competitive procurement, if
    26  any; 4. The current approach for addressing  Person  Centered  care  for
    27  people with  behavioral health needs enrolled with Medicaid managed care
    28  plans,  including   but not limited to special needs managed care organ-
    29  izations authorized to  offer Health and Recovery Plans (HARPs) and  the
    30  integration  of  those  benefits   with Mainstream Medicaid Managed Care
    31  (MMMC);  5. Provider network access that may result  from  competitively
    32  procuring   plans in each region and potential improvements in standards
    33  governing  network    adequacy;    6.  Managed  care  enrollee   service
    34  disruptions  that  may result from  competitively procuring managed care
    35  plans in each region;   7. Impacts to providers  that  contract  or  are
    36  affiliated  with  Medicaid    managed care organizations that may result
    37  from a competitive procurement;   8. An evaluation  of  new  performance
    38  standards  or  requirements that could  be imposed upon Medicaid managed
    39  care organizations that participate in the  managed care program  pursu-
    40  ant  to  a contract with the department of health; and  9. An assessment
    41  of current  mechanisms  for  enforcement  of  performance  requirements,
    42  including  but  not limited to oversight of Medicaid managed care organ-
    43  izations  and penalties.
    44    § 2. Subparagraphs (v) and (vi) of paragraph (b) of subdivision  1  of
    45  section  268-d of the public health law, as added by section 2 of part T
    46  of chapter 57 of the laws of 2019, are amended to read as follows:
    47    (v) meets standards  specified  and  determined  by  the  Marketplace,
    48  provided that the standards do not conflict with or prevent the applica-
    49  tion of federal requirements; [and]
    50    (vi)  contracts  with  any national cancer institute-designated cancer
    51  center licensed by the department within the health plan's service  area
    52  that is willing to agree to provide cancer-related inpatient, outpatient
    53  and  medical services to enrollees in all health plans offering coverage
    54  through the Marketplace in such cancer center's service area  under  the

        S. 8007--C                         23                         A. 9007--C
 
     1  prevailing  terms and conditions that the plan requires of other similar
     2  providers to be included in the plan's provider network,  provided  that
     3  such  terms  shall  include reimbursement of such center at no less than
     4  the  fee-for-service medicaid payment rate and methodology applicable to
     5  the center's inpatient and outpatient services; and
     6    (vii) complies with the insurance law and  this  chapter  requirements
     7  applicable  to health insurance issued in this state and any regulations
     8  promulgated pursuant thereto that do not conflict with  or  prevent  the
     9  application of federal requirements; and
    10    §  3.  Subdivision  4  of  section 364-j of the social services law is
    11  amended by adding a new paragraph (w) to read as follows:
    12    (w) A managed care provider shall  provide  or  arrange,  directly  or
    13  indirectly,  including  by  referral,  for  access  to  and  coverage of
    14  services provided by any  national  cancer  institute-designated  cancer
    15  center  licensed  by  the  department  of health within the managed care
    16  provider's service area that is willing to agree to  provide  cancer-re-
    17  lated  inpatient, outpatient and medical services to participants in all
    18  managed care providers offering coverage to medical  assistance  recipi-
    19  ents in such cancer center's service area under the prevailing terms and
    20  conditions  that  the  managed  care  provider requires of other similar
    21  providers to  be  included  in  the  managed  care  provider's  network,
    22  provided  that  such terms shall include reimbursement of such center at
    23  no less than the fee-for-service medicaid payment rate  and  methodology
    24  applicable to the center's inpatient and outpatient services.
    25    §  4.  Paragraph  (c) of subdivision 1 of section 369-gg of the social
    26  services law, as amended by section 2 of part H of  chapter  57  of  the
    27  laws of 2021, is amended to read as follows:
    28    (c)  "Health  care  services"  means  (i) the services and supplies as
    29  defined by the commissioner in consultation with the  superintendent  of
    30  financial  services,  and  shall  be  consistent with and subject to the
    31  essential health benefits as defined by the commissioner  in  accordance
    32  with  the  provisions  of the patient protection and affordable care act
    33  (P.L. 111-148) and consistent with the benefits provided by  the  refer-
    34  ence plan selected by the commissioner for the purposes of defining such
    35  benefits,  and  shall  include coverage of and access to the services of
    36  any national cancer institute-designated cancer center licensed  by  the
    37  department  of  health within the service area of the approved organiza-
    38  tion that is willing  to  agree  to  provide  cancer-related  inpatient,
    39  outpatient  and  medical services to all enrollees in approved organiza-
    40  tions' plans in such cancer center's service area under  the  prevailing
    41  terms  and  conditions  that the approved organization requires of other
    42  similar providers to be included in the approved organization's network,
    43  provided that such terms shall include reimbursement of such  center  at
    44  no  less  than the fee-for-service medicaid payment rate and methodology
    45  applicable to the center's inpatient and outpatient services;  and  (ii)
    46  dental and vision services as defined by the commissioner;
    47    § 5. Severability. If any clause, sentence, paragraph, section or part
    48  of  this act shall be adjudged by any court of competent jurisdiction to
    49  be invalid and after exhaustion of  all  further  judicial  review,  the
    50  judgment  shall  not affect, impair or invalidate the remainder thereof,
    51  but shall be confined in its operation to the  clause,  sentence,  para-
    52  graph,  section or part of this act directly involved in the controversy
    53  in which the judgment shall have been rendered.
    54    § 6. Sections one and five of this act shall take  effect  immediately
    55  and  shall  be deemed to have been in full force and effect on and after
    56  April 1, 2022. Sections two, three, and four  of  this  act  shall  take

        S. 8007--C                         24                         A. 9007--C
 
     1  effect  on  the  first  of  January next succeeding the date on which it
     2  shall have become a law and shall apply  to  all  coverage  or  policies
     3  issued  or  renewed on or after such effective date and shall expire and
     4  be  deemed  repealed five years after such date; provided, however, that
     5  the amendments to section 364-j of  the  social  services  law  made  by
     6  section three of this act, and the amendments to paragraph (c) of subdi-
     7  vision  1  of  section 369-gg of the social services law made by section
     8  four of this act shall not affect the repeal of such  sections  or  such
     9  paragraph and shall be deemed repealed therewith.
 
    10                                   PART Q
 
    11                            Intentionally Omitted
 
    12                                   PART R
 
    13    Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
    14  amended by adding a new paragraph 36 to read as follows:
    15    (36) (A) Every policy which provides hospital,  surgical,  or  medical
    16  coverage  and  which offers maternity coverage pursuant to paragraph ten
    17  of this subsection shall also provide coverage for abortion services for
    18  an enrollee.
    19    (B) Coverage for abortion shall not be subject to  annual  deductibles
    20  or  coinsurance,  including  co-payments,  unless  the  policy is a high
    21  deductible health plan as defined in section 223(c)(2) of  the  internal
    22  revenue code of 1986, in which case coverage for abortion may be subject
    23  to the plan's annual deductible.
    24    § 2. Subsection (k) of section 3221 of the insurance law is amended by
    25  adding a new paragraph 22 to read as follows:
    26    (22)  (A)  Every  policy which provides hospital, surgical, or medical
    27  coverage and which offers maternity care coverage pursuant to  paragraph
    28  five  of  this  subsection  shall  also  provide  coverage  for abortion
    29  services for an enrollee.
    30    (B) Coverage for abortion shall not be subject to  annual  deductibles
    31  or  coinsurance,  including  co-payments,  unless  the  policy is a high
    32  deductible health plan as defined in section 223(c)(2) of  the  internal
    33  revenue code of 1986, in which case coverage for abortion may be subject
    34  to the plan's annual deductible.
    35    (C)  Notwithstanding any other provision, a group policy that provides
    36  hospital, surgical, or medical expense coverage delivered or issued  for
    37  delivery  in  this state to a religious employer, as defined in item one
    38  of subparagraph (E) of paragraph  sixteen  of  subsection  (l)  of  this
    39  section, may exclude coverage for abortion only if the insurer:
    40    (i)  obtains  an annual certification from the group policyholder that
    41  the policyholder is a religious employer and that the religious employer
    42  requests a policy without coverage for abortion;
    43    (ii) issues a rider to each certificate holder at  no  premium  to  be
    44  charged  to  the certificate holder or religious employer for the rider,
    45  that provides coverage for abortion subject to the same rules  as  would
    46  have been applied to the same category of treatment in the policy issued
    47  to  the  religious  employer.  The rider shall clearly and conspicuously
    48  specify that the religious employer does not administer  abortion  bene-
    49  fits,  but that the insurer is issuing a rider for coverage of abortion,
    50  and shall provide the insurer's contact information for questions; and

        S. 8007--C                         25                         A. 9007--C
 
     1    (iii) provides notice of the issuance of the policy and rider  to  the
     2  superintendent in a form and manner acceptable to the superintendent.
     3    §  3.  Section  4303  of  the insurance law is amended by adding a new
     4  subsection (ss) to read as follows:
     5    (ss)(1) Every policy which provides  hospital,  surgical,  or  medical
     6  coverage and which offers maternity care coverage pursuant to subsection
     7  (c)  of  this  section shall also provide coverage for abortion services
     8  for an enrollee.
     9    (2) Coverage for abortion shall not be subject to  annual  deductibles
    10  or  coinsurance,  including  co-payments,  unless  the  policy is a high
    11  deductible health plan as defined in section 223(c)(2) of  the  internal
    12  revenue code of 1986, in which case coverage for abortion may be subject
    13  to the plan's annual deductible.
    14    (3)  Notwithstanding any other provision, a group policy that provides
    15  hospital, surgical, or medical expense coverage delivered or issued  for
    16  delivery  in this state to a religious employer, as defined in paragraph
    17  five of subsection (cc)  of  this  section,  may  exclude  coverage  for
    18  abortion only if the insurer:
    19    (A)  obtains an annual certification from the group policy holder that
    20  the policy holder is a religious employer and that the religious employ-
    21  er requests a contract without coverage for abortion;
    22    (B) issues a rider to each certificate holder  at  no  premium  to  be
    23  charged  to  the certificate holder or religious employer for the rider,
    24  that provides coverage for abortions subject to the same rules as  would
    25  have been applied to the same category of treatment in the policy issued
    26  to  the  religious  employer.  The rider shall clearly and conspicuously
    27  specify that the religious employer does not administer  abortion  bene-
    28  fits,  but that the insurer is issuing a rider for coverage of abortion,
    29  and shall provide the insurer's contact information for questions; and
    30    (C) provides notice of the issuance of the policy  and  rider  to  the
    31  superintendent in a form and manner acceptable to the superintendent.
    32    § 4. Severability. If any provision of this act, or any application of
    33  any  provision  of  this act, is held to be invalid, or to violate or be
    34  inconsistent with any federal law or regulation, that shall  not  affect
    35  the  validity or effectiveness of any other provision of this act, or of
    36  any other application of any provision of this act, which can  be  given
    37  effect  without  that  provision  or  application;  and to that end, the
    38  provisions and applications of this act are severable.
    39    § 5. This act shall take effect on the first of January next  succeed-
    40  ing  the date on which it shall have become a law and shall apply to all
    41  policies and contracts issued, renewed, modified, altered, or amended on
    42  or after such date. Effective immediately, the addition,  amendment,  or
    43  repeal  of  any  rule  or regulation necessary for the implementation of
    44  this act on its effective date are authorized to be made  and  completed
    45  on or before such effective date.
 
    46                                   PART S
 
    47                            Intentionally Omitted
 
    48                                   PART T
 
    49                            Intentionally Omitted

        S. 8007--C                         26                         A. 9007--C
 
     1                                   PART U
 
     2                            Intentionally omitted
 
     3                                   PART V
 
     4    Section  1. Paragraphs (x) and (y) of subdivision 2 of section 2999-cc
     5  of  the  public health law, as amended by section 3 of part F of chapter
     6  57 of the laws of 2021, are amended to read as follows:
     7    (x) certified peer recovery advocate services providers  certified  by
     8  the  commissioner of addiction services and supports pursuant to section
     9  19.18-b of the mental hygiene law, peer providers  credentialed  by  the
    10  commissioner  of  addiction services and supports and peers certified or
    11  credentialed by the office of mental health; [and]
    12    (y) a mental health practitioner  licensed  pursuant  to  article  one
    13  hundred sixty-three of the education law; and
    14    (z)  any  other provider as determined by the commissioner pursuant to
    15  regulation or, in consultation with the commissioner, by the commission-
    16  er of the office of mental health, the commissioner  of  the  office  of
    17  addiction  services  and supports, or the commissioner of the office for
    18  people with developmental disabilities pursuant to regulation.
    19    § 2. Subdivision 1 of section 2999-dd of the  public  health  law,  as
    20  amended  by  chapter  124  of  the  laws  of 2020, is amended to read as
    21  follows:
    22    1. Health care services delivered by  means  of  telehealth  shall  be
    23  entitled  to  reimbursement under section three hundred sixty-seven-u of
    24  the social services law on the same basis, at the same rate, and to  the
    25  same  extent  the  equivalent services, as may be defined in regulations
    26  promulgated by  the  commissioner,  are  reimbursed  when  delivered  in
    27  person;  provided, however, that health care services delivered by means
    28  of telehealth shall not require reimbursement to a  telehealth  provider
    29  for  certain  costs, including but not limited to facility fees or costs
    30  reimbursed through ambulatory patient groups or other clinic  reimburse-
    31  ment  methodologies  set  forth in section twenty-eight hundred seven of
    32  this chapter, if such costs were not incurred in the provision of  tele-
    33  health services due to neither the originating site nor the distant site
    34  occurring  within  a  facility  or  other  clinic  setting;  and further
    35  provided, however, reimbursement  for  additional  modalities,  provider
    36  categories  and  originating  sites specified in accordance with section
    37  twenty-nine hundred ninety-nine-ee of this article, and audio-only tele-
    38  phone communication  defined  in  regulations  promulgated  pursuant  to
    39  subdivision  four  of section twenty-nine hundred ninety-nine-cc of this
    40  article, shall  be  contingent  upon  federal  financial  participation.
    41  Notwithstanding   the  provisions  of  this  subdivision,  for  services
    42  licensed, certified or otherwise authorized pursuant to article sixteen,
    43  article thirty-one or article thirty-two of the mental hygiene law, such
    44  services provided by telehealth, as deemed appropriate by  the  relevant
    45  commissioner,  shall  be reimbursed at the applicable in person rates or
    46  fees established by law, or otherwise established or  certified  by  the
    47  office  for  people  with  developmental  disabilities, office of mental
    48  health, or the office of addiction services  and  supports  pursuant  to
    49  article forty-three of the mental hygiene law.
    50    §  3.  Subsection (a) of section 3217-h of the insurance law, as added
    51  by chapter 6 of the laws of 2015, is amended to read as follows:

        S. 8007--C                         27                         A. 9007--C
 
     1    (a) (1) An insurer shall not exclude from coverage a service  that  is
     2  otherwise  covered  under  a policy that provides comprehensive coverage
     3  for hospital, medical or surgical care because the service is  delivered
     4  via  telehealth,  as  that  term  is  defined  in subsection (b) of this
     5  section;  provided, however, that an insurer may exclude from coverage a
     6  service by a health care provider where the provider  is  not  otherwise
     7  covered  under  the  policy.  An  insurer  may subject the coverage of a
     8  service delivered via telehealth to co-payments, coinsurance or  deduct-
     9  ibles  provided  that  they  are at least as favorable to the insured as
    10  those established for the same service  when  not  delivered  via  tele-
    11  health.  An  insurer may subject the coverage of a service delivered via
    12  telehealth to reasonable utilization management  and  quality  assurance
    13  requirements  that  are  consistent  with those established for the same
    14  service when not delivered via telehealth.
    15    (2) An insurer that  provides  comprehensive  coverage  for  hospital,
    16  medical  or  surgical care shall reimburse covered services delivered by
    17  means of telehealth on the same basis, at the same rate, and to the same
    18  extent that such services  are  reimbursed  when  delivered  in  person;
    19  provided that reimbursement of covered services delivered via telehealth
    20  shall  not  require  reimbursement of costs not actually incurred in the
    21  provision of the telehealth services, including charges related  to  the
    22  use  of a clinic or other facility when neither the originating site nor
    23  distant site occur within the clinic or other facility.
    24    (3) An insurer that  provides  comprehensive  coverage  for  hospital,
    25  medical,  or surgical care with a network of health care providers shall
    26  ensure that such network is adequate to meet  the  telehealth  needs  of
    27  insured individuals for services covered under the policy when medically
    28  appropriate.
    29    §  4.  Subsection (a) of section 4306-g of the insurance law, as added
    30  by chapter 6 of the laws of 2015, is amended to read as follows:
    31    (a) (1) A corporation shall not exclude from coverage a  service  that
    32  is otherwise covered under a contract that provides comprehensive cover-
    33  age for hospital, medical or surgical care because the service is deliv-
    34  ered  via  telehealth, as that term is defined in subsection (b) of this
    35  section; provided, however, that a corporation may exclude from coverage
    36  a service by a health care provider where the provider is not  otherwise
    37  covered under the contract.  A corporation may subject the coverage of a
    38  service  delivered via telehealth to co-payments, coinsurance or deduct-
    39  ibles provided that they are at least as favorable  to  the  insured  as
    40  those  established  for  the  same  service when not delivered via tele-
    41  health. A corporation may subject the coverage of  a  service  delivered
    42  via  telehealth  to reasonable utilization management and quality assur-
    43  ance requirements that are consistent with  those  established  for  the
    44  same service when not delivered via telehealth.
    45    (2)  A  corporation that provides comprehensive coverage for hospital,
    46  medical or surgical care shall reimburse covered services  delivered  by
    47  means of telehealth on the same basis, at the same rate, and to the same
    48  extent  that  such  services  are  reimbursed  when delivered in person;
    49  provided that reimbursement of covered   services  delivered  via  tele-
    50  health  shall  not require reimbursement of  costs not actually incurred
    51  in the provision of the telehealth services,  including charges  related
    52  to  the  use  of a clinic or other facility when neither the originating
    53  site nor the distant site occur within the clinic or other facility. The
    54  superintendent may promulgate regulations to implement the    provisions
    55  of this section.

        S. 8007--C                         28                         A. 9007--C

     1    (3)  A  corporation that provides comprehensive coverage for hospital,
     2  medical, or surgical care with a network of health care providers  shall
     3  ensure  that  such  network  is adequate to meet the telehealth needs of
     4  insured individuals for services covered under the policy when medically
     5  appropriate.
     6    §  5. Section 4406-g of the public health law is amended by adding two
     7  new subdivisions 3 and 4 to read as follows:
     8    3. A  health  maintenance  organization  that  provides  comprehensive
     9  coverage  for hospital, medical or surgical care shall reimburse covered
    10  services delivered via telehealth on the same basis, at the  same  rate,
    11  and  to  the  extent that such services are reimbursed when delivered in
    12  person; provided that reimbursement of  covered  services  delivered  by
    13  means  of telehealth shall not require reimbursement of  costs not actu-
    14  ally incurred in the provision of  the  telehealth  services,  including
    15  charges  related  to  the use of a clinic or other facility when neither
    16  the originating site nor the distant site occur  within  the  clinic  or
    17  other  facility.  The commissioner, in consultation with the superinten-
    18  dent, may promulgate regulations to implement  the  provisions  of  this
    19  section.
    20    4.  A  health  maintenance  organization  that  provides comprehensive
    21  coverage for hospital, medical, or  surgical  care  with  a  network  of
    22  health care providers shall ensure that such network is adequate to meet
    23  the  telehealth  needs of insured individuals for services covered under
    24  the policy when medically appropriate.
    25    § 6. The superintendent of financial services, in  collaboration  with
    26  the  commissioner of health, shall report on the impact of reimbursement
    27  for telehealth services that, pursuant to the insurance law  and  public
    28  health  law,  will be reimbursed by an accident and health insurer and a
    29  corporation subject to article 43 of  the  insurance  law,  including  a
    30  health  maintenance  organization,  on the same basis, at the same rate,
    31  and to the same extent  the  equivalent  services  are  reimbursed  when
    32  delivered  in  person. The report shall, at a minimum, and to the extent
    33  possible, contain information regarding the use of  telehealth  services
    34  broken  down  by:  social  service district or county; age and gender of
    35  patients; procedure codes, diagnosis codes, and associated  descriptions
    36  or  modifiers;  claims  paid  amount  totals; claims information such as
    37  categories of services, specialty or type codes; and trends in the types
    38  of telehealth services used such as primary care, behavioral and  mental
    39  health  care,  and the number of telehealth visits by provider type. The
    40  report shall include such utilization information dating from the effec-
    41  tive date of this act and ending on the  one-year  anniversary  of  such
    42  effective  date,  and  shall be submitted to the governor, the temporary
    43  president of the senate, and the speaker of the assembly by December 31,
    44  2023.
    45    § 7. This act shall take effect immediately and  shall  be  deemed  to
    46  have been in full force and effect on and after April 1, 2022; provided,
    47  however, this act shall expire and be deemed repealed on and after April
    48  1, 2024.
    49                                   PART W
 
    50    Section 1. Section 365-g of the social services law, as added by chap-
    51  ter  938 of the laws of 1990, subdivisions 1 and 3 as amended by chapter
    52  165 of the laws of 1991, subdivisions 2 and 4 as amended by  section  31
    53  of  part C of chapter 58 of the laws of 2008, clause (B) of subparagraph
    54  (iii) of paragraph (b) of subdivision 3 as amended by chapter 59 of  the
    55  laws  of 1993, subparagraphs (vi) and (vii) of paragraph (b) of subdivi-

        S. 8007--C                         29                         A. 9007--C
 
     1  sion 3 as amended and subparagraph (viii) as added by  section  31-b  of
     2  part  C  of  chapter 58 of the laws of 2008, subdivision 5 as amended by
     3  chapter 41 of the laws of 1992, paragraphs (f) and (g) of subdivision  5
     4  as  amended  by  and  paragraphs (h) and (i) as added by section 31-a of
     5  part C of chapter 58 of the laws of 2008, is amended to read as follows:
     6    § 365-g. Utilization [thresholds] review for  certain  care,  services
     7  and  supplies.  1. The department may implement a system for utilization
     8  [controls] review, pursuant to this section, for  persons  eligible  for
     9  benefits  under  this  title,  [including  annual service limitations or
    10  utilization thresholds above which the department may not pay for  addi-
    11  tional  care,  services  or  supplies,  unless  such  care,  services or
    12  supplies have been previously approved by the department or unless  such
    13  care,  services or supplies were provided pursuant to subdivision three,
    14  four or five of this section] to evaluate the appropriateness and quali-
    15  ty of medical assistance, and safeguard against unnecessary  utilization
    16  of  care and services, which shall include a post-payment review process
    17  to develop and review beneficiary utilization profiles, provider service
    18  profiles, and exceptions criteria to correct misutilization practices of
    19  beneficiaries and providers; and for referral to the office of  Medicaid
    20  inspector  general  where suspected fraud, waste or abuse are identified
    21  in the unnecessary or inappropriate use of care,  services  or  supplies
    22  furnished under this title.
    23    2.  The  department may [implement] review utilization [thresholds] by
    24  provider service type, medical procedure and  patient,  in  consultation
    25  with  the  state  department  of mental hygiene, other appropriate state
    26  agencies, and other stakeholders including provider and consumer  repre-
    27  sentatives.    In  [developing]  reviewing utilization [thresholds], the
    28  department shall consider  historical  recipient  utilization  patterns,
    29  patient-specific  diagnoses  and burdens of illness, and the anticipated
    30  recipient needs in order to maintain good health.  The system for utili-
    31  zation review shall not be used to determine a recipient's medical care,
    32  services or supplies under this section.
    33    3. [If the department implements a utilization threshold program, at a
    34  minimum, such program must include:
    35    (a) prior notice to the recipients affected by the utilization thresh-
    36  old program, which notice must describe:
    37    (i) the nature and extent of the utilization program,  the  procedures
    38  for  obtaining an exemption from or increase in a utilization threshold,
    39  the recipients' fair hearing rights, and referral  to  an  informational
    40  toll-free hot-line operated by the department; and
    41    (ii) alternatives to the utilization threshold program such as enroll-
    42  ment  in  managed  care  programs and referral to preferred primary care
    43  providers designated pursuant to subdivision twelve of  section  twenty-
    44  eight hundred seven of the public health law; and
    45    (b) procedures for:
    46    (i) requesting an increase in amount of authorized services;
    47    (ii)  extending  amount of authorized services when an application for
    48  an increase in the amount of authorized services is pending;
    49    (iii) requesting  an  exemption  from  utilization  thresholds,  which
    50  procedure must:
    51    (A)  allow  the  recipient, or a provider on behalf of a recipient, to
    52  apply to the department for an exemption from one  or  more  utilization
    53  thresholds  based  upon  documentation  of  the  medical  necessity  for
    54  services in excess of the threshold,
    55    (B) provided for exemptions consistent with department guidelines  for
    56  approving  exemptions,  which  guidelines  must  be  established  by the

