Bill Text: NY S05145 | 2025-2026 | General Assembly | Introduced


Bill Title: Directs the commissioner of health to provide authorizations to all fiscal intermediaries that timely submit a request for authorization prior to January 1, 2026; details information required for such authorizations; makes related provisions.

Spectrum: Partisan Bill (Democrat 9-0)

Status: (Introduced) 2025-02-19 - REFERRED TO HEALTH [S05145 Detail]

Download: New_York-2025-S05145-Introduced.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                          5145

                               2025-2026 Regular Sessions

                    IN SENATE

                                    February 19, 2025
                                       ___________

        Introduced by Sens. COMRIE, ADDABBO, CLEARE, FERNANDEZ, MARTINEZ, MYRIE,
          SALAZAR,  SANDERS,  SEPULVEDA  --  read twice and ordered printed, and
          when printed to be committed to the Committee on Health

        AN ACT to amend the social services law, in relation to certain authori-
          zations to fiscal intermediaries

          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 4-a of section 365-f of the
     2  social services law, as amended by section 2 of part HH of chapter 57 of
     3  the laws of 2024, is amended to read as follows:
     4    (b) [Notwithstanding section one  hundred  sixty-three  of  the  state
     5  finance  law,  section  one  hundred twelve of the state finance law, or
     6  section one hundred  forty-two  of  the  economic  development  law  the
     7  commissioner  shall enter into a contract under this subdivision with an
     8  eligible contractor that submits an  offer  for  a  contract,  provided,
     9  however, that:
    10    (i) the department shall post on its website:
    11    (A)  a  description  of  the  proposed  statewide  fiscal intermediary
    12  services to be provided pursuant to a contract in accordance  with  this
    13  subdivision;
    14    (B)  the  criteria for selection of the statewide fiscal intermediary,
    15  which shall include at a minimum that the eligible contractor is capable
    16  of performing statewide fiscal intermediary services  with  demonstrated
    17  cultural and language competencies specific to the population of consum-
    18  ers  and  those of the available workforce, has experience serving indi-
    19  viduals with disabilities, and as of April first, two  thousand  twenty-
    20  four is providing services as a fiscal intermediary on a statewide basis
    21  with at least one other state;
    22    (C)  the  manner  by  which  prospective  contractors  may  seek  such
    23  selection, which may include submission by electronic means;

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05945-01-5

        S. 5145                             2

     1    (ii) all offers that are received from prospective  contractors  in  a
     2  timely  fashion  and  that  meet the criteria set forth in clause (B) of
     3  subparagraph (i) of this paragraph shall be reviewed by the  commission-
     4  er; and
     5    (iii)  the  commissioner  shall  award such contract to the contractor
     6  that meets the criteria for selection and  offers  the  best  value  for
     7  providing  the  services required pursuant to this section and the needs
     8  of consumers.] The commissioner shall provide authorizations under  this
     9  subdivision  to  all  fiscal intermediaries that timely submit a request
    10  for authorization prior to January first, two thousand  twenty-six,  and
    11  meet the requirements of this section.  No entity shall provide, direct-
    12  ly  or  through  contract,  fiscal  intermediary services without having
    13  received an authorization as a fiscal intermediary issued by the commis-
    14  sioner in accordance with  this  subdivision,  or  that  has  a  pending
    15  authorization  timely  submitted  and  currently  in processing, review,
    16  appeal, or legal challenge.
    17    (i) An application for authorization as a fiscal intermediary shall be
    18  filed with the commissioner, together with such other forms and informa-
    19  tion as shall be prescribed by, or acceptable to the commissioner.  Such
    20  information shall consist of the following:
    21    (A) the name  and  employer  identification  number,  of  the  entity,
    22  including  any  subsidiary  corporations,  if applicable, and   any name
    23  under which the entity does business;
    24    (B) all addresses at which the organization operates;
    25    (C) the names, titles and contact  information  of  all  officers  and
    26  directors  in  a  not-for-profit  company  or business, or managers in a
    27  limited liability company, as well as the name and employment history of
    28  the individual ultimately accountable for operation of the fiscal inter-
    29  mediary; and for a not-for-profit entity, the number of  director  posi-
    30  tions set by the company's by-laws, and how many are currently filled;
    31    (D)  a  history  of  the  organization,  along with an overview of the
    32  organization and all services it  offers,  including  any  relationships
    33  with  outside  agencies that may influence in any way the ability of the
    34  organization to provide fiscal intermediary services consistent with the
    35  manner described in its application;
    36    (E) all policies and procedures of the fiscal intermediary,  including
    37  any contracts or other documents used in communications with consumers;
    38    (F) plans to solicit and consider input from the fiscal intermediary's
    39  consumers, staff, personal assistants and other interested parties which
    40  may  be charged with roles including, but not limited to, quality assur-
    41  ance review, referral, program monitoring or development or establishing
    42  and responding to community needs; such input may be in the  form  of  a
    43  board of directors, committee, survey, or other mechanism, provided that
    44  the  majority  of  input  obtained  as part of this process must be from
    45  individual consumers and consumer advocates of the fiscal intermediary;
    46    (G) the organization's plan to address  the  needs  of  consumers  and
    47  their  personal  assistants in a timely manner, regardless of where they
    48  live, including, but not limited to,  input  from  consumers,  obtaining
    49  physicals and other health information from personal assistants, obtain-
    50  ing time records for payroll, and timely processing of payroll; and
    51    (H)  a  written sworn statement by an officer of the entity disclosing
    52  any pending litigation, unsatisfied judgments or penalties,  convictions
    53  for fraud or sanctions imposed by government authorities.
    54    (ii) The entity shall reasonably promptly notify the department of any
    55  change  in the information submitted to the department for authorization
    56  under this subdivision.

