senate Bill S4181

Requires the state to pay medicare part A premiums for certain persons and requires local social services to appeal denial of medicare for long term care

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Bill Status


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

  • 22 / Mar / 2011
    • REFERRED TO HEALTH
  • 04 / Jan / 2012
    • REFERRED TO HEALTH

Summary

Requires the state to pay medicare part A premiums for persons eligible for medicare part A and medical assistance and requires local commissioners of social services to appeal denial of medicare coverage before approving medical assistance coverage for long term care.

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Bill Details

See Assembly Version of this Bill:
A2284
Versions:
S4181
Legislative Cycle:
2011-2012
Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Amd §§364-i, 365-f, 366, 367-a, 367-c, 367-e & 367-f, add §366-j, Soc Serv L
Versions Introduced in Previous Legislative Cycles:
2009-2010: S6874, A6658A
2007-2008: A4692, A4692

Sponsor Memo

BILL NUMBER:S4181

TITLE OF BILL:
An act
to amend the social services law, in relation to requiring the state to
pay medicare part A premiums for persons eligible for medicare part A
and medical assistance and to require local commissioners of social
services to appeal denial of medicare coverage before approving medical
assistance coverage for long term care

PURPOSE OF THE BILL:
This bill would require the state to pay for
Medicare Part A premiums for those persons dually eligible for
Medicare Part A and Medicaid and requires local commissioners of
social services to appeal denials of Medicare coverage before
approving Medicaid coverage for long term care.

SUMMARY OF SPECIFIC PROVISIONS:
§1- Amends subdivisions 1 and 2 of
364-i of the Social Services Law, as amended by Chapter 693 of the
Laws of 1996, and as amended by Chapter 626 of the Laws of 1987,
respectively, to remove "long-term home health care program" from the
subdivisions.

§2, §3, §4, §5, §6 and §10 - Amends various sections of the Social
Services Law to require: that persons receiving or seeking long-term
care and who are eligible for Medicare must fully utilize those
benefits, and if such person's application is denied, he or she must
appeal such denial or permit the local social services official to do
so on his or her behalf.

§7- Amends subdivision 3 of 367-a of the Social Services Law by adding
a new paragraph (e) to provide that the state pay for Medicare Part A
premiums for those persons dually eligible for Medicare Part A and
Medicaid

§8- Amends subdivision 7 of 367-c of the Social Services Law to
require that in the instance when a person receives Medicare coverage
and then such person's Medicare coverage is terminated, such person
must appeal such denial or permit the local social services official
to do so on his or her behalf.

§9- Amends subdivision 3 of 367-e of the Social Services Law to direct
the Commissioner of Health to apply for any waivers needed to
implement these provisions.

§ 11 - Effective date.

JUSTIFICATION:
It is an established fact that New York State receives
less than its fair share of federal financial assistance for its
Medicaid program. While the federal government pays greater than 70%
of the cost of some states' Medicaid programs, it pays only 50% of
New York's.
Additionally, the cost of Medicare premiums and the complexity of
Medicare long term care reimbursement applications have discouraged


people who are eligible for Medicare from seeking this assistance.
This has allowed the federal government, which funds Medicare, to
avoid paying for these services that Medicare eligibles are entitled
to receive. Instead, when these individuals are unable to afford
long-term care, state taxpayers are forced to pay for this care
through Medicaid. While the state has so far been unable to secure a
higher federal Medicaid share. This bill will at least help to ensure
that the federal government meets its obligation to Medicare
recipients.

PRIOR LEGISLATIVE HISTORY:

2009-2010: S.6874/A.6658-A
2007-2008: A.4692
2005-2006: A.5462/S.3444

FISCAL IMPLICATIONS:
Yet to be determined. Cost savings to both counties and the State
are expected.

