Bill Text: NY S01617 | 2025-2026 | General Assembly | Introduced
Bill Title: Provides for automatic enrollment and recertification simplification for Medicaid managed care plans and long term care plans.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Introduced) 2025-01-27 - ADVANCED TO THIRD READING [S01617 Detail]
Download: New_York-2025-S01617-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 1617 2025-2026 Regular Sessions IN SENATE January 13, 2025 ___________ Introduced by Sens. RIVERA, JACKSON, MAY -- 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 the designee of such 6 commissioner to require community-based long term care services for more 7 than a continuous period of one hundred twenty days, and the Medicaid 8 recipient has not selected and enrolled in a managed long term care plan 9 prior to any expiration date of such determination of need for long term 10 care, after being provided with information to make an informed choice, 11 the 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: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04128-01-5S. 1617 2 1 (b) Notwithstanding the provisions of paragraph (a) of this subdivi- 2 sion, an applicant or recipient may attest to the amount of [his or her] 3 their accumulated resources, unless such applicant or recipient is seek- 4 ing medical assistance payment for long term care services for the first 5 time. A recipient who has already provided documentation of resources 6 may attest to the amount of accumulated resources if it has remained the 7 same or is less than the amount originally documented. For purposes of 8 this paragraph, long term care services shall mean care, treatment, 9 maintenance, and services described in paragraph (b) of subdivision [1] 10 one of section three hundred sixty-seven-f of this title, with the 11 exception of short term rehabilitation, as defined by the commissioner 12 of health. 13 § 3. Paragraph (d) of subdivision 5 of section 366-a of the social 14 services law, as amended by section 12 of part D of chapter 56 of the 15 laws of 2013, is relettered paragraph (e) and three new paragraphs (f), 16 (g) and (h) are added to read as follows: 17 (f) Notwithstanding paragraph (b) of subdivision two of this section 18 and paragraphs (a), (b), (c) and (d) of this subdivision, the following 19 recipients will be recertified automatically, unless there has been a 20 finding of lack of eligibility for Medicaid: 21 (i) enrollees in Medicaid managed long term care plans as defined in 22 section forty-four hundred three-f of the public health law; 23 (ii) enrollees in Medicaid managed care plans as defined in section 24 three hundred sixty-four-j of this title who receive personal care 25 services pursuant to paragraph (e) of subdivision two of section three 26 hundred sixty-five-a of this title or consumer directed personal assist- 27 ance services pursuant to section three hundred sixty-five-f of this 28 title; 29 (iii) enrollees receiving Medicaid in the Aged, Blind and Disabled 30 category who receive fixed income from the Social Security Adminis- 31 tration (SSA); and 32 (iv) Medicare Savings Program (MSP) recipients who have a fixed income 33 from the Social Security Administration (SSA). 34 (g) Nothing in paragraph (e) of this subdivision should be construed 35 to alter a Medicaid recipient's obligation to inform the public welfare 36 district of changes in income or other factors that might impact eligi- 37 bility pursuant to subdivision four of this section. 38 (h) Upon a finding of lack of eligibility, recipients identified in 39 paragraph (e) of this subdivision will be entitled to notice and hearing 40 rights as provided in section twenty-two of this chapter. 41 § 4. This act shall take effect on the one hundred eightieth day after 42 it shall have become a law; provided that the amendments to paragraph 43 (b) of subdivision 7 of section 4403-f of the public health law made by 44 section one of this act shall be subject to the expiration and reversion 45 of such paragraph and shall expire and be deemed repealed therewith and 46 provided further that such amendments shall not affect the repeal of 47 such section and shall expire and be deemed repealed therewith. Effec- 48 tive immediately, the commissioner of health shall make regulations and 49 take other actions reasonably necessary to implement this act on that 50 date. Provided, further, that sections two and three of this act shall 51 only take effect when the federal center for Medicaid and Medicare 52 services (CMS) approves in writing to the state commissioner of health 53 that the changes do not affect federal financial participation; provided 54 that the commissioner of health shall notify the legislative bill draft- 55 ing commission upon the occurrence of the enactment of the legislation 56 provided for in sections two and three of this act in order that theS. 1617 3 1 commission may maintain an accurate and timely effective data base of 2 the official text of the laws of the state of New York in furtherance of 3 effectuating the provisions of section 44 of the legislative law and 4 section 70-b of the public officers law.
