Bill Text: NY S07507 | 2017-2018 | General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2018-2019 state fiscal year; relates to distributions from the general hospital indigent care pool; directs a review of the feasibility of creating a burn center in Kings county; and relates to rates of reimbursement for certain residential health care facilities (Part A); relates to payments to residential health care facilities; relates to assisted living program providers licensed in the state; relates to limitations on licensed home care service agency contracts and registration of licensed home care services agencies; relates to advertising by fiscal intermediaries; and relates to medicaid reimbursement rates for hospice providers (Part B); relates to health homes and penalties for managed care providers (Part C); relates to drug coverage, updating the professional dispensing fee, copayments, and amends the Medicaid drug cap (Part D); requires a report on monies collected under the false claims act detailing what monies were collected and how such monies were spent (Part J); relates to home care services, direct care costs, and medicaid expenditures; and extends the medicaid global cap (Part K); relates to extending provisions relating to coverage for malpractice and professional medical conduct (Part M); establishes a cost of living adjustment for designated human services and provides for the repeal of certain provisions of law relating thereto (Part N); relates to the health care facility transformation program (Part Q); relates to integrated services (Subpart B); relates to telehealth services (Subpart C) (Part S); relates to the effectiveness of provisions of law relating to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data; relates to the effectiveness of provisions of law relating to adjustments of rates; relates to the effectiveness of provisions of law relating to authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof; relates to the effectiveness of provisions relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities; relates to rate of payments; relates to agreements with pharmaceutical manufacturers; relates to amending the social services law and other laws relating to supplemental rebates; and relates to participation and membership in a demonstration period (Part T); clarifies the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs; extender (Part U); relates to the membership of subcommittees for mental health of community service boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account relating to extending such provisions relating thereto (Part V); relates to the receipt of federal and state benefits received by individuals receiving care in facilities operated by an office of the department of mental hygiene; extender (Part X); relates to persons practicing in certain licensed programs or services who are exempt from practice requirements of professionals licensed by the department of education (Part Y); adds demonstration waivers to waivers allowable for home and community-based services; relates to waivers for high quality integrated care (Part Z); establishes a cost of living adjustment for designated human services programs; extender (Part AA); expands the list of controlled substances (Part BB); relates to inquiries or complaints of professional misconduct (Part CC); relates to authorizing a licensed pharmacist to administer influenza vaccine to children between two and eighteen years of age pursuant to a non-patient specific regimen; extends certain provisions of law relating thereto; provides reporting requirements for vaccines administered by pharmacists to individuals less than 19 years of age (Part DD); relates to insurance payments for independent practitioner services for individuals with developmental disabilities (Part EE); relates to establishing the office of the independent substance use disorder and mental health ombudsman for the purpose of assisting individuals with a substance use disorder and/or mental illness (Part FF); creates a certified peer recovery advocate services program (Part GG); ensures that sexual assault survivors are not billed for sexual assault forensic exams and are notified orally and in writing of the option to decline to provide private health insurance information and have the office of victim services reimburse the hospital for the exam; also provides that if such exam is covered by insurance, such coverage shall not be subject to annual deductibles or coinsurance; requires collection and storage of such evidence; relates to state-operated individualized residential alternatives; and relates to the closure or transfer of a state-operated individualized residential alternative (Part II); establishes a training program for first responders for handling emergency situations involving individuals with autism spectrum disorder and other developmental disabilities (Part JJ); requires bids submitted to the state or any agency or department of the state to contain a certification concerning sexual harassment (Subpart A); prohibits mandatory arbitration clauses (Subpart B); relates to reimbursement of funds paid by state agencies, state entities and public entities for the payment of awards adjudicated in sexual harassment claims (Subpart C); relates to nondisclosure agreements (Subpart D); establishes a model policy regarding the prevention of sexual harassment and a model training program to prevent sexual harassment in the workplace (Subpart E); relates to sexual harassment relating to non-employees (Subpart F) (Part KK); authorizes a voluntary public water system consolidation study (Part LL); relates to pharmacy audits by pharmacy benefit managers; relates to contracts between pharmacy benefit managers and pharmacies; relates to outpatient treatment; relates to establishing the children and recovering mothers program and a workgroup to study and evaluate barriers and challenges in identifying and treating expectant mothers, newborns and new parents with a substance use disorder; relates to screening students for lead when enrolling in child care, pre-school or kindergarten; relates to the lead service line replacement grant program; directs the New York state department of health to conduct a study of the high burden of asthma in the boroughs of Brooklyn and Manhattan in the city of New York; and relates to providing coverage for pasteurized donor human milk (PDHM) (Part MM); and enacts the opioid stewardship act; repealer (Part NN).
Spectrum: Committee Bill
Status: (Passed) 2018-04-12 - SIGNED CHAP.57 [S07507 Detail]
Download: New_York-2017-S07507-Introduced.html
Bill Title: Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2018-2019 state fiscal year; relates to distributions from the general hospital indigent care pool; directs a review of the feasibility of creating a burn center in Kings county; and relates to rates of reimbursement for certain residential health care facilities (Part A); relates to payments to residential health care facilities; relates to assisted living program providers licensed in the state; relates to limitations on licensed home care service agency contracts and registration of licensed home care services agencies; relates to advertising by fiscal intermediaries; and relates to medicaid reimbursement rates for hospice providers (Part B); relates to health homes and penalties for managed care providers (Part C); relates to drug coverage, updating the professional dispensing fee, copayments, and amends the Medicaid drug cap (Part D); requires a report on monies collected under the false claims act detailing what monies were collected and how such monies were spent (Part J); relates to home care services, direct care costs, and medicaid expenditures; and extends the medicaid global cap (Part K); relates to extending provisions relating to coverage for malpractice and professional medical conduct (Part M); establishes a cost of living adjustment for designated human services and provides for the repeal of certain provisions of law relating thereto (Part N); relates to the health care facility transformation program (Part Q); relates to integrated services (Subpart B); relates to telehealth services (Subpart C) (Part S); relates to the effectiveness of provisions of law relating to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data; relates to the effectiveness of provisions of law relating to adjustments of rates; relates to the effectiveness of provisions of law relating to authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof; relates to the effectiveness of provisions relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities; relates to rate of payments; relates to agreements with pharmaceutical manufacturers; relates to amending the social services law and other laws relating to supplemental rebates; and relates to participation and membership in a demonstration period (Part T); clarifies the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs; extender (Part U); relates to the membership of subcommittees for mental health of community service boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account relating to extending such provisions relating thereto (Part V); relates to the receipt of federal and state benefits received by individuals receiving care in facilities operated by an office of the department of mental hygiene; extender (Part X); relates to persons practicing in certain licensed programs or services who are exempt from practice requirements of professionals licensed by the department of education (Part Y); adds demonstration waivers to waivers allowable for home and community-based services; relates to waivers for high quality integrated care (Part Z); establishes a cost of living adjustment for designated human services programs; extender (Part AA); expands the list of controlled substances (Part BB); relates to inquiries or complaints of professional misconduct (Part CC); relates to authorizing a licensed pharmacist to administer influenza vaccine to children between two and eighteen years of age pursuant to a non-patient specific regimen; extends certain provisions of law relating thereto; provides reporting requirements for vaccines administered by pharmacists to individuals less than 19 years of age (Part DD); relates to insurance payments for independent practitioner services for individuals with developmental disabilities (Part EE); relates to establishing the office of the independent substance use disorder and mental health ombudsman for the purpose of assisting individuals with a substance use disorder and/or mental illness (Part FF); creates a certified peer recovery advocate services program (Part GG); ensures that sexual assault survivors are not billed for sexual assault forensic exams and are notified orally and in writing of the option to decline to provide private health insurance information and have the office of victim services reimburse the hospital for the exam; also provides that if such exam is covered by insurance, such coverage shall not be subject to annual deductibles or coinsurance; requires collection and storage of such evidence; relates to state-operated individualized residential alternatives; and relates to the closure or transfer of a state-operated individualized residential alternative (Part II); establishes a training program for first responders for handling emergency situations involving individuals with autism spectrum disorder and other developmental disabilities (Part JJ); requires bids submitted to the state or any agency or department of the state to contain a certification concerning sexual harassment (Subpart A); prohibits mandatory arbitration clauses (Subpart B); relates to reimbursement of funds paid by state agencies, state entities and public entities for the payment of awards adjudicated in sexual harassment claims (Subpart C); relates to nondisclosure agreements (Subpart D); establishes a model policy regarding the prevention of sexual harassment and a model training program to prevent sexual harassment in the workplace (Subpart E); relates to sexual harassment relating to non-employees (Subpart F) (Part KK); authorizes a voluntary public water system consolidation study (Part LL); relates to pharmacy audits by pharmacy benefit managers; relates to contracts between pharmacy benefit managers and pharmacies; relates to outpatient treatment; relates to establishing the children and recovering mothers program and a workgroup to study and evaluate barriers and challenges in identifying and treating expectant mothers, newborns and new parents with a substance use disorder; relates to screening students for lead when enrolling in child care, pre-school or kindergarten; relates to the lead service line replacement grant program; directs the New York state department of health to conduct a study of the high burden of asthma in the boroughs of Brooklyn and Manhattan in the city of New York; and relates to providing coverage for pasteurized donor human milk (PDHM) (Part MM); and enacts the opioid stewardship act; repealer (Part NN).
Spectrum: Committee Bill
Status: (Passed) 2018-04-12 - SIGNED CHAP.57 [S07507 Detail]
Download: New_York-2017-S07507-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ S. 7507 A. 9507 SENATE - ASSEMBLY January 18, 2018 ___________ IN SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti- cle seven of the Constitution -- read twice and ordered printed, and when printed to be committed to the Committee on Finance IN ASSEMBLY -- A BUDGET BILL, submitted by the Governor pursuant to article seven of the Constitution -- read once and referred to the Committee on Ways and Means AN ACT to amend the public health law, in relation to establishing a temporary workgroup on capital rate methodology for capital expendi- tures to hospitals and residential nursing facilities; and to amend the social services law, in relation to standard coverage for physical therapy services under medical assistance for needy persons programs (Part A); to amend the public health law, in relation to payments to residential health care facilities; to amend the social services law and the public health law, in relation to assisted living program providers licensed in the state; to amend the social services law, in relation to payments for certain medical assistance provided to eligi- ble persons participating in the New York traumatic brain injury waiv- er program; and to repeal certain provisions of section 366 of the social services law relating to furnishing medical assistance (Part B); to amend the social services law and the public health law, in relation to health homes and penalties for managed care providers (Part C); to amend the social services law and the public health law, in relation to drug coverage, updating the professional dispensing fee, copayments, pharmacist physician collaboration and comprehensive medication management; and to repeal certain provisions of the social services law relating thereto (Part D); to amend the social services law, in relation to reimbursement of transportation costs, reimburse- ment of emergency transportation services and supplemental transporta- tion payments; and repealing certain provisions of such law relating thereto (Part E); providing for not-for-profit and tax exempt corpo- rations' Medicaid capitation rates (Part F); to amend the public health law, in relation to authorizing certain retail practices to offer health services (Part G); to amend the education law, in relation to the practice of nursing by certified registered nurse anesthetists (Part H); to amend the social services law and the public health law, in relation to managed care organizations (Part I); to EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD12671-01-8S. 7507 2 A. 9507 amend the state finance law, in relation to the false claims act (Part J); authorizing the department of health to require certain health care providers to report on costs incurred; and to amend chapter 59 of the laws of 2011 amending the public health law and other laws relat- ing to known and projected department of health state fund medicaid expenditures, in relation to extending the medicaid global cap (Part K); to amend the social services law and the public health law, in relation to the child health insurance program (Part L); to amend chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, in relation to apportioning premium for certain policies; to amend part J of chapter 63 of the laws of 2001 amending chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, relat- ing to the effectiveness of certain provisions of such chapter, in relation to extending certain provisions concerning the hospital excess liability pool; and to amend part H of chapter 57 of the laws of 2017, amending the New York Health Care Reform Act of 1996 and other laws relating to extending certain provisions relating thereto, in relation to extending provisions relating to excess coverage (Part M); to amend part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for designated human services, in relation to the determination thereof; and to repeal certain provisions thereof relating to eligible programs (Part N); to amend the public health law and the insurance law, in relation to the early intervention program for infants and toddlers with disabilities and their families (Part O); to amend the public health law, in relation to the empire clinical research investigator program and hospital resident hour audits; and to repeal certain provisions of the public health law relating thereto (Part P); to amend the public health law, in relation to the health care facility transformation program (Part Q); to amend the public health law, the executive law, and the real property law, in relation to lead abatement and enforcement (Part R); to amend the public health law and the social services law, in relation to the establishment of community paramedicine collaboratives (Subpart A); to amend the public health law and the mental hygiene law, in relation to integrated services (Subpart B); and to amend the public health law, in relation to the definitions of telehealth provider, originating site and remote patient monitoring (Subpart C)(Part S); to amend chapter 59 of the laws of 2016, amending the social services law and other laws relating to authorizing the commissioner of health to apply federally estab- lished consumer price index penalties for generic drugs, and authoriz- ing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data, in relation to the effectiveness of certain provisions of such chapter; to amend chapter 58 of the laws of 2007, amending the social services law and other laws relating to adjustments of rates, in relation to the effec- tiveness of certain provisions of such chapter; to amend chapter 54 of the laws of 2016, amending part C of chapter 58 of the laws of 2005, authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof, in relation to the effectiveness thereof; to amend chapter 906 of the laws of 1984, amending the social services law relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities, in relation to the effectiveness thereof; and to amend chapter 56 of theS. 7507 3 A. 9507 laws of 2013, amending chapter 59 of the laws of 2011 amending the public health law and other laws relating to general hospital reimbursement for annual rates relating to the cap on local Medicaid expenditures, in relation to rates of payments (Part T); to amend part NN of chapter 58 of the laws of 2015 amending the mental hygiene law relating to clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs, in relation to the effectiveness thereof (Part U); to amend chapter 62 of the laws of 2003, amending the mental hygiene law and the state finance law relating to the community mental health support and workforce reinvestment program, the membership of subcommittees for mental health of community services boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account, in relation to extending such provisions relating thereto (Part V); to amend the criminal procedure law, in relation to amending the definition of appropriate institu- tion; and providing for the repeal of such provisions upon expiration thereof (Part W); to amend chapter 111 of the laws of 2010 amending the mental hygiene law relating to the receipt of federal and state benefits received by individuals receiving care in facilities operated by an office of the department of mental hygiene, in relation to the effectiveness thereof (Part X); to amend the education law, in relation to persons practicing in certain licensed programs or services who are exempt from practice requirements of professionals licensed by the department of education; to amend chapter 420 of the laws of 2002, amending the education law relating to the profession of social work, in relation to extending the expiration of certain provisions thereof; to amend chapter 676 of the laws of 2002, amending the education law relating to the practice of psychology, in relation to extending the expiration of certain provisions; and to amend chap- ter 130 of the laws of 2010, amending the education law and other laws relating to the registration of entities providing certain profes- sional services and licensure of certain professions, in relation to extending certain provisions thereof (Part Y); to amend the social services law, in relation to adding demonstration waivers to waivers allowable for home and community-based services; to amend the social services law, in relation to adding successor federal waivers to waiv- ers granted under subsection (c) of section 1915 of the federal social security law, in relation to nursing facility services; to amend the social services law, in relation to waivers for high quality and inte- grated care; to amend part C of chapter 58 of the laws of 2007, amend- ing the social services law and other laws relating to enacting the major components of legislation necessary to implement the health and mental hygiene budget for the 2007-2008 fiscal year, in relation to the effectiveness thereof; to amend the mental hygiene law, in relation to adding new and successor federal waivers to waivers in relation to home and community-based services; to amend part A of chapter 56 of the laws of 2013, amending the social services law and other laws relating to enacting the major components of legislation necessary to implement the health and mental hygiene budget for the 2013-2014 state fiscal year, in relation to the effectiveness of certain provisions thereof; to amend the public health law, in relation to expansion of comprehensive health services plans; to amend chapter 659 of the laws of 1997, amending the public health law and other laws relating to creation of continuing care retirement communi- ties, in relation to extending provisions thereof; to amend the publicS. 7507 4 A. 9507 health law, in relation to managed long term care plans, health and long term care services and developmental disability individual support and care coordination organizations; to amend chapter 165 of the laws of 1991, amending the public health law and other laws relat- ing to establishing payments for medical assistance, in relation to extending the provisions thereof; to amend the mental hygiene law, in relation to reimbursement rates; and to amend chapter 710 of the laws of 1988, amending the social services law and the education law relat- ing to medical assistance eligibility of certain persons and providing for managed medical care demonstration programs, in relation to extending the provisions thereof (Part Z); and to amend part C of chapter 57 of the laws of 2006, relating to establishing a cost of living adjustment for designated human services programs, in relation to the inclusion and development of certain cost of living adjustments (Part AA) The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. This act enacts into law major components of legislation 2 which are necessary to implement the state fiscal plan for the 2018-2019 3 state fiscal year. Each component is wholly contained within a Part 4 identified as Parts A through AA. The effective date for each particular 5 provision contained within such Part is set forth in the last section of 6 such Part. Any provision in any section contained within a Part, includ- 7 ing the effective date of the Part, which makes a reference to a section 8 "of this act", when used in connection with that particular component, 9 shall be deemed to mean and refer to the corresponding section of the 10 Part in which it is found. Section three of this act sets forth the 11 general effective date of this act. 12 PART A 13 Section 1. The public health law is amended by adding a new section 14 2827 to read as follows: 15 § 2827. Temporary workgroup on capital rate methodology. (a) The 16 commissioner shall convene a temporary workgroup comprised of represen- 17 tatives of hospitals and residential nursing facilities, as well as 18 representatives from the department, to develop recommendations for 19 streamlining the capital reimbursement methodology to achieve a one 20 percent reduction in capital expenditures to hospitals and residential 21 nursing facilities, including associated specialty and adult day health 22 care units. Pending the development of the workgroup's recommendations 23 and the implementation of any such recommendations accepted by the 24 commissioner, the commissioner shall be authorized to reduce the overall 25 amount of capital reimbursement as necessary to achieve a one percent 26 reduction in capital expenditures beginning with state fiscal year two 27 thousand eighteen--two thousand nineteen. 28 (b) The commissioner may promulgate regulations to effectuate the 29 provisions of this section. 30 § 2. Subdivision 5-d of section 2807-k of the public health law, as 31 amended by section 1 of part E of chapter 57 of the laws of 2015, is 32 amended to read as follows: 33 5-d. (a) Notwithstanding any inconsistent provision of this section, 34 section twenty-eight hundred seven-w of this article or any otherS. 7507 5 A. 9507 1 contrary provision of law, and subject to the availability of federal 2 financial participation, for periods on and after January first, two 3 thousand thirteen, through December thirty-first, two thousand [eigh-4teen] nineteen, all funds available for distribution pursuant to this 5 section, except for funds distributed pursuant to subparagraph (v) of 6 paragraph (b) of subdivision five-b of this section, and all funds 7 available for distribution pursuant to section twenty-eight hundred 8 seven-w of this article, shall be reserved and set aside and distributed 9 in accordance with the provisions of this subdivision. 10 (b) The commissioner shall promulgate regulations, and may promulgate 11 emergency regulations, establishing methodologies for the distribution 12 of funds as described in paragraph (a) of this subdivision and such 13 regulations shall include, but not be limited to, the following: 14 (i) Such regulations shall establish methodologies for determining 15 each facility's relative uncompensated care need amount based on unin- 16 sured inpatient and outpatient units of service from the cost reporting 17 year two years prior to the distribution year, multiplied by the appli- 18 cable medicaid rates in effect January first of the distribution year, 19 as summed and adjusted by a statewide cost adjustment factor and reduced 20 by the sum of all payment amounts collected from such uninsured 21 patients, and as further adjusted by application of a nominal need 22 computation that shall take into account each facility's medicaid inpa- 23 tient share. 24 (ii) Annual distributions pursuant to such regulations for the two 25 thousand thirteen through two thousand [eighteen] nineteen calendar 26 years shall be in accord with the following: 27 (A) one hundred thirty-nine million four hundred thousand dollars 28 shall be distributed as Medicaid Disproportionate Share Hospital ("DSH") 29 payments to major public general hospitals; and 30 (B) nine hundred ninety-four million nine hundred thousand dollars as 31 Medicaid DSH payments to eligible general hospitals, other than major 32 public general hospitals. 33 (iii)(A) Such regulations shall establish transition adjustments to 34 the distributions made pursuant to clauses (A) and (B) of subparagraph 35 (ii) of this paragraph such that no facility experiences a reduction in 36 indigent care pool payments pursuant to this subdivision that is greater 37 than the percentages, as specified in clause (C) of this subparagraph as 38 compared to the average distribution that each such facility received 39 for the three calendar years prior to two thousand thirteen pursuant to 40 this section and section twenty-eight hundred seven-w of this article. 41 (B) Such regulations shall also establish adjustments limiting the 42 increases in indigent care pool payments experienced by facilities 43 pursuant to this subdivision by an amount that will be, as determined by 44 the commissioner and in conjunction with such other funding as may be 45 available for this purpose, sufficient to ensure full funding for the 46 transition adjustment payments authorized by clause (A) of this subpara- 47 graph. 48 (C) No facility shall experience a reduction in indigent care pool 49 payments pursuant to this subdivision that: for the calendar year begin- 50 ning January first, two thousand thirteen, is greater than two and one- 51 half percent; for the calendar year beginning January first, two thou- 52 sand fourteen, is greater than five percent; and, for the calendar year 53 beginning on January first, two thousand fifteen[,]; is greater than 54 seven and one-half percent, and for the calendar year beginning on Janu- 55 ary first, two thousand sixteen, is greater than ten percent; and for 56 the calendar year beginning on January first, two thousand seventeen, isS. 7507 6 A. 9507 1 greater than twelve and one-half percent; and for the calendar year 2 beginning on January first, two thousand eighteen, is greater than 3 fifteen percent; and for the calendar year beginning on January first, 4 two thousand nineteen, is greater than seventeen and one-half percent. 5 (iv) Such regulations shall reserve one percent of the funds available 6 for distribution in the two thousand fourteen and two thousand fifteen 7 calendar years, and for calendar years thereafter, pursuant to this 8 subdivision, subdivision fourteen-f of section twenty-eight hundred 9 seven-c of this article, and sections two hundred eleven and two hundred 10 twelve of chapter four hundred seventy-four of the laws of nineteen 11 hundred ninety-six, in a "financial assistance compliance pool" and 12 shall establish methodologies for the distribution of such pool funds to 13 facilities based on their level of compliance, as determined by the 14 commissioner, with the provisions of subdivision nine-a of this section. 15 (c) The commissioner shall annually report to the governor and the 16 legislature on the distribution of funds under this subdivision includ- 17 ing, but not limited to: 18 (i) the impact on safety net providers, including community providers, 19 rural general hospitals and major public general hospitals; 20 (ii) the provision of indigent care by units of services and funds 21 distributed by general hospitals; and 22 (iii) the extent to which access to care has been enhanced. 23 § 3. Subdivision 14-a of section 2807 of the public health law, as 24 added by section 11 of part B of chapter 57 of the laws of 2015, is 25 amended to read as follows: 26 14-a. (a) Notwithstanding any provision of law to the contrary, and 27 subject to federal financial participation, the commissioner is author- 28 ized to establish, pursuant to regulations, a statewide general hospital 29 quality pool for the purpose of incentivizing and facilitating quality 30 improvements in general hospitals. 31 (b) Such regulations shall include provisions: 32 (i) to create a performance target to reduce potentially preventable 33 emergency department visits; 34 (ii) to reduce or eliminate the payment of the rates, published by the 35 department on the hospital inpatient publication schedules and hospital 36 ambulatory patient group schedules, which are paid by contractors to 37 hospitals, based on the quality and safety scores of a hospital as 38 determined by the department; and 39 (iii) to facilitate necessary quality improvements in hospitals, as 40 determined by the commissioner. 41 (c) Awards from such pool shall be subject to approval by the director 42 of budget. If federal financial participation is unavailable, then the 43 non-federal share of awards made pursuant to this subdivision may be 44 made as state grants. 45 [(a)] (d) Thirty days prior to adopting or applying a methodology or 46 procedure for making an allocation or modification to an allocation made 47 pursuant to this subdivision, the commissioner shall provide written 48 notice to the chairs of the senate finance committee, the assembly ways 49 and means committee, and the senate and assembly health committees with 50 regard to the intent to adopt or apply the methodology or procedure, 51 including a detailed explanation of the methodology or procedure. 52 [(b)] (e) Thirty days prior to executing an allocation or modification 53 to an allocation made pursuant to this subdivision, the commissioner 54 shall provide written notice to the chairs of the senate finance commit- 55 tee, the assembly ways and means committee, and the senate and assembly 56 health committees with regard to the intent to distribute such funds.S. 7507 7 A. 9507 1 Such notice shall include, but not be limited to, information on the 2 methodology used to distribute the funds, the facility specific allo- 3 cations of the funds, any facility specific project descriptions or 4 requirements for receiving such funds, the multi-year impacts of these 5 allocations, and the availability of federal matching funds. The commis- 6 sioner shall provide quarterly reports to the chair of the senate 7 finance committee and the chair of the assembly ways and means committee 8 on the distribution and disbursement of such funds. 9 (f) Notwithstanding any inconsistent provision of law or regulation to 10 the contrary, the hospital quality pool shall allocate ten million 11 dollars annually to expand preventative services as the commissioner may 12 determine in regulation. Such preventative services may include but not 13 be limited to mental health counseling provided by a licensed clinical 14 social worker or a licensed master social worker, physical therapy, 15 diabetes prevention, or treatment by an applied behavior analyst. 16 § 4. Subparagraph (ii) of paragraph (f) of subdivision 2-a of section 17 2807 of the public health law, as amended by section 43 of part B of 18 chapter 58 of the laws of 2010, is amended to read as follows: 19 (ii) notwithstanding the provisions of paragraphs (a) and (b) of this 20 subdivision, for periods on and after January first, two thousand nine, 21 the following services provided by general hospital outpatient depart- 22 ments and diagnostic and treatment centers shall be reimbursed with 23 rates of payment based entirely upon the ambulatory patient group meth- 24 odology as described in paragraph (e) of this subdivision, provided, 25 however, that the commissioner may utilize existing payment methodol- 26 ogies or may promulgate regulations establishing alternative payment 27 methodologies for one or more of the services specified in this subpara- 28 graph, effective for periods on and after March first, two thousand 29 nine: 30 (A) services provided in accordance with the provisions of paragraphs 31 (q) and (r) of subdivision two of section three hundred sixty-five-a of 32 the social services law; and 33 (B) all services, but only with regard to additional payment amounts, 34 as determined in accordance with regulations issued in accordance with 35 paragraph (e) of this subdivision, for the provision of such services 36 during times outside the facility's normal hours of operation, as deter- 37 mined in accordance with criteria set forth in such regulations; and 38 (C) individual psychotherapy services provided by licensed social 39 workers, in accordance with licensing criteria set forth in applicable 40 regulations[, to persons under the age of twenty-one and to persons41requiring such services as a result of or related to pregnancy or giving42birth]; and 43 (D) individual psychotherapy services provided by licensed social 44 workers, in accordance with licensing criteria set forth in applicable 45 regulations, at diagnostic and treatment centers that provided, billed 46 for, and received payment for these services between January first, two 47 thousand seven and December thirty-first, two thousand seven; 48 (E) services provided to pregnant women pursuant to paragraph (s) of 49 subdivision two of section three hundred sixty-five-a of the social 50 services law and, for periods on and after January first, two thousand 51 ten, all other services provided pursuant to such paragraph (s) and 52 services provided pursuant to paragraph (t) of subdivision two of 53 section three hundred sixty-five-a of the social services law; 54 (F) wheelchair evaluation services and eyeglass dispensing services; 55 andS. 7507 8 A. 9507 1 (G) immunization services, effective for services rendered on and 2 after June tenth, two thousand nine. 3 § 5. Paragraph (h) of subdivision 2 of section 365-a of the social 4 services law, as amended by chapter 220 of the laws of 2011, is amended 5 to read as follows: 6 (h) speech therapy, and when provided at the direction of a physician 7 or nurse practitioner, physical therapy including related rehabilitative 8 services and occupational therapy; provided, however, that speech thera- 9 py[, physical therapy] and occupational therapy [each] shall be limited 10 to coverage of twenty visits per year; physical therapy shall be limited 11 to coverage of forty visits per year; such limitation shall not apply to 12 persons with developmental disabilities or, notwithstanding any other 13 provision of law to the contrary, to persons with traumatic brain inju- 14 ry; 15 § 6. This act shall take effect immediately. 