EFFECTIVE DATE:
This act shall take effect on the one hundred twentieth day
after it shall have become a law.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4181

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             March 22, 2011
                               ___________

Introduced  by  Sen.  RANZENHOFER -- read twice and ordered printed, and
  when printed to be committed to the Committee on Health

AN ACT to amend the social services law, in relation  to  requiring  the
  state  to  pay medicare part A premiums for persons eligible for medi-
  care part A and medical assistance and to require local  commissioners
  of  social  services  to  appeal  denial  of  medicare coverage before
  approving medical assistance coverage for long term care

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

  Section  1.  Subdivisions  1  and  2  of  section  364-i of the social
services law, as amended by chapter 693 of the laws of 1996, are amended
to read as follows:
  1. An individual, upon application for medical  assistance,  shall  be
presumed  eligible  for  such assistance for a period of sixty days from
the date of transfer from a general  hospital,  as  defined  in  section
twenty-eight  hundred  one  of the public health law to a certified home
health agency [or long term home health care  program],  as  defined  in
section thirty-six hundred two of the public health law, or to a hospice
as  defined in section four thousand two of the public health law, or to
a residential health care facility as defined  in  section  twenty-eight
hundred  one of the public health law, if the local department of social
services determines that the  applicant  meets  each  of  the  following
criteria:  (a)  the  applicant is receiving acute care in such hospital;
(b) a physician certifies that such applicant no longer  requires  acute
hospital  care, but still requires medical care which can be provided by
a certified home health agency, [long term home  health  care  program,]
hospice or residential health care facility; (c) the applicant or his OR
HER  representative  states  that  the applicant does not have insurance
coverage for the required medical care and  that  such  care  cannot  be
afforded;  (d)  it  reasonably  appears  that the applicant is otherwise
eligible to receive medical assistance; (e) it reasonably  appears  that

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02537-01-1

S. 4181                             2

the  amount expended by the state and the local social services district
for medical assistance in a certified home  health  agency,  [long  term
home  health care program,] hospice or residential health care facility,
during the period of presumed eligibility, would be less than the amount
the  state  and  the  local  social  services  district would expend for
continued acute hospital care for such person; and (f) such other deter-
minative criteria as the commissioner shall provide  by  rule  or  regu-
lation. If a person has been determined to be presumptively eligible for
medical  assistance,  pursuant  to this subdivision, and is subsequently
determined to be ineligible for such assistance,  the  commissioner,  on
behalf  of  the  state and the local social services district shall have
the authority to recoup from the individual the sums expended  for  such
assistance during the period of presumed eligibility.
  2.  Payment  for  up to sixty days of care for services provided under
the medical assistance program shall be made for an  applicant  presumed
eligible  for  medical  assistance  pursuant  to subdivision one of this
section provided, however, that such payment shall not exceed sixty-five
percent of the rate payable under this title for services provided by  a
certified  home  health  agency,  [long  term home health care program,]
hospice or residential health care facility. Notwithstanding  any  other
provision  of  law,  no federal financial participation shall be claimed
for services provided to a person while presumed  eligible  for  medical
assistance  under  this program until such person has been determined to
be  eligible  for  medical  assistance  by  the  local  social  services
district.  During the period of presumed medical assistance eligibility,
payment for services  provided  persons  presumed  eligible  under  this
program  shall be made from state funds. Upon the final determination of
eligibility by the local social services district, payment shall be made
for the balance of the cost of such care and services provided  to  such
applicant  for  such  period of eligibility and a retroactive adjustment
shall be made by the department to appropriately reflect federal  finan-
cial  participation  and  the  local  share  of  costs  for the services
provided during the period of presumptive eligibility. Such federal  and
local financial participation shall be the same as that which would have
occurred  if a final determination of eligibility for medical assistance
had been made prior to the provision of the services provided during the
period of presumptive eligibility. In instances where an individual  who
is  presumed  eligible for medical assistance is subsequently determined
to be ineligible, the cost for  services  provided  to  such  individual
shall  be  reimbursed in accordance with the provisions of section three
hundred sixty-eight-a of this [article] TITLE.   Provided,  however,  if
upon  audit the department determines that there are subsequent determi-
nations of ineligibility for medical  assistance  in  at  least  fifteen
percent  of  the cases in which presumptive eligibility has been granted
in a local social services district, payments for services  provided  to
all persons presumed eligible and subsequently determined ineligible for
medical  assistance  shall  be  divided  equally  by  the  state and the
district.
  S 2. Paragraph (d) of subdivision 2 of section  365-f  of  the  social
services  law, as added by chapter 81 of the laws of 1995, is amended to
read as follows:
  (d) meets such other criteria, as may be established  by  the  commis-
sioner,  which  are necessary to effectively implement the objectives of
this section. SUCH CRITERIA SHALL INCLUDE, BUT  NOT  BE  LIMITED  TO,  A
REQUIREMENT  THAT  ANY PERSON WHO IS ELIGIBLE FOR, OR REASONABLY APPEARS
TO MEET THE CRITERIA OF ELIGIBILITY FOR, BENEFITS UNDER SUBCHAPTER XVIII

