assembly Bill A7860

Amended

Provides for establishment of the New York Health plan and makes an appropriation to the temporary commission on implementation of the plan

download pdf

Sponsor

GOTTFRIED

Co-Sponsors

view all co-sponsors

Multi-Sponsors

view all multi-sponsors

Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
view actions

actions

  • 19 / May / 2011
    • REFERRED TO HEALTH
  • 04 / Jan / 2012
    • REFERRED TO HEALTH
  • 18 / May / 2012
    • AMEND (T) AND RECOMMIT TO HEALTH
  • 18 / May / 2012
    • PRINT NUMBER 7860A
  • 05 / Jun / 2012
    • REPORTED REFERRED TO CODES
  • 18 / Jun / 2012
    • REPORTED REFERRED TO WAYS AND MEANS

Summary

Establishes the New York Health program, a comprehensive system of access to health insurance for New York state residents: provides for administrative structure of the plan; provides for powers and duties of the board of trustees, the scope of benefits, payment methodologies and care coordination; establishes the New York Health Trust Fund which would hold monies from a variety of sources to be used solely to finance the plan; enacts provisions relating to financing of New York Health, including a payroll assessment, similar to the Medicare tax; establishes a temporary commission on implementation of the plan; provides for collective negotiations by health care providers with New York Health.

do you support this bill?

Bill Details

See Senate Version of this Bill:
S5425
Versions:
A7860
A7860A
Legislative Cycle:
2011-2012
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Ren Art 50 §§5000 - 5003 to be Art 80 §§8000 - 8003, add Art 51 §§5100 - 5110, add Art 49 Title 3 §§4920 - 4927, amd §270, Pub Health L; add §89-h, St Fin L
Versions Introduced in Previous Legislative Cycles:
2009-2010: A2356, S2370, S5425A, S2370
2007-2008: A7354, S3316A
view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

    S. 5425                                                  A. 7860

                       2011-2012 Regular Sessions

                      S E N A T E - A S S E M B L Y

                              May 19, 2011
                               ___________

IN  SENATE  --  Introduced  by  Sens.  DUANE,  PERKINS -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Finance

IN  ASSEMBLY  --  Introduced  by M. of A. GOTTFRIED, BENEDETTO, BRONSON,
  BROOK-KRASNY, CYMBROWITZ, ENGLEBRIGHT, GANTT, HIKIND, JAFFEE,  JACOBS,
  KELLNER,  LAVINE,  MAISEL,  PEOPLES-STOKES, SCHROEDER, SWEENEY, TITUS,
  KAVANAGH -- Multi-Sponsored by -- M. of  A.  ABBATE,  AUBRY,  BOYLAND,
  BRENNAN,  CAHILL, CAMARA, CLARK, COLTON, COOK, FARRELL, GUNTHER, HOYT,
  LENTOL, V. LOPEZ, LUPARDO, MAGEE, MAGNARELLI, McENENY, MILLMAN, ORTIZ,
  PAULIN,  PERRY,  PRETLOW,   RAMOS,   REILLY,   J. RIVERA,   N. RIVERA,
  P. RIVERA,   ROBINSON,  ROSENTHAL,  SCARBOROUGH,  THIELE,  WEISENBERG,
  WEPRIN, WRIGHT -- read once and referred to the Committee on Health

AN ACT to amend the public health law, the state finance law and the tax
  law, in relation to the establishment of the New York health plan  and
  making  an appropriation to the temporary commission on implementation
  of the New York health plan and providing for the  repeal  of  certain
  provisions upon expiration thereof

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Article 50 and sections 5000, 5001, 5002 and  5003  of  the
public  health  law  are  renumbered article 80 and sections 8000, 8001,
8002 and 8003 and a new article 51 is added to read as follows:
                                ARTICLE 51
                          NEW YORK HEALTH PLAN
SECTION 5100. LEGISLATIVE FINDINGS.
        5101. SHORT TITLE.
        5102. DEFINITIONS.
        5103. PLAN CREATED.
        5104. BOARD OF GOVERNORS.
        5105. POWERS AND DUTIES OF THE BOARD.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02490-01-1

S. 5425                             2                            A. 7860

        5106. POWERS AND DUTIES OF THE EXECUTIVE DIRECTOR.
        5107. PLAN ELIGIBILITY.
        5108. PLAN BENEFITS.
        5109. PAYMENT FOR SERVICES.
        5110. OUT-OF-STATE PARTICIPATION AND PAYMENTS.
  S  5100. LEGISLATIVE FINDINGS. THE LEGISLATURE FINDS AND DECLARES THAT
ALL RESIDENTS OF THE  STATE  OF  NEW  YORK  HAVE  THE  RIGHT  TO  HEALTH
SERVICES, YET AN INCREASING NUMBER OF NEW YORKERS ARE UNABLE TO EXERCISE
THIS  RIGHT BECAUSE OF A LACK OF HEALTH COVERAGE. NEW YORKERS HAVE EXPE-
RIENCED A RAPID RISE IN THE COST OF HEALTH CARE IN  RECENT  YEARS.  THIS
INCREASE  HAS  RESULTED  IN  A  LARGE NUMBER OF PEOPLE   WHO HAVE HAD TO
DISCONTINUE THEIR HEALTH  COVERAGE.  BUSINESSES  HAVE  ALSO  EXPERIENCED
EXTRAORDINARY  INCREASES  IN THE COSTS OF HEALTH CARE BENEFITS FOR THEIR
EMPLOYEES. OVER THREE MILLION NEW YORKERS HAVE NO HEALTH  COVERAGE,  AND
ANOTHER ESTIMATED THREE MILLION ARE SEVERELY UNDERINSURED. HOSPITALS AND
OTHER  HEALTH  CARE  PROVIDERS  ARE  ALSO  AFFECTED BY INADEQUATE HEALTH
INSURANCE COVERAGE IN NEW YORK STATE. A LARGE PORTION OF  VOLUNTARY  AND
PUBLIC  HOSPITALS,  HEALTH  CENTERS  AND  OTHER PROVIDERS NOW EXPERIENCE
SUBSTANTIAL LOSSES DUE TO THE PROVISION OF CARE THAT  IS  UNCOMPENSATED.
TO ADDRESS THE FISCAL CRISIS FACING THE HEALTH CARE SYSTEM AND TO ASSURE
NEW  YORKERS  CAN  EXERCISE  THEIR  RIGHT TO HEALTH CARE, AFFORDABLE AND
COMPREHENSIVE HEALTH COVERAGE MUST BE PROVIDED. PURSUANT  TO  THE  STATE
CONSTITUTION'S  CHARGE  TO  THE LEGISLATURE TO PROVIDE FOR THE HEALTH OF
NEW YORKERS, THIS ARTICLE IS AN  ENACTMENT  OF  STATE  CONCERN  FOR  THE
PURPOSE  OF  ESTABLISHING A COMPREHENSIVE UNIVERSAL HEALTH CARE COVERAGE
PROGRAM AND A HEALTH CARE COST CONTROL SYSTEM FOR  THE  BENEFIT  OF  ALL
RESIDENTS OF THE STATE OF NEW YORK.
  S  5101.  SHORT TITLE. THIS ARTICLE SHALL BE KNOWN AND MAY BE CITED AS
THE "NEW YORK HEALTH PLAN".
  S 5102. DEFINITIONS. FOR THE PURPOSES  OF  THIS  ARTICLE,  UNLESS  THE
CONTEXT CLEARLY REQUIRES OTHERWISE:
  1. "BOARD" MEANS THE BOARD OF GOVERNORS OF THE NEW YORK HEALTH PLAN AS
CREATED BY SECTION FIFTY-ONE HUNDRED FOUR OF THIS ARTICLE.
  2.  "PLAN" MEANS THE NEW YORK HEALTH PLAN AS CREATED BY SECTION FIFTY-
ONE HUNDRED THREE OF THIS ARTICLE.
  3. "PLAN MEMBER" MEANS ANY PERSON WHO QUALIFIES FOR BENEFITS UNDER THE
PLAN UNDER SECTION FIFTY-ONE HUNDRED SEVEN OF THIS ARTICLE.
  4. "PARTICIPATING PROVIDER" MEANS ANY PERSON, PARTNERSHIP, CORPORATION
OR OTHER ENTITY, AUTHORIZED TO FURNISH COVERED SERVICES PURSUANT TO THIS
ARTICLE.
  5. "PLAN RATE" MEANS THE RATE OF PAYMENT FOR A COVERED SERVICE,  UNDER
THE PLAN, ESTABLISHED IN ACCORDANCE WITH THIS ARTICLE.
  6.  "GLOBAL BUDGET" MEANS AN INSTITUTION-WIDE BUDGET FOR THE FIXED AND
OPERATING COSTS FOR THE PROVISION OF HEALTH CARE SERVICES, EXCLUSIVE  OF
CAPITAL  EXPENDITURES  COVERED UNDER SUBPARAGRAPH (III) OF PARAGRAPH (E)
OF SUBDIVISION TWO OF SECTION FIFTY-ONE HUNDRED FIVE OF THIS ARTICLE.
  7. "RESIDENT" MEANS A PERSON WHO HAS ESTABLISHED THEIR  PRIMARY  PLACE
OF  ABODE  IN  THIS STATE, AS DETERMINED ACCORDING TO REGULATIONS OF THE
BOARD.
  S 5103. PLAN CREATED. THERE IS HEREBY ESTABLISHED THE NEW YORK  HEALTH
PLAN,  TO  PROVIDE, AS SET OUT IN THIS ARTICLE, AND RELATED LEGISLATION,
UNIVERSAL HEALTH COVERAGE FOR ALL RESIDENTS OF THIS STATE, ACCESS TO AND
CHOICE OF HEALTH CARE PROVIDERS, CONTROLS ON HEALTH CARE COSTS, DEVELOP-
MENT OF HEALTH CARE SERVICES, AND  PUBLIC  FINANCING  FOR  THE  PROGRAM.
SUCH PLAN SHALL BE A CORPORATE GOVERNMENTAL AGENCY CONSTITUTING A PUBLIC
BENEFIT CORPORATION.