16 PART B 17 Section 1. Subdivision 2-c of section 2808 of the public health law is 18 amended by adding a new paragraph (g) to read as follows: 19 (g) The commissioner shall reduce Medicaid revenue to a residential 20 health care facility in a payment year by two percent if in each of the 21 two most recent payment years for which New York state nursing home 22 quality initiative data is available, the facility was ranked in the 23 lowest two quintiles of facilities based on its nursing home quality 24 initiative performance, and was ranked in the lowest quintile in the 25 most recent payment year. The commissioner may waive the application of 26 this paragraph to a facility if the commissioner determines that the 27 facility is in extreme financial distress. 28 § 2. Subdivision 3 of section 461-l of the social services law is 29 amended by adding four new paragraphs (k), (l), (m) and (n) to read as 30 follows: 31 (k)(i) Existing assisted living program providers licensed on or 32 before April first, two thousand eighteen may apply to the department 33 for up to nine additional assisted living program beds, by a deadline to 34 be determined by the department. The department may utilize an expedited 35 review process to allow eligible applicants in good standing the ability 36 to be licensed for the additional beds within ninety days of the depart- 37 ment's receipt of a satisfactory application. Eligible applicants are 38 those that: do not require major renovation or construction; serve only 39 public pay individuals; and are in substantial compliance with appropri- 40 ate state and local requirements as determined by the department. 41 (ii) Existing assisted living program providers licensed on or before 42 April first, two thousand twenty may submit additional applications for 43 up to nine additional assisted living program beds on June thirtieth, 44 two thousand twenty, and by a deadline to be determined by the depart- 45 ment. Every two years thereafter, existing providers licensed on or 46 before April first of such year may submit such applications on June 47 thirtieth of such year, and by a deadline to be determined by the 48 department. The number of additional assisted living program beds shall 49 be based on the total number of previously awarded beds either withdrawn 50 by the applicant or denied by the department. 51 (l) The commissioner of health is authorized to solicit and award 52 applications for up to a total of five hundred new assisted living 53 program beds in those counties where there is one or no assisted livingS. 7507 9 A. 9507 1 program providers, pursuant to criteria to be determined by the commis- 2 sioner. 3 (m) The commissioner of health is authorized to solicit and award 4 applications for up to five hundred new assisted living program beds in 5 counties where utilization of existing assisted living program beds 6 exceeds eighty-five percent. All applicants shall comply with federal 7 home and community-based settings requirements, as set forth in 42 CFR 8 Part 441 Subpart G. To be eligible for an award, an applicant must agree 9 to: 10 (i) Serve only public pay individuals; 11 (ii) Develop and execute collaborative agreements within twenty-four 12 months of an application being made to the department, in accordance 13 with guidance to be published by the department, between at least one of 14 each of the following entities: an adult care facility; a residential 15 health care facility; and a general hospital; 16 (iii) Enter into an agreement with an existing managed care entity; 17 and 18 (iv) Participate in value based payment models, where such models are 19 available for participation. 20 (n) The commissioner of health is authorized to create a program to 21 subsidize the cost of assisted living for those individuals living with 22 Alzheimer's disease and dementia who are not eligible for medical 23 assistance pursuant to title eleven of article five of this chapter. The 24 program shall authorize up to two hundred vouchers to individuals 25 through an application process and pay for up to seventy-five percent of 26 the average private pay rate in the respective region. The commissioner 27 may propose rules and regulations to effectuate this provision. 28 § 3. Subparagraph (i) of paragraph (b) of subdivision 7 of section 29 4403-f of the public health law, as amended by section 41-b of part H of 30 chapter 59 of the laws of 2011, is amended to read as follows: 31 (i) The commissioner shall, to the extent necessary, submit the appro- 32 priate waivers, including, but not limited to, those authorized pursuant 33 to sections eleven hundred fifteen and nineteen hundred fifteen of the 34 federal social security act, or successor provisions, and any other 35 waivers necessary to achieve the purposes of high quality, integrated, 36 and cost effective care and integrated financial eligibility policies 37 under the medical assistance program or pursuant to title XVIII of the 38 federal social security act. In addition, the commissioner is authorized 39 to submit the appropriate waivers, including but not limited to those 40 authorized pursuant to sections eleven hundred fifteen and nineteen 41 hundred fifteen of the federal social security act or successor 42 provisions, and any other waivers necessary to require on or after April 43 first, two thousand twelve, medical assistance recipients who are twen- 44 ty-one years of age or older and who require community-based long term 45 care services, as specified by the commissioner, for more than one 46 hundred and twenty days, to receive such services through an available 47 plan certified pursuant to this section or other program model that 48 meets guidelines specified by the commissioner that support coordination 49 and integration of services. Such guidelines shall address the require- 50 ments of paragraphs (a), (b), (c), (d), (e), (f), (g), (h), and (i) of 51 subdivision three of this section as well as payment methods that ensure 52 provider accountability for cost effective quality outcomes. Such other 53 program models may include long term home health care programs that 54 comply with such guidelines. Copies of such original waiver applications 55 and amendments thereto shall be provided to the chairs of the senate 56 finance committee, the assembly ways and means committee and the senateS. 7507 10 A. 9507 1 and assembly health committees simultaneously with their submission to 2 the federal government. 3 On or after October first, two thousand eighteen, the commissioner 4 may, through such an approved waiver, limit enrollment in a plan certi- 5 fied under this section to individuals who achieve a score of nine or 6 above when assessed using the Uniform Assessment System for New York 7 assessment tool and who require community-based long term care services 8 for a continuous period of more than one hundred twenty days from the 9 date of enrollment and from the dates when continuing enrollment is 10 reauthorized; however, medical assistance recipients enrolled in a 11 managed long term care plan on October first, two thousand eighteen may 12 continue to be eligible for such plans, irrespective of whether the 13 enrollee meets these level of care requirements, provided that once such 14 recipients are disenrolled from their managed long term care plan, any 15 applicable level of care requirements would apply to future eligibility 16 determinations. 17 § 4. Subparagraphs (vii) and (viii) of paragraph (b) of subdivision 7 18 of section 4403-f of the public health law are redesignated as subpara- 19 graphs (viii) and (ix) and a new subparagraph (vii) is added to read as 20 follows: 21 (vii) If another managed long term care plan certified under this 22 section is available, medical assistance recipients required to enroll 23 in such plans pursuant to this section may change plans without cause 24 within thirty days of notification of enrollment or the effective date 25 of enrollment into a plan, whichever is later, by making a request of 26 the local social services district or entity designated by the depart- 27 ment, except that such period shall be forty-five days for recipients 28 who have been assigned to a provider by the commissioner. However, after 29 such thirty or forty-five day period, whichever is applicable, a recipi- 30 ent may be prohibited from changing plans more frequently than once 31 every twelve months, as permitted by federal law, except for good cause 32 as determined by the commissioner. 33 § 5. Clauses 11 and 12 of subparagraph (v) of paragraph (b) of subdi- 34 vision 7 of section 4403-f of the public health law, as amended by 35 section 48 of part A of chapter 56 of the laws of 2013, are amended to 36 read as follows: 37 (11) a person who is eligible for medical assistance pursuant to para- 38 graph (b) of subdivision four of section three hundred sixty-six of the 39 social services law; [and] 40 (12) Native Americans; and 41 (13) a person who is permanently placed in a nursing home for a 42 consecutive period of six months or more. 43 § 6. Paragraph (a) of subdivision 3 of section 366 of the social 44 services law is REPEALED and a new paragraph (a) is added to read as 45 follows: 46 (a) Medical assistance shall be furnished without consideration of the 47 income and resources of an applicant's legally responsible relative if 48 the applicant's eligibility would normally be determined by comparing 49 the amount of available income and/or resources of the applicant, 50 including amounts deemed available to the applicant from legally respon- 51 sible relatives, to an applicable eligibility standard, and: 52 (1) (i) the legally responsible relative is a community spouse, as 53 defined in section three hundred sixty-six-c of this title; 54 (ii) such relative is refusing to make his or her income and/or 55 resources available to meet the cost of necessary medical care, 56 services, and supplies; andS. 7507 11 A. 9507 1 (iii) the applicant executes an assignment of support from the commu- 2 nity spouse in favor of the social services district and the department, 3 unless the applicant is unable to execute such assignment due to phys- 4 ical or mental impairment or to deny assistance would create an undue 5 hardship, as defined by the commissioner; or 6 (2) the legally responsible relative is absent from the applicant's 7 household, and fails or refuses to make his or her income and/or 8 resources available to meet the cost of necessary medical care, 9 services, and supplies. 10 In such cases, however, the furnishing of such assistance shall create 11 an implied contract with such relative, and the cost thereof may be 12 recovered from such relative in accordance with title six of article 13 three of this chapter and other applicable provisions of law. 14 § 7. Subparagraph (i) of paragraph (d) of subdivision 2 of section 15 366-c of the social services law is amended by adding a new clause (C) 16 to read as follows: 17 (C) on and after July first, two thousand eighteen, twenty-four thou- 18 sand one hundred eighty dollars or such greater amount as may be 19 required under federal law; 20 § 8. Subdivision 1 of section 367-a of the social services law is 21 amended by adding a new paragraph (h) to read as follows: 22 (h) Amounts payable under this title for medical assistance in the 23 form of freestanding clinic services pursuant to article twenty-eight of 24 the public health law provided to eligible persons participating in the 25 New York traumatic brain injury waiver program who are also benefici- 26 aries under part B of title XVIII of the federal social security act or 27 who are qualified medicare beneficiaries under part B of title XVIII of 28 such act shall not be less than the approved medical assistance payment 29 level less the amount payable under part B. 30 § 9. The commissioner of health shall conduct a study of home and 31 community based services available to recipients of the Medicaid program 32 in rural areas of the state. Such study shall include a review and anal- 33 ysis of factors affecting such availability, including but not limited 34 to transportation costs, costs of direct care personnel including home 35 health aides, personal care attendants and other direct service person- 36 nel, opportunities for telehealth services, and technological advances 37 to improve efficiencies. Consistent with the results of the study, the 38 commissioner of health is authorized to provide a targeted Medicaid rate 39 enhancement to fee-for-service personal care rates and rates under Medi- 40 caid waiver programs such as the nursing home transition and diversion 41 waiver and the traumatic brain injury program waiver, in an aggregate 42 amount of three million dollars minus the cost of conducting the study; 43 provided further, that nothing in this section shall be deemed to affect 44 payment for the costs of the study and any related Medicaid rate 45 enhancement if federal participation is not available for such costs. 46 § 10. This act shall take effect immediately; provided, however, that 47 the amendments made to paragraph (b) of subdivision 7 of section 4403-f 48 of the public health law made by sections three, four and five of this 49 act shall not affect the expiration of such paragraph pursuant to subdi- 50 vision (i) of section 111 of part H of chapter 59 of the laws of 2011, 51 as amended, and shall be deemed to expire therewith; provided, further, 52 that the amendments to paragraph (b) of subdivision 7 of section 4403-f 53 of the public health law made by sections three, four and five of this 54 act shall not affect the repeal of such section pursuant to chapter 659 55 of the laws of 1997, as amended, and shall be deemed repealed therewith;S. 7507 12 A. 9507 1 provided, further, that section four of this act shall take effect on 2 October 1, 2018. 3 PART C 4 Section 1. Subdivision 2 of section 365-l of the social services law, 5 as amended by section 1 of part S of chapter 57 of the laws of 2017, is 6 amended to read as follows: 7 2. In addition to payments made for health home services pursuant to 8 subdivision one of this section, the commissioner is authorized to pay 9 additional amounts: (a) to providers of health home services that meet 10 process or outcome standards specified by the commissioner; and (b) to 11 Medicaid managed care enrollees who are members of health homes in the 12 form of incentive payments to reward such enrollees for participating in 13 wellness activities and for avoiding unnecessary hospitalizations and 14 unnecessary utilization of hospital emergency department services. Such 15 additional amounts may be paid with state funds only if federal finan- 16 cial participation for such payments is unavailable. 17 § 2. Section 365-l of the social services law is amended by adding a 18 new subdivision 2-d to read as follows: 19 2-d. The commissioner shall establish targets for health home partic- 20 ipation by enrollees of special needs managed care plans designated 21 pursuant to subdivision four of section three hundred sixty-five-m of 22 this title and by high-risk enrollees of other Medicaid managed care 23 plans operating pursuant to section three hundred sixty-four-j of this 24 title, and shall require the managed care providers to work collabora- 25 tively with health homes to achieve such targets. The commissioner may 26 assess penalties under this subdivision against managed care providers 27 that fail to meet the participation targets established pursuant to this 28 subdivision, except that managed care providers shall not be penalized 29 for the failure of a health home to work collaboratively toward meeting 30 the participation targets. 31 § 3. Subdivision 6 of section 2899 of the public health law, as 32 amended by chapter 471 of the laws of 2016, is amended to read as 33 follows: 34 6. "Provider" shall mean (a) any residential health care facility 35 licensed under article twenty-eight of this chapter; or any certified 36 home health agency, licensed home care services agency or long term home 37 health care program certified under article thirty-six of this chapter; 38 any hospice program certified pursuant to article forty of this chapter; 39 or any adult home, enriched housing program or residence for adults 40 licensed under article seven of the social services law; or (b) a health 41 home, or any subcontractor of such health home, who contracts with or is 42 approved or otherwise authorized by the department to provide health 43 home services to all those enrolled pursuant to a diagnosis of a devel- 44 opmental disability as defined in subdivision twenty-two of section 1.03 45 of the mental hygiene law and enrollees who are under twenty-one years 46 of age under section three hundred sixty-five-l of the social services 47 law, or any entity that provides home and community based services to 48 enrollees who are under twenty-one years of age under a demonstration 49 program pursuant to section eleven hundred fifteen of the federal social 50 security act. 51 § 4. Paragraph (b) of subdivision 9 of section 2899-a of the public 52 health law, as added by chapter 331 of the laws of 2006, is amended to 53 read as follows:S. 7507 13 A. 9507 1 (b) Residential health care facilities licensed pursuant to article 2 twenty-eight of this chapter and certified home health care agencies and 3 long-term home health care programs certified or approved pursuant to 4 article thirty-six of this chapter or a health home, or any subcontrac- 5 tor of such health home, who contracts with or is approved or otherwise 6 authorized by the department to provide health home services to all 7 those enrolled pursuant to a diagnosis of a developmental disability as 8 defined in subdivision twenty-two of section 1.03 of the mental hygiene 9 law and enrollees who are under twenty-one years of age under section 10 three hundred sixty-five-l of the social services law, or any entity 11 that provides home and community based services to enrollees who are 12 under twenty-one years of age under a demonstration program pursuant to 13 section eleven hundred fifteen of the federal social security act, may, 14 subject to the availability of federal financial participation, claim as 15 reimbursable costs under the medical assistance program, costs reflect- 16 ing the fee established pursuant to law by the division of criminal 17 justice services for processing a criminal history information check, 18 the fee imposed by the federal bureau of investigation for a national 19 criminal history check, and costs associated with obtaining the finger- 20 prints, provided, however, that for the purposes of determining rates of 21 payment pursuant to article twenty-eight of this chapter for residential 22 health care facilities, such reimbursable fees and costs shall be 23 reflected as timely as practicable in such rates within the applicable 24 rate period. 25 § 5. Subdivision 10 of section 2899-a of the public health law, as 26 amended by chapter 206 of the laws of 2017, is amended to read as 27 follows: 28 10. Notwithstanding subdivision eleven of section eight hundred 29 forty-five-b of the executive law, a certified home health agency, 30 licensed home care services agency or long term home health care program 31 certified, licensed or approved under article thirty-six of this chapter 32 or a home care services agency exempt from certification or licensure 33 under article thirty-six of this chapter, a hospice program under arti- 34 cle forty of this chapter, or an adult home, enriched housing program or 35 residence for adults licensed under article seven of the social services 36 law, or a health home, or any subcontractor of such health home, who 37 contracts with or is approved or otherwise authorized by the department 38 to provide health home services to all enrollees enrolled pursuant to a 39 diagnosis of a developmental disability as defined in subdivision twen- 40 ty-two of section 1.03 of the mental hygiene law and enrollees who are 41 under twenty-one years of age under section three hundred sixty-five-l 42 of the social services law, or any entity that provides home and commu- 43 nity based services to enrollees who are under twenty-one years of age 44 under a demonstration program pursuant to section eleven hundred fifteen 45 of the federal social security act may temporarily approve a prospective 46 employee while the results of the criminal history information check and 47 the determination are pending, upon the condition that the provider 48 conducts appropriate direct observation and evaluation of the temporary 49 employee, while he or she is temporarily employed, and the care recipi- 50 ent. The results of such observations shall be documented in the tempo- 51 rary employee's personnel file and shall be maintained. For purposes of 52 providing such appropriate direct observation and evaluation, the 53 provider shall utilize an individual employed by such provider with a 54 minimum of one year's experience working in an agency certified, 55 licensed or approved under article thirty-six of this chapter or an 56 adult home, enriched housing program or residence for adults licensedS. 7507 14 A. 9507 1 under article seven of the social services law, a health home, or any 2 subcontractor of such health home, who contracts with or is approved or 3 otherwise authorized by the department to provide health home services 4 to those enrolled pursuant to a diagnosis of a developmental disability 5 as defined in subdivision twenty-two of section 1.03 of the mental 6 hygiene law and enrollees who are under twenty-one years of age under 7 section three hundred sixty-five-l of the social services law, or any 8 entity that provides home and community based services to enrollees who 9 are under twenty-one years of age under a demonstration program pursuant 10 to section eleven hundred fifteen of the federal social security act. If 11 the temporary employee is working under contract with another provider 12 certified, licensed or approved under article thirty-six of this chap- 13 ter, such contract provider's appropriate direct observation and evalu- 14 ation of the temporary employee, shall be considered sufficient for the 15 purposes of complying with this subdivision. 16 § 6. Subdivision 3 of section 424-a of the social services law, as 17 amended by section 3 of part Q of chapter 56 of the laws of 2017, is 18 amended to read as follows: 19 3. For purposes of this section, the term "provider" or "provider 20 agency" shall mean: an authorized agency; the office of children and 21 family services; juvenile detention facilities subject to the certif- 22 ication of the office of children and family services; programs estab- 23 lished pursuant to article nineteen-H of the executive law; non-residen- 24 tial or residential programs or facilities licensed or operated by the 25 office of mental health or the office for people with developmental 26 disabilities except family care homes; licensed child day care centers, 27 including head start programs which are funded pursuant to title V of 28 the federal economic opportunity act of nineteen hundred sixty-four, as 29 amended; early intervention service established pursuant to section 30 twenty-five hundred forty of the public health law; preschool services 31 established pursuant to section forty-four hundred ten of the education 32 law; school-age child care programs; special act school districts as 33 enumerated in chapter five hundred sixty-six of the laws of nineteen 34 hundred sixty-seven, as amended; programs and facilities licensed by the 35 office of alcoholism and substance abuse services; residential schools 36 which are operated, supervised or approved by the education department; 37 health homes, or any subcontract or of such health homes, who contracts 38 with or is approved or otherwise authorized by the department of health 39 to provide health home services to all those enrolled pursuant to a 40 diagnosis of a developmental disability as defined in subdivision twen- 41 ty-two of section 1.03 of the mental hygiene law and enrollees who are 42 under twenty-one years of age under section three hundred sixty-five-l 43 of this chapter, or any entity that provides home and community based 44 services to enrollees who are under twenty-one years of age under a 45 demonstration program pursuant to section eleven hundred fifteen of the 46 federal social security act; publicly-funded emergency shelters for 47 families with children, provided, however, for purposes of this section, 48 when the provider or provider agency is a publicly-funded emergency 49 shelter for families with children, then all references in this section 50 to the "potential for regular and substantial contact with individuals 51 who are cared for by the agency" shall mean the potential for regular 52 and substantial contact with children who are served by such shelter; 53 and any other facility or provider agency, as defined in subdivision 54 four of section four hundred eighty-eight of this chapter, in regard to 55 the employment of staff, or use of providers of goods and services and 56 staff of such providers, consultants, interns and volunteers.S. 7507 15 A. 9507 1 § 7. Paragraph (a) of subdivision 1 of section 413 of the social 2 services law, as amended by section 2 of part Q of chapter 56 of the 3 laws of 2017, is amended to read as follows: 4 (a) The following persons and officials are required to report or 5 cause a report to be made in accordance with this title when they have 6 reasonable cause to suspect that a child coming before them in their 7 professional or official capacity is an abused or maltreated child, or 8 when they have reasonable cause to suspect that a child is an abused or 9 maltreated child where the parent, guardian, custodian or other person 10 legally responsible for such child comes before them in their profes- 11 sional or official capacity and states from personal knowledge facts, 12 conditions or circumstances which, if correct, would render the child an 13 abused or maltreated child: any physician; registered physician assist- 14 ant; surgeon; medical examiner; coroner; dentist; dental hygienist; 15 osteopath; optometrist; chiropractor; podiatrist; resident; intern; 16 psychologist; registered nurse; social worker; emergency medical techni- 17 cian; licensed creative arts therapist; licensed marriage and family 18 therapist; licensed mental health counselor; licensed psychoanalyst; 19 licensed behavior analyst; certified behavior analyst assistant; hospi- 20 tal personnel engaged in the admission, examination, care or treatment 21 of persons; a Christian Science practitioner; school official, which 22 includes but is not limited to school teacher, school guidance counse- 23 lor, school psychologist, school social worker, school nurse, school 24 administrator or other school personnel required to hold a teaching or 25 administrative license or certificate; full or part-time compensated 26 school employee required to hold a temporary coaching license or profes- 27 sional coaching certificate; social services worker; employee of a publ- 28 icly-funded emergency shelter for families with children; director of a 29 children's overnight camp, summer day camp or traveling summer day camp, 30 as such camps are defined in section thirteen hundred ninety-two of the 31 public health law; day care center worker; school-age child care worker; 32 provider of family or group family day care; employee or volunteer in a 33 residential care facility for children that is licensed, certified or 34 operated by the office of children and family services; or any other 35 child care or foster care worker; mental health professional; substance 36 abuse counselor; alcoholism counselor; all persons credentialed by the 37 office of alcoholism and substance abuse services; employees of a health 38 home or health home care management agency contracting with a health 39 home as designated by the department of health and authorized under 40 section three hundred sixty-five-l of this chapter or such employees who 41 provide home and community based services under a demonstration program 42 pursuant to section eleven hundred fifteen of the federal social securi- 43 ty act; peace officer; police officer; district attorney or assistant 44 district attorney; investigator employed in the office of a district 45 attorney; or other law enforcement official. 46 § 8. Section 364-j of the social services law is amended by adding a 47 new subdivision 34 to read as follows: 48 34. (a) The commissioner may, in his or her discretion, apply penal- 49 ties to managed care providers that do not submit a performing provider 50 system partnership plan by July first, two thousand eighteen, in accord- 51 ance with any submission guidelines issued by the department prior ther- 52 eto. For purposes of this subdivision, "performing provider system part- 53 nership plan" shall mean a plan submitted by such managed care providers 54 to the department that includes both short and long term approaches for 55 effective collaboration with each performing provider system within its 56 service area.S. 7507 16 A. 9507 1 (b) Such penalties shall be as follows: for managed care providers 2 that do not submit a performing provider system partnership plan in 3 accordance with this subdivision, Medicaid premiums shall be reduced by 4 eighty-five one-hundredths of one percent for the rate period from April 5 first, two thousand eighteen through March thirty-first, two thousand 6 nineteen. 7 § 9. This act shall take effect immediately; provided, however, that 8 the amendments made to subdivision 6 of section 2899 of the public 9 health law made by section three of this act shall take effect on the 10 same date and in the same manner as section 8 of chapter 471 of the laws 11 of 2016, as amended, takes effect and shall not affect the expiration of 12 such subdivision and shall be deemed expired therewith; provided 13 further, however, that the amendments made to section 364-j of the 14 social services law made by section eight of this act shall not affect 15 the repeal of such section and shall be deemed repealed therewith. 16 PART D 17 Section 1. Paragraph (d) of subdivision 9 of section 367-a of the 18 social services law, as amended by section 7 of part D of chapter 57 of 19 the laws of 2017, is amended to read as follows: 20 (d) In addition to the amounts paid pursuant to paragraph (b) of this 21 subdivision, the department shall pay a professional pharmacy dispensing 22 fee for each such drug dispensed in the amount of ten dollars and eight 23 cents per prescription or written order of a practitioner; provided, 24 however that this professional dispensing fee will not apply to drugs 25 that are available without a prescription as required by section sixty- 26 eight hundred ten of the education law but do not meet the definition of 27 a covered outpatient drug pursuant to Section 1927K of the Social Secu- 28 rity Act. 29 § 2. Paragraph (a) of subdivision 4 of section 365-a of the social 30 services law, as amended by chapter 493 of the laws of 2010, is amended 31 to read as follows: 32 (a) drugs which may be dispensed without a prescription as required by 33 section sixty-eight hundred ten of the education law; provided, however, 34 that the state commissioner of health may by regulation specify certain 35 of such drugs which may be reimbursed as an item of medical assistance 36 in accordance with the price schedule established by such commissioner. 37 Notwithstanding any other provision of law, [additions] modifications to 38 the list of drugs reimbursable under this paragraph may be filed as 39 regulations by the commissioner of health without prior notice and 40 comment; 41 § 3. Paragraph (c) of subdivision 6 of section 367-a of the social 42 services law is amended by adding a new subparagraph (v) to read as 43 follows: 44 (v) Notwithstanding any other provision of this paragraph, co-payments 45 charged for drugs dispensed without a prescription as required by 46 section sixty-eight hundred ten of the education law but which are reim- 47 bursed as an item of medical assistance pursuant to paragraph (a) of 48 subdivision four of section three hundred sixty-five-a of this title 49 shall be one dollar. 50 § 4. Paragraph (b) of subdivision 3 of section 273 of the public 51 health law, as added by section 10 of part C of chapter 58 of the laws 52 of 2005, is amended to read as follows: 53 (b) In the event that the patient does not meet the criteria in para- 54 graph (a) of this subdivision, the prescriber may provide additionalS. 7507 17 A. 9507 1 information to the program to justify the use of a prescription drug 2 that is not on the preferred drug list. The program shall provide a 3 reasonable opportunity for a prescriber to reasonably present his or her 4 justification of prior authorization. [If, after consultation with the5program, the prescriber, in his or her reasonable professional judgment,6determines that the use of a prescription drug that is not on the7preferred drug list is warranted, the prescriber's determination shall8be final.] The program will consider the additional information and the 9 justification presented to determine whether the use of a prescription 10 drug that is not on the preferred drug list is warranted. 11 § 5. Subdivisions 25 and 25-a of section 364-j of the social services 12 law are REPEALED. 13 § 6. The public health law is amended by adding a new section 280-c to 14 read as follows: 15 § 280-c. Comprehensive medication management. 1. Definitions. For 16 purposes of this section: 17 (a) Qualified pharmacist. The term "qualified pharmacist" shall mean a 18 pharmacist who maintains a current unrestricted license pursuant to 19 article one hundred thirty-seven of the education law, who has a minimum 20 of two years of experience in patient care as a practicing pharmacist 21 within the last five years, and who has demonstrated competency in the 22 medication management of patients with a chronic disease or diseases, 23 including but not limited to, the completion of one or more programs 24 which are accredited by the accreditation council for pharmacy educa- 25 tion, recognized by the education department and acceptable to the 26 patient's treating physician. 27 (b) Comprehensive medication management. The term "comprehensive medi- 28 cation management" shall mean a program conducted by a qualified pharma- 29 cist that ensures a patient's medications, whether prescription or 30 nonprescription, are individually assessed to determine that each medi- 31 cation is appropriate for the patient, effective for the medical condi- 32 tion, safe given comorbidities and other medications being taken, and 33 able to be taken by the patient as intended. Comprehensive medication 34 management conducted by a qualified pharmacist shall include sharing of 35 applicable patient clinical information with the treating physician as 36 specified in the comprehensive medication management protocol. 37 (c) Comprehensive medication management protocol. The term "comprehen- 38 sive medication management protocol" means a written document pursuant 39 to and consistent with any applicable state and federal requirements, 40 that is entered into voluntarily by either a physician licensed pursuant 41 to article one hundred thirty-one of the education law or a nurse prac- 42 titioner certified pursuant to section sixty-nine hundred ten of the 43 education law, and a qualified pharmacist which addresses a chronic 44 disease or diseases as determined by the treating physician or nurse 45 practitioner and that describes the nature and scope of the comprehen- 46 sive medication management services to be performed by the qualified 47 pharmacist, in accordance with the provisions of this section. Compre- 48 hensive medication management protocols between licensed physicians or 49 nurse practitioners and qualified pharmacists shall be made available to 50 the department for review and to ensure compliance with this article, 51 upon request. 52 2. Authorization to establish comprehensive medication management 53 protocols. A physician licensed pursuant to article one hundred thirty- 54 one of the education law or a nurse practitioner certified pursuant to 55 section sixty-nine hundred ten of the education law shall be authorized 56 to voluntarily establish a comprehensive medication management protocolS. 