        S. 8007--C                         30                         A. 9007--C

     1  department in consultation with the department of health and, as  appro-
     2  priate,  with  the department of mental hygiene, and consistent with the
     3  current regulations of the office of mental health governing  outpatient
     4  treatment.
     5    (C)  provide  for an exemption when medical and clinical documentation
     6  substantiates a condition of a chronic  medical  nature  which  requires
     7  ongoing and frequent use of medical care, services or supplies such that
     8  an  increase  in  the amount of authorized services is not sufficient to
     9  meet the medical needs of the recipient;
    10    (iv) reimbursing a provider, regardless of  the  recipient's  previous
    11  use  of services, when care, services or supplies are provided in a case
    12  of urgent medical need, as defined by the department, or  when  provided
    13  on an emergency basis, as defined by the department;
    14    (v)  notifying  recipients  of and referring recipients to appropriate
    15  and accessible managed care  programs  and  to  preferred  primary  care
    16  providers  designated  pursuant to subdivision twelve of section twenty-
    17  eight hundred seven of the public health  law  at  the  same  time  such
    18  recipients are notified that they are nearing or have reached the utili-
    19  zation threshold for each specific provider type;
    20    (vi)  notifying  recipients at the same time such recipients are noti-
    21  fied that they have received an exemption from a utilization  threshold,
    22  an increase in the amount of authorized services, or that they are near-
    23  ing  or  have  reached  their  utilization  threshold, of their possible
    24  eligibility for federal disability benefits and directing  such  recipi-
    25  ents to their social services district for information and assistance in
    26  securing such benefits;
    27    (vii)  cooperating  with social services districts in sharing informa-
    28  tion collected and developed by  the  department  regarding  recipients'
    29  medical records; and
    30    (viii)  assuring  that no request for an increase in amount of author-
    31  ized services or for an exemption from utilization thresholds  shall  be
    32  denied  unless  the  request  is first reviewed by a health care profes-
    33  sional possessing appropriate clinical expertise.
    34    4.] The utilization [thresholds] review established pursuant  to  this
    35  section  shall not apply to [mental retardation and] developmental disa-
    36  bilities services provided in clinics certified  under  article  twenty-
    37  eight  of  the public health law, or article twenty-two or article thir-
    38  ty-one of the mental hygiene law.
    39    [5.] 4. Utilization [thresholds] review established pursuant  to  this
    40  section  shall  not  apply  to services, even though such services might
    41  otherwise be subject to utilization [thresholds] review,  when  provided
    42  as follows:
    43    (a) through a managed care program;
    44    (b) subject to prior approval or prior authorization;
    45    (c) as family planning services;
    46    (d) as methadone maintenance services;
    47    (e) on  a  fee-for-services  basis to in-patients in general hospitals
    48  certified under article twenty-eight of the public health law or article
    49  thirty-one of the mental hygiene law and residential health care facili-
    50  ties, with the exception of podiatrists' services;
    51    (f) for hemodialysis;
    52    (g) through or by referral from  a  preferred  primary  care  provider
    53  designated  pursuant  to  subdivision  twelve  of  section  twenty-eight
    54  hundred seven of the public health law;
    55    (h) pursuant to a court order; or

        S. 8007--C                         31                         A. 9007--C
 
     1    (i) as a condition  of  eligibility  for  any  other  public  program,
     2  including but not limited to public assistance.
     3    [6.]  5.  The department shall consult with representatives of medical
     4  assistance providers, social services districts, voluntary organizations
     5  that represent or advocate on behalf of  recipients,  the  managed  care
     6  advisory  council  and other state agencies regarding the ongoing opera-
     7  tion of a utilization [threshold] review system.
     8    [7.] 6. On or before February first, nineteen hundred ninety-two,  the
     9  commissioner  shall  submit  to the governor, the temporary president of
    10  the senate and the speaker of the assembly a report detailing the imple-
    11  mentation of  the  utilization  threshold  program  and  evaluating  the
    12  results  of  establishing  utilization  thresholds.    Such report shall
    13  include, but need not be limited to, a description  of  the  program  as
    14  implemented;  the  number of requests for increases in service above the
    15  threshold amounts by provider and type of service; the number of  exten-
    16  sions  granted;  the  number of claims that were submitted for emergency
    17  care or urgent care above the threshold level; the number of  recipients
    18  referred  to  managed  care;  an  estimate  of the fiscal savings to the
    19  medical assistance program as a result of the  program;  recommendations
    20  for  medical  condition  that  may  be more appropriately served through
    21  managed care programs; and the costs of implementing the program.
    22    § 2. This act shall take effect July 1, 2022; provided, however, that:
    23    a. the amendments to subdivision 5 of  section  365-g  of  the  social
    24  services  law made by section one of this act shall not affect the expi-
    25  ration and reversion of paragraphs  (f)  and  (g)  of  such  subdivision
    26  pursuant  to  subdivision (i-1) of section 79 of part C of chapter 58 of
    27  the laws of 2008, as amended; and
    28    b. the amendments to subdivision 5 of  section  365-g  of  the  social
    29  services law made by section one of this act shall not affect the repeal
    30  of  paragraphs  (h)  and (i) of such subdivision pursuant to subdivision
    31  (i-1) of section 79 of part C of chapter 58 of  the  laws  of  2008,  as
    32  amended.
 
    33                                   PART X
 
    34                            Intentionally Omitted
 
    35                                   PART Y
 
    36    Section  1.  The  domestic  relations  law  is amended by adding a new
    37  section 20-c to read as follows:
    38    § 20-c. Certification of marriage; new certificate in case  of  subse-
    39  quent  change  of name or gender. 1. A new marriage certificate shall be
    40  issued by the town or city clerk where the marriage license and  certif-
    41  icate  was  issued,  upon receipt of proper proof of a change of name or
    42  gender designation. Proper proof shall consist of: (a) a judgment, order
    43  or decree affirming a change of name or  gender  designation  of  either
    44  party  to  a  marriage; (b) an amended birth certificate demonstrating a
    45  change of name or gender designation; (c) in the case  of  a  change  of
    46  gender  designation, a notarized affidavit from the individual attesting
    47  to their change of gender designation; or (d) such other proof as may be
    48  established by the commissioner of health.
    49    2. When a new marriage certificate is made pursuant to  this  section,
    50  the  town  or  city  clerk shall substitute such new certificate for the
    51  marriage certificate then on file, if any,  and  shall  send  the  state

        S. 8007--C                         32                         A. 9007--C
 
     1  commissioner of health a digital copy of the new marriage certificate in
     2  a  format prescribed by the commissioner, with the exception of the city
     3  clerk of New York who shall retain their copy. The town  or  city  clerk
     4  shall  make  a copy of the new marriage certificate for the local record
     5  and hold the contents of the original marriage certificate  confidential
     6  along  with  all  supporting documentation, papers and copies pertaining
     7  thereto. It shall not be released or otherwise divulged except by  order
     8  of a court of competent jurisdiction.
     9    3.  The  town  or city clerk shall be entitled to a fee of ten dollars
    10  for the amendment and certified copy  of  any  marriage  certificate  in
    11  accordance with the provisions of this section.
    12    4.  The  state commissioner of health may, in their discretion, report
    13  to the attorney general any town or  city  clerk  that,  without  cause,
    14  fails  to  issue a new marriage certificate upon receipt of proper proof
    15  of a change of name  or  gender  designation  in  accordance  with  this
    16  section.  The attorney general shall thereupon, in the name of the state
    17  commissioner of health or the people of the state, institute such action
    18  or proceeding as may be necessary to compel the  issuance  of  such  new
    19  marriage certificate.
    20    §  2. This act shall take effect six months after it shall have become
    21  a law.
 
    22                                   PART Z
 
    23    Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
    24  of the laws of 1986, amending the civil practice law and rules and other
    25  laws relating  to  malpractice  and  professional  medical  conduct,  as
    26  amended  by  section  1  of part K of chapter 57 of the laws of 2021, is
    27  amended to read as follows:
    28    (a) The superintendent of financial services and the  commissioner  of
    29  health  or  their  designee  shall, from funds available in the hospital
    30  excess liability pool created pursuant to subdivision 5 of this section,
    31  purchase a policy or policies for excess insurance coverage, as  author-
    32  ized  by  paragraph 1 of subsection (e) of section 5502 of the insurance
    33  law; or from an insurer, other than an insurer described in section 5502
    34  of the insurance law, duly authorized to write such coverage and actual-
    35  ly writing  medical  malpractice  insurance  in  this  state;  or  shall
    36  purchase equivalent excess coverage in a form previously approved by the
    37  superintendent  of  financial  services for purposes of providing equiv-
    38  alent excess coverage in accordance with section 19 of  chapter  294  of
    39  the  laws of 1985, for medical or dental malpractice occurrences between
    40  July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30,  1988,
    41  between  July  1,  1988 and June 30, 1989, between July 1, 1989 and June
    42  30, 1990, between July 1, 1990 and June 30, 1991, between July  1,  1991
    43  and  June 30, 1992, between July 1, 1992 and June 30, 1993, between July
    44  1, 1993 and June 30, 1994, between July  1,  1994  and  June  30,  1995,
    45  between  July  1,  1995 and June 30, 1996, between July 1, 1996 and June
    46  30, 1997, between July 1, 1997 and June 30, 1998, between July  1,  1998
    47  and  June 30, 1999, between July 1, 1999 and June 30, 2000, between July
    48  1, 2000 and June 30, 2001, between July  1,  2001  and  June  30,  2002,
    49  between  July  1,  2002 and June 30, 2003, between July 1, 2003 and June
    50  30, 2004, between July 1, 2004 and June 30, 2005, between July  1,  2005
    51  and  June 30, 2006, between July 1, 2006 and June 30, 2007, between July
    52  1, 2007 and June 30, 2008, between July  1,  2008  and  June  30,  2009,
    53  between  July  1,  2009 and June 30, 2010, between July 1, 2010 and June
    54  30, 2011, between July 1, 2011 and June 30, 2012, between July  1,  2012

        S. 8007--C                         33                         A. 9007--C
 
     1  and  June 30, 2013, between July 1, 2013 and June 30, 2014, between July
     2  1, 2014 and June 30, 2015, between July  1,  2015  and  June  30,  2016,
     3  between  July  1,  2016 and June 30, 2017, between July 1, 2017 and June
     4  30,  2018,  between July 1, 2018 and June 30, 2019, between July 1, 2019
     5  and June 30, 2020, between July 1, 2020 and June 30, 2021, [and] between
     6  July 1, 2021 and June 30, 2022, and between July 1, 2022  and  June  30,
     7  2023  or  reimburse the hospital where the hospital purchases equivalent
     8  excess coverage as defined in  subparagraph  (i)  of  paragraph  (a)  of
     9  subdivision 1-a of this section for medical or dental malpractice occur-
    10  rences  between July 1, 1987 and June 30, 1988, between July 1, 1988 and
    11  June 30, 1989, between July 1, 1989 and June 30, 1990, between  July  1,
    12  1990  and June 30, 1991, between July 1, 1991 and June 30, 1992, between
    13  July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30,  1994,
    14  between  July  1,  1994 and June 30, 1995, between July 1, 1995 and June
    15  30, 1996, between July 1, 1996 and June 30, 1997, between July  1,  1997
    16  and  June 30, 1998, between July 1, 1998 and June 30, 1999, between July
    17  1, 1999 and June 30, 2000, between July  1,  2000  and  June  30,  2001,
    18  between  July  1,  2001 and June 30, 2002, between July 1, 2002 and June
    19  30, 2003, between July 1, 2003 and June 30, 2004, between July  1,  2004
    20  and  June 30, 2005, between July 1, 2005 and June 30, 2006, between July
    21  1, 2006 and June 30, 2007, between July  1,  2007  and  June  30,  2008,
    22  between  July  1,  2008 and June 30, 2009, between July 1, 2009 and June
    23  30, 2010, between July 1, 2010 and June 30, 2011, between July  1,  2011
    24  and  June 30, 2012, between July 1, 2012 and June 30, 2013, between July
    25  1, 2013 and June 30, 2014, between July  1,  2014  and  June  30,  2015,
    26  between  July  1,  2015 and June 30, 2016, between July 1, 2016 and June
    27  30, 2017, between July 1, 2017 and June 30, 2018, between July  1,  2018
    28  and  June 30, 2019, between July 1, 2019 and June 30, 2020, between July
    29  1, 2020 and June 30, 2021, [and] between July 1, 2021 and June 30, 2022,
    30  and between July 1, 2022 and June 30, 2023 for  physicians  or  dentists
    31  certified as eligible for each such period or periods pursuant to subdi-
    32  vision  2  of  this  section  by a general hospital licensed pursuant to
    33  article 28 of the public health law; provided  that  no  single  insurer
    34  shall  write  more  than fifty percent of the total excess premium for a
    35  given policy year; and provided, however, that such eligible  physicians
    36  or  dentists  must  have  in force an individual policy, from an insurer
    37  licensed in this state of  primary  malpractice  insurance  coverage  in
    38  amounts  of  no less than one million three hundred thousand dollars for
    39  each claimant and three million nine hundred thousand  dollars  for  all
    40  claimants  under  that  policy during the period of such excess coverage
    41  for such occurrences or be  endorsed  as  additional  insureds  under  a
    42  hospital professional liability policy which is offered through a volun-
    43  tary  attending physician ("channeling") program previously permitted by
    44  the superintendent of financial  services  during  the  period  of  such
    45  excess  coverage  for  such occurrences. During such period, such policy
    46  for excess coverage or  such  equivalent  excess  coverage  shall,  when
    47  combined with the physician's or dentist's primary malpractice insurance
    48  coverage  or  coverage  provided through a voluntary attending physician
    49  ("channeling") program, total an aggregate level of  two  million  three
    50  hundred  thousand dollars for each claimant and six million nine hundred
    51  thousand dollars for all claimants from all such policies  with  respect
    52  to  occurrences  in each of such years provided, however, if the cost of
    53  primary malpractice insurance coverage in excess of one million dollars,
    54  but below the excess medical  malpractice  insurance  coverage  provided
    55  pursuant  to  this act, exceeds the rate of nine percent per annum, then
    56  the required level of primary malpractice insurance coverage  in  excess

        S. 8007--C                         34                         A. 9007--C
 
     1  of  one  million  dollars for each claimant shall be in an amount of not
     2  less than the dollar amount of such coverage available at  nine  percent
     3  per  annum;  the required level of such coverage for all claimants under
     4  that  policy  shall be in an amount not less than three times the dollar
     5  amount of coverage for each claimant; and excess coverage, when combined
     6  with such primary malpractice insurance  coverage,  shall  increase  the
     7  aggregate  level  for  each  claimant  by  one million dollars and three
     8  million dollars for all claimants;  and  provided  further,  that,  with
     9  respect to policies of primary medical malpractice coverage that include
    10  occurrences  between  April  1, 2002 and June 30, 2002, such requirement
    11  that coverage be in amounts no less than one million three hundred thou-
    12  sand dollars for each claimant and three million nine  hundred  thousand
    13  dollars  for all claimants for such occurrences shall be effective April
    14  1, 2002.
    15    § 2. Subdivision 3 of section 18 of chapter 266 of the laws  of  1986,
    16  amending  the  civil  practice  law and rules and other laws relating to
    17  malpractice and professional medical conduct, as amended by section 2 of
    18  part K of chapter 57 of the laws of 2021, is amended to read as follows:
    19    (3)(a) The superintendent of financial services  shall  determine  and
    20  certify  to  each general hospital and to the commissioner of health the
    21  cost of excess malpractice insurance for medical or  dental  malpractice
    22  occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
    23  and  June 30, 1989, between July 1, 1989 and June 30, 1990, between July
    24  1, 1990 and June 30, 1991, between July  1,  1991  and  June  30,  1992,
    25  between  July  1,  1992 and June 30, 1993, between July 1, 1993 and June
    26  30, 1994, between July 1, 1994 and June 30, 1995, between July  1,  1995
    27  and  June 30, 1996, between July 1, 1996 and June 30, 1997, between July
    28  1, 1997 and June 30, 1998, between July  1,  1998  and  June  30,  1999,
    29  between  July  1,  1999 and June 30, 2000, between July 1, 2000 and June
    30  30, 2001, between July 1, 2001 and June 30, 2002, between July  1,  2002
    31  and  June 30, 2003, between July 1, 2003 and June 30, 2004, between July
    32  1, 2004 and June 30, 2005, between July  1,  2005  and  June  30,  2006,
    33  between  July  1,  2006 and June 30, 2007, between July 1, 2007 and June
    34  30, 2008, between July 1, 2008 and June 30, 2009, between July  1,  2009
    35  and  June 30, 2010, between July 1, 2010 and June 30, 2011, between July
    36  1, 2011 and June 30, 2012, between July  1,  2012  and  June  30,  2013,
    37  between  July  1,  2013 and June 30, 2014, between July 1, 2014 and June
    38  30, 2015, between July 1, 2015 and June 30, 2016, between July  1,  2016
    39  and  June 30, 2017, between July 1, 2017 and June 30, 2018, between July
    40  1, 2018 and June 30, 2019, between July  1,  2019  and  June  30,  2020,
    41  between  July  1, 2020 and June 30, 2021, [and] between July 1, 2021 and
    42  June 30, 2022, and between July 1, 2022 and June 30, 2023  allocable  to
    43  each  general  hospital for physicians or dentists certified as eligible
    44  for purchase of a policy for excess insurance coverage by  such  general
    45  hospital in accordance with subdivision 2 of this section, and may amend
    46  such determination and certification as necessary.
    47    (b)  The  superintendent  of  financial  services  shall determine and
    48  certify to each general hospital and to the commissioner of  health  the
    49  cost  of  excess malpractice insurance or equivalent excess coverage for
    50  medical or dental malpractice occurrences between July 1, 1987 and  June
    51  30,  1988,  between July 1, 1988 and June 30, 1989, between July 1, 1989
    52  and June 30, 1990, between July 1, 1990 and June 30, 1991, between  July
    53  1,  1991  and  June  30,  1992,  between July 1, 1992 and June 30, 1993,
    54  between July 1, 1993 and June 30, 1994, between July 1,  1994  and  June
    55  30,  1995,  between July 1, 1995 and June 30, 1996, between July 1, 1996
    56  and June 30, 1997, between July 1, 1997 and June 30, 1998, between  July

        S. 8007--C                         35                         A. 9007--C
 
     1  1,  1998  and  June  30,  1999,  between July 1, 1999 and June 30, 2000,
     2  between July 1, 2000 and June 30, 2001, between July 1,  2001  and  June
     3  30,  2002,  between July 1, 2002 and June 30, 2003, between July 1, 2003
     4  and  June 30, 2004, between July 1, 2004 and June 30, 2005, between July
     5  1, 2005 and June 30, 2006, between July  1,  2006  and  June  30,  2007,
     6  between  July  1,  2007 and June 30, 2008, between July 1, 2008 and June
     7  30, 2009, between July 1, 2009 and June 30, 2010, between July  1,  2010
     8  and  June 30, 2011, between July 1, 2011 and June 30, 2012, between July
     9  1, 2012 and June 30, 2013, between July  1,  2013  and  June  30,  2014,
    10  between  July  1,  2014 and June 30, 2015, between July 1, 2015 and June
    11  30, 2016, between July 1, 2016 and June 30, 2017, between July  1,  2017
    12  and  June 30, 2018, between July 1, 2018 and June 30, 2019, between July
    13  1, 2019 and June 30, 2020, between July 1, 2020 and June 30, 2021, [and]
    14  between July 1, 2021 and June 30, 2022, and between  July  1,  2022  and
    15  June  30,  2023  allocable  to  each  general hospital for physicians or
    16  dentists certified as eligible for  purchase  of  a  policy  for  excess
    17  insurance  coverage or equivalent excess coverage by such general hospi-
    18  tal in accordance with subdivision 2 of this section, and may amend such
    19  determination and certification  as  necessary.  The  superintendent  of
    20  financial  services shall determine and certify to each general hospital
    21  and to the commissioner of health the ratable share of such cost alloca-
    22  ble to the period July 1, 1987 to December 31, 1987, to the period Janu-
    23  ary 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31,
    24  1988, to the period January 1, 1989 to June 30, 1989, to the period July
    25  1, 1989 to December 31, 1989, to the period January 1, 1990 to June  30,
    26  1990,  to  the  period  July 1, 1990 to December 31, 1990, to the period
    27  January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December
    28  31, 1991, to the period January 1, 1992 to June 30, 1992, to the  period
    29  July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June
    30  30, 1993, to the period July 1, 1993 to December 31, 1993, to the period
    31  January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December
    32  31,  1994, to the period January 1, 1995 to June 30, 1995, to the period
    33  July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June
    34  30, 1996, to the period July 1, 1996 to December 31, 1996, to the period
    35  January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December
    36  31, 1997, to the period January 1, 1998 to June 30, 1998, to the  period
    37  July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June
    38  30, 1999, to the period July 1, 1999 to December 31, 1999, to the period
    39  January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December
    40  31,  2000, to the period January 1, 2001 to June 30, 2001, to the period
    41  July 1, 2001 to June 30, 2002, to the period July 1, 2002  to  June  30,
    42  2003, to the period July 1, 2003 to June 30, 2004, to the period July 1,
    43  2004  to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to
    44  the period July 1, 2006 and June 30, 2007, to the period  July  1,  2007
    45  and  June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the
    46  period July 1, 2009 and June 30, 2010, to the period July  1,  2010  and
    47  June  30,  2011,  to  the  period July 1, 2011 and June 30, 2012, to the
    48  period July 1, 2012 and June 30, 2013, to the period July  1,  2013  and
    49  June  30,  2014,  to  the  period July 1, 2014 and June 30, 2015, to the
    50  period July 1, 2015 and June 30, 2016, to the period July  1,  2016  and
    51  June 30, 2017, to the period July 1, 2017 to June 30, 2018, to the peri-
    52  od July 1, 2018 to June 30, 2019, to the period July 1, 2019 to June 30,
    53  2020,  to  the period July 1, 2020 to June 30, 2021, [and] to the period
    54  July 1, 2021 to June 30, 2022, and to the period July 1,  2022  to  June
    55  30, 2023.