S. 5425                             3                            A. 7860

  S  5104. BOARD OF GOVERNORS. 1. A BOARD OF GOVERNORS TO ADMINISTER THE
PLAN IS HEREBY CREATED. THE BOARD SHALL BE COMPOSED OF EIGHTEEN MEMBERS,
TO CONSIST OF THE CHAIR AND SEVENTEEN ADDITIONAL MEMBERS,  APPOINTED  BY
THE  GOVERNOR WITH THE ADVICE AND CONSENT OF THE SENATE. THE COMMISSION-
ER,  THE  SUPERINTENDENT  OF INSURANCE, AND THE COMMISSIONER OF TAXATION
AND FINANCE SHALL SERVE AS NONVOTING EX OFFICIO MEMBERS OF THE BOARD.
  OF THE SEVENTEEN ADDITIONAL MEMBERS APPOINTED BY THE GOVERNOR:
  (A) FIVE SHALL BE REPRESENTATIVE  OF  HEALTH  CARE  CONSUMER  ADVOCACY
ORGANIZATIONS WHICH HAVE A STATEWIDE OR REGIONAL CONSTITUENCY,  WHO HAVE
BEEN  INVOLVED  IN  ACTIVITIES RELATED TO HEALTH CARE CONSUMER ADVOCACY,
INCLUDING ISSUES OF INTEREST TO LOW AND MODERATE-INCOME INDIVIDUALS;
  (B) THREE SHALL BE REPRESENTATIVE OF LABOR ORGANIZATIONS;
  (C) THREE SHALL BE REPRESENTATIVE OF BUSINESS AND INDUSTRY;
  (D) TWO SHALL BE REPRESENTATIVE OF HOSPITALS;
  (E) TWO SHALL BE REPRESENTATIVE OF PHYSICIANS; AND
  (F) TWO SHALL BE REPRESENTATIVE OF LICENSED NON-PHYSICIAN HEALTH  CARE
PROFESSIONALS.
  2.  MEMBERS  SHALL SERVE FOR A TERM OF FIVE YEARS; EACH TERM SHALL END
ON DECEMBER THIRTY-FIRST. EACH MEMBER OF THE  BOARD  SHALL  HOLD  OFFICE
FROM  THE DATE OF QUALIFICATION FOR OFFICE UNTIL THE END OF THE TERM FOR
WHICH THE MEMBER WAS APPOINTED. ANY MEMBER APPOINTED TO FILL  A  VACANCY
OCCURRING  PRIOR  TO THE EXPIRATION OF A TERM, SHALL HOLD OFFICE FOR THE
REMAINDER OF THAT TERM.
  3. EACH MEMBER SHALL CONTINUE IN OFFICE SUBSEQUENT TO  THE  EXPIRATION
DATE OF THE TERM UNTIL A SUCCESSOR TAKES OFFICE.
  4. THE GOVERNOR MAY REMOVE THE CHAIR OF THE BOARD FOR GOOD CAUSE PRIOR
TO  THE  EXPIRATION OF HIS OR HER TERM. IN THE EVENT OF A VACANCY IN THE
CHAIR, THE GOVERNOR MAY APPOINT A PERSON TO  BE  ACTING  CHAIR  UNTIL  A
CHAIR SHALL BE CONFIRMED BY THE SENATE.
  5. THE BOARD SHALL MEET AT LEAST FOUR TIMES IN A CALENDAR YEAR.
  6.  MEETINGS  SHALL BE HELD UPON THE CALL OF THE CHAIR AND AS PROVIDED
BY THE BOARD.
  7. TEN MEMBERS OF THE BOARD SHALL CONSTITUTE A QUORUM, AND THE  AFFIR-
MATIVE VOTE OF TEN MEMBERS SHALL BE NECESSARY FOR ANY ACTION TO BE TAKEN
BY THE BOARD.
  8.  THE  BOARD  MAY  ESTABLISH AN EXECUTIVE COMMITTEE TO CARRY OUT ANY
POWERS OR DUTIES OF THE BOARD AS IT MAY PROVIDE, AND OTHER COMMITTEES TO
ASSIST THE BOARD OR THE EXECUTIVE COMMITTEE.  THE  CHAIR  OF  THE  BOARD
SHALL  BE  THE  CHAIR  OF  THE EXECUTIVE COMMITTEE AND SHALL APPOINT THE
CHAIRS OF OTHER  COMMITTEES.  THE  BOARD  MAY  ALSO  ESTABLISH  ADVISORY
COMMITTEES, CONSISTING OF PERSONS OTHER THAN MEMBERS OF THE BOARD.
  9.  MEMBERS OF THE BOARD, WITH THE EXCEPTION OF THE CHAIR, SHALL SERVE
WITHOUT COMPENSATION, BUT SHALL BE REIMBURSED FOR  THEIR  NECESSARY  AND
ACTUAL EXPENSES INCURRED WHILE ENGAGED IN THE BUSINESS OF THE BOARD.
  10.  NOTWITHSTANDING  ANY  INCONSISTENT  PROVISIONS  OF  LAW, GENERAL,
SPECIAL OR LOCAL, NO OFFICER OR EMPLOYEE OF THE STATE OR  OF  ANY  CIVIL
DIVISION  THEREOF SHALL BE DEEMED TO HAVE FORFEITED OR SHALL FORFEIT HIS
OR HER OFFICE OR EMPLOYMENT BY REASON OF BEING A MEMBER OF THE BOARD.
  S 5105. POWERS AND DUTIES OF THE BOARD.  1. EXCEPT AS OTHERWISE LIMIT-
ED BY THIS ARTICLE, THE BOARD SHALL HAVE THE FOLLOWING CORPORATE POWERS:
  (A) TO SUE AND BE SUED;
  (B) TO HAVE A SEAL AND ALTER THE SAME AT PLEASURE;
  (C) TO MAKE AND EXECUTE CONTRACTS AND ALL OTHER INSTRUMENTS  NECESSARY
OR  CONVENIENT  FOR  THE EXERCISE OF ITS POWERS AND FUNCTIONS UNDER THIS
ARTICLE;