7507 18 A. 9507 1 with a qualified pharmacist to provide comprehensive medication manage- 2 ment services for a patient who has not met clinical goals of therapy, 3 is at risk for hospitalization, or for whom the physician or nurse prac- 4 titioner deems it is necessary to receive comprehensive medication 5 management services. Participation by the patient in comprehensive medi- 6 cation management services shall be voluntary. 7 3. Scope of comprehensive medication management protocols. (a) Under a 8 comprehensive medication management protocol, a qualified pharmacist 9 shall be permitted to: 10 (i) adjust or manage a drug regimen for the patient, pursuant to the 11 patient specific order or protocol established by the patient's treating 12 physician or nurse practitioner, which may include adjusting drug 13 strength, frequency of administration or route of administration. 14 Adjusting the drug regimen shall not include substituting or selecting a 15 different drug which differs from that initially prescribed by the 16 patient's treating physician or nurse practitioner unless such substi- 17 tution is expressly authorized in the written order or protocol. The 18 qualified pharmacist shall be required to immediately document in the 19 patient's medical record changes made to the drug therapy. The patient's 20 treating physician or nurse practitioner may prohibit, by written 21 instruction, any adjustment or change in the patient's drug regimen by 22 the qualified pharmacist; 23 (ii) evaluate and only if specifically authorized by the protocol, and 24 only to the extent necessary to discharge the responsibility set forth 25 in this section, order or perform routine patient monitoring functions 26 or disease state laboratory tests related to the drug therapy comprehen- 27 sive medication management for the specific chronic disease or diseases 28 specified within the written agreement or comprehensive medication 29 management protocol; 30 (iii) only if specifically authorized by the written order or protocol 31 and only to the extent necessary to discharge the responsibilities set 32 forth in this section, order or perform routine patient monitoring func- 33 tions as may be necessary in the drug therapy management, including the 34 collecting and reviewing of patient histories, and ordering or checking 35 patient vital signs, including pulse, temperature, blood pressure, 36 weight and respiration; and 37 (iv) access the complete patient medical record maintained by the 38 treating physician or nurse practitioner with whom the qualified pharma- 39 cist has the comprehensive medication management protocol and shall 40 document any adjustments made pursuant to the protocol in the patient's 41 medical record and shall notify the patient's treating physician or 42 nurse practitioner of any adjustments in a timely manner electronically 43 or by other means. 44 (b) Under no circumstances shall the qualified pharmacist be permitted 45 to delegate comprehensive medication management services to any other 46 licensed pharmacist or other pharmacy personnel. 47 4. Medication adjustments. Any medication adjustments made by the 48 qualified pharmacist pursuant to the comprehensive medication management 49 protocol, including adjustments in drug strength, frequency or route of 50 administration, or initiation of a drug which differs from that initial- 51 ly prescribed and as documented in the patient medical record, shall be 52 deemed an oral prescription authorized by an agent of the patient's 53 treating physician or nurse practitioner and shall be dispensed consist- 54 ent with section sixty-eight hundred ten of the education law. For the 55 purposes of this section, a pharmacist who is not an employee of theS. 7507 19 A. 9507 1 physician or nurse practitioner may be authorized to serve as an agent 2 of the physician or nurse practitioner. 3 5. Referrals. A physician licensed pursuant to article one hundred 4 thirty-one of the education law or a nurse practitioner certified pursu- 5 ant to section sixty-nine hundred ten of the education law, who has 6 responsibility for the treatment and care of a patient for a chronic 7 disease or diseases as determined by the physician or nurse practitioner 8 may refer the patient to a qualified pharmacist for comprehensive medi- 9 cation management services, pursuant to the comprehensive medication 10 management protocol that the physician or nurse practitioner has estab- 11 lished with the qualified pharmacist. The protocol agreement shall 12 authorize the pharmacist to serve as an agent of the physician or nurse 13 practitioner as defined by the protocol. Such referral shall be docu- 14 mented in the patient's medical record. 15 6. Patient participation. Participation in comprehensive medication 16 management services shall be voluntary, and no patient, physician, nurse 17 practitioner or pharmacist shall be required to participate. The refer- 18 ral of a patient for comprehensive medication management services and 19 the patient's right to choose not to participate shall be disclosed to 20 the patient. Comprehensive medication management services shall not be 21 utilized unless the patient or the patient's authorized representative 22 consents, in writing, to such services. Such consent shall be noted in 23 the patient's medical record. If the patient or the patient's authorized 24 representative who consented chooses to no longer participate in such 25 services, at any time, the services shall be discontinued and it shall 26 be noted in the patient's medical record. 27 § 7. Subdivision 4 of section 365-a of the social services law is 28 amended by adding a new paragraph (h) to read as follows: 29 (h) opioids prescribed to a patient initiating or being maintained on 30 opioid treatment for pain which has lasted more than three months or 31 past the time of normal tissue healing, unless the medical record 32 contains a written treatment plan that includes: goals for pain manage- 33 ment and functional improvement based on diagnosis; information on 34 whether non-opioid therapies have been tried and optimized or are 35 contraindicated; a statement that the prescriber has explained to the 36 patient the risks of and alternatives to opioid treatment; an evaluation 37 of the patient for risk factors of harm and misuse of opioids; an 38 assessment of the patient's adherence to treatment with respect to other 39 conditions treated by the same provider; the signature of the patient 40 and/or an attestation by the prescriber that the patient verbally agreed 41 to the treatment plan; and any other information required by the depart- 42 ment. Such treatment plan shall be updated twice within the year imme- 43 diately following its initiation and annually thereafter. The require- 44 ments of this paragraph shall not apply in the case of patients who are 45 being treated for cancer that is not in remission, who are in hospice or 46 other end-of-life care, or whose pain is being treated as part of palli- 47 ative care practices. 48 § 8. Subdivision 2 of section 280 of the public health law, as amended 49 by section 1 of part D of chapter 57 of the laws of 2017, is amended to 50 read as follows: 51 2. The commissioner shall establish a year to year department of 52 health state-funds Medicaid drug spending growth target as follows: 53 (a) for state fiscal year two thousand seventeen--two thousand eigh- 54 teen, be limited to the ten-year rolling average of the medical compo- 55 nent of the consumer price index plus five percent and minus a pharmacy 56 savings target of fifty-five million dollars; [and]S. 7507 20 A. 9507 1 (b) for state fiscal year two thousand eighteen--two thousand nine- 2 teen, be limited to the ten-year rolling average of the medical compo- 3 nent of the consumer price index plus four percent and minus a pharmacy 4 savings target of eighty-five million dollars[.]; and 5 (c) for state fiscal year two thousand nineteen--two thousand twenty, 6 be limited to the ten-year rolling average of the medical component of 7 the consumer price index plus four percent and minus a pharmacy savings 8 target of eighty-five million dollars. 9 § 9. This act shall take effect immediately and shall be deemed to 10 have been in full force and effect on and after April 1, 2018; provided, 11 however, that sections two and three of this act shall take effect July 12 1, 2018; and provided further, however, that the amendments to paragraph 13 (d) of subdivision 9 and paragraph (c) of subdivision 6 of section 14 367-a of the social services law made by sections one and three, respec- 15 tively, of this act shall not affect the expiration or repeal of such 16 provisions and shall expire or be deemed repealed therewith. 17 PART E 18 Section 1. Subdivision 4 of section 365-h of the social services law, 19 as separately amended by section 50 of part B and section 24 of part D 20 of chapter 57 of the laws of 2015, is amended to read as follows: 21 4. The commissioner of health is authorized to assume responsibility 22 from a local social services official for the provision and reimburse- 23 ment of transportation costs under this section. If the commissioner 24 elects to assume such responsibility, the commissioner shall notify the 25 local social services official in writing as to the election, the date 26 upon which the election shall be effective and such information as to 27 transition of responsibilities as the commissioner deems prudent. The 28 commissioner is authorized to contract with a transportation manager or 29 managers to manage transportation services in any local social services 30 district, other than transportation services provided or arranged for 31 enrollees of [managed long term care plans issued certificates of32authority under section forty-four hundred three-f of the public health33law] a program designated as a Program of All-Inclusive Care for the 34 Elderly (PACE) as authorized by Federal Public law 1053-33, subtitle 1 35 of title IV of the Balanced Budget Act of 1997. Any transportation 36 manager or managers selected by the commissioner to manage transporta- 37 tion services shall have proven experience in coordinating transporta- 38 tion services in a geographic and demographic area similar to the area 39 in New York state within which the contractor would manage the provision 40 of services under this section. Such a contract or contracts may include 41 responsibility for: review, approval and processing of transportation 42 orders; management of the appropriate level of transportation based on 43 documented patient medical need; and development of new technologies 44 leading to efficient transportation services. If the commissioner elects 45 to assume such responsibility from a local social services district, the 46 commissioner shall examine and, if appropriate, adopt quality assurance 47 measures that may include, but are not limited to, global positioning 48 tracking system reporting requirements and service verification mech- 49 anisms. Any and all reimbursement rates developed by transportation 50 managers under this subdivision shall be subject to the review and 51 approval of the commissioner. 52 § 2. The opening paragraph of subdivision 1 and subdivision 3 of 53 section 367-s of the social services law, as amended by section 53 ofS. 7507 21 A. 9507 1 part B of chapter 57 of the laws of 2015, are amended to read as 2 follows: 3 Notwithstanding any provision of law to the contrary, a supplemental 4 medical assistance payment shall be made on an annual basis to providers 5 of emergency medical transportation services in an aggregate amount not 6 to exceed four million dollars for two thousand six, six million dollars 7 for two thousand seven, six million dollars for two thousand eight, six 8 million dollars for the period May first, two thousand fourteen through 9 March thirty-first, two thousand fifteen, and six million dollars [annu-10ally beginning with] on an annual basis for the period April first, two 11 thousand fifteen through March thirty-first, two thousand [sixteen] 12 eighteen pursuant to the following methodology: 13 3. If all necessary approvals under federal law and regulation are not 14 obtained to receive federal financial participation in the payments 15 authorized by this section, payments under this section shall be made in 16 an aggregate amount not to exceed two million dollars for two thousand 17 six, three million dollars for two thousand seven, three million dollars 18 for two thousand eight, three million dollars for the period May first, 19 two thousand fourteen through March thirty-first, two thousand fifteen, 20 and three million dollars [annually beginning with] on an annual basis 21 for the period April first, two thousand fifteen through March thirty- 22 first, two thousand [sixteen] eighteen. In such case, the multiplier 23 set forth in paragraph (b) of subdivision one of this section shall be 24 deemed to be two million dollars or three million dollars as applicable 25 to the annual period. 26 § 3. Subdivision 5 of section 365-h of the social services law is 27 REPEALED. 28 § 4. This act shall take effect immediately and shall be deemed to 29 have been in full force and effect on and after April 1, 2018; provided, 30 however, that section one of this act shall take effect October 1, 2018; 31 provided, further that the amendments to subdivision 4 of section 365-h 32 of the social services law made by section one of this act shall not 33 affect the repeal of such section and shall expire and be deemed 34 repealed therewith. 35 PART F 36 Section 1. Notwithstanding any inconsistent provision of law, rule or 37 regulation to the contrary, if a Medicaid managed care plan or managed 38 long term care plan that has been issued a certificate of authority 39 pursuant to article 44 of the public health law and that satisfies the 40 definition of corporation in subparagraph 5 of paragraph (a) of section 41 102 of the not-for-profit corporation law or is exempt from taxation 42 under section 501 of the Internal Revenue Code of 1986 has an aggregate 43 accumulated contingent reserve, across all of its Medicaid lines of 44 business, in an amount that exceeds the minimum contingent reserve 45 amount required by regulations of the department of health, the commis- 46 sioner of health shall be authorized to make prospective adjustments to 47 the Medicaid capitation rates of such plan and shall apply any relevant 48 criteria as determined necessary in his or her discretion, in order to 49 achieve a reduction in Medicaid reimbursement to the plan equal to the 50 amount of the excess, or such lesser amount as determined by the commis- 51 sioner of health. 52 § 2. This act shall take effect April 1, 2018. 53 PART GS. 7507 22 A. 9507 1 Section 1. The public health law is amended by adding a new article 2 29-J to read as follows: 3 ARTICLE 29-J 4 HEALTH SERVICES OFFERED BY RETAIL PRACTICES 5 Section 2999-hh. Definitions. 6 2999-ii. Retail practice sponsors. 7 2999-jj. Retail practices. 8 2999-kk. Accreditation. 9 2999-ll. Other laws. 10 § 2999-hh. Definitions. For purposes of this article: 11 1. "Reportable event" shall mean: 12 (a) the transfer of an individual who visits a retail practice to a 13 hospital or emergency department during such visit; or 14 (b) the death of an individual who visits a retail practice during 15 such visit. 16 2. "Collaborative relationship" shall mean an arrangement between a 17 retail practice and one or more of the following entities located within 18 the same geographic region as the retail practice, designed to facili- 19 tate development and implementation of strategies that support the 20 provision of coordinated care within the population served by the 21 parties to such relationship: 22 (a) a hospital licensed pursuant to article twenty-eight of this chap- 23 ter; 24 (b) a physician practice; 25 (c) an accountable care organization certified pursuant to article 26 twenty-nine-E of this chapter; or 27 (d) a performing provider system under the delivery system reform 28 incentive payment program. 29 3. "Retail health services" shall mean the services offered and 30 provided by a retail practice. 31 (a) Retail health services shall include: 32 (i) the provision of treatment and services to patients for minor 33 acute episodic illnesses or conditions; 34 (ii) episodic preventive and wellness treatments and services such as 35 immunizations, except as otherwise specified in paragraph (c) of this 36 subdivision; 37 (iii) treatment and services for minor traumas that are not reasonably 38 likely to be life threatening or potentially disabling if ambulatory 39 care within the capacity of the retail practice is provided; 40 (iv) administration of an opioid antagonist in the event of an emer- 41 gency; and 42 (v) limited screening and referral for behavioral health conditions. 43 (b) Retail health services may include laboratory tests at the option 44 of the retail practice, provided that: 45 (i) such tests are administered solely as an adjunct to treatment of 46 patients visiting the retail practice, with all specimens collected and 47 testing performed on-site; 48 (ii) such tests are "waived tests", meaning a clinical laboratory test 49 that has been designated as a waived test or is otherwise subject to 50 certificate of waiver requirements pursuant to the federal clinical 51 laboratory improvement act of nineteen hundred eighty-eight, as amended; 52 and 53 (iii) the retail practice obtains approval from the department pursu- 54 ant to section five hundred seventy-nine of this chapter. 55 (c) Retail health services shall not include:S. 7507 23 A. 9507 1 (i) the performance of procedures involving the provision of sedation 2 or anesthesia; 3 (ii) the provision of services to patients twenty-four months of age 4 or younger; 5 (iii) the provision of immunizations to patients between twenty-four 6 months and eighteen years of age, other than immunizations against 7 influenza; 8 (iv) services provided by pharmacists pursuant to article one hundred 9 thirty-seven of the education law; 10 (v) health services provided on-site by an employer to its employees 11 in a retail business operation; 12 (v) health services provided on a time-limited basis such as flu clin- 13 ics or health fairs; or 14 (vi) educational courses offered to individuals on health topics, 15 including instruction in self-management of medical conditions. 16 4. "Retail practice" shall mean an entity which: 17 (a) is located within the space of a retail business operation open to 18 the general public, such that customer access to the retail practice 19 location is available within the main premises of the retail operation; 20 (b) provides retail health services, as defined in subdivision three 21 of this section; 22 (c) is established and overseen by a retail practice sponsor, as 23 defined in subdivision five of this section; 24 (d) is staffed at all times by, at a minimum, one or more of the 25 following: a physician licensed pursuant to article one hundred thir- 26 ty-one of the education law, a physician assistant licensed pursuant to 27 article one hundred thirty-one-A of the education law, and/or a nurse 28 practitioner licensed pursuant to article one hundred thirty-nine of the 29 education law; provided that no more than four physician assistants 30 employed by a retail practice sponsor shall be supervised by a single 31 physician; and 32 (e) is accredited as set forth in section twenty-nine hundred ninety- 33 nine-kk of this article. 34 5. "Retail practice sponsor" shall mean an entity formed under the 35 laws of the state of New York, which may include stockholders or members 36 which are not natural persons, and which operates one or more retail 37 practices. Retail practice sponsors may include business corporations, 38 and general hospitals, nursing homes, and diagnostic and treatment 39 centers licensed pursuant to article twenty-eight of this chapter. 40 § 2999-ii. Retail practice sponsors. 1. Notwithstanding any law to the 41 contrary, a retail practice sponsor may operate one or more retail prac- 42 tices to provide retail health services in accordance with this article. 43 2. A retail practice sponsor shall: 44 (a) employ or otherwise retain the services of a medical director who 45 is licensed and currently registered to practice medicine in the state 46 of New York to oversee the development of and adherence to medical poli- 47 cies and procedures used in the retail practices operated by the retail 48 practice sponsor; 49 (b) establish and maintain policies and procedures requiring retail 50 practices to comply with the provisions of section twenty-nine hundred 51 ninety-nine-jj of this article; 52 (c) notify the department when it is prepared to commence operation of 53 a retail practice by: 54 (i) identifying the corporate name of the retail practice sponsor, 55 providing documentation of its organization under the laws of the stateS. 7507 24 A. 9507 1 of New York, and identifying the individual who will serve as the point 2 of contact between the retail practice sponsor and the department; 3 (ii) identifying the location of the retail practice, the services to 4 be offered by the retail practice, the name of the individual employed 5 with the overall responsibility for the on-site management of the retail 6 practice, and the staffing plan for the retail practice; 7 (iii) identifying the entities with which the retail practice will 8 collaborate pursuant to subdivision two of section twenty-nine hundred 9 ninety-nine-hh of this article; and 10 (iv) identifying the date on which it anticipates that the retail 11 practice will be open for business; 12 (d) promptly update the department as to any changes in the informa- 13 tion required under subdivision three of this section; and 14 (e) provide information to the department at a frequency and in a 15 manner determined by the department, which at a minimum shall include an 16 annual report that provides data, for each retail practice operated by 17 the retail practice, on: 18 (i) the number of visits that occurred during the timeframe identified 19 by the department; 20 (ii) the services provided to patients; 21 (iii) the source of payment for services provided; 22 (iv) the number of referrals to primary care practitioners made; and 23 (v) the number of reportable events that occurred. 24 3. (a) In discharging the duties of their respective positions, the 25 board of directors, committees of the board, and individual directors 26 and officers of a retail practice sponsor that operates three or more 27 retail practices shall consider the effects of any action upon: 28 (i) the ability of the business corporation to accomplish its purpose; 29 (ii) the shareholders of the business corporation; 30 (iii) the interests of patients of the retail practices; 31 (iv) community and societal considerations, including those of the 32 communities in which retail practices are located. 33 (b) The consideration of interests and factors in the manner required 34 in paragraph (a) of this subdivision: 35 (i) shall not constitute a violation of the provisions of section 36 seven hundred fifteen or seven hundred seventeen of the business corpo- 37 ration law; and 38 (ii) is in addition to the ability of directors to consider interests 39 and factors as provided in section seven hundred seventeen of the busi- 40 ness corporation law. 41 (c) A retail practice sponsor that operates three or more retail prac- 42 tices shall publish on a publicly available website a description of how 43 its operation of existing and planned retail practices: 44 (i) will improve access to services in the communities where they are 45 located; 46 (ii) supports a commitment to offer assistance to individuals who do 47 not have health care coverage; 48 (iii) supports an overall commitment by the retail practice sponsor to 49 operate some of its retail practices in medically underserved areas of 50 the state as defined by the commissioner; and 51 (iv) will otherwise benefit the communities where they are located. 52 § 2999-jj. Retail practices. 1. Retail health services shall not be 53 provided in a retail business operation open to the public except in 54 accordance with this article. 55 2. Notwithstanding any law to the contrary, a retail practice shall: 56 (a) provide retail health services and only retail health services;S. 7507 25 A. 9507 1 (b) provide treatment without discrimination as to source of payment; 2 (c) maintain a policy offering a sliding scale for payment for 3 patients who do not have health care coverage and publish such policy on 4 a publicly available website; 5 (d) provide to patients who indicate that they do not have health care 6 coverage information on the state health benefit exchange, including the 7 website address for the exchange and contact information for local navi- 8 gators offering in-person enrollment assistance; 9 (e) accept walk-in patients without previously scheduled appointments; 10 (f) offer business hours for a minimum of twelve hours per day and six 11 days per week or, if the retail business in which the retail practice is 12 located is open for less than twelve hours per day and six days per 13 week, then the retail practice shall offer the same business hours as 14 the retail business; 15 (g) publish a list of the retail health services it offers on a 16 publicly available website together with the prices of such services; 17 (h) post signs in a conspicuous location in large type stating that 18 prescriptions and over-the-counter supplies may be purchased by a 19 patient from any business and do not need to be purchased on-site; 20 (i) enter into and maintain at least one collaborative relationship as 21 defined in subdivision two of section twenty-nine hundred ninety-nine-hh 22 of this article; 23 (j) inquire of each patient whether he or she has a primary care 24 provider; 25 (k) maintain and regularly update a list of local primary care provid- 26 ers and provide such list to each patient who indicates that he or she 27 does not have a primary care provider; 28 (l) refer patients to their primary care providers or other health 29 care providers as appropriate; 30 (m) transmit, by electronic means whenever possible, records of 31 services to patients' primary care providers and maintain records of 32 services for a minimum of six years; 33 (n) execute participation agreements with health information organiza- 34 tions, also known as qualified entities, pursuant to which the retail 35 practice shall agree to participate in the statewide health information 36 network for New York (SHIN-NY); 37 (o) attain and maintain accreditation pursuant to section twenty-nine 38 hundred ninety-nine-kk of this section; and 39 (p) report reportable events to the accrediting entity within three 40 business days of the occurrence of such reportable event. 41 3. Entities meeting the definition of a retail practice as set forth 42 in this article and providing services on or before the effective date 43 of this article shall have one hundred twenty days after such effective 44 date to notify the department of compliance therewith. 45 § 2999-kk. Accreditation. 1. A retail practice shall be required to 46 attain and maintain accreditation by a nationally recognized accrediting 47 entity as determined by the department. 48 2. The accrediting entity shall be required to notify the department 49 promptly if a retail practice loses its accreditation. 50 3. The accrediting entity shall be required to report data on all 51 retail practices accredited by such entity to the commissioner. 52 § 2999-ll. Other laws. 1. Nothing in this article shall be deemed to 53 alter the scope of practice of any practitioner licensed or certified 54 under title eight of the education law. 55 2. Nothing in this article shall be deemed to mitigate the responsi- 56 bility of any individual practitioner licensed or certified under titleS. 7507 26 A. 9507 1 eight of the education law from accountability for his or her actions 2 under applicable provisions of law. 3 3. A retail practice shall be deemed to be a "health care provider" 4 for the purposes of title two-D of article two of this chapter. 5 4. A prescriber practicing in a retail practice shall not be deemed to 6 be in the employ of a pharmacy or practicing in a hospital for purposes 7 of subdivision two of section sixty-eight hundred seven of the education 8 law. 9 § 2. This act shall take effect immediately. 10 PART H 11 Section 1. Section 6902 of the education law is amended by adding a 12 new subdivision 4 to read as follows: 13 4. (a) The practice of registered professional nursing by a certified 14 registered nurse anesthetist, certified under section sixty-nine hundred 15 twelve of this article may include the practice of nurse anesthesia. 16 (i) Subject to the provisions of paragraph (e) of this subdivision, 17 nurse anesthesia includes: the administration of anesthesia and anes- 18 thesia related care to patients; pre-anesthesia evaluation and prepara- 19 tion; anesthetic induction, maintenance and emergence; post anesthesia 20 care; perianesthesia nursing and clinical support functions; and pain 21 management. 22 (ii) Nurse anesthesia must be provided in collaboration with a 23 licensed physician qualified to determine the need for anesthesia 24 services, provided such services are performed in accordance with a 25 written practice agreement and written practice protocols as set forth 26 in paragraph (b) of this subdivision or pursuant to collaborative 27 relationships as set forth in paragraph (c) of this subdivision, which- 28 ever is applicable. 29 (iii) Prescriptions for drugs, devices, and anesthetic agents, anes- 30 thesia related agents, and pain management agents may be issued by a 31 certified registered nurse anesthetist, in accordance with the written 32 practice agreement and written practice protocols described in paragraph 33 (b) of this subdivision if applicable. The certified registered nurse 34 anesthetist shall obtain a certificate from the department upon success- 35 fully completing a program including an appropriate pharmacology compo- 36 nent, or its equivalent, as established by the commissioner's regu- 37 lations, prior to prescribing under this subparagraph. The certificate 38 issued under section sixty-nine hundred twelve of this article shall 39 state whether the certified registered nurse anesthetist has successful- 40 ly completed such a program or equivalent and is authorized to prescribe 41 under this subdivision. 42 (b) A certified registered nurse anesthetist certified under section 43 sixty-nine hundred twelve of this article and practicing for thirty-six 44 hundred hours or less shall do so in accordance with a written practice 45 agreement and written practice protocols agreed upon by a licensed 46 physician qualified by education and experience to determine the need 47 for anesthesia. 48 (i) The written practice agreement shall include explicit provisions 49 for the resolution of any disagreement between the collaborating physi- 50 cian and the certified registered nurse anesthetist regarding a matter 51 of anesthesia or pain management treatment that is within the scope of 52 practice of both. To the extent the practice agreement does not so 53 provide, then the collaborating physician's treatment shall prevail.S. 7507 27 A. 9507 1 (ii) Each practice agreement shall provide for patient records review 2 by the collaborating physician in a timely fashion but in no event less 3 often than every three months. The names of the certified registered 4 nurse anesthetist and the collaborating physician shall be clearly post- 5 ed in the practice setting of the certified registered nurse anesthe- 6 tist. 7 (iii) The practice protocol shall reflect current accepted medical and 8 nursing practice. The protocols shall be filed with the department 9 within ninety days of the commencement of the practice and may be 10 updated periodically. The commissioner shall make regulations establish- 11 ing the procedure for the review of protocols and the disposition of any 12 issues arising from such review. 13 (c) A certified registered nurse anesthetist certified under section 14 sixty-nine hundred twelve of this article and practicing for more than 15 thirty-six hundred hours shall have collaborative relationships with one 16 or more licensed physicians qualified to determine the need for anes- 17 thesia services or a hospital, licensed under article twenty-eight of 18 the public health law, that provides services through licensed physi- 19 cians qualified to determine the need for anesthesia services and having 20 privileges at such institution. 21 (i) For purposes of this paragraph, "collaborative relationships" 22 shall mean that the certified registered nurse anesthetist shall commu- 23 nicate, whether in person, by telephone or through written (including 24 electronic) means, with a licensed physician qualified to determine the 25 need for anesthesia services or, in the case of a hospital, communicate 26 with a licensed physician qualified to determine the need for anesthesia 27 services and having privileges at such hospital, for the purposes of 28 exchanging information, as needed, in order to provide comprehensive 29 patient care and to make referrals as necessary. 30 (ii) As evidence that the certified registered nurse anesthetist main- 31 tains collaborative relationships, the certified registered nurse 32 anesthetist shall complete and maintain a form, created by the depart- 33 ment, to which the certified registered nurse anesthetist shall attest, 34 that describes such collaborative relationships. Such form shall also 35 reflect the certified registered nurse anesthetist's acknowledgement 36 that if reasonable efforts to resolve any dispute that may arise with 37 the collaborating physician or, in the case of a collaboration with a 38 hospital, with a licensed physician qualified to determine the need for 39 anesthesia services and having privileges at such hospital, about a 40 patient's care are not successful, the recommendation of the physician 41 shall prevail. Such form shall be updated as needed and may be subject 42 to review by the department. The certified registered nurse anesthetist 43 shall maintain documentation that supports such collaborative relation- 44 ships. 45 (d) Nothing in this subdivision shall be deemed to limit or diminish 46 the practice of the profession of nursing as a registered professional 47 nurse under this article or any other law, rule, regulation or certif- 48 ication, nor to deny any registered professional nurse the right to do 49 any act or engage in any practice authorized by this article or any 50 other law, rule, regulation or certification. 51 (e)(i) Anesthesia services may be provided by certified registered 52 nurse anesthetists only in the following settings: 53 (A) general hospitals, hospital outpatient surgical departments, and 54 diagnostic and treatment centers licensed by the department of health 55 pursuant to article twenty-eight of the public health law and authorizedS. 7507 28 A. 9507 1 to provide sedation, anesthesia services, and/or pain management 2 services in connection with such licensure; 3 (B) practices where office-based surgery, as defined by section two 4 hundred-thirty-d of the public health law, is performed and/or pain 5 management services are provided; and 6 (C) dentists' and periodontists' offices where sedation and/or anes- 7 thesia services are provided. 8 (ii) Anesthesia services offered in such settings, including services 9 provided by certified registered nurse anesthetists, shall be directed 10 by a physician, dentist, or periodontist, as applicable, who is respon- 11 sible for the clinical aspects of all anesthesia services offered by the 12 provider and is qualified to determine the need for and administer anes- 13 thesia. Such physician shall have the discretion to establish parameters 14 for supervision of certified registered nurse anesthetists where he or 15 she makes a reasonable determination that the circumstances of a partic- 16 ular case or type of cases, although within the scope of practice of a 17 certified registered nurse anesthetist as set forth in paragraph (a) of 18 this subdivision, are of such complexity that they should be conducted 19 under supervision. In such cases, such supervision shall be provided by 20 an anesthesiologist who is immediately available as needed or by the 21 operating physician who is qualified to determine the need for anes- 22 thesia services and supervise the administration of anesthesia. 23 § 2. The education law is amended by adding a new section 6912 to read 24 as follows: 25 § 6912. Certificates for nurse anesthesia practice. 