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S04965 Summary:

Amd §4403-f, Pub Health L; amd §366-a, Soc Serv L
Provides for automatic enrollment and recertification simplification for Medicaid managed care plans and long term care plans.
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S04965 Actions:

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S04965 Text:

                STATE OF NEW YORK
                               2021-2022 Regular Sessions
                    IN SENATE
                                    February 19, 2021
        Introduced  by  Sen.  RIVERA -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health
        AN ACT to amend the public health law and the social  services  law,  in
          relation  to  automatic  enrollment and recertification simplification
          for Medicaid eligible recipients

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Paragraph  (b)  of subdivision 7 of section 4403-f of the
     2  public health law is amended by adding a new subparagraph (iv)  to  read
     3  as follows:
     4    (iv) Where a person determined eligible for Medicaid ("Medicaid recip-
     5  ient") has been determined by the commissioner or his or her designee to
     6  require  community-based long term care services for more than a contin-
     7  uous period of one hundred twenty days, and the Medicaid  recipient  has
     8  not  selected and enrolled in a managed long term care plan prior to any
     9  expiration date of such determination of need for long term care,  after
    10  being  provided with information to make an informed choice, the commis-
    11  sioner shall assign the recipient to a  managed  long  term  care  plan,
    12  taking  into  account  consistency with any prior community-based direct
    13  care workers having recently served the recipient,  quality  performance
    14  criteria,  capacity, and geographic accessibility.  The commissioner may
    15  assign participants pursuant to such criteria on a weighted  basis.    A
    16  recipient  assigned to a managed long term care plan under this subpara-
    17  graph shall be deemed to have been determined to be in need of long term
    18  care services for more than a continuous period of  one  hundred  twenty
    19  days and eligible to be enrolled in a managed long term care plan.
    20    §  2.  Paragraph  (b)  of subdivision 2 of section 366-a of the social
    21  services law, as added by section 51 of part A of chapter 1 of the  laws
    22  of 2002, is amended to read as follows:
    23    (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
    24  sion, an applicant or recipient may attest to the amount of his  or  her
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        S. 4965                             2
     1  accumulated  resources,  unless  such  applicant or recipient is seeking
     2  medical assistance payment for long term care  services  for  the  first
     3  time.  A  recipient  who has already provided documentation of resources
     4  may attest to the amount of accumulated resources if it has remained the
     5  same  or is less than the amount originally documented.  For purposes of
     6  this paragraph, long term care  services  shall  mean  care,  treatment,
     7  maintenance,  and services described in paragraph (b) of subdivision [1]
     8  one of section three hundred  sixty-seven-f  of  this  title,  with  the
     9  exception  of  short term rehabilitation, as defined by the commissioner
    10  of health.
    11    § 3. Paragraph (d) of subdivision 5 of section  366-a  of  the  social
    12  services  law,  as  amended by section 12 of part D of chapter 56 of the
    13  laws of 2013, is relettered paragraph (e) and three new paragraphs  (f),
    14  (g) and (h) are added to read as follows:
    15    (f)  Notwithstanding  paragraph (b) of subdivision two of this section
    16  and paragraphs (a), (b), (c) and (d) of this subdivision, the  following
    17  recipients  will  be  recertified automatically, unless there has been a
    18  finding of lack of eligibility for Medicaid:
    19    (i) enrollees in Medicaid managed long term care plans as  defined  in
    20  section forty-four hundred three-f of the public health law;
    21    (ii)  enrollees  in  Medicaid managed care plans as defined in section
    22  three hundred sixty-four-j of  this  title  who  receive  personal  care
    23  services  pursuant  to paragraph (e) of subdivision two of section three
    24  hundred sixty-five-a of this title or consumer directed personal assist-
    25  ance services pursuant to section three  hundred  sixty-five-f  of  this
    26  title;
    27    (iii)  enrollees  receiving  Medicaid  in the Aged, Blind and Disabled
    28  category who receive fixed income  from  the  Social  Security  Adminis-
    29  tration (SSA); and
    30    (iv) Medicare Savings Program (MSP) recipients who have a fixed income
    31  from the Social Security Administration (SSA).
    32    (g)  Nothing  in paragraph (e) of this subdivision should be construed
    33  to alter a Medicaid recipient's obligation to inform the public  welfare
    34  district  of changes in income or other factors that might impact eligi-
    35  bility pursuant to subdivision four of this section.
    36    (h) Upon a finding of lack of eligibility,  recipients  identified  in
    37  paragraph (e) of this subdivision will be entitled to notice and hearing
    38  rights as provided in section twenty-two of this chapter.
    39    § 4. This act shall take effect on the one hundred eightieth day after
    40  it  shall  have  become a law; provided that the amendments to paragraph
    41  (b) of subdivision 7 of section 4403-f of the public health law made  by
    42  section one of this act shall be subject to the expiration and reversion
    43  of  such paragraph and shall expire and be deemed repealed therewith and
    44  provided further that such amendments shall not  affect  the  repeal  of
    45  such  section  and shall expire and be deemed repealed therewith. Effec-
    46  tive immediately, the commissioner of health shall make regulations  and
    47  take  other  actions  reasonably necessary to implement this act on that
    48  date.
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