S. 5425                             4                            A. 7860

  (D) TO MAKE AND  ALTER  BY-LAWS  FOR  ITS  ORGANIZATION  AND  INTERNAL
MANAGEMENT;
  (E)  TO  ACQUIRE, HOLD AND DISPOSE OF PERSONAL PROPERTY FOR ITS CORPO-
RATE PURPOSES;
  (F) TO APPOINT OFFICERS, AGENTS AND EMPLOYEES, PRESCRIBE THEIR  DUTIES
AND QUALIFICATIONS AND FIX THEIR COMPENSATION;
  (G)  TO  BORROW MONEY AND ISSUE NEGOTIABLE NOTES, BONDS OR OTHER OBLI-
GATIONS FOR ITS CORPORATE PURPOSES AND TO PROVIDE FOR THE RIGHTS OF  THE
HOLDERS THEREOF;
  (H)  TO  INVEST  ANY  FUNDS  HELD  IN RESERVE OR SINKING FUNDS, OR ANY
MONIES NOT REQUIRED FOR  THE  IMMEDIATE  USE  OR  DISBURSEMENT,  AT  THE
DISCRETION OF THE PLAN, IN OBLIGATIONS OF THE STATE OR THE UNITED STATES
GOVERNMENT,  OR IN ANY OTHER OBLIGATIONS IN WHICH THE COMPTROLLER OF THE
STATE  OF  NEW  YORK  IS  AUTHORIZED  TO  INVEST  PURSUANT  TO   SECTION
NINETY-EIGHT OF THE STATE FINANCE LAW;
  (I)  TO  ACCEPT  ANY  GIFTS OR GRANTS OR LOANS OF FUNDS OR PROPERTY OR
FINANCIAL OR OTHER AID IN ANY FORM FROM THE FEDERAL  GOVERNMENT  OR  ANY
AGENCY  OR  INSTRUMENTALITY  THEREOF OR FROM THE STATE OR FROM ANY OTHER
SOURCE AND TO COMPLY, SUBJECT TO THE PROVISIONS OF  THIS  ARTICLE,  WITH
THE TERMS AND CONDITIONS THEREOF; AND
  (J)  TO DO ANY AND ALL THINGS NECESSARY OR CONVENIENT TO CARRY OUT ITS
PURPOSES AND EXERCISE THE POWERS EXPRESSLY GIVEN  AND  GRANTED  IN  THIS
ARTICLE.
  2. THE BOARD SHALL HAVE THE ADDITIONAL POWER TO DO THE FOLLOWING:
  (A)  (I)  ESTABLISH  A  BUDGET TO INCLUDE ALL HEALTH CARE EXPENDITURES
MADE BY THE PLAN, INCLUDING THE ESTABLISHMENT OF  AGGREGATE  EXPENDITURE
TARGETS  APPLICABLE TO CATEGORIES OF HEALTH SERVICES. (II) IN ESTABLISH-
ING THE BUDGET, THE BOARD SHALL LIMIT  THE  ANNUAL  AGGREGATE  LEVEL  OF
EXPENDITURES  FOR  ANY YEAR TO A SUM EQUIVALENT TO THE LEVEL OF EXPENDI-
TURES IN THE PRECEDING YEAR INCREASED BY ONE HUNDRED TWENTY  PERCENT  OF
THE  ANNUAL INCREASE IN THE CONSUMER PRICE INDEX - URBAN AS DEVELOPED BY
THE UNITED STATES DEPARTMENT OF COMMERCE.   (III)  IN  ESTABLISHING  THE
BUDGET,  GLOBAL BUDGETS, ALLOCATIONS FOR CAPITAL EXPENDITURES, AND OTHER
BUDGET AND EXPENDITURE ACTIONS, THE BOARD SHALL CONSIDER REGIONAL  NEEDS
AND  RESOURCES,  FOR  REGIONS  THAT  ARE  GEOGRAPHICAL  AREAS REASONABLY
RELATED TO THE NEED FOR, AND DELIVERY AND USE OF, PARTICULAR HEALTH CARE
FACILITIES AND SERVICES, AND SHALL ENCOURAGE THE SHARING AND COOPERATIVE
USE OF FACILITIES AND SERVICES BY HEALTH CARE PROVIDERS.
  (B) ESTABLISH PLAN RATES, IN ACCORDANCE WITH SECTION FIFTY-ONE HUNDRED
NINE OF THIS ARTICLE;
  (C) ESTABLISH  GLOBAL  BUDGETS,  AND  DEVELOP  RULES  AND  REGULATIONS
CONCERNING  ALLOWABLE EXPENDITURES TO BE INCLUDED IN GLOBAL BUDGETS, FOR
INSTITUTIONAL  PROVIDERS  OF  SERVICES,  IN  ACCORDANCE   WITH   SECTION
FIFTY-ONE HUNDRED NINE OF THIS ARTICLE;
  (D) ADMINISTER, IMPLEMENT AND MONITOR THE OPERATION OF THE PLAN;
  (E)  ADMINISTER  THE  NEW  YORK  HEALTH TRUST FUND CREATED PURSUANT TO
SECTION EIGHTY-NINE-H OF THE STATE FINANCE LAW, AND INCLUDE  WITHIN  THE
FUND ALLOCATIONS FOR THE FOLLOWING PURPOSES:
  (I)  HEALTH  PROMOTION  AND  PRIMARY  PREVENTION  PROGRAMS,  INCLUDING
PROGRAMS WHICH UTILIZE COMMUNITY SETTINGS, SCHOOLS AND PLACES  OF  WORK,
TO  PROMOTE HEALTHY LIFESTYLES, ENABLE CONSUMERS TO MAKE INFORMED HEALTH
DECISIONS AND PROVIDE SCREENING TESTS NOT PERFORMED AS PART  OF  ROUTINE
CARE.  MONEY ALLOCATED FOR THIS PURPOSE SHALL EQUAL AT LEAST ONE-HALF OF
ONE PERCENT OF THE MONIES IN THE TRUST FUND;
  (II) PAYING PARTICIPATING PROVIDERS IN ACCORDANCE WITH SECTION  FIFTY-
ONE HUNDRED NINE OF THIS ARTICLE;

S. 5425                             5                            A. 7860

  (III) CAPITAL EXPENDITURES FOR THE FOLLOWING PURPOSES:
  (A)  CONSTRUCTION,  RENOVATION,  AND  EQUIPPING  OF HEALTH CARE INSTI-
TUTIONS, INCLUDING INSTITUTIONAL PROVIDERS OF INPATIENT CARE AND AMBULA-
TORY FACILITIES FOR DIAGNOSIS, TREATMENT  AND  SURGERY,  DIAGNOSTIC  AND
TREATMENT CENTERS PROVIDING A COMPREHENSIVE RANGE OF PRIMARY HEALTH CARE
SERVICES,  AND MAJOR MEDICAL EQUIPMENT ACQUIRED FOR USE IN PRIVATE PRAC-
TITIONER OFFICES;
  (B) A LOAN PROGRAM FOR FACILITIES AND EQUIPMENT FOR USE BY HEALTH CARE
PROFESSIONALS WHO DESIRE TO ESTABLISH PRACTICES IN AREAS OF  THIS  STATE
IN  WHICH,  ACCORDING TO CRITERIA ESTABLISHED BY THE BOARD, THE LEVEL OF
DELIVERY OF HEALTH CARE SERVICES IS INADEQUATE;
  (IV) TRANSPORTATION OF PLAN MEMBERS FROM ONE GLOBALLY-BUDGETED  INSTI-
TUTION  TO  ANOTHER FOR THE PROVISION OF COVERED SERVICES, AND OTHERWISE
TO EFFECT COOPERATION AND COMMUNICATION  BETWEEN  INSTITUTIONS  FOR  THE
DELIVERY OF HEALTH CARE SERVICES; AND
  (V)  EDUCATION  AND  TRAINING  OF  WORKERS  IN  THE HEALTH CARE FIELD,
INCLUDING, BUT NOT LIMITED TO, RETRAINING OF WORKERS WHO EXPERIENCE  JOB
LOSS  OR  DISLOCATION ASSOCIATED WITH THE IMPLEMENTATION OF THE NEW YORK
HEALTH PLAN; AND A PROGRAM OF LOAN REPAYMENTS  OR  OTHER  INCENTIVES  TO
ENCOURAGE  HEALTH  CARE  PRACTITIONERS  TO  SERVE  IN UNDERSERVED AREAS,
SPECIALTIES  OR  FACILITIES.  MONIES  ALLOCATED  SHALL  EQUAL  AT  LEAST
ONE-QUARTER OF ONE PERCENT OF THE MONIES IN THE TRUST FUND.
  (F)  IN  CARRYING  OUT ITS POWERS AND DUTIES, ESTABLISH REASONABLE AND
EFFECTIVE MEANS OF:
  (I) COST CONTAINMENT, INCLUDING BUT NOT LIMITED TO:  REDUCING  INEFFI-
CIENCIES  IN  HEALTH  CARE DELIVERY; PROMOTING EFFECTIVE AND APPROPRIATE
USE OF ADVANCEMENTS IN CLINICAL PRACTICE AND TECHNOLOGY; ENCOURAGING THE
USE OF LESS COSTLY ALTERNATIVE PROVIDERS WHERE APPROPRIATE;  AND  ESTAB-
LISHING  TREATMENT  NORMS  FOR  PROVIDERS  TO  REDUCE  THE INAPPROPRIATE
PROVISION OR USE OF SERVICES;
  (II) QUALITY ASSURANCE, INCLUDING BUT NOT LIMITED TO: DEVELOPING CLIN-
ICAL PRACTICE GUIDELINES; AND PROMOTING SYSTEMS FOR  REVIEW  OF  PATIENT
OUTCOMES, AND QUALITY AND APPROPRIATENESS OF SERVICES;
  (III)  PROMOTING  ACCESS  TO  SERVICES,  INCLUDING BUT NOT LIMITED TO:
AVAILABILITY OF PRIMARY, PREVENTIVE AND OTHER SERVICES FOR CONTINUITY OF
CARE; ASSURING CONSUMERS FREEDOM TO SELECT AMONG QUALIFIED PROVIDERS FOR
APPROPRIATE SERVICES WITHIN THEIR RECOGNIZED SCOPE OF PRACTICE; RESPECT-
ING THE PROFESSIONAL JUDGMENT OF PROVIDERS AND THE RIGHTS  OF  PATIENTS,
AND THEIR FAMILIES AND REPRESENTATIVES WHERE APPROPRIATE, TO PARTICIPATE
IN  DECISIONS AFFECTING THEIR CARE; AND ELIMINATING AND PREVENTING INEQ-
UITIES IN, OR BARRIERS TO, ACCESS TO SERVICES BASED ON GEOGRAPHY, SOCIAL
OR ECONOMIC STATUS, RACE, RELIGION, GENDER,  AGE,  ETHNICITY,  LANGUAGE,
SEXUAL ORIENTATION, FAMILY STATUS OR DEFINITION, AND HEALTH CONDITION;
  (G)  ESTABLISH,  AS  THE  BOARD  CONSIDERS  IT  NECESSARY, A SYSTEM TO
PROMOTE CONTINUITY OF CARE;
  (H) ESTABLISH AN INDEMNITY PLAN TO CARRY OUT THE PURPOSES SET FORTH IN
SECTION FIFTY-ONE HUNDRED TEN OF THIS ARTICLE;
  (I) ESTABLISH  A  PRESCRIPTION  DRUG  FORMULARY,  IN  ACCORDANCE  WITH
SECTION FIFTY-ONE HUNDRED EIGHT OF THIS ARTICLE;
  (J)  AWARD  CONTRACTS TO ADMINISTER THE PAYMENT OF COVERED SERVICES TO
PARTICIPATING PROVIDERS, AND OTHER ELEMENTS OF THE  PLAN  AS  THE  BOARD
DEEMS APPROPRIATE;
  (K)  (I)  STUDY  AND EVALUATE THE OPERATION OF THE PLAN, INCLUDING BUT
NOT LIMITED TO THE ADEQUACY AND QUALITY OF SERVICES  COVERED  UNDER  THE
PLAN,  THE  COST  OF  EACH TYPE OF SERVICE AND THE EFFECTIVENESS OF COST
CONTAINMENT MEASURES UNDER THE PLAN; AND