1. For issuance 26 of a certificate to practice as a certified registered nurse anesthetist 27 under subdivision four of section sixty-nine hundred two of this arti- 28 cle, the applicant shall fulfill the following requirements: 29 (a) Application: file an application with the department; 30 (b) License: be licensed as a registered professional nurse in the 31 state; 32 (c) Education: (i) have satisfactorily completed educational prepara- 33 tion for provision of these services in a program registered by the 34 department or in a program accredited by a national body recognized by 35 the department or determined by the department to be the equivalent; and 36 (ii) submit evidence of current certification or recertification by a 37 national certifying body, recognized by the department; 38 (d) Fees: pay a fee to the department of fifty dollars for an initial 39 certificate authorizing nurse anesthesia practice and a triennial regis- 40 tration fee of thirty dollars; and 41 (e) Information and documentation: in conjunction with and as a condi- 42 tion of each triennial registration, provide to the department, and the 43 department shall collect, such information and documentation required by 44 the department, in consultation with the department of health, as is 45 necessary to enable the department of health to evaluate access to need- 46 ed services in this state, including, but not limited to, the location 47 and type of setting wherein the certified registered nurse anesthetist 48 practices and other information the department, in consultation with the 49 department of health, deems relevant. The department of health, in 50 consultation with the department, shall make such data available in 51 aggregate, de-identified form on a publicly accessible website. Addi- 52 tionally, in conjunction with each triennial registration, the depart- 53 ment, in consultation with the department of health, shall provide 54 information on registering in the donate life registry for organ and 55 tissue donation, including the website address for such registry.S. 7507 29 A. 9507 1 After a certified registered nurse anesthetist's initial registration, 2 registration under this section shall be coterminous with the certified 3 registered nurse anesthetist's registration as a professional nurse. 4 2. Only a person certified under this section shall use the title 5 "certified registered nurse anesthetist," except as set forth in subdi- 6 vision three of this section. 7 3. Nothing in this section shall be deemed from preventing any other 8 professional licensed or certified under this chapter or the public 9 health law from carrying out any responsibilities established by rele- 10 vant sections of such chapters. 11 4. An individual who meets the requirements for certification as a 12 certified registered nurse anesthetist and who has been performing the 13 duties of a certified registered nurse anesthetist for two of the five 14 years prior to the effective date of this article may be certified with- 15 out meeting additional requirements, provided that such individual 16 submits an application, including an attestation from the applicant's 17 supervising physician as to the applicant's experience and competence, 18 to the department within two years of the effective date of this 19 section. Such individual may use the title "certified registered nurse 20 anesthetist" in connection with that practice while such application is 21 pending. 22 5. (a) A registered professional nurse licensed under section sixty- 23 nine hundred five of this article who has satisfactorily completed a 24 program of educational preparation as provided in subdivision one of 25 this section may, for a period not to exceed twenty-four months imme- 26 diately following the completion of such educational program, practice 27 nurse anesthesia under subdivision four of section sixty-nine hundred 28 two of this article as a graduate nurse anesthetist in the same manner 29 as a certified registered nurse anesthetist under that subdivision. 30 (b) A registered professional nurse licensed under section sixty-nine 31 hundred five of this article who is duly enrolled in a program of educa- 32 tional preparation may practice nurse anesthesia as a student nurse 33 anesthetist under the supervision of an anesthesiologist or a certified 34 registered nurse anesthetist, who is immediately available as needed. 35 § 3. This act shall take effect immediately. 36 PART I 37 Section 1. Section 364-j of the social services law is amended by 38 adding a new subdivision 34 to read as follows: 39 34. Monies paid by the department to managed care organizations are 40 public funds and retain their status as public funds regardless of any 41 payments made by the managed care organization to subcontractors or 42 providers. 43 § 2. Section 364-j of the social services law is amended by adding a 44 new subdivision 35 to read as follows: 45 35. Recovery of overpayments from network providers. (a) Where the 46 Medicaid inspector general, during the course of an audit or investi- 47 gation, identifies improper medical assistance payments made by a 48 managed care organization to its subcontractor or subcontractors or 49 provider or providers, the state shall have the right to recover the 50 improper payment from the subcontractor or subcontractors, provider or 51 providers, or the managed care organization. 52 (b) Where the state is unsuccessful in recovering the improper payment 53 from the subcontractor or subcontractors or provider or providers, the 54 Medicaid inspector general may require the managed care organization toS. 7507 30 A. 9507 1 recover the improper medical assistance payments identified in paragraph 2 (a) of this subdivision. The managed care organization shall remit to 3 the state the full amount of the identified improper payment no later 4 than six months after receiving notice of the overpayment. 5 (c) The managed care organization may charge its subcontractor or 6 subcontractors or provider or providers a collection fee to account for 7 the reasonable costs incurred by the managed care organization to 8 collect the debt. Any collection fee imposed shall not exceed five 9 percent of the total amount owed. 10 § 3. Section 364-j of the social services law is amended by adding a 11 new subdivision 36 to read as follows: 12 36. Reporting acts of fraud. (a) All managed care organizations shall 13 promptly refer to the office of the Medicaid inspector general all cases 14 of potential fraud, waste, or abuse. 15 (b) Any managed care organization making a complaint or furnishing a 16 report, referral, information or records in good faith pursuant to this 17 section shall be immune from civil liability for making such complaint, 18 referral, or report to the office of the Medicaid inspector general. 19 (c) A managed care organization that willfully fails to promptly make 20 a referral to the Medicaid inspector general when there is actual know- 21 ledge that an act of fraud is being or has been committed may be fined 22 in an amount not exceeding one hundred thousand dollars for each deter- 23 mination. 24 § 4. The public health law is amended by adding a new section 37 to 25 read as follows: 26 § 37. Violations of medical assistance program laws, regulations or 27 directives; fines. 1. (a) Any individual or entity participating in the 28 medical assistance program that fails to comply with or violates any 29 statute, rule, regulation, or directive of the medical assistance 30 program, may be fined in an amount not exceeding the sum of five thou- 31 sand dollars for each violation. 32 (b) Every failure to comply with or violation of any statute, rule, 33 regulation, or directive of the medical assistance program shall be a 34 separate and distinct offense and, in the case of a continuing 35 violation, every day's continuance thereof shall be a separate and 36 distinct offense. 37 2. (a) Any entity authorized to operate under article forty-four of 38 this chapter or article forty-three of the insurance law, including any 39 subcontractor or provider thereof, and participating in the medical 40 assistance program that fails to comply with or violates any statute, 41 rule, regulation, or directive of the medical assistance program, or any 42 term of its contract with the department, may be fined in an amount not 43 exceeding the sum of five thousand dollars for each violation. 44 (b) Every failure to comply with or violation of any statute, rule, 45 regulation, or directive of the medical assistance program, or term of 46 the entity's contract with the department shall be a separate and 47 distinct offense and, in the case of a continuing violation, every day's 48 continuance thereof shall be a separate and distinct offense. 49 3. Any entity participating in the medical assistance program and 50 authorized to operate under article forty-four of this chapter or arti- 51 cle forty-three of the insurance law that submits a cost report to the 52 medical assistance program that contains data which is intentionally or 53 systematically inaccurate or improper, may be fined in an amount not 54 exceeding one hundred thousand dollars for each determination. 55 4. Any entity authorized to operate under article forty-four of this 56 chapter or article forty-three of the insurance law, and participatingS. 7507 31 A. 9507 1 in the medical assistance program that intentionally or systematically 2 submits inaccurate encounter data to the state may be fined in an amount 3 not exceeding one hundred thousand dollars for each determination. 4 5. The Medicaid inspector general shall, in consultation with the 5 commissioner, consider the following prior to assessing a fine against 6 an individual or entity under this section and have the discretion to 7 reduce or eliminate a fine under this section: 8 (a) the effect, if any, on the quality of medical care provided to or 9 arranged for recipients of medical assistance as a result of the acts of 10 the individual or entity; 11 (b) the amount of damages to the program; 12 (c) the degree of culpability of the individual or entity in commit- 13 ting the proscribed actions and any mitigating circumstances; 14 (d) any prior violations committed by the individual or entity relat- 15 ing to the medical assistance program, Medicare or any other social 16 services programs which resulted in either criminal or administrative 17 sanction, penalty, or fine; 18 (e) the degree to which factors giving rise to the proscribed actions 19 were out of the control of the individual or entity; 20 (f) the number and nature of the violations or other related offenses; 21 (g) any other facts relating to the nature and seriousness of the 22 violations including any exculpatory facts; and/or 23 (h) any other relevant factors. 24 6. The Medicaid inspector general shall, in consultation with the 25 commissioner, promulgate regulations enumerating those violations which 26 may result in a fine pursuant to subdivisions one and two of this 27 section, the amounts of any fines which may be assessed under this 28 section, and the appeal rights afforded to individuals or entities 29 subject to a fine. 30 § 5. Paragraph (d) of subdivision 32 of section 364-j of the social 31 services law, as added by section 15 of part B of chapter 59 of the laws 32 of 2016, is amended to read as follows: 33 (d) (i) Penalties under this subdivision may be applied to any and all 34 circumstances described in paragraph (b) of this subdivision until the 35 managed care organization complies with the requirements for submission 36 of encounter data. (ii) No penalties for late, incomplete or inaccurate 37 encounter data shall be assessed against managed care organizations in 38 addition to those provided for in this subdivision, provided, however, 39 that nothing in this paragraph shall prohibit the imposition of penal- 40 ties, in cases of fraud or abuse, otherwise authorized by law. 41 § 6. This act shall take effect on the ninetieth day after it shall 42 have become a law; provided, however, that the amendments to section 43 364-j of the social services law made by sections one, two, three and 44 five of this act shall not affect the repeal of such section and shall 45 be deemed repealed therewith. 46 PART J 47 Section 1. Paragraph (h) of subdivision 1 of section 189 of the state 48 finance law, as amended by section 8 of part A of chapter 56 of the laws 49 of 2013, is amended to read as follows: 50 (h) knowingly conceals or knowingly and improperly avoids or decreases 51 an obligation to pay or transmit money or property to the state or a 52 local government, or conspires to do the same; shall be liable to the 53 state or a local government, as applicable, for a civil penalty of not 54 less than six thousand dollars and not more than twelve thousandS. 7507 32 A. 9507 1 dollars, as adjusted to be equal to the civil penalty allowed under the 2 federal False Claims Act, 31 U.S.C. sec. 3729, et seq., as amended, as 3 adjusted for inflation by the Federal Civil Penalties Inflation Adjust- 4 ment Act of 1990, as amended (28 U.S.C. 2461 note; Pub. L. No. 101-410), 5 plus three times the amount of all damages, including consequential 6 damages, which the state or local government sustains because of the act 7 of that person. 8 § 2. This act shall take effect immediately. 9 PART K 10 Section 1. Notwithstanding any contrary provision of law, the depart- 11 ment of health is authorized to require any Medicaid-enrolled provider, 12 and any health care provider that is part of a network of providers of a 13 managed care organization operating pursuant to section 364-j of the 14 social services law or section 4403-f of the public health law, to 15 report on costs incurred by the provider in rendering health care 16 services to Medicaid beneficiaries. The department of health may specify 17 the frequency and format of such reports, determine the type and amount 18 of information to be submitted, and require the submission of supporting 19 documentation. In the case of a provider in a managed care network, the 20 department of health may require the managed care organization to obtain 21 the required information from the network provider on behalf of the 22 department. 23 § 2. Subdivision 1 of section 92 of part H of chapter 59 of the laws 24 of 2011, amending the public health law and other laws relating to known 25 and projected department of health state fund medicaid expenditures, as 26 amended by section 1 of part G of chapter 57 of the laws of 2017, is 27 amended to read as follows: 28 1. For state fiscal years 2011-12 through [2018-19] 2019-20, the 29 director of the budget, in consultation with the commissioner of health 30 referenced as "commissioner" for purposes of this section, shall assess 31 on a monthly basis, as reflected in monthly reports pursuant to subdivi- 32 sion five of this section known and projected department of health state 33 funds medicaid expenditures by category of service and by geographic 34 regions, as defined by the commissioner, and if the director of the 35 budget determines that such expenditures are expected to cause medicaid 36 disbursements for such period to exceed the projected department of 37 health medicaid state funds disbursements in the enacted budget finan- 38 cial plan pursuant to subdivision 3 of section 23 of the state finance 39 law, the commissioner of health, in consultation with the director of 40 the budget, shall develop a medicaid savings allocation plan to limit 41 such spending to the aggregate limit level specified in the enacted 42 budget financial plan, provided, however, such projections may be 43 adjusted by the director of the budget to account for any changes in the 44 New York state federal medical assistance percentage amount established 45 pursuant to the federal social security act, changes in provider reven- 46 ues, reductions to local social services district medical assistance 47 administration, minimum wage increases, and beginning April 1, 2012 the 48 operational costs of the New York state medical indemnity fund and state 49 costs or savings from the basic health plan. Such projections may be 50 adjusted by the director of the budget to account for increased or expe- 51 dited department of health state funds medicaid expenditures as a result 52 of a natural or other type of disaster, including a governmental decla- 53 ration of emergency. 54 § 3. This act shall take effect immediately.S. 7507 33 A. 9507 1 PART L 2 Section 1. Subdivision 7 of section 369 of the social services law, as 3 amended by section 7 of part F of chapter 56 of the laws of 2012, is 4 amended to read as follows: 5 7. Notwithstanding any provision of law to the contrary, the depart- 6 ment shall, when it determines necessary program features are in place, 7 assume sole responsibility for commencing actions or proceedings in 8 accordance with the provisions of this section, sections one hundred 9 one, one hundred four, one hundred four-b, paragraph (a) of subdivision 10 three of section three hundred sixty-six, subparagraph one of paragraph 11 (h) of subdivision four of section three hundred sixty-six, and para- 12 graph (b) of subdivision two of section three hundred sixty-seven-a of 13 this chapter, to recover the cost of medical assistance furnished pursu- 14 ant to this title and title eleven-D of this article. The department is 15 authorized to contract with an entity that shall conduct activities on 16 behalf of the department pursuant to this subdivision, and may contract 17 with an entity to conduct similar activities on behalf of the child 18 health insurance program established pursuant to title one-A of article 19 twenty-five of the public health law to the extent allowed by law. 20 Prior to assuming such responsibility from a social services district, 21 the department of health shall, in consultation with the district, 22 define the scope of the services the district will be required to 23 perform on behalf of the department of health pursuant to this subdivi- 24 sion. 25 § 2. Section 2511 of the public health law is amended by adding a new 26 subdivision 22 to read as follows: 27 22. Notwithstanding the provisions of this section, section twenty- 28 five hundred ten of this title, and any other inconsistent provision of 29 law, in the event federal funding pursuant to Title XXI of the federal 30 social security act is reduced or eliminated on and after October first, 31 two thousand seventeen: 32 (a) The director of the division of the budget, in consultation with 33 the commissioner, shall identify the amount of such reduction or elimi- 34 nation and notify the temporary president of the senate and the speaker 35 of the assembly in writing that the federal actions will reduce or elim- 36 inate expected funding to New York state by such amount. 37 (b) The director of the division of the budget, in consultation with 38 the commissioner, shall determine if programmatic changes are necessary 39 to continue covering eligible children within state-only funding levels, 40 identify available resources or actions, identify specific changes need- 41 ed to align the program with current funding levels, and establish a 42 plan for implementing such changes which may include emergency regu- 43 lations promulgated by the commissioner. Such plan shall be submitted to 44 the legislature prior to its implementation. 45 § 3. This act shall take effect immediately. 46 PART M 47 Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 48 266 of the laws of 1986, amending the civil practice law and rules and 49 other laws relating to malpractice and professional medical conduct, as 50 amended by section 15 of part H of chapter 57 of the laws of 2017, is 51 amended to read as follows: 52 (a) The superintendent of financial services and the commissioner of 53 health or their designee shall, from funds available in the hospitalS. 7507 34 A. 9507 1 excess liability pool created pursuant to subdivision 5 of this section, 2 purchase a policy or policies for excess insurance coverage, as author- 3 ized by paragraph 1 of subsection (e) of section 5502 of the insurance 4 law; or from an insurer, other than an insurer described in section 5502 5 of the insurance law, duly authorized to write such coverage and actual- 6 ly writing medical malpractice insurance in this state; or shall 7 purchase equivalent excess coverage in a form previously approved by the 8 superintendent of financial services for purposes of providing equiv- 9 alent excess coverage in accordance with section 19 of chapter 294 of 10 the laws of 1985, for medical or dental malpractice occurrences between 11 July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988, 12 between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 13 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 14 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 15 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, 16 between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 17 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 18 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 19 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, 20 between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 21 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 22 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 23 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, 24 between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 25 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 26 and June 30, 2013, between July 1, 2013 and June 30, 2014, between July 27 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, 28 between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and 29 June 30, 2018, and between July 1, 2018 and June 30, 2019 or reimburse 30 the hospital where the hospital purchases equivalent excess coverage as 31 defined in subparagraph (i) of paragraph (a) of subdivision 1-a of this 32 section for medical or dental malpractice occurrences between July 1, 33 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between 34 July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, 35 between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 36 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 37 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 38 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, 39 between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 40 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 41 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 42 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, 43 between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 44 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 45 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 46 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012, 47 between July 1, 2012 and June 30, 2013, between July 1, 2013 and June 48 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 49 and June 30, 2016, between July 1, 2016 and June 30, 2017, [and] between 50 July 1, 2017 and June 30, 2018, and between July 1, 2018 and June 30, 51 2019 for physicians or dentists certified as eligible for each such 52 period or periods pursuant to subdivision 2 of this section by a general 53 hospital licensed pursuant to article 28 of the public health law; 54 provided that no single insurer shall write more than fifty percent of 55 the total excess premium for a given policy year; and provided, however, 56 that such eligible physicians or dentists must have in force an individ-S. 7507 35 A. 9507 1 ual policy, from an insurer licensed in this state of primary malprac- 2 tice insurance coverage in amounts of no less than one million three 3 hundred thousand dollars for each claimant and three million nine 4 hundred thousand dollars for all claimants under that policy during the 5 period of such excess coverage for such occurrences or be endorsed as 6 additional insureds under a hospital professional liability policy which 7 is offered through a voluntary attending physician ("channeling") 8 program previously permitted by the superintendent of financial services 9 during the period of such excess coverage for such occurrences. During 10 such period, such policy for excess coverage or such equivalent excess 11 coverage shall, when combined with the physician's or dentist's primary 12 malpractice insurance coverage or coverage provided through a voluntary 13 attending physician ("channeling") program, total an aggregate level of 14 two million three hundred thousand dollars for each claimant and six 15 million nine hundred thousand dollars for all claimants from all such 16 policies with respect to occurrences in each of such years provided, 17 however, if the cost of primary malpractice insurance coverage in excess 18 of one million dollars, but below the excess medical malpractice insur- 19 ance coverage provided pursuant to this act, exceeds the rate of nine 20 percent per annum, then the required level of primary malpractice insur- 21 ance coverage in excess of one million dollars for each claimant shall 22 be in an amount of not less than the dollar amount of such coverage 23 available at nine percent per annum; the required level of such coverage 24 for all claimants under that policy shall be in an amount not less than 25 three times the dollar amount of coverage for each claimant; and excess 26 coverage, when combined with such primary malpractice insurance cover- 27 age, shall increase the aggregate level for each claimant by one million 28 dollars and three million dollars for all claimants; and provided 29 further, that, with respect to policies of primary medical malpractice 30 coverage that include occurrences between April 1, 2002 and June 30, 31 2002, such requirement that coverage be in amounts no less than one 32 million three hundred thousand dollars for each claimant and three 33 million nine hundred thousand dollars for all claimants for such occur- 34 rences shall be effective April 1, 2002. 35 § 2. Subdivision 3 of section 18 of chapter 266 of the laws of 1986, 36 amending the civil practice law and rules and other laws relating to 37 malpractice and professional medical conduct, as amended by section 16 38 of part H of chapter 57 of the laws of 2017, is amended to read as 39 follows: 40 (3)(a) The superintendent of financial services shall determine and 41 certify to each general hospital and to the commissioner of health the 42 cost of excess malpractice insurance for medical or dental malpractice 43 occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988 44 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 45 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, 46 between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 47 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 48 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 49 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, 50 between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 51 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 52 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 53 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, 54 between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 55 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 56 and June 30, 2010, between July 1, 2010 and June 30, 2011, between JulyS. 7507 36 A. 9507 1 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, and 2 between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 3 30, 2015, between July 1, 2015 and June 30, 2016, and between July 1, 4 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, 5 and between July 1, 2018 and June 30, 2019 allocable to each general 6 hospital for physicians or dentists certified as eligible for purchase 7 of a policy for excess insurance coverage by such general hospital in 8 accordance with subdivision 2 of this section, and may amend such deter- 9 mination and certification as necessary. 10 (b) The superintendent of financial services shall determine and 11 certify to each general hospital and to the commissioner of health the 12 cost of excess malpractice insurance or equivalent excess coverage for 13 medical or dental malpractice occurrences between July 1, 1987 and June 14 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 15 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 16 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, 17 between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 18 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 19 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 20 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, 21 between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 22 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 23 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 24 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, 25 between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 26 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 27 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 28 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, 29 between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30 30, 2016, [and] between July 1, 2016 and June 30, 2017, [and] between 31 July 1, 2017 and June 30, 2018, and between July 1, 2018 and June 30, 32 2019 allocable to each general hospital for physicians or dentists 33 certified as eligible for purchase of a policy for excess insurance 34 coverage or equivalent excess coverage by such general hospital in 35 accordance with subdivision 2 of this section, and may amend such deter- 36 mination and certification as necessary. The superintendent of financial 37 services shall determine and certify to each general hospital and to the 38 commissioner of health the ratable share of such cost allocable to the 39 period July 1, 1987 to December 31, 1987, to the period January 1, 1988 40 to June 30, 1988, to the period July 1, 1988 to December 31, 1988, to 41 the period January 1, 1989 to June 30, 1989, to the period July 1, 1989 42 to December 31, 1989, to the period January 1, 1990 to June 30, 1990, to 43 the period July 1, 1990 to December 31, 1990, to the period January 1, 44 1991 to June 30, 1991, to the period July 1, 1991 to December 31, 1991, 45 to the period January 1, 1992 to June 30, 1992, to the period July 1, 46 1992 to December 31, 1992, to the period January 1, 1993 to June 30, 47 1993, to the period July 1, 1993 to December 31, 1993, to the period 48 January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December 49 31, 1994, to the period January 1, 1995 to June 30, 1995, to the period 50 July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June 51 30, 1996, to the period July 1, 1996 to December 31, 1996, to the period 52 January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December 53 31, 1997, to the period January 1, 1998 to June 30, 1998, to the period 54 July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June 55 30, 1999, to the period July 1, 1999 to December 31, 1999, to the period 56 January 1, 2000 to June 30, 2000, to the period July 1, 2000 to DecemberS. 7507 37 A. 9507 1 31, 2000, to the period January 1, 2001 to June 30, 2001, to the period 2 July 1, 2001 to June 30, 2002, to the period July 1, 2002 to June 30, 3 2003, to the period July 1, 2003 to June 30, 2004, to the period July 1, 4 2004 to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to 5 the period July 1, 2006 and June 30, 2007, to the period July 1, 2007 6 and June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the 7 period July 1, 2009 and June 30, 2010, to the period July 1, 2010 and 8 June 30, 2011, to the period July 1, 2011 and June 30, 2012, to the 9 period July 1, 2012 and June 30, 2013, to the period July 1, 2013 and 10 June 30, 2014, to the period July 1, 2014 and June 30, 2015, to the 11 period July 1, 2015 and June 30, 2016, and between July 1, 2016 and June 12 30, 2017, and to the period July 1, 2017 [and] to June 30, 2018, and to 13 the period July 1, 2018 to June 30, 2019. 14 § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section 15 18 of chapter 266 of the laws of 1986, amending the civil practice law 16 and rules and other laws relating to malpractice and professional 17 medical conduct, as amended by section 17 of part H of chapter 57 of the 18 laws of 2017, are amended to read as follows: 19 (a) To the extent funds available to the hospital excess liability 20 pool pursuant to subdivision 5 of this section as amended, and pursuant 21 to section 6 of part J of chapter 63 of the laws of 2001, as may from 22 time to time be amended, which amended this subdivision, are insuffi- 23 cient to meet the costs of excess insurance coverage or equivalent 24 excess coverage for coverage periods during the period July 1, 1992 to 25 June 30, 1993, during the period July 1, 1993 to June 30, 1994, during 26 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995 27 to June 30, 1996, during the period July 1, 1996 to June 30, 1997, 28 during the period July 1, 1997 to June 30, 1998, during the period July 29 1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30, 30 2000, during the period July 1, 2000 to June 30, 2001, during the period 31 July 1, 2001 to October 29, 2001, during the period April 1, 2002 to 32 June 30, 2002, during the period July 1, 2002 to June 30, 2003, during 33 the period July 1, 2003 to June 30, 2004, during the period July 1, 2004 34 to June 30, 2005, during the period July 1, 2005 to June 30, 2006, 35 during the period July 1, 2006 to June 30, 2007, during the period July 36 1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30, 37 2009, during the period July 1, 2009 to June 30, 2010, during the period 38 July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June 39 30, 2012, during the period July 1, 2012 to June 30, 2013, during the 40 period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to 41 June 30, 2015, during the period July 1, 2015 [and] to June 30, 2016, 42 during the period July 1, 2016 [and] to June 30, 2017, [and] during the 43 period July 1, 2017 [and] to June 30, 2018, and during the period July 44 1, 2018 to June 30, 2019 allocated or reallocated in accordance with 45 paragraph (a) of subdivision 4-a of this section to rates of payment 46 applicable to state governmental agencies, each physician or dentist for 47 whom a policy for excess insurance coverage or equivalent excess cover- 48 age is purchased for such period shall be responsible for payment to the 49 provider of excess insurance coverage or equivalent excess coverage of 50 an allocable share of such insufficiency, based on the ratio of the 51 total cost of such coverage for such physician to the sum of the total 52 cost of such coverage for all physicians applied to such insufficiency. 53 (b) Each provider of excess insurance coverage or equivalent excess 54 coverage covering the period July 1, 1992 to June 30, 1993, or covering 55 the period July 1, 1993 to June 30, 1994, or covering the period July 1, 56 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,S. 7507 38 A. 9507 1 1996, or covering the period July 1, 1996 to June 30, 1997, or covering 2 the period July 1, 1997 to June 30, 1998, or covering the period July 1, 3 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30, 4 2000, or covering the period July 1, 2000 to June 30, 2001, or covering 5 the period July 1, 2001 to October 29, 2001, or covering the period 6 April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to 7 June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or 8 covering the period July 1, 2004 to June 30, 2005, or covering the peri- 9 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to 10 June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or 11 covering the period July 1, 2008 to June 30, 2009, or covering the peri- 12 od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to 13 June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or 14 covering the period July 1, 2012 to June 30, 2013, or covering the peri- 15 od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to 16 June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or 17 covering the period July 1, 2016 to June 30, 2017, or covering the peri- 18 od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to 19 June 30, 2019 shall notify a covered physician or dentist by mail, 20 mailed to the address shown on the last application for excess insurance 21 coverage or equivalent excess coverage, of the amount due to such 22 provider from such physician or dentist for such coverage period deter- 23 mined in accordance with paragraph (a) of this subdivision. Such amount 24 shall be due from such physician or dentist to such provider of excess 25 insurance coverage or equivalent excess coverage in a time and manner 26 determined by the superintendent of financial services. 