        S. 8007--C                         36                         A. 9007--C
 
     1    § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
     2  18  of  chapter 266 of the laws of 1986, amending the civil practice law
     3  and rules and  other  laws  relating  to  malpractice  and  professional
     4  medical  conduct, as amended by section 3 of part K of chapter 57 of the
     5  laws of 2021, are amended to read as follows:
     6    (a)  To  the  extent  funds available to the hospital excess liability
     7  pool pursuant to subdivision 5 of this section as amended, and  pursuant
     8  to  section  6  of part J of chapter 63 of the laws of 2001, as may from
     9  time to time be amended, which amended this  subdivision,  are  insuffi-
    10  cient  to  meet  the  costs  of  excess insurance coverage or equivalent
    11  excess coverage for coverage periods during the period July 1,  1992  to
    12  June  30,  1993, during the period July 1, 1993 to June 30, 1994, during
    13  the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
    14  to June 30, 1996, during the period July  1,  1996  to  June  30,  1997,
    15  during  the period July 1, 1997 to June 30, 1998, during the period July
    16  1, 1998 to June 30, 1999, during the period July 1,  1999  to  June  30,
    17  2000, during the period July 1, 2000 to June 30, 2001, during the period
    18  July  1,  2001  to  October 29, 2001, during the period April 1, 2002 to
    19  June 30, 2002, during the period July 1, 2002 to June 30,  2003,  during
    20  the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
    21  to  June  30,  2005,  during  the  period July 1, 2005 to June 30, 2006,
    22  during the period July 1, 2006 to June 30, 2007, during the period  July
    23  1,  2007  to  June  30, 2008, during the period July 1, 2008 to June 30,
    24  2009, during the period July 1, 2009 to June 30, 2010, during the period
    25  July 1, 2010 to June 30, 2011, during the period July 1,  2011  to  June
    26  30,  2012,  during  the period July 1, 2012 to June 30, 2013, during the
    27  period July 1, 2013 to June 30, 2014, during the period July 1, 2014  to
    28  June  30,  2015, during the period July 1, 2015 to June 30, 2016, during
    29  the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
    30  to June 30, 2018, during the period July  1,  2018  to  June  30,  2019,
    31  during  the period July 1, 2019 to June 30, 2020, during the period July
    32  1, 2020 to June 30, 2021, [and] during the period July 1, 2021  to  June
    33  30,  2022, and during the period July 1, 2022 to June 30, 2023 allocated
    34  or reallocated in accordance with paragraph (a) of  subdivision  4-a  of
    35  this  section to rates of payment applicable to state governmental agen-
    36  cies, each physician or dentist for whom a policy for  excess  insurance
    37  coverage  or  equivalent  excess  coverage  is purchased for such period
    38  shall be responsible for payment to the  provider  of  excess  insurance
    39  coverage  or  equivalent  excess  coverage of an allocable share of such
    40  insufficiency, based on the ratio of the total cost of such coverage for
    41  such physician to the sum of the total cost of  such  coverage  for  all
    42  physicians applied to such insufficiency.
    43    (b)  Each  provider  of excess insurance coverage or equivalent excess
    44  coverage covering the period July 1, 1992 to June 30, 1993, or  covering
    45  the period July 1, 1993 to June 30, 1994, or covering the period July 1,
    46  1994  to  June 30, 1995, or covering the period July 1, 1995 to June 30,
    47  1996, or covering the period July 1, 1996 to June 30, 1997, or  covering
    48  the period July 1, 1997 to June 30, 1998, or covering the period July 1,
    49  1998  to  June 30, 1999, or covering the period July 1, 1999 to June 30,
    50  2000, or covering the period July 1, 2000 to June 30, 2001, or  covering
    51  the  period  July  1,  2001  to October 29, 2001, or covering the period
    52  April 1, 2002 to June 30, 2002, or covering the period July 1,  2002  to
    53  June  30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
    54  covering the period July 1, 2004 to June 30, 2005, or covering the peri-
    55  od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
    56  June 30, 2007, or covering the period July 1, 2007 to June 30, 2008,  or

        S. 8007--C                         37                         A. 9007--C
 
     1  covering the period July 1, 2008 to June 30, 2009, or covering the peri-
     2  od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
     3  June  30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
     4  covering the period July 1, 2012 to June 30, 2013, or covering the peri-
     5  od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
     6  June  30, 2015, or covering the period July 1, 2015 to June 30, 2016, or
     7  covering the period July 1, 2016 to June 30, 2017, or covering the peri-
     8  od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
     9  June 30, 2019, or covering the period July 1, 2019 to June 30, 2020,  or
    10  covering the period July 1, 2020 to June 30, 2021, or covering the peri-
    11  od July 1, 2021 to June 30, 2022, or covering the period July 1, 2022 to
    12  June  30,  2023  shall  notify  a  covered physician or dentist by mail,
    13  mailed to the address shown on the last application for excess insurance
    14  coverage or equivalent excess  coverage,  of  the  amount  due  to  such
    15  provider  from such physician or dentist for such coverage period deter-
    16  mined in accordance with paragraph (a) of this subdivision. Such  amount
    17  shall  be  due from such physician or dentist to such provider of excess
    18  insurance coverage or equivalent excess coverage in a  time  and  manner
    19  determined by the superintendent of financial services.
    20    (c)  If  a physician or dentist liable for payment of a portion of the
    21  costs of excess insurance coverage or equivalent excess coverage  cover-
    22  ing  the  period  July  1, 1992 to June 30, 1993, or covering the period
    23  July 1, 1993 to June 30, 1994, or covering the period July  1,  1994  to
    24  June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
    25  covering the period July 1, 1996 to June 30, 1997, or covering the peri-
    26  od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
    27  June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
    28  covering the period July 1, 2000 to June 30, 2001, or covering the peri-
    29  od  July  1,  2001  to October 29, 2001, or covering the period April 1,
    30  2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
    31  2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
    32  the period July 1, 2004 to June 30, 2005, or covering the period July 1,
    33  2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
    34  2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
    35  the period July 1, 2008 to June 30, 2009, or covering the period July 1,
    36  2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
    37  2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
    38  the period July 1, 2012 to June 30, 2013, or covering the period July 1,
    39  2013 to June 30, 2014, or covering the period July 1, 2014 to  June  30,
    40  2015,  or covering the period July 1, 2015 to June 30, 2016, or covering
    41  the period July 1, 2016 to June 30, 2017, or covering the period July 1,
    42  2017 to June 30, 2018, or covering the period July 1, 2018 to  June  30,
    43  2019,  or covering the period July 1, 2019 to June 30, 2020, or covering
    44  the period July 1, 2020 to June 30, 2021, or covering the period July 1,
    45  2021 to June 30, 2022, or covering the period July 1, 2022 to  June  30,
    46  2023  determined  in  accordance  with paragraph (a) of this subdivision
    47  fails, refuses or neglects to make payment to  the  provider  of  excess
    48  insurance coverage or equivalent excess coverage in such time and manner
    49  as  determined  by  the superintendent of financial services pursuant to
    50  paragraph (b) of this subdivision, excess insurance coverage  or  equiv-
    51  alent excess coverage purchased for such physician or dentist in accord-
    52  ance  with  this section for such coverage period shall be cancelled and
    53  shall be null and void as of the first day on or after the  commencement
    54  of  a  policy  period  where  the liability for payment pursuant to this
    55  subdivision has not been met.

        S. 8007--C                         38                         A. 9007--C
 
     1    (d) Each provider of excess insurance coverage  or  equivalent  excess
     2  coverage  shall  notify the superintendent of financial services and the
     3  commissioner of health or their designee of each physician  and  dentist
     4  eligible  for  purchase  of  a  policy  for excess insurance coverage or
     5  equivalent  excess coverage covering the period July 1, 1992 to June 30,
     6  1993, or covering the period July 1, 1993 to June 30, 1994, or  covering
     7  the period July 1, 1994 to June 30, 1995, or covering the period July 1,
     8  1995  to  June 30, 1996, or covering the period July 1, 1996 to June 30,
     9  1997, or covering the period July 1, 1997 to June 30, 1998, or  covering
    10  the period July 1, 1998 to June 30, 1999, or covering the period July 1,
    11  1999  to  June 30, 2000, or covering the period July 1, 2000 to June 30,
    12  2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
    13  ing the period April 1, 2002 to June 30, 2002, or  covering  the  period
    14  July  1,  2002  to June 30, 2003, or covering the period July 1, 2003 to
    15  June 30, 2004, or covering the period July 1, 2004 to June 30, 2005,  or
    16  covering the period July 1, 2005 to June 30, 2006, or covering the peri-
    17  od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
    18  June  30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
    19  covering the period July 1, 2009 to June 30, 2010, or covering the peri-
    20  od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
    21  June 30, 2012, or covering the period July 1, 2012 to June 30, 2013,  or
    22  covering the period July 1, 2013 to June 30, 2014, or covering the peri-
    23  od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
    24  June  30, 2016, or covering the period July 1, 2016 to June 30, 2017, or
    25  covering the period July 1, 2017 to June 30, 2018, or covering the peri-
    26  od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
    27  June 30, 2020, or covering the period July 1, 2020 to June 30, 2021,  or
    28  covering the period July 1, 2021 to June 30, 2022, or covering the peri-
    29  od  July  1, 2022 to June 1, 2023 that has made payment to such provider
    30  of excess insurance coverage or equivalent excess coverage in accordance
    31  with paragraph (b) of this subdivision and of each physician and dentist
    32  who has failed, refused or neglected to make such payment.
    33    (e) A provider of  excess  insurance  coverage  or  equivalent  excess
    34  coverage  shall  refund to the hospital excess liability pool any amount
    35  allocable to the period July 1, 1992 to June 30, 1993, and to the period
    36  July 1, 1993 to June 30, 1994, and to the period July 1,  1994  to  June
    37  30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
    38  period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
    39  June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
    40  the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
    41  to June 30, 2001, and to the period July 1, 2001 to  October  29,  2001,
    42  and to the period April 1, 2002 to June 30, 2002, and to the period July
    43  1,  2002  to  June  30, 2003, and to the period July 1, 2003 to June 30,
    44  2004, and to the period July 1, 2004 to June 30, 2005, and to the period
    45  July 1, 2005 to June 30, 2006, and to the period July 1,  2006  to  June
    46  30,  2007,  and  to the period July 1, 2007 to June 30, 2008, and to the
    47  period July 1, 2008 to June 30, 2009, and to the period July 1, 2009  to
    48  June  30,  2010, and to the period July 1, 2010 to June 30, 2011, and to
    49  the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
    50  to June 30, 2013, and to the period July 1, 2013 to June 30,  2014,  and
    51  to  the  period July 1, 2014 to June 30, 2015, and to the period July 1,
    52  2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017,  and
    53  to  the  period July 1, 2017 to June 30, 2018, and to the period July 1,
    54  2018 to June 30, 2019, and to the period July 1, 2019 to June 30,  2020,
    55  and  to the period July 1, 2020 to June 30, 2021, and to the period July
    56  1, 2021 to June 30, 2022, and to the period July 1,  2022  to  June  30,

        S. 8007--C                         39                         A. 9007--C
 
     1  2023  received  from  the hospital excess liability pool for purchase of
     2  excess insurance coverage or equivalent  excess  coverage  covering  the
     3  period  July  1,  1992 to June 30, 1993, and covering the period July 1,
     4  1993  to June 30, 1994, and covering the period July 1, 1994 to June 30,
     5  1995, and covering the period July 1, 1995 to June 30, 1996, and  cover-
     6  ing  the  period  July 1, 1996 to June 30, 1997, and covering the period
     7  July 1, 1997 to June 30, 1998, and covering the period July 1,  1998  to
     8  June  30,  1999,  and covering the period July 1, 1999 to June 30, 2000,
     9  and covering the period July 1, 2000 to June 30, 2001, and covering  the
    10  period  July  1, 2001 to October 29, 2001, and covering the period April
    11  1, 2002 to June 30, 2002, and covering the period July 1, 2002  to  June
    12  30,  2003,  and  covering  the period July 1, 2003 to June 30, 2004, and
    13  covering the period July 1, 2004 to June  30,  2005,  and  covering  the
    14  period  July  1,  2005 to June 30, 2006, and covering the period July 1,
    15  2006 to June 30, 2007, and covering the period July 1, 2007 to June  30,
    16  2008,  and covering the period July 1, 2008 to June 30, 2009, and cover-
    17  ing the period July 1, 2009 to June 30, 2010, and  covering  the  period
    18  July  1,  2010 to June 30, 2011, and covering the period July 1, 2011 to
    19  June 30, 2012, and covering the period July 1, 2012 to  June  30,  2013,
    20  and  covering the period July 1, 2013 to June 30, 2014, and covering the
    21  period July 1, 2014 to June 30, 2015, and covering the  period  July  1,
    22  2015  to June 30, 2016, and covering the period July 1, 2016 to June 30,
    23  2017, and covering the period July 1, 2017 to June 30, 2018, and  cover-
    24  ing  the  period  July 1, 2018 to June 30, 2019, and covering the period
    25  July 1, 2019 to June 30, 2020, and covering the period July 1,  2020  to
    26  June  30,  2021,  and covering the period July 1, 2021 to June 30, 2022,
    27  and covering the period July 1, 2022 to June 30, 2023 for a physician or
    28  dentist where such excess insurance coverage or equivalent excess cover-
    29  age is cancelled in accordance with paragraph (c) of this subdivision.
    30    § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
    31  practice law and rules  and  other  laws  relating  to  malpractice  and
    32  professional medical conduct, as amended by section 4 of part K of chap-
    33  ter 57 of the laws of 2021, is amended to read as follows:
    34    §  40.  The superintendent of financial services shall establish rates
    35  for policies providing coverage  for  physicians  and  surgeons  medical
    36  malpractice  for the periods commencing July 1, 1985 and ending June 30,
    37  [2022] 2023; provided, however, that notwithstanding any other provision
    38  of law, the superintendent shall not establish or approve  any  increase
    39  in  rates  for  the  period  commencing July 1, 2009 and ending June 30,
    40  2010. The superintendent shall direct insurers to  establish  segregated
    41  accounts  for premiums, payments, reserves and investment income attrib-
    42  utable to such premium periods and shall require periodic reports by the
    43  insurers regarding claims and expenses attributable to such  periods  to
    44  monitor whether such accounts will be sufficient to meet incurred claims
    45  and  expenses. On or after July 1, 1989, the superintendent shall impose
    46  a surcharge on premiums  to  satisfy  a  projected  deficiency  that  is
    47  attributable  to the premium levels established pursuant to this section
    48  for such periods; provided, however, that such  annual  surcharge  shall
    49  not  exceed  eight  percent of the established rate until July 1, [2022]
    50  2023, at which time and thereafter such surcharge shall not exceed twen-
    51  ty-five percent of the approved adequate  rate,  and  that  such  annual
    52  surcharges shall continue for such period of time as shall be sufficient
    53  to  satisfy  such  deficiency.  The superintendent shall not impose such
    54  surcharge during the period commencing July 1, 2009 and ending June  30,
    55  2010.  On  and  after  July  1,  1989,  the surcharge prescribed by this
    56  section shall be retained by insurers to the extent  that  they  insured

        S. 8007--C                         40                         A. 9007--C
 
     1  physicians  and surgeons during the July 1, 1985 through June 30, [2022]
     2  2023 policy periods; in the event  and  to  the  extent  physicians  and
     3  surgeons  were  insured by another insurer during such periods, all or a
     4  pro  rata  share of the surcharge, as the case may be, shall be remitted
     5  to such other insurer in accordance with rules  and  regulations  to  be
     6  promulgated by the superintendent.  Surcharges collected from physicians
     7  and  surgeons  who  were not insured during such policy periods shall be
     8  apportioned among all insurers in proportion to the premium  written  by
     9  each  insurer  during such policy periods; if a physician or surgeon was
    10  insured by an insurer subject to rates established by the superintendent
    11  during such policy periods, and  at  any  time  thereafter  a  hospital,
    12  health  maintenance organization, employer or institution is responsible
    13  for responding in damages for liability arising out of such  physician's
    14  or  surgeon's  practice  of medicine, such responsible entity shall also
    15  remit to such prior insurer the equivalent amount  that  would  then  be
    16  collected  as  a  surcharge if the physician or surgeon had continued to
    17  remain insured by such prior insurer. In  the  event  any  insurer  that
    18  provided  coverage  during  such  policy  periods is in liquidation, the
    19  property/casualty insurance security fund shall receive the  portion  of
    20  surcharges to which the insurer in liquidation would have been entitled.
    21  The surcharges authorized herein shall be deemed to be income earned for
    22  the  purposes of section 2303 of the insurance law.  The superintendent,
    23  in establishing adequate rates and in determining  any  projected  defi-
    24  ciency  pursuant  to  the requirements of this section and the insurance
    25  law, shall give substantial weight, determined  in  his  discretion  and
    26  judgment,  to  the  prospective  anticipated  effect  of any regulations
    27  promulgated and laws enacted and the  public  benefit  of    stabilizing
    28  malpractice rates and minimizing rate level fluctuation during the peri-
    29  od  of  time  necessary for the development of more reliable statistical
    30  experience as to the efficacy of such  laws  and  regulations  affecting
    31  medical, dental or podiatric malpractice enacted or promulgated in 1985,
    32  1986,  by this act and at any other time.  Notwithstanding any provision
    33  of the insurance law, rates already established and to be established by
    34  the superintendent pursuant to this section are deemed adequate if  such
    35  rates  would be adequate when taken together with the maximum authorized
    36  annual surcharges to be imposed for a reasonable period of time  whether
    37  or  not  any  such  annual surcharge has been actually imposed as of the
    38  establishment of such rates.
    39    § 5. Section 5 and subdivisions (a) and (e) of section 6 of part J  of
    40  chapter  63  of  the  laws  of 2001, amending chapter 266 of the laws of
    41  1986, amending the civil practice law and rules and other laws  relating
    42  to malpractice and professional medical conduct, as amended by section 5
    43  of  part  K  of  chapter  57 of the laws of 2021, are amended to read as
    44  follows:
    45    § 5. The superintendent of financial services and the commissioner  of
    46  health shall determine, no later than June 15, 2002, June 15, 2003, June
    47  15,  2004,  June  15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
    48  June 15, 2009, June 15, 2010, June 15, 2011, June  15,  2012,  June  15,
    49  2013,  June  15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, June
    50  15, 2018, June 15, 2019, June 15, 2020, June 15, 2021,  [and]  June  15,
    51  2022,  and  June  15, 2023 the amount of funds available in the hospital
    52  excess liability pool, created pursuant to section 18 of chapter 266  of
    53  the  laws of 1986, and whether such funds are sufficient for purposes of
    54  purchasing excess insurance coverage for eligible  participating  physi-
    55  cians  and  dentists during the period July 1, 2001 to June 30, 2002, or
    56  July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July

        S. 8007--C                         41                         A. 9007--C
 
     1  1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or  July  1,
     2  2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008
     3  to  June  30, 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to
     4  June 30, 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June
     5  30,  2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
     6  2015, or July 1, 2015 to June 30, 2016, or July  1,  2016  to  June  30,
     7  2017,  or  July  1,  2017  to June 30, 2018, or July 1, 2018 to June 30,
     8  2019, or July 1, 2019 to June 30, 2020, or July  1,  2020  to  June  30,
     9  2021, or July 1, 2021 to June 30, 2022, or July 1, 2022 to June 30, 2023
    10  as applicable.
    11    (a)  This section shall be effective only upon a determination, pursu-
    12  ant to section five of this act,  by  the  superintendent  of  financial
    13  services  and  the  commissioner  of health, and a certification of such
    14  determination to the state director of the  budget,  the  chair  of  the
    15  senate  committee  on finance and the chair of the assembly committee on
    16  ways and means, that the amount of funds in the hospital excess  liabil-
    17  ity  pool,  created pursuant to section 18 of chapter 266 of the laws of
    18  1986, is insufficient for purposes of purchasing excess insurance cover-
    19  age for eligible participating physicians and dentists during the period
    20  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
    21  1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or  July  1,
    22  2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
    23  to  June  30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
    24  June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
    25  30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June  30,
    26  2014,  or  July  1,  2014  to June 30, 2015, or July 1, 2015 to June 30,
    27  2016, or July 1, 2016 to June 30, 2017, or July  1,  2017  to  June  30,
    28  2018,  or  July  1,  2018  to June 30, 2019, or July 1, 2019 to June 30,
    29  2020, or July 1, 2020 to June 30, 2021, or July  1,  2021  to  June  30,
    30  2022, or July 1, 2022 to June 30, 2023 as applicable.
    31    (e)  The  commissioner  of  health  shall  transfer for deposit to the
    32  hospital excess liability pool created pursuant to section 18 of chapter
    33  266 of the laws of 1986 such amounts as directed by  the  superintendent
    34  of  financial  services  for  the purchase of excess liability insurance
    35  coverage for eligible participating  physicians  and  dentists  for  the
    36  policy  year  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
    37  2003, or July 1, 2003 to June 30, 2004, or July  1,  2004  to  June  30,
    38  2005,  or  July  1,  2005  to June 30, 2006, or July 1, 2006 to June 30,
    39  2007, as applicable, and the cost of administering the  hospital  excess
    40  liability pool for such applicable policy year,  pursuant to the program
    41  established  in  chapter  266  of the laws of 1986, as amended, no later
    42  than June 15, 2002, June 15, 2003, June 15, 2004, June  15,  2005,  June
    43  15,  2006,  June  15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
    44  June 15, 2011, June 15, 2012, June 15, 2013, June  15,  2014,  June  15,
    45  2015,  June  15, 2016, June 15, 2017, June 15, 2018, June 15, 2019, June
    46  15, 2020, June 15, 2021, [and] June 15,  2022,  and  June  15,  2023  as
    47  applicable.
    48    §  6. Section 20 of part H of chapter 57 of the laws of 2017, amending
    49  the New York Health Care Reform Act of 1996 and other laws  relating  to
    50  extending  certain provisions thereto, as amended by section 6 of part K
    51  of chapter 57 of the laws of 2021, is amended to read as follows:
    52    § 20. Notwithstanding any law, rule or  regulation  to  the  contrary,
    53  only  physicians  or dentists who were eligible, and for whom the super-
    54  intendent of financial services and the commissioner of health, or their
    55  designee, purchased, with funds available in the hospital excess liabil-
    56  ity pool, a full or partial policy for  excess  coverage  or  equivalent

        S. 8007--C                         42                         A. 9007--C
 
     1  excess  coverage  for  the coverage period ending the thirtieth of June,
     2  two thousand [twenty-one] twenty-two, shall be  eligible  to  apply  for
     3  such  coverage  for the coverage period beginning the first of July, two
     4  thousand [twenty-one] twenty-two; provided, however, if the total number
     5  of  physicians  or  dentists for whom such excess coverage or equivalent
     6  excess coverage was purchased for the policy year ending  the  thirtieth
     7  of  June,  two thousand [twenty-one] twenty-two exceeds the total number
     8  of physicians or dentists certified as eligible for the coverage  period
     9  beginning  the first of July, two thousand [twenty-one] twenty-two, then
    10  the general hospitals may  certify  additional  eligible  physicians  or
    11  dentists in a number equal to such general hospital's proportional share
    12  of  the  total number of physicians or dentists for whom excess coverage
    13  or equivalent excess coverage was purchased with funds available in  the
    14  hospital excess liability pool as of the thirtieth of June, two thousand
    15  [twenty-one] twenty-two, as applied to the difference between the number
    16  of eligible physicians or dentists for whom a policy for excess coverage
    17  or  equivalent  excess  coverage  was  purchased for the coverage period
    18  ending the thirtieth of June, two thousand [twenty-one]  twenty-two  and
    19  the  number of such eligible physicians or dentists who have applied for
    20  excess coverage or equivalent excess coverage for  the  coverage  period
    21  beginning the first of July, two thousand [twenty-one] twenty-two.
    22    §  7.  This  act  shall take effect immediately and shall be deemed to
    23  have been in full force and effect on and after April 1, 2022.
 
    24                                   PART AA
 
    25    Section 1.  This act enacts into law major components  of  legislation
    26  relating  to  the  federal no surprises act and administrative simplifi-
    27  cation.  Each component is wholly contained within a Subpart  identified
    28  as  Subparts  A  through  C.  The  effective  date  for  each particular
    29  provision contained within such Subpart is set forth in the last section
    30  of such Subpart.  Any  provision  in  any  section  contained  within  a
    31  Subpart,  including  the  effective  date  of the Subpart, which makes a
    32  reference to a section "of this act", when used in connection with  that
    33  particular  component,  shall  be deemed to mean and refer to the corre-
    34  sponding section of the Subpart in which it is found.  Section three  of
    35  this act sets forth the general effective date of this act.
 