S. 5425                             6                            A. 7860

  (II) STUDY UTILIZATION OF HEALTH CARE SERVICES UNDER THE PLAN, ENROLL-
MENT OF NEW PLAN MEMBERS, EFFECT OF THE PLAN ON  PROVIDERS  AND  PRACTI-
TIONERS, INCLUDING RECRUITMENT AND RETENTION OF PRACTITIONERS, AND OTHER
MATTERS  RELATING  TO  PLAN  EXPERIENCE, OPERATION AND IMPACT. THE BOARD
SHALL  ESPECIALLY EXAMINE THE PHENOMENON OF INDIVIDUALS BECOMING MEMBERS
OF THE PLAN (OTHER THAN BY BIRTH) FOR  THE  PURPOSE  OF  OBTAINING  PLAN
BENEFITS FOR PRE-EXISTING CONDITIONS FOR WHICH THEY HAD INADEQUATE OR NO
HEALTH  CARE  COVERAGE,  AND ITS EXTENT, NATURE AND FINANCIAL AND HEALTH
CARE SYSTEM IMPACTS.  THE BOARD SHALL CONSIDER THE NEED FOR, AND  PROBA-
BLE  EFFECTIVENESS, ADVANTAGES AND DISADVANTAGES OF, POSSIBLE CHANGES IN
THE PLAN INCLUDING LIMITING PLAN BENEFITS  FOR  SUCH  CONDITIONS  FOR  A
PERIOD OF TIME TO EXCLUDE SUCH CONDITIONS OR IMPOSE REQUIREMENTS SUCH AS
DEDUCTIBLES, MAXIMUM BENEFITS OR CO-INSURANCE;
  (L)  REPORT ANNUALLY TO THE GOVERNOR AND THE LEGISLATURE ON ITS ACTIV-
ITIES AND RECOMMEND ANY CHANGES IN LAWS TO  IMPROVE  ACCESS  TO  QUALITY
HEALTH  CARE  AND TO MORE EFFECTIVELY CONTROL COSTS OF SERVICES PROVIDED
UNDER THE PLAN, CONSISTENT WITH QUALITY HEALTH CARE;
  (M) DISSEMINATE, TO PROVIDERS OF SERVICES AND TO THE PUBLIC,  INFORMA-
TION  CONCERNING  THE PLAN AND THE PERSONS ELIGIBLE TO RECEIVE THE BENE-
FITS UNDER THE PLAN;
  (N) CONDUCT NECESSARY INVESTIGATIONS AND  INQUIRIES  AND  REQUIRE  THE
SUBMISSION  OF INFORMATION, DOCUMENTS AND RECORDS IT CONSIDERS NECESSARY
TO CARRY OUT ITS DUTIES UNDER THIS ARTICLE;
  (O) CREATE A PROGRAM FOR THE RESOLUTION OF COMPLAINTS BROUGHT BY  PLAN
MEMBERS  OR PARTICIPATING PROVIDERS REGARDING ANY MATTER ASSOCIATED WITH
COVERAGE UNDER THE PLAN, OR THE OPERATION OF THE PLAN;
  (P) NO LATER THAN FIVE YEARS AFTER THE EFFECTIVE  DATE  OF  THE  PLAN,
DEVELOP  A  PROPOSAL FOR PROVISION BY THE PLAN OF LONG-TERM CARE  COVER-
AGE, INCLUDING THE DEVELOPMENT OF A PROPOSAL FOR ITS FUNDING. IN  DEVEL-
OPING  THE PROPOSAL, THE BOARD SHALL CONSULT WITH AN ADVISORY COMMITTEE,
APPOINTED BY THE  CHAIR  OF  THE  BOARD,  INCLUDING  REPRESENTATIVES  OF
CONSUMERS  AND POTENTIAL CONSUMERS OF LONG-TERM CARE, PROVIDERS OF LONG-
TERM CARE, BUSINESS, LABOR, SOCIAL SERVICES DISTRICTS, AND OTHER  INTER-
ESTED PARTIES;
  (Q)  DEVELOP  A  PLAN TO COORDINATE ITS ACTIVITIES, INCLUDING PLANNING
FOR THE ADEQUACY OF HEALTH CARE SERVICES AND  THE  APPROVAL  OF  CAPITAL
EXPENDITURES,  WITH APPROPRIATE STATE AND LOCAL BODIES, INCLUDING HEALTH
SYSTEMS AGENCIES AND THE HOSPITAL REVIEW AND PLANNING COUNCIL;
  (R) NO LATER THAN ONE YEAR AFTER  THE  EFFECTIVE  DATE  OF  THE  PLAN,
RECOMMEND  TO  THE  GOVERNOR AND STATE LEGISLATURE THE REORGANIZATION OF
STATE GOVERNMENT AGENCIES TO MOST EFFECTIVELY CARRY OUT ACTIVITIES TO BE
CONDUCTED BY THE BOARD; AND
  (S) CONDUCT OTHER ACTIVITIES NECESSARY AND APPROPRIATE  TO  CARRY  OUT
THE  PURPOSES  OF THIS ARTICLE, INCLUDING THE EMPLOYMENT OF STAFF AND AN
EXECUTIVE DIRECTOR.
  3. THE BOARD, AFTER PROVIDING NOTICE TO THE  PUBLIC    AND  INTERESTED
PARTIES, MAY HOLD HEARINGS IN CONNECTION WITH ANY ACTIVITIES IT PROPOSES
TO UNDERTAKE.
  4.  THE BOARD SHALL MAINTAIN THE CONFIDENTIALITY OF ALL DATA AND OTHER
INFORMATION COLLECTED IN FULFILLING ITS DUTIES WHEN SUCH DATA  WOULD  BE
NORMALLY  CONSIDERED CONFIDENTIAL DATA BETWEEN A PATIENT AND HEALTH CARE
PROVIDER.  AGGREGATE DATA WHICH IS DERIVED FROM  CONFIDENTIAL  DATA  BUT
DOES  NOT  VIOLATE  PATIENT  CONFIDENTIALITY  SHALL BE CONSIDERED PUBLIC
INFORMATION.
  S 5106. POWERS AND DUTIES OF THE EXECUTIVE DIRECTOR. 1. THE  EXECUTIVE
DIRECTOR OF THE PLAN SHALL BE THE CHIEF EXECUTIVE OFFICER OF THE PLAN.