27 (c) If a physician or dentist liable for payment of a portion of the 28 costs of excess insurance coverage or equivalent excess coverage cover- 29 ing the period July 1, 1992 to June 30, 1993, or covering the period 30 July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to 31 June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or 32 covering the period July 1, 1996 to June 30, 1997, or covering the peri- 33 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to 34 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or 35 covering the period July 1, 2000 to June 30, 2001, or covering the peri- 36 od July 1, 2001 to October 29, 2001, or covering the period April 1, 37 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30, 38 2003, or covering the period July 1, 2003 to June 30, 2004, or covering 39 the period July 1, 2004 to June 30, 2005, or covering the period July 1, 40 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30, 41 2007, or covering the period July 1, 2007 to June 30, 2008, or covering 42 the period July 1, 2008 to June 30, 2009, or covering the period July 1, 43 2009 to June 30, 2010, or covering the period July 1, 2010 to June 30, 44 2011, or covering the period July 1, 2011 to June 30, 2012, or covering 45 the period July 1, 2012 to June 30, 2013, or covering the period July 1, 46 2013 to June 30, 2014, or covering the period July 1, 2014 to June 30, 47 2015, or covering the period July 1, 2015 to June 30, 2016, or covering 48 the period July 1, 2016 to June 30, 2017, or covering the period July 1, 49 2017 to June 30, 2018, or covering the period July 1, 2018 to June 30, 50 2019 determined in accordance with paragraph (a) of this subdivision 51 fails, refuses or neglects to make payment to the provider of excess 52 insurance coverage or equivalent excess coverage in such time and manner 53 as determined by the superintendent of financial services pursuant to 54 paragraph (b) of this subdivision, excess insurance coverage or equiv- 55 alent excess coverage purchased for such physician or dentist in accord- 56 ance with this section for such coverage period shall be cancelled andS. 7507 39 A. 9507 1 shall be null and void as of the first day on or after the commencement 2 of a policy period where the liability for payment pursuant to this 3 subdivision has not been met. 4 (d) Each provider of excess insurance coverage or equivalent excess 5 coverage shall notify the superintendent of financial services and the 6 commissioner of health or their designee of each physician and dentist 7 eligible for purchase of a policy for excess insurance coverage or 8 equivalent excess coverage covering the period July 1, 1992 to June 30, 9 1993, or covering the period July 1, 1993 to June 30, 1994, or covering 10 the period July 1, 1994 to June 30, 1995, or covering the period July 1, 11 1995 to June 30, 1996, or covering the period July 1, 1996 to June 30, 12 1997, or covering the period July 1, 1997 to June 30, 1998, or covering 13 the period July 1, 1998 to June 30, 1999, or covering the period July 1, 14 1999 to June 30, 2000, or covering the period July 1, 2000 to June 30, 15 2001, or covering the period July 1, 2001 to October 29, 2001, or cover- 16 ing the period April 1, 2002 to June 30, 2002, or covering the period 17 July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to 18 June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or 19 covering the period July 1, 2005 to June 30, 2006, or covering the peri- 20 od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to 21 June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or 22 covering the period July 1, 2009 to June 30, 2010, or covering the peri- 23 od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to 24 June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or 25 covering the period July 1, 2013 to June 30, 2014, or covering the peri- 26 od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to 27 June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or 28 covering the period July 1, 2017 to June 30, 2018, or covering the peri- 29 od July 1, 2018 to June 30, 2019 that has made payment to such provider 30 of excess insurance coverage or equivalent excess coverage in accordance 31 with paragraph (b) of this subdivision and of each physician and dentist 32 who has failed, refused or neglected to make such payment. 33 (e) A provider of excess insurance coverage or equivalent excess 34 coverage shall refund to the hospital excess liability pool any amount 35 allocable to the period July 1, 1992 to June 30, 1993, and to the period 36 July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June 37 30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the 38 period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to 39 June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to 40 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000 41 to June 30, 2001, and to the period July 1, 2001 to October 29, 2001, 42 and to the period April 1, 2002 to June 30, 2002, and to the period July 43 1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30, 44 2004, and to the period July 1, 2004 to June 30, 2005, and to the period 45 July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June 46 30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the 47 period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to 48 June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to 49 the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012 50 to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and 51 to the period July 1, 2014 to June 30, 2015, and to the period July 1, 52 2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017, and 53 to the period July 1, 2017 to June 30, 2018, and to the period July 1, 54 2018 to June 30, 2019 received from the hospital excess liability pool 55 for purchase of excess insurance coverage or equivalent excess coverage 56 covering the period July 1, 1992 to June 30, 1993, and covering theS. 7507 40 A. 9507 1 period July 1, 1993 to June 30, 1994, and covering the period July 1, 2 1994 to June 30, 1995, and covering the period July 1, 1995 to June 30, 3 1996, and covering the period July 1, 1996 to June 30, 1997, and cover- 4 ing the period July 1, 1997 to June 30, 1998, and covering the period 5 July 1, 1998 to June 30, 1999, and covering the period July 1, 1999 to 6 June 30, 2000, and covering the period July 1, 2000 to June 30, 2001, 7 and covering the period July 1, 2001 to October 29, 2001, and covering 8 the period April 1, 2002 to June 30, 2002, and covering the period July 9 1, 2002 to June 30, 2003, and covering the period July 1, 2003 to June 10 30, 2004, and covering the period July 1, 2004 to June 30, 2005, and 11 covering the period July 1, 2005 to June 30, 2006, and covering the 12 period July 1, 2006 to June 30, 2007, and covering the period July 1, 13 2007 to June 30, 2008, and covering the period July 1, 2008 to June 30, 14 2009, and covering the period July 1, 2009 to June 30, 2010, and cover- 15 ing the period July 1, 2010 to June 30, 2011, and covering the period 16 July 1, 2011 to June 30, 2012, and covering the period July 1, 2012 to 17 June 30, 2013, and covering the period July 1, 2013 to June 30, 2014, 18 and covering the period July 1, 2014 to June 30, 2015, and covering the 19 period July 1, 2015 to June 30, 2016, and covering the period July 1, 20 2016 to June 30, 2017, and covering the period July 1, 2017 to June 30, 21 2018, and covering the period July 1, 2018 to June 30, 2019 for a physi- 22 cian or dentist where such excess insurance coverage or equivalent 23 excess coverage is cancelled in accordance with paragraph (c) of this 24 subdivision. 25 § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil 26 practice law and rules and other laws relating to malpractice and 27 professional medical conduct, as amended by section 18 of part H of 28 chapter 57 of the laws of 2017, is amended to read as follows: 29 § 40. The superintendent of financial services shall establish rates 30 for policies providing coverage for physicians and surgeons medical 31 malpractice for the periods commencing July 1, 1985 and ending June 30, 32 [2018] 2019; provided, however, that notwithstanding any other provision 33 of law, the superintendent shall not establish or approve any increase 34 in rates for the period commencing July 1, 2009 and ending June 30, 35 2010. The superintendent shall direct insurers to establish segregated 36 accounts for premiums, payments, reserves and investment income attrib- 37 utable to such premium periods and shall require periodic reports by the 38 insurers regarding claims and expenses attributable to such periods to 39 monitor whether such accounts will be sufficient to meet incurred claims 40 and expenses. On or after July 1, 1989, the superintendent shall impose 41 a surcharge on premiums to satisfy a projected deficiency that is 42 attributable to the premium levels established pursuant to this section 43 for such periods; provided, however, that such annual surcharge shall 44 not exceed eight percent of the established rate until July 1, [2018] 45 2019, at which time and thereafter such surcharge shall not exceed twen- 46 ty-five percent of the approved adequate rate, and that such annual 47 surcharges shall continue for such period of time as shall be sufficient 48 to satisfy such deficiency. The superintendent shall not impose such 49 surcharge during the period commencing July 1, 2009 and ending June 30, 50 2010. On and after July 1, 1989, the surcharge prescribed by this 51 section shall be retained by insurers to the extent that they insured 52 physicians and surgeons during the July 1, 1985 through June 30, [2018] 53 2019 policy periods; in the event and to the extent physicians and 54 surgeons were insured by another insurer during such periods, all or a 55 pro rata share of the surcharge, as the case may be, shall be remitted 56 to such other insurer in accordance with rules and regulations to beS. 7507 41 A. 9507 1 promulgated by the superintendent. Surcharges collected from physicians 2 and surgeons who were not insured during such policy periods shall be 3 apportioned among all insurers in proportion to the premium written by 4 each insurer during such policy periods; if a physician or surgeon was 5 insured by an insurer subject to rates established by the superintendent 6 during such policy periods, and at any time thereafter a hospital, 7 health maintenance organization, employer or institution is responsible 8 for responding in damages for liability arising out of such physician's 9 or surgeon's practice of medicine, such responsible entity shall also 10 remit to such prior insurer the equivalent amount that would then be 11 collected as a surcharge if the physician or surgeon had continued to 12 remain insured by such prior insurer. In the event any insurer that 13 provided coverage during such policy periods is in liquidation, the 14 property/casualty insurance security fund shall receive the portion of 15 surcharges to which the insurer in liquidation would have been entitled. 16 The surcharges authorized herein shall be deemed to be income earned for 17 the purposes of section 2303 of the insurance law. The superintendent, 18 in establishing adequate rates and in determining any projected defi- 19 ciency pursuant to the requirements of this section and the insurance 20 law, shall give substantial weight, determined in his discretion and 21 judgment, to the prospective anticipated effect of any regulations 22 promulgated and laws enacted and the public benefit of stabilizing 23 malpractice rates and minimizing rate level fluctuation during the peri- 24 od of time necessary for the development of more reliable statistical 25 experience as to the efficacy of such laws and regulations affecting 26 medical, dental or podiatric malpractice enacted or promulgated in 1985, 27 1986, by this act and at any other time. Notwithstanding any provision 28 of the insurance law, rates already established and to be established by 29 the superintendent pursuant to this section are deemed adequate if such 30 rates would be adequate when taken together with the maximum authorized 31 annual surcharges to be imposed for a reasonable period of time whether 32 or not any such annual surcharge has been actually imposed as of the 33 establishment of such rates. 34 § 5. Section 5 and subdivisions (a) and (e) of section 6 of part J of 35 chapter 63 of the laws of 2001, amending chapter 266 of the laws of 36 1986, amending the civil practice law and rules and other laws relating 37 to malpractice and professional medical conduct, relating to the effec- 38 tiveness of certain provisions of such chapter, as amended by section 19 39 of part H of chapter 57 of the laws of 2017, are amended to read as 40 follows: 41 § 5. The superintendent of financial services and the commissioner of 42 health shall determine, no later than June 15, 2002, June 15, 2003, June 43 15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, 44 June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15, 45 2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, [and] 46 June 15, 2018, and June 15, 2019 the amount of funds available in the 47 hospital excess liability pool, created pursuant to section 18 of chap- 48 ter 266 of the laws of 1986, and whether such funds are sufficient for 49 purposes of purchasing excess insurance coverage for eligible partic- 50 ipating physicians and dentists during the period July 1, 2001 to June 51 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 52 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 53 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June 30, 54 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June 30, 55 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 30, 56 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,S. 7507 42 A. 9507 1 2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30, 2 2016, or July 1, 2016 to June 30, 2017, or [to] July 1, 2017 to June 30, 3 2018, or July 1, 2018 to June 30, 2019 as applicable. 4 (a) This section shall be effective only upon a determination, pursu- 5 ant to section five of this act, by the superintendent of financial 6 services and the commissioner of health, and a certification of such 7 determination to the state director of the budget, the chair of the 8 senate committee on finance and the chair of the assembly committee on 9 ways and means, that the amount of funds in the hospital excess liabil- 10 ity pool, created pursuant to section 18 of chapter 266 of the laws of 11 1986, is insufficient for purposes of purchasing excess insurance cover- 12 age for eligible participating physicians and dentists during the period 13 July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 14 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 15 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 16 to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to 17 June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 18 30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30, 19 2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30, 20 2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30, 21 2018, or July 1, 2018 to June 30, 2019 as applicable. 22 (e) The commissioner of health shall transfer for deposit to the 23 hospital excess liability pool created pursuant to section 18 of chapter 24 266 of the laws of 1986 such amounts as directed by the superintendent 25 of financial services for the purchase of excess liability insurance 26 coverage for eligible participating physicians and dentists for the 27 policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 28 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 29 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30, 30 2007, as applicable, and the cost of administering the hospital excess 31 liability pool for such applicable policy year, pursuant to the program 32 established in chapter 266 of the laws of 1986, as amended, no later 33 than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June 34 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010, 35 June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15, 36 2015, June 15, 2016, June 15, 2017, [and] June 15, 2018, and June 15, 37 2019 as applicable. 38 § 6. Section 20 of part H of chapter 57 of the laws of 2017, amending 39 the New York Health Care Reform Act of 1996 and other laws relating to 40 extending certain provisions thereto, is amended to read as follows: 41 § 20. Notwithstanding any law, rule or regulation to the contrary, 42 only physicians or dentists who were eligible, and for whom the super- 43 intendent of financial services and the commissioner of health, or their 44 designee, purchased, with funds available in the hospital excess liabil- 45 ity pool, a full or partial policy for excess coverage or equivalent 46 excess coverage for the coverage period ending the thirtieth of June, 47 two thousand [seventeen] eighteen, shall be eligible to apply for such 48 coverage for the coverage period beginning the first of July, two thou- 49 sand [seventeen] eighteen; provided, however, if the total number of 50 physicians or dentists for whom such excess coverage or equivalent 51 excess coverage was purchased for the policy year ending the thirtieth 52 of June, two thousand [seventeen] eighteen exceeds the total number of 53 physicians or dentists certified as eligible for the coverage period 54 beginning the first of July, two thousand [seventeen] eighteen, then the 55 general hospitals may certify additional eligible physicians or dentists 56 in a number equal to such general hospital's proportional share of theS. 7507 43 A. 9507 1 total number of physicians or dentists for whom excess coverage or 2 equivalent excess coverage was purchased with funds available in the 3 hospital excess liability pool as of the thirtieth of June, two thousand 4 [seventeen] eighteen, as applied to the difference between the number of 5 eligible physicians or dentists for whom a policy for excess coverage or 6 equivalent excess coverage was purchased for the coverage period ending 7 the thirtieth of June, two thousand [seventeen] eighteen and the number 8 of such eligible physicians or dentists who have applied for excess 9 coverage or equivalent excess coverage for the coverage period beginning 10 the first of July, two thousand [seventeen] eighteen. 11 § 7. This act shall take effect immediately. 12 PART N 13 Section 1. The opening paragraph of subdivision 1 of section 1 of part 14 C of chapter 57 of the laws of 2006, establishing a cost of living 15 adjustment for designated human services, is amended to read as follows: 16 Subject to available appropriations, the commissioners of the office 17 of mental health, office of mental retardation and developmental disa- 18 bilities, office of alcoholism and substance abuse services, [department19of health,] office of children and family services and the state office 20 for the aging shall establish an annual cost of living adjustment 21 (COLA), subject to the approval of the director of the budget, effective 22 April first of each state fiscal year, provided, however, that in state 23 fiscal year 2006-07, the cost of living adjustment will be effective 24 October first, to project for the effects of inflation, for rates of 25 payments, contracts or any other form of reimbursement for the programs 26 listed in paragraphs (i), (ii), (iii), (iv)[,] and (v) [and (vi)] of 27 subdivision four of this section. The COLA shall be applied to the 28 appropriate portion of reimbursable costs or contract amounts. 29 § 2. Paragraph (iv) of subdivision 4 of section 1 of part C of chapter 30 57 of the laws of 2006, establishing a cost of living adjustment for 31 designated human services, is REPEALED and paragraphs (v) and (vi) are 32 renumbered paragraphs (iv) and (v). 33 § 3. This act shall take effect immediately. 34 PART O 35 Section 1. Subdivisions 9 and 10 of section 2541 of the public health 36 law, as added by chapter 428 of the laws of 1992, are amended to read as 37 follows: 38 9. "Evaluation" means a multidisciplinary professional, objective 39 [assessment] examination conducted by appropriately qualified personnel 40 and conducted pursuant to section twenty-five hundred forty-four of this 41 title to determine a child's eligibility under this title. 42 10. "Evaluator" means a [team of two or more professionals approved43pursuant to section twenty-five hundred fifty-one of this title] provid- 44 er approved by the department to conduct screenings and evaluations. 45 § 2. Section 2541 of the public health law is amended by adding three 46 new subdivisions 12-a, 14-a and 15-a to read as follows: 47 12-a. "Multidisciplinary" means the involvement of two or more sepa- 48 rate disciplines or professions, which may mean the involvement of one 49 individual who meets the definition of qualified personnel as defined in 50 subdivision fifteen of this section and who is qualified, in accordance 51 with state licensure, certification or other comparable standards, to 52 evaluate all five developmental domains.S. 7507 44 A. 9507 1 14-a. A "partial evaluation" shall mean an evaluation in a single 2 developmental area for purposes of determining eligibility, and may also 3 mean an examination of the child to determine the need for a modifica- 4 tion to the child's individualized family service plan. 5 15-a. "Screening" means the procedures used by qualified personnel, as 6 defined in subdivision fifteen of this section, to determine whether a 7 child is suspected of having a disability and in need of early inter- 8 vention services, and shall include, where available and appropriate for 9 the child, the administration of a standardized instrument or instru- 10 ments approved by the department, in accordance with subdivision three 11 of section twenty-five hundred forty-four of this title. 12 § 3. Subdivision 3 of section 2542 of the public health law, as 13 amended by chapter 231 of the laws of 1993, is amended to read as 14 follows: 15 3. [The] (a) Unless an infant or toddler has already been referred to 16 the early intervention program or the health officer of the public 17 health district in which the infant or toddler resides, as designated by 18 the municipality, the following persons and entities, within two working 19 days of identifying an infant or toddler suspected of having a disabili- 20 ty or at risk of having a disability, shall refer such infant or toddler 21 to the early intervention official or the health officer [of the public22health district in which the infant or toddler resides, as designated by23the municipality], as applicable, but in no event over the objection of 24 the parent made in accordance with procedures established by the depart- 25 ment for use by such primary referral sources[, unless the child has26already been referred]: hospitals, child health care providers, day 27 care programs, local school districts, public health facilities, early 28 childhood direction centers and such other social service and health 29 care agencies and providers as the commissioner shall specify in regu- 30 lation; provided, however, that the department shall establish proce- 31 dures, including regulations if required, to ensure that primary refer- 32 ral sources adequately inform the parent or guardian about the early 33 intervention program, including through brochures and written materials 34 created or approved by the department. 35 (b) The primary referral sources identified in paragraph (a) of this 36 subdivision shall, with parental consent, complete and transmit at the 37 time of referral, a referral form developed by the department which 38 contains information sufficient to document the primary referral 39 source's concern or basis for suspecting the child has a disability or 40 is at risk of having a disability, and where applicable, specifies the 41 child's diagnosed condition that establishes the child's eligibility for 42 the early intervention program. The primary referral source shall inform 43 the parent of a child with a diagnosed condition that has a high proba- 44 bility of resulting in developmental delay, that (i) eligibility for the 45 program may be established by medical or other records and (ii) of the 46 importance of providing consent for the primary referral source to tran- 47 smit records or reports necessary to support the diagnosis, or, for 48 parents or guardians of children who do not have a diagnosed condition, 49 records or reports that would assist in determining eligibility for the 50 program. 51 § 4. Section 2544 of the public health law, as added by chapter 428 of 52 the laws of 1992, paragraph (c) of subdivision 2 as added by section 1 53 of part A of chapter 56 of the laws of 2012 and subdivision 11 as added 54 by section 3 of part B3 of chapter 62 of the laws of 2003, is amended to 55 read as follows:S. 7507 45 A. 9507 1 § 2544. Screening and evaluations. 1. Each child thought to be an 2 eligible child is entitled to [a multidisciplinary] an evaluation 3 conducted in accordance with this section, and the early intervention 4 official shall ensure such evaluation, with parental consent. 5 2. (a) [The] Subject to the provisions of this title, the parent may 6 select an evaluator from the list of approved evaluators as described in 7 section twenty-five hundred forty-two of this title to conduct the 8 applicable screening and/or evaluation in accordance with this section. 9 The parent or evaluator shall immediately notify the early intervention 10 official of such selection. The evaluator shall review the information 11 and documentation provided with the referral to determine the appropri- 12 ate screening or evaluation process to follow in accordance with this 13 section. The evaluator may begin the screening or evaluation no sooner 14 than four working days after such notification, unless otherwise 15 approved by the initial service coordinator. 16 (b) [the evaluator shall designate an individual as the principal17contact for the multidisciplinary team] Initial service coordinators 18 shall inform the parent of the applicable screening or evaluation proce- 19 dures that may be performed. For a child referred to the early inter- 20 vention official who has a diagnosed physical or mental condition that 21 has a high probability of resulting in developmental delay, the initial 22 service coordinator shall inform the parent that the evaluation of the 23 child shall be conducted in accordance with the procedures set forth in 24 subdivision five of this section. 25 (c) If, in consultation with the evaluator, the service coordinator 26 identifies a child that is potentially eligible for programs or services 27 offered by or under the auspices of the office for people with develop- 28 mental disabilities, the service coordinator shall, with parent consent, 29 notify the office for people with developmental disabilities' regional 30 developmental disabilities services office of the potential eligibility 31 of such child for said programs or services. 32 3. [(a) To determine eligibility, an evaluator shall, with parental33consent, either (i) screen a child to determine what type of evaluation,34if any, is warranted, or (ii) provide a multidisciplinary evaluation. In35making the determination whether to provide an evaluation, the evaluator36may rely on a recommendation from a physician or other qualified person37as designated by the commissioner.38(b)] Screenings for children referred to the early intervention 39 program to determine whether they are suspected of having a disability. 40 (a) For a child referred to the early intervention program, the evalu- 41 ator shall first perform a screening of the child, with parental 42 consent, to determine whether the child is suspected of having a disa- 43 bility. 44 (b) The evaluator shall utilize a standardized instrument or instru- 45 ments approved by the department to conduct the screening. If the evalu- 46 ator does not utilize a standardized instrument or instruments approved 47 by the department for the screening, the evaluator shall document in 48 writing why such standardized instrument or instruments are unavailable 49 or inappropriate for the child. 50 (c) The evaluator shall explain the results of the screening to the 51 parent and shall fully document the results in writing. 52 (d) If, based upon the screening, a child is [believed to be eligible,53or if otherwise elected by the parent] suspected of having a disability, 54 the child shall, with [the consent of a parent] parental consent, 55 receive [a multidisciplinary evaluation. All evaluations shall be56conducted in accordance with] an evaluation to be conducted in accord-S. 7507 46 A. 9507 1 ance with the procedures set forth in subdivision four of this section, 2 the coordinated standards and procedures, and [with] regulations promul- 3 gated by the commissioner. 4 (e) If, based upon the screening, a child is not suspected of having a 5 disability, an evaluation shall not be provided, unless requested by the 6 parent. The early intervention official shall provide the parent with 7 written notice of the screening results, which shall include information 8 on the parent's right to request an evaluation. 9 (f) A screening shall not be provided to children who are referred to 10 the early intervention program who have a diagnosed physical or mental 11 condition with a high probability of resulting in developmental delay 12 that establishes eligibility for the program or for children who have 13 previously received an evaluation under the early intervention program. 14 4. The evaluation of [each] a child shall: 15 (a) include the administration of an evaluation instrument or instru- 16 ments approved by the department. If the evaluator does not utilize an 17 instrument or instruments approved by the department as part of the 18 evaluation of the child, the evaluator shall document in writing why 19 such instrument or instruments are not appropriate or available for the 20 child; 21 (b) be conducted by personnel trained to utilize appropriate methods 22 and procedures; 23 [(b)] (c) be based on informed clinical opinion; 24 [(c)] (d) be made without regard to the availability of services in 25 the municipality or who might provide such services; [and26(d)] (e) with parental consent, include the following: 27 (i) a review of pertinent records related to the child's current 28 health status and medical history; and 29 (ii) an evaluation of the child's level of functioning in each of the 30 developmental areas set forth in paragraph (c) of subdivision seven of 31 section twenty-five hundred forty-one of this title[;] to determine 32 whether the child has a disability as defined in this title that estab- 33 lishes the child's eligibility for the program; and 34 (f) if the child has been determined eligible by the evaluator after 35 conducting the procedures set forth in paragraphs (a) through (e) of 36 this subdivision, the evaluation shall also include: 37 [(iii)] (i) an assessment [of the unique needs of the child in terms38of] for the purposes of identifying the child's unique strengths and 39 needs in each of the developmental areas [set forth in paragraph (c) of40subdivision seven of section twenty-five hundred forty-one of this41title, including the identification of] and the early intervention 42 services appropriate to meet those needs; 43 [(iv)] (ii) a family-directed assessment, if consented to by the fami- 44 ly, in order to identify the family's resources, priorities, and 45 concerns and the supports necessary to enhance the family's capacity to 46 meet the developmental needs of the child. The family assessment shall 47 be voluntary on the part of each family member participating in the 48 assessment; 49 (iii) an [evaluation] assessment of the transportation needs of the 50 child, if any; and 51 [(v)] (iv) such other matters as the commissioner may prescribe in 52 regulation. 53 5. Evaluations for children who are referred to the early intervention 54 official with diagnosed physical or mental conditions that have a high 55 probability of resulting in developmental delay. (a) If a child has a 56 diagnosed physical or mental condition that has a high probability ofS. 7507 47 A. 9507 1 resulting in developmental delay, the child's medical or other records 2 shall be used, when available, to establish the child's eligibility for 3 the program. 4 (b) The evaluator shall, upon review of the referral form provided in 5 accordance with section twenty-five hundred forty-two of this title or 6 any medical or other records, or at the time of initial contact with the 7 child's family, determine whether the child has a diagnosed condition 8 that establishes the child's eligibility for the program. If the evalu- 9 ator has reason to believe, after speaking with the child's family, that 10 the child may have a diagnosed condition that establishes the child's 11 eligibility but the evaluator has not been provided with medical or 12 other documentation of such diagnosis, the evaluator shall, with 13 parental consent, obtain such documentation, when available, prior to 14 proceeding with the evaluation of the child. 15 (c) The evaluator shall review all records received to document that 16 the child's diagnosis as set forth in such records establishes the 17 child's eligibility for the early intervention program. 18 (d) Notwithstanding subdivision four of this section, if the child's 19 eligibility for the early intervention program is established in accord- 20 ance with this subdivision, the evaluation of the child shall (i) 21 consist of a review of the results of the medical or other records that 22 established the child's eligibility, and any other pertinent evaluations 23 or records available and (ii) comply with the procedures set forth in 24 paragraph (f) of subdivision four of this section. The evaluation proce- 25 dures set forth in paragraphs (a) through (e) of subdivision four of 26 this section shall not be required or conducted. 27 6. An evaluation shall not include a reference to any specific provid- 28 er of early intervention services. 29 [6.] 7. Nothing in this section shall restrict an evaluator from 30 utilizing, in addition to findings from his or her personal examination, 31 other examinations, evaluations or assessments conducted for such child, 32 including those conducted prior to the evaluation under this section, if 33 such examinations, evaluations or assessments are consistent with the 34 coordinated standards and procedures. 35 [7.] 8. Following completion of the evaluation, the evaluator shall 36 provide the parent and service coordinator with a copy of a summary of 37 the full evaluation. To the extent practicable, the summary shall be 38 provided in the native language of the parent. Upon request of the 39 parent, early intervention official or service coordinator, the evalu- 40 ator shall provide a copy of the full evaluation to such parent, early 41 intervention official or service coordinator. 42 [8.] 9. A parent who disagrees with the results of an evaluation may 43 obtain an additional evaluation or partial evaluation at public expense 44 to the extent authorized by federal law or regulation. 45 [9.] 10. Upon receipt of the results of an evaluation, a service coor- 46 dinator may, with parental consent, require additional diagnostic infor- 47 mation regarding the condition of the child, provided, however, that 48 such evaluation or assessment is not unnecessarily duplicative or inva- 49 sive to the child, and provided further, that: 50 (a) where the evaluation has established the child's eligibility, such 51 additional diagnostic information shall be used solely to provide addi- 52 tional information to the parent and service coordinator regarding the 53 child's need for services and cannot be a basis for refuting eligibil- 54 ity; 55 (b) the service coordinator provides the parent with a written expla- 56 nation of the basis for requiring additional diagnostic information;S. 7507 48 A. 9507 1 (c) the additional diagnostic procedures are at no expense to the 2 parent; and 3 (d) the evaluation is completed and a meeting to develop an IFSP is 4 held within the time prescribed in subdivision one of section twenty- 5 five hundred forty-five of this title. 6 [10.] 11. (a) If the screening indicates that the infant or toddler is 7 not an eligible child and the parent elects not to have an evaluation, 8 or if the evaluation indicates that the infant or toddler is not an 9 eligible child, the service coordinator shall inform the parent of other 10 programs or services that may benefit such child, and the child's family 11 and, with parental consent, refer such child to such programs or 12 services. 13 (b) A parent may appeal a determination that a child is ineligible 14 pursuant to the provisions of section twenty-five hundred forty-nine of 15 this title, provided, however, that a parent may not initiate such 16 appeal until all evaluations are completed. In addition, for a child 17 referred to the early intervention official who has a diagnosed physical 18 or mental condition that establishes the child's eligibility for the 19 program in accordance with subdivision five of this section, the parent 20 may appeal the denial of a request to have the evaluator conduct the 21 evaluation procedures set forth in paragraphs (a) through (e) of subdi- 22 vision four of this section, provided, however, that the parent may not 23 initiate the appeal until the evaluation conducted in accordance with 24 subdivision five of this section is completed. 25 [11.] 12. Notwithstanding any other provision of law to the contrary, 26 where a request has been made to review an IFSP prior to the six-month 27 interval provided in subdivision seven of section twenty-five hundred 28 forty-five of this title for purposes of increasing frequency or dura- 29 tion of an approved service, including service coordination, the early 30 intervention official may require an additional evaluation or partial 31 evaluation at public expense by an approved evaluator other than the 32 current provider of service, with parent consent. 