S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2006
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 17, 2017
                                ___________
 
 Introduced  by M. of A. SCHIMMINGER, GOODELL -- Multi-Sponsored by -- M.
   of A.  DiPIETRO, GIGLIO, HAWLEY, HOOPER, MAGEE, RIVERA  --  read  once
   and referred to the Committee on Health
 
 AN  ACT  to  amend the social services law, in relation to the character
   and adequacy of Medicaid assistance and to  repeal  paragraph  (n)  of
   subdivision  2 of section 365-a of the social services law relating to
   the care and services of audiologists
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (a)  of  subdivision 2 of section 365-a of the
 social services law, as amended by chapter 47 of the laws  of  1996,  is
 amended to read as follows:
   (a)  services  of qualified physicians, [dentists, nurses, and private
 duty nursing services shall be further  subject  to  the  provisions  of
 section  three  hundred  sixty-seven-o  of  this chapter,] optometrists,
 NURSE MIDWIVES, NURSE  PRACTITIONERS,  and  other  related  professional
 personnel;
   §  2.  Paragraph  (f)  of subdivision 2 of section 365-a of the social
 services law, as added by chapter 184 of the laws of 1969 and as  relet-
 tered by chapter 478 of the laws of 1980, is amended to read as follows:
   (f)  preventive,  prophylactic and other routine dental care, services
 and supplies ONLY WHEN PROVIDED  IN  A  HOSPITAL  OUTPATIENT  OR  CLINIC
 FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS SUBDIVISION;
   §  3.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
 services law, as amended by section 21 of part A of chapter  56  of  the
 laws of 2013, is amended to read as follows:
   (g)  sickroom  supplies,  eyeglasses,  AND  prosthetic appliances [and
 dental prosthetic appliances] furnished in  accordance  with  the  regu-
 lations  of  the department; provided further that: (i) the commissioner
 of health is authorized to implement a preferred diabetic supply program
 wherein the department of health  will  receive  enhanced  rebates  from
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD05815-01-7

 A. 2006                             2
 
 preferred  manufacturers of glucometers and test strips, and may subject
 non-preferred  manufacturers'  glucometers  and  test  strips  to  prior
 authorization  under  section  two  hundred  seventy-three of the public
 health law; (ii) enteral formula therapy and nutritional supplements are
 limited  to  coverage  only for nasogastric, jejunostomy, or gastrostomy
 tube feeding, for treatment of  an  inborn  metabolic  disorder,  or  to
 address  growth  and  development  problems  in children, or, subject to
 standards established by the commissioner, for persons with a  diagnosis
 of  HIV  infection,  AIDS  or  HIV-related illness or other diseases and
 conditions; (iii) prescription  footwear  and  inserts  are  limited  to
 coverage  only  when  used  as an integral part of a lower limb orthotic
 appliance, as part of a diabetic treatment plan, or  to  address  growth
 and  development  problems  in  children;  (iv)  compression and support
 stockings are limited to coverage only for  pregnancy  or  treatment  of
 venous stasis ulcers; [and] (v) the commissioner of health is authorized
 to  implement  an  incontinence supply utilization management program to
 reduce costs without  limiting  access  through  the  existing  provider
 network,  including  but  not  limited  to  single  or  multiple  source
 contracts or,  a  preferred  incontinence  supply  program  wherein  the
 department  of  health  will  receive  enhanced  rebates  from preferred
 manufacturers of incontinence supplies, and  may  subject  non-preferred
 manufacturers' incontinence supplies to prior approval pursuant to regu-
 lations of the department, provided any necessary approvals under feder-
 al  law have been obtained to receive federal financial participation in
 the costs of incontinence supplies provided pursuant  to  this  subpara-
 graph;  AND  (VI)  THE  COMMISSIONER  OF HEALTH IS AUTHORIZED TO REQUIRE
 PRIOR APPROVAL OF ANY PRESCRIPTION DRUG THAT IS PRESCRIBED FOR  A  RESI-
 DENT OF A NURSING HOME AND THAT IS NOT REIMBURSED AS PART OF THE NURSING
 HOME'S MEDICAID RATE;
   §  4.  Paragraph  (l)  of subdivision 2 of section 365-a of the social
 services law, as amended by chapter 81 of the laws of 1995,  is  amended
 to read as follows:
   (l)  care  and services of podiatrists, CLINICAL PSYCHOLOGISTS, NURSES
 AND AUDIOLOGISTS, INCLUDING SUCH CARE AND SERVICES PROVIDED IN A  HOSPI-
 TAL  OUT-PATIENT OR CLINIC FACILITY REFERRED TO IN PARAGRAPH (C) OF THIS
 SUBDIVISION, AND  DENTISTS,  which  care  and  services  shall  only  be
 provided  upon  referral by a physician, nurse practitioner or certified
 nurse midwife in accordance with  the  program  of  early  and  periodic
 screening  and  diagnosis  established  pursuant to subdivision three of
 this section or to persons eligible for benefits under  title  XVIII  of
 the  federal  social security act as qualified medicare beneficiaries in
 accordance with federal requirements therefor [and private  duty  nurses
 which  care and services shall only be provided in accordance with regu-
 lations of the department of health;  provided,  however,  that  private
 duty  nursing  services  shall  not be restricted when such services are
 more appropriate and cost-effective than nursing services provided by  a
 home health agency pursuant to section three hundred sixty-seven-l];
   §  5.  Paragraph  (n)  of subdivision 2 of section 365-a of the social
 services law, as added by chapter 556 of the laws of 1986, is REPEALED.
   § 6. The commissioner of health is authorized to promulgate  or  adopt
 any  rules  or regulations necessary to implement the provisions of this
 act and any procedures, forms, or instructions necessary for such imple-
 mentation may be adopted and issued on or after the  effective  date  of
 this act. Notwithstanding any inconsistent provision of the state admin-
 istrative  procedure  act  or  any other provision of law, rule or regu-
 lation, the commissioner of health and the superintendent  of  financial

 A. 2006                             3
 
 services  and any appropriate council is authorized to adopt or amend or
 promulgate on an emergency basis any regulation he or she or such  coun-
 cil  determines  necessary to implement any provision of this act on its
 effective date.
   § 7. This act shall take effect on the one hundred eightieth day after
 it shall have become a law.