S. 5425                             7                            A. 7860

  2.  THE  EXECUTIVE  DIRECTOR SHALL PERFORM SUCH DUTIES IN THE ADMINIS-
TRATION OF THE PLAN AS THE BOARD MAY ASSIGN,  INCLUDING  THE  EMPLOYMENT
AND SUPERVISION OF STAFF.
  3.  THE  BOARD MAY DELEGATE TO THE EXECUTIVE DIRECTOR ANY OF ITS FUNC-
TIONS OR DUTIES UNDER THIS ARTICLE OTHER THAN THE ISSUANCE OF RULES  AND
REGULATIONS AND THE ESTABLISHMENT OF THE ANNUAL PLAN BUDGET.
  S  5107.  PLAN  ELIGIBILITY. 1. EVERY PERSON WHO IS A RESIDENT OF THIS
STATE IS ELIGIBLE TO RECEIVE BENEFITS FOR  COVERED  SERVICES  UNDER  THE
PLAN AND SHALL BE A PLAN MEMBER.
  2.  EVERY  PLAN MEMBER IS ENTITLED TO RECEIVE BENEFITS FOR ANY COVERED
SERVICE FURNISHED WITHIN THIS STATE BY A PARTICIPATING PROVIDER, IF  THE
SERVICE IS NECESSARY OR APPROPRIATE FOR THE MAINTENANCE OF HEALTH OR FOR
THE  DIAGNOSIS  OR  TREATMENT  OF,  OR REHABILITATION FOLLOWING, INJURY,
DISABILITY OR DISEASE.
  S 5108. PLAN BENEFITS.  1.  COVERED  SERVICES  UNDER  THE  PLAN  SHALL
INCLUDE,  BUT  ARE NOT LIMITED TO, ALL OF THE FOLLOWING MEDICALLY NECES-
SARY INPATIENT AND OUTPATIENT SERVICES:
  (A) HOSPITAL SERVICES;
  (B) MEDICAL AND OTHER PROFESSIONAL SERVICES  FURNISHED  BY  AUTHORIZED
HEALTH  CARE  PROFESSIONALS  WHO ARE AUTHORIZED TO PROVIDE SUCH SERVICES
UNDER THE LAWS OF THIS STATE INCLUDING PRIMARY, PREVENTIVE AND SPECIALTY
SERVICES;
  (C) LABORATORY TESTS AND IMAGING PROCEDURES;
  (D) SHORT-TERM HOME HEALTH SERVICES  FOR  PERSONS  REQUIRING  SERVICES
PERFORMED  BY  OR  UNDER  THE  SUPERVISION  OF PROFESSIONAL OR TECHNICAL
PERSONNEL;
  (E) REHABILITATIVE SERVICES WHERE A PATIENT IS RECEIVING  ACTIVE  CARE
WITH A THERAPEUTIC OUTCOME;
  (F)  PRESCRIPTION  DRUGS AND DEVICES, PROVIDED, HOWEVER, THAT THE PLAN
SHALL PARTIALLY COVER THE COST OF A DRUG DISPENSED IN A PACKAGE, OR FORM
OF DOSAGE OR ADMINISTRATION, AS TO WHICH THE  BOARD  DETERMINES  THAT  A
LESS EXPENSIVE PACKAGE, OR FORM OF DOSAGE OR ADMINISTRATION IS AVAILABLE
THAT  IS  PHARMACEUTICALLY  EQUIVALENT AND EQUIVALENT IN ITS THERAPEUTIC
EFFECT. IF A PLAN MEMBER CHOOSES TO PURCHASE A MORE EXPENSIVE DRUG  THAT
HAS  A  PHARMACEUTICAL AND THERAPEUTIC EQUIVALENT, THE PLAN MEMBER SHALL
BE FINANCIALLY RESPONSIBLE FOR PAYING THE AMOUNT EQUAL TO THE DIFFERENCE
BETWEEN THE COST OF SUCH DRUG AND ITS EQUIVALENT UNLESS THE  PRESCRIBING
PRACTITIONER  CERTIFIES THAT THE MORE EXPENSIVE DRUG IS MEDICALLY NECES-
SARY, IN WHICH CASE THE PLAN SHALL COVER THE FULL COST;
  (G) MENTAL HEALTH SERVICES SUBJECT TO APPROPRIATENESS  GUIDELINES  AND
REVIEW;
  (H) SUBSTANCE ABUSE TREATMENT SERVICES;
  (I) PRIMARY AND ACUTE DENTAL SERVICES;
  (J)  VISION  APPLIANCES,  INCLUDING LENSES, FRAMES AND CONTACT LENSES,
ACCORDING TO A SCHEDULE ESTABLISHED BY THE BOARD;
  (K) MEDICAL SUPPLIES, DURABLE MEDICAL EQUIPMENT AND SELECTED ASSISTIVE
DEVICES; AND
  (L) HOSPICE CARE.
  2. COVERED SERVICES DO NOT INCLUDE ANY OF THE FOLLOWING:
  (A) SURGERY  FOR  COSMETIC  PURPOSES  OTHER  THAN  FOR  RECONSTRUCTIVE
SURGERY;
  (B)  MEDICAL  EXAMINATIONS  CONDUCTED AND MEDICAL REPORTS PREPARED FOR
ANY OF THE FOLLOWING PURPOSES:
  (I) PURCHASING OR RENEWING LIFE INSURANCE;
  (II) APPLICATIONS FOR EMPLOYMENT; OR

S. 5425                             8                            A. 7860

  (III) PARTICIPATING AS A PLAINTIFF OR DEFENDANT IN A CIVIL ACTION  FOR
THE RECOVERY OR SETTLEMENT OF DAMAGES;
  (C) BASIC OR CUSTODIAL CARE RENDERED IN A NURSING HOME;
  (D)  CUSTODIAL  CARE  RENDERED IN A FACILITY LICENSED UNDER THE MENTAL
HYGIENE LAW; OR
  (E) COSMETIC DENTAL SERVICES.
  3. COINSURANCES, DEDUCTIBLES AND COPAYMENTS SHALL NOT BE APPLICABLE TO
BENEFITS COVERED UNDER THE PLAN.
  4. INSURERS AUTHORIZED TO UNDERWRITE COVERAGE PURSUANT TO  THE  INSUR-
ANCE  LAW  OR  A HEALTH MAINTENANCE ORGANIZATION CERTIFIED IN ACCORDANCE
WITH ARTICLE FORTY-FOUR OF THIS CHAPTER, MAY OFFER BENEFITS THAT DO  NOT
DUPLICATE  COVERAGE  THAT  IS  OFFERED  UNDER THE PLAN BUT MAY NOT OFFER
BENEFITS THAT DUPLICATE COVERAGE THAT IS COVERED BY THE PLAN.  PROVIDED,
HOWEVER, THAT NOTHING IN THIS SUBDIVISION SHALL PROHIBIT THE OFFERING OF
BENEFITS  TO  OR FOR PERSONS, INCLUDING THEIR FAMILIES, WHO ARE EMPLOYED
OR SELF-EMPLOYED IN THIS STATE BUT ARE NOT RESIDENTS OF THE STATE.
  5. NO PARTICIPATING PROVIDER SHALL REFUSE TO  FURNISH  SERVICES  TO  A
PLAN  MEMBER  ON  THE BASIS OF RACE, COLOR, CREED, AGE, NATIONAL ORIGIN,
ALIENAGE OR CITIZENSHIP STATUS, GENDER, SEXUAL ORIENTATION,  DISABILITY,
MARITAL  STATUS,  OR ARREST RECORD, EXCEPT AS APPROPRIATE TO THE PROVID-
ER'S PROFESSIONAL SPECIALIZATION, OR OTHER MEDICALLY APPROPRIATE CIRCUM-
STANCES.
  6. A PLAN MEMBER MAY CHOOSE ANY PARTICIPATING PROVIDER, WHETHER  PRAC-
TICING  ON  AN  INDEPENDENT  BASIS,  IN A SMALL GROUP, OR IN A CAPITATED
PRACTICE. A PLAN MEMBER WHO ENROLLS IN A  CAPITATED  PRACTICE  SHALL  BE
SUBJECT  TO  RULES  AND  REQUIREMENTS  OF  THE PLAN AS TO DISENROLLMENT,
CHOICE OF PROVIDER, AND AVAILABILITY OF BENEFITS OUTSIDE  THE  CAPITATED
PRACTICE.
  S  5109.  PAYMENT  FOR SERVICES. 1. THE PLAN SHALL PAY THE EXPENSES OF
INSTITUTIONAL PROVIDERS LICENSED  UNDER  ARTICLE  TWENTY-EIGHT  OF  THIS
CHAPTER  FOR  COVERED  SERVICES  ON THE BASIS OF GLOBAL BUDGETS THAT ARE
APPROVED BY THE BOARD.
  2. THE GLOBAL BUDGET OF EACH INSTITUTIONAL PROVIDER SHALL BE SET ANNU-
ALLY BY THE PLAN AFTER CONSULTATION AND NEGOTIATION  WITH  THE  INSTITU-
TIONAL  PROVIDERS, AND SHALL COVER THE COSTS OF ITS ANTICIPATED SERVICES
FOR THE NEXT YEAR, BASED ON PAST PERFORMANCE AND  PROJECTED  CHANGES  IN
FACTOR PRICES AND SERVICE LEVELS.
  3.  EVERY INDIVIDUAL HEALTH CARE PROVIDER EMPLOYED BY A GLOBALLY BUDG-
ETED INSTITUTIONAL PROVIDER SHALL BE PAID THROUGH AND IN A MANNER DETER-
MINED BY THE INSTITUTIONAL PROVIDER.
  4. THE BUDGETING PROCEDURE DESCRIBED  IN  SUBDIVISIONS  ONE,  TWO  AND
THREE  OF  THIS  SECTION  ALSO APPLIES TO INSTITUTIONS THAT PROVIDE PLAN
SERVICES AND THAT ARE FUNDED BY ANY POLITICAL SUBDIVISION OR ANY  AGENCY
OR INSTRUMENTALITY OF A POLITICAL SUBDIVISION.
  5.  THE PLAN SHALL REIMBURSE NON-INSTITUTIONAL PARTICIPATING PROVIDERS
ON A FEE-FOR-SERVICE BASIS, ESTABLISHED BY THE BOARD. THE  FEE  SCHEDULE
SHALL  VARY  THE  PAYMENT  AMOUNT  AMONG DIFFERENT SERVICES BASED ON THE
RELATIVE VALUE OF THE INPUT FACTORS TO PROVIDE THE SERVICES.
  6. FEE SCHEDULES MAY TAKE INTO ACCOUNT  RECOGNIZED  DIFFERENCES  AMONG
GEOGRAPHIC AREAS REGARDING COST OF PRACTICE.
  7.  TO  THE  GREATEST  EXTENT  FEASIBLE, FEE SCHEDULE CATEGORIES SHALL
INCLUDE PAYMENT FOR ALL PROCEDURES ROUTINELY PERFORMED FOR A GIVEN DIAG-
NOSIS.
  8. (A) A MULTI-SPECIALTY ORGANIZATION OF PROVIDERS  MAY  ELECT  TO  BE
REIMBURSED ON A CAPITATION BASIS, IN LIEU OF A FEE-FOR-SERVICE BASIS.