33 § 5. Section 3235-a of the insurance law, as added by section 3 of 34 part C of chapter 1 of the laws of 2002, subsection (c) as amended by 35 section 17 of part A of chapter 56 of the laws of 2012, is amended to 36 read as follows: 37 § 3235-a. Payment for early intervention services. (a) No policy of 38 accident and health insurance, including contracts issued pursuant to 39 article forty-three of this chapter, shall exclude coverage for other- 40 wise covered services solely on the basis that the services constitute 41 early intervention program services under title two-A of article twen- 42 ty-five of the public health law; provided, however, the insurer, 43 including a health maintenance organization issued a certificate of 44 authority under article forty-four of the public health law and a corpo- 45 ration organized under article forty-three of this chapter shall pay for 46 such services to the extent that the services are a covered benefit 47 under the policy. 48 (b) Where a policy of accident and health insurance, including a 49 contract issued pursuant to article forty-three of this chapter, 50 provides coverage for an early intervention program service, such cover- 51 age shall not be applied against any maximum annual or lifetime monetary 52 limits set forth in such policy or contract. Any documentation obtained 53 pursuant to subparagraph (ii) of paragraph (a) of subdivision three of 54 section twenty-five hundred fifty-nine of the public health law and 55 submitted to the insurer shall be considered as part of precertif- 56 ication, preauthorization and/or medical necessity review imposed underS. 7507 49 A. 9507 1 such policy of accident and health insurance, including a contract 2 issued pursuant to article forty-three of this chapter. Visit limita- 3 tions and other terms and conditions of the policy will continue to 4 apply to early intervention services. However, any visits used for early 5 intervention program services shall not reduce the number of visits 6 otherwise available under the policy or contract for such services. 7 (c) Any right of subrogation to benefits which a municipality or 8 provider is entitled in accordance with paragraph (d) of subdivision 9 three of section twenty-five hundred fifty-nine of the public health law 10 shall be valid and enforceable to the extent benefits are available 11 under any accident and health insurance policy. The right of subrogation 12 does not attach to insurance benefits paid or provided under any acci- 13 dent and health insurance policy prior to receipt by the insurer of 14 written notice from the municipality or provider, as applicable. The 15 insurer shall provide [the] such municipality and service coordinator 16 with information on the extent of benefits available to the covered 17 person under such policy within fifteen days of the insurer's receipt of 18 written request and notice authorizing such release. The service coordi- 19 nator shall provide such information to the rendering provider assigned 20 to provide services to the child. 21 (d) No insurer, including a health maintenance organization issued a 22 certificate of authority under article forty-four of the public health 23 law and a corporation organized under article forty-three of this chap- 24 ter, shall refuse to issue an accident and health insurance policy or 25 contract or refuse to renew an accident and health insurance policy or 26 contract solely because the applicant or insured is receiving services 27 under the early intervention program. 28 § 6. Paragraph (a) of subdivision 3 of section 2559 of the public 29 health law, as amended by section 11 of part A of chapter 56 of the laws 30 of 2012, is amended to read as follows: 31 (a) Providers of evaluations and early intervention services, herein- 32 after collectively referred to in this subdivision as "provider" or 33 "providers", shall in the first instance and where applicable, seek 34 payment from all third party payors including governmental agencies 35 prior to claiming payment from a given municipality for evaluations 36 conducted under the program and for services rendered to eligible chil- 37 dren, provided that, the obligation to seek payment shall not apply to a 38 payment from a third party payor who is not prohibited from applying 39 such payment, and will apply such payment, to an annual or lifetime 40 limit specified in the insured's policy. If such a claim is denied by a 41 third party payor, the provider shall request an appeal of such denial, 42 in a manner prescribed by the department, in accordance with article 43 forty-nine of this chapter and article forty-nine of the insurance law, 44 and shall receive a determination of such appeal prior to submitting a 45 claim for payment from another third party payor or from the munici- 46 pality. A provider shall not delay or discontinue services to eligible 47 children pending payment of the claim or pending a determination of any 48 denial for payment that has been appealed. 49 (i) [Parents] In a form prescribed by the department, parents shall 50 provide the municipality [and], service coordinator and provider infor- 51 mation on any insurance policy, plan or contract under which an eligible 52 child has coverage. 53 (ii) [Parents] In a timeline and format as prescribed by the depart- 54 ment, the municipality shall request from the parent, and the parent 55 shall provide the municipality [and the service coordinator], who shall 56 provide such documentation to the service coordinator and provider,S. 7507 50 A. 9507 1 with: (A) a written order, referral [from a primary care provider as2documentation, for eligible children, of] or recommendation, signed by a 3 physician, physician assistant or nurse practitioner, for the medical 4 necessity of early intervention evaluation services to determine program 5 eligibility for early intervention services; 6 (B) a copy of an individualized family service plan agreed upon pursu- 7 ant to section twenty-five hundred forty-five of this title that 8 contains documentation, signed by a physician, physician assistant or 9 nurse practitioner on the medical necessity of early intervention 10 services included in the individualized family service plan; 11 (C) written consent to contact the child's physician, physician 12 assistant or nurse practitioner for purposes of obtaining a signed writ- 13 ten order, referral, or recommendation as documentation for the medical 14 necessity of early intervention evaluation services to determine program 15 eligibility for early intervention services; or 16 (D) written consent to contact the child's physician, physician 17 assistant or nurse practitioner for purposes of obtaining signed 18 documentation of the medical necessity of early intervention services 19 contained within the individualized family service plan agreed upon 20 pursuant to section twenty-five hundred forty-five of this title. 21 (iii) [providers] Providers shall utilize the department's fiscal 22 agent and data system for claiming payment and for requesting appeals of 23 claims denied by third party payors, for evaluations and services 24 rendered under the early intervention program. 25 § 7. Paragraph (d) of subdivision 3 of section 2559 of the public 26 health law, as amended by section 11 of part A of chapter 56 of the laws 27 of 2012, is amended to read as follows: 28 (d) A municipality, or its designee, and a provider shall be subrogat- 29 ed, to the extent of the expenditures by such municipality or for early 30 intervention services furnished to persons eligible for benefits under 31 this title, to any rights such person may have or be entitled to from 32 third party reimbursement. The provider shall submit any documentation 33 obtained pursuant to subparagraph (ii) of paragraph (a) of this subdivi- 34 sion and shall submit notice to the insurer or plan administrator of his 35 or her exercise of such right of subrogation upon the provider's assign- 36 ment as the early intervention service provider for the child. The right 37 of subrogation does not attach to benefits paid or provided under any 38 health insurance policy or health benefits plan prior to receipt of 39 written notice of the exercise of subrogation rights by the insurer or 40 plan administrator providing such benefits. 41 § 8. Subdivision 7 of section 4900 of the public health law, as 42 amended by chapter 558 of the laws of 1999, is amended to read as 43 follows: 44 7. "Health care provider" means a health care professional or a facil- 45 ity licensed pursuant to articles twenty-eight, thirty-six, forty-four 46 or forty-seven of this chapter [or], a facility licensed pursuant to 47 article nineteen, twenty-three, thirty-one or thirty-two of the mental 48 hygiene law, qualified personnel pursuant to title two-A of article 49 twenty-five of this chapter or an agency as defined by the department of 50 health in regulations promulgated pursuant to title two-A of article 51 twenty-five of this chapter. 52 § 9. Subdivision 1 of section 4904 of the public health law, as added 53 by chapter 705 of the laws of 1996, is amended to read as follows: 54 1. An enrollee, the enrollee's designee and, in connection with retro- 55 spective adverse determinations or adverse determinations for services 56 rendered in accordance title two-A of article twenty-five of this chap-S. 7507 51 A. 9507 1 ter, an enrollee's health care provider, may appeal an adverse determi- 2 nation rendered by a utilization review agent. 3 § 10. The opening paragraph of subdivision 2 of section 4910 of the 4 public health law, as amended by chapter 237 of the laws of 2009, is 5 amended to read as follows: 6 An enrollee, the enrollee's designee and, in connection with concur- 7 rent and retrospective adverse determinations or adverse determinations 8 for services rendered in accordance with title two-A of article twenty- 9 five of this chapter, an enrollee's health care provider, shall have the 10 right to request an external appeal when: 11 § 11. Paragraph (a) of subdivision 4 of section 4914 of the public 12 health law, as amended by chapter 237 of the laws of 2009, is amended to 13 read as follows: 14 (a) Except as provided in paragraphs (b) and (c) of this subdivision, 15 payment for an external appeal, including an appeal for services 16 rendered in accordance with title two-A of article twenty-five of this 17 chapter, shall be the responsibility of the health care plan. The health 18 care plan shall make payment to the external appeal agent within forty- 19 five days from the date the appeal determination is received by the 20 health care plan, and the health care plan shall be obligated to pay 21 such amount together with interest thereon calculated at a rate which is 22 the greater of the rate set by the commissioner of taxation and finance 23 for corporate taxes pursuant to paragraph one of subsection (e) of 24 section one thousand ninety-six of the tax law or twelve percent per 25 annum, to be computed from the date the bill was required to be paid, in 26 the event that payment is not made within such forty-five days. 27 § 12. Subsection (g) of section 4900 of the insurance law, as amended 28 by chapter 558 of the laws of 1999, is amended to read as follows: 29 (g) "Health care provider" means a health care professional or a 30 facility licensed pursuant to article twenty-eight, thirty-six, forty- 31 four or forty-seven of the public health law [or], a facility licensed 32 pursuant to article nineteen, twenty-three, thirty-one or thirty-two of 33 the mental hygiene law, qualified personnel pursuant to title two-A of 34 article twenty-five of the public health law, or an agency as defined by 35 the department of health in regulations promulgated pursuant to title 36 two-A of article twenty-five of the public health law. 37 § 13. Subsection (a) of section 4904 of the insurance law, as added by 38 chapter 705 of the laws of 1996, is amended to read as follows: 39 (a) An insured, the insured's designee and, in connection with retro- 40 spective adverse determinations or adverse determinations for services 41 rendered in accordance with title two-A of article twenty-five of the 42 public health law, an insured's health care provider, may appeal an 43 adverse determination rendered by a utilization review agent. 44 § 14. The opening paragraph of subsection (b) of section 4910 of the 45 insurance law, as amended by chapter 237 of the laws of 2009, is amended 46 to read as follows: 47 An insured, the insured's designee and, in connection with concurrent 48 and retrospective adverse determinations or adverse determinations for 49 services rendered in accordance with title two-A of article twenty-five 50 of the public health law, an insured's health care provider, shall have 51 the right to request an external appeal when: 52 § 15. Paragraph 1 of subsection (d) of section 4914 of the insurance 53 law, as amended by chapter 237 of the laws of 2009, is amended to read 54 as follows: 55 (1) Except as provided in paragraphs two and three of this subsection, 56 payment for an external appeal, including an appeal for servicesS. 7507 52 A. 9507 1 rendered in accordance with title two-A of article twenty-five of the 2 public health law, shall be the responsibility of the health care plan. 3 The health care plan shall make payment to the external appeal agent 4 within forty-five days, from the date the appeal determination is 5 received by the health care plan, and the health care plan shall be 6 obligated to pay such amount together with interest thereon calculated 7 at a rate which is the greater of the rate set by the commissioner of 8 taxation and finance for corporate taxes pursuant to paragraph one of 9 subsection (e) of section one thousand ninety-six of the tax law or 10 twelve percent per annum, to be computed from the date the bill was 11 required to be paid, in the event that payment is not made within such 12 forty-five days. 13 § 16. Paragraph 1 of subsection (c) of section 109 of the insurance 14 law, as amended by section 55 of part A of chapter 62 of the laws of 15 2011, is amended to read as follows: 16 (1) If the superintendent finds after notice and hearing that any 17 [authorized] insurer, representative of the insurer, [licensed] insur- 18 ance agent, [licensed] insurance broker, [licensed] adjuster, or any 19 other person or entity [licensed, certified, registered, or authorized20pursuant] subject to this chapter, has wilfully violated the provisions 21 of this chapter or any regulation promulgated thereunder, then the 22 superintendent may order the person or entity to pay to the people of 23 this state a penalty in a sum not exceeding the greater of: (i) one 24 thousand dollars for each offense; or (ii) where the violation relates 25 to either the failure to pay a claim or making a false statement to the 26 superintendent or the department, the greater of (A) ten thousand 27 dollars for each offense, or (B) a multiple of two times the aggregate 28 damages attributable to the violation, or (C) a multiple of two times 29 the aggregate economic gain attributable to the violation. 30 § 17. Upon enactment of the amendments to paragraph (a) of subdivision 31 3 of section 2559 of the public health law made by section six of this 32 act, providers of early intervention services shall receive a two 33 percent increase in rates of reimbursement for early intervention 34 services provided that for payments made for early intervention services 35 to persons eligible for medical assistance pursuant to title eleven of 36 article five of the social services law, the two percent increase shall 37 be subject to the availability of federal financial participation. 38 § 18. This act shall take effect immediately and shall be deemed to 39 have been in full force and effect on or after April 1, 2018; provided 40 that the amendments to section 3235-a of the insurance law made by 41 section five of this act shall apply only to policies and contracts 42 issued, renewed, modified, altered or amended on or after such date. 43 PART P 44 Section 1. The opening paragraph of paragraph (b) of subdivision 5-a 45 of section 2807-m of the public health law, as amended by section 6 of 46 part H of chapter 57 of the laws of 2017, is amended to read as follows: 47 Nine million one hundred twenty thousand dollars annually for the 48 period January first, two thousand nine through December thirty-first, 49 two thousand ten, and two million two hundred eighty thousand dollars 50 for the period January first, two thousand eleven, through March thir- 51 ty-first, two thousand eleven, nine million one hundred twenty thousand 52 dollars each state fiscal year for the period April first, two thousand 53 eleven through March thirty-first, two thousand fourteen, up to eight 54 million six hundred twelve thousand dollars each state fiscal year forS. 7507 53 A. 9507 1 the period April first, two thousand fourteen through March thirty- 2 first, two thousand seventeen, and up to eight million six hundred 3 twelve thousand dollars each state fiscal year for the period April 4 first, two thousand seventeen through March thirty-first, two thousand 5 [twenty] eighteen, shall be set aside and reserved by the commissioner 6 from the regional pools established pursuant to subdivision two of this 7 section to be allocated regionally with two-thirds of the available 8 funding going to New York city and one-third of the available funding 9 going to the rest of the state and shall be available for distribution 10 as follows: 11 § 2. Subparagraph (xiii) of paragraph (a) of subdivision 7 of section 12 2807-s of the public health law, as amended by section 4 of part H of 13 chapter 57 of the laws of 2017, is amended to read as follows: 14 (xiii) twenty-three million eight hundred thirty-six thousand dollars 15 each state fiscal year for the period April first, two thousand twelve 16 through March thirty-first, two thousand eighteen, and fifteen million 17 two hundred twenty-four thousand dollars for each state fiscal year for 18 the period April first, two thousand eighteen through March thirty- 19 first, two thousand twenty; 20 § 3. Subdivision 9 of section 2803 of the public health law is 21 REPEALED. 22 § 4. This act shall take effect immediately; provided, however, that 23 the amendments to subparagraph (xiii) of paragraph (a) of subdivision 7 24 of section 2807-s of the public health law made by section two of this 25 act shall not affect the expiration of such section and shall be deemed 26 to expire therewith. 27 PART Q 28 Section 1. The public health law is amended by adding a new section 29 2825-f to read as follows: 30 § 2825-f. Health care facility transformation program: statewide III. 31 1. A statewide health care facility transformation program is hereby 32 established under the joint administration of the commissioner and the 33 president of the dormitory authority of the state of New York for the 34 purpose of strengthening and protecting continued access to health care 35 services in communities. The program shall provide funding in support of 36 capital projects, debt retirement, working capital or other non-capital 37 projects that facilitate health care transformation activities includ- 38 ing, but not limited to, merger, consolidation, acquisition or other 39 activities intended to: (a) create financially sustainable systems of 40 care; (b) preserve or expand essential health care services; (c) modern- 41 ize obsolete facility physical plants and infrastructure; (d) foster 42 participation in value based payments arrangements including, but not 43 limited to, contracts with managed care plans and accountable care 44 organizations; (e) for residential health care facilities, increase the 45 quality of resident care or experience; or (f) improve health informa- 46 tion technology infrastructure, including telehealth, to strengthen the 47 acute, post-acute and long-term care continuum. Grants shall not be 48 available to support general operating expenses. The issuance of any 49 bonds or notes hereunder shall be subject to section sixteen hundred 50 eighty-r of the public authorities law and the approval of the director 51 of the division of the budget, and any projects funded through the issu- 52 ance of bonds or notes hereunder shall be approved by the New York state 53 public authorities control board, as required under section fifty-one of 54 the public authorities law.S. 7507 54 A. 9507 1 2. The commissioner and the president of the dormitory authority shall 2 enter into an agreement, subject to approval by the director of the 3 budget, and subject to section sixteen hundred eighty-r of the public 4 authorities law, for the purposes of awarding, distributing, and admin- 5 istering the funds made available pursuant to this section. Such funds 6 may be distributed by the commissioner for grants to general hospitals, 7 residential health care facilities, diagnostic and treatment centers and 8 clinics licensed pursuant to this chapter or the mental hygiene law, and 9 community-based health care providers as defined in subdivision three of 10 this section for grants in support of the purposes set forth in this 11 section. A copy of such agreement, and any amendments thereto, shall be 12 provided to the chair of the senate finance committee, the chair of the 13 assembly ways and means committee, and the director of the division of 14 the budget no later than thirty days prior to the release of a request 15 for applications for funding under this program. Projects awarded, in 16 whole or part, under sections twenty-eight hundred twenty-five-a and 17 twenty-eight hundred twenty-five-b of this article shall not be eligible 18 for grants or awards made available under this section. 19 3. Notwithstanding section one hundred sixty-three of the state 20 finance law or any inconsistent provision of law to the contrary, up to 21 four hundred and twenty-five million dollars of the funds appropriated 22 for this program shall be awarded without a competitive bid or request 23 for proposal process for grants to health care providers (hereafter 24 "applicants"). Provided, however, that a minimum of: (a) sixty million 25 dollars of total awarded funds shall be made to community-based health 26 care providers, which for purposes of this section shall be defined as a 27 diagnostic and treatment center licensed or granted an operating certif- 28 icate under this article; a mental health clinic licensed or granted an 29 operating certificate under article thirty-one of the mental hygiene 30 law; a substance use disorder treatment clinic licensed or granted an 31 operating certificate under article thirty-two of the mental hygiene 32 law; a primary care provider; a home care provider certified or licensed 33 pursuant to article thirty-six of this chapter; or an assisted living 34 program approved by the department pursuant to subdivision one of 35 section four hundred sixty one-1 of the social services law; and (b) 36 forty-five million dollars of the total awarded funds shall be made to 37 residential health care facilities. 38 4. Notwithstanding any inconsistent subdivision of this section or any 39 other provision of law to the contrary, the commissioner, with the 40 approval of the director of the budget, may expend up to twenty million 41 dollars of the funds appropriated for this program and designated for 42 community-based health care providers pursuant to subdivision three of 43 this section for awards made pursuant to paragraph (l) of subdivision 44 three of section four hundred sixty-one-l of the social services law. 45 5. In determining awards for eligible applicants under this section, 46 the commissioner shall consider criteria including, but not limited to: 47 (a) the extent to which the proposed project will contribute to the 48 integration of health care services or the long term sustainability of 49 the applicant or preservation of essential health services in the commu- 50 nity or communities served by the applicant; 51 (b) the extent to which the proposed project or purpose is aligned 52 with delivery system reform incentive payment ("DSRIP") program goals 53 and objectives; 54 (c) the geographic distribution of funds; 55 (d) the relationship between the proposed project and identified 56 community need;S. 7507 55 A. 9507 1 (e) the extent to which the applicant has access to alternative 2 financing; 3 (f) the extent to which the proposed project furthers the development 4 of primary care and other outpatient services; 5 (g) the extent to which the proposed project benefits Medicaid enrol- 6 lees and uninsured individuals; 7 (h) the extent to which the applicant has engaged the community 8 affected by the proposed project and the manner in which community 9 engagement has shaped such project; and 10 (i) the extent to which the proposed project addresses potential risk 11 to patient safety and welfare. 12 6. Disbursement of awards made pursuant to this section shall be 13 conditioned on the awardee achieving certain process and performance 14 metrics and milestones as determined in the sole discretion of the 15 commissioner. Such metrics and milestones shall be structured to ensure 16 that the goals of the project are achieved, and such metrics and mile- 17 stones shall be included in grant disbursement agreements or other 18 contractual documents as required by the commissioner. 19 7. The department shall provide a report on a quarterly basis to the 20 chairs of the senate finance, assembly ways and means, and senate and 21 assembly health committees, until such time as the department determines 22 that the projects that receive funding pursuant to this section are 23 substantially complete. Such reports shall be submitted no later than 24 sixty days after the close of the quarter, and shall include, for each 25 award, the name of the applicant, a description of the project or 26 purpose, the amount of the award, disbursement date, and status of 27 achievement of process and performance metrics and milestones pursuant 28 to subdivision six of this section. 29 § 2. This act shall take effect immediately and shall be deemed to 30 have been in full force and effect on and after April 1, 2018. 31 PART R 32 Section 1. Section 1373 of the public health law is amended by adding 33 two new subdivisions 1-a and 1-b to read as follows: 34 1-a. Every municipality that administers the New York state uniform 35 fire prevention and building code, and that contains an area designated 36 as high risk by the commissioner pursuant to subdivision one of this 37 section, shall submit to the department aggregate reports summarizing 38 the outcomes of inspections and remediation conducted pursuant to subdi- 39 vision seven of section three hundred eighty-one of the executive law, 40 in a format to be determined by the commissioner in consultation with 41 the secretary of state. 42 1-b. The commissioner shall have the authority to monitor each munici- 43 pality's compliance with subdivision seven of section three hundred 44 eighty-one of the executive law, including authority to perform 45 inspections of residential and non-residential properties and to ensure 46 implementation of lead remediation measures. 47 § 2. Section 378 of the executive law is amended by adding a new 48 subdivision 17 to read as follows: 49 17. For any area designated as high risk by the commissioner of health 50 pursuant to subdivision one of section thirteen hundred seventy-three of 51 the public health law: 52 a. A presumption that all paint on any residential building on which 53 the original construction was completed prior to January first, nineteen 54 hundred seventy-eight, and the exterior of any nonresidential structureS. 7507 56 A. 9507 1 on which the original construction was completed prior to January first, 2 nineteen hundred seventy-eight, is lead-based. 3 b. A requirement that the interior and exterior of any residential 4 building on which the original construction was completed prior to Janu- 5 ary first, nineteen hundred seventy-eight, and the exterior of any 6 nonresidential structure on which the original construction was 7 completed prior to January first, nineteen hundred seventy-eight, be 8 maintained in a condition such that the paint thereon does not become 9 deteriorated paint, unless the deteriorated paint surfaces comprise a 10 minimal surface area. 11 § 3. Section 381 of the executive law is amended by adding a new 12 subdivision 7 to read as follows: 13 7. Notwithstanding any other provision of law, the secretary shall 14 promulgate rules and regulations with respect to areas designated as 15 high risk by the commissioner of health pursuant to subdivision one of 16 section thirteen hundred seventy-three of the public health law: 17 a. Requiring that local code enforcement officers conduct inspections 18 of residential rental property periodically and at specified times 19 including, but not limited to, as part of an application for a certif- 20 icate of occupancy, a renewal of a certificate of occupancy, or based 21 upon the filing of a complaint. Such inspections shall include at a 22 minimum a visual assessment for deteriorated paint and bare soil present 23 within the dripline of the building. 24 b. Establishing remedies for violations of uniform code provisions 25 adopted pursuant to subdivision seventeen of section three hundred 26 seventy-eight of this article, which shall include as appropriate: 27 (i) Certification by a lead-based paint inspector or risk assessor 28 that the property has been determined through a lead-based paint 29 inspection conducted in accordance with appropriate federal regulations 30 not to contain lead-based paint. 31 (ii) Certification by a lead-based paint inspector or risk assessor 32 that all cited violations have been abated, or interim controls imple- 33 mented, and clearance has been achieved in accordance with the uniform 34 code. 35 (iii) Where exterior deteriorated paint violations, including deteri- 36 orated paint violations on an open porch, and/or bare soil violations 37 are cited, or where interior deteriorated paint violations are cited in 38 a common area, clearance may be established through a visual assessment 39 by a local code enforcement officer after reduction measures have been 40 implemented. 41 c. Establishing standards for a clearance examination and report. 42 § 4. Paragraphs b and c of subdivision 1 of section 223-b of the real 43 property law, as amended by chapter 584 of the laws of 1991, is amended 44 to read as follows: 45 b. Actions taken in good faith, by or in behalf of the tenant, to 46 secure or enforce any rights under the lease or rental agreement, under 47 section two hundred thirty-five-b of this chapter, or under any other 48 law of the state of New York, or of its governmental subdivisions, or of 49 the United States which has as its objective the regulation of premises 50 used for dwelling purposes or which pertains to the offense of rent 51 gouging in the third, second or first degree; [or] 52 c. The tenant's participation in the activities of a tenant's organ- 53 ization; or 54 d. The tenant's reporting of a suspected lead-based paint hazard to 55 the owner or to any state or local agency.S. 7507 57 A. 9507 1 § 5. This act shall take effect on the one hundred eightieth day after 2 it shall have become a law. 3 PART S 4 Section 1. This Part enacts into law major components of legislation 5 which are necessary to effectuate recommendations made as part of the 6 Regulatory Modernization Initiative undertaken by the Department of 7 Health. Each component is wholly contained within a Subpart identified 8 as Subparts A through C. The effective date for each particular 9 provision contained within such Subpart is set forth in the last section 10 of such Subpart. Any provision in any section contained within a 11 Subpart, including the effective date of the Subpart, which makes a 12 reference to a section "of this act," when used in connection with that 13 particular component, shall be deemed to mean and refer to the corre- 14 sponding section of the Subpart in which it is found. Section three of 15 this Part sets forth the general effective date of this Part. 16 SUBPART A 17 Section 1. The public health law is amended by adding a new section 18 2805-z to read as follows: 19 § 2805-z. Community paramedicine collaboratives. 1. For purposes of 20 this section: 21 (a) A "community paramedicine collaborative" shall mean an initiative 22 comprised of the participants set forth in subdivision two of this 23 section and organized to carry out a community paramedicine program as 24 defined in paragraph (b) of this subdivision. 25 (b) A "community paramedicine program" shall mean a program carried 26 out by a community paramedicine collaborative for the purpose of achiev- 27 ing objectives identified by the collaborative, pursuant to which indi- 28 viduals who are certified under regulations issued pursuant to section 29 three thousand two of this chapter shall perform community paramedicine 30 services in residential settings other than the initial emergency 31 medical care and transportation of sick and injured persons, provided 32 that such individuals are: 33 (i) certified pursuant to article thirty of this chapter; 34 (ii) employees or volunteers of an emergency medical services provider 35 that participates in the collaborative; 36 (iii) providing services that are within their education or training; 37 and 38 (iv) working under medical control as defined by subdivision fifteen 39 of section three thousand one of this title. 40 (c) "Community paramedicine services" shall mean services provided in 41 residential settings by individuals who are certified under regulations 42 issued pursuant to section three thousand two of this chapter and 43 employees or volunteers of an emergency medical services provider, other 44 than the initial emergency medical care and transportation of sick and 45 injured persons. 46 (d) An "emergency medical services provider" shall mean an ambulance 47 service or an advanced life support first response service that is 48 certified under article thirty of this chapter to provide ambulance or 49 advanced life support first response services and staffed by individuals 50 who are certified under regulations issued pursuant to section three 51 thousand two of this chapter to provide basic or advanced life support.S. 7507 58 A. 9507 1 2. (a) At a minimum, a community paramedicine collaborative shall 2 include the participation of at least one hospital licensed under this 3 article, at least one physician who may but need not be employed or 4 otherwise affiliated with a hospital participating in such collabora- 5 tive, at least one emergency medical services provider and, if the 6 community paramedicine services are to be provided in a private resi- 7 dence, at least one home care services agency licensed or certified 8 under article thirty-six of this chapter. 9 (b) Where the collaborative's objectives include a focus on serving 10 individuals with behavioral health conditions and/or individuals with 11 developmental disabilities, the collaborative shall include the partic- 12 ipation of providers operated, licensed, or certified by the office of 13 mental health, the office of alcoholism and substance abuse services, 14 and/or the office for people with developmental disabilities, as appro- 15 priate. 16 (c) Such collaborative may also include additional participants such 17 as payors and local health departments. 18 3. A community paramedicine collaborative may establish a community 19 paramedicine program to provide community paramedicine services to indi- 20 viduals living in residential settings for the purpose of achieving 21 objectives identified by the collaborative such as: preventing emergen- 22 cies, avoidable emergency room visits, avoidable medical transport, and 23 potentially avoidable hospital admissions and readmissions; improving 24 outcomes following discharge from a general hospital or other inpatient 25 admission; and/or promoting self-management of health or behavioral 26 health care conditions. 27 4. A community paramedicine collaborative shall be required to provide 28 or arrange for appropriate orientation and training for staff partic- 29 ipating in the community paramedicine program. In all cases, such orien- 30 tation and training shall address the assessment of the needs of indi- 31 viduals with behavioral health conditions and individuals with 32 developmental disabilities. 33 5. An emergency medical services provider participating in a community 34 paramedicine collaborative shall: (a) ensure that the provision of 35 community paramedicine services occurs within the provider's primary 36 operating territory pursuant to article thirty of this chapter; and (b) 37 make reasonable efforts to ensure that it has sufficiently staffed the 38 provision of initial emergency medical care and transportation of sick 39 and injured persons before making staff available to provide community 40 paramedicine services. 41 6. (a) No community paramedicine collaborative shall begin providing 42 services under a community paramedicine program until it has notified 43 the department of the initiation of such collaborative by: 44 (i) identifying the participants of the collaborative and the individ- 45 ual who will serve as the point of contact; 46 (ii) describing the goals of the collaborative in carrying out a 47 community paramedicine program; 48 (iii) describing the population to be served by the community paramed- 49 icine program and the geographic area in which the program will focus; 50 (iv) identifying the services to be offered under the community param- 51 edicine program and the collaborative participants that will provide 52 such services; 53 (v) describing the collaborative's plan to assure, to the extent 54 possible, that care provided under the community paramedicine program is 55 coordinated with other providers of the individuals served;S. 7507 59 A. 9507 1 (vi) describing the quality assurance and improvement procedures that 2 will be used by the collaborative in carrying out the community paramed- 3 icine program; and 4 (vii) identifying the date of the anticipated start of activities. 