    36                                  SUBPART A
 
    37    Section  1.    Section  601 of the financial services law, as added by
    38  section 26 of part H of chapter 60 of the laws of 2014,  is  amended  to
    39  read as follows:
    40    §  601.  Dispute  resolution  process  established. The superintendent
    41  shall establish a dispute resolution process by which a  dispute  for  a
    42  bill  for  emergency  services  or  a surprise bill may be resolved. The
    43  superintendent shall have the power to grant and  revoke  certifications
    44  of independent dispute resolution entities to conduct the dispute resol-
    45  ution  process.  The  superintendent shall promulgate regulations estab-
    46  lishing standards for the dispute resolution process, including a  proc-
    47  ess   for   certifying  and  selecting  independent  dispute  resolution
    48  entities. An independent dispute resolution entity  shall  use  licensed
    49  physicians  in  active  practice in the same or similar specialty as the
    50  physician providing the service that is subject to  the  dispute  resol-
    51  ution  process  of  this  article  for  disputes  that involve physician
    52  services.  To the extent practicable, the physician shall be licensed in

        S. 8007--C                         43                         A. 9007--C
 
     1  this state.   Disputes shall be  submitted  to  an  independent  dispute
     2  resolution  entity  within  three years of the date the health care plan
     3  made the original payment on the  claim  that  is  the  subject  of  the
     4  dispute.
     5    §  2.   Subsection (b) of section 602 of the financial services law is
     6  REPEALED.
     7    § 3.  Subsection (h) of section 603 of the financial services law,  as
     8  added  by  section  26  of  part H of chapter 60 of the laws of 2014, is
     9  amended to read as follows:
    10    (h) "Surprise bill" means a bill for health care services, other  than
    11  emergency services, [received by] with respect to:
    12    (1)  an  insured  for services rendered by a non-participating [physi-
    13  cian] provider  at  a  participating  hospital  or  ambulatory  surgical
    14  center,  where  a participating [physician] provider is unavailable or a
    15  non-participating [physician]  provider  renders  services  without  the
    16  insured's  knowledge,  or  unforeseen medical services arise at the time
    17  the health  care  services  are  rendered;  provided,  however,  that  a
    18  surprise  bill  shall  not mean a bill received for health care services
    19  when a participating [physician] provider is available and  the  insured
    20  has  elected  to  obtain  services  from a non-participating [physician]
    21  provider;
    22    (2) an insured for services rendered by a non-participating  provider,
    23  where  the services were referred by a participating physician to a non-
    24  participating provider without explicit written consent of  the  insured
    25  acknowledging  that the participating physician is referring the insured
    26  to a non-participating provider and that  the  referral  may  result  in
    27  costs not covered by the health care plan; or
    28    (3)  a patient who is not an insured for services rendered by a physi-
    29  cian at a hospital or ambulatory surgical center, where the patient  has
    30  not  timely received all of the disclosures required pursuant to section
    31  twenty-four of the public health law.
    32    § 4. Section 604 of the financial services law, as amended by  chapter
    33  377 of the laws of 2019, is amended to read as follows:
    34    §  604.  Criteria for determining a reasonable fee. In determining the
    35  appropriate amount to pay for a  health  care  service,  an  independent
    36  dispute  resolution  entity shall consider all relevant factors, includ-
    37  ing:
    38    (a) whether there is a gross disparity between the fee charged by  the
    39  [physician or hospital] provider for services rendered as compared to:
    40    (1) fees paid to the involved [physician or hospital] provider for the
    41  same  services rendered by the [physician or hospital] provider to other
    42  patients in health care plans  in  which  the  [physician  or  hospital]
    43  provider is not participating, and
    44    (2)  in  the case of a dispute involving a health care plan, fees paid
    45  by the health care plan to reimburse similarly qualified [physicians  or
    46  hospitals]  providers  for  the same services in the same region who are
    47  not participating with the health care plan;
    48    (b) the level of training, education and experience of the [physician]
    49  health care professional, and in the case of a  hospital,  the  teaching
    50  staff, scope of services and case mix;
    51    (c)  the  [physician's  and  hospital's]  provider's  usual charge for
    52  comparable services with regard to patients  in  health  care  plans  in
    53  which the [physician or hospital] provider is not participating;
    54    (d) the circumstances and complexity of the particular case, including
    55  time and place of the service;

        S. 8007--C                         44                         A. 9007--C
 
     1    (e) individual patient characteristics; [and, with regard to physician
     2  services,]
     3    (f) the median of the rate recognized by the health care plan to reim-
     4  burse  similarly qualified providers for the same or similar services in
     5  the same region that are participating with the health care plan; and
     6    (g) with regard to physician services, the usual and customary cost of
     7  the service.
     8    § 5. Subsections (a) and (c) of section 605 of the financial  services
     9  law,  as  amended by chapter 377 of the laws of 2019, paragraphs 1 and 2
    10  of subsection (a) as amended by section 1 of part YY of  chapter  56  of
    11  the laws of 2020, are amended to read as follows:
    12    (a)  Emergency  services  for  an insured. (1) When a health care plan
    13  receives a bill for emergency services from a non-participating  [physi-
    14  cian  or  hospital]  provider,  including  a bill for inpatient services
    15  which follow an emergency room visit, the health care plan shall pay  an
    16  amount  that  it  determines  is  reasonable for the emergency services,
    17  including inpatient services  which  follow  an  emergency  room  visit,
    18  rendered  by  the non-participating [physician or hospital] provider, in
    19  accordance with section three thousand two hundred twenty-four-a of  the
    20  insurance  law,  except  for  the  insured's  co-payment, coinsurance or
    21  deductible, if any, and shall ensure that the  insured  shall  incur  no
    22  greater  out-of-pocket costs for the emergency services, including inpa-
    23  tient services which follow an emergency room visit,  than  the  insured
    24  would have incurred with a participating [physician or hospital] provid-
    25  er.  [If an insured assigns benefits to a non-participating physician or
    26  hospital in relation to emergency services, including inpatient services
    27  which follow an emergency room visit, provided by such non-participating
    28  physician  or  hospital, the] The non-participating [physician or hospi-
    29  tal] provider may bill the health care plan for the  services  rendered.
    30  Upon  receipt of the bill, the health care plan shall pay the non-parti-
    31  cipating [physician or hospital] provider the amount prescribed by  this
    32  section  and  any subsequent amount determined to be owed to the [physi-
    33  cian or  hospital]  provider  in  relation  to  the  emergency  services
    34  provided,  including  inpatient  services which follow an emergency room
    35  visit.
    36    (2) A non-participating [physician or hospital] provider or  a  health
    37  care  plan may submit a dispute regarding a fee or payment for emergency
    38  services, including inpatient services which follow  an  emergency  room
    39  visit, for review to an independent dispute resolution entity.
    40    (3)  The  independent  dispute resolution entity shall make a determi-
    41  nation within thirty business days of receipt of the dispute for review.
    42    (4) In determining a reasonable fee  for  the  services  rendered,  an
    43  independent  dispute  resolution  entity  shall select either the health
    44  care plan's payment or the non-participating [physician's or hospital's]
    45  provider's fee. The independent dispute resolution entity  shall  deter-
    46  mine  which  amount  to select based upon the conditions and factors set
    47  forth in section six hundred four of this  article.  If  an  independent
    48  dispute  resolution  entity  determines, based on the health care plan's
    49  payment and the non-participating [physician's or hospital's] provider's
    50  fee, that a settlement between the health care plan and  non-participat-
    51  ing  [physician or hospital] provider is reasonably likely, or that both
    52  the health care plan's payment and the non-participating [physician's or
    53  hospital's] provider's fee represent  unreasonable  extremes,  then  the
    54  independent dispute resolution entity may direct both parties to attempt
    55  a  good  faith negotiation for settlement. The health care plan and non-
    56  participating [physician or hospital] provider may be granted up to  ten

        S. 8007--C                         45                         A. 9007--C
 
     1  business  days  for  this negotiation, which shall run concurrently with
     2  the thirty business day period for dispute resolution.
     3    (c)  The  determination  of  an  independent dispute resolution entity
     4  shall be binding on  the  health  care  plan,  [physician  or  hospital]
     5  provider  and  patient,  and shall be admissible in any court proceeding
     6  between the health  care  plan,  [physician  or  hospital]  provider  or
     7  patient,  or in any administrative proceeding between this state and the
     8  [physician or hospital] provider.
     9    § 6. Subsection (d) of section 605 of the financial  services  law  is
    10  REPEALED and subsection (e) of section 605 of the financial services law
    11  is relettered subsection (d).
    12    §  7. Section 606 of the financial services law, as amended by section
    13  3 of part YY of chapter 56 of the laws of 2020, is amended  to  read  as
    14  follows:
    15    §  606.  Hold  harmless [and assignment of benefits] for insureds from
    16  bills for emergency services and surprise bills.  (a) [When  an  insured
    17  assigns  benefits  for a surprise bill in writing to a non-participating
    18  physician that knows the insured is insured under a  health  care  plan,
    19  the]  A  non-participating  [physician] provider shall not bill [the] an
    20  insured for a surprise bill except for any applicable copayment, coinsu-
    21  rance or deductible that would be owed if the insured utilized a partic-
    22  ipating [physician] provider.
    23    (b) [When an insured assigns benefits for emergency services,  includ-
    24  ing  inpatient  services which follow an emergency room visit, to a non-
    25  participating physician or hospital that knows the  insured  is  insured
    26  under  a health care plan, the] A non-participating [physician or hospi-
    27  tal] provider shall not bill [the] an insured  for  emergency  services,
    28  including  inpatient  services  which  follow  an  emergency room visit,
    29  except for any applicable  copayment,  coinsurance  or  deductible  that
    30  would  be  owed  if  the  insured utilized a participating [physician or
    31  hospital] provider.
    32    § 8.  Subsections (a), (b) and (c) of section  607  of  the  financial
    33  services law, as added by section 26 of part H of chapter 60 of the laws
    34  of 2014, are amended to read as follows:
    35    (a)  Surprise  bill  [received  by]  involving an insured [who assigns
    36  benefits]. (1) [If] For a surprise bill involving  an  insured  [assigns
    37  benefits  to  a non-participating physician], the health care plan shall
    38  pay the non-participating [physician] provider in accordance with  para-
    39  graphs two and three of this subsection.
    40    (2)  The  non-participating  [physician]  provider may bill the health
    41  care plan for the health care services rendered,  and  the  health  care
    42  plan  shall  pay  the  non-participating [physician] provider the billed
    43  amount or attempt to negotiate reimbursement with the  non-participating
    44  [physician] provider.
    45    (3)  If the health care plan's attempts to negotiate reimbursement for
    46  health care services provided by a non-participating [physician] provid-
    47  er does not result in a resolution of the payment  dispute  between  the
    48  non-participating  [physician]  provider  and  the health care plan, the
    49  health care plan shall pay the non-participating [physician] provider an
    50  amount the health care plan determines is reasonable for the health care
    51  services rendered, except for the insured's  copayment,  coinsurance  or
    52  deductible,  in accordance with section three thousand two hundred twen-
    53  ty-four-a of the insurance law, and shall ensure that the insured  shall
    54  incur  no  greater  out-of-pocket  costs  for the surprise bill than the
    55  insured would have incurred with a participating provider.

        S. 8007--C                         46                         A. 9007--C
 
     1    (4) Either the health care plan or the  non-participating  [physician]
     2  provider  may  submit the dispute regarding the surprise bill for review
     3  to an independent  dispute  resolution  entity,  provided  however,  the
     4  health  care plan may not submit the dispute unless it has complied with
     5  the requirements of paragraphs one, two and three of this subsection.
     6    (5)  The  independent  dispute resolution entity shall make a determi-
     7  nation within thirty business days of receipt of the dispute for review.
     8    (6) When determining a reasonable fee for the services  rendered,  the
     9  independent  dispute  resolution  entity  shall select either the health
    10  care plan's payment or the  non-participating  [physician's]  provider's
    11  fee.  An  independent  dispute  resolution  entity shall determine which
    12  amount to select based upon the conditions  and  factors  set  forth  in
    13  section  six  hundred  four  of  this article. If an independent dispute
    14  resolution entity determines, based on the health  care  plan's  payment
    15  and  the  non-participating [physician's] provider's fee, that a settle-
    16  ment between the health  care  plan  and  non-participating  [physician]
    17  provider  is  reasonably  likely,  or  that  both the health care plan's
    18  payment and the non-participating [physician's] provider's fee represent
    19  unreasonable extremes, then the independent  dispute  resolution  entity
    20  may  direct both parties to attempt a good faith negotiation for settle-
    21  ment. The health care plan and  non-participating  [physician]  provider
    22  may be granted up to ten business days for this negotiation, which shall
    23  run  concurrently with the thirty business day period for dispute resol-
    24  ution.
    25    (b) Surprise bill received by [an insured who does not assign benefits
    26  or by] a patient who is not an insured.
    27    (1) [An insured who  does  not  assign  benefits  in  accordance  with
    28  subsection (a) of this section or a] A patient who is not an insured and
    29  who receives a surprise bill may submit a dispute regarding the surprise
    30  bill for review to an independent dispute resolution entity.
    31    (2)  The  independent  dispute  resolution  entity  shall  determine a
    32  reasonable fee for the services rendered based upon the  conditions  and
    33  factors set forth in section six hundred four of this article.
    34    (3)  A  patient [or insured who does not assign benefits in accordance
    35  with subsection (a) of this section] shall not be required  to  pay  the
    36  physician's  fee  to be eligible to submit the dispute for review to the
    37  independent dispute resolution entity.
    38    (c) The determination of  an  independent  dispute  resolution  entity
    39  shall  be  binding  on the patient, [physician] provider and health care
    40  plan, and shall be  admissible  in  any  court  proceeding  between  the
    41  patient  or insured, [physician] provider or health care plan, or in any
    42  administrative proceeding between this state and the [physician] provid-
    43  er.
    44    § 9.  Subsection (a) of section 608 of the financial services law,  as
    45  amended  by  chapter  375  of  the  laws  of 2019, is amended to read as
    46  follows:
    47    (a) For disputes involving an insured, when  the  independent  dispute
    48  resolution  entity  determines the health care plan's payment is reason-
    49  able, payment for the dispute resolution process shall be the  responsi-
    50  bility  of the non-participating [physician or hospital] provider.  When
    51  the independent dispute resolution entity determines the non-participat-
    52  ing [physician's or hospital's] provider's fee  is  reasonable,  payment
    53  for  the  dispute  resolution process shall be the responsibility of the
    54  health care plan. When a good faith negotiation directed  by  the  inde-
    55  pendent   dispute  resolution  entity  pursuant  to  paragraph  four  of
    56  subsection (a) of section six hundred five of this article, or paragraph

        S. 8007--C                         47                         A. 9007--C
 
     1  six of subsection (a) of section  six  hundred  seven  of  this  article
     2  results in a settlement between the health care plan and non-participat-
     3  ing  [physician or hospital] provider, the health care plan and the non-
     4  participating  [physician  or hospital] provider shall evenly divide and
     5  share the prorated cost for dispute resolution.
     6    § 10.  Subparagraph (A) of paragraph 1 of subsection  (b)  of  section
     7  4910  of  the  insurance  law,  as amended by chapter 219 of the laws of
     8  2011, is amended to read as follows:
     9    (A) the insured has had coverage of the  health  care  service,  which
    10  would  otherwise  be  a  covered  benefit under a subscriber contract or
    11  governmental health benefit program, denied on appeal, in  whole  or  in
    12  part,  pursuant  to  title  one of this article on the grounds that such
    13  health care service does not meet the health  care  plan's  requirements
    14  for  medical  necessity,  appropriateness, health care setting, level of
    15  care, [or] effectiveness of a covered benefit, or other ground  consist-
    16  ent with 42 U.S.C. § 300gg-19 as determined by the superintendent, and
    17    §  11.   Subparagraph (i) of paragraph (a) of subdivision 2 of section
    18  4910 of the public health law, as amended by chapter 219 of the laws  of
    19  2011, is amended to read as follows:
    20    (i)  the  enrollee  has  had  coverage of a health care service, which
    21  would otherwise be a covered benefit  under  a  subscriber  contract  or
    22  governmental  health  benefit  program, denied on appeal, in whole or in
    23  part, pursuant to title one of this article on  the  grounds  that  such
    24  health  care  service  does not meet the health care plan's requirements
    25  for medical necessity, appropriateness, health care  setting,  level  of
    26  care,  [or] effectiveness of a covered benefit, or other ground consist-
    27  ent with 42 U.S.C. § 300gg-19  as  determined  by  the  commissioner  in
    28  consultation with the superintendent of financial services, and
    29    § 12.  This act shall take effect immediately.
 
    30                                  SUBPART B
 
    31    Section 1.  Paragraph 1 of subsection (c) of section 109 of the insur-
    32  ance  law,  as amended by section 55 of part A of chapter 62 of the laws
    33  of 2011, is amended to read as follows:
    34    (1) If the superintendent finds after  notice  and  hearing  that  any
    35  authorized  insurer,  representative  of the insurer, licensed insurance
    36  agent, licensed insurance broker, licensed adjuster, or any other person
    37  or entity licensed, certified, registered,  or  authorized  pursuant  to
    38  this  chapter,  has [wilfully] willfully violated the provisions of this
    39  chapter or any regulation promulgated  thereunder  or  with  respect  to
    40  accident  and  health  insurance,  any provision of titles one or two of
    41  division BB of the Consolidated Appropriations Act of 2021 (Pub. L.  No.
    42  116-260),  as  may  be  amended  from  time-to-time, and any regulations
    43  promulgated thereunder, then the superintendent may order the person  or
    44  entity to pay to the people of this state a penalty in a sum not exceed-
    45  ing one thousand dollars for each offense.
    46    §  2.   Paragraph 17 of subsection (a) of section 3217-a of the insur-
    47  ance law, as amended by section 9 of subpart A of part BB of chapter  57
    48  of the laws of 2019, is amended to read as follows:
    49    (17) where applicable, a listing by specialty, which may be in a sepa-
    50  rate  document  that  is  updated  annually, of the name, address, [and]
    51  telephone number, and digital contact information of  all  participating
    52  providers,  including  facilities,  and:  (A)  whether  the  provider is
    53  accepting new patients; (B) in the case of mental  health  or  substance
    54  use  disorder  services  providers,  any affiliations with participating

        S. 8007--C                         48                         A. 9007--C
 
     1  facilities certified or authorized by the office of mental health or the
     2  office of [alcoholism] addiction services and [substance abuse services]
     3  supports, and any restrictions regarding the availability of  the  indi-
     4  vidual  provider's  services;  and  (C) in the case of physicians, board
     5  certification, languages spoken and any affiliations with  participating
     6  hospitals. The listing shall also be posted on the insurer's website and
     7  the insurer shall update the website within fifteen days of the addition
     8  or termination of a provider from the insurer's network or a change in a
     9  physician's hospital affiliation;
    10    §  3. Section 3217-b of the insurance law is amended by adding two new
    11  subsections (m) and (n) to read as follows:
    12    (m) A contract between an insurer and a  health  care  provider  shall
    13  include  a  provision  that requires the health care provider to have in
    14  place business processes to ensure  the  timely  provision  of  provider
    15  directory  information  to  the  insurer.   A health care provider shall
    16  submit such provider directory information to an insurer, at a  minimum,
    17  when  a provider begins or terminates a network agreement with an insur-
    18  er, when there are material changes  to  the  content  of  the  provider
    19  directory  information  of  the  health  care provider, and at any other
    20  time, including upon the insurer's request, as the health care  provider
    21  determines to be appropriate.  For purposes of this subsection, "provid-
    22  er  directory  information"  shall include the name, address, specialty,
    23  telephone number, and digital contact information of  such  health  care
    24  provider;  whether  the  provider  is accepting new patients; for mental
    25  health and substance use disorder services providers,  any  affiliations
    26  with  participating  facilities certified or authorized by the office of
    27  mental health or the office of addiction services and supports, and  any
    28  restrictions  regarding  the  availability  of the individual provider's
    29  services; and in the case of physicians, board certification,  languages
    30  spoken, and any affiliations with participating hospitals.
    31    (n)  A  contract  between  an insurer and a health care provider shall
    32  include a provision that states that the provider  shall  reimburse  the
    33  insured for the full amount paid by the insured in excess of the in-net-
    34  work  cost-sharing  amount, plus interest at an interest rate determined
    35  by the superintendent in accordance with 42 U.S.C. §  300gg-139(b),  for
    36  the  services  involved  when  the  insured  is provided with inaccurate
    37  network status information by the insurer in a provider directory or  in
    38  response  to a request that stated that the provider was a participating
    39  provider when the provider was not a participating  provider.    In  the
    40  event  the insurer provides inaccurate network status information to the
    41  insured   indicating the provider was a participating provider when such
    42  provider was not a participating provider, the insurer  shall  reimburse
    43  the  provider  for the out-of-network services regardless of whether the
    44  insured's coverage includes out-of-network services.   Nothing  in  this
    45  subsection  shall  prohibit a health care provider from requiring in the
    46  terms of a contract with an insurer that the insurer remove, at the time
    47  of termination of such contract, the provider from the insurer's provid-
    48  er directory or that  the  insurer  bear  financial  responsibility  for
    49  providing inaccurate network status information to an insured.
    50    §  4.  Paragraph 17 of subsection (a) of section 4324 of the insurance
    51  law, as amended by section 34 of subpart A of part BB of chapter  57  of
    52  the laws of 2019, is amended to read as follows:
    53    (17) where applicable, a listing by specialty, which may be in a sepa-
    54  rate  document  that  is  updated  annually, of the name, address, [and]
    55  telephone number, and digital contact information of  all  participating
    56  providers,  including  facilities,  and:  (A)  whether  the  provider is

        S. 8007--C                         49                         A. 9007--C
 
     1  accepting new patients; (B) in the case of mental  health  or  substance
     2  use  disorder  services  providers,  any affiliations with participating
     3  facilities certified or authorized by the office of mental health or the
     4  office of [alcoholism] addiction services and [substance abuse services]
     5  supports,  and  any restrictions regarding the availability of the indi-
     6  vidual provider's services; (C) in the case of physicians, board certif-
     7  ication, languages spoken and any affiliations with participating hospi-
     8  tals. The listing shall also be posted on the corporation's website  and
     9  the  corporation  shall  update  the  website within fifteen days of the
    10  addition or termination of a provider from the corporation's network  or
    11  a change in a physician's hospital affiliation;
    12    §  5.   Section 4325 of the insurance law is amended by adding two new
    13  subsections (n) and (o) to read as follows:
    14    (n) A contract between a corporation and a health care provider  shall
    15  include  a  provision  that requires the health care provider to have in
    16  place business processes to ensure  the  timely  provision  of  provider
    17  directory  information to the corporation.  A health care provider shall
    18  submit such provider directory information to a corporation, at a  mini-
    19  mum,  when  a  provider  begins or terminates a network agreement with a
    20  corporation, when there are material  changes  to  the  content  of  the
    21  provider  directory  information of the health care provider, and at any
    22  other time, including upon the corporation's request, as the health care
    23  provider determines to be appropriate.  For purposes of this subsection,
    24  "provider  directory  information"  shall  include  the  name,  address,
    25  specialty,  telephone  number,  and  digital contact information of such
    26  health care provider; whether the provider is  accepting  new  patients;
    27  for  mental  health  and  substance use disorder services providers, any
    28  affiliations with participating facilities certified  or  authorized  by
    29  the  office  of  mental  health  or the office of addiction services and
    30  supports, and any restrictions regarding the availability of  the  indi-
    31  vidual provider's services; and in the case of physicians, board certif-
    32  ication,  languages  spoken,  and  any  affiliations  with participating
    33  hospitals.
    34    (o) A contract between a corporation and a health care provider  shall
    35  include  a  provision  that states that the provider shall reimburse the
    36  insured for the full amount paid by the insured in excess of the in-net-
    37  work cost-sharing amount, plus interest at an interest  rate  determined
    38  by  the  superintendent in accordance with 42 U.S.C. § 300gg-139(b), for
    39  the services involved when  the  insured  is  provided  with  inaccurate
    40  network status information by the corporation in a provider directory or
    41  in response to a request that stated that the provider was a participat-
    42  ing provider when the provider was not a participating provider.  In the
    43  event  the corporation provides inaccurate network status information to
    44  the insured indicating the provider was a  participating  provider  when
    45  such  provider  was  not a participating provider, the corporation shall
    46  reimburse the provider for the  out-of-network  services  regardless  of
    47  whether  the insured's coverage includes out-of-network services.  Noth-
    48  ing in this subsection  shall  prohibit  a  health  care  provider  from
    49  requiring  in the terms of a contract with a corporation that the corpo-
    50  ration remove, at the time of termination of such contract, the provider
    51  from the corporation's provider directory or that the  corporation  bear
    52  financial  responsibility for providing inaccurate network status infor-
    53  mation to an insured.
    54    § 6.  Section 4406-c of the public health law is amended by adding two
    55  new subdivisions 11 and 12 to read as follows:

        S. 8007--C                         50                         A. 9007--C
 
     1    11. A contract between a health care plan and a health  care  provider
     2  shall include a provision that requires the health care provider to have
     3  in  place  business processes to ensure the timely provision of provider
     4  directory information to the health care plan.  A health  care  provider
     5  shall  submit such provider directory information to a health care plan,
     6  at a minimum, when a provider begins or terminates a  network  agreement
     7  with  a health care plan, when there are material changes to the content
     8  of the provider directory information of such health care provider,  and
     9  at any other time, including upon the health care plan's request, as the
    10  health care provider determines to be appropriate.  For purposes of this
    11  subsection,  "provider  directory  information"  shall include the name,
    12  address, specialty, telephone number, and digital contact information of
    13  such health  care  provider;  whether  the  provider  is  accepting  new
    14  patients;  for mental health and substance use disorder services provid-
    15  ers, any affiliations with participating facilities certified or author-
    16  ized by the office of mental health or the office of addiction  services
    17  and  supports,  and  any  restrictions regarding the availability of the
    18  individual provider's services; and in the  case  of  physicians,  board
    19  certification, languages spoken, and any affiliations with participating
    20  hospitals.
    21    12.  A  contract between a health care plan and a health care provider
    22  shall include a provision that states that the provider shall  reimburse
    23  the  enrollee  for the full amount paid by the enrollee in excess of the
    24  in-network cost-sharing amount, plus interest at an interest rate deter-
    25  mined by the commissioner in accordance with 42 U.S.C.  §  300gg-139(b),
    26  for  the services involved when the enrollee is provided with inaccurate
    27  network status information by the health care plan in a provider  direc-
    28  tory  or  in  response  to a request that stated that the provider was a
    29  participating provider when the provider was not a participating provid-
    30  er.   In the event the health  care  plan  provides  inaccurate  network
    31  status information to the enrollee indicating the provider was a partic-
    32  ipating  provider  when  such provider was not a participating provider,
    33  the health care plan shall reimburse the provider for the out-of-network
    34  services regardless of whether the enrollee's coverage includes  out-of-
    35  network  services.   Nothing in this subdivision shall prohibit a health
    36  care provider from requiring in the terms of a contract  with  a  health
    37  care  plan  that the health care plan remove, at the time of termination
    38  of such contract, the provider from  the  health  care  plan's  provider
    39  directory or that the health care plan bear financial responsibility for
    40  providing inaccurate network status information to an enrollee.
    41    §  7.    Paragraph  (r) of subdivision 1 of section 4408 of the public
    42  health law, as amended by section 41 of subpart A of part BB of  chapter
    43  57 of the laws of 2019, is amended to read as follows:
    44    (r)  a  listing by specialty, which may be in a separate document that
    45  is updated annually, of the name, address [and], telephone  number,  and
    46  digital  contact  information  of all participating providers, including
    47  facilities, and: (i) whether the provider  is  accepting  new  patients;
    48  (ii)  in  the  case  of mental health or substance use disorder services
    49  providers, any affiliations with participating facilities  certified  or
    50  authorized  by the office of mental health or the office of [alcoholism]
    51  addiction services and [substance  abuse  services]  supports,  and  any
    52  restrictions  regarding  the  availability  of the individual provider's
    53  services; and (iii) in the  case  of  physicians,  board  certification,
    54  languages  spoken and any affiliations with participating hospitals. The
    55  listing shall also be posted on the  health  maintenance  organization's
    56  website and the health maintenance organization shall update the website

        S. 8007--C                         51                         A. 9007--C

     1  within  fifteen  days  of the addition or termination of a provider from
     2  the health maintenance organization's network or a change  in  a  physi-
     3  cian's hospital affiliation;
     4    §  8.   Subdivision 8 of section 24 of the public health law is renum-
     5  bered subdivision 9 and a new subdivision 8 is added to read as follows:
     6    8. A health care professional, or a  group  practice  of  health  care
     7  professionals,  a  diagnostic  and  treatment  center or a health center
     8  defined under 42 U.S.C. § 254b on behalf of  health  care  professionals
     9  rendering  services  at  the  group  practice,  diagnostic and treatment
    10  center or health center, and a hospital shall make  publicly  available,
    11  and  if  applicable, post on their public websites, and provide to indi-
    12  viduals who are enrollees of  health  care  plans,  a  one-page  written
    13  notice,  in clear and understandable language, containing information on
    14  the requirements and prohibitions  under  42  U.S.C.  §§  300gg-131  and
    15  300gg-132  and  article  six  of  the financial services law relating to
    16  prohibitions on balance billing  for  emergency  services  and  surprise
    17  bills, and information on contacting appropriate state and federal agen-
    18  cies  if  an individual believes a health care provider has violated any
    19  requirement described in 42 U.S.C. §§ 300gg-131 and 300gg-132 or article
    20  six of the financial services law.
    21    § 9. Subsection (e) of section 4804 of the insurance law, as added  by
    22  chapter 705 of the laws of 1996, is amended to read as follows:
    23    (e)  (1)  If  an  insured's  health care provider leaves the insurer's
    24  in-network benefits portion of its network of providers  for  a  managed
    25  care  product  for reasons other than those for which the provider would
    26  not be eligible to receive  a  hearing  pursuant  to  paragraph  one  of
    27  subsection (b) of section forty-eight hundred three of this chapter, the
    28  insurer  shall  provide  written notice to the insured of the provider's
    29  disaffiliation and permit the insured to continue an ongoing  course  of
    30  treatment with the insured's current health care provider during a tran-
    31  sitional  period  of  [(i) up to]: (A) ninety days from the later of the
    32  date of the notice to the insured of the provider's disaffiliation  from
    33  the  insurer's network or the effective date of the provider's disaffil-
    34  iation from the insurer's network; or [(ii)] (B)  if  the  insured  [has
    35  entered  the  second  trimester of pregnancy] is pregnant at the time of
    36  the provider's disaffiliation, [for a transitional period that includes]
    37  the [provision of]  duration  of  the  pregnancy  and  post-partum  care
    38  directly related to the delivery.
    39    (2)   [Notwithstanding   the  provisions  of  paragraph  one  of  this
    40  subsection, such care shall be authorized by the insurer during]  During
    41  the  transitional  period [only if] the health care provider [agrees (i)
    42  to] shall: (A) continue to accept reimbursement from the insurer at  the
    43  rates  applicable  prior  to  the  start of the transitional period, and
    44  continue to accept the in-network cost-sharing from the insured, if any,
    45  as payment in full; [(ii) to] (B) adhere to the insurer's quality assur-
    46  ance requirements and [to] provide  to  the  insurer  necessary  medical
    47  information related to such care; and [(iii) to] (C) otherwise adhere to
    48  the  insurer's  policies  and  procedures including, but not limited to,
    49  procedures regarding referrals and  obtaining  pre-authorization  and  a
    50  treatment plan approved by the insurer.
    51    §  10.  Paragraph  (e)  of subdivision 6 of section 4403 of the public
    52  health law, as added by chapter 705 of the laws of 1996, is  amended  to
    53  read as follows:
    54    (e)  (1) If an enrollee's health care provider leaves the health main-
    55  tenance organization's network of providers for reasons other than those
    56  for which the provider would not be eligible to receive a hearing pursu-

        S. 8007--C                         52                         A. 9007--C
 
     1  ant to paragraph a of subdivision  two  of  section  forty-four  hundred
     2  six-d of this chapter, the health maintenance organization shall provide
     3  written  notice  to  the  enrollee  of the provider's disaffiliation and
     4  permit  the enrollee to continue an ongoing course of treatment with the
     5  enrollee's current health care provider during a transitional period of:
     6  (i) [up to] ninety days from the later of the date of the notice to  the
     7  enrollee  of  the  provider's  disaffiliation  from  the  organization's
     8  network or the effective date of the provider's disaffiliation from  the
     9  organization's  network; or (ii) if the enrollee [has entered the second
    10  trimester of pregnancy] is pregnant at the time of the provider's disaf-
    11  filiation, [for a transitional period that includes] the [provision  of]
    12  duration  of  the pregnancy and post-partum care directly related to the
    13  delivery.
    14    (2) [Notwithstanding the provisions of subparagraph one of this  para-
    15  graph, such care shall be authorized by the health maintenance organiza-
    16  tion  during]  During  the transitional period [only if] the health care
    17  provider [agrees] shall: (i) [to] continue to accept reimbursement  from
    18  the health maintenance organization at the rates applicable prior to the
    19  start  of the transitional period, and continue to accept the in-network
    20  cost-sharing from the enrollee, if any, as payment in  full;  (ii)  [to]
    21  adhere  to  the  organization's  quality  assurance  requirements and to
    22  provide to the organization necessary  medical  information  related  to
    23  such  care;  and (iii) [to] otherwise adhere to the organization's poli-
    24  cies and procedures, including but not limited to  procedures  regarding
    25  referrals  and obtaining pre-authorization and a treatment plan approved
    26  by the organization.
    27    § 11. This act shall take effect immediately.
 
    28                                  SUBPART C
 
    29    Section 1. Section 3217-d of the insurance law is amended by adding  a
    30  new subsection (e) to read as follows:
    31    (e)  An insurer that issues a comprehensive policy that uses a network
    32  of providers and is not a managed care  health  insurance  contract,  as
    33  defined  in subsection (c) of section four thousand eight hundred one of
    34  this chapter, shall establish and maintain procedures  for  health  care
    35  professional  applications and terminations consistent with the require-
    36  ments of section four thousand eight hundred three of this  chapter  and
    37  procedures for health care facility applications consistent with section
    38  four thousand eight hundred six of this chapter.
    39    §  2.  Section  4306-c of the insurance law is amended by adding a new
    40  subsection (e) to read as follows:
    41    (e) A corporation, including a municipal  cooperative  health  benefit
    42  plan  certified  pursuant  to  article forty-seven of this chapter and a
    43  student health plan established or maintained pursuant  to  section  one
    44  thousand one hundred twenty-four of this chapter as added by chapter 246
    45  of  the  laws  of  2012,  that issues a comprehensive policy that uses a
    46  network of  providers  and  is  not  a  managed  care  health  insurance
    47  contract,  as  defined  in subsection (c) of section four thousand eight
    48  hundred one of this chapter, shall establish and maintain procedures for
    49  health care professional applications and terminations  consistent  with
    50  the  requirements  of  section four thousand eight hundred three of this
    51  chapter and procedures for health care facility applications  consistent
    52  with section four thousand eight hundred six of this chapter.
    53    § 3. The insurance law is amended by adding a new section 4806 to read
    54  as follows:

        S. 8007--C                         53                         A. 9007--C
 
     1    § 4806. Health care facility applications.  (a) An insurer that offers
     2  a  managed care product shall, upon request, make available and disclose
     3  to facilities written application procedures and  minimum  qualification
     4  requirements  that a facility must meet in order to be considered by the
     5  insurer  for  participation  in  the  in-network benefits portion of the
     6  insurer's network for the managed  care  product.    The  insurer  shall
     7  consult with appropriately qualified facilities in developing its quali-
     8  fication  requirements  for  participation  in  the  in-network benefits
     9  portion of the insurer's network for  the  managed  care  product.    An
    10  insurer  shall  complete review of the facility's application to partic-
    11  ipate in the in-network portion of the  insurer's  network  and,  within
    12  sixty  days  of  receiving a facility's completed application to partic-
    13  ipate in the insurer's network, shall notify the facility as  to:    (1)
    14  whether  the facility is credentialed; or (2) whether additional time is
    15  necessary to make a determination because of a failure of a third  party
    16  to  provide necessary documentation.  In such instances where additional
    17  time is necessary because of  a  lack  of  necessary  documentation,  an
    18  insurer  shall  make  every effort to obtain such information as soon as
    19  possible and shall make a final determination within twenty-one days  of
    20  receiving the necessary documentation.
    21    (b)  For  the purposes of this section, "facility" shall mean a health
    22  care provider that is licensed or certified pursuant  to  article  five,
    23  twenty-eight,  thirty-six,  forty,  forty-four,  or  forty-seven  of the
    24  public health law or article sixteen, nineteen, thirty-one,  thirty-two,
    25  or thirty-six of the mental hygiene law.
    26    §  4.  The public health law is amended by adding a new section 4406-h
    27  to read as follows:
    28    §  4406-h. Health care facility applications.  1. A health  care  plan
    29  shall,  upon  request, make available and disclose to facilities written
    30  application procedures and minimum  qualification  requirements  that  a
    31  facility must meet in order to be considered by the health care plan for
    32  participation  in  the  in-network  benefits  portion of the health care
    33  plan's network.  The health care plan shall consult  with  appropriately
    34  qualified  facilities  in  developing its qualification requirements.  A
    35  health care plan shall complete review of the facility's application  to
    36  participate  in the in-network portion of the health care plan's network
    37  and shall, within sixty days of receiving a facility's completed  appli-
    38  cation  to  participate  in  the  health care plan's network, notify the
    39  facility as to:  (a) whether the facility is credentialed; or (b) wheth-
    40  er additional time is necessary to make a  determination  because  of  a
    41  failure  of  a  third  party to provide necessary documentation. In such
    42  instances where additional time is necessary because of a lack of neces-
    43  sary documentation, a health care plan shall make every effort to obtain
    44  such information as soon as possible and shall  make  a  final  determi-
    45  nation within twenty-one days of receiving the necessary documentation.
    46    2.  For  the  purposes of this section, "facility" shall mean a health
    47  care provider entity or  organization  that  is  licensed  or  certified
    48  pursuant  to  article five, twenty-eight, thirty-six, forty, forty-four,
    49  or forty-seven of this chapter or article sixteen, nineteen, thirty-one,
    50  thirty-two, or thirty-six of the mental hygiene law.
    51    § 5. Subsection (g) of section 4905 of the insurance law, as added  by
    52  chapter 705 of the laws of 1996, is amended to read as follows:
    53    (g)  When  making  prospective,  concurrent and retrospective determi-
    54  nations, utilization review agents shall collect only  such  information
    55  as  is  necessary  to  make  such  determination and shall not routinely
    56  require health care providers to numerically code  diagnoses  or  proce-

        S. 8007--C                         54                         A. 9007--C
 
     1  dures  to be considered for certification or routinely request copies of
     2  medical records of all patients reviewed. During prospective or  concur-
     3  rent  review,  copies  of  medical  records  shall only be required when
     4  necessary to verify that the health care services subject to such review
     5  are  medically  necessary. In such cases, only the necessary or relevant
     6  sections of the medical record shall be required. A  utilization  review
     7  agent  may request copies of partial or complete medical records retros-
     8  pectively. [This subsection shall not apply to health maintenance organ-
     9  izations licensed pursuant to article forty-three  of  this  chapter  or
    10  certified pursuant to article forty-four of the public health law.]
    11    §  6. Subdivision 7 of section 4905 of the public health law, as added
    12  by chapter 705 of the laws of 1996, is amended to read as follows:
    13    7. When making  prospective,  concurrent  and  retrospective  determi-
    14  nations,  utilization  review agents shall collect only such information
    15  as is necessary to make  such  determination  and  shall  not  routinely
    16  require  health  care  providers to numerically code diagnoses or proce-
    17  dures to be considered for certification or routinely request copies  of
    18  medical  records of all patients reviewed. During prospective or concur-
    19  rent review, copies of medical  records  shall  only  be  required  when
    20  necessary to verify that the health care services subject to such review
    21  are  medically  necessary. In such cases, only the necessary or relevant
    22  sections of the medical record shall be required. A  utilization  review
    23  agent  may request copies of partial or complete medical records retros-
    24  pectively. [This subdivision  shall  not  apply  to  health  maintenance
    25  organizations  licensed pursuant to article forty-three of the insurance
    26  law or certified pursuant to article forty-four of this chapter.]
    27    § 7.  This act shall take effect immediately; provided, however,  that
    28  sections  one  through  four  of  this  act shall apply to credentialing
    29  applications received on or after the ninetieth day after this act shall
    30  have become a law; and provided further, that sections five and  six  of
    31  this  act  shall apply to health care services performed on or after the
    32  ninetieth day after this act shall have become a law.
    33    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
    34  sion, section or subpart of this act shall be adjudged by any  court  of
    35  competent  jurisdiction  to  be invalid, such judgment shall not affect,
    36  impair, or invalidate the remainder thereof, but shall  be  confined  in
    37  its  operation  to the clause, sentence, paragraph, subdivision, section
    38  or subpart thereof directly involved in the controversy  in  which  such
    39  judgment  shall  have  been  rendered.   It is hereby declared to be the
    40  intent of the legislature that this act would have been enacted even  if
    41  such invalid provisions had not been included herein.
    42    §  3.  This act shall take effect immediately, provided, however, that
    43  the applicable effective dates of Subparts A through C of this act shall
    44  be as specifically set forth in the last section of such Subparts.
 
    45                                   PART BB
 
    46                            Intentionally Omitted
 
    47                                   PART CC
 
    48    Section 1. Paragraph (m) of subdivision 3  of  section  461-l  of  the
    49  social  services  law,  as added by section 2 of part B of chapter 57 of
    50  the laws of 2018, is amended to read as follows:

        S. 8007--C                         55                         A. 9007--C
 
     1    (m) Beginning April first, two  thousand  [twenty-three]  twenty-five,
     2  additional  assisted  living program beds shall be approved on a case by
     3  case basis whenever the commissioner of health is satisfied that  public
     4  need  exists  at  the time and place and under circumstances proposed by
     5  the applicant.
     6    (i)  The  consideration  of  public need may take into account factors
     7  such as, but not limited to, regional occupancy  rates  for  adult  care
     8  facilities and assisted living program occupancy rates and the extent to
     9  which the project will serve individuals receiving medical assistance.
    10    (ii) Existing assisted living program providers may apply for approval
    11  to  add  up  to nine additional assisted living program beds that do not
    12  require major renovation or construction under an expedited review proc-
    13  ess. The expedited review process is available to applicants that are in
    14  good standing with the department of health, and are in compliance  with
    15  appropriate state and local requirements as determined by the department
    16  of health. The expedited review process shall allow certification of the
    17  additional  beds  for which the commissioner of health is satisfied that
    18  public need exists within ninety days of such department's receipt of  a
    19  satisfactory application.
    20    §  2.  Subdivision  (f)  of section 129 of part C of chapter 58 of the
    21  laws of 2009, amending the public health  law  relating  to  payment  by
    22  governmental  agencies  for  general  hospital  inpatient  services,  as
    23  amended by section 6 of part E of chapter 57 of the  laws  of  2019,  is
    24  amended to read as follows:
    25    (f)  section  twenty-five  of  this  act  shall  expire  and be deemed
    26  repealed April 1, [2022] 2025;
    27    § 3. Subdivision (c) of section 122 of part E of  chapter  56  of  the
    28  laws  of  2013  amending  the  public health law relating to the general
    29  public health work program, as amended by section 7 of part E of chapter
    30  57 of the laws of 2019, is amended to read as follows:
    31    (c) section fifty of this act shall take effect immediately and  shall
    32  expire [nine years after it becomes law] and be deemed repealed April 1,
    33  2031;
    34    §  4.  Paragraph (a) of subdivision 1 of section 212 of chapter 474 of
    35  the laws of 1996, amending the education law and other laws relating  to
    36  rates for residential healthcare facilities, as amended by section 22 of
    37  part E of chapter 57 of the laws of 2019, is amended to read as follows:
    38    (a) Notwithstanding any inconsistent provision of law or regulation to
    39  the  contrary,  effective beginning August 1, 1996, for the period April
    40  1, 1997 through March 31, 1998, April 1, 1998 for the  period  April  1,
    41  1998  through  March  31,  1999, August 1, 1999, for the period April 1,
    42  1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
    43  through March 31, 2001, April 1, 2001, for  the  period  April  1,  2001
    44  through  March  31,  2002,  April  1, 2002, for the period April 1, 2002
    45  through March 31, 2003, and for the state fiscal year beginning April 1,
    46  2005 through March 31, 2006, and for the  state  fiscal  year  beginning
    47  April  1,  2006  through  March  31, 2007, and for the state fiscal year
    48  beginning April 1, 2007 through March 31, 2008, and for the state fiscal
    49  year beginning April 1, 2008 through March 31, 2009, and for  the  state
    50  fiscal  year beginning April 1, 2009 through March 31, 2010, and for the
    51  state fiscal year beginning April 1, 2010 through March  31,  2016,  and
    52  for  the  state  fiscal  year  beginning April 1, 2016 through March 31,
    53  2019, and for the state fiscal year  beginning  April  1,  2019  through
    54  March  31,  2022,  and for the state fiscal year beginning April 1, 2022
    55  through March 31, 2025, the department of health is  authorized  to  pay
    56  public  general  hospitals, as defined in subdivision 10 of section 2801

        S. 8007--C                         56                         A. 9007--C
 
     1  of the public health law, operated by the state of New York  or  by  the
     2  state  university  of New York or by a county, which shall not include a
     3  city with a population of over one million, of the state  of  New  York,
     4  and those public general hospitals located in the county of Westchester,
     5  the  county  of  Erie  or  the county of Nassau, additional payments for
     6  inpatient hospital services as medical assistance payments  pursuant  to
     7  title  11  of article 5 of the social services law for patients eligible
     8  for federal financial participation  under  title  XIX  of  the  federal
     9  social  security  act in medical assistance pursuant to the federal laws
    10  and regulations governing disproportionate share payments  to  hospitals
    11  up to one hundred percent of each such public general hospital's medical
    12  assistance  and uninsured patient losses after all other medical assist-
    13  ance, including disproportionate share payments to such  public  general
    14  hospital  for  1996,  1997,  1998, and 1999, based initially for 1996 on
    15  reported 1994 reconciled data as further reconciled to  actual  reported
    16  1996  reconciled  data,  and  for  1997 based initially on reported 1995
    17  reconciled data as further reconciled to actual reported 1997 reconciled
    18  data, for 1998 based initially  on  reported  1995  reconciled  data  as
    19  further  reconciled  to  actual  reported 1998 reconciled data, for 1999
    20  based initially on reported 1995 reconciled data as  further  reconciled
    21  to  actual  reported  1999  reconciled data, for 2000 based initially on
    22  reported 1995 reconciled data as further reconciled to  actual  reported
    23  2000  data, for 2001 based initially on reported 1995 reconciled data as
    24  further reconciled to actual reported 2001 data, for 2002 based initial-
    25  ly on reported 2000 reconciled data  as  further  reconciled  to  actual
    26  reported  2002  data,  and  for state fiscal years beginning on April 1,
    27  2005, based initially on reported 2000 reconciled data as further recon-
    28  ciled to actual reported data for  2005,  and  for  state  fiscal  years
    29  beginning  on April 1, 2006, based initially on reported 2000 reconciled
    30  data as further reconciled to actual reported data for 2006,  for  state
    31  fiscal  years  beginning  on  and  after April 1, 2007 through March 31,
    32  2009, based initially on reported 2000 reconciled data as further recon-
    33  ciled to actual reported data for 2007 and 2008, respectively, for state
    34  fiscal years beginning on and after April 1, 2009,  based  initially  on
    35  reported  2007  reconciled  data,  adjusted for authorized Medicaid rate
    36  changes applicable to the state fiscal year, and as  further  reconciled
    37  to  actual  reported  data for 2009, for state fiscal years beginning on
    38  and after April 1, 2010, based initially  on  reported  reconciled  data
    39  from  the  base  year  two years prior to the payment year, adjusted for
    40  authorized Medicaid rate changes applicable to the  state  fiscal  year,
    41  and  further  reconciled to actual reported data from such payment year,
    42  and to actual reported data for each respective succeeding  year.    The
    43  payments  may be added to rates of payment or made as aggregate payments
    44  to an eligible public general hospital.
    45    § 5. Section 5 of chapter 21 of the laws of 2011, amending the  educa-
    46  tion  law  relating  to authorizing pharmacists to perform collaborative
    47  drug therapy management with physicians in certain settings, as  amended
    48  by  section  20 of part BB of chapter 56 of the laws of 2020, is amended
    49  to read as follows:
    50    § 5. This act shall take effect on the one hundred twentieth day after
    51  it shall have become a law, provided, however, that  the  provisions  of
    52  sections  two,  three,  and  four of this act shall expire and be deemed
    53  repealed July 1, [2022] 2024; provided, however, that the amendments  to
    54  subdivision  1  of section 6801 of the education law made by section one
    55  of this act shall be subject to the expiration  and  reversion  of  such
    56  subdivision  pursuant  to  section 8 of chapter 563 of the laws of 2008,