S. 5425                             9                            A. 7860

  (B) IF THE ORGANIZATION MEETS ENROLLMENT AND OTHER REQUIREMENTS ESTAB-
LISHED  BY THE BOARD, THE ORGANIZATION MAY ELECT TO HAVE INCLUDED IN ITS
CAPITATION PAYMENTS, INPATIENT SERVICES PROVIDED BY INSTITUTIONS  FUNDED
UNDER  A  BUDGET DESCRIBED IN SUBDIVISION ONE OF THIS SECTION. UPON THAT
ELECTION,  THE  INSTITUTIONAL  BUDGETS  OF  SUCH  INSTITUTIONS  SHALL BE
ADJUSTED ACCORDINGLY.
  (C) IF THE ORGANIZATION ELECTS, AND MEETS REQUIREMENTS OF  THE  BOARD,
THE BOARD MAY INCLUDE IN THE ORGANIZATION'S CAPITATION PAYMENTS FUNDS TO
BE  PASSED  ON  BY THE ORGANIZATION TO PLAN MEMBERS WHO ARE ITS ENROLLED
MEMBERS AS A REBATE OR INCENTIVE TO ENCOURAGE MEMBERSHIP IN  THE  ORGAN-
IZATION;  PROVIDED  THAT THE BOARD FINDS THAT THE REBATE OR INCENTIVE IS
IN THE FINANCIAL INTERESTS OF THE PLAN.
  9. EVERY PARTICIPATING PROVIDER SHALL FURNISH TO THE PLAN SUCH  INFOR-
MATION,  AND  PERMIT  EXAMINATION  OF ITS RECORDS BY THE PLAN, AS MAY BE
REASONABLY REQUIRED FOR PURPOSES OF UTILIZATION REVIEW,  QUALITY  ASSUR-
ANCE  AND  COST  CONTAINMENT, FOR THE MAKING OF PAYMENTS AND FOR STATIS-
TICAL OR OTHER STUDIES OF THE OPERATION OF THE PLAN.
  10. RATES OF PAYMENT ESTABLISHED UNDER THIS SECTION SHALL  BE  CONSID-
ERED PAYMENT IN FULL. A PROVIDER OF SERVICES SHALL NOT CHARGE RATES THAT
ARE  IN  EXCESS  OF SUCH REIMBURSEMENT LEVELS, NOR CHARGE SEPARATELY FOR
COVERED SERVICES PROVIDED UNDER SECTION FIFTY-ONE HUNDRED EIGHT OF  THIS
ARTICLE. PROVIDED, HOWEVER, THE PROVISIONS OF THIS SUBDIVISION SHALL NOT
APPLY  TO  SERVICES  RENDERED  OUTSIDE  OF  THIS  STATE,  OR TO SERVICES
RENDERED TO PERSONS WHO ARE NOT PLAN MEMBERS.
  S 5110. OUT-OF-STATE PARTICIPATION AND PAYMENTS. 1.  (A) THE PLAN,  IN
ACCORDANCE  WITH SUBDIVISION FOUR OF THIS SECTION AND EXCEPT AS PROVIDED
IN PARAGRAPH (B) OF THIS SUBDIVISION, SHALL PAY FOR SERVICES RENDERED TO
PLAN MEMBERS WHILE THEY ARE OUT OF THE STATE (I) WHILE THEY  ARE  TEMPO-
RARILY OUT OF THE STATE FOR REASONS OTHER THAN TO OBTAIN THE SERVICES OR
(II)  WHERE  THE  PLAN  MEMBER OBTAINS THE SERVICES OUT OF THE STATE FOR
COMPELLING REASONS RELATING TO THE SUITABILITY OF SERVICES,  THE  NATURE
OF THE CONDITION AND PERSONAL CIRCUMSTANCES.
  (B)  WHERE THE PLAN MEMBER IS ELIGIBLE FOR HEALTH BENEFITS UNDER TITLE
XVIII OR TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT, THEN OUT-OF-STATE
SERVICES FOR THE PLAN MEMBER SHALL, TO THE EXTENT  ALLOWED  BY  LAW,  BE
PAID FOR UNDER THOSE TITLES.
  2.  WHERE AN EMPLOYEE OR SELF-EMPLOYED INDIVIDUAL IS NOT A RESIDENT OF
NEW YORK STATE (AND THEREFORE NOT ELIGIBLE TO BE A PLAN MEMBER)  BUT  IS
EMPLOYED OR SELF-EMPLOYED IN THE STATE, THE EMPLOYER OR THE EMPLOYEE, OR
THE  SELF-EMPLOYED  INDIVIDUAL,  MAY  PURCHASE  HEALTH  COVERAGE FOR THE
PERSON, INCLUDING THE PERSON'S FAMILY, FROM  ANY  ENTITY  AUTHORIZED  TO
OFFER  THAT  COVERAGE  OR  FROM THE PLAN PURSUANT TO SUBDIVISION FIVE OF
THIS SECTION.
  3. ANY PRIVATE OR STATE COLLEGE, UNIVERSITY OR  OTHER  INSTITUTION  OF
HIGHER  EDUCATION SITUATED IN THIS STATE MAY PURCHASE COVERAGE UNDER THE
PLAN FOR ANY STUDENT, OR THEIR DEPENDENTS,   WHO IS NOT  A  RESIDENT  OF
THIS STATE.
  4.  THE BOARD SHALL ESTABLISH AND OPERATE AN INDEMNITY PLAN TO PROVIDE
PAYMENTS FOR  SERVICES  UNDER  SUBDIVISION  ONE  OF  THIS  SECTION.  THE
PAYMENTS  SHALL  BE MADE AT THE RATES ESTABLISHED BY THE BOARD FOR BENE-
FITS FOR COMPARABLE SERVICES PROVIDED BY THE PLAN IN THIS STATE. CHARGES
IN EXCESS OF THE PAYMENT  RATES  ESTABLISHED  IN  ACCORDANCE  WITH  THIS
SECTION SHALL BE THE RESPONSIBILITY OF THE PLAN MEMBER.
  5.  THE BOARD SHALL ESTABLISH AND OPERATE AN INDEMNITY PLAN TO PROVIDE
HEALTH COVERAGE FOR EMPLOYEES AND SELF-EMPLOYED INDIVIDUALS WHO ARE  NOT
RESIDENTS  OF THIS STATE BUT ARE EMPLOYED OR SELF-EMPLOYED IN THE STATE,

S. 5425                            10                            A. 7860

INCLUDING THEIR FAMILIES, TO BE OFFERED FOR PURCHASE BY THE EMPLOYER  OR
EMPLOYEE,  OR  SELF-EMPLOYED  INDIVIDUALS, UNDER SUBDIVISION TWO OF THIS
SECTION. THE INDEMNITY PLAN SHALL BE OFFERED ON A NOT-FOR-PROFIT  BASIS.
ITS  SCOPE  OF BENEFITS AND RATES OF PAYMENT SHALL BE ESTABLISHED BY THE
BOARD AND SHALL, TO THE EXTENT PRACTICABLE, BE COMPARABLE TO THOSE UNDER
THE NEW YORK HEALTH PLAN.
  6. NOTHING IN THIS ARTICLE SHALL IMPACT THE EXISTING OR  FUTURE  OBLI-
GATIONS  OF  EMPLOYERS TO PROVIDE SUPPLEMENTARY HEALTH BENEFITS TO RETI-
REES WHO NO LONGER RESIDE IN THIS STATE.
  S 2. The state finance law is amended by adding a new section 89-h  to
read as follows:
  S  89-H. NEW YORK HEALTH TRUST FUND. 1. THERE IS HEREBY ESTABLISHED IN
THE JOINT CUSTODY OF THE STATE COMPTROLLER AND THE COMMISSIONER OF TAXA-
TION AND FINANCE A SPECIAL REVENUE FUND TO BE KNOWN  AS  THE  "NEW  YORK
HEALTH TRUST FUND", HEREINAFTER KNOWN AS "THE FUND".
  2. THE FUND SHALL CONSIST OF:
  (A)  ALL  MONIES  OBTAINED  FROM  PREMIUM PAYMENT REVENUES PURSUANT TO
ARTICLE THIRTY-FIVE OF THE TAX LAW;
  (B) FEDERAL PAYMENTS RECEIVED AS A RESULT OF ANY  WAIVER  OF  REQUIRE-
MENTS  GRANTED  BY  THE  UNITED  STATES  SECRETARY  OF  HEALTH AND HUMAN
SERVICES FOR HEALTH CARE PROGRAMS ESTABLISHED UNDER TITLES XVIII  (MEDI-
CARE)  AND  XIX  (MEDICAL  ASSISTANCE  FOR NEEDY PERSONS) OF THE FEDERAL
SOCIAL SECURITY ACT;
  (C) THE AMOUNTS PAID BY THE DEPARTMENT OF HEALTH AND BY  LOCAL  SOCIAL
SERVICES DISTRICTS THAT ARE EQUIVALENT TO THOSE AMOUNTS THAT ARE PAID ON
BEHALF  OF RESIDENTS OF THIS STATE UNDER TITLES XVIII (MEDICARE) AND XIX
(MEDICAL ASSISTANCE FOR NEEDY PERSONS) OF THE  FEDERAL  SOCIAL  SECURITY
ACT,  AND  ARTICLE  FIVE,  TITLE  ELEVEN  OF THE SOCIAL SERVICES LAW FOR
HEALTH BENEFITS WHICH ARE EQUIVALENT TO HEALTH  BENEFITS  COVERED  UNDER
ARTICLE FIFTY-ONE OF THE PUBLIC HEALTH LAW;
  (D)  ALL  SURCHARGES  THAT  ARE  IMPOSED ON RESIDENTS OF THIS STATE TO
REPLACE PAYMENTS MADE BY THE RESIDENTS UNDER THE COST-SHARING PROVISIONS
OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT;
  (E) FEDERAL, STATE AND LOCAL FUNDS FOR PURPOSES OF  THE  PROVISION  OF
SERVICES  AUTHORIZED  UNDER  TITLE XX OF THE FEDERAL SOCIAL SECURITY ACT
THAT WOULD OTHERWISE BE COVERED UNDER ARTICLE FIFTY-ONE  OF  THE  PUBLIC
HEALTH LAW; AND
  (F)  STATE  AND LOCAL GOVERNMENT MONIES THAT WOULD OTHERWISE BE APPRO-
PRIATED TO ANY GOVERNMENTAL AGENCY, OFFICE, PROGRAM, INSTRUMENTALITY  OR
INSTITUTION  WHICH  PROVIDES  HEALTH SERVICES, FOR SERVICES AND BENEFITS
COVERED UNDER ARTICLE FIFTY-ONE OF THE PUBLIC HEALTH  LAW.  PAYMENTS  TO
THE  FUND  PURSUANT TO THIS PARAGRAPH SHALL BE IN AN AMOUNT EQUAL TO THE
MONEY APPROPRIATED FOR SUCH PURPOSES  IN  THE  FISCAL  YEAR  IMMEDIATELY
PRECEDING  THE  EFFECTIVE DATE OF ARTICLE FIFTY-ONE OF THE PUBLIC HEALTH
LAW.
  3. MONIES IN THE FUND SHALL ONLY  BE  USED  FOR  PURPOSES  ESTABLISHED
UNDER ARTICLE FIFTY-ONE OF THE PUBLIC HEALTH LAW.
  4.  REVENUES HELD IN THE FUND SHALL NOT BE SUBJECT TO APPROPRIATION OR
ALLOTMENT BY THE STATE OR ANY POLITICAL SUBDIVISION THEREOF.
  5. THE BOARD OF GOVERNORS OF THE NEW YORK HEALTH  PLAN  UNDER  ARTICLE
FIFTY-ONE OF THE PUBLIC HEALTH LAW SHALL:
  (A)  ADMINISTER  THE  FUND AND SHALL CONDUCT A QUARTERLY REVIEW OF THE
EXPENDITURES FROM AND REVENUES RECEIVED BY THE FUND; AND
  (B) INVEST THE FUND IN INVESTMENTS THAT ARE AUTHORIZED BY THE LAWS  OF
THIS  STATE FOR THE INVESTMENT OF THE CAPITAL, SURPLUS AND ACCUMULATIONS

