Bill Text: NY A01435 | 2017-2018 | General Assembly | Introduced

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Bill Title: Relates to amounts payable under medical assistance; insures access to essential health care services and supplies by elderly and disabled individuals who are dually eligible for Medicaid and Medicare.

Spectrum: Partisan Bill (Democrat 6-0)

Status: (Introduced - Dead) 2018-01-03 - referred to health [A01435 Detail]

Download: New_York-2017-A01435-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          1435
                               2017-2018 Regular Sessions
                   IN ASSEMBLY
                                    January 12, 2017
                                       ___________
        Introduced by M. of A. CAHILL -- Multi-Sponsored by -- M. of A. CYMBROW-
          ITZ,  ENGLEBRIGHT, PEOPLES-STOKES, RIVERA -- read once and referred to
          the Committee on Health
        AN ACT to amend the social services law, in relation to amounts  payable
          under medical assistance
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. Paragraph (d) of subdivision 1  of  section  367-a  of  the
     2  social services law, as amended by section 1 of part J1 of chapter 63 of
     3  the  laws of 2003, subparagraph (iii) as amended by section 31 of part B
     4  of chapter 57 of the laws of 2015, subparagraph (iv) as added by section
     5  16 of part B of chapter 59 of the laws of 2016, is amended  to  read  as
     6  follows:
     7    (d)  [(i)] Amounts payable under this title for medical assistance for
     8  items and services provided to eligible persons who are  also  benefici-
     9  aries  under  part  A  and/or part B and/or part C of title XVIII of the
    10  federal social security act and items and services provided to qualified
    11  medicare beneficiaries under part A and/or part B and/or part C of title
    12  XVIII of the federal social security act shall  not  be  less  than  the
    13  amount  of  any  deductible  and co-insurance liability of such eligible
    14  persons or for which such eligible persons or  such  qualified  medicare
    15  beneficiaries  would  be liable under federal law were they not eligible
    16  for medical assistance or were they not qualified medicare beneficiaries
    17  with respect to such benefits under such  part  A  and/or  such  part  B
    18  and/or part C.
    19    [(ii)  Amounts  payable  under  this  title for medical assistance for
    20  items and services provided to eligible persons who are  also  benefici-
    21  aries under part B of title XVIII of the federal social security act and
    22  items  and  services  provided to qualified medicare beneficiaries under
    23  part B of title XVIII of the federal social security act  shall  not  be
    24  less  than  the  amount  of  any  deductible  liability of such eligible

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01416-01-7
        A. 1435                             2

     1  persons or for which such eligible persons or  such  qualified  medicare
     2  beneficiaries  would  be liable under federal law were they not eligible
     3  for medical assistance or were they not qualified medicare beneficiaries
     4  with respect to such benefits under such part B.
     5    (iii)  With respect to items and services provided to eligible persons
     6  who are also beneficiaries under part B of title XVIII  of  the  federal
     7  social  security  act and items and services provided to qualified medi-
     8  care beneficiaries under part B of title XVIII  of  the  federal  social
     9  security  act,  the amount payable for services covered under this title
    10  shall be the amount of  any  co-insurance  liability  of  such  eligible
    11  persons  pursuant  to  federal  law  were  they not eligible for medical
    12  assistance or  were  they  not  qualified  medicare  beneficiaries  with
    13  respect  to  such  benefits  under such part B, but shall not exceed the
    14  amount that otherwise would be made under this title if provided  to  an
    15  eligible person other than a person who is also a beneficiary under part
    16  B  or is a qualified medicare beneficiary minus the amount payable under
    17  part B; provided, however, amounts payable under this  title  for  items
    18  and  services  provided  to  eligible persons who are also beneficiaries
    19  under part B or to qualified  medicare  beneficiaries  by  an  ambulance
    20  service  under the authority of an operating certificate issued pursuant
    21  to article thirty of the public  health  law,  a  psychologist  licensed
    22  under article one hundred fifty-three of the education law, or a facili-
    23  ty  under  the  authority of an operating certificate issued pursuant to
    24  article sixteen, thirty-one or thirty-two of the mental hygiene law  and
    25  with  respect  to  outpatient  hospital  and  clinic  items and services
    26  provided by a facility under the authority of an  operating  certificate
    27  issued  pursuant to article twenty-eight of the public health law, shall
    28  not be less than the amount of any co-insurance liability of such eligi-
    29  ble persons or such qualified medicare beneficiaries, or for which  such
    30  eligible  persons  or  such  qualified  medicare  beneficiaries would be
    31  liable under federal law were they not eligible for  medical  assistance
    32  or  were  they not qualified medicare beneficiaries with respect to such
    33  benefits under part B.
    34    (iv) If a health plan participating in part C of title  XVIII  of  the
    35  federal  social  security  act  pays  for items and services provided to
    36  eligible persons who are also beneficiaries under part B of title  XVIII
    37  of  the  federal  social security act or to qualified medicare benefici-
    38  aries, the amount payable for services under this title shall be  eight-
    39  y-five  percent  of  the  amount  of  any co-insurance liability of such
    40  eligible persons pursuant to federal law if they were not  eligible  for
    41  medical  assistance  or  were  not qualified medicare beneficiaries with
    42  respect to such benefits under such part B; provided,  however,  amounts
    43  payable  under  this  title  for items and services provided to eligible
    44  persons who are also beneficiaries under part B or to qualified medicare
    45  beneficiaries by an ambulance service under the authority of an  operat-
    46  ing  certificate  issued pursuant to article thirty of the public health
    47  law, or a psychologist licensed under article one hundred fifty-three of
    48  the education law, shall not be less than the amount of any co-insurance
    49  liability of such eligible persons or such qualified medicare  benefici-
    50  aries,  or  for  which  such eligible persons or such qualified medicare
    51  beneficiaries would be liable under federal law were they  not  eligible
    52  for medical assistance or were they not qualified medicare beneficiaries
    53  with respect to such benefits under part B.]
    54    §  2.  This  act  shall take effect immediately and shall be deemed to
    55  have been in full force and effect on and after July 1, 2003.