        S. 8007--C                         57                         A. 9007--C
 
     1  when upon such date the provisions of section one-a of  this  act  shall
     2  take  effect;  provided,  further, that effective immediately, the addi-
     3  tion, amendment and/or repeal of any rule or  regulation  necessary  for
     4  the  implementation of this act on its effective date are authorized and
     5  directed to be made and completed on or before such effective date.
     6    § 6. Section 2 of part II of chapter 54 of the laws of 2016,  amending
     7  part  C  of  chapter  58  of  the  laws  of 2005 relating to authorizing
     8  reimbursements for expenditures made by or on behalf of social  services
     9  districts  for  medical  assistance for needy persons and administration
    10  thereof, as amended by section 1 of item C of subpart H of part  XXX  of
    11  chapter 58 of the laws of 2020, is amended to read as follows:
    12    §  2.  This  act shall take effect immediately and shall expire and be
    13  deemed repealed March 31, [2022] 2024.
    14    § 7. Paragraph (c) of subdivision 6 of section 958  of  the  executive
    15  law,  as added by chapter 337 of the laws of 2018, is amended to read as
    16  follows:
    17    (c) prepare and issue a report on the  working  group's  findings  and
    18  recommendations  by  May  first, two thousand [nineteen] twenty-three to
    19  the governor, the temporary president of the senate and the  speaker  of
    20  the assembly.
    21    § 8. Subdivision 2 of section 207-a of the public health law, as added
    22  by chapter 364 of the laws of 2018, is amended to read as follows:
    23    2.  Such  report  shall be submitted to the temporary president of the
    24  senate and the speaker of the assembly no later than October first,  two
    25  thousand  [nineteen]  twenty-two. The department and the commissioner of
    26  mental health may engage stakeholders in the compilation of the  report,
    27  including but not limited to, medical research institutions, health care
    28  practitioners, mental health providers, county and local government, and
    29  advocates.
    30    §  9.  Sections  2 and 3 of chapter 74 of the laws of 2020 relating to
    31  directing the department of health to  convene  a  work  group  on  rare
    32  diseases,  as amended by chapter 199 of the laws of 2021, are amended to
    33  read as follows:
    34    § 2. The department of health, in collaboration with the department of
    35  financial services, shall convene a workgroup of individuals with exper-
    36  tise in rare diseases, including physicians,  nurses  and  other  health
    37  care  professionals  with experience researching, diagnosing or treating
    38  rare diseases; members of  the  scientific  community  engaged  in  rare
    39  disease  research;  representatives  from the health insurance industry;
    40  individuals who have a rare disease or caregivers of  a  person  with  a
    41  rare disease; and representatives of rare disease patient organizations.
    42  The  workgroup's focus shall include, but not be limited to: identifying
    43  best practices that could improve the awareness  of  rare  diseases  and
    44  referral of people with potential rare diseases to specialists and eval-
    45  uating  barriers to treatment, including financial barriers on access to
    46  care. The department of health shall prepare a written report  summariz-
    47  ing  opinions  and  recommendations  from the workgroup which includes a
    48  list of existing, publicly accessible resources on research,  diagnosis,
    49  treatment, coverage options and education relating to rare diseases. The
    50  workgroup  shall  convene no later than December twentieth, two thousand
    51  twenty-one and this report shall be submitted to the  governor,  speaker
    52  of  the  assembly  and  temporary  president of the senate no later than
    53  [three] four years following the effective date of this act and shall be
    54  posted on the department of health's website.
    55    § 3. This act shall take effect on the  same  date  and  in  the  same
    56  manner  as a chapter of the laws of 2019, amending the public health law

        S. 8007--C                         58                         A. 9007--C
 
     1  relating to establishing the rare disease advisory council, as  proposed
     2  in  legislative  bills  numbers  S. 4497 and A. 5762; provided, however,
     3  that the provisions of section two of  this  act  shall  expire  and  be
     4  deemed repealed [three] four years after such effective date.
     5    §  10.  Sections  5 and 6 of chapter 414 of the laws of 2018, creating
     6  the radon task force, as amended by section 1 of item M of subpart B  of
     7  part  XXX  of  chapter  58  of  the laws of 2020, are amended to read as
     8  follows:
     9    § 5. A report of the findings and recommendations of  the  task  force
    10  and  any proposed legislation necessary to implement such findings shall
    11  be filed with the governor, the temporary president of the  senate,  the
    12  speaker  of  the  assembly,  the  minority leader of the senate, and the
    13  minority leader of the assembly on or before November first,  two  thou-
    14  sand [twenty-one] twenty-two.
    15    §  6.  This  act shall take effect immediately and shall expire and be
    16  deemed repealed December 31, [2021] 2022.
    17    § 11. This act shall take effect immediately and shall  be  deemed  to
    18  have been in full force and effect on and after April 1, 2022; provided,
    19  however,  that  section  ten of this act shall be deemed to have been in
    20  full force and effect on and after  December  31,  2021;  and  provided,
    21  further,  that  the amendments to section 2 of chapter 74 of the laws of
    22  2020 made by section nine of this act and the amendments to section 5 of
    23  chapter 414 of the laws of 2018 made by section ten of this  act,  shall
    24  not  affect  the  repeal  of  such sections and shall be deemed repealed
    25  therewith.
 
    26                                   PART DD
 
    27    Section 1. 1. Subject to available appropriations and approval of  the
    28  director  of  the  budget,  the  commissioners  of  the office of mental
    29  health, office for people with  developmental  disabilities,  office  of
    30  addiction  services  and  supports,  office  of temporary and disability
    31  assistance, office of children and family services, and the state office
    32  for the aging shall establish a state fiscal year 2022-23 cost of living
    33  adjustment (COLA), effective April  1,  2022,  for  projecting  for  the
    34  effects  of  inflation  upon  rates of payments, contracts, or any other
    35  form of reimbursement for the programs and services listed in paragraphs
    36  (i), (ii), (iii), (iv), (v),  and  (vi)  of  subdivision  four  of  this
    37  section.   The COLA established herein shall be applied to the appropri-
    38  ate portion of reimbursable costs or contract amounts.  Where  appropri-
    39  ate,  transfers  to  the  department  of  health  (DOH) shall be made as
    40  reimbursement for the state share of medical assistance.
    41    2. Notwithstanding any inconsistent provision of law, subject  to  the
    42  approval  of  the  director  of  the budget and available appropriations
    43  therefore, for the period of April 1, 2022 through March 31,  2023,  the
    44  commissioners  shall  provide  funding to support a five and four-tenths
    45  percent (5.4%) cost of living adjustment  under  this  section  for  all
    46  eligible  programs  and  services  as determined pursuant to subdivision
    47  four of this section.
    48    3. Notwithstanding any inconsistent provision of law, and as  approved
    49  by the director of the budget, the 5.4 percent cost of living adjustment
    50  (COLA) established herein shall be inclusive of all other cost of living
    51  type  increases,  inflation  factors,  or  trend  factors that are newly
    52  applied effective April 1, 2022.   Except for the 5.4  percent  cost  of
    53  living  adjustment  (COLA) established herein, for the period commencing
    54  on April 1, 2022 and ending March 31, 2023 the commissioners  shall  not

        S. 8007--C                         59                         A. 9007--C
 
     1  apply any other new cost of living adjustments for the purpose of estab-
     2  lishing rates of payments, contracts or any other form of reimbursement.
     3  The  phrase "all other cost of living type increases, inflation factors,
     4  or  trend  factors"  as  defined  in  this subdivision shall not include
     5  payments made pursuant to the American Rescue Plan Act or other  federal
     6  relief  programs  related  to  the  Coronavirus  Disease 2019 (COVID-19)
     7  pandemic Public Health Emergency.
     8    4. Eligible programs and services. (i) Programs and  services  funded,
     9  licensed, or certified by the office of mental health (OMH) eligible for
    10  the  cost  of  living  adjustment  established  herein,  pending federal
    11  approval where applicable, include: office  of  mental  health  licensed
    12  outpatient programs, pursuant to parts 587 and 599 of title 14 CRR-NY of
    13  the office of mental health regulations including clinic, continuing day
    14  treatment,  day  treatment,  intensive  outpatient  programs and partial
    15  hospitalization;  outreach;  crisis  residence;  crisis   stabilization,
    16  crisis/respite  beds;  mobile crisis, part 590 comprehensive psychiatric
    17  emergency program  services;  crisis  intervention;  home  based  crisis
    18  intervention;  family  care;  supported single room occupancy; supported
    19  housing; supported housing  community  services;  treatment  congregate;
    20  supported   congregate;   community  residence  -  children  and  youth;
    21  treatment/apartment; supported  apartment;  community  residence  single
    22  room occupancy; on-site rehabilitation; employment programs; recreation;
    23  respite  care;  transportation;  psychosocial  club; assertive community
    24  treatment; case management; care  coordination,  including  health  home
    25  plus  services;  local  government  unit  administration; monitoring and
    26  evaluation; children and youth  vocational  services;  single  point  of
    27  access;  school-based mental health program; family support children and
    28  youth; advocacy/support services; drop  in  centers;  recovery  centers;
    29  transition management services; bridger; home and community based waiver
    30  services;  behavioral  health waiver services authorized pursuant to the
    31  section 1115 MRT waiver; self-help programs; consumer  service  dollars;
    32  conference  of local mental hygiene directors; multicultural initiative;
    33  ongoing integrated supported employment services;  supported  education;
    34  mentally   ill/chemical  abuse  (MICA)  network;  personalized  recovery
    35  oriented services; children and family treatment and  support  services;
    36  residential treatment facilities operating pursuant to part 584 of title
    37  14-NYCRR;   geriatric  demonstration  programs;  community-based  mental
    38  health family treatment  and  support;  coordinated  children's  service
    39  initiative; homeless services; and promises zone.
    40    (ii)  Programs  and  services  funded,  licensed,  or certified by the
    41  office for people with developmental disabilities (OPWDD)  eligible  for
    42  the  cost  of  living  adjustment  established  herein,  pending federal
    43  approval where applicable, include: local/unified services; chapter  620
    44  services;  voluntary operated community residential services; article 16
    45  clinics; day treatment  services;  family  support  services;  100%  day
    46  training;  epilepsy services; traumatic brain injury services; hepatitis
    47  B services;  independent  practitioner  services  for  individuals  with
    48  intellectual  and/or  developmental  disabilities;  crisis  services for
    49  individuals with intellectual and/or developmental disabilities;  family
    50  care  residential  habilitation;  supervised  residential  habilitation;
    51  supportive residential habilitation; respite; day habilitation; prevoca-
    52  tional services; supported employment; community habilitation;  interme-
    53  diate  care  facility  day and residential services; specialty hospital;
    54  pathways to employment; intensive behavioral services;  basic  home  and
    55  community  based  services  (HCBS)  plan  support;  health home services
    56  provided  by  care  coordination  organizations;  community   transition

        S. 8007--C                         60                         A. 9007--C
 
     1  services;  family  education  and training; fiscal intermediary; support
     2  broker; and personal resource accounts.
     3    (iii)  Programs  and  services  funded,  licensed, or certified by the
     4  office of addiction services and supports (OASAS) eligible for the  cost
     5  of  living adjustment established herein, pending federal approval where
     6  applicable, include: medically supervised withdrawal services - residen-
     7  tial; medically supervised withdrawal services -  outpatient;  medically
     8  managed  detoxification; medically monitored withdrawal; inpatient reha-
     9  bilitation services; outpatient  opioid  treatment;  residential  opioid
    10  treatment; KEEP units outpatient; residential opioid treatment to absti-
    11  nence;  problem  gambling  treatment;  medically  supervised outpatient;
    12  outpatient  rehabilitation;   specialized   services   substance   abuse
    13  programs;  home and community based waiver services pursuant to subdivi-
    14  sion 9 of section 366 of the social services law;  children  and  family
    15  treatment and support services; continuum of care rental assistance case
    16  management;  NY/NY  III  post-treatment  housing;  NY/NY III housing for
    17  persons at risk for homelessness;  permanent  supported  housing;  youth
    18  clubhouse;  recovery  community  centers;  recovery community organizing
    19  initiative; residential rehabilitation services for youth (RRSY); inten-
    20  sive residential; community residential; supportive living;  residential
    21  services;  job  placement  initiative;  case  management; family support
    22  navigator; local government unit administration; peer engagement;  voca-
    23  tional   rehabilitation;   support   services;  HIV  early  intervention
    24  services; dual diagnosis coordinator; problem gambling resource centers;
    25  problem  gambling  prevention;  prevention  resource  centers;   primary
    26  prevention services; other prevention services; and community services.
    27    (iv)  Programs  and  services  funded,  licensed,  or certified by the
    28  office of temporary and disability assistance (OTDA)  eligible  for  the
    29  cost  of  living adjustment established herein, pending federal approval
    30  where applicable, include:  nutrition  outreach  and  education  program
    31  (NOEP).
    32    (v) Programs and services funded, licensed, or certified by the office
    33  of  children  and family services (OCFS) eligible for the cost of living
    34  adjustment established herein, pending federal approval  where  applica-
    35  ble,  include:  programs  for  which  the  office of children and family
    36  services establishes maximum state aid rates pursuant to  section  398-a
    37  of  the social services law and section 4003 of the education law; emer-
    38  gency foster homes; foster family boarding homes and therapeutic  foster
    39  homes as defined by the regulations of the office of children and family
    40  services;  supervised  settings  as defined by subdivision twenty-two of
    41  section 371 of the  social  services  law;  adoptive  parents  receiving
    42  adoption subsidy pursuant to section 453 of the social services law; and
    43  congregate  and  scattered  supportive  housing  programs and supportive
    44  services provided under the NY/NY III supportive  housing  agreement  to
    45  young adults leaving or having recently left foster care.
    46    (vi) Programs and services funded, licensed, or certified by the state
    47  office  for  the aging (SOFA) eligible for the cost of living adjustment
    48  established herein, pending federal approval where applicable,  include:
    49  community  services  for  the elderly; expanded in-home services for the
    50  elderly; and supplemental nutrition assistance program.
    51    5. Each local government unit or direct  contract  provider  receiving
    52  funding  for  the  cost  of  living  adjustment established herein shall
    53  submit a written certification, in such form and at such  time  as  each
    54  commissioner  shall prescribe, attesting how such funding will be or was
    55  used to first promote the recruitment  and  retention  of  non-executive
    56  direct  care staff, non-executive direct support professionals, non-exe-

        S. 8007--C                         61                         A. 9007--C
 
     1  cutive clinical staff, or respond to other critical non-personal service
     2  costs prior to supporting any salary increases or other compensation for
     3  executive level job titles.
     4    6.  Notwithstanding any inconsistent provision of law to the contrary,
     5  agency commissioners shall be authorized to recoup funding from a  local
     6  governmental  unit  or  direct  contract provider for the cost of living
     7  adjustment established herein determined to have been used in  a  manner
     8  inconsistent  with  the  appropriation,  or  any other provision of this
     9  section. Such agency commissioners shall be  authorized  to  employ  any
    10  legal mechanism to recoup such funds, including an offset of other funds
    11  that are owed to such local governmental unit or direct contract provid-
    12  er.
    13    §  2.  This  act  shall take effect immediately and shall be deemed to
    14  have been in full force and effect on and after April 1, 2022.
 
    15                                   PART EE
 
    16    Section 1. Short title. This act shall be known and may  be  cited  as
    17  the "9-8-8 suicide prevention and behavioral health crisis hotline act".
    18    §  2.  The mental hygiene law is amended by adding a new section 36.03
    19  to read as follows:
    20  § 36.03 9-8-8 suicide prevention and behavioral  health  crisis  hotline
    21                  system.
    22    (a)  Definitions.  When  used in this article, the following words and
    23  phrases shall have the following meanings unless  the  specific  context
    24  clearly indicates otherwise:
    25    (1)  "9-8-8"  means  the  three  digit  phone number designated by the
    26  federal communications commission for the purpose of connecting individ-
    27  uals experiencing a behavioral health crisis with suicide prevention and
    28  behavioral health crisis counselors, mobile  crisis  teams,  and  crisis
    29  stabilization  services  and  other  behavioral  health  crises services
    30  through the national suicide prevention lifeline.
    31    (2) "9-8-8 crisis hotline center" means a state-identified and  funded
    32  center participating in the National Suicide Prevention Lifeline Network
    33  to respond to statewide or regional 9-8-8 calls.
    34    (3)  "Crisis  stabilization centers" means facilities providing short-
    35  term observation and crisis stabilization services jointly  licensed  by
    36  the  office  of  mental  health and the office of addiction services and
    37  supports under section 36.01 of this article.
    38    (4) "Crisis  residential  services"  means  a  short-term  residential
    39  program  designed to provide residential and support services to persons
    40  with symptoms of mental illness who are at risk  of  or  experiencing  a
    41  psychiatric crisis.
    42    (5)  "Crisis  intervention  services"  means  the continuum to address
    43  crisis intervention, crisis stabilization, and crisis residential treat-
    44  ment needs that are wellness, resiliency, and recovery oriented.  Crisis
    45  intervention  services  include but not limited to: crisis stabilization
    46  centers, mobile crisis teams, and crisis residential services.
    47    (6) "Behavioral health professional" shall mean any of the  following,
    48  but shall not be limited to:
    49    (i)  a  licensed  clinical  social  worker, licensed under article one
    50  hundred fifty-four of the education law;
    51    (ii) a licensed  psychologist,  licensed  under  article  one  hundred
    52  fifty-three of the education law;
    53    (iii)  a  registered  professional  nurse,  licensed under article one
    54  hundred thirty-nine of the education law;

        S. 8007--C                         62                         A. 9007--C
 
     1    (iv) a licensed master  social  worker,  licensed  under  article  one
     2  hundred  fifty-four  of  the  education  law, under the supervision of a
     3  physician, psychologist or licensed clinical social worker;
     4    (v)  a  licensed  mental  health counselor, licensed under article one
     5  hundred sixty-three of the education law; or
     6    (vi) a credentialed alcoholism and  substance  use  counselor  with  a
     7  valid  credential issued or approved by the office of addiction services
     8  and supports.
     9    (7) "Certified peer specialist" means an individual who  is  certified
    10  as  a  peer  in New York state from a certifying authority recognized by
    11  the commissioner of the office of mental health.
    12    (8) "Certified recovery peer advocate" means an individual who holds a
    13  certification issued by an entity approved and recognized by the commis-
    14  sioner of the office of addiction services and supports.
    15    (9) "Credentialed family peer advocate" means  an  individual  who  is
    16  credentialed  as  a  peer  in New York state from a certifying authority
    17  recognized by the commissioner of the office of  mental  health  or  the
    18  commissioner of the office of addiction services and supports.
    19    (10)  "Credentialed  youth  peer  advocate" means an individual who is
    20  credentialed as a peer in New York state  from  a  certifying  authority
    21  recognized  by  the  commissioner  of the office of mental health or the
    22  commissioner of the office of addiction services and supports.
    23    (11) "Mobile crisis  teams"  means  a  team  licensed,  certified,  or
    24  authorized  by  the  office of mental health and the office of addiction
    25  services and  supports  to  provide  community-based  mental  health  or
    26  substance  use disorder interventions for individuals who are experienc-
    27  ing a mental health or substance use disorder  crisis.    Members  of  a
    28  mobile crisis team may include, but not be limited to: behavioral health
    29  professionals, certified peer specialists, certified recovery peer advo-
    30  cates,  credentialed  family peer advocates, and credentialed youth peer
    31  advocates.
    32    (12) "National  suicide  prevention  lifeline"  or  "NSPL"  means  the
    33  national network of local crisis centers that provide free and confiden-
    34  tial  emotional  support  to  people  in  suicidal  crisis  or emotional
    35  distress twenty-four hours a day, seven days  a  week  via  a  toll-free
    36  hotline  number, which receives calls made through the 9-8-8 system. The
    37  toll-free number is maintained by the  Assistant  Secretary  for  Mental
    38  Health  and  Substance  Use  under  Section  50-E-3 of the Public Health
    39  Service Act, Section 290bb-36c of Title 42 of the United States Code.
    40    (b) The commissioner of the office of mental  health,  in  conjunction
    41  with  the commissioner of the office of addiction services and supports,
    42  shall have joint oversight of the 9-8-8 suicide  prevention  and  behav-
    43  ioral  health crisis hotline and shall work in concert with NSPL for the
    44  purposes of ensuring consistency of public messaging.
    45    (c) The commissioner of the office of mental  health,  in  conjunction
    46  with  the commissioner of the office of addiction services and supports,
    47  shall, on or before July sixteenth, two thousand twenty-two, designate a
    48  crisis hotline center or centers to provide or arrange for crisis inter-
    49  vention services to individuals accessing the 9-8-8  suicide  prevention
    50  and  behavioral  health  crisis  hotline  from anywhere within the state
    51  twenty-four hours a day, seven days a week. Each  9-8-8  crisis  hotline
    52  center shall do all of the following:
    53    (1)  A  designated  hotline center shall have an active agreement with
    54  the administrator  of  the  National  Suicide  Prevention  Lifeline  for
    55  participation within the network.

        S. 8007--C                         63                         A. 9007--C

     1    (2)  A designated hotline center shall meet NSPL requirements and best
     2  practices guidelines for operation and clinical standards.
     3    (3)  A designated hotline center may utilize technology, including but
     4  not limited to, chat and text that is interoperable between  and  across
     5  the 9-8-8 suicide prevention and behavioral health crisis hotline system
     6  and the administrator of the National Suicide Prevention Lifeline.
     7    (4)  A  designated  hotline  center shall accept transfers of any call
     8  from 9-1-1 pertaining to a behavioral health crisis.
     9    (5) A designated hotline center shall ensure coordination between  the
    10  9-8-8  crisis hotline centers, 9-1-1, behavioral health crisis services,
    11  and, when appropriate, other specialty behavioral health warm lines  and
    12  hotlines  and  other emergency services.  If a law enforcement, medical,
    13  or fire response is also needed, 9-8-8 and 9-1-1 operators shall coordi-
    14  nate the simultaneous deployment of those services  with  mobile  crisis
    15  services.
    16    (6)  A  designated  hotline  center shall have the authority to deploy
    17  crisis intervention services, including but not limited to mobile crisis
    18  teams, and coordinate access to crisis stabilization centers, and  other
    19  crisis  intervention  services,  as appropriate, and according to guide-
    20  lines and best practices established by New York State and the NSPL.
    21    (7) A designated hotline center shall meet the requirements set  forth
    22  by  New  York  State  and the NSPL for serving high risk and specialized
    23  populations including but  not  limited  to:  Black,  African  American,
    24  Hispanic,  Latino,  Asian,  Pacific  Islander,  Native American, Alaskan
    25  Native; lesbian, gay, bisexual, transgender, nonbinary, queer, and ques-
    26  tioning individuals; veterans; members of rural communities; individuals
    27  with intellectual and developmental disabilities; individuals experienc-
    28  ing homelessness or housing instability; immigrants and refugees;  chil-
    29  dren and youth; older adults; and religious communities as identified by
    30  the  federal  Substance Abuse and Mental Health Services Administration,
    31  including training requirements  and  policies  for  providing  linguis-
    32  tically and culturally competent care.
    33    (8)  A  designated  hotline center shall provide follow-up services as
    34  needed to individuals accessing the 9-8-8 suicide prevention and  behav-
    35  ioral health crisis hotline consistent with guidance and policies estab-
    36  lished by New York State and the NSPL.
    37    (9)  A  designated hotline center shall provide data, and reports, and
    38  participate  in  evaluations  and  quality  improvement  activities   as
    39  required  by  the  office  of  mental health and the office of addiction
    40  services and supports.
    41    (d) The commissioner of the office of mental  health,  in  conjunction
    42  with  the commissioner of the office of addiction services and supports,
    43  shall establish a comprehensive list of reporting metrics regarding  the
    44  9-8-8  suicide  prevention and behavioral health crisis hotline's usage,
    45  services and impact which, to  the  maximum  extent  practicable,  shall
    46  include, at a minimum:
    47    (1)  The  volume  of  requests  for  assistance that the 9-8-8 suicide
    48  prevention and behavioral health crisis hotline received;
    49    (2) The average length of time taken to respond to  each  request  for
    50  assistance, and the aggregate rates of call abandonment;
    51    (3)  The  types  of  requests  for  assistance  that the 9-8-8 suicide
    52  prevention and behavioral health crisis hotline received;
    53    (4) The number of mobile crisis teams dispatched;
    54    (5) The number of individuals engaged by mobile crisis teams;
    55    (6) The number of individuals transported by mobile  crisis  teams  to
    56  crisis intervention services or other behavioral health crisis services;

        S. 8007--C                         64                         A. 9007--C
 
     1    (7)  The  number  of individuals engaged by mobile crisis teams trans-
     2  ported to an emergency room;
     3    (8)  The  number  of individuals transferred by mobile crisis teams to
     4  the custody of law enforcement;
     5    (9) The number of times a mobile crisis team was the  first  responder
     6  to  a behavioral health crisis and the mobile crisis team had to request
     7  deployment of law enforcement; and
     8    (10) The age, gender,  race,  and  ethnicity  of  the  individual,  if
     9  reasonably  ascertainable,  of  individuals  contacted,  transported, or
    10  transferred by each mobile crisis team.
    11    (e) The commissioner of the office of mental  health,  in  conjunction
    12  with  the commissioner of the office of addiction services and supports,
    13  shall submit an annual report on or by December thirty-first, two  thou-
    14  sand  twenty-three  and annually thereafter, regarding the comprehensive
    15  list of reporting metrics to the governor, the  temporary  president  of
    16  the  senate,  the  speaker  of  the assembly, the minority leader of the
    17  senate and the minority leader of the assembly.
    18    (f) Moneys allocated for the payment of costs determined in  consulta-
    19  tion with the commissioners of mental health and the office of addiction
    20  services  and  supports  associated  with  the  administration,  design,
    21  installation, construction, operation, or maintenance of a 9-8-8 suicide
    22  prevention and behavioral  health  crisis  hotline  system  serving  the
    23  state,  including,  but  not limited to:   staffing, hardware, software,
    24  consultants, financing and other administrative costs to operate  crisis
    25  call-centers  throughout the state and the provision of acute and crisis
    26  services for mental  health  and  substance  use  disorder  by  directly
    27  responding  to  the  9-8-8  hotline established pursuant to the National
    28  Suicide Hotline Designation Act of 2020 (47 U.S.C.  §  251a)  and  rules
    29  adopted  by  the Federal Communications Commission, including such costs
    30  incurred by the state, shall not supplant any separate existing,  future
    31  appropriations,  or future funding sources dedicated to the 9-8-8 crisis
    32  response system.
    33    § 3. This act shall take effect immediately.
 