S. 4181                             3

OF THE FEDERAL SOCIAL SECURITY ACT SHALL BE REQUIRED TO  APPLY  FOR  AND
FULLY  UTILIZE  SUCH  BENEFITS IN ACCORDANCE WITH THIS CHAPTER TO DEFRAY
THE COSTS OF THE PROGRAM. IF SUCH PERSON APPLIES FOR SUCH BENEFITS UNDER
SUBCHAPTER  XVIII  OF  THE FEDERAL SOCIAL SECURITY ACT AND SUCH PERSON'S
APPLICATION THEREFOR IS DENIED, SUCH PERSON MUST APPEAL SUCH  DENIAL  OR
PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL TO DO SO ON HIS OR HER BEHALF.
IF  SUCH  PERSON  RECEIVES  SUCH  BENEFITS UNDER SUBCHAPTER XVIII OF THE
FEDERAL SOCIAL SECURITY ACT AND SUCH PERSON'S CONTINUING RECEIPT THEREOF
IS TERMINATED, SUCH PERSON MUST APPEAL SUCH TERMINATION  OR  PERMIT  THE
LOCAL SOCIAL SERVICES OFFICIAL TO DO SO ON HIS OR HER BEHALF.
  S  3.  Subparagraph 1 of paragraph (b) of subdivision 2 of section 366
of the social services law, as amended by chapter 638  of  the  laws  of
1993  and  designated  by chapter 170 of the laws of 1994, is amended to
read as follows:
  (1) In establishing standards  for  determining  eligibility  for  and
amount  of  such assistance, the department shall take into account only
such income and resources, in accordance with federal  requirements,  as
are available to the applicant or recipient and as would not be required
to  be  disregarded  or set aside for future needs, and there shall be a
reasonable evaluation of any such income or  resources.  The  department
shall  not  consider  the  availability  of an option for an accelerated
payment of death benefits or special surrender value pursuant  to  para-
graph one of subsection (a) of section one thousand one hundred thirteen
of  the  insurance law, or an option to enter into a viatical settlement
pursuant to the provisions of article  seventy-eight  of  the  insurance
law,  as  an available resource in determining eligibility for an amount
of such assistance, provided, however, that the payment of such benefits
shall be considered in determining eligibility for and  amount  of  such
assistance.  There  shall  not be taken into consideration the financial
responsibility of any individual  for  any  applicant  or  recipient  of
assistance  under  this title unless such applicant or recipient is such
individual's spouse or such individual's child who is  under  twenty-one
years of age. In determining the eligibility of a child who is categori-
cally  eligible  as  blind  or disabled, as determined under regulations
prescribed by the social security act for medical assistance, the income
and resources of parents or spouses of parents are not considered avail-
able to that child if [she/he] HE OR SHE does not  regularly  share  the
common  household  even if the child returns to the common household for
periodic visits. In the application of  standards  of  eligibility  with
respect  to income, costs incurred for medical care, whether in the form
of insurance premiums or otherwise, shall be  taken  into  account.  Any
person  who  is eligible for, or reasonably appears to meet the criteria
of eligibility for, benefits  under  [title]  SUBCHAPTER  XVIII  of  the
federal  social  security  act  shall be required to apply for and fully
utilize such benefits in accordance with this chapter. IN THE CASE OF  A
PERSON  WHO  IS  RECEIVING  OR  SEEKING  LONG  TERM CARE, BENEFITS UNDER
SUBCHAPTER XVIII OF THE FEDERAL  SOCIAL  SECURITY  ACT  SHALL  BE  FULLY
UTILIZED  IN  ACCORDANCE  WITH  THIS CHAPTER TO DEFRAY THE COSTS OF SUCH
LONG TERM CARE. IF SUCH PERSON APPLIES FOR SUCH BENEFITS UNDER  SUBCHAP-
TER  XVIII OF THE FEDERAL SOCIAL SECURITY ACT AND SUCH PERSON'S APPLICA-
TION THEREFOR IS DENIED, SUCH PERSON MUST APPEAL SUCH DENIAL  OR  PERMIT
THE  LOCAL  SOCIAL  SERVICES OFFICIAL TO DO SO ON HIS OR HER BEHALF.  IF
SUCH PERSON RECEIVES SUCH BENEFITS UNDER SUBCHAPTER XVIII OF THE FEDERAL
SOCIAL SECURITY ACT AND SUCH  PERSON'S  CONTINUING  RECEIPT  THEREOF  IS
TERMINATED, SUCH PERSON MUST APPEAL SUCH TERMINATION OR PERMIT THE LOCAL
SOCIAL SERVICES OFFICIAL TO DO SO ON HIS OR HER BEHALF.

