Bill Text: NY A09017 | 2019-2020 | General Assembly | Introduced

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Bill Title: Provides for automatic enrollment and recertification simplification for Medicaid managed care plans and long term care plans.

Spectrum: Slight Partisan Bill (Democrat 2-1)

Status: (Introduced - Dead) 2020-01-10 - referred to health [A09017 Detail]

Download: New_York-2019-A09017-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          9017

                   IN ASSEMBLY

                                    January 10, 2020
                                       ___________

        Introduced  by M. of A. GOTTFRIED, DINOWITZ -- read once and referred 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 (iii) to  read
     3  as follows:
     4    (iii)  Where  a  person  determined  eligible  for Medicaid ("Medicaid
     5  recipient") has been determined by the commissioner or his or her desig-
     6  nee to require community-based long term care services for more  than  a
     7  continuous period of one hundred twenty days, and the Medicaid recipient
     8  has  not selected and enrolled in a managed long term care plan prior to
     9  any expiration date of such determination of need for  long  term  care,
    10  after  being  provided  with information to make an informed choice, the
    11  commissioner shall assign the recipient to  a  managed  long  term  care
    12  plan,  taking  into  account  consistency with any prior community-based
    13  direct care  workers  having  recently  served  the  recipient,  quality
    14  performance  criteria,  capacity,  and  geographic  accessibility.   The
    15  commissioner may assign participants pursuant  to  such  criteria  on  a
    16  weighted  basis.   A recipient assigned to a managed long term care plan
    17  under this subparagraph shall be deemed to have been determined to be in
    18  need of long term care services for more than a continuous period of one
    19  hundred twenty days and eligible to be enrolled in a managed  long  term
    20  care plan.
    21    §  2.  Paragraph  (b)  of subdivision 2 of section 366-a of the social
    22  services law, as added by section 51 of part A of chapter 1 of the  laws
    23  of 2002, is amended to read as follows:
    24    (b)  Notwithstanding  the provisions of paragraph (a) of this subdivi-
    25  sion, an applicant or recipient may attest to the amount of his  or  her
    26  accumulated  resources,  unless  such  applicant or recipient is seeking
    27  medical assistance payment for long term care  services  for  the  first

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11182-05-0
        A. 9017                             2

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