        S. 5145                             3

     1    (iii) The commissioner shall not withhold approval of any  application
     2  for authorization that demonstrates the fiscal intermediary's ability to
     3  provide  fiscal  intermediary  services,  in  accordance with the manner
     4  required by this subdivision and the rules  and  regulations  hereunder.
     5  All such applications shall be approved by the commissioner.
     6    (iv)  If  the commissioner denies an application for authorization, he
     7  or she shall include a narrative explanation of the  reason  or  reasons
     8  for  its  denial  and provide the fiscal intermediary with sixty days to
     9  submit additional information for reconsideration by the commissioner.
    10    (v) The commissioner shall consider and evaluate any response received
    11  by the fiscal intermediary before reaching a final determination,  which
    12  likewise  shall be accompanied by a narrative explanation, if the appli-
    13  cation is still denied.
    14    (vi) All orders or determinations  under  this  subdivision  shall  be
    15  subject  to  review  as  provided  in article seventy-eight of the civil
    16  practice law and rules.
    17    § 2. Subparagraphs (i) and (ii) of paragraph (a) of subdivision 4-a of
    18  section 365-f of the social services law, as amended  by  section  1  of
    19  part  HH  of  chapter  57  of  the  laws of 2024, are amended to read as
    20  follows:
    21    (i) "Statewide fiscal intermediary"  means  an  entity  that  provides
    22  fiscal  intermediary  services  and  has  a  contract for providing such
    23  services with [the department of health  and  is  selected  through  the
    24  procurement process described in paragraph (b) of this subdivision.]:
    25    (A)  a  local  department of social services; an organization licensed
    26  under article forty-four of the public health law; or
    27    (B) an accountable care organization certified under  article  twenty-
    28  nine-E  of  the  public  health  law  or  an  integrated delivery system
    29  composed primarily of health care providers recognized by the department
    30  as a performing provider system under the delivery system reform  incen-
    31  tive payment program.
    32    (ii)   Fiscal   intermediary  services  shall  include  the  following
    33  services, performed on behalf of the consumer to facilitate the  consum-
    34  er's role as the employer:
    35    (A) wage and benefit processing for consumer directed personal assist-
    36  ants;
    37    (B) processing all income tax and other required wage withholdings;
    38    (C)  complying with workers' compensation, disability and unemployment
    39  requirements;
    40    (D) maintaining personnel records for each consumer directed  personal
    41  assistant,  including  time  records  and other documentation needed for
    42  wages and benefit processing and a copy  of  the  medical  documentation
    43  required pursuant to regulations established by the commissioner;
    44    (E) ensuring that the health status of each consumer directed personal
    45  assistant  is assessed prior to service delivery pursuant to regulations
    46  issued by the commissioner;
    47    (F) maintaining records of service authorizations or reauthorizations;
    48    (G) monitoring the consumer's or, if applicable, the designated repre-
    49  sentative's continuing ability to fulfill  the  consumer's  responsibil-
    50  ities under the program and promptly notifying the authorizing entity of
    51  any  circumstance  that may affect the consumer's or, if applicable, the
    52  designated representative's ability to fulfill such responsibilities;
    53    (H) complying with regulations established by the commissioner  speci-
    54  fying  the  responsibilities of fiscal intermediaries providing services
    55  under this title;

        S. 5145                             4

     1    (I) entering into a department approved  memorandum  of  understanding
     2  with  the  consumer  that  describes the parties' responsibilities under
     3  this program[; and
     4    (J) other related responsibilities which may include, as determined by
     5  the  commissioner, assisting consumers to perform the consumers' respon-
     6  sibilities under this section and department  regulations  in  a  manner
     7  that does not infringe upon the consumer's responsibilities and self-di-
     8  rection].
     9    §  3.  Paragraph (c) of subdivision 4-d of section 365-f of the social
    10  services law, as added by section 7 of part G of chapter 57 of the  laws
    11  of 2019, is amended to read as follows:
    12    (c)  Where  a  fiscal  intermediary is suspending or ceasing operation
    13  pursuant to an order under subdivision four-b of this section,  [or  has
    14  failed  to submit an offer for a contract, or has been denied a contract
    15  under this section,] all the provisions of this subdivision shall  apply
    16  except  subparagraph (i) of paragraph (a) of this subdivision, notice of
    17  which to all parties shall be provided by the department as appropriate.
    18    § 4. This act shall take effect immediately and  shall  be  deemed  to
    19  have been in full force and effect on and after April 1, 2025.
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