S. 5425                            11                            A. 7860

OF DOMESTIC LIFE INSURANCE COMPANIES. THE LIMITATIONS SET FORTH IN THESE
LAWS APPLY TO THE INVESTMENTS OF THE FUND.
  S  3.  The  tax  law  is amended by adding a new article 35 to read as
follows:
                                ARTICLE 35
                  NEW YORK HEALTH PLAN PREMIUM PAYMENTS
SECTION 1650. DEFINITIONS.
        1651. PREMIUM PAYMENTS.
        1652. PROCEDURAL PROVISIONS.
  S 1650. DEFINITIONS. FOR THE PURPOSES  OF  THIS  ARTICLE,  UNLESS  THE
CONTEXT CLEARLY REQUIRES OTHERWISE:
  1. "EMPLOY" MEANS TO SUFFER OR PERMIT TO WORK.
  2.  "EMPLOYER"  MEANS  AN INDIVIDUAL, PARTNERSHIP, ASSOCIATION, CORPO-
RATION, BUSINESS TRUST, THE STATE OF NEW YORK, ITS INSTRUMENTALITIES AND
ITS POLITICAL SUBDIVISIONS AND THEIR INSTRUMENTALITIES, OR ANY PERSON OR
GROUP OF PERSONS, ACTING IN THE INTEREST OF AN EMPLOYER IN  RELATION  TO
AN EMPLOYEE.
  3. "EMPLOYEE" MEANS ANY INDIVIDUAL WHO WORKS FOR AN EMPLOYER.
  S 1651. PREMIUM PAYMENTS. FOR THE PURPOSE OF PROVIDING REVENUE FOR THE
NEW  YORK  HEALTH  PLAN ESTABLISHED PURSUANT TO ARTICLE FIFTY-ONE OF THE
PUBLIC HEALTH LAW, AND TO PAY THE EXPENSE OF  PLAN  ADMINISTRATION,  THE
FOLLOWING PREMIUM PAYMENTS ARE HEREBY LEVIED:
  1.  ON  EACH  EMPLOYER,  A PREMIUM PAYMENT EQUAL TO TEN PERCENT OF THE
EMPLOYER'S PAYROLL. THE  EMPLOYER  MAY  CHOOSE,  SUBJECT  TO  COLLECTIVE
BARGAINING AGREEMENTS, TO DEDUCT TWO PERCENT OF EACH EMPLOYEE'S WAGES OR
GROSS SALARY AS PARTIAL PAYMENT OF THIS PREMIUM PAYMENT.
  2.  ON  EACH  SELF-EMPLOYED INDIVIDUAL, A PREMIUM PAYMENT EQUAL TO TEN
PERCENT OF THE INDIVIDUAL'S SELF-EMPLOYMENT INCOME, SUBJECT TO THE LIMIT
ON TAXABLE SELF-EMPLOYMENT INCOME FOR MEDICARE HOSPITAL INSURANCE  UNDER
THE  "FEDERAL  INSURANCE  CONTRIBUTIONS  ACT",  68A STAT. 415 (1954), 26
U.S.C.A. 3101, AS AMENDED.
  3. A PERSON SUBJECT TO TAXATION  UNDER  THIS  CHAPTER,  OTHER  THAN  A
PERSON  WHO  IS  ENTITLED  TO  COVERAGE UNDER TITLE XVIII OF THE FEDERAL
SOCIAL SECURITY ACT, WHO HAS NOT HAD THE PREMIUM PAID ON  FIFTY  PERCENT
OR MORE OF HIS OR HER ADJUSTED GROSS INCOME UNDER SUBDIVISION ONE OR TWO
OF  THIS  SECTION,  SHALL MAKE A PREMIUM PAYMENT EQUAL TO TEN PERCENT OF
THE DIFFERENCE BETWEEN FIFTY PERCENT OF THE INDIVIDUAL'S ADJUSTED  GROSS
INCOME  AND  THE  TOTAL AMOUNT OF INCOME ON WHICH THE INDIVIDUAL HAS HAD
PREMIUMS PAID UNDER SUBDIVISIONS ONE AND TWO OF THIS SECTION;  PROVIDED,
HOWEVER,  THAT  THE  TOTAL  AMOUNT  OF  ADJUSTED GROSS INCOME SUBJECT TO
PREMIUM PAYMENTS UNDER THIS SUBDIVISION SHALL NOT EXCEED  THE  LIMIT  ON
TAXABLE  SELF-EMPLOYMENT INCOME FOR MEDICAL HOSPITAL INSURANCE UNDER THE
"FEDERAL INSURANCE CONTRIBUTIONS ACT," 68A STAT. 415 (1954), 26 U.S.C.A.
3101, AS AMENDED.
  4. (A) WHERE A NEW YORK STATE RESIDENT IS EMPLOYED OUTSIDE  THE  STATE
BY  AN  EMPLOYER  THAT  DOES BUSINESS IN THE STATE, OR THAT ELECTS TO BE
SUBJECT TO THIS SUBDIVISION, THEN THE EMPLOYER  SHALL  PAY  THE  PREMIUM
UNDER  SUBDIVISION  ONE  OF  THIS  SECTION,  CALCULATED  ON THE PRO RATA
PORTION OF THE EMPLOYER'S PAYROLL ATTRIBUTABLE TO  ALL  NEW  YORK  STATE
RESIDENTS EMPLOYED BY THE EMPLOYER.
  (B)  WHERE  A  NEW  YORK  RESIDENT IS EMPLOYED OUTSIDE THE STATE BY AN
EMPLOYER THAT DOES NOT DO BUSINESS IN THE STATE AND THAT DOES NOT  ELECT
TO  BE  SUBJECT  TO  THIS  SUBDIVISION,  THEN THE EMPLOYEE SHALL PAY THE
PREMIUM UNDER SUBDIVISION ONE OF THIS  SECTION,  AS  IF  THE  EMPLOYEE'S
INCOME FROM THE EMPLOYER WAS SELF-EMPLOYMENT INCOME.