S. 4181                             4

  S 4. Subparagraph (v) of paragraph b of subdivision 6-a of section 366
of  the  social  services  law, as amended by chapter 627 of the laws of
2004, is amended to read as follows:
  (v) meet such other criteria as may be established by the commissioner
of health as may be necessary to administer the provision of this subdi-
vision  in  an equitable manner. SUCH CRITERIA SHALL INCLUDE, BUT NOT BE
LIMITED TO, A REQUIREMENT THAT  ANY  PERSON  WHO  IS  ELIGIBLE  FOR,  OR
REASONABLY  APPEARS  TO  MEET  THE CRITERIA OF ELIGIBILITY FOR, BENEFITS
UNDER SUBCHAPTER XVIII OF THE  FEDERAL  SOCIAL  SECURITY  ACT  SHALL  BE
REQUIRED TO APPLY FOR AND FULLY UTILIZE SUCH BENEFITS IN ACCORDANCE WITH
THIS CHAPTER TO DEFRAY THE COSTS OF THE PROGRAM.  IF SUCH PERSON APPLIES
FOR  SUCH BENEFITS UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURITY
ACT AND SUCH PERSON'S APPLICATION THEREFOR IS DENIED, SUCH  PERSON  MUST
APPEAL SUCH DENIAL OR PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL TO DO SO
ON  HIS  OR  HER  BEHALF.    IF SUCH PERSON RECEIVES SUCH BENEFITS UNDER
SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURITY ACT  AND  SUCH  PERSON'S
CONTINUING  RECEIPT  THEREOF IS TERMINATED, SUCH PERSON MUST APPEAL SUCH
TERMINATION OR PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL TO DO SO ON HIS
OR HER BEHALF.
  S 5. Subparagraph (viii) of paragraph b of subdivision  9  of  section
366  of  the social services law, as added by chapter 170 of the laws of
1994, is amended to read as follows:
  (viii) meet such other criteria as may be established by  the  commis-
sioner of mental health, in conjunction with the commissioner, as may be
necessary to administer the provisions of this subdivision in an equita-
ble manner, including those criteria established pursuant to paragraph e
of this subdivision. SUCH CRITERIA SHALL INCLUDE, BUT NOT BE LIMITED TO,
A REQUIREMENT THAT ANY PERSON WHO IS ELIGIBLE FOR, OR REASONABLY APPEARS
TO MEET THE CRITERIA OF ELIGIBILITY FOR, BENEFITS UNDER SUBCHAPTER XVIII
OF  THE  FEDERAL  SOCIAL SECURITY ACT SHALL BE REQUIRED TO APPLY FOR AND
FULLY UTILIZE SUCH BENEFITS IN ACCORDANCE WITH THIS  CHAPTER  TO  DEFRAY
THE COSTS OF THE PROGRAM. IF SUCH PERSON APPLIES FOR SUCH BENEFITS UNDER
SUBCHAPTER  XVIII  OF  THE FEDERAL SOCIAL SECURITY ACT AND SUCH PERSON'S
APPLICATION THEREFOR IS DENIED, SUCH PERSON MUST APPEAL SUCH  DENIAL  OR
PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL TO DO SO ON HIS OR HER BEHALF.
IF  SUCH  PERSON  RECEIVES  SUCH  BENEFITS UNDER SUBCHAPTER XVIII OF THE
FEDERAL SOCIAL SECURITY ACT AND SUCH PERSON'S CONTINUING RECEIPT THEREOF
IS TERMINATED, SUCH PERSON MUST APPEAL SUCH TERMINATION  OR  PERMIT  THE
LOCAL SOCIAL SERVICES OFFICIAL TO DO SO ON HIS OR HER BEHALF.
  S  6. The social services law is amended by adding a new section 366-j
to read as follows:
  S 366-J. LONG TERM CARE; OTHER CASES.   IN  ALL  CASES  NOT  OTHERWISE
PROVIDED  FOR IN THIS TITLE OF A PERSON WHO IS RECEIVING OR SEEKING LONG
TERM CARE, BENEFITS UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURI-
TY ACT SHALL BE FULLY UTILIZED IN ACCORDANCE WITH THIS CHAPTER TO DEFRAY
THE COSTS OF SUCH LONG TERM CARE.  IF SUCH PERSON APPLIES FOR SUCH BENE-
FITS UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURITY ACT AND  SUCH
PERSON'S  APPLICATION  THEREFOR  IS DENIED, SUCH PERSON MUST APPEAL SUCH
DENIAL OR PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL TO DO SO ON  HIS  OR
HER  BEHALF.    IF  SUCH  PERSON RECEIVES SUCH BENEFITS UNDER SUBCHAPTER
XVIII OF THE FEDERAL SOCIAL SECURITY ACT AND  SUCH  PERSON'S  CONTINUING
RECEIPT  THEREOF IS TERMINATED, SUCH PERSON MUST APPEAL SUCH TERMINATION
OR PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL TO DO  SO  ON  HIS  OR  HER
BEHALF.
  S  7.  Subdivision  3  of  section 367-a of the social services law is
amended by adding a new paragraph (e) to read as follows:

S. 4181                             5

  (E) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION  OR  OF
ANY OTHER LAW, FOR ANY PERSON WHO IS ELIGIBLE FOR MEDICAL ASSISTANCE AND
FOR  MEDICARE UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURITY ACT,
THE COST OF THE PREMIUM FOR MEDICARE PART A SHALL BE BORNE BY THE STATE.
  S  8.  Subdivision  7  of section 367-c of the social services law, as
added by chapter 895 of the laws of 1977 and renumbered by  chapter  854
of the laws of 1987, is amended to read as follows:
  7. No social services district shall make payments pursuant to [title]
SUBCHAPTER XIX of the federal Social Security Act for benefits available
under  [title]  SUBCHAPTER  XVIII of such act without documentation that
[title] SUBCHAPTER XVIII claims have been filed and  denied.  UPON  SUCH
DENIAL,  SUCH  PERSON MUST APPEAL SUCH DENIAL OR PERMIT THE LOCAL SOCIAL
SERVICES OFFICIAL TO DO SO ON HIS OR HER BEHALF. IF SUCH PERSON RECEIVES
SUCH BENEFITS UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURITY  ACT
AND  SUCH PERSON'S CONTINUING RECEIPT THEREOF IS TERMINATED, SUCH PERSON
MUST APPEAL SUCH TERMINATION OR PERMIT THE LOCAL SOCIAL  SERVICES  OFFI-
CIAL TO DO SO ON HIS OR HER BEHALF.
  S  9.  Subdivision  3  of section 367-e of the social services law, as
added by chapter 622 of the laws of 1988, is amended to read as follows:
  3. The commissioner shall apply for any waivers,  including  home  and
community  based  services  waivers pursuant to section nineteen hundred
fifteen-c of the social security act, necessary to implement  AIDS  home
care  programs.  Notwithstanding  any  inconsistent provision of law but
subject to expenditure limitations of this  section,  the  commissioner,
subject to the approval of the state director of the budget, may author-
ize  the  utilization  of  medical  assistance funds to pay for services
provided by AIDS home  care  programs  in  addition  to  those  services
included  in  the medical assistance program under section three hundred
sixty-five-a of this [chapter]  TITLE,  so  long  as  federal  financial
participation  is  available for such services.  Expenditures made under
this subdivision shall be deemed payments  for  medical  assistance  for
needy  persons  and  shall  be  subject to reimbursement by the state in
accordance with the provisions of section three hundred sixty-eight-a of
this [chapter] TITLE.  ANY PERSON WHO IS  ELIGIBLE  FOR,  OR  REASONABLY
APPEARS TO MEET THE CRITERIA OF ELIGIBILITY FOR, BENEFITS UNDER SUBCHAP-
TER  XVIII OF THE FEDERAL SOCIAL SECURITY ACT SHALL BE REQUIRED TO APPLY
FOR AND FULLY UTILIZE SUCH BENEFITS IN ACCORDANCE WITH THIS  CHAPTER  TO
DEFRAY  THE  COSTS OF THE PROGRAM. IF SUCH PERSON APPLIES FOR SUCH BENE-