5 (b) A community paramedicine collaborative shall: 6 (i) promptly update the department as to any changes in the informa- 7 tion required under paragraph (a) of this subdivision; and 8 (ii) provide information to the department about the collaborative's 9 activities and outcomes at a frequency and in a manner determined by the 10 department, which at a minimum shall include an annual report. 11 7. Nothing in this section shall be deemed to prohibit the performance 12 of any tasks or responsibilities by any person licensed or certified 13 under this chapter or under title VIII of the education law or by any 14 entity licensed or certified under this article or under the mental 15 hygiene law, provided such tasks or responsibilities are permitted 16 pursuant to such statutory provisions. 17 § 2. Subdivision 15 of section 3001 of the public health law, as 18 amended by chapter 445 of the laws of 1993, is amended to read as 19 follows: 20 15. "Medical control" means: (a) advice and direction provided by a 21 physician or under the direction of a physician to certified first 22 responders, emergency medical technicians or advanced emergency medical 23 technicians who are providing medical care at the scene of an emergency 24 or en route to a health care facility; [and] (b) indirect medical 25 control including the written policies, procedures, and protocols for 26 prehospital emergency medical care and transportation developed by the 27 state emergency medical advisory committee, approved by the state emer- 28 gency medical services council and the commissioner, and implemented by 29 regional medical advisory committees; and (c) in a community paramedi- 30 cine program established by a community paramedicine collaborative 31 pursuant to section twenty-eight hundred five-z of this chapter, advice 32 and direction provided and policies, procedures, and protocols issued by 33 a physician within the collaborative who is responsible for the overall 34 clinical supervision of the community paramedicine program. 35 § 3. The public health law is amended by adding a new section 3001-a 36 to read as follows: 37 § 3001-a. Community paramedicine services. Notwithstanding any incon- 38 sistent provision of this article, an individual who is certified under 39 regulations issued pursuant to section three thousand two of this arti- 40 cle to provide basic or advanced life support may, in the course of his 41 or her work as an employee or volunteer of an ambulance service or an 42 advanced life support first response service certified under this arti- 43 cle, also participate as an employee or volunteer of such service in a 44 community paramedicine program established by a community paramedicine 45 collaborative pursuant to section twenty-eight hundred five-z of this 46 chapter. 47 § 4. Subdivision 2 of section 365-a of the social services law is 48 amended by adding a new paragraph (ff) to read as follows: 49 (ff) subject to the availability of federal financial participation, 50 community paramedicine services provided in accordance with the require- 51 ments of section twenty-eight hundred five-z of the public health law. 52 § 5. This act shall take effect immediately. 53 SUBPART BS. 7507 60 A. 9507 1 Section 1. Subdivision 1 of section 2801 of the public health law, as 2 amended by chapter 397 of the laws of 2016, is amended to read as 3 follows: 4 1. "Hospital" means a facility or institution engaged principally in 5 providing services by or under the supervision of a physician or, in the 6 case of a dental clinic or dental dispensary, of a dentist, or, in the 7 case of a midwifery birth center, of a midwife, for the prevention, 8 diagnosis or treatment of human disease, pain, injury, deformity or 9 physical condition, including, but not limited to, a general hospital, 10 public health center, diagnostic center, treatment center, dental clin- 11 ic, dental dispensary, rehabilitation center other than a facility used 12 solely for vocational rehabilitation, nursing home, tuberculosis hospi- 13 tal, chronic disease hospital, maternity hospital, midwifery birth 14 center, lying-in-asylum, out-patient department, out-patient lodge, 15 dispensary and a laboratory or central service facility serving one or 16 more such institutions, but the term hospital shall not include an 17 institution, sanitarium or other facility engaged principally in provid- 18 ing services for the prevention, diagnosis or treatment of mental disa- 19 bility and which is subject to the powers of visitation, examination, 20 inspection and investigation of the department of mental hygiene except 21 for those distinct parts of such a facility which provide hospital 22 service. The provisions of this article shall not apply to a facility or 23 institution engaged principally in providing services by or under the 24 supervision of the bona fide members and adherents of a recognized reli- 25 gious organization whose teachings include reliance on spiritual means 26 through prayer alone for healing in the practice of the religion of such 27 organization and where services are provided in accordance with those 28 teachings. No provision of this article or any other provision of law 29 shall be construed to: (a) limit the volume of mental health or 30 substance use disorder services that can be provided by a provider of 31 primary care services licensed under this article and authorized to 32 provide integrated services in accordance with regulations issued by the 33 commissioner in consultation with the commissioner of the office of 34 mental health and the commissioner of the office of alcoholism and 35 substance abuse services, including regulations issued pursuant to 36 subdivision seven of section three hundred sixty-five-l of the social 37 services law or part L of chapter fifty-six of the laws of two thousand 38 twelve; (b) require a provider licensed pursuant to article thirty-one 39 of the mental hygiene law or certified pursuant to article thirty-two of 40 the mental hygiene law to obtain an operating certificate from the 41 department if such provider has been authorized to provide integrated 42 services in accordance with regulations issued by the commissioner in 43 consultation with the commissioner of the office of mental health and 44 the commissioner of the office of alcoholism and substance abuse 45 services, including regulations issued pursuant to subdivision seven of 46 section three hundred sixty-five-l of the social services law or part L 47 of chapter fifty-six of the laws of two thousand twelve. 48 § 2. Section 31.02 of the mental hygiene law is amended by adding a 49 new subdivision (f) to read as follows: 50 (f) No provision of this article or any other provision of law shall 51 be construed to require a provider licensed pursuant to article twenty- 52 eight of the public health law or certified pursuant to article thirty- 53 two of this chapter to obtain an operating certificate from the office 54 of mental health if such provider has been authorized to provide inte- 55 grated services in accordance with regulations issued by the commission- 56 er of the office of mental health in consultation with the commissionerS. 7507 61 A. 9507 1 of the department of health and the commissioner of the office of alco- 2 holism and substance abuse services, including regulations issued pursu- 3 ant to subdivision seven of section three hundred sixty-five-l of the 4 social services law or part L of chapter fifty-six of the laws of two 5 thousand twelve. 6 § 3. Subdivision (b) of section 32.05 of the mental hygiene law, as 7 amended by chapter 204 of the laws of 2007, is amended to read as 8 follows: 9 (b) (i) Methadone, or such other controlled substance designated by 10 the commissioner of health as appropriate for such use, may be adminis- 11 tered to an addict, as defined in section thirty-three hundred two of 12 the public health law, by individual physicians, groups of physicians 13 and public or private medical facilities certified pursuant to article 14 twenty-eight or thirty-three of the public health law as part of a chem- 15 ical dependence program which has been issued an operating certificate 16 by the commissioner pursuant to subdivision (b) of section 32.09 of this 17 article, provided, however, that such administration must be done in 18 accordance with all applicable federal and state laws and regulations. 19 Individual physicians or groups of physicians who have obtained authori- 20 zation from the federal government to administer buprenorphine to 21 addicts may do so without obtaining an operating certificate from the 22 commissioner. (ii) No provision of this article or any other provision 23 of law shall be construed to require a provider licensed pursuant to 24 article twenty-eight of the public health law or article thirty-one of 25 this chapter to obtain an operating certificate from the office of alco- 26 holism and substance abuse services if such provider has been authorized 27 to provide integrated services in accordance with regulations issued by 28 the commissioner of alcoholism and substance abuse services in consulta- 29 tion with the commissioner of the department of health and the commis- 30 sioner of the office of mental health, including regulations issued 31 pursuant to subdivision seven of section three hundred sixty-five-l of 32 the social services law or part L of chapter fifty-six of the laws of 33 two thousand twelve. 34 § 4. This act shall take effect on the one hundred eightieth day after 35 it shall have become a law; provided, however, that the commissioner of 36 the department of health, the commissioner of the office of mental 37 health, and the commissioner of the office of alcoholism and substance 38 abuse services are authorized to issue any rule or regulation necessary 39 for the implementation of this act on or before its effective date. 40 SUBPART C 41 Section 1. Paragraphs (s) and (t) of subdivision 2 of section 2999-cc 42 of the public health law, as amended by chapter 454 of the laws of 2015, 43 are amended and a new paragraph (u) is added to read as follows: 44 (s) a hospice as defined in article forty of this chapter; [and] 45 (t) credentialed alcoholism and substance abuse counselors creden- 46 tialed by the office of alcoholism and substance abuse services or by a 47 credentialing entity approved by such office pursuant to section 19.07 48 of the mental hygiene law; 49 (u) providers authorized to provide services and service coordination 50 under the early intervention program pursuant to article twenty-five of 51 this chapter; and 52 (v) any other provider as determined by the commissioner pursuant to 53 regulation or, in consultation with the commissioner, by the commission- 54 er of the office of mental health, the commissioner of the office ofS. 7507 62 A. 9507 1 alcoholism and substance abuse services, or the commissioner of the 2 office for people with developmental disabilities pursuant to 3 regulation. 4 § 2. Subdivision 3 of section 2999-cc of the public health law, as 5 separately amended by chapters 238 and 285 of the laws of 2017, is 6 amended to read as follows: 7 3. "Originating site" means a site at which a patient is located at 8 the time health care services are delivered to him or her by means of 9 telehealth. Originating sites shall be limited to (a) facilities 10 licensed under articles twenty-eight and forty of this chapter[,]; (b) 11 facilities as defined in subdivision six of section 1.03 of the mental 12 hygiene law[,]; (c) private physician's or dentist's offices located 13 within the state of New York[,]; (d) any type of adult care facility 14 licensed under title two of article seven of the social services law[,]; 15 (e) public, private and charter elementary and secondary schools, school 16 age child care programs, and child day care centers within the state of 17 New York; and[, when a patient is receiving health care services by18means of remote patient monitoring,] (f) the patient's place of resi- 19 dence located within the state of New York or other temporary location 20 located within or outside the state of New York; subject to regulation 21 issued by the commissioner of the office of mental health, the commis- 22 sioner of the office of alcoholism and substance abuse services, and the 23 commissioner of the office for people with developmental disabilities. 24 § 3. Subdivision 7 of section 2999-cc of the public health law, as 25 added by chapter 6 of the laws of 2015, is amended to read as follows: 26 7. "Remote patient monitoring" means the use of synchronous or asyn- 27 chronous electronic information and communication technologies to 28 collect personal health information and medical data from a patient at 29 an originating site that is transmitted to a telehealth provider at a 30 distant site for use in the treatment and management of medical condi- 31 tions that require frequent monitoring. Such technologies may include 32 additional interaction triggered by previous transmissions, such as 33 interactive queries conducted through communication technologies or by 34 telephone. Such conditions shall include, but not be limited to, conges- 35 tive heart failure, diabetes, chronic obstructive pulmonary disease, 36 wound care, polypharmacy, mental or behavioral problems, and technolo- 37 gy-dependent care such as continuous oxygen, ventilator care, total 38 parenteral nutrition or enteral feeding. Remote patient monitoring 39 shall be ordered by a physician licensed pursuant to article one hundred 40 thirty-one of the education law, a nurse practitioner licensed pursuant 41 to article one hundred thirty-nine of the education law, or a midwife 42 licensed pursuant to article one hundred forty of the education law, 43 with which the patient has a substantial and ongoing relationship. 44 § 4. This act shall take effect on the ninetieth day after it shall 45 have become a law; provided, however, that the commissioner of the 46 department of health, the commissioner of the office of mental health, 47 the commissioner of the office of alcoholism and substance abuse 48 services, and the commissioner of the office for people with develop- 49 mental disabilities are authorized to issue any rule or regulation 50 necessary for the implementation of this act on or before its effective 51 date. 52 § 2. Severability clause. If any clause, sentence, paragraph, subdivi- 53 sion, section or subpart of this act shall be adjudged by any court of 54 competent jurisdiction to be invalid, such judgment shall not affect, 55 impair, or invalidate the remainder thereof, but shall be confined in 56 its operation to the clause, sentence, paragraph, subdivision, sectionS. 7507 63 A. 9507 1 or subpart thereof directly involved in the controversy in which such 2 judgment shall have been rendered. It is hereby declared to be the 3 intent of the legislature that this act would have been enacted even if 4 such invalid provisions had not been included herein. 5 § 3. This act shall take effect immediately; provided, however, that 6 the applicable effective date of Subparts A through C of this act shall 7 be as specifically set forth in the last section of such Subparts. 8 PART T 9 Section 1. Subdivision (a) of section 31 of part B of chapter 59 of 10 the laws of 2016, amending the social services law relating to authoriz- 11 ing the commissioner of health to apply federally established consumer 12 price index penalties for generic drugs, and authorizing the commission- 13 er of health to impose penalties on managed care plans for reporting 14 late or incorrect encounter data, is amended to read as follows: 15 (a) section eleven of this act shall expire and be deemed repealed 16 March 31, [2018] 2023; 17 § 2. Subdivision 6-a of section 93 of part C of chapter 58 of the laws 18 of 2007, amending the social services law and other laws relating to 19 adjustments of rates, as amended by section 20 of part B of chapter 56 20 of the laws of 2013, is amended to read as follows: 21 6-a. section fifty-seven of this act shall expire and be deemed 22 repealed on [December 31, 2018] March 31, 2023; provided that the amend- 23 ments made by such section to subdivision 4 of section 366-c of the 24 social services law shall apply with respect to determining initial and 25 continuing eligibility for medical assistance, including the continued 26 eligibility of recipients originally determined eligible prior to the 27 effective date of this act, and provided further that such amendments 28 shall not apply to any person or group of persons if it is subsequently 29 determined by the Centers for Medicare and Medicaid services or by a 30 court of competent jurisdiction that medical assistance with federal 31 financial participation is available for the costs of services provided 32 to such person or persons under the provisions of subdivision 4 of 33 section 366-c of the social services law in effect immediately prior to 34 the effective date of this act. 35 § 3. Section 2 of part II of chapter 54 of the laws of 2016, amending 36 part C of chapter 58 of the laws of 2005 authorizing reimbursements for 37 expenditures made by or on behalf of social services districts for 38 medical assistance for needy persons and administration thereof, is 39 amended to read as follows: 40 § 2. This act shall take effect immediately and shall expire and be 41 deemed repealed [two years after it shall have become a law] March 31, 42 2023. 43 § 4. Section 3 of chapter 906 of the laws of 1984, amending the social 44 services law relating to expanding medical assistance eligibility and 45 the scope of services available to certain persons with disabilities, as 46 amended by section 25-a of part B of chapter 56 of the laws of 2013, is 47 amended to read as follows: 48 § 3. This act shall take effect on the thirtieth day after it shall 49 have become a law and shall be of no further force and effect after 50 [December 31, 2018] March 31, 2023, at which time the provisions of this 51 act shall be deemed to be repealed. 52 § 5. Section 4-a of part A of chapter 56 of the laws of 2013, amending 53 chapter 59 of the laws of 2011 amending the public health law and other 54 laws relating to general hospital reimbursement for annual rates relat-S. 7507 64 A. 9507 1 ing to the cap on local Medicaid expenditures, as amended by section 9 2 of part I of chapter 57 of the laws of 2017, is amended to read as 3 follows: 4 § 4-a. Notwithstanding paragraph (c) of subdivision 10 of section 5 2807-c of the public health law, section 21 of chapter 1 of the laws of 6 1999, or any other contrary provision of law, in determining rates of 7 payments by state governmental agencies effective for services provided 8 on and after January 1, [2019] 2017 through March 31, 2019, for inpa- 9 tient and outpatient services provided by general hospitals, for inpa- 10 tient services and adult day health care outpatient services provided by 11 residential health care facilities pursuant to article 28 of the public 12 health law, except for residential health care facilities or units of 13 such facilities providing services primarily to children under twenty- 14 one years of age, for home health care services provided pursuant to 15 article 36 of the public health law by certified home health agencies, 16 long term home health care programs and AIDS home care programs, and for 17 personal care services provided pursuant to section 365-a of the social 18 services law, the commissioner of health shall apply no greater than 19 zero trend factors attributable to the 2017, 2018, and 2019 calendar 20 [year] years in accordance with paragraph (c) of subdivision 10 of 21 section 2807-c of the public health law, provided, however, that such no 22 greater than zero trend factors attributable to such 2017, 2018, and 23 2019 calendar [year] years shall also be applied to rates of payment 24 provided on and after January 1, [2019] 2017 through March 31, 2019 for 25 personal care services provided in those local social services 26 districts, including New York city, whose rates of payment for such 27 services are established by such local social services districts pursu- 28 ant to a rate-setting exemption issued by the commissioner of health to 29 such local social services districts in accordance with applicable regu- 30 lations[,]; and provided further, however, that for rates of payment for 31 assisted living program services provided on and after January 1, [2019] 32 2017 through March 31, 2019, such trend factors attributable to the 33 2017, 2018, and 2019 calendar [year] years shall be established at no 34 greater than zero percent. 35 § 6. This act shall take effect immediately. 36 PART U 37 Section 1. Section 2 of part NN of chapter 58 of the laws of 2015, 38 amending the mental hygiene law relating to clarifying the authority of 39 the commissioners in the department of mental hygiene to design and 40 implement time-limited demonstration programs, is amended to read as 41 follows: 42 § 2. This act shall take effect immediately and shall expire and be 43 deemed repealed March 31, [2018] 2021. 44 § 2. This act shall take effect immediately. 45 PART V 46 Section 1. Section 7 of part R2 of chapter 62 of the laws of 2003, 47 amending the mental hygiene law and the state finance law relating to 48 the community mental health support and workforce reinvestment program, 49 the membership of subcommittees for mental health of community services 50 boards and the duties of such subcommittees and creating the community 51 mental health and workforce reinvestment account, as amended by sectionS. 7507 65 A. 9507 1 3 of part G of chapter 60 of the laws of 2014, is amended to read as 2 follows: 3 § 7. This act shall take effect immediately and shall expire March 31, 4 [2018] 2021 when upon such date the provisions of this act shall be 5 deemed repealed. 6 § 2. This act shall take effect immediately. 7 PART W 8 Section 1. Subdivision 9 of section 730.10 of the criminal procedure 9 law, as added by section 1 of part Q of chapter 56 of the laws of 2012, 10 is amended to read as follows: 11 9. "Appropriate institution" means: (a) a hospital operated by the 12 office of mental health or a developmental center operated by the office 13 for people with developmental disabilities; [or] (b) a hospital licensed 14 by the department of health which operates a psychiatric unit licensed 15 by the office of mental health, as determined by the commissioner 16 provided, however, that any such hospital that is not operated by the 17 state shall qualify as an "appropriate institution" only pursuant to the 18 terms of an agreement between the commissioner and the hospital ; or (c) 19 a mental health unit operating within a correctional facility or local 20 correctional facility; provided however, that any such mental health 21 unit operating within a local correctional facility shall qualify as an 22 "appropriate institution" only pursuant to the terms of an agreement 23 between the commissioner of mental health, director of community 24 services and the sheriff for the respective locality, and any such 25 mental health unit operating within a correctional facility shall quali- 26 fy as an "appropriate institution" only pursuant to the terms of an 27 agreement between the commissioner of mental health and the commissioner 28 of corrections and community supervision. Nothing in this article shall 29 be construed as requiring a hospital, correctional facility or local 30 correctional facility to consent to providing care and treatment to an 31 incapacitated person at such hospital, correctional facility or local 32 correctional facility. In a city with a population of more than one 33 million, any such unit shall be limited to twenty-five beds. The commis- 34 sioner of mental health shall promulgate regulations for demonstration 35 programs to implement restoration to competency within a correctional 36 facility or local correctional facility. Subject to annual appropri- 37 ation, the commissioner of mental health may, at such commissioner's 38 discretion, make funds available for state aid grants to any county that 39 develops and operates a mental health unit within a local correctional 40 facility pursuant to this section. Nothing in this article shall be 41 construed as requiring a hospital, correctional facility or local 42 correctional facility to consent to providing care and treatment to an 43 incapacitated person at such hospital, correctional facility or local 44 correctional facility. 45 § 2. This act shall take effect immediately and shall be deemed to 46 have been in full force and effect on and after April 1, 2018; provided, 47 however, this act shall expire and be deemed repealed March 31, 2023. 48 PART X 49 Section 1. Section 3 of part A of chapter 111 of the laws of 2010 50 amending the mental hygiene law relating to the receipt of federal and 51 state benefits received by individuals receiving care in facilities 52 operated by an office of the department of mental hygiene, as amended byS. 7507 66 A. 9507 1 section 1 of part LL of chapter 58 of the laws of 2015, is amended to 2 read as follows: 3 § 3. This act shall take effect immediately; and shall expire and be 4 deemed repealed June 30, [2018] 2021. 5 § 2. This act shall take effect immediately. 6 PART Y 7 Section 1. Subdivision 10 of section 7605 of the education law, as 8 added by section 4 of part AA of chapter 57 of the laws of 2013, is 9 amended and a new subdivision 12 is added to read as follows: 10 10. (a) A person without a license from: performing assessments such 11 as basic information collection, gathering of demographic data, and 12 informal observations, screening and referral used for general eligibil- 13 ity for a program or service and determining the functional status of an 14 individual for the purpose of determining need for services [unrelated15to a behavioral health diagnosis or treatment plan. Such licensure16shall not be required to create, develop or implement a service plan17unrelated to a behavioral health diagnosis or treatment plan]; coun- 18 seling individuals regarding the appropriateness of benefits they are 19 eligible for; providing general counseling that is not psychotherapy and 20 assisting individuals or groups with difficult day to day problems such 21 as finding employment, locating sources of assistance, and organizing 22 community groups to work on a specific problem; providing peer services; 23 or to select for suitability and provide substance abuse treatment 24 services or group re-entry services to incarcerated individuals in state 25 correctional facilities. 26 (b) A person without a license from creating, developing or implement- 27 ing a service plan or recovery plan that is not a behavioral health 28 diagnosis or treatment plan. Such service or recovery plans shall 29 include, but are not limited to, coordinating, evaluating or determining 30 the need for, or the provision of the following services: job training 31 and employability[,]; housing[,]; homeless services and shelters for 32 homeless individuals and families; refugee services; residential, day or 33 community habilitation services; general public assistance[,]; in home 34 services and supports or home-delivered meals[, investigations conducted35or assessments made by]; recovery supports; adult or child protective 36 services including investigations; detention as defined in section five 37 hundred two of the executive law; prevention and residential services 38 for victims of domestic violence; services for runaway and homeless 39 youth; foster care, adoption, preventive services or services in accord- 40 ance with an approved plan pursuant to section four hundred four of the 41 social services law, including, adoption and foster home studies and 42 assessments, family service plans, transition plans [and], permanency 43 planning activities, and case planning or case management as such terms 44 are defined in part four hundred twenty-eight of title eighteen of the 45 New York codes, rules and regulations; residential rehabilitation; home 46 and community based services; and de-escalation techniques, peer 47 services or skill development. [A license under this article shall not48be required for persons to participate] 49 (c)(i) A person without a license from participating as a member of a 50 multi-disciplinary team to develop or implement a [behavioral health51services or] treatment plan; provided [however,] that such team shall 52 include one or more professionals licensed under this article or arti- 53 cles one hundred thirty-one, one hundred thirty-nine, one hundred 54 fifty-four or one hundred sixty-three of this chapter who must directlyS. 7507 67 A. 9507 1 observe each patient either in person or by electronic means, prior to 2 the rendering of a diagnosis; and provided, further, that the activities 3 performed by members of the team shall be consistent with the scope of 4 practice for each team member licensed or authorized under title VIII of 5 this chapter, and those who are not so authorized may not independently 6 engage in the following restricted practices, but may assist licensed 7 professionals or multi-disciplinary team members with: the diagnosis of 8 mental, emotional, behavioral, addictive and developmental disorders and 9 disabilities; patient assessment and evaluating; the provision of 10 psychotherapeutic treatment; the provision of treatment other than 11 psychotherapeutic treatment; [and/or] or the development and implementa- 12 tion of assessment-based treatment plans as defined in section seventy- 13 seven hundred one of this [chapter] title. 14 (ii) As used in this subdivision, a treatment plan shall be limited to 15 plans for treatment within the following settings: facilities or 16 programs operating pursuant to article nineteen-G of the executive law 17 or pursuant to articles seven, sixteen, thirty-one and thirty-two of the 18 mental hygiene law. 19 (iii) As used in this subdivision, the term "assist" shall include the 20 provision of services within the practice of psychology, under the 21 supervision of a person licensed under this article. 22 (d) Provided, further, that nothing in this subdivision shall be 23 construed as requiring a license for any particular activity or function 24 based solely on the fact that the activity or function is not listed in 25 this subdivision. 26 12. Notwithstanding any other provision of law to the contrary, noth- 27 ing in this article shall be construed to prohibit or limit the activ- 28 ities or services provided by any person who is employed or who 29 commences employment in a program or service operated, regulated, fund- 30 ed, or approved by the department of mental hygiene, the office of chil- 31 dren and family services, the department of corrections and community 32 supervision, the office of temporary and disability assistance, the 33 state office for the aging and the department of health or a local 34 governmental unit as that term is defined in section 41.03 of the mental 35 hygiene law or a social services district as defined in section sixty- 36 one of the social services law on or before July first, two thousand 37 twenty. Provided, however, that any person who commences employment in 38 such program or service after July first, two thousand twenty and 39 performs services that are restricted under this article shall be appro- 40 priately licensed or authorized under this article. 41 § 2. Paragraph (f) of subdivision 1 of section 7702 of the education 42 law, as amended by chapter 230 of the laws of 2004, is amended and a new 43 paragraph (m) is added to read as follows: 44 (f) [Assist] General counseling that is not psychotherapy, and assist- 45 ing individuals or groups with difficult day to day problems such as 46 finding employment, locating sources of assistance, and organizing 47 community groups to work on a specific problem. 48 (m) Provide peer services. 49 § 3. Subdivision 7 of section 7706 of the education law, as added by 50 section 5 of part AA of chapter 57 of the laws of 2013, is amended and a 51 new subdivision 8 is added to read as follows: 52 7. (a) Prevent a person without a license from: performing assessments 53 such as basic information collection, gathering of demographic data, and 54 informal observations, screening and referral used for general eligibil- 55 ity for a program or service and determining the functional status of an 56 individual for the purpose of determining need for services [unrelatedS. 7507 68 A. 9507 1to a behavioral health diagnosis or treatment plan. Such licensure shall2not be required to create, develop or implement a service plan unrelated3to a behavioral health diagnosis or treatment plan]; counseling individ- 4 uals regarding the appropriateness of benefits they are eligible for; 5 providing general counseling that is not psychotherapy and assisting 6 individuals or groups with difficult day to day problems such as finding 7 employment, locating sources of assistance, and organizing community 8 groups to work on a specific problem; providing peer services; or to 9 select for suitability and provide substance abuse treatment services or 10 group re-entry services to incarcerated individuals in state correction- 11 al facilities. 12 (b) Prevent a person without a license from creating, developing or 13 implementing a service plan or recovery plan that is not a behavioral 14 health diagnosis or treatment plan. Such service or recovery plans shall 15 include, but are not limited to, coordinating, evaluating or determining 16 the need for, or the provision of the following services: job training 17 and employability[,]; housing[,]; homeless services and shelters for 18 homeless individuals and families; refugee services; residential, day or 19 community habilitation services; general public assistance[,]; in home 20 services and supports or home-delivered meals[, investigations conducted21or assessments made by]; recovery supports; adult or child protective 22 services including investigations; detention as defined in section five 23 hundred two of the executive law; prevention and residential services 24 for victims of domestic violence; services for runaway and homeless 25 youth; foster care, adoption, preventive services or services in accord- 26 ance with an approved plan pursuant to section four hundred four of the 27 social services law, including, adoption and foster home studies and 28 assessments, family service plans, transition plans [and], permanency 29 planning activities, and case planning or case management as such terms 30 are defined in part four hundred twenty-eight of title eighteen of the 31 New York codes, rules and regulations; residential rehabilitation; home 32 and community based services; and de-escalation techniques, peer 33 services or skill development. [A license under this article shall not34be required for persons to participate] 35 (c)(i) Prevent a person without a license from participating as a 36 member of a multi-disciplinary team to develop or implement a [behav-37ioral health services or] treatment plan; provided [however,] that such 38 team shall include one or more professionals licensed under this article 39 or articles one hundred thirty-one, one hundred thirty-nine, one hundred 40 fifty-three or one hundred sixty-three of this chapter who must directly 41 observe each patient either in person or by electronic means, prior to 42 the rendering of a diagnosis; and provided, further, that the activities 43 performed by members of the team shall be consistent with the scope of 44 practice for each team member licensed or authorized under title VIII of 45 this chapter, and those who are not so authorized may not independently 46 engage in the following restricted practices, but may assist licensed 47 professionals or multi-disciplinary team members with: the diagnosis of 48 mental, emotional, behavioral, addictive and developmental disorders and 49 disabilities; patient assessment and evaluating; the provision of 50 psychotherapeutic treatment; the provision of treatment other than 51 psychotherapeutic treatment; [and/or] or the development and implementa- 52 tion of assessment-based treatment plans as defined in section seventy- 53 seven hundred one of this article. 54 (ii) As used in this subdivision, a treatment plan shall be limited to 55 plans for treatment within the following settings: facilities or 56 programs operating pursuant to article nineteen-G of the executive lawS. 7507 69 A. 9507 1 or pursuant to articles seven, sixteen, thirty-one and thirty-two of the 2 mental hygiene law. 3 (iii) As used in this subdivision, the term "assist" shall include the 4 provision of services within the practice of master social work or clin- 5 ical social work, under the supervision of a person licensed under this 6 article. 7 (d) Provided, further, that nothing in this subdivision shall be 8 construed as requiring a license for any particular activity or function 9 based solely on the fact that the activity or function is not listed in 10 this subdivision. 