S. 5425                            12                            A. 7860

  5.  WHERE  AN EMPLOYEE IS NOT A RESIDENT OF NEW YORK STATE (AND THERE-
FORE NOT ELIGIBLE TO BE A NEW YORK HEALTH PLAN MEMBER), AND THE EMPLOYER
PURCHASES HEALTH COVERAGE FOR THE  EMPLOYEE,  INCLUDING  THE  EMPLOYEE'S
FAMILY,  UNDER  SUBDIVISION  TWO OF SECTION FIFTY-ONE HUNDRED TEN OF THE
PUBLIC  HEALTH  LAW,  THE EMPLOYER MAY TAKE A CREDIT AGAINST THE PREMIUM
PAID UNDER SUBDIVISION ONE OF THIS SECTION, UP TO THE PRO  RATA  PORTION
OF  THE EMPLOYER'S PREMIUM ATTRIBUTABLE TO THAT EMPLOYEE, FOR THE AMOUNT
PAID BY THE EMPLOYER TO PURCHASE THAT COVERAGE. WHERE SUCH  AN  EMPLOYEE
PURCHASES  OR  PAYS A PORTION OF THE COST OF SUCH COVERAGE, THE EMPLOYEE
MAY TAKE A CREDIT FOR THE AMOUNT PAID BY HIM OR HER  FOR  THAT  COVERAGE
AGAINST  ANY  PREMIUM  THE  EMPLOYEE  IS REQUIRED BY THE EMPLOYER TO PAY
UNDER SUBDIVISION ONE OF THIS SECTION.
  6. WHERE A SELF-EMPLOYED INDIVIDUAL IS NOT  A  RESIDENT  OF  NEW  YORK
STATE  (AND THEREFORE NOT ELIGIBLE TO BE A NEW YORK HEALTH PLAN MEMBER),
AND THE PERSON  PURCHASES  HEALTH  COVERAGE  UNDER  SUBDIVISION  TWO  OF
SECTION  FIFTY-ONE  HUNDRED  TEN  OF THE PUBLIC HEALTH LAW, THE SELF-EM-
PLOYED INDIVIDUAL MAY TAKE A CREDIT FOR THE AMOUNT PAID BY  HIM  OR  HER
FOR  THAT  COVERAGE AGAINST THE PREMIUM PAID BY THE SELF-EMPLOYED PERSON
UNDER SUBDIVISION ONE OF THIS SECTION.
  7. THE TOTAL AMOUNT OF CREDITS TAKEN UNDER SUBDIVISIONS FIVE  AND  SIX
OF  THIS  SECTION,  AGAINST PREMIUMS PAID UNDER THIS SECTION, FOR HEALTH
COVERAGE FOR A PERSON, INCLUDING THAT PERSON'S FAMILY, SHALL NOT  EXCEED
THE  TOTAL  AMOUNT  OF  PREMIUM  PAID BY OR ATTRIBUTABLE TO THAT PERSON,
WHETHER PAID BY THAT PERSON OR BY AN EMPLOYER.
  8. NEW YORK HEALTH PLAN MEMBERS ENTITLED TO COVERAGE UNDER TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT, WHO ARE NOT ALSO ENTITLED TO  COVER-
AGE  UNDER  TITLE  XIX  OF  THE  FEDERAL SOCIAL SECURITY ACT, SHALL MAKE
PREMIUM PAYMENTS EQUAL TO THE PREMIUM PAYMENT DEVELOPED BY  THE  FEDERAL
SECRETARY  OF  HEALTH  AND  HUMAN  SERVICES FOR COVERAGE UNDER PART B OF
TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT; PROVIDED, HOWEVER,  THAT
PLAN  MEMBERS  WHO  MAKE  PREMIUM  PAYMENTS DIRECTLY TO THE SECRETARY OF
HEALTH AND HUMAN SERVICES SHALL BE ENTITLED  TO  A  CREDIT  AGAINST  THE
AMOUNT PAID UNDER THIS SUBDIVISION.
  S  1652. PROCEDURAL PROVISIONS. THE BOARD OF GOVERNORS OF THE NEW YORK
HEALTH PLAN SHALL ADOPT RULES REGARDING THE LEVY AND COLLECTION  OF  THE
PREMIUM  PAYMENTS  UNDER  THIS ARTICLE AND MAY ENTER INTO CONTRACTS WITH
THE DEPARTMENT FOR THE COLLECTION OF THE PREMIUM PAYMENTS LEVIED BY THIS
ARTICLE. FOR PURPOSES OF ENFORCEMENT, PREMIUM PAYMENTS  DUE  UNDER  THIS
ARTICLE SHALL BE SUBJECT TO THE PROVISIONS OF THIS CHAPTER APPLICABLE TO
INCOME TAXES DUE UNDER ARTICLE TWENTY-TWO OF THIS CHAPTER.
  S  4.  1. There is hereby established a temporary commission on imple-
mentation of the New York health plan, hereinafter to be  known  as  the
commission,  consisting  of fifteen members: five members, including the
chair, shall be  appointed  by  the  governor;  five  members  shall  be
appointed  by  the temporary president of the senate, two of which shall
be upon recommendation of the senate minority leader; and, five  members
shall be appointed by the speaker of the assembly, two of which shall be
upon  recommendation  of the assembly minority leader.  The commissioner
of health, the superintendent of  insurance,  and  the  commissioner  of
taxation  and  finance,  or  their  designees  shall serve as non-voting
ex-officio members of the commission.
  2.  Members of the commission shall receive such assistance as may  be
necessary  from  other  state  agencies  and entities, and shall receive
necessary expenses incurred in the  performance  of  their  duty.    The
commission  may  employ staff as needed, prescribe their duties, and fix
their compensation within amounts appropriate for the commission.

S. 5425                            13                            A. 7860

  3. The commission shall examine the statutes of this  state  and  make
such recommendations as are necessary to conform the laws of this state,
and  to  eliminate any inconsistency between the laws of this state, and
the provisions of article 51 of the public health law  establishing  the
New  York  health  plan  as  added by section one of this act, and other
provisions of law relating to the New York health plan, and  to  improve
and implement the plan.
  4.  On or before 270 days subsequent to the enactment of this act, the
commission shall report to the governor and the legislature, with recom-
mendations, as provided in subdivision three of this section.
  S  5.  The superintendent of insurance, in consultation with a techni-
cal advisory committee which shall include representation from insurers,
consumers, organized labor, and business, shall examine the premium rate
structure for insurance underwritten and offered in this state by insur-
ers licensed pursuant to the insurance law, and determine the extent  to
which  such  premiums  reflect  expenditures  for  health  care services
covered under the provisions of article 51  of  the  public  health  law
establishing  the  New  York health plan as added by section one of this
act.  On or before 270 days following the enactment  of  this  act,  the
superintendent  shall  report to the governor and the legislature on the
extent to which the premium rate structure for  insurance,  by  line  of
insurance,  underwritten and offered in this state reflects expenditures
for health care services covered under article 51 of the  public  health
law  as  added by section one of this act, and make such recommendations
as are necessary for an adjustment in such premium  rate  structures  to
reflect a reduction in health care expenditures due to implementation of
the New York health plan.
  S  6.  The sum of five hundred thousand dollars ($500,000), or so much
thereof as may be necessary, is hereby  appropriated  to  the  temporary
commission  on implementation of the New York health plan created pursu-
ant to section four of this act out of any moneys in the state  treasury
in  the  general  fund  to  the credit of the state purposes account not
otherwise appropriated.   Such sum shall be payable  on  the  audit  and
warrant  of  the  state comptroller on vouchers certified or approved by
the chair of the temporary commission on implementation of the New  York
health plan created pursuant to section four of this act.
  S  7.  (a)  This  act  shall  take effect on the first of January next
succeeding the date on which it shall have become a law provided, howev-
er, that sections four and five of this act shall take effect immediate-
ly and shall remain in full force and effect until the first of  January
following  the  date  upon which benefits under article 51 of the public
health law as added by section one of  this  act  begin  whereupon  such
sections  shall  be  deemed  repealed.  The commissioner of health shall
notify the Legislative Bill Drafting Commission of such event.
  (b) Not later than the thirty-first of March following  the  effective
date  of  this  act,  the  commissioner  of  health shall do both of the
following:
  1. Apply to the secretary of health and human services for all waivers
of requirements under health  care  programs  established  under  titles
XVIII  and  XIX of the federal social security act that are necessary to
enable this state to deposit all federal payments under  those  programs
in  the  state  treasury to the credit of the New York health trust fund
created pursuant to section 89-h of the state finance law, as  added  by
section two of this act;
  2.  Identify any other federal programs that provide federal funds for
payment of health care services  to  individuals.  The  commissioner  of

S. 5425                            14                            A. 7860

health shall comply with any requirements under those programs and apply
for  any waivers of those requirements that are necessary to enable this
state to deposit such federal funds to the credit of the New York health
trust fund.
  (c) No later than the thirty-first of December following the effective
date of this act, the board of governors of the New York health plan and
the  commissioner of health shall explore and cooperate with, enter into
any necessary contract or other arrangement with, and  otherwise  pursue
any  other reasonable course of action with, the secretary of health and
human services to establish procedures, standards and  conditions  under
which  the commissioner of health shall pay to the New York health trust
fund amounts equivalent to those amounts that, on the effective date  of
this  section,  are paid on behalf of residents of this state for health
benefits covered under the plan under titles XVIII and XIX of the feder-
al social security act.
  (d) Commencing on the first of January following the effective date of
this act the following shall occur:
  1. New York health premium payments that are  authorized  pursuant  to
article  35 of the tax law, as added by section three of this act, shall
be levied.
  2. Benefits under the New York health  plan  established  pursuant  to
article 51 of the public health law, as added by section one of this act
shall begin.
  3.  Payments  into  the New York health trust fund created pursuant to
section 89-h of the state finance law shall begin.
  (e) Not later than the twenty-eighth of February following the  effec-
tive  date of this act, the governor shall make the initial appointments
to the board of governors of the New York health plan established pursu-
ant to article 51 of the public health law, as added by section  one  of
this  act,  provided,  however, that of the initial appointments made by
the governor, four shall be for a term of one year; four shall be for  a
term of two years; three shall be for a term of three years; three shall
be for a term of four years; and four, including the chair, shall be for
a  term  of five years. Thereafter, all appointments shall be for a term
of five years, except in those instances where an appointment is to fill
a vacancy occurring prior to the expiration of a term.

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.