FITS UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURITY ACT AND  SUCH
PERSON'S  APPLICATION  THEREFOR  IS DENIED, SUCH PERSON MUST APPEAL SUCH
DENIAL OR PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL TO DO SO ON  HIS  OR
HER  BEHALF.    IF  SUCH  PERSON RECEIVES SUCH BENEFITS UNDER SUBCHAPTER
XVIII OF THE FEDERAL SOCIAL SECURITY ACT AND  SUCH  PERSON'S  CONTINUING
RECEIPT  THEREOF IS TERMINATED, SUCH PERSON MUST APPEAL SUCH TERMINATION
OR PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL TO DO  SO  ON  HIS  OR  HER
BEHALF.
  S  10.  Subdivision  2 of section 367-f of the social services law, as
added by chapter 659 of the laws of 1997, is amended to read as follows:
  2. Notwithstanding any inconsistent provision of this chapter  or  any
other  law  to  the contrary, the partnership for long term care program
shall provide Medicaid extended coverage to a person receiving long term
care services if there is federal participation pursuant to such  treat-
ment  and  such  person: (a) is or was covered by an insurance policy or
certificate providing coverage for long term care which meets the appli-
cable minimum benefit standards of the superintendent of  insurance  and
other requirements for approval of participation under the program; and,

S. 4181                             6

(b)  has exhausted the coverage and benefits as required by the program.
ANY SUCH PERSON WHO IS RECEIVING MEDICAL ASSISTANCE AND WHO IS  ELIGIBLE
FOR,  OR  REASONABLY  APPEARS  TO  MEET THE CRITERIA OF ELIGIBILITY FOR,
BENEFITS UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURITY ACT SHALL
BE  REQUIRED  TO APPLY FOR AND FULLY UTILIZE SUCH BENEFITS IN ACCORDANCE
WITH THIS CHAPTER TO DEFRAY THE COSTS OF THE  PROGRAM.  IF  SUCH  PERSON
APPLIES  FOR  SUCH BENEFITS UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL
SECURITY ACT AND SUCH PERSON'S  APPLICATION  THEREFOR  IS  DENIED,  SUCH
PERSON MUST APPEAL SUCH DENIAL OR PERMIT THE LOCAL SOCIAL SERVICES OFFI-
CIAL  TO  DO SO ON HIS OR HER BEHALF. IF SUCH PERSON RECEIVES SUCH BENE-
FITS UNDER SUBCHAPTER XVIII OF THE FEDERAL SOCIAL SECURITY ACT AND  SUCH
PERSON'S  CONTINUING  RECEIPT  THEREOF  IS  TERMINATED, SUCH PERSON MUST
APPEAL SUCH TERMINATION OR PERMIT THE LOCAL SOCIAL SERVICES OFFICIAL  TO
DO SO ON HIS OR HER BEHALF.
  S  11.  This  act  shall  take effect on the one hundred twentieth day
after it shall have become a law;  provided  that  the  commissioner  of
health is authorized to promulgate any and all rules and regulations and
take any other measures necessary to implement this act on its effective
date on or before such date.

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