11 8. Notwithstanding any other provision of law to the contrary, nothing 12 in this article shall be construed to prohibit or limit the activities 13 or services provided by any person who is employed or who commences 14 employment in a program or service operated, regulated, funded, or 15 approved by the department of mental hygiene, the office of children and 16 family services, the department of corrections and community super- 17 vision, the office of temporary and disability assistance, the state 18 office for the aging and the department of health or a local govern- 19 mental unit as that term is defined in section 41.03 of the mental 20 hygiene law or a social services district as defined in section sixty- 21 one of the social services law on or before July first, two thousand 22 twenty. Provided however, that any person who commences employment in 23 such program or service after July first, two thousand twenty and 24 performs services that are restricted under this article shall be appro- 25 priately licensed or authorized under this article. 26 § 4. Subdivision 8 of section 8410 of the education law, as added by 27 section 6 of part AA of chapter 57 of the laws of 2013, is amended and a 28 new subdivision 9 is added to read as follows: 29 8. (a) Prevent a person without a license from: performing assessments 30 such as basic information collection, gathering of demographic data, and 31 informal observations, screening and referral used for general eligibil- 32 ity for a program or service and determining the functional status of an 33 individual for the purpose of determining need for services [unrelated34to a behavioral health diagnosis or treatment plan. Such licensure35shall not be required to create, develop or implement a service plan36unrelated to a behavioral health diagnosis or treatment plan]; coun- 37 seling individuals regarding the appropriateness of benefits they are 38 eligible for; providing general counseling that is not psychotherapy and 39 assisting individuals or groups with difficult day to day problems such 40 as finding employment, locating sources of assistance, and organizing 41 community groups to work on a specific problem; providing peer services; 42 or to select for suitability and provide substance abuse treatment 43 services or group re-entry services to incarcerated individuals in state 44 correctional facilities. 45 (b) Prevent a person without a license from creating, developing or 46 implementing a service plan or recovery plan that is not a behavioral 47 health diagnosis or treatment plan. Such service or recovery plans shall 48 include, but are not limited to, coordinating, evaluating or determining 49 the need for, or the provision of the following services: job training 50 and employability[,]; housing[,]; homeless services and shelters for 51 homeless individuals and families; refugee services; residential, day or 52 community habilitation services; general public assistance[,]; in home 53 services and supports or home-delivered meals[, investigations conducted54or assessments made by]; recovery supports; adult or child protective 55 services including investigations; detention as defined in section five 56 hundred two of the executive law; prevention and residential servicesS. 7507 70 A. 9507 1 for victims of domestic violence; services for runaway and homeless 2 youth; foster care, adoption, preventive services or services in accord- 3 ance with an approved plan pursuant to section four hundred four of the 4 social services law, including, adoption and foster home studies and 5 assessments, family service plans, transition plans [and], permanency 6 planning activities, and case planning or case management as such terms 7 are defined in part four hundred twenty-eight of title eighteen of the 8 New York codes, rules and regulations; residential rehabilitation; home 9 and community based services; and de-escalation techniques, peer 10 services or skill development. [A license under this article shall not11be required for persons to participate] 12 (c)(i) Prevent a person without a license from participating as a 13 member of a multi-disciplinary team to develop or implement a [behav-14ioral health services or] treatment plan; provided [however,] that such 15 team shall include one or more professionals licensed under this article 16 or articles one hundred thirty-one, one hundred thirty-nine, one hundred 17 fifty-three or one hundred fifty-four of this chapter who must directly 18 observe each patient either in person or by electronic means, prior to 19 the rendering of a diagnosis; and provided, further, that the activities 20 performed by members of the team shall be consistent with the scope of 21 practice for each team member licensed or authorized under title VIII of 22 this chapter, and those who are not so authorized may not independently 23 engage in the following restricted practices, but may assist licensed 24 professionals or multidisciplinary team members with: the diagnosis of 25 mental, emotional, behavioral, addictive and developmental disorders and 26 disabilities; patient assessment and evaluating; the provision of 27 psychotherapeutic treatment; the provision of treatment other than 28 psychotherapeutic treatment; [and/or] or the development and implementa- 29 tion of assessment-based treatment plans as defined in section seventy- 30 seven hundred one of this chapter. 31 (ii) As used in this subdivision, a treatment plan shall be limited to 32 plans for treatment within the following settings: facilities or 33 programs operating pursuant to article nineteen-G of the executive law 34 or pursuant to articles seven, sixteen, thirty-one and thirty-two of the 35 mental hygiene law. 36 (iii) As used in this subdivision, the term "assist" shall include the 37 provision of services within the practice of mental health counseling, 38 marriage and family therapy, creative arts therapy or psychoanalysis, 39 under the supervision of a person licensed under this article. 40 (d) Provided, further, that nothing in this subdivision shall be 41 construed as requiring a license for any particular activity or function 42 based solely on the fact that the activity or function is not listed in 43 this subdivision. 44 9. Notwithstanding any other provision of law to the contrary, nothing 45 in this article shall be construed to prohibit or limit the activities 46 or services provided by any person who is employed or who commences 47 employment in a program or service operated, regulated, funded, or 48 approved by the department of mental hygiene, the office of children and 49 family services, the department of corrections and community super- 50 vision, the office of temporary and disability assistance, the state 51 office for the aging and the department of health or a local govern- 52 mental unit as that term is defined in section 41.03 of the mental 53 hygiene law or a social services district as defined in section sixty- 54 one of the social services law on or before July first, two thousand 55 twenty. Provided however, that any person who commences employment in 56 such program or service after July first, two thousand twenty andS. 7507 71 A. 9507 1 performs services that are restricted under this article shall be appro- 2 priately licensed or authorized under this article. 3 § 5. Not later than July 1, 2019 the department of mental hygiene, the 4 office of children and family services, the office of temporary and 5 disability assistance, the department of corrections and community 6 supervision, the state office for the aging, or the department of health 7 (hereinafter referred to as "agencies") shall individually or collec- 8 tively consult with the state education department (hereinafter referred 9 to as "department") to develop formal guidance for service providers 10 authorized to operate under the respective agencies to identify the 11 tasks and functions performed by each agency's service provider work- 12 force categorized as tasks and functions restricted to licensed person- 13 nel including tasks and functions that do not require a license under 14 articles 153, 154 and 163 of the education law. Subsequent to such 15 consultation, and not later than December 31, 2019, the department shall 16 issue guidance to each such agency with respect to each agency's service 17 provider workforce. Each agency may issue additional guidance from time 18 to time, subject to consultation with the department. Notwithstanding 19 any provision of law to the contrary, no person shall be held liable for 20 unauthorized practice of a profession subject to licensure under arti- 21 cles 153, 154 and 163 of the education law if such person acts in 22 accordance with such agency guidance until July 1, 2020, to allow 23 further consultation on guidance as necessary. Upon issuance by such 24 state agency of guidance, the department shall have 180 days from the 25 date of the issuance of such guidance to issue a statement of disagree- 26 ment with the agency's guidance. If the department has issued a state- 27 ment of disagreement, the department and state agency shall engage in a 28 collaborative process to gather input from stakeholders to resolve the 29 issues. 30 § 6. Programs and services operated, regulated, funded, or approved by 31 the department of mental hygiene, the office of children and family 32 services, the department of corrections and community supervision, the 33 office of temporary and disability assistance, the state office for the 34 aging and the department of health or a local governmental unit as the 35 term is defined in section 41.03 of the mental hygiene law or a social 36 services district as defined in section 61 of the social services law 37 shall not be required to receive a waiver pursuant to section 6503-a of 38 the education law and, further, such programs and services shall also be 39 considered to be approved settings for the receipt of supervised experi- 40 ence for the professions governed by articles 153, 154 and 163 of the 41 education law. 42 § 7. Subdivision a of section 9 of chapter 420 of the laws of 2002 43 amending the education law relating to the profession of social work, as 44 amended by section 1 of part J of chapter 59 of the laws of 2016, is 45 amended to read as follows: 46 a. Nothing in this act shall prohibit or limit the activities or 47 services on the part of any person in the employ of a program or service 48 operated, regulated, funded, or approved by the department of mental 49 hygiene, the office of children and family services, the office of 50 temporary and disability assistance, the department of corrections and 51 community supervision, the state office for the aging, the department of 52 health, or a local governmental unit as that term is defined in article 53 41 of the mental hygiene law or a social services district as defined in 54 section 61 of the social services law, provided, however, this section 55 shall not authorize the use of any title authorized pursuant to articleS. 7507 72 A. 9507 1 154 of the education law, except that this section shall be deemed 2 repealed on July 1, [2018] 2020. 3 § 8. Subdivision a of section 17-a of chapter 676 of the laws of 2002, 4 amending the education law relating to the practice of psychology, as 5 amended by section 2 of part J of chapter 59 of the laws of 2016, is 6 amended to read as follows: 7 a. In relation to activities and services provided under article 153 8 of the education law, nothing in this act shall prohibit or limit such 9 activities or services on the part of any person in the employ of a 10 program or service operated, regulated, funded, or approved by the 11 department of mental hygiene or the office of children and family 12 services, or a local governmental unit as that term is defined in arti- 13 cle 41 of the mental hygiene law or a social services district as 14 defined in section 61 of the social services law. In relation to activ- 15 ities and services provided under article 163 of the education law, 16 nothing in this act shall prohibit or limit such activities or services 17 on the part of any person in the employ of a program or service oper- 18 ated, regulated, funded, or approved by the department of mental 19 hygiene, the office of children and family services, the department of 20 corrections and community supervision, the office of temporary and disa- 21 bility assistance, the state office for the aging and the department of 22 health or a local governmental unit as that term is defined in article 23 41 of the mental hygiene law or a social services district as defined in 24 section 61 of the social services law, pursuant to authority granted by 25 law. This section shall not authorize the use of any title authorized 26 pursuant to article 153 or 163 of the education law by any such employed 27 person, except as otherwise provided by such articles respectively. 28 This section shall be deemed repealed July 1, [2018] 2020. 29 § 9. Section 16 of chapter 130 of the laws of 2010, amending the 30 education law and other laws relating to the registration of entities 31 providing certain professional services and the licensure of certain 32 professions, as amended by section 3 of part J of chapter 59 of the laws 33 of 2016, is amended to read as follows: 34 § 16. This act shall take effect immediately; provided that sections 35 thirteen, fourteen and fifteen of this act shall take effect immediately 36 and shall be deemed to have been in full force and effect on and after 37 June 1, 2010 and such sections shall be deemed repealed July 1, [2018] 38 2020; provided further that the amendments to section 9 of chapter 420 39 of the laws of 2002 amending the education law relating to the profes- 40 sion of social work made by section thirteen of this act shall repeal on 41 the same date as such section repeals; provided further that the amend- 42 ments to section 17-a of chapter 676 of the laws of 2002 amending the 43 education law relating to the practice of psychology made by section 44 fourteen of this act shall repeal on the same date as such section 45 repeals. 46 § 10. This act shall take effect immediately. 47 PART Z 48 Section 1. Subparagraph (vii) of paragraph e of subdivision 3 of 49 section 364-j of the social services law, as amended by section 38 of 50 part A of chapter 56 of the laws of 2013, is amended to read as follows: 51 (vii) a person with a developmental or physical disability who 52 receives home and community-based services or care-at-home services 53 through a demonstration waiver under section eleven hundred fifteen of 54 the federal social security act, existing waivers under section nineteenS. 7507 73 A. 9507 1 hundred fifteen (c) of the federal social security act, or who has char- 2 acteristics and needs similar to such persons; 3 § 2. Clause (x) of subparagraph 1 of paragraph (e) of subdivision 5 of 4 section 366 of the social services law, as added by section 26-a of part 5 C of chapter 109 of the laws of 2006, is amended to read as follows: 6 (x) "nursing facility services" means nursing care and health related 7 services provided in a nursing facility; a level of care provided in a 8 hospital which is equivalent to the care which is provided in a nursing 9 facility; and care, services or supplies provided pursuant to a waiver 10 granted pursuant to subsection (c) of section 1915 of the federal social 11 security act or successor federal waiver. 12 § 3. Section 366 of the social services law is amended by adding a new 13 subdivision 7-c to read as follows: 14 7-c. The commissioner of health in consultation with the commissioner 15 of developmental disabilities is authorized to submit the appropriate 16 waivers, including, but not limited to, those authorized pursuant to 17 section eleven hundred fifteen of the federal social security act, in 18 order to achieve the purposes of high-quality and integrated care and 19 services for a population of persons with developmental disabilities, as 20 such term is defined in section 1.03 of the mental hygiene law. 21 § 4. Subdivision 6-a of section 93 of part C of chapter 58 of the laws 22 of 2007, amending the social services law and other laws relating to 23 enacting the major components of legislation necessary to implement the 24 health and mental hygiene budget for the 2007-2008 state fiscal year, as 25 amended by section 20 of part B of chapter 56 of the laws of 2013, is 26 amended to read as follows: 27 6-a. section fifty-seven of this act shall expire and be deemed 28 repealed on December 31, [2018] 2024; provided that the amendments made 29 by such section to subdivision 4 of section 366-c of the social services 30 law shall apply with respect to determining initial and continuing 31 eligibility for medical assistance, including the continued eligibility 32 of recipients originally determined eligible prior to the effective date 33 of this act, and provided further that such amendments shall not apply 34 to any person or group of persons if it is subsequently determined by 35 the Centers for Medicare and Medicaid services or by a court of compe- 36 tent jurisdiction that medical assistance with federal financial partic- 37 ipation is available for the costs of services provided to such person 38 or persons under the provisions of subdivision 4 of section 366-c of the 39 social services law in effect immediately prior to the effective date of 40 this act. 41 § 5. Paragraph (a) of subdivision 2 of section 366-c of the social 42 services law, as amended by section 68 of part A of chapter 56 of the 43 laws of 2013, is amended to read as follows: 44 (a) For purposes of this section an "institutionalized spouse" is a 45 person (i) who is in a medical institution or nursing facility and 46 expected to remain in such facility or institution for at least thirty 47 consecutive days; or (ii) who is receiving care, services and supplies 48 pursuant to a waiver pursuant to subsection (c) of section nineteen 49 hundred fifteen of the federal social security act, or successor to such 50 waiver, or is receiving care, services and supplies in a managed long- 51 term care plan pursuant to section eleven hundred fifteen of the social 52 security act; and (iii) who is married to a person who is not in a 53 medical institution or nursing facility or is not receiving waiver 54 services described in subparagraph (ii) of this paragraph; provided, 55 however, that medical assistance shall be furnished pursuant to this 56 paragraph only if, for so long as, and to the extent that federal finan-S. 7507 74 A. 9507 1 cial participation is available therefor. The commissioner of health 2 shall make any amendments to the state plan for medical assistance, or 3 apply for any waiver or approval under the federal social security act 4 that are necessary to carry out the provisions of this paragraph. 5 § 6. The closing paragraph of subdivision 4 of section 366-c of the 6 social services law, as amended by section 42 of part D of chapter 58 of 7 the laws of 2009, is amended to read as follows: 8 provided, however, that, to the extent required by federal law, the 9 terms of this subdivision shall not apply to persons who are receiving 10 care, services and supplies pursuant to the following waivers under 11 section 1915(c) of the federal social security act: the nursing facility 12 transition and diversion waiver authorized pursuant to subdivision six-a 13 of section three hundred sixty-six of this title; the traumatic brain 14 injury waiver authorized pursuant to section twenty-seven hundred forty 15 of the public health law, the long term home health care program waiver 16 authorized pursuant to section three hundred sixty-seven-c of this 17 title, and the home and community based services waiver for persons with 18 developmental disabilities, or successor to such waiver, administered by 19 the office [of mental retardation and] for people with developmental 20 disabilities pursuant to an agreement with the federal centers for medi- 21 care and Medicaid services. 22 § 7. Paragraph 4 of subdivision (a) of section 16.03 of the mental 23 hygiene law, as added by section 6 of part MM of chapter 58 of the laws 24 of 2015, is amended to read as follows: 25 (4) The provision of home and community based services approved under 26 a waiver program authorized pursuant to section eleven hundred fifteen 27 of the federal social security act or subdivision (c) of section nine- 28 teen hundred fifteen of the federal social security act and subdivisions 29 seven and seven-a of section three hundred sixty-six of the social 30 services law, provided that an operating certificate issued pursuant to 31 this paragraph shall only authorize services in a home or community 32 setting. 33 § 8. Paragraph 2 of subdivision (a) of section 16.11 of the mental 34 hygiene law, as added by section 10 of part MM of chapter 58 of the laws 35 of 2015, is amended to read as follows: 36 (2) The review of providers of services, as defined in paragraph four 37 of subdivision (a) of section 16.03 of this article, shall ensure that 38 the provider of services complies with all the requirements of the 39 applicable federal home and community based services waiver program, or 40 other successor Medicaid waiver program, and applicable federal regu- 41 lation, subdivisions seven and seven-a of section three hundred sixty- 42 six of the social services law and rules and regulations adopted by the 43 commissioner. 44 § 9. Subdivision (b) of section 80.03 of the mental hygiene law, as 45 amended by chapter 37 of the laws of 2011, is amended to read as 46 follows: 47 (b) "A patient in need of surrogate decision-making" means a patient 48 as defined in subdivision twenty-three of section 1.03 of this chapter 49 who is: a resident of a mental hygiene facility including a resident of 50 housing programs funded by an office of the department or whose federal 51 funding application was approved by an office of the department or for 52 whom such facility maintains legal admission status therefor; or, 53 receiving home and community-based services for persons with mental 54 disabilities provided pursuant to section 1915 or 1115 of the federal 55 social security act; or receiving individualized support services; or, 56 case management or service coordination funded, approved, or provided byS. 7507 75 A. 9507 1 the office for people with developmental disabilities; and, for whom 2 major medical treatment is proposed, and who is determined by the surro- 3 gate decision-making committee to lack the ability to consent to or 4 refuse such treatment, but shall not include minors with parents or 5 persons with legal guardians, committees or conservators who are legally 6 authorized, available and willing to make such health care decisions. 7 Once a person is eligible for surrogate decision-making, such person may 8 continue to receive surrogate decision-making as authorized by this 9 section regardless of a change in residential status. 10 § 10. Subdivision 1-a of section 84 of part A of chapter 56 of the 11 laws of 2013, amending the social services law and other laws relating 12 to enacting the major components of legislation necessary to implement 13 the health and mental hygiene budget for the 2013-2014 state fiscal 14 year, is amended to read as follows: 15 [1-a. sections seventy-three through eighty-a shall expire and be16deemed repealed September 30, 2019] 17 § 11. Paragraph (a-1) of subdivision 8 of section 4403 of the public 18 health law, as amended by chapter 474 of the laws of 2015, is amended to 19 read as follows: 20 (a-1) If the commissioner and the commissioner of the office for 21 people with developmental disabilities determine that such organization 22 lacks the experience required in paragraph (a) of this subdivision, the 23 organization shall have an affiliation arrangement with an entity or 24 entities that are controlled by non-profit organizations with experience 25 serving persons with developmental disabilities, as demonstrated by 26 criteria to be determined by the commissioner and the commissioner of 27 the office for people with developmental disabilities, with such crite- 28 ria including, but not limited to, residential, day, and employment 29 services such that the affiliated entity will coordinate and plan 30 services operated, certified, funded, authorized or approved by the 31 office for people with developmental disabilities or will oversee and 32 approve such coordination and planning; 33 § 12. Section 97 of chapter 659 of the laws of 1997, amending the 34 public health law and other laws relating to creation of continuing care 35 retirement communities, as amended by section 20 of part D of chapter 57 36 of the laws of 2015, is amended to read as follows: 37 § 97. This act shall take effect immediately, provided, however, that 38 the amendments to subdivision 4 of section 854 of the general municipal 39 law made by section seventy of this act shall not affect the expiration 40 of such subdivision and shall be deemed to expire therewith and provided 41 further that sections sixty-seven and sixty-eight of this act shall 42 apply to taxable years beginning on or after January 1, 1998 and 43 provided further that sections eighty-one through eighty-seven of this 44 act shall expire and be deemed repealed on December 31, [2019] 2024 and 45 provided further, however, that the amendments to section ninety of this 46 act shall take effect January 1, 1998 and shall apply to all policies, 47 contracts, certificates, riders or other evidences of coverage of long 48 term care insurance issued, renewed, altered or modified pursuant to 49 section 3229 of the insurance law on or after such date. 50 § 13. Paragraph (a-1) of subdivision 12 of section 4403-f of the 51 public health law, as amended by chapter 474 of the laws of 2015, is 52 amended to read as follows: 53 (a-1) If the commissioner and the commissioner of the office for 54 people with developmental disabilities determine that such plan lacks 55 the experience required in paragraph (a) of this subdivision, the plan 56 shall have an affiliation arrangement with an entity or entities thatS. 7507 76 A. 9507 1 are controlled by non-profit organizations with experience serving 2 persons with developmental disabilities, as demonstrated by criteria to 3 be determined by the commissioner and the commissioner of the office for 4 people with developmental disabilities, with such criteria including, 5 but not limited to, residential, day and employment services, such that 6 the affiliated entity will coordinate and plan services operated, certi- 7 fied, funded, authorized or approved by the office for people with 8 developmental disabilities or will oversee and approve such coordination 9 and planning; 10 § 14. Paragraph (d) of subdivision 1 of section 4403-g of the public 11 health law, as added by section 73 of part A of chapter 56 of the laws 12 of 2013, is amended to read as follows: 13 (d) "Health and long term care services" means comprehensive health 14 services and other services as determined by the commissioner and the 15 commissioner of the office for people with developmental disabilities, 16 whether provided by state-operated programs or not-for-profit entities, 17 including, but not limited to, habilitation services, home and communi- 18 ty-based and institution-based long term care services, and ancillary 19 services, that shall include medical supplies and nutritional supple- 20 ments, that are necessary to meet the needs of persons whom the plan is 21 authorized to enroll[, and may include primary care and acute care if22the DISCO is authorized to provide or arrange for such services]. Each 23 person enrolled in a DISCO shall receive health and long term care 24 services designed to achieve person-centered outcomes, to enable that 25 person to live in the most integrated setting appropriate to that 26 person's needs, and to enable that person to interact with nondisabled 27 persons to the fullest extent possible in social, workplace and other 28 community settings, provided that all such services are consistent with 29 such person's wishes to the extent that such wishes are known and in 30 accordance with such person's needs. 31 § 15. Paragraph (b) of subdivision 3 of section 4403-g of the public 32 health law, as added by section 73 of part A of chapter 56 of the laws 33 of 2013, is amended to read as follows: 34 (b) A description of the services to be covered by such DISCO, which 35 must include all health and long term care services, as defined in para- 36 graph (d) of subdivision one of this section, and other services as 37 determined by the commissioner and the commissioner of the office for 38 people with developmental disabilities; 39 § 16. Paragraph (j) of subdivision 4 of section 4403-g of the public 40 health law, as added by section 73 of part A of chapter 56 of the laws 41 of 2013, is amended to read as follows: 42 (j) Readiness and capability [to arrange and manage covered services] 43 of organizing, marketing, managing, promoting and operating a health and 44 long term care services plan, or has an affiliation agreement with an 45 entity that has such readiness and capability; 46 § 17. Subdivision (c) of section 62 of chapter 165 of the laws of 47 1991, amending the public health law and other laws relating to estab- 48 lishing payments for medical assistance, as amended by section 17 of 49 part D of chapter 57 of the laws of 2015, is amended to read as follows: 50 (c) section 364-j of the social services law, as amended by section 51 eight of this act and subdivision 6 of section 367-a of the social 52 services law as added by section twelve of this act shall expire and be 53 deemed repealed on March 31, [2019] 2024 and provided further, that the 54 amendments to the provisions of section 364-j of the social services law 55 made by section eight of this act shall only apply to managed care 56 programs approved on or after the effective date of this act;S. 7507 77 A. 9507 1 § 18. Subdivision (c) of section 13.40 of the mental hygiene law, as 2 added by section 72-b of part A of chapter 56 of the laws of 2013, is 3 amended to read as follows: 4 (c) No person with a developmental disability who is receiving or 5 applying for medical assistance and who is receiving, or eligible to 6 receive, services operated, funded, certified, authorized or approved by 7 the office, shall be required to enroll in a DISCO, HMO or MLTC in order 8 to receive such services until program features and reimbursement rates 9 are approved by the commissioner and the commissioner of health, and 10 until such commissioners determine that a sufficient number of plans 11 that are authorized to coordinate care for individuals pursuant to this 12 section or that are authorized to operate and to exclusively enroll 13 persons with developmental disabilities pursuant to subdivision twenty- 14 seven of section three hundred sixty-four-j of the social services law 15 are operating in such person's county of residence to meet the needs of 16 persons with developmental disabilities, and that such entities meet the 17 standards of this section. No person shall be required to enroll in a 18 DISCO, HMO or MLTC in order to receive services operated, funded, certi- 19 fied, authorized or approved by the office until there are at least two 20 entities operating under this section in such person's county of resi- 21 dence, unless federal approval is secured to require enrollment when 22 there are less than two such entities operating in such county. Notwith- 23 standing the foregoing or any other law to the contrary, any health care 24 provider: (i) enrolled in the Medicaid program and (ii) rendering hospi- 25 tal services, as such term is defined in section twenty-eight hundred 26 one of the public health law, to an individual with a developmental 27 disability who is enrolled in a DISCO, HMO or MLTC, or a prepaid health 28 services plan operating pursuant to section forty-four hundred three-a 29 of the public health law, including, but not limited to, an individual 30 who is enrolled in a plan authorized by section three hundred sixty- 31 four-j or the social services law, shall accept as full reimbursement 32 the negotiated rate or, in the event that there is no negotiated rate, 33 the rate of payment that the applicable government agency would other- 34 wise pay for such rendered hospital services. 35 § 19. Section 11 of chapter 710 of the laws of 1988, amending the 36 social services law and the education law relating to medical assistance 37 eligibility of certain persons and providing for managed medical care 38 demonstration programs, as amended by section 1 of part F of chapter 73 39 of the laws of 2016, is amended to read as follows: 40 § 11. This act shall take effect immediately; except that the 41 provisions of sections one, two, three, four, eight and ten of this act 42 shall take effect on the ninetieth day after it shall have become a law; 43 and except that the provisions of sections five, six and seven of this 44 act shall take effect January 1, 1989; and except that effective imme- 45 diately, the addition, amendment and/or repeal of any rule or regulation 46 necessary for the implementation of this act on its effective date are 47 authorized and directed to be made and completed on or before such 48 effective date; provided, however, that the provisions of section 364-j 49 of the social services law, as added by section one of this act shall 50 expire and be deemed repealed on and after March 31, [2019] 2024, the 51 provisions of section 364-k of the social services law, as added by 52 section two of this act, except subdivision 10 of such section, shall 53 expire and be deemed repealed on and after January 1, 1994, and the 54 provisions of subdivision 10 of section 364-k of the social services 55 law, as added by section two of this act, shall expire and be deemed 56 repealed on January 1, 1995.S. 7507 78 A. 9507 1 § 20. This act shall take effect immediately; provided, however, that 2 the amendments to subparagraph (vii) of paragraph e of subdivision 3 of 3 section 364-j of the social services law made by section one of this act 4 shall not affect the repeal of such section and shall be deemed repealed 5 therewith; provided further, however, that the amendments to subdivision 6 4 of section 366-c of the social services law made by section six of 7 this act shall not affect the expiration of such subdivision and shall 8 be deemed to expire therewith; provided further, however, that the 9 amendments to paragraph (a-1) of subdivision 12 of section 4403-f of the 10 public health law made by section thirteen of this act shall not affect 11 the repeal of such section and shall be deemed to be repealed therewith. 12 PART AA 13 Section 1. Subdivisions 3-b and 3-c of section 1 of part C of chapter 14 57 of the laws of 2006, relating to establishing a cost of living 15 adjustment for designated human services programs, as amended by section 16 1 of part Q of chapter 57 of the laws of 2017, are amended to read as 17 follows: 18 3-b. Notwithstanding any inconsistent provision of law, beginning 19 April 1, 2009 and ending March 31, 2016 and beginning April 1, 2017 and 20 ending March 31, [2018] 2019, the commissioners shall not include a COLA 21 for the purpose of establishing rates of payments, contracts or any 22 other form of reimbursement, provided that the commissioners of the 23 office for people with developmental disabilities, the office of mental 24 health, and the office of alcoholism and substance abuse services shall 25 not include a COLA beginning April 1, 2017 and ending March 31, 2019. 26 3-c. Notwithstanding any inconsistent provision of law, beginning 27 April 1, [2018] 2019 and ending March 31, [2021] 2022, the commissioners 28 shall develop the COLA under this section using the actual U.S. consumer 29 price index for all urban consumers (CPI-U) published by the United 30 States department of labor, bureau of labor statistics for the twelve 31 month period ending in July of the budget year prior to such state 32 fiscal year, for the purpose of establishing rates of payments, 33 contracts or any other form of reimbursement. 34 § 2. This act shall take effect immediately and shall be deemed to 35 have been in full force and effect on and after April 1, 2018; provided, 36 however, that the amendments to section 1 of part C of chapter 57 of the 37 laws of 2006 made by section one of this act shall not affect the repeal 38 of such section and shall be deemed repealed therewith. 39 § 2. Severability clause. If any clause, sentence, paragraph, subdivi- 40 sion, section or part of this act shall be adjudged by any court of 41 competent jurisdiction to be invalid, such judgment shall not affect, 42 impair, or invalidate the remainder thereof, but shall be confined in 43 its operation to the clause, sentence, paragraph, subdivision, section 44 or part thereof directly involved in the controversy in which such judg- 45 ment shall have been rendered. It is hereby declared to be the intent of 46 the legislature that this act would have been enacted even if such 47 invalid provisions had not been included herein. 48 § 3. This act shall take effect immediately provided, however, that 49 the applicable effective date of Parts A through AA of this act shall be 50 as specifically set forth in the last section of such Parts.