    34                                   PART FF
 
    35    Section 1. Subdivision 5 of section 365-m of the social services  law,
    36  as  added  by section 11 of part C of chapter 60 of the laws of 2014, is
    37  amended to read as follows:
    38    5. (a) Pursuant to appropriations within the offices of mental  health
    39  or addiction services and supports, the department of health shall rein-
    40  vest  [funds allocated for behavioral health services, which are general
    41  fund savings directly related to] savings realized through  the  transi-
    42  tion of populations covered by this section from the applicable Medicaid
    43  fee-for-service  system  to  a  managed  care  model,  including savings
    44  [resulting from the reduction of  inpatient  and  outpatient  behavioral
    45  health  services provided under the Medicaid programs licensed or certi-
    46  fied pursuant to article thirty-one or thirty-two of the mental  hygiene
    47  law,  or  programs that are licensed pursuant to both article thirty-one
    48  of the mental hygiene law and article twenty-eight of the public  health
    49  law,  or  certified  under both article thirty-two of the mental hygiene
    50  law and article twenty-eight of the public health law] realized  through
    51  the  recovery  of premiums from managed care providers which represent a
    52  reduction of spending on qualifying behavioral health  services  against
    53  established  premium  targets  for  behavioral  health  services and the
    54  medical loss ratio applicable to special needs managed care  plans,  for

        S. 8007--C                         65                         A. 9007--C
 
     1  the  purpose  of  increasing  investment  in  community based behavioral
     2  health services, including residential services certified by the  office
     3  of  [alcoholism  and  substance  abuse] addiction services and supports.
     4  The  methodologies  used  to calculate the savings shall be developed by
     5  the commissioner of health and the director of the budget  in  consulta-
     6  tion  with  the  commissioners  of  the  office of mental health and the
     7  office of  [alcoholism  and  substance  abuse]  addiction  services  and
     8  supports.  In  no  event  shall  the full annual value of the [community
     9  based behavioral health service] reinvestment [savings  attributable  to
    10  the  transition to managed care] pursuant to this subdivision exceed the
    11  [twelve month value of the department of health general fund  reductions
    12  resulting  from  such  transition]  value of the premiums recovered from
    13  managed care providers which represent a reduction of spending on quali-
    14  fying behavioral health services. Within any fiscal year where appropri-
    15  ation increases are recommended for  reinvestment,  insofar  as  managed
    16  care  transition  savings  do  not occur as estimated, [and general fund
    17  savings do not result,] then  spending  for  such  reinvestment  may  be
    18  reduced  in the next year's annual budget itemization. [The commissioner
    19  of health shall promulgate regulations, and prior to October first,  two
    20  thousand  fifteen,  may  promulgate emergency regulations as required to
    21  distribute funds pursuant to this subdivision; provided,  however,  that
    22  any  emergency  regulations  promulgated  pursuant to this section shall
    23  expire no later than December thirty-first, two thousand fifteen.]
    24    (b) Beginning April first, two  thousand  twenty-two,  the  department
    25  shall  post  on  its  website information about the recovery of premiums
    26  from managed care providers which represent a reduction of  spending  on
    27  qualifying   behavioral  health  services  against  established  premium
    28  targets for behavioral health services and the medical loss ratio appli-
    29  cable to special  needs  managed  care  plans.  Such  information  shall
    30  include  at  a  minimum:  (i) a copy of the department's notification to
    31  each managed care provider that seeks a recovery of such  premiums;  and
    32  (ii)  a list of managed care providers by name that have been subject to
    33  a recovery of such premiums, specifying the amount of premium  that  has
    34  been  recovered from each managed care provider and year. In the initial
    35  posting, the department shall include all premiums recovered to date  as
    36  required by this subdivision, by named managed care provider, amount and
    37  year.
    38    (c) The commissioner shall include [detailed descriptions of the meth-
    39  odology  used  to  calculate  savings]  information  regarding the funds
    40  available for reinvestment[, the results of applying such methodologies,
    41  the details regarding implementation of  such  reinvestment],  including
    42  how  savings are calculated and how the reinvestment was utilized pursu-
    43  ant to this section[, and any regulations promulgated under this  subdi-
    44  vision,]  in  the  annual  report required under section forty-five-c of
    45  part A of chapter fifty-six of the laws of two thousand thirteen.
    46    § 2. This act shall take effect immediately.
 
    47                                   PART GG
 
    48    Section 1. Section 7 of part H of chapter 57  of  the  laws  of  2019,
    49  amending  the  public  health  law  relating  to waiver of certain regu-
    50  lations, as amended by section 7 of part S of chapter 57 of the laws  of
    51  2021, is amended to read as follows:
    52    §  7.  This  act  shall take effect immediately and shall be deemed to
    53  have been in full force and effect on and after April 1, 2019, provided,

        S. 8007--C                         66                         A. 9007--C
 
     1  however, that section two of this act shall expire on  April  1,  [2022]
     2  2024.
     3    §  2.  This  act  shall take effect immediately and shall be deemed to
     4  have been in full force and effect on and after April 1, 2022.
 
     5                                   PART HH
 
     6                            Intentionally Omitted
 
     7                                   PART II
 
     8    Section 1. Subdivision 38 of section 1.03 of the mental  hygiene  law,
     9  as  amended  by  chapter  281  of the laws of 2019, is amended and a new
    10  subdivision 59 is added to read as follows:
    11    38. "Residential services facility"  or  "Alcoholism  community  resi-
    12  dence" means any facility licensed or operated pursuant to article thir-
    13  ty-two  of  this  chapter  which  provides  residential services for the
    14  treatment of an addiction disorder and a homelike environment, including
    15  room, board and responsible supervision as part of  an  overall  service
    16  delivery  system.  Provided  however,  "certified recovery residence" as
    17  defined in subdivision fifty-nine of this section shall not  be  consid-
    18  ered a residential services facility for the purposes of this chapter.
    19    59.  "Certified  recovery residence" means a shared living environment
    20  in the state that has been certified by the office of addiction services
    21  and supports and utilizes connection to services  to  promote  sustained
    22  recovery from a substance use disorder.
    23    §  2.  Subdivision  (a)  of section 32.05 of the mental hygiene law is
    24  amended by adding a new paragraph 1-a to read as follows:
    25    1-a. operation of a certified recovery residence  in  accordance  with
    26  section  32.05-a of this article for the promotion of sustained recovery
    27  of persons suffering from a substance use disorder;
    28    § 3. The mental hygiene law is amended by adding a new section 32.05-a
    29  to read as follows:
    30  § 32.05-a Certified recovery residences.
    31    1. The commissioner shall promulgate regulations consistent with  this
    32  section  for  the  voluntary  certification  of certified recovery resi-
    33  dences.
    34    2. Such regulations shall  be  evidence-based,  utilizing  information
    35  from sources with expertise in treatment and recovery.  Such regulations
    36  shall, at a minimum, provide guidance for:
    37    (a) staffing;
    38    (b)  referrals  to  and  coordination  with  community  and peer based
    39  supports including support related to co-occurring disorders;
    40    (c) resident safety;
    41    (d) resident rights;
    42    (e) confidentiality;
    43    (f) reoccurance support;
    44    (g) application of tenants rights;
    45    (h) administrative and operational policies and procedures; and
    46    (i) housing standards which shall meet or exceed the  housing  quality
    47  standards  for  safe and habitual housing which are established by local
    48  housing codes.
    49    3. Once the commissioner has  certified  a  location  as  a  certified
    50  recovery  residence, such certified recovery residence shall be included

        S. 8007--C                         67                         A. 9007--C
 
     1  on the office's website as an available option for  individuals  seeking
     2  such an environment.
     3    4.  The  commissioner  shall regulate and ensure that residences which
     4  are certified to be certified recovery residences are continuing to meet
     5  the requirements of this section. The commissioner has the authority  to
     6  inspect such certified recovery residences and impose penalties, includ-
     7  ing  limiting,  revoking  or suspending a certification, as appropriate,
     8  for failure to comply with the provisions of this section.
     9    § 4. Subdivisions 1, 2 and 3 of section 32.06 of  the  mental  hygiene
    10  law, as added by chapter 223 of the laws of 2018, are amended to read as
    11  follows:
    12    1.  For  purposes of this section, unless the context clearly requires
    13  otherwise, "provider" shall mean any person, firm,  partnership,  group,
    14  practice association, fiduciary, employer, representative thereof or any
    15  other  entity  who  is  providing or purporting to provide substance use
    16  disorder services or operating or  purporting  to  operate  a  certified
    17  recovery  residence.    Provided,  however,  that  "provider"  shall not
    18  include a person receiving substance  use  disorder  services  from  the
    19  provider.
    20    2.  No  provider shall intentionally solicit, receive, accept or agree
    21  to receive or accept any payment, benefit or other consideration in  any
    22  form to the extent such payment, benefit or other consideration is given
    23  for  the  referral  of a person as a potential patient for substance use
    24  disorder services or as a resident at a certified recovery residence.
    25    3. No provider providing or purporting to provide substance use disor-
    26  der services or operating or purporting to operate a certified  recovery
    27  residence  pursuant  to  this  chapter, shall intentionally make, offer,
    28  give, or agree to make, offer, or give any  payment,  benefit  or  other
    29  consideration  in  any form to the extent such payment, benefit or other
    30  consideration is given for the referral  of  a  person  as  a  potential
    31  patient for substance use disorder services.
    32    § 5. This act shall take effect on the one hundred eightieth day after
    33  it  shall have become a law. Effective immediately, the addition, amend-
    34  ment and/or repeal of any rule or regulation necessary for the implemen-
    35  tation of this act on its effective date are authorized to be  made  and
    36  completed on or before such effective date.
 
    37                                   PART JJ
 
    38                            Intentionally Omitted
 
    39                                   PART KK
 
    40                            Intentionally Omitted

    41                                   PART LL
 
    42    Section  1.  Section  48-a of part A of chapter 56 of the laws of 2013
    43  amending the public health law and other laws relating to general hospi-
    44  tal reimbursement for annual rates, as amended by section 18 of  part  E
    45  of chapter 57 of the laws of 2019, is amended to read as follows:
    46    §  48-a. 1. Notwithstanding any contrary provision of law, the commis-
    47  sioners of the office of  [alcoholism  and  substance  abuse]  addiction
    48  services  and  supports  and the office of mental health are authorized,

        S. 8007--C                         68                         A. 9007--C
 
     1  subject to the approval of the director of the budget,  to  transfer  to
     2  the commissioner of health state funds to be utilized as the state share
     3  for  the  purpose  of  increasing payments under the medicaid program to
     4  managed  care  organizations  licensed  under  article  44 of the public
     5  health law or under article 43 of the insurance law. Such  managed  care
     6  organizations  shall  utilize  such funds for the purpose of reimbursing
     7  providers licensed pursuant to article 28 of the public  health  law  or
     8  article 36, 31 or 32 of the mental hygiene law for ambulatory behavioral
     9  health services, as determined by the commissioner of health, in consul-
    10  tation  with  the  commissioner  of  [alcoholism  and  substance  abuse]
    11  addiction services and supports and the commissioner of  the  office  of
    12  mental  health,  provided  to  medicaid enrolled outpatients and for all
    13  other behavioral health services except inpatient included in  New  York
    14  state's  Medicaid  redesign  waiver approved by the centers for medicare
    15  and Medicaid services (CMS).  Such reimbursement shall be in the form of
    16  fees for such services which are equivalent to the payments  established
    17  for  such services under the ambulatory patient group (APG) rate-setting
    18  methodology as utilized by the  department  of  health,  the  office  of
    19  [alcoholism and substance abuse] addiction services and supports, or the
    20  office of mental health for rate-setting purposes or any such other fees
    21  pursuant  to the Medicaid state plan or otherwise approved by CMS in the
    22  Medicaid redesign waiver; provided, however, that the increase  to  such
    23  fees that shall result from the provisions of this section shall not, in
    24  the  aggregate  and  as  determined  by  the  commissioner of health, in
    25  consultation with the commissioner of [alcoholism and  substance  abuse]
    26  addiction  services  and  supports and the commissioner of the office of
    27  mental health, be greater than the increased funds made available pursu-
    28  ant to this section.  The increase of such ambulatory behavioral  health
    29  fees  to  providers  available  under this section shall be for all rate
    30  periods on and after the effective date of section [1] 18 of part [P]  E
    31  of  chapter  57 of the laws of [2017] 2019 through March 31, [2023] 2027
    32  for patients in the city of New York, for all rate periods on and  after
    33  the  effective date of section [1] 18 of part [P] E of chapter 57 of the
    34  laws of [2017] 2019 through March 31, [2023] 2027 for  patients  outside
    35  the  city  of New York, and for all rate periods on and after the effec-
    36  tive date of such chapter through March 31, [2023] 2027 for all services
    37  provided to persons under the age of twenty-one; provided, however,  the
    38  commissioner  of health, in consultation with the commissioner of [alco-
    39  holism and substance abuse] addiction  services  and  supports  and  the
    40  commissioner  of  mental health, may require, as a condition of approval
    41  of such ambulatory behavioral health fees, that aggregate  managed  care
    42  expenditures  to eligible providers meet the alternative payment method-
    43  ology requirements as set forth in attachment I of the  New  York  state
    44  medicaid section one thousand one hundred fifteen medicaid redesign team
    45  waiver  as  approved  by the centers for medicare and medicaid services.
    46  The commissioner of health shall, in consultation with the  commissioner
    47  of  [alcoholism and substance abuse] addiction services and supports and
    48  the commissioner of mental health, waive such conditions if a sufficient
    49  number of providers, as determined by the commissioner, suffer a  finan-
    50  cial  hardship  as a consequence of such alternative payment methodology
    51  requirements, or if he or she  shall  determine  that  such  alternative
    52  payment methodologies significantly threaten individuals access to ambu-
    53  latory  behavioral  health  services.    Such waiver may be applied on a
    54  provider specific or industry wide basis. Further, such  conditions  may
    55  be  waived,  as  the  commissioner  determines necessary, to comply with
    56  federal rules or  regulations  governing  these  payment  methodologies.

        S. 8007--C                         69                         A. 9007--C
 
     1  Nothing  in  this  section shall prohibit managed care organizations and
     2  providers from negotiating different rates and methods of payment during
     3  such periods described above, subject to the approval of the  department
     4  of  health.  The  department  of health shall consult with the office of
     5  [alcoholism and substance abuse] addiction services and supports and the
     6  office of mental health in determining whether  such  alternative  rates
     7  shall  be approved. The commissioner of health may, in consultation with
     8  the commissioner of [alcoholism and substance abuse] addiction  services
     9  and  supports  and  the  commissioner  of  the  office of mental health,
    10  promulgate  regulations,  including  emergency  regulations  promulgated
    11  prior  to  October  1, 2015 to establish rates for ambulatory behavioral
    12  health services, as are necessary to implement the  provisions  of  this
    13  section.  Rates  promulgated under this section shall be included in the
    14  report required under section 45-c of part A of this chapter.
    15    2. Notwithstanding any contrary provision of law,  the  fees  paid  by
    16  managed  care  organizations  licensed  under  article  44 of the public
    17  health law or under article  43  of  the  insurance  law,  to  providers
    18  licensed  pursuant to article 28 of the public health law or article 36,
    19  31 or 32 of the mental hygiene law,  for  ambulatory  behavioral  health
    20  services  provided  to  patients  enrolled in the child health insurance
    21  program pursuant to title 1-A of article 25 of the  public  health  law,
    22  shall  be  in the form of fees for such services which are equivalent to
    23  the payments established for such services under the ambulatory  patient
    24  group  (APG) rate-setting methodology or any such other fees established
    25  pursuant to the Medicaid state plan. The commissioner  of  health  shall
    26  consult  with  the  commissioner  of  [alcoholism  and  substance abuse]
    27  addiction services and supports and the commissioner of  the  office  of
    28  mental  health  in determining such services and establishing such fees.
    29  Such ambulatory behavioral health fees to providers available under this
    30  section shall be for all rate periods on and after the effective date of
    31  this chapter through March 31,  [2023]  2027,  provided,  however,  that
    32  managed  care  organizations and providers may negotiate different rates
    33  and methods of payment during such periods described above,  subject  to
    34  the  approval  of  the  department of health.   The department of health
    35  shall consult with  the  office  of  [alcoholism  and  substance  abuse]
    36  addiction  services  and  supports  and  the  office of mental health in
    37  determining whether such alternative  rates  shall  be  approved.    The
    38  report  required  under section 16-a of part C of chapter 60 of the laws
    39  of 2014 shall also include the population of patients  enrolled  in  the
    40  child  health  insurance  program pursuant to title 1-A of article 25 of
    41  the public health law in its examination on the transition of behavioral
    42  health services into managed care.
    43    § 2. Section 1 of part H of chapter 111 of the laws of  2010  relating
    44  to increasing Medicaid payments to providers through managed care organ-
    45  izations  and  providing  equivalent  fees through an ambulatory patient
    46  group methodology, as amended by section 19 of part E of chapter  57  of
    47  the laws of 2019, is amended to read as follows:
    48    Section  1.  a.  Notwithstanding  any  contrary  provision of law, the
    49  commissioners of mental health  and  [alcoholism  and  substance  abuse]
    50  addiction  services and supports are authorized, subject to the approval
    51  of the director of the budget, to transfer to the commissioner of health
    52  state funds to be utilized  as  the  state  share  for  the  purpose  of
    53  increasing payments under the medicaid program to managed care organiza-
    54  tions  licensed under article 44 of the public health law or under arti-
    55  cle 43 of the insurance  law.  Such  managed  care  organizations  shall
    56  utilize  such  funds  for  the purpose of reimbursing providers licensed

        S. 8007--C                         70                         A. 9007--C
 
     1  pursuant to article 28 of the public health law, or pursuant to  article
     2  36, 31 or article 32 of the mental hygiene law for ambulatory behavioral
     3  health  services, as determined by the commissioner of health in consul-
     4  tation with the commissioner of mental health and commissioner of [alco-
     5  holism and substance abuse] addiction services and supports, provided to
     6  medicaid  enrolled  outpatients  and  for  all  other  behavioral health
     7  services except inpatient included in New York state's Medicaid redesign
     8  waiver approved by the centers for medicare and Medicaid services (CMS).
     9  Such reimbursement shall be in the form of fees for such services  which
    10  are  equivalent  to the payments established for such services under the
    11  ambulatory patient group (APG) rate-setting methodology as  utilized  by
    12  the  department of health or by the office of mental health or office of
    13  [alcoholism and substance abuse] addiction  services  and  supports  for
    14  rate-setting  purposes  or  any such other fees pursuant to the Medicaid
    15  state plan or otherwise approved by CMS in the Medicaid redesign waiver;
    16  provided, however, that the increase to such fees that shall result from
    17  the provisions of this section shall not, in the aggregate and as deter-
    18  mined by the commissioner of health in consultation with the commission-
    19  ers of mental health and  [alcoholism  and  substance  abuse]  addiction
    20  services  and  supports, be greater than the increased funds made avail-
    21  able pursuant to this section. The increase of  such  behavioral  health
    22  fees  to  providers  available  under this section shall be for all rate
    23  periods on and after the effective date of section [2] 19 of part [P]  E
    24  of  chapter  57 of the laws of [2017] 2019 through March 31, [2023] 2027
    25  for patients in the city of New York, for all rate periods on and  after
    26  the  effective date of section [2] 19 of part [P] E of chapter 57 of the
    27  laws of [2017] 2019 through March 31, [2023] 2027 for  patients  outside
    28  the  city  of New York, and for all rate periods on and after the effec-
    29  tive date of section [2] 19 of part [P] E of chapter 57 of the  laws  of
    30  [2017]  2019  through March 31, [2023] 2027 for all services provided to
    31  persons under the age of twenty-one; provided, however, the commissioner
    32  of health, in consultation with  the  commissioner  of  [alcoholism  and
    33  substance abuse] addiction services and supports and the commissioner of
    34  mental health, may require, as a condition of approval of such ambulato-
    35  ry  behavioral  health fees, that aggregate managed care expenditures to
    36  eligible providers meet the alternative payment methodology requirements
    37  as set forth in attachment I of the New York state medicaid section  one
    38  thousand  one  hundred fifteen medicaid redesign team waiver as approved
    39  by the centers for medicare and medicaid services. The  commissioner  of
    40  health  shall,  in consultation with the commissioner of [alcoholism and
    41  substance abuse] addiction services and supports and the commissioner of
    42  mental health, waive such conditions if a sufficient number  of  provid-
    43  ers, as determined by the commissioner, suffer a financial hardship as a
    44  consequence  of such alternative payment methodology requirements, or if
    45  he or she shall determine that such  alternative  payment  methodologies
    46  significantly  threaten  individuals  access  to  ambulatory  behavioral
    47  health services.  Such waiver may be applied on a provider  specific  or
    48  industry  wide  basis.  Further,  such  conditions may be waived, as the
    49  commissioner determines necessary, to comply with federal rules or regu-
    50  lations governing these payment methodologies. Nothing in  this  section
    51  shall prohibit managed care organizations and providers from negotiating
    52  different  rates  and  methods of payment during such periods described,
    53  subject to the approval of the department of health. The  department  of
    54  health shall consult with the office of [alcoholism and substance abuse]
    55  addiction  services  and  supports  and  the  office of mental health in
    56  determining whether  such  alternative  rates  shall  be  approved.  The

        S. 8007--C                         71                         A. 9007--C
 
     1  commissioner  of  health  may, in consultation with the commissioners of
     2  mental health and [alcoholism and substance  abuse]  addiction  services
     3  and  supports,  promulgate  regulations, including emergency regulations
     4  promulgated prior to October 1, 2013 that establish rates for behavioral
     5  health  services,  as  are necessary to implement the provisions of this
     6  section. Rates promulgated under this section shall be included  in  the
     7  report  required  under section 45-c of part A of chapter 56 of the laws
     8  of 2013.
     9    b. Notwithstanding any contrary provision of law,  the  fees  paid  by
    10  managed  care  organizations  licensed  under  article  44 of the public
    11  health law or under article  43  of  the  insurance  law,  to  providers
    12  licensed  pursuant to article 28 of the public health law or article 36,
    13  31 or 32 of the mental hygiene law,  for  ambulatory  behavioral  health
    14  services  provided  to  patients  enrolled in the child health insurance
    15  program pursuant to title 1-A of article 25 of the  public  health  law,
    16  shall  be  in the form of fees for such services which are equivalent to
    17  the payments established for such services under the ambulatory  patient
    18  group  (APG)  rate-setting methodology. The commissioner of health shall
    19  consult with  the  commissioner  of  [alcoholism  and  substance  abuse]
    20  addiction  services  and  supports and the commissioner of the office of
    21  mental health in determining such services and establishing  such  fees.
    22  Such ambulatory behavioral health fees to providers available under this
    23  section shall be for all rate periods on and after the effective date of
    24  this  chapter  through  March  31,  [2023] 2027, provided, however, that
    25  managed care organizations and providers may negotiate  different  rates
    26  and  methods  of payment during such periods described above, subject to
    27  the approval of the department of health. The department of health shall
    28  consult with the office of [alcoholism and  substance  abuse]  addiction
    29  services  and  supports  and  the office of mental health in determining
    30  whether such alternative rates shall be approved.   The report  required
    31  under  section  16-a  of  part C of chapter 60 of the laws of 2014 shall
    32  also include the population of patients enrolled  in  the  child  health
    33  insurance  program  pursuant  to  title  1-A of article 25 of the public
    34  health law in its examination on the  transition  of  behavioral  health
    35  services into managed care.
    36    §  3. Section 2 of part H of chapter 111 of the laws of 2010, relating
    37  to increasing Medicaid payments to providers through managed care organ-
    38  izations and providing equivalent fees  through  an  ambulatory  patient
    39  group  methodology,  as amended by section 20 of part E of chapter 57 of
    40  the laws of 2019, is amended to read as follows:
    41    § 2. This act shall take effect immediately and  shall  be  deemed  to
    42  have been in full force and effect on and after April 1, 2010, and shall
    43  expire on March 31, [2023] 2027.
    44    §  4.  This  act shall take effect immediately; provided, however that
    45  the amendments to section 1 of part H of chapter  111  of  the  laws  of
    46  2010,  relating  to  increasing  Medicaid  payments to providers through
    47  managed care organizations and  providing  equivalent  fees  through  an
    48  ambulatory  patient  group  methodology, made by section two of this act
    49  shall not affect the expiration of such section and shall expire  there-
    50  with.
 
    51                                   PART MM
 
    52                            Intentionally Omitted

        S. 8007--C                         72                         A. 9007--C
 
     1                                   PART NN
 
     2    Section  1.  Section  41.38  of  the mental hygiene law, as amended by
     3  chapter 218 of the laws of 1988, is amended to read as follows:
     4  § 41.38 Rental and mortgage payments of community residential facilities
     5            for the mentally ill.
     6    (a) "Supportive housing" shall mean, for the purpose of  this  section
     7  only,  the  method by which the commissioner contracts to provide rental
     8  support and funding for non-clinical support services in order to  main-
     9  tain recipient stability.
    10    (b)  Notwithstanding  any  inconsistent provision of this article, the
    11  commissioner may reimburse voluntary agencies for the reasonable cost of
    12  rental of or the reasonable mortgage payment or the reasonable principal
    13  and interest payment on a loan for the purpose of financing an ownership
    14  interest in, and proprietary lease from, an organization formed for  the
    15  purpose of the cooperative ownership of real estate, together with other
    16  necessary  costs  associated with rental or ownership of property, for a
    17  community residence [or], a  residential  care  center  for  adults,  or
    18  supportive  housing,  under  [his]  their  jurisdiction  less any income
    19  received from a state or federal agency or third party insurer which  is
    20  specifically  intended  to  offset the cost of rental of the facility or
    21  housing a client at the facility, subject to the availability of  appro-
    22  priations  therefor and such commissioner's certification of the reason-
    23  ableness of the rental cost, mortgage payment,  principal  and  interest
    24  payment  on  a loan as provided in this section or other necessary costs
    25  associated with rental or ownership of property, with  the  approval  of
    26  the director of the budget.
    27    § 2. This act shall take effect April 1, 2022.
 
    28                                   PART OO
 
    29    Section  1.  Section  4  of  part L of chapter 59 of the laws of 2016,
    30  amending the mental hygiene law relating to the appointment of temporary
    31  operators for the continued operation of programs and the  provision  of
    32  services  for  persons  with serious mental illness and/or developmental
    33  disabilities and/or chemical dependence, as amended by section 1 of part
    34  U of chapter 57 of the laws of 2021, is amended to read as follows:
    35    § 4. This act shall take effect immediately and  shall  be  deemed  to
    36  have been in full force and effect on and after April 1, 2016; provided,
    37  however,  that  sections  one  and  two  of this act shall expire and be
    38  deemed repealed on March 31, [2022] 2025.
    39    § 2. This act shall take effect immediately.
 
    40                                   PART PP
 
    41    Section 1. Subdivision 4 of section 365-f of the social  services  law
    42  is REPEALED.
    43    §  2.  The  opening  paragraph of subparagraph (i) of paragraph (a) of
    44  subdivision 4-a of section 365-f of the social services law, as  amended
    45  by  section 3 of part G of chapter 57 of the laws of 2019, is amended to
    46  read as follows:
    47    "Fiscal intermediary" means an entity that  provides  fiscal  interme-
    48  diary  services  and has a contract for providing such services with the
    49  department of health and is selected  through  the  procurement  process
    50  described  in [paragraph] paragraphs (b), (b-1), (b-2) and (b-3) of this
    51  subdivision.  Eligible applicants for contracts shall be  entities  that

        S. 8007--C                         73                         A. 9007--C
 
     1  are  capable  of  appropriately  providing fiscal intermediary services,
     2  performing the responsibilities of a fiscal intermediary, and  complying
     3  with this section, including but not limited to entities that:
     4    § 3. Paragraph (b-1) of subdivision 4-a of section 365-f of the social
     5  services law, as added by section 2 of part LL of chapter 57 of the laws
     6  of 2021, is amended to read as follows:
     7    (b-1) Following the initial selection of contractors on February elev-
     8  enth,  two  thousand  twenty-one, pursuant to the commissioner's request
     9  for offers #20039 ("RFO")  in  accordance  with  this  subdivision,  the
    10  commissioner  is  instructed  to [survey for information relating to the
    11  additional selection criteria under this paragraph and  paragraph  (b-2)
    12  of  this  subdivision,  in writing in a manner determined by the commis-
    13  sioner, from] accept the offer to enter into contracts with  all  appli-
    14  cants  that  were not initially selected on February eleventh, two thou-
    15  sand twenty-one, but that were qualified by the commissioner as  meeting
    16  minimum  requirements of the [procurement process described in paragraph
    17  (b) of this subdivision including those that were not awarded  contracts
    18  under  that  process]  RFO, provided that such qualified applicants that
    19  were not initially selected attest that:
    20    (i) [whether the applicant is formed as a charitable corporation under
    21  article two of the not-for-profit corporation law  or  authorized  as  a
    22  foreign  corporation under article thirteen of the not-for-profit corpo-
    23  ration law;
    24    (ii) was the applicant performing administrative services as a  fiscal
    25  intermediary  prior  to  January  first,  two thousand twelve and has it
    26  continuously provided such services for eligible individuals pursuant to
    27  this section since that date;
    28    (iii) the address the applicant listed as its primary mailing  address
    29  on  its  most  recently  filed state corporate tax return or its Federal
    30  Return of Organization Exempt From Income Tax form (form 990);
    31    (iv) whether the applicant is currently authorized,  funded,  approved
    32  or  certified  to  deliver state plan or home and community-based waiver
    33  supports and services to individuals with intellectual and developmental
    34  disabilities by the office for people with developmental disabilities;
    35    (v) whether the applicant has historically  provided  fiscal  interme-
    36  diary administrative services to racial and ethnic minority residents or
    37  new Americans, as defined in section ninety-four-b of the executive law,
    38  in  such  consumers'  primary  language, as evidenced by information and
    39  materials provided to consumers in the consumers'  primary  language  or
    40  languages; and
    41    (vi)  whether  the  applicant is verified as a minority or woman-owned
    42  business enterprise pursuant to section three hundred  fourteen  of  the
    43  executive  law] the applicant was providing fiscal intermediary services
    44  for at least two hundred consumers in a city with a population  of  more
    45  than  one million at any time between January first, two thousand twenty
    46  and March thirty-first, two thousand twenty; or
    47    (ii) the applicant was providing fiscal intermediary services  for  at
    48  least  fifty  consumers in another area of the state at any time between
    49  January first, two thousand twenty and March thirty-first, two  thousand
    50  twenty.
    51    § 4. Paragraphs (b-2) and (b-3) of subdivision 4-a of section 365-f of
    52  the  social  services  law are REPEALED and two new paragraphs (b-2) and
    53  (b-3) are added to read as follows:
    54    (b-2) Upon the publication of an attestation form or  process  to  the
    55  department's  website,  the  remaining qualified applicants described in
    56  paragraph (b-1) of this subdivision shall have sixty days to  submit  an

        S. 8007--C                         74                         A. 9007--C
 
     1  attestation and all required supporting documentation to the commission-
     2  er.
     3    (i)  Any late submission shall disqualify the applicant from receiving
     4  a contract award under paragraph (b-1) of this subdivision.
     5    (ii) The number of consumers served by an applicant during the  period
     6  between  January  first, two thousand twenty and March thirty-first, two
     7  thousand twenty may be measured by  the  greatest  number  of  consumers
     8  served  in  the specified region by the applicant on any day during that
     9  period.
    10    (iii) Applicant attestations shall be audited by the office  of  Medi-
    11  caid  inspector  general,  and any false or inaccurate attestation shall
    12  render any contract awarded under paragraph (b-1)  of  this  subdivision
    13  null  and void; this provision shall not be construed to limit or super-
    14  sede any other applicable sanctions or penalties  that  may  be  imposed
    15  under the medical assistance program.
    16    (b-3)  Contracts  awarded  under  paragraph  (b-1) of this subdivision
    17  shall be limited to the  service  areas  indicated  on  the  applicants'
    18  submission to the RFO.
    19    § 5. This act shall take effect immediately.
 
    20                                   PART QQ
 
    21    Section 1. Subdivision 10 of section 365-a of the social services law,
    22  as  added by section 11 of part MM of chapter 56 of the laws of 2020, is
    23  amended to read as follows:
    24    10. The department of health shall establish or procure  the  services
    25  of  an  independent assessor or assessors no later than October 1, 2022,
    26  in a manner and schedule as determined by the commissioner of health, to
    27  take over from local departments of social  services,  Medicaid  Managed
    28  Care providers, and Medicaid managed long term care plans performance of
    29  assessments  and  reassessments  required  for  determining individuals'
    30  needs for personal care services,  including  as  provided  through  the
    31  consumer  directed  personal  assistance  program, and other services or
    32  programs available pursuant to the state's medical assistance program as
    33  determined by such commissioner for the purpose of improving efficiency,
    34  quality, and reliability in assessment  and  to  determine  individuals'
    35  eligibility  for  Medicaid managed long term care plans. Notwithstanding
    36  the provisions of section one hundred sixty-three of the  state  finance
    37  law,  or  sections  one hundred forty-two and one hundred forty-three of
    38  the  economic  development  law,  or  any  contrary  provision  of  law,
    39  contracts  may  be  entered or the commissioner may amend and extend the
    40  terms of [a contract awarded prior to the  effective  date  and  entered
    41  into  pursuant  to subdivision twenty-four of section two hundred six of
    42  the public health law, as added by section  thirty-nine  of  part  C  of
    43  chapter  fifty-eight  of the laws of two thousand eight, and] a contract
    44  awarded prior to the effective date and entered into to conduct  enroll-
    45  ment  broker  and  conflict-free  evaluation  services  for the Medicaid
    46  program, if such contract or contract amendment is for  the  purpose  of
    47  procuring  such  assessment  services  from  an  independent  assessor[;
    48  provided, however, in the case of a  contract  entered  into  after  the
    49  effective date of this section, that:
    50    (a)  The  department of health shall post on its website, for a period
    51  of no less than thirty days:
    52    (i) A description of the proposed services to be provided pursuant  to
    53  the contract or contracts;

        S. 8007--C                         75                         A. 9007--C

     1    (ii) The criteria for selection of a contractor or contractors includ-
     2  ing,  but  not  limited to, being unaffiliated with any entity certified
     3  under article forty-four of the public health law or any service provid-
     4  er licensed under article thirty-six of the public  health  law,  demon-
     5  strated cultural and linguistic competence, experience in evaluating the
     6  service  needs  of  individuals with disabilities seeking to live in the
     7  community, and demonstrated compliance with  all  applicable  state  and
     8  federal  laws.  Furthermore,  the  selection criteria shall consider and
     9  give preference to whether a prospective contractor is a  not-for-profit
    10  organization;
    11    (iii)  The  period  of  time during which a prospective contractor may
    12  seek selection, which shall be no  less  than  thirty  days  after  such
    13  information is first posted on the website; and
    14    (iv)  The  manner  by  which  a  prospective  contractor  may submit a
    15  proposal for selection,  which  may  include  submission  by  electronic
    16  means;
    17    (b)  All  reasonable and responsive submissions that are received from
    18  prospective contractors in a timely fashion shall  be  reviewed  by  the
    19  commissioner of health;
    20    (c)  The  commissioner  of  health  shall  select  such  contractor or
    21  contractors that are best suited to serve the purposes of  this  section
    22  and the needs of recipients; and
    23    (d)  All  decisions made and approaches taken pursuant to this section
    24  shall be documented in a procurement record as defined  in  section  one
    25  hundred  sixty-three of the state finance law].  Contracts entered into,
    26  amended, or extended pursuant to this subdivision shall  not  remain  in
    27  force beyond September 30, 2025.
    28    §  2.  Section 8 of part C of chapter 57 of the laws of 2018, amending
    29  the social services law and the public health  law  relating  to  health
    30  homes and penalties for managed care providers, as amended by section 12
    31  of  part  MM  of  chapter  56 of the laws of 2020, is amended to read as
    32  follows:
    33    § 8. Notwithstanding any inconsistent provision of [section]  sections
    34  112  and  163  of  the state finance law, or sections 142 and 143 of the
    35  economic development law,  or  any  other  contrary  provision  of  law,
    36  excepting  the  13  responsible vendor requirements of the state finance
    37  law, including, but not limited to, sections 163 and 139-k of the  state
    38  finance law, the commissioner of health is authorized to amend or other-
    39  wise  extend the terms of a contract awarded prior to the effective date
    40  and entered into pursuant to subdivision 24 of section 206 of the public
    41  health law, as added by section 39 of part C of chapter 58 of  the  laws
    42  of 2008[, and a contract awarded prior to the effective date and entered
    43  into  to conduct enrollment broker and conflict-free evaluation services
    44  for the Medicaid program, both for a period of three years],  without  a
    45  competitive bid or request for proposal process, upon determination that
    46  the  existing  contractor  is  qualified  to  continue  to  provide such
    47  services, and provided that efficiency savings are achieved  during  the
    48  period  of  extension;  and  provided,  further,  that the department of
    49  health shall submit a request for applications for such contract  during
    50  the time period specified in this section and may terminate the contract
    51  identified  herein  prior  to  expiration of the extension authorized by
    52  this section.  Contracts entered into, amended, or extended pursuant  to
    53  this section shall not remain in force beyond August 19, 2026.
    54    §  3. Section 20 of part MM of chapter 56 of the laws of 2020, direct-
    55  ing the department of health to establish or procure the services of  an

        S. 8007--C                         76                         A. 9007--C
 
     1  independent panel of clinical professionals and to develop and implement
     2  a uniform task-based assessment tool, is amended to read as follows:
     3    §  20. The department of health shall establish or procure services of
     4  an independent panel or panels of clinical professionals no  later  than
     5  October  1,  2022, in a manner and schedule as determined by the commis-
     6  sioner of health, to provide as  appropriate  independent  physician  or
     7  other  applicable clinician orders for personal care services, including
     8  as provided through the consumer directed personal  assistance  program,
     9  available  pursuant  to  the  state's  medical assistance program and to
    10  determine eligibility for  the  consumer  directed  personal  assistance
    11  program.    Notwithstanding  the  provisions of section 163 of the state
    12  finance law, or sections 142 and 143 of the economic development law, or
    13  any contrary provision of law, contracts may be entered or  the  commis-
    14  sioner  of  health may amend and extend the terms of [a contract awarded
    15  prior to the effective date and entered  into  pursuant  to  subdivision
    16  twenty-four  of  section  two  hundred  six of the public health law, as
    17  added by section thirty-nine of part C of  chapter  fifty-eight  of  the
    18  laws  of two thousand eight, and] a contract awarded prior to the effec-
    19  tive date and entered into to conduct enrollment  broker  and  conflict-
    20  free  evaluation  services for the Medicaid program, if such contract or
    21  contract amendment is for the purpose  of  establishing  an  independent
    22  panel or panels of clinical professionals as described in this section[;
    23  provided,  however,  in  the  case  of a contract entered into after the
    24  effective date of this section, that:
    25    (a) The department of health shall post on its website, for  a  period
    26  of no less than 30 days:
    27    (i)  A description of the proposed services to be provided pursuant to
    28  the contract or contracts;
    29    (ii) The criteria for selection of a contractor or contractors;
    30    (iii) The period of time during which  a  prospective  contractor  may
    31  seek  to be selected by the department of health, which shall be no less
    32  than 30 days after such information is first posted on the website; and
    33    (iv) The manner  by  which  a  prospective  contractor  may  submit  a
    34  proposal  for  selection,  which  may  include  submission by electronic
    35  means;
    36    (b) All reasonable and responsive submissions that are  received  from
    37  prospective  contractors  in  timely  fashion  shall  be reviewed by the
    38  commissioner of health; and
    39    (c) The  commissioner  of  health  shall  select  such  contractor  or
    40  contractors  that, in such commissioner's discretion, are best suited to
    41  serve the purposes of this section and the needs of recipients; and
    42    (d) all decisions made and approaches taken pursuant to  this  section
    43  shall  be  documented  in a procurement record as defined in section one
    44  hundred sixty-three of the state finance law]. Contracts  entered  into,
    45  amended,  or extended pursuant to this section shall not remain in force
    46  beyond September 30, 2025.
    47    § 4. This act shall take effect immediately and  shall  be  deemed  to
    48  have  been in full force and effect on and after April 1, 2022 and shall
    49  apply to all contracts entered into, amended, or extended on or after it
    50  shall have taken effect.
 
    51                                   PART RR
 
    52    Section 1. Paragraph 7 of subdivision (c) of section 1261 of  the  tax
    53  law is REPEALED.

        S. 8007--C                         77                         A. 9007--C
 
     1    §  2.  Subparagraph  (ii) of paragraph 5 of subdivision (c) of section
     2  1261 of the tax law, as amended by section 2 of part ZZ of chapter 56 of
     3  the laws of 2020, is amended to read as follows:
     4    (ii)  After  withholding  the taxes, penalties and interest imposed by
     5  the city of New York on and after August first, two  thousand  eight  as
     6  provided  in  subparagraph  (i) of this paragraph, the comptroller shall
     7  withhold a portion of such taxes, penalties and interest  sufficient  to
     8  deposit  annually  into  the  central  business district tolling capital
     9  lockbox established pursuant to section five  hundred  fifty-three-j  of
    10  the  public authorities law: (A) in state fiscal year two thousand nine-
    11  teen - two  thousand  twenty,  one  hundred  twenty-seven  million  five
    12  hundred thousand dollars; (B) in state fiscal year two thousand twenty -
    13  two  thousand  twenty-one,  one  hundred seventy million dollars; (C) in
    14  state fiscal year two thousand twenty-one - two thousand twenty-two  and
    15  every  succeeding  state fiscal year, an amount equal to one hundred one
    16  percent of the amount  deposited  in  the  immediately  preceding  state
    17  fiscal year. The funds shall be deposited monthly in equal installments.
    18  During  the  period that the comptroller is required to withhold amounts
    19  and make payments described in this paragraph, the city of New York  has
    20  no right, title or interest in or to those taxes, penalties and interest
    21  required  to be paid into the above referenced central business district
    22  tolling capital lockbox. In addition, the comptroller shall  withhold  a
    23  portion of such taxes, penalties and interest in the amount of [two] one
    24  hundred fifty million dollars, to be withheld in four quarterly install-
    25  ments  on January fifteenth, April fifteenth, July fifteenth and October
    26  fifteenth of each year, and shall deposit such amounts into the New York
    27  State Agency Trust Fund, Distressed Provider Assistance Account.
    28    § 3. Section 5 of part ZZ of chapter 56 of the laws of  2020  amending
    29  the  tax  law  and  the social services law relating to certain Medicaid
    30  management, is amended to read as follows:
    31    § 5. This act shall  take  effect  immediately  and  shall  be  deemed
    32  repealed [two] five years after such effective date.
    33    §  4. This act shall take effect immediately; provided that the amend-
    34  ments to subparagraph (ii) of paragraph 5 of subdivision (c) of  section
    35  1261 of the tax law made by section two of this act shall not affect the
    36  expiration of such subparagraph and shall be deemed expired therewith.
 
    37                                   PART SS
 
    38    Section  1.  1.  The department of health shall conduct a study within
    39  Kings county to determine ways to improve access to health services  and
    40  facilities.
    41    (a)  In  reviewing  accessibility  to services and facilities in Kings
    42  county, the study shall consider inequities in the health care system in
    43  such county, including, but not limited to, racial, ethnic,  sex,  immi-
    44  gration  status,  and  socio-economic status disparities that may impose
    45  barriers to care.
    46    (b) The study shall also consider the need for  medical  services  for
    47  women  and children in Kings county, including the need for construction
    48  of medical facilities serving women and children,  or  capital  improve-
    49  ments to existing regional perinatal centers.
    50    2.  The  department  of  health  shall complete a report based on such
    51  study, which shall provide recommendations for the improvement of acces-
    52  sibility to health services and facilities in Kings county.
    53    3. The study shall be completed within eighteen months of  the  effec-
    54  tive  date of this act and a report of the findings from the study shall

        S. 8007--C                         78                         A. 9007--C
 
     1  be presented to the governor, the speaker of the assembly and the tempo-
     2  rary president of the senate within ninety days of the completion of the
     3  study.
     4    § 2. This act shall take effect immediately.
 
     5                                   PART TT
 
     6    Section  1.  Section  26  of part H of chapter 59 of the laws of 2011,
     7  amending the public health law and  other  laws,  relating  to  targeted
     8  Medicaid reimbursement rate reductions, is amended to read as follows:
     9    § 26. Notwithstanding any provision of law to the contrary and subject
    10  to  the  availability of federal financial participation, for periods on
    11  and after April 1, 2011, clinics certified pursuant  to  [articles  16,]
    12  article  31 or 32 of the mental hygiene law shall be subject to targeted
    13  Medicaid reimbursement rate reductions in accordance with the provisions
    14  of this section. Such reductions shall be based on  utilization  thresh-
    15  olds  which  may  be established either as provider-specific or patient-
    16  specific thresholds. Provider-specific  thresholds  shall  be  based  on
    17  average patient utilization for a given provider in comparison to a peer
    18  based  standard to be determined for each service.  The commissioners of
    19  the office of mental health[, the office for persons with  developmental
    20  disabilities,]  and  the  office  of  [alcoholism  and  substance abuse]
    21  addiction services and supports, in consultation with  the  commissioner
    22  of  health,  are authorized to waive utilization thresholds for patients
    23  of clinics certified pursuant to article [16,] 31[,] or 32 of the mental
    24  hygiene law who are enrolled in specific treatment programs or otherwise
    25  meet criteria as may be specified by such commissioners.  When  applying
    26  a  provider-specific  threshold,  rates will be reduced on a prospective
    27  basis based on the amount any provider is over the determined  threshold
    28  level.  Patient-specific  thresholds  will be based on annual thresholds
    29  determined for each service over which the per visit  payment  for  each
    30  visit  in  excess  of the standard during a twelve month period shall be
    31  reduced by a pre-determined amount. The thresholds, peer based standards
    32  and the payment reductions shall be  determined  by  the  department  of
    33  health,  with the approval of the division of the budget, and in consul-
    34  tation with the office of mental health[, the  office  for  people  with
    35  developmental  disabilities] and the office of [alcoholism and substance
    36  abuse] addiction services and supports, and  any  such  resulting  rates
    37  shall  be  subject  to  certification  by  the appropriate commissioners
    38  pursuant to subdivision (a) of section 43.02 of the mental hygiene  law.
    39  The  base  period  used  to  establish  the thresholds shall be the 2009
    40  calendar year. The total annualized reduction in payments shall  be  not
    41  more  than $10,900,000 for Article 31 clinics[, not more than $2,400,000
    42  for Article 16 clinics,] and not more than $13,250,000  for  Article  32
    43  clinics. The commissioner of health may promulgate regulations to imple-
    44  ment the provisions of this section.
    45    § 2. This act shall take effect immediately.
    46    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
    47  sion,  section  or  part  of  this act shall be adjudged by any court of
    48  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    49  impair,  or  invalidate  the remainder thereof, but shall be confined in
    50  its operation to the clause, sentence, paragraph,  subdivision,  section
    51  or part thereof directly involved in the controversy in which such judg-
    52  ment shall have been rendered. It is hereby declared to be the intent of
    53  the  legislature  that  this  act  would  have been enacted even if such
    54  invalid provisions had not been included herein.

        S. 8007--C                         79                         A. 9007--C
 
     1    § 3. This act shall take effect immediately  provided,  however,  that
     2  the applicable effective date of Parts A through TT of this act shall be
     3  as specifically set forth